HomeMy WebLinkAboutseptic info CITY OF ORONO Date
ADDRESS Connected to
CODE SEPTIC SYSTEM INVENTORY CARD Municipal Sewer
Address y�.�5 ���` �1,�= ��-�. Property I.D. 3 1'(I�;�-'�c-3 I Z GL��Z wE LL DATA
�Standard trench � ( I
❑ Mound '/ J �
System type O Other Legal Description 7�-��/ -/��� � p
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Permit No. ZG`7 i Date of permit -3-/'�-�� Installer S:�LLI V�ti= �° p
a�
No. Bedrooms Garbage ,� d I
Buildingtype ����yzsaJ�_�� orGPD � Q�� Laundry�c Dishwasher Disposal `� � = (
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SEPTIC TANKS: Material Pr��,4s"' Ct�Nc. Capacity 1) IG�C>C�j z) �y'C5(:� ° o� � �
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Proper outlet and inlet Baffles Liquid depth to RO level •
m �
m
Height of tank bottom above water table Distance to nearest building 7C�/ � � N m
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DRAINFIELD: Total length of lines �C� � Number of lines �� Trench width �_ �
Y � Y!
Total treatment area (sq.ft.) ��(� Height of drainfield above water table /vEQ-►'� � �
.1 �u " 5
Type of filter material y"I� RoCK Soil type ,a, 1 n �
Vi
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Distance from nearest bldg. 30 � Tile size Perc rate min/in o � � .c
� ? � �
U N
Depth of fill over drainfield Depth of rock over tile under tile � a ' "
p a� U �
�� LOCATION �„��y�
INSPECTION RECORD PUMPOUT RECORD ���` �� �
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DATE COMPLIANCE DATE GALLONS �
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�Z—��1 NU S�'RF�IC/N G Na� � •22- $ �ICI>[98 � — --—
st. ;j- -��• p�scNAR6in/t E�f'c��sl L —82.
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Inctude: 1) Well location
2) Distance from house to
septic tanks,dist.box,
and drainfield
� CONFORMING ��SUBSTANDARD � NONCONFORMING 3) North arrow and road
� a 3
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3'E 3 Lyndale Ave >( �`
� NPw Prague, Nin. 56071 (� �-� ' � " � �
Phone (612) 232-9737 ��/ �
.� � , ;�� Fax (952) 758-6278 ��
emo
�7 � To: Kyle White, Inc. Attn: Diane
Frrom: Tom Klanchnik
� Date: December 22, 2012 �,���- ,5 ,X +� � �� � �
Re: Compliance Inspection.: . . , .
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Please findLthe enclosed M.P.C,A. compliance inspection information.The .
septic system�compliance inspection forthe above mentioned location iiva"s compfeted "�"
on December 9, 2012.
���:�,, A physical inspection of the entire septic system area was conducted. No discharc�e of any
` `�; kind was evident.
'r` ` - The 2 X1000 gallon Septic Tank$and the 1000 gallon Pump Chamber were probed to verify as
° precast with solid bottoms. This confirtrl�d LGU As-Built and existing 8/6/20012 compliance Data on
record. �
The'existing'1'992 three bedroom design pressure mound type drain field was field located. A
soil boring was comp�eted and flagged in the drain field area(please see sketch).This soil boring
revealed"an absence of the condition noted as"Redox Features"to 18 inches below the original surface
grade,."Redox Feature�" indicate a high water table condition. Regulations for this system require 24
inch���f separation between the bottom of the drain field rock bed with a raised sandbase down to the
redox features. It Is apparent there is the reauired 24"seaaration as this 1992 mound was
c�nt�ucked to 36"of separation. This also confirmed LGU As-Built and 8/6/2012 compliance Qata on
record.
Based upon my site evaluation of December 9, 2012 the septic system has
been classified as a passing or complying system. Please note fihat no
determin tion,of-future hydraulic perFormance has been nor can be made;d,ue�o ;
unknown�c.onditipns during system construction, abuse of the system,,.i�adequate -,.
rr�aintena��e, ar fu�ure water usage. If you have any questions please feel free to T
contact e at (612) 232-9737.Thanks!
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'��' ���` � Mi�nesata Pollution
� � � �� �� Compliance Inspe�tion Form
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`�'= �� 9 ��y" Existing Subsurtace Sewage Tr�tmelrt Systems (SSTS)
520 Lafayette Road North
St Paul,MN 55155-4194 ' Doc Type:Compliance and Er►fi�rCement
Iri�sp�i:tion results bssed on Minnesote Pollution Control Agency(MPCA) For local tracking purposes:
requirements and attached forms-additional local requirements mey also appry.
Submit completed form to Local llnit of Gov�mment(LUG)and system owner
within 15 d�ys ��
System Status �
Sysbem status on date(mmldd/yyyy): 12/9/2012 �
,. , .
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� Compliant-Certificate of Compliar�ce ❑ Noncompliant- Notice of Noncomplia�ce
(Valid for 3 years from report dat�, unless shorter time (See Upgrede Requi�ments on page 3.)
fr�me oudined in Local Ortirnence.)
-,Reason(s)for noncompliance(check all applica6le)
� .�- � . - ,
�'�I�p�ctbFi'I�E3b�lc9l��i��(�omplia�csComponent 1)'=��Jl�ntti►ie8t'to"public' ��� I� r �w�
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., � �� ,; ���� :
- p'Other�d�mpliarla��onditions(Com_Iiance Com on � ��r
ent#3) ,=Imminent thieat to public, ealth and safety
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. ���nk�R�9��Y(�m�(iance Componerit�#2)-�Failirig to pibtectgroundwater _. ,.. `.➢ '.. � ��' '. .
�Other Complia�c��onditions(Comp/iance Componenf#3)-Failing fo proiect groufidwater�� �;�-� ��
❑Soil Separation(Complience Component#4)-Failing fo protect groundwater
❑Operating permit/monRoring plan requirements(Compliance Componerrt#5)-Noncompliant ___„_ _. .
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���PertY �nformatian;,a �.a � , . � � , i Parcel ID#or 9eclTwp/Range: �I���g"Z3^/2�00/Z
P�r� �
��'�y aaar�ss: 4225 County Road 6 Orono� MN.55356 Reason ior inspec�ion:�--Prnperr�Transfer ,
Property owner. Owner's phone:
��rsar����►�������, ��.� ���-�
-4�aaer'-s representative;-- Mif►nas�cta Home Team:Com Attn: Kyle�VUhite Representative{�hene����-�852)•2,ZFrT/31�.,��-. -. -
Local i�cj�llatory autho�ity: �fa Ci of�Oroii�aY)� Regulatory authority phone: (95�249-4600
�� �o�t�comm�endeYl�Cfklst�- .' , , , y d Pressure Mound r s
B' sc�s,tem description:�Se tic Tani6(/bOa Pum Chamber an
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� '.Cit}�.. , ., -!t; . . , . .. � �.7r _ . . , , . �-��:Ir,� � , � ��, ��t',����i'l..a ;Bl`..
�@t't1�1Cat10L1 _ .� �i�,c� ;'��ur�, , � .��r ,. , ��� . � , �-t:rc ���a.rr� �-���it:.��E::v
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1 hereby cer�if�`tNat�l1 Che neeessary infom►a6on hes bee►�gathered Eo deteimine the compliance status of this system. No
determrnation of futu�,$y�tem, p�iwrmance has b,een nor cen;�e mac�e duQ to unknown cardi�on�,dur�ng sysi�em construction,
possible abuse of the s�!sfem,in�,dgquate maintenence, or future waf�r usepe.
lnspector name; ��h�,�a.s„�,,Klan�nik , � Certfication number,;,,�R,a945
-•B�siAess�r�arpe_. .AdvaFlead-� _ .-� ._ License number:. _��666 .-..___ . :.. ,., ..
lnspector signature: v� • ' Phone number: (612)232�737
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Ne'��s�ry'o'r"Lb�ailji'Required Attachmerpt5 '�� ''� .- � p ���---`� ` '' -
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��1�IeSoil borin lo s- ;r, ,{ .
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g g — �S�ystem/As-built drawing - d Fo�ms per Iocal ordinance- -
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Property address:�4225 Coun Road B Orono MN.55 6 Inspector ini6alslDste: 12/9/2012
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1. Impatt on Pub�ic Health—,Compliance component#1 of 5
Com liance criteria: ' ' Verification method(s):
System discharges�ewage to the ' �Yes � No �Searched for surtace outlet
� round surface. � �Searched for seeping in yard/backup in home
�;System discharges�ew�,g�,to drain ❑Yes � No ,, ❑Excessive ponding in soilsystem/D-boxes
tile or surFace waters.
p Homeowner�testimony(See Comments/Explanatron)
�9yistem causes sew�ge backup irito ❑Yes �No ❑"Black soil"above soil dispe�sal system
dwelling or establishment.
❑System requires"emergenc�'pumping
_Any"yes"answer above indicates the ❑ Pertormed dye test
system is an�mm�nent threat�to public ❑ Unable to verify(See Comments/Explanetion)
.health and safety. "
�� � � ❑Other methods nat listed(See Comments/Exp/anation)
Commerrts/Explan tion: . �
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Tank Integrity-Compliance component#2�of 5�^
� m liance criteria:�_; > - . � � Verificatio� method(s):
_ ._ ._ _ .. .,; _ .. _ _
System consists of a seepage pd, "� ❑Yes � No � Probed tank(s)bottom.�
eesspool,d . ell,or leaching pit., .. __ , � Examined construcction�records
Seepege pits ting 7�08o�25s0�may be � Examined Tank Integrlty FoRn(Attech)
m liant if al owed in loca!ordinance.
S��age,�nl�s) leakb�slowtheir. ❑Yes �No q � P��bng deptYi
[� Observed li uid Igval b�low v
d g perating depth. ❑ EXamined empty(pumped)ta'nks(s) �
If es�which�ewage.,tank(s)le�ks; ❑ Probed outside t2nk(s)for"b�ack soil'
• ❑ Unabfe to veri (See��ommsnfslExp�anation)
_An'y'�",y�s'=`answe�above mdicates the _ �
�,: r rt ,:,�,
,�� e .is=#aili g to�- ,rotect;(�!�[IlfdWatel. 0 �er methods not listed(See Comments/�Eicp/anallon)
Gomments/Explahatio�►t � -,: . . d �/'e��'�[�� L��l, ...�?"r����.N .
•,. ..
�cirisulted� U for Records � /
� _____ �d Nj��/��-. 'g' 1i 2�O1�' . .r .
__ ..... . ._ _ ,. '
t,aar�� � �i � , ,�ti��� r�•� �
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3. Other Co�ptiance Conditions—Compliance component#3 of 5
a. Mainten�nce hole cove�s are damaged,cracked,unsecured,or appear to be structurally unsound. ❑Yes` �No ❑Unknown
��• �.�'Othi�r issues electr�l•li�iard etc. to immetli�l snd adve im act I'
___._ ..(.... ,__.__.w.. �._...�._ Y.' �X. A Pyb�c health Of&��Ety...._._D Yes"..�.�IQ D unknown
. .... _...
Syysi�eem is$n=rmminent thl+eat to pablic hea/th aRd safety. , � ���r}�;
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Explain:
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-cr'" System is'ndn�r�at�'ctnis�of ground water for other oonditions as determined by inspector.,� ukp.YesF f�No
, ,�m is faiUn9.�o prtoaect groundwatar. ;,.; .
rt :_ . (' �;n r ��;:� �
Explam` `"` ` � e�,►'Yl C� �a.. �tor•�.�
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roperly address: 4 Z5 Count Road 6 Orono MN. 55356 Ins ector initials/Date:� 1 Z/9/2012 -4��-
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(mm/dd�yyyy) �.
. Soil Se ara ion—Compliance component#4 of 5
ate of installati n: Z, O Unknown V�riflcatlon �nethod(s):
� �� � Soil obsenrabon does nof expire.Pr+avious soil
horela�dNVellhead protsctloNFood bovarage �Yes � No observaHons by iwo independent parties are s�cier�t,
�dging? unless site cand/Hons have been alte�d or lacal
om liance criteria; �quir�ments difiFer.
rsystems builtpn�ortoApri/1, 1996, and �Yes ❑No �Conduded soil observation(s)(Attadrboringlogs)
ot locafed in ShoreVand orWellhead ❑Two previous verifications(Attech boring logs)
rotection Area or nof serving a fpod,
everage or lodging establishmer�t.• I i ❑Not applicable(Ho/ding tank(s),no drair►fiel�
rainfield has at lea t a twafoot yerU I ❑ Unable to verify(See Comments/Explar�atlon)
eparadon distance m periodi Ily ❑Other(See Comments/Explanatron)
aturated soil or bed ck.
onperformance sy'stems kuilt April , ❑Yes ❑ No CommeMsiExplanation:
'�� '�j996,orlaterorfornorr-perforrnance y �
$ystsms/ocated in Shoreland or Wellhead , (/�/'1��'G� ��U II��
Protection Areas ar senring a food,
beverag�,orlodgingestablishment: �0��l�R""i'' ��17��Z -
'[�llaln�eld has a three-foot•!ver4cal .; � �, .��,. . . �_�-- _.-_, ,., _ �,..._ ��,,.
_ . ------ _ _,--__ __ :. � _ _ .__--
separation distance from periodically
satu�ted soil or bedrodc,*
,'�xx�ehimental; "Othe�', or� °Perfomi�nce" ❑Yes p No Indicate de ths or eleva�ions
�ystems bui/t under pns-2008 Rules;Type!V • �
br V systems built under20E�8 Rules,(T080: � A. Bottom of dlstrlbudon r�edia �Q ,,
350 or 7080.2400 (Advanced InspeCtor ,, ;
�cense required) ` : , ,� qQ
�.<.-� �
B.�.Periodicall Saturdted Soil/bedroCk / p.
�rainfield meets the designed vertical C. �S m se aratlon � �o��
p�retian distance from periodically _
!i
�a�l'ated soil or bedrock.,, ,t; �,, , D. R uired com liance sa arat(on*
�4n 't�no"answer above f�di�afes fhe system is *May be reduoed up to 15 percent if allowed by Lacal
�v��ig.fa protect grou�►c�atpr. Ordinance.
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5r�;,�lperating Per,mit �ind Nitrogen BMP'`—Compliance component#5 of�5 � Not applicable
_ _. _ __ _
�,r�,�s�he,system operabed un�er,-�n O,perating Permit? �Yes ❑No If"yes",A below is requi�ed
�`ls the system required to'empioy a Nitrogen BMP7 ❑Yes ❑ No If"yes",B belo�;�is,,�nequired
s; . �: ,. ±, ,
f�r;.;;,. BMP=8est Manag�e�ttt,Practice(s)apecified!n the system dssign },.� � �� . -
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��lfthe ar►swer[+o both�questions is "no", this section does no!need to be comp/eted.
��� . . .
`"'Lbm lisnce cr+iteria "
s�� _
` ber: _---
�,. ,, P 9 ❑Yes ❑.Nc �,, m.
a: 0 eratin ennitnu���� uire. e�s been met? .
Have the 0 rati P
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c�� t b;:;,sils the.re ui ed nitr en�BMP in lace and rv erl functionin ? Yes No��' ' ::_. _ . ... _ _
z'i4�y'"no"'ah w�er in�iicates'Noncompliance.
i:., .... . _
�E,���nefe R � ul�'A�'feltLs MrM:'��SYat� 1 t&55 An Immlr�ent threat to ub/ic health and saTe ITPHS must�y
uP9 eq f § ) p ty l 1 be upgraded��eplaced,or�Ta use
s � rrtinaed within ien months bf�ecelpt of thia noNce or within a shorder peNod if required by/oeal oMirt�nC�; [he system is failing.�o protect -
3.�1g�und water;�the Sysfem must be upgraded,replaced,orits use d/sconUnued wi7hin the Hme required by/oca!wdinanca.!f an e9rlsting system
----is-nat failing as defiped in/aw,and has at/east hvo feet of design soi/separaGon,then the system need not b��upgiaded,iepaire'tl,nep/aced,or
�wrl�y9 uSe,discantinueQ,notwithstanabng any loe�o�d/nance t,�lat is more s6rck This provision does not apply to�sysEems in shor�elend areas,
� ,�/,{A�,eUhead Protectian Areas,or.thqse used in oonnecUon wn7h food,beverage,and/odging establishments as deflned/n/aw.
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313 Lyndale Ave_
New rague, MN. 56071 � � , , � � .
Phon : (952)461-2356
Fax: ( 52) 45&6278 `
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To: Kyle White, Inc. Attn: Diane From: Tom K{anchnik
Fa�c (952)226-773� � Date: • pecember�,2012
Phone: (952) 22C�7731 � � Pagess
Ra: Compliance Inspec�ion CC:
, ,.. •,, ,. � _ _ _
❑ Uw�ent t�J�'or Re�riew ❑ P Coremerrt 0 Please Reply �Please Recy�cle
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These are the MPCA Compli �nce forms for Kyle White, lnc. of Minnesota
, �, Home Team.com�far 4225 County oad 6 Orono, MN. 55356. The system is
;,;� Passin or Compliarrt. Please ca if you have Please call if you have any
quesfions. Thanksl �,�( �
m�� o� 1=nva,"� hy �l�i�C •
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� Minnesota Poilution � Compl�ance Inspection Form
Control Agency
520 Lafayette Road North Existing Subsurface Sewage Treatment Systems (SSTS)
St.Paul,MN 55155-4194 Ooc Type:Compliance and Enforoement
__ _. __._.-- ----
Inspection results based on Minnesota Pollution Control Agency(MPCA) i For local tracking purposes: '
requirements and attached forms-additional local requirements may also apply.
Submit completed fom►to Local Unit of Government(LUG)and system owner �I
within 15 days _._�__�
System Status
System status on date(mm/dd/yyyy►: 8/6/2012
� Compliant— Certificate of Compliance ❑ Noncompliant— Notice of Noncompliance
(Valid for 3 years from report date, unless sho►ter time (See Upgrade Requirements on page 3.)
frame outlined in Local Orclinance.)
Reason(s)for noncompliance(check all applicab/e)
❑ Impact on Public Health (Compliance Component#1)-Imminent threat fo public health and safety
❑Other Compliance Conditions(Compliance Component#3)-lmminent thieat to public health and safety
❑Tank Integrity(Compliance Component#2)-Failing to protect groundwater
❑Other Compliance Conditions(Compliance Component#3)-Failing to p�tect groundwater
❑ Soil Separation(Compliance Component#4)-Failing to protect groundwater
❑Operating permiUmonitoring plan requirements(Compliance Component#5)-Noncompliant
Property Information Parcel ID#or Sec!'fwp/Range:
Property address: 4225 County Road 6 Orono Reason for inspection: Property Transfer
Property owner: Bank Owned _ Owner's phone: ___
_ _------ - ___—
or
Owner's representative: Ryan Johnson Representative phone: 612-816-5764
--
Local regulatory authority: City of Orono Regulatory authority phone: ____
Brief system description: 2_1000�allon_tanks, 1000 gallon lift station, mound system
__ _ -- . --- — �
Comments or recommendations: �
\
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Certification
1 hereby certi/y that all fhe necessary infom►a6on has been gathered to determine the compliance stafus of fhis system. No
deferminaGon of futuie system performance has 6een nor can be made due to unknown conditions during system construction,
possible abuse of the system, inadequate mainte , or future water usage.
Inspector name: Chad Lashinski __ ___ Certification number. C3054
Business name: Lashinski Sep' __ License number: 65
Inspector signature: Phone number: 612-991-7004
Necessary or Locally Required Attachments
❑ Soil boring logs � SystemlAs-built drawing ❑ Forms per local ordinance
❑ Other information(list): _
_ --- __- _ ___ _. --- ---
www.pca.state.mn.us • 651-296-6300 • 800-657-3864 • TTY 651-282-5332 or 800-657-3864 • Available in alternative formats
wq•wwists4-31 • 3/16/12 Poqe 1 oj 3
�
Property address: 4225 County Road 6 Orono Inspector initials/Date: ___ 1 __ ____
---- _-- _ _._.—____ __
(mMdd/yyyy)
1. Impact on Public Health —Compliance component#1 of 5
Compliance criteria: Verification method�s):
__ -- _---
System discharges sewage to the ❑Yes � No � Searched for surface outlet
ground surface. ________ ___i _ � Searched for seeping in yard/backup in home
------- ---
System discharges sewage to drain � ❑Yes � No ❑ Excessive ponding in soil system/D-boxes
tile or surface waters.
--------- -- .----- - .---- ❑ Homeownertestimony(SeeComments/Explanetion)
System causes sewage backup into ' ❑Yes � No �"Black soil"above soil dispersal system
dwelling or establishment.
--- ------- ---- ---- - ❑ System requires"emergency"pumping
Any"yes"answer above indicates the ❑ Performed dye test
system is an imminenf threat to public
hea/th and safety. ❑ Unable to verify(See Comments/Explanation)
❑ Other methods not listed(See CommentsiExplanation)
Com mentslExplanation:
2. Tank Integrity—Compliance component#2 of 5
Compliance criteria: Verification method(s):
System consists of a seepage pit, ❑Yes � No � Probed tank(s)bottom
cesspool,drywell,or leaching pit. '
� Examined construction records
Seepage pits meeting 7080.2550 may be ❑ Examined Tank Integrity Form(Attach)
comPliant if allowed in local ordinance.
_ _ _ _____ ___---
— Observed liquid level below operating depth
Sewage tank(s)leak below their ❑Yes � No
designed operating depth. ' � Examined empty(pumped)tanks(s)
If yes,which sewage tank(s) leaks: ❑ Probed outside tank(s)for"black soil"
--- _-- _ ._ --- __
Any"yes"answer above indicates !he ❑ Unable to verify(See CommentsiExp/anation)
system is failing to protect groundwater. ❑Other methods not listed(See Comments/Expfanation)
Comments/Explanation:
3. Othe�COmplia�Ce COnditlOns—Compliance component#3 of 5
a. Maintenance hole covers are damaged,cracked,unsecured,or appear to be structurally unsound. ❑Yes" �No ❑Unknown
b. Other issues(electrical hazards,etc.)to immediately and adversely impact public health or safety. p Yes' �No ❑Unknown
"System is an imminent threat to public health and safety.
Explain:
c. System is non-protective of ground water for other conditions as determined by inspector. ❑Yes• �No
"System is failing to protect groundwater.
Explain:
--- __ _ _- - ------ -- __. —
www.pca.state.mn.us • 651-296•6300 • 800•657-3864 • TTY 651-282-5332 or 800-657-3864 • Available in alternative formats
wq-wwists4-31 • 3/16/12 Page 2 of 3
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� Property address: 4225 County Road 6 Orono Inspector initials/Date: �
. . _ _____— - -__ _
(mrNdd/yYYY)
4. Soil Separation - Compliance component#4 of 5
Date of installation: � Unknown Verification method�s):
(mMdd/yyyy)
ShorelandNVellhead protectioNFood beverage Soil observa6on does not expire. Previous soif
lodging? ❑ Yes � No observations by two independent parties are su�cient,
unless site conditions have been altered or local
Compliance criteria: requirements ditfer.
—_ __ ____—
For systems burlt prior to April 1, 1996, and ❑Yes ❑ No ❑Conducted soil observation(s)(Attach boring logs)
not locafed in Shoreland or Wedhead
Protection Area or not se►ving a food, ❑Two previous verifications(Attach boring logs)
beverage orlodging establishment: ❑ Not applicable(Ho►ding tank(s),no drainfreid)
Drainfield has at least a two-foot vertical ❑ Unable to verify(See Comments/Explanation)
separation distance from periodically ❑Other(See CommentsiExplanat;on)
saturated soil or bedrock.
Non-pe�formance systems builtApril 1, �Yes ❑ No Comments/Explanation:
1996, or fater or for non-performance
systems located in Shoreland or Wellhead
Protection Areas or serving a food,
beverage, orlodging establishment:
Drainfield has a three-foot vertical
separation distance from periodically
saturated soil or bedrock."
"Experimental'; "Other', or "Performance" ❑Yes ❑ No Indicate depths or elevations
systems built under p�-2008 Rules; Type N
or V systems built unde�2008 Rules(7080. A. Bottom of distribution media
-- --- —_ _ _
2350 or 7080.2400 (Advanced Inspector �
License required) B. Periodically saturated soil/bedrock � 36"
Drainfield meets the designed vertical C. System separation 36"
separation distance from penodically ---—�
saturated soil or bedrock.
D. Required compliance seQaration'
--- -—-- --- __ - -
Any "no"answer above indicates the system is 'May be reduced up to 15 percent if allowed by Local
failing to protect groundwater. ordinance.
5. Operating Permit and Nitrogen BMP*-Compliance component#5 of 5 � Not applicable
Is the system operated under an Operating Permit? ❑Yes ❑ No If"yes",A below is required
Is the system required to employ a Nitrogen BMP? ❑Yes ❑ No If"yes", B below is required
BMP=Best Management Practice(s)specified in the system design
If the answer to both questions is "no", this section does not need to be completed.
Compliance criteria
_ _ - - _---- --_- ,
a. Operating Permit number: �
___ __ ❑ Yes ❑ No
Have the Operating Permit requirements been met?
b. Is the required nitro�en BMP inplace and properly functioning? ❑Yes ❑ No
Any "no"answer indicates Noncompliance.
Upgrade Requirements(Minn. Stat.§f 15.55)An imminent threat to pu6lic health and sefety(ITPNS)must be upgraded,replaced,orits use
discontinued within ten months of recerpf ol this notice or within a shoRer period if nsquinsd by local ordinance.If the system is failing to protect
ground water,the system must be upgraded,replaced,or its use discontinued wilhin the time required by local ordinance.lf an existing system
is not failing as defined in/aw,and has at feast two feet of design soil separatron, then the system need nol 6e upgraded,2paired,replaced,or
its use discontrnued,nofwithstanding any loca!ordinance fhat is more strict. This provision does not apply to systems in shoreland areas,
We/lhead Protection Areas,or those used in connection with food,beverage, and lodging esta6lishments as defrned in law.
_ • — _.__ _______ ___---- —
www pca.state.mn.us • 651-296-6300 800-657-3864 • TTY 651-282•5332 or 800-657-3864 • Available in alternative formats
wq-wwPsts4-3 f • 3/16/12 Page 3 of 3
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Street Address: Mailing Address:
��9xEsxp'4�� 2150 Kelley Parkway PA, Box 66
.,
.. _ Orono, MN 55356 Crystai Bay, MN 6
To: The Cun•ent Owner of Address L'l ,�� � c� �' � �'�''�
City Ordina.nce requires that onsite sewage treatment systems in Orono be
inspected on a periodic basis. The onsite sewage treatment system at the above
address has been inspected and the following is known about the system. A
sketch of the known components of the system is available for most properties at
the Orono City Hall.
Imminent Public Health Threat
Yes �No
If yes, please contact the Onsite Systems Manager at 952-249-4626 within 10
days of receipt of this notice. The septic system must be brought into compliance
within 90 days. Failure to do so will result in referral to the City Attorney for
legal action.
System Identified as Non-Compliant
Yes �No
If yes, system must be brought into compliance by:
December 31, 2007
December 31, 2010
Other
Septic Tank(s) Pump out Needed
Yes �No
The City recommends the septic tank(s) and/or lift tanic be serviced and pumped
o«t every thr e years. Citv records indicate t�le tank(s) were last pumped out on
� � 1"� � . The tank(s) should be cleaned through the manhole and
not through the inspection pipes, this allows for proper cleaning.
Comments:
w� � �, �
Inspect� � .�� ����� Date of Inspection
'Ilelephone(9�21 2�9-�&600 � &'ao (9�Zj 249-461�a
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�-���- CITY of ORONO
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�' '�'��� ;.�, 1�'�'�,G . str�t�wareas: �Isa-�49-�t6o o Mai�ie`Il�arou:
�;ggKO'�" 2750 Keliey Parkway P.�. �c�6
Orono, MN 55356 Crystal �r, MN 55323-0066
To Current Owner: Address: y�� s� �t- /✓-i
City Ordinance 199 requires that each existing on-site sewage trea��t system in Orono be inspected every two years.
The on-site sewage treat�nent system a#the above address has been inspected and appears to fall into the categories checked below.
SYSTEM CONFORMITY (1-3): . �
- - .:_. . -_ -- -
1 "CODE SYSTEA�I"An LSTS which meets all the location,design snd construixion atandards of tl�e current Orono Municipal Code.
2 "COMPLIANT SYSTEM" An ISTS which does not moet all the locarion,design and construction standards of the curnat Orono
Munioipal C.ode but does meet die three foot separation requirement or iwo foot requireme�t for systems installed 1996 or earlier,and
��wl»ch is not failing or an i�inent Uueat to publi��alth or safdy.
( 3 J"NON-COMPLIANT SYSTEM" A prohitrited�S7'S;an IS�'S located within a designated 100-year 800d plain,any ISTS which may
�� or may noi meet all the locarion,design,or cons�ucbon stanc�rds of the ciure�t Urono Municipel Code aad wLich is failing for any
reason;and any ISTS with less than Wrce feet of unsadn�ted soil or sand be4ween the distn'bution device and the limiting soil charactaistics.
TANK CONDIT ION(5-71: �
inspection indicates:
5 Aunpout notn�at this time.
�Septic tanks must be pumped out this year (city code recommends tanks to be pumped out once every 3 years.
Tank was last pumped �7^Z..�03 ).
Ma1ce sure seotic#aaks are�amned Wrea�h�anhole and not throu¢6 white insaectioe�iues. T�is allows for t�e nroner
cleaaias. Keen water sotiner and irou filter dischar�e out of seatic svstem to nroione fife ef drxinfield. Ask oumner to test
alarm 8oat to verifv:slarm i4 sti11 werkiog in vonr�onse. The adarm warns owner ffiat se�tage is tbout to backuo iato basement
7 Inspection risers missing-taaks could not be inspected. Iflspection risers(4"dia.pipe)must be installed in each tank. If
tanks have not been pumped out within the last three years,they should be pumped ou#now.
IELD CONDITION 8-10 : � -�
Drainfield is dry,no surfacing evident. ,
9 Some evidence of surfacing,not critica�yet.
10 Drainfield is sai.urated and visibly discharging untreated effluent to the surface. Contact the City Inspeetor
immediately.Repairs must be complexsd witlun 9U days.
co�rrrs: 1`�0,�..J ,- Sfp�.z �� - (aok v� :
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. 1 �-�°�=d`� G�`�S-
Date of Inspection Matt Bolterman- Septic System Inspector
Note: In the eveat th�t Wis inspaxion report is used w satisfy the requirements for a mortgage or otha�h�ansfer of P�P�Y,be advised tha2 this repott does
not guarantce or cr�tify that � existing syst�will continue to fundion ProperlY, but is merely an opinion of tge edequacy of the system nnder cumut .
conditions based�the ava�7sble�nformation.
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'� �y:�:#��i��g'�Y " Street Addreu: Mailing Address:
�H . 2750 Kelley Parkway P.O. Box 66
� Orono, MN 55356 . � Crystal Bay. MN 55323•0066
� 95d-�4q-y600
To Current Owner: Address: �a'�� S;k� A�C ��
City Ordinance 199 requires that each existin�on-site sewage treatment system in Orono be inspected every two years.
The on•site sewa�e treatment system at the above address has been inspected and appears to fall into the categories checked below.
SYSTEM CONFORMITY 1-3 : 1
1 "CODE SYSTEM"An IS'IS which meets aIl the location�daign and construction standards of the current Orono hiunicipal Cade.
2 "CO�LIANT SYST'EM" An iSTS which does not meet all the Iocation,design and construction standards of the cwrent Orono bfunicipaI
Cade but does meet the t}u�ee foot separation tequirement or two foot rcquinment for rystems installed 1996 or earlier.and which is not failing or
�an Imm3nent threat to public health oc safery.
3 "NON-CO�iPLIANT SYSTEI�i" A prohibited ISTS;an ISTS located within a daignated 100-year flcod plain.any ISTS which may
or may not meet a1t the location.duign,or conswcdon standards of�e current Orono I�Sunicipal Code and whtch is failing for any reason;and
any ISTS with less than three feet of unsacuratcd soil o�sand between tfie d'utribution device and the limidng soil characurisda.
TANK CQNDITION(5:71: 6 A �
Tank inspection indicates: .
� Pumpout not needed at this time. �
Septic tanks must be pumped out this year (city code requires tanks to be pumped out once every 3 years.
Tank was last pumped_ �-`I-9� �, �
1�Iake sure seotic tanks are oumned throu?h manhole and not through white insoection oioes
This allo«•s for the oroner cleanin;;
7 Ins�ection risers missing-tanks could not be inspected. Inspection risers(4"dia.pipe)must be instalIed in each tank.
pRAINFIELD CONDITtON!$-1Q): <<�
8 Dninfield is dry,no surfacing evident. _-
9 Some evidence of surfacin„not critical ye� _ ;; =�""- �
10 Drainfield is saturated and visibly dischazging untreated ef�luent to the surface. Contact the Ciry Inspector
unmediately. ,
CO�I,I�NTS: /"�c���� : S � t���:� . �� �:� ' o�� 6e lace�e�fi
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1�g �.�O — �� �ct�, - �
Date of Inspecdon l�tatt Bolterman- Sepeic System Inspector
Note:In the event that this inspection tepart Lt used to satisfy the rcquirements fe�a mortgage or other trar�sfer ofproperry.be advised that this report Coes not guars�:e=
or certity thu an existing rystem will continue to function p:operly.but is merefy an opinion ofthe adcquary olthe system tmdercurrent condidons based on the avaifabie
informstion.
CITY OF ORONO � O�
Municipal Offices O O
Post Office Box 66
Crystal Bay, MN 55323-0066 � � ON—SITE SEWA6E TREATMENT
r�,, � INSPECTION REPORT
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Owner: lJr II I�YIU�.I�E,� Address: T 22_S S� 14V'E /� ( CS53S� I
Permit �'s: � Dates:_ /� /� /Z Contractors: E�S� Y�JCS�Y1 ��
City ordinance nunber 100 requires that each on-site sewage treatment system in Orono be inspected on a regutar besis.
The on-site sewage treatment system at the above address has been inspected and appears to fall into the category
checked below.
(This is�n existing system [ ] neu construction)
TEM CONFORMITY 1-3 :
1 "CODE SYSTEM"-A stem which meets all the location, design, and construction standards of the current City
Codes, and which is operating satisfactorily by treating and disposing of the entire current sewage input
without discharging any poltutants into ground or surface waters.
2 "CONFORMING SYSTEM"-A system which does not meet all the location, design, and construction standards of the
current City Codes, but was installed according to the code in effect at the time of installation, and which
is operating satisfactorily by treating and disposing of the entire current sewage input without discharging
any pollutants into ground or surface waters.
"NON-CONFORMING SYSTEM"-A prohibited system; a system located within a designated 100-year floodplain; any
system which may or may not meet all the location, design, and construction standards of the current City
Codes and which is failing for any reason; and any system with less than 3 feet of unsaturated soil or sand
between the distribution device and the limiting soil characteristics.
(The limiting soil characteristic�has or [ ] has not been identified at this time. If the limiting soil
characteristic has not been identifi , this ctassification may be subject to revision.)
TANK CONDITION (5-10):
Tank inspection indicates:
Pumpout not needed at this time.
6 Solids accumulation in tanks indicates they should be cxmped out this year to help prevent future problems.
Solids accumulation in tanks is at a critical level. Tanks should be purtiped out as soon as possible.
8 System is discharging to the surface. Tanks must be punped out within 48 hours to eliminate surface dischar�e.
9 lnspection risers missing-tanks could not be inspected. lnspection risers (4" dia. pipe) must be instelled in each
tank at next pun�out. If tanks have not been ptn�ed out within the last three years, they should be punped
out now.
10 Inspection pipe is located directly over tank baffle (does not give accurate measurement of solids accunulation).
If tanks have not been punped out within the last three years, they should be punped out now.
DRAINFIELD CONDITION 11-14 :
ainfi ld inspection indicates:
11 rainfield is dry, no surfacing evident.
Sane evidence of surfacing, not critical yet.
13 Drainfield is saturated and visibly discharging untreated effluent to the surface. Contact the City lnspector
immediately. Repairs must be completed within 90 days.
14 Drainfield extent and condition unknown.
LIMITING S1TE FACTORS (sloae.setbacks.etc.): R, �
POTENTIAL FOR SYSTEM FAILURE (decends on soils,water table.etc.): /0�
COMMENTS: S
r
Date of Insp ction Septic System Inspector
Note: In the event that this inspection report is used to satisfy the requirements for a mortgage or other transfer of
property, be advised that this report does not guarantee or certify that an existing system will continue to function
properly� but is merely an optnion ot the adequacy of the system under current conditions based on the available
informetion.
This report must be kept on the premises with the system locstion and pumping records.
WHITE COPY/Inspectors File YELLOW COPY/Homeowner
- ___
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�_ �l^� Street Address: Mailing Address:
�`��'E� O�'�� 2750 Kelley Parkway P.O. Box 66
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� �--__� Orono, MN 55356 Crystal Bay, MN 55323-0066
Owner��? � � �,:��'�Y Address:4225 Sixth Ave. N.
Permit #' s:4471 Dates:7/7/92 Contractors:E. J. Peterson Co.
(This is [�] an existing system [ ] new construction)
YSTEM COMPLIANCE 1-3 : 1
1 Code Svstem: Meets or exceeds current City standards in all respects relating to
design, construction, and location. Appears to be operating properly.
2 Compliant Svstem: Does not meet all current City standards for new construction,
but in most respects appears to be designed, located, and constructed in accordance
with previous codes and is functioning properly.
3 Non-Compliant System: System may or may not meet current City standards for design,
construction, or location, but is failing to properly treat and dispose of the
current input; and any system with less than three feet of vertical separation
between the bottom of the drainfield and the saturated soil level.
r
(The saturated soil level [� has or [ ] has not been identified at this time. If the
saturated soil level has not been identified, this classification is subject to revision.)
K CONDITION 5-9 : 5
5 Pumpout not needed at this time
6 Solids accumulation in tanks indicates they should be pumped out this year.
7 System is discharging to the surface. Tanks must be pumped out within 48 hours.
8 Inspection risers missing-tanks could not be inspected. If tanks have not been
pumped out within three years, they should be pumped out and risers installed now.
9 Inspection pipe is located over tank baffle-can not measure solids accumulation. If
tanks have not been pumped out within three years, they should be pumped out now.
(During the last septic tank Maintenance Pumpout the tanks [ ] were or [�] were not
confirmed to be watertight by the licensed pumping contractor. If the t,�anks were not
confirmed to be watertight, this classification is subject to revision.)
D AINFIELD CONDITION 11-14 : 11
Drainfield is dry, no surfacing evident.
2 Some evidence of surfacing, not critical yet. Repair is not required at this time.
13 Drainfield is saturated and visibly discharging untreated effluent to the surface.
Contact the City Inspector immediately. Repair must be completed within 90 days.
14 Drainfield extent and condition unknown.
POTENTIAL FOR SYSTEM FAILURE: (system aae and condition, soils, etc. ) : low
COMMENTS:
�
r
���-�� ��� -=� . � ��.-----
-D� of Inspection Sept'c System Inspector
Note: In the event that this inspection report is used to satisfy the requirements for a
transfer of property, this report does not guarantee that an existing system will continue
to function properly, but indicates the operation of the system under current conditions.
Telephone (612) 473-7357 • FAX 473-0510
CITY OF ORONO �O�
Municipal Offices O O
Post Office Box 66
Crystal Bay, MN 55323-0066 � � ON—SITE SEWA(�E TREATMENT
r�`, � INSPECTION REPORT
ti
��9kESH0��G
Owner: ��f ///��IP� Address: `7`��,�)�/�.)`"f1/�.,./L/t
Permit �'s: ��u_Dates:�' " Contractors: '�iT�il b��L.f+'�
City ordinance number 100 requires that each on-site sewage treatment .system in Orono be inspected on a regular basis.
The on-site sewage treatment system at the above address has been inspected and appears to fall into the category
checked below.
(7his is [�an existing system [ ] new construction>
SYSTEM CONFORMITY (1-3):
1 "CODE SYSTEM"-A system which meets all the location, design, and construction standards of the current City
Codes, and which is operating satisfactorily by treating and disposing of the entire current sewage input
without discharging any pollutants into ground or surface uaters.
2 "CONfORMING SYSTEM"-A system which does not meet all the location, design, and construction standards of the
current City Codes, but was installed according to the code in effect at the time of installation, and which
is operating satisfactorily by treating and disposing of the entire current sewage input without discharging
any pollutants into ground or surface uaters.
3 "NON-CONFORMING SYSTEM"-A prohibited system; a system located Within a designated 100-year floodplain; any
system which may or may not meet all the location, design, and construction standards of the current City
Codes and which is tailing for any reason; and any system with less than 3 feet of unsaturated soil or sand
between the distribution device and the limiting soil characteristics.
(The limiting soil characteristic L�has or [ ] has not been identified at this time. If the limiting soil
characteristic has not been identified, this classification may be subject to revision.)
TANK CONDITION C5-10): �
T inspection indicates:
5 Pumpout not needed at this time.
Solids accumulation in tanks indicates they should be pumped out this year to help prevent future problems.
7 Solids accumulation in tanks is at a critical level. Tanks should be pumped out as soon as possible.
8 System is discharging to the surface. Tanks must be p�nped out uithin 48 hours to eliminate surface dischar�e.
9 Inspection risers missing-tanks could not be inspected. Inspection risers (4" dia. pipe) must be installed in each
tank at next pumpout. If tanks have not been punped out within the last three years, they should be pumped
out now.
10 lnspection pipe is located directly over tank baffle (does not give accurate measurement of solids accumulation).
If tanks have not been punped out within the last three years, they should be punped out now.
DRAINFIELD CONDITION (11-14):
D field inspection indicates:
Drainfield is dry, no surfacing evident.
12 Some evidence of surfacing, not critical yet.
73 Drainfield is saturated and visibly discharging untreated effluent to the surtace. Contact the City Inspector
immediately. Repairs must be completed within 90 days.
14 Drainfield extent and condition unknoWn.
LIMITING SITE FACTORS (slope,setbacks.etc.):
POTENTIAL FOR SYSTEM FAILURE Cdepends on soils,water table.etc.): �/
COMMENTS:
Date o Inspection Sep c System nspector
Note: In the event that this inspection report is used to satisfy the requirements for a mortgage or other transfer of
property, be advised that this report does not guarantee or certify that an existing system will continue to function
properly� but is merely an opinion of the adequacy of the system under current conditions based on the available
information.
This report must be kept on the pre�nises with the system locption and punping records.
WHITE COPY/Inspectors File YELLOW COPY/Homeowner
CITY OF ORONO �O�
Municipal Offices O O
Post Office eox 66
Crystal Bay, MN 55323-0066 a � ON—SITE SEWAC�E TREATI�NT
� � INSPECTION REPORT
ti
'�',�9kE o��G
sH
Owner: A�I�1��'�lV �I.��IIc� Address: `T�J ,�1^YTi'� 1�1/c./(/+
Permit �'s: Dates: !"'/'�d Contractors: �J� t�e� ��.
City ordinance nunber 100 requires that each on-site sewage treatment .system in Orono be inspected on a regular basis.
The on-site sewage treatrt�ent system at the above address has been �nspected and appears to fall into the category
checked below.
(This is � an existing system [ ] new construction)
SYSTEM CONFORMITY 1-3 :
1 "CODE SYSTEM"-A system which meets all the location, design, and construction standards of the current City
Codes, and which is operating satisfactorily by treating and disposing of the entire current sewage input
without discharging any pollutants into ground or surface waters.
2 "CONFORMING SYSTEM"-A system which does not meet all the location, design, and construction standards of the
current City Codes, but was installed according to the code in effect at the time of instaltation, and which
is operating satisfactorily by treating and disposing of the entire current sewage input without discharging
any pollutants into ground or surface waters.
3 "NON-CONFORMING SYSTEM'�-A prohibited system; a system located within a designated 100-year floodplain; any
system which may or may not meet all the location, design, and construction standards of the current City
Codes and which is failing for any reason; and any system with less than 3 feet of unsaturated soil or sand
between the distribution device and the limiting soil characteristics.
(The limiting soil characteristic [ ] has or [ ] has not been identified at this time. If the limiting soil
characteristic has not been identified, this classification may be subject to revision.)
TANK CONDITION (5-10): .`'
T�f9k inspection indicates:
cy Pumpout not needed at this time.
6 Solids accunulation in tanks indicates they should be punwed out this�year to help prevent future problems.
7 Solids accumulation in tanks is at a critical level. Tanks should be punped out as soon as possible.
8 System is discharging to the surface. Tanks must be pumped out within 48 hours to eliminate surface dischar�e.
9 Inspect�on risers missing-tanks could not be inspected. Inspection risers (4" dia. pipe) must be installed in each
tank at next p�mpout. If tanks have not been puiped out within the last three years, they should be punped
out now.
10 Inspection pipe is located directly over tank baffle (does not give accurate measurement of solids accumulation).
If tanks have not been punped out within the last three years, they should be puiped out now.
DRAINFIELD CONDITION (11-14):
Drp�nfietd inspection indicates:
(yf Drainfield is dry, no surfacing evident.
12 Some evidence of surfacing, not critical yet. '
13 Drainfield is saturated and visibly discharging untreated effluent to the surface. Contact the City Inspector
immediately. Repairs must be completed within 90 days.
14 Drainfield extent and condition unknown.
LIMITING SITE FACTORS (slooe.setbacks,etc.):
POTENTIAL FOR SYSTEM FAILURE (deaends on soils.water table.etc.):
COMMENTS:
Date of Inspection ptic System Inspector
Note: In the event that this inspection report is used to satisfy the requirements for a mortgage or other transfer of
property, be advised that this report does not guarantee or certify that an existing system will continue to f�mction
properlyi but is merely an opinion of the adequacy of the system under current conditions based on the available
information.
This report must be kept on the premises with the system locQtion and punping records.
WHITE COPY/Inspectors File YELLOW COPY/Homeowner
CITY OF ORONO � O�
Municipal Offices O O
- Post Office Box 66
Crystel Bay, MN 55323-0066 � � ON—SITE SEWA(�E TREAT�dSNT
� . �, INSPECTION REPORT
ti
���kEsHo��G
Owner: f/Q✓VY�` l�Y<1�hG1� Address: 7�� .SIYIl� �. M
Permit #�'s: 7 Dates:_�//�7� f Contractors: .�V/1'I,��r�
City ordinance number 100 requires that each on-site sewage treatment .system in Orono be inspected on a regular basis.
The on-site sewage treatment system at the above address has been inspected and appears to fall into the category
checked below.
(This is L� an existing system [ l new construction)
SYSTEM CONFORMITT C1-3): �
1 "CODE SYSTEM"-A system which meets all the location, design, and construction standards of the current City
Codes, and which is operating satisfactorily by treating and disposing of the entire current sewage input
without discharging any pollutants into ground or surface waters.
2 "CONFORMING STSTEM"-A system which does not meet all the location, design, and construction standards of the
current City Codes, but was installed according to the code in effect at the time of installation, and which
is operating satisfactorily by treating and disposing of the entire current sewage input without discharging
any pollutants �nto ground or surface waters.
"NON-CONFORMING SYSTEM��-A prohibited system; a system located within a designated 100-year floodplain; any
system which may or may not meet all the location, design, and construction standards of the current City
Codes and which is failing for any reason; and any system with less than 3 feet of unsaturated soil or sand
between the distribution device and the limiting soil characteristics.
(The limiting soil characteristic [ ] has or has not been identified at this time. If the limiting soil
characteristic has not been identified, this c assification may be subject to revision.)
TANK CONDITION (5-10): �
Tank inspection indicates:
Punpout not needed at this time.
Solids accumuletion in tanks indicates they should be pun�ped out this year to help prevent future problems.
Solids accumulation in tanks is at a critical level. Tanks should be punped out as soon as possible.
8 System is discharging to the surface. Tanks must be punped out within 48 hours to eliminate surface dischar�e.
9 Inspection risers missing-tanks could not be inspected. Inspection risers (4�� dia. pipe) must be installed in each
tank at next punpout. If tanks have not been punped out within the last three years, they should be punped
out now.
10 Inspection pipe is located directly over tank baffle (does not give accurate measurement of solids accumulation).
If tanks have not been punped out within the last three years, they should be puiped out now.
DRAtNFIELD CONDITION (71-14): �
Drainfield inspection indicates:
11 Drainfield is dry, no surfacing evident.
� Some evidence of surfacing, not critical yet.
(I� Drainfield is saturated and visibly discharging untreated effluent to the surface. Contact the City Inspector
i iately. ReM+rc m�cr M �rm,lPted u_ �_ 't�q� days.
14 Drainfield extent ana � .
LIMITING S1TE FACTORS Csloce.setbacks,etc.):
POTENTIAL POR SYSTEM FAILURE Cdeaends on soils.water table.etc.):
Co TS: ,� � al ��
.
Date of Inspection Septic System Inspector
Note: In the event that this inspection report is used to satisfy the requirements for a mortgage or other transfer of
property, be advised that this report does not guarantee or cert�fy that an existing system will continue to function
properly� but is merely an opinion of the adequacy of the system under current conditions based on the available
information.
This report must be kept on the premises with the system locetion and pumping records.
WHITE COPY/Inspectors File YELLOW COPY/Homeow�er
On the North Sbore o f
Lake Minnetonka
ON-SITE SEWAGE TREATMENT
INSPECTION REPORT � POST OFFICE BOX 66
1335 S. Brown Rd.
� � � Crystal Bay, MN 55323
473-7357
OWNER //���1'� �' C�Vl7)P1'� ��'YOI ADDRESS ��� � e�
PERMIT NO.'S. �7I DATES 3��1 CONTRACTORS �U�i�/.J�Y�
City Ordinance No. 210 requires that each on-site sewage treatment system in Orono be inspected on a regular basis.The onsite sewage
ueatment systern at the above address has been inspected and appears to fail into the category checked below.
(This is �an existing system ❑ new construction)
� � Meets or exoeeds curcent City standards in all respects relating to deaign,construction,and locetion.Appears to be operating
properly.
� 2 Does not meet all current City standards for �ew construction (1878 Code) but in most respects appears to be designed,
locsted, and constructed generally in accordance with previous codes.System appears to be functioning properly;no major
upgreding of the system is required at this time.
� 3 Does nat meet current City standards in many respects relating to design,construction,or location.Appears to be operating
adequately at this time,but has a relatively high potential for future problems. No major upgrading of system is required at
this time.
�4 System may or may �ot meet current City standards for design,construction or location,but is failing to properly treat and
dispose of the current input,and is endangering a water supply,or is a source of pollution to surface or groundwaters,or is
creating a safety hazard,or is otherwise creating a public nuisance.Please contact the City Inspector to discuss system repair/
replacement procedures. If drainfield replacement is necessary,soil testing will usually be required,and a design and site plan
must be submitted for review.Your contractor must obtain a permit before work is started.
SYSTEM CONDITION ( m Checked items may�equire your action)
Tank inspection indicates: ❑ Inspection pipe is located directly over tank beffte.(Does not
� ❑ Pumpout not needed at thia time. give accurate measurement of solids eccumulation.) If tanks
�Solida accumulation in tsnks indicates they should be pump- have �ot been pumped out within the last three years,they
ed out this year to help prevent future problems. ahould be pumped out now.
❑ Solids eccumulation in tanks is at a critical level. Tenks Drainfield inspection indicates:
should be pumped out as soon as possible. ❑ Drainfield is dry,no surfacing evident.
❑ System is discharging to surface. Tanks must be pumped Some evidence of surfacing,not critical yet.
within 48 hours to eliminate surfa�discharge. �.Drainfield is saturated and visibly discharging untreated
❑ Inspection risera missing—tanks could not be inspected, effluent to the surface. This condition may require replace-
Inspection risera (4"dia.pipe)must be installed in each tank ment or additions to drainfield. Contact the City Inspector
at next pumpout. If tanks have not been pumped out within immediately.Repairs must be completed within 90 days.
the last three years,they should be pumped out now. ❑ Dreinfield extent and condition unknown,
SITE CHARACTERISTICS:
Limiting Site Factors Potential for System Failure Site Capabilities for
❑ Slope (depends on soil types,water Future Expansion
❑ Soil table,and system condition) �Adequate
❑ High water table ❑ Low ❑ Fair
❑ Lot size ❑Medium O Poor
❑ Lake,wetland,or stream �] High ❑ Inadequate
❑ Drainage �-System is causing visible
surface discharge.
COMMENTS: S � 0 �
�P G 'G �
. /�'
�-/
Date of Inspection Septic System Inspector
Note: In the event that this inspection report is used to satisfy the requirements for a mortgage or other transfer of property,be advised that
this report does not guarentee or certify that an existing system will continue to function properly,but is merely an opinion of the adequacy
of the system under current conditions based on the available information.
This report must be kept o�the premises with system locetion and pumping records.
WHITE COPY/Inspector's File GOLD COPY/Homeowner