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Home My WebLink About2016-01023 - fuel storage tank � + CITY OF ORONO * 2 PJ 1 6 - 0 1 0 2 3 * _. 2750 KELLEY PARKWAY DATE ISSUED: 08/29/2016 ORONO,MN 55356- (952)249-4600 FAX: (952)249-4616 ADDRESS : 2040 SPATES AVE PIN : 10-117-23-31-0090 LEGAL DESC : ORA PARK ON LAKE MTKA : LOT 000 BLOCK 000 PERMIT TYPE : MECHANICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FUEL STORAGE TANK VALUATION : $ 950.00 NOTE: TANK REMOVAL-550 GALLONS APPLICANT MECHANICAL 50.00 STATE SURCHARGE MECH(VALUATION) 0.48 DEAN'S TANK INC. MAIL-IN FEE 2.00 P.O.BOX 22515 ROBBINSDALE,MN 55422 TOTAL 52.48 (763)535-0194 Payment(s) Minnesota State License#:BUIL-475 CREDIT CARD 4925 52.48 OWNER DAMMEN,SUSAN 2040 SPATES AVE WAYZATA,MN 55391- AGREEMENT AND SWORl�1 STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and dces not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within I80 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This petmit may be revoked at any time for due cause. ` � ,��', !(� Applicant Permitee Signature Date Issued Signature Date , � F � �' C USE OPiLY City of Orono ;� ��0 P.O.Box 66 Date Receive � 1 Permit#� � 2750 Kelley Pazkway Crystal Bay,MN 55323 Approved Amount�: Phone(952)249-4600 Fax(952)249-4616 � � ti ` `� �� CITY OF ORONO—MECHANICAL PERMIT ��5 N QQ" (All Commercial permits must be approved by the Building Official or Inspector and/or Fire Marshall) G�"NERAL,INFOR,I�l�`T"I{?N 1. You may apply for mechanical permits by mail or in person at the City offices. Applications will be reviewed and a permit will be issued within two working days. 2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Mechanical Desiens—Complete calculations,details and specifications are required for each heating,ventilation,humidification-dehumidification,and air conditioning installation including heat loss/heat gain calculation,design temperatures,equipment ratings and identification as to type,manufacturer and model. Data shall be presented on form provided. 4. When any new construction or remodeling is involved,a separate building permit must be obtained. 5. All work must be done in accordance with the Uniform Mechanical Code/State Building Code requirements. 6. All work must be inspected(rough-in and final). Call(952)249-4600. (24-48 hour notice required) 7. House Heating Test Record must be submitted before final. TYPE QF PERMIT Check All That A 1 �Residential ❑Commercial(Approval Required) ❑New ❑Additional ❑Repairs ❑Replace x RemoVal 7ob Site/Owner Information: Site Address: 2040 Spates Ave Owner: Susan Dammon Mailing Address: susandammon@comcast.net City: Zip: Home Phone: 612-850-5193 Alternate Phone: Contractor Information: Contractor: Dean's Tank, Inc. Contact Person: Doug Nething Address: PO Box 22515 State Bond#: 0475 City: Robbinsdale Zlp; 55422 Expiration Date: 3/25/17 Phone: 763-535-0194 Alternate Phone: ❑ Insurance—Current: 1 i � Z � Note: All Geothermal Systems will now require a Site Plan&Review by our Building Official. IS THIS GEOTHERMAL? ❑ Yes ❑No HEATING SYSTEMS Quantity: Make: ModeL• Fuel: Flue Size: Input BTUs: Output BTUs: CFM: COOLING SYSTEMS Quantity: Make: Model: Tons: H.Power FIREPLACES ❑ Gas Factory Fireplace Brand Name: ❑ Wood Burning Fireplace ❑ Wood Stove Model No.: ❑ Wood Stove with Flue/Masonry VENTILATION ❑ Na Kitchen Exhaust duct recirculating cfin ❑ No. Bath Exhaust(must have duct outside) cfin ❑ No. Other Fans: Locations cfin FUEL STORAGE (Must 6e approved by Fire Marshall if proposing to abandon tank in place.) ❑ Installation � Removal Fuel Oil: 550 gallons ❑x Underground ❑Inside ❑Outside LP Gas: gallons Other: GAS LINE ONLY ❑ Outdoor Grill ❑ Other/List What&Where: 2 , � � ❑ Yes,this section applies The replacement of a Residential fixture or appliance that meets all three of the following requirements: 1. Does not require modification to electrical or gas service. 2. Has a total cost of$500.00 or less;excludine the cost of the fixture or appliance:and 3. Is improved,installed or replaced by the homeowner or licensed contractor. Skip next section,if this applies; Cost of Permit $ 15.00 State Surcharge $ 5.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ �, If above does not apply;follow guidelines below: 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) �/ �. � x.0125$ (conVact price) (minimum$50.00) 2. STATE SURCHARGE x.0005 $ (contract price) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted work including materials, labor,profit,and other fixed costs. It is the amount to be charged to the customer for the work done. If any material, equipment, labor or installations are furnished by the owner,tenant or any other party,the reasonable market value of such items must be added to the estimated cost or contract price for permit fee purposes. In the event that there is a dispute on the amount of the job cost, the City may request the submission of a signed copy of the actual contract. The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all work in strict accordance with the ordinances of the City and the regulations of the State of Minnesota, and certifies that all statements made on this application are complete, true and correct. Applicant's Signature: ��'��-.L-/�Q�� Date: 8/24/16 3 � Pace Analytical Services,Inc. �ceAnalytical� 1700 Elm Street-Suite 200 _ Minneapolis,MN 55414 wx�v.pecelebs.com (612)607-1700 i �� r O� . �� August 18, 2016 Doug Nething Deans Tank, Inc 3701 50th Ave N Minneapolis, MN 55429 RE: Project: 2040 Spates Pace Project No.: 10358767 Dear poug Nething: Enclosed are the analytical results for sample(s) received by the laboratory on August 11, 2016. The results relate only to the samples included in this report. Results reported herein conform to the most current TNI standards and the laboratory's Quality Assurance Manual, where applicable, unless otherwise noted in the body of the report. If you have any questions concerning this report, please feel free to contact me. Sincerely, Dan Nguyen dan.nguyen@pacelabs.com Project Manager Enclosures �p O /r ' REPORT OF LABORATORY ANALYSIS This report shall not be reproduced,except in full, ,q j' without the written consent of Pace Analytical Services,I�c.. PBge 1 of 11 9 Pace Analytical Services,Inc. • � 1700 Elm Street-Suite 200 aceAnalyticai Minneapolis,MN 55414 - „�ww.pecedees.con, cs,z�so�-,�oo i CERTIFICATIONS Project: 2040 Spates Pace Project No.: 10358767 Minnesota Certification IDs 1700 Elm Street SE Suite 200, Minneapolis,MN 55414 Minnesota Certification#:027-053-137 525 N 8th Street,Salina,KS 67401 Mississippi Certification#: Pace A2LA Certification#:2926.01 Montana Certification#:MT0092 Alaska Certification#:UST-078 Nevada Certification#:MN_00064 Alaska Certification#MN00064 Nebraska Certification#:Pace Alabama Certification#40770 New Jersey Certification#:MN-002 Arizona Certification#:AZ-0014 New York Certification#: 11647 Arkansas Certification#:88-0680 North Carolina Certification#:530 California Certification#:01155CA North Carolina State Public Health#:27700 Colorado Certification#Pace North Dakota Certification#:R-036 Connecticut CeRification#:PH-0256 Ohio EPA#:4150 EPA Region 8 Certification#:8TMS-L Ohio VAP CeRification#:CL101 Florida/NELAP Certification#:E87605 Oklahoma Certification#:9507 Guam Certification#:14-008r Oregon Certification#:MN200001 Georgia Certification#:959 Oregon Certification#:MN300001 Georgia EPD#:Pace Pennsylvania Certification#:68-00563 Idaho Certification#:MN00064 Puerto Rico Certification Hawaii Certification#MN00064 Saipan(CNMI)#:MP0003 Illinois Certification#:200011 South Carolina#:74003001 Indiana Certification#C-MN-01 Texas Certification#:T104704192 lowa Certification#:368 Tennessee Certification#:02818 Kansas Certification#:E-10167 Utah Certification#:MN000642013-4 Kentucky Dept of Envi. Protection-DW#90062 Virginia DGS Certification#:251 Kentucky Dept of Envi.Protection-WW#:90062 VirginiaNELAP Certification#:Pace Louisiana DEQ Certification#:3086 Washington Certification#:C486 Louisiana DHH#:LA140001 West Virginia CeRification#:382 Maine Certification#:2013011 West Virginia DHHR#:9952C Maryland Certification#:322 Wisconsin Certification#:999407970 Michigan DEPH Certification#:9909 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced,except in full, without the written consent of Pace Analytical Services,Inc.. PagB 2 Of 11 � PaceAnalytical3ervicea,Inc. Q�/�� • 1700 Elm SVeet-Suite 200 C`ryK+�� Minneapolis,MN 55414 �.�.� cs,z>so�-,�oo SAMPLE SUMMARY Project: 2040 Spates Pace Project No.: 10358767 Lab ID Sample ID Matrix Date Collected Date Recelved 10358767001 2040 Spates SP Solid 08/11/16 09:00 08/11/16 17:02 10358767002 2040 Spates B Solid 08/11/16 09:00 08/11/16 17:02 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced,except in full, without the written consent of Pace Analytical Services,Inc.. Page 3 of 11 Pace Analytical Services,Inc.� . ��.L�• 1700 Elm SUeet-Suite 200 VrI J Minneapolis,MN 55414 �►•P�� (612)607-1700 SAMPLE ANALYTE COUNT Project: 2040 Spates Pace Project No.: 10358767 Analytes Lab ID Sample ID Method Analysts Reported 10358767001 2040 Spates SP WI MOD DRO MT 2 ASTM D2974 JDL 1 10358767002 2040 Spates B WI MOD DRO MT 2 ASTM D2974 JDL 1 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced,except in full, without the written consent of Pace Malytical Services,Inc.. Page 4 of 11 ' Pace Analytical Services,Inc. CQ/�„„�A,�„^,�'� 1700 Elm Street-Suite 200 `/�/�/��/�Ks Minneapolis,MN 55414 x�napsoeR�bd.ocm (612)607-1700 ANALYTICAL RESULTS Project: 2040 Spates Pace Project No.: 10358767 Sample: 2040 Spates SP Lab ID: 10358767001 Collected: 08/11/16 09:00 Received: OS/11/16 17:02 Matrix: Solid Resuks reported on a"dry wefght"basls and are adjusted for percent moisture,samp/e size and any dilWons. Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual WIDRO GCS Analytical Method:WI MOD DRO Preparation Method:WI MOD DRO WDRO C10-C28 7.6 mg/kg 5.3 1 08/16/16 09:13 OS/17/16 11:19 Surrogates n-Triacontane(S) 82 %. 50-150 1 08/16/16 09:13 OS/17/16 17:19 638-68-6 Dry Weight Analytical Method:ASTM D2974 Percent Moisture 22.5 % 0.10 1 08/16/16 74:44 Sample: 2040 3pates B Lab ID: 10358767002 Collected: OS/11/16 09:00 Received: 08/71/16 17:02 Matrix: Solid Results reported on a"dry weight"basis and are adjusted for percent moisture,samp/e size and any dilutions. Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual WIDRO GCS Analytical Method:WI MOD DRO Preparation Method:WI MOD DRO WDRO C10-C28 ND mg/kg 5.9 1 08/16/16 09:13 08/17/16 11:49 Sunogates n-Triacontane(S) 90 %. 50-150 1 08/16/16 09:13 OS/17/16 11:49 638-6&6 Dry Weight Analytical Method:ASTM D2974 Percent Moisture 21.0 % 0.10 1 08/16/16 14:44 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced,except in full, Date:08/18/2016 04:14 PM without the written consent of Pace Analytical Services,Inc.. Page 5 of 11 Pace Analytical Services,Inc. • Q/�,�,�� /��• 1700 Elm Street-Suite 200 CGI'U(QI�VW Minneapolis,MN 55414 wwwpsceke..oan cs,z�o�-,�oo QUALITY CONTROL DATA Project: 2040 Spates Pace Projed No.: 10358767 QC Batch: 430872 Analysis Method: ASTM D2974 QC Batch Method: ASTM D2974 Analysis Description: Dry WeighUPercent Moisture Associated Lab Samples: 10358767001,10358767002 SAMPLE DUPLICATE: 2343845 10358125001 Dup Max Parameter Units Result Result RPD RPD Qualifiers Percent Moisture % 11•9 13.0 9 30 SAMPLE DUPLICATE: 2343896 10359072001 Dup Max Parameter Units Result Result RPD RPD Qualfiers Percent Moisture °k 52.4 53.7 2 30 Reaulb pressMed on this page are In the unib Indicated by the"Unks"column except where an altemale unk la presented to Me rlgM oi the resuk REPORT OF LABORATORY ANALYSIS This report shall not be reproduced,except in full, Date:O8/18/2016 04:14 PM without the written consent of Pace Malytical Services,Inc.. Page 6 of 11 � � Pace AnalyGcal Services,lnc. ^Q/��,�ti,/;^,�'� 1700 Elm Street-Suite 200 VG/'y/QI��LI{K� Minneapolis,MN 55414 w�rwrw.pecalebac+cm (612)607-1700 QUALITY CONTROL DATA Project: 2040 Spates Pace Project No.: 10358767 QC Batch: 430767 Analysis Method: WI MOD DRO QC Batch Method: WI MOD DRO Analysis Description: WIDRO GCS Associated Lab Samples: 10358767001,10358767002 METHOD BLANK: 2343276 Matrix: Solid Associated Lab Samples: 10358767001,10358767002 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers WDRO C10-C28 mg/kg ND 10.0 08/17/16 10:18 n-Triacontane(S) %. 94 50-150 08/77/16 10:18 LABORATORY CONTROL SAMPLE&LCSD: 2343277 2343278 Spike LCS LCSD LCS LCSD %Rec Max Parameter Units Conc. Result Result %Rec %Rec Limits RPD RPD Qualifiers WDRO C10-C28 mg/kg 80 67.0 65.5 84 82 70-120 2 20 n-Triacontane(S) %. 92 92 50-150 Results preserhed on this paga are in!he units Indlcated by Me"Units"column axcapt whare an altemate unit ia pnsaMed to tha Aght of tl�e result REPORT OF LABORATORY ANALYSIS Thia report shall not be reproduced,except in full, Dete:08/18/2016 04:14 PM without the written consent of Pace Analytical Services,Inc.. Page 7 of 11 Pace AnalyBcal Servfcea,Inc.� - CQ��• 1700 Elm Street-Suite 200 � Minneapolis,MN 55414 �P�R� (612)607-1700 QUALIFIERS Project: 2040 Spates Pace Project No.: 10358767 DEFINITION3 DF-Dilution Factor,if reported,represents the factor applied to the reported data due to dilution of the sample aliquot. ND-Not Detected at or above adjusted reporting limit. J-Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit. MDL-Adjusted Method Detection Limit. PQL-Practical Quantitation Limit. RL-Reporting Limit. S-Surrogate 1,2-Diphenylhydrazine decomposes to and cannot be separated from Azobenzene using Method 8270.The result for each analyte is a combined concentration. Consistent with EPA guidelines,unrounded data are displayed and have been used to calculate%recovery and RPD values. LCS(D)-Laboratory Control Sample(Duplicate) MS(D)-Matrix Spike(Duplicate) DUP-Sample Duplicate RPD-Relative Percent Difference NC-Not Calculable. SG-Silica Gel-Clean-Up U-Indicates the compound was analyzed for,but not detected. N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for each analyte is a combined concentration. Pace Analytical is TNI accredited.Contact your Pace PM for the current list of accredited analytes. TNI-The NELAC Institute. REPORT OF LABORATORY ANALYSIS This repoR shall not be reproduced,except in full, Date:08/18/2016 04:14 PM without the written consent of Pace Analytical Services,Inc.. Page 8 of 11 ' � Pace Analytical Services,Inc. �d/'�' I � 1700 Elm Street-Suite 200 'r��I� Minneapolis,MN 55414 wwv.paoelebe.com (612)607-1700 QUALITY CONTROL DATA CROSS REFERENCE TABLE Project: 2040 Spates Pace Project No.: 10358767 Analytical Lab ID Sample ID QC Batch Method QC Batch Analytical Method Batch 70358767001 2040 Spatea SP WI MOD DRO 430767 WI MOD DRO 431076 10358767002 2040 Spates B WI MOD DRO 430767 WI MOD DRO 431076 10358767007 2040 Spates SP ASTM D2974 430872 10358767002 2040 Spates B ASTM D2974 430872 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced,except in full, Date:08/18/2016 04:14 PM without the written consent of Pace Analytical Services,Inc.. Page 9 Of 11 � • � a.- �� . ► �• _ , � � !w ., - �� a � � - .,. - r . - �, - '� ' r••�� .'. � -' • � _ • i��. '�' ?�:i�i�- � � � .,;,. .:.. . , - ::- :, :: ��11��1111 , : � �� . � .; . . � _ � , . . - � . _ .. : . � . . , � • ► ,�._��'�C'1�1t1 'G��■�L'�■■�■■■ i7f�0■■�■�■�■■■ �: � ��■��■�■■�■■■■■ ■��■�■■■■ � �.:• �i:.�.i► ■'��__�� I�l±,�� ril 0 ��___�� -��____�� -��____�� ____�� -��____�� -��____�� -��____�� ____�� m ��____�� _ � _ . i � ".!:''Jf�' - ' . • �� ' .- �•� � r. : �i► � , �'�R►� ,y��7�:', , . . ►L►.�=►�►r,, � r�i�l�IfZ��1�;�Wt'� _ r __ __.�-� _ __ __--_- _ __ _�--__ ,� • ' _ L - `u _ .��/� �t ', .�.��1 1 � �� a �AI! . �r� _ � �i Document Name: Dowment Revised:oaA�rtols h,�,,�te Sam k C�ditlon U on Recei Form Pa e i of 1 • '�'��`"'t" DocumentNo„ . � tssuingAuthority: FMN-L-213-►ev.16 Pece Minnesote Qual Otfice Client Wame: Project�: WO# : 1�358767 ; D�h' T�i(� ,iv�c � Courier. • (]fed 6c ❑UPS ❑USPS ent ' �"I,i I I I"i 1 �`"I�f I` (]Commerdal ❑pace ❑SpeeDee �Other, � 103g8787 ----�xaskingNamber-------. _..... _..___..... .. _..._.__._._. ---•— Custody Seai on Cooler/Box present7 DYes �No Sesls IrKectP QYea �No ��oaal: ProJ.Due Date: Proj.Name: ' Packin`Material: ❑8ubble Wrap []Bubble Bags �one ❑Other. 7emp Blenk7� DYes �o • «- ��,/// Thermometer _rJ�1401163 ❑B88A912t67504 Ty��: �yy� �81ue [�Norte ❑SempMs on ka,cooli USQd: �r 15340�64 ❑688N0143310098 ng praau hes begun Cooler Tamp R�d('�: _'r�q CoolerTemp Corrected('C): �•� B{ologlcol Tlawe Frozen7 DYes No A Temp shouid be sbove freezing to 6'C Correction Factor: k Date and lnitts{s of Pe►sort Examining Con�Ms: ! USDA Re;ulated Soil([]N/A,water sampie} Did samples origtnate In a quarantine zonewfthin the United States:AL,AR,AZ,U,f�,GA,1D, 3 Old samples origlnate from aforelgn source pnte►mti� M5,NC,NM,NY,OI(,OR,SG,7Tt,'fX or VA(theck maps)7 ❑Y2s o includlr�Hawaii and Puerto Rlco)i �Yas o !f Yes to elthar queatfon,flil out a Re;ulated 5oil Checkprt(F-M B)and include with SCURJCOC pspvw.ork. COMMEN`f5: Chain ofCusto Present7 . �s No N/a i, Chaln ofCVsto Fllkd Out? Yes No N A I. Chain ofCusto Reltn ulshed? y� � p q 3. Sam ler Name and/or Si ature on COC? ra wo n 4. Sam les Arrived with[n Hold Time7 Yea nb A 5. s1+ort Hdd nme Anai is <72 hr T Yes Mo N A 6, nush Tum Around TIrrK Ra uostad7 Y� p A 7, . SufficientVolume7 Yes No n 8. Correct Containers Used? res ❑Np �la/t/p 9. ' -Pace Contalners Used? res No �a/A Containers Int�Cti � Yes No N A 10. � Piltered Volume Received far Dissofved 7ests7 es roo n ii. Note if sediment is visible in the dissolved con�lner Sampfe labels Match COC? �f es ❑no ❑N/A 12. . ( -Includa Date/Time/ID/Arnal is Matrix: `1 Atl contafiers needing acid/base preservaUon have been 13. ❑HNOe ❑H�SO4 ❑NaOH ❑HCI chedced7` � �Yes �No �/A All coniainers needing preservatfon are fpund to be Sn r � Sampfe# comptiance wfth EPA reummendadon? . (HNO,,H:S�y HCf�2;NaOH>9 Sulfide,Na0l1>12 Cyanide) QYas ❑No A Exceptions:VOA,Col'rform,T0�Oil and Grease, Inklal when Lot#af added DRO 8015 water DOC Yes rro A com leted: reserv�tNe: Heads ce in VOA Vials >6rnm 7 Yes No N/A 14. Frlp Blank Preserrtl [�Yec (]No N/a 15. Trip BlankCustodySealsPresentl ❑Yes ❑Mo C�Y/A Pace Tri Blank Lot#(lf urchased): T e• u n ..n � a� n� nNa Person Contacted: p�rnm�; Comments/Resolutian: Project Manager Rev : '� � Dste: No�: Whenever there Is a disaepanry� l;ar01 ne compliarwe sampies,a oopy of this form wllt be seM to the Nortn Carolina DEHNR C�rtificadon Offfu(I.e out of hold,inwrrect preservative,out of temp,incorraat�ntslnera). Page 11 of 11