HomeMy WebLinkAboutseptic info SEPTIC SYSTEM INVENTORY
Site Address: 3050 Sussex Rd PID 04-117-23-32-0010
Owner Name: Ronald & Susan Hornbaker
Owner Address: 3050 Sussex Rd Long Lake MN 55356-
BuildingTvpe: residence Installer: Bauer Trucking
Date of Permit: 10/8/96
System Type: mound BR's Designed for 4
In Musa?: No Shoreland?:
SEPTIC TANKS:
Material: precast concrete Capacity: 1000, 1000, 1000 Tank Filter:
DRAINFIELD:
Treatment Area: 93*41 Soil Boring: yes DF Ht above Wt: 3
WELL DATA
Setbacks -Well Tanks: Well DF: Report In File: Depth:
INSPECTION RECORDS PUMPOUT RECORDS_
Date I Notes Date GallonsOfLiquid
3/19/2012 septic system certification valid until 3/19/15 7/18/2018 2000
7/1/2007 Okay 4/21/2015 2500
6/21/2005 Okay 6/4/2012 3750
10/1/2003 no surfacing 4/23/2009 0
9/18/2001 no surfacing, pump tanks 6/11/2003 3000
4/28/1999 no surfacing 6/11/2003 3000
5/1/1997 installation
5/1/1997 installation
Mar 21 2 04:46p ^�� 763-213-0695 p,1
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Minnesota Pol�uron `� � � Com tiance Ins ection Form
- Control Agenty /�.� P P
5Z0 Lafayette Road North ���9 �bsurface Sew�ge Tr�trnent Systems
St.Pau�,MN 55i55-4�94 (SSTS�
Doc Type:Compliance arxi Enfomement
Inst�uctians: inspection resulis based on Minnesota Pollution Conlrol Agency(MPCA) For lacal tracking purposes:
requ#remer�ts and attached forms—additionai iocal requirements may also apply_ „ ' Q �— �n/�
Sub it completed form to Local Unit of Go�ernment(LUG)and system owner o �i U
with�n 15 days
Syslem Status
�System status on date(mm/ddlyyyy): 3 .r j�' — �'�--
II� Compliant— Certificate of Compliance ❑ Noncvmpliant— Notice of Noncornpliance �
(Valid for 3 years from report date, unless shorfer time (See Upgrade Requiremenfs orr page 3)
frame outlined in Loca!Ordinance.)
Reaso�(s)for noncompliance (check a!1 applicable)
❑ Impact on Public Health (Complisnce Component #1)—Immrnent threat to public health and safety
❑ Other Complianoe Conditions(Compfrance Component�3)—lmminent fhr�at to public health and safety
❑Tank Integriry(Oomp/iance Comporrenr #2)—Farlrng fo pr+otectgroundwater
❑Other Complianoe Conditions (Compfiance Cormponenf#3)—Failing to pmtect groundwater
❑Soil Separation (Compliance Component #4)—Failing to protect groundwater
❑Operating permit/monftoring plan requirements(Comp/iance Component #5)—Noncompliant
P�O I@rt)/ �I1f01'lilatlOn Parcel ID#or Sed'fwp/Range:
Prope address: � Reason for inspection:
Prope owner: ' Owner's phone:
or
Owne s represeni�tive: �,��, ����{ Representaiive phone: �lj� � ;�.q`3.-j y �, (
Local �latory authority: � �� Regulatcry authority phone:
Brief s stem description: ' �D � '
Com nts or recammendaiions:
, ��
Certi ication
1 here certify that aN the necessary infarmatron has been gathered to deteimine the compliance stafus of this syste�. IVo
dete 'nation of/uture system perfnrmance has been nor can be made due to unknown conditions during system construetron,
possi abuse of fhe system,inadequat mainfenance, or fufure wafer usage.
Inspe r r�ame: ����c d � Certification number: � �' ��
BLsine narne: _ �- -�j �,�.d•�p D-c� � License number: �j �j 3
Inspe rsignature: __� �z�y,�t�v1����a,�.'� Phone number. '�f_,�l,/ —'.,�.1,�
Nece sary or Locally Required Attachments
(�S il boring bgs �Sysfem/As-built drawing ��Fortns per local ordinance
❑ O er information (list):
www.p .state.mn.us • 651-296-6300 • 800-657-3864 • TTY 651-282-5332 or 800-657•3864 • Available in alternative formats
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Qro ress: O ` lnspector ir�itialslDate: —� '(� �
1. Imp ct on Pubtic Health—Compliance oorr�ponent#1 of 5
liance criteria: Verification method(s�:
discharge sewage to ihe �Yes (� No � Searched for surface oudet
ou surface. � Searched for seeping in yardlbackup in home
ys discharge sewage t�drain ble ❑Yes �No � ��ss�ve ponding in sol systerND-boxes
� ��t�. � Homeowner testimony(See Gbmments/ficplanetiorr)
"Bladc soiP above soil disper5al system
ys cause sew�e backup irrto ❑Yes � No ❑ gystem�equires`emergency'pumping
d II g or establisfimerrt.
❑ Perfortned dy�e test
ny'yes"answer above Indicates d�e system is ❑ Unable to�eri�y(See Commenfs/Explanation)
n/ minent Threat to Public Health and Safety. ❑ p�er methods not listed(see commencs�c�anation�
C�om ents/Exp(anation:
2. l�an Integrlty—Compliance componerrt#2 of 5
C liance criteria: Verification method(s):
54 consists of a seepage pit, ❑Yes �No I� Probed lantc(s}bottom
dess I,drywell,or ieaching pit. � Examined oonstruction re�cords
S�ee pits meating 7a80.2550mey be � Examined Tan[c Ir�tegrily Form(Attach)
nt if al/awed in loca!au'iaar�e.
� Observed liquid level below�perarting depth
e tank(s) leak below iheir �Yes �J No ❑ Examined em '
d si d eratin de pty(pumped)tanks(s)
ye ich sewage tank(s)leaks: ❑ Probed outside tar�k(s)for"black sal"
n yes"answer above in�cates the ❑ Unable to verity(See Camments/Ezp/anation)
ys is Fail�ng to Protect G�oundwater. ��er methods not listed(SeeCommentslExplanation)
dom MsJE�►lanation:
3. C�th Cornpliance Condifiions—Compliance cornponent#3 of 5
. ' M rrtenance hole covers are damaged,cxacked,unsewred,or appear to struduraly unsound. p Yes" I�1 No p Unknown
, er issues(e�ecbica!h�ard�etc.)to immedia�teiy and adve�sely impact public health or safeiy. ❑Yes* �No p Unknawn
m is an imminent thr+eiat�p�rblk heallfh and safety ,.
' lain:
S is non-protectivc of ground waba�or other conditions as detamined by inspector ❑Yos• �tro
is fiiling�o pr�tectgroundMrat�er •
lain:
www. .mn.us • 651•296-6300 • 800-657-3664 • TTY 651-282-5332 or 8D0-657-3864 • Avallable in alternative formats
Mar 21 12 p4; p 763-213-0695 p.3
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• Pr I a ress: �O J � .�0�,�,�- Inspector initialslDete: � "1���� ��
4. S il eparation—Compliance comAonent#4 of 5
C� f installation: ' ❑ Unknown Verification method(s):
s�w ndNYeUhead protectioNFood Be�erage (�Yes ❑No 5oi!observation a�oes rrot expire. P►�evious soi!
�'!�� � obsenraBons by tw�o indepe�ent panies are suf�rcienG
o liance criteria: unless site conditions have been altered or local
�quirements dilfer.
or ms built prior to Apri!1, �996, an�d Q Yes ❑ No
t I ated�n Siro�laad or Wellhead � Conducted soil observation(s)(Altad�boring logs)
f� ion Anea or not serving a foa1, ❑ Twa previaus verifications(Attach boRng logs�
61eve ge orlodging establishmenC •
❑ Noi applicable(HaJdng lank(s),no drainfie�
rai Id has at IeasE a twafoot vertical ❑ Unable to verify(See Camrt�ntsiExplanation)
s pa 'on distance from periodically
s d soil or bedrock. ❑ Other(See Comments/Ex�anaaor�)
o rformance sys[ems 6u+Jt April i, �Yes ❑ No Comments/ExpJanafian:
1 9 rlaterorfornon-pe�fwrnance
sy s located in Shor�eland or We!lhead
Pro�t 'on Ar�sas or serving a food,
bleve e, orbdging estaWishmenk
rai Id has a three-ioot verlical
s pa ' n dstance from periodically
s tu sal or bedrodc'
�x 'menta�', `Otner, or °Perfo�mance' �Yes ❑No Ind"icate de ths of elevations
s buil�under pre-2008 Rufes;Type!V . ��
�V tems built under2008 Rufes(7080.' R. Bottom of dislr�upon media
2�3 7080.2400 (Advanced Inspector
required) B. Penodicall salureted soil/badrock
rai Id meets the designed verlical ' '��, �
s pa tion distence from periodically C. tem s ara6on '
siatu d soil or bedrodc. ! ��
D. R uired com liaoce se arad�n" �F�
`RO"aRSW@f'e1LIOV6 J/1dCat@.S�I@ SySf@I11 IS •�y be reduced up to 15 percent if allowed by Local
ail to Protect Gror�naM+ster. Ordinanae.
5. p cltin� Perntit �nd Nlt1'ogel� BMP'"—Compliance component#5 of 5 �Not applicable
fhe m operated under an Operating Permit? �Yes ❑No It"yes",A below is required
s Rhe m required to employ a Nitrogen BMP? ❑Yes ❑ No If"yes", B below is required
' B P�Best Managerrtent Practice(s)specaifred in fhe system design
e nswer to both que�ons is "no;this secfion does nof need to be compleiBd.
m iance criter�a
rating Rermit number.
ve ihe O eratin Permit r uirements been met? �Yes ❑No
I the re uired n' en SMP in lace and erl functioni ? Yes No
y o"answer Indicates Noncompliarrce.
rs Requieements(Minn.Stat§115.5�An im�nt�at to p�b6c hea�th and saf�ty(1TPHS)must be upgradad,rapfaced, orlts nse
widlun ferr rr�a�lhs of receipf of N�is noGce or wrlha+a shorter penod ifrequined by loc�!o�inan�.!f tlte syatem is faMng to protect
und ater,the sysfem mvsl be upgraded,repfeced,orits use dlscontinued within the trme requlred by focal ordinance.lfan exiating aystem
ot f n�es ded'med b►law,and hes af least twv fest of�sign soi!separntion,then the syst�m need not be uppQr�deal,rtspal�d,replaced,or
�wnue�d,.,onvrmsrandiny arry rocer wwnance rnar is more safcr. mis provisrvn does nor appry m s�srernns in srrare�ana areas,
h PmtedMn Areas,or those us�ed in coruierxfon wlfh tood,beverage,arrd lodging estaWi'shments as afefined in lew.
www .mn.us • 651•296-6300 • 800-657•3864 • TTY 651-282-5332 or 800-657-3864 • Available in altematfve foRnats
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' Site Sketch:
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uggated items for site sketcb: Wei�,well setbadc to system.dwelling or ather establlshment,tank(s�soil trestraau sysum�
, served soil creauncnt area.cuRain drain,properry l3na,watcnvays.and 6uriod lina (tl�osc NOT iostailed b�the utiGry).
I Eude siza aad lasgth and approximate distances trom fuced rcfereace poincs such as streels and buildiags�Pkase actach
rovious as-built drawings,iaspcction rtports,Ccrtificate(s)of CompUance and No[ia(s)ofNo�omptiancG
o�l rin;s(SB #): Locate each boring on the map above, indicaze on the right af the columns
•Vow e texture, strueture, coEor,depth of each differeat soil type, evidence of mottting, bedrock and
.�idi water. Also indicate if the material is F11.
SB # SB# SH#
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, To: Orono residents on mound type septic systerns
�� From: Wiliie Gibbs, ISTS Manager
i Date: May 10,2006
� Re: Landscaping Do's and Don'ts for Mound Systems, Quick Reminder
II Do plant and maintain a full cover of grass and keep mowed to a normal height, this grass cover aids
, in the evaporation of large amounts of effluent(the liquid left after the"ather" stuff has been removed)
in the summer time and allows the mQund system to help breakdown nitrogen in the effluent,
' Do water the grass over the mound in extreme dry conditions, sparingly.
Do avoid unnecessary foot traffic over the mound,mow it and stay off of it This is especially true in the
winter time. Even human foot traffic can cause frost to penetrate the mound resutting in potential
freezing problems.
Do inspect your mound system annually for winter kill, (reseed if necessary) animal damage,
(burrowing)or signs of potential failure.
Do not plant trees or shrubs on the mound system, smaller trees and shrubs may be planted at the
edges. Remember,that sunshine is fihe key to a healthy mound system.
� Do ask questions, if you have any concems or questions concerning your mound system
please feel free to call me,I can be reached at 952-249-4626.
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O O CI'TY OF ORONO
Municipal Offices
��,, ��, 3treet Address Mailing Address:
'� G 2750 Kelley Parkway P.O.Box 66
'� .¢� Orono,MN 55356 Crystal Bay,MN 55323-0066
, �ESH�
� The Current Owner of Address 3050 SUSSEX RD
y Ordinance requires that onsite sewage treatment systems in Orono be inspected on a
'� p 'odic basis. The onsite sewage treatrnent system at the above address has been inspected and
following is known about the system. A sketch of the known components of the system is
a �lable for most properties at the Orono City Hall.
, I minent Public Health Threat
' Yes �
No
�� If es, please contact the Onsite Systems Manager at 954-249-4626 within 10 days of receipt of
notice. The septic system must be brought into compliance within 90 days. Failure to do so
� w result in referral to the City Attorney for legal action.
' S tem Identified as Non-Compliant
� Yes �
No
',If s, system must be brought into compliance by: / .---�"f
, December 31, 2007 �
December 31, 2010
'� � Other
�
Se 'c Tank(s) Pum t Needed
Yes
No �
ity recommends the septic tank(s) and/or lift tank be serviced and pumped out every three
��3) ars. City records indicate the tank(s)were last pumped out on
_ �e ank(s) should be cleaned through the manhole and not through the inspection pipes, this
�llo s for proper cleaning.
, � _ _. _
o ents: .
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_�--�- " al�`�"''��.a Q�
�S tOr: �� �-
p Date of Inspection: _ � � �
_1._
�� Telephone (952) 249-4600 • Fax(952) 249-4616
� www.ci.orono.mn.us
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4��:X��- CITY of ORONO
`a.�' _, ,'�
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�-.��'.�G/ St�eet Address: °153.-a49-y6o O Mailing Address:
� `!�'�`��p'g'/ 2750 Keiley Parkway P.O. Box 66
ESI1�/
, Orono, MN 55356 Crystal Bay, MN 55323•0066
To C en wner: Address: ��4,�0 ��S�S��' `�'� � c-�
City O i�an 199 requires that each existing on-site sewage treatment system in Orono be inspected every iwo yeazs.
The on sij[e s age treatment system at the above address has been inspected and appears to fall into the categories checked below.
S S n' CONFORMITY 1-3 : �
1 `�C E SYS1'EM"An LSTS which meets all the location,design and construction standards of the current Orono Municipal Code.
2 `f C LIANT SYSTEM" An ISTS which does not meet all the location,design and construction standards of the current Orono .
�un� al Code but does meet the three foot sepazation requirement or two foot requirement for systems installed 1996 or earlier,and
hic not failing or an imminent threat to public health or safety.
3 `�NO -COMPLIANT SYST'EM" A prohibited ISTS;an ISTS located within a designated 100-year flood plain,any ISTS which may
o�ma ot meet all the location,design,or constrvction stan�ards of the current Orono Municipal Code and which is failing for any
reas nf an y ISTS with less than three feet of unsaturated soil or sand between the dishiburion device and the limiting soil characteristics.
TA K CO ITION 5-7 : �_
Tan1 i�psp tion indicates:
5 �mp t not needed at this time.
6 pti must be pumped out-this year (city code recommends tanks to be pumped out once every 3 yeazs.
T as last pumped ).
Ma e ur tic tanks are um ed.throu h manhole and not throu h white ins ection i s. This allows for the ro er
clean n . ee water softner and iron filter dischar e out of se tic s stem to rolon life of drainfield. Ask um er to test
alar oat veri alarm is still workin in our house. The alarm warns owaer that se ta e is about to backu into basement
7 sp 'on risers missing-tanks couid not be inspected. Inspection risers(4"dia.pipe)must be installed in each tank. If
e not been pumped-out within the last three years,they.should be pumped out now.
D IE CONDITION(8-10):�
8 D ain ld is dry,no surfacing evident.
9 dme idence of surfacing,not critical yet.
10 �ain ld is saturated and visibly discharging untreated effluent to the surface. Contact the City Inspector
i edi ely.Repairs must be completed within 90 days.
COM �T :
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I D of Inspection Septic System Inspector
Note: In i ven at this inspection report is used to satisfy the requirements for a mortgage or other transfer of property,be advised that this report does
not guaran �or 'fy that an existing system will continue to function properly, but is merely an opinion of the adequacy of the system under current
O �
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:�:� ciTY o� oRONo
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r r :r ��,^� ��r MIIII1Cf� D�1CCS
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! � •�'�f.��.: ,� Street Address: Mail(ng Address:
'910EgH04' 2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, M 55323-0066
�V �d �i
� C ent Owner: Address: �� �U s SC7r
i inance 199 requires that each existing on-site sewage treatment system in Orono be inspected every two years.
e o site sewage treatment system at the above address has been inspected and appears to fall into the categories checked belowr�
I S STEM CONFORMITY 1-3 : f
I 1 'CODE SYSTEM"M ISTS which meets aii the location,design and construction standards of the current Orono Municipal Code.
I 2 "COMPLIANT SYSTEM" An ISTS which does not meet all the location,design and construcdon standards of the curnnt Orono Municipal
Code but does meet the three foot seperation requirement or two foot requirement for systems instatled 1996 or earlier,and which is not failing or
an imminent threat to public health or safety.
I� 3 'T10N-COMPLIANT SYST`EM" A prohibited ISTS;an ISTS located within a designated 100-year flood plain,any IST'S which may
or may not meet all the location,design,or construction standards of the current Orono Municipal Code and which is faiiing for any reason;and
any ISTS with less than thtee feet of unsaturated soil or sand between the distribution device and the limiting soil characteristics.
T C CONDITION 5-7 : �
Iinspection indicates:
5 Pumpout not needed at this time.
I Septic tanks must be pumped out this�ear (city code requires tanks to be pumped out once every 3 years.
Tank was last putnped ��11`b ).
I e sure se tic tanks are um ed throu 6 manhole aad not throu h white ins ection i es. This allows for the
r er cleanin . Keeo water softner and iron filter dischar�e out of seutic system.
I 7 Inspection risers missing-tanks could not be inspected. Inspection 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 out now.
IELD CONDITION 8-10 : �
8 rainfield is dry,no surfacing evident.
Some evidence of surfacing,not critical yet.
�� 10 Drainfield is saturated and visibly discharging untreated effluent to the surface. Contact the City Inspector
immediately.Repairs must be completed within 90 days.
C� NTS: r�o�� �-- s�a�.L ��.s �a��. 61c.,
o -�-0"5 �'`�: ��
�� Date of Inspection Matt Bolterman- Septic System Inspector
: in event thatthis inspection report is used to satisfy the requiroments for a mortgage ar other transfer of property,be advised that this roport does not guaranue
o fy at en existing system will continue to function properly,but is merely an opinion ofthe adequacy ofthe system under current conditions based on the available
i o eti .
i Telephone(952)249-4600 • Fax(952)249-4616
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�������T`, � CITY of ORONO
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�fi, ��,� G'ti Municipal offices
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� �'� ,?'i�t4,�i Street Addreu: Mai11n�Addreu:
I �E'S�I� 2750 Keliey Paricway P.O. Box 66
Orono, MN 55356 Crystai Bay, MN 55323-0066
' J 3�Sb S�SSe �
Own r1 �� 2 �V �S� Address:
X U
Citt• 'n e 199 requires that each esisting on-site sewage treatment system in Orono be inspected every rivo years.
The o -s te wage treatment system at the above address has been inspected and appeazs to fall into the categories checked belo�v.
S STE COIVFORI�IITY 1-3 : �
1 'C E SYSTEM" An ISTS which meets a�l the location,desi�and consKructiup stattd,ards ofthe curreat prana�funicipal Code.
2 C lPLIANT SYSTEM" An ISTS which does not meet ail the locatioq design and constcuction standardy ofthe cunent prono Municipai
C but does meet the threa foot separation requirement,and w}uch is not failing or an icnminent threat to public heaith or safety,
3 �'N -CONIPLIANf SYSTEM" A prohibited ISTS;an ISTS located within a designated 100-year tlood p(aic�any ISTS which rtmy
� or y not meet all tha localion,design,or coastructiun staadar d�a f�����p�n o�f unicip a l Co de an d which is failing for any reacon;and
ISTS with las than three feet of unsaturstad soil or sand betwern the distnbution device and the limiting soil characteristics,
T. I C ITION 5-10 : �
Ts i p 'on indicates:
� Rum t not naeded at this time.
6 �ank ust be pumped out this year (city code tequires tanks to be pumped out every 3 yeazs. Tank wic last pumpad v^���U�v,� �.
7 S lids cumulation in tanlcs is at a critical a aiticat level. Tanks should be pumpad out as soon as poss�blo.
8 yst is discharging to the surface. Tanks must be pumped out within 48 houts to eliminate surface dischuge,
9 pe on risers missing-tan{cs could not be inspeceed Inspection risecs(4"dia,pipz�m�yt����d in zach tank at ne:ct pumpout If tanks
ve bern pumped outµithin the last three yeazs,thoy shau(d be pumped out now.
10 I�spe on pipe is located directly over tank ba�le(dors not give accucate measuremrnt of solids accumulation). If tacilcs have not bern pumped
o�t wi ' tha lact threa years,they should be pumpad out now.
D CONDITION 11-1�1 : �
�
11 ' ie is dry,no surfacing evidrnt
1? o t e ca of surfacing,not critical yet
13 ie is saturaced and visibly dischar�ng untrea�zd effluert to the surfaca Contsct the City Inspector irnmediate(y.R�pairs must ba
rr�plat within 90 days.
1� " ie e.�tent and condition unknoKn. �'
co► � s 5 Sfie� �oa�5 b
- P� � � 5 -
� �- 6 �
��
�ace Inspcction • S 6c S �
�p ystem Inspeetor
Note: In the ' inspection repoR is used to satisfy the requue��for a mortgage or other transfer of property,be advised that this repoR does not guarantee
or certify that e ' ' syscem will continue to function proprrly,but is maely an opinioa of the adequacy of the system unda curzrnt eoadition.hx�,,.,rti.,.,,c�,ti�.
infom�atioa