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HomeMy WebLinkAboutSeptic Compliance Inspection Form 4-24-19 Minnesota Pollution Compliance Inspection Form r �4 Control Agency 520 Lafayette Road North Existing Subsurface Sewage Treatment Systems (SSTS) St.Paul,MN 55155-4194 Doc Type:Compliance and Enforcement Inspection results based on Minnesota Pollution Control Agency(MPCA) For local tracking purposes: requirements and attached forms—additional local requirements may also apply. Submit completed form to Local Unit of Government(LUG)and system owner within 15 days System Status System status on date(mmldd/yyyy): 4/24/2019 17 Compliant— Certificate of Compliance I I Noncompliant— Notice of Noncompliance (Valid for 3 years from report date, unless shorter time (See Upgrade Requirements on page 3.) frame outlined in Local Ordinance.) Reason(s)for noncompliance (check all applicable) ❑ Impact on Public Health (Compliance Component#1)—Imminent threat to public health and safety ❑ Other Compliance Conditions(Compliance Component#3)—Imminent threat to public health and safety ['Tank Integrity(Compliance Component#2)—Failing to protect groundwater ❑ Other Compliance Conditions(Compliance Component#3)—Failing to protect groundwater ❑ Soil Separation (Compliance Component#4)—Failing to protect groundwater ❑ Operating permit/monitoring plan requirements(Compliance Component#5)—Noncompliant Property Information Parcel ID#or Sec/Twp/Range: Property address: 1520 Fox Street, Orono Reason for inspection: Sale Property owner: Edward Conlin Owner's phone: 952-476-8580 or Owner's representative: Representative phone: Local regulatory authority: City Regulatory authority phone: Brief system description: 2- 1000 gal septic& 1000 gal pump tank with a mound system Comments or recommendations: There is a large hole dug in downslope of mound from an animal. Not causing a leak at this time but there is a decent size hole with about 1/4 yard of sand pulled out. Recommend removing the animal and filling the hole in with black dirt. Certification I hereby certify that all the necessary information has been gathered to determine the compliance status of this system. No determination of future system performance has been nor can be made due to unknown conditions during system construction, possible abuse of the system, inadequate maintenance, or future water usage. Inspector name: Josh Swedlund Certification number: C1659 Business name: Sewer Se __s In License number: 2502 Inspector signature: �� Phone number: 952-873-3292 Necessary or Loc•tly Required Attachments ® Soil boring logs ® System/As-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 Page 1 of 3 Prgperty address: 1520 Fox Street, Orono Inspector initials/Date: JS 14/24/2019 (mm/dd/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, ® 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. ❑ Homeowner testimony(See Comments/Explanation) 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 imminent threat to public ❑ Unable to verify(See Comments/Explanation) health and safety. ❑ Other methods not listed (See Comments/Explanation) Comments/Explanation: 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. Sewage tank(s) leak below their ❑ Yes No ❑ Observed liquid level below operating depth 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 the ❑ Unable to verify (See Comments/Explanation) system is failing to protect groundwater. ❑ Other methods not listed (See Comments/Explanation) Comments/Explanation: 3. Other Compliance Conditions—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. ❑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 Property address: 1520 Fox Street, Orono Inspector initials/Date: JS 14/24/2019 (mm/dd/yyyy) • 4. Soil Separation — Compliance component#4 of 5 Date of installation: 10/30/2001 ❑ Unknown Verification method(s): (mm/dd/yyyy) Shoreland/Wellhead protection/Food beverage Soil observation does not expire. Previous soil lodging? ® Yes ❑ No observations by two independent parties are sufficient, unless site conditions have been altered or local Corn•fiance criteria: requirements differ. For systems built prior to April 1, 1996, and ❑ Yes ❑ No ® Conducted soil observation(s) (Attach boring logs) not located in Shoreland or Wellhead ❑Two previous verifications(Attach boring logs) Protection Area or not serving a food, beverage or lodging establishment: ❑ Not applicable(Holding tank(s), no drain field) Drainfield has at least a two foot vertical El to verify(See Comments/Explanation) separation distance from periodically saturated soil or bedrock. ❑ Other(See Comments/Explanation) Non-performance systems built April 1, [Si Yes ❑ No Comments/Explanation: 1996, or later or for non-performance systems located in Shoreland or Wellhead Boring: Protection Areas or serving a food, 1-14" 10yr 2/2 Loam beverage, or lodging establishment: 15-26" 10yr 4/4 Clay Loam Drainfield has a three-foot vertical separation distance from periodically No Redox saturated soil or bedrock.* "Experimental", "Other', or "Performance" ❑Yes ❑ No Indicate depths or elevations systems built under pre-2008 Rules; Type IV or V systems built under 2008 Rules(7080. A. Bottom of distribution media 12"+ 2350 or 7080.2400 (Advanced Inspector License required) B. Periodically saturated soil/bedrock 26"1- Drainfield 6"+Drainfield meets the designed vertical C. System separation 38"+ separation distance from periodically saturated soil or bedrock. D. Required compliance separation" 36" 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 nitrogen BMP in place and properly functioning? ❑Yes D No Any "no"answer indicates Noncompliance. Upgrade Requirements (Minn. Stat. § 115,55)An imminent threat to public health and safety(ITPHS)must be upgraded, replaced, or its use discontinued within ten months of receipt of this notice or within a shorter period if required by local ordinance. If the system is failing to protect ground water, the system must be upgraded, replaced, or its use discontinued within the time required by local ordinance. If an existing system is not failing as defined in law,and has at least two feet of design soil separation, then the system need not be upgraded, repaired,replaced, or its use discontinued, notwithstanding any local ordinance that is more strict. This provision does not apply to systems in shoreland areas, Wellhead Protection Areas, or those used in connection with food, beverage, and lodging establishments as defined 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-wwists4-31 • 3/16/12 Page 3 of 3 ► 5c>) O RD)( St . a C kvr,X B C C a !� nit T, too' 93 Ta lo")o' c b, T3 S _a3`_ OD, LOGS OF SOIL BORINGS Location or Project_ __/ z0 A2X • Borings made by SWEDLUND Date 8-27— ' / Classification System: ❑AASHO 2 USDA-SCS ❑ Unified ❑Other Auger used (check two): E Hand D or Power; ❑ Flight © or Bucket; 0 Other Depth, Boring Number / Depth, Boring Number A3 Z feet Surface Elevation in feet Surface Elevation o /J/aNzz// 4{, 0 de 'rl /rte y„,e-, SAS 4rq,v. 3/Z to 1 - a , - '— . 4),--di -f .Z/7- 2 - �� �fl 2 3n SA�� / I/O .S Ar ,/,vign,., '3/Z- 3 - , ZofriqAri J7V 3 3 v _ (,. q A( / o'7,1 Eel Z /Z / ,' 1c 7tLE ci 'z i/ a - 6'Z ‘eA y : _ (Ph ‘e A y 5 - 5 6 - 6 - 7 - 7 - 8 - 8 _ 9 - 9 - 10 - 10 - End of boring at 3 _ feet. End of boring at_ , feet. Standing water table: Standing water table: ❑ Present at feet of depth, ❑ Present at feet of depth, hours after boring. _ hours after boring. Not present in boring hole. i, Not present in boring hole Mottled Soil: �/ Mottled Soil: / // ❑ Observed at � z feet of depth. ❑ Observed at 2 s _feet of depth. O Not present in boring hole. ❑ Not present in boring hole. LOGS OF SOIL BORINGS Location or Project X5--- '...C9 p Borings made by SWEDC?LUND Date -.27—en./ Classification System: ❑ AASHO 0 USDA-SCS ❑ Unified ❑Other Auger used (check two): CEJ Hand ❑ or Power; ❑ Flight RI or Bucket; 0 Other Depth, Boring Number �- Depth, Boring Number �. in feet Surface Elevation in feet Surface Elevation 0 t1nJs f / /e9 y -.- 0 4e7 ctS-04 4-6,4_,3/2- 2 - /28 �_ -4 .�- _ `1/ 2 z% 4 6..$X."..' '37/ 3 - 3 -- , -77 ci 4 - Z ` 7 �� 4 G/a 4:e. Y 5 - a - 6 - 6 -- 7 - 7 - 8 - 8 9 - 9 - 10 - 10 End of boring at feet. End of boring at feet. Standing water table: Standing water table: ❑ Present at feet of depth, ❑ Present at feet of depth, hours after boring. hours after boring. f Not present in boring hole. 0 Not present in boring hole. Mottled Soil: / 1/ Mottled Soil: ❑ Observed at 2 7 feet of depth. ❑ Observed at feet of depth. ❑ Not present in boring hole. 0 Not present in boring hole. Pumping Report Sewer Service Inc. 'c: 250 Date Serviced: T7,3 /1 Driver: 0 Typ . _ esident as Commercial jIndustrial Scheduled Maintenance: U Emergency Services: Start time: Stop time: Name: EAL � � � / Cary 1 . q-74(t/\ Phone: " � g 8d Address: 15a,a �dK 51- City: o-r-Itor Did you measure the accumulation of scum and sludge? Yes _o, pumped regardl Tank 1 Tank 2 Tank 3 Tank 4 Pretreatment Pump Tank Gallons Billed (aGO 1000 Scum Sludge full Operating Depth Access used ) if &I IT Depth to lid1)--co I , refuse to allow the removal of the solids and liquids through the maintenance hole. I understand that removal of solids and liquids through other access points is not considered a compliant method of solids removal and does not fulfill the solids removal requirements of Minn. R. 7080.2450 and 7082.0600 Owner's Signature: Tank Typerecas Block - Concrete - Plastic - Other Filter: Yes 6c Type of system: t' V ookvoi Type of waste: oomesti - Holding - Commercial - Industrial - Flammable waste trap Are tanks leaking above or below flow line? Yes imp If yes, where: Did you observe sewage discharging onto the ground surface No Yes, Pump Size: )9E5-7 Electrical condition: 004 Are all of the covers securely replaced?, ej)Jo, Safety concerns: (ye, Disposal site: kA _ 4o c-14 Next recommended pumping:3 yeacg Other : Comments/Troubleshooting/Repairs: P J� A-` I TO, 4)45— ( CcrHr/ ,J is 2 in S ~or, - a f 1J�1 bar,iJ- frlac'k1 co V OVe 6 1a 0(3,40 5-Q ai(70 A popif w , Sewer Services Inc. 25648 200th Street - Belle Plaine, MN 56011 - 952-873-3292 Pumping Report Sewer Service Inc. c: 250 Date Serviced: �� 'l Driver: /� Typide tii Commercial Industrial Scheduled Maintenance: Emergency Services: Start time: Stop time: r 1 S Name: E( �jR.Y' r CoA 1 i Phone: Ica q-74 8586 Address: 15 a,c7 1-26X ems — City: crr cA.& Did you measure the accumulation of scum and sludge? Yes 10 sum sed regardles Tank 1 Tank 2 Tank 3 Tank 4 Pretreatment Pump Tank Gallons Billed (000 1600 �l Scum Sludge % full Operating Depth Access used i1 I' - Depth to lid pfcc I , refuse to allow the removal of the solids and liquids through the maintenance hole. I understand that removal of solids and liquids through other access points is not considered a compliant method of solids removal and does not fulfill the solids removal requirements of Minn. R. 7080.2450 and 7082.0600 Owner's Signature: Tank Type Precasir',Block - Concrete - Plastic - Other I Filter: Yes Type of system: frvoi Type of waste: Oomesti - Holding - Commercial - Industrial - Flammable waste trap Are tanks leaking above or below flow line? Yes . If yes, where: Did you observe sewage discharging onto the ground surface No Yes, Pump Size: f2E5-7 Electrical condition: 004 Are all of the covers securely replaced?Jo, Safety concerns: OA Disposal site: %4/. Next recommended pumping:3 c j f$ Other : Comments/Troubleshooting/Repairs: P 'J� , p1)/ 7 4rk -(fectr*-or sc;j1.-- -o-F bo,cik- yeA-rok / o vey o ieC� 1 a 0 a a. 0tr0 1,9q p(./kui Sewer Services Inc. 25648 200th Street - Belle Plaine, MN 56011 - 952-873-3292 SEPTIC SYSTEM INVENTORY Site Address: 1520 Fox St PID 02-117-23-32-0002 Owner Name: Edward &Joan Conlin Owner Address: 1520 Fox St Wayzata MN 55391 BuildingTvpe: residence Installer: Swedlund Date of Permit: 10/08/01 System Type: mound BR's Designed for 4 In Musa?: No Shoreland?: No SEPTIC TANKS: Material: precast concrete Capacity: 1000, 1000, 1000 Tank Filter: DRAINFIELD: Treatment Area: 39*80 Soil Boring: yes DF Ht above Wt: 3 WELL DATA Setbacks -Well Tanks: 50 Well DF: 50 Report In File: Depth: 133 INSPECTION RECORDS PUMPOUT RECORDS 4/24/2019Compliance Certificate valid until 4/24/2022 4/24/2019 2000 9/1/2006,0K 10/20/2017 2500 7/20/2004,0K 7/2/20121 2400 10/29/20011 installation 6/29/2009 2500 5/3/2000non-complaint, repair by 12/31/2010 pump 6/23/2004, 2000 8/18/19971non-compliant-repair by 12/31/2007 6/22/1996; 1200 11/17/1994 no surfacing 6/15/1994 1800 6/11/1992 no surfacing 1/11/19941 1800 10/30/19901no surfacing 11/1/19921 1800 7/6/19881no surfacing 5/1/1992 1800 8/6/1986',no surfacing 10/1/1991 1800 9/28/19811no surfacing 7/1/19911 _ 1500 9/28/1981 no surfacing 5/28/1991 1500 ---------- ------------- 1/21/1991 1500 7/1/1989 1000 1/18/1989 800 12/7/1987 800 12/7/1987F 800