HomeMy WebLinkAboutseptic info Jul 11 13 06:44a Joseph Olson CV"-) 763-498-8290 p.2
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Minnesota Pollution Compliance Inspection Form
l
ControAgency
Co Road North Existing Subsurface Sewage Treatment Systems
Lafayette A
St.Paul,MN 55155-4194 (SSTS)
Doc Type.-Compliance and Enforcement
Instructions: 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(mm/ddlyyyy): 711012013
® Compliant-Certificate of Compliance 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 permitimonitoring plan requirements(Compliance Component 45)—Noncompliant
Property Information Parcel ID#or Sec/Twp/Range: 3D1182332D007
Property address: 1100 Town Line Road,Orono,MN Reason for inspection: Property Transfer
Property owner: Eileen M Carter Et Al Owner's phone: unknown
or
Owner's representative: Douglas Deakins Representative phone: 480-229-0894
Local regulatory authority: _.City of Orono Regulatory authority phone: 952-249-4600
2-1000 gallon septic tanks,1-1000 gallon lift station and 410 square feel of mound rockbed.per city
Brief system description: records
Comments or recommendations:
Certification
1 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, of future water usage.
Inspector name: Joseph J Olson Certification number: 1255
Business name: Rus Olscn's Soil&Pert.Testing License number: 810
Inspector signature: Phone number: 763-498-8779
Necessary or Locally 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 - 1124112 Page 1 of 3
Jul 11 13 06:45a Joseph Olson 763-498-8290 p.3
Property address: 1100 Town Line Road,Orono, MN Inspector initials/Date: J.O.7111/13
1. Impact on Public Health—Compliance component#1 of 5
Compliance criteria: Verification method(s):
System discharge sewage to the ❑Yes ® No ® Searched for surface outlet
round surface. ® Searched for seeping in yardibackup in home
System discharge sewage to drain file ❑Yes ®No ❑ Excessive ponding in soil system/D-boxes
or surface waters. ❑ Homeowner testimony(See CvmmentvExplanation)
System cause sewage backup into ❑Yes ® No ❑ "Black soil'above soil dispersal system
dwelling or establishment ❑ System requires`emergency`pumping
❑ Performed dye test
Any"yes"answer above indicates the system is ❑ Unable to verify(See Commentsl&pianabon)
an Imminent Threat to Public Health and Safety. ❑ Other methods not listed(See Comments/Explanation)
Comments/Explanation-
2.
ommentslExplanation: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 7030.2550 may be ❑ Examined Tank Integrity Form(Attach)
compliantYaAowed in tical ordinance.
❑ Observed liquid level blow operating depth
Sewage tank(s)leak below their i ❑Yes ® No
designed operating depth. ❑ Examined empty(pumped)tanks(s)
If yes,which sewage tank(s)leaks: i ❑ Probed outside tank(s)for`black soil`
Any"yes"answer above indicates the El Unable to verify(See Comments�Explanation)
system is Failing to Protect Groundwater. ®Other methods not listed(See Comments/Exptanation)
Comments/Explanation:
3. Other Compliance Conditions—Compliance component#3 of 5
a. Maintenance hole covers are damaged,cracked,unsecured,or appear to structurally unsound. ❑Yes* ®No [:]Unknown
b. Other issues(eiedricai 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:
a System is non-protective of ground water for other conditions as determined by inspector ❑Yes' ®No
*System is failing to protectgmundwater
Explain:
www.pca.state.mn.us • 651-2%-6300 . 800-657-3864 TTY 651-282-5332 or 800-657-3864 - Available in alternative formats
wq-wwists4-31 • 1/24/12 Page 2 of 3
Jul 11 13 06:45a Joseph Olson 763-498-8290 p.4
ti
Property address: 1100 Town Line Road,Orono,MN Inspector initialsAlate: J.0.7111113
4. Soil Separation–Compliance component#4 of 5
Date of installation: 7120106 — El Unknown Verification ntethod(s):
ShorerandNVollhead protectioNFood Beverage ❑Yes ® No Soil observation does not expire.Previous soil
Lodging? observations by two independent parties are sufficient,
Compliance criteria: unless site conditions have been altered or local
For systems built prior to April 1, 1996,and ❑Yes ❑No requirements differ_
not located in Shoreland or Wellhead ® Conducted soil observation(s)(Attach boring fogs)
Protection Area or not serving a food, ❑ Two previous verifications(Attach boring logs)
beverage or lodging establishment: ❑ Not applicable(Holding tank(s), no drainfield)
Drainfield has at feast a two-foot vertical ❑ Unable to verify(See CommenwExpianation)
separation distance from periodically
saturated soil or bedrock. ❑ Other(See Comments/Explanation)
Alondrerformance systems built April 1, ®Yes ❑No Comments/Explanation:
4996,or later 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 of elevations
systems built under pre-2008 Rules;Type IV
or V systems built under 2008 Rules(7080. A. Bottom of distribution media 102.8
2350 or 7080.2400 (Advanced Inspector
License required) B. Periodically saturated soilfbedrock 100.0
Drainfield meets the designed vertical C. §ptem separation 2.8
separation distance from periodically
saturated soil or bedrock. D. Required compliance separation* 2.6
Any"no"answer above indicates the system is — *May be reduced up to 15 percent if allowed by Local
FaMog 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. �T
—"� E]Yes ❑ No
Have the Operating Permit requirements been met?
b. is the required nitrogen BMP in place and To rl functionin ? ❑Yes ❑ No
Any"no"answer indicates Noncompliance.
Upgrade Requirements(Atm.Stat§115.55)An imminent threat to public health and safety(fTPHS)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 falling 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 lain,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 shorefand areas,
Wellhead Protection Areas,or those used in connection with food,beverage,and lodging establishments as defined in law.
www.pca.state.ntn.us • 651-2%-6300 • B00-657.3664 TTY 651-282-5332 or 806-657-3864 • Available in alternative formats
wq•wwf5ts4-3f • 1124112 Page 3 of 3
Jul 11 13 06:45a Joseph Olson 763-498-8290 p.5
Logs of Soil Borings
License #810
Location or Project: 1100 Town Line Road
Borings made by: Rusty Olson's Soil and Perc testing 7/10/2013
Classification System: AASHO ; USDS•USDS-SCS X Unified ; Other
Auger used(check two): Hand_X_,or Power , Flight, Bucket or Probe_X
Boring Number_1_Surface elevation_101.3_ Mottled Soil at_1.7 feet
0"-12" Dark brown loam 10yr3/2 H2O present at—X-
12"-20"Brown loam 10yr4/4
20"-24" Rusty brown Ioam10yr5/3
Boring Number-2—Surface elevation_103.0_ Mottled Soil at_1.3_feet
0"-18"FILL H2O present at—X-
18"-28" Dark brown loam 10yr3/2
28"-34" Brown loam 10yr4/4
34"-42"Rusty Brown loam 10y5/3
TBM:Top of the existing well Elv.-100.00 assumed
Original soil under the rockbed Elv-101.3
Bottom of rock bed Elv.-102.8
There is 1.5 feet of sand under the rockbed
Jul 11 1306:45a Joseph Olson 763-498-8290 p.6
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CITY of ORONO
Municipal Offices
t f1�riU C G~� Street Address: °15a-a49-460 O Mailing Address:
`q$ p '/ 2750 Kelley Parkway P.O. Box 66
ESI3 .- '"
Orono, MN 55356 Crystal Bay, MN 55323-0066
To Current Owner: Address: 1 1 0 0
City Ordinance 199 requires that each existing on-site sewage treatment system in Orono be inspected every two years.
The on-site sewage treatment system at the above address has been inspected and appears to fall into the categories checked below.
SYSTEM CONFORMITY (1-3): 2
1 "CODE SYSTEM"An ISTS which meets all the location,design and construction standards of the current Orono Municipal Code.
2 "COMPLIANT SYSTEM" An ISTS which does not meet all the location,design and construction standards of the current Orono
Municipal Code but does meet the three foot separation requirement or two foot requirement for systems installed 1996 or earlier,and
�which is not failing or an inmminent threat to public health or safety.
Q )"NON-COMPLIANT SYSTEM" A prohibited ISTS;an ISTS located within a designated 100-year flood plain,any ISTS which may
-�or may not meet all the location,design,or construction standards of the current Orono Municipal Code and which is failing for any
reason;and any ISTS with less than three feet of unsaturated soil or sand between the distribution device and the limiting soil characteristics.
TANK CONDITION(5-7):
Tank inspection indicates:
5 Pumpout not needed 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—I—G_L ).
Make sure septic tanks are pumped through manhole and not through white inspection pipes. This allows for the proper
cleaning Keep water softner and iron filter discharge out of septic system to prolong life of drainfield. Ask pumper to test
alarm float to verify alarm is still working in your house. The alarm warns owner that septsae is about to backup into basement.
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.
DRAINFIELD CONDITION(8-10):
80 Drainfield is dry,no surfacing evident.
9 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.
COMMENTS: �SA=r`�.�c1t� Z' SSP �- fi�^X� ( U°lam or,
Date of Inspection Matt Bolterman - 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 opinion of the adequacy of the system under current
conditions based on the available information.
.t
- -� CITYof ORONO '
Municipal Offices
Z ' ,,;;,� gni Street Address: Mailing Addressi
E$Yi� 2150 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323.0066
qsa-a4q-4600
Owner: Ad O
T�Current• Address:- � �
City Ordinance 199 requires that each existing on-site sewage treatment system in Orono be inspected every two years.
The on-site sewage treatment system at the above address has been inspected and appears to fall into the categories checked below.
SYSTEM CONFORMITY (1-3): 3
1 "CODE SYSTEM"An ISTS which meets all the location,design and construction standards of the current Orono Municipal Code.
2 "COMPLIANT SYSTEM" An ISTS which does not meet all the location,design and construction standards of the current Orono Municipal
Code but does meet the three foot separation requirement or two foot requirement for systems installed 1996 or earlier,and which is not failing or
an imminent threat to public health or safety.
O-NON-COMPLIANT SYSTEM" A prohibited ISIS;an ISTS located within a designated 100-year flood plain,any ISTS which may
or may not meet all the location,design,or construction standards of the current Orono Municipal Code and which is failing for any reason;and
any ISTS with less than three feet of unsaturated soil or sand between the distribution device and the limiting soil characteristics.
TANK CONDITION(r-.71:
Tank inspection indicates:
QPumpout not needed at this time.
6 Septic tanks must be pumped out this year (city code requires tanks to be pumped out once every 3 years.
Tank was last pumped 7'1 -O a 1.
Make sure septic tanks are humped through manhole and not through white inspection pipes
This allows for the proper cleaning.
7 Inspection risers missing-tanks could not be inspected. Inspection risers(4"dia.pipe)must be installed in each tank.
15AINFIELD CONDITION(S-1Q): ,
8 DminfieId is dry,no surfacing evident. _
Some evidence of surfacing,not critical yet.
10 Drainfield is sa_urated and visibly discharging untreated effluent to the surface. Contact the City Inspector
immediately.Repairs must be completed within 90 days.
COUNTS'
Date of Inspection Matt Bolter man- Septic System Inspector
Note:In the er.at that thiinspection report is used to satisfy the requirements for a mortgage or other transfer of property.be advised that this report does not gua=te'
orcertity that an existing s stem will continue to function properly,but is merely an opinion ofthe adequacy of the system under cur,crit conditions bksed on the availabl-
information.
CITY of ORONO
P '' y titi Municipal Offices
V G Street Address: Mailing Address:
'W. ,+gHOg' 2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
June 15, 2000
Harold Diesen
1100 Townline Road
Maple Plain,Mn 55359
Dear Mr. Diesen:
An inspection of your septic system was conducted on June 14, 2000. A summary of the inspection
is below.
Septic Tank Condition
1. Pumpout needed within one year(last pumpout 6/28/96).
The septic system is non-compliant due to a lack of a three foot separation distance between the bottom
of the drainfield to the seasonally high watertable. The three foot requirement is a State Code, not a City
Code. A soil boring was conducted to determine the depth of the seasonally watertable. The septic
system must be replaced no later than December 31,2010.
Enclosed is a list of state licensed septic contractors who work in Orono on a regular basis. Also
enclosed is a fact sheet explaining how a septic system functions properly. Finally, an as-built drawing
is enclosed that shows the approximate location of the septic system.
If you have any questions regarding this report,please contact me at the City Offices at 249-4600.
l
c ly,
Chris Pence
On-Site Systems Manager
Enclosures
In the event this inspection report is used to satisfy the requirements for a mortgage or other transfer of property,be
advised that this report does no guarantee or certify the 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 location and pumping records.
Telephone(952)2494600 - Fax(952)2494616
www ci.orono.mmus
0 A4. 7-
CITY of ORONO
Municipal Offices
Street Address: Mailing Address:
�$EggOg' 2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323.0066
9
bi
Owner: Address:1100 Townline Rd.
Permit #'s:none Dates: Contractors:unknown
(This is L an existing system [ ] new construction)
SYSTEM COMPLIANCE (1-3) : 3
1 Code System: Meets or exceeds current City standards in all respects relating to
design, construction, and location. Appears to be operating properly.
2 Compliant System: 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 an s ' hs than three feet of vertical separation
between the bottom of the drainfield and the satura
.(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.)
TANK CONDITION (5-9) : 8
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.
(9 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 A were not
confirmed to be watertight by the licensed pumping contractor. If the tanks were not
confirmed to be watertight, this classification is subject to revision.)
DRAINFIELD CONDITION 11-14) : 11
Drainfield is dry, no surfacing evident.
1 .
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 acre and condition soils etc. ) : medium
COMMENTS: The non-compliant septic system must be repaired by 12/31/2006 or within 90 days
of failure (surface discharge) , whichever comes first.
Date of InspectionSep is System Inspector
Or 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 SEWAGE TREATMENT
INSPECTION REPORT
ti
��9kESH0
Owner: #aaja� Aeser--% Address: �/00 /36t.,�
Permit #'B: 10= Dates: — Contractors:_L/I7PVr3J.,&.
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 04.an existing system [ ) new construction)
SYSTEM CONFORMITY (1-3): 1-2
1 "CODE SYSTEM11-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.
"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.
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 I ) 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):
Tank inspection indicates:
5 Pumpout not needed at this time.
6 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.
System is discharging to the surface. Tanks must be pumped out within 48 hours to eliminate surface discharge.
Inspection risers missing-tanks could not be inspected. Inspection risers (4" dia. Ripe) must be installed to each
tank at next pumpout. If tanks have not been WIVeU VUt W11n1n Ine Lastthey s ou
out nog.
10 Inspection pipe is located directly over tank baffle (does not give accurate measurement of solids accumulation).
If tanks have not been pumped out within the last three years, they should be pumped out now.
DRAINFIELD CONDITION (11-14):
Drainfield inspection indicates:
11 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 (slope.setbacks.etc.):
POTENTIAL FOR SYSTEM FAILURE (depends on soils.water table,etc.):
COMMENTS:
Date of Inspection Se is Sys em 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 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 location and pumping records.
WHITE COPY/Inspectors File YELLOW COPY/Homeowner
On the North Shore of
Lake Minnetonka
ON-SITE SEWAGE TREATMENT CITY
INSPECTION REPORT OF POST OFFICE BOX 66
1335 S. Brown Rd.
0_ Crystal Bay,MN 55323
473-7357
OWNER AMOY bi�Sr� ADDRESS /IM rad/t'►I/ e )U
PERMIT NO.'S. ))pnleDATES CONTRACTORS —
City Ordinance No.210 requires that each on-site sewage treatment system in Orono be inspected on a regular basis.The onsite sewage
treatment system at the above address has been inspected and appears to fall into the category checked below.
(This is 56 an existing system ❑ new construction)
1 Meets or exceeds current City standards in all respects relating to design,construction,and location.Appears to be operating
properly.
Cyl 2 Does not meet all current City standards for new construction (1978 Code) but in most respects appears to be designed,
I�1 located, and constructed generally in accordance with previous codes.System appears to be functioning properly;no major
upgrading of the system is required at this time.
3 Does not 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 not 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 require your action)
Tank inspection indicates: ❑ Inspection pipe is located directly over tank baffle.(Does not
❑ Pumpout not needed at this time. give accurate measurement of solids accumulation.) If tanks
❑ Solids accumulation in tanks indicates they should be pump- have not been pumped out within the last three years,they
ed out this year to help prevent future problems, should be pumped out now.
❑ Solids accumulation in tanks is at a critical level. Tanks 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 surface discharge. ❑ Drainfield is saturated and visibly discharging untreated
Inspection risers missing—tanks could not be inspected, effluent to the surface. This condition may require replace-
Inspection risers (4"dia, pipe)must be installed in each tank ment or additions to drainfield. Contact the City Inspector
at next pumpout. If nks have not been pumped out within immediately.Repairs must be completed within 90 days.
the last three years,they s pumped out now. Drainfield 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 ❑Poor
❑ Lake,wetland,or stream ❑ High ❑ Inadequate
❑ Drainage ❑System is causing visible
ssuurfa discharge.
COMMENTS: G S� ✓� -VK/
40
—7 r /'Y�l.✓.
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 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 premises with system location and pumping records.
WHITE COPY/Inspector's File GOLD COPY/Homeowner
On the North Shore of
Lake Minnetonka
ON-SITE SEWAGE TREATMENT CITY
INSPECTION REPORT OF POST OFFICE BOX 66
O.O O 1335 S. Brown Rd.
Ilk Crystal Bay, MN 55323
473-7357
OWNER ADDRESS72%& /d� �o A
PERMIT NO.'S. DATES CONTRACTORS —
City Ordinance No.210 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 IN an existing system ❑ new construction)
0 1 Meets or exceeds current City standards in all respects relating to design,construction,and location.Appears to be operating
properly.
�1 2 Does not meet all current City standards for new construction (1978 Code) but in most respects appears to be designed,
ISI located, and constructed generally in accordance with previous codes.System appears to be functioning properly;no major
upgrading of the system is required at this time.
3 Does not 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 not 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 require your action)
Tank inspection indicates: ❑ Inspection pipe is located directly over tank baffle.(Does not
❑ Pumpout not needed at this time. give accurate measurement of solids accumulation.) If tanks
❑ Solids accumulation in tanks indicates they should be pump- have not been pumped out within the last three years,they
ad out this year to help prevent future problems, should be pumped out now.
❑ Solids accumulation in tanks is at a critical level. Tanks Drainfield inspection indicates:
should be pumped out as soon as possible. E4 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 surface discharge. ❑ Drainfield is saturated and visibly discharging untreated
51 Inspection risen missing—tanks could not be inspected, effluent to the surface. This condition may require replace-
Inspection risers (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. ❑ Drainfield 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) 11Adequate
❑ High water table Low Fair
❑ Lot size ❑ Medium ❑Poor
❑ Lake,wetland,or stream ❑ High . ❑ Inadequate
❑ Drainage ❑System is causing visible
surface discharge.
COMMENTS:� �nSLYG a,-, sErc rn�� JI�'15 Y�ir
Date of Inspection ASeptic 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 opinion of the adequacy
of the system under current conditions based on the available information.
This report must be kept on the premises with system location and pumping records.
WHITE COPY/Inspector's File GOLD COPY/Homeowner
On the North Shore of
Lake Minnetonka
ON-SITE SEWAGE TREATMENTCITY
INSPECTION REPORT OF POST OFFICE BOX 66
O.ONO 1335 S. Brown Rd.
Crystal Bay, MN 55323
473-7357
OWNER / I mw o /V ADDRESS N (Do
PERMIT NO.'S. DATES CONTRACTORS
City Ordinance No. 210 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 ress has been inspected and appears to fall into the category checked below.
(This is 0an existing system ❑ new construction)
1 Meets or exceeds current City standards in all respects relating to design,construction,and location.Appears to be operating
` properly.
2 Does not meet all current City standards for new construction (1978 Code) but in most respects appears to be designed,
located, and constructed generally in accordance with previous codes.System appears to be functioning properly; no major
upgrading of the system is required at this time.
D3 Does not 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 not 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 require your action)
k inspetion indicatces: ❑ Inspection pipe is located directly over tank baffle.(Does not
Pumpout not needed at this time. give accurate measurement of solids accumulation.) If tanks
❑ Solids accumulation in tanks indicates they should be pump- have not been pumped out within the last three years, they
ed out this year to help prevent future problems. should be pumped out now.
❑ Solids accumulation in tanks is at a critical level. Tanks 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 surface discharge. ❑ Drainfield is saturated and visibly discharging untreated
❑ Inspection risers missing—tanks could not be inspected. effluent to the surface. This condition may require replace-
Inspection risers (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. DrT ta�infield extent and condition unknown.
SITE CHARACTERISTICS: RE-54MED RRER DaY
Limiting Site Factors Potential for System Failure Site Capabilities for
❑ Slope (depends on soil types,water lure Expansion
❑ Soil table,and system condition) Adequate
❑ High water table �❑ Low ❑ Fair
❑ Lot size �C] Medium ❑ Poor
❑ Lake,wetland,or stream ❑ High ❑ Inadequate
❑ Drainage ❑ System is causing visible
surface discharge.
COMMENTS:
�&if I C) I 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 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 premises with system location and pumping records.
WHITE COPY/Inspector's File GOLD COPY/Homeowner