HomeMy WebLinkAboutseptic info 08/20/2010 15:42 7634988290 RUSTYS PERC TESTING PAGE 02
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Minnesota Pollution Compliance Inspection Form
Control Agency
520 Lafayette Road North Existing Subsurface Sewage Treatment Systems (SSTS)
St.Paul,MN 55155-4194
Instructions on page 7
Parcel number: 0411723210010 For Local Tracking Purposes:
System status: ® Compliant ❑ Noncompliant
(based on all compliance requirements)
Summary Form
Property Information
Property owner name(s): Michael Francis
Property address: 2995 Watertown Road, Orono,MN 56366
Property owner's address(If dltferent):
County: Hennepin Property owner phone: Permitting authority: _Ci!y of Orono
Date system constructed: _6/11/01 Reason for Inspection: Property Transfer
System Description ----
Approximately 2-1300 gallon septic tanks, 1-1300 gallon lift station and Approximately 7500 square
Brief system description: feet of mound rockbed.
Local permit number: _ Number of bedrooms: B Design flow rate: 83
Is the system: _._ _
In Shoreland area? ❑Yes ® No In Wellhead Protection Area? ❑Yes ® No
An U.S. Environmental Protection System serving a Minnesota Department
Agency(EPA)Class V Injection Well?❑ Yes 0 No of Heath(MDH) licensed facility? ❑Yes ® No
Compliance Status(Based on state requirements—additional local requirements may also apply.)
Based on the information gathered and reported on attached forms,the compliance status of this system is(check one):
®Certificate of Compliance—valid until (3 years from date of report): 8/16/2010
❑ Notice of Noncompliance-For Nonoompliant systems:
The reason for noncompliance is:
his noncompliant system Is classified as(check one below).
❑ Imminent threat to public health&safety ❑ Failing to protect ground water ❑ Not in compliance with operating permit
Certification (Completed form must be submitted to the local unit of govemment within 15 days.)
I hereby certify that all the necessary informa6on has been gathered to determine the compliance status of this system. No
determinahon 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.
Name: Joseph J_Olson x Certification number: 1255 _
Business license name and number Rusty Olson's soil and perculation testing Lic#810 _ _ or
Name of local unit of government: City of Orono
Signature Date: 8/20/10
Required Attachments Inspector Complete:This Inspection Report is pages long.
Check compliance forms attached: ®Hydraulic Performance ❑Tank Integrity ®Soil Separation ❑Operating Permit Form(if
applicable) ❑System drawing/As-built drawing ❑An assessment of any local raqulrements that are different from what is required on this
form ®Soil Boring Loge 0 Abandonment form Cif approprtaw) ❑Other information(fist):
Upgrade RegUlrememB(derived ftn"Minn. Star.§995.55)An immment threat to public health and s&MW(ITPH$)must be upgraded,replaced,or
ib sae dlScartt/nued within ten months of receipf of this notice or within a shower pwloe Jf mqubed by Aoml ordinance.ff the systam Is railing to protect ground
water.Me system must Of upgraded replaced,or Ire use discontinued wphin the time requlmd by act/ordinance.If an existing systtm is not failing as defined in
few,and has of least two feet of design soli separation,then Me system need not be upgraded,repaired,replaced,or its use discontinued,notwithstanding any
local ordinance that Is more sma This provision does nor apply to systems in shomiand areas,wellheed Protection Areas,or those used In connection with food,
beverage,and lodging esteolishmonta as der►ned in law.
wq-wwlsts4-31 Compliance Inspection Form for Existing SSTS
A/.rrno
08/20/2010 15:42 7634988290 RUSTYS PERC TESTING PAGE 03
Parcel number 0411723210010 System status: ®Compliant ❑Noncompliant
(as determined by tills lam)
l"ll'sulic PerFor1111UMM and Other Compliance
COMPHance Issue#1 of 4
Date of observation: 8/16110 Reason for observation: _Pmpft Transfer
This foam expires upon next inspection or in three yam,whichever ooaxs tir8t 8/16113
Compliance qundons/cliteda: (Required) VeMdcation Method': (Optional)
Check the appippriate.bout (Check the appropriate bac)
Does the system discharge sewage to the ❑Yes O No surface? ® Searched for surface outlet
round
Does the system discharge sewage to drain ❑Yek ®No ❑ Performed hydraulic test
We or surface waters? ® Searched for seeping in yard
Does the system cause sewage backup ❑Yes ®No ® Checked for backup in home
Into OL*Nna or establishment? ❑ Excessive ponding in soil system/D-boxes
Do other situations wrist that have the ❑Yes ONO Q Homeowner testimony
potential to Immediately and adversely
Impact or threaten public health or safety ❑ Examined for surging in tank
electrical unsefe covers,oft.?
Any"yes"ensnarer Mdrea w that the system/s an imminent ❑ 'Bled loll'shove soil dispersal System
tlrrawttoputift hsalM andsati3ty. ❑ System requires'emergenc "pumping
❑ Performed dye test
Does the system pose a threat to grand ❑Yes ®No 00W.
protective
water for any conditions deemed non-
' as determined by the
Yes"Ind that the system Rs to protect
ground waster.If wyes",deacdbo the condltlon noted.
'Alb standard pn)kxd exists. This list is not exhaustive,
in sequential cider,nor does it indicate which
combinations are necessary to make this determination.
Certification
This form Is to be completed and attached to the Summary Form of the Minnesota Pollution Control Agency's(MPCA)Compliance
Inspection Farm for Erdsting Subsurface Sewage Treatment Systems.Observations,interpretations,and conclusions must be
completed by an inspector.Complatad form must be submWed to the local Limit of government within 15 days.
Property owner name(s): Michael Francis
Property address. 2W5 Watertown Road,Orono,MN 55356
Property uwners address(If diifesnt):
County: Hennepin Phone:
I hereby cer6Tjr that I personally made the obsemb rig,ir►terpretatkuns,and conclusions reported on this ftm and that they are
correct.
Name: Joseph J.Olson Certi(ication number: 1255
Business license name and number; Rushy Olson's soil and peryuMon mina Lic S 810 or
Name of local unit of government: Cites of Orono
Signature: Date: 8/20/10
wq-wwbts+31 Compliance inspection Form for Existing 5ST5
08/20/2010 15:42 7634988290 RUSTYS PERC TESTING PAGE 04
,uv arc-torr P.G
Percef number: SYetam statae
❑Compliant ❑Noncompiiart
(aa deremdrled by this Ibrm
Ts"k 1"ft and Safi Comphails" -Comp"noe kWP0Cd0n Fvlln !bf Existing SSTS
Compliance Issue #2 of 4
Date of observation: Resson for obmwvsoon: Request from Eric Myhran-Resitor
This form expires on(three years): 811?/10
Compllawvequeistions/ClRN 4: (Required) lhrllication AAsAfvd":(Optionral)
`ak Ills
Does the (Check the sppra Pride box)
syacem cotterel of a seepage plY, El Yes {�No
teas ool d I,or Iescn ❑ Probed tank bafom
Do any sew W tanks)leak below their ❑Yes No 13 Observed iNonr li�r(0!ever
assigned oWdng dt th? ❑ Examined contitruccon reconea
If yes,identify which Examined amplyy(pumped)tank
sewage tank leaks
AiW"yea4 enwWMXpgW"fbWow graham ii fmring so P+'�f ❑ Probed mods tank for•black sal'
ground**far. ❑ Pressuretva mum check
Seepegs pib Ift UhIll 7080.2550 may be eompik M If allowed ❑ Other
in ordinance by local permitting eutho*.
No alsnndord p►*cW sa sts. This liai is dot exbar:avw'in
mwerba wdsr.nor db@v iYk iv@w whir~h wmbm&6W s
are naceasary to mate dhls daleimkofion.
Safety Check
1. Are mirirOfmce able covers dalnetged,craciaea,or appeared to be madly unsound? ❑Yes' ®No
2, Were maintenance hole covers replaced in e segued manner(s.g.,screws replamed)? ®You []No-
3. Was ssoonttary access restrdnt present(eallegr pan,second cover,or salbgt rending)-highly recommended. ❑YesA' No
4. Are other saft- wi>e t issue pressat? Q Yes' ■Na
%yallaw is an bnAinewir dt►so p publk health aw sanely.
Certification
Ttla form is to tie completed end attached to the Summery Form clans Minnesota POHlution Control Agency's(MPGA)Conolance
Inspedton Form for Existing Subsurface Sewage Treabuset8ysbems.Observations,interpretations,and conclusions must be
completed by on inspector, ma intsiner,or seriice provider.Completed form must be subri ftted m the local unit oh govemment within
15 days.
Property owner narrWsh mel Fronds
Property address: 2995 Watertown Ind. Orono, MN 5585iB
Property owners address(If dllamrp:
Counitr. Hennepin Property owner phone; Erlo Myhren 1112$10-37415
I h&raby certify that I permnefly trade the absenvoWns,lnterpnetat(ons,and oombbrsions rapaled an flus farm and that they ata
correct.
Mame: James BrasgelMsrn Certfficallon number.
Busing"license name and number Domer J. Peterson Co. LicarrAW219 or-�
Nam:7re-
www-PO4tift-MUS
Sign - 661-296.6300 . 6"7-3564 TTY 651-2112-532'2 or f M4S7--3864 . Available in ammathve formats
w q-wwlsrs4-J1 s 4124!09
Phe 3 of 8
08/20/2010 15:42 7634988290 RUSTYS PERC TESTING PAGE 05
Parcel number 0411723210010 System status: ®Compliant ❑Noncompliant
(as detem*W by this form)
Solt Sepatrattfon Compliance and Otlw Commigmae
Compliance Issue i#3 of 4
Date of observation: 8/18/10 Reason for observation: !ERM Transfer
This wftrnahm on this form does not expire.
Compliance questlonWadoffia:(Required) Vstftkatlon Method''; (Options!)
Check the be hour (Check the e
Ppmprist@ box)
For systems!wilt prior to April 1, 1986,and not ® Conducted soil observation ng )
located in Shoreland or Wellhead Protection (s)(attach boring
Area or not serving a food,beverage or ❑ Two previous verifications(attach boring logs)
lodging establishment
❑ Other_
Does the system have at least a two-foot
vertical separation distance from periodically
saturated soil or bedrock? Yes ❑No
For non-performance systema built April 1,
1858.or later or for non-performance systems
located in Shoreland or Wellhead Protection Soil observation does not expire,Previous observations
Areas or serving a food,beverage or lodging by two independent parties are suffiderk unless site
establishment. conditions have been altered.
Does the System have a three-foot vertical
separation distance from periodically saturated
_soil or bedrock?• Yes No
For reduced separation distance systems(i.e.,
"performance systems under old 7080.0179 or ' May be reduced by up to 15 percent K allowed in local
Type IV or V system under now 7080.2350 or ordinance.
7080.2400): "No standard protocol exists. This Ilst is rot exhaustive,
Doss the system meet the designed vertical In sequential order,nor does it indicate which
separation distance from periodically saturated coembinaaons are necessary to flake this
soil or bedrock?* D Yes El No determination.
Mdkoft OW the s~is failM9 to pmjWt
Certification
This form is to be completed and attached to the Summary Form of the Minnesota Poqution Control Agency's(MPCA)Compliance
Inspection Form for Existing Subsurface Sewage Treatment Systems.Observations,interpretations,and conclusions must be
completed by an inspector or designer.Completed form must be submitted to the local unit of government within 15 days.
Property owner name(s): Michael Francis
Property address: 2955 Watertown Road Orono,MN 55356
Property owneys address(if different):
County: Hennepin Phone:
I hereby 0e1tfly that I personafy made the observations, lnterpretaucm,and conciuslons reported on this form and that they are
coned.
Name: Joseph J.Olson Certification number. 1255
Business license name and number __RugjOWWs9oilsndpercu itiontestIngLic#810 or
Name of local unit moment: City of Orono
G-'
Date: 8/20/10
wq-wwlsts4-31
Compliance 1
pl nWecbon Form for Existing SSTS
08/20/2010 15:42 7634988290 RUSTYS PERC TESTING PAGE 06
LOUS Qf Soil Borinas
License 0810
Location or Project: 2995 Watertown Road
Borings made by: Rusty Olson's Soil and Perc testing 8/1W2010
Classification System: AASHO ; USDS•USDS-SCS X ; Unified ; Other
Auger used (check two): Hand_X_,or Power____, Flight, Bucket or Probe X
Bench mark is top of basement concrete slab. Elv.-100.00 Assumed _
Boring Number_1_Surrace elevation 95.4^ Mottled Soil at_1.7 feet
0"-12" Dario brown loam 10y�/2 H2O present at X
12"-20"Brown loam 10yr4/4
20"-26" Rusty brown loam to clay loam 10yr5/3
TBM: Top of threshold of basement door Elv.-100.00 assumed
Original soil under the rockbed Elv.-95.2
Bottom of rack bed Elv:97.0
There is1.8 feet of sand under the rockbed
08/20/2010 15:42 7634988290 RUSTYS PERC TESTING PAGE 07
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CITY of ORONO
\ 'A {/ Municipal Offices
Street Address: Mailing Address:
�kE8I104 .'' 2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323.0066
To: The Current Owner of Address ,217475- (,j A+cll-cc. A/
City Ordinance 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 tank be serviced and pumped
out every three years. City records indicate the tank(s) were last pumped out on
),2• o i --o 3 . The tank(s) should be cleaned through the manhole and
not through the inspection pipes,this allows for proper cleaning.
Comments:
Inspecto _ Date of Inspection
Telephone(952)249-4600 o Fax(952)249-4616
www.ci.orono.mn.us
1.0,x.
O
CITYof ORONO
Municipal Offices
Street Address: Mailing Address:
Kpg' 2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
To Current Owner: Address: a qq s,
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): 1
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.
3 "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 mason;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:
Pumpout not needed at this time.
Septic tanks must be pumped out this ear (city code requires tanks to be pumped out once every 3 years.
Tank was last pumped i�-1—O ).
Make sure septic tanks are pumped through manhole and not through white inspection nines. This allows for the
prover cleaning. Keep water softner and iron filter discharge out of septic system.
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):
(j)Dramfield 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: fv a— L_ fi�mks )bob 0 k
10 '9-()3 &t—,
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 Swan existing systemwill continue to function properly,but is merely an opinion ofthe adequacy of the system undercurrent conditions based on the available
information.
Tdephone(952)24946M • Fax(952)249-4616
w r ci orono.mn.ns