HomeMy WebLinkAbout09-12-2019 Septic Compliance Inspection Minnesota Pollution Compliance Inspection Form
Control Agency
520 Lafayette Road North Existing Subsurface Sewage Treatment Systems
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): 9112/19
Z 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 permit/monitoring plan requirements(Compliance Component #5)—Noncompliant
Property Information Parcel lD#or Sec/Twp/Range: 0411723120009
Property address: 2800 Countryside Drive W., Orono, MN Reason for inspection: Property Transfer T�
Property owner: Jewel Vitas Owner's phone: 952-215-2854
or
Owner's representative: Representative phone:
Local regulatory authority: City of Orono Regulatory authority phone: 952-249-4600
Approximately 2-1300 gallon septic tanks,/-1300 gallon lift station and approximately 630 square feet
Brief system description: of mound rockbed.
Comments or recommendations:
TBM:Top of lift ststion manhole cover.The rock bed has 1.3 feet of sand under it.There is major corrosion on the lift station and the
second tank. They are not cracked or leaking at this time. Someday they will need to be replaced. See pumping report.
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: Joseph J Olson Certification number: 1255
Business name: Rusty 0 ores Soil &Pero.Testing_ License number: 810
Inspector signature:P 9 Phone number: 763-498-8779
Necessary or Locally Required Attachments
El 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 • 1/24/12 Page 1 of 3
Property address: 2800 Countryside Drive W., Orono, MN Inspector initials/Date: J. 0. 9/12/19
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
ground surface. ® Searched for seeping in yard/backup in home
System discharge sewage to drain tile 0 Yes ® No ❑ Excessive ponding in soil system/D-boxes
or surface waters. ❑ Homeowner testimony(See Comments/Explanation)
❑ "Black soil"above soil dispersal system
System cause sewage backup into ❑Yes ® No ❑ System requires"emergency" pumping
dwelling or establishment. ❑ Performed dye test
Any"yes"answer above indicates the system is
an Imminent Threat to Public Health and Safety. ❑ Unable to verify (See Comments/Explanation)
❑ 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.
0 Observed liquid level below operating depth
Sewage tank(s) leak below their ❑Yes ® No 0 Examined empty (pumped)tanks(s)
designed operating depth.
If yes,which sewage tank(s) leaks: ❑ Probed outside tank(s)for"black soil"
Any "yes"answer above indicates the 0 Unable to verify(See Comments/Explanation)
®
system is Failing to Protect Groundwater. Other methods not listed (See Comments/Explanation)
Comments/Explanation:
Elmer J. Peterson pumped the tanks.
3. Other Compliance Conditions—Compliance component#3 of 5
a. Maintenance hole covers are damaged,cracked,unsecured,or appear to structurally unsound. El Yes* ®No Li Unknown
b. Other issues(electrical hazards,etc.)to immediately and adversely impact public health or safety. 0 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-wwists4-3l • 1/24/12 Page 2 of 3
• Property address: 2800 Countryside Drive W., Orono, MN Inspector initials/Date: J. O. 9/12/19
4. Soil Separation —Compliance component#4 of 5
Date of installation: 7/27/1995 0 Unknown Verification method(s):
Shoreland/Wellhead protection/Food 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
requirements differ.
For systems built prior to April 1, 1996, and ®Yes El No
not located in Shore/and or Wellhead ® Conducted soil observation(s) (Attach boring logs)
Protection Area or not serving a food, ❑ Two previous verifications(Attach boring logs)
beverage or lodging establishment: El Not applicable(Holding tank(s),no drainfield)
Drainfield has at least a two-foot vertical ❑ Unable to verify(See Comments/Explanation)
separation distance from periodically
1:11 Other(See Comments/Explanation)
saturated soil or bedrock.
Non-performance systems built April 1, ❑Yes 0 No Comments/Explanation:
1996, or later or for non-performance
systems located in Shoreland or Wellhead
Protection Areas or serving a food,
beverage, or lodging establishment:
Drainfield has a three-foot vertical
separation distance from periodically
saturated soil or bedrock.*
"Experimental", "Other" or "Performance" Yes No
p ❑ ❑ Indicate depths of elevations
systems built under pre-2008 Rules; Type IV
or V systems built under 2008 Rules(7080. A. Bottom of distribution media102.2
2350 or 7080.2400 (Advanced Inspector
License required) B. Periodically saturated soil/bedrock 99.8
Drainfield meets the designed vertical C. System separation 2.4
separation distance from periodically
saturated soil or bedrock.
D. Required compliance separation*_ 2.0
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? 0 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? ! 0 Yes ❑ 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 • 7TY 651-282-5332 or 800-657-3864 • Available in alternative formats
wq-wwists4-31 • 1/24/12 Page 3 of 3
Tank Report
Date: August 1, 2019
Elmer J. Peterson Co.
5921 Dague Ave.
Delano, MN 55328
Phone 763-972-2420
Fax 763-972-7217
MPCA License# 219
Jewel Vitos
2800 Countryside Drive W
Orono, MN 55356
952-215-2854
BafflesON / OFF
Tank Capacity: 3-1300 Gallon Tanks Per City Records
#of Tanks: 3
Type of Tanks: Concrete
Gallons Pumped: 3000
Manholes to Grade: / NO
Comments:
On August 1, 2019, Elmer J. Peterson Co. pumped tanks. No cracks or water leaking in tanks at the time
of pumping.
NOTE OF CONCERN: There is major corrosion in the lift station and some starting in the 2"d tank.
NOTE:This is only a tank report. This is not a compliance inspection for point of sale nor does
it replace a compliance inspection.
Property address: 2800 Count side Drive W Inspector initials/Date: 8/1/19
1. Impact on Public Health—Compliance component#1 of 5
Com•liance criteria: Verification method(s):
System discharge sewage to the ❑Yes ID No 0 Searched for surface outlet
_ground surface. 0 Searched for seeping in yard/backup in home
System discharge sewage to drain tile ❑Yes ❑ No ❑ Excessive ponding in soil system/D-boxes
or surface waters. ❑ Homeowner testimony(See Comments/Explanation)
❑ "Black soil"above soil dispersal system
System cause sewage backup into ❑Yes ❑ Na
dwelling or establishment. ❑ System requires"emergency"pumping
0 Performed dye test
Any"yes"answer above indicates the system Is ❑ Unable to verify(See Comments/Explanation)
an Imminent Threat to Public 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.
0 Observed liquid level below operating depth
Sewage tank(s)leak below their ❑Yes ® No
designed operating depth. ® Examined empty(pumped)tanks(s)
If yes,which sewage tank(s)leaks: ❑ Probed outside tank(s)for`black soil"
❑ Unable to verify(See Comments/Explanation)
Any"yes"answer above indicates the ❑ Other methods not listed (See Comments/Explanation)
system is Failing to Protect Groundwater.
Comments/Explanation:
On 8/1/19, Elmer J. Peterson Co.pumped tanks. Major Corrosion in the lift station and some starting in the 2"d tank,
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(electrical hazards,etc,)to immediately and adversely impact publichealth or safety. ❑Yes* 0 No 0 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 0 Yes" 0 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 • 1/24/12 Page 2 of 3
Soil Observation Log
www.SepticResource.com vers 12,4
Owner Information
Property Owner/project: Jewel Vitos Date 9/10/2019
Property Address/PID: 2800 Countryside Drive
Soil Survey Information ❑ refer to attached soil survey
Parent matl's: []Till ❑ Outwash ❑ Lacustrine ❑Alluvium ❑ Organic ❑ Bedrock
landscape position: ❑ Summit ❑ Shoulder ❑✓ Side slope ❑Toe slope
soil survey map units: L22D2 slope % direction- Lineal
Soil Log#1
Q Boring ❑ Pit Elevation 103.2 Depth to SHWT 43 Inches
Depth(in) Texture fragment% matrix color redox color consistence grade shape
0-30 Fill <35 Loose Loose Single grain
30-38 Topsoil <35 10yr3/1 Friable Moderate Blocky
38-43 Clay Loam <35 10yr4/3 Friable Strong Blocky
43-48 Clay Loam <35 10yr5/3 10y418,1-6/l0y Firm Strong Blocky
loose loose single grain
<35 friable weak
35-50 granular blocky
firm moderate prismatic platy
>50 rigid strong massive
Comments: TBM top of lift station manhole cover
2800 Countryside Drive Soil Log#2
El Boring ❑ Pit Elevation 102.8 Depth to SHWT 40 Inches
Depth(in) Texture fragment% matrix color redox color consistence grade shape
0-25 Fill <35 Loose Loose Single grain
25-33 Topsoil <35 10yr3/1 Friable Moderate Blocky
33-40 Clay Loam <35 10yr4/3 Friable Strong Blocky
40-46 Clay Loam <35 10yr5/4 10y4/8,1-6/10y Firm Strong Blocky
loose loose
<35 single grain
35 50 friable weak granular blocky
firm moderate prismatic platy
>50 rigid strong massive
2800 Countryside Drive Soil Log#3
0 Boring ❑ Pit Elevation Depth to SHWT
Depth(in) Texture fragment% matrix color redox color consistence grade shape
loose loose
<35 single grain
friable weak granular blocky
35-50
firm moderate prismatic platy
>50 rigid strong massive
<35 loose loose single grain
friable weak granular blocky
35 -50
firm moderate prismatic platy
>50 rigid strong massive
<35 loose loose single grain
friable weak granular blocky
35 -50 firm moderate prismatic platy
>50 rigid strong massive
<35 loose loose single grain
' friable weak granular blocky
35-50
firm moderate prismatic platy
>50 rigid strong massive
loose loose
<35 single grain
friable weak granular blocky
35 50 firm moderate prismatic platy
>50
rigid strong massive
I hereby cert/'this work was completed in accordance with MN 7080 and any local reqs.
Rusty Olson's Soil & Pero 810
/ieesigner 1:•.ture , Company License#
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