HomeMy WebLinkAbout08-19-2019 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/dd/yyyy): 8/19/2019
® 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 1D#or Sec/Twp/Range: 3311823340006
Property address: 55 Wear Lane., Orono, MN Reason for inspection: Property Transfer
Property owner: Michael Kelderman Owner's phone: 612-801-2332
or
Owner's representative: Representative phone:
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 feet of mound rockbed.per city
Brief system description: records
Comments or recommendations:
TBM:Top of the lift station manhole cover.There is 1.1 feet of sand under the rock bed.
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 OI 's Soil&Pere.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):
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Property address: 55 Wear Lane., Orono,MN _ Inspector initials/Date: J. O. 8/19/19
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. 0 Homeowner testimony(See Comments/Explanation)
Y sewagebackup
—_— "Black soil"above soil dispersal system
System cause into 0 Yes ® No
dwelling or establishment, 0 System requires"emergency"pumping
_._ ❑ Performed dye test
Any"yes"answer above indicates the system is 0 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 0 Examined Tank Integrity Form (Attach)
compliant if allowed in local ordinance.
❑ 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"
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:
Elmer J. Peterson Company 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. ❑Yes* ®No El Unknown
b. Other issues(electrical hazards,etc.)to immediately and adversely impact public health or safety. ❑Yes* ®No D 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:
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Property address: 55 Wear Lane., Orono, MN Inspector initials/Date: J. O. 8/19/19
4. Soil Separation—Compliance component#4 of 5
Date of installation: 10/17/97 ❑ 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 0 Yes ❑ No
not located in Shoreland 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:
0 Not applicable(Holding tank(s),no drainfreld)
Drainfield has at least a two-foot vertical ❑ Unable to verify(See Comments/Explanation)
separation distance from periodically
❑ Other(See Comments/Explanation)
saturated soil or bedrock.
Non-performance systems built April 1, ®Yes ❑ 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 0 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 107.3
2350 or 7080.2400 (Advanced Inspector
License required)q ) B. Periodically saturated soil/bedrock 104.2
Drainfield meets the designed vertical C. System separation 3.1
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
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? El Yes ❑ No If"yes",A below is required
Is the system required to employ a Nitrogen BMP? 0 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 0 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
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Tank Report
Date: August 19, 2019
Elmer J. Peterson Co.
5921 Dague Ave.
Delano, MN 55328
Phone 763-972-2420
Fax 763-972-7217
MPGA License# 919
Michael Kelderman
55 Wear Lane N
Orono, MN 55356
612-801-2332
Baffles: ON / OFF
Tank Ca aci ty3-1000 Gallon Tanks
P :
#of Tanks: 3
Type of Tanks: Concrete
Gallons Pumped: 2500
Manholes to Grade: YES / NO
Comments:
On August 19, 2019, Elmer J. Peterson Co. uncovered manholes (1st&2nd manholes both 3 inches deep,
lift station manhole to grade)and pumped tanks. No cracks or water leaking in tanks at the time of
pumping.
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: 55 Wear Lane N Inspector initials/Date: _8/19/19
1. Impact on Public Health-Compliance component#1 of 5
Compliance criteria: Verification method(s):
System discharge sewage to the ❑Yes ❑ No 0 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
emdwaters. ❑ Homeowner testimony(See Comments/Explanation)
0 "Black soil"above soil dispersal system
System cause sewage backup into ❑Yes Cl No 0 System requires"emergency"pumping
dwelling or establishment.
0 Performed dye test
Any"yes"answer above indicates the system is El 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. 0 Examined construction records
Seepage pits meeting 7080.2550 maybe 0 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"
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:
On 8/19/19,Elmer J.Peterson Co-pumped tanks.
3. Other Compliance Conditions-Compliance component#3 of 5
a Maintenance hole covers are damaged,cracked,unsecured,or appear to structurally unsound. 0 Yes* ❑No 0 Unknown
b. Other issues(electrical hazards,etc.)to immediately and adversely impact public health or safety. 0 Yes* 0 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 0 Yes- ❑No
*System is failing to protect groundwater
Explain:
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Soil Observation Log
www.SepticResource.corn vers 12.4
Owner Information
Property Owner/project: Michael Kelderman Date 8/19/2019
Property Address/PID: 55 Wear Lane
Soil Survey Information El refer to attached soil survey
Parent matl's: El Till El Outwash ❑ Lacustrine 1]Alluvium ❑ Organic ❑ Bedrock
landscape position: ❑ Summit 0 Shoulder El Side slope El Toe slope
soil survey map units: 123A slope % direction- Lineal
Soil Log#1
RI Boring ❑ Pit Elevation 107.2 Depth to SHWT 24 inches
Depth(in) Texture fragment% matrix color redox color consistence grade shape
0-24 Topsoil <35 10yr2/1 Friable Moderate Blocky
loose loose
<35 single grain
friable weak granular blocky
35 -50 firm moderate prismatic-platy
>50
rigid strong massive
loose loose single grain
<35 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
<35 loose loose single grain
friable weak granular blocky
35 50 firm moderate prismatic platy
>50 rigid strong massive
Comments:
55 Wear Lane Soil Log#2
El Boring ❑ pit Elevation 106.2 Depth to SHWT 24 inches
Depth(in) Texture fragment% matrix color redox color consistence grade shape
0-16 Topsoil <35 10yr2/l Friable Moderate Blocky
16-20 Clay Loam <35 10yr3/2 Friable Strong Blocky
20-24 Clay Loam <35 10yr4/3 Friable Strong Blocky
loose loose
<35 single grain
35 -50 friable weak granular blocky
firm moderate prismatic platy
>50 rigid strong massive
loose loose
<35 single grain
35 -50 friable weak granular blocky
firm moderate prismatic platy
>50 rigid strong massive
55 Wear Lane Soil Log#3
❑ Boring ❑ Pit Elevation Depth to SHWT
Depth(in) Texture fragment% matrix color redox color consistence grade shape
loose loose
<35 single grain
35 -50 friable weak granular blocky
firm moderate prismatic platy
>50 rigid strong massive
loose loose single grain
<35 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
loose loose grain
single
friable weak granular blocky
35 50 firm moderate prismatic platy
>50 rigid strong massive
loose loose single grain
<35 friable weak
granular blocky
35 50 firm moderate prismatic platy
>50 massive
rigid strong
I hereby certifi,this work was completed in accordance with MN 7080 and any local reqs.
Rusty Olson's Soil & Pere 810
4nerSitture Company License#
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