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Home My WebLink AboutCompliance Inspection Form Minnesota Pollution Compliance Inspection Form Control Agency Control Subsurface Sewage Treatment Systems (SETS) 520 Lafayette Road North 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 fors—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): 1/11/2017 ® 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 ID#or Sec/Twp/Range: Property address: 3330 Watertown Rd Orono,MN Reason for inspection: property transfer Property owner: Leonard Busch Owner's phone: 763458-8352 or Owner's representative: Sue Busch Representative phone: 612-701-8184 Local regulatory authority: City of Orono Regulatory authority phone: Brief system description: 2-1 000gal septic tanks 1000gal pump tank mound treatment witn 10ftX55ft rockbed Comments or recommendations: 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: Andrew Kleindl Certification number: 7927 Business name: Jim's Excavating LLC License number: 2926 Inspector signature: (:4�Dao2 Phone number: 952-442-9282 r 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-wwists4-31b • 614114 Page 1 of 3 Property address: 3330 Watertown Rd Orono,MN Inspector initials/Date: I (mm/dd/YM) 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 round 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 CommentslExplanation) health and safety. ❑Other methods not listed(See CommenWExplanation) 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. ❑Observed liquid level below operating depth Sewage tank(s)leak below their ❑Yes ®No ❑Examined empty(pumped)tanks(s) designed operating depth. If yes,which sewage tank(s)leaks: [:1 Probed outside tank(s)for"black soil" Any"yes"answer above indicates the El Unable to verity(Sae Comments/Explanation) system is failing to protect groundwater. El Other methods not listed(See Comments/Explanation) Com ments/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(alecbical 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 falling 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-wwists4-31b • 614114 Page 2 of 3 Property address: 3330 Watertown Rd Orono, MN Inspector initials/Date: ) ��✓!' (mnYdd/yyyy) 4. Soil Separation—Compliance component#4 of 5 Date of installation: 12/9/2004 ❑ Unknown Verification method(s): (mmldd/yyyy) ShorelandNVellhead 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 Compliance 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 drainfield) Drainfield has at least a two-foot vertical ❑ Unable to verify(See CommenwExp/anation) 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 ❑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_ 23 inch 2350 or 7080.2400 (Advanced Inspector License required) B. Periodically saturated soil/bedrock 16inch Drainfield meets the designed vertical C. System separation 39 inch separation distance from periodically saturated soil or bedrock. D. Required complianceseparation* 36 inch 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 property functioning? ❑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 TTY 651-282-5332 or 800-657-3864 • Available in alternative formats wq-wwists4-31b • 614114 Page 3 of 3 a � Wdl ell � -" Co rc �11 } 1 t Y• � j � ! 1oy12 jlR + f ; 97—� a I0yp3g3 ++- x� u — _ z •rarsst' 's� �c �,ti i'v'r, Ii�X�,�5�`l- Y'9�°��, �/I2G�► S�'�� 1?DTT� G� /�P �y►GL► CITY of ORONO Municipal Offices � Street Address: Mailing Address: �`9kEST�IOg 2150 Kelley Parkway P.O. Box 66 Orono, MN 55356 Crystal Bay, MN 55323.0066 To: The Current Owner of Address 'S 3 370 eft 4--cf 4C - l j 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 . q -c,) . 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 a Fax (952)249-4616 www.ci.orono.mn.us