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Home My WebLink About2018 MPCA Compliance Inspection Form 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): 6/20/2018 ® 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: 3311823430006 Wit+ -. _ --- _----- Property address: Old Crystal Bay Road N.,Orono, MN _ Reason for inspection: -- —Property Transfer — _ Property owner: LeAnn Coe Owner's phone: 612-812-6178 or Owner's representative: _ Representative phone: Local regulatory authority: City of Orono Regulatory authority phone: 952-249-4600 Brief system description: 2-1500 and 1-1000 gallon lift station and 680 square feet of mound rockbed. per cit records Comments or recommendations: TBM: Bottom of the rock bed.There is 1.6 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: I Rum son's Soil&Perc.Testing License number: 810 Inspector signatur 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 Property address: 106 Old Costal Bay Road N., Orono, MN Inspector initials/Date: J.O.6/20/18 1. Impact on Public Health —Compliance component#1 of 5 Compliance criteria: Verification method(s): �— ® Searched for surface outlet System discharge sewage to the F1 Yes ® No round surface. ® 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. ElHomeowner testimony(See Comments/Explanation) ❑ "Black soil"above soil dispersal system System cause sewage backup into ❑Yes ® No El System requires"emergency"pumping dwelling or establishment. —_ __ �_ ____. ❑ Performed dye test Any"yes"answer above indicates the system is ❑ Unable to verify(See CommentslExplanation) 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 [I 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-N allowed in local ordinance. - ❑ Observed liquid level below operating depth Sewage tank(s)leak below their [:]Yes ®No El Examined empty(pumped)tanks(s) El designed operating depth__ _____� Probed outside tank(s)for"black soil" If yes,which sewage tank(s) leaks: "—_- - --- _..___ ❑ Unable to verify(See Comments/Explanation) Any "yes"answer above indicates the ®Other methods not listed (See CommentslExplanation) system is Failing to Protect Groundwater. Com ments/Explanation: The tanks where pumped on 7/09/17.they are operating at normal level. 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 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 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 • 1124112 Page 2 of 3 • Property address: 106 Old C sry tal Bay Road N.,Orono,MN Inspector initials/Date: J. O.6120/18 4. Soil Separation—Compliance component#4 of 5 Date of installation: 7/13/06 __ El Unknown Verification method(s): ShorelandMellhead protection/Food Beverage ❑Yes ® No Soil observation does not expire. Previous soil Lodging? observations by two independent patties are sufficient, _Com liance criteria: unless site conditions have been altered or local requirements differ. For systems built prior to April 1, 1996, and ❑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: I ❑ 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 ❑ 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." - _ ---- } or systems built under ere,-2008 Rules Type c 1V ❑Yes ❑ No Indicate depths of elevations Y p or V systems built under 2008 Rules(7080. A. Bottom of distribution media 100.0 2350 or 7080.2400 (Advanced Inspector License required) B. Periodical saturated soil/bedrock 97.0 Drainfield meets the designed vertical C. System separation 3.0 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? ❑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 Have the Operating Permit requirements been met? Yes No b. Is the required nitrogen BMP in place and properly 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-wwists4-31 • 1124112 Page 3 of 3 Soil Observation Log www.Sept icResource.com vers 12.4 Owner Information Property Owner/project: LeAnn Coe Date 6/20/2018 Property Address/PID: 160 Old Crystal Bay Road N. Soil Survey Information ❑refer to attached soil survey Parent matl's: ❑Q Till ❑ Outwash ❑ Lacustrine ❑Alluvium ❑Organic ❑ Bedrock landscape position: ❑Summit ❑Shoulder ❑✓ Side slope ❑Toe slope soil survey map units: L37B slope % direction- Soil Log#1 Boring ❑ Pit Elevation 101.2 Depth to SHWT 52 Inches Depth(in) Texture fragment% matrix color redox color consistence grade shape 0-34 Fill <35 34-38 Topsoil <35 IOyr4/2 Friable Moderate Blocky 38-52 Clay Loam <35 1Oyr5/4 Finn Strong Blocky <3 5 loose loose single grain 35-50 friable weak granular block\ >50 finn moderate prismatic platy rigid strong massive <35 loose loose single grain 35-50 friable weak granular block\ firm moderate prismatic platy >50 rigid strong massive Comments: 160 Old Crystal Bay Road N. Soil Log#2 ❑Q Boring Q.pit Elevation 101.6 Depth to SHWT 58 Inches Depth(in) Texture fragment% matrix color redox color consistence grade shape 0-+39 Fill <35 39-50 Topsoil <35 10yr3J1 Friable Moderate Blocky 50-58 Clay Loam <35 10yr4/3 Friable Strong Blocky <35 loose loose single grain friable weak granular blocky 35 -50 firm r >- moderate prismatic plan rigid strong massive <J5 loose loose single grain 35 -50 friable weak granular block. >50 firm moderate prismatic plate rigid strong massive 160 Old Crystal Bay Road N. Soil Log#3 ❑ Boring ❑ Pit Elevation Depth to SHWT Depth(in) Texture fragment% matrix color redox color consistence grade shape <35 loose loose single grain 35-50 friable weak granular blodN >50 firm moderate prismatic plat} rigid strong massive <35 loose loose single grain 35-50 friable weak granular block% firm moderate prismatic platy >50 rigid strong massive <J5 loose loose single grain friable weak granular blocky j 35-50 >50 firm moderate prismatic plat% I rigid strong massive i i i ! <35 loose loose single grain 35-50 - friable weak granular block firm moderate prismatic platy >50 rigid strong massive <35 loose loose single grain 35-50 friable weak granular blocky firm moderate prismatic plate >50 rigid Istrong I massive 1 hereby cer 0,this work was completed in accordance tivith AIN 7080 and army local reqs. Rusty Olson's Soil & Perc 810 Designer Signature Company License 4 i 6N S- +A I BA14 , leo ti ss°g A Cama _ Drives ,6M t�o.00 i 1 i