HomeMy WebLinkAboutonsite sewage treatment system/compliance inspection form 0510912011 10:05 9528733112 PAGE 01/04
Minnesota Pollution Compliance Inspection ControlAgency p tion Form
520 Lafayette yNteRoad
5.g194 h Existing Subsurface Sewage Treatment Systems (SSTS)
St,Paul,MN 55155.4194
Parcel number:
Instructions on pave
�c
System status; Compliant [] Noncompliant V For Local Tracking Purposes
(based on all compliance requirements)
J.
Summary Form
Property Information
Property owner name($):
Property address; 3 0
Property owner's address (it different); ----
County; jL Property owner phone: -�1��ZlQ
Date system constructed: Permitting authority:
Reason for inspection: - --
System Description
Brief system description:
Local permit number;
Number of bedrooms: 3 Design flow rate;
Is the system: D __. •._
In Shoreland area?
❑Yes [ No In Wellhead Protection Area? �I
An U.S. Environmental Protection ❑ Yes AlNc
Agency(EPA) Class V Injection Well?❑ Yes Ne of Heath(MON)System serving a rose facility?partment nsed
0 Yes/KNa
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.
rtiftcate of Compliance—valid until (3 years from date of report);
❑ Notice of Noncompliance -For Noncompliant systems: — --- —
The reason for noncompliance is:
This noncompliant system 1S classified as (check one below); —11 Imminent threat to public health &safety U Failing to protect ground water ❑Not in compliance wilh Operating perm.:
CC rtification (Completed form must be submitted to the local unit of government within 15 days.)
I hereby certify that all the necessary information has been gathered to determine the compliance status of this sysrerl, Jc
determination of future system performance has been nor can be made due to unknown conditions during system car srr;;cf,;:r
possible abuse of file system, inadequate maintenance, or future water usage.
Name: — ��sq
- � Certification number:
Business license name and number: � _ 1� O� . . .
Name of local uni over ent; - _.... .. or
Signature; �— ----
_ Cates �. 1.r .....
Required Attachments Inspector Complete: This Inspection Report is Pages long.
Check compliance forms attached, �'draulic Performance �ank Integrity Soil Separation P 9
mii Pori, 1,f
applicable) stem drawing/As-built rd awing ❑An assessment of any local requirements that are differ❑eni from tw aP is eco rec on :r*,z
forth ❑Sofl boring Logs Q Abandonment form(if appropriate) ❑ other Information(liyt):
r
Upgrade Requirements(derived Inpm Minn. Stat. §115.55)An imminent theaf to public health and safery(1TPHsl must be upgraeeo,rep acec
as use Oiscontlnued with/n fen months o/reeelpr aphis notice or within a ahoner rtod if re uired b local ordinance. it(nes stem i
Nater,ane system n+usl be upOmdad,replaced,or its vse disconlinued within the lime required by Joest ordineneo,iron existing systema sng to t fa rocs as7c=r::=:
lair,and has ar feast two feet Ordesiyn soil SeparaLon, then(no system need nor be upgraded. Y loco d,r ino ce. or its use d�sconunuPd.no;w:trs� .;y j..•
local ordinance That is mare sffict, This provision does nol apply Io syslems in shoreland areas. Wellhead Prprecd, Areas,or inose vsea r ;,�n.,$; „ •,•
beverage, and lodging es1a611shh1onfs as der in law
wq-wwi5ts4.31 Compliance Inspection Fnrm (r)r F.jc-!nc i;T(
05/09/2011 10:06 9528733112 PAGE 01101
System status: Compliant C]Noncompliant
Parcel numbet. _.,_..._.—.--__�l^' (as determinedhis form)
Soil Separation Compliance and Other Compliance
Compliance Issue #3 of 4 Al, — ^—
Reason for observation:
Date of observation:
This information on this form does of expire. Verification Method"', (Optional)
Compliance questionslcriteria: (Required) (Check the appropriate box)
Check the a ro nate box Conducted soil observation(s)(attach boring logs
For systems built prior to April 1, Prot and not � Two previous verifications(attach boring logs)
located in Shoreland or W ellhead Protection^�� 0
Area or not serving a food,beverage or [] Other:
lodging establishment: 19
Does the system have at least a two-foot )0 ✓��
vertical separation distance from periodically Yes No `�. v►
w i 1�vkvS
saturated soil or bedrock? �
For non-performance systems built April 1, Soil observation does not expire.Previous observations
1996,or later or for non-performance systems tection by two independent parties are sufficient, unless site
located In Shoreland or Wellhea Prolodg g conditions have been altered.
Areas or serving a food,beverage
establishment:
Does the system have a three-foot vertical
separation distance from periodically saturated E3 Yes ELNo
soli or bedrock?' to 15 percent if allowed in local
'
For reduced separation distance systems (I.e., May be reduced by up ordinance-
TypeormanceIV or V system under newems under 17080 23 0.0 17 0 or r
"• No standard protocol exists. This list is not exhaustive.
7080.2400): in sequential order, nor does it indicate which
combinations are necessary to make this
Does the system meet the designed vertical determination,
separation distance from periodically saturated Des YNo
soil or bedrock?'
Any"no"answer indicates that the system is failing to protect
ground water.
Certification ta
This form is to be completed and attached to the
e Treatment Systems.Observations, interpretations,ontrol Cand(conclusions ns mulst be
Inspection Form for Existing Subsurface g
completed by an inspector or designer. Completed form must be submitted to the local unit of government within 15 ays.
Property owner name(s): 1-1
Property address:
Property owner's address (if different): --
County: � Phone: _.. .-------• -------._. .. .
I hereby certify that(personalty made the observations, interpretations, and conclusions reported on this form and that they are
correct. J
Name: �� L,11 ] Certification number;
Business license name and number: L � —�P.'I` MRS r/��'r— _ o�
Name of local unit over 57)
en : „•_
Signature: Date:37�p
05/09/2011 10:05 9528733112 PAGE 02/04
Parcel number:
—'-- -- System statusAby
Compliant ❑ Noncompliant
(as determinehis/arm)
Hydraulic Performance and Other Compliance
Compliance Issue #1 of 4
Data of observation: ��A_ Reason for observation:
This form expires upon next Inspection or in three years,whichever occurs first;
Compliance questions/criteria: (Required)
Check the ro rials bvx Verification Method'": (Optional)
Does the system discharge sewage to the (Check the appropriate box)
round surface? ❑Yes No K.Searched for surface outlet
Does the system discharge sewage to drain y❑Yes N0 ® Performed hydraulic test
file or surface waters? Searched for 9in y seeping and
p
Does the system cause sewage backup ❑Yes No ❑ Checked for backup in home
into dwelling or establishment?
Do other situations exist that have the ❑Yes No ❑ Excessive ponding In soil system/D-boxes
potential to immediately and adversely ❑ Homeowner testimony
Impact or threaten public health or safety
electrical unsafe covers etc.)? ,(Examined for surging In tank
Any"yes"answer Indicates that the system Is an imminent ❑ 'Black soir above soil dispersal system
threat to public health and safety.
❑ System requires"emergency'pumping
Does the system pose a threat to ground ❑Yes No ❑ Performed dye test
water for any conditions deemed non- ❑ Other:
protective as determined b the ins ecto� -""---' ----
"Yes"indicates that the system is failing to protect
ground water. if"yes'; describe the condit/on noted: _..,,_. .. ..
'No standard protocol exists. This list is not exhaustive,
in sequential order, 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 Form for Existing Subsurface Sewage Treatment Systems. Observations, interpretations,and conclusions must be
completed by an inspector.Completed form must be submitted to the local unit of government within 15 days,
Property owner name(s);
Property address: -- ---- ---- - ..
IPA
Property owner' address(if dlfferent): - --
County: /j
Phone:
I hereby certify that l personalty made the observations,interpretations, and conclusions reported on this form and that They are
correct.
Name: Certification number:
Business license name and number: 1 - ^ -- •-
(gs or
Name of local unit of ernm ----
Signature:
Date:
wq-wwfsts4-3 f
411108 Compliance Inspection Form for Existing 55TS
05/09/2011 10:05 9528733112 PAGE 03/04
Parcel number:
System status:Pyy(t�cis
mpliant ❑Noncompliant
(as determined form)
Tank Integrity and Safety Compliance
Compliance Issue #2 of 4
Date of observation: a1) Reason for observation:
This form expires on(three years): —�-
Compliance questions/criteria: (Required)
Check thea ro rials�epogs`
Vertflcation Method'": (Optional)
Does the system consist of a (Check the appropriate box)
cess ool d II,or leachin ItP ❑YesNo X probed tank bottom
Do any sewage tanks)leak below their ❑Yes KNo ❑ Observed low liquid level
des" redo eratin de t? Examined construction records
It yes,identify which sewage Examined em )
tank leaks. PtY(pumped)tank
Any"yes"answer indlcafes that the sysfem is failing
ground water. to protect 13 Probed outside tank for"black soil"
❑ Pressure/vacuum check
Seepage pits meeting 7080.2550 may be compliant if allowed ❑ Other:
in ordinance by local permitting authority.
".No standard protocol exists, This list is not exhaustive,in
sequential Order,nor does it indicate which combinations
Safety Check are necessary to make this determination,
1. Are any maintenance hole covers damaged,cracked,or appeared to be structurally unsound? �!,
2. Were all maintenance hole covers replaced in a secured manner(e.g., all screws replaced)? ❑Yes' Ivo
resent(safety Yes [I No'
3, Was secondary access restraint
P ( fety pan,second cover,or safety netting)-highly recommended. ❑ Yes
No
4. Was any other safety/health issue present?
Explain: ❑Yes- Q�No
'System is an imminent threat to public health and safety. — f
Certification
This form is to be completed and attached to the Summary Form of the Minnesota Polluton Control Agency's(MPGA)Compliance
Inspection Form for Existing Subsurface Sewage Treatment Systems.Observations,interpretations, and conclusions must be
completed by an inspector, maintainer,or service provider. Completed form must be submitted to the local unit of government within
15 days.
Property owner name(s): (� l0
Property address:
Property owner's address(if different): �-- —
County: - _
Phone:
coI herebyrrect, certify that I personally made the observations, interpretations,and conclusions reported on this form and that they are
Name: t sWeb,
Certification number;
Business license name and number: Q goal
Name of local unit ofmart _ or
Signature:
Date:
wq-wwisrs4-3 f
411108 Compliance inspection form for Exisrino SSTS
05109,//2011 10:05 9528733112 PAGE 04104
,T 28-1011 OZ:IZpm From-CITY OF ORONO
+A511494616 T-687 P.00Z/002 F,701
3'7 10 In1c�- r-f o,,vh �cl
f
DO
Ill'
CITY of ORONO
Municipal Offices
Mailing Address:
Street Address: B
9kESI;pg 2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
To: The Current Owner of Address
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 V.
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 Tanks) p 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
—30-()( . The tank(s) should be cleaned through the manhole and
not through the inspection pipes,this allows for proper cleaning.
Comments:
Inspector:
Date of Inspection 10—0 S
Telephone(952)249-4600 • Fax(952)249-4616
www.ci.orono.mmus
O
O :* O
CITY of ORONO
;AW-
:*
�! Municipal Offices
Sheet Address: Mailing Address:
2750 Kelley Parkway P.O. Box 66
ESS
Orono, MN 55356 Crystal Bay, MN 55323-0066
To Current mer:
Address: 60
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 "CODE SYSTEM"An ISTS which meets all the location,design and construction standards of the current Orono Municipal Code.
"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 reason;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):
ZVnspection indicates:
unipout not needed at this time.
6 Septic tanks must be pumped o t this year (city code requires tanks to be pumped out once every 3 years.
Tank was last pumped � o"O � )
Make sure septic tanks are pumped through manhole and not through white inspection Pines. This allows for the
proper 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.
DRAINFMLD CONDITION(8-10):
8 Drainfield 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: Sl k=.� � 0 4- Ot
Date of Inspection Matt Boltenman- Septic System Inspector
Note: In the event that this impection report is used to satisfy the requirements for a mortgage or otter transfer ofproperty,be advised that this report does not guarantee
or certify that an existing system will continue to function properly,but is merely an opinion ofthe adequacy ofthe system under current conditions based on the available
information.
Telephone(952)2494600 • Fax(952)249-4616
www Lorono mn us
0 � T O
CITY of ORONO
A11 � . �►
4:11 nj ti Municipal Offices
Street Address:
Melling Address:
EggOg' 2150 Kelley Parkway P.O. Box 66
p (' Orono, MN 55356 Crystal Bay, MN 55323-0066
Owner: -G Address: 3766 \-_Ajtr}-p,,,,, M/
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 ofthe current Orono Municipal
Code but does meet the three foot separation requirement,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 reason;and
any ISTS with less than three feet of unsaturated soil or sand between the distribution device and the limiting soil characteristics.
TANK CONDITION(5-10):
Tank inspection indicates:
5 Pumpout not needed at this time.
Tank must be pumped out this year (city code requires tanks to be pumped out every 3 year:. Tank was last pumped q y
7 Solids accumulation in tanks is at a critical a critical level. Tanks should be pumped out as soon as possible.
8 System is discharging to the surface. Tanks must be pumped out within 48 hours to eliminate surface discharge.
9 Inspection risen missing-tanks could not be inspected. Inspection risers(4"din pipe)must be installed in each tank at next pumpout. If tanks
have not been pumped out within the last three years,they should be pumped out now.
10 Inspection pipe is located directly over tank baffle(does not give accurate measurement of solids accumulation). If tanks have not been pumped
out within the last three years,they should be pumped out now.
,2 LD CONDITION 11-14 : \\
11 Drainfield is dry,no surfacing evident
12 Some evidence of surfacing,not critical yet
13 Drainfield is saturated and visibly discharging untreated effluent to the surface. Contact the City Inupector immediately.Repairs must be
completed within 90 days.
14 Drainfield extent and condition unknown
COMMENTS: S`ES'89,^ �oo'f.� (3 _ �y•�Q �\Cs nt'.kt- S I�f�^�
Date of Inspection Septic System Yam 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 that an existing system will continue to function properly,but is merely an opinion of the adequacy of the system under current conditions based on the available
information.
CITY OF ORONO O O
Municipal Offices
Post Office Box 66
Crystal Bay, MN 55323-0066 ON—SITE SEWAGE TREATMENT
r� INSPECTION REPORT
ti
kEs110��G
Owner:CA-07�Y�l/'l.Q.� GZW1� Address: 376y �(.jc4�T�7Z'��1� C5-5' 352
Permit #'s: Dates: 1-G Contractors:
City ordinance number 100 requires that each on-site sewage treatment system in Orono be inspected on a regular basis.
The on-site sewage treatment system at the above address has been inspected and appears to fall into the category
checked below.
(This is Kan existing system [ ) new construction)
SYSTEM CONFORMITY (1-3):
1 "CODE SYSTEM"-A system which meets all the location, design, and construction standards of the current City
Codes, and which is operating satisfactorily by treating and disposing of the entire current sewage input
without discharging any pollutants into ground or surface waters.
2 "CONFORMING SYSTEM"-A system which does not meet all the location, design, and construction standards of the
current City Codes, but was installed according to the code in effect at the time of installation, and which
is operating satisfactorily by treating and disposing of the entire current sewage input without discharging
any pollutants into ground or surface waters.
3 "NON-CONFORMING SYSTEM"-A prohibited system; a system located within a designated 100-year floodplain; any
system which may or may not meet all the location, design, and construction standards of the current City
Codes and which is failing for any reason; and any system with Less than 3 feet of unsaturated soil or sand
between the distribution device and the Limiting soil characteristics.
(The limiting soil characteristichas or [ ) has not been identified at this time. If the limiting soil
characteristic has not been identifie , this classification may be subject to revision.)
TANK CONDITION (5-10):
- �tnspection indicates:
Y Pumpout not needed at this time.
6 Solids accumulation in tanks indicates they should be pumped out this year to help prevent future problems.
7 Solids accumulation in tanks is at a critical level. Tanks should be pumped out as soon as possible.
8 System is discharging to the surface. Tanks must be pumped out within 48 hours to eliminate surface discharge.
9 inspection risers missing-tanks could not be inspected. Inspection risers (4" dia. pipe) must be installed to each
tank at next pumpout. If tanks have not been pumped out within the Last three years, they should be pumped
out now.
10 Inspection pipe is located directly over tank baffle (does not give accurate measurement of solids accumulation).
If tanks have not been pumped out within the last three years, they should be pumped out now.
DRAINFIELD CONDITION (11-14):
at ield inspection indicates:
11 Drainfield is dry, no surfacing evident.
Some evidence of surfacing, not critical yet.
13 Drainfield is saturated and visibly discharging untreated effluent to the surface. Contact the City Inspector
immediately. Repairs must be completed within 90 days.
14 Drainfield extent and condition unknown.
LIMITING SITE FACTORS (slope.setbacks.etc.):
POTENTIAL FOR SYSTEM FAILURE (depends on soils,water table,etc.): rQ
COMMENTS:
Date of I spection eptic S stem 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 that an existing system will continue to function
properly, but is merely an opinion of the adequacy of the system under current conditions based on the available
information.
This report must be kept on the premises with the system location and pumping records.
WHITE COPY/Inspectors File YELLOW COPY/Homeowner
O O
a CITY of ORONO
Municipal Offices
Street Address: Mailing Address:
` EggOg' 2150 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
Owner: o ]{,2a►' i e- A . Ora Yk1 Address: 3760 Watertown Rd.
Permit #'s: 980 Dates: 7/6/88 Contractors: Jerry Johnson
(This is [� an existing system [ ] new construction'* .
YSTEM COMPLIANCE (1-3) : 1
Code System: Meets or exceeds current City standards in all respects relating to design,
construction, and location. Appears to be operating properly.
2 Compliant System: Does not meet all current City standards for new construction, but in
most respects appears to be designed, located, and constructed in accordance with previous
codes and is functioning properly.
3 Non-Compliant System: System may or may not meet current City standards for design,
construction, or location, but is failing to properly treat and dispose of the current
input; and any system with less than three feet of vertical separation between the bottom
of the drainfield and the saturated soil level.
(The saturated soil level [ L`�] has or [ ] has not been identified at this time. If the
saturated soil level has not been identified, this classification is subject to revision.)
TANK CONDITION (5-9) : 6
�
5 Pumpout not needed at this time.
C_°�� Solids accumulation in tanks indicates they should be pumped out this year.
7 System is discharging to the surface. Tanks must be pumped out within 48 hours.
8 Inspection risers missing-tanks could not be inspected. If tanks have not been pumped out
within three years, they should be pumped out and risers installed now.
9 Inspection pipe is located over tank baffle-can not measure solids accumulation. If tanks
have not been pumped out within three years, they should be pumped out now.
(During the last septic tank Maintenance Pumpout the tanks [ ] were or [ ] were not confirmed
to be watertight by the licensed pumping contractor. If the tanks were not confirmed to be
watertight, this classification is subject to revision.)
D INFIELD CONDITION (11-14) : 11
I.V Drainfield is dry, no surfacing evident.
12 Some evidence of surfacing, not critical yet. Repair is not required at this time.
13 Drainfield is saturated and visibly discharging untreated effluent to the surface.
Contact the City Inspector immediately. Repair must be completed within 90 days.
14 Drainfield extent and condition unknown.
POTENTIAL FOR SYSTEM FAILURE: (system age and condition, soils, etc.) : low
COMMENT'S:
G/io l5 �
Date of Inspection ept c System Inspector
Note: In the event that this inspection report is used to satisfy the requirements for a
transfer of property, this report does not guarantee that an existing system will continue to
function properly, but indicates the operation of the system under current conditions.
Telephone (612) 473-7357 • FAX 4734510
CITY OF ORONO O
Municipal Offices O O
Post Office Box 66
Crystal Bay, MN 55323-0066 ON—SITE SEWAGE TREATMENT
INSPECTION REPORT
ti
��9kEsHo4�G
Owner:' r,;bP_ C12�/)'1 Address:__,K7&
Permit Dates: :;�7 Contractors: LiYIkIZVY) /�AYyt/ .TanSBV�
City ordinance number 100 requires that each on-site sewage treatment system in Orono be inspected on a regular basis.
The on-site sewage treatment system at the above address has been inspected and appears to fall into the category
checked below.
(This is $4.an existing system I ) new construction)
SYSTEM CONFORMITY (1-3):
1 "CODE SYSTEM"-A system which meets all the location, design, and construction standards of the current City
Codes, and which is operating satisfactorily by treating and disposing of the entire current sewage input
without discharging any pollutants into ground or surface waters.
2 "CONFORMING SYSTEM"-A system which does not meet all the location, design, and construction standards of the
current City Codes, but was installed according to the code in effect at the time of installation, and which
is operating satisfactorily by treating and disposing of the entire current sewage input without discharging
any pollutants into ground or surface waters.
3 "NON-CONFORMING SYSTEM"-A prohibited system; a system located within a designated 100-year floodplain; any
system which may or may not meet all the location, design, and construction standards of the current City
Codes and which is failing for any reason; and any system with less than 3 feet of unsaturated soil or sand
between the distribution device and the limiting soil characteristics.
(The limiting soil characteristic fryer has or I I has not been identified at this time. If the limiting soil
characteristic has not been identified, this classification may be subject to revision.)
TANK CONDITION (5-
Tank inspection indicates:
5 Pumpout not needed at this time.
6 Solids accumulation in tanks indicates they should be pumped out this year to help prevent future problems.
7 Solids accumulation in tanks is at a critical level. Tanks should be pumped out as soon as possible.
8 System is discharging to the surface. Tanks must be pumped out within 48 hours to eliminate surface discharge.
9 Inspection risers missing-tanks could not be inspected. Inspection risers (4" dia. pipe) must be installed to each
tank at next pumpout. If tanks have not been pumped out within the last three years, they should be pumped
out now.
Inspection pipe is located directly over tank baffle (does not give accurate measurement of solids accumulation).
If tanks have not been pumped out within the last three years, they should be pooped out now.
DRAINFIELD CONDITION (11-14):
Dr field inspection indicates:
111Y Drainfield is dry, no surfacing evident.
Some evidence of surfacing, not critical yet.
13 Drainfield is saturated and visibly discharging untreated effluent to the surface. Contact the City Inspector
immediately. Repairs must be completed within 90 days.
14 Drainfield extent and condition unknown.
LIMITING SITE FACTORS (slope.setbacks.etc.):
POTENTIAL FOR SYSTEM FAILURE (depends on soils.water table.etc.):
COMMENTS:
17
Date of Inspection 66ptkc 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 that an existing system will continue to function
properly, but is merely an opinion of the adequacy of the system under current conditions based on the available
information.
This report must be kept on the premises with the system location and pumping records.
WHITE COPY/Inspectors File YELLOW COPY/Homeowner
On the North Shore of
Lake Minnetonka
ON-SITE SEWAGE TREATMENT CITY
INSPECTION REPORT OF POST OFFICE BOX 66
1335 S. Brown Rd.
ORON� Crystal Bay, MN 55323
Ilk 473-7357
OWNERADDRESS
PERMIT NO.'S. DATES 1-7-1(2E�b f CONTRACTORS
City Ordinance No.210 requires that each on-site sewage treatment system in Orono be inspected on a regular basis.The on site sewage
treatment system at the above address has been inspected and appears to fall into the category checked below.
(This is A an existing system ❑ new construction)
Meets or exceeds current City standards in all respects relating to design,construction,and location.Appears to be operating
properly.
2 Does not meet all current City standards for new construction (1978 Code) but in most respects appears to be designed,
located, and constructed generally in accordance with previous codes.System appears to be functioning properly;no major
upgrading of the system is required at this time.
3 Does not meet current City standards in many respects relating to design,construction,or location.Appears to be operating
adequately at this time,but has a relatively high potential for future problems. No major upgrading of system is required at
this time.
ED4 System may or may not meet current City standards for design,construction or location, but is failing to properly treat and
dispose of the current input,and is endangering a water supply,or is a source of pollution to surface or groundwaters,or is
creating a safety hazard,or is otherwise creating a public nuisance.Please contact the City Inspector to discuss system repair/
replacement procedures. If drainfield replacement is necessary,soil testing will usually be required,and a design and site plan
must be submitted for review.Your contractor must obtain a permit before work is started.
SYSTEM CONDITION.( m Checked items may require your action)
Tank' spection indicates: ❑ Inspection pipe is located directly over tank baffle.(Does not
Pumpout not needed at this time. give accurate measurement of solids accumulation.) If tanks
Solids accumulation in tanks indicates they should be pump- have not been pumped out within the last three years,they
ed out this year to help prevent future problems. should be pumped out now.
❑ Solids accumulation in tanks is at a critical level. Tanks Drai field inspection indicates:
should be pumped out as soon as possible. Drainfield is dry,no surfacing evident.
❑ System is discharging to surface. Tanks must be pumped It Some evidence of surfacing,not critical yet.
within 48 hours to eliminate surface discharge. ❑ Drainfield is saturated and visibly discharging untreated
❑ Inspection risers missing—tanks could not be inspected, effluent to the surface. This condition may require replace-
Inspection risers (4"dia. pipe)must be installed in each tank ment or additions to drainfield. Contact the City Inspector
at next pumpout. If tanks have not been pumped out within immediately.Repairs must be completed within 90 days.
the last three years,they should be pumped out now. ❑ Drainfield extent and condition unknown.
SITE CHARACTERISTICS:
Limiting Site Factors Potential for System Failure Site Capabilities for
❑ Slope (depends on soil types,water Future Expansion
❑ Soil table and system condition) ❑ Adequate
High water table �I&Low -Fair
❑ Lot size ❑Medium ❑Poor
❑ Lake,wetland,or stream ❑ High ❑ Inadequate
❑ Drainage ❑System is causing visible
surface discharge.
COMMENTS:
Date of Inspection Weptic 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 that an existing system will continue to function properly,but is merely an opinion of the adequacy
of the system under current conditions based on the available information.
This report must be kept on the premises with system location and pumping records.
WHITE COPY/Inspector's File GOLD COPY/Homeowner
CITY of ORONO
Municipal Offices
Street Address: Mailing Address:
9kES1rI0g :' 2150 Kelley Parkway P.O. Box 66
-- = Orono, MN 55356 Crystal Bay, MN 55323-0066
To: The Current Owner of Address -3-? r o CSA+-Cr+MJ'k-1
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 Tanks p 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
�? - 3(D-0 1 . The tank(s) should be cleaned through the manhole and
not through the inspection pipes, this allows for proper cleaning.
Comments:
InspecfotrCJ/ (? Date of Inspection o r b
Telephone(952)249-4600 • Fax(952)249-4616
www.ci.orono.mn.us
O
CITY of ORONO
a tiff
Municipal Offices
*yG Street Address: Mailing Address:
` EggO�" 2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
TO Current Omer: Address:
37S o
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):
( "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 reason;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):
Qinspection indicates:
Pumpout not needed at this time.
6 Septic tanks must be pumped out this year (city code requires tanks to be pumped out once every 3 years.
Tank was last pumped
Make sure septic tanks are pumped through manhole and not through white inspection pies This allows for the
proper cleaning. Keep water softner and iron filter discharge out of septic Wstem.
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.
PP
gA,MIELD CONDITION ti-10
Drainfield is dry,no surfacing evident.
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: r-14Vrj 60k5
(.vis- tC5 V � �"—d�•� �o�S w�l� t�� . .ti. �l� �d�1
10 -A L-6
Date of Inspection Matt Bolterman- Septic System Inspector
Note: In the event that this imps ction report is used to satisfy the requirements for a mortgage or other transfer of property,be advised that this report does sot gumantee
or oerti€y dnt w exisft syman will continue to function properly,but is merely an opinion ofthe adequacy of the system under current conditions based on the available
Telephone(952)2494600 • Fax(952)2494616
WW w ci orm"Mus
CITY of ORONO
Municipal Offices
l '�G Street Address: Mailing Address:
Off' 2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
Owner: ��� �afi z'CA Address: 3 7 V—"r Q w,\ �J
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):
0 "CODE SYSTEM" An ISTS which meets all the location,design and constriction standards ofthe current Orono Municipal Code.
2 "COMPLIANT SYSTEM" An ISTS which does not meet all the location,design and construction standards ofthe current Orono Municipal
Code but does meet the three foot separation requirement,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 ofthe current Orono Municipal Code and which is failing for any reason;and
any ISTS with less than three feet of unsaturated soil or sand between the distribution device and the limiting soil characteristics.
TANK CONDITION(5-10): 6
Tank inspection indicates:
/`5 Pumpout not needed at this time.
6 J Tank must be pumped out this year (city code requires tanks to be pumped out every 3 years. Tank was last pumped ).
7 / Solids accumulation in tanks is at a critical a critical level. Tanks should be pumped out as soon as possible.
8 System is discharging to the surface. Tanks must be pumped out within 48 hours to eliminate surface discharge.
9 Inspection risers missing-tanks could not be inspected. Inspection risers(4"dia.pipe)must be installed in each tank at next pumpout. If tanks
have not been pumped out within the last three years,they should be pumped out now.
10 Inspection pipe is located directly over tank baffle(does not give accurate measurement of solids accumulation). If tanks have not been pumped
out within the last three years,they should be pumped out now.
DRAINFIELD CONDITION 01-14 .: 1
11 Drainfleld is dry,no surfacing evident
12 Some evidence of surfacing,not critical yet
13 Drainf eld is saturated and visibly discharging untreated effluent to the surface. Contact the City Inspector immediately.Repairs must be
completed within 90 days.
14 Drainf eld extent and condition unknown
COMMENTS: S _(S fie-• 1 t,a�, C 0 f'v finks �e S �� Ne e�
S o>1 '��N -
Date of Inspection 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 that an existing system will continue to function properly,but is merely an opinion of the adequacy of the system under current conditions based on the available
information.
CITY OF ORONO 0
Municipal Offices O O
Post Office Box 66
Crystal Bay, MN 55323-0066 ON—SITE SEWAGE TREATMENT
r� INSPECTION REPORT
�9kksli
Owner: C. ,4 , C,z*. Address: J?ay Wcxi"U 1563cS7)
Permit #'s: Dates: 6 --2—F6 Contractors: "SWC-6t(toJ
City ordinance number 100 requires that each on-site sewage treatment system in Orono be inspected on a regular basis.
The on-site sewage treatment system at the above address has been inspected and appears to fall into the category
checked below.
(This isXan existing system [ I new construction)
SYSTEM CONFORMITY (1-3): 1
1 "CODE SYSTEM"-A system which meets all the location, design, and construction standards of the current City
Codes, and which is operating satisfactorily by treating and disposing of the entire current sewage input
without discharging any pollutants into ground or surface waters.
2 "CONFORMING SYSTEM11-A system which does not meet all the location, design, and construction standards of the
current City Codes, but was installed according to the code in effect at the time of installation, and which
is operating satisfactorily by treating and disposing of the entire current sewage input without discharging
any pollutants into ground or surface waters.
3 "NON-CONFORMING SYSTEM"-A prohibited system; a system Located within a designated 100-year floodplain; any
system which may or may not meet all the location, design, and construction standards of the current City
Codes and which is failing for any reason; and any system with less than 3 feet of unsaturated soil or sand
between the distribution device and the limiting soil characteristics.
(The limiting soil characteristic}- has or [ I has not been identified at this time. If the limiting soil
characteristic has not been identified, this classification may be subject to revision.)
TANK CONDITION (5-10):
nspection indicates:
5 umpout not needed at this time.
Solids accumulation in tanks indicates they should be pumped out this year to help prevent future problems.
7 Solids accumulation in tanks is at a critical level. Tanks should be pumped out as soon as possible.
8 System is discharging to the surface. Tanks must be pumped out within 48 hours to eliminate surface discharge.
9 Inspection risers missing-tanks could not be inspected. inspection risers (411 dia. pipe) must be installed in each
tank at next pumpout. If tanks have not been pumped out within the Last three years, they should be pumped
out now.
10 Inspection pipe is located directlyover tank baffle (does not give accurate measurement of solids accumulation).
If tanks have not been pumped out within the last three years, they should be pumped out now.
DRAINFIELD CONDITION (11-14):
P649-nNeLd inspection indicates:
�_:11,4rainfield is dry, no surfacing evident.
Some evidence of surfacing, not critical yet.
13 Drainfield is saturated and visibly discharging untreated effluent to the surface. Contact the City Inspector
immediately. Repairs must be completed within 90 days.
14 Drainfield extent and condition unknown.
LIMITING SITE FACTORS (slope.setbacks.etc.):
POTENTIAL FOR SYSTEM FAILURE (depends on soils.water table,etc.): vi
COMMENTS:
Date of Inspection 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 that an existing system will continue to function
properly, but is merely an opinion of the adequacy of the system under current conditions based on the available
information.
This report must be kept on the premises with the system location and pumping records.
WHITE COPY/Inspectors File YELLOW COPY/Homeowner
O O
,.N
T CITY of ORONO
N .
,O ( !S� Municipal Offices
9 ,a ¢ Street Address: Mailing Address:
2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323.0066
i
Owner Address:3780 Watertown Rd.
Permit #'s:8047 Dates:6/7/96 Contractors:Swedlund
(This is [ ] an existing system X new construction)
STEM COMPLIANCE (1-3) : 1
1 Code System: Meets or exceeds current City standards in all respects relating to
design, construction, and location. Appears to be operating properly.
2 Compliant System: Does not meet all current City standards for new construction,
but in most respects appears to be designed, located, and constructed in accordance
with previous codes and is functioning properly.
3 Non-Compliant System: System may or may not meet current City standards for design,
construction, or location, but is failing to properly treat and dispose of the
current input; and any system with less than three feet of vertical separation
between the bottom of the drainfield and the saturated soil level.
(The saturated soil level [ has or [ ] has not been identified at this time. If the
saturated soil level has not been identified, this classification is subject to revision.)
TANK CONDITION (5-9) : 5
5 Pumpout not needed at this time
Solids accumulation in tanks indicates they should be pumped out this year.
7 System is discharging to the surface. Tanks must be pumped out within 48 hours.
8 Inspection risers missing-tanks could not be inspected. If tanks have not been
pumped out within three years, they should be pumped out and risers installed now.
9 Inspection pipe is located over tank baffle-can not measure solids accumulation. If
tanks have not been pumped out within three years, they should be pumped out now.
(During the last septic tank Maintenance Pumpout the tanks A were or [ ] were not
confirmed to be watertight by the licensed pumping contractor. If the tanks were not
confirmed to be watertight, this classification is subject to revision.)
DRAINFIELD CONDITION (11-14) : 11
"'A Drainfield is dry, no surfacing evident.
2 Some evidence of surfacing, not critical yet. Repair is not required at this time.
13 Drainfield is saturated and visibly discharging untreated effluent to the surface.
Contact the City Inspector immediately. Repair must be completed within 90 days.
14 Drainfield extent and condition unknown.
POTENTIAL FOR SYSTEM FAILURE: (system acre and condition, soils, etc. ) : low
COMMENTS:
Date of Inspection Sept/(5 System Inspector
Note: In the event that this inspection report is used to satisfy the requirements for a
transfer of property, this report does not guarantee that an existing system will continue
to function properly, but indicates the operation of the system under current conditions.
Telephone (612) 473-7357 a FAX 473-0510
o o
V':
r ^y CITY of ORONO
En
r�
Municipal Offices
�' �G Street Address: Mailing Address:
9�ESII�g
. 2150 Kelley Parkway P.O. Box 66
/�
Orono, MN 55356 Crystal Bay, MN 55323-0066
Owner: OaL�ri'n � A . Address: 3780 Watertown Rd.
Permit Vs: X8047 Dates: 6/7/96 Contractors: 3wedlund
(This is [ ✓J an existing system [ J new construction) .
STEM COMPLIANCE (1-3) : 1
1 Code System: Meets or exceeds current City standards in all respects relating to design,
construction, and location. Appears to be operating properly.
2 Compliant System: Does not meet all current City standards for new construction, but in
most respects appears to be designed, located, and constructed in accordance with previous
codes and is functioning properly.
3 Non-Compliant System: System may or may not meet current City standards for design,
construction, or location, but is failing to properly treat and dispose of the current
input; and any system with less than three feet of vertical separation between the bottom
of the drainfield and the saturated soil level.
(The saturated soil level [lam] has or [ ] has not been identified at this time. If the
saturated soil level has not been identified, this classification is subject to revision.)
T K CONDITION (5-9) : 5
Pumpout not needed at this time.
6 Solids accumulation in tanks indicates they should be pumped out this year.
7 System is discharging to the surface. Tanks must be pumped out within 48 hours.
8 Inspection risers missing-tanks could not be inspected. If tanks have not been pumped out
within three years, they should be pumped out and risers installed now.
9 Inspection pipe is located over tank baffle-can not measure solids accumulation. If tanks
have not been pumped out within three years, they should be pumped out now.
(During the last septic tank Maintenance Pumpout the tanks [ ] were or [ ) were not confirmed
to be watertight by the licensed pumping contractor. If the tanks were not confirmed to be
watertight, this classification is subject to revision.)
D INFIELD CONDITION (11-14) : 11
Drainfield is dry, no surfacing evident.
12 Some evidence of surfacing, not critical yet. Repair is not required at this time.
13 Drainfield is saturated and visibly discharging untreated effluent to the surface.
Contact the City Inspector immediately. Repair must be completed within 90 days.
14 Drainfield extent and condition unknown.
POTENTIAL FOR SYSTEM FAILURE: (system age and condition soils etc.) : low
COMMENTS:
�40/9 7
Date of Inspection c System Inspecto
Note: In the event that this inspection report is used to satisfy the requirements for a
transfer of property, this report does not guarantee that an existing system will continue to
function properly, but indicates the operation of the system under current conditions.
Telephone (612) 473-7357 • FAX 473-0510
CITY OF ORONO O
Municipal Offices O O
Post Office Box 66
Crystal Bay, MN 55323-0066 ON—SITE SEWAGE TREATMENT
INSPECTION REPORT
ti
9kEs1;0
Owner: 4.,LQI � 1( Y h�- l , I.�YY\ Address:
Permit #Is: ft3hiQ . Dates: Contractors: 14 )./Y,,
City ordinance number 100 requires that each on-site sewage treatment system in Orono be inspected on a regular basis.
The on-site sewage treatment system at the above address has been inspected and appears to fall into the category
checked below.
(This is §�'an existing system ( ) new construction)
SYSTEM CONFORMITY 0-3):
1 "CODE SYSTEM"-A system which meets all the location, design, and construction standards of the current City
Codes, and which is operating satisfactorily by treating and disposing of the entire current sewage input
without discharging any pollutants into ground or surface waters.
2 "CONFORMING SYSTEM"-A system which does not meet all the Location, design, and construction standards of the
current City Codes, but was installed according to the code in effect at the time of installation, and which
is operating satisfactorily by treating and disposing of the entire current sewage input without discharging
any pollutants into ground or surface waters.
"NON-CONFORMING SYSTEM11-A prohibited system; a system Located within a designated 100-year floodplain; any
system which may or may not meet all the Location, design, and construction standards of the current City
Codes and which is failing for any reason; and any system with less than 3 feet of unsaturated soil or sand
between the distribution device and the Limiting soil characteristics.
(The limiting soil characteristic I ) has orhas not been identified at this time. If the limiting soil
characteristic has not been identified, this Asification may be subject to revision.)
TANK CONDITION (5-10): V
Tank inspection indicates:
5 Pumpout not needed at this time.
6 Solids accumulation in tanks indicates they should be pumped out this year to help prevent future problems.
7 Solids accumulation in tanks is at a critical level. 'tanks should be pumped out as soon as possible.
8 System is discharging to the surface. Tanks must be pumped out within 48 hours to eliminate surface discharge.
9 Inspection risers missing-tanks could not be inspected. Inspection risers (4" dia. pipe) must be installed in each
tank at next punpout. If tanks have not been pumped out within the Last three years, they should be pumped
out now.
10 Inspection pipe is located directly over tank baffle (does not give accurate measurement of solids accumulation).
If tanks have not been pumped out within the last three years, they should be pumped out now.
DRAINFIELD CONDITION (11-14):
Drainfield inspection indicates:
11 Drainfield is dry, no surfacing evident.
PSome evidence of surfacing, not critical yet.
1y�
Drainfield is saturated and visibly discharging untreated effluent to the surface. Contact the City Inspector
iRepairs must be completed within 90 days.
14 Drainfim d extent ana ion unKnown.
LIMITING SITE FACTORS (slope.setbacks.etc.):
POTENTIAL FOR SYSTEM FAILURE (depends on soils.water table.etc.):
COMMENTS:
Date of Inspection Sdl5t.Yc 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 that an existing system will continue to function
properly, but is merely an opinion of the adequacy of the system under current conditions based on the available
information.
This report must be kept on the premises with the system Location and pumping records.
WHITE COPY/Inspectors File YELLOW COPY/Homeowner
CITY OF ORONO O
Municipal Offices O O
Post Office Box 66
Crystal Bay, MN 55323-0066 ON–SITE SEWAGE TREATMENT
INSPECTION REPORT
ti
ti
9kEsHo4�
Z P.?Fn 14
Owner: bra � Address: Dp+ih--�.
Permit #'s: lazw_ —Dates: f Contractors:o2k2 +,/
City ordinance number 100 requires that each on-site sewage treatment system in Orono be inspected on a regular basis.
The on-site sewage treatment system at the above address has been inspected and appears to fall into the category
checked below.
(This is iL an existing system I ) new construction)
SYSTEM CONFORMITY 0-3):
1 "CODE SYSTEM"-A system which meets all the location, design, and construction standards of the current City
Codes, and which is operating satisfactorily by treating and disposing of the entire current sewage input
without discharging any pollutants into ground or surface waters.
2 "CONFORMING SYSTEM"-A system which does not meet all the location, design, and construction standards of the
current City Codes, but was installed according to the code in effect at the time of installation, and which
is operating satisfactorily by treating and disposing of the entire current sewage input without discharging
any pollutants into ground or surface waters.
3 "NON-CONFORMING SYSTEM"-A prohibited system; a system located within a designated 100-year floodplain; any
System which may or may not meet all the location, design, and construction standards of the current City
Codes and which is failing for any reason; and any system with less than 3 feet of unsaturated soil or sand
between the distribution device and the limiting soil characteristics.
(The limiting soil characteristic I I has orhas not been identified at this time. If the limiting soil
characteristic has not been identified, this c assification may be subject to revision.)
TANK CONDITION (5-10):
Tank inspection indicates:
5 Pumpout not needed at this time.
6 Solids accumulation in tanks indicates they should be pumped out this year to help prevent future problems.
7 Solids accumulation in tanks is at a critical level. 'tanks should be pumped out as soon as possible.
8 System is discharging to the surface. Tanks must be pumped out within 48 hours to eliminate surface discharge.
9 Inspection risers missing-tanks could not be inspected. Inspection risers (4" dia. pipe) must be installed to each
tank at next pumpout. If tanks have not been pumped out within the last three years, they should be pumped
out now.
49 Inspection pipe is located directly over tank baffle (does not give accurate measurement of solids accumulation).
If tanks have not been Pumped out within the last three years, they should be pumped out now.
DRAINFIELD CONDITION (11-14):
Drainfield inspection indicates:
11 Drainfield is dry, no surfacing evident.
Some evidence of surfacing, not critical yet.
1 Drainfield is saturated and visibly discharging untreated effluent to the surface. Contact the City Inspector
immediately. Repairs must be Leted within 20-days.
14 Drainfield extent dMtI t�rVWLIV" un nown.9mp
LIMITING SITE FACTORS (slope.setbacks.etc.):
POTENTIAL FOR SYSTEM FAILURE (depends on soils.water table.etc.):
COMMENTS:
Date of Inspection Siggyic 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 that an existing system will continue to function
properly, but is merely an opinion of the adequacy of the system under current conditions based on the available
information.
This report must be kept on the premises with the system location and pumping records.
WHITE COPY/Inspectors File YELLOW COPY/Homeowner
CITY OF ORONO 0
Municipal Offices O O
Post Office Box 66
Crystal Bay, MN 55323-0066 ON—SITE SEWAGE TREATMENT
INSPECTION REPORT
ti
��9kEsHo��G
Owner: e Aavejf)el Address:
Permit #'s: A70G Dates: Contractors:
City ordinance number 100 requires that each on-site sewage treatment system in Orono be inspected on a regular basis.
The on-site sewage treatment system at the above address has been inspected and appears to fall into the category
checked below.
(This is 0 an existing system l I new construction)
SYSTEM CONFORMITY (1-3):
1 "CODE SYSTEM"-A system which meets all the location, design, and construction standards of the current City
Codes, and which is operating satisfactorily by treating and disposing of the entire current sewage input
without discharging any pollutants into ground or surface waters.
2 "CONFORMING SYSTEM"-A system which does not meet all the location, design, and construction standards of the
current City Codes, but was installed according to the code in effect at the time of installation, and which
is operating satisfactorily by treating and disposing of the entire current sewage input without discharging
any pollutants into ground or surface waters.
3 "NON-CONFORMING SYSTEM"-A prohibited system; a system located within a designated 100-year floodplain; any
system which may or may not meet all the location, design, and construction standards of the current City
Codes and which is failing for any reason; and any system with less than 3 feet of unsaturated soil or sand
between the distribution device and the limiting soil characteristics.
(The limiting soil characteristic I ) has or/talssifias not been identified at this time. If the limiting soil
characteristic has not been identified, thiscation may be subject to revision.)
TANK CONDITION (5-10):
Tank inspection indicates:
4Pumpout not needed at this time.
Solids accumulation in tanks indicates they should be pumped out this year to help prevent future problems.
"`777 Solids accumulation in tanks is at a critical level. Tanks should be pumped out as soon as possible.
8 System is discharging to the surface. Tanks must be pumped out within 48 hours to eliminate surface discharge.
9 Inspection risers missing-tanks could not be inspected. Inspection risers (41, dia. pipe) must be installed in each
tank at next pumpout. If tanks have not been pumped out within the last three years, they should be pumped
out now.
10 Inspection pipe is located directly over tank baffle (does not give accurate measurement of solids accumulation).
If tanks have not been pumped out within the last three years, they should be pumped out now.
DRAINFIELD CONDITION (11-14):
Drainfield inspection indicates:
11 Drainfield is dry, no surfacing evident.
Some evidence of surfacing, not critical yet.
3 Drainfield is saturated and visibly discharging untreated effluent to the surface. Contact the City Inspector
immediately. Repairs must be completed within 90 days.
14 Drainfield extent and condition unknown.
LIMITING SITE FACTORS (slope.setbacks.etc.):
POTENTIAL FOR SYSTEM FAILURE (depends on soils,water table.etc.):
COMMENTS:
Date of Inspection Sept 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 that an existing system will continue to function
property i but is merely an opinion of the adequacy of the system under current conditions based on the available
information.
This report must be kept on the premises with the system location and pumping records.
WHITE COPY/Inspectors File YELLOW COPY/Homeowner
On the North Shore of
Lake Minnetonka
ON-SITE SEWAGE TREATMENT CITY
INSPECTION REPORT OF POST OFFICE BOX 66
_ONO 1335 S. Brown Rd.
Crystal Bay, MN 55323
473-7357
OWNER '--'� f� _A ADDRESS -X703
PERMIT NO.'S. DATES CONTRACTORS
City Ordinance No.210 requires that each on-site sewage treatment system in Orono be inspected on a regular basis.The onsite sewage
treatment syktem at the above address has been inspected and appears to fall into the category checked below.
(This is 0 an existing system ❑ new construction)
ElMeets or exceeds current City standards in all respects relating to design,construction,and location.Appears to be operating
properly.
E2 Does not meet all current City standards for new construction (1978 Code) but in most respects appears to be designed,
located, and constructed generally in accordance with previous codes.System appears to be functioning properly;no major
upgrading of the system is required at this time.
El3 Does not meet current City standards in many respects relating to design,construction,or location.Appears to be operating
adequately at this time, but has a relatively high potential for future problems. No major upgrading of system is required at
this time.
4 System may or may not meet current City standards for design,construction or location, but is failing to properly treat and
dispose of the current input,and is endangering a water supply,or is a source of pollution to surface or groundwaters,or is
creating a safety hazard,or is otherwise creating a public nuisance.Please contact the City Inspector to discuss system repair/
replacement procedures. If drainfield replacement is necessary,soil testing will usually be required,and a design and site plan
must be submitted for review.Your contractor must obtain a permit before work is started.
SYSTEM CONDITION.( m Checked items may require your action)
Tank'nspection indicates: ❑ Inspection pipe is located directly over tank baffle.(Does not
Pumpout not needed at this time. give accurate measurement of solids accumulation.) If tanks
❑ Solids accumulation in tanks indicates they should be pump- have not been pumped out within the last three years,they
ed out this year to help prevent future problems. should be pumped out now.
❑ Solids accumulation in tanks is at a critical level. Tanks Drair4leld inspection indicates:
should be pumped out as soon as possible. Drainfield is dry,no surfacing evident.
❑ System is discharging to surface. Tanks must be pumped ❑ Some evidence of surfacing,not critical yet.
within 48 hours to eliminate surface discharge. ❑ Drainfield is saturated and visibly discharging untreated
❑ Inspection risers missing—tanks could not be inspected, effluent to the surface. This condition may require replace-
Inspection risers (4"dia.pipe)must be installed in each tank ment or additions to drainfield. Contact the City Inspector
at next pumpout. If tanks have not been pumped out within immediately.Repairs must be completed within 90 days.
the last three years,they should be pumped out now. ❑ Drainfield extent and condition unknown.
SITE CHARACTERISTICS:
Limiting Site Factors Potential for System Failure Site Capabilities for
❑ Slope (depends on soil types,water Future Expansion
❑ Soil table,and system condition) q Adequate
❑ High water table ❑ Low Fair
❑ Lot size edium ❑Poor
❑ Lake,wetland,or stream ❑ High ❑ Inadequate
❑ Drainage ❑System is causing visible J
surface dischar e.
COMMENTS: �° as
Date of Inspection 86ptic 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 that an existing system will continue to function properly,but is merely an opinion of the adequacy
of the system under current conditions based on the available information.
This report must be kept on the premises with system location and pumping records.
WHITE COPY/Inspector's File GOLD COPY/Homeowner
On the North Shore of
Lake Minnetonka
ON-SITE SEWAGE TREATMENT CITY
INSPECTION REPORT OF POST OFFICE BOX 66
O_ONO 1335 S. Brown Rd.
Crystal Bay, MN 55323
473-7357
OWNER `�� ADDRESS 371Ta AIATEI-Td WW RD
Z
PERMIT NO.'S. r DATES CONTRACTORS
City Ordinance No. 210 requires that each on-site sewage treatment system in Orono be inspected on a regular basis.The onsite sewage
treatment system at the above dress has been inspected and appears to fall into the category checked below.
This
( is an existing system ❑ new construction)
1 Meets or exceeds current City standards in all respects relating to design,construction,and location.Appears to be operating
properly.
�7 2 Does not meet all current City standards for new construction (1978 Code) but in most respects appears to be designed,
IBJ located, and constructed generally in accordance with previous codes.System appears to be functioning properly; no major
upgrading of the system is required at this time.
F13 Does not meet current City standards in many respects relating to design, construction,or location.Appears to be operating
adequately at this time, but has a relatively high potential for future problems. No major upgrading of system is required at
this time.
4 System may or may not meet current City standards for design,construction or location, but is failing to properly treat and
dispose of the current input, and is endangering a water supply,or is a source of pollution to surface or groundwaters,or is
creating a safety hazard,or is otherwise creating a public nuisance.Please contact the City Inspector to discuss system repair/
replacement procedures. If drainfield replacement is necessary,soil testing will usually be required,and a design and site plan
must be submitted for review.Your contractor must obtain a permit before work is started.
SYSTEM CONDITION ( m Checked items may require your action)
nk inspection indicates: ❑ Inspection pipe is located directly over tank baffle.(Does not
Pumpout not needed at this time. give accurate measurement of solids accumulation.) If tanks
❑ Solids accumulation in tanks indicates they should be pump- have not been pumped out within the last three years, they
ed out this year to help prevent future problems. should be pumped out now.
❑ Solids accumulation in tanks is at a critical level. Tanks Drainfield inspection indicates:
should be pumped out as soon as possible. ❑ Drainfield is dry,no surfacing evident.
❑ System is discharging to surface. Tanks must be pumped ❑ Some evidence of surfacing,not critical yet.
within 48 hours to eliminate surface discharge. ❑ Drainfield is saturated and visibly discharging untreated
❑ Inspection risers missing—tanks could not be inspected, effluent to the surface. This condition may require replace-
Inspection risers (4" dia. pipe)must be installed in each tank ment or additions to drainfield. Contact the City Inspector
at next pumpout. If tanks have not been pumped out within immediately.Repairs must be completed within 90 days.
the last three years,they should be pumped out now. Drainfield extent and condition unknown.
SITE CHARACTERISTICS: pjgc5amr-b Xr
Limiting Site Factors Potential for System Failure Site Capabilities for
❑ Slope (depends on soil types,water future Expansion
❑ Soil table,and system condition) ❑ Adequate
\ ❑ High water table \ ❑ Low Fair
Lot size Medium ❑ Poor
❑ Lake,wetland,or stream ❑ High ❑ Inadequate
❑ Drainage ❑System is causing visible
surface discharge.
COMMENTS:
"l 0
Date of Inspection eptic 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 that an existing system will continue to function properly,but is merely an opinion of the adequacy
of the system under current conditions based on the available information.
This report must be kept on the premises with system location and pumping records.
WHITE COPY/Inspector's File GOLD COPY/Homeowner