HomeMy WebLinkAboutonsite sewage treatment systems . 1
1► CITY of ORONO
Municipal Offices
A
Street Address. Mailing Address.
2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
To: The Current Owner of Address 3$-570 w -CrIOCIJN
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 H lth 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 Tan>prlup 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
-5- ,A5-f-6The tank(s) should be cleaned through the manhole and
not through the inspection pipes,this allows for proper cleaning.
Comments:
Inspector: )ZI r,;f/ Date of Inspection to r d
Telephone(952)249-4600 • Fax(952)249-4616
www.ci.orono.mn.us
1.0�
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CITY of ORONO
r G,�14 Municipal Offices
�y Street Address: Mailing Address:
' EgHO�' 2150 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
To Curr W Owner: Address: 325'0
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.
STEM 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 ortwofoot 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): 5
Tank inspection indicates:
(a 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 TAW-O-L ).
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 syatem.
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.
DILAINFIELD CONDITION(8-10):
8 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:
Date of Inspection Matt Bolterman- Septic System Inspector
Note: In the event that"impoction 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 dut n eaaftsysioni will continue to function properly,but is merely an opinion ofthe adequacy ofthe system under current conditions based on die available
Telephone(952)2494600 • Fax(952)2494616
www.ci.oronomnus
0
0 0
_ CITY of ORONO
Municipal Offices
Street Address: Mailing Address:
EggO�' 2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
Owner: St-,,j Address: 'IcVSb �'`ryk� o.��. 0
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.
SX�TEM CONFORMITY (1-3): 1
1 ODE 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,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):
Tank inspection indicates:
5 Puinpout not needed at this time.
<J C/
Tank must be pumped out this year (city code requires tanks to be pumped out every 3 years. Tank was last pumped b `h—c�_7 1,
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(11-14): ,1
lm"freld 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 Draintield extent and condition unknown.
COMMENTS: s -15 re 0�,
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 O 0
Municipal Offices
Post Office Box 66
Crystal Bay, MN 55323-0066 ON–SITE SEWAGE TREATMENT
r� INSPECTION REPORT
tslio
Owner: SyeV- /-&P;t S Address: 3850 i4d,44&� �I,)di Rel ( SS35�)
Permit #'s: L//9 Dates: —T Contractors:__[ ` tRS
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. I /
(This is p�1 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 X has or [ I has not been identified at this time. If the limiting soil
characteristic has not been ident fie , this classification may be subject to revision.)
TANK CONDITION (5-10):
�nspection indicates:
Pumpout 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 (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):
teLd inspection indicates:
rainfield is dry, no surfacing evident.
2 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.): too
o
COMMENTS:
Date of Inspection Septi6 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
Rr Municipal Offices
Street Address: Mailing Address:
2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
Owner: Address: 3850 Watertown Rd.
Permit #'s:_ 1419 Dates: 1119188 Contractors: Hayes Exc.
(This is [ b-]/an existing system [ ] new construction) .
SYSTEM 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 [ [/] 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.
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.)
DRAINFIELD CONDITION (11-14) : 11
1 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:
�A6
Date of Inspection Se 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 a FAX 473-0510
CITY OF ORONO O O
Municipal Offices
Post Office Box 66
Crystal Bay, MN 55323-0066 ON—SITE SEWAGE TREATMENT
r� INSPECTION REPORT
9kESH0
Owner: ` C.V� !�Yri� Address: �d ` aii�
Permit ,#'s: Dates: Contractors: /?Dl✓P.S CxC.
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 ,J*an 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 characteristic, has or [ ) 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):
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.
0 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):
D field 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.):
COMMENTS:+ Lie, -bzakc /.;E-� a —Z4&-f.
Date of Inspection tic Sy tem 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
W71-.qw
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 tyi ADDRESS
PERMIT NO.'S. fin 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 address 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.
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.
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 inspection indicates: 19 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 oLlt within the last three
ed out this year to help prevent future problems. should um
❑ Solids accumulation in tanks is at a critical level. Tanks Drai ie 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) Adequate
CRIf High water table Low &Fair
❑ Lot size Medium ❑Poor
❑ Lake,wetland,or stream ❑ High ❑ Inadequate
❑ Drainage ❑System is causing visible
surface discharge.
COMMENTS:
Date of Inspection leptic 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
M
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No 1307 2/9
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' } Ste4A . e �lti Cert.
.. B 'Schirm""� • ' i�C� No 627
P�(?r,g('lcl�ut'matl�n 1+E Y� _.Y.:.... � _....._._._.
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3850 Watertown R v t
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-- #anks, 1
. i'
on W . tng_� afnber&a pressurized ound system Witift 1� ��'�r��rrcck�ed��g
f t`#fir a o0 on e. -§oil boring #1 found mottled (redox features . it. .7, eiow the
a ; )
R r� u #3 original soil at elev.94.6 &the bottom of the
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t t11rt127 -
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below the ground surface. Soil boring found the original soi at
bottom of the rock,bed at elev.95.9 leaving 1.4' of sand below the ro `'�1
fseparation from th ;bottom of the rock bed &-redox features. This system'mee t e`3 -
spearation,auing-15% reduction & is classified as in compliance with Minnesota
terra arri:►
M. gR ped by Elmer J. Peterson Co. & were found to be compliant at this
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Urn nesota Pollution ¢ Compliance Inspection Form
.. Contrq�wA-gen --
,��._. Existing SubI fte v SewaWe-j MMM System-
520 Lafayette Road North (SrSTS)
U Paul,MN 55155-4194 1j
Doc Type:Compliance and Entoroement
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d,M .4diAnect6rPropi
1, �JMIn:PU 11C It ompliak component#1 of5.._..., �.
op.JIV.044. {AtPC ou i I er•: N,_ r. '.nu 1'oW ib tiiiMi"HCn,.
Cpm I n lon meth"
Syste fdl�ch aNilthe ❑Yee, No Searched for surface otitl
rotan�sulrj POP 1 S Searched for seeping In yanilbadcup In home N�
dit 114i.46"dtq" rairill. ❑Yell ®NO�` � 4 ,..?,�. ppese v9 p9q,41... A l syMem(Q-boxes W
❑ Homeowner testimo See Commw tft
or surface waters . �Y( pmnaMon)
og;i 4 Ar It r tl r ® Black soar ebwe sdi dispersal system 140
ceuse-sewage' intof' "4
❑Yes No __._ _
tiiirellirlf' ll�fi'r`frttn)b r _ ._ ,:
System requires'emergetrcyr pumping
,� ❑ Pterfotmed dye teal r,
the s fe►ir fs .. _-.._ . _- !� �-Unatrte iQ verify(S'+m Co►nrrrent�rpierFation)
tw�ilich and Salhbr,
(See Commenta ftlanatlon)
d li M1lc 1�6 P + 7
Flops ocr _ �,+ ,I J ''� Il sFls c�or Initiawop'ie
`I: _ _- 1i*1 of 6ferI ication method(i)c... ._ .
System consists of seepage pit. [:]Yes ❑No ~�=Probedtank(s)bottom
P1t- r _ am6d Ch i records.:
rn4eg 6Qtnsyb .. ;Yes IN No F�$r iied`f"ah16% ! 1)
1h iba" Inenoe. �x�fl , Spiro n a 11 iio a �
ys ode
Rhin to I IMARIDJ
P
de ��tsx rreratPon
,� ta4utsi + �lflerr} .if.
LdemurgAw
Or f: D *8W to
r; '4 )
_
all i 119- rifietho"hWilsted°(See 0 mraenw**wtion)
R1A er,►r� r? Urahle rfl (Soca Co nrrrantsl�dsp(tar;aGnR
)►lung t" t;ta.: ;ubfi't; ea" 4 ZFy Ot)4, [; ;Jthe� .. Al�riot listed(<;ea�strlmsntslExpianallot
3. ®ther Com #ance CQn ns—Cvmp 4nee component#3 of 5
rtilEN� r' LIQ Sto Khrally JJow nd bid M l Intrnrnxfft_
p trEc. b Immediately and adversely knP"iR wkt h qtl );❑Yes' 0 No ❑Unkntnvn
an
/Mm reatrtn paW/c. tend
��nttsib ai a �e* ago pit, a' Yea �_.I R. '
Systt
nor le"' .!�l13�pik
i;,. �`1; C- amir. jast ttcdi'A records
Seepage pts Mtleettn; bei t-aam►nt !''";ink'.dtegYlt�*orm(Agoc;h)
'":� alcwved rn P��ral rrn�lnanr�7 :a
_ } }bs,JVk Jld It�vei Meow aper Ing depth
,e iW. U bfgroutxl waterft otheiO&WItIons asdefel"Oilp
)fXp ►,s�w ;le�t�nK(go1 �artaer . de et# ,,"•fes
chic ".�IB,;,�,C:a
�- ❑ y �11x1d711�AtiJ�'K��ilE7'Sttt}l3)
Any*Yes an.wl►e a 6lt'0ve t ► ic.0 the.
w6gem is Falffo9 fGj RT`atructGrin,i►4tt,Fs`: id: Ej '(her rr}c;. .Os arra 11st rd'(See Comments'F.So)snatosb i
` I
�`cr:zrmentivDpiarEatto►+. . .._ �: •� :�,:,,9
11
`!�PaYf�� .z� ,. .' •�' c�:t.4'�h?er� _ No. 1303. P.
{. X5/9
Prop i{y`a�d :, y 3 d -Its aJ;J - Inspect"'or initials to
rvH .i ;5ia,e,mr .us asI•�9t.,Fa:w:,7 a.>T ;d.. i ::5'� L82 f: :i 7 ';i...i �vei6i,t�in:attp,na'"fwx�rrttf;s
41-gS t Sdoardtf6h-complianc#component#4 of 5
G U. rtvnm vii:' ti
�h Vorifca on mtaNta.d`s.);m
in, pWWanicV / IhiMilt WFeod' rage '�` NO r 9 x tic
:� gin , FIs; ,k,;• :u ,. ,H,,t�,i,�. � ., :� Of/,observa8ondo�s RXpFM'�f�"r, r � s
4 observadone by tw i pa ares ,
bm Ilance criteria' unless site aondfions have been abred or local
r .. .
Pr Vnofi�ity iis' i'�or to 1, ,and -N-Yes- 0 No- .. . requirements dHXer,
PI Conducted sou obsen►ation(s)(Afbacb being loge)
Protecftn Area or,hd'aeift a wn�i(4 3•o 0 Two previous verifications(Aped,boring bp)w,
Pte,belre�d�ffrfbl�`6�l�/t�nt:- -- _. 3 G _. __._�._.....,....._ .__ ..__
- .. ., a Not appiicaitle(How+en►Ks),no dralrrfie/d)
Cc''� infidd'�tnasleest er4N+o�ooE IEeI clo�S, "��
separallQ�distpoee from periodical
is d Unable to verify(See CammenfalEicplerieBai) __
L.hq tilrB eli t1'DS df0t' Y rrreu t1 n; „3 nu O Other:(See Go►mnerNalEnplanadon) F►,a, 3.E'.
Non-performance sysbems,buON 1, ❑Yes ❑No CounnentSExplanAW.
Pr
1,100 do
r.xAP*W4QD "Oka ,j &a
beiiera ,or lodgdng blishmegf :_. 0.
Prop.g
as a th v '�"?L Inspv,.Ior initiaiis/Date:
_.
_..
,eaturaited soil or,bedrock.`-
4 r.:. L
•t*i"dMentar°, °Other",or ' ; ce=vM 0 YesW ON Indicate de of elevation$
IV Q U�rix u,Yrn �ie7iF�1 7tf°; t , 3 91�•p 1,41 S�►S+aee.
A. Bottom of distnbi fion I A�p
� � piedra SKr y 9 •O .l..
' 80.F4O d l dor Q Ye!s .;rail vx.'4irrr: r I.;aes no qxp re. A f a
�;, cense required) ' r "fr lent
am
Rance c a' '
:. Mee= —
ti6n i r
3 1
t 1D iu3A 1i I Fr::: ®Yet N S a - C"),
r g ti3(Ip r�rfl6iell+;o t I Condl-jct Sol observation(s,( acl't[,� tags)
ReqUired a se
p@Qrfi CBtAS w,, ,� utul�t ?4ty Local
f
-J lr�iVik
%. .'erity(See Ccmtirerrls/Faplanstiprl)
seperr,tlon distance Pram pen iceii j
L a
Other( Cvfnmentaeplanaflon)
5.l n BjMR�— tpNaAse component#5 of 5 ®Not applicable
arr-pe ►mance s s ems ur r : es ^vc� tr; rre � . �._;r on'
Iq s yq� a
'ng Pe Yes ❑No I�`'y ;osu, �e�ow ie required
I �i�t f iiltr l ns P? ❑Yes No If"yes",B below Is required
n310 o;r re®.�c ise,vin a tend .
be�BlDfbtEte►s s) fed the system design
rrcs Wd h w''�Wdie "no , section does not neW to be comploAW,
p�ratldn�Jistancefrom�rfodicet - -=- --_
"Exp Me aT' `G Pe r� ncr en ' rli? ! In" y �$ of eDeyatlons
--.. • w
,4K VI d 1iu in ? !� flat +•an meadia • ., CIO
.;, of I ( vancetl rl (1?C).
,�t�� trer indicates once Ilance.
�. �'e�irvl�c,- sYj i'ed 9aitiliadrw.:ic '.fie �.� J 't I
f3rainYrew meem die d"1 rata vaitl 1 1 s •'" 3,!
$ C. u n IrL r . i
__xT _ _ s a,
r ti ' d` •
riceft - I E�; VL:� —
•.
15.65)Alrjoq kwt throat to puW(mIM and sahq►(IT1�IS)mustGo ,rep/amsd,pr Its use
o Ihls portae or,wlMln a slater iE�udrifd # Is ruing
oto prefect
eAK
rpareBortiNliirernr omr
mss>~ TINs pb illCllbea rrot apply to systems M sbox*ne areae,
fiV Prat ion Arae o fhpse ln wff mflon with Wd,bsveretge,.wd/odging asmbl'Win eftas"dellrietlln le w.
sic tplierible
-0/1N-�i7^NM.•.......T`-.^ MF1FrY'h''!M'fMq`#/SRR'
n lNan. H. 201 3;41 PMl'ei.erson o. ti a 763-972-7217No, 1307 P. 6/9
r `
Parcel number. System status: SConnplient ❑Noncompliant
(as determined by this folrn)
6
Tarok Irate "ty and Safety Compliance— Compliance Inspection Form for Existing SSTS
Compliance Issue #2 of
Date of ob�56rvll�idh. 1I1$Itt ' Resot�for obsetvstioH': ' °Pant of Sale t' IJ ' i E r;
.6
This form mpo4vn.Mrrp,yyjrp } 11.'6116.
Compliance questions/criteria."(R quired) Verification Method":(Optional)
• Check file Awmidate box (Check the apprvpdate box)
Doesthe s consist a•seepage []Yes IN o ❑ Probed tank bottom
cesspool,d I or leach it?
Observed low liquid level
Do any sewage k(s�yte ittaf low1hairi ❑Yes'"1 o < 11, r l< :11'7 a t,), rii,r. i N 1'Y"tt1:4
desi ned er+ de th [T.Examined construction records
t �pt' 1 ,
�° ear; i�Ires,,Jdentdyr,rrbich, i Paterson o. ® Examin } d to
s wa�e'tank j
Any"yes".nawerfindtoates that the s is ftway to rotes! Probed outside tank for" (ask ail"
g P ElPressurelvecuum check
.�, ground water.
Seepage p14s meeting 7080.2550 may be compliant if allowed
0 Other
in ori arca by local permitting authorty.
PHR: TI�fT1D�r
-- -_� fa"j LAOpOardprokcclRXO#. This fist is not exhaustive,in
sequential order,'nor does it ind/cete Which combinations
are rrecassary to make(his defenrlhin ion,
lllllwlc.#t ty and Safaty *t,, '.ancra — lnsfle °if:.' 'cr&lsting SSTS
22L.o rl trz)t�kgl ,9 s4am d,cracked,or eppeered b be siructually unsound? ❑Yes" ®No
DeteWp��,main�once}��p ��.ppvers rept in.a s��red manner(e g. rrws )? ®Yes ❑No*
OT OpSE'Nfi`Fj�:il: TAT7�T�S 3.�85ol! :C1 741:.it.' a�r:.lrl•
-- —
�Itles seconder y q rest Int pr )rit.(sa[ety pan,second cover,or safety netyng)-highly recomms 6d—, Yes No
his urm Qxplre n i re years
4. Are otlier sefetylhealth issue presen _ es W ho
Go � e ; ae+wt�aris e�ritem7: (F Eru,r,. VH�iii;.atitir: ths,;f•'; (Opticnal)
_ C�T"-N t ,a {Cha..is:ra Sox)
s an mm nen t rearto '551 �hea� as cry.
Does . , to n con,st nta seepape p �s r l�.
cesseco, drrrwelly of i aching it? _
[moi Cl w,�r: yr tiaaUid� level�I! Q�nk(si it-;rk}x)alEs�r It;rair �: . :s !!�NO ,ctw. r%
PCA)1 r a u` '
ars A n r c Rs ln�PCA)Compliance
d t the Sun�trs�dorm of the Minn o o ui,on ar gen s
R i"in for Exlsttng•, u,_ a Sewage Treatment Systems-Q�dnratidns,u�ter�(a drtbaWicluslons must be
6fi # �arl. speclor, mein 'mer; `service provider.Completed form be submied to fi o pn' of pvernmenbvrithin
15i1§`•ermwer Inc6c,.0as that the sy wn e: ,..: j'f1ji?to jrf'UjL� �1 r E3s 3cF,Jm ct)�ic
g unc Ovate).
Property owner name(s): Steven Her-
Ej
�i�i��8i'6se"e�BlliD?'�1e�+tblD -l�lapid F�ili,�ihl �59 __
or;finanre-b; r 16t73 pmrmfrong'000,01ty.
Pr9 `arty owner's address-(IF dltfnrwc:
County: Hennepin Property owner ph erG12.64t1-2Z6fte:it inelcete onco
drF rtt"Gf i.'5ti :G :"'Jife Wis detneq4,w(1 o!7•
i personally made the observations,�"taffons,and ponclusions reported on this lcm►and,that they are
caa,,A,.re
` .
rnaLnfen-ance Ijole uvr'�,dar 1 d c;:✓ or^pP E� : ne�-trucsue�i,y �n,o1a, [�Yez" �; No
aer„Ja. es Brae (mann CertlNcpor�jnumber.-
are
uEur uy5' ec �{� �Spr mer J.Petesbn Co- Lice-, rase#11 - . -q;Q
mer .
r .
Va��rr�oMI,, e
Fa enrt.
Date; 1/1611
' a 4r n, a r.•
�� -M 1.TTY 651-26Z-5332 or SOa657-38b4 Available in alternative formats
lscs4,31 4124109
_ Pose 3 of 8
r —64 AL •.+,a.... r
Jan 18 J a n p�+ i6a y/z-/z1
, .Q: 201 3: '3:41`ftgfr' n,�,o. , , ti)Y�� .;
'No. 1307 P. -1/9
'Wank Report
Date: January 16, 2013
N, 11
FiNst
''��� •Elm tryJ. Pet�ih�an` `o': :>.�� ° .., . '.P- �a
5921 Dague Ave.
Dela►r p, n 5 P. 101
Fax ^631-979,.7217
MP ,Lce# 91�`
nn rr,11 n x,` 71 1107 ^ //1
Steve Hams
3850 Watertown Road 1'
Maple Plain, MN 55359!
Baffles: ON / OFF
3-1250 Gallon Tanks Per City Records
Tank Capacitv: 6, 70 13
s # of Tanks: 13 _. •....—.._ .�--._
•pp f [= arnnn- Concrete
2500
7133--972-2120
al . t�C YES N
+e yp
k, ✓ ;.,-
�r�l� cens
e# 20
Comments
Sieve Ha,rns
385014-Arertown Roan
r J. Peterson o. uncovered manholes(1"t—7 Inches Deep, 2nd—30 Inches
Deep; Lift Station —12 Inches Deep) and pumped tanks. No cracks or water leaks a1 that time. Concrete
pad for pool plumbing is p�rdally over first manhole.
E3ff1 OFF
. I
'Tar7lc ��", acity:
3-1 1 Tt T€ t1.: f oc:SS
NOTE:'Y' is only a report:' is iiof a coinp�li�nceinspection#'or pomp of sale nor does
} rgpl ance inspection,
p V-1e -)'"To-aks- D41ryvii :_' ;0-nr(Lizense #
i .
ifs ilydil.S .f�li r 25P(�
iy/I:''Y11C ie.E: t!l �iYaCIY �( \? .r
Jan. 22. 013 3:41 PMI No. 1307, P. 8/9
P TES TING., INC. Steven B. Schirmers - MPCA Cert.No. 627
951 Katydid 'ane NE - St. Michael, MN 55376 - (763) 497-3566
FAX (763) 497-5011
Site License#394
Stev Harris';
385 Watertown Rd.
Oror o, Mn
Bori gs completed on 1-14-13, with a hand bucket auger.
"NG NU h iB 81-Elev.96.0 - MOTTLED SOIL AT32", 20" into the original soil no standing
water present in boring.
`- 1t' I `loam! " ` - s
1'2" 6 roar`oihdark
9 15 6cotLvh Ioatn:
26" - 32" Gray brown loam 10YR 5/3
32" - 40" Brown clay loam 10YR 5/3 -distinct mottles 10YR 7/1, 10YR 6/$g� . 4,,, N'
BORING NI I B - Elev.95.4 dTTLEO0 " ► `26", 16" into the original soil - no standing
:rent in the boring.
3850 4f'v,-,A ,Iowa Rd.
;11o" Fill soil clay loam
6" - 10" Fill medium sand
10" - 16" Original soil dark brown loam 10YR 3/3
lringc -, m lF � � IQam jqy, S/3� i:c;:c;k��* ajt,;:�, .
26' -` 38 Brown clay loam 10YR 5/3 -distinct mottles 10YR 7/1, 10YR 6/8
1'1101
... lev.97.6 -t rough the mound.6 •. C1�gig")czl-�.'o jl a•r n� � rp .,19
`i"-" " '
F + s
L: II
UAL:�, ..,.gums nl ►n
dark b' , loam 10YR 3/3
32' - 40" Brown la _� ;� /R �;` f I�� �isti�„ rr'ir: ... ,, 7/,, 1 CYR 5/8 461
BORING NUMB Elev.97,0 -through the mound)
_>.. �. , ti, �. ,.he or}gia;al suif �� s ar�ding
$1 ,ten PDX';,
Fi
ll Ott i�
F I soil medium san
3f'� dao �Idark,b wn loam 10YR 3/3
6 - 11 Fill me;.jiu
10" _ 16or Origin "F sr 1 rciwr} F)3, h ' 1J 'R 31:3
� Browr l :R
, `�
26" 811 Rrc-jwr� f
4
S
tom -T-Oce�L-- '`_-'_t -�� �- � ���;.yZ_�-..__' � `l._-_ 'Qt9�.'*dG�L to,o j,4" X",s W w
' ,-- v 14
- ---- -
J . .; = — ✓r+ 1,. ^,'V �Lb I _-t S s: ��`a ®�. L V I i*o I'LL,
lho�►�+p
' S`SSSIpw�
Ti. -
- 6a V
Y.I (
i
Bai&. Mak
r S
1�a �� _ e: This s�slem is b be mnstcucied to mer!
Chapter 7080 & Local Ordinance
;A p •i_ ��, `' r ,;, . -. ;_i1 it es
It �y,� - Check all underground Atilities
SRN OF3
om
S-P TEST/NG!NG
—3566
"� :_ ._e _lt:+_._ . : -�.; :06• Oc�5e=1/IWIS PH763-497