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Home My WebLink About11-05-2019 Septic Compliance Inspection Form Minnesota Pollution Control Agency Compliance Inspection Form 520 Lafayette Road North Existing Subsurface Sewage Treatment Systems St.Paul,MN 55155-4194 (SSTS) Doc Type:Compliance and Enforcement Instructions: Inspection results based on Minnesota Pollution Control Agency(MPCA) I For local tracking purposes: requirements and attached forms—additional local requirements may also apply. Submit completed form to Local Unit of Government(LUG)and system owner within 15 days System Status System status on date(mm/dd/yyyy): 1115/2019 ® Compliant—Certificate of Compliance ❑ Noncompliant— Notice of Noncompliance (Valid for 3 years from report date, unless shorter time (See Upgrade Requirements on page 3) frame outlined in Local Ordinance.) Reason(s)for noncompliance(check all applicable) ❑ Impact on Public Health (Compliance Component #1)—Imminent threat to public health and safety 0 Other Compliance Conditions(Compliance Component#3)—Imminent threat to public health and safety 0 Tank Integrity(Compliance Component #2)—Failing to protect groundwater ❑Other Compliance Conditions(Compliance Component#3)—Failing to protect groundwater ❑Soil Separation(Compliance Component #4)—Failing to protect groundwater ❑Operating permitimonitoring plan requirements(Compliance Component #5)—Noncompliant Property Information Parcel ID#or Sec/Twp/Range: 3211823240006 Property address: 350 Stubbs Bay Road N.,Orono, MN Reason for inspection: Property Transfer Property owner: Chris Bollis Owner's phone: 612-296-4011 or Owner's representative: Representative phone: Local regulatory authority: City of Orono Regulatory authority phone: 952-249-4600 Brief system description: 2-1000 gallon septic tanks,1-1000 gallon lift station and 500 square feet of mound rockbed. Comments or recommendations: TBM:Top of the lift station manhole cover Elv.-100.0 1.0 feet of sand under the rock bed. Certification I hereby certify that all the necessary information has been gathered to determine the compliance status of this system. No determination of future system performance has been nor can be made due to unknown conditions during system construction, possible abuse of the system,inadequate maintenance, or future water usage. Inspector name: Joseph J Olson Certification number: 1255 Business name: Rusty Olson's Soil&Perc.Testing _ License number: 810 Inspector signature: — ----_ .__ Phone number: 763-498-8779 Necessary or Locally Required Attachments ®Soil boring logs ®System/As-built drawing 0 Forms per local ordinance 0 Other information(list): www.pca.state.mn.us • 651-296-6300 • 800-657-3864 • TTY 651-282-5332 or 800-657-3864 • Available in alternative formats wq-wwists4-31 • 1/24/12 Page 1 of 3 Property address: 350 Stubbs Bay Road N., Orono,MN Inspector initials/Date: J.0. 11/05/19 1. Impact on Public Health —Compliance component#1 of 5 Compliance criteria: Verification method(s): System discharge sewage to the ❑Yes ® No ® Searched for surface outlet ground surface. ® Searched for seeping in yard/backup in home System discharge sewage to drain tile 0 Yes ® No ❑ Excessive ponding in soil system/D-boxes or surface waters. 0 Homeowner testimony(See Comments/Explanation) 0 "Black soil"above soil dispersal system System cause sewage backup into , ❑Yes ®No 0 System requires"emergency"pumping dwelling or establishment. 0 Performed dye test Any"yes"answer above indicates the system is ❑ Unable to verify(See Comments/Explanation) an Imminent Threat to Public Health and Safety. ❑ Other methods not listed(See Comments/Explanation) Comments/Explanation: 2. Tank Integrity—Compliance component#2 of 5 Compliance criteria: Verification method(s): System consists of a seepage pit, 0 Yes ®No ❑ Probed tank(s)bottom cesspool,drywell,or leaching pit. ® Examined construction records Seepage pits meeting 7080.2550 may be 0 Examined Tank Integrity Form(Attach) compliant if allowed in local ordinance. Observed liquid level below operating depth Sewage tank(s)leak below their 0 Yes el No designed operating depth. ❑ Examined empty(pumped)tanks(s) If yes,which sewage tank(s)leaks: 0 Probed outside tank(s)for"black soil" 0 Unable to verify(See Comments/Explanation) Any"yes"answer above indicates the system is Failing to Protect Groundwater. ® Other methods not listed(See Comments/Explanation) Comments/Explanation: Elmer J. Peterson pumped the tanks.See report. 3. Other Compliance Conditions—Compliance component#3 of 5 a. Maintenance hole covers are damaged,cracked,unsecured,or appear to structurally unsound. 0 Yes* ®No ❑Unknown b. Other issues(electrical hazards,etc.)to immediately and adversely impact public health or safety. ❑Yes* ®No 0 Unknown *System is an Imminent threat to public health and safety Explain: c. System is non-protective of ground water for other conditions as determined by inspector ❑Yes* ®No *System is falling to protect groundwater Explain: www.pca.state.mn.us • 651-296-6300 • 800-657-3864 • TTY 651-282-5332 or 800-657-3864 • Available in alternative formats wq-wwists4-31 • 1/24112 Page 2 of 3 Property address: 350 Stubbs Bay Road N., Orono,MN Inspector initials/Date: J.O. 11/05/19 4. Soi( Separation —Compliance component#4 of 5 Date of installation: 7/19/07 ❑Unknown Verification method(s): Shoreland/Wellhead protection/Food Beverage ❑Yes No Soil observation does not expire. Previous soil Lodging? observations by two independent parties are sufficient, Compliance criteria: unless site conditions have been altered or local requirements differ. For systems built prior to April 1, 1996, and 0 Yes 0 No not located in Shore/and or Wellhead ® Conducted soil observation(s) (Attach boring logs) Protection Area or not serving a food, 0 Two previous verifications(Attach boring logs) beverage or lodging establishment: 0 Not applicable(Holding tank(s),no drainfie/d) Drainfield has at least a two-foot vertical 0 Unable to verify(See Comments/Explanation) separation distance from periodically saturated soil or bedrock. E] Other(See Comments/Explanation) Non-performance systems built April 1, ►5 Yes 0 No Comments/Explanation: 1996,or later or for non-performance systems located in Shore/and or Wellhead Protection Areas or serving a food, beverage, or lodging establishment: Drainfield has a three-foot vertical separation distance from periodically saturated soil or bedrock.* "Experimental", "Other" or "Performance" 0 Yes 0 No Indicate depths of elevations systems built under pre-2008 Rules; Type IV 1__ or V systems built under 2008 Rules(7080. A. Bottom of distribution media 100.8 2350 or 7080.2400 (Advanced Inspector License required) B. Periodically saturated soil/bedrock 97.8 Drainfield meets the designed vertical C. ystem separation.... __- 3.0 separation distance from periodically saturated soil or bedrock. D. Required compliance separation* ! 2.6 Any"no"answer above indicates the system is *May be reduced up to 15 percent if allowed by Local Failing to Protect Groundwater. Ordinance. 5. Operating Permit and Nitrogen BMP*—Compliance component#5 of 5 ® Not applicable Is the system operated under an Operating Permit? 0 Yes 0 No If"yes",A below is required Is the system required to employ a Nitrogen BMP? 0 Yes ❑No If"yes", B below is required BMP=Best Management Practice(s)specified in the system design If the answer to both questions is "no", this section does not need to be completed. Compliance criteria a. Operating Permit number: —.--._..._.. 0 Yes 0 No Have the Operating Permit requirements been met? b. Is the required nitrogen BMP in place and properly functioning? 0 Yes allo Any "no"answer indicates Noncompliance. Upgrade Requirements(Minn.Stat.§115.55)An imminent threat to public health and safety(ITPHS)must be upgraded,replaced,or its use discontinued within ten months of receipt of this notice or within a shorter period if required by local ordinance.If the system is failing to protect ground water,the system must be upgraded,replaced,or its use discontinued within the time required by local ordinance.If an existing system is not failing as defined in law,and has at least two feet of design soil separation,then the system need not be upgraded,repaired,replaced,or its use discontinued,notwithstanding any local ordinance that is more strict. This provision does not apply to systems in shoreland areas, Wellhead Protection Areas,or those used in connection with food,beverage,and lodging establishments as defined in law. www.pca.state.mn.us • 651-296-6300 • 800-657-3864 • TTY 651-282-5332 or 800-657-3864 • Available in alternative formats wq-wwists4-31 • 1/24/12 Page 3 of 3 Tank Report Date: November 5,2019 Elmer I Peterson Co. 5921 Dague Ave. Delano,MN 55328 Phone 763-972-2420 Fax 763-972-7217 MPCA License# 219 Chris Bollis 350 Stubbs Bay Road Orono, MN 55356 612-296-4011 Baffles: ON / OFF 3-1000 Gallon Tanks Tank Capacity: #of Tanks: 3 Type of Tanks: Concrete Gallons Pumped: 2500 Manholes to Grade: YES / NO Comments: On November 5,2019, Elmer J. Peterson Co. uncovered manholes(1m and 2"d both 12 inches deep, lift station to grade)and pumped tanks. No cracks or water leaking in tanks at the time of pumping. NOTE:This is only a tank report. This is not a compliance inspection for point of sale nor does it replace a compliance inspection. rl Property address: 350 Stubbs Bay Road Inspector initials/Date: 11/5/18 1. Impact on Public Health-Compliance component#1 of 5 Compliance criteria: Verification method(s): System discharge sewage to the ❑Yes ❑No 0 Searched for surface outlet ground surface, .__ 0 Searched for seeping in yard/backup in home System discharge sewage to drain tile ( 0 Yes 0 No ID Excessive ponding in soil system/D-boxes or surface waters. 0 Homeowner testimony(See Comments/Explanation) System cause sewage backup into i 0 Yes 0 No 0 "Black soil"above soil dispersal system dwelling or establishment. ❑ System requires"emergency pumping ❑ Performed dye test Any"yes"answer above indicates the system is 0 Unable to verify(See Comments/Explanation) an Imminent Threat to Public Health and Safety. ❑ Other methods not listed(See Comments/Explanation) Comments/Explanation: 2. Tank Integrity-Compliance component#2 of 5 Compliance criteria: Verification method(s): System consists of a seepage pit, 0 Yes ®No El Probed tank(s)bottom cesspool,drywall,or leaching pit. 0 Examined construction records Seepage pits meeting 7080.2550 may be 0 Examined Tank Integrity Form(Attach) compliant if allowed in local ordinance. 0 Observed liquid level below operating depth Sewage tank(s)leak below their 0 Yes ®No IM Examined empty(pumped)tanks(s) designed operating depth. If yes,which sewage tank(s)leaks: ❑ Probed outside tank(s)for"black soil" ❑ Unable to verify(See Comments/Explanation) Any"yes"answer above indicates the ❑Other methods not listed(See Comments/Explanation) system is Failing to Protect Groundwater. Comments/Explanation: On 11/5/19,Elmer J.Peterson Co.pumped tanks. 3. Other Compliance Conditions-Compliance component#3 of 5 a. Maintenance hole covers are damaged,cracked,unsecured,or appear to structurally unsound. ❑Yes" ❑No 0 Unknown b. Other issues(electrical hazards,etc.)to immediately and adversely impact public health or safety. 0 yes* 0 No 0 Unknown `System is an imminent threat to public health and safety Explain: c. System is non-protective of ground water for other conditions as determined by inspector 0 Yes" 0 No *System is failing to protect groundwater Explain: www.pca.state.mn.us • 651-296-6300 • 800-657-3864 • TTY 651-282-5332 or 800-657-3864 . Available in alternative formats wq-wwists4-31 • 1124/12 Page 2 of 3 Soil Observation Log www.SepticResource.com vers 12.4 Owner Information Property Owner/project: Chris Bollis Date 11/5/2019 Property Address/PID: 350 Stubbs Bay Road N. Soil Survey Information E] refer to attached soil survey Parent matl's: El Till ❑Outwash ❑ Lacustrine ❑Alluvium ❑Organic ❑ Bedrock landscape position: ❑Summit ❑Shoulder 0 Side slope ❑Toe slope soil survey map units: L22C2 slope % direction- Lineal Soil Log#1 El Boring ❑ Pit Elevation 102.6 Depth to SHWT 48 inches Depth(in) Texture fragment% matrix color redox color consistence grade shape loose loose single grain friable weakranular 0-24 Fill <35 g blocky firm moderate prismatic platy rigid strong massive 24-36 Topsoil <35 10yr3/1 Friable Moderate Blocky 36-42 Topsoil <35 10yr3/2 Friable Strong Blocky 42-48 Clay Loam <35 10yr4/3 Friable Strong Blocky loose loose single grain <35 35-50 friable weak granular blocky firm moderate prismatic platy >50 rigid strong massive Comments: 350 Stubbs Bay Road N. Soil Log#2 0 Boring ❑ Pit Elevation 102.9 Depth to SHWT 56 inches Depth(in) Texture fragment% matrix color redox color consistence grade shape loose loose single grain 0-32 Fill <35 friable weak granular blocky firm moderate prismatic platy rigid strong massive 32-50 Topsoil <35 10yr3/1 Friable Moderate Blocky 50-56 Clay Loam <35 10yr4/3 Friable Strong Blocky <35 loose loose single grain friable weak granular blocky 35-50 firm moderate prismatic platy >50 rigid strong massive <35 loose loose single grain friable weak granular blocky 35-50 firm moderate prismatic platy >50 rigid strong massive 350 Stubbs Bay Road N. Soil Log#3 Q Boring ❑Pit Elevation Depth to SHWT Depth(in) Texture fragment% matrix color redox color consistence grade shape loose loose single grain <35 friable weak 35-50 granular blocky firm moderate prismatic platy >50 rigid strong massive loose loose single grain <35 friable weak 35-50 granular blocky >50 firm moderate prismatic platy rigid strong massive <35 loose loose single grain 35 50 friable weak granular blocky firm moderate prismatic platy >50 rigid strong massive loose loose single grain <35 friable weak granular blocky 35 50 firm moderate prismatic platy >50 rigid strong massive loose loose single grain <35 friable weak granular blocky 35-50 firm moderate prismatic platy >50 rigid strong massive I hereby certify this work was completed in accordance with MN 7080 and any local req's. r' Rusty Olson's Soil & Pere 810 " Designer Signature Company License# DATE TIME �,,/� CITY OF ORONO CALLED IN ' Nell INSPECTION N C SCHEDULED .-:-111/S..,%, "Y PERMIT NO. r I (4 COMPLETED r0 Alin ADDRESS .33kwb3 i fcI Iv OWNER CONTR. 15 44. TELEPHONE NO. LP ( I.4/ Cl . - w E DESCRIPTIONR ^ 6f •+� U 01 FOOTING 11 MECHANI •L RI 18 EXCAVIGRADIN IFILLINL Q 02 FRAMING 13 MECHA AL FINAL 19 i 1!.,RE/WE LANDS y 03 INSULATIONE--.... 24/25 WOOF BURNER/FIREPLA ONO CI • 04 WALL BD. 12 WATER •O'-UP TION ,a.. cZ 05 FINAL 14 S R HO•• UP 'ROGRE -,yti 07 DEMO-SITE 27 S: .y'- • , . . J(�21LCOMPLAINT J 07 DEMO-FINAL 15 SEP IC INSTA . Q X22 F•L • W 09 PLUMBING RI 23 SEP C FINAL ‘k.k- HARD COVER REMOVAL = 10 PLUMBING FINAL 36 FOUNDA2N/REMOVAL ...1 t, (� Z OWNER/CONTRACTOR TO MEET YOU: YES_NO J X �1)c, COMMENTS:cc q)(31 �� r �(�- LIJQ. 0 % Imo► cl44.3_ F-i) - i,„„ ` f" Q gA,c4 119 O I i 43tiiL 0.5 is Tom :,$S Z 1LX' ( S3Aci t cc Lu C U. WORK SAT FACTORY:PROCEED 0 PROJECT MPLETE W ❑ CORRECT ORK&PROCEED 0 ISSUE CER FICATE OF OCCUPANCY CZ 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY d BEFORE COVERING • PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. 0 PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑ CITATION ISSUED O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor on site: Inspector. Li is ( .s White Copy/Inspector's File Canary Copy/Site Notice