HomeMy WebLinkAboutSeptic System Inventory SEPTIC SYSTEM INVENTORY
Site Address: 1925 West Farm Rd PID 27-118-23-43-0014
Owner Name: Charles Schroeder
Owner Address: 1925 West Farm Rd Long Lake MN 55356
BuildingTvpe: residence Installer: Ritter Exc.
Date of Permit: 3/19/85
System Type: mound BR's Designed for 4
In Musa?: Yes Shoreland?: YES
SEPTIC TANKS:
Material: precast concrete Capacity: 1000, 1000, 800 Tank Filter:
DRAINFIELD:
Treatment Area: 90*45 Soil Boring: yes DF Ht above Wt: 3.6
WELL DATA
Setbacks -Well Tanks: 70 Well DF: 85 Report In File: Depth: 158
INSPECTION RECORDS PUMPOUT RECORDS
Date Notes Date GallonsOfLiquid
8/22/2013 Point of sale inspection, valid until 8/21/2016 I 8/20/2012 2500
11/1/2006 Okay 6/20/2011 0
10/27/2004 Okay I 6/12/2009 2000
10/22/2002 no surfacing 2/7/2005 2500
6/21/2000 no surfacing, pump tanks I 1/18/2005 3000
8/31/1998 compliant 3/6/2003 2500
8/1/1995 no surfacing-pump tanks 4/14/1997 1500
10/29/1992 no surfacing 8/2/1996 2000
6/20/1990 no surfacing 7/5/1990 2000
9/14/1989 no surfacing
6/12/1986 installation
Aug 24 13 06:03p Joseph Olson 763-498-8290 p.2
Minnesota Pollution COm dance Inspection
Control Agency P Form
Existin Subsurface Sewage Treatment Systems
520 Lafayette Road North 9 9 y
St.Paul,MN 55155-4194 / (SSTS)
Doc Type:Compliance and Enforcement
Instructions: Inspection results based on Minnesota Pollution Control Agency(MPCA) For local tracking purposes:
requirements and attached forms—additional local requirements may also apply.
Submit completed form to Local Unit of Government(LUG)and system owner
within 15 days
System Status
System status on date(mmlddlyyyy): 8122/2013
® Compliant— Certificate of Compliance ❑ Noncompliant— Notice of Noncompliance
(Valid for 3 years from report date, unless shorter time (See Upgrade Requirements on page 3)
frame outlined in Local Ordinance.)
Reason(s)for noncompliance(check all applicable)
❑ Impact on Public Health(Compliance Component #1)—Imminent threat to public health and safety
❑Other Compliance Conditions(Compliance Component#3)—imminent threat to public health and safely
❑Tank Integrity(Compliance Component #2)—Failing to protect groundwater
❑ Other Compliance Conditions(Compliance Component#3)—Failing to protect groundwater
❑ Soil Separation (Compliance Component #4)—Failing to protect groundwater
❑ Operating permit/moniloring plan requirements(Compliance Component #5)—Noncompliant
Property Information Parcel IQ##or Sec/Twp/Range: 2711823430014
Property address: 1925 West Farm Road,Orono, MN Reason for inspection: Property Transfer
Property owner Pamela Schroeder Owner's phone:. 612-382-4068
or
Owner's representative: Representative phone: _
Local regulatory authority: City of Orono Regulatory authority phone: 952-249-4600
2-1000 gallon septic tanks,1-1000 gallon lift station and 550 square feet of mound rockbed. per city
Brief system description: records
Comments or recommendations:
Certification
I hereby certify that all the necessary information has been gathered to determine the compliance status of this system. No
determination of future system performance has been nor can be made due to unknown conditions during system construction,
possible abuse of the system,inadequate maintenance, or future water usage.
Inspector name: 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
El 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 - Avaitabte in alternative formats
wq-wwists4-31 • 1124/12 Page 1 of 3
Aug 24 13 06:03p Joseph Olson 763-498-8290 p.3
Property address: 1925 West Farm Road, Orono, MN Inspector initials/Date: J. O.8/22113
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 ❑Yes ®No ❑ Excessive ponding in soil system/D-boxes
or surface waters. ❑ Homeowner testimony(See Comments/Explanation)
9 "Black soil"above soil dispersal system
System cause sewage backup into ❑Yes ® No 9 System requires"emergency'pumping
dwelling or establishment.
0 Un
Any"yes"answer above indicates the system is
❑ Unaabbllee ttood dye test
verify(See Comments/Explanation)
an Imminent Threat to Public Health and Safety. 0 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 9 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 ❑Yes ® No
designed operating depth. ❑ Examined empty(pumped)tanks(s)
If yes,which sewage tank(s)leaks: ❑ Probed outside tank(s)for"black soil"
Any"yes"answer above indicates the ❑ Unable to verify(See Comments/Explanation)
®
system is Failing to Protect Groundwater. Other methods not listed(See Comments/Explanation)
Comments/Explanation:
Elmer J Peterson pumped the tanks on 8/20/12
3. Other Compliance Conditions—Compliance component#3 of 5
a. Maintenance hole covers are damaged,cracked,unsecured,or appear to structurally unsound. ❑Yes* ®No ❑ Unknown
b. Other issues(electrical hazards,etc.)to immediately and adversely impact public health or safety. p Yes* ®No ❑Unknown
*System is an imminent threat to public health and safety
Explain:
c. System is non-protective of ground water for other conditions as determined by inspector ❑Yes' ®No
*System is failing to protect groundwater
Explain:
www.pca.state.mn.us • 651-296-6300 • 800-657-3864 • TTY 651-282-5332 or 800-657-3864 • Available in alternative formats
wq-wwists4-31 • 1/24/12 Page 2 of 3
Aug 24 13 06:04p Joseph Olson 763-498-8290 p.4
Property address: 1925 West Farm Road,Orono, MN Inspector initials/Date: J. 0.8122113
4. Soil Separation—Compliance component#4 of 5
Date of installation: 6112/86 ❑ Unknown Verification method(s):
Soodgina?NVellhead protectionlFood 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 ❑Yes ❑ No
not located in Shoreland or Wellhead ® Conducted soil observation(s)(Attach boring logs)
Protection Area or not serving a food, ❑ Two previous verifications(Attach boring logs)
beverage or lodging establishment
0 Not applicable(Holding tank(s),no drainfiekl)
Drainfield has at least a two-foot vertical ❑ Unable to verify(See Comments/Explanation)
separation distance from periodically
saturated soil or bedrock. ❑ Other(See Comments/Explanation)
Non-performance systems built April 1, ®Yes ❑ No Comments/Explanation:
1996, or later or for non-performance
systems located in Shoreland or Wellhead
Protection Areas or serving a food,
beverage, or lodging establishment:
Drainfield has a three-foot vertical
separation distance from periodically
saturated soil or bedrock.*
"Experimental" 'Other'; or "Performance" ❑Yes ❑ No Indicate depths of elevations
systems built under pre-2008 Rules; Type 111 - •
or V systems built under 2008 Rules(7080. A. Bottom of distribution media 103.1
2350 or 7080.2400 (Advanced Inspector
License required) B. Periodically saturated soilbedrock 99.5
Drainfield meets the designed vertical C. System separation 3.6
separation distance from periodically
saturated soil or bedrock.
D. Required compliance separation` 2.6
Any"no"answer above indicates the system is *May be reduced up to 15 percent if allowed by Local
Failing to Protect Groundwater. Ordinance.
5. Operating Permit and Nitrogen BMP*—Compliance component#5 of 5 ® Not applicable
Is the system operated under an Operating Permit? ❑Yes ❑ No If"yes",A below is required
Is the system required to employ a Nitrogen BMP? ❑Yes ❑No If"yes",B below is required
BMP=Best Management Practice(s)specified in the system design
if the answer to both questions is "no", this section does not need to be completed.
Compliance criteria
a- Operating Permit number.
Have the Operating Permit requirements been met? ❑Yes ❑No
b. Is the required nitrogen BMP in place and properly functioning? 1 ❑Yes 0 No
Any "no"answer indicates Noncompliance.
Upgrade Requirements(Minn. Stat.§115.55)An imminent threat to public health and safety(ITPHS)must be upgraded,replaced,or its use
discontinued within ten months of receipt of this notice or within a shorter period if required by local ordinance.if the system is failing to protect
ground water,the sysfem 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 sail 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 3of3
Aug 24 13 06:04p Joseph Olson 763-498-8290 p,5
Tank Report
Date: August 20, 2012
Elmer J. Peterson Co.
.592,1 Dague Ave.
Delano, MN 55328
Phone 768-972-24.20
Fax 763-972-7217
MPGA License# 219
Pamela Schroeder
1925 W. Farm Rd.
Long Lake, MN 55356
(Orono)
612-382-4068
Baffles:, ON OFF
�4 •
Tank Capacity: 3-1000 Gallon Tanks
# of Tanks: 3
Type of Tanks: Concrete
Gallons Pumped: .2cnn
Manholes to Grade: 4 / NO
Comments:
On August 20,2012, Elmer J. Peterson Co. pumped septic tanks. No cracks or water leaking at that time.
NOTE:This is only a tank report. This is not a compliance inspection for point of sale nor does
it replace a compliance inspection.
Aug 2413 06:04p Joseph Olson 763-498-8290 p.6
Property address: 1925 W. Farm Road inspector initials/Date: 8/20/
1. Impact on Public Health—Compliance component#1 of 5
Compliance criteria: Verification method(s):
System discharge sewage to the I ❑ Yes ❑ No 0 Searched for surface cutlet
ground surface. f ❑ Searched for seeping in yard/backup in home
System discharge sewage to drain tile ❑Yes ❑No El Excessive ponding in soil systemlD-boxes
or surface waters. ; ❑ Homeowner testimony(See Comments/Explanation)
❑ "Black soir above soil dispersal system
System cause sewage backup into 0 Yes ❑No ❑ System requires"emergency'pumping
dwelling or establishment.
•
❑ 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, I ❑Yes ®No El Probed tank(s)bottom
cesspool, drywell, or leaching pit. I ❑ Examined construction records
Seepage pits meeting 7080.2550 may be El Examined Tank Integrity Form (Attach)
compliant if allowed in local ordinance. j
0 Observed liquid level below operating depth
Sewage tank(s)leak below their ❑ Yes ® No
designed operating depth. ® Examined empty(pumped)tanks(s)
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 8/20/12, Elmer J. Peterson Co. pumped septic tanks. See notes on attached tank report.
•
3. Other Compliance Conditions-Compliance component#3 of 5
a. Maintenance hole covers are damaged,cracked,unsecured, or appear to structurally unsound. p Yes" E No 0 Unknown
b. Other issues(electrical hazards,etc.)to immediately and adversely impact public health or safety. El 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 ❑Yes- ❑No
*System is failing to protect groundwater
Explain:
www.pca.state.mn.us • 651.296-5300 • 800.657-3864 • TTY 651-282-5332 or 800-657-3864 • Available in alternative formats
wq•wwists4-31 • 1/24/12 Page 2 of 3
Aug 2413 06:04p Joseph Olson 763-498-8290 p.7
Logs of Soil Borings
License#810
Location or Project: 1925 Vilest Farm Road
Borings made by: Rusty Olson's Soil and Perc testing 812212013
Classification System: AASHO ; USDS.USDS-SCS X ; Unified ; Other
Auger used(check two): Hand X_, or Power_, Right, Bucket or Probe X
Boring Number_1_Surface elevation_101.5 Mottled Soil at_X_ feet
0"-20"Dark brown loam 10yr3/2 H2O present at_X
20"-24"Brown loam 10yr4/4
Boring Number_2 Surface elevation_98.8_ Mottled Soil at_X_ feel
0-4" Loam fill H2O present at_X_
4"-12" Dark brown loam 10yr3/2
12"-18" Brown loam 10yr414
18"-24" Brown loam 10y514
TBM:Top of lift station manhole cover Eiv.-100.00 assumed
Original soil under the rockbed Elv.-101.5
Bottom of rock bed Ely.-103.1
There is 1.6 feet of sand under the rockbed
Aug 2413 06:04p Joseph Olson 763-498-8290 p.8
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