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Home My WebLink About2017 - MPCA compliance inspec form Jan 09 2017 01:07PM HP FaxRusty Olson 7634988290 page 2 Minnesota Pollution Compliance Inspection Form Control Agency 520 Lafayette Road North Existing Subsurface Sewage Treatment Systems St.Paul,MN 55155-4194 (SSTS) Doc Type:Compliance and Enforcement RECEIVED Instructions: Inspection results based on Minnesota Pollution Control Agency(MPCA) ! For local tracking purposes: requirements and attached forms-additional local requirements may also apply. JAN 0 y 2017 Submit completed form to Local Unit of Government(LUG)and system owner ' within 15 days CITY OF ORONO System Status System status on date(mmlddlyyyy): 116/2017 ® 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) 0 Impact on Public Health(Compliance Component #1)-Imminent threat to public health and safety ❑Other Compliance Conditions(Compliance Component#3)-Imminent threat to public health and safety El Tank Integrity(Compliance Component #2)-Failing to protect groundwater ❑Other Compliance Conditions(Compliance Component#3)-Failing to protect groundwater ❑Soil Separation(Compliance Component 114)-Failing to protect groundwater ❑Operating permit/monitoring plan requirements(Compliance Component #5)-Noncompliant Property Information Parcel ID#or Secfrwp/Range: 0411723420016 Property address: 2 White Oak Circle.,Orono,MN Reason for inspection: Property Transfer Property owner: atrick Doherty Owner's phone: or Owner's representative: Mimi Ryerse Representative phone: 612-280-8284 Local regulatory authority: City of Orono Regulatory authority phone: 952-249-4600 1-2250 gallon septic tank,1-1000 gallon lift station and 500 square feet of mound rockbed.per city Brief system description: records Comments or recommendations: Certification 1 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 O n's Soil&Perc.Testing License number: 810 Inspector signature: Phone number: 763-498-8779 Necessary r/Locally Required Attachments ®Soil boring logs ®System/As-built drawing ❑ 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 Jan 09 2017 01:07PM HP FaxRusty Olson 7634988290 page 3 Property address: 2705 White Oak Circle.,Orono, MN Inspector initials/Date: J. 0. 1/06/17 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® CI Excessive ponding in soil system/D-boxes or surface waters. ❑ Homeowner testimony(See Comments/Explanation) ❑ "Black soil"above soil dispersal system System cause sewage backup into ❑Yes ® No ❑ System requires"emergency"pumping dwelling or establishment. ❑ Performed dye test Any"yes"answer above indicates the system is 0 Una ble to 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, ❑Yes ® No 0 Probed tank(s)bottom cesspool, drywell,or leaching pit. ® Examined construction records Seepage pits meeting 7080.2550 may be ❑ Examined Tank Integrity Form(Attach) compliant if allowed in local ordinance. Sewage tank(s)leak below their ❑Yes ® No Ci Observed liquid level below operating depth designed operating depth. ❑ Examined empty(pumped)tanks(s) If yes,which sewage tank(s)leaks: ED Probed outside tank(s)for"black soir „ Cl Unable to verify(See Comments/Explanation) "yes"yes answer above indicates the ❑Other methods not listed(See Comments/Explanation) system is Failing to Protect Groundwater. Comments/Explanation: 3. Other Compliance Conditions—Compliance component#3 of 5 a. Maintenance hole covers are damaged,cracked,unsecured,or appear to structurally unsound. ❑Yes* ® No D Unknown b. Other issues(electrical hazards,etc.)to immediately and adversely impact public health or safety. ❑Yes* ®No ❑ Unknown 'System is an imminent threat to public health and safety Explain: c. System is non-protective of ground water for other conditions as determined by inspector ❑Yes* ®No *System is failing to protect groundwater Explain: www.pca,state.mn.us • 651-296-6300 • 800-657-3864 • TTY 651.282-5332 or 800.657-3864 • Available in alternative formats wq-wwists4-31 • 1/24112 Page 2 of 3 Jan 09 2017 01:07PM HP FaxRusty Olson 7634988290 page 4 Property address: 2705 White Oak Circle.,Orono, MN Inspector initials/Date: J. 0. 1/06/17 4. Soil Separation -Compliance component#4 of 5 Date of installation: 9/30/2015 El unknown Verification method(s): ShorelandlWellhead protection/Food Beverage ®Yes lodging? ❑ NO Soil observation does not expire.Previous soil 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: ❑ Not applicable(Holding tank(s),no drainfreld) 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 stablishment.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 IV or V systems built under 2008 Rules(7080. A. Bottom of distribution media 101.2 2350 or 7080.2400 (Advanced Inspector License required) B. Periodically saturated soilibedrock 98.2 Drainfield meets the designed vertical C. System separation 3.0 separation distance from periodically saturated soil or bedrock. D. Required compliance separation' j 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 Practices)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? ID Yes 1] No b. Is the required nitrogen BMP in place and properly functioning? ❑Yes ❑ No Any "no"answer indicates Noncompliance. Upgrade Requirements(Minn.Stat.§115.55)An imminent threat to public health and safely(ITPI-fS)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 falling 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 • 600.657-3864 • TTY 651-282-5332 or 800-657-3864 • Available in alternative formats wq-wwists4-31 • 1124/12 Page 3 of 3 Jan 09 2017 01:07PM HP FaxRusty Olson 7634988290 page 5 Soil Observation Log ti,,,,++Selniu'Resouree.com+ers 12.4 Owner Information Property Owner project: Patrick Dohertx Date 8/31/2015 Property Address •MD: 279(} White Oak Circle Soil Survey Information i refer to attached soil survey Parent marl's: E Till E Outwash u Lacustrine 7 Alluvium 7 Organic .L._ Bedrock landscape position: Summit _._j Shoulder [ S de slope ` Toe slope soil survey map units: 37E3 slope 9 °o direction- Linear Soil Log#1 Boring L Pit Elevation 9g,7 Depth to SH WT l 8" Depth(in) Texture fragment as matrix color redox color consistence grade shape 0-6 Topsoil =35 iOyr3 Loose Loose Single grain 6-18 Clay Loam -35 IOyr4 4 Firm Strong ikiock:, 18-24 Loam <15 I O}TJ 4 10>4 8.1-6.10> Friable Strong Prnmatia <..,j 5 loose loose siaglc grain :5 - 5� tiiahlc weak granular biorAs >50 timt moderate prismatic nigh rigid strong "'assIv ..;; loose base single_rain 35_50 friable yeah granular hlnck� >50 firm moderate Pr1srIanc plan rigid strong rnas.ne Comments: Jan 09 2017 01:07PM HP FaxRusty Olson 7634988290 page 6 2790 White Oak Circle Soil Log#2 Boring _ Pit E_1rnntiuu 99.7 Depth to SHWT 24" Depth I in) Texture fragment"0 matrix color redox color consistence grade shape I 4-10 lopsoiI • 35 IUr3 2 Loose Loose single grain 10-18 CIa> Loam z: I0'r44 Firm Strong itloclo I 8-24 CIa} Loam • 35 111)r5 4 Finn Strom_ Block!, 24-30 Loam 35 I0 r5 4 I0�48,1-6 10 friable Strong. Pri.nia,• Jan 09 2017 01:07PM HP FaxRusty Olson 7634988290 page 7 ). City of Orono Septic Asbuilt Form Address Z 7 ?0 to 4(44_ ec It Building Use S F Installer 14 .a.y.r� ,�S o.%S License# L b f o Date! 42`/S Septic Tanks 2 i so c,,*,,, b c. Pump Tank i cop • System Type Il I ❑II ❑III Mound ❑Trenches ❑Pressure Bed 0 Other Draw detailed diagram with measurements indicating distances to tank risers using 2 points from a permanent structure. Show location of drop boxes and length of trenches. • :14-) f L .47,4%%•4k8 sa.� itsi � - 3 °:7 0 14°If 2. 3 ' 3C LOX5 L.) k5ez.Q pES�t C9-0 -410 vmP