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Home My WebLink About01-31-2020 Septic ComplianceMinnesota 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 Instructions. Inspection results based on Minnesota Pollution Control Agency (MPGA) 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 (mmfddlyyyy): 1131/2020 ® Compliant - Certificate of Compliance (Valid for 3 years from report date, unless shorter time frame outlined in Local Ordinance.) Reason(s) for noncompliance (check all applicable) ❑ Noncompliant - Notice of Noncompliance (See Upgrade Requirements on page 3) ❑ 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 ❑ 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/monitoring plan requirements (Compliance Component #5) — Noncompliant Property Information Parcel ID# or SecfTwp/Range: 351 1 82341 0006 Property address: 920 Wayzata Blvd. W., Orono, MN Reason for inspection: Property Transfer Property owner: Michael Chiodin Owner's phone: 763-337-6715 or Owner's representative: Local regulatory authority: City of Orono Brief system description: 2-1000 and 1-1000 gallon lift station and 380 Comments or recommendations: Certification Representative phone: _ Regulatory authority phone: 952-249-4600 uare feet of mound rock bed. 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 Business name: Rusty Olson's Soil & Perc. Testing Inspector signature; Necessary or Locally Required Attachments Certification number: 1255 License number: 810 Phone number: 763-498-8779 ® Soil boring logs ® System/As-built drawing ❑ Forms per local ordinance ❑ Other information (list): www.pca.state.mn.us 651-296-6304 800-657-3864 TTY 651-282.5332 or 800-657-3864 • Available in alternative formats wq-wwist54-31 • 1124111 Page 1 of 3 Property address: 920 Wayzata Blvd. W., Orono, MN 1. Impact on Public Health —Compliance component #1 of 5 Compliance criteria: System discharge sewage to the ❑ Yes [I No around surface. System discharge sewage to drain the ❑ Yes ❑ No or surface waters. System cause sewage backup into ❑ Yes ® No dwelling or establishment. Any "yes" answer above indicates the system is an Imminent Threat to Public Health and Safety. Comments/Explanation: 2. Tank Integrity —Compliance component #2 of 5 Compliance criteria: System consists of a seepage pit, ❑ Yes ® No cesspool, drywell, or leaching pit. Seepage pits meeting 7080.2550 may be compliant if allowed in local ordinance. Sewage tank(s) leak below their ❑ Yes Z No designed operating depth. If yes, which sewage tank(s) leaks: Any "yes" answer above indicates the system is Failing to Protect Groundwater. Comments/Explanation: Albin's Septic Pumping LLC. Pumped the tanks. See tank report. Inspector initials/Date: J. 0. 1/3112020 Verification method(s): ® Searched for surface outlet ® Searched for seeping in yard/backup in home ❑ Excessive ponding in soil systemlD-boxes ❑ Homeowner testimony (See Comments/Explanation) ❑ "Slack soil" above soil dispersal system ❑ System requires "emergency" pumping ❑ Performed dye test ❑ Unable to verify (See Comments/Explanation) ❑ Other methods not listed (See Comments/Explanation) Verification method(s): ❑ Probed tank(s) bottom ❑ Examined construction records ❑ Examined Tank Integrity Form (Attach) ❑ Observed liquid level below operating depth ❑ Examined empty (pumped) tanks(s) ❑ Probed outside tank(s) for "black soil" ❑ Unable to verify (See Comments/Explanation) 0 Other methods not listed (See 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 ❑ 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-wMsts4-31 • 1124112 Page 2 of 3 Property address: 920 Wayzata Blvd. W., Orono, MN 4. Soil Separation —Compliance component #4 of 5 Date of installation: 2010 ❑ Unknown Shoreland/Wel Ihead protection/Food Beverage ❑ Yes ® No Lodging? Compliance criteria: For systems built prior to April 1, 1996, and ❑ Yes ❑ No not located in Shoreland or Wellhead Protection Area or not serving a food, beverage or lodging establishment Drainfield has at least a two -foot vertical separation distance from periodically saturated soil or bedrock. Non-performance systems built April 1, ❑ Yes ❑ No 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" systems built under pre -2008 Rules; Type lV or V systems built under 2008 Rules (7080. 2350 or 7080.2400 (Advanced Inspector License required) Drainfield meets the designed vertical separation distance from periodically saturated soil or bedrock. ❑ Yes ❑ No Any "no" answer above indicates the system is Failing to Protect Groundwater. Inspector initials/Date: J. O. 1/31/2020 Verification method(s): Soil observation does not expire. Previous soil observations by two independent parties are sufficient, unless site conditions have been altered or local requirements differ. Z Conducted soil observation(s) (Attach boring logs) ❑ Two previous verifications (Attach boring logs) ❑ Not applicable (Holding tank(s), no drainfield) ❑ Unable to verify (See CommentslExplanation) ❑ Other (See CommentslExplanation) CommentslExplanation: Indicate depths of elevations A. Bottom of distribution media 104.0 B. -.Periodicallv saturated soil/bedrock 101.0 C. System separation 3.0 D. Reauired compliance separation' 2.6 *May be reduced up to 15 percent if allowed by Local Ordinance. 5. Operating Permit and Nitrogen BMP* —Compliance component #5 of 5 M 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. ComDliance criteria a. Operating Permit number: ❑ Yes ❑ No Have the Operating Permit requirements been met? 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 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 • Availabte in alternative formats wq-wwists4-31 • 1124112 Page 3 of 3 Property address: 920 Wayzata Blvd _ _ _ . Parcel to: 35-118-23-41-0006 city: Orono _ state. MN zip code: 55391 _ Optional section: Sewage Tank Compliance Certification This form does not represent a complete system inspection report and only certifies sewage tank compliance status. Instructions: This section of the form may be completed and signed by a Designated Certified individual (DCI) of a licensed SSTS Maintenance Business who personally conducts the necessary procedures to assess the compliance status of each sewage tank in the system. When this section of the form is signed by a qualified certified professional, it becomes necessary supporting documentation to an Existing System Compliance Inspection Report: Compliance inspection form - Existing system w -wwi -31W. This form can be found on the MPGA website at httos:/fwawr.oca,state.mn.us/water/ssts and-msts4echnical- nd-compliance-criteria. The information and certified statement on this form is required when existing septic tank compliance status is determined by an individual other than the SSTS Inspector that submits the inspection report. It represents a third party assessment of SSTS component compliance and is allowable under Minn. R. 7082.0700, subp. 4 Item (B) subitem (1). This form is valid for a period of three years beyond the signature dale on this form unless a new evaluation is requested by the owner or owner's agent or is required according to local regulations. Additional Administrative Rule references for this activity can be found at Minn. R. 7082.0700, subp. 4 Items B, C, and D; 7083.0730 Item C. XCertificate of sewage tank compliance ❑ Notice of sewage tank non-compliance irm all three statements: Select all that apply: The SSTS does not contain a seepage pit, cesspool, ❑ The SSTS has a seepage pit, cesspool, drywell, rywell, leaching pit, or other pit. leaching pit, or other pit. It does not contain a sewage tank that was designed ❑ It has a sewage tank that was designed to be be watertight, but subsequently leaks below the watertight, but subsequently leaks below the designed SSuf�lesigned operating depth. operating depth. It does not represent an imminent safety threat by ❑ it presents a threat to public safety by reason of ason of unsecured, damaged, or weak unsecured, damaged, or weak maintenance hole maintenance hole cover(s) or other unsafe condition. cover(s) or other unsafe condition. Company information Company name: Albin'sSeptiie Pumping LLC _ Business license number. 3346 _.. Designated Certified Individual (DCI) information Print name: Peter Peterson Certification number: 9227 1 personally conducted the work described above as a Designated Certifiers Individual of a Minnesota -licensed SSTS Maintenance Business. l personally conducted the no ary procedures to assess the compliance status of each sewage tank in this SSTS: Designated Certified 06/f)512019 Individual's signature: t Date (mmlddlyyyy): _ www.pca.state.mn.us • 651-296.6300 800•657.3864 use your preferred relay service Available in alternative formats wq-wwists4-38 • 1127/17 Page 3 of 3 20117. SEPTIC MAINTENANCE REPORT Siteaddress: Number of tanks: 3 Date hast pumped: `v � Gallons pumped- Flame of pumper/ maintenance provider; G r Q—c. tanks watertight?. - Y£S NO (% (please circle one) Is the system Ru ctioning Properly? l (ie slow drainage, wetness in the drdinfield?) Do yo u f-6 have any specific concerns or issues that you'd like to discuss with the SSTS Program Manager? if so, please indicate best time and telephone number(s) to be reached between 8 am and 4:30 pm. Best Times Telephone Number(s) RETURN IN THE ENCLOSED ENVELOPE AS SOOW AS PiOSS1BlE ROGER PETTSO CITY OF ORONO PO BOX 66 CRYSTAL BAY MN 553234XW Soil Observation Log www.SepticResource.com vers 12.4 Owner Information Property owner / project: Michael Chiodin Date 1/31/2020 Property Address / PID: 920 Wayzata Blvd. W Soil Survey Information ❑ refer to attached soil survey Parent matl's: 21 Till [I Outwash ❑ Lacustrine ❑ Alluvium ❑ Organic ❑ Bedrock landscape position: ❑ summit ❑ Shoulder ® Side slope ❑ Toe slope soil survey map units: L22C:2 slope % direction- Linear Soil Log #1 R] Boring ❑ Pit Elevation 101.7 Depth to SHWT 16 Inches Depth (in) Texture fragment % matrix color redox color consistence grade shape 0-6 Topsoil <35 l 0yr3/2 Friable Moderate Blocky 6-16 Topsoil •=35 10yr4/3 Friable Strong 131c)ckp 16-24 Clay Loam « 3 S I ON rai4 10y4/8,1 -6/10y Finn Strong Blocky <35 loose loose single grain friable wear granular blocky 35-50 firm moderate prismatic platy >50 rigid strong massive <35 loose loose single grain 35-50 friable weak granular blocky firm moderate Prismatic platy >50 rigid strong massive Comments: 920 Wayzata Blvd. W Soil Log #2 Rl Baring ❑ Pit Elevation 102.5 Depth to SHWT 16 Inches Depth (in) Texture fragment % matrix color redox color consistence grade shape 0-6 Topsoil <35 10yr3/2 Friable Moderate Blocky 6-16 Topsoil -35 10yr4/3 Friable Strong Blocky 16-24 Cla" Loam =' 35 IOyr5/4 IQy4/5,1-6/l0y FirmStrong Blocky <35 loose loose single grain 35-50 friable weak granular blocky >50 firm moderate prismatic platy rigid strong massive <35 loose loose single grain 35-50 friable weak granular blocky >50 firm moderate prismatic platy rigid strong massive 920 Wayzata Blvd. W Soil Log #3 ❑ Boring ❑ Pit Elevation Depth to SHWT Depth (in) Texture fragment % matrix color redox color consistence grade shape <35 loose loose single grain 35-50 friable weak granular blocky firm moderate prismatic platy >50 rigid strong massive < 35 loose loose single grain 35-50 friable weak granular blocky firm moderate prismatic platy >50 rigid strong massive <35 loose loose single grain 35 - 50 friable weak granular blocky firm moderate prismatic platy >SQ rigid strong massive <35 loose loose single grain 35-50 friable weak granular blocky firm moderate prismatic platy >50 rigid strong massive <35 loose loose single grain 35-50 friable weak granular blocky firm moderate prismatic platy >50 rigid strong massive I hereby certi this work was completed in accordance with MN 7080 and any local reqs. Rusty Olson's Soil & Perc 810 esigner Signature Company License # tA 12 12 05:28p Brad MMIRMIMIUMM WORKSHEET FOR SEWAGE DISPOSAL WORK Date— S- l d /0 inspector ] I' Building Permit No. Owner Property Address_9 2. Kind of Buildin SSTS Insfmller _ Q.'"`'` License Septic Tanks Material Y +� Number of Tanks Sita Drain Field: 1 Total length of lines Number of Ernes Type of sail clr� Percolation Test ^ (t j .5 ±21 Width of trench Type of tuber mateftl Size of Rock Bed1 0 lC ' S•iza of Absorption Area. Craw detailed diagram with measumments indicating distances to s c tank risers from a permanent structure - 6k -41) k 41)k W p.4 j