Loading...
HomeMy WebLinkAboutCompliance Inspection Form - 2-29-2016 Feb 29 2016 05:06RM HP FaxRusty Olson 7634988290 page 2 Minnesota Pollution Compliance Inspection Form Control Agency S20 Ufa yette Road North Existing Subsurface Sewage Treatment Systems St.Paul,MN 55155-4194 (SETS) Doc Type:Compliance and Enforcement Instructions: Inspection results based on Minnesota Pollution Control Agency(MPCA) For ores: requirements and attached forms-additional local requirements may also apply. Submit completed form to Local Unit of Government(LUG)and system owner FEB 2 9 2016 within 15 days t crrY of ORON , System Status System status on date(mm/dd/yyyy): 2125/2016 ® 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 #i)-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: 26-118-23-41-0009 Property address: 1185Wyndamere Road.,Orono MN _ Reason for inspection: Property Transfer Property owner: Gary Gronneberg Owner's phone: 612-860-5475 or Owner's representative: Representative phone: Local regulatory authority: City of Orono Regulatory authority phone: 952-249-4600 Brief system description: 2-1000 and 1-1000 gallon lift station and 1500 square feet of Trench per city 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: Rus on'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 ❑ Forms per local ordinance ❑ 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 • 1/24112 Page 1 of 3 Feb 29 2016 05:06PM HP FaxRusty Olson 7634988290 page 3 Property address: 1185WYndamere Road.,Orono MN Inspector initials/Date: J.0.2/25116 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 the � E]Yes ®Na ❑ Excessive ponding in soil system/D-boxes or surface waters. [I Homeowner testimony(See Comments/Explanation) [I "Black soil"above soil dispersal system System cause sewage backup into El Yes ®No dwelling or establishment. [I System requires"emergency"pumping ElAny"yes"answer above Indicates the system is an Imminent Threat to Public Health and Safety. ❑ Unable too verify(See Comments/Explanation) dye test Unable ❑ Other methods not listed(See Comments/Explanation) Com ments/Explanation: 2. Tank Integrity—Compliance component#2 of 5 Compliance criteria: Verification method(s): System consists of a seepage pit, ❑Yes ®No ❑ 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 craYnence. ❑ Observed liquid level below operating depth Sewage tank(s)leak below their ❑Yes ®No ❑ Examined empty(pumped)tanks(s) designed operafina depth. If yes,which sewage tank(s)leaks: ❑ Probed outside tank(s)for"black soil" I Any"yes"answer above inahcates the ElUnable to verify(See CommentarExplanation) system is Failing to Protect Groundwater. ®Other methods not listed (See CommentslExplanation) Comments/Explanation: Elmer J Peterson pumped the tanks on 2/25/16 3. other Compliance Conditions—Compliance component#3 of 5 a. Maintenance hole covens are damaged,cracked,unsecured,or appear to structurally unsound. ❑Yes• E No ❑Unknown b. Other issues(elecaical hazards,etc.)to immediately and adversely impact public health or safety. ❑Yes' END ❑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• E No *System is failing to protect groundweew Explain: www.pca.state.mn.us • 651.296-6300 • 8OD-657-3864 TTY 651-282-5332 or 800.657-3864 • Available in alternative formats wq-wwists4-31 • 1124112 Page 2 of 3 Feb 29 2016 05:06PM HP FaxRusty Olson 7634988290 page 4 Property address: 1185Wyndamere Road.,Orono MN Inspector initials/Date: J. 0.2/25/16 4. Soi l Separation —Compliance component#4 of 5 Date of Installation: 11/18/84 ❑ Unknown Verification method(s): Shoreland/Wellhead p►otecGon/Food Beverage Lodgi ❑Yes ® No Soil observation does not expire. Previous soil Lodglnp4 observations by two Independent parties are sufficient, Compliance criteria: unless site conditions have been altered or local For systems built prior to April 1, 1996, and ®Yes [:] No requirements differ 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 dra/nfield) i Drainfield has at least a two-foot vertical ❑ Unable to verify(See CommentarExplanation) separation distance from periodically saturated soil or bedrock. El Other(See CommentarExprenation) Non-penb►mance systems built April 1, ❑ Yes []No CommentslExplanation: 1996,or later or fornon-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 IV or V systems built under 2008 Rules(7080. A. Bottom of distrlbutlon media 99.4 2350 or 7080.2400 (Advanced Inspector License required) B. Periodically saturated soil bedrock 96.4 Drainfield meets the designed vertical C. System separation 3.0 separation distance from periodically saturated soil or bedrock. D. Required compliance separation* 2.0 Any"no"answer above indicates the system is *May be reduced up to 15 percent if allowed by Local Failing to Protect Groundwater: Ordinance. S. 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 H 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? ❑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 ordbnence.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 rot fairing as dermed in raw,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 • 651-296-63DO • 800-657.3864 TTY 651-282-5332 or BOD-657.3864 • Available in alternative formats wq-ww1sts4.31 • 1/24112 Page 3 of 3 Feb 29 2016 05,06PM HP FaxRusty Olson 7634988290 page 5 Tank Report Date: February 25, 2016 Elmer J. Peterson Co. 5921 Dague Ave. Delano,NIN 55328 Phone 763-972-2420 Fax 763-972-7217 MPCA License#219 Gary Gronneberg 1185 Wyndmere Road Wayzata, MN 55391 (Orono) 612-860-5475 Baffles; ON OFF Tank Capacity: 3-1000 Gallon Tanks #of Tanks: 3 Type of Tanks: Concrete Gallons Pumped: 2500 Manholes to Grade: YES / NO Comments: On February 25,2016, Eimer J. Peterson Co uncovered manholes(2^d manhole—6 inches deep, 1st manhole and lift station manhole to grade)and 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. Feb 29 2016 05:06PM HP FaxRusty Olson 7634988290 page 6 Property address: 1185 WyndmWe Road Inspector initiate/pate: 22611 g 1, Impact on Public Health—Compliance component#1 of 5 Compliance criteria: Verification mealod(s): System discharge sewage to the 12 Yes ❑No ❑ Searched for surface outlet _Jround surface. ❑ Searched for seeping In yard/backup in home System discharge sewage to drain 1119 ❑Yes ❑No ❑ Excessive ponding In soU system/D-boxes or surface waters. ❑ HOmeOwnef testimony(See��WlanaBan) System cause sewage backup into ❑Yes ❑ ❑ •Biadc sole atxrre Soil dispersal system dweIling or establishment. ❑ System requires"emergency pumping Any"Yes"answer above indicates the sysftm s ❑ Performed dye test an Imminent Thr"t to pub/k Hea/tJh and Safety, ❑ Unable to verity flee Cornrwn(VExplenaVM) ❑ Commerrts�anation: Other methods not Hated(see Commer►ts/ExpranaWn) 2. Tank Integrity—Compliance compOnent#2 of 5 Com Illance criteria: Viiwftadon method(&): System consists ora seepage 70t �Yes ❑ Probed tank(&)bottom cesspool,drywell,or leaching ❑ Examined oonatrucfiori records Seepage Ars 11ee6M 7080.2460»ley be cont lent 4 albwed in local ordnarm, ❑ Examined Tank Integrity Form(Attach) Sewage teink(s)leak below their [111 Yes ®Ivo 11 Observed liquid level below operating depth designed o h. ® Examined empty(pumped)tanks(.) If yes,which sewage tanks)leaks: ❑ Probed outside tank(s)for"black soil" Any "�W„answer above indicates the ❑ Unable to verity(see Ca,enta�Exp/anarlon) system is Fairing tO Prott+ct Groundwater. ❑Other methods not listed(See Cor mentwaplaneaon) Comments/Explanation: On 2/25/16,Elmer J.Peterson Co.pumped septic tanks. 3. Other Compliance Conditions—Compliance component#3 of 5 a. Mair*ermnoe hole covets are damaged,cracked,unsecured,or appear to structurally ur>sound. ❑Yes* ❑No ❑Unknown b, Other issues is an lit"MkMVt 911110W to P r Y and Impact public heath or safety. ❑Y.s` [3 [3[3 UNcnown uWJc lisattlr and aadety Explain. C. System is non-protective of ground water for other conditions as demd by Inspector ❑Yes• ❑No 'SyBterrt is f"np to probed 9youndMeter Explain: v;ww•Pca-state-mn.us • 651-296-6300 800-657-3864 TTY 651.282-5332 ora00.657-3864 . Available to altemattve formats vr'Q-wwis&+31 . 1124112 Page 2 of 3 Feb 29 2016 05:07PM HP FaxRusty Olson 7634988290 page 7 Logs of Soil Borings License#810 Location or Project: 1185 Wyndamere Road Borings made by: Rusty Olson's Soil and Perc testing 10118/2010 Classification System: AASHO USDS-USDS-SCS X ; Unified : Other Auger used(check two): Hand Xor Power , Flight, Bucket or Probe_X Bench mark is top of basement concrete slab. Elv.-100.00 Assumed Boring Number–I—Surface elevation_102.0 Mottled Soil at—X feet 0"-10"Dark brown sandy loam 10yr312 H2O present at—X- 1 T-18" X10"-18"Brown sandy loam 10yr4/4 18"-36"Brown sandy loam 10yr5/4 36"-48"Brown loamy sand 10yr5/4 48"-66"Brown loamy sand 10yr5/4 Boring Number 2_Surface elevation_104.5_ Mottled Soil at—X_feet 0"-6" Dark brown loam 10yr312 H2O present at—X— W-12"Brown loam 10yr4/4 12"-20"Brown day loam 10yr5/4 20"-44"Brown loam 10yr514 44"-58" Brown loam 10yr6/4 58"-72" Brown loamy sand 10yr7/4 TBM:Top of garage concrete slab. Elv:100.00 assumed Bottom of rock in trench#6 Elv.-99.4 Mottled soils not present to an Eiv.-97.0 Feb 29 2016 05:07PM HP FaxRusty Olson 7634988290 page 8 Loos of Soil Borinas License#810 Location or Project: 1185 Wyndamere Road Borings made by: Rusty Olson's Soil and Perc Testing Date: 2/29/16 Classification System: AASHO ; USDS-USDS-SCS X Unified___; Other Auger used(check two): Hand_X,-_,or PowerBucket or Probe X_, Pit Boring Number_3_Surface elevation_103.8_ Mottled Soil at_X feet 0"-10"Dark brown sandy loam 10yr3/2 H2O present at X_feet 10"-20"Brown sandy loam 10yr4/4 20"-32"Brown sandy loam 10yr5/4 32"-44"Brown loamy sand 10y5/4 44"-72"Brown loamy medium sand 10yr6/4 Feb 29 2016 05:07PM HP FaxRusty Olson 7634988290 page 9 I I i - .+ Dal 72"i rrG� r� ' r-W W' t w o to '}'j w 3AB 23's 3y,r' 4 � i r rf q4. 0 I Feb 29 2016 05:07PM HP FaxRusty Olson 7634988290 page 10 Joseph Olson D.B.A. Rusty Olson's Soil& Percolation Testing 11481 Riverview Road NE• Hanover, MN 55341 • 763-498$779 MPCA Lie,#1810 NF T At N CfuSo, ODRES Ol� � I�FJSr � N M IZvA� 0 OTY D96CRIPTJON PRICE MOUNT alto st ►e TK Heel on 3 5� ted 'it bill 14 not paid In iC days,this oonstltutes right to loin, tTgM .Q 8iGNATURS 'TOTAL Sj Cu THANK YOU Feb 29 2016 05:06PM HP FaxRusty Olson 7634988290 page 1 r � � r� Fax Transmittal Form Date: 2/29/2016 Total Pages: 119 To: City of Orono Phone Number: Fax Number: 952-249-4616 E-mail: From: Joseph J Oison Phone Number: 763-498-8779 Fax Number: 763-498-8290 E-mail rust 2654 comcast net ❑ Urgent ❑� For Review ❑ Please Comment ❑ Please Reply Message: This is the septic cert for 1185 Wyd mere Road- Please file.