HomeMy WebLinkAbout05-28-20 Septic Compliance InspectionO.A.Minnesota Pollution Compliance Inspection Form
Control Agency
520 Lafayette Road North Existing Subsurface Sewage Treatment Systems (SETS)
St. Paul, MN 55155-4194I Doc Type: Compliance and Enforcement
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 (mm/dd/yyyy): 5/28/2020
® Compliant - Certificate of Compliance
(Valid for 3 years from report date, unless shorter time
frame outlined in Local Ordinance.)
❑ Noncompliant- Notice of Noncompliance
(See Upgrade Requirements on page 3.)
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 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 permittmonitoring plan requirements (Compliance Component#5) — Noncompliant
Property Information
Parcel ID# or Secfrwp/Range:
Property address: 4565 Bayside Road Reason for inspection: Sale
Property owner: Tim & Mary Doubek Owner's phone: 612-801-3076
or
Owner's representative:
Local regulatory authority:
Brief system description:
Representative phone:
City Orono Regulatory authority phone:
2- 1250 gallon septic tanks with 1250 pal pump tank & a mounds stem
Comments or recommendations:
The design has 4 different numbers for the sand depth of the mound, each page says something different.
I went 24" on boring with no redox so mound will pass no matter which number was correct
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: Josh Swedlund Certification number: C1659
Business name: Sewer S es I e! License number: 2502
Inspector signature: - 0OOk Phone number: 952-873-3292
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 or800-657-3864 • Available in alternative formats
wq-wwists4-31 • 3/16/12 Page 1 of 3
Property address: 4565 Bayside Road Inspector initials/Date: JS 1 5/28/2020
(mm/dd/yyyy)
1. Impact on Public Health — Compliance component #1 of 5
System discharges sewage to the I ❑ Yes ® No
discharges sewage to drain I ❑ Yes ® No
System causes sewage backup into ❑ Yes ® No
dwelling or establishment.
Any "yes" answer above indicates the
system is an imminent threat to public
health and safety.
Com ments/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 f allowed in local ordinance.
Sewage tank(s) leak below their ❑ Yes ® No
designed operating depth.
If yes, which sewage tank(s) leaks:
Any "yes" answer above indicates the
System is failing to protect groundwater.
Com ments/Explanation:
Verification method(s):
® Searched for surface outlet
® Searched for seeping in yard/backup in home
❑ Excessive ponding in soil system/D-boxes
❑ Homeowner testimony (See CommentsrExplanation)
❑ "Black soil" above soil dispersal system
❑ System requires "emergency' pumping
❑ Performed dye test
❑ Unable to verify (See CommentsrExplanation)
❑ Other methods not listed (See CommentsrExplanation)
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)
❑ Other methods not listed (See CommentsrExplanation)
3. Other Compliance Conditions -Compliance component #3 of 5
a. Maintenance hole covers are damaged, cracked, unsecured, or appear to be 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
wq-wwists4-31 • 3/16/12
• TTY 651-282.5332 or 800-657-3864
• Available in altemative formats
Page 2 of
Property address: 4565 Bayside Road Inspector initials/Date: JS 1 5/28/2020
(mm/dd/yyyy)
4. Soil Separation — Compliance component #4 of 5
Date of installation: 3/5/2015
(mm/dd/yyyy)
ShorelandMellhead protection/Food beverage
lodging?
criteria:
For systems built prior to April 1, 1996, and
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
Non-performance systems built April 1,
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 IV
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.
❑ Unknown Verification method(s):
Soil observation does not expire. Previous soil
❑ Yes ® No observations by two independent parties are sufficient,
unless site' conditions have been altered or local
requirements differ.
❑ Yes ❑ No ® Conducted soil observation(s) (Attach boring logs)
❑ Two previous verifications (Attach boring logs)
❑ Not applicable (Holding tank(s), no drainfield)
❑ Unable to verify (See CommentsrExplanation)
❑ Other (See CommentsrExplanation)
® Yes ❑ No
❑ Yes ❑ No
Comments/Explanation:
Boring:
1-22" 10yr 2/2 loam
23-26" 10yi 4/4 Clay Loam
No Redox
Indicate depths or elevations
A. Bottom of distribution media 12"+
B. Periodically saturated soil/bedrock 24"+
C. System separation 36"+
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.
a. Operating Permit number:
Have the ODeratina Permit reauirements been met? E-1 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 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.
wwvr.pca.state.mn.us • 651-296-6300 800-657-3864 TTY 651-282-5332 or 800-657-3864 • Available in alternative formats
wq-ww1sts4-31 • 3116112 Page 3 of 3
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