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Home My WebLink About10/29/2020 Compliance Inspection FormMinnesota Pollution Control Agency compliance Inspection Form C 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 (MPCA) I 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): 10/29/2020 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 I] 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 JD# or SeclTwp/Range: 3311823330003 Property address: 75 Crystal Creek Road, Orono, MN Reason for inspection: Property Transfer Property owner: _ Eric Larson — _ Owner's phone: 612-805-7288 or Owner's representative: Representative phone: Local regulatory authority: City of Orono Regulatory authority phone: 952-249-4600 1-1250 and 1-1000 gallon septic tanks and 1-1250 gallon lift station and 630 square feet of mound Brief system description: rockbed. per city records Comments or recommendations: TBM: Top of the lift station manhole cover. There is 1.2 Feet of sand under the rock bed. I drilled through the rock bed there is 0.6 feet of rock 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 Business name: Rusty Olsep's Soil & Perc. Testing Inspector signature: r Necessary or Locally Required Attachments 0 Soil boring logs ® System/As-built drawing Other information (list): www.pca.state.mn.us • 651-296-6300 . 800-657-3864 wq-wwists4-31 • 1124112 Certification number: 1255 License number: 810 Phone number: 763-498-8779 ❑ Forms per local ordinance TTY 651-282-5332 or 800-657.3864 • Available in alternative formats Page 1 of 3 Property address: 75 Crystal Creek Road, Orono, MN Inspector initials/Date: J. 4. 10/29/2020 I. Impact on Public Health —Compliance component #1 of 5 Compliance criteria: System discharge sewage to the ❑ Yes ® No ground surface. System discharge sewage to drain tile [:]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. CommentslExplanation: 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 ❑ No designed operating depth. If yes, which sewage tank(s) leaks: Any "yes" answer above indicates the system is Failing to Protect Groundwater. CommentslExplanation: Duane's Septic Service. pumped the tanks. 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 CommentslExplanation) ❑ "Black soil" above soil dispersal system ❑ System requires "emergency" pumping ❑ Performed dye test ❑ Unable to verify (See CommentslExplanation) ❑ Other methods not listed (See CommentslExplanation) 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 CommentslExplanation) ® Other methods not listed (See CommentslExplanation) 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-wwist54-31 • 1124112 Page 2 of 3 Property address: 75 Crystal Creek Road, Orono, MN 4. Soil Separation — Compliance component #4 of 5 Date of installation: 5126/1998 ❑ Unknown ShorelandNVelIhead protectionlFood Beverage ® Yes ❑ No Lodging? Compliance 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 saturated soil or bedrock. ❑ Yes ❑ No Non-performance systems built April 1, Z Yes ❑ No 9996, 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. ❑ Yes ❑ No Any "no" answer above indicates the system is Failing_ to Protect Groundwater. Inspector initials/Date: J. O. 10/29/2020 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. Conducted soil observation(s) (Attach boring logs) ❑ Two previous verifications (Attach boring logs) ❑ Not applicable (Holding tank(s), no drainfreld) ❑ Unable to verify (See Comments/Explanation) ❑ Other (See CommentsfExplanation) Comments/Explanation. Indicate depths of elevations A. Bottom of distribution media 98.1 B. Periodically saturated soillbedrock 95.5 C. system separation 2.6 D. Required compliance separation* 2.55 *May be reduced up to 15 percent if allowed by Local Ordinance. 5. Operating Permit and Nitrogen BMP* — Compliance component #5 of 5 E Not applicable Is the system operated under an Operating Permit? ❑ Yes ❑ No Is the system required to employ a Nitrogen BMP? ❑ Yes ❑ No BMP=Best Management Practice(s) specified in the system design If "yes", A below is required If "yes", B below is required If the answer to both questions is "no", this section does not need to be completed. Compliance criteria a. Operating Permit number: -- T[:] Yes ❑ No Have the Operating Permit requirements been met? b. Is the required nitrorly functioning? L_I Yes ❑ No Any "no" answer indicates Noncompliance. Upgrade Requirements (Minn. Stat. § 115.55) An imminent threat to public health and safety (1TPHS) 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 • Available in atternative formats wq-ww1sts4.31 • 1124112 Page 3 of 3 Property address: _ City: C rbc iC OCA State: Ar Optional section: Sewage 'Tank Compliance Certification Parcel ID: Zip code: 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 - Existin s ste, w _wwists4-31 b). This form can be found on the MPCA website at htt s://www. ca,state.mn.us/water/ssts-and-msts-technical-and-com liance-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 date 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. Certificate of. _ sewage tank compliance ❑Notice of sewage tank non-compliance Affirp4l three statements: The SSTS does not contain a seepage pit, cesspool, djDwell, leaching pit, or other pit. t does not contain a sewage tank that was designed to be watertight, but subsequently leaks below the signed operating depth. It does not represent an imminent safety threat by reason of unsecured, damaged, or weak maintenance hole covers) or other unsafe condition. Company information Company same: Duane's Septic Service Business license number: 654 Select all that apply: 0 The SSTS has a seepage pit, cesspool, drywell, leaching pit, or other pit. [] It has a sewage tank that was designed to be watertight, but subsequently leaks below the designed operating depth. It presents a threat to public safety by reason of unsecured, damaged, or weak maintenance hole cover(s) or other unsafe condition. Designated Certified Individual (DCI) information Print name: Certification number: 02084 /personally conducted the work described above as a Designated Certified Individual of a Minnesota -licensed SSTS Maintenance Business. /personally conducted the necessary procedures to assess the compliance status of each sewage tank In this SSTS.- Designated CertifiedJ % Individual's signature: / Date (mm/dd/yyyy): www.pca.State.mn.us • 651-296-6300 800.657-3864 Use your preferred relay service Available in alternative formats wq-wwists4-38 • 1127117 Page 3 of 3 SEPTIC SYSTEM INVEN'T'ORY Site Address: 75 Crystal Creek Rd PID 33-116-23-33-0003 Owner dame: Eric & Pamela Larson Owner Address: 75 Crystal Creek Rd Long Lake MN 55356- BuiidinaTvpe: residence Installer: Patnode Bros. Date of Permit: 2111198 Svstem Type: mound BR's Designed for 5 In Musa?: No Shoreland?: No SEPTIC TANKS: Material: precast concrete Capacity; 1250, 1000, 1250 Tank Filter: DRAINFIELD: Treatment Area: 96'38 Sail Boring: yes OF Ht above Wt: 3 WELL DATA Setbacks - Well Tanks: Well DF: Report In File: Depth: 155 INSPECTION RECORDS PUMPOUT RECORDS Date Notes Date GallonsOfLiquid 7/15/2011 Point of sale septic certification expires July 15, 2014 6/26/2014 2500 8/16/2005 OK 7/15/2011 0 7/17/2003 surfacing, replace by 6/1/04 9/22/2009 3000 6/28/2001 no surfacing, pump tanks 3/15/2007 3000 5/26/1998 installation 10/23/2003 3000 8/5/2002 2000 Property Owner / project: Property Address / PID: Soil Observation Log www.SeDticResource.com vers 12. Owner Information Eric Larson 75 Crystal Creek Road Date 10129/2020 Soil Survey Informlation ❑ refer to attached soil survey Parent mates: 0 Till ❑ Outwash ❑ Lacustrine ❑ Alluvium ❑ Organic Cl Bedrock landscape position: ❑ Summit ❑ Shoulder ❑ Side slope ❑ Toe slope soil survey map units: L25A slope % direction- Linear Soil Log #1 0 Boring ❑ pit Elevation 94.4 Depth to SHWT 20 inches Depth (in) Texture fragment % matrix color redox color consistence grade shape 0-10 Topsoil <35 10yr3/1 Friable Moderate Blocky 10-14 Clay Loam <35 10yr4/3 Friable Strong Blocky 14-20 Clay Loam <35 10yr5/4 Friable Strong Blocky 20-28 Clay Loam <35 10yr514 10y4/8,1 -6/10y Firm Strong Blocky <35 loose loose single grain 35-50 friable weak granular blocky >50 firm moderate prismatic platy rigid strong massive Comments: 75 Crystal Creek Road Soil Log #2 ❑ Boring ❑ Pit Elevation 96.9 Depth to SHWT 20 inches Depth (in) Texture fragment % matrix color redox color consistence grade shape 0-20 Topsoil <35 10yr2/'] Friable Moderate Blocky 20-26 Clay Loam <35 10yr4/3 10y4/8,1-6/l0y Friable Strong 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 <35 loose loose single grain 35-50 friable weak granular blocky >50 firm moderate Prismatic platy rigid strong massive 75 Crystal Creek Road Soil Log 43 ❑ Boring ❑ pit Elevation Depth to SHWT Inches Depth (in) Texture fragment % matrix color redox color consistence grade shape <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 <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 <35 loose loose single grain 35-50 friable weak granular blocky >50 firm moderate Prismatic platy rigid strong massive I hereby certify this work was completed in accordance with MN 7080 and any local reqs. 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