HomeMy WebLinkAbout04-15-2021 Septic Compliance Report v MINNESOTA POLLUTION Compliance inspection report form
CONTROL AGENCY
520 Lafayette Road North Existing Subsurface Sewage Treatment System (SSTS)
St.Paul,MN 55155-4194 Doc Type:Compliance and Enforcement
Instructions: Inspection results based on Minnesota Pollution Control Agency(MPCA)requirements and attached supporting
documentation—additional local requirements may also apply. Further information can be found here:
https://www.pca.state.mn.us/sites/default/files/wq-wwists4-31a.pdf.
Inspector must submit completed form to Local Governmental Unit(LGU)and system owner within 15 days of final
determination of compliance or noncompliance.
Property information Local tracking number:
Parcel ID#or Sec/Twp/Range: Local regulatory authority: City of Orono
Property address: 425 Hunter Pass,Orono
Owner/representative: Mark Allen Owner's phone: 952-941-5750
Brief system description: 1300 and 1000 gallon septic with 1300 gallon pump tank and a mound system
System status
System status on date(mm/dd/yyyy): 4/15/2021
® Compliant—Certificate of compliance` ❑ Noncompliant—Notice of noncompliance
(Valid for 3 years from report date unless evidence of An imminent threat to public health and safety(ITPHS)must be
an imminent threat to public health or safety requiring upgraded, replaced, or its use discontinued within ten months of
removal and abatement under section 145A.04, receipt of this notice or within a shorter period if required by
subdivision 8 is discovered or a shorter time frame exists local ordinance or under section 145A.04 subdivision 8.
in Local Ordinance.) Systems failing to protect ground water must be upgraded,
*Note:Compliance indicates conformance with Minn. replaced, or use discontinued within the time required by local
R. 7080.1500 as of system status date above and ordinance.
does not guarantee future performance.
Reason(s)for noncompliance (check all applicable)
❑ Impact on public health(Compliance component#1)—Imminent threat to public health and safety
❑ Tank integrity(Compliance component#2)—Failing to protect groundwater
❑ Other Compliance Conditions(Compliance component#3)—Imminent threat to public health and safety
❑ Other Compliance Conditions(Compliance component#3)—Failing to protect groundwater
❑ System not abandoned according to Minn. R. 7080.2500(Compliance component#3)—Failing to protect groundwater
❑ Soil separation(Compliance component#5)—Failing to protect groundwater
❑ Operating permit/monitoring plan requirements(Compliance component#4)—Noncompliant-local ordinance applies
Comments or recommendations
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.
By typing my name below, I certify the above statements to be true and correct,to the best of my knowledge, and that this information
can be used for the purpose of processing this form.
Business name: Sewer Serf s Inc.,---- Certification number: C1659
Inspector signature: �7 License number: 2502
his docu 'int has been electronically signed) Phone: 952-873-3.292
Necessary or locally required supporting documentation (must be attached)
® Soil observation logs ® Locally required forms ® Tank Integrity Assessment
❑ Operating Permit
❑ Other information(list):
https://www.pca.state.mn.us • 651-296-6300 • 800.657-3864 • Use your preferred relay service • Available in alternative formats
wq-wwists4-31b • 1/11/21 Page 1 of 4
1. Impact on public health — Compliance component #1 of 5
Compliance criteria: Attached supporting documentation:
System discharges sewage to the 0 Yes ® No ❑ Other:
ground surface
Z Not applicable
System discharges sewage to drain 10 Yes ® No
tile or surface waters.
System causes sewage backup into 0 Yes' ®No
dwelling or establishment.
Any"yes"answer above indicates the system is an
imminent threat topublic health and safety.
Describe verification methods and results:
Searched for surface outlet or ground discharge
Checked for back-up
2. Tank integrity— Compliance component #2 of 5
Compliance criteria: Attached supporting documentation:
System consists of a seepage pit, 0 Yes ®No 0 Pumped at time of inspection
cesspool, drywell, leaching pit,
or other pit? Name of maintenance business: Sewer Services
Sewage tank(s)leak below their .0 Yes' ® No License number of maintenance business: 2502
designed operating depth?
Date of maintenance: 4/14/2021
O Existing tank integrity assessment(Attach)
Date of maintenance
If yes, which sewage tank(s)leaks: (mm/dd/yyyy): (must be within three years)
Any "yes"answer above indicates the system (See form instructions to ensure assessment complies with
is failing to protect groundwater. Minn. R. 7082.0700 sub p. 4 B(1))
O Tank is Noncompliant(pumping not necessary—explain below)
O Other:
Describe verification methods and results:
Pumped& Inspected
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wq-wwists4-31b • 1/11/21 Page 2 al
3. Other compliance conditions—Compliance component #3 of 5
3a. Maintenance hole covers appear to be structurally unsound(damaged, cracked, etc.), or unsecured?
0 Yes' ®No 0 Unknown
3b. Other issues (electrical hazards,etc.)to immediately and adversely impact public health or safety?❑Yes' ® No 0 Unknown
"Yes to 3a or 3b-System is an imminent threat to public health and safety.
3c. System is non-protective of ground water for other conditions as determined by inspector? 0 Yes' ® No
3d. System not abandoned in accordance with Minn. R. 7080.2500? 0 Yes' ® No
*Yes to 3c or 3d- System is failing to protect groundwater
Describe verification methods and results:
Inspected
Attached supporting documentation: ® Not applicable ❑
4. Operating permit and nitrogen BMP* — Compliance component #4 of 5 ® Not applicable
Is the system operated under an Operating Permit? 0 Yes 0 No If"yes",A below is required
Is the system required to employ a Nitrogen BMP specified in the system design? ❑Yes 0 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.
Compliance criteria:
a. 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.
Describe verification methods and results:
Attached supporting documentation: ❑ Operating permit(Attach) ❑
https://www.pca.state.mn.us • 651-296-6300 • 800-657-3864 • Use your preferred relay service • Available in alternative formats
wy-wwists4-31b • 1/11/21 Page 3 of 4
5. Soil separation — Compliance component #5 of 5
Date of installation 6/1/1997 ❑ Unknown
(mm/dd/yyyy)
Shoreland/Wellhead protection/Food ❑ Yes ® No Attached supporting documentation:
beverage lodging?
® Soil observation logs completed for the report(Attach)
Compliance criteria (select one): ❑ Two previous verifications of required vertical
separation(Attach)
5a.For systems built prior to April 1, 1996, ❑ Yes ❑ No'
and not located in Shoreland or Wellhead ❑ Not applicable(No soil treatment area)
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.
5b.Non-performance systems built April 1, „® Yes ❑ No' Indicate depths or elevations
1996, or later or for non-performance
systems located in Shore/and or Wellhead A. Bottom of distribution media 18"+
Protection Areas or serving a food,
B. Periodically saturated soil/bedrock 18" Design
beverage, or lodging establishment:
C. System separation 36"
Drainfield has a three-foot vertical
separation distance from periodically D. Required compliance separation* 36"
saturated soil or bedrock.* *May be reduced up to 15 percent if allowed by Local
Ordinance.
5c."Experimental'; "Other", or "Performance" ❑ Yes ❑ No'
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.
*Any "no"answer above indicates the system is
failing to protect groundwater,
Describe verification methods and results:
Boring
1-9" 10yr 3/3 Loam
10-24" 10yr 4/4 Clay Loam
Redox @ 24"
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.
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wq-wwists4-31b • 1/11/21 Page 4 of 4
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12/05/2007 20:45 7634975011 SPTESTINGINC PAGE 06/07
S-P TESTING, INC. Steven B. Schirmers • MPCA Cert.No. 627
951 Katydid Lane NE • St. Michael, MN 55376 • (763) 497-3566
FAX • (763) 497--5011
State License#394
1.P S-.OLSOIL BO IN
Dan &Betsy Yamron
425 Hunter Pass
Oron, Henn. Co., MN
Borings completed on 11-19-07, with a hand bucket auger.
13,ORIN NLJMBERi Elev.95.6- MOTTLED SOIL AT 18" - no standing water present
in boring.
0 - 8" Topsoil dark brown loam 10YR 3/3
8" - 18" Brown clay loam 10YR 5/3
18" - 28" Rusty brown clay loam 10YR 5/3 - mottles 10YR 7/1,6/8
R G NUM, EB.k Elev.96.3 - MOTTLED SOIL AT 28"- no standing water present
in the boring.
0 - 8" Topsoil dark brown loam 10YR 3/3
8" - 16" Brown loam 10YR 4/3
16" - 28" Brown clay loam 10YR 5/3
28" - 36" Rusty brown clay loam 10YR 5/3 - mottles 10YR 7/1,6/8
36" - 42" Rusty gray brown clay loam 10YR 6/2 - mottles 10YR 7/1,6/8
13.0.RING N JMB.ER3�Elev.99.6 -through the mound.
0 - 6" Fill soil loam
6" - 40" Fill soil medium sand
40" - 46" Original soil dark gray loam 10YR 3/2
1gQ lG_IALTh t4- E1ev.99.9-through the mound.
0 - 10" Fill soil loam
10" - 38" Fill soil medium sand
38" - 46" Original soil dark brown loam 10YR 4/2