HomeMy WebLinkAbout12-16-2021 Septic Compliance InspectionM MINNESOTA POLLUTION Com liance inspection report form
� CONTROL AGENCY p p p
520 Lafayette Road North Existing Subsurface Sewage Treatment System (SSTS)
St. Paul, MN 55155-4194 Doc Tpe: compliance and Enforcement
Instructions: Inspection results based on Minnesota Pollution Control Agency (MPGA) requirement and attached supporting
documentation — additional local requirements may also apply. Further it formation can be found here:
httos://www. oca. state. mn. us/sites/default/files/we-wwists4-31 a. odf.
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
Parcel ID# or See/Twp/Range: Local regu
Property address: 745 Ferndale Rd North, Orono
Owner/representative: Mike Frey
Brief system description: 1250 & 1000 gal septic tanks with a 1250 gal p
System status
System status on date (mm/dd/yyyy): 12/16/2021
®Compliant — Certificate of compliance*
El No
(Valid for 3 years from report date unless evidence of
An
an imminent threat to public health or safety requiring
UM
removal and abatement under section 145A.04,
rec
subdivision 8 is discovered or a shorter time frame exists
/oc
in Local Ordinance.)
Syr
*Note: Compliance indicates conformance with Minn.
rep
R. 7080.1500 as of system status date above and
oro
does not guarantee future performance.
Reason(s) for noncompliance (check all applicable)
❑ Impact on public health (Compliance component #1) — Imminent thrc
❑ Tank integrity (Compliance component #2) — Failing to protect group
❑ Other Compliance Conditions (Compliance component #3) — Immine
❑ Other Compliance Conditions (Compliance component #3) — Failing
❑ System not abandoned according to Minn. R. 7080.2500 (Compliant
❑ Soil separation (Compliance component #5) — Failing to protect groL
❑ Operating permittmonitoring plan requirements (Compliance compos
Comments or recommendations
Called City 3 times to get original design for mound, was told they don't
though it was in house well beyond when this was installed. Original de
feet of sand.
Certification
I hereby certify that all the necessary information has been gathered to
determination of future system performance has been nor can be made
abuse of the system, inadequate maintenance, or future water usage.
By typing my name below, l certify the above statements to be true at
can be used for the purpose o7fp
ssing this form.
Business name: Sewer Se Inc
Inspector signature:
Necessary or locally rec
ng docu
:cry authority: City of Orono
Owner's phone: 952-476-0301
no tank and a mound syst m
:ompliant
—Notice of noncompliance
eminent threat to public health and safety (ITPHS) must be
ided, replaced, or its use discontinued within ten months of
ct of this notice or within a shorter period if required by
ordinance or under section 145A. 04 subdivision 8.
ems failing to protect ground water must be upgraded,
cad, or use discontinued within the time required by local
once.
to public health and safety
threat to public health and safety
protect groundwater
component #3) — Failing to protect groundwater
fwater
nt #4) — Noncompliant - local ordinance applies
it because they out source septic inspections even
hieght couldn't be confirmed but appears to be 2
mine the compliance statuo of this system. No
to unknown conditions durng system construction, possible
mact, to the best of my know/edge, and that this information
Certification number: C1659
License number: 2502
Phone: 952-873-3292
® 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
wq-ww1sts4-31b • 1/11121
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Page 1 of 4
1. Impact on public health — Compliance component #1 of 5
criteria:
System discharges sewage to the
ground surface
❑ Yes' ® No
System discharges sewage to drain( ❑ Yes' ® No
tile or surface waters.
System causes sewage backup into I ❑ Yes' ®No
A .... Hinn nr neMhlieFmenl I
Any "yes" answer above indicates the system is an
imminent threat to public 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 �
System consists of a seepage pit, ❑Yes' ®No
cesspool, drywell, leaching pit,
nr nhYer nif9
Sewage tank(s) leak below their ❑ Yes' ® No
designed operating depth?
If yes, which sewage tank(s) leaks: I
Any "yes" answer above indicates the system
is failing to protect groundwater.
Describe verification methods and results:
Pumped & Inspected
https://www.pca.state. mn, us
wq-ww1sts4-31b • 1/11/21
Attached supporting documentation:
❑ Other:
® Not applicable
ached supporting dol un
Pumped at time of inspection
Name of maintenance business: Sewer Services
License number of maintenance business: 2502
Date of maintenance: 12/16/2021
Existing tank integrity assessment (Attach)
Date of maintenance J
(mm/dd/yyyy): ((must be within three years)
(See form instructions to $$nsure assessment complies with
Minn. R. 7082.0700 subp 4 8 (1))
Tank is Noncompliant (pu ping not necessary — explain below)
Other:
651-296-6300 800-657-3864Use your preferred relay service Available in alternative formats
Page 2 of
3. Other
conditions — Compliance
3a. Maintenance hole covers appear to be structurally unsound (i
❑ Yes' ® No ❑ Unknown
3b. Other issues (electrical hazards, etc.) to immediately and adven
*Yes to 3a or 3b - System is an imminent threat to public
3c. System is non -protective of ground water for other conditions
3d. System not abandoned in accordance with Minn. R. 7080.25(
*Yes to 3c or 3d - System is failing to protect groundwate
Describe verification methods and results:
Inspected
Attached supporting documentation: ® Not applicable
4. Operating permit and nitrogen BMP* — Comp
Is the system operated under an Operating Permit?
Is the system required to employ a Nitrogen BMP specified in the
BMP = Best Management Practice(s) specified in the systel
If the answer to both questions is "no" this section do
Compliance criteria:
a. Have the operating permit requirements been met?
b. Is the required nitrogen BMP in place and properly function
Any "no" answer indicates noncompliance.
Describe verification methods and results:
Attached supporting documentation: ❑ Operating
nent #3 of 5
cracked, etc.), or unsecured?
impact public health or safety? ❑ Yes* ® No ❑ Unknown
dth and safety.
determined by inspector? ❑ Yes* ® No
❑ Yes* ® No
of 5 ® Not
❑ Yes ❑ N If "yes", A below is required
design? ❑ Yes ❑ N If "yes", B below is required
not need to be
❑ Yes ❑ No
❑ Yes ❑ No
(Attach) ❑
https://www.pca.state.mn.us 651.296-6300 800-657-3864 Use your preferred relay service Available in alternative formats
wq-ww1sts4-31b • 1/11/21 Page 3 oJ4
5. Soil separation — Compliance component #5 of 5
Date of installation 10/24/1989 ❑ Unknown
(mn✓dd/yyyy)
Shoreland[Wellhead protection/Food
beverage lodging?
Compliance criteria (select one):
5a. 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
5b. Non-performance systems built April 1,
1996, or later or for non-performance
systems located in Shore/and 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.*
5c. "Experimental, "Other", or "Performance"
systems built under pre -2008 Rules;
Type /V 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
G Nm
❑ Yes ❑ No*
® Yes ❑ No*
❑ Yes ❑ No*
*Any "no" answer above indicates the system is
failing to protect groundwater.
Describe verification methods and results:
Boring
1-10" 10yr 3/2 loam
11-14" 10yr 4/4 clay loam
Redox @ 12"
Upgrade requirements: (Minn. Stat. § 115.55) An imminent threat to F
or its use discontinued within ten months of receipt of this notice or with
system is failing to protect ground water, the system must be upgraded
local ordinance. if an existing system is not failing as defined in law, an
system need not be upgraded, repaired, replaced, or its use discontinue
This provision does not apply to systems in shore/and areas, Wellhead
beverage, and lodging establishments as defined in law.
https://www.pca.state. mn.us 651-296-6300 800-657-3864
wq-wwists4-31b • 1/11/21
Attached supporting documentation:
® Soil observation logs completed for the report (Attach)
❑ Two previous verifications of required vertical
separation (Attach)
❑ Not applicable (No soil treatment area)
Fl
Indicate depths or elevations
or use d b
A. Bottom of distribution
media
24"+
B. Periodically saturated
soil/bedrock
12"
C. System separation
36"
D. Required compliance
separation*
36"
*May be reduced up to 15
percent if allowed by Local
Ordinance.
blic health and safety (ITPHS)
must be upgraded, replaced,
i a shorter period if require{
by local ordinance. if the
re /aced its d' t'h
d 7h' th t'
p scon a ue w m e ema require y
has at least two feet of design soil separation, then the
d, notwithstanding any local ordinance that is more strict.
'rolect/on Areas, or those used in connection with food,
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Page 4 cf4
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SEPTIC SYSTEM INVENTORY
Site Address: 745 Ferndale Rd N
Owner Name: Karen Frey
Owner Address: 745 Ferndale Rd N Wayzata MN 55391
BuildingTvpe: residence
Date of Permit: 10/23/89
System Type: mound
In Musa?: No
PID 36-118-23-12-0007
Installer: Ritter Exc.
BR's Designed for 5
Shoreland?: Yes
SEPTIC TANKS: p5b tZK-o
Material: precast concrete Capacity: �14W. 1000'AeOT� Tank Filter: �10
DRAINFIELD:
Treatment Area: 90'40 Soil Boring: Yes DF Ht above Wt: 3
WELL DATA
Setbacks -Well Tanks: 50 Well DF: 75 Report In File: Depth: 320
INSPECTION RECORDS
PUMPOUT RECORDS
Date Notes
Date GallonsOfLiquid
8/1/2005 OK
5/17/2017
2500
8/7/2003 no surfacing
7/1/2014
2500'
7/25/2001 code system, no surfacing
5/1/2011
0
6/22/1998 compliant
.i 5/19/2008
2500
5/23/1995 no surfacing -pump tanks
10/5/2006
2500
9/3/1992 no surfacing
8/1/2003
2000
7/2/1990 no surfacing, but DF moist (NW corner)
9/19/2001
1500
10/24/1989 installation
6/25/1996
2000
10/24/1989 installation
6/25/1996
2.000