HomeMy WebLinkAboutSeptic info %o
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� _ , ° � i Street Address: Mailing Address:
`9$'Egg04'� 2150 Kelley Park ay P.O. Box 66
Orono, MN 5535 Crystal Bay, MN 55323-0066 ' .
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To Current Owner: Address: L11ys L�`'� S ��e 1�.C�
City Ordinance 199 requires that each existing on-site sewa�e treatment ystem in Orono be inspected every two years.
The on-site sewa�e treatment system at the above address has been inspe ted and appears to fall into the categories checked below.
SYSTEM CONFORMITY (1-3): �
�"CODE SYSTEM" An[STS which meeu all the locanon,design and con ction standazds of the current Orono Municipal Code.
2 "COMPLIANT SYSTEM" An ISTS which does nc�t meet all the locatio ,design and conswction standards of the current Orono Municipal
Code but does meet the three foot separation requirer.�at or two foot requir ment for systems installed 1996 or earlier,and which is not failing or
an imminent threat to public health or safety.
3 "NON-COMPLIANT SYSTEtii" A prohibited ISTS;an ISTS located ithin_a designated ]00-year flood plain,any ISTS which may
or may not meet all the location.dzsign,or corli-miction standards of the c rrent Orono Municipal Code and which is failing for any reason;and
any ISTS with less than three feet of unsaturated soil or sand betueen the d suibution device and the limiting soil characteristics.
TANK CONDITION(5-7): �
Tank inspection indicates:
QPumpout not needed at this time.
6 Septic tanks must be pumped out this year (cih•code requires ta ks to be pumped out once every 3 years.
Tank was last pumped )_
Make sure se tic tanks are um ed throu h manhole and not th ou h white ins ection i es. This ailows for the
proaer cleaning. Kee water softner and iron filter dis har e out of se tic s stem.
7 Inspection risers missing-tanks could not be inspected. Inspecti n risers(4" dia. pipe)must be installed in each tank. If
tanks have not been pumped out within the last three years,they hould be pumped out now.
DRAINFIELD CONDITION 8-10 : J
8 Drainfield is dry,no surfacin�evident.
9 Some evidence of surfacing,not critical}�et.
10 Drainfield is saturated and visibly dischar�in�untreated effluent o the surface. Contact the City Inspector
immediately. Repairs must be completed�r•ithin 90 days.
COMMENTS: ��:;�.� `o�� C� �Y� . .�� �-v\� , t��i�! c:.�nc�
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Date of Inspection I�tatt Bolterman - Septic System Inspector
tiote: [n the event that this inspection report is used to satisfy the requ�ments for a mort'a�e or other transfer of property,be advised that this report does not guarantee
or certify that an existin�system will continue to function properly,but is merely an opinion o the adequacy of the system under current conditions based on the available
information.
Telephone(952)2.�9-4600 • F (952)249-4616
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Street Address: Mailing Address:
�t9 � 'Sc��'G 2750 Kelley Parkway P.O. Box 66
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Orono, MN 55356 Crystal Bay, MN 55323-0066
To: The Cunent Owner of Address ���� � 3'4 �t 5' `��'
City Ordinance requires that onsite sewage treatmen systems in Orono be
inspected on a periodic basis. The onsite sewage tre tment system at the above
address has been inspected and the followin�is kno about the system. A
sketch of the known components of the system is av ilable for most properties at
the Orono City Hall.
Imminent Public Health Threat
Yes �1\To
If yes, please contact the Onsite Systems Manager a 952-249-4626 within 10
days of receipt of this notice. The septic system mu t be brought into compliance
within 90 days. Failure to do so will result in referr 1 to the City Attorney for
legal action.
System Identified as Non-Compliant
Yes ��
No
If yes, system must be brought into compliance by:
December 31, 2007
December 31, 2010
Other
Septic Tank(s) ump out Needed
Yes
No
The City recommends the septic tank(s) and/or lift t nlc be serviced and pumped
out every three years. City records indicate the ta s) were last pumped out on
� �- ,Z`i�-c � , The tank(s) should be clean d through the manhole and
not throu�h the inspection pipes, this allows for pro er cleanin�.
Comments:
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Inspector�� Date o Inspection
Telephone(9�2) 3�9-4600 � Fa. (9�2) 2�9-4615
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9 ; ;:°;,. g� Street Address: Mailing Address:
�C'EggO 2750 Keiley Parfc ay P.O. Box 66
Orono, MN 5535 Crystal Bay, MN 55323-0066
Owner: A� �S Wh��� Address:_ 4a4S (�qyS��de Rd
City Ordinance 199 requires that each existing on-site sewage treatment sy tem in Orono be inspected every two years.
The on-site se�vage treatment system at the above address has been inspect and appears to fall into the categories checked belo�v.
SYSTEM CONFORMITY (1-3): �
� ��CODE SYSTEM�� An ISTS which meets all the location,design and constcucti standards ofthe current Orono Municipal Code.
2 '�COMPLIANT SYSTEM�� An ISTS which does not meet all the location,des and construction standards ofthe currrnt Orono Municipal
Code but does meet the three foot sepazation requirement,and which is not failing o an immincnt threat to public health or safety.
3 NON-CO�fPLIANT SYSTEM" A prohibited ISTS;an ISTS located wi a designated 100-year flood plain,any ISTS which may
, or may not meet all the localion,design,or construction standards of the curtent O no Municipal Code and which is failing for any reason;and
any ISTS with lus than three feet of unsaturated soil or sand between the distributi device and the limiting soil chazaderistics.
TANK CONDITION(5-10): 6 .
Tank inspection indicates: -
� Pumpout not naeded at this tima.
� Tank must ba pumpzd out this yeaz (city code requires tanks to be pumped out every years. Tank was last pumped 6- 9 7 ),
7 Solids accumu(ation in tanks is at a ttitical a critical levet. Tanks should be pumped t as soon as possibla.
8 S}•stem is discharging to the surface. Tanks must be pumped out within 48 hours to e iminatz surface discharge.
9 Inspzction risecs missing-tanks could not be inspected. Inspzction rise�(4"dia,pipe)must be installed in each tank at next pumpout If tanks
ha�•e not brzn pumped out within the last three yzars,they should be pumped out now
10 Inspectiun pipe is located directly over tank baf}le(does not give accurate measurem t of solids accumulation). If tanks have not been pumped
out�vithin the l�st three years,thay should be pumped out now.
DRAINFIELD COi�1DITION(11-14): Jl_
� Drainfield is dry,no surfacing evident .
i 2 Somt evidence of surfacing,not critical yet � ' ,
13 Drainfield is saturated and visib(y dischuging untreated e$luent to tha surface. Conta the City Inspector immediately.Repairs must be
completed within 90 days.
1=� Draintield z�tent and condition unknown
COMNIENTS: S Srte� IookS O�C , Oo� ecordS S�o� �qS�- ��,, don
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Date ot:Inspection Septic System Inspector
Nota: In the evznt that this inspeclion repoR u used to satisfy the requirements for a moRgage or o er transfer of property,be advised that this repoR does not guarantee
or ceRify that an cxisting system will continue to function propedy,but is merely an opinion of the adequacy of the system under cuirent conditions based on the available
infocmalion.
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CITY OF ORONO O
Municipal Offices �
Post Office eox 66
Crystal Bay, MN 55323-0066 a � ON–SITE SEWAGE TREATMENT
r�y, INSPECTION REPORT
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Owner• 171�IS ��l���TE Address• 7 C'l�f.= �Cl'I
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Permit �'s: � Dates: C���zZ'G' Con ractors: �i,i [rl (/e¢!/l,S�
City ordinance number 100 requires that each on-site sewage tr atm nt system in Orono be inspected on a reg�lar basis.
The on-site sewage treatment system at the above address ha be inspected and appears to fall into the category
checked below.
(This is � an existing system [ ] neu constructi n)
SYSTEM CONFORMITY 1-3 :
1 ��CODE SYSTEM"-A system uhich meets all the location, design, and construction standards of the current City
Codes, and which is operating satisfactorily by tre ting and disposing of the entire current sewage input
without discharging any pollutants into ground or s rfac waters.
2 "CONfORMING SYSTEM"-A system uhich does not meet all the ocation, design, and construction standards of the
current City Codes, but uas installed according to he c de in effect at the time of installation, and which
is operating satisfactorily by treating and disposi g of the entire current sewage input without discharging
any pollutants into ground or surface waters.
3 "NON-CONFORMING SYSTEM"-A prohibited system; a syste lo ated uithin a designated 100-year floodplain; any
system which may or may not meet all the location, des gn, and construction standards of the current City
Codes and which is failing for any reason; and any syst uith less than 3 feet of unsaturated soil or sand
between the distribution device and the limiting soil ch ,racteristics.
<The limiting soil characteristic � has or [ ] ha not been identified at this time. If the limiting soil
characteristic has not been identi ied, this classificatiun may be subject to revision.)
TANK CONDIT[ON (5-10): I
Tank inspection indicates:
5 Pumpout not needed at this time.
6 Solids accumulation in tanks indicates they should be purt�ped o t this year to help prevent future problems.
7 Solids accumulation in tanks is at a critical level. Tanks sh ld be pumped out as soon as possible.
System is discharging to the surface. Tanks must be pumped ou within 48 hours to eliminate surface dischar�e.
9 [nspection risers missing-tanks could not be inspected. I spe tion risers (4" dia. pipe) must be installed in each
tank at next purtipout. If tanks have not been pump ou uithin the last three years, they should be pumped
out now.
10 Inspection pipe is located directly over tank baffle (do s no give accurate measurement of solids accumulation).
If tanks have not been punped out uithin the last th ee ars, they should be pumped out now.
DRAINFIELD CONDITION (11-14):
ai ield inspection indicates:
1 Drainfield is dry, no surfacing evident.
Some evidence of surfacing, not critical yet.
13 Drainfield is saturated and visibly discharging untreat ef luent to the surface. Contact the City Inspector
imnediately. Repairs must be completed uithin 90 da s.
14 Drainfield extent and condition unknown.
LIMITING SITE FACTORS (slope,setbacks,etc.): .—
POTENTIAL FOR SYSTEM FAILURE de nds on soils water table etc. : `,�f
COMME TS: �i(l / C9v^ �7o�t°S - t� p c^� cl Yl�� y '�S.S L�G[!' " �'
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Date of Inspection S ptic System Inspector
Note: In the event that this inspection report is used to sati fy t e requirements for a mortgage or other transfer of
property, be advised that this report does not guarantee or ce tif that an existing system uill continue to function
properly� but is merely an opinion of the adequacy of the syste under current conditions based on the available
informatton.
This report must be kept on the premises with the s stem locatien and pumping records.
WHITE COPY/Inspectors File YELLOW COPY/Homeowner
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.� ��"'��;��'.� SVeet Address: Mailing Address:
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�C'EggO 2750 Kelley Parkw y P.O. Box 66
Orono, MN 5535 Crystal Bay, MN 55323-0066
Owner: �I(�S N/�•�� Ad ress: 4245 Bayside Rd.
Permit #'s: 4464, 934 Dates: 6/23/76, 6/22/88 Co tractors: Earl Day, Sullivan
(This is [ X� an existing system [ ] new construction .
SYSTEM COMPLIANCE (1-3) : 1
�11 Code System: Meets or exceeds current City stan ards in all respects relating to design,
�� construction, and location. Appears to be operati g properly.
2 Comgliant System: Does not meet all current Ci y standards for new construction, but in
most respects appears to be designed, located, a d constructed in accordance with previous
codes and is functioning properly.
3 Non-ComAliant System: System may or may rlot eet current City standards for design,
construction, or location, but is failing to p operly treat and dispose of the current
input; and any system with less than three feet of vertical separation between the bottom of
the drainfield and the saturated soil level.
(The saturated soil level [ �] has or [ J has no been identified at this time. If the
saturated soil level has not been identified, this clas ification is subject to revision.)
TANK CONDITION (5-9) : 9
5 Pumpout not needed at this time.
6 Solids accumulation in tanks indicates they should be pumped out this year.
7 System is discharging to the surface. Tanks must e pumped out within 48 hours.
8 Inspection risers missing-tanks could not be insp cted. If tanks have not been pumped out
�, within three years, they should be pumped out and isers installed now.
VInspection pipe is located over tank baffle-can ot measure solids accumulation. If tanks
have not been pumped out within three years, they hould be pumped out now.
(During the last septic tank Maintenance Pumpout the t nks [ ] were or [x] were not confirmed
to be watertight by the licensed pumping contractor. If the tanks were not confirmed to be
watertight, this classification is subject to revision.
DRAINFIELD CONDITION (11-14) : 11
Drainfield is dry, no surfacing evident.
12 Some evidence of surfacing, not critical yet. Rep ir is not required at this time.
13 Drainfield is saturated and visibly discharging u treated effluent to the surface. Contact
the City Inspector immediately. Repair must be co pleted within 90 days.
14 Drainfield extent and condition unknown.
R .) : low
COMMENTS:
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Date of Inspection Se ic System Inspector
Note: In the event that this inspection report is used to satisfy the requirements for a
transfer of property, this report does not guarantee that an existing system will continue to
function properly, but indicates the operation of the s stem under current conditions.
Telephone (612) 473-7357 � F 473-0510
Jan 28 14 05:33p Joseph Olson 763-498-8290 p.1
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Fax ransmittal Farm
Date: 1/2$/2014 Total Pages: II8
To: City of Orono
Phone Number:
Fax Number: 952-249-4b16
E-mail:
From: Jaseph J Olson
Phone Number: 763-498-8779
Fax Number: 763-498-8290
E-mail: rust�r265�C�%com�ast.net
❑ Urgent
0 For ReviBw
❑ Please Comment
❑ Please Reply
Message: This is the septic cert for 245 Bnyside Road.
Please file
Jan 28 14 05:34p Joseph Olson 763-498-8290 p.2
Minnesata Potfution �prp liance Inspect�on Form
Eontro! Agency
520 Lafayette Road North Existing S bswrface Sewage Treatment Systems
st.�aui,MN 5 51 5 5-41 9q (SSTS)
Doc Type:Compliance and Enfor�ement
Instructions: Inspection resuEfs based on Minnesota Pollution Control Agen (MPCA} Far(ocal tradcing purposes:
requirements and attached forms—additional local requiremerrts may also a ly.
Submit completed form to Local Unit of Govemment(LUG)and syste owner
within 95 days
System Status
System stattts on date(mmlddlyyyy): 12/i812U13
� Compliant—Certificate of Camplia�ce ❑ f�oncompliant—Notice of No�compliar�ce
{Valid for 3 years from reporf date, unless shorter bine (See Upgrade Requiremenfs on page 3J
frame oudined in Loca!Oro'inance.J
Reaso�(s)for noncompliance{check all applicable)
❑Jmpact on Public Health{Compliance Component #7)—Immin t threat to pubkc heafffi and safety
❑Oiher Compliance Conditions(Compliance Componenf#3)—1 inent threat to public healfh and safety
❑Tank Jntegrity(Complian�e Camponent #2)—Farling to protect roundwat�r
❑Other Cor�pliance Conditions(Compliance Cornponenf�t3J—F i/ing fo proteet grnundwater
❑Soil Separation(Compliance Component #4)—Fai6ng to prr�fe groundwater
❑ Operating permitJm�nitoring plan requirements(Compliance Co ponent #5)—Noncomplianf
Property Inform�tion Parcel ID#ar Se wplRange: 0611723130001
Property address: 4245 Bayside Road,Orono AAN ^ Reason for inspecE+on: Property Transfar
Property owner: � Owners phone:
or ----
Owner's represerrtative: Catherine Wersat Representative phone: 612-597-&S61
�ocal regulatory authority: City of Orono __ Regulabory authflnty phone: 952-2A9-4600
2-1 Q00 galiot�septic tanks,1-1000 ga[lan lift sta n and fi30 square feet of mound rockbed.per ciry
Brief sys3em description: records
Commenis or recommendations:
Certificatton
J heneby cert�fy that al!the necessary informafion has been gafhered to dete ine the compliance sfalus of thfs system.No
deterrnination of futu�system perfarnrance has been nor can be made due unknawrt corrditions during system constructron,
possible abuse ofthe system,inadequa2e maintenance, arfuture wat�rusa .
Inspector name: Joseph J Olson Certifica5on number: i 255
— - _.. _
Business name: Rus son's Soil 8�Perc.7esiing License ne�mber: 810
InspecEor sigRatcare: ��----�'"'�� � Phone number. T63-498-8779
Necessary or Locally Required Attachments
�Soil boring togs �S�rstem/As-built dtawEng ❑ F rms per local ordinance
0�ther information pist}:
www.pcastate.m�.us - 551-296-630� • 8D0-657-3864 • T�'Y 651-28 -5332 or 800-657-3864 • Available in alCemative formats
wq•wwists4-3i • r�24rr2 ?age 1 of 3
Jan 28 14 05:34p Joseph Olson 763-498-8290 p.3
Property address: 4245 Sa �de Road,Orono,MN inspectoe initialslDate: J.O. 1/16/14
i. impact or� Public Hed(th—Compliance component#1 of 5
_Compliance criteria: _ VerificatioR method(s):
System discharge sewage to the ❑Yes �No � Searched for surface ovtlet
ground surface, � Searcfted fior seepiRg in yardJbackup in home
System discharge sewage So drain tile ❑Yes � No ❑ �cessive ponding in soil systemlD-boxes
or sUrface waters. � Homeowner testimony(Sea Comments/F�planation)
System cause sewage backup into ❑Yes ❑ "slack soil'above soiE dispersal system
dwelfing or establishment.
� N° ❑ System requires"emergenc�l'pumping
Performed dye test
Any"yes"answer above indicates the system is Unable to verify(see Commer�ts�cptanason)
an lmminen�Threaf fo Pub�ic Health and Safety. Other methods not listed(see cvmments�cpranation}
CommerttslExpla nation:
2. Tdnk Int2�r'ity—Compliance corrzponent#2 of 5
_Compliance cnteria: erification method(s):
System consists of a seepage pit, ❑Yes � No Prabed tank(s)bottom
cesspool,drywell,or leaching pit. Examined construction records
Seepage pifs m�eting 7080.2550 may 6e ' Examined�ank integr�ty Form(Attach)
com fiant if aAowed in local ordinance.
Observed liq�id level below operating depth
Sewage 2ank(s�feak below their ❑Yes �No F�camined empty{pumped)tanks(s)
designed operafin4 depth.
If yes,which sewage tank(s} leaks: Probed outside tank(s)for"black soil"
Any "yes"8rlsvYef BboVe 1I�diCateS the Unable to verify(5ee Comments/Explanatiort)
sys�em is Failing fo Protecf Groundwater. �her r7lethods not listed(5ee CommentsiExplanalionJ
Co m me n tslE xpla n at io n:
Petersan Comparry pumped the tanks
3. dther Compltante Conditions—Compliance component of 5
a. Maintenas�ce hole cavers are damaged,craciced,unsecured,or a� to structurally unsound. ❑Yes' �nlo ❑Unknown
b. Otl�er issues[efeclrical hazarris,etc.)to imme�ately and adversely impa publiC heatth or safety_ ❑Yes" �No ❑Unknown
�'Sys(em is an imrninent threat i�public heafth and saiety
Exp(ain_
c. S7rstem is non-protec#ive of ground water for other conditions as cfete ined by inspecEor ❑Yes� �No
"`Syrstem es fariing i�o praiect groundwater
Expfain:
www_ptastate.mn.us - 651-296-6300 • 80p-657-3864 • 77Y 651-282 5332 or 8D0-657-3864 • Availahle in altemative formats
wq-wwists4-31 - f l24!72
Page 2 of 3
Jan 28 14 05:34p Joseph Olson 763-498-8290 p,4
Property address: 4245 Ba side Road,Orono,MN I
--- Inspector initiafslQate: J. O. 1/16/14
4. Soil Separation—ComRlian�e componer�f#4 of 5
�ate of instaElation: 6/28/88 ❑ Unknown Verificafion method(s�:
ShorelandANellhead protecttoNFood Beverage � Yes
l.odging? � No Soi!observafion does not expi�, previous soi!
o6serva6ons by two independent partres are sufi'cient,
COIt1 lianCe Ctiteria: unless site condfions have been alfered orlocal
For sysfems built prior to Apri!1, 7996, and ❑Yes ❑ I�o �qu����ts differ.
nof located in Shoreland vr Wellhead � Conducted soil observation(s)(Attach bonrrg rogs)
Pratection Area vr nof serving a food,
beverage orlodging establrshment: ❑ �Wo previous venfications(Aetach boring Jogs)
❑ Not applicable(Nolding tank(s),no drainfieldj
€�rainfield has at feast a two-fooi vertical �
separation distanoe from periodically ❑ Unable to verify(See CommentslFxplanalion)
saturated soil or bedrock. _ 0 Other(See Comments✓Explanation)
Non perfo�mance systems built,4pril 1, �Yes ❑No Cornmerrts/Explanation.•
�996,or fater or for non perforrnance
systems located in Shor�fand or tNellhead
Protectron Ar�as orserving a fooct,
beverage, orlodgingestablishment
Drainfield has a three-foot�ertical
separation distance from periodicalfy
saiurated soil or bedrock.*
'�xperimerrtal'; 'Other'; or Pe�ormance" ' ❑Yes 0 No lndicate de ths of elevations
sysferns built under pre�-2008 Rules; Type IV
or'V systems built under 2008 Rules(708U. . BoStom of distr+bution media 100.0
2350 or 7080.2Q00 (Advar�ced Inspector —
License required) . Periodicall saturated soiUbedrock 97.0
Drainfield meets the desFgned vertical
separation distance from pe�iodicaliy - stem se aretion __ _ 3.0
saturated soil or bedrock.
. Re uired com liance se aration` 2.6
Any "no"answer above indicates the system is �ay be reduced up to 15 percerrt'rf altowed by E�ocal
Failin to Protect Grot�ndwafer. Ordinance.
5. Operatin� Permit and Nitrogen BMP'�—Compliance co ponent#S of 5 � Not app�icable
Is the system operated under an Operating Permit? Q Yes ❑ N If`yes",A betow is r�quired
Is tfie system required to employ a Nitr�gen BMP? ❑Yes ❑N if"yes",8 below is required
BMP=6es1 Managemenf Prac�ce(s)specifi�ed in the systerr�design
!f the answer to boih questions is "no", this section daes n need to be cempleted,
Compliance criteria
a. Operating�ermit number.
Ftave the O eratin Permit r uirements been met? � ❑Yes ❑ N�
b. Is the required nitroqen BMP in�lace and properl functionin ? ❑Yes ❑No
Any"no"answer indicates Noncornp/iance.
iJpgrade 12equiremertts(Minn. Stat.§115.55)Rn imminenf threat to public hea h and safely(ITPHS}musl be upgraded,r2placed,or its uSe
drscontinved within ten monlhs ofreceipf of lhis nolice or wiUrin a sho�fer oeriod if uir�d hy loca!ordinance.!f fhe syslerrr is failing to proh;ct
graund water,the sysfem must be upgraded,replaced,or its use drsconiirrued ovit n the fime required by local orrlinance. If an enisting system
is not failirtg as defrned in 1a w, and has at Je2st Iwo ieet of desig�sa!separatron,t en the system Reed not be upgraded,repafred,repfaced,or
its use discont/nued,nofwifhstandiny any locaf ordrnance ffiat rs mae slrrcL This p vision does not apply to systems in shorefand areas,
We!lhead Protection A�as,or fhose used in connection Hritry food,heverage,and/ ging establrshments as defined i�law.
www.pca.state.rnn.us • 651-296-b300 • 800-b57-3864 • TTY 651-282 5332 or 800-657-3864 • Avaitable in altemaiive formats
wc7-wwists4-3t • i/24/11 AQge 3 of 3
Jan 28 14 05;34p Joseph Olson 763-498-8290 p.5
I aTik �e O
Date: �ecember 1$,2Gi3
Llrner.�. i�etersos� Ca
�9��1 Dague Ave.
Delano, '��N ����g
PlZci�e f fi�-9;2-2��?0
Fa?� 7�g-9 i��-7?1 i
VIPCA License# ��19
�i2�5 BaysidP�Coad
;G�ono)
612-597-6661 —Gather�ne Wersaf-Reallor
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ga�es: i:YQiv�)/ OFF
.�i
Tanlc Capacity: 3`1000 Ga�ion Tanks
� of Tanks: 3
Type of Tanks: concrete
Gallons Ptzrr3ped� ����
�lanhoies ta Gracle: �Y�S % NQ See Comme ts
Comments: �
On December�$,2033. ��merJ. Peferson Co. uncovereG 2nhafes('("rpanhole-36 inch�sds�p, 2ntl
manhofe—28 in;,has deep, Irft stat�on mar�hole fo gra�ie)an purn��d septic tanks_ No cracks or waier
Ieaking at that iime.
�?OTE:Tl�is is on3y�a t�k ��e�ort. TIiis is izot a compliance ins�ection Forpoi�t ofsaie nor does
it re�tace a compiiwce snspec[iou.
i
_ ----_
Jan 28 14 05:34p Joseph Olson 763-498-8290 p.6
Propert{address: 4245 Sayside Road� _ inspector init�'aisfbate: 12li8l13' Y`
1. Irnpact on Publt� I-Eeafth—Cornpiiance compo�eRt#1 o 5
Camp9iance criteria: _ __,_ Ve�ificatsan method(sy:
System discharge sewage to the � Q Yes ❑No ❑ Searched for svrface outiet
�round surface. _^_ ___ �_ ��__ ❑ 5earched for seeping in yardlbackup in horne
System discharge sewage to drain tile ; ❑ Yes ❑No ❑ �cessiva ponding ir�scil systemlD-boxes
or surtace waters. _^_� Q Ffomeow�er testimony{See Comments�ExptaraGon)
System cause sewage baekup into j ❑Yes ❑ "���c�saif"above soit dispersal system
dweflirtg or es�ablishment. � G N� ❑ System requires"emerge�c�pumping
� Periormed dye test
Any"yes"a�swer ahove indicates the sysfern is � Unable to ve�fy(See Commenfs�Explanation)
an lmrrtinenf Tt�reat to Puh/ic�Iea/th and Safety.
--- —__. ❑ Other methods not{isted(See Comments�E.xpfar,atlorrf
Comments/Expfanafion:
2. Tar9K Entegrity—Compliance component#2 of 5
eompl;ance criter�a. � �_ _ �__ erification method(s):
5ystam consists of a seepage pit, j ❑Yes �C] No Probed tank(sj boftom
cess�ool, drywell, or feaching pit Examined construction records
seepage pits meetinp 7080.2554may be I Exar�ined Tank Integri.ry Form(Attach)
compliantlfa/lowed rn�oca!ordlnanee-
�—- Observed lic{uid level befow operating de�th
Sewage tank(s}lea�C be;ow Yheir j ❑ Yes
desicned operaling�th. ��a Examined err,pty(pumped}tanks(s)
t�Ves,wh:ch sewa5e tank(sj feaks: � Probed outside tank(sl for"black sn�1°
Any "31@S",3RSN�E/'a�OV�1/td/C�lLS th@ `� �lnabie 2o verfy (See Comments/Expfanaoon)
S�/S�In f5 F3!llR�20 �t0�$Ct GJ'OURdW8f21'. Other methods nat listed(See CammentsrExplanation)
Comments/Explanation: J – - T�
On 12J18/13,Elmer..�.Pefe�son Co. uncovered and purr�ped septic tan s. See rotes on at#acned tank report.
3. �ther CompEiance Cac�ditions—compliance component af 5
a. Maintenance hole covers are�amaged, crac}ced,unsecu�ed,cr appea to sfructutally unsound. 0 Yes" p tvo ❑Unknov�,
b. Otfier issues,elecfncat hazards,etc.}to i-nmecffately and adverszly impa � public health or safety. ❑Yes" [�No ❑UnkRown
'�ystem Fs an imminenf threat ta putrlic heahfi and safety
Expiain,
c. System is non-protective of ground��ater for other conditions as dete ined by ihspedor ❑Yes` �No
*Sysiem is failing tD proi�cct groundwater
E�ca?ain:
wvnv.pca.state_mn.us �651•296-63G0 • 80D-657-3864 • Ti1'651-282 5332 or 800�697-3854 • Availabte in atternative formats
+✓q-mvists4-31 • 1I24112 Poge 2 of 3
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Jan 28 14 05:35p Joseph Olson 763-498-8290 p.7
�o s of Soil B rin s
Licerrse#81 U �
Locatiort or Project: 4245 8ayside Road
Borings made by: Rusty O�son's Soi1 and Perc testing 12/18I2043
Classification System: AA5HQ ; USDS�USDS�SCS X ; Unified ; Ofher
Auger used {check two): Hand�X`, or Power , Fligh , 6ucket or Probe X
Boring �lumbet_1_Surface efevation_99.0 Mattled Soil at 2.0 feet
Q"-16" Dark brown sandy loarn 10yr3/2 H20�resent at_X`
16"-24" Brown loam iQyr414
Boring Number_2 S�€face elevation_99.0_ Mattled Sail at 2.0 feet
fl"-16" Dark brown sandy foam 10yr312 H20 prese�t at X
16"-24" Brown loam 10yr414 –` —
TBM:Top of lifi statio�t ManhQle Co�er Elv.-700.Q0 assumed
Original so�[ under ihe roekbed 99.D
Bottom of rock bec€ 10Q.Q
There is 12 inches of sand under the rockbed
Jan 28 14 05:35p Joseph Olson 763-498-8290 p.8
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