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HomeMy WebLinkAbout05-05-2022 Septic ComplianceM MINNESOTA POLLUTION Compliance inspection report form CONTROL AGENCY 520 Lafayette Road North Existing Subsurface Sewage Treatment System (SSTS) 5t. Paul, MN 55155-4194 Doc Type: Compliance and Enforcement Instructions: Inspector must submit completed form to Local Governmental Unit (LGU) and system owner within 15 days of final determination of compliance or noncompliance. Instructions for filling out this form are located on the Minnesota Pollution Control Agency (MPGA) website at htti)s://www.pca.state.mn.us/sites/default/files/wa-wwists4-31a.pdf. Property information Local tracking number: Parcel ID# or Sec/Twp/Range: 0411723240014 Reason for Inspection Property Transfer Local regulatory authority info: City Of Orono, 952 249-4600 Property address: 2680 Deer Run Trail, Orono Owner/representative: John Cumming _ Owner's phone: 612-916-3636 Brief system description: 2 -1250 -gallon septic tanks, 1 -1250 -gallon lift station and 630 Square feet Rock bed System status System status on date (mm/dd/yyyy): 5/5/2022 ® Compliant— Certificate of compliance* (Valid for 3 years from report date unless evidence of an imminent threat to public health or safety requiring removal and abatement under section 145A. 04, subdivision 8 is discovered or a shorter time frame exists in Local Ordinance.) ❑ Noncompliant -- Notice of noncompliance Systems failing to protect ground water must be upgraded, replaced, or use discontinued within the time required by local ordinance. An imminent threat to public health and safety (1TPHS) must be upgraded, replaced, or its use discontinued within ten months of receipt *Mote: Compliance indicates conformance with Minn. of this notice or within a shorter period if required by local ordinance or R. 7080.1500 as of system status date above and does not under section 145A. 04 subdivision 8. 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) — Falling 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 95) — Failing to protect groundwater ❑ Operating permit/monitoring plan requirements (Compliance component #4) — Noncompliant - local ordinance applies Comments or recommendations The system is designed for a five bedroom house. There is 1.0 feet of sand under the rock bed. 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: Rusty Olson Soil & percolation Testing Certification number: C1255 Inspector signature: Joseph J. Olson License number: L810 (This document has been electronically signed) Phone: 763-498-8779 Necessary or locally required supporting documentation (must be attached) ❑ Soil observation logs ❑ System/As-Built ❑ Locally required forms ® Tank Integrity Assessment ❑ Operating Permit ❑ Other information (list): https://www.pca.state.mn.us 651-296-6300 800-657-3864 wq-wwists4-336 • 4/28/2021 Use your preferred relay service Available in alternative formats Page 1 of 4 Property Address: 2680 Deer Run Trail, Orono-- Business rono_Business Name: Rusty Olson Soil & percolation Testi 1. Impact on public health — Compliance component #1 of 5 Compliance criteria: System discharges sewage to the ! ❑ Yes* ®No ground surface System discharges sewage to drain ❑ Yes* E No tile or surface waters. 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. Describe verification methods and results: Visual. Nothing was found Date: 5/512022 Attached supporting documentation: ❑ Other: ® Not applicable 2. Tank integrity — Compliance component #2 of 5 Compliance criteria: System consists of a seepage pit, ❑ Yes* ® No cesspool, drywell, leaching pit, or other it? Sewage tank(s) leak below their ❑ Yes* Z No designed operating depth? If yes, which sewage tanks leaks: Any "yes" answer above indicates the system is failing to protect groundwater. Describe verification methods and results: Duane's Septic Service pumped the tanks. https://www.pca.state.mn.us wq-wwists4-31b • 4/28/2021 651-296-6300 Attached supporting documentation: ❑ Empty tank(s) viewed by inspector Name of maintenance business: License number of maintenance business: Date of maintenance: I5C] Existing tank integrity assessment (Attach) Date of maintenance 5/3/2022 (mmlddlyyyy): (must be within three years) (See form instructions to ensure assessment complies with Minn. R. 7082.0700 subp. 4 S (1)) ❑ Tank Is Noncompliant (pumping not necessary - explain below) ❑ Other: • 800-657-3864 Use your preferred relay service Available in alternative formats Page 2 of 4 Property Address: 2680 Deer Run Trail, Orono Business Name: Rusty Olson Soil & percolation Testing Date: 5(512022 3• other compliance conditions — Compliance component #3 of 5 3a. Maintenance hole covers appear to be structurally unsound (damaged, cracked, etc.), or unsecured? ❑ Yes* ® No ❑ Unknown 3b. Other issues (electrical hazards, etc.) to immediately and adversely impact public health or safety? ❑ Yes* 0 No ❑ 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? ❑ Yes* 0 No 3d. System not abandoned in accordance with Minn. R. 7080.2500? ❑ Yes* ❑ No *Yes to 3c or 3d - System is failing to protect groundwater. Describe verification methods and results: Visual. Nothing was found Attached supporting documentation: N Not applicable ❑ 4. Operating permit and nitrogen BMP* — Compliance component #4 of 5 2 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 specified in the system design? ❑ Yes ❑ No If "yes", B below is required BMP = Best Management Practice(s) specified in the system design !f the answer to both questions is "no", this section does not meed 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 500-657-3$64 + use your preferred relay service Available in alternative formats wq-wwists4-31b • 4/28/2021 Page 3 of 4 Property Address: 2680 Deer Run Trail, Orono Business Name: Rusty Olson Soil & percolation Testing 5. Soil separation — Compliance component #5 of 5 Date of installation 11/8/1994 ❑ Unknown (mmldcVyyyy) Shore I andfWel lhead protection/Food ❑ Yes 0 No beverage lodging? Compliance criteria (select one): 5a. Far systems built prior to April 1, 1996, and ® Yes ❑ No* 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. 5b. Non-performance systems built ❑ Yes ❑ No" 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.* 5c. Experimental", "Other", or `Performance" 70 Yes ❑ No* systems built under pre -2008 Rules; Type 1V or V systems built under 2008 Rules 7080. 2350 or 7080.2400 (Intermediate Inspector License required:5 2,500 gallons per day; Advanced Inspector License required > 2,500 gallons per day) 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: Date: 515/2022 Attached supporting documentation: ® Soil observation logs completed for the report ❑ Two previous verifications of required vertical separation ❑ Not applicable (No soil treatment area) 0 Indicate depths or elevations A. Bottom of distribution media 99.8 B. Periodically saturated soil/bedrock 96.8 C. System separation 3.0 D. Required comp liance separation* 2.0 *May be reduced up to 15 percent if allowed by Local Ordinance. 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. https://www.pca.state.mn.us 651-296-6300 800-657-3564 Use your preferred relay service Available in alternative formats wq-wwists4-31b • 4/2$/2021 Page 4 of 4 MINNESOTA SOTA PO5?. k tON CON'pROL AC-RENC- 520 Lafayette Road North 5t. Paul, MN 55155-4194 Sewage tank integrity assessment form Property address: `�� "V'� T City: 0 State: Subsurface Sewage Treatment Systems (SSTS) Program ParcelOi _ Zip code Purpose: This form may be used to certify the compliance status of the sewage tank components of the SSTS. This form is not a complete SSTS inspection report, only a tank integrity assessment, and may only certify sewage tank compliance status when entirely completed and signed by a qualified professional. SSTS compliance inspection report forms can be found at: iMr" j)s1/www.pca state. m#1_ush"JateLlIii G'cti�si5. Instructions: This form may be completed, and signed, by a designated Certified Individual (DCI) of a licensed SSTS inspection, maintenance, installation, or service provider business who personally conducts the necessary procedures to assess the compliance status of each sewage tank in the system. A copy of this information should be submitted to the system owner and be maintained by the licensed SSTS business for a period of five (5) years from the assessment date. When this form is signed by a qualified certified professional, it becomes necessary supporting documentation to an Existing System Compliance Inspection Report: Com .pfiance inspcVan for , - xi;tii�ctcrT r fy-vratists4 3?l�'i. This form can be found on the MPGA website at tames ll�v�rv_ti�t cawst�a:.r7r�.t�si�masringet€_,. 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 an inspection report. This form represents a third party assessment of SSTS component compliance and is allowable under Minn. R. 7082.0700, subp. 4 Item (B) subitem (f). 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 Affirrn,,ail three statements: The SSTS does not contain a seepage pit, cesspool, Ar�w-ell, leaching pit, or other pit. It does not contain a sewage tank that was designed to be watertight, but subsequently leans below the signed operating depth. It does not represent an imminent safety threat by reason of unsecured, damaged, or weak maintenance hole cover(s) or other unsafe condition. ❑ Notice of sewage tank non-compliance — 12-50 -s l oA, ►1 k Le– Select all that apply: ❑ The SSTS has a seepage pit, cesspool, drywell, leaching pit, or other pit — "Failure to Protect Groundwater." ❑ It has a sewage tank that was designed to be watertight, but subsequently leaks below the designed operating depth — "Failure to Protect Groundwater." ❑ It presents a threat to public safety by reason of unsecured, damaged, or weak maintenance hole cover(s) or other unsafe condition — w"Imminent Threat to Public Health or Safety." CO k; e r,' Company information Designated Certified Individual (DCI) information Company name: Duane's Septic Service _ Print name: •�} t✓1ti! C1 Business license number: 654 Certification number: b 1-7 I personally conducted the work described above as a Designated Certified Individual of a Minnesota -licensed SSTS inspection, maintenance, installation, or service provider Business. 1 personally conducted the necessary procedures to assess the compliance status of each sewage tank in this SSTS. By typing/signing my .name below, 1 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. Designated Certified C-- Individual's signature: �� Date (mmidd/yyyy): o A. 3 (T s document has been electronically signed.) www. pca,state. m n, us wq-wwists4-91 • 1/5/21 • 651-296-6300 800-657-3864 Use your preferred relay service • Available to alternative formats Page 1 of 1 Soil Observation Log www.SepticResource.com vers 12.4 Owner Information Property Owner/ project: John Cumming Date 5/1/2022 Property Address / PID: 2860 Deer Run Trail Soil Survey Information ❑ refer to attached soil survey Parent mati's: D Till ❑ Outwash ❑ Lacustrine ❑ Alluvium ❑ Organic ❑ Bedrock landscape position: ❑ summit ❑ shoulder D Side slope ❑ Toe slope soil survey map units: L37B slope % direction- Lineal Soil Log #1 ❑ Boring ❑ pit Elevation 100.9 Depth to SHWT 36 Inches Depth (in) Texture fragment % matrix color redox color consistence grade shape 0-8 Mound sand fill <35 8-20 Loam <35 10yr3/1 Friable Strong BlockN 20-26 Clay Loam 13 5 10yr4/3 Friable Strong Blocky 26-36 Clay Loam <35 10yr5/4 Friable Strong Blocky <35 loose loose single grain 35-50 friable weak granular blocky firm moderate prismatic platy >50 rigid strong massive Comments: TBM: Top of the lift station manhole cover Elv.-100.0 2860 Beer Run Trail Soil Log #2 d Boring ❑ pit Elevation 98.8 Depth to SHWT 26 Inches Depth (in) Texture fragment % matrix color redox color consistence grade shape 0-12 Loam <35 10yr3/l Friable Strong Blocky 12-20 Clay Loam <35 10yr4/3 Friable Strong Hlock� 20-26 Clay Loam <35 10yr5/4 Friable Strong Blocky < loose loose single grain 35--50 friable weak granular blocky firm moderate prismatic platy >SO rigid strong massive <35 loose loose single grain 35-50 friable weak granular blocky firm moderate prismatic platy >50 rigid I strong Imassive 2860 Deer Run Trail Soil Log #3 0 Boring ❑ pit Elevation Depth to SHWT Depth (in) Texture fragment % matrix color redox color consistence grade shape <35 loose loose single grain 35-50 friable weak granular blocky firm moderate prlSmfltlCplaty >50 rigid strong massive <35 loose loose single grain 35-50 friable weak granular blocky firm moderate prismatic platy >50 rigid strong massive <35 loose loose single grain 35-50 friable weak granular blocky X50 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 I hereby certify this work was completed in accordance with MAV 7080 and any local reqs. Rusty Olson's Soil & Pere 810 Designer Signature Company License # ;�?60 Dee- Run Tr, b G 111 g'a T, M# T2m 4