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05-22-22 Septic Compliance Inspection
MINNESOTA P LLUTION Compliance inspection report form CONTROL AGENCY h' 520 Lafayette Road North Existing Subsurface Sewage Treatment System (SS'T's) 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: rhJp�,, / ,ry w,Dca.state._E in.us/site/default/files/wg� 1sts4-31a.pdf. ( r v0C4 for-na f.,.o. err +trf. -.. z of i w s,. �i �tia E rt�;r�- 4...a Property information Local tracking number: Parcel ID# or Sec/Twp/Range: Local regulatory authority: City of Orono Property address: 1520 Tanglewood Road, Orono Owner/representative: Dr.. Roby Thompson Owner's phone: 952-475-1294 Brief system description: 2-1000 gal precast tanks from original system, newer 1000 gal pump tank with a mound System status System status on date (mrn/dd/yyyy): 5/22/2022 ® 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 (I TPHS) must be an irnminent 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. 7080.9500 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 W. �, � s11 1 hereby certify that all the necessary infonnation has been gathered to determine the compliance status of this systern. No detennination 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 infonnation can be used for the purpose of professing this,fo n. Business name: Sewer See's ) x Certification number: C1659 Inspector signature: V�License number: 2502 his docrYinent has been electror Cally signed) Phone 952-873-3292 Necessary or locally required supporting documentation at tize,. ❑ 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 2. 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" ® No tile or surface waters. System causes sewage backup into ❑ Yes" ® No dwelling or establishment.. na t we ,dicaUs ter:,., ao u.: e .t,i rt, pct .ej. Describe verification methods and results: Searched for surface outlet or ground discharge Checked for back-up 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 pit? Sewage tank(s) leak below their i❑ Yes ® No designed operating depth? If yes, which sewage tank(s) leaks above Describe verification methods and results: Pumped & Inspected Attached supporting documentation: ® Pumped at tirne of inspection Name of maintenance business: Sewer Services License number of maintenance business: 2502 Date of maintenance: 5/16/2022 ❑ Existing tank integrity assessment (Attach) Date of maintenance (mm/dd/yyyy): (must be within three years) (See form instructions to ensure assessment complies with Minn. R. 7082.0700 subp. 4 B (1)) ❑ Tank is Noncompliant (pumping not necessary — explain below) ❑ Other: https://www.pca.state.mn.us 651-296-6300 800-657-3864 Use your preferred relay service Available in alternative formats wq-wwists4-31b o 1/21/21 Page 2 of 4 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` ® No ❑ Unknown 'Yes _o a,., c,,r 3b c y t i E ",s an imams¢ n "n ee t€,.� .,,.tet v h.;,,. f.., an, safe-, 3c. System is non -protective of ground water for other conditions as determined by inspector? 3d. System not abandoned in accordance with Minn. R. 7080.2500? ... ..';. or 3 fir. b.,mF, is fs P Describe verification methods and results: Inspected Attached supporting documentation: ❑ Not applicable ❑ ❑ Yes ® No ❑ Yes, ® No 4. Operating permit and nitrogen BMP* — Compliance component #4 of 5 E] Not applicable I 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 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 ,v Cates Describe verification methods and results: Attached supporting documentation: ❑ Operating permit (Attach) ❑ iittps://www,pca,state.inn.us 651-296-6300 800-657-3864 Use your preferred relay service Available in alternative formats wq-wwists4-31b o 1/11/21 Page 3 of 4 5. Soil separation — Compliance component #5 of 5 Date of installation 10/14/1996 ❑ Unknown (mm/ddlyyyy) Shoreland/WelIhead protection/Food ❑ Yes © No beverage lodging? Compliance criteria (select one): 5a. For systems built prior to April 1, 1996, ❑ Yes ❑ No and not located in Shore/and 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 April 1, ® Yes ❑ No` 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"'! ❑ 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. Describe verification methods and results: Boring 1-10" 10yr 3/2 Loam 11-14" 10yr 4/4 Clay Loam Redox @ 12" 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) Indicate depths or elevations 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. 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 • 800-657-3864 Use your preferred relay service • Available in alternative formats wq-wwists4-31b • 1/11/21 Page 4 of 4