HomeMy WebLinkAbout08-19-2022 Septic Compliance Inspection ReportMINNESOTA POLLUTION re Com liance inspection ort form
CONTROL AGENCY p p p
520 Lafayette Road North Existing Subsurface Sewage Treatment System (SSTS)
St, 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 https://www.pca.state.mn,us/sites/default/files/wq-wwists4-31a pdf.
Property information Local tracking number
Parcel ID# or Secfrwp/Range: 3311823440039 Reason for Inspection Propery Transfer
Local regulatory authority info: City of Orono
Property address: 125 Truffala Trail.
Owner/representative: Bill Hunt Owners phone: 207-776-2222
Brief system description: Approximately 2 -1000 -gallon septic tanks, 1 -1000 -gallon lift station and 500 square feet of mound rock bed
System status
System status on date (mm/dd/yyyy): 8/19/2022
❑ 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.)
*Note.: Compliance indicates conformance with Minn.
R. 7080.1500 as of system status date above and does not
guarantee future performance.
❑ 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 (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 or
under section 145A.04 subdivision 8.
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
There is 1.7 feet of sand under the rock bed.
TBM: Top of the lift station manhole cover. ELV.-100.0
There is a filter in the second tank.
Certification
1 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 7
Inspector signature: Joseph J. Olson
(This document has been electronically signed)
Certification number: 01255
License number: L810
Necessary or locally required supporting documentation (must be attached)
Phone: 763-498-8779
® Soil observation logs ® System/As-Built ❑ Locally required forms Z Tank Integrity Assessment 0 Operating Permit
❑ Other information (list):
https://www.pca.state.mn.us 651-296-6300 800-657-3864
wq-wwi5ts4-31b • 4/28/2021
Use your preferred relay service Available in alternative formats
Page 1 of 4
Property Address: 125 Truffala Trail.
Business Name: Rusty Olson Soil & percolation Testing
1. Impact on public health — Compliance component #1 of 5
Hance 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- 0 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: 8/19/2022
Attached supporting documentation:
❑ Other:
Not applicable
2. Tank integrity — Compliance component #2 of 5
Compliance criteria:
System consists of a seepage pit,
cesspool, drywell, leaching pit,
or other pit?
Sewage tank(s) leak below their
designed operating depth?
❑ Yes' ❑ No
❑ Yes" ❑ No
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:
Elmer J. Peterson Company pumped the tanks.
Attached supporting documentation:
❑ Empty tank(s) viewed by inspector
Name of maintenance business:
License number of maintenance business:
Date of maintenance:
Existing tank integrity assessment (Attach)
Date of maintenance 8/11/2022
(mm/dd/yyyy): (must be within three years)
(See form instructions to ensure assessment complies with
Minn. R. 7082.0700 subp. 4 8 (1))
Tank is Noncompliant (pumping not necessary—explain below)
❑ Other:
https://www.pca,state.mn.us 651-296-6300 800-657-3564 Use your preferred relay service Available in alternative formats
wq-wwists4-31 b • 4/28/2021 Page 2 of 4
Property Address: 125 Truffala Trail.
Business Name: Rusty Olson Soil & percolation Testing
3. Other compliance conditions — Compliance component #3 of 5
Date: 8/19/2022
3a. Maintenance hole covers appear to be structurally unsound (damaged, cracked, etc.), or unsecured?
YesM No ❑ Unknown
3b. Other issues (electrical hazards, etc.) to immediately and adversely impact public health or safety? ❑ Yes' ® 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? [I Yes' 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: ® Not applicable ❑
4. Operating permit and nitrogen BMP* Compliance component #4 of 5 L]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
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
In. 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
wq-wwists4-31b • 412812021 Page 3 of 4
Property Address: 125 Truffala Trail.
Business Name: Rusty Olson Soil &percolation Testing
5. Soil separation — Compliance component #5 of 5
Date of installation 10/3/1997 ❑ Unknown
(mm/ddlyyyy)
ShorelandIWel I head protection/Food
beverage lodging?
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
saturated soil or bedrock.
Date: 8/19/2022
❑ Yes ❑ No Attached supporting documentation:
® Soil observation logs completed for the report
❑ Two previous verifications of required vertical separation
❑ Yes ❑ No* ❑ Not applicable (No soil treatment area)
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" ❑ Yes ❑ No*
systems built under pre -2008 Rules;
Type IV or V systems built under 2008
Rules 7080. 2350 or 7080.2400
(Intermediate Inspector License required <_ I'
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:
0
Indicate depths or elevations
A. Bottom of distribution media 1.04.7
B. Periodically saturated soil/bedrock 101.7
C. System separation 3.0
D. Required compliance separation* 2.55
*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 • 4/28/2021 Page 4 of 4
Tank Report
Elmer J. Peterson Co.
5921 I)agne :" vv.
Delano, NIN 5532S
Phone 763-972-2420
Fax
MICA License# 11:)
Bill blunt
125 Truffala Trail
Orono, MN 55356
207-776-2222
Baffles: SON / OFF
Tank Capacity: 3-1000 Gallon Tanks
# of "1`anks: 3
Type ofTanks: _
Gallons Pumped:
Concrete
2500
Manholes to Grade: E S / NO
Comments:
Date,: August IL 2022
On August 1 1. 2022, Elmer J. Peterson Co. pumped tanks. Filter in 2"1 tank. No cracks or water leaking in
tanks at the time of pumping.
NOTE, This is only a tank report. This is not a compliance inspection fior point of sale nor does it
replace a compliance inspection.
M MINNESOTA POLLUTION Sewage tank integrity assessment form
CONTROL AGENCY integrity
520 Lafayette Road North Subsurface Sewage
5t. Paul, MN 55155-4194 Treatment Systems (SSTS) Program
Doc Type Compliance and Enforcement
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
https Ilwww pca.state.mn us/waterimspections
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 lank in the system Only a licensed maintenance business is authorized to pump the tank for assessment A
copy of this information should be submitted to the system owner and he 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: Coat mance inspection. form - Exis*riq system 1wQ viviists4-31 b This form can be found on
the MPCA website at nttps !Iwmnvpca state mn us/wateffinspection .
The informalton 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(B)(1). This foram 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 owners 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(B),(C),
and (D) and: Minn. R. 7083 0730(C)
Owner information
Owner/Representative Bill Hunt
Property address 125 Truffala Trail Orono, MN 55356
Local Regulatory Authority:
System status
System status on date (mmlddlyyyy) 8111/2022
Parcel ID:
Q Certificate of sewage tank compliance ❑ Notice of sewage tank non-compliance
Compliance criteria:
The SSTS has a seepage pit cesspool, drywell, leaching pit. or other pit - .'Failure to Protect ❑Yes' ®No
Groundwater."
The SSTS has a sewage tank that leaks below the designed operating depth - "Failure to Protect Yes' ®No
Groundwater." El
The SSTS presents a threat to public safety by reason of structurally unsound (damaged cracked.
or weak) maintenance hole cover(s) or lids or any other unsafe condition - "Imminent Threat to ❑ Yes' 2 No
Public Health or Safety."
Any "yes" answer above indicates sewage tank non-compliance.
Company information Designated Certified Individual (DCI) information
Company name: Elmer J Peterson Co
Business license number 219
Print name James L Braegelmann
Certification number
I personalty conducted the work described above as a Designated Certified Individual of a Minnesota -licensed SSTS inspection,
maintenance. installation or service provider Business I personally conducted the necessary procedures to assess the compliance
status of each sewage tank in this SSTS
By typinglsigning my name below. 1 certify the above statements to be true and correct to the best of my knowledge and that
this infomralion can be used for the purpose of processing this form.
Designated Certified Individual's signature James L Braegelmann Date (mmidd/yyyy) 8111/2022
(This document has been electronically signed..)
www.pcastate.mn.us • 651 296-6300 800-657 3864 • Use your preferred relay service Available in alternative formats
wq-wwists4-91 • 5/10/21 Page 1 of I
Property Owner / project:
Property Address / PID:
Soil Observation Log
www.SepticResource.com vers 12,4
Owner Information
Bill Hunt
125 Truffala Trail.
Date $/19/2022
Soil Survey Information ❑ refer to attached soil survey
Parent marl's: ❑ Till ❑ Outwash ❑ Lacustrine ❑ Alluvium ❑ Organic ❑ Bedrock
landscape position: F1 Summit ❑ Shoulder 1] Side slope ❑ Toe slope
soil survey map units: L3'/B slope % direction- Lineal
Soil Log #1
0 Boring ❑ pit Elevation 103.0 Depth to SHWT 16 Inches
Depth (in) Texture fragment % matrix color redox color consistence grade shape
0-10
Loam
<35
10yr3/1
Friable
Strong
Blocky
10-16
Clay Loam
<35
10yr4/3
Friable
Strong
Block;.
16-24
Clay Loam
<35
10yr5/4
10y4/8,1 -6/10y
Firm
Strong
Blocky
<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 block}
firm
moderate
prismatic platy
>50
rigid
strong
massive
Comments:
125 Truffala Trail. Soil Log #2
El Boring ❑ Pit Elevation 104.7 Depth to SHWT 26 Inches
Depth (in) Texture fragment % matrix color redox color consistence grade shape
0-14
Fill
<35
Loose
Loose
single grain
14-18
Loam
<35
10yr3/1
Friable
Strong
Blocky
18-26
Clay Loam
<35
10yr4/3
Friable
Strong
Blocky
26-30
Clay Loam
<35
10yr5/4
10y4/8,1-6/l0y
Firm
Strong
Blocky
<3 5
loose
loose
single grain
35 0
- 5
friable
weak
granular blocky
firm
moderate
prismatic platy
>50
rigid
strong
massive
125 Traffala
Trail. Soil Log #3
❑ Boring ❑ pit Elevation Depth to SHWT
Depth (in) Texture fragment % matrix color redox color consistence grade shape
<35
loose
loose
single grain
35-50
triable
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
<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
<35
loose
loose
single grain
35-50
friable
weals
granular blocky
>50
firm
moderate
prismatic platy
rigid
strong
massive
I hereby cerci this work was completed in accordance with
esigner Signature
MN 7080 and any local reqs.
Rusty Olson's Soil & Pere 810
Company License #
IaSTiv�$'ol� Tr. �
N
' 6v-- a'6 76'