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Home My WebLink About08-21-2022 Septic Compliance Inspection reportMINNESOTA POLLUTION Compliance inspection report form CONTROL AGENCY I" 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 (MPCA) website at https://www.pca.state.mn.us/sites/defaulVfiles/wa-wwists4-31a.K)df. Property information Local trackina number: Parcel ID# or Sec/Twp/Range: 0411723420016 Reason for Inspection Propery Transfer Local regulatory authority info: City of Orono Property address: 2790 White Oak Circle Owner/representative: Pat Hiller Owner's phone: 612-804-9821 Brief system description: Approximately 2 -1300 -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): 8/2112022__ Z 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.) *Mote: 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 (1TPNS) 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 1.5 feet of sand under the rock bed. This system is sized for a four bedroom house. 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: 01255 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) Z 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 500-557-3864 + wq-wwists4-31b + 4/28/2021 Use your preferred relay service Available in alternative formats Page 1 of 4 Property Address: 2790 White Oak Circle Business Name: Rusty Olson Soil & percolation Testing 1. Impact on public health — Compliance component #1 of 5 Compliance criteria: System discharges sewage to the ground surface ❑ Yes' ® No System discharges sewage to drain ❑ Yes* 0 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: 8/21/2022 Attached supporting documentation: ❑ Other: El Not applicable 2. Tank integrity — Compliance component #2 of 5 iance criteria: System consists of a seepage pit, ❑ Yes* ❑ No cesspool, drywell, leaching pit, or other pit? Sewage tank(s) leak below their ❑ Yes* [--]No designed operating depth? If yes, which sewage tank(s) leaks: Any "yes" answer above indicates the system is failing to protect groundwater. Describe verification methods and results: Albin's Septic Pumping, LLC. 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 8/15/2022 (mm/ddiyyyy): (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 651-296-5300 800-657-3864 Use your preferred relay service Available in alternative formats wq-wwists4-31b • 4/28/2021 Page 2 of 4 Property Address: 2790 White Oak Circle Business Name: Rusty Gilson Soil & percolation Testing Date: 8121/2022 3. Other compliance conditions — Compliance component #3 of 5 3a. Maintenance hole covers appear to be structurally unsound (damaged, cracked, etc.), or unsecured? ❑ Yes' Z 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? ❑ Yes ® No 3d. System not abandoned in accordance with Minn. R. 70802500? ❑ Yes` 0 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 ❑ 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 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 800-657-3864 Use your preferred relay service Available in alternative formats wq-wwists4-31b • 4/28/2021 Page 3 of 4 Property Address: 2790 White Oak Circle Business Name: Rusty Olson Soil & percolation Testing Date; 8/21/2022 5. Soil separation — Compliance component #5 of 5 Date of installation 9124/2015 ❑ Unknown (mmldd/yyyy) 5horelandlWelIhead protection/Food ❑ Yes ® No beverage lodging? CornMiance criteria (select one): 5a. For 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 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.* Attached supporting documentation: ❑ Soil observation logs completed for the report El Two previous verifications of required vertical separation ❑ Not applicable (No soil treatment area) EJ ® Yes ❑ No* Indicate depths or elevations 5c. 'Experimental, "Other", or "Performance" ❑ Yes ❑ Na* systems built under pre -2008 Rules; Type IV or V systems built under 2008 Rules 7080. 2350 or 7080.2400 (Intermediate Inspector License required <_ 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: A. Bottom of distribution media 971.5 B. Periodical!y saturated soillbedrock 968.5 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 500-657-3864 Use your preferred relay service Available in alternative formats wq-wwists4-31b • 4/28/2021 Page 4 of 4 2022 SEPTIC MAINTENANCE REPORT Site address: 2790 White Oak Circle Nicholas & Suzanne Hansen ) Number of tanks: 3 Date last pumped: 08/1512022 Gallons pumped: 2700 Name of pumper/ maintenance provider: Albin's Septic Pumping, LLC Are tanks watertight?: YES NO (please circle one) Is the system functioning properly? Yes (le slow drainage, wetness in the drainfield?j Do you have arty specific concerns or issues that you'd like to discuss with the SSTS Program Manager? Note: Recommend filiing tanks back to operating level to prevent movement during winter! ring frost as home is being demolished and a new home built by Norton Homes, LLC. if so, please indicate best time and telephone number(s) to be reached between 8 am and 4:30 pm. Best Times Telephone Number(s) RETURN IN THE ENCLOSED ENVELOPE AS SOON AS POSSIBLE Alicia Johnson CITY OF ORONO PO BOX 6S CRYSTAL BAY MN 55323-0056 Property address: 2.790 White Oak Circle icholas & Suzanne Hansen.) Parcel lo; 0411723420016 city. Orono state: M N _ zip code: 55356 -Optional section: Sewage Tank Compliance Certification This form does not represent a campiete spm inspection report and only certifies sewage tank compliance statue. Irmtructionsed certified Individual of a ticensed SSTS Maintenance lBusines o personection at the alty conducts themay be pleted and r awry proed by a cedures too assess the compliance status ofl)each sewage tank in the system. When this section of the form is signed by a qualified certified professional, it becomes necessary supporting documentation to an Existing Systsm Compliance Inspection Report Com2 lance ins pe don tom - Facistino s; 9+�rn fv�a rvwists4 This form can be found on the MPCA website at hM:/A~Dca,staia.mn.us �ra=.r.a'e_+""finical and-0ornolian -criteria. The information and certified statement on this Than is required when: existing septic tank compliance status is determined by an individual other than the SSTS Inspector that submits the inspection report. It represents a third party assessment of SSTS component compliance and is allowable under Minn. R, 7082.0700, subp. 4 Item (B) subitem (1). This farm 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 C; 7083.0730 Item C. IM Certificate of sewage tank compliance Affirm all three statements: ® The SSTS does not contain a seepage pit, cesspool, drywell, leaching pit, or other pit. b containit does not io be watertight� but sudesigned subsequently leaks ks belovw the designed 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 Select all that apply: The SSTS hes a seepage pit, cesspool* drywall, leaching pit, or other ph. D it has a sewage tank that was designed to be watertight, but subsequently leaks below the designed operating depth. It presents a threat topublic safety by reason of unsecured, damaged, or weak maintenance hole cover(s) or other unsafe condition. Company Information Designated Certified Individual (DCI) information Company name: Albin's Se Pumping, LLC _ Print name: Peter Peterson _ Business license number: 3346_ Certification number. 9227 -- - . -- - -- I personally conducted the work described above as a Designated Certified individual of a Minneade-licensed SSTS MainienarcG Business. t personally cond�sd the n ry procedures to assess rile compliance status of each sewage tank in finis SSTS: Designated Certified 08/15/2022 individual's signature: __ Cate (mmldd/yyyy): _ www.pca.state.mn.us . 651-296-63W • 800-657-3864 use your preferred relay service • Available in aittemttve formats wq-wwists4-38 • 1127117 Page 3 of 3 Property Owner / project: Property Address / PID: Soil Observation Log www.SepticResource.com vers 12.4 Owner Information 2790 White Oak Circle Date 8/19/2022 Soil Survey Information ❑ refer to attached soil survey Parent matl's: 0 Till ❑ Outwash ❑ Lacustrine ❑ Alluvium ❑ Organic ❑ Bedrock landscape position: ❑ Summit ❑ Shoulder p Side slope ❑ Toe slope soil survey map units: L37B slope % direction - Soil Log #1 ❑ Boring ❑ Pit Elevation 971.7 Depth to SHW T 18 inches Depth (iii) Texture fragment % matrix color redox color consistence grade shape 0-8 Loam <35 10yr2;'I Friable Strong Blocky 8-18 Cay Loam <35 10yr4/3 Friable Strong Blocky 18-24 Clay Loam <35 10yr5/4 10y4/8,1 -6/10y Firm Strong Blocky <35 loose loose single grain 35-50 friable weak granular blocky >50 firm moderate prismatic platy rigid strong massive <35 loose ose w single grain 35-50 friable eak granular blocky >50 firm moderate prismatic platy rigid strong massive Comments: TBM: Detached garage concrete slab. E1-970.6 2790 White Oak Circle Soil Log #2 ❑ Boring ❑ pit Elevation 970.0 Depth to SHWT 24 inches Depth (in) Texture fragment % matrix color redox color consistence pr-ade shape 0-8 Loam <35 10yr2/1 Friable Strom Block 8-18 Clay Loam -35 10yr4/3 Friable Strong Blocky 18-24 Clay Loam <35 10yr5/4 Friable Strong Blocky 24-28 Clay Loam <35 10yr5/4 10y4/8,1 -6!10y Firm Strong Blocky 2790 White Oak Circle Soil Log 93 ® Boring ❑ pit Elevation Depth to SHWT inches Depth (in) Texture fragment % matrix color redox calor consistence grade shape <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 weak granular blocky >50 firm moderate prismatic platy ty rigid strong massive <35 loose loose single grain 35-50 friable weak granular blocky >50 firm moderate prismatic platy rigid strong massive I hereby certify this work was completed in accordance with MN 7080 and any local reqs. /57 Rusty Olson's Soil & Pere. 810 Designer Signature Company License # Ofi N89'5 4'w 345.73 --44 ----------- OCEOM OF JIEITED ---------- M4 Wk. X, Li zn lu -0-0 A Tot AJKS .0 ml ----------- 161.4 ---------- — ------------ — --------------- T la -T — -------------- zrz -PU C) DEN SCREEN --- Rai '00. ------- 570 ]0.0 ---- Ia IM .0 Pk�� AAVDUT 790 �.m o" cmx ------------ - -- ---- - -------------------- 8 H4 I 4 4'1 '4 220 0 11.0 —a- TIle , e91 54"5 'E 83.15