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Home My WebLink About12/19/2022 Septic ComplianceMMINNESOTA POLLUTION Compnliance inspection report form CONTROL AGENCY N N 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 httos://www.K)ca,state.mn.us/sites/default/fileslwq-wwists4-31a.gdf. Property information Local trackina number: Parcel ID# or Sec/TwplRange: 3111823410001 Reason for Inspection Propery Transfer Local regulatory authority info: City of Orono Property address: 4040 Watertown Road Owner/representative: Adam Westling Owner's phone: 612-562-7402 Brief system description: Approximately 2 -1000 -gallon septic tanks, 1 -1000 -gallon lift station and 380 square feet of mound rock bed System status System status on date (mm/dd/yyyy): 12/19/2022 ® 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. 7080.9500 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 1.0 feet of sand under the rock bed. TBM: Top of the lift station manhole cover. ELV.-100.0 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, 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 fonn. Business name: Rusty Olson Soil & percolation Testing Inspector signature: Josepo J. Olson (Thus document has been electronically signed) Certification number: 01255 License number: L810 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-wwists4-31b • 41281202I Use your preferred relay service Available in alternative formats Page 1 of 4 Property Address: 4040 Watertown Road Business Name: Rusty Olson Soil & percolation Testing 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` ®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: 12/19/2022 Attached supporting documentation: ❑ Other: ® Not applicable 2. Tank integrity — Compliance component #2 of 5 Compliance criteria: System consists of a seepage pit, El es* ® No cesspool, drywell, leaching pit, or other it? 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 11/25/2022 (mmiddlyyyy): (must be within three years) (See form instructions to ensure assessment complies with Minn, R. 7082.0700 subp. 4 B (9)) ❑ Tank is Noncompliant (pumping not necessary - explain below) ❑ Other: haps://www.pca.state,mn.us 651-296-6300 • 800-657-3864 Use your preferred relay service Available in alternative formats wq-wwists4-31b • 4/28/1021 Page 2 of 4 Property Address: 4040 Watertown Road Business Name: Rusty Olson Soil & percolation Testing Date: 12/19/2022 3. Other compliance conditions — Compliance component #3 of 5 3a. Maintenance hole covers appear to be structurally unsound (damaged, cracked, etc.), or unsecured? ❑ Yes" ® No I] Unknown 3b. Other issues (eiectricat 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. 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 ❑ 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 wq-wwists4-31b - 4/28/2021 • 800-657-3864 Use your preferred relay service Available in alternative formats Page 3 of 4 Property Address: 4040 Watertown Road Business Name: Rusty Olson Soil & percolation Testing_ _ Date: 12/19/2022 5. Soil separation — Compliance component #5 of 5 Date of installation 6/7/1989 ❑ Unknown (mm/dd/yyyy) ShorelandlWellhead protection/Food ❑ Yes ® No beverage lodging? Compliance 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. 5 b. 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.* 5c. `Experimental, "Other", or Performance" 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. ❑ Yes [:]No* ❑ Yes ❑ No* *Any "no" answer above indicates the system is failing to protect groundwater. Describe verification methods and results: Attached supporting documentation: ❑ Soil observation logs completed for the report ❑ Two previous verifications of required vertical separation ❑ Not applicable (No soil treatment area) Indicate depths or elevations A. Bottom of distribution media 99.8 B. Periodica!!y saturated soil/bedrock 96.8 C. System separation 3.0 D. Required compliance 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 (1TPHS) 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 2022 SEPTIC MAINTENANCE REPORT Site address: 4040 Watertown Rd (Adam & Hannah Westling) Number of tanks:_ 3 Date last pumped: 11/25/2022 Gallons pumped: 2100 Name of pumper)' maintenance provider: Albin's Septic Pumping, LLC Are tanks waterftht?: Is the system functioning properly? Yes Y£S NO (please circle one) (ie slow drainage, wetness in the drainfieid?) Do you have any specific concerns or issues that you'd like to discuss with the SSTS Program Manager? No. Note: Please see Tank Certification attached as Rusty's Percolation is doing a Compliancy; Inspection. as the home is for sale. If so, please indicate best time and telephone number(s) to be reached between S am and 4:30 pm. Best Times Telephone Numbers) RETURN IN THE ENCLOSED ENVELOPE AS SOON AS POSSIBLE Alicia Johnson CITY OF ORONO PO BOX 66 CRYSTAL BAY MN 55323.0066 Property address: 4.040 Watertown_ Rd Adam &Hannah Westlinc) Parcel ID: 3111823410001 city: Orono state:_ MN _ _ zip code:_55359 _ section: Sewage Tank Compliance Certification This form does not repissent a complete system inspection report and only csrtliies sewage Instructions: This seen of the form may be completed and signed by a Designated Certified individual (DCI} of a tswnsed btj 15 Maintsnarm Business who personally conducts the necessary procedures to assess the compliance status of each sewage tank in the system. When this section of the form is signed by a qualified certified professional, it becomes necessary suppofft rbowirw1afian to an Existing System Compliance Inspection Report: Compliance inspection fa - . This form can be found on the MPCA webiae at The information and certilled statement on this form 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 surd is allowable under Minn. R. 7082.0700, subp. 4 Item (B) subiitem (1). 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 adMty can be found at Minn. R. 7082.0700, subp. 4 Items B, C, and D; 7083.0730 Item C. ]MCwUfieate of sewage tank compliance Affirm all three statements: �( The SSTS does not contain a seepage pit, cesspool, drywell, leaching pit, or other pit. �[ It does not contain a sewage tank that was designed to be wateftight, but subsequently leaks below the designed operating depth. X It does not represent an imminent safety threat by reason of unsecured, damaged, or weak maintenance We cover(s) or other unsafe condition. Company lnformatlon Company name: Albin''s Se ' _Pumping, LLC ❑ Notice of sewage tank non-compliance Select all that apply: ❑ The SSTS has a seepage pit. cesspool, drywell, leaching pit, or other pit, ❑ It has a sewage tank that was designed to be watertight, but subsequently leaks below the designed operating depth. ❑ It presents a threat to pubtic safety by reason of unsecured, damaged, or weak maintenance hole covers) or other unsafe condition. Designated Certified Individual (DCI) Inibrmatlon Print name: Peter Peterson Business license number: 3346 Certification number: 9227 I personafy conducted Re work described above as a Designated Ceram ln&Wdual of a Minnesota- icensed SETS Mahrtenance Business. I permw0y conducted the ry pmcedures to assess the compliance status of each sewage tank in this SSTS: Designated Certified Individual's signature: y % _ flare (mwddlyyyy): _ 11/25/2022 www.pca.stat,e.mn.us . 651-2%-6300 • 800.657-3864 Use your preferred relay service Available in alternative formats wq-ww1at34-3d • 1127117 page 3 of 3 Soil Observation Log www.SepticResource.corn vers 12.4 Owner Information Owner / project: Adam Westling Address / PID: 4040 Watertown Road Date 12/1/2022 Soil Survey Information ❑ refer to attached soil survey Parent matl's: El Till ❑ Outwash ❑ Lacustrine ❑ Alluvium ❑ Organic ❑ Bedrock landscape position: ❑ summit ❑ Shoulder 21 Side slope ❑ Toe slope soil survey map units: L41 C;2 slope % direction - Soil Log #1 21 Boring ❑ Pit Elevation 100.0 Depth to SHWT 34 inches Depth (in) Texture fragment % matrix color redox color consistence grade shape 0-10 Fill <35 10-20 Loam <35 10yr3/1 Friable Strong Blocky 20-28 Clay Loam <35 1 Oyr4!3 Friable Strong Blocky 28-34 Clay Loam <35 1 Oyr5/4 Friable Strong Blocky 34-40 Clay Loam <35 1Oyr5/4 IOy4/8,1-6/IOy Firm Strong Blocky Continents: TBM: Top of the lift station manhole cover Evl.-100.0 59"J- 71- An -