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oft <br />ON-SITE SEWAGE TREATMENT <br />INSPECTION REPORT <br />OWNER , J 0 Cc- — _) tl C..c )C N 1.1 k: <br />PHON E <br />On the North Shore of <br />Lake Minnetonka <br />POST OFFICE BOX 66 <br />1335 S. Brown Rd. <br />Crystal Bay, MN 55323 <br />473-7357 <br />ADDRESS IFIV.� <br />PERMIT NO'S. �" '7 - <br />DATES L/ �s <br />City Ordinance No. 210 requires that each on-site sewage treatment system in Orono be inspected on a regular basis. <br />The on-site sewage treatment syr -tem at the above address has been inspected and appears to fall into the category checked <br />below: <br />Meets or exceeds current city standards in all respects relating to design, construction, and location. Appears <br />1 to be operating <br />P 9 <br />Does not meet current city standards in some respects relating to design, construction, or location. Appears <br />2 to be operating properly.(TA_-tJ/< <br />-� <br />Does not meet current city standards in many respects relating to design, construction, or location. Appears <br />3 to be operating adequately. <br />ade uatel . <br />Does not meet current city standards of design, construction or location, is being overused, or is failing to <br />4 properly treat and input dispose of the current in n <br />P p and is therefore endangering a water supply, is a source of <br />pollution to surface or groundwaters, is creating a safety hazard, or is otherwise creating a public nuisance. <br />Please contact the inspector to discuss requirements for repairs to your system. Soil testing may be re- <br />quired. In all cases a design and site plan must be submitted for review. Your contractor must obtain a permit <br />before work is started. <br />WORK REQUIRED: <br />❑ Septic tanks must be pumped within 48 hours. <br />ElDrainfield must be repaired or replaced within 90 days. <br />❑ Inspection riser (4" diam. pipe) must be installed in Each tank. <br />Tank <br />El <br />inspection <br />indicates <br />maintenance pumpout is needed as soon as possible <br />tanks <br />be pumped <br />out every <br />three years. <br />SITE CHARACTERISTICS: <br />Limiting Site Factors <br />❑ Slope <br />Noil <br />High water table <br />❑ Lot size <br />❑ Lake, wetland, or stream <br />ADrainage <br />COMMENTS: <br />Date of Inspection <br />Potential for System Failure <br />(depends on soil types, water <br />table, and system condition) <br />❑ Low <br />,Medium <br />❑ High <br />[:]System is causing visible <br />surface discharge. <br />Septic System <br />City ordinance requires that <br />or <br />This report must be <br />kept on the <br />premises with <br />system location and pumping records. <br />WHITE COPY <br />/ Inspector's <br />File <br />GOLD COPY / Homeowner <br />Site Capabilities for <br />Future Expansion <br />Adequate <br />❑ Fair <br />❑ Poor <br />❑ inadequate <br />