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ON-SITE SEWAGE TREATMENT <br />INSPECTION REPORT <br />On the No►tb Sbore of <br />Lake Mixnetonka <br />POST OFFICE BOX 66 <br />1336 S. Brown Rd. <br />Crystal Bary, MN 56323 <br />473-7357 <br />OWNER P�TL7i' AcNEY ADDRESS 72 10 RAycine k > <br />PHONE PERMIT NO'S. /Sr,/ DATES -7-/'7-!v-7 <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 system 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 />to be operating properly. <br />Does not meet current city standards in some respects relating to design, construction, or location. Appears <br />Z2 to be operating properly. <br />loes not meet current city standards in many respects relating to design, construction, or location. Appears <br />to be operating adequately. <br />❑ Does not meet current city standards of design, construction or location, is being overused, or is failing to <br />properly treat and dispose of the current input and is therefore endangering a water supply, is a source of <br />pollution to surface or groundwatem, is creating a safety hazard, or is otherwise treating 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 />❑ Drainfield must be repaired . r replaced within 90 days. <br />14 Inspection riser (4" diem. pipe) must be installed in each tank.Tb Sur2WU /f /UJ7- A LgCAbY ' *CAE1L' <br />❑ Tank inspection indicates maintenance pumpout is needed as soon as possible. City ordinance requires that <br />tanks be pumped out every three years. <br />SITE CHARACTERISTICS: <br />Limiting Site Factors <br />❑ Slope <br />[:]Soil <br />❑High water table <br />XLOt size. <br />❑Lake, wetland, or stream <br />❑Drainage <br />COMMENTS: <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 />Date of Inspection Septic System Inspector <br />This report must be kept on the premises with system location and pumping records. <br />WHITE COPY / Inspector's File GOLD COPY / Homeowner <br />Site Capabilities for <br />Future Expansion <br />❑ Adequate <br />19 Fair <br />❑ Poor <br />❑ Inadequate <br />