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HomeMy WebLinkAbout9.11.24 3445 Watertown Road septic certMINNESOTA POLLUTION CONTROL AGENCY Compliance inspection report form 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.r)ca.state.mn.us/sites/default/files/wg-wwists4-31a pdf. Property information Local tracking number: Parcel ID# or Sec/Twp/Range: 3211823430009 Reason for Inspection Property Transfer _ Local regulatory authority info: City Of Orono, 952 249-4600 Property address: 3445 Watertown Road, Orono Owner/representative: Joe McPherson Owner's phone: 612-369-3736 Brief system description: 2-1300-gallon septic tanks, 1-1300-gallon lift station and 630 Square feet Rock bed System status System status on date (mm/dd/yyyy): 9/11/2024 ® 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 The system is designed for a five bedroom house. There is 1.5 feet of sand under the rock bed on the East side and there is 2.0 feet of sand under the rock bed on the West side. TBM: Top of the door thresholod. Elv.-100.G 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 Testing Certification number: C1255 Inspector signature: Joseph J. Olson _ (This document has been electronically signed) 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 Use your preferred relay service Available in alternative formats wq-wwists4-31b • 412812021 Page 1 of 4 Property Address: 3445 Watertown Road, Orono Business Name: Rusty Olson Soil & percolation Testing Date: 9/11/2024 1. Impact on public health — Compliance component #1 of 5 Pee 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 dwellinq 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 Attached supporting documentation: ❑ Other: ® Not applicable 2. Tank integrity — Compliance component #2 of 5 !lance criteria: System consists of a seepage pit, ❑ Yes- ® No cesspool, drywell, leaching pit, or other it? Sewage tank(s) leak below their ❑ Yes- ® No designed operating depth? If yes, which sewage tanks leaks: Any "yes" answer alcove indicates the system is failing to protect groundwater. Describe verification methods and results: Duane's Septic Service 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 8/13/2024 (mmidd/yyyy): (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 651-296-6300 800-657-3864 Use your preferred relay service Available in alternative formats wg-wwists4-31b • 412812021 Poge 2 of 4 Property Address: 3445 Watertown Road, Orono Business Name: Rusty Olson Soil & percolation Testis 3. Other compliance conditions — Compliance component #3 of 5 Date: 9/11/2024 3a. Maintenance hole covers appear to be structurally unsound (damaged, cracked, etc.), or unsecured? ❑ Yes' ® 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. 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 800-657-3864 use your preferred relay service • Available in alternative formats wq-wwists4-31b • 4/28/2021 Page 3 of 4 Property Address: 3445 Watertown Road, Orono Business Name: Rusty Olson Soil & percolation Testing Date: 9/11/2024 5. Soil separation — Compliance component #5 of 5 Date of installation 7/2712015 ❑ Unknown fmm/dd/Wy) ShorelandlWel[head protection/Food ❑ Yes ® No beverage lodging? ComDliance criteria (select one): 5a. For systems built prior to April 1, 1996, and ❑ Yes ❑ Now 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 j 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.* Attached supporting documentation: ® Soil observation logs completed for the report ❑ Two previous verifications of required vertical separation ❑ Not applicable (No soil treatment area) 01 ® Yes ❑ No* Indicate depths or elevations 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 5 2,500 gallons per day; Advanced Inspector License required a 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 102.3 B. Periodically saturated soil/bedrock ! 99.3 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-wwists4-31 b • 412812021 Poge 4 of 4 ' RAIN CONTROL AGENCY POLLUTION Sewage tank integrity assessment form 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,./Atvww.pca.state.mn.us/waterfinspecfions. 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 tank 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 be 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: Compliance inspection form - Existing system L,6-wwists4-31 b). This form can be found on the I IPCA website at htt;)s://www.oce.state.mn.usiwaterl'ins1)ections. The information 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 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 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 Property address: q � � h 1 Local Regulatory Authority: nro.1fs Parcel ID: system status r System=erfificate date (mm/ddlyyyy): c; ? 3 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 Groundwater." — - - ❑ Yes ]o The SSTS has a sewage tank that leaks below the designed operating depth - "Failure to Protect Groundwater." ❑ Yes No 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' ffeNo Public Health or Safety." Any ",yes'; answer above la ica:es ser,^rage rank non-compliance. Company information Designated Certified Individual (DCQ information Company name: Duane's Septic Service LLC Print name:[ fi c:� Business license number: L4286 Certification number: C 191`7 1 personally 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 typing/signing my name below, I certify the ab ve statements to be true and correct to the best of my knowledge, and that this infonvation can be used for the purpose of c sing th' nn. Designated Certified Individual's signature: L Date (mm/dd/yyyy): Q f 3 7o;Lv rcument has been electronically signed.} tirrww.pca.state.mmus 651-296-6300 - 800-657-3864 Use your preferred relay service Availabie in alternative formats wq-ww1sts4-91 • 5110121 Page 1 of 1 Soil Observation Log www.SepticResource.com vers 12.4 Owner Information Property Owner / project: Joe McPherson Property Address 1 PID: 3445 Watertown Road Date 9/4/2024 Soil Survey Information ❑ refer to attached soil survey Parent matl's: ❑r Till ❑ Outwash ❑ Lacustrine ❑ Aliuvium ❑ Organic ❑ Bedrock landscape position: ❑ Summit ❑ Shoulder 0 Side slope ❑ Toe slope soil survey map units: L40B slope % direction- Lineal Soil Log #1 D Boring ❑ pit Elevation 103.8 Depth to SHWT 65 inches Depth (in) Texture fragment % matrix color redox color consistence grade shape 0-43 Mound sand Fill <35 43-58 Loam <35 10yr3!1 Friable Moderate Blocky 58-65 Loam <35 10yr4/3 Friable Strong Block} <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 Comments: TBM: Top of door threshold. Elv.- 100.0 3445 Watertown Road Soil Log 92 21 Boring ❑ Pit Elevation 103.7 Depth to SHWT 54 inches Depth (in) Texture fragment % matrix color redox color consistence grade shape 0-35 Mound sand Fill <35 35-42 Loam <35 10yr3/1 Friable Moderate Blocky 42-48 Loam <35 10yr4/3 Friable Strong Blocky 48-54 Clay Loam <35 10yr5/4 Friable Strong Blocky 54-60 Clay Loam <35 10yr5/4 10y4/8,1-6/10y Firm Strong stocky 3445 Watertown Road 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 friable weak granular blocky firm moderate Prismatic platy h' >50 rigid strong massive <35 loose loose single grain 35 - 50 friable weak granular blocky >50 % 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 #-ff n moderate prismatic platy rigid strong massive I hereby certify this work was completed in accordance with MN 7080 and any local req's. 00, Rusty Olson's Soil & Perc 810 Designer Signature Company License # METRO WEST INSPECTION SERVICES, INC. • 763-479-1720 BOX 248 • LORETTO, MN 55357 Inspector, Owner CITY OF OL� Q N WORKSHEET FOR SEWAGE DISPOSAL WORK Date -7 a 7 7 -~ )S Building Permit No. 1 '� A 1M e-D% ..✓_ Property Address :3 L4 Lt i�3 i,L'-'•Yo,ti. �_ Kind of Building SSTS Installer License # �. Septic Tanks Material C' v'wl�-Number of Tanks Size rr Drain Field; Total length of lines (y 1 Number of lines Type of soil _1g �— Percolation Test _LsS D E5 Width of trench Type of filter material C- 1 Size of Rock Bed _L&)4 (b Size of Absorption Area Draw detailed diagram with measurements indicating distances to septic tank risers from a ran wins ndnf �.4winfrs N I 41 '— —0 Lu tt f�' vM } jj k o u c� I , )