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HomeMy WebLinkAbout2025 MPCA Compliance Inspection ReportMINNESOTA POLLUTION Compliance inspection report form CONTROL AGENCY 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/default/files/wq-wwists4-31a.pdf. Property information Local tracking number: Parcel ID# or Sec/Twp/Range: 3311823430006 Reason for Inspection Property Transfer Local regulatory authority info: City Of Orono, (952) 249-4600 _ Property address: 160 Old Crystal Bay Road N., Orono Owner/representative: James Redmond _ _ Owner's phone: 612-618-4411 _ Brief system description: 2-1500-gallon combination septic tanks, 1-1000-gallon lift station and 630 Square feet Rock bed per city records System status System status on date (mm/dd/yyyy): 3/1/2025 ® 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 1.6 feet of sand under the rock bed. TBM: Bottom of the rock bed. 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, 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 License number: L810 (This document has been electronically signed) 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 • 412812021 Use your preferred relay service 0 Available in alternative formats Page 1 of 4 Property Address: 160 Old Crystal Bay Road N., Orono 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* ® No the 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: 3/1/2025 Attached supporting documentation: ❑ Other: ® Not applicable 2. Tank integrity— Compliance component #2 of 5 Compliance 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 leaks: Any "yes" answer above 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 2/27/2025 (mmidd/yyyy): (must be within three years) (See form instructions to ensure assessment complies with Minn. R. 7082.0700 subp. 4 8 (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 wq-wwists4-31b • 412812021 Page 2 of 4 Property Address: 160 Old Crystal Bay Road N., Orono ___ _ Business Name: Rusty Olson Soil & percolation Testing Date 3/1/2025 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 ❑ Unknown 3b. Other issues (electrical hazards. etc.) to immediately and adversely impact public health or safety? ❑ Yes El No ❑ Unknown *Yes to 3a or 3b - System is an imminent threat to pubnc neann arm sarety. 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: E 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 • 412812021 Page 3 of 4 Property Address: 160 Old CD(stal Bay Road N. Orono Business Name: Rusty Olson Soil & pffcolabon Testing S. Soil separation — Compliance component #5 of 5 Date of installation 7/13/2006 ❑ Unknown (i 1' 111/ WW1.')'YY/ ShorelandNVellhead protection/Food ❑ Yes ❑ No beverage lodging? Compliance criteria (select one): 5a. For systems built prior to April 11, 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. i 5b. Non-performance systems built ❑ Yes ❑ No 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" ❑ 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 <_ 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: Date: 3/1/2025 Attached supporting documentation: ❑ Soil observation logs completed for the report ® Two previous verifications of required vertical separation ❑ Not applicable (No soil treatment area) 1-1 Indicate depths or elevations A. Bottom of distribution media--100.0 B. Periodically saturated soil/bedrock 97.0 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-wwists4-31b • 412812021 Page 4 of 4 s�-, MINN FSOTA POLLUTION Sewage tank integrity L CONTROL AGENCY g assessment form 520 Lafayette Road North Subsurface Sewage St. Paul, MN 55155-4194 Treatment Systems (SSTS) Program Doc Type: Compliance and Embry ement 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•//www,postate mn us/waierlinspe ions. 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 ttie assessment date. When this farm is signed by a qualified certified professional, it becomes necessary supporting documentation to an Existing System Compliance inspection Report: Compliance inspection form - Existing system (wq-ww1sts4-31 b). This form can be found on the MPCA website at https:I/www.pca.state.mn.us/waterfinspections. 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). �7 Owner information Owner/Representative ed rwrtX, Property address. Gr 4 STci cc Local Regulatory Authority: C) rO^0 ` Parcel ID: System Status Syste7CU_8_;�"ci sate (mm/dd/yyyy): � 1 ; ca ',15- te of sewage tank c mplian ® El 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 ❑ Yes* No Groundwater." 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* Public Health or Safety." Any "yes" answer above indicates sewage tank non-compliance. Company information Designated Certified individual ff information Company name: Duane's Septic Service LLC Print name: C.- Business license number: L4286 Certification number. C 5r ( -) 2 1 personally conducted the work described above as a Designated Certified Indivdual of a Minnesota-Ucensed 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 itypinglsigning 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 WjWW slily thy. _ Date (mm/dd/yyyy): O Z tP.635 Designated Certfied Individuars signature: been www.pca.state.mn.us 651296-6300 800-657-3864 • Use your preferred relay service wq-ww1sts4-91 • 5110121 Available in alternative formats Page 1 of 1 SEPTIC SYSTEM INVENTORY Site Address: 160 Old Crystal Bay Rd N Owner Name: Leann Coe Owner Address: 160 Old Crystal Bay Rd N Long Lake MN 55356- PID 33-118-23-43-0006 BuildinpTvpe: residence Installer: Hayes and Sons Date of Permit: 11/30/06 Svstem Tvpe: mound BR's Designed for 5 In Musa?: No Shoreland?: SEPTIC TANKS: Material: precast concrete Capacity: 1500,1500,1000 Tank Filter: DRAINFIELD: Treatment Area: 630 Soil Boring: yes DF Ht above Wt: 3 WELL DATA Setbacks - Well Tanks: 50+ Well DF: 100+ Report In File: Depth: INSPECTION RECORDS Date Notes 6/20/2018 Compliance Cert Valid until 6/22/2021 7/13/2006 installation 9/8/2003 non -compliant, replace by 12/31/2010 8/22/2001 non -compliant, replace by 12/31/2010 10/25/1999 noncompliant, repair 12/31/2007, no surface 12/1/1997 noncompliant -slight surfacing, repair 2007 i 8/7/1997 non-compliant-DF surfacing, 12/31/97 ' 7/20/1993 no surfacing -pump tanks 10/9/1991 no surfacing -pump tanks 8/8/1988 no surfacing -pump tanks 8/18/1986 no surfacing 8/10/1981 no surfacing 8/10/1981 no surfacing PUMPOUT RECORDS I Date GallonsOfLiquid 7/9/2017 2600 6/26/2014 2600 6/2/2011 2500 7/13/2006 15001 9/24/1998 1500 9/24/1998 1500; __ j Property Owner! project: Property Address! P1 D: Soil Observation Log Owner Information LeAnn Coe 160 Old Crystal Ray Road N. Date 6/20/2018 Soil Survey Information ❑ refer to attached soil survey Parent matl's: [Q Till ❑ Outwash ❑ Lacustrine ❑ Alluvium ❑ Organic ❑ Bedrock landscape position: ,77 Summit ❑ Shoulder [) Side slope ❑ Toe slope soil survey map units: L37B slope °o direction - Soil Log #1 ❑ Boring ❑ Pit Elevation 101.2 Depth to SNWT 52 Inches Depth (in) Texture franment ti o matrix color redox color consistence grade shape 0-34 Fill <3 5 34-3$ Topsoil <35 10yr4,2 Friable Moderate block. 38-52 Clay Loam <3)5 IOyr54 Firm Strom 131ockN 35 loose loose simile grain 15 5O friable weak Lranular hlock� -,aU firm moderate prismatic plat rigid strong massi%c -,35 loose loose singlc grain -35-50 friable weak 2rannlar blockN >50 firm moderate prismatic plaix rigid strong massne Comments: 160 Old Crystal Bay Road N. Soil Log #2 F-1, Boring ❑ Pit Elevation 101.6 (depth to SIIWT 58 Inches i Depth (in) Texture fragment �o matrix color redox color consistence grade shape 0- - 39 Fill <35 39-50 Topsoil <.3 10yr3 1 Friable Moderate Bl ck% 50-58 Clay Loam <35 1Oyr4l3 Friable Strong l3loc:kN <, J5 loose loose single gain 35 - 50 triable weak granular block >50 fine moderate prismatic plat% rigid strong massiVe �35 loose loose single grain 35 - sa friable weak granular block% - >50 firnl moderate prismatic plat rigid strong massi%c 160 Old Crystal Ba Road N. Soil Log #3 ❑ Boring ❑ Pit Elevation Depth to SI IWT Depth (in) Texture fragment % matrix color redox color consistence grade shape loose loose ;5 - 35 50 triable weak %in -le < -rain granular block,, _ ,50 firm moderate prismatic platN rigid strong :3$ loose loose single ;gain 35-50 friable weak granular block >50 firm moderate prismatic plaiN rigid strong massive loose loose single grain 35 - 50 friable weak granular hlock� - >50 fin- moderate prismatic plat\ rigid strong massi� r = 35 loose loose sinale `grain 35 - 50 fi-iable weak "ranular hlockt >50 firm moderate prismatic plat\ rigid strong ntassi%c <35 loose loose sinalc 4` rain _ 35 - 50 friable weak granular hl,ckN >50 firm moderate: prismatic plat} rigid strong massive herein' ce jili• this work ► as completed in accordance ►0th ; IA! 7080 and 41171' local i-eq:s. -� Rusty Olson Soil & Perc 810 Dtrsigner Signature Company License C. W. L UNSER COMPANY INC. ti Pere testing & Septic Designs -Sop Borings & Septic Evaluations Minnesota Pollution Control Agency Licensed and Bonded— - -- AWwWrta Ana St Cloud At" 2753 Le Nommw Dieu Heiahb NE 2233 RooMve t Rd Suits 10 Aiaxwodds MN 3630d Et Cloud MN 56301 Busirms S Fax (320) T63-5M Huskw : (320) 248-2262 Property Owner: Lee- A„ %,. Coe Address: i (,ao N- o16 c,:: gQ,, R6 l.oAc La �. M N SS3 sG 1. Soil map unit(s) at project site: kG so: i . Soil Survey page number. % (or attach copy of page.) 2. Percolation range: / mpi, depth to watertable: / ft., slope: / %. (SEE SOIL SURVEY INDEX). 3. Is this project in shoreland? Yes / < low (NOTE: Construction within 1000 feet of a lake or 300 feet from a river or stream is considered shoreland. Use scale in Soil Survey map to determine applicability.) 4. If yes, name of water body: . Public water classification: 5. Is this project located within a 10 yr. floodplain? (i.e. a river) Yes / No. Ten yr. flood elevation: (IF YES, PLEASE CALL ENVIRONMENTAL SERVICES BEFORE CONTINUING WITH THE DESIGN OF THIS SYSTEM.) 6. SOIL OBSERVATIONS: (A MINIMUM OF ONE OBSERVATION IS REQUIRED. iT MUST BE TO A DEPTH OF EITHER: 7 FEET; 3 FEET BELOW THE PROPOSED SYSTEM; OR TO WATER OR BEDROCK NOTE: IF THE SOIL OBSERVATION INDICATES A MOUND SYSTEM, THE DESIGN MUST BE BASED ON THE MEASURED PERCOLATION RATE OR THE SLOWEST RANGE FROM THE SOIL SURVEY INDEX.) Soil Observation No.: / . Method used for observation: Exposed pit / and au e / Probe. Surface elevation at soil boring (in reference to bench mark): 9 y • 10 . Depth to mottled soil: ZZ DEPTH MUNSELL SOIL COLOR CHART SOIL TEXTURE Water Bedrock Cinches) (Y/N) (YIN) MUNSELL MUNSELL MOTTLE COLOR HueNalue/Chroma Hue/Value/Chroma i �12 L 1 Q V- B- ? r a ..+ V. 3 / i I -i- C 142 L SY S /y Z-'o C, I G � • 5 v cif, � �, 8 •�. Soil Observation No.: . Method used for observation: Exposed pit ( au an / Probe. Surface elevation at soil boring (in reference to bench mark): 9 Y • ! a Depth to mottled soil: 8` DEPTH (inches) MUNSELL. SOIL COLOR CHART SOIL TEXTURE Water (YIN) Bedrock (YIN) i MUNSELL COLOR MUNSELL HueNalue/Chroma MOTTLE Hue/ValuelChroma o - { t� 5v JJ �� �� �'� �° z v 3�z►� S' I f L 10. \ L_ 0 Ir, 04� v* Je- �N —two la�y� 6;5"r ct NSPECTO APPR vED AS SL:�l AITTED NOT 'Y P'RCWFD-C[►RkPCT A RFSU, ��IT for ur informa!tlo . All *or ahall tm dim It Cali lv r3; I !we win Jul :i'►rawaole Septic and ?t ilag Code. Rcquir"=cuts inchuli»g item tint 4w6ftcally twitxi in 111ia €Vview. KLEP THIS PLAN SET ON SITE AT ALL TIMES ►Go o �n rq 8A14)