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):
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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:
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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) ❑
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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.
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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
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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
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NOT
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Rcquir"=cuts inchuli»g item tint 4w6ftcally twitxi in 111ia €Vview.
KLEP THIS PLAN SET ON SITE AT ALL TIMES
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