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HomeMy WebLinkAbout2025 MPCA Compliance Inspection ReportMINNESOTA POLLUTION Compliance inspection repnort form CONTROL AGENCY p N 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.usisitesidefault/filesiwg-wwists4-31a.pdfi. Property information Local tracking number: Parcel ID# or Sec/Twp/Range: 1111723230015 Reason for Inspection ProQer�r Transfer Local regulatory authority info: City of Orono Property address: 1510 Green Trees Road ------------------------- Owner/representative: Gregg Larsen (Realtor)______ Owner's phone: 612-719-4477 Brief system description: Approximately 2-1000-gallon septic tanks and 880 square feet of trench system per city records System status System status on date (mm/dd/yyyy): 3/1/2024 M. 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.) ❑ 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 *Note: Compliance indicates conformance with Minn. of this notice or within a shorter period if required by local ordinance or R. 7080.1500 as of system status date above and does not under section 145A. 04 subdivision 8. guarantee future performance. 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 Thgis system was designed for a four bedroom house. TBM: Top of the basement door threshold. 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 Use your preferred relay service Available in alternative formats wq-wwists4-31b • 412812021 Page 1 of 4 Property Address: 1510 Green Trees Road Business Name: Rusty Olson Soil & percolation Testing 1. Impact on public health — Compliance component #1 of 5 Compliance 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 dwelling or establishment. Any "yes" answer above indicates the system is an imminent threat topublic health and safety. Describe verification methods and results: Visual. Nothing was found Date: 3/1 /2024 Attached supporting documentation: ❑ Other: ❑ Not applicable 2. Tank integrity — Compliance component #2 of 5 Compliance criteria: System consists of a seepage pit, cesspool, drywell, leaching pit, or other pit? Sewage tank(s) leak below their designed operating depth? [:]Yes* ® No ❑ Yes ® No If des, -which sewage tank(s) leaks___ Any "yes" answer above indicates the system is failing to protect groundwater. Describe verification methods and results: Elmer J. Peterson Company 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 2/14/2025 _ (mm/dd/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: 1510 Green Trees Road Business Name: _ Rusty Olson Soil & percolation Testing I Other compliance conditions — Compliance component #3 of 5 Date: 3/ 1 /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 great 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: 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: 1510 Green Trees Road Business Name: Rusty Olson Soil 8 percolation Testin�c - S. Soil separation — Compliance component #5 of 5 Date of installation 11/16/1989 ❑ Unknown (mm/ddlyyyy) Shoreland/Wellhead protection/Food ❑ Yes ❑ No beverage lodging? Compliance criteria (select one): 5a. For systems built prior to April 1, 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 I separation distance from periodically J saturated soil or bedrock. 5b. Non-performance systems built April 1, 1996, or later or for non- performance systems located in Shore/and 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.* Date: 3/1/2024 Attached supporting documentation: ❑ Soil observation logs completed for the report ® Two previous verifications of required vertical separation ❑ Not applicable (No soil treatment area) ® attached are three sets of soil borings El Yes ❑ No* Indicate depths or elevations A. Bottom of distribution media 89.4 B. Periodically saturated soil/bedrock > 86.8 C. System separation - >2.6 D. Required compliance separation* 2.55 5c. "Experimental", "Other", or "Performance" ❑ Yes ❑ No systems built under pre-2008 Rules; Type /V 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: *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 Tank Report Date: February 14, 2025 Amer J. Peterson Co. 5921 Dague Ave. Delano, MN 55.,328 Phone 763-972-2420 Fax 763-972-7217 MPCA License# 219 Scott Stevenson 1510 Greentrees Road Orono, MN b 12-719-4477 Gregg Larsen - Realtor Baffles: 6 / OFF Tank Capacity: # of Tanks: 2 Type of Tanks: Gallons Pumped: 2-1000 Gallon Tanks Per City Records Concrete 2000 Manholes to Grade:(31 / NO Comments: On February 14, 2025, Elmer J. Peterson Co. pumped tanks. No cracks or water leaking in tanks at the time of pumping. NOTE: This is only a tank report. This is not a compliance inspection for point of sale nor does it replace a compliance inspection. MINNESOTA POLLUTION Sewage tank integrity assessment form CONTROL AGENCY Y 520 Lafayette Road North Subsurface Sewage St_ Paul, N,N 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://www.pca.state.mn.us/water/inspections, 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 systern 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 suppnrtirlg documentation to an Existing System Compliance Inspection Report: Compliance inspection form - Existing system (wg-wwists4 This form can be found an the MPCA website at https:!/www..ma.state.mn.us/waterhnspections. 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 Scott Stevenson Property address: 1510 Greentrees Road Orono, MN Local Regulatory Authority: Parcel ID: System status System status on date (mmidd/yyyy): 2/14/2025 0 Certificate 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 I Yes No Groundwater." 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" 0 No Public Health or Safety." Any "yes" answer above indicates sewage tank non-compliance. Company information Designated Certified Individual (DCI) information Company name: Elmer J. Peterson Co Print name: James L Braegelmann Business license number: 219 Certification number* I personally conducted the work desciibed 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 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. Designated Certified Individual's signature: James L Braegelmann Date (mm/dd/yyyy): _2/14/2025 (This document has been electronically signed.) www.pca.state.mn.us 651-296-63DO 800-657-3864 Use your preferred relay service Available n alternative formats wq-wwists4-91 • 5110121 Page 1 of 1 SEPTIC SYSTEM INVENTORY Site Address: 1610 Green Trees Rd Owner Name: Scott Stevenson Owner Address: 1510 Green Trees Rd Wayzata MN 55391- PID 11-117-23-23-0015 BuildingTvpe: residence Installer: Sullivan Date of Permit: 11/16/89 Svstem Tvpe: standard trench BR's Designed for 4 In Musa?: Yes Shoreland?: No SEPTIC TANKS: Material: precast concrete Capacity: 1000,1000 Tank Filter: DRAINFIELD: Treatment Area: 880 Soil Boring: no DF Ht above Wt: 3 WELL DATA Setbacks - Well Tanks: 100 Well DF: 100 Report In File: Depth: 166 INSPECTION RECORDS PUMPOUT RECORDS Date Notes Date GallonsOfLiquid 12/6/2019 Compliance Inspection - Valid until 12-06-2022 10/23/2019 2000 5/17/2013 Point of sale certification valid until 5/16/2016 3/30/2017 2000 6/1/2006 OK 5/17/2013 2000 8/6/2004 OK 11/21/2011 2000 7/26/2002 no surfacing,pump tanks 10/21/2008 2000 10/20/2000 no surfacing, pump tanks 7/16/2004 2000 11/7/1997 no surfacing 10/31/2000 1000 5/9/1994 no surfacing 11/3/1995 2000 10/2/1992 no surfacing -pump tanks 10/15/1992 2000 4/2/1992 no surfacing -pump tanks 10/15/1992 2000 11/16/1989 installation 11/16/1989 installation Property Owner / project: Property Address / PID: Soil Observation Log Owner Information Scott Stevenson 1510 Green Trees Road www.SepticResource.com vers 12.4 Date 11/25/2019 Soil Survey Information ❑ refer to attached soil survey Parent matl's: ❑ Till 0 Outwash ❑ Lacustrine ❑ Alluvium ❑ Organic ❑ Bedrock landscape position: ❑ Summit 2 Shoulder ❑ Side slope ❑ Toe slope soil survey map units: L22L2 slope % direction- Linear Soil Log #1 0 Boring ❑ Pit Elevation 93.8 Depth to SHWT 66 inches Depth (in) Texture fragment % matrix color redox color consistence grade shape 0-8 Topsoil <35 10yr3/2 Friable Moderate Granular 8-12 Sandy Loam <35 10yr4/3 Friable Moderate Granular 12-40 Sandy Loam <35 10yr5/4 Friable Moderate Granular 40-46 Sandy Loam <35 10yr3/2 Friable Moderate Granular 46-66 Sandy Loam <35 10yr5/4 Friable Moderate Granular Comments: 1510 Green Trees Road Soil Log #2 O Boring ❑ Pit Elevation 91.4 Depth to SHWT 66 inches Depth (in) Texture fragment % matrix color redox color consistence grade shape 0-6 Topsoil <35 10yr3/2 Friable Moderate Blocky 6-10 Clay Loam <35 1 Oyr4/3 Friable Strong Blocky 10-24 Clay Loam <35 10yr5/4 Friable Strong Blocky 24-42 Sandy Loam <35 10yr6/4 Friable Moderate Granular 42-66 Med Sand <35 10yr6/3 Loose Loose Granular 1510 Green Trees Road Soil Log #3 ❑ Boring ❑ Pit Elevation Depth to SHWT inches 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 >50 rigid strong massive <35 loose loose single grain 35 - 50 friable weak granular blocky firm moderate prismatic platy >50 rigid strong massive <35 loose loose single grain 35-50 friable weak granular blocky firm moderate prismatic platy >50 rigid strong massive <35 loose loose single grain 3 5 - 50 friable weak granular blocky firm moderate prismatic platy >50 rigid strong massive <35 loose loose single grain 35 - 50 friable weak granular blocky firm moderate prismatic platy >50 rigid I strong massive I I hereby certify this work was completed in accordance with MN 7080 and any local req's. Rusty Olson's Soil & Perc. 810 esigner Signature Company License # r nt TF T C A"" F" n r Location, or Prof eect 17 c, ?i n "'urn''_acer, Lot5 & Cutlo-In D. Green Trees on . . . . ........ .. Dorinas mai�,o by sm v -z C!7 W � rn -arnaqer .Aake, Orono C"ther Alw'cer .,seof two' eN r n— w r t ",c, r n c e e e va t- o n 5 4 r. dar- loam 4 C7 4-' 954.6 Topsoil dark brown loam Brown sang clay loam _2,rown SandV of 2 ' 2" Brown sa -.P' v loam 2" 1 2 to - 21 2. B.-own medium 21 '!Aff - 31411 salrid I "rows medium sand to ,,,,brown i2amy I 4 -, san 4 4 4 R -_-�n�:­ 'oam, - i 4 4" i I Brown loamy sand w/a thi- -ayer Cr loam f to Brown medium Olive brown loam G 51F" - 6'411-MOTTLING �,_,stv olive brown sandy 514" - 7' loam 7 IJT- ROCK 414tv 81 End of borino at ee e t at 7 Standing water table: Stand-,nc - water tab:e: present at feet of dentl."491 nresent at -net of deolt ho--,rs after bori-a. ,ours after bor:ncl. Not oresent in hole x 'Not oresent x SO4 Mottled Observed at V 4- 4- 4- 6 14 to t h 'j-1 3 CERTI.PTACATTCN 0 00627, IV Oas of Soil BorinEs Location or Project John Turnblacer, Lot5,Elk.l. & Outlot 0, Green Trees on Borings made by s-p , Tanager Lake, OFono ts Dato C-lassifiction System: AAS!-"'-( Sr*,A-SCS X n e d e r V1, Auger used (check two): Hand X or Power____—, ---c-ht or Buckt.?t x Depth.. Bor-Ang number i!)epth,, Borina number 2 A. - in Feet Surface elevation 951.7 'feet Surface elevation 951.4 Topsoildark brown 0 CR T Toosoil dark brown loam Brown clay loam 0 1'41' IV I Brown sandy loam Brown loam 4 2-1/21 3 2 ✓r o w n. a An Y I C am 31P" r ow n m e d I T"I C-a I �dq 31 S 4 12 It 4 0-, iv(:� bruv.� .2 4 Si +.v Brown medium sand r own med4um sand r 4f_?I' 7? 2-1/21 71 7 F I T ROCK NTT ROCK !,'nd of bor-ing at feet. TZ.nd of boring at 71 feet. Standing water -table: Standing water 4 ..ab'-e: present at feet of dept- _,�resent at feet of 2e0th' hoLirs *after bor incr hours after borinc. Nc,-- present -4n hole Not 4 c. x Yottled so-i-':. 0_1:)sorved at '17(*.et of eeoth. Not oresent in. Comments: Cbserved a-z feet of dei3th. Not !:'rest�nt x Comments: ISI� Grain i,2es '�. LFONU PAGE ?21'?2 0* in Vfl--�TT ov� q103 C613 w 6 85? V ,a TIO 771 Da3 ITO LEM ter! i in Jay, gip © 86'6 Ravf ! ffi0006 !gf,6 Vo 1 •C" lot P • r a 4 d • \ r'` 1 s t .- 3 �^r r a s fLj Tests �_•Y+;f: Mork Nose Note : Check all underground utilities Th:5 ,yt Lm is to be cvts',vc'rd !o m.eet the kfinne5vf0 Pcollulion Cori,ol A�.'•,cy Chapter 7080 & Local Ordin.Ince P TESTING INC. Dole L /1.!_ AQ, PH, 6,2 - 497-3565