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Home My WebLink About840 North Shore Drive West - Septic ComplianceMINNESOTA 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 (LG'U) 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: 0711723220005 Reason for Inspection Propery Transfer Local regulatory authority info: City of Orono Property address: 840 North Shore Drive W. Owner/representative: Jim Hatchett Owner's phone: 612-791-3309 Brief system description: Approximately 2-1000-gallon septic tanks, 1-1000-gallon lift station and 410 square feet of mound rock bed. System status System status on date (mm/dd/yyyy): _12/18/2025 ® 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.) ❑ 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 The system was designed for a three bedroom house. There is 1.7 feet of sand found under the rock bed. TBM: Top of the lift station manhole cover. ELV.-100.0 The second tank is starting to corrode. See tank report. The original designs soil borings are included. 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: 840 North Shore Drive W. Business Name: Rusty Olson Soil & percolation Testing _------ _ — Date: 12/18/2025 1. Impact on public health — Compliance component #1 of 5 Compliance criteria: Attached supporting documentation: System discharges sewage to the ❑ Yes ® No ❑ Other: ground surface ® Not applicable System discharges sewage to drain ❑Yes` ®No the or surface waters. System causes sewage backup into ❑ Yes ' ® No dwelling_or establishment. j Any "yes" answer above indicates the system is an imminent threat to public health and safetV. Describe verification methods and results: Visual. Nothing was found 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 yes, which sewage tanker 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 12/15/2025 --------- ------ ----------- (mm/dd/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 wq-wwists4-31b • 412812021 Page 2 of 4 Property Address: 840 North Shore Drive W. Business Name: Rusty Olson Soil & percolation Testing 3. Other compliance conditions — Compliance component #3 of 5 Date: 12/18/2025 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 • 412812021 Page 3 of 4 Property Address: 840 North Shore Drive W. Business Name: Ruspf Olson Soil & percolation Tes#gg _ Date: 12/18/2025 S. Soil separation — Compliance component #5 of 5 Date of installation 10/27/1989 ❑ Unknown (mmlddlyyyy) Shoreland/Wellhead protection/Food ® Yes ❑ No Attached supporting documentation: beverage lodging? ® Soil observation logs completed for the report Compliance criteria (select one): ❑ Two previous verifications of required vertical separation 5a. For systems built prior to April 1, 1996, and ❑ Yes ❑ No ❑ Not applicable (No soil treatment area) not located in Shbreland or Wellhead Protection Area qr not serving a food, ® Original borings included beverage or lodging establishment. Drainfield has at east a two -foot vertical separation dista Ice from periodically saturated soil or bedrock. 5b. Non-performanc systems built !®Yes ❑ No Indicate depths or elevations April 1, 1996, orOter or for non- performance systems located in Shoreland A. Bottom of distribution media 103.2 or Wellhead Protection Areas or serving a B. Periodically saturated soil/bedrock 100.3 food, beverage, or lodging establishment: C. System separation 2.9 Drainfield has a t �ree-foot vertical ------- -------- _____ _. separation distance from periodically D. Required compliance separation* 2.55 _ saturated soil or bedrock.* *May be reduced up to 15 percent if allowed by Local Ordinance. 5c. "Experimental, "Other", or "Performance" ❑ Yes ❑ No systems built under pre-2008 Rules; Type IV or V systems built under 2008 Rules 7080, 235Q or 7080.2400 (Intermediate Inspector License required <_ 2,500 gallons pe day; Advanced Inspector License required > 2,500 gallons per day) Drainfield meets he designed vertical separation dista ce from periodically saturated soil or edrock. *Any "no" answer above indicates the system is failing to protect groundwater. Describe verification methods and results: 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 Data: December 15, 2025 Elmer J. Petersen Co. 5921 Dague Ave. Delano, 11-'(N 5531h Phone -, 63-972-2420 Fax ,6,s3-9,2-721, MF'C1 License# Z IF) Jim Hatchett 840 North Shore Drive W Orono, MN 612-791-3309 Baffles: C)N / U FF ~-- 3-1000 Gallon Tanks Per City Records 'I'ank Capacity: # of Tanks. 3 Type of'Tanks: Concrete Gallons Pumped. 2500 4 Manholes to Gracie: F:S ��/ NO Cortunents: On December 15, 2025, Elmer J. Peterson Co. pumped tanks. 21" tank is starting to corrode. N01"F: 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 t� 520 Lafayette Road North Subsurface Sewage St, Paul, MN 55155-4194 Treatment Systems (SETS) 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.I)ca.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 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 (wg-wwists4-31 b). This farm can be found on the MPCA website at https_//www.pca.state.mn.us/water/inspections. 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(13)(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(8),(C), and (D) and; Minn. R. 7083.0730(C). Owner information Owner/Representative Jim Hatchett Property address: 840 North Shore Drive W Orono, MN Local Regulatory Authority: Parcel ID: System status System status on date (mmlddlyyyy): 12/15/2025 ® 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 ❑ Yes' No Groundwater," 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 ❑ YesA 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 i- Braegelmann Business license number: 219 Certification number. i personally conducted the work described above as a Designated Certified Individual of a Minnesota -licensed SSTS inspection, maintenance, installation, or service provider Business. l 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): 12/15/2025 (This document has been electronically signed.) www.pra.state.mn.us wq-wwists4-91 • 5110121 • 6S1-296-6300 800-657-3864 Use your preferred relay service Available in alternative formats Poge 1 of 1 Property Owner / project: Property Address / PID: Soil Observation Log ,A-,vw.SepticResource.com vers 12.4 Owner Information Jim Hatchett 840 North Shore Drive W. Date 12/ 17/2025 Soil Survey Information ❑ refer to attached soil survey Parent matl's: Q Till ❑ Outwash ❑ Lacustrine ❑ Alluvium ❑ Organic ❑ Bedrock landscape position: ❑ Summit ❑ Shoulder ❑ Side slope O Toe slope soil survey map units: L41 C 2 slope % direction- Lineal Soil Log #1 p Boring ❑ Pit Elevation 104.4 Depth to SHWT 49 Inches Depth (in) Texture fragment % matrix color redox color consistence grade shape loose loose single grain 0-3 5 Mound sand fill <35 friable weak granular blocky firm moderate prismatic platy rigid strong massive 35-49 Loam <35 10yr3/2 Friable Strong Blocky 49-54 Clay Loam <35 10yr5/4 10y4/8,1-b/l0y Friable Strong Blocky <35 loose loose single grain 35 - 50 friable weak granular blocky firm moderate prismatic platy >50 rigid strong massive <3 5 loose loose single grain 35-50 friable weak granular blocky firm moderate prismatic platy >50 rigid strong massive Comments: TBM: Top of the lift station manhole cover Elv.-100.0 840 North Shore Drive W. Soil Log #2 p Boring ❑ Pit Elevation 103.7 Depth to SHWT 41 Inches Depth (in) Texture fragment % matrix color redox color consistence grade shape loose loose single grain 0-20 Mound sand fill <3 5 friable weak granular blocky firm moderate prismatic platy rigid strong massive 20-36 Loam <35 10yr2/1 Friable Strong Blocky 36-42 Loam <35 1Oyr4/3 Friable Strong Blocky <35 loose loose single grain 35 - 50 friable weak granular blocky firm moderate prismatic p platy >50 rigid strong massive <3 5 loose loose Single grain 35 - 50 friable weak granular blocky firm moderate prismatic platy >50 rigid strong massive 840 North Shore Drive W. 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 >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 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 I hereby certify this work was completed in accordance with AN 7080 and ally local req`s. Rusty Olson's Soil & Perc 810 D er Signature Company License # 540 06"+A Stiore, Dr. V. A I 1� c 4 7-1 (n :S3 lq �Uffl<r-ytq'i T9 L, JP_ 11 ---- - -- ----- 1 ' 6�s f SEPTIC SYSTEM INVENTORY Site Address: 840 North Shore Dr W Owner Name: Jim & Judy Hatchett Owner Address: 840 North Shore Dr W Mound MN 55364- PID 07-117-23-22-0005 BuildinqTvae: residence Installer: Peterson Co. Date of Permit: 10/24/89 Svstem Tvpe: mound BR's Designed for 3 In Musa?: No Shoreland?: SEPTIC TANKS: Material: precast concrete Capacity: 10009100091000 Tank Filter: DRAINFIELD: Treatment Area: 75*43 Soil Boring: yes DF Ht above Wt: 3 WELL DATA Setbacks - Well Tanks: 50 Well DF: 150 Report In File: Depth: 100 INSPECTION RECORD-5 PUMPOUT RECORDS Date E GailvnsOfLiquid 7/17/2017 2500 8/14/2013 2500 8/28/2010 ` 2500 8/4/2007= 2500 6/10/2002 2000 6/10/2002 :2000 .� �fi s � s f+ s nR ti c � � +s • �' 4 } � s + r x.o' 9r. «`: s. �" ii y'' /u''w i!! , ps ♦ y t .k 'V' .ys ;"4 '7'Ik l'j-Y` _ _.:__ v Da te ed Other o-, r v 1.rr r s ' ! ..t ..: w t J t +r a► ♦ - 't Cr Power , F. _Ct!'t t � or Bucket X Dept, 3or I ng number 2 h .�.in99.1 fee: Surface elevation Topsoil dark gray . � loam y' cam 1'_ -___1' 4"-MOTTLING +«aq� �. ..� �r R .• • .. ry ..,� 1040 �. f 1 1fg,rJt`Ya ?o AW Rusty gray brown ::-_,r a+•rn ` I clay loam strong k y, _a�{, a:n' 3 4 " ,z. IJ .....�:.w, 4 - Rusty gray brown loam ??:z ty c' ire brown ! 3' 10" - 6' s ; ' oxr _ � r � k S q. 7 ' 4 " it 6 ' _ F 7 - t r ' 8 + End of ^cr : ng at feet. -End of boring at 6' feat. Stand �_c waver tat_' e : Standing water table o_-esen a • fee_ of dept.,.,? :ours -after borine . %.,o present in hole X ' m o t t _' e..� so--. �?St3r••:wd a~ fee. of depth• Not `p es tt In hole Cow° M 5 present at feet of depth, hours after boring. Not present in hole x Mottled soil: Observed at 1' feet of Not present in hole Comments: a depth. 13 4 0M6oSoi! 9�r 4 ' ' ,yy�r i p ia$'L � Lat • {. fi' P'r.. 44,•e, ct mar.;, Xra�er,_840 Co.Rd.19# Orono } , V �, r~ , .:. c `� S-eve Cc*jfi r!"ers Date 4'r�•'88 , ,.,, "S^A-SCS X Unified other •. . w o y o rw. Power ► Y+ � *yk .ad � w �# aj two* r.rrr.s I F ! ; Q a � trrwirr or Bucket Ji .. _ o b 3 ! IDepth,, Boring number n ..,' fee. St-ate e.vati-�.: Q Meet Surface elevation f t �t Graf brown C Can i � .� !i i �ONr it e x '.. ir` f Vr..w.�h,. LeA Cis _oa^« a r 3 { E 7 - _ 1 $ - End of bogy Ing at ` ` free:. Srd of boring at feet. Standing water table: Standing water table: present at feet of dent`:, present at feet of depth, ho::rs after bc: :.ne. hours after boring. Xot -resent in hole x Not present in hole +�Qt'�ed sc . ? • l Mottled so-;-':.. .' bserved a w =-1I2' feet of depth. Observed at feet of depth. xo - present in 110'e Not present in hole • Cb!,,�,s ; Comments