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ON -SITE SEWAGE TREATMENT <br />INSPECTION REPORT <br />On the .North Shore of <br />Lake Minnetonka <br />CITY POST OFFICE BOX 66 <br />1335 S. Brown Rd. <br />O . O O Crystal Bay, MN 55323 <br />473-7357 <br />OWNER LA�(S SF_G �° __ ' _ADDRESS L <br />PHONE PERMIT NO'S. __ DATES h 29-7;7 <br />City Ordinance No. 210 requires that each on -site sewage treatment system in Ornro be inspected oti a regular bass. <br />The on -site sewage treatment system at the above address has been inspected and appears to fall into the category checked <br />below: <br />Meets or exceeds current city standards in all respects relating to design, construction, and location. Appears <br />to be operating prop Orly. <br />n A Does not meet current cit; standards in some respects relating to design, construction, or location. Appears <br />LJ L to be operating properly. <br />❑ Does not meet current city stan,'a,ds in many respects relating to design, construction, or location- Appears <br />to be operating adequately. <br />Does not meet current city standards of design, construction or location, is being overused, or is failing to <br />04 properly treat and dispose of the current input and is therefore endangering a water supply, is a source of <br />pollution to surface or groundwaters, is creating a safety hazard, or is otherwise creating a public nuisance. <br />Please contact the inspector to discuss requirements for repairs to your system. Soil testing may be re- <br />quired. In alp cases a design and site plan must be submitted for review. Your contractor must obtain a permit <br />before work is ;ta,ted. <br />WORK REQUIRED: <br />Septic tanks must be pumped within 48 hours. <br />Drainfield must be repaired or replaced within 90 days. <br />Inspection riser (4" diam, pipe) must be installea each tank. <br />f —1 Tank inspection indicates maintenance pumpout is needed as soon as possible. City ordinance requires that <br />l—I tanks be pumped out every three years. <br />SITE CHARACTERISTICS: <br />Limiting Site Factors <br />❑ Slope <br />El Soil <br />❑High water table <br />❑ Lot size <br />[:]Lake, wetland, w stream <br />❑ Drainage <br />COMMENTS: <br />Potential for System Failure <br />(depends on soil types, water <br />table, and system condit..,n) <br />0Low <br />❑ Medium <br />❑ High <br />❑ System is causing visible <br />surface discharge. <br />Site Capabilities for <br />Future Expansion <br />Adequate <br />Fair <br />❑ Poor <br />❑ Inadequate <br />Date a�* Inspection <br />Septic System IM&Ctor <br />This re, art must be kept on the premises with system location and pumping records. <br />WHITE COPY / Inspector's File GOLD COPY ,' Homeowner <br />