460 Orchard Park Road - Septic Compliance - 2025

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MINNESOTA POLLUTION CONTROL AGENCY 520 Lafayette Road North St, Paul, MN 55155-4194 Compliance inspection report form Existing Subsurface Sewage Treatment System (SSTS) Doc Type: Compliance and Enforcement Instructions: Inspector must submit completed Corm to Loral 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/def ault/f iles/wq-wwi sts4 - 31 a. pdf I Property Information Local tracking number: Parcel ID# or Sec/Twp/Range: 3211823230012 _Reason for Inspection Property Transfer Local regulatory authority info: City Of Orono, (952) 2494600 Property address: 460 Orchard Park Road, Orono Owner/representative: Patrick Mulheran Owner's phone: 612-702-8693 Brief system description: 2-1300-gallon combination septic tanks, 1-1300-gallon lift station and 630 Square feet Rock bed System status System status on date (mm/dd/yyyy): 6/4/2025 __ ® 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 wum.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 is designed for a five bedroom house. There is 1.7 feet of sand or greater under the rock bed. The soils were verified by the city inspector on 10/03/2016. TBM: Top of the back door threshold. Elv.-100.0 Certification 1 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 El 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-wwists431b • 412812021 Page 1 of 4