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r' <br />7 <br />« <br />I'i <br />1 <br />k. <br />ON SITE SEWAGE TREATMENT <br />INSPECTION REPORT <br />OWNER. <br />PHONE. <br />/feTU <br />it', <br />'*•» the North Shore of <br />t.okc Minot fonktj <br />POSTOI-FICE nox 6R <br />1335 S. Brown Rrt. <br />Crystal Boy. MN 55323 <br />473 7357 <br />i<c <br />.ADORE r <br />PERMITNO-S. DATjs ^/rO?/g & a_ <br />r«l«lrw thit Mch on-site sewage treatment system in Ofono be tnspoctetf on a regular basis. <br />Thi^»><ltt lewagi Veatmant system at the above address has been inspected and appears to fall into the category checked <br />Maatl or ixcaedi current city standards in all respects relating to design, construction, and location. Appears <br />to be operating properly. <br />pi M Ooei not meet current city standards in some respects relating to design, construction or loceiion Appears <br />I—J w to be operating properly. <br />□ 3 Does not meet current city standards in many respects relating to design, construction, or location. Appears <br />to be operating adequately. <br />□ 4 Ooeinw meat current city standards of design, construction or location, is being overused, or is failing to <br />property treat and dispose ot the current input and is therefore endangering a water supply, is a source of <br />pollution to turface or groundwaters, ii creating a safety hazard, or is otherwise creating a public nuisance. <br />Please contact the inspector to discuss requirements fo. 'e.iairs to your system. Soil testing may be re­ <br />quired. In all cases a design and site plan must be submitted for review. Your contractor must obuin a permit <br />btiore work is started. <br />WORK REQUIRED: <br />Q] Septic tanks must be pumped within 48 hours. <br />I I Orainfield must be repaired or replaced within 90 days. <br />Q Inspection riser 14” diam. pipe) must be installed in each tank. <br />n inspection indicates maintenance pumpout is needed as soon as possible. City ordinance requires that <br />tanka be pumped out every three years. <br />SITE CHARACTERISTIC^: <br />Urmting Site Factors <br />□ Slope <br />HSoil <br />□High water uMe <br />□Lot size <br />□Lake, wetland, or stream <br />□Drainage <br />Potential for System Failure <br />(tfcpends on soil types, water <br />tabi^ and system condition) <br />)K(i.ow <br />□ Medium <br />□ High <br />□ System is causing visible <br />surface discharge. <br />Site Capfibilities for <br />Future Expansion <br />Q Adequate <br />□ Fair <br />□ Poor <br />□ Inadequate <br />COMMENTS:, uyWTZ-V <br />A^cnr^ LK:Ttb^ ftU Oi/C^ <br />/CA <br />Date ot Inspection " Septic Sysjar^^pccior <br />This report must be kept on the premise^ with system location and pumping records. <br />WHITE COPY / Inspector's File GOLD COPY / Homeowner