HomeMy WebLinkAboutSeptic info �� � � � l���fi�� �� f������.�� � �
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C ITY of ORONO
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�, Municipal Offices
�� G~ Street Address: Mailing Address:
�`4$EsKp4�' 2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
October 26, 2004
Dear Project Area Residents;
Sanitary Sewer Assessments
1. Assessment Amount and Time Period.
The assessment ainount adopted for your property is$6,4000.The assessmeiit will appear on your 2005
tax statement and is for a 15-year period
2. Interest Rate.
The interest rate applied to the assessment is 6.25%.
3. Initial Prepayment Period.
The final date for full or partial prepayment of the assessment without interest is Monday,November
30"', 2004.
4. Future Prepayment Periods.
Beginning in 2005, and every year thereafter, the reinaining outstanding assessment may be paid off
in fiill before November 15"', or interest will be charged through December 31 of the next succeeding
year.
Senior Citizen Assessment Deferral
Owners of homestead property who are 65 years or older may apply far a defernient of the special assessment if
they meet the income criteria set forth in City Council Resolution#2864.
Sanitary Sewer Connection Information
Your property has a nonconforming septic system, and City policy requires connection to sewer by the same
date that a nonconforming septic system would need to be replaced.The current deadline for the replacement of
nonconforming septic systems, in this neighborhood is, Deceinber 31, 2007. Any building permits for house
additions that would require enlargement of a nonconforniing septic system will require connection to the sewer
before completion of the building project. The septic systems in the Homestead neighborhood will still be
inspected by the City and sewer connection will be required within 90 days for failing septic systems with
surface discharge of effluent.
Telephone(952)249-4600 • Fax(952)249-4616
ww�v.ci.orono.mn.us
The new sewer system is available for connection by property owners. The property owner is responsible for
� the sewer connection between the service stub,at the property line,and the house. The sewer connection must
be completed by a licensed plumber, and the plumber must obtain a City sewer connection permit before
' beginning work. The connection permit fee is $35.00. The City does not make recommendations on specific
plumbers to use for sewer connections.It may be prudent to obtain quotes from several contractors for this work
and to also verify contractor references and previous experience.
The Sewer Availability Charge (SAC) must be paid to the City before the plumber can be issued a sewer
Connection permit. This SAC fee is submitted by the City to the MCES(Metropolitan Council Environmental
Services) and helps finance the cost of the reserve capacity built into the MCES sewer interceptor system for
new sewer connections. The 2004 SAC fee is $1,350 and this fee has been increasing by $50 each year. The
SAC fee must be paid in the same year that the sewer connection is completed.
A pressure sewer system was installed in this neighborhood which requires the purchase, installation, and
maintenance of a grinder pump. Progressive cavity grinder pumps that are capable of pumping at a constant
flow rate over widely varying pumping head conditions are required for connection to this pressure sewer
system. Environment One (El)brand pumps are the most common and widely used pumps for these types of
pressure sewer systems. The plumber will need to provide the City information on the type of pump used
when obtaining a sewer connection permit to ensure that the correct type of pump is installed.
Thank you for your assistance in this matter. Please contact me at 952-249-4621 should you have any
questions.
Sincerely;
� ����� �,���� ���-1�
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, �,J�; 1,�,
Greg Gappa
J
Director of Public Services
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" ;i;l AR�r�. �'� C ITY of UROloTO
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` �,�� �� �r-i,�°' ',���G Street Address: °15a—a4q—�16� 0 Mailing Address:
'`4k�Kpg' 2750 Kelley Parkway P.O. Box 66
- Orono, MN 55356 Crystal Bay, MN 55323-0066
To Current Owner: Address: �0� `�'f�w`^ �, 'v �
City Ordinance 199 requires that each existing on-site sewage treatment system in Orono be inspected every two years.
The on-site sewage treatment system at the above address has been inspected and appears to fall into the categories checked below.
SYSTEM CONFORMITY (1-31: �
1 "CODE SYSTEM" An LSTS which meets all the location,design and construction standards of_the current Orono Municipal Code. _
2 "COMPLIANT SYSTEM" An LSTS which does not meet all the location,design and construction standards of the current Orono
Municipa!Code but does meet the tlu�ee foot separation requ'vemettt or rivo foot requirement for systems installed 1946 or earlier,and
/''�which is not fiiling or an imminent threat to public health or safety.
l 3 ,"NON-COMPLIANT SYSTEM" A prohibited ISTS;an ISTS located within a designated 1d0-year flood plain,any ISTS which may
v or may not meet all the location,design,or construction standards of the cuaent Orono Municipal Code and which is failing for any
reason;and any ISTS with less than threE feet of unsaturated soil or sand betrveen the distribution�vice and the limiting soIl characteristics.
TANK CONDITION(5-71: �
T k inspection indicates:
5 1 Pumpout not needed at this time.
6 Septic tanks must be pumped out this year (city oode recommends tanks to be pumped out once every 3 years.
Tank was last pumped ).
Make sure septic tanks are pumped throuEh manhole and not through white inspection pipes. This allows for the proper
cleanin� Keep water softner and iron filter discharge out of septic svstem to prolone life of drainfield. Ask aumper to test
alarm float to verify alarm is still workin�in your house The alarm warns owner that septa�e is about to backup into basement.
7 Inspection risers missing-tanks could not be inspected. Inspection risers(4"dia.pipe)must be installed in each tank. If
tanks have not been pumped out within the last three years,they should be pumped out now.
D INFIELD CONDITION 8-10 : �
8 Drainfield is dry,no surfacing evident.
9 Some evidence of surfacing,not critical yet.
10 Drainfield is saturated and visibly discharging untreated eftluent to the surface. Contact the City Inspector
immediately.Repairs must be completed within 90 days.
COMMENTS: �c A:c��-t\t� _ j S n 0 n- C�r•p\:a��' .�-- ,�v S fi �L
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Date of Inspection Matt Bolterman - Septic System Inspector
No�e: In the event that this inspection report is used to satisfy the requirements for a mortgage or other transfer of property, be advised that dlis report does
not �uarantee or certify that an existing system �vill continue tu function properly. but is mereiy an opinion of the adequacy of the system under current
cunJitions based on the available ini'onnation.
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,, ��:r��_� �, CITY of ORONO
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P����-;'��`;�n ,�F� Municipal Offices
��.� ��'�;;�r,h','-�+t�`.�G Street Address: Mailing Address:
`�kE+gg0g 2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
9sa-�49-y600
To Current Owner: Address: ��0 �faw� ��1 �✓ .
Ciry Ordinance 199 requires that each existing on-site sewage treatment system in Orono be inspected every two yeazs.
The on-site sewage treatment system at the above address has been inspected and appears to fall into the categories checked below.
SYSTEM CONFORMITY (1-31: �
1 '�CODE SYSTEM�� An[STS which meets all the location,design and construction standards of the current Orono Municipal Code.
2 "COMPLIANT SYSTEM" An ISTS which does not meet all the location,design and conswction standards of the current Orono Municipal
Code but does meet the three foot separation requirement or rivo foot requirement for systems installed 1996 or earlier,and which is not failing or
�� an imminent threat to public health or safety.
1 3 I "NON-COMPLIANT SYSTEM" A prohibited ISTS;an ISTS located within a designated 100-year flood plain,any ISTS which may
�J or may not meet al(the location,design,or construction standards of the current Orono Municipal Code and which is failing for any reason;and
any ISTS with less than three feet of unsaturated soil or sand between the distribution device and the limiting soil characteristics.
TANK CONDITION(5-10): �
Tank inspection indicates:
� Pumpout not needed at this time.
6 Septic tanks must be pumped out this year (city code requires tanks to be pumped out once every 3 years.
Tank was last pumped '��-'�--5� )•
Make sure septic tanks are pumped throu�h manhole and not throu�h white inspection pipes.
This allows for the proper cleanin�.
7 Inspection risers missing-tanks could not be inspected. Inspection risers(4"dia.pipe)must be installed in each tank.
DRAINFIELD CONDITION 11-�: �
8 Drainfield is dry,no surfacing evident.
9 Some evidence of surfacing,not critical yet.
10 Drainfield is saturated and visibly discharging untreated effluent to the surface. Contact the City Inspector
immediately.Repairs must be completed within 90 days.
COMNIENTS: S S�� �v��" �� • t 'GiCi�� �� �t- '�- Z.C�,7 Cr .-� ��}'
S�cC-��c�� �-e qr�.. _ Ntzc� �t•.._ :��{�ccr�., C�A o� !«c„�� '-��►�
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Date of Inspection Matt Bolterman - Septic System Inspector
Note: In the event that this inspection report is used to satisfy the requiremenu for a mortgage or other transfer of property,be advised that this report does not guarantee
or certify that an existing system will continue to function properly,but is merely an opinion ofthe adequacy ofthe system under current conditions based on the available
information.
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�.� �F -� ��` Street Address: MailinQ Address:
�����,��CEggO�� 2750 Keliey Parkway P.O. Box 66
July 24;26QE1— Orono, MN 55356 Crystal Bay, MN 55323•0066
Victor Stein
800 Bro��n Road North
Lon� Lake, 1�In 5�3�6
Dear Ms. Stein:
:�n inspection of your septic system���as conducted on July 20, 2000. A summary of the inspecrion is
below.
Septic Tank Condition
l. Pumpout not needed at this time.
The septic system is non-compliant due to a lack of a three foot separarion distance beriveen the bottom
of the drainfield to the seasonally high�vatertable. The three foot requirement is a State Code, not a City
Code. A soil boring �vas conducted to determine the depth of the seasonally watertable. The septic
s��stem must be replaced by December 31,2007.
Enclosed is a list of state licensed septic contractors �vho work in Orono on a regular basis. Also
enclosed is a fact sheet elplaining how a septic system functions properly. Finally, an as-built dra�ving
is enclosed that sho�ti�s the approtimate location of the septic system.
If you have any questions regarding this report, please contact me at the City Offices at 249-4600.
Res ectfull ,
( ��
Chris Pence
On-Site Sy�stems Manager
Enclosures
In the event this inspection repart is used to satisfy the requirements for a mortgage or other transfer of property,be
�d��ised that this repurt does no guarantee or certify the esisting system will continue to function properly,but is
merel}�an opinion of the adequacy of the system under current conditions based on the available information.
This report must be kept on the premises with the system location and pumping records.
Telephone(952)249-4600 • Fax(952)249-4616
www.ci.orono.mn.us
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��'� '� ��` ' �" ����, � ��� Street Address: Mailing Address:
'����9 � ' � 4��i' 2750 Kelley Parkway P.O. Box 66
�,_,,kE3II0 �..
���_� Orono, MN 55356 Crystai Bay, MN 55323-0066
To: The Current Owner of Address ��G � r0� ti �
City Ordinance requires that onsite sewage treatment systems in Orono be
inspected on a periodic basis. The onsite sewage treatment system at the above
address has been inspected and the following is known about the system. A
sketch of the known components of the system is available for most properties at
the Orono City Hall.
Imminent Public Health Threat
Yes
No —�/
If yes, please contact the Onsite Systems Manager at 952-249-4626 within 10
days of receipt of this notice. The septic system must be brought into compliance
within 90 days. Failure to do so will result in referral to the City Attorney for
legal action.
System Identifi as Non-Compliant
Yes
No
If yes, system must be brough � compliance by:
December 31, 2007
December 31, 2010
Other
Septic Tank s p out Needed
Yes
No
The City recommends the septic tank(s) and/or lift tank be serviced and pumped
out every three years. City records indicate the tank(s) were last pumped out on
� t - 3r °( � . The tank(s) should be cleaned through the manhole and
not through the inspection pipes, this allows for proper cleaning.
Comments:
�
Inspectoz!(�,,,,.1��'��` "�"' Date of Inspection �' d�'
Telephone (9�2)249-4600 • Fax(9�2)249-4616
www.ci.orono.mn.us
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� Street Address: Mailing Address:
���`��CEggO�'� 2750 Kelley Parkway P.O. Box 66
_�- Orono, MN 55356 Crystal Bay, MN 55323-0066
i �
Owner: 7 J Address: 800 Brovm Rd. N.
Permit #'s: 5235, 3411 Dates: 6/29/7B, 11/10/72 Contractors: Widmer Bros.
(This is � an existing system [ ] new construction) .
SYSTEM COMPLIANCE (1-3) : 3
1 Code System: Meets or exceeds current City standards in all respects relating to design,
construction, and location. Appears to be operating properly.
2 Compliant System: Does not meet all current City standards for new construction, but in
most respects appears to be designed, located, and constructed in accordance with previous
� codes and is functioning properly.
� Non-C�mpliant System: System may or may not meet current City standards for design,
construction, or location, but is failing to properly treat and dispose of the current
input; and any system with less than three feet of vertical separation between the bottom
of the drainfield and the saturated soil level.
(The saturated soil lavel is [ ] or is not [ ] idantified undar this septic system. If the
saturated soil level is not i en ifiad, this classification is subject to ravision.)
TANK CONDITION (5-9) : 8
5 Pumpout not needed at this time.
6 Solids accumulation in tanks indicates they should be pumped out this year.
7 System is discharging to the surface. Tanks must be pumped out within 48 hours.
� Inspection risers missing-tanks could not be inspected. If tanks have not been pumped out
�`,/ within three years, they should be pumped out and risers installed now.
9 Inspection pipe is located over tank baffle-can not measure solids accumulation. If tanks
have not been pumped out within three years, they should be pumped out now.
10 One or more tanks are cesspools, which means the septic system is non-compliant.
(The tanks are [ ] or are not [ ] water tight or the condition is [ ] unknown. If the tanks
are not confirmed to be watartight, this classification is subject to revision.)
DRAINFIELD CONDITION (11-14) : 11
11 Drainfield is dry, no surfacing evident.
Some evidence of surfacing, not critical yet. Repair is not required at this time.
13 Drainfield is saturated and visibly discharging untreated effluent to the surface.
Contact the City Inspector immediately. Repair must be completed within 90 days.
14 Drainfield extent and condition unknown.
POTENTIAL FOR SYSTEM FAILURE: (system age and condition, soils, etc. ) : medium
COMMENTS: The septic system is non-compliant, but does not appear to pose an imminent threat to
public health or safety (surface discharge or backup into the dwelling) . The system must be
repaired or replaced by 12/31/2002 or within ninety days of posing an imminent threat to public
health or safety, whichever comes first.
�` 1 �
Date of Insp ction S tic System Inspector
Note: In the event that this inspection report is used to satisfy the requirements for a
transfer of property, this report does not guarantee that an existing system wi11 continue to
function properly, but indicates the operation of the system under current conditions.
Telephone (612) 473-7357 • FAX 473-0510
CITY OF ORONO � O�
Municipal Offices O O
Post Office eox 66
Crystal eay, MN 55323-0066 � � ON—SITE SEWAGE TREATNIENT
� � INSPECTION REPORT
ti
��9kESH���G
Owner: j �(.,��1� ���Y�i�, Addres s: p�]l� �rnla/�'\ �. A V i
Permit #'s: Dates: ���`— — Contractors: 1/��l��f"v� ����...
City ordinance number 100 requires that each on-site sewage treatment system in Orono be inspected on a regular basis.
The on-site sewage treatment system at the above address has been inspected and appears to fall into the category
checked below.
(This is �an existing system [ ] new construction)
SYSTEM CONFORMITY (1-3): �
1 "CODE SYSTEM"-A system which meets all the location, design, and construction standards of the current City r
Codes, and which is operating satisfactorily by treating and disposing of the entire current sewage input
without discharging any pollutants into ground or surface uaters.
2 "CONFORM[NG SYSTEM"-A system which does not meet all the location, design, and construction standards of the
current City Codes, but was installed according to the code in effect at the time of installation, and which
is operating satisfactorily by treating and disposing of the entire current sewage input without discharging
any pollutants into ground or surface waters.
3 "NON-CONFORMING SYSTEM"-A prohibited system; a system located within a designated 100-year floodplain; any
system which may or may not meet all the location, design, and construction standards of the current City
Codes and uhich is failin for any reason; and an s stem with less of unsaturated soil or sand
between the dis ' ' ' ' ristics.
� ��;'r. 1�3l�
(The limiting soil characteristic �has or [ ] has not been identifie a t s ttme If the limit n�soil
characteristic has not been identi te , this classification may be subject to revision.)
TANK CONDITION (5-10):
Tank inspection indicates:
5 Purtipout not needed at this time.
6 Solids accumulation in tanks indicates they should be pumped out this year to help prevent future problems.
7 Solids accixnulation in tanks is at a critical level. 7anks should be pumped out as soon as possible.
8 System is discharging to the surface. Tanks must be pumped out uithin 48 hours to eliminate surface discharge.
9 [nspection risers missing-tanks could not be inspected. Inspection risers (4" dia. pipe) must be installed in each
tank at next purtipout. If tanks have not been pumped out uithin the last three years, they should be purt�ped
out now.
Inspection pipe is located directly over tank baffle (does not give accurate measurement of solids accumulation).
If tanks have not been p�xnped out within the last three years, they should be pumped out now.
DRAINFIELD CONDITION (11-14):
D field inspection indicates:
11 Drainfield is dry, no surfacing evident.
Some evidence of surfacing, not critical yet.
13 Drainfield is saturated and visibly discharging untreated effluent to the surface. Contact the City Inspector
irtmediately. Repairs must be completed within 90 days.
14 Drainfield extent and condition unknown.
LIMITING SITE FACTORS (slope,setbacks,etc.):
POTENTIAL FOR SYSTEM FAILURE (depends on soils,water table,etc.): �1�,,�
�COMME TS• � � n � ✓ Y -�(d'�^,�
;r-
Sf ' - r
Date o nspection System Inspector
Note: In the event that this inspection report is used to satisfy the requirements for a mortgage or other transfer of
property, be advised that this report does not guarantee or certify that an existing system will continue to function
properly� but is merely an opinion of the adequacy of the system under current conditions based on the available
information.
This report must be kept on the prEmises with the system Loc�tion and pumping records.
WHITE COPY/Inspectors File YELLOW COPY/Homeowner
CITY OF ORONO � O�
Municipal Offices O � O
Post Office Box 66
Crystal Bay, MN 55323-0066 � � ON—SITE SEWAGE TREATMENT
r� � INSPECTION REPORT
'�� G~
�kEsHo4�
Owner: ��T�Y ,�� Address• �
Permit #'s: Dates:Z� �� n �� Contractors: �7+. �dS.
City ordinance number 100 requires that each on-site sewage treatment system in Orono be inspected on a regular basis.
7he on-site sewage treatment system at the above address has been inspected and appears to fall into the category
checked below.
(This is V4_ an existing system [ ] new construction)
SYSTEM CONFORMITY (1-3):
"CODE SYSTEM"-A system which meets all the location, design, and construction standards of the current City
Codes, and which is operating satisfactorily by treating and disposing of the entire current sewage input
without discharging any pollutants into ground or surface waters.
2 "CONFORMING SYSTEM"-A system which does not meet all the location, design, and construction standards of the
current City Codes, but was installed according to the code in effect at the time of installation, and which
is operating satisfactorily by treating and disposing of the entire current sewage input without discharging
any pollutants into ground or surface wat�rs.
3 "NON-CONFORMING SYSTEM'�-A prohibited system; a system located within a designated 100-year floodplain; any
system which may or may not meet all the location, design, and construction standards of the current City
Codes and uhich is failing for any reason; and any system with less than 3 feet of unsaturated soil or sand
between the distribution device and the limiting soil characteristics.
(The limiting soil characteristic [ ] has or � has not been identified at this time. If the limiting soil
characteristic has not been identified, this classification may be subject to revision.)
TANK CONDITION (5-10): �
T�ak inspection indicates:
C�5/ Purtipout not needed at this time.
6 Solids accumulation in tanks indicates they should be pumped out this year to help prevent future problems.
7 Solids accumulation in tanks is at a critical level. Tanks should be pumped out as soon as possible.
8 System is discharging to the surface. Tanks must be pumped out within 48 hours to eliminate surface dischar�e.
9 Inspection risers missing-tanks could not be inspected. Inspection risers (4" dia. pipe> must be installed in each
tank at next pumpout. If tanks have not been p�xnped out within the last three years, they should be punped
out now.
10 Inspection pipe is located directly over tank baffle (does not give accurate measurement of solids accumulation).
If ta�ks have not been punped out within the last three years, they should be pumped out now.
DRAINFIELD CONDITION (11-14): '
Dr field insPection indicates:
�Drainfie[d is dry, no surfacing evident.
12 Some evidence of surfacing, not critical yet.
13 Drainfield is saturated and visibly discharging untreated effluent to the surface. Contact the City Inspector
immediately. Repairs must be completed uithin 90 days.
14 Drainfield extent and condition unknown.
LIMITING S1TE FACTORS (slope,setbacks,etc.):
POTENTIAL fOR SYSTEM FAILURE (depends on soils,water table,etc.): ��yyy�_
COMMENTS:
� /Z r
Date of Inspection Septic System Inspector
Note: In the event that this inspection report is used to satisfy the requirements for a mortgage or other transfer of
property, be advised that this report does not guarantee or certify that an existing system will continue to function
properly� but is merely an opinion of the adequacy of the system under current conditions based on the available
information.
This report must be kept on the prEmises uith the system loc=_tien and pumping records.
WHITE COPY/Inspectors File YELLOW COPY/Homeowner
On the North Shore of
Lake Minnetonka
ON-SITE SEWAGE TREATMENT
INSPECTION REPORT � POST OFFICE BOX 66
1335 S. Brown Rd.
� � � Crystal Bay, MN 55323
473-7357
OWNER kV/��t�'✓� .� -/►� ADDRESS ��� FJ✓�\ /`��
��3s 6 aq 7� �- y�
PERMITNO.'S. �3`��� DATES b"!� ` a CONTRACTORS l'l���r►� /,►r�5�
City Ordinance No, 210 requires that each on-site sewage treatment system in Orono be inspected on a regular basis.The onsite sewage
treatment system at the above address has bee�inspected and appears to fall i�to the category checked below.
(This is ipi an existing system O new construction)
� � Meets or exceeds current City standards in all respects relating to design,construction,and location.Appears to be operating
properly.
� 2 Does not meet all current City standards for new construction (1978 Code) but in most respects appears to be designed,
located, and constructed generally in accordance with previous codes.System appears to be functioning properly;no major
upgrading of the system is required at this time.
D3 Does not meet current City standards in many respects relating to design,construction,or location.Appears to be operating
adequately at this time, but has a relatively high potential for future problems. No major upgrading of system is required at
this time.
� 4 System may or may not meet current City standards for design, construction or location, but is failing to properly treat and
dispose of the current input,and is endangering a water supply, or is a source of pollution to surface or groundwaters,or is
creating a safety hazard, or is otherwise creating a public nuisance.Please contact the City Inspector to discuss system repair/
replacement procedures. If drainfield replacement is necessary,soil testing will usually be required,and a design and site plan
must be submitted for review.Your contractor must obtain a permit before work is started.
SYSTEM CONDITION ( m Checked items may require your action)
Tank inspection indicates: � �-Inspection pipe is located directly over tank baffle.(Does not
❑ Pumpout not needed at this time, give accurate measurement of solids accumulation.) If tanks
❑ Solids accumulation in tanks indicates they should be pump- have not been pumped out within the last three years,they
ed out this year to help prevent future problems. should be pumped out now.
❑ Solids accumulation in tanks is at a critical level. Tanks Drainfield inspection indicates:
should be pumped out as soon as possible. �Drainfield is dry,no surfacing evident.
❑ System is discharging to surface. Tanks must be pumped ❑ Some evidence of surfacing,not critical yet.
within 48 hours to eliminate surface discharge. ❑ Drainfield is saturated and visibly discharging untreated
❑ Inspection risers missing—tanks could not be inspected. effluent to the surface. This condition may require replace-
Inspection risers (4" dia. pipe)must be installed in each tank ment or additions to drainfield. Contact the City Inspector
at next pumpout. If tanks have not been pumped out within immediately.Repairs must be completed within 90 days.
the last three years,they should be pumped out now. ❑ Drainfield extent and condition unknown.
SITE CHARACTERISTICS:
Limiting Site Factors Potential for System Failure Site Capabilities for
❑ Slope (depends on soil types,water Future Expansion
❑ Soil table,and system conditio�l �Adequate
❑ High water table �Low ❑ Fair
❑ Lot size ❑ Medium ❑ Poor
❑ Lake,wetla�d,or stream ❑ High ❑ Inadequate
❑ Drainage ❑System is causing visible
surface discharge.
COMMENTS: � ` //-�- ��-5 r�All�a�P ��17 I/`G �hk� L�/1_°✓�P /as-�- n�.�nr,��� 0 O 7GylY�1
�'`��/ !`3 Gli(7`�13-FYa SQ7Yl�
/C/`�/V �
Date of Inspection Septic System Inspector
Note: In the event that this inspection report is used to satisfy the requirements for a mortgage or other transfer of property,be advised that
this report does not guarantee or certify that an existing system will continue to function properly,but is merely an opinion of the adequacy
of the system under current conditions based on the available information.
This report must be kept on the premises with system location and pumping records.
WHITE COPY/ Inspector's File GOLD COPY/Homeowner