HomeMy WebLinkAboutSeptic info .�,L Minnesota Pollution Compliance Ins ec�i:ion Form
,�.;, -
Controi Agency p
520 Lafayette Road North �0�� ���e �age Treatment �ystems (SSTS)
St.Paui,MN 55155-4194 Doc Type:Cor��pliance and Enforcement
Inspection reSuitS based on Minnesota Pollution Control Agency(MPCA) I For�racking pu�poses: �
requirements and attached forms-additional local requirements may also apply.
Submit completed form to Local Unit of Government(LUG)and system owner �,
within 15 days
System Status
System status on date(mm/dd/YYYY1: 7/25/2017
� Compliant— Certificate of Compliance ❑ Noncompliant— Notice of Noncompliance
(Valid for 3 years from report date, unless shorter time (See Upgrade Requi�ments on peg�; 3.)
frame outlined in Loca/Ordinance.)
Reason(s)for noncompllance (check all applicab/e)
❑ Impact on Public Health (Compliance Component#1)-Imminent threat to public health and safe�y
❑Other Compliance Conditions(Compliance Componenf#3)-Imminent threat to public health anc�safety
❑Tank Integrity(Compliance Component#2)-Failing to prvfect grr�undwater
❑ Other Compliance Conditions(Compliance Component#3)-Failing to protect groundwater
❑ Soil Separation(Compliance Component#4)-Failing to prntect groundwater
❑Operating permit/monitoring plan requirements(Compliance Component#5)-Noncompliant
Property Information Parcel ID#or SeGTwp/Range: _
Property address: 145 S. Brown Rd. Orono _ Reason for inspection: Transf��r
Property owner: John Winton Owner's phone: 612-708-012t:
or ---
Owner's representative: Representative phone:
Local regulatory authority: Hennepin County Regulatory authority phone:
Brief system description: Septic, secondary,pump chamber,gravity trenches
Comments or recommendations:
�
Certification
1 hereby cert'rfy that all fhe necessary informadon has been gathered to dete►mine the compliance status of thi;�system. No
determination of future system pe�formance has been nor can be made due to unknown conditions during sys�am construction,
possible abuse of the system, inadequate maintenance, or fufune water usage.
Inspector name: Matt Mckinle�_ _ _ _ Certification number: 8067
Business name: Mike's Septic+Mckinle Sewer Services _ _ License number: 2899
Inspector signature: Phone number: 952-440-�S00
Necessary or Locatly Re uired ttachments
� Soil boring logs � SystemlAs-built drawing � Forms per local ordinance
❑ Other information(list):
- _ ___
— _ _ .__ --- _ _
www.pca.state.mn.us • 651-2%-6300 • 800-657-3864 • TTY 651-282-5332 or 800-657-3864 • Available in altemative formats
wq-wwists4-31b • 6/4/14 Poge 1 of 3
Property address: 145 S. Brown Rd. Orono _ Inspedor�/pate: I�A_M. � 725r1017
_ ����
_1. Impact on Public Health—Compliance componerrt#1 of 5
Compliance criteria: _ Veriflcatlon method(s):
System discharges sewage to the ❑Yes � No �Searched for surface outlet
ground surtace. _ � Searched for seeping in yard/ba:.kup in home
System discharges sewage to drain � ❑Yes � No ❑ Excessive ponding in soil syster /D-boxes
tile or surface waters. ;
--�— � Homeowner testimony(See Com•rrents/Explanstion)
System causes sewage backup into ; ❑Yes � No ❑�Black soil"above soil dispersal yystem
dwelling or establishment.
- ' --- ❑System requires"emergency"pumping
Any"yes"answer above indicates the ❑ Performed dye test
system is an imminent ihreat to public ❑ Unable to verify(See Comments/E:rplanarion)
hea/th and safety. ❑pther methods not listed (See Ccmments/Explana6on)
Com ments/Explanation:
''s
_2. Tank Integrity—Compliance component#2 of 5
Compliance crite�ia: Verification method(s):
System consists of a seepage pit, , ❑Yes � No � Probed tank(s)bottom
cesspool,drywell,or leaching pii.
� Examined construction records
Seepege pits meeting 7080.2550 may be , ❑ Examined Tank Integrity Form(A�tech)
complient N e1/owed in locel ordinance
Sewage tank(s)leak below their ��Yes � No ❑Observed liquid level below oper�ting depth
designed operating depth. ❑ Examined empty(pumped)tank�:s)
If yes,which sewage tank(s) leaks: � Probed outside tank(s)for"black soil"
Any "yes"answer above indicates ihe ❑ Unable to verify(See Comments/E�planation)
system is failing to protect�roundwater. ❑Other methods not listed(See CornmentsiExplanation)
C om ments/Exp l a nati o n:
�
3. Oth@�CO�T1p118110E ConditlonS—Compliance component#3 of 5
a. Maintenance hole covers are damaged,c.�acked,unsecured,or appear to be strudurally unsound. ❑ti�,s• �No ❑unknown
b. Other issues(e/ecxrical hsza�ds,etc.)to immediately and adversely impad public heafth or safety. Q tias• �No ❑Unknown
*Syst+em!s an imminent threat to publfc healih and safety.
Exptaln:
c. System is non-protedive of ground water for other oonditions as determined by inspedor. Q Yes� ;�No
*System is failing to protect groundwater.
Explain:
�
• www.pca.state.mn.us . 651-2%-63W • B0�-657-3664 • TTY 651-282•5332 or 800-657-3664 • Available in altemative formats
wq-wwists4-31b • 6/4/14 Poqe 2 of 3
!
Property address: 145 S. Brown Rd. Ororw Inspedor irritialslp�ate: ;�A.M. ( 7252017
— �m�� -
4. Soil Separation-Complianoe componerrt#4 of 5
Date of installation: 1/1/1999 __ ❑ Unknown Verfication method(s):
(mMddtyyyy)
ShorelandNVellhead protectioNFood beverage Sorl o6servation does noi expire. Prc�vious soi!
lodging� ❑Yes � No observations by two independent pa ties are suKcient,
unless site conditions have been altt�red or local
ComplianCe criteria: requirements differ.
For systems built prior to April 1, 1996, and ❑Yes ❑ No � Conducted soil observation(s)(At'ach bonng logs)
not located in Shore/and or Wetlhead
Protection A�ea or not serving a food, ❑Two previous verifications(Anach boring logs)
beverage or lodging establishment. '� ❑ Not applicable(Holding tank(s),no �rainfield)
Drainfield has at least a two-foot vertical ❑ Unable to verify(See Comments/E���anation)
separation distance from periodically ❑ Other(See Comments�Explanation)
satureted soil or bedrock.
Non-performance systems built April 1, � Yes ❑ No Comments/Explanation:
1996, or later or for non-performance
systems located in Shore/and or Wellhead
Protection Areas or serving a food,
beverage, or lodging establishment.� '
Drainfield has a three-foot vertical
separation distance from periodically
saturated soil or bedrock.*
"Experimental", "Othe�", or "Performance" ❑ Yes ❑ No Indicate depths or elevations
systems built under pre-2008 Rules: Type IV , - -- -
or V systems built under 2008 Rules(7080. A. Bottom of distribution media 24 inches
50 or 7080.2400 (Advanced Inspector
- - --- -- - ___
License�equired) B. Penodically saturated soiubedrodc 60 inches
— _ --- , --
_ _._.._
rain ield meets the designed vertical C. System separation 36 inches
separation distance from periodically — - - ____ _
_.___
saturated soil or bedrock. �
-- - _. D. R uired comptiance separation' i 36 inches
__—____ - -
AI1y "no"answer above indicates the system is 'May be reduced up to 15 percent if:dlowed by Local
failing to protect groundwater. Ordinance.
5. Operating Permit and Nitrogen BMP*— Compliance component#5 of 5 � N�:�t applicable
Is the system operated under an Operating Permit? ❑Yes ❑ No If"yes",A below is requi�j
Is the system required to employ a Nitrogen BMP? ❑Yes ❑ No If"yes", B below is requir��
BMP=Best Management Practice(s)specified in the system design
/f the answer fo boih questions is "no'; this sectlon does not need to be completed.
Com Ifance criteria _
--- __ _
a. Operating Permit number:
Have the Operating Permit requirements been met? ❑ Yes ❑ No
_ __ ____ ----
b. Is the reguired nitro eg n BMP in place and proPerly functioninc�?_ ❑ Yes ❑ No
Any "no"answer indicates Noncompliance.
Upgrade Requirementa(Minn. Stat.§115.55)An imminent threat to public health and safety(ITPHS)must be upgr�ied, repleced,or its use
discontinued withrn ten monfhs of neceipt ol this notice or within a shorter period if required by local ordinance. !f the sy::tem is failing fo protect
ground weter, the system must be upqraded,replaced, or its use disoontinued within the time requi�ed by loca/ordinani.e. !/an existing system
is not failing as defined in faw, and has at/east two feet of design soil separatron, then the system need not be upgrade.l.repaired,replaCed, or
its use discontinued, notwifhstanding any loca/ordinance that is mom strict. This provision does not app/y to systems ir shoreland ar�as,
WeRhead Protection Artsas,or those used in connecfion with food,beverage,and lodging establishments as defined in �w.
— --- - -- -- __
_ __ --- — . _
www.pca.state.mn.us • 651-296-6300 • 800-657•3864 • TTY 651-282•5332 or 800-657-3864 • Avaitat e in alternative formats
wq-wwrsts4-31b • 6/4/14 Page 3 of 3
'] ' k
���f�' •
• r��• -�
�,
.
�B'�►
��h
�r
�� .
I
1 _ ��ti
,��.
�
�
�
�
�
�
�
��
� , �-���-
p,,7+ �o ,�r .�Nca1 �.,v� D_,7' ,o � 5,�,�►a
� � �.��
2/ /I
u �o�r
it ���� �iae. I7- � 31` �� Ne.
17'�PO .3> ��D /`� Sa.,�l�
/�
�t�
�d� ��t a��
����
�� ,�'�,
i� O��
�� _ _ ���� c�TY o� o�o�a
�
� � � r ,r ° ��� Municipal Offices
r ,' � , � ;/
�'� '� �j+''� ' ���`��� � �-'% Street Address: Mailing Address:
' ���9j� � ���p'Sc��i�� 2750 Kelley Parkway P.O. Box 66
��� E8H �:.
`���i Orono, MN 55356 Crystal Bay, MN 55323-0066
To: The Current Owner of Address � �� � ���-`-'� �
City Ordinance requires that onsite sewage treatment systems in Orono be
inspected on a periodic basis. The onsite sewa�e 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 Identified as Non-Compliant
Yes �No
If yes, system must be brought into compliance by:
December 31, 2007
December 31, 2010
Other
Septic Tank(s) Pump 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
Cp � �3-�6 . The tank(s) should be cleaned through the manhole and
not through the inspection pipes, tlus allows for proper cleaning.
Comments:
-��C,� ���� .
Inspector: Date of Inspection �'" ��
Telephone(952) 249-4600 • Faa (9�2)249-4616
www.ci.orono.mn.us
� \
�• � _ : _.
1� O O`\\`,
�� � � CITY of OIZOl\TO
, .;,:r,:�.
,� 1� .� �
,,; .
'�'.� �' �� d) ��. ,�ti ' Municipal Offices
t9 ' ' �tig.�,G Street Address: �lSa-d49-y6o � Mailing Address:
�ESH� 2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
To Current Owner: Address: I �� �J��""^ 0�-� S ,
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 (1-3): I
(1 / "CODE SYSTEM"An ISTS which meets all the location,design and construction standards of the current Orono Municipal Code.
v
2 "COMPLIANT SYSTEM" An ISTS which does not meet all the location,design and construction standards of the current Orono
Municipal Code but does meet the three foot separation requirement or rivo foot requuement for systems instafled 1996 or eazlier,and
which is not failing or an imminent threat to public health or safety.
3 "NON-COMPLIANT SYSTEM" A prohibited ISTS;an ISTS located within a designated 100-year flood plain,any ISTS which may
or may not meet all the location,design,or construction stanc�rds 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(5-7):
Tank inspection indicates:
Pumpout not needed at this time.
6 Septic tanks must be pumped out this year (city code recommends tanks to be pumped out once every 3 years.
Tank was last pumped ).
Make sure seatic tanks are pumped throu2h manhole and not throush white inspection aipes This allows for the proper
cleaninQ. Keep water softner and iron filter discharae out of septic svstem to prolone life of drainfield Ask pomper to test
alarm float to verifv alarm is still working in vour house. The alarm warns owner that septaQe 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.
DRAINFIELD CONDITION 8-10 : d
Drainfield is dry,no surfacing evident.
9 Some evidence of surfacing,not criticat 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.
COMMENTS: i�� ``����e�d �ob�CS �� � P���. .: S(� �-L ���I
S��-�-�� Z�O�
�-1b-e� ��
Date of Inspection Matt Bolterman - 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 do�s
nut euarantee or certif� that an existing svstem �vill continue to fiuiction properl�. but is merely an opinion of the adequacy of the s�stem under current
ronditions bascd on the availablc inlonnation.
o �
� �
0 0
=;,jA^,�:j�;�� ,, CITY of ORONO
.� �
J�t 1�� f a<..,�
�����i;.,��`j:,� �1�1' MUIIICI� ��CPS
�",� f:�;,�,,� �"h G
'�','�G���� �,�,�� Street Address: Mailing Address:
�`9jfEg�KOg'� 2750 Kelley Parkway P.O. Box 66
Orano, MN 55356 Crystal Bay, MN 55323-0066
95d-�49-4600
To Current Owner: Address: I �l S �ro'^'^ I`��, S�
City Ordinance 199 requires that each existin�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 1-3 : I
1 ��CODE SYSTEM" An ISTS which meets all the location,design and conswction standards of the current Orono Municipal Code.
2 "COMPLIANT SYSTEM" An ISTS which does not meet all the location,design and construction standards of the current Orono Municipal
Code but does meet the three foot separation requirement or two foot requirement for systems installed 1996 or eazlier,and which is not failing or
an imminent threat to public health or safety.
3 "NON-COMPLIANT SYSTEM" A prohibited ISTS;an ISTS located within a designated 100-year flood plain,any ISTS which may
or may not meet all 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 chazacteristics.
TANK CONDITION(5-10): 5
Tank inspection indicates:
SO 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 )•
Mal.e sure septic tanks are pumped throu�h manhole and not throu�h white inspection_pines•
This allows for the proper cleanin�.
7 Inspection risers missina tanks could not be inspected. Inspection risers(4"dia.pipe)must be installed in each tank.
DRAINFIELD CONDITION 11-14 : �
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.
COMMENTS: 5�(S�^� \oc�ks p neec� "��S «:�-�,o� c�� Sec«d
5� fi:� ��,�1 _ P��, � s n z s���.�.�r .
�_�,o -c� �1� ?�n�—
Date of Inspection Matt Bolterman - Septic System Inspector
Note: In the event that this inspection report is used to satisfy the requirements for a mortgage or other vansfer of property,be advised that this report does not guazantee
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 bated on the available
information.
� r
� O�
O O
��:� , ,� CITY of ORONO
� �lS� Municipal Offices
G
Street Address: Mailing Address:
�`�$Egg04'� 2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
September 25, 2000
Gladys E. Stinson
145 Brown Road South
Long Lake, Mn 55356
Dear Ms. Stinson:
An inspection of your septic system was conducted on September 18, 2000. A summary of the
inspection is below.
Septic Tank Condition
1. Pumpout not needed at this time.
The septic system is a compliant system, meaning it meets all or most current City and State
Standards. Enclosed is a list of licensed contractors who work in Orono on a regular basis. This
list is enclosed simply for your reference in case your septic system needs maintenance in the future.
Also enclosed is a fact sheet explaining your septic system and how it functions. Finally, an as-built
drawing is enclosed showing the approximate location of the septic system.
If you have any questions regarding this report, please contact me at the City Offices at 249-4600.
R pectfully,
� ��
� ( l
;�;"ti;��fi"�;t�u/
Chris Pence
On-Site Systems Manager
Enclosures
In the event this inspection report is used to satisfy the requirements for a mortgage or other transfer of property,
be advised that this report does no guarantee or certify the existing system will eontinue 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 location and pumping records.
Telephone(952)249-4600 • Fax(952)249-4616
www.ci.orono.mn.us
I
� O�
�
i�/ O O \I
' � CITY of ORONO
'i; , L j�� � � I I
� � �
,"� � y �°t, �-�� ,�,�' Municipal Offices
�'��,� �r��I�,;��:�;�ti�°,�G Street Add�ess: Mailing Address:
'`9I�'��p4' 2750 Kelley Parkway P.O. Box 66
� Orono, MN 55356 Crystal Bay, MN 55323-0066
Owner: � Address: 145 Brown Rd. S.
Permit #'s: 7200 Dates: 10/13/83 Contractors: E. J. Paterson
(This is [ X an existing system [ J new construction) .
l\
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-Compliant 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 level is (�]. or is not [ ] idanti£iad undar this saptic system. If the
saturated soil lavel is not identified, this classification is subjact to revision.)
K CONDITION (5-9) : 5
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.
8 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 ara not [ ] water tight or the condition is [�] uaknown. If the tanks
are not confirmed to be watartight, this classification is subject tol revision.)
INFIELD CONDITION (11-14) : 11
1 Drainfield is dry, no surfacing evident.
12 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.) : low
COMMENTS: In order to confirm that your septic system meets Minnesota standards, soil borings
were performed to verify a 3 foot separation between the drainfield and the seasonal water
table. The separation is 1 feet and the system is non-compliant. Repair or replacement of the
septic system is required by 12/31/2008.
����� �
Date of Inspection ep c 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 will 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 Box 66
Crystal Bay, MN 55323-0066 � � ON—SITE SEWAGE TREATMENT
� � INSPECTION REPORT
'�� G~
9kESHa4'�
Owner: (��C�/��� `�rL��Y� Address:�� ��A a'�� ��t J.
Permit #'s: � ates:__/�'/�f�� Contractors: ��d �f�1�,!C"�"1
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
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 uhich does not meet all the location, design, and construction standards of the
current City Codes, but uas 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 failing for any reason; and any system with less than 3 feet of unsaturated soil or sand
betueen the distribution device and the limiting soil characteristics.
(The limiting soil characteristic �Q has or [ ] has not been identified at this time. If the limiting soil
characteristic has not been identi�iea, this classification may be subject to revision.)
TANK CONDITION (5-10):
Tank inspection indicates:
5 Pumpout 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. 7anks should be pumped out as soon as possible.
8 System is discharging to the surface. Tanks must be p�mped 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 pumped out uithin the last three years, they should be pumped
out now.
10 Inspection pipe is located directly over tank baffle (does not give accurate measurement of solids accurtiulation).
If tanks have not been p�xnped out within the last three years, the sh uld be p mped out now. r `
)�
j��-/3
DRAINFIELD CONDITION (11-14):
DC 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,uater table,etc.): �,/����
�l!
COMMENTS:
v
� .. � �� _
Date of Inspection 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 pre�nises with the system locetion 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
„� � INSPECTION REPORT
ti
'�'� �G
9kESH��'
Owner: VK���S �/`3'�C)� Address: �7� [��! �a. K(�. ,�.
� r � /� �
Permit #'s: �' r� Dates: t�i3-�3 Contractors: L, T/�ptp�s�h�n_
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 D� an existing system [ ] new construction)
SYSTEM CONFORMITY <1-3): 1
—1—
1 "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 seuage 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 which 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 1�Q has or [ ] has not been identified at this tir,ie. If the limiting soil
characteristic has not been identified, this classification may be subject to revision.)
TANK CONDITION (5-10):
Tank inspection indicates:
� Pumpout not needed at this time.
Solids accumulation in tanks indicates they should be purnped 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 discharge.
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 pumped out within the last three years, they should be pumped
out now.
10 inspection pipe is located directly over tank baffle (does not give accurate measurement of solids accumulation).
!f tanks have not been punped out within the last three years, they should be pumped out now.
DRAINFIELD CONDITION (11-14):
Dr field inspection indicates:
�Drainfield 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
imnediately. 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.): f�,�
�
COMMENTS:
�._.--
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
properlyi 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 pre�nises with the system loc�tion 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 ������ � � �h�}� ADDRESS ��� ���1'� �c�`' S�
PERMIT NO.'S. �`�^�� �-�' —�DATES — / �f�~�� CONTRACTORS � �L1�T ��'l��^
City Ordinance No. 210 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)
�� 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.
� 3 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)
Ta�k 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 condition) ❑ Adequate
❑ High water table � Low � Fair
❑ Lot size ❑ Medium � Poor
❑ Lake,wetland,or stream ❑ High ❑ Inadequate
❑ Drainage ❑ System is causing visible
s rface discharge.
COMMENTS: � P �VG- ����T S� �V '�% �'Ql'�T/G�t'�✓�i�✓
� ��.� /�Y?[",f� .ri1/172��/✓�l•
�(/��`�Q �i----
Date of Inspection eptic 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
On t.he North Shore o f
Lake Mi�znetoraka
ON-SITE SEWAGE TREATMENT
INSPECTION REPORT � POST OFFICE BOX 66
� _ � � 1335 S. Brown Rd.
Crystal Bay, MN 55323
473-7357
'�� ' �� ^ p :
OWNER �l�!af'�.�C ��1�1�/)�:�rl ADDRESS I'—t� r`�(T;.i��'1 �",C�'C�l ._;�y_,��f�� � �y�r.��U_�:�.
PERMIT NO.'S. � / ��—� DATES � / %� �J�� CONTRACTORS '/ ��.� j�'-t���r1
City Ordinance No. 210 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 fali into the category checked below.
(This is�an existing system ❑ new construction)
� � Meets or exceeds current City standards in all respects relating to design,construction,and location.Appears to be operating
properlY• 1�.6.'�1I� �'�::ty�l�vl_
� 2 Does not meet all current City standards for new construction (1978 Codel 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. �r�,��.- -f��r7l
❑ ,_
3 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 probiems. No major upgrsding 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 usuaily 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 ( � 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.
❑ Sotids accumulation in tanks is at a critical level. Tanks Drainfield inspection indicates:
shouid 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 criticai yet.
ithin 48 hours to eliminate surface discharge. ❑ Orainfield is saturated and visibiy discharging untreated
Inspection risers missing—tanks could not be inspected, effluent to the surface. This condition may require replace-
nspection 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 shouid 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 Futu Expansion
❑ Soil table, nd system conditionl �Adequate
❑ High water table '�Low �� Fair
❑ Lot size Medium ❑ Poor
/�'Lake,we�, t _land,or stream � High ❑ Inadequate
❑ Drainage ❑ System is causing visible
surface discharge.
COMMENTS: ��,f.l, i�1'�.�./�i L�� �I')/.l/./L/� I,//,I�.�J',./ t�-�,�nCJ�..?'� h., /.��lf:� �( i ���L�i`V.���� %�✓C l`l%��' ��/�
.�r ;�' %j't�l�'ri:i�'�L� .�)�%��'%.�'i✓�(.f �1�i�_v_' i.��i�ii;(A.�l y, .� .% ;�x!.r's.:l ��� �i.f/��� �'7"��(t/ !��'l��G%ly_j
�i� � �,
�—
•.f _� �'%� _ %r. .�t!,r y/
Date of Inspection `�'' Septic Systern Flispector
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 properiy,but is merely an opinion of the adequacy
of the system under current conditio�s 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
On the North Shore o f
Lake Minnetorzka
ON-SITE SEWAGE TREATMENT
INSPECTION REPORT � POST OFFICE BOX 66
� _ � � 1335 S. Brown Rd.
Crystal Bay, MN 55323
473-7357
- � (
OWNER �L/�"DY S � I�/ti>C�Iv� ADDRESS � �I��� �'��� Ic��i'_GL�%Jv� (\p
� �
PERMIT NO.'S. �'` �' � DATES � CONTRACTORS
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 ab,o�ve address has been inspected and appears to fall into the category checked below.
�i l�-W � (This is I� an existing system ❑ new construction)
T�t��j�v f'i�Y�� � Meets or exceeds current City standards in all respects relating to design,construction,and location.Appears to be operating
properly.
�L n ��i 2 Does not meet all current City standards for new construction (1978 Code) but in most respects appears to be designed,
LJ �ocated, and constructed generally in accordance with previous codes. System appears to be functioning properly; no major
7��r�� upgrading of the system is required at this time.
❑ 3 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/
repiacement 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
�fl 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 instalied 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
❑ Siope (depends on soil types,water Future Expansion
❑ Soil table,and system condition) ❑ Adequate
❑ High water table �-� Low ❑ Fair
r�� Lot size ❑ Medium --fl Poor
�� Lake,wetland,or stream ❑ High ❑ Inadequate
❑ Drainage ❑ System is causing visible
surface discharge.
COMMENTS:
� �C1 C�l f S/ � 7 ��r�(, � ;�.�-.-
Date of Inspection eptic 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 conditio�s 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