HomeMy WebLinkAboutSeptic info �� -o�
�. �
. O O�'�
'� ''' CITY of OI�ONO
„ -�- ., .�
,, }:,r,�;� �
,
� `�i`� �. �;�j,��! �. �, . Municipal Offices
;'' �1` ;��:�' ; ~ Mailing Address:
�,t :<:i;;'� `•;t;j�G Street Address: �lSa-a4q-y6o O
`4x�xp4' 2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
To Current Owner: Address: �0 L(� IJ(�o�-� �U, 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 (1-31: I
1 "CODE SYSTEM" An ISTS which meets all the location,design and construction standards of the cuirent 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 tlu-ee foot separation requirement or two foot requirement for systems installed 1996 or earlier,and
which is not fiiling or an innninent threat to public health or safety.
3 "NON-COMPLIANT SYST'EM" 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 stanchrds of the current Orono Municipal Code and which is failing for any
reason;and any IST'S 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 septic tanks are pumped throu�h manhole and not throu�h white inspection pipes. This allows for the proper
cleaning Keep water softner and iron filter discharee out of septic svstem to prolone life of draintield. Ask aumper to test
alarm float to verifv alarm is still workine in your house The alarm warns owner that septage 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 ta.nk. If
tanks have not been pumped out within the last three years,they should be pumped out now.
DRAINFIELD CONDITION 8-10 : d
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: /`'�a v�J d— S t� �-,L ���kS �oo�� b K�
�-21-0�-1 �w� /��
Date of Inspection Matt Bolterman - Septic System Inspector
vote: In the event diat this inspection report is used to satisfy the requirements for a mortgage or other transfer of property, be advised tl�at dzis report does
not guarantee or certih� that an existing system rvill continue to function properlq. but is mercly an opinion of tl�e adequacy of the system under current
conditiuns based on die available intomia[ion.
C
� �'��``,,
, � o ���,�
� _ _ _ . ', ��T�' o� 41i�1�d�►
,, ,�, �
I1 � ', ' `,r ,i� �, �l Municipal Offices
`�� �� ,:" �, � ' � , ,
�'` � �"� �� � ''�� G /i Mailin Address:
��,'� !� , � � r .:,�� k Street Address: g
�`��9 � ���� 2750 Kelley Parkway P.O. Box 66
�_:�,,kESH� i% C stal Ba MN 55323-0066
��� Orono, MN 55356 ry Y,
To: The Cunent Owner of Address % �" `-� S ����� 5 '
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 Ha1L
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 brou�ht 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 l�Teeded
Yes
No ✓
The City recommends the septic tanl:(s) and/or lift tank be serviced and pumped
out every three years. City records indicate the tank(s) were last pumped out on
7 - ��-�.3 . The tank(s) should be cleaned through the manhole and
not throu�h the inspection pipes, tlus allows for proper cleaning.
Comments:
F
.r� �_� �
Inspector: Date of Inspection
Telephone(952)249-4600 • Faa (952)249-4616
www.ci.orono.mn.us
SEPTIC SYSTEM APPROVAL �
r �• ��*��
�" *;;`'.J
� �� �� ��
O O �,, �.�
���
,� � f�.� �,
CITY of ORONO ��`�� �'�
ti Municipal Offices
� �
�.t9 �.�G Street Address: Mailing Address:
JC'EgKp 2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
Owner ��r2 P c�-:�c���.� Phone (Home) (Work)
Address �n�S ���N� R � City C�(e?�'�c: State M P�J Zip �S 3�.'�
Site Evaluator�ct t�l st;', State License # �'� Phone# '?63-- �f�y- � �7`i
Type of Establishment: Single Family� Multi Family
Commercial � Est. Gallons Per Day �,�C�
No. Potential Bedrooms s Slope: I `/���
Depth of Sand: Upslope: 1 Downslope: (� 1 Soil Sizing Factor � •� �
Perc Rates P-1 1�.� P-2 �.y P-3�i: P-4 �`�.� P-5 P-6 P-7
Restricting Layer Depth B-1 �.1 B-2�•Ck B-3 �-I B-4 �.� B-5�•� B-6 3.i.s
Type of Treatment System:
Standard ��( Alternative Other Performance
Pressurized Mound System � At-Grade System
Gravity Trenches System Pressurized Trench System
Gravity Trenches W/ Lift Pressurized Bed System
Holding Tank W/Alarm
Septic Tank Size 1 SC C'� # of Tanks � Lift Tank Size �S C�?
Pump Brand GPM W 7 Head i 7
Treatment System:
Minimum Square Feet with � inches of rock below pipe
Mound Bed t 0'� 6a Mound Treatment Area `3'� X�i`�
THIS IS NOT A PERMIT. This is a design approval form which must accompany the site plan.
A permit must be issued to a licensed septic contractor prior to installation.
NOTICE TO INSTALLERS: Any changes to the approved plans must have prior approval of the
inspector (952-249-4600) Call for inspection 24 hours in advance.
ALL DRAINFIELD AREAS MUST BE FENCED OFF prior to building site excavation and
fencing must renzain in place until final site grading. Approval to pour footings will not be granted
until the Inspections Department has verified the primary and alternate sites are protected.
NO VEHICULAR TRAFFIC OF ANY KIND is allowed within 20'of tested drainfield sites ever.
ACCEPTED �( DENIED By the City of Orono sub�ect to existing reg lations and
the following conditions: — �. � �-��\�S 1�t,� �,e '�•� ��1 <}- c ��,�.e
._ w �.�� t^��L 5 t-� k,� {e c�u v e.� , � F J ttlf� 5�1t �S �5 e c� ,
�- �<f�li �`^�;��� }y� ��y•T � }� �jCG�f< <,r.y cQn�YS�It,U•�. y'"��tS ��ri�Q �
—V�',�;'�RC� 1-� j c, ....�.,r., 1� {t �j- c'� �'a"�1 t`i r.� �..:� CI vC IT) S 1,c�1� C�'
—� �
to;- r�.q) �,t� _ �X.�,�.�, ht:l� ��5
By: ��-��. ��c,�;�,,,� I�.— �� — C� �
Matt Bolterman, On-Site Systems Manager Date
Telephone(952)249-4600 • Fax(952)249-4616
www.ci.orono.mn.us
� o�
o.::,, o
-�=������ CITY of �R�NO
,a ' ����-'? �
��j��1�.�> ..Ty�
�,� ;��,�����f�,� G.y�' �lunicipal offices
l ���`'�`•;;,``�g�i Street Address: Mailing Addressc
�E$fI� 2150 Kelley Paricway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
9sa-�49-y5oo
To Current Owner: Address: �0 y� U�o:�� �� S_
City Ordinance 199 requires fhat each existin�on-site sewage treatment system in Orono be inspected every two years.
The on-site sewa�e treatment system at the above address has been inspected and appears to fall into the categories checked below.
SYSTEM CONFOR1�tITY (1-3): �
1 '�CODE SYSTEM"An ISTS which meets all the location,design and constrvction standards of the current Orono Municipal Codc.
O2 "COMPLIANT SYSTEM" An ISTS which does not meet all thc location,design and conswction standards of the current Orono biunicipal
Code but does meet the three foot seParation requirement or two foot requirement for systems installed 1996 or earlier,and which is not failing or
an imminent threat to public health or safety.
3 "NON-COMPLIANT SYSTEI�1" A prohibited ISTS;an ISTS located within a designated 100-year flood plain,any ISTS which may
or may not mect all the location,design,or conswction standards of t�e current Orono hiunicipal Code and which is failing for any reason;and
any ISTS with less than three feet of unsaturated soil or sand betwcen the distribution devico and the limidng soi]chazacteristics.
TANK CONDITION(5.7�: 6
Tank inspection indicates:
5 Pumpout not needed at this time.
6� Septic tanks must be pumped out this ear (city code requires tanks to be pumped out once every 3 years.
Tank was last pumped �4-I�-�� ).
Nlake sure septic tanks are pumped throuah manhole and not throuQh white inspection pipes.
This allo�ss for the proaer cleaning.
7 Inspection risers missin�tanks could not be inspected. Inspection risers(4"dia.pipe)must be installed in each tank.
DRAINFIELD CONDITION(�-�Q2: _�
� Drainfield is dry,no surfacin�evident.
9 Some evidence of surfacin„not critical yet. �
10 Drainfield is saturated and visibly dischar�ing un�reated effluent to the surface. Contact the City Inspector �
immediately.Repairs must be completed within 90 days.
CO�II�NTS: �c�,-.�.c\� \o���� Ok_ �Lr..�, Y��1(� �-�- -��cy �n�� ���'
b�c.� ,,�., cJ �.��-. 1R1-3-- � �Pc,�S _ . ���r- co�c� c r� ���c�-��.c_
�n c o r. Se« �.�
� '�- ���— ��t� G���-�---�
Date of Insptction Matt Bolterman- Septic Systcm Inspector
Notc: In the event that this inspection rcport is used to satisfy the rcquiremencs far a mottga;e or other transfer of property,be advised that this report does not guarantee
or certify that an existing system wili continue to function properly,but is merely an opinion ofthe adequacy of the system under eurrent conditions based on the availabie
information.
=0 `\
� 11�' y
,
�����0 O ��������
� ..; �;,, � �_ ,� ;�;� CITY of ORONO
� !4 Municipal Oftices
'�,� ;:; ..__ G� ;,
� Street Address: Mailing Addtess:
� �9 � �� �� 4��'%
_ � ,$EggO �� 2750 Kelley Parkway P.O. Box 66
=- -- �� Orono, MN 55356 Crystal Bay, MN 55323-0066
September 25, 2000
Steven O. VanDeVerie
1045 Brown Road South
Wayzata, MN 55391
Dear Mr. VanDeVerie:
An inspection of your septic system was conducted on September 21, 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.
Res ectfully
��' �v�'� .,v�
C ris 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 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.omno.mn.us
/_� O �\
;'� �.
�:�
ii
/�'O O
,;�,.. ;; C ITY of ORONO
,� 5 . � .
i � tS ';� Municipal Offices
;,,'�+�'�� �: ' ;,�G'� ,
Street Address: Mailing Address:
��ESH��� 2750 Kelley Parkway P.O. Box 66
__=�� Orono, MN 55356 Crystal Bay, MN 55323-0066
�� �
Owner: l���' 1 � � � � Address: 1045 Brown Rd. S.
Permit #'s: 5317 Dates: 9/20/78 Contractors: Jerry Johnson
(This is [x] an existing system [ ] new construction) .
SYSTEM COMPLIANCE (1-3) : 2
1 Code System: Meets or exceeds current City standards in all respects relating to design,
�} construction, and location. Appears to be operating properly.
UCompliant 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 ar.d is functioning properly.
3 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 [ ] identified under this septic system. If the
saturated soil level is not identified, this classification is subject to revision.)
TANK CONDITION (5-9) : 6
� Pumpout not needed at this time.
f6, 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 are not [ ] water tight or the condition is ( ] unknown. If the tanks
are not confirmed to be watertight, this classification is subject to e ision.)
INFIELD CONDITION (11-14) : 11
1 Drainfield is dry, no surfacing evident.
2 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:
� � -� �,/ �--
Da e�of Inspection ep c System Inspect r
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~
�9kESH04'�
1� �-
Owner: ,�-TF.I�C�r� �.�1�'�I ,,,1� Y i(_�►ddress:__[��k� � �G�J� •�3.
s
� �s� �� �P�Y�/ )�rr'�Y1
Permit #'s: �.��.� Dates: �.�" Contractors:�� � � �,
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 ;[)9, an existing system [ ] neu construction)
SYSTEM CONFORMITY (1-3):
1 "CODE SYS7EM"-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 whtch 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 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� has or [ ] has not been identified at this time. If the limiting soil
,,�/ characteristic has not been ident'Kie?J, this classification may be subject to revision.)
J�
TANK CONDITION (5-10):
Tank inspection indicates:
5 Pumpout not needed at this time. -- ^
/b'� Solids ac ' ' indicates�they shoutd be ed out this e
�Jf' So i s accumulation in tanks is a a ca eve a pumped out as soon as possible.
8 System is discharging to the surface. 7anks must be pumped out uithin 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 punped 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 acc�nulation).
If tanks have not been pumped out within the last three years, they should be pumped out now.
DRAINFIELD CONDITION (11-14):
Dr,a�field inspection indicates:
Cl1J Drainfield is dry, no surfacing evident.
T2 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 unknoun.
LIMITING SITE FACTORS (slope,setbacks,etc.):
POTENTIAL FOR SYSTEM FAILURE (depends on soils,water table,etc.): ` �
' ��coririE Ts: ,, . .� r � ��
.� � � � � � �
� ' i
I
Date of Inspection ep ic System nspector
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 locQtien 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 a � ON—SITE SEWAGE TREATMENT
,�,, �C�, INSPECTION REPORT
ti
��9kESH���G
Owner: �l0�?'1 ��1'� � ►1L�1/!� Address: iV7`�,OY�.�/'� /�CG7, ,�
Permit #'s: ��/ Dates: / O�✓"7 o Contractors:Jf��' ��►'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 uhich is operating satisfactorily by treating and disposing of the entire current sewage input
without discharging any pollutants into ground or surface waters.
"CONFORMING SYSTEM"-A system which 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 �nto 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 [ ] 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):�
Tank inspection indicates:
Pumpout not needed at this time.
6 Solids accumulation in tanks indicates they should be pumped out this year to help prevent future problems.
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 pumped out within 48 hours to eliminate surface discharse.
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 punped
out now.
10 Inspection pipe is located directly over tank baffle (does not give accurate measurement of solids accumulation).
If tanks have not been pumped out uithin 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
immediately. Repairs must be completed within 90 days.
14 Drainfield extent and condition unknown.
LIMITING SITE FACTORS (slope,setbacks,etc.):
POTENTIAL FOR SYSTEM FAILURE Cdepends on soils,water table,etc.): /j'����
/��'
COMMENTS:
3'_'� J
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 pre�nises with the system loc=tien and pumping records.
WHITE COPY/Inspectors File YELLOW COPY/Homeowner
On tl�e 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 > Upn ��rar;G� ;P. ADDRESS �7� �✓cawh K-G�'. �
PERMIT NO.'S. ���? DATES �6���-,��i CONTRACTORS���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 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.
❑ 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)
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 i� 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
surface discharge.
COMMENTS:
����" f� `i 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 conditions based on the available information.
This report must be kept o�the premises with system location and pumping records.
WHITE COPY/Inspector's File GOLD COPY/Homeowner