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HomeMy WebLinkAboutseptic info � �� � �\ '� � . _ i� ��,� ,�;�� ,�;,_�.._ ,� II CITY of ORONO � '�'r�` ` : �'�I���,;-��;�� ti Munici al Offices \�'',� ��:,L� jd, G^c�1� Gti p .� , ' :� Street Address: Mailing Address: 9kE3HOg' 2750 Kelley Parkway P.O. Box 66 Orono, MN 55356 Crystal Bay, MN 55323-0066 � t Owner��I(�,� `Y� (/ /� Address:4325 Chippewa Ln. Permit #'s:4597 Dates:9/1/92 Contractors:Volkenant (This is �] an existing system [ ] new construction) SYSTEM COMPLIANCE 1-3 : 1 1 Code Svstem: Meets or exceeds current City standards in all respects relating to design, construction, and location. Appears to be operating properly. 2 Compliant Svstem: 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. 3 Non-Compliant Svstem: 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 j� has or [ ] has not been identified at this time. If the saturated soil level has not been identified, this classification is subject to revision.) TANK CONDITION 5-9 : 5 5 Pumpout not needed at this time 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. (During the last septic tank Maintenance Pumpout the tanks [ ] were or [� were not confirmed to be watertight by the licensed pumping contractor. If the tanks were not confirmed to be watertight, this classification is subject to revision. ) DRAINFIELD 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: (sVstem aqe and condition, soils etc. ) : low COMMENTS: ��i�9� .��.� ;l�'�--- bate of Inspection Sep ic 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 r$)� �, INSPECTION REPORT ti ���kESH��`'�G Owner: ��/�«=L- �� �G(l f2 Address: �32.J �1�i//1C1�r1 C.��%t/LC �SJ��`� Permit �'s: `'�5 ! ! Dates: ���' <2- Contractors: V ����F'li1Ai1 JL 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 belou. (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 which is failing for any reason; and any system uith 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 timiting soil characteristic has not been identtfied,- this classification may be subject to revision.) TANK CONDITION (5-10): Tank inspection indicates: � Pumpout not needed at this time. C6) Solids accumulation in tanks indicates they should be pumped out this year to help prevent future problems. T Solids accumulation in tanks is at a critical level. Tanks should be pixnped out as soon as possible. 8 System is discharging to the surface. Tanks must be pu�nped 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 purt�out. If tanks have not been punped out uithin the last three years, they should be pumped out nou. 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): ai 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 irtmediately. Repairs must be completed uithin 90 days. 14 Drainfield extent and condition unknown. LIMITING SITE FACTORS (slope,setbacks,etc.): ' R�f� t� POTENTIAL FOR SYSTEM FAILURE (depends on soils,water table,etc.): ���� COMMENTS: �j�.( 5• � � 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 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 .�, o.� o ��,. o , � �=j=-� ����=� � CITY of ORONO � , _-���.= .a ���� . t�.�-._� � �'�,'�,� ►� � ���`,' titi M�;�;� ot��� ��� � � �y � � ,. � � . a ��� '�`,�"<��°,��`.w�' Street Address: Mailing Addreu: `�'EggOg' 2750 Kelley Parkway P.O. Bax 66 Orono, MN 55356 Crystal Bay, MN 55323-0066 Owner: a,�•�.F_� S��.vl�'Z Address:_ �3aS L�,(�Pfwq �n � Cin�Ordinance 199 requires that each esisUng on-site sewage treatment system in Orono be inspected every two}•ears. The on-site sewage trf;atment system at the above address has been inspected and appears to fall into the categories checked below. SYSTEM CONFORI�LITY (1-3): � O ��CODE SYSTEM�� An ISTS which meets al(the location,design and construction standards of the cuaent Orono Niunicipal Code. 2 ��COMPLIA21"T SYS'I'EM�� An ISTS which does not meet all the location,desi�and construcKion standards of the current Orono�funicipal Code but doe:meet the three foot sepazation requirement,and which is not failing or an irtuninent thteat to public hzalth or safzTy. 3 °NON-COMPLIANT SYSTEM° A prolubited ISTS;an ISTS located within a designated 100-yzaz flood plain,any ISTS which may or ma� nct meet all the localion,dzsigt,or construction sLuidards oY the current Orono Municipal Code and which is failing for any re�son;and any ISTS with lzss than threz feet of unsaturated soil or sand between the distribution device and the limiting soil characteristics. TANK CONDITIUN(5_10): 7 Tank inspection in3icates: � Pumpout not ne�dzd at this tima. 6 Tank must be pumped out this year (city code requires tanks to be pumped out every 3 years. Tank was last pumped U��^O�v.� ), OSolids accumut�tion in tanks is at a critica(a crilical leval. Tanks should be pumpzd out as soon as possibla. g System is dischsrging to the surface. Tanks must be pumped out within 48 hours to eliminatz surface discharge. 9 Inspection nsers missing-tanlcs could not be inspected. Inspection risers(4"dia.pipe)must be installed in ea�h tanlc at nz�ct pumpouG If tanlcs have not been pumped out within thz last three yea[s,Utey should bz pumped out now. 10 Inspection pipe is located directly over tank bat2le(does not give accurate measuremznt of solids accumulation). If tanks have not been pumped out within tht t,�st t}uee years,they should be pumpzd out now. DRAINFIELD COi�TDITION(11-1-F): �� 1 1 Drairitield is dry,no surfacing evident 1? Some evidznce o`'surfacing,not cr:ucal yet 13 Drai�eld is satu-ated and visibly dischazging unVzated a@luent to the surface. Contact the City Inspector immediatzly.Repaus must bz complated withit 90 days. 1-� Draintield e��tent and condition unknoun. COMi�NTS: P�M � t a�1�5 . R�S�- �� sy�tc�.. �ooks o k �_�- o � �w� Date of Inspection Seplic System Inspector f; Note: In the zvent that this irspection report is used to satisfy the requuemenis for a moRgage or other transfzr of property,be advised that this repoR does not guazantee or certify that an esisting systam will continue to function propetly,but is merely an opinion of the adequacy of the system under cucrent conditions based on the available information. � / O %�� � ��. i%0 � � ��-� � CITY of ORON4 I� �'a'�,; '\�fr _ �1� �� ��� , r�l �\�,� `1 ��1��.�„�_� G,�'ti Municipal Offices � ��; � ��' `�'i`,�?��`R �'y� Street Address: Mailing Address: �' `�k'�,+ggOg' 2750 Kelley Parkway P.O. Box 66 Orono, MN 55356 Crystal Bay, MN 55323-0066 . __ --.— ______ __ To Current Owner: Address: y�5� C��1'��`"`� �`^�. 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): � � '�CODE SYS1'EM" An ISTS which meets all the location,design and construction standazds 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 sepazation requirement or two foot requirement for systems installed 1996 or eazlier,and which is not failing or an imminent threat to public health or safery. 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 failin;for any reason;and any[STS with less than three feet of unsaturated soil or sand between the distribution device and the limitin;soil characteristics. TANK CONDITION(5-7): � Tank inspection indicates: 5 Pumpout not needed at this time. � Septic tanks must be pumped out this year (city code requires tanks to be pumped out once every 3 years. Tank was last pumped ). Nlake sure seatic tanks are pumped through manhole and not through white inspection pipes This allows for the proaer cleaning. Keep water softner and iron filter discharge out of septic svstem. 7 Inspection risers missing-tanks could not be inspected. Inspection risers(4"dia. pipe)must be installed in each tanl:. If tanks have not been pumped out within the last three years,they should be pumped out now. II�FIELD CONDITION 8-10 : � 8 Drainfield is dry, no surfacing evidenl. 9 Some evidence of surfacin�, not critical yet. 10 Drainfield is saturated and visibly dischargin�untreated effluent to the surface. Contact the City Inspector immediately. Repairs must be completed within 90 days. COMMENTS: n� S����`-i N`�u 1 � c��� C K � F t,--� �iF �-: ` fi,-.k� 'f'`-�S S G� =^� _ 6-�� � �'� ��T ���-�-�--� Date of Inspection I�fatt 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 does not guaran[ee 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. Telephone(952)249-4600 • Fax(952)249-4616 www.ci.orono.mn.us / � o� , � ,:: ° Y �f oRONo � ,::� - �IT I� ' �"��,`7��� �+ Munici al Offices ��r�j �, r���1• = P , �� �� �(�,, ,." ti 1, �� ' ` '` G~%% Street Address: qsa"a4q��6o o Mailing Address: ��• � I����,;���II I��3�t�` .�i �`;� ��•'�� 2750 Kelley Parkway P.O. Box 66 . ,1�4 g'� _�\�5�,,=,�' Crystal Bay, MN 55323-0066 � Orono, MN 55356 To Current Owner: Address: �� ��� � ��' �����"�`� 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 cate;ories checked below. SYSTENS CONF'ORMITY 1-3 : � ] "CODE SYSTEM" An ISTS which meets all the location,design and conshuction standards of the current Orono Municipai Code. ? "COMPLTANT 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 sepazation 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 SYSTEM" A prohibited ISTS;an ISTS located within a designated 100-year flood plain,any ISTS which ma}' 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 characteristics. TANK CONDITION(5-7): �" Tank inspection indicates: 5 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 `U''v� i ��� • Malce sure se tic tanks are um ed throu h manhole and not throu h white ins ection i es. This allows for the ro er cleanin . ICee water softner and�C�n�Imr our houseOThe alarm warn owner that seetaf e is boutto backu Rinto basement. alarm float to verif aiarm is still wo 7 Inspection risers missing-tanks could not be inspected. ��he°tshould be pu1mpedpout nowst be installed in each tanlc. I tanks have not been pumped out within the last three years, y DgpINFIELD CONDITION 8-10 : � 3 Drainfield is dry,no surfacing evident. 9 Some evidence of surfacing,not critical yet. 10 Drainfield is saturatedand visibly discharging untreated effluent to the surface. Contact the City Inspector immediately.Repairs must be completed within 90 days. _ .��.:� � � �� .� � ,�� ��' .� � COMv1ENTS: � �� _`> �..�'' �,��-- � �:� Septic System Inspector Date of Inspection �_ _�__,._e�., tiP a�t�,;ceci that thi; report does J � O� O , O CI'TY OF ORONO -���z..- � ,� � Municipal Offices �, Street Address Mailing Address: �� G'�' 2750 Kelley Parkway P.O. Box 66 �i Orono, MN 55356 Crystal Bay, MN 55323-0066 9kESH0�' To: The Current Owner of Address 4325 CHIPPEWA LA 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 954-249-4626 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) Pu ut Needed Yes No The city recommends the septic tank(s) and/or lift tank be serviced and pumped out every three (3) years. City recards indicate the tank(s) were last pumped out on �JD �'/`.�d The tank(s) should be cleaned through the manhole and not through the inspection pipes, this allows for proper cleaning. Comments: � ���� ���� Inspector: Date of Inspection: � " V� Telephone (952) 249-4600 • Fax (952) 249-4616 www.ci.orono.mn.us request.pdf https://word-view.officeapps.live.com/wv/WordViewer/request.pdf?F... �� . f�-;:�.n�sota Poi�u�i�r. � Comptiance inspectian Form �_ontroi Agenc,.� ` @�xisting Subsueface Sewage Treatment Systems (SSTS) 52Q Lafayette Roa�s t�.,rt � Q St.Paul,MN 55155-�1u�! �/' �`�' �uc 7ype Ct;rnpliance and Enforcemerrt ,lj� � C 0 � Inspection results based on Minnesoia Pollution Ccntroi,'vgency{tvlPCkj F����ca!tracking pt:rposes requirements and attached foRns—additional local requirements may also apply. Submit completed form to Local Unit of Government(LUG)and system owner within 15 days $y5tef11 StdtUS System status on�fate(mm/ddlyyyy): 10/18/2012 � Compliant— Certificate of Compliance ❑ Noncompliant— Notice of Noncompliance (Valid for 3 years fram report date. unlcss shorter time (See Upgradc Reqc�iremenls a�page 3) frame outlined in Lr�cai Ordinance.) Reason(s)for nc;ncompliance (check all applicable) ❑ Impaci on Pi�blic Health (Comp/iance Component tt 1)—ImminenC threat to public healtl�and sa(ety ❑ Other Comp'.iance Cond�tions(Compliance Cornpanent#3)—lmminent fhrsat to public health and safety ❑Tank Integri'y{Compliar�ce Component#2)—Failing to protect groi�ndwater ❑ Other Comp!ianc;e Conditions(Compliance Cornponent#3)—Faiting to protect groundwater ❑ Soil Separafion(Compliance Component#4}—Failrng to protect grounclwafer ❑ Operating permit/monitoring plan requirements (Compliance Component#5)—Noncomp/�ant Property Information Parcel ID#or SeclT'wplRange: 3111823420009 Property address: 4325 Chippewa Lane, Orono, MN 55359 Reason for inspection_ Property Transfer Property owner Stacsy Flfeli Owner's phone: _ _--- -- or Owner's representative: Representative phone: �ocal regulatory authorit••: Orono Regulatory authority phone� Brief system description: Pressurized Mound, 2-1000 Septic Tanks. and Pump Station Comments or recomm�>ndations: Certification I hereby certify that alt th,�ner,essary informa6on has been gathered to determine the compJiance status of thrs system. No detennination ot fi�ture s�stem�erformance has been r�or can be rnade clere lo unlv�own condilions dunng system constrirctian, possible ab«se of ihe sys'em, inadequate maii�tenance, or future water usage. tnspector name: Date Jenn Certification number. 3226 Business name: George'�ExcavaTing License number. L3368 Inspector signat�re;�r ' _ Phone number 612 310-7887 Necessary or Loc��ly Required Attachments ❑ Soil borirg logs � System/As-built drawing ❑ Forms per iocaf ordinance � Uther infor,mation(' ,t): City Sep:ic Systam Ir�ventory Form _- _ _ __ _ _ _ -- _ --- www.pcastate.mn.us • 651-296-6300 • 800-657-3864 • TTY 651-282-5332 or 800 657 38b4 • Available in aitemative fonnat, .vq wtivhts4-31 • 3l 15;`11 P a ,';>: , 3 of 7 3/25/L�b13 6`:�2 PM Irequest.pdf https://word-view.officeapps.live.com/wv/WordViewer/request.pdf?F... r=roperty address 432� �'��ppewa Lane vrono, MN 55�5� Inspector initialsr�aie ��d ; "ur?8/2r�1� _ irnm;dd/YYYY.� 1 . Impact on Pub(ic Hea(th— Compliance component#1 of 5 Compliance criter�a: _ Verification method�s): System discharges sewaqe to the ; ❑Yes � No U Searched tor surface outlet yround su�face. ___ ' � Searched for seeping in yard/backup in home System discharges sewage to drain ❑Yes � No ❑ Excessive ponding in soil system/D-boxes tile or surFace waters. _ ❑ Homeowner testimony(See CommentsiExpiana6on) System causes sewage backup into ❑ Yes � No ❑ "Black soil"above soil dispersai system dvrelfing or estabiishment. _ __ _ ❑ System requires"emergency"pumping Any"yes"ansWer ahove indicates ihe ❑ Perfo�med dye test system is an imminent threaf to public ❑ Unable to verify(See Comments/Explanation) /1@c'i/fh cil�d Saf@rJ/. ❑ Other methods not listed (See Cvmmenis/Explanatron) Com ments/Explanation: System causes sewage backup into home not confirmed. Nome is vacant. 2. Tank Integrity—Compiiance component#2 of 5 Com�liance criteria: Verification method{s): System consists of a seepaye pit, []Yes � No ❑ Probed tank(s)bottom cesspool,drywell, or leach�ng pit. ❑ Exam�ned construction records Seepaqe prts meeting 7G80.2550 may be ❑ Examined Tank Integnty Form(Attach) compliant ff a!lowed rn 1oc:a!ordinarx,r. _ — — -- ❑ Observed liquid level below operating depth Sewage tank(s) leak Celow their ❑ Yes � No � Examined empty(pumped)tanks(s) designed operating depth. I If yes,which sewage tank(s) feaks: i ❑ Probed outside tank(s)for �black soil" ❑ Unable to venFy(See Comrnents/ExplanaUon) Any "yes"answer above indicates the sysfem is failing to pratect groundwater. ❑ otner methods not��sted�see com�e��r�rEX��Bnar�on� CommentslExplanation: Tanks pumped by others tank integrity appears sound. 3. Other Compliance ConditionS—Compliance component#3 of 5 a Maintenance hole .overs are damaged.cracked unsecured,or appear to be stnicturally unsound. ❑Yes` �No �Unknawn b. Other issues�e�ectr�ca�nazards.etc.)to immediaiely and adversely impact public health or safery. ❑Yes` � No ❑ Unknown *Sysfem is an imminent ihreaf to public healih and safety. Explain: c. System fs non-protedive of ground water for other canditions as determined by inspector. ❑Yes' � No `System is faifing to protect groundwater. Explain: _ _ _ __ ,4ww.pca.s.atc.mn.us • b`.�1 296-G300 • 800-657-386a • 'T"651-282-53;2 0-8Q0-657-?Str'! • Avai(ahi��n a;tc�r;�at�vc•�o�r��a�� 4 of 7 «;,-�;sts4 3t • 3i 16!t2 3/25/�b��3�5:�12'PM ��:�«-wi5:5-� s� • .�. .� ,� 5 of 7 3/25/2013 6:12 PM request.pdf https://word-view.officeapps.live.com/wv/WordViewer/request.pdf?F... ('�ooerty address 43`L5 Chippewa Lane. Jrono, MN 55359 Inspector indials/Date d�d ; 1UI18;2C12 -- {�rinVdcifYYYYi 4. Soil Separation— Compliance component#4 of 5 Date of installation: t992 ❑ Unknown Verification method�s): �mMdl}/YYYY) Soil observatron does noi expire Previous soiJ ShorelandNVeUhead protectioNFood beverage �Yes ❑ No observ�tioris by two+ndependent panres are suflicienl. lodging? un/ess site corlditions have been altered or local Compliance criteria: requirements dif/er. For systenis built pnor to April 1. 1996. and ❑Yes ❑ No ❑Conducied soil observation(s)(Attach boring fogs) not located in Sho�etand o�Weflhead ❑ Two previous verifications(Attach bormg logs) Protection Area or not se►vrr�g a food. beveiaye or lodgn�g estabGshment: ❑ Not applicable(Holdrng tank(s},no dramfie►d) I Drainfield has at least a two-foot vertical � ❑ Unable to verify(See Comments/Exp►anation) separat�on distance from periodicalty � Other(See CommenlsiExplanalro��) saturated soil or bedrock. Nor�-perfom�ance systems bu�lt Apnl 1, � Yes Q No CommentslExplanation: 1996, orlater orfornon-�e�forrnance Soif seperation conf�med by Orono Septic System systems located in Shoreland or Wellhead Inventory Form-attached for reference. System may r>e in Protectron Areas orse�vinr a food. wellhead protection area. System would need 3 feet of beverage, or todgrng estabbshment vertical seperation as verified by Inventory Form. Dramfield has a three-foot vertical separation distance from periodically saturated soil or bedrock.` -Expenr►,ental", �Ot1�er". or "Performance" ❑Yes ❑ No Indicate depths or elevations systems huilt ur�der p�e-2008 Rules: Type N or V systems buift under 2008 Ru1es(7080. A eottom of d�stnbu6on media . 2350 or 7080.2=F00 (Advanced Inspector License required) B Periodically saturated soiUbedrock Drafnfield meets the designed verticat C system separat�on 36 separation distance from periodicafly saturated soil or bedrock. D Reqwred compliance separation'_ 36 _ _ Any "no"answer above indicates the system is 'May be reduced up to �5 percent if allowed by Local failing to protect groundwafer. ordinance. 5. Operafiing Permit and Nitrogen BMP*— Compliance component#5 of 5 � Not applicable Is the system operated under an Operating Permit? ❑ Yes ❑ No If"yes",A below is required Is the systern required to employ a Nitr�yen BMP? ❑Yes ❑ No If"yes", B below is required BMP=Best Management Practice(s)specified in the system design If the answer to both questians is "no", this section does not need to be comp/eted. Compliance criteria a Operating Permit number. � �] Yes ❑ No Have the Operating Permit reqwrements been met? b. Is the required nitrogen BMP in place and properiy functioning? U Yes ❑No Any "no"answer indicates Noncompliance. Upgrade Requirements(M�nn Sta! § 115 55J An imrnment threat to pubbc health and salery(ITPHS)must be upgraded, replaced.or its use discontmued�vdh�n ten months of receipt of fhis notice or w�thin a shorter penod if required by local ordinance. !f the system is failing fo protec! ground wafer. the syslern rnust be up,qraded, ieplaced, or ds use d�scontinued within the time�etluved by Ivca1 urdinance. ll an existmg sysfem is no!tailing as ciefined�n law. arrci has at least nvo/eet of Ues�gn soil separatron, then the system need nof be upgraded. repa�red. replaced, or its use discontinued,notwirhsfanding any loca!ordinance thai rs more stricL This provision does n�t app/y to systerns�n shore/and aieas. Wellhead ProtecGon Areas,or those used�n connectron wifh Jood,beverage. and todgmg establishments as defined m�aw. ___ __ _ _------ ------__--____ _ ._ wvnv.�ca.state.mr..us • 651-296 6300 • 800-657-3864 • TTY 651 282 5332 of 80L'-657-3864 • Available in alternative formats wc.�-wwists-i�j: - �i 1bl f� Pn;r��of.� 5 of 7 3/25/2013 6:(2 PM request.pdf https:/lword-view.officeapps.(ive.com/wv/WordViewer/request.pdf?F... � SEPTIC SYSTEM INVENTORY ._ - - -__ _- - -- -- - - -- -. Site Address: 4325 Chippewa Ln "��" PID: 31118234200Q9 .. _ - Owner Name: ,lchn 8 Stacey Elfeft Owner Address: �612 3rd Ave Anoka MN 55303 Building Type: resi9ence - - Installer. Date of Pern��t: 9 r`. i92 Volkenant Sysiem Typ��: mcund � BRs Designed tor. �3 In MusB?: �o Shoreland?: No SEP'!'IC COMPLIANCE IRSPECTION Repori Date: Compliant7: � Expires: _ � - Non-Compiiant?: Repon in Street File? SPE. NQT - SEPTIC�'ANKS � M�,���� p;-�cast concrete CapacRy: 1000, 1000. 1000 Tank Fiter: aRAIMFi��D . _ __. __._ _ ?realmEni A'ea: '�6:"33 Soil Boring: yes DF Ht above 1Nt: ��--- Wf:LL f:►�"fA Sa+i;�::s-1'+e;l-Tanks� � - --- Well-DF: �� Report in File?� � Depth• 128 {N�PE':TION RECOR[3 PUMPOUT RECORD n�Yt Description Date Gallons _ . ---- . _ _ _ . .___ _ __ � 9/29l92 replacemenilnstal;ation ,_,_,,,_ ..- -__-_. � ...__ . 5 112l93 no surfacing ..... 10111/90 no suri•.cing _ - .. � .... _ g;2g/gg � code��cte:n,no surfacin� � --_. _,,.,,,._ ..............—..--..--• -- - _ _____ __.__ G/i17i�]1 no sur'�.�in9,pump tanks `{�p3pjp3 �� no sur`.xiiig,pump tanks 2004 f-....._ - - -- - �` �"""""""`"� ••. I_,_- - - . - _ __ _-_ �_ . ._ �r„r, ----�-- - .-.,.�,. - - - �r---�- �. _ -- - ��.�...:�._.�� �---�-``. ' �_ __�_.. �� �.._ _ �-- __. �...._-�:. ���_�:. -- - __._...� - �.."�- . .. . _ _ _ _ _ . 7 of 7 3/25/2013 6:12 PM request.pdf https://word-view.officeapps.live.com/wv/WordViewer/request.pdf?F... 1 ���lJ���� J�r U�� �--f 'o ; � ! � �' i C{,� ,� l.h. ' i i ' I � � � � � .7, /}?�4 353 �!�o � ou� `�t 6 �tg 0 � I Ta�,� y3�q �9,� I ; ��- ��3 �a'q T�� ��6 �3'6 1 I �'6 �7'6 A i � � � ; � , I . ; � � � , � � � ; ---� i -' ' � � I �� i � N � � � � ; . � � ' � f i � �� ; � � � �r���( �;�e, �_ �, i 6 of 7 3/25/2013 6:12 PM request.pdf https://word-view.off3ceapps.live.com/wv/WordViewer/request.pdf?F... . ° HENNES SEPTi� PUMFfNG �OR OF�CE:;s�OR��' ` 2237 ValBey�liew Rd � �� Sltako�pee, MN 55379 � u��i�'�£� _ — . . • � � �e��xc T�nk _Pumping Ce�°t��c��� ���.tP� --- --- ; ; ; U�arnef �iam� _ _ .___ _ _ _ _ - ---- i3�te of pumping--�-_-��. __ , , . ., . , ; .. : �-Tra�sfer of�roperty Proj�ct Acidress `"; ' . ' '-� � � . � ;" : _f----v � P.outine Pu�pin� '! �istina tank-new system Septic Tank Siae: gallons Inlet Baffle;� , i j Hoiding tank ��arn�artments� �� One �� Tv+,o t�iareriai __.� 1==`"`` =- %;larr� pres�rt _ _ 5�p�ic Tank Constre+ctior�: intact� ��Yes ❑ No IF SYS�'E�►f INC�UD�S �:"Concrete �teplac2�i? � Yes ❑ No MClRE's'�l�N fllVE T�NK, ❑ Fiberg{ass Cltitlet Baf�le.� CO�+�IPL�`T'��"NIS S��L'TION !i Plastic Vateriai �.._ �i'--_`_`__` �O�R E�►�i� A�i�;�il�t�Ai. � Metai ir:iaci% �Yes ❑ No �Af�K £�N A �E�ARATE � Ottjer _ -_. ---__ Rep{ac�? J Yes � No P�lMPIldC �E�t��.�.Cl��� ;,�,-�,,._ F€?RM :4l�i? �?TArH. Se�at�ge r�cnt��ed �_ � , 4ailons U Additiona! tank(s) l���i� +�sn �hro� h: ;- - _ --------- __------__.—�—___--_.�_._------- � � � i ;t�;;;;anta Ru1�s;Q9apter 7CSi;.f1?TSSuL�.3.C. I°�e osmner C;oivrter's a,gent refusK:s tv allow. the;�mesat � �i�IdlCli�Tlat1C� cICCeSS ! tJrrouyh a maintenaiKe hole,the l�censed purnper�twsi obidin a sryi�ecl.itetenrenl iruitl U�owner��owner`s � ri '�'i 15�3'c'�LVOr pl}�3£ aqent that ltre cemer or aaenF w,as inf.�xmer:ofCt�rrPCt remnva�Prnrcx+ures and the r�s�n h�r relusal." � *Reasan l�t�r�u€��a�r�g througi� inspection pipe: *Komeowner sic�nature-rr'pumped througn inspec.�tion pipe:-- —__--`-------_--_-_.- �a3ii"3�et3��Ce Ac��''S P�C�Se�tt? �] NG �j Y�s Diam�ter of maintenanc� access: ' � inches at least dimension (must �?e 2Q"ta be �art of �ev� system) �►ccess within 12"Qf ground surface"� Risers (r exisrin9�acidee�: inS�3e+Ctid�t �pipeS pr�S�tlt? �±Yes - Iniet % Outlet I C:enter ,��.Conc�ete �' ',es - �r� iniet J Outiet J Center [� No ,--,=�-' � � Plasiic ❑ tvc ❑ Added ta: Inlet / C�.�*let/ Cen�er � Nane ❑ Added in,/ft. to iniet! �ut�et ! Center T�e septic tank j,�l70ES J ❑ Dt�ES 1�aT a��rear waiertight as of today`s da�te. Tank iea(�age observed iseiow o�erating depth2 ❑ 1'es ��No Ta�k ieakage a�t�served �bove o�eratinc� �ie�tl�? ❑ Yes �No �ny drair.bacK from soil tre�tment are� ncat�Ge�!? L, Yes �No � C��spasai met�toti: ��_Nlunicipal �reatmer�t _ _�,t.:_;•.,�- �; _, l -- . _ _ __ __- �] i.and applicatior, � � �ll l�� U -._."'_ �_ Comme�ts���servation of any non-compiiance[re�nairs: ________ 1 _._ >._ , i . s,' � `tit � �— �+�!' fk i�`� �.� - 1 ne�eby cerbfv wi�i n�v sronanire as a lVlivi-licenseo FiimUer tnat my ob.servanons rerurdeo on thls tor�n a�e acru�ate to the hesc uf my p�oies�runal knn�v/er/ge.as of Ghe date s�gnee fcr ttre pro,�e�fy stat�d aboe e. No determrn,�tion of future�rfnrmanre ca.n he made due tn unknown c'orxfitinrxs nfch as abuse o(the syste;;,rr,u/or i,�ac'��;uaie:�;ainrcna�xe, ot whic/�riil!Jes�er�:rly:�ffec.t�e life of t7=sy�cc-,. _ 1� _J--r _. . w s (._ ; - �� __ _ � � _ . - � _. _ _ 4'um{�er n�me(PieasB^rintl 5tatr iicFncA ni.imhr�r Date --. , _ . . � f, � � � , .,, :_,; ,, �. .. . , ,_. _ ; . . _ . .. � . , - -- �L � -� -- __---_, � ._+_. _ _ -- _ _- --__ __- Rim�signahire � Company Fnone number Please subm�i�is record to th�homec��✓�_e.r ant�local unit o�ovemment wrthin 30_day_s__of�ur.�pin�,!��spection,_ 2 of 7 3/25/2013 6:12 Pr' . • • • • e To: Orono residents on mound type septic systems From: Willie Gibbs, ISTS Manager Date: May 10, 2006 Re: Landscaping Do's and Don'ts for Mound Systems, Quick Reminder Do plant and maintain a fuli cover of grass and keep mowed to a normal height, this grass cover aids in the evaporation of large amounts of effluent (the iiquid left after the "othe�" stuff has been removed) in the summer time and allows the mound system to help breakdown nitrogen in the effluent, Do water the grass over the mound in extreme dry conditions, sparingly. Do avoid unnecessary foot traffic over the mound, maw it and stay off of it. This is especially true in the winter time. Even human foot traffic can cause frost to penetrate the mound resuiting in potential freezing problems. Do inspect your mound system annually for winter kill, (reseed if necessary) anima! damage, (burrowing)or signs af potential failure. Do not plant trees or shrubs on the mound system, smaller trees and shrubs may be planted at the edges. Remember, that sunshine is the key to a healthy mound system. Do ask questions, if you have any concerns or questions concerning your mound system please feel free to call me, I can be reached at 952-249-4626. 1