HomeMy WebLinkAboutseptic info CITY OF ORONO � O�
Municipal Offices O � O
Post Office Box 66
Crystal Bay, MN 55323-0066 � � ON—SITE SEWAGE TREATMENT
�„� �� INSPECTION REPORT
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Owner: (�r9✓Z��'Qr1 �7/;�Glqt=RC'� Address:_ J�`��J �hvi�-�r'�tL (J2�,v� �55.�S�q�
Permit ,�'s: �J�C� 7 Dates: /(—�6 ` �i�1 contractors: ( lc�l'JL?Z- �i�ll �c:i.
City ordinance rnmber 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 [ ] neu construction)
SYSTEM CONFORMITY (1-3):
t "COOE SYSTEM"-A system which meets all the location, design, and corsstruction standards of the current City
Codes, and which is operating satisfactorily by treating and disposing of the entire current sewage input
without discharging any poltutants 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 instaltation, and Which
is operating satisfactorily by treating and disposing of the eritire current sewage input uithout 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
betueen the distribution device and the limiting soil characteristics.
(The limiting soit characteristic�has or [ ] has not been identified at this time. If the limiting soil
characteristic has not been identifi , this classification may be subject to revision.>
TANK CONDITION (5-10): S
ari inspection indicates:
LY Purtpout not needed at this time.
6 Solids acctmulation in tanks indicates they should be punped out this year to help prevent future problems.
7 Solids accunulation in tanks is at a critical level. Tanks should be p�rnped out as soon as possible.
8 System is discharging to the surface. Tanks must be punped out uithin 48 hours to eliminate surface dischar�e.
9 lnspection risers missing-tanks could not be inspected. Inspection risers (4" dia. pipe) must be installed in each
tank at next pinipout. If tanks have not been punped out within the last three years, they should be p�mped
out now.
10 Inspection pipe is located directl over tank baffle (does not give accurate measurement of solids accunulation).
if tanks have not been pu�out uithin the last three years, they should be p�xnped out nou.
DRAINFIELD CONDITION (11-14): jf
L'_
�y�infield inspection indicates:
e 1 Drainfield is dry, no surfacing evident.
�Sane 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 unknoun.
LIMITING SITE PACTORS (slope,setbacks.etc.): �,�J� p�� (,�
POTENTIAL FOR S1'STEM FAILURE Cdepends on soils uater table etc ): 1 Q G.J
� ' COMMENTS: O(�.l S - � P�'' () SL« t�C li'C GL� i✓ZS ' /(�
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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
tnformation.
This report must be kept on the pre�rises with the system locetion and p�mping records.
WHITE COPYllnspectors File YELLOW COPY/Homeowner
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�`���=� CITY of ORONO
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'�� �i�+�'}^' �,� ,�,ti Municipal ofFices
� l;}�� „���G Street Address: Mall(nQ Addnss:
�ESII�4 2750 Kelley Parlcway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
Owner: /V1G,� ;e Naq ber � Address: 3�f 8S C�� ;St;n 0�
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): 1
lO °CODE SYSTEM" An ISTS which meets ail the location,design and construction standards ofthe cucrerrt Orono Municipat Code.
2 COMPLIANT SYSTEM�� An ISTS which does not meet all the location,design and construction standards ofihe cwtetrt Orono Municipal
Code but does meet Ute thtee foot separation requ'uement,and which is not failing or an imminertt 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,desi�,or cons�uction standards of the current Orono Municipal Code and which is failing for any reason;and
any ISTS with less than three feet of unsaturated soil or sand between the distribution device and the limiting soil characteristics,
TANK CONDITION(5-10): S
Tank inspection indicates:
SO Pumpout not needed at this time.
6 Tank must be pumped out this yeaz (city code requires tanks to be pumped out every 3 yeats. Tank was last pumped I 9 9 9 �
7 Solids accumulation in tanks is at a ecitical a critical level. Tanks should be pumped out as soon as possible.
g 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"di�pipe)must be installed in each tank at next pumpout Iftanks
have not been pumped out within the last three years,they should be pumped out now.
1� Inspection pipe is located directiy over tank baflle(does not give accurate measuremerrt of solids accumulation). If tanks have not been pumped
out within the last three years,they should be pumped out now.
DRAINFIELD CONDITION(11-141: I I
� Drainf'ield is dry,no surf'acing evide�rt.
12 Some evidence of surfacing,not critical yet
13 Drainfield is saturated and visibly discharging untteated e�luent to the surface. Contact the City Inspector immediately.Repairs must be
completed within 90 days.
14 Drainfield extent and condition unknown.
coNnv�NTs:_ s,�stc�, �s d k
�-as-o� �'''�a�z ��
n,w.n,,,_
Date of Inspection Septic System Inspector "
Note: In the event that this inspedion report is used ta satisfj,the requiremeirts for a mortgage or other transfer of propeRy,be advised that this report does not guarazrtee
or ceRify that an existing system will continue to function properly,but is merely an opinion of the adequacy of the system under curreirt conditions based on the available
information.
�
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'' ������� ����� � CITY of ORONO
,\ � ��,�a�:r�� , � I'
'�'n ��� ��.���;':�~ ,�ti�/ Municipal offices
'� � '�A~, �� �
�`` '�ra'�.�`���¢�� Street Address:
�� � ; . Mailing Address:
$EggO 2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066 �•
To Current Owner: Address: 3y � S C�t:S}�:c, p �
City Ordinance 199 requires that each existing on-site sewa�e treatment system m 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 : �
1 "CODE SYSTEM" An ISTS which meets all the location,design and construction srandards 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 rystems installed 1996 or earlier,and which is not failing or
an imminent threat to public health or safety.
3 "NON-COMPLIANT SYSTEM" A prohibited[STS;an ISTS located withina desi�nated 100-yeaz 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 characteristics.
TANK CONDITION(5-7): b
Tank inspection indicates: •
5 Pumpout not needed at this time.
OSeptic tanks must be pumped out this year (city code requires tanks to be pumped out once every 3 years.
Tank was last pumped �l—1 —R5 ).
Make sure seatic tanks are pumped throueh manhole and not throueh R-hite inspection aipes This allows for the
proper 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 tank. If
tanks have not been pumped out within the last three years,they should be pumped out now.
DRAINFIELD CONDITION 8-10 : _�
8 Drainfield is dry, no surfacing evident.
9 Some evidence of surfacing,not critical yet.
10 Drainfield is saturated and visibly discharging untreated effluent to the surface. Contact the City Inspector
immediately. Repairs must be completed within 90 days.
COMMENTS: 1� ►�:� 5���v�.�.. C�, .i,�(S � ' � ; r�•o,;�� , $1-e +� • .�rd•�
� ���:� P�" � SC�r� L ����I�S Qc�t � ZvC�—f � V�° �S
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Date of Inspection hfatt Botterman - Septic System Inspector
Note: In the event that this inspection report is used to satisfy the requiremen�for a mortgage or other transfer of property,be advised that this report does not guarantee
or certify that an existing system will continue to function properly,but is merely an opinion ofthe adeGuacy of the system under current conditions ba�ed on the available
infortnation.
Telephone(952)249-4b00 • Fax(952)2�i9-4616
www.ci.orono.mn.us
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� ,�r �����;�,:;- �' CI�'� of �RONO
��\� °� '',,,� �t ,;:�.��_ �C�,�� Municipal Offices
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� �'i�`�� r� �,�`�`{`` G--; Street Address: q Sa-a4 q—y bo O Mailing Address:
�'`�"9$ESKp4'���:= 2750 Kelley Parkway P.O. Box 66
���-��� Orono, MN 55356 Crystal Bay, MN 55323-0066
To Current Owner: Address: ��� �� ����.�.���'!/l!'� � �
City Ordinance 199 requires that each existing on-site sewaje treatment system in Orono be inspected every rivo years.
The on-site sewage treatment system at the above address has been inspected and appears to fall into the categories checked below.
SYSTENi CONFORMITY (1-3): �
1 "CODE SYSTEM" An ISTS which meets all the location,design and construction standards of the current Orono Municipal Code.
2 "COMPLIANT SYSTEM" An ISTS which does not meet all the location;design and construction standards of tlie 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 i�ninent threat to public health or safety.
3 "NON-COibIPLIANT SYSTEM" A prohibited ISTS;an ISTS located within a designated 100-yeaz flood plain,any ISTS which may
or may no[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(5-7): S�
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 )•
Make sure septic tanks are pumped throuQh manhole and not throuah�vhite inspection pipes. This allows for the proper
cleanin� I�eep water softner and iron filter dischar�e out of septic system to prolon�life of drainfield. Ask pumper to test
alarm float to verifv alarm is still workin�in Vour house. The alarm warns owner that septaae is about to backup into basement.
7 Inspection risers missin�-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 COiVDITION(8-10): �
8 Drainfield is dry,no surfacing evident.
9 Some evidence of surfacing,not critical yet.
10 Drainfield is saturated and visibly discharging untreated effluent to the surface. Contact the City Inspector
immediately.Repairs must be completed within 90 days.
COMMENTS:
_ � � -- - 1
� '� ��^ �
Date of Inspeciion Septie System Inspecto;
_ /
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O �,s, � O CITY OF ORONO
� � Municipal Offices
r�,, � � �, Street Address Mailing Address:
�� G'�' 2750 Kelley Parkway P.O. Box 66
�i Orono, MN 55356 Crystal Bay,MN 55323-0066
�kESH��'
To: The Current Owner of Address 3485 CHRISTINE DR
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) Pump out Needed
Yes �No
The city recommends the septic tank(s) and/or lift tank be serviced and pumped out every three
(3) years. City records indicate the tank(s) were last pumped out on � ( � d �
The tank(s) should be cleaned through the manhole and not through the inspection pipes, this
allows for proper cleaning.
Comments:
�
Inspector: °� � DateofInspection: � "G�
Telephone (952) 249-4600 • Fax (952) 249-4616
www.ci.orono.mn.us
• � • •
e
To: Orono residents on mound type septic systems
From: Wiliie Gibbs, ISTS Manager
Date: May 10, 2006
Re: Landscaping Do's and Don'ts for Mound Systems, Quick Reminder
Do plant and maintain a full cover of grass and keep mowed to a normal height, this grass cover aids
in the evaporation of large amounts of effluent (the fiquid 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, sparingiy.
Do avoid unnecessary foot traffic over the mound, mow it and sfiay off of it. This is especially true in the
winter time. Even human foot traffic can cause frost to penetrate the mound resulting in potential
freezing problems.
Do inspect your mound system annualiy for winter kill, (reseed if necessary) animal damage,
(burrowing)or signs of potential failure.
Do not plant trees or shrubs on the mound system, smalfer 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
09/16/2010 16:16 7634988290 RUSTVS PERC TESTING PAGE 02 /
✓
' � Minnesota Pollution Compliance Inspection Form
Control Agency
520 Lafayette Road North �stlryr Subsurlace Ss�vvage Troat�nent Syst�ms (SSTS)
St.Peul,MN 55155-4194 Instructions on page 7
Parcel nwnber: 051 1 7231 20021 For Local Tracking Purposes:
System status: � ComplieM ❑ Noncompliant
(based o�►ell�ompllance requlr�ments)
Summary Form
Property Information
Property aiwrter neme(s): CartGon H
propetry addrsss_ 3485 Christine Drive,Ororw,MN 55359
Ptc�pe�ij►vwne�'s eddress(if dilfwonq: „__�
CcuM�r: Hennepin Properiy owner pho�ne: 612-38�0-8118 Pe�mitdrtg eutFwrity: Cit rLof Orono
Date system constructed: 77/16/89 Reason fo�inspecdon' , Property Transfer
System Descriptlon
Ap�rCaclmstely 2-1 SW gallori septic t8nk8,1-15Q0 gallon lift stadon end Appro�aimately 630 aquare
Brief system description: feet of mound roc9cbed.
l.ocal pe�mlt number ____.. Numbe�of bedrooms: 6 Design flow rate: .83
b tlw sy�6am:
In Shor�e�d aree? ❑Yes � No In WeQhead Prvtectlon Area? ❑Yes �No
An U_S.Environmer�tel Protection System serving a Minnesota Departrner�t
Agency(EPA)Class V 4njecUon Well?�Yes � No oi Heath(MOH)licansed f�cility? ❑Yes �Nv
C0111p�tdllCe St8tU5(Besed on SFat�requiremer�ts–addilional locel requfremar�ts may elSfl apply.�
Based on tho information gathered end repoRed on atteched fortns,the�mpllence steius of this system is(chedc one):
Q�CerfHica�e of CompliBnCe–valid until(3 yee►s!ra►t da6e af iepo►Q: ' �I14J2010
❑Naboe Of Noncomplience-For Noncomp�ieM sy�ems:
The�son For nonoornpl�r�Ce is:
This noncompllant syateim I�clas�lfled as(check one bolow):
❑lmminent threat to public health&safet}r ❑Feiling to protect pround water ❑Not fn mmplianCe with ope►ating nermft
C@ft�f4C8t1011(Completed form mu�t be submitted to the locel unN afi gavemment wlthin 15 days.)
1 hereby ce►tify thst sll the ne[�esssry infvimetion hss bee►►gsthe►ea to de(�em�►re tt►e co/►Iplia/x�e staius o!thls system_1Va
detemy��an of futu�p sysllam peifivrrnance has been r►o�can be made due to uMaiow»aa►di�ions du►Ing system aonstn�ctlon,
possible abus+e of dl►e system,inadequa�e meintenanoe.a�r fidu►e water u�8ae-
Neme: Joaeph J OI� Certific�tiori nurt� 1255
Business Ifcenae name and number Rusty Otson's soil and perailatlon bestfng Lic i�810 or
Neme of local unit af govemment C of Orono ..—
Signatune: DaLe: 8V15J10
Requi�ed Attachments Inap�ctor Completie:This Inspectlo�Report is�pape�long.
Ct�cic compliance foems atmched: �����wertormence Q�Tar�c�ntegr9ty �so��sepa�adoa D���'�9 Po^„a Fom,(�
aPP�b�) 0��draxring/As�Dullt drawin9 ❑An s�nenl of arry local nequlrort�s thet are dMls�erit iram wAat I�required on thi6
fOrrrl �SoN Borin9 Lops ❑Abandonmord 1am(If appropria�) ❑ONIer IrrMnnatbn(1'st):
UP8f8d@ Requi�mwtb(deui�d fiOm Mlnn_Stat§115,551 M tmminent M►wt to DVOIIc heeAHr srrd sall�b fl7nHS)must Ae uP9��.�spec�Gl or
Rar use dle�vntinustl w�IhM ten monHrs of rettlpf o/M�s notloe or rriMln a sAa/[er Derlod�7►e9uhsd�Y bCel ordinencs.A'�Je syaUovn is f9ilinp to D/obBd�ur�n0
wetsr tlw sys►e+n muat bs upylsae0,�pfeoad,or ita uss 0(eoonMwed w�ln fA.tlmo►eCul�6d by bcal aO/n�noo,If en exLstiny BY�w�is rrnt faiNnp es Oelb+ad in
lew,en0 Aas at l�rst nro Imat ot�sign sadl s��sdlo�.Ghen ehs ayanrm nee0 nd be upg,adetl.�ah�d��el�aoed,or fts u.st dlsoontinueol.natwlthaRenGing e►►y
lacsl ordlrrance Met�S mo►s a6id 7Ats p�vlsl�on doea not appryr 90 sysOsms!n aho�afend areaa.NbN4hoad PmtecE�on Msas,a those ussd M conrtectlon wi�faoq
bAYMiGe,N�d lodg'ag effisDl�f►IIIN►!8 99 denned in law.
wq-wwlsts4-31 Canpliance/respevccfon Form for EkisNng 5575
09/16/2616 10: 16 7634988296 RUSTYS PERC TESTING PAGE 03
Paroel number. 0511723120021 � System status: �CompliaM ❑Noricompliant
(as determined by tltafs fom�)
Hydraulic Peirforn�ancv and Othor Compllance
Compliance Issue #1 of 4
Oate of obaervation: 2/15/10 Reasvn for oDsenratlon: Property 7ransfer
Thig form expires upon naxt inspection or in ttu�ae years,whichever occurs first: 2/15/13 _
Cvmpliance questiorfs/Criberi�: (Requiroed) VerfRCadae Metl�od': (Optianal)
Check the a riate box (Check the app►opriet�a box)
Does the system dlscherge sewage to the ❑Yes � No � Searched for surface outlet
round surfeae?
Ooes the s�rstem dis�erge sewage m drain ❑Yes � No � P�"��draulic t�est
tile or surface waters? � Seerched fo�seeping in yard
Does the system cause sewege backup ❑Yea � Na � Chedcod for badcup in home
into dwellin or establlahment7
❑ 6coesBive ponding in soll systeml0-boxes
Do othe�situa�vns eudst tfiat have the ❑Yes �No [] Homeowner testimony
potentiat io immediately end edversely
impact or threaten public heal�or safety ❑ Exsmined for surging in tank
elgCt�iCal unsafe covers etc. ?
Any"yea"an�aw�er Indlcebs Uwt tIw ay►atem(s an ImrMnmrt ❑ "81adc so��"above soil dispe�sal system
����pq���ry���/�y, ❑ S�rstem requlres'emergenc.y"pumping
❑ PerfioRned dy�e test
Doea the sys6em po�e a threet to�round ❑Yes �No ❑ Ottier:
water for any aondi6o►►s deenred rwn-
�rotecdve 8s de4ennlned the' ,,,,� .
"Yes"ind�taCY�s ohat tlw�ys�n ia falliny to pro69Ct _
ground wet�r.If"ysa",describe drs�ondltbn noted:
'No standercl proi9ocoJ eixists- Thls//st!a not exhaustive,
in s+�quendal oNer, nor dbes it indicete which
combinatior►s�ie ne�essary to meke this determinstfon.
Certification
This form is to be oomple�ted and aKach�d to the Summary Fom�of the Minnesota Pollution Corrtrol Agencys(MPCA)Compllamce
Inspection Form for Exl�tir�Subsurigca Sewage Treatrnent Systems.Obs�netivns,ir�berpretations,and candusions must be
completed by an inspector.Completed fvm►must be suMrdlb�d b the Ixa)unit of govemme�withfn 15 days.
P�operty awner name(s): Cartton Hagberg _ .,.__
Prvperty address: 3485 Chris6n�Drlve,Orono, Mld 55359 � _
Property ovmeNs address(if d9tPerenq:
County: Henne In _ „ ,_,�_ Phone: 612-36fl-8118
1 hereby caertify thet 1 persana0y made the observetlons,int�rprel�tions.and oonduaiars repOR+ed on this larm and that they ar�r
norreCt-
Name: Joseph J.Olsqn Certiflcation number: 1255
Business license name and number: Ru�y Olson's soil and�„er+culetion teeting Lic#810 or
Name of local unit govemment: C�d ,' ,of Orono ,
SignaUure: _ Date: 8l15/10.,.„'.__- -
r„4_�saq_3� Compliance In��,pection Fvrm�nr Exlsting SSTS
09/16I2616 10:16 7634988296 RUSTVS PERC TESTING PAGE 04
_�r . . .� .. ..• .r. �....... ��. ................. �v.,-.i��-r��i N.c
Darcel number �Rem atatus: ❑Compliamt ❑Nonco�ltar�t
(es estermined by thla fbtrrtl
Tsak Intopr�ty ��d Ss��ty Cornplla�ce - Compliance lnspecffon Form for Existing SSTS
Cornp�ance I�sue #2 oF 4
Odb of�rvatfon: 9/14l10 Rsason 1or of�erva�n: �Gueat b�m Nnmeawner
This f�rn sxpirss an(t�res lr�sr�)- 9I44/10
Compliwnce quQstbnslp'16ae1�: (R�qulrod) V�riflciljo�t M�fiod":(G�onal)
Check ths -ats (Chec�r fhe sp,propasts box)
Does�e syatem r�►�siet af�se�ade piC, []Yes �No � Probsd tarfk�ottom
xas ocl d ell or I achin
❑ Observrd law liquid kvN
pa any s*w�p tfnk(s)Ioak Eelow their ❑Yes �No
de�gn.d opar�tinD de�� ❑ Examined construction recorda
if yc�,idenU�y whioh � Exam�ned�fi/iP�mP�dJ cank
sewage hnk leaka. Q Probed oLffiids osnk for'�blacK�of!�'
,4ny'yea"i►�r�'lndlost�s edat A�sy�tesr is lidNay to prr�ci p Pre�ut�elvacuum check
pround�r.
❑ Oiher.
' Seepsp�pNs moef�9 70�.28�may be comp�snt f(dlowad
in ordinen�by Ixsl pemut�n�aud�orlty.
"No�i�OtM Prolowl eY�. Tlria liat ls nof�xha�Nur.in
y�qu�tisJ o�ir,nor Qoe�li indica(m whloh corabFn6f(onw
�r�tisosestry Eo make Ehia dafe�tnTn�6'on.
58f8'�G'IHCMC
1. Are maln�ensnoo hole coar�t d�rrsaQed,c»claed,or appeared b ba struc�uralip unsoucd? ❑Yes' �Alo
2 lhlere melnber►ance hole�ovsrs ropia�xd irt e seaaed mrmer(e.p.,sva�n�s replocsd)? �Yes ❑No`
3. H/es meoandary aooe�s re��i�rtp�esor�t(s�lf9hr Ra���^d cover.a►ash�tyY nq�8r�—hignhr roca�mend�d. ❑Y���No
a_ are aiher saietvm�s i�uo P'r�m7 =]Ye6• �Wo
6�lain: "
�Sy�tan Is an(mmlrw►n dtn�to puMlc hNff��nd safiey.
Cerdffcetion
Tfti�finn fs eo be c:omPlmt�d�nd�tschad to Ote Stemm�y Form of th.Marmetota Pollution Cortrd A9■ncy'e(M PCA)Compllance
Inspootlon Form 1bt Ex1�n0 Sabsurmae Swvap�Tre�tm�nt S�slenw.Obaervetlans,Ir�t�erpret�tions�gnd ccnchasions must be
camplat�ed bq an inmpedor, nwir�alner,or sqrvice prrn►i�sr.CcmpfsEsd tbrm�ba��mit�ed ho the locm unit of S+ovsrnm�nt within
1 S days.
propeny aymar rtame(s); Carl6on H be
Property ad�9ree�: 3483 GhNs�na O�e MePie P1�in.MN SS359
Property owr�6 aAd�(a�rent�
:.Ovrrty_ l�n�� FioV�tY ovme�{�+a��_ $1238P$116
f he+�by csrtifY ihet I peraonalty rnade 1Fie observab+o�ini�+tioil►B.�oondUsfona roporced on this Ibrm�►1d cP+et lhoy are
��.
Nams: Jamee B+'a msm Certlfir.atlon rwrnbe�
6u�ine�6cena�name and n�mder: Elmer�-P�ete�x►co• Ucens�218 or
Nsme of I it oT gov
����. p�: 9V'I4f10
www.pCa.stah.mn.u9 651-1�6-6�0 • 80o-6S7-3d6� • TTY 651-18�2-l33Z or 800-6�7-36ba � Aveiteble ih elGernatfve lormetc
,.,�,....�.�.?te . uat�o9 Aage 3 0l8
09/16/2610 10: 16 7634988290 RUSTVS PERC TESTING PAGE 05
Parcel number: 0511T23120021 Syst�em st�tus: �Compliant ❑Noncompliar►t
(es detem►ined by this form)
Soil Separation Con�pfla�e� and Othar Cornpllsnc�
Compliance Is�sue #3 of 4
Date of observation: Z/15/10 Reeson for�: Prope�iy Tiansfer
This infi�me�a►an�ii�m dnes n�ea�pWi�.
Compllanc�que�tion�JcMte�it: (Required) Verfticatlon Method": (Optional)
Che�k the riete box (Check the epp►oprfete box)
For systems buik prior to April t,1966,and not � Conduded soll observation(s)(attach bvring logs)
located in Shorelend or Wellh�d Protectton
Area or not serving a fvod,beverage or ❑ Two previous verificatione(attsch boring loga)
lodging esteblishment: 0 Oit�e�:
Doea the eystem heve at leaat�two-foot
ve�ticel separ�tion di�tance from pe�iodlcally
setur�ted soil or b�dr�pck? Yes No
For no�rperformance systems built April 1, �
1886,or later or for non-perfnrmence Bysf�ems
localed in Shor+el�nd or Wellh�d Protecticn Sol{obsLwatlan does nol expire.Previovs observ�tlone
Areas or eerving e food,beverage or lodging by two inclependent perties are s�iderrt,unless site
�stabli�hmeM: cond�ions h�ve been altered.
Does the system heve a three-foot vertical
sepere6on distance from periodicaliy s�turabed
soil or bedrock?' Yes No
For reduoed seperaUon dlstance syst�m�(i.�.,
"perfo►mance°systems under old 708U.D179 or ' MeY be reduced by up ta 15 pen:er►t if eaowed in loce/
Type IV or V system under new 7080.2350 or Q���•
��•2��� -�!Va stenderd pio�tor.o!exists- This dst rs not euchaustive,
Do�s the sy�tem meet the designed vertiCal �n�quential order, nor does It Irrd�ete which
seperation distenoe from pe�iodically satu►�t,ed c�ombineha�s are n�ce�ssary t+o meke this
soil or bedrock?" Yes No deCennlnadfon.
Airy`no'anaws�r ti�dlcsbs Ni.t ths s'►a�b�m is f9�il/ng 1�pro1�.'t
��
Certffication
This Torm Is to be campleted and etteched to the Summary Fortn Of the Mlnnesute Pollution Control Apenq's(MPCA)Complisnoe
Inspectlon Form Mr E�clating Subaurfiace S�wage Treatrnerrt Systsms.Observe�ons, iMerpratations, and condueions must be
completed by an inspedor or designer.Completed form must be suhmitted to the local unit oi govemment within 15 dsys_
Property owner name(s): Carlton Hegberg
Property address: 3495 Christi�e Drfire,Orono,MN 55359 ,,, „w
Property owners address(if d�fsrenU: ---�,
Courn�r: Henne�i,n Phone: 612-380-8118
!here9y oe►tilS+tflat/personeNy mede the observations, int�rpretetions, and concluslons reported on this form end thet�hey e►e
cbI►ecr
Name: Joseph J.Oleon Certification�umber: 1256
Buslnese Ilcense name and numbe�: Rushr Olson's soil and percu{ation beetlng Llc�810 or
Name of loc�)unit of ganremment= Cih ot Orono
��; Date; 2115110
woq-wwTsts4-31 • Compliance Ira,pectfon Form for Exlstfng SSTS
09/16/2010 16:16 7634988290 RUSTYS PERC TESTING PAGE 06
Los�s of Soil Borinas
License#610
Location or Project: 3485 Christine Drive
Bonngs made by: Rusty Olson's Soil and Perc�esting 2/15l2010
ClassiTication Sys�em: AASHO ; U3DS•USDSSCS X ; Un�ed ; Other
Auger used (check two�: Hand X , or Puwer , Flight, Bucket or Probe_X
Bench maric is top of basem�nt concrete slab. Elv.•100.00 Assumed
Boring Number_1!Su�face elevation 100.0_ Mottled Soil �t�3.3_feet
0"-40" Dack brown loam 10yr3/1 H20 present at_X
40"-6�" Rusiy brown loam to clay loam 10yr4/2
80"-72" Rusty brown clay laam 10yr5/3
TBM: Ground at soil baring#1 Elv.-100.00 assumed
Original soil under the rockbed Elv.-99.5
Bottom of rock bed Elv.-100_5
There is1.0 feet of sand under the rockbed
09f16/2010 10:16 7634988290 RUSTYS PERC TESTING PAGE 67
vaN i-� i���.��N �niimi �.ra�via�ii�.v. rwv�i 6-r�� � r,�
Z`aIlk R�OTL
Date: ����14,2010
�Imer J. Peterson Ca.
�9�?1 Dagve Ave.
Delano, MN 5332s
Phone i63-9?�L-2�20
Fax 763-s72-'FL1�
MPC.�1 Licen.se# 219
Ceriton Hagberg
3485 Chri�ine D�ive
Maple�eln, MN 55359
13at1`1es: ON OFF
Tank Csipacity: �'��0 ���onTenks
# of Tanks: g
Type of Tanks: Con«�ec�
3300
Gallons:
�Ianholes co Grade: YES � NO
Comments:
On Sep�ember 14.2010� Elmer J. Pelerson Co. Pumped TaMcs- No Crecics ar Waler Leaks At Thet Time.
�iOTE=Tliis is only a tank neport. Tbis i�,not a campliance inapection for point of sal�nor docs
it replacc n complisnce in�poction.
License # �19
69/1612010 16: 16 7634988296 RUSTYS PERC TESTING PAGE 61
FAX COVER SHEET
Ruaty Olson's Soll And Asrc. Test/ng
11481 Riverview Road NE.
Hanover, MN 55341
OfTice 763-498-8779
Fex 763-498-8290
SEND TO
Compeny neme F�om
Ci of Orono Jose h J.Olson
Af�►nHon pe�
Willi�Gibbs 9/18/2010
Office location OfiCA focetion
11481 Riven►iew ro8d NE.
Fex number Phone number
952-249-461B 763-448-8779
❑ Urgwrt ❑ R�plY A3AP � Plesss oo�mmOnt � Pl�sar►aWew x� For�rour InADrn�+Bon
Total peqe8,including cover. 7
COMMENTS
Septic cert for 3485 Chnsti�e Drive
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sefile .:............_....�........_..........__.._._.._...,:,..:.,..,......__..__..
_._.__._.._.._.._.__..._......................................:....:.. ......... .......... -____..._.�..._._._...
If ou have en uestions .�ease.call... Thenk You__..__..... ..._. ._.._.__»..---:�,..__. .... .....................-..._........._.�....._..._.
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��orua c.a P
Certificateof Survey �
forBetz Builders , Inc .
of Lot 4 , Block 1 , BETZ ADDITION
Hennepin County , Minnesota
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e `$o�� ]o`N17.L7 �n /^ � r
d�� � �; ��y$Z��� Q � I : hereby certi fy that th i s i s
'� �ar= o F F � �9� s" ,._ .. -�' a t r u e, a n d c o r r e.c t r e p r e s e n-
'r '� "'i ' -"'—"' '" � �� tation of. a survey of the� .
'� boundarie.s of Lot 4 , _ Block 1 , '�
_ -- - �� _ �
�' BETZ ADDIT:ON , Heh,nepin. C_ounty
.� � ,- ' 9��•'� � Min.n.esota , and the propo.sed
�!- �' � � ° location of a proposed, bui �d- �
, � rl � � ' ���es�'�� � ing...thereon . :It does n.ot pur-
� �� a ;- �,
C �w'� ✓ port to�� show a:ny other� im.-,
\� �~ �`" � �, pro,vements or enc�ro?.chments .
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COFFIN & GRONQERG , INC .
�
�
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� t� 1� ��-�°��
� h ark S . Gr'onber'g f�1n . Lic . No . � 12755
� Engineers , Land Surveyors and Planners
\ Long Lake , Minnesota
� � �� - �
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, '�tf J%�,+�,�r�ti::�
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` � Sca-1e , : 1 'inch = S'o feet
�- - � Date : 8-24-89
• o : iron marker
Datum • Mean sea ;l,evel
. (9�3,�) : Spot .elevation. , _
79_7 ?lI
.
►
Certifi w� ��� ! � � �.��,� � � 'r'� � , .
for Betz
o f L o t 4 , B 1 c l �,�.5� w 1��';v��`T � S.��� C-
Hennepin C (T `J
. �-/dv,A.'c.- �lN•�-'L . ���z /��`r��S
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9a ,�) s� �; ��5$ �� I; hereby certify tha.t , th,is _ is
'� �.�wt�rs _n�- r�c.� C .. f a� true:. and corre.ct • repre.sen-
`� " '' ' ' '�T� �� "�— � �— t.ation of: .a surv� of the�
Y.:
boundaries of Lot 4 ; . Block 1 ,
� � �� - �� B.E:TZ ADD:ITION , Heh,nepl.n:; County
� � � � � �y��"�� � o Min.n.esota , and the propos,ed
��--- \ � l;ocation of a propose�, :b.ui !d-
� � �,�-J �, -- �` �• 9s�'9� � ing.:.thereon ::� :It doe,s. not pur-
�� ��u'� �. -� � � port� to�- show a:ny o;ther�, im:-_ .
� pr. o,vements or encro�.chments .
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'`��' COFFIN & GRONBERG , INC .
..-, ' �
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� ,.t�� � /�-n,�l���,
� � � a��S . Gr"o bn erg f�n . Lic . No . � 12755
� �` Engineers , Land Surveyors and Planners
� \ Long Lake , Minnesota
\ (� \��,,
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•' = so feet
..: . . . � . . Scale . : . 1. i_rtch
._ . � Date : 8-24-89
` - ' � o : iron marker
_ Datum - . : Mean ;sea ;l,eve;l `
, . :. � (9c3.�) . : . �� Spot: .e,le:va;t�o.n. .,� ; �:
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