HomeMy WebLinkAboutseptic info Oct 10 14 12:07p Joseph Olson 763-498-8290 p.1
. . . RE��" .n.
OCT 13 2014
, CITI° OF ����J6'��3
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Fax Trans�n.ittal Form
Date: 10/1�/2014 Tatal Pages: I� �
To: City of Orono
Phone Number:
Fax Number: 952-249-4616
E-mail:
From: Joseph J Olson
Phone Number: 763-498-$779
Fax Number: 763-498-8290
E-fTtell: rust 2654 corncast.net
� Urgent
[ For Review
[ Please Commenr
[ Please Reply
Message: This is the septic cert far 2b�5 Countryside Drive
W. Please file.
Oct 10 14 12:07p Joseph Olson 763-498-8290 p.2
. �
Minnesota Pol6ution Compliance Inspection Form
Co�tral Agenty
SZOlatayetieRoadFVorth Existing Subsurface Sewage Treatment Systems
5t.Pauf,MN 55155-4144 �$$TS�
Doc Type:Compliance and En(orcement
For loeal trackin —�
Instructions: inspection results based on Minnesata Potlution Control Agency(MPCA) ���yED I
requiremenis and attached forms—addfional local requirements may also apply. � I
Submit completed form to Locar Unitof Govemment(LUG)and system owner i �1��^ � 3 �
within 45 days u 1 ��14
System Status
CITY OF ORONO
System status on dat,e�rr�mfddlyyyy): 10/7/2014
� Compliant-Certificate of Compliance � Noncompliant- Notice of Noncompliance
{Valid for 3 years from reporf date, unless shorter time {See Upgrade Requirements on page 3)
frame outlined in Loca(Orziinance.J
Reason(s)for noncompliance (check all appJicable)
❑ Impact on Public Health(Complrance Cornponent #1)—lmmrnent fhr�at to public health anc!safety
❑�ther Compliance Conditions(Complrance Component#3)—lmminent threat to public heafth and safefy
❑Tank Integrity(Compfiance Component #2)—Failing to protectgr�undwafer
❑Other Com�liance Conditions(Compliance Component#3)—Fai�ing to protect groundwater
❑Soil Separation(Compliance Componenf #4)—Faifrng to profect gr�undwater
i� Operating permitlmonitonng plan requirements (Compliance Component #5)—Noncompliant
Property Inforrnation Parcef IO#or 5eclTwp/Range: 04117-23-13-0006
Properry address: 2655 Cauntryside Dri�e W.,Orono, MN _ _ Reason for inspect9on: Property Transfer
Property owner: _hJeil Levy _ � _ Owner's phone: 612-747-8265
or
Owne�s representative: __ __ Representative phone:
Local r�gulatory auihonty: City of Orono Regulatory authority phone: 952-249-4600
2-1300 gallon septic tanks,l-1300 gallon lift statian and 630 square feet of mound rockbed.per city
Brief system description: records
Comments or recommendations:
C�ftlflCd�'IOrI
1 hereby cerfify that a!1 the necessary informatian has been gaYhered to determine the compfrance status af this system. No
determinaUon of future system performance has been nor can be made due to unknown conditions dunng system construction,
possrble abuse of fhe system, inadequate maintenance, or future water usage.
Inspector name: _Joseph J Olson _ _ _ _ Certifica#ion number: 1255
Business name: _Rusty _Ison's Soil 8�Pe stin� � License nurnbec 890 A
Inspector signature- _____ Phone nurnber: 763-498-8779
Necessary or L�calty Required Attachments
�Soil boring logs �System/As-buift drawing ❑ Forms per local ordinance
❑Other information(list}:
wvrw.pca.state.mn,us • b51-296-636Q - 800-657-3864 • TfY 651•Z82-5332 or 800-657-3864 • Available in aitemative formats
wq-wwrsts4-31 � 1/Z4112
Poge 1 of 3
Oct 10 14 12:07p Joseph Olson 763-498-8290 p.3
Propsrty address: 2655 Counfryside Drive W., Orono,MN � Inspector initialslDate: J. O. 10/07/9�
1, frtlpaCt o� PUbIiC Hedith —Compliance component#1 of 5
Compliance criteria: _ ` Verff�catior�rnethod{s�:
System discharge sewage to the � ❑Yes 0 Na I� Searched for surface ouUet
ground surface. _ � Searched for seepiRg in yard/backup in home
System discharge sewage io drain tile Q Yes �No ❑ Excessive ponding in soPl system/D-boxes
or surface waters. _ ❑ Nomeowner testirnony(See CommentsiExpla�ationj
System cause sewage backup into ❑Yes �No � �glack soil'ahove sail dispersai system
dwelling or establishment. , ❑ System requfres"emergenc�'pumping
- - -- ❑ Performed dye test
AAy"ye,s"answer above indicafes the system is ❑ Unable to verify(See Comments/Fxplanation)
an lmminent Threat to P�blic Hea/th a»d Satety.
--- _____ ❑ Other methods not listed(See Comments/Fxplanahbn)
Com ments/F�cplanati on:
2. Tdnk Itltegrlty—CompJiance component#2 of 5
_Compliance criteria: __ _ _ _ Verification method(s):
System coRsists of a seepage pit, �Yes B;No � Probed tank(s) bottom
cesspool, drywell, or leaching pit. I
� Examined construction records
Seepaye pits meeting 7080.2550 may be ' ❑ Exarnined Tank Integrity Forrn(Ad'ach)
complianY if aJlowed in hxaf orrlrnance.
❑ Observed liquid leyel below operating depth
Sewage tank(s) leak betow their ❑Yes ,� No
desi ned o eratin de th. ❑ Examined empty(pumped)tanks(s)
If yes,which sewage tank(s)leaks: I ❑ Probed oulside tank(s)for"black soi!"
Any"yes"a11SW�.'r BL}OVE 1lIC/fCBt@5 fI1@ ❑ Unable to verify(See Comments/ExplanaL'on)
system is Fai�ing to Protect Groundwater. ❑�her methods not listed (See CommerrtsiExplana�ion)
C om menis�Explanati an:
3. Other Campliance Conditions—Cflmpliance component#3 of 5
a. Maintenance hole covers are damaged,cracked,unsecured,or appear to structurally unsound. ❑Yes* � No ❑Unknow�
b. Other issues(eiecbicalhazards,etc.)to immediately and adversely impaci public health or safety_ ❑Yes" �No ❑Unknavn
`Systern rs an immirrenf ttr�at to public healNe and safety
Explain:
c. System is non-protec[ive of ground water for other conditions as deiermined by inspector ❑Yes' �No
'System fs failing to protect groundwater
Escplain:
v,nwv.pca.state.mn.us - 651-29b•6300 - 800-657-3864 . TrY 651-282-5332 or 800-b57•3864 • Available in alLernative formats
wq-wwiscs4-3i . 1124/?2 Page 2 of 3
Oct 10 14 12:07p Joseph Olson 763-498-8290 p.4
Tank Report
bQtP' OCtot��r7 2�14__
Elrrter J. Peterson Co.
�Q27 Daaue Ave.
�eiano.MN 553�8
Phone 763-972-2420
�ax 763-972-7217
MPCA License#219
'�ei!cr f,�ene L�vv
2655 Coun4rvside Drive UV
�ong LakE, MN 55356
fOrono)
612-?47-8255 I rene
Baff�es: ' ON / �FF
Tan�C Capacity: ____3`1300 Gallon Tanks Per City Records
#of Ta nks: 3
Type of Tan�,s; Cortcrete
Gallons Pumped: __3000
----------------------------------
T
Ma�holes to Grade:'� YES / NO
�- .J
Comments:
On Octcber?. 2014, Elmer J. Peterson Co pumped septic tanks. No cracks or wate�leakina at that t:ma
NO7E:Th is Rs only a tank report. 7his is not a compliance inspection ror poini oF saie nor
does it replace a compliance ins�ection.
Oct 1,0 14 12:08p Joseph Olson 763-498-8290 p.5
Property address: _2655 Countryside Drive W Inspector inikfalslDate= 1017/1d
'�. Impdc# Otl PUbI�C HE'dlth—Campliance component#� of 5
Compliance criter�a: _ Verifrcation method�s):
System discharge sewage to the � �Yes ❑No Q Searched for surface outlet
grovnd surface. _� I ` ❑ Searched for seeping in yardlbacicup in home
System discharge se�,vage fo drain tile � ❑Yes ❑No ❑ Excessive ponding in soil systemlD-bwces
or surtace waters. � ❑ Homeowrter testimony(5ee Comments/E�cplanation}
System quse sewa e backu nto ❑ °B!ack soil'above soit dispersal system
9 pi I 0 Yes ❑No
dwelling or establishment. �� ❑ System requires"emergenc�'pumping
❑ Performed dye test
Any°°yes"answer above indicates the systern is � �jng�j�e to verify(See Comments�Expfanatfon)
an Imminent Threat to Public Healfh and Safety. ❑ �her methods not i�sted (see commencs�XprB,�adon)
Com m sntslF�1 a na ti o n:
2. Tank tnte�rity—Compliance component#2 0€5
Compliance_criteria: ��� Verification metFtod(sj:
Sysfem consists of a seepage pii, i ❑Yes � No ❑ Probed tank(s)botfom
cesspool,cirywell, or leaching pit.
❑ Examined cQnstruction records
Seepage pits meeung 7080_2550 may be � F�camined Tank Iniegrity Form{Attach)
com �ant if aflowed in foca!orJinanca. _I
❑ Observed iiquid fevel befaw operating depth
Sewage tank(s)leak befow their ; (-'� Yes �No
designed operating depth. � � Examined empiy(pumped}tanks(s)
( --- -
If yes,which sewage tank(s) leaks: i ❑ Probed outside tank(s)for"black soil'
❑ Unable to veriiy(Ses Commenis�Explanation}
Any"yes"answer above indicates the
system is Failing ta Protect Groundwater: Q Qther methods not fisted(See CommentsiExplanaGon)
C omments/Explanatfon:
On 10/7/14,Elmer J.Peterson Co.pumped tanks_ See notes on adaehed tank repoR.
3. Other Compliance Conditions—Compi�ance component#3 of 5
a_ Maintenance hole covers are damageci,cracked,unsecured,or appear to siruCturaEly unsound. ❑Yes' ❑No ❑Unknawn
b. Otherissues(elecfricalhazards,et�.)to immecfiately and adversely impact public health orsafety. ❑Yes• ❑No ❑Unknown
'$ystem is an imminer�t threat ta public health and safiety
Explain:
c. System�s non-protedive of ground water for other conditions as dekermined by inspector p Yes" ❑No
*System is failing to protectgroa»afwater
Explain:
www.pcastate.mn.us . 651-296-630p • 800-657-3864 • T7Y 65f-282-5332 or 8D0-657-3864 • Available in aEtemative formats
wq-wwists4-31 . 7/1d/i2 Page 2 uf 3
Oct 10 14 12:08p Joseph Olson 763-498-8290 p.6
Property address: 26�5 Countryside Dri�e W., Orono, MN _ Inspedor initialslDate: J. O. 10/07194
4. SOiI Sepdt'atiOn—Compliance componer�t#4 of 5
Date of installation: 1112119 _ ❑ Unknown Verifica#ion method(s):
5horelandM/ellhead protectionlFood Beverage
todging? ❑ Yes � M1�o Soil observafion does nof expire. P�vrous soi!
observations by two independent parties are suffrcient,
Compliarece Criteria: unless srte condrtions have been altered orlocaf
i � � T— requir�ments ditfer.
For systems built prror to Apn/1, 1996, and �' � Yes ❑ No
notlocated in 5horeland orWellhead � Corfducted soil observation(s) (Attach 6oringlogs)
Protecfron Area ornotservinq a food, ❑ Two previous venfications(Ah'ach boring logs)
beveraga orlodging estab/rshmenf: �
❑ Not appliC2bfe(Holding tank(sJ,no drairrr7eld)
Drainfield has at least a two-foot vertical I ❑ Unable to verify(See Comments�Explanation)
separation distance from periodically
saturated soil or bedrock. Q other(See Comments/Exp�anation)
Non-performance systems built Apri!9, ❑Yes ❑ No Comments/Explanatlon:
1996, or later or for non perfonnance �
sysfems Jocated in Shoreland or We/Ihead
Proteclion Areas o�serving a food,
beverage, or lodging establisflment_ j
Drainfield has a three-foot verlical
separation distance from periodically
saturated soil or bedrock'�
�Expe,imenfal'; aOther�,or "Performance" ❑Yes ❑ No Indicate depths of elevations
systems built under p�-200&Rules; Type IV I - — ----
or V systems built under 2008 Rules(7080. A. Bottom of distribution med�a 99.0
2350or7080.24D0 (Advanced lnspector !
LiCense requfred) �I B, Pertodicaily sat�rated soillbedrock 98.0
Drainfiefd meets the designed vertical � C. System separation 2.7
separation distance from penodically I
saturated soil or hedrocEc.
D. Recruired comp�iance separation' 2.0
AfJy "!)O"answer above indicates fhe system is *May be reduced up to '15 percent if allowed by Local
Failing to Profect Groundwater. Ordinance.
5. Operating Permit and Nitrogen BMP*— Cornpliance component#5 of 5 � Notapplicable
Is the system operated under an Operating Permit? ❑Yes ❑No If"yes", A be�ow is required
Is the system required to employ a Nitrogen BMP? ❑Yes ❑ No If"yes", B be[ow is required
BMP=Best Managemenf Practice(s)specified in the system design
lf the answe�to both questrons is "no'; fhis section does not need to be completed
Compliance criteria
a_ Operating Permif nurnber — . []Yes ❑ No
Have 2he dperating Permit requirements been met?
b. Is#he required nitrogen BMP in�lace and pro�nc#ioning? ❑Yes ❑ No
Any "no"answer indicates Noncompliance.
Upgrade Requirements(Minn.Stat §'115.55)An imminent threat to putrlic heafth and sa(ety(f'fPHS)mus�be upqraded,replaced,orits use
dfscontrnUed sv,�thin ten monfhs of�eceipt of fhis rroilce o�wifhin a shonerperiod if reqvrred by local orriinanae. !f Ihe system is failing to profect
ground water,the system mustbe upgraded, repfaced,orits use discon6nued withrn the(rrrre requ�red bylocal ordinance. Jf an exisirng system
is nof faiGng as def+rred in law, and has at least two feet of design soii separation,then the system rreed not 6e upgraded,repaired,replaced,or
its use discontinued, nolwithstar�ding any loca!orr/inance fhat is more stricf. This pravision does rrot apply to syst�ms rn shoreland areas,
WelJhead Protection Areas, or those used in connect�orr with food,beverage,and lodging esfablishments as defined in law.
vrvvw.pca.state.mn.us . 651-2%-b300 • 800-657-3864 • TTY 651-282-5332 or 800-657•3864 • Avai�abte in alternative formats
wq-wwists4-31 - 1/24/f2 Poqe 3 af 3
Oct 10 14 12:08p Joseph Olson 763-498-8290 p.7
Loqs of Soil Borinqs
License#810
Location or Project: 2655 Countryside Dnve W.
Borings mac�e by; Rusty Otson's Soil and Perc testing 101312014
Classification System: AASHO ; USDS•USDS-SCS X ; Unified ; Other
Auger used (check twoj: Hand_X_, or Pawer , Flight, Bucket or Probe X
Boring Number_1____Surface elevation_97.9_ Moitled Soil ai X fest
���� F��� in origirral soils '
4"-14" Darfc brown loam 1 Dyr3/2 H20 present af_X
14"-26" Brown loam 10yr413
Boring Number_2_Slirface elevation_98.4` Moitled Soif at X �feet
D-o" Fi�! in original soils �
6"-16" Dark browrt loam 14yr312 H20 present ai_X_
16"-26" Brown loam 10yr4/3
TBM: Top of!ift staiion rr�anhole cover Elv.-100.D assumed
Boriom of rock bed Elv:99.0
Original soil urder the rockbed Elv.-98.0
There is 1.0 feet of sand under the rockbed
Oct 10 14 12:08p Joseph Olson 763-498-8290 p.8
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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 full cover of grass and keep mowed to a normal height, this grass cover aids
in the evaporation of large amounts of effluent(the (iquid left after the "other" 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 stay 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
freezin� probiems.
Do inspect your mound system annually for winter kill, (reseed if necessary) animal damage,
(burrowing)or signs of potential failure.
Do not piant 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 rnound system
please feel free to call me, !can be reached at 952-249-4626.
1
� . ,
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O � O CITY OF ORONO
�� -
� s �, MunicipalOffices
r�,, �,b' �, Street Address Mailing Address:
'''D
'C� G'�' 2750 Kelley Parkway P.O. Box 66
'�9 '�i Orono,MN 55356 Crystal Bay,MN 55323-0066
kESH�4
To: The Current Owner of Address 2655 COUNTRYSIDE DR W
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]egal 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 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 r p - d S '0.3
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: � 0 �
Telephone (952� 249-4600 • Fax (952) 249-4616
www.ci.orono.mn.us
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O
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:;-�;=�� � ,� CITY of ORONO
�, Z����,�-�� tiF► M�;��� ot���
� �i',:-�-r'�'��� �
� �,,-,r�,� � Street Address: MailinQ Address:
9$EggO�' 2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MM 55323-U066
To Current Owner: Address:__ a65.� Cauntrys;�e Qf , l.v�
City Ordinance 199 requires that each existing on-site sewage treatment system in Orono be inspected every two years_
The on-site sewage treatment system at the above address has been inspected and appears to fall into the categories checked below.
SYSTEM CONFORMITY 1-3 : �
1 ��CODE SYSTEM" An ISTS which meets a(1 the location,design and conswction standards of the current Orono Municipal Codc_
2 "COMPLIANT SYSTEM" An ISTS which does not meet all the location,design and mastruction standards of the current Oro��tunieipal
Code but does meet the three foot sepazation requirement or two foot requirement for systzms irtstalled 1996 or eazlier,and which�s not failia�or
an imminent threat to public health or safety.
3 "NON-COMPLIANT SYSTEM" A prohibited ISTS;an ISTS located within a desi�ated 104-year flood plain,any ISTS whiuh may-
or may not meet all the location,design,or construction standards of the current Orono�funicipal Code and which is failing for any reason;and
any ISTS with less than three feet of unsaturated soil or sand between the distribution de�ice and the limiting soil characteristics.
TANK CONDITION(5-7): �
Tank inspection indicates:
OPumpout 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 �0�5-b� ).
Make sure septic tanks are pumped through manhole and not through white inspection pipes 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 tanl:. 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.
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: N�o� �U �� SC��"� � '���k5 )pC�� (;�
-� � _ v3 - �,�
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 does noc warantee
or certify that an existing system will continue[o function property,but is merely an opinion ofthe adequan ofthe s��stem under curtent conditions baud on tbe ar ailable
information.
Telephone(952)249-4600 • Fax(952)2A9-4616
www.ci.orono.mn.us
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�� �= � ��--� � CITY of OR011T0
I,`�� A����;�; 'y ti I I Municipal �ces
�\,��f��4 7!,I:�°�n, �'/
, . .�'``k��G Street Address: Mailin� Address:
,
�9�CEggOg' 2750 Kelley Parlcway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
Owner: Neti� ��,v�� Address:_ abSS Ca�
nr�ys.de Dr �,v
Cit��Ordinance 199 requires that each esisUng on-site sewage treatment system in Orono be inspected every n��o years.
The on-site sewage treatment system at the above address has been inspected and appears to fall into the categories checked belo«�.
SYSTEi�1 CONFORI�IITY (1-3): �_
� ��C�DE SYS�M" r�,n ISTS which meets all thz location,design and construction standards of the wrrent Orono Vfunicipal Code.
2 '�C�N1Pj..If�IT $YS��1" An ISTS which does not meet all the location,design and constn�ction standards of the cucrent Orono hiunir.�al
Code but does meet the three foot separalion requirement,and which is not failing or an imminent t}ueat to public health or safzty.
3 "NON-COI�IPLIANT SYSTEM° A prohibited ISTS;an ISTS located within a dzsignated 100-year flood plain,any ISTS which ma�
or may not meet all the location,dzsigq or construction standards of the current Orono�funicipal Code and which is failing for any reason;a:_�
any ISTS with less than three feet of unsaturatzd soil or sand bztween thz distribution dzvice and thz limiting soil characteristics.
Tr�NF�CONDITION(�-10): S
Tanl:inspection indicates:
OPumpout not needed at this timz.
6 Tank must be pumped out this year (city code requires tarilcs to be pumped out zvery 3 years. Tank was last pumped S' d� ).
7 Solids accumulation in tanks is at a critical a critical 1zceL Tanks should be pumped out as soon as possible.
� Systzm is discharging to the surface. Tanks must be pumped out within 48 hours to eliminate surtace discharge.
y Inspection risers missing-tanks could not be inspected. Inspection risers(4"dia.pipz)must be installed in each tank at neM pumpout. If tanks
have nut been pumped out within the list three years,they should be pumped out now.
1 U Inspaction pipe is located duzctly ovet tank baY�le(does not give accuratz measuremznt of solids accumulation). If tanks have not bzen pumped
out within thz last thrze years,thzy should be pumped out now.
DRAINFIELD CONDITION(11-1=1): I I
1 1 Drainfield is dry,no surfacing evident
1� Somz zvidenca of surfacing,not critical}'et
1� DrainYield is saturatzd and visibly discharging untreated e@luent to the surface. Contact the City Inspector irnmediately.Rzpaus must be
complztzd within 90 days.
1-4 Drainfield e�ctent and condition unknowa
COM��NTS: 5Y 5�"eM I ook5 Ok
6-�� - o � �att
Date of Inspeclion Septic System Inspector �`
\ote: In tha event that Uus inspeclion report is used to satisfy the tequiremrnts for a mortgage or other transfer of property,be advised that this repoR does nct guarantee
or certify that an z�cisting system will continuz to function properly,but is merely an opinion ofthe adequacy of the system under current conditioc�s based on'�:a available
infonnation.
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} ;,, CITY of ORONO
� �
�, Municipal Offices
ti
�,�9 ¢,�G Street Address: Mailing Address:
kEBI;� 2150 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
�
Owner: / � �� Address: 2655 Countryside Dr. W.
Permit #'s: 7191 Dates: 7/27/95 Contractors: Clover Hill Co.
(This is [ �(] an existing system [ ] new construction) .
i �
SYSTEM COMPLIANCE (1-3) : 1
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.
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 id tified, this classification is subject to revision.)
NK 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.
10 One or more tanks are cesspools, which means the septic system is non-compliant.
i
(The tanks are [ ] or are not [ ] water tight or the condition is [ ] unknown. If the tanks
are not confirm to be watertight, this classification is subject to revision.)
��1INFIELD 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. ) : low
COMMENTS:
�
� � . �
Date of Inspection pt'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)249-4600 • Fax(612)249-4616
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CITY of ORONO
,� ,r;��. �,
tS� Municipal Offices
�� G~ Street Address: Mailing Address:
�`9jfEgK04'� 2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
�'— —
Owner: :�� Address: 2655 Countryside Dr. W.
Permit #'s: 7191 Dates: 7/27/95 Contractors: Clover Hill Co.
(This is � ] an existing system ( ] new construction) .
YSTENS COMPLIANCE (1-3) : 1
Code System: Meets or exceeds current City standards in all respects relating to design,
ccnstruction, 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.
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 [,X ] or is not [ � identified under this septic system. If the
saturated soil level is not identified, this classification is subject to revision.)
NK CONDITION (5-9) : 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 are not [ ] water tight or the condition is [ ] unknown. If the tanks
are not confirmed to be watertight, this classification is subject to revision.)
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. ) : low
COMMENTS:
�/-^���� , , ,_____.
Date of Inspection ptic System Zn pector
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
�
SEPTIC SYSTEM INVENTORY
Addr: 2655 Countryside Dr. W. PID: 04-117-23 12 0006
Building Type : residence # BRs/GPD: 5 # Systems/units : 1/1
Permit No: 7191 Date of Permit : 7/27/95 Installer: Clover Hill Co.
System Type : mound Appliances : lndry, dshw,dspl
SYSTEM CONDITION
Conformity: 1 Tank Condition: 5 DF condition: 11
Failure Pot : low
SEPTIC TANKS
Material : precast concrete Capacity: 1300 , 1300 , 1300
Setback to Bldg: 70
DRAINFIELD
Length of Lines : 200 No. Lines : 3 Trench Width: 10
Treatment Area: 97*40 Type of Filter: rock, clean sand
Tile Size : 1 . 5 Under Tile : 9 Perc Rate mn/in: 5 . 1
Setback DF-Bldg: 50 DF Ht above WT: 3
Soil Type : loam, clay loam Limitations : water table
WELL DATA
Setbacks - Well-Tanks : Well-DF:
Report in File? : Pump Type :
Depth: Diameter: Method:
INSPECTION RECORD PUMPOUT RECORD
Date Compliance Date Gallons
11/21/95 installation 1
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