HomeMy WebLinkAboutseptic info 05/ 9 14:20 9528733112 PAGE 61/69
� minnesota Pollution Compliance Inspe�tion Farm
• Control Agenty
SZO�afayetteRoadNorth Existing Subsurface Sewage Treatment Systems (SSTS)
St.Paul,MN 55155•419q
instructions on pag� '
Parcel number For Local Tracking PurposEs
System status; Compliant 0 Noncompliant
(based on aJ!com Ir ce requirements)
Summary Form
Property Information
Property vwner name(s): �, r` S' �
---.._...._,. ._ .._...
Property address; � �
,.....----... ....._... ---�
Property owner's address (if dlfferenq:
COun � - • - ---..._.
ry= Pro erty o ner phone; Permitti g authority:
Date system const ucted; � t�? Reason for lnspection: �jQ _� .
System Oescript3on
Brief system descr+ption: ��"G1,/'�f'�-� ►�� �(.Q r�l
�ocal pe�,nit number; umber of bedrooms: � Design(low rate; __.. �j� .
Is the systam; `�
In Shoreland area? Z�L Yes ❑ No In Wellhead Protection Area? ❑ Yes �No
An U S, Environmental Protection �—` 5ystem serving a Mlnnesota bepartment
Agency (EPA)Class V Injection Well?❑ Yes �No of Heath (MQH)�icensed facllity? ❑ Yes �No
Complld�Ce Status (6ased on state requlrements-additional local requlrements may also apply,)
Based on the information gathered and reported on atteched forms,the compliance status oi this system is(check on�t
�ertiFicate of Compllance-valid until (3 years from dete of r�portJ; ___`__ _
❑ Notice oI Noncompliance- Fo�Noncompliant systems:
7he reason for noncompl;ance is:
This noncompllant system Is classlffed as fcheck one below): ' �
❑ Imminern threat to public health& saf�ty ❑ Falling to protect ground water ❑ Not in compliance with operaung per�r.�
Ce�tlflCdt10t1 (Completed form must be submitted to the local unit of government within 15 days.)
!hereby certify fhaf aU the necessary informarion hes been gathered fo determine the compllance sfa�us ol th�s sysr�n� r��
determinafion ol luture system per�o�mance has been nor can be msda oue to unknown conditions durrng systern ca�sr��c;,���.
possible abuse o!the system,inadequ fe m�inlenance, oi future weter usage.
Name: __��,���b�►('��)�,(� Ce�tification number. ���,p�j�
Business license name and number: ���,�� SQ r�J I1.25 ,�L ��Qot __...__._. „ „ or
Name of local unit vern t;
_ _,�. __ . 9 . _
Signature: Date; �� Q
Required Atta�hments Inspector Complete: This Inspection Report is J`� pages long.
Check compli�r�Ce fom75 attaGhAd: Q�draulic Pe�ormance�Tank Integrity�oll SeFaration ❑Operating Perm��F�rrt,� f
applicable) �,ystem drawing/As-built drawing ❑An assessme a�y local requ e nls that are diflerent from whai�s req��rea on i���s
lorm ❑ Soil Bonn'g Logs ❑Abaneonmenl fortn(if approprlate) ❑Other intOrmation(1�31):
Upgrade Requirements (derrved frnm Minn. Sfaf. § 115.55)a�imminelif N1rt+al fo public heaph ond saltty(IrPHSJ musl De upgiaoeo.reo�acec :
�ts vse eJseonunued wilhi��sn mon�h�of�ece�pl o/IAis�ofin o�wifAin�ahohei penod�I repuired Dy locel ordlnance,/1 fAe sy,ster�r�s lad�ng ro orolecl o�a�rc
waler,IAe sysfem mvs(D�uppr8dsd,repl�ced,or Jts use eiseont�nued wilhln fne Gme repulred by loca!ordine�ce.ll an exislinq syslem�s no�I.v��.n<<5��;'r.=, •
low,and has al lees!Iwo lee!of Cespn soil separal+on,then fhe syelem nCed nof De upgre0ed,repei�e0,reD�acad, or its use O�sconnnueC.no;�v;rrs�,ar:=.::;;-,
�ocar orainence f�af is more slr9cl. Th/s provlsJon Qoes nol a0p�y�o sysiems�n s�oreland arees, WNlneqd Pro(eclion Arees,oi�nose used���;orT.�a;�,;r„;�• •
oeveraoe, and looginy esfabliaAmen�a as de/lned in law `�'
wq-wwis[s4•31 Compliance Inspection Form fo�E.��S;;ng SSTS
.�� �.,e
05/� 14:20 9528733112 PAGE 02I09
Parcel number; _ � System status: �ompHant � Noncompliant
� (as determined�y this formJ
5oil Separatiort Compliance and Other Compllance
Compliance Issue #3 of q � "
Date of observation: J / (� Reason for observation: _ � _
This information on thrs form od es ot expir�.
CompNarlce questionslC�iteria: (Required) VerifiCation Method": (Optional)
Check th��ropriate box) (Check the appropriate 6ox)
Far systems built priorto April 1, 1996, and not �Conducted soil observation(s) (attach boring logs)
located in Shoreland or Wellhead Protection
Area or not serving a food,beverage or ❑ Two previous veriflcations (att�ch boring Iogs)
lodging establishment:
❑ Other:
Does the system have at least a two-foot "' "" "�
vertical separation dlstance from periodlcally . .�,�
saturated soit or bedrock? Yes ❑ No
For non-performance systems built Apnl 1,
1996,or later or for non-performance systems —""' -" � - �
located in Shoreland or Wellhead Protection Sofl observaGon daes not expire, Previous observations
Areas or serving a food, beverage or lodging by lwo independent parties are sufficient. unless site
establishment: conditions have been altered.
Does the system have a three-foot vertical
separativn distance from periodicatly saturated
soil or bedrock?' _ Yes ❑ No
For reduced separation distance systems(i.e.,
"performance"systems under old 7080.0179 or " May be reduced by up to 15 pereent if allowed in loca!
Type IV vr V system under new 7080. 2350 0� ordinance.
7080.2400): "No 5tandard protocol exrsPs. This list is not exhaustive,
Does the system meet the designed vertical in sequentia!order, nor does if indicate which
separation distance from periodically satu�ated combinatrons are necessary to make this
,sail ar bedrock7' .,_ Yes ❑ No determinst/on.
Any"no"answer/nd�cates fhat fhe sysfem Is lailing to protect
ground water.
Certification
This form is to be completed and attached to the Summary Form of the Min�esota Pollution Control Agency's (MPCA)Compliance
Inspectlon Form for Existing Subsurtace Sewage Treatment Systems. Observations, inte�pretations, and oonclusions must be
completed by an inspector or designer. Co pleted form must be submitted to the local unit of govemment within 15 days.
Property owner name(s): � _ 5 , ..`--� ----•. --- . .^ __
Prqperty address: JQ�� _ ^_, l C�_.,..--,-.----- -._..._.
Properry owne 's address(if different):
—. .....,_.. _...... .... ,. _..._._ .__
County; _ 1�-- _._.. Phone: _,,, ----•, ..--�---
/hereby certify that 1 personally made the observations, inlerprefafions, and conclusions reported on fhis form and th�f they are
correcL
Nams; c�����'1(� _ _ Certification number: �1(�rj�_____ _
Business license name and number: ��j(� ���I(Q„� �l'1G _��
_,�. _.._... __ or
Name of Ioc21 unit of o rnme .
Signature: " ~ Date: ��-�--_� .__ -- —
� ,
wq-wwists4•31 Compliance Inspe[fion Form for �xisCing SSTS
4l1l08
05/ � 14:26 9528733112 PAGE 03169
Parcel number __ �_� ,� System status: �Compllant Q Noncompliant
(as determined��is form)
Tank Integrity and Safety Compliance
Compliance Issue #2 of 4 '
Date of observation: ^�>��(�� Reason for observation: . —
This form expires vn (three years):
Compliance questions/criteria: (Required) Verification Method"": (Uptionaf}
_ (Check the ap,propriate box) (Cheek the appropriate box)
Does the system consist of a seepage pit', ❑Yes �No Q probed tank bottom
cesspool,drywell, or leaching it?
Do any sewage tank(s)leak below their ❑Yes �No ❑ Observed low liquid level
desi ned o eraCln de th? ❑ Examined construdlon records
If yes, Identify which sewage �Examined empty(pumped)ta�k
tank leaks.
❑ Probed outside tank for"black soil"
Any"yes"a�swer!ndlcates that the system/s fa!ling to protecf
ground water. • ❑ Pressure/vacuum check
(] Other:
' Seepage plts meeting�080,2550 may be cvmpliant if allowed ��
in ordinance by local permitting authority.
"No standard protocol erists. This list ls not exhaustive, in
sequential order, nordoes if indicafe which cambinations
are necessary fo make�hrs determination.
Safety Check
1. Are any mainlenance hole covers damaged,tracked,ar appeared�o be struclurally unsound� ❑ Ye5' �No
2. wore atl maintenance hole covers replaced In a secured manner(e,g„ all screws repla�ed)? �,Yes ❑ No'
3, Was secondary access restraint present(safety pan,second cover, or safgty netting)-highly recommended. ❑ Yes �No
4, Was any ather safety/health issue present? ❑ Yes' �No
Explain;
•Systpm is an Imminent thr�eat to pu6Jlc health and sefety_
Certification
This form is to be completed and atteched to the Summary Form of the Minnesuta Pollution Control Agency's (MPCA) Compllance
Inspectlon Fortn for Existing subsurtace Sewage Treatment 3ystems.Observations,interpretations,and conclusions must be
completcd by an inspector,maintainer,vr servlce provider.Completed fonn must be submitted to the local unit of go�ernment within
75 days.
Property owner name(s): J
Property address: � _ _ 1"1� l'1 �.. _�.------- .._. ---_.
Property owner' address (li d�fferent):
�...�_....------ -
COunty: ��, � _ PhOn@: _..._�_ _„ ,. ----. .
l hereby certify that I personalfy made the observat�ons, interpretetions,and conclusions reported on this form and that they are
correct. '
Name: �(�� �a�`l�� _, Certification number. �p5�_�
9usiness Ilcense name and number: _ \ 'C� .�„___. _ or
Name o(local unit o ern , �
Signature: _ � _ Date: J/ _�.._ ..----�-_
`--7
wq•wwisrs4-31 Compliance Inspecrion Form�o�Existing SSTS
4/1/OE1
05� 14:20 9528733112 PAGE 04/09
Parcel number: _ � Systern status: Compliant ❑ Noncompliant
� ` (as determined y f is form)
Hydraulic Perfarn�ance and Other Compliance
Compliance Issue ##1 f '
Date of observ�tion: � � Reason for observation: `�
This fo�m expires upon next inspection or in three years, whichever occurs first:
Complian�e questfons/c�iteria: (Requlred) Verfficatlon Method*: (Optional)
(Ch�ck the appropriate box) (Check the appropriate boxJ
Does the system discharge sewage to thQ ❑Yes �No �Searched for surface outlet
yround surface?
�-,J� � PerFvrmed hydraulic test
D�es the system discharge sewage to draln [� Yes �xNo
_tif�or surtece waters? � � �Searched for seeping in yard
Does the system cause sewage backup ❑ Yes No ❑ Checked for backup in home
into dwellin or establishment? ❑ E�ccessive ponding in soil syst�m/p-boxes
Do other situations exist that have the ❑Yes No
potential to immediately and adversely ❑ Homeowner testimony
impact o�threaten public health or safety �Examined For surging in tank
etectncal, unsafe covers,etc.)? »
�^"""'' � "Black soil"above soil dispersal system
Any"yes"answerindlcafes fhat the system!s an imminent
threat to�ublic hea/th and safety. ❑ System requires"emergency'pumping
"' ❑ Perfortned dye test
Does the system pose a threat to ground [� Yes No ��
water for any conditions deemed nan- ❑ Other: ,_.t�l� /o Y1�_._�.�.. ��2�..
rotective as determined b the ins ector? IL?���_f,� � �! �Q_.�Oa y�
�� . .
"Yes"indicafes fhat the sysfem!s falling te pratect _ ,t �' _
ground wafer. If"yes'; deswTbe the conditivn noted: ---' "
*No standard protoco!exists. This list is not oxhausfrve.
-- --• in sequentiaJ order, nor does ii indicate which
combinatlons ere necessary to make fhis defermrnarion.
Certification
This form is to be compteted and attached to the Summary Form of the Minnesota Pollution Control A�ency's(MPCA)Compliance
I�spectio� Form fio�Exlsting Subsurface Sewage Treatment Systems. Observations, interpretations, and conclusions must be
completed by an inspector. Completed form must be submitted to the local unit of government withln 15 days.
Property owner name(s); _� (r , � _ __+___!
Property address' G7��— �� ` ----. . _-----.
Property owner's address(if different)=
County: _���u v� 1���'�i�l�-- Phone: __ ._�._... ...---------
�
!hereby certify that�personally made the observafions, rnterprefations, end conclusions reported on this form and fhat they are
r,orrect,
Name: _��_ __ O _ Certifioation number: ���D�-I
-- ---••-_�....-.-•.-•----
6us�ness license name and number: Cj�� ,�2,(�U�..(QS �'l1L_ ��j'_Q� __,__________, or
Name of loCal unit o orn t:
S�gnature; . _, _,_ � Date: , �
— (�._.._.....—...�_. ..
wq•wwists4-31 Complio�ce Inspection Form for Existing SSTS
4/1/08
05"�'��� 14: 26 9528733112 PAGE 05109 _
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�t.�� o CI'TY OF ORONO �
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,� �� � �-,�� � MunicipalOffices
�,, , ���' ti Street Address Mailing Address:
`C� �j'�' 2750 Kelley Parkway P.O. Box 66
'L9 '� Orono, MN 55356 Crystal Bay,MN 55323-0066
kESH��'
To: The Current Owner of Address 2965 DEER RUN TR
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) Pum 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���� ,1/l,�'O
The tank(s) should be cleaned through the manhole and not through the inspection pipes, this
allows for proper cleaning.
Comments:
�e)~ �����
��
Inspe�'Cb�" Date of Ins ection: r� �
�
Telephone (952) 249-4600 • Fax(952) 249-4616
www.ci.orono.mn.us
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To: Orono reside^ts 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 fuft cover of grass and keep mowed to a normal height, this grass cover aids
in the evaporation of large amounts of effluent (the liquid 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, 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
freezing problems.
Do inspect your mound system annuaily for winter kill, (reseed if necessary) animal damage,
(burrowingj or sigr�s o`potential failure.
Do not plant trees or shrubs on the mound system, smaller trees and shrubs may be pianted at the
edges. Remember, that sunshine is the key to a healthy mound system.
Do ask questions, if you have any concerns or questions concernang yaur rvaoun� syster�
please feel free to call me, B can be reached at 952-249-4626.
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�j�,,�► �b, 'y- .'�f:` :�_�,, �C, �� Municipal Offices
i ��';i;:� f � `1�_ ~'�
�`� ' ".� � `,�C� �-'� Street Address: qsa'a4q"y6� � Mailing Address:
���`�kESKp'¢'� �' 2750 Kelley Parkway P.O, Box 66
���---=' Orono, MN 55356 Crystal Bay, MN 55323-0066
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To Current Owner: Address: ,��l �: `� ��J�"� ��.%�'�
City Ordinance 199 requires that each existin�on-site sewage treatment system in Orono be inspected every two years.
The on-site sewage treatment system at the above address has been inspected and appears to fall into the categories checked below.
SYSTEM CONFORMITY (1-3): �
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 the current Orono
Municipal Code but does meet the three foot separation requirement or ttvo foot requirement for systems installed 1996 or earlier,and
which is not failing or an imminent tluea[to public health or safety.
3 "NON-COMPLIANT SYSTEM" A prohibited ISTS;an ISTS located within a designated 100-year flood plain,any ISTS which may
or may not meet all the location,design,or construction standards of the current Orono Municipal Code and which is failing for any
reason:and anv ISTS tivith]ess than three feet of unsaturated soil or sand between the distribution device and the limiting soil characteristics.
I �
TANK CONDITION(5-7): �
Tank inspection indicates:
� Pumpout not needed at this time.
6 Septic tanl:s must be pumped out this year (city code recommends tanl:s to be pumped out once every 3 years.
Tanl:was last pumped !t,! ,� ).
Make sure septic tanks are pumped throu�h manhofe and not throu�h white inspection pipes. This allows for the proper
cleaninQ I�eep water softner and iron filter discharae out of septic svstem to prolona life of drainfield. Ask pumper to test
alarm float to verifv alarm is still working in vour house. The alarm warns owner that septaae is about to backup into basement.
7 Inspection risers missing-tanks could not be inspected. Inspection risers(4" dia.pipe)must be installed in each tank. If
tanks have not been pumped out�vithin the last three years,they should be pumped out now.
DRAINFIELD CONDFTION(8-10): �
3 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 comp]eted within 90 days.
3
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�'C�MMENTS: �'��.% -��'� ' �o� ��'a
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,�7/� ��. F b
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Date of Inspection Septic Systern Inspector
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O��t.`�'. O
�� ,�,�:�-��r� ,� � CITY of ORONO
� ��1��,�`;,� ,��,►J ,i�� otr��
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�� "'�•;���7�,����G Street �idress: Mailing Address:
'�$EggOg' 2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
ToCurrentOwner: Address: � o�`�GS Q�tf f�u� ����; �
City Ordinance 199 requires that each existing on-site sewage treatinent system in Orono be inspected every two years.
The on-site sewage treaunent system at the above address has been inspected and�pears to fall into the categories checked below.
SYSTEM CONFORMITY 1-3 : (
"CODE SYSTEM�' An ISTS which meeu all the location,de�and construction st=.iards of the current Orono Municipal Code.
2 "COMPLIANT SYSTEM" An ISTS which does not meet�the location,design�.onsuuction standazds of the curzent Orono biunicipal
Code but dors meet the three foot separation requirement or tc�foot requirement for sz�tems�stalled 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 LSTS located within a dc-�ated 100-year flood plain,any ISTS which may
or may not mzet all the location,design,or wnstruction stan�ds of the current Oron:ltuni�al Code and which is failing for any reason;and
any ISTS with less than three feet of unsaturated soil or sand batween the distribution.Yvice and the limiting soil characteristics.
TANK CONDITIOV(5-7): 6
Tank inspection indicates:
5 Pumpout not needed at this time.
6U Septic tanks must be pumped out this year (city code requires tanks to be Fumpe�out once every 3 years.
Tank was last pumped ).
Make sure septic tanks are pumped throush manhole and not through w-hite inspection nipes This allows for the
proper cleaning. Keep water softner and iron filter dischar�e oat of septic system.
7 Inspection risers missing-tanks could not be inspecte3 Inspection risers f�"di�pipe)must be installed in each tank. If
tanks have not been pumped out within the last three��ears,they should tx pumped out now.
DRAINFIELD CO\"DITION 8-10 : �
8 Drainfield is dry,no surfacing evident.
9 Some evidence of surfacing,not critical yet.
10 Drainfield is saturated and visibly discharging untreate�effluent to the sL::ace_ Contact the City Inspector
immediately.Repairs must be completed within 90 da�s.
COMMENTS: Mo�� I ocj�j 0�, Qv� Se h L ,�1�5 �.; S
S.� �r,�� c� . �v ��� ��-- ��5 «j-.:o� - , c;a� o�
i�cv�•\ .
7 1-2' �� " "�ctt� i �G
Date of Ins�ction Niatt Bo`_�:man - Septic System Inspector
Note: In the event that this inspection report is used to satisfy the requirements Sr a mortgage or other�-ssfer ofproperty,be advised that this report does not guazantee
or certify thai an existing sysum will continue to function prope�ty,but is merei�an opinion ofthe adeq�:ofthe system under current conditions bued on the available
infortnation.
Telephone(952)249-�600 • Fax(952)2�9-4616
www.ciorono.mn.us
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�����=�=� CITY of ORONO
,����..-.
,� t�.��. a.
� � �' Munici Offices
"�, 'y��,� �_ � F' P�
� ��'�.-'�'"���� G~ street Address:
� ,,��„ �i Mailin� Address:
�'E+gg0¢ 2150 Keliey ParlcwaY P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
Owner:___ S�t2 p�,�c� �2�S 12�f Address: a� 65 Dee� 2�� �r
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.
SYSTEI�i CONFORMITY (1-31: �
� °CODE SYSTEM" An ISTS which meets all the localion,design and construction standards ofthe wrrent Orono Municipal Code.
2 ��COMPLIANT SYS'I'EM° An ISTS which does not meet all the localion,design and construction standards ofthe current Orono Municipal
Code but does meet the three foot sepazation requirement,and which is not failing or an imminetrt threat to public health or safety.
3 NON-CONIPLIANT SYSTEM" A prohibited ISTS;an ISTS located within a designated 100-year flood plain,any ISTS which may
I' or may not meet all the locatioq design,or construction standards ofthe cunent Orono btunicipal Code and which is failing for any reason;and
any ISTS with less than thrze feet of unsaturated soil or sand between the distribution device and the limiting soil chazacteristics.
TANK CONDITION(�-10): �
Tank inspection indicates:
QPumpout not nzeded at this timz.
f) Tank must bt pumpzd out this yeaz (city code requires tanlcs to be pumped out every 3 years. Tank was last pumped ),
7 Solids accumulalion in tanks is at a critical a critical level. Tanks should be pumpzd out as soon as possible.
8 System is discharging to the surface. Tanks must be pumped out within 48 hou�to eliminate surface discharge.
9 Inspection risers missing-tanks could not be inspected. Inspection rise�(4"dia,pipe)must be installed in each tank at next pumpout. If tanks
have not been pumped out within the Iast three yeacs,they should be pumped out now.
1� Inspection pipe is locatzd duecdy over tarilc baffle(does not give accurate measurement of solids accumulalion). If tanks have not been pumped
out within tha last three years,they should be pumped out now.
DRAINFIELD CONDITION(11-14): �1
11 Draintield is dry,no surfacing evident
12 Some evidence of surfacing,not crilical yet
13 Drairtfield is saturated and visibly discharging untreated e�luert to the surface. Corrtact the City Inspedor immediately.Repairs must bz
compfeted withirt 90 days.
1� Drainfield extent and condilion unknown
CONIl�IENTS:__ S�► Sfie � \o o�� 0 ��
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Date of Inspection Septic System Inspector '
Note: In the evrnt that this inspection repoR is used to satisfy the requiremenLs for a mortgage or other trensfer of propeRy,be advised that this report does�ot guazantee
or certify that an existing system will continue to function properly,but is merely an opuuon of the adequacy of the system under curreirt conditions based on the availabla
informatioa
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: i ;, CITY of ORONO
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ti Municipal Offices
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�,�� ¢,�G Street Address: Mailing Address:
kE81I� 2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
Owner: � s Address: 2965 Deer Run Tr.
Permit #'s: 7706 Dates: 2/28/96 Contractors: Swedlund
(This is [�] an existing system [ ] new construction) .
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 identified, this classification is subject to revision.)
TANK CONDITION (5-9) : 8
5 Pumpout not needed at this time.
6 Solids accumulation in tanks indicates they should be pumped out this year.
� System is discharging to the surface. Tanks must be pumped out within 98 hours.
/ ts� Inspection risers missin -tanks could not be inspected. If tanks have not been pumped out
�"� wit in years, they should be pumped out and risers installed now.
9 Inspection pipe is located over tank baffle-can not measure so i cumulation. 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.)
RAINFIELD CONDITION (11-14) : 11
1 Drainfield is dry, no surfacing evident.
12 Some evidence of surfacing, not critical yet. Repair is not required at this time.
13 Drainfield is saturated and visibly discharging untreated effluent to the surface. Contact
the City Inspector immediately. Repair must be completed within 90 days.
14 Drainfield extent and condition unknown.
POTENTIAL FOR SYSTEM FAILURE: (system age and condition, soils, etc. ) : low
COMMENTS:
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Date of Inspection ept'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