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Home My WebLink Aboutseptic info Jun 07 2016 07:49AM HP FaxRusty Olson 7634988290 page 10 � # . � ~� � Fax Transmittal Form Date: 6/7/2016 Total Pages: II9 To: City of �rona Phone Number: Fax Number: 952-249-4616 E-mail: From: Joseph J Olson Phane Number: 763-498-8779 Fax Number: 763-49$-829� E-maEl: rusty2654Cc7comcast net ❑ Urgent � For Review ❑ Please Comment ❑ Please Reply Message: This is the septic cert for 2879Farview Lane. Please file. Jun 07 2016 07:49AM HP FaxRusty Olson 7634988290 page 11 � MinneSota Poilutian Compliance Inspection Form Control Agency SZOLafayetteRoadNorth ��sting Subsurface Sewage Treatment Systems St.Paul,MN 55155-4194 (SSTS� Doc Type�Complrance and Enfom.emeni RECEIVED Instructions; Inspection results based an Minnesota Pollution Control Agency(MPCA) I Fo cr o al tracking purposes� requiremenis and attached forms—additional local requirements may also apply. �IUN Q 7 2016 i Submit completed fortn to Local Unit of Government(LUG)and system owner within 15 days ' CITY OF O Systern Status ' System status on date(mmldd/yyyy): 5H7l2016 � Compliant- Certificate of Compliance ❑ Noncompliant-Notice of Noncompliance (Valid for 3 years frorn report date, unless shorfer time (See Upgrade Requirements on page 3) irame outllned(n Loca!O�dinance.J Reason(s) fo�noncompliance(check all applicable) [ Impact an Puolic Health (Compliance Component #!)—Jmmineni threat to public heaJth and safety C Other Compiiance Cond'+tions (Compliance Component#3}—lmminent threat to public healfh and safefy ❑Tank Integrity(Compliance Componenf #2)—Failing fo profectgroundwater ❑ Other Compliance Conditions (Compliance Component#3}—Fa;ling to protect groundwater C Soil Separation (Compliance Component #4}—Failing to protect groundwater ❑ Operating permiUmonitoring plan requirements(Compliance Component #5J—Noncompliant Property Information Parcel ID#or Sec/Twp/Range: 04-117-23-34-0002 Property address: 2879 Farview Lane., Orono,MN Reason for inspection: Property Transfer Property owner: James&Amy L�oyd Owner's phone: 612-310-7683 or - Owner's representative: f2epresentative phone: Local regulatory authority: City of Orono` Regulatory authority phone: 952-249-4600 2-1000 gallon septic tanks,l-1000 gallon lift station and 500 square feet of mound rockbed.per city Brief system description: recards Comments or recommendations: Certification !hereby certify that al!fhe necessary infonnafion has been gathered to determine the compliance status of this sysfem. No determination of future sysfem performance has been nor can be made due to unknown conditions dunng system construction, possible abuse ofthe system, rnadequate maintenance, or future waterusage. Inspecior name: Joseph J Olsor, _ Certification number: 1255 Business name: Rust r Ison's Soil&Perc.Testing License number: 81Q Inspectorsignatur � ~"` _ Phone number. 763-498-8779 Necessary or LocalEy Required Atta�hments � Soil boring logs �Sysiem/As-built drawing ❑ Forms per iocal ordinance ❑Other information (list): www.pca.state.mn.us • 651•296-6300 . 800-657•3864 • TTY 651-282•5332 or 800•657-3864 • Available in alternative formats wq•wwists4•3f • 1/24/i2 P�ge i ot3 Jun 07 2016 07:49AM HP FaxRusty Olson 7634988290 page 12 / � .. Property address: 2879 Farview Lane., Orano,MN Inspector initials/Qate: J Q.5117/16 1. II11pdCt on Publt'C Hedlth —Compliance component#1 of 5 Compliance criteria: Veritication method(s): System discharge sewage to the � ❑Yes � No � Searched for surface outlet ground surface. � � Searched tor seeping in yardR�ackup in home System discharge sewage to drain tile ; ❑Yes � No � Excessive ponding in soil systemlD-boxes or surtace waters. � ❑ Nomeowner testimony (See Comments✓Exp�anation) System cause sewage backup intC ❑Yes � No � ��B�ack soiP'abave soil dispersal system dwelling or establishment. I ❑ System requires"emergency"purnping — ❑ Performed dye test Any"yes"answer above indicates the sysfem is ❑ Unable to verify(See CommentslExplanation) an lmminent Threat to Public Health and Safety. ❑ pther methods not listed (see Comments�xptanatron) CommentslExplanation: 2. Td11k Integrity—Compliance component#2 of 5 Comptiance criteria: Verification method(s): System consists of a seepage pit, ❑ Yes � No ❑ Probed tank(s)botiom cesspool,drywell, or leaching pit. � ❑ Examined construction reco�ds Sespage pits meeb'ng 7080.2550 may be � ❑ Examined Tank Integrity Fofrn(Attach) cornpliani rt a!lowed in/ocal ordinance. ! ❑ Ohserved liquid level below operating depth 5ewage lank(s)feak below their I ❑Yes �No ❑ Examined empty(pumped)tarks(s) designed operating depth. � If yes,which sewage tank(s)leaks' ❑ Probed outside tank{s) for"black soil" ARy "yes"answer above indicates the ❑ �nable t0 verify(See Comments/Explanation) system is Failing to Protect Groundwater. �Other methods not listed{See CommenrsiExplanation) CommentslExpla nation� Pete�son Company pumped the tanks. 3. Other COfllplidn�e Conditi0n5 —Compliance component#3 of 5 a. Maintenance hole covers are damaged,cracked,unsecur�ed,or appear to structurally unsound. ❑Yes" �No � Unknown b. Other issues(electrical hazards,eta)to immediatefy and adversely impact public health or safety. C Yes* �No ❑ unknown "System is an imminent threat to publ;c health and safety Explain: c. System is non-protective of ground wa?ertor other conditions as determined by inspector ❑Yes` �No `System is failing to proi�ec[groundwater Explain: www.pca.state.mn.us • 651-246•6300 • 800-657-3864 • 7TY 651•282•5332 or 800-657-3864 • Available in alternative formats wq•wwists4-31 . f/24/f1 Page 1 of 3 SEPTIC SYSTEM INVENTORY Site Address: 2$79 Farview La PID 04-117-23-34-0002 Owner Name: 2336 Owner Address: 2879 Farview La Long Lake MN 55356- BuildinqTvpe: residence Installer: Clover Hill Co. Date of Permit: 10/21/99 Svstem Tvpe: mound BR's Designed for 4 In Musa?: Yes Shoreland?: No SEPTIC TANKS: Material: precast concrete Capacitv: 1000,1000,1000 Tank Filter: DRAINFIELD: Treatment Area: 78*38 Soil Boring: yes DF Ht above Wt: 3 WELL DATA Setbacks -Well Tanks: 75 Well DF: 75 Report In File: Depth: 128 INSPECTION RECORDS _ _ _ , _ PUMPOUT RECORDS __ _ _— _ ___ .__—_ _ � Date Notes � Date GallonsOfLiquid 9/1/2005 OK 5/17/2016 2500 I 7/29/2003 no surfacing,pump tanks 2004 5/24/2013 2500 7/10/2001 code system, no surfacing I � 6/15/2012 0 I 1/6/2000 no surfacing � � 4/21/2009 2500 I 11/2/1999 final ok 7/23/2004 2500' , 10/21/1999 replacement installation �I 11/5/1996 1500; , 6/1/1999 non-compliant-repair by 12/31/2006 I 11/7/1994 2000 I—___—__ _ __ _ _ _�_ � 8/23/1996 non-conforming-repair by 12/31/2006 , 10/28/1994 no surfacing-pump tanks ii 7/18/1991 no surfacing-need risers, pump tanks 7/30/1990 no surfacing-need risers, pump tanks 8/6/1987 no surfacing � 8/30/1984 no surfacing I f 6/26/1981 installation �I I _ _ —_ ____ ____ __ _ - — � �� 0,�� O -� �-� CITY of ORONO ,,��.,r�� -. ,�,'� ' �`� J� 1 � ��`�[� ,`��`°;;=t� �, / Municipal Oftices �� 11��y��!,`r'�Y�l� �� ,t9 ;,,,�-�;�.��4�/ Street Address: Mailing Address: �E$H� i� 2750 Kelley Parkway P.O. Boz 66 Orono, MN 55356 Crystal Bay, MN 55323-0066 To Current Owner: Address: �� `��v�`� �'��- City Ordinance 149 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 : f 1 CODE SYSTEM" An ISTS which meets all the location,design and construction standards of the current Orono Municipa]Code. 2 "COMPLIANT SYSTEM" An ISTS which does not meet all the location,design and construction standazds of the current Orono Municipal Code but does meet the three foot separation requirement or rivo foot requirement for systems installed 1996 or earlier,and which is not failing or an imminent threat to public heal[h or safety. 3 "NON-COMPLIANT SYSTEM" A prohibited ISTS;an 1STS located within a designated 100-yeaz flood plain,any ISTS which may or may not meet all the location,design,or constniction standards of the current Orono Municipal Code and which is failing for any reason;and any ISTS with less than three feet ofunsaturated soil or sand between the distribution device and the limiting soil characteristics. TANK CONDITION(5-71: `c; Tank inspection indicates: 5 Pumpout not needed at this time. �eptic tanks must be pumped out this year (city code requires tanks to be pumped out once every 3 years. Tank was last pumped ). Make sure septic tanks are �umped throu�h manhole and not throu2h white inspection nipes. This allows for the �roper 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): �, � 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: l`^� �..tl �a�i�� Ic._ ��! M� 5 c Q ��,� ��,1c.5 S J hP-��' Zo� c:`-�, . ��y_�"� �.�� G�\� Date of Inspection Matt Bolterman - Septic System Inspector Note: In the event that this inspection report is used to satisfy the reGuirements for a mortgage or other transfer of property,be advised that this rcport 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 inforcnation. Telephone(952)249-4600 • Fax(952)249-4616 avavav nS nrnnm m�ne � o� o�,„ o ��=�=� CITY of ORONO ' ��'l. � � ��1" `��-� '� h: � '� '� � Ml1D1C1� ��1CeS r'� ' � 'ti �'t '�'�;��`yr�i i�'�� liG Street Addross: MailinQ Address: �'F,+ggOg' 2750 Kelley Paricway P.O. Bax 66 Orono, MN 55356 Crystal Bay, MN 55323•0066 Owner: W�I Mq� Nah2�e.� Address:_a43 7� f��„�,c�,,, � � City Ordinance 199 requires that each existing on-site sewage treatment system in Orono be inspected every two yeazs. The on-site sewage treaiment system at the above address has been inspected and appears to fall into the categories checked below. SYSTEM CONFORMITY (1-3): I O °CODE SYS'I'EM�� An ISTS which meets all the location,design and consttuction standards ofthe current Orono Municipal Code. 2 °COMPLIANT SYSTEM" An ISTS which does not meet all the location,design and construction standards of ihe currerrt Orono Municipal Code but does meet the three foot sepazaIIon requirement,and which is not failing or an immine�threat to public health or safety. 3 NON-CONfPLIANT SYS'I'EM�� A prohibited ISTS;an ISTS located withirt a designated 100-yeaz flood plain,any ISTS which may 11 or may not meet all the location,design,or construction standards ofthe cucreirt 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: � Pumpout not needed at this time. 6 Tank must be pumped out this yeaz (city code requires tarilcs to be pumped out every 3 years. Tank was last pumped ), 7 Solids accumulation in taiilcs is at a critical a critical level. Tanks should be pumped out as soon as possible. 8 Systzm is dischazging to the surface. Tanks must be pumped out within 48 houts to zliminate surfar.e discharge. 9 Inspection risers missing-tanks could not be inspected. Inspeetion risers(4"dia pipe)must be installed in eaeh tank at next pumpout If tarilcs have not been pumpzd out withitt the last three yeats,they should be pumped out now. 1� Inspzction pipe is located directly over tank baffle(does not give accurate measurerurnt of solids accumulalion). If tanks have not been pumped out within the last three years,they should be pumped out now. DRAINFIELD CONDITION 11-14 : \\ Drainfield is dry,no surfacing eviderrt, I Z Some evidence of surfacing,not mlical yeL . 13 Drainfield is saturatzd and visibly dischuging urrtreated eHluent to the surface. Contact the City InspecKor unmediately.Repairs must be completed within 90 days. 1=� Drainfield estent and condition unknown. COMI��NTS: S�/sfic�. IooICS b (� 7 -10 — O 1 '��C �,�,,,,� . Date of Inspection Septic System Inspector � Note: In the everit that this inspection repott is used to satisfy the requiremec�ts for a mortgage or other trarufer of property,be advised that this report does not guarantee or certify that an e�risting system will continue to function properly,but is merely art opinion of the adequacy of the system undet current condilions based on the available info[malioa ,%�\ . % � � � ��o . o� -� �� ,��:�� c�TY of oRONo �� 'i � -� �, �� Municipal Offices \�� ,r �.,>>'�� i,. G'�/� 1► �Y.. t,.+ n . � , Stra�+, !!��ss: Mailing Address: ��'`4�('E$HQ� 2150 Kelley Parkway P.O. Box 66 ��=_---- Orono, MN 55356 Crystal Bay, MN 55323-0066 Owner:�i'11�,��/�� Address: 2879 Farview Ln. Permit #'s: 6357 Dates: 6/25/81 Contractors: Hoff Plbg. (This is [� an existing system [ � new construction) . SYSTEM COMPLIANCE (1-3) : 3 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. 1 Ncn-Compiiant System: System ::.�; ,-,�a-y nut �;,22t current Cit;• staadards 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) : 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. � 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. 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.) : medium CO[�IENTS: The septic system is non-compliant, but does not appear to pose an imminent threat to public health or safety (surface discharge or backup into the dwelling) . The system must be repaired or replaced by 12/31/2006 or within ninety days of posing an imminent threat to public health or safety, whichever comes first. _ , � Date o Insp ction S ic System Insp c or 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 �� O �;; , ,, .., '�;`;� CITY of OROI�TU� , � � � ,� ��G, ' Municipal Offices Street Address: Mailing Address: ��4k ' � pS�c'�'G 2150 Kelley Parkway P.O. Box 66 EsK _- Orono, MN 55356 Crystal Bay, MN 55323-0066 To: The Current Owner of Address ��( �'� �c�'Q�✓ �.� 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 952-249-4626 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 mp out Needed Yes No The City recommends the septic tank(s) and/or lift tank be serviced and pumped out every three years. City records indicate the tank(s) were last pumped out on , � - �-`�� . The tanl:(s) should be cleaned throuQh the manhole and not through the inspection pipes, this allows for proper cleaning. Comments: c Inspectc�� i .' ;� .>�� `` �` Date of Inspection � �_� ; _ �ti. �,,,,�,'—�-�,-�,��— Telephone (9�2) 249-�i600 � Fax (9�2) 249-4616 w ww.ci.orono.mn.us /' � =O \\� / � � \ ��o o ��, ��' -�. -��f�,; �� CITY of ORONO � � � ;*�- �� •� �;� Municipal Offices �l . � � "��" � �� Street Address: Mailing Address: �` .� �'�"z ` .�, � �\kEggO� 2750 Keliey Parkway P.O. Box 66 ==� Orono, MN 55356 Crystal Bay, MN 55323-0066 � Owner: 1'�,/i ��/• ��1�� Address:2879 Farview Ln. Permit #'s:6357 Dates :6/25/81 Contractors :Hoff Plbg. (This is [� an existing system [ ) new construction) SYSTEM COMPLIANCE (1-3) : 3 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. (� 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 separa ion between the bottqm of the drainf� �_��d tk��.��atux�,.e��,oil level. (The saturated soil level � 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) : 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. � 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. ) 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: (svstem aqe and condition, soils etc. ) : medium COMMENTS: The non-compliant septic system must be repaired by 12/31/2006 or within 90 days of failure (surface discharge) , whichever comes first. ��6 �---%.� �---- 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) 473-7357 • FAX 473-0510 CITY OF ORONO � O� Municipal Offices O O Post Office eox 66 Crystal Bay, MN 55323-0066 a � ON—SITE SEWAGE TREATMENT �`, �C�. INSPECTION REPORT �� G~ 9kESH�4'� Owner: �.�� 1.1�'�c �� Address: O � QI��'lJ �/ " Permit �'s: �� Dates: /�—'o�\, �/ Contractors: ^ � City ordinance number 100 requires that each on-site seuage 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 [ ] neu construction) SYSTEM CONFORMITY (1-3): "CODE SYS7EM"-A system which meets all the location, design, and construction standards of the current City Codes, and uhich is operating satisfactorily by treating and disposing of the entire current sewage input without discharging any pollutants into ground or surface waters. 2 "CONFORMING SYSTEM"-A system which does not meet all the location, design, and construction standards of the current City Codes, but uas installed according to the code in effect at the time of installation, and which is operating satisfactorily by treating and disposing of the entire current seuage input without discharging any pollutants into ground or surface uaters. 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 uhich is failing for any reason; and any system with less than 3 feet of unsaturated soil or sand between the distribution device and the limiting soil characteristics. (The limiting soil characteristic [ � has or [ ] has not been identified at this time. if the limiting soil characteristic has not been identi ied, this classification may be subject to revision.) TANK CONDITION (5-10): Tank inspection indicates: 5 Pumpout not needed at this time. 6 Solids accumulation in tanks indicates they should be pumped out this year to help prevent future problems. 7 Solids accumulation in tanks is at a critical level. Tanks should be pumped out as soon as possible. 8 System is discharging to the surface. Tanks must be pumped out within 48 hours to eliminate surface dischar�e. 9 lnspection risers missing-tanks could not be inspected. Inspection risers (4" dia. pipe) must be installed in each tank at next pumpout. If tanks have not been pumped out within the last three years, they should be pumped � out now. 10 Inspection pipe is located directly over tank baffle (does not give accurate measurement of solids accumulation). If tanks have not been punped out within the last thrP�v��c� they should be pumped out now. DRAINfIELD CONDITION (11-14): Drainfield inspection indicates: 11 Drainfield is dry, no surfacing evident. 12 Sane evidence of surfacing, not critical yet. 13 Drainfield is saturated and visibly discharging untreated effluent to the surface. Contact the City Inspector immediately. Repairs must be completed uithin 90 days. 14 Drainfield extent and condition unknown. LIMITING SITE FACTORS (slope,setbacks,etc.): POTENTIAL FOR SYSTEM fAILURE (depends on soils,water table,etc.): ,j� ��^ COMMENTS: . � � � .P� � Date of Inspection S2 t' 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 uill continue to function properly� but is merely an opinion of the adequacy of the system under current conditions based on the available information. This report must be kept on the premises uith the system loc�tion and pumping records. WHITE COPY/Inspectors File YELLOW COPY/Homeowner On the North Shore o f Lake Minnetonka ON-SITE SEWAGE TREATMENT INSPECTION REPORT � POST OFFICE BOX 66 1335 S. Brown Rd. � � � Crystal Bay, MN 55323 473-7357 OWNER /��' �� v�^'rt'� ADDRESS �/ ,�Y�✓rP1.J �-J 1� 7 PERMIT NO.'S. DATES '�SgI CONTRACTORS D � City Ordinance No, 210 requires that each on-site sewage treatment system in Orono be inspected on a regular basis.The on-site sewage treatment system at the above address has been inspected and appears to faii into the category checked below. (This is � an existing system ❑ new construction) � � Meets or exceeds current City standards in all respects relating to design,constructio�,and location.Appears to be operating properly. � 2 Does not meet all current City standards for new construction (1978 Code1 but in most respects appears to be designed, located, and constructed generally in accordance with previous codes. System appears to be functioning properly; no major upgrading of the system is required at this time. ❑ 3 Does not meet current City standards in many respects relating to design,construction, or location.Appears to be operating adequately at this time, but has a relatively high potential for future problems. No major upgrading of system is required at this time. � 4 System may or may not meet current City standards for design, construction or location, but is failing to properly treat and dispose of the current input,and is endangering a water supply, or is a source of pollution to surface or groundwaters,or is creating a safety hazard, or is otherwise creating a public nuisance.Please contact the City Inspector to discuss system repair/ replacement procedures. If drainfield replacement is necessary, soil testing will usually be required,and a design and site plan must be submitted for review.Your contrector must obtain a permit before work is started. SYSTEM CONDITION ( m Checked items may require your action) Tank inspection indicates: ❑ Inspection pipe is located directly over tank baffle.(Does not ❑ Pumpout not needed at this time, give accurate measureme�t of solids accumulation.) If tanks ❑ Solids accumulation in tanks indicates they should be pump- have not been pumped out within the last three years, they ed out this year to help prevent future problems. should be pumped out now. ❑ Solids accumulation in tanks is at a critical level. Tanks Drain ield inspection indicates: should be pumped out as soon as possible. �Drainfield is dry,no surfacing evident. ❑ System is discharging to surface. Tanks must be pumped ❑ Some evidence of surfacing,not critical yet. within 48 hours to eliminate surface discharge. ❑ Drainfield is saturated and visibly discharging untreated ��Inspection risers missing-tanks_could not__be_ inspected, effluent to the surface. This condition may require replace- Inspection risers (4" dia. pipe) must be installed in each tank' ment or additions to drainfield. Contact the City Inspector n x pum u a out withi immediately.Repairs must be completed within 90 days. t e last three years they should be pumpe o��itv, ❑ Drainfield extent and condition unk�own. SITE CHARACTERISTICS: Limiting Site Factors Potential for System Failure Site Capabilities for ❑ Slope (depends on soil types,water Future Expansion ❑ Soil table,and system condition) �-Adequate ❑ High water table Cj Low �C� Fair ❑ Lot size �••Medium ❑ Poor ❑ Lake,wetland,or stream ❑ High ❑ Inadequate ❑ Drainage ❑System is causing visible ' surf ce discharge. 1/ �j� / COMMENTS: �r ��S ✓P �C' E� S✓�C. � �ns�oil ov�.. -�5�, n � r s D' , .J � r e rr� 7-/ -`�/ ,..� � 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 �ot guarantee or certify that an existing system will continue to function properly,but is merely an opinion of the adequacy of the system under current conditions based on the available information. This report must be kept on the premises with system location and pumping records. WHITE COPY/ Inspector's File GOLD COPY/Homeowner