HomeMy WebLinkAboutSeptic info < +.
� Minnesota Pollution Compliance Inspection Form
Control Agency
520 Lafayette Road North Existing Subsurface Sewage Treatment Systems (SSTS)
St.Paul,MN 55155-4194 Doc Type:Compliance and Enforcement
Inspection results based on Minnesota Pollution Control Agency(MPCA) I For local tracking purposes: '
requirements and attached forms—additional local requirements may also apply. I !
Submit completed form to Local Unit of Government(LUG)and system owner �
within 15 days !
System Status
System status on date(mm/dd/yyyy): 10/06/2015
� Compliant— Certificate of Compliance ❑ Noncompliant— Notice of Noncompliance
(Valid for 3 years from report date, unless shorter time (See Upgrade Requirements on page 3.)
frame outlined in Local Ordinance.)
Reason(s) for noncompliance (check al/applicable)
❑ Impact on Public Health (Compliance Component#1)—Imminent threat to public health and safety
❑ Other Compliance Conditions (Compliance Component#3)—Imminent threat to public health and safety
❑Tank Integrity(Compliance Component#2)—Failing to protect groundwater
❑ Other Compliance Conditions(Compliance Component#3)—Failing to protect groundwater
❑ Soil Separation (Compliance Component#4)—Failing to protect groundwater
❑ Operating permit/monitoring plan requirements(Compliance Component#5)—Noncompliant
Property Information Parcel ID#or Sec/Twp/Range:
Property address: 1205 French Creek Drive Reason for inspection: Replacement system
Property owner: Sharon&Clark Winslow Owner's phone:
or
Owner's representative: Sewer Services • Representative phone: 952-873-3292
Local regulatory authority: City of Orono Regulatory authority phone: 952-249-4600
Brief system description: Type I Pressure Bed
Comments or recommendations:
Replacement
Certification
1 hereby certify that all the necessary information has been gathered to determine the compliance status of this system. No
determination of future system performance has been nor can be made due to unknown conditions during system construction,
possible abuse of the system, inadequate maintenance, or future water usage.
Inspector name: Roger Peitso _ Certification number: _C6683
Business name: License number:
Inspector signature: __ Phone number. _952-249-4625 _ _
Necessary or Locally Required Attachments
!! FORMCHECKBOX 1 Soil boring logs ❑ System/As-built drawing ❑ Forms per local
❑ 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-wwists4-316 • 6/4/14 Page 1 of 3
�' -,
� Property address: 1205 French Creek Drive __ Inspector initials/Date: RLF I 10/06/2015
(mm/dd/yyyy)
1. Impact on Public Health — Compliance component#1 of 5
Compliance criteria: Verification method(s):
System discharges sewage to the ❑Yes � No ❑ Searched for surface outlet
ground surface. __ __ ____ , _ __ ___ __ ❑ Searched for seeping in yard/backup in home
System discharges sewage to drain ❑Yes � No ❑ Excessive ponding in soil system/D-boxes
tile or surface waters.
❑ Homeowner testimony(See CommentslExplanation)
System causes sewage backup into ❑ Yes � No ❑ "Black soil"above soil dispersal system
dwelling or establishment
- --- -- --- -- ❑ System requires"emergency° pumping
Any"yes"answer above indicates the ❑ Performed dye test
system is an imminent threat to public ❑ Unable to verify(See Comments/Explanation)
health and safety.
❑ Other methods not listed (See Comments/Explanation)
Comments/Explanation:
Replacement system Type I Pressure Bed
2. Tank Integrity— Compliance component#2 of 5
Compliance criteria: Verification method(s):
System consists of a seepage pit, ❑ Yes � No ❑ Probed tank(s) bottom
cesspool, drywell, or leaching pit.
❑ Examined construction records
Seepage pits meeting 7080.2550 may be
compliant if allowed in local ordinance. ❑ Examined Tank Integrity Form (Attach)
Sewage tank(s) leak below their ❑ Yes � No � Observed liquid level below operating depth
designed operating depth. I ❑ Examined empty(pumped)tanks(s)
If yes,which sewage tank(s) leaks: �, ❑ Probed outside tank(s)for°black soiP'
Al1y "yes"answer above indicates the ❑ Unable to verify(See Comments/Explanation)
system is failing to protect groundwater. ❑ Other methods not listed (See Comments/Explanation)
Comments/Explanation:
Existing tanks inspected and passed by pumping contractor
3. Other COmplianCe COnditiOns—Compliance component#3 of 5
a. Maintenance hole covers are damaged,cracked, unsecured,or appear to be structurally unsound. ❑Yes" � No ❑ Unknown
b. Other issues(electrical hazards,etc.)to immediately and adversely impact public health or safety. ❑Yes" �No ❑Unknown
*System is an imminent threat to public hea/th and safety.
Explain:
c. System is non-protective of ground water for other conditions as determined by inspector. ❑Yes" � No
*System is failing to protect groundwater.
Explain:
www.pca.state.mn.us • 651-296-6300 • 800-657-3864 • TTY 651-282-5332 or 800-657-3864 • Available in alternative formats
wq-wwists4-31b • 6/4/14 Page 2 of 3
` Property address: 1205 French Creek Drive Inspector initials/Date: RLP � 10/06/2015
(mm/dd/yyyy)
4. Soil Separation — Compliance component#4 of 5
Date of installation: 10/06/2015 _ ❑ Unknown Verification method(s):
(mm/dd/yyyy)
Shoreland/Wellhead protection/Food beverage Soil observation does not expire. Previous soil
lod in � ❑ Yes � No observations by two independent parties are su�cient,
g 9� unless site conditions have been altered or local
Compliance criteria: requirements differ.
For systems built pnor to Apnl 1, 1996, and ❑Yes ❑ No ❑ Conducted soil observation(s) (Attach boring/ogs)
not located in Shoreland or Wellhead
Protection Area or not serving a food, ❑ Two previous verifications (Attach boring logs)
beverage or lodging establishment: ❑ Not applicable (Holding tank(s),no drainfield)
Drainfield has at least a two-foot vertical � ❑ Unable to verify(See Comments/Explanation)
separation distance from periodically � ❑ Other(See Comments/Explanation)
saturated soil or bedrock. i
Non-performance systems builtApnl 1, ' � Yes ❑ No Comments/Explanation:
1996, or later or for non-perfo�rnance i Mound Replacement
systems located in Shoreland or Wellhead i
Protection Areas or serving a food,
beverage, or lodging establishment: ��
Drainfield has a three-foot vertical I
separation distance from periodically I
saturated soil or bedrock.*
"Expenmental'; "Other", or "Performance" �' ❑ Yes ❑ No Indicate depths or elevations
systems built under pre-2008 Rules; Type IV �'
or V systems built under 2008 Ru/es(7080. A. Bottom of distribution media
2350 or 7080.2400 (Advanced Inspector �
LiCense required) ' B. Periodically saturated soil/bedrock
Drainfield meets the designed vertical � C. System separation
separation distance from periodically � — '
saturated soil or bedrock. ' '
__ _ ___ D. Required compliance separation` ;
AI1y "l10"answer above indicates the system is "May be reduced up to 15 percent if allowed by Local
failing to protect groundwater, ordinance.
5. Operating Permit and Nitrogen BMP*— Compliance component#5 of 5 � Not applicable
Is the system operated under an Operating Permit? ❑Yes ❑ No If"yes",A below is required
Is the system required to employ a Nitrogen BMP? ❑Yes ❑ No If"yes", B below is required
BMP=Best Management Practice(s)specified in the system design
If the answer to both questions is "no", this section does not need to be completed.
Compliance criteria
a. Operating Permit number:
Have the Operating Permit requirements been met? ❑ Yes ❑ No
b. Is the required nitrogen BMP in place and properly functioning? ❑Yes ❑ No
Any "no"answer indicates Noncompliance.
Upgrade Requirements (Minn. Stat. § 115.55)An imminent threat to public health and safety(ITPHS)must be upgraded, replaced,or its use
discontinued within ten months of receipt of this notice or within a shorter period if required by local ordinance. If the system is failing to protect
ground water, the system must be upgraded, replaced, or its use discontinued within the time required by local ordinance. If an existing system
is not failing as defined in law, and has at least two feet of design soil separation, then the system need not be upgraded,repaired, replaced, or
its use discontinued, notwithstanding any local ordinance that is more strict. This provision does not apply to systems in shoreland areas,
Wellhead Protection Areas, or those used in connection with food,beverage, and lodging establishments as defined in law.
www.pca.state.mn.us • 651-296-6300 • 800-657-3864 • TTY 651-282-5332 or 800-657-3864 • Available in alternative formats
wq-wwists4-316 • 6/4/14 Page 3 of 3
// ���,
/,i � •
ii ��
j� � ��•.
l�� ���`��`I
�� .- . _ �, ��T� o� o�o�a�
�`� � _ ��
� � �,J/ Municipal Offices
1t f ,�
� �� �'� i
� i�` ' , ,'� �: G.// Street Address: Mailing Address:
;� � � ' � ' '� : P.O. Box 66
:.. �q �¢ 2750 Kelley Parkway
,kESI3� �%' / Crystal Ba MN 55323-0066
���� Orono, MN 55356 Y�
To: The Current Owner of Address
i,,? O � }-'�-l��Cd-� �'fE��'�� ��
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 brou�ht 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 tanl:be serviced and pumped
out every three years. City records indicate the tank(s) were last pumped out on
�{ _ � ��,(� . The tar�(s) should be cleaned throuah the manhole and
�_�>-
not throu�h the inspection pipes, tlus allows for proper cleaninQ.
Comtnen�s: —
Y �� � � ��'
��9 �� �' � ��
Inspectft���'�°�''��� � �� ___ Date of Inspection �= �
Telephone (9�2) 249-460U • �'ar 19�?) 2�9-461h
/ /�O�
/j/� � \�
'��// O O '.� .
, � � �
CI�Y of ORONO
,,, .
���� � �, ,,, _ ,, �
';�+, �! ��^ ,�,�' ��� Municipal Offices
� G � Street Address: �15�.-a49-�-I6o O
� �� � ',¢�i,�;' Mailing Address:
�ESHD 2750 Kelley Parkway P.O. Box 66
__- Orono, MN 55356 Crystal Bay, MN 55323-0066
To Current Owner: Address: ��Q 5 fi�tnL� �-�;�� �J�
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 CONFORMIT'Y (1-3): �
O "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 bu[does meet the three foot separation requirement or two foot requirement for systems installed 1996 or earlier,and
which is not failing or an imminent threat to public health or safety.
3 "NON-COMPLIANT SYSTEM" A prohibited ISTS;an ISTS located within a designated 100-year flood plain,any ISTS which may
or may not meet all the location,design,or construction stan�rds of the current Orono Municipal Code and which is faIling for any
reason;and any ISTS with less than three feet of unsaturated soil or sand between the distribution device and the limiting soil characteristics.
TANK CONDITION(5-7): �
Tank inspection indicates:
� 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_ 5-Z-6'0�-1 ).
Make sure_septic tanks are pumped through manhole and not throu�h white inspection pipes This allows for the proper
cleanin� Keep water softner and iron filter dischar�e out of septic svstem to prolon�life of drainfield Ask pumper to test
alarm float to verifv alarm is still working in your house The alarm warns owner that septa�e 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 ff
tanks have not been pumped out within the last three years,they should be pumped out now.
DRAINFIELD CONDITION(8-10): a
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: �s�:��-�\� � 5���--.� -�,�k� �E��1� ��
�7-\6^t�� �� -'
Date of Inspection Matt Bolterman - Septic System Inspector
Note: In the event that this inspection report is used to satisfy the requireme�ts for a mortgage or other transfer of property, be advised that this report does
not guarairtce 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.
� °�
O :� O
����-� CITY of �RONO �
� '�1�`�� ��-� �''''
`� ���: +�� �� G,�, MunIcipal Oflices
> !A+�`�.
��L;�{�i 0,�� Street Address: MailinQ Address:
E$�I 2150 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
95d-�49-4600
To G�urent Owner: Address: � � � s F�t��� C�c e.� Q�
City Ordinance 199 requires that each existing on-site sewage treatment system in Orono be inspected every two years.
The on-site sewage treatment system at the above address has been inspected and appears to fall into the categories checked below.
SYSTEM CONFORMITY 1-3 : �
1 "CODE SYSTEM"M ISTS which meets all the location,duign and construction standards of the currcnt Orono Municipa!Coda
2 "COMPLIANT SYSTEM" An iSTS which does not mect all the location,design and construction standards of the current Orono Municipal
Codc but docs mcct the thrce foot separation requircmcnt or two foot rcquircmcnt for systertu instalted 1996 or earlier,and which is not failing or
an imminent threat to public health or safety.
3 "NON-COMPLIANT SYSTEM" A prohibited ISTS;an ISTS located within a designated 100-year flood plain,any ISTS which may
or may not meet all the location,design,or wnswction standards of the current Orono Municipal Code and which is failing for any reason;and
any IS'I'S with less than Huce fcet of unsaturated soil or sand bctwecn the distribution device and the limiting soii charactcristics.
TANK CONDITION(5-:7�: 6
Tank inspection indicates:
5 Pumpout not needed at this time.
6U Septic tanks must be pumped out this year (city code requires tanks to be pumped oat once every 3 years.
Tank was last pumped 4-1$—`Z� ),
Make sure seatic tanks are pumped throu�h manhole and not through white inspection pines.
This allows for the proper cleaninQ.
7 Inspection risers missing-tanks could not be inspected. Inspection risers(4"dia.pipe)must be installed in each tank.
DRAINFIELD CONDITION -t(� : �S
8 Drainfield is dry,no surfacing evident. �
9 Some evidence of surfacing,not critical yet. �
10 Drainfield is saturated and visibly discharging untreated ef�luent to the surface. Contact the City Inspector �
immediately.Repairs must be completed within 90 days.
co�rrrs: S�rs�� ��oks oK._ P��.p �.��T s�}:� ��� � ex�.�
�-_s� o c- Sc4T=�. 5��s�� _
� 2'� -o�. �a�
Date of Inspection Matt Bo(tcrman- Septic System Inspector
Note: In the event that this inspecGon rcport is used to satisfy the rcquirements for a mortgage or other transfer of propecty,be advised that this rcport doa not guarantee
or certify that an exisdng rystem will continuc to function properiy,but is mercly an opinion of the adequacy ofthe sysum under current condi6ons based on the available
information.
- O�, ,
� 11�'�.
O O
,� , °t;�� a�
CITY of ORONO
. ti �I Mu�;�;� ot���
�� � .�.� ��, �ti, ,;
�9 4.�,� Street Address: Mailing Address:
�� $EggO ;;�' 2750 Kelley Parkway P.O. Box 66
\ -' Orono, MN 55356 Crystal Bay, MN 55323-0066
June 13, 2000
Michael & Jennifer Cashman
1205 French Creek Drive
Wayzata, Mn 55391
Dear Mr. & Mrs. Cashman:
An inspection of your septic system was conducted on June 7, 2000. A summary of the inspection
is below.
Septic Tank Condition
1. Pumpout not needed at this time.
The septic system is a compliant system, meaning it meets all or most current City and State
Standards. Enclosed is a list of licensed contractors who work in Orono on a regular basis. This
list is enclosed simply for your reference in case your septic system needs maintenance in the future.
Also enclosed is a fact sheet explaining your septic system and how it functions. Finally, an as-built
drawing is enclosed showing the approximate location of the septic system.
If you have any questions regarding this report, please contact me at the City Offices at 249-4600.
Resp�ectfi�l ,
�� �G�
ris Pence
On-Site Systems Manager
Enclosures
In the e��ent this inspection report is used to satisfy the requirements for a mortgage or other transfer of property,
be ad��ised that this report does no guarantee or certify the eaisting system will continue to function properly,6ut
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 the system location and pumping records.
Telephone(952)249-4600 • Fax(952)249-4616
www.ci.orono.mn.us