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Minnesota Pollution Compliance Inspection Form
��:; ��' Control Agency
520�afayette Road North Existing Subsurface Sewage Treatment Systems
St.Paul,MN 55155-4144 (SSTS)
Doc Type:Compliance and Enforoement
Instructions: inspection results based on Minnesota Pollution Control Agency(MPCA) for local tradcing purposes:
requirements and attached forms—addi6onal locai requirements may aiso apply.
Submit complebed form to Local Unit of Govemment(LUG)and system owner f
within 15 days � T �
System Status
System status on date(mmJdd/yyyy): 1/9/2014
❑ Compliant-Certificate of Compliance � Noncompliant- Notice of Noncompliance
(Valid for 3 years from r�port date, unless shorter time (See Upgrade Requiiements on page 3)
frame outlined in Local Orolinance.)
Reason(s�for noncompliance(check all applicable)
❑ Impact on Public Health(Compliance Component #1}—tmmirtenf threat to public health and safety
❑Other Compliance Conditions(Compliance Component�i3)—lmminenf threaf to public health and safety
❑Tank Integrity(Compliance Component #2)—Failing to protect gn�undwater
❑Other Compliance Conditions(CompNance Component#3)—Failing to protect groundwater
�Sal Separation(Compliance Component #4)—Failtng#o protect grroundwater
❑Operating permitlmonitoring ptan requirements(Compliance Component #5)—Noncompliant
Property Information Parcet ID#or SeclTwp/Range: 10-117-23-32-0014
Property address: 1270 French Creek Drive.,Orono, MN Reason for inspection: Property Transfer
Property owner_ Andrea Mueller __ Owner's phone: 612-369-0414
or
Owner's representative: ____ Representative phone:
Local regulatory authority: City of Orono Regulatory authority phone: 952-249-4600
2-1000 gallon septic tanks, 1-1000 Gallon lift station and approximately 750 square feet of trench per
Brief system descnption: city records
Comments or recommendations:
�ertification
t hereby certify ti►af aN the necessary information has been gathered to detennine the comp(iance sfatus of th+s system. No
determination of futur�sysfem performance has been nor can be made due to unknown conditions during system const�uction,
possible atruse of the system, fnadequete mairrtenance, or future water usage.
Inspector name: Joseph J Olson Ce�tification number: 1255
Business name: Rusty Olson's Soil&Perc.Testing License number: 810
Inspector signature: _______ ___ Phone number. 763-498-8779 �
Necessary or Locatty Required Attachments
�Soil boring logs �System/As-built drawing ❑Forms per local ordinance
❑Other information(list): i �
www.pca.state.mn.us • 65i-296-6300 • 800-657-3864 • TfY 651-282-5332 or 800-657•3864 • Available in altemative formats
wq-wwists4-31 • tl24/12 Poge 1 of 3
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Property address: 1270 French Creek Dnve.,Orono, MN ______ Inspector initials/Date: J.O.01/09h4
1, tmpaCt On PubliC Health—Compliance companent#1 of 5
Compliance criteria: ----- --- Verif'�cation method(sy:
System discharge sewage to the ❑Yes �No � ����for surface outlet
_ round surtace. _____ _ � Searched fw seeping in yard/backup in home
System discharge sewage to drain tile ❑Yes �No ❑ Excessive ponding in soil system/D-boxes
or surface waters. _ I ❑ Homeowner testittlony(See Comments/Exptanafion)
S stem cause sewa e backu mto � �g�����abave soit dispersa!system
Y 9 P� ❑Yes �No � System requires"emergency"pumping
dwelling or estabtishmerrt.
❑ Pertormed dye test
Any"yes"answer above indicates the system is ❑ Unable to veriry�see comments�icp�anar�on)
an tmminent Threat to Publfc Hea/th and Safety. ❑ Other methods not listed(See CommentsiEarplanation)
Comments/Expfanation:
2. Tdt7k (Rt2g�lty—Compliance component#2 of 5
Com�liance criteria: _� Verification method(s):
System consists of a seepage pit, I ❑Yes �No ❑ Probed tank(s)bottom
cesspool,drywell,or leaching pit. '
I ❑ Examined construction records
Seepage pits meeting 7080.2550 may be + ❑ Examined Tank Integrity Form(Attach)
Complranf if el/owed in loca!ordinanc�. �
� ❑ Observed liquid leve!below operating depth
Sewage tank(s)leak below their ; ❑Yes � No
designed operatin9 dePth__ �_ � Examined empty(pumped)tanks(s)
If yes,which sewage tank(s)leaks: i ❑ Probed outside tank{s)for"black soil"
-- ❑ Unable to veI'ify(See Comments/Explanation)
Any "yes"answer above lndicates the �pther methods not listed(See Comments/6cplanation)
system Is Failing to Protect Groundwater.
Comments/Explanation:
Elmer J Peterson pumped the tanks on 12/27/13
3. Other Compliante Conditions—Compliance component#3 of 5
a. Maintenance hole covers are damaged,cracked,unsecured,or appear to struduraHy unsound. ❑Yes* �No O Unknown
b. Other issues(s�ecfica�hazards,etc.)to immediately and adversely impad public health or safety. ❑Yes' �No p Unknawn
"System is an imminent thr+aat to pubfic health and safety
Explain:
c. System is non-protective of g�nd water for other conditions as determined by inspector ❑Yes` �No
*Syst�em is failing M protect groundwater
Explain:
www.pca.state.mn.us • 651-296-63� • 800-657-3864 • TTY 651-282-5332 or 800-657•3864 • Avaitable in alternative formau
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Property address: 1270 Fre�ch Creek Drnre.,Orono,MN ____ Inspector initials/Date: J.O.01/09/14
4. SOiI Stpd�atloh—Comptiance component#4 of 5
Date of installation: 7/27/89 _ ❑ilnknown Verification method(s):
�grelandMleli6ead protectionlFood Beverage �Yes ❑ No
Soil observation does not expire.Previous soi!
obse�va6ons by two independent parties are sulficient
COmplianCe cttite�ia;`_ _ unless site conditions have been altered orlocaJ
For systems built prior to April 1, 1996, and ❑Yes ❑No �Qu��ments di(fer.
not located in Shoreland or Wellhead � Condu�ted soil observation(s)(Attach boring/ogs)
Protection A�a or not serving a food, �
beverage orlodging establishment: ❑ T+'�P►�evious verifications(Attach borirrg togs)
❑ Not applicable(Holding tank{s),no drainfreld}
Drainfield has at least a twafoot vertical `
separation distance from periodically � ❑ Unab�e to verify(See CommentsiExplanetion)
saturated soil or bedrock. ❑ Other(see commenrsiEirp�ana6on)
Non performance sysfems built April i, � ❑Yes �No Comments/ExplanaGon:
1996,or(ater or for non perfom►ance
sysfems loceted in Shoreland or Wellhead
Protection Areas or serving a food,
beve►age, or lodging establishment:
Drainfield has a three-foot vertica!
separation distance from periodicafly
satt�rated soil or bedrodc.*
Experimental; 'Other; or Ferfomrance" �
❑Yes ❑No Indicate depths of elevations
systems built under pre-2008 Rules; Type IV -- — —
or V systems built under 2008 Rules(7080. A_Bottom of distribution media g7,2
235Q or 7080.2400 (Advanced Inspector --
LicenSe reqUired) B, Periodically saturated soi!lbedrpdc 95.6
Drainfield meets the designed vertical �`
separation distance from periodically C__System separation 1.6_
saturated soil or bedrock.
� D. Re uired com liance se aration• 2.6
Any"no"answer above indicates the system is *May be reduced up to 15 percent if allowed by Local
Faili�o Protect Groundwater. Ordinance.
5. 4perating Permit and Nitrogen BMP"—Comptiance component#5 of 5 �Not applica6te
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 tf"yes",B below is required
BMP=Best Managemenf Practice(s)specified in the sysfem design
If the answer to both questfons is "no`; this section does not need to be comp/eted.
Campliance criteria
a. Operating Permit number:
Have the Operatin Permit requirements been met? ��Yes ❑ No
b. ts the required nitro en BMP in place and properly functioning? � ❑Yes ❑No
Any"no"answer indicates Noncompliance.
Upgrade Requirements(Minn. Stat.§115.55)An imminent threat to pubfic hea/th and safety(fTPHS)must be upgraded,replaced,or its use
discarWttnued wilfiin ten mo�rths of retaeipf of thrs notice or withirt a shorter period it requirsd by locat ordinance.If the system is failing ir�profect
ground water,the system must be upgraded,replaced,or its use discontinued within the dme►�qui�ed by local ordinance.ff an exisfing system
is rat feiling es defrned in law,and has at least two feet of design soil sepsration,fhen the system need nof 6e upgraded,repafmd,rep�aced,or
Ifs use discontinued,notwifhstanding any local ordinance that is more sfict. This provision does rt�t apply to systerrrs in shoreland areas,
Wel/head Protection Areas,or those used in connectton with food,beverage,and/odging establishments as defined in law.
www.pca.state.mn.us •��651•296-6300 • ^800-b57-3864 • TTY 651-282-5332 or 800-657-3864 • Available in atternative formats
wq-ww15ts4-31 . t/I4/f1
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Tank �e�ort
L?ate; Decemher 27. 2�13
Elmer J. Peterson Co.
�921 Dague Ave.
Delano, MN 55328
Phone 768-972-2420
Fax 76�-972-7217
MPCA License# 219
Andrea Nfueifer
127Q French Creek Drive
Wayzata, MN 55391
(orono)
952-475-6654
Baf�les: �ON '� OFF`
-_..._�'
Tank Capacity: 3—���Ga11on Tanks
�
# of Tanks:3 _.___ __ ... _._ _ �'�
Type of Tanks_ GQ�crete
Gallans Yuznped: Z$�a
��' Manholes to Grade: YES / I�t� See Comments
I Comments:
On December 27,2013, Eimer J. Pe#erson Co. uncovered 2"�manhole(12 inches deep) and pumped
septic tanks. 18`manhole and(ift station manhole to grade. No cracks or water teaking at fhat time.
NOTE:This is only a tank report. This is not a connpliance insgection for point of sale nor does ,
it replace a compiiance inspection.
www.pca.state.mn.us . 551-296-6300 • --800-557-386a �'--T7'Y 651-282-5332 or 8(3Q-b57-38b4 `--- —
'+vq-wwist54-31 • 7/24/12 • Availabte in alternative formats
Pag�'�of 3
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Loqs of Soil Borinqs
License#84�
Location or Project: 1270 French Creek Drive
Borings made by: Rusty Olson's Soit and Perc testing �/g/2p'q
Classification System: AASHO ; USDS�USDS-SCS X ; Unified ; Other
�►uger used (check twa}: Hand_X^, or Power , Flight, Bucket ar Prabe_X^
Boring Number_1_Surface efevation_98.9_ Mottied So[t at 3.0 fee#
o"-8" Dark brown sandy loam 10yr3/2 H20 present at_3.5_
8"-20"Srawn sandy loam 90yr4/4
20"-36" Brown sandy loam to loam 10yr514
30"-36" Brown clay loam 1 Qyr5/4
36"-48" Rusty brown clay foam 10yr5/4
Boring Number_2_Surface e�levation_99.7_ Mottfed Soil at 1.3 feet
0"-8" Dark brown ioam 10yr4/2 i � ^
8"-16"Brown loam to sandy loa�n 10yr5/4
16"-36" Rusty brown loam to silU�y loam with iayers of sandy ioam 10yr5/4
TSM:Top offirst tank manhole cover. Efv.-100.00 assumed
Sottom of trench #1 Elv.-97.2 Mottled soils af Elv-95.6
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�' '� i�`"{ �' � .�� `� G "' Street Address: Mailing Address:
'��t�4 S�c��.�- "'�' 2150 Kelley Parkway P.O. Box 66
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���� Orono, MN 55356 Crystal Bay, MN 55323�0066
To: The Current Owner of Address �'� �C% ����'�� ��`��� �� '
City Ordinance requires that onsite sewa�e treatment systems iil0rono be
inspected on a periodic basis. The onsite sewage treatment system at the above
address has been inspected and the following is l:nown 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 tank be serviced and pumped
out every three years. City records indicate the tank(s) were last pumped out on
�, ��,� -�;'j . The tank(s) should be cleaned throuQh the manhole and
not throuQh the inspection pipes, tlus allows for proper cleaning.
Comments:
�.
�°�� � �� Date of Inspection � '�-���
Inspector: .. �
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Telephone i9�2j 249-�600 • Far (9�?1 249-4616
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�`9��Hpg'� 2750 Kelley Parkway P.O. Box 66
- - Orono, MN 55356 Crystal Bay, MN 55323-0066
To Cunent Owner: Address: �a�� ��t^�� ��t t�( 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 : `
"CODE SYSTEM" An ISTS which meets all the location,design and construction standards of the current Orono Municipal Code.
2 "COMPLIANT SYSTEM" An LSTS which does not meet all the location,design and construction standards of the current Orono
Municipal Code but does meet the three foot sepazation requirement or two foot requirement for systems installed 1996 or eazlier,and
which is not failing or an imminent threat to public health or safery.
3 "NON-COMPLIANT SYSTEM" A prohibited ISTS;an ISTS located within a designated 100-yeaz flood plain,any ISTS which may
or may not meet all the location,design,or construction standards of the current Orono Municipal Code and which is failing for any
reason;and any ISTS with less than three feet of unsaturated soil or sand between the distribution device and the limiting soil characteristics.
TANK CONDITION(5-7): �
Tank inspection indicates:
QS 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 \�L�-��-u3 ).
Make s�re septic tanks are pumped through manhole and not through white inspection pipes. This allows for the proper
cleanin� Keep water softner and iron filter discharge out of septic svstem to prolong life of drainfield. Ask pumper to test
alarm float to verifv alarm is still working in vour 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 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 dischargin�untreated effluent to the surface. Contact the City Inspector
immediately.Repairs must be completed within 90 days.
coMMErrTs: p��.�.�:-.���1 �- Se��-.�. -�.�,1C) � ���I� b� .
-? -�� -u� ��,-� �L�-
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
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 information.
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��.'� i'``'{ � � �� `� G '/ Street Address: Mailing Address:
��� ��kESHO�i��� 2150 Kelley Parkway P.O. Box 66
\:,.
`��� Orono, MN 55356 Crystal Bay, MN 55323-0066
To: The Cunent Owner of Address %� �rG ���' 2 �• �. C"ft�F�r �,�
City Ordinance requires that onsite sewage treatment systems in Orono be
inspected on a periodic basis. The onsite sewaae 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 Mana�er 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 Attomey 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
� � . ���j -u� . The tank(s) should be cleaned throuQh the manhole and
not throuQh the inspection pipes, tlus allows for proper cleanin�.
Comments:
�
Inspec� �,� � Y� �F� Date of Inspection � • �% � .
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Telephone l9�2) 2�9-4600 • Fa� (9�2) 2�9-�3616
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-��-��=� CITY of URONO
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�� 'i��r`��`��` G Street Address:
.�9 �.�; `�;,�¢�'y Mailing Address:
$$+gHO 2150 Kelley Parkway P.O. Box 66
Orano, MN 55356 Crystal Bay, MN 55323-0066
9sa-�49-4600
To Current Owner: Address: 1a7� �f c��� �('c2�� �r _
City Ordinance 199 requires that each existing on-site sewage treatment system in Orono be inspected every two years.
T'he on-site sewa�e treatment system at the above address has been inspected and appears to fall into the categories checked below.
SYSTEM CONFORMITY (i-31: �
lO "CODE SYSTEM"An ISTS which meets all the location,desion and conswction standards of the current Orono Municipa]Code.
2 ��COivIPLIANT SYSTEM�� An ISTS which does not meet all the location,design and conswction standards of the current Orono Municipal
Code but does meet the three foot sepazation requirement or two foot requirement for systems installed 1996 or earlier,and which is not failing or
an imminent threat to public heal[h or safety.
3 "NON-COMPLIANT SYSTEM" A prohibited ISTS;an ISTS located within a desipnated 100-year flood plain,any ISTS which may
or may not meet al(the location,design,or construction standazds of the current Orono Municipal Code and which is failing for any reason;and
any ISTS with less than chree feet of unsaturated soil or sand between the distribution device and the limiting soil chazacteristics.
TANK CONDITION(5�?: �
Tank inspection indicates:
5 Pumpout not needed at this time.
� Septic tanks must be pumped out this year (city code requires tanks to be pumped out once every 3 years.
Tank was last pumped 1 b -1�`- `�'�� )•
1V1ake sure septic tanl:s are pumped throu�h manhole and not throu�h white inspection pipes.
This allows for the proper cleaning.
7 Inspection risers missina tanks could not be inspected. Inspection risers(4"dia.pipe)must be installed in each tanlc.
D INFIELD CONDITION' - a�: �
8 Drainfield is dry,no surfacing evident.
9 Some evidence of surfacin�,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�� ���kS �k - �� �.�5 r ���� � ex�� I-�
L F C�f c.: ��;C1 L ,
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Date of Inspection Matt Bolterman - Septic System Inspector
Note: In[he event that this inspection report is used to satisfy the requirements for a moRga�e or other transfer of property,be advised that this report does not guarantee
or ceRify 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
infortnation.
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CITY of ORONO
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�'„ . ,�ti MunicipalOffices
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9 � ��4��'�'"
1fEgg0, % 2750 Kelley Parkway P.O. Box 66
�__-___%' Orono, MN 55356 Crystal Bay, MN 55323-0066
June 13, 2000
P. Eric & Andrea Siegert
1270 French Creek Drive
Wayzata, Mn 55391
Dear Mr. & Mrs. Siegert:
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.
Respect lly,
/
�
���%�, �`��
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 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 the system location and pumping records.
Telephone(952)249-4600 • Fax(952)249-4616
www.ci.orono.mn.us
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�,� ; : j � , ` ,� ;) CITY of ORONO
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V` v�,, �' �. �° �� �!� Municipal Offices
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� � '�� �� :� Street Address: Mailing Address:
`9�i'EggOg' 2750 Kelley Parkway P.O. Box 66 �
Orono, MN 55356 Crystal Bay, MN 55323-0066
Owner: � i � �,� w, (`'�C l Tc��r e- Address: 1270 French Creek Dr.
Permit #'s: 1861 Dates: 6/20/89 Contractors: Ingleside Engr.
(This is [�,/f 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 [� has or [ ] has not been identified at this time. If the
saturated soil lavel has not been idantified, 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.
�j 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 confirmad
to be watertight by the licensed pumping contractor. If the tanks were not confirmed to be
watertight, this classification is subject to ravision.)
DRAINFIELD 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 SY5TEM FAILURE: (system age and condition, soils, etc. ) : low
COMMENTS:
�
�l,��l�� .�---
Date of Inspection Se tic 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 conditiuns.
Telephone (612) 473-7357 • FAX 473-0510
CITY OF ORONO � O�
Municipal Offices O � O
Post Office Box 66
Crystal Bay, MN 55323-0066 � � ON—SITE SEWAGE TREATMENT
r�,� � INSPECTION REPORT
'C�� G~
9kESH�4'�
Owner:___1�I1��/��i'r\ ///l' (�U�� Address: /v��� �I�Lal�'� �I�C�I�- ��':
Permit #'s: � Dates: ���� i Contractors:�i°���(+►�! �1'�t1;
City ordinance number 100 requires that each on-site sewage treatment system in Orono be inspected on a regular basis.
The on-site sewage treatment system at the above address has been inspected and appears to fall into the category
checked below.
(This is � an existing system [ ] new construction)
SYSTEM CONFORMITY (1-3):
1 "CODE SYSTEM"-A system which meets all the location, design, and construction standards of the current City
Codes, and which 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 uhich does not meet all the location, design, and construction standards of the
current City Codes, but Was installed according to the code in effect at the time of installation, and uhich
is operating satisfactorily by treating and disposing of the entire current sewage input uithout discharging
any pollutants into ground or surface Waters.
3 "NON-CONFORMING SYSTEM"-A prohibited system; a system located within a designated 100-year floodplain; any
system which may or may not meet all the location, design, and construction standards of the current City
Codes and which is failing for any reason; and any system uith less than 3 feet of unsaturated soil or sand
between the distribution device and the limiting sotl characteristics.
(The limiting soil characteristic �.-has or [ ] has not been identified at this time. If the limiting soil
characteristic has not been identtfted, this classification may be subject to revision.)
TANK CONDITION (5-10): �"
Tpt�lq inspection indicates:
l5% Pixnpout not needed at this time.
6 Solids accumulation in tanks indicates they should be purtiped out this year to help prevent future problems.
7 Solids accurtiulation in tanks is at a critical level. Tanks should be pixnped out as soon as possible.
8 System is discharging to the surface. Tanks must be purnped out within 48 hours to eliminate surface dischar�e.
9 Inspection risers missing-tanks could not be inspected. Inspection risers (4" dia. pipe) must be installed in each
tank at next purtipout. If tanks have not been punped out uithin 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 p�xnped out within the last three years, they should be pumped out now.
DRAINFIELD CONDITION (11-14):
D field inspection indicates:
�Drainfie[d is dry, no surfacing evident.
12 Some 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 within 90 days.
14 Drainfield extent and condition unknown.
LIMITING SITE FACTORS Cslope,setbacks,etc.):
POTENTIAL FOR SYSTEM FAILURE (depends on soils,water table,etc.): ���
COMMENTS:
Date of nspection ep c Syste 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 pre�nises with the system loc�tion and pumping records.
WHITE COPY/Inspectors File YELLOW COPY/Homeowner
CITY OF ORONO � O�
Municipal Offices O � O
Post Office Box 66
Crystal Bay, MN 55323-0066 � � ON—SITE SEWAGE TREATMENT
r�,� � INSPECTION REPORT
ti
��9kESH0�'�G
Owner: . ,C�iI1 /�///�f'/I� Address: � /�C . (�Vi"P� �.
Permit #'s: �J���f Dates: O���� Contractors:��/[�)� t_a. �1!
City ordinance number 100 requires that each on-site sewage treatment system in Orono be inspected on a regular basis.
The on-stte seuage 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 SYSTEM"-A system uhich meets all the location, design, and construction standards of the current City
Codes, and which 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 was 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 sewage input without discharging
any pollutants into ground or surface waters.
3 "NON-CONFORMING SYSTEM"-A prohibited system; a system located uithin a designated 100-year floodplain; any
system which may or may not meet aLl the location, design, and construction standards of the current City
Codes and which is failing for any reason; and any system with less than 3 feet of unsaturated soil or sand
between the distribution device and the limiting sotl characteristics.
(The limiting soil characteristic �} has or [ ] has not been identified at this time. If the limiting soil
characteristic has not been identified, this classification may be subject to revision.)
TANK CONDITION (5-10): �
Tpr�c inspection indicates:
C5� P�pout 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 discharge.
9 Inspection 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 uithin 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 pumped out within the last three years, they should be pumped out nou.
DRAINFIELD CONDITION (11-14): �
Dr field inspection indicates:
Drainfield is dry, no surfacing evident.
2 Some evidence of surfacing, not critical yet.
13 Drainfield is saturated and visibly discharging untreated effluent to the surface. Contact the City inspector
irtmediately. Repairs must be completed within 90 days.
14 Drainfield extent and condition unknoun.
IIMITING S1TE FACTORS (slope,setbacks,etc.): �
POTEN7IAL FOR SYSTEM fAILURE (depends on soils,water table,etc.): ��
COMMENTS:
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 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
information.
This report must be kept on the prE�nises with the system loc>ti�n and pumping records.
WHITE COPY/Inspectors File YELLOW COPY/Homeowner