HomeMy WebLinkAboutseptic info � 05/01/2014 07:03 9528733112 PAGE 61/04
�� Minnesata Potiution Compliance Inspectian Form
contrcl Agency
520LafayetieRoedNarth ����t��g Subsurface Sewage Treat�t�nt Systems (SSTS)
St.Paul,MN 55155�194 Doc Type�Compliance and E»fprCement
For local track �
Itlsp�c#ion resultS b�sed on Mlnnesota Pollutian Control Ag�ncy(MPCA) ��ED
r$quirements and attached forrns—additional Iocal roquirements may also apply.
Submlt completed form tp LoCal Unit vf Government(LUG)and system own�r J�� ? � i(���:
withfn 15 deys
CITI'OF ORONO
System Status
System st�tus on date(mrnlddlyyyy): 5/1/2pi4
�f Compliant— Certificate of Compliance ❑ �oncoimpliant— Nvtioe af Noncampliance
(Valid fnr 3 years from report date, unless shorter time (See Upgrade Requirements on page 3.)
irame outlirred in Loca!Ordinance.)
�#easan(s)for noncompliance (check aD applicable)
[] Impaat on Public Health(Compliance C�mponent#1)—lmminent threat to public healih and safety
❑Other Compfiance Conditions(Gomplian�e Component#3)—lmmrnent fhreat to publrc health and safety
❑Tank Integrity(Complianae Gomponent#2)—Fail�ng to protect groundwater
❑Other Compliance Conditions(CompGance Componenf#3)—Feiling to protect groundwater
Q Soil Separation (Compliance Component#4)—Farling to protecf groundwater
(�Oper�ting permi�/monitoring plan requiremants(Compliance Component l�5)—Noncompliant
Property In�Formatian Parcel ID#or Sec/Twp/Range:
Prop�rty address: 125 Goldan ViEw Drive-Long Lake Reason for inspection: sale
Property awner; �Cra�Johnson__ __ Owner's phone: � ���^ M^
or _.._ �._�
Qwner's representative; Representative phone:
Lacal regulatory authority: Counry pegufatory authority phone:
Brief system descriptio�: 2- 7�00 septics& 1004 pump tank,mound system
Comments or recommiendations:
Mound onfy had about 6"of dlrt over�ockbed instead of the 18" required when installed. Adding 12"of topsoil to mound would help
protect from freeaing. This does not cause the system to tail compliance
Certification
1 hereby certiFy that a!f the necessary information l�as been gathered to determine the cvmpliancs status of thrs system_ No
determrnafion of luture systam parformance has beeR nor can be made due to unknown condirions during system construcr;on,
possibfe abuse o!the systern, inadequate mairrtenance,or fu#ure water usaQe.
Inspector name; Josh Swedlund Certification number: C1659
Business name; Swedlun ti rv' Licenss number: 2502
Inspector signature: Phone number; 952-873-3�9a
Necessary or Locally Required Attachments
�Soil boring logs �System/As•built drawing � Forms per local ordinanCe
❑Oth�r information(list}: � ����� ��� �
www.p�asta[e.mn.us . 651-296•b300 . 800-657-3864 . TTY 651•282-5332 Or$00•657•3864 • Available�n altemati�e formats
wq-wwists4-31 • 3J 16/12 Page l of 3
. � 05/01/2014 07:03 9528733112 PAGE 02/a4
Prop�rty address: 125�xolden View Drive• Lang Lake __^ Inspector fnitials/Date: J5 � 5/1/��1a _
(mm/ddly}ryyJ
1. Impact on Public Health—Compliance component #1 of 5
Com lianc�cri#�ria: . Verlfication method(s):
System dischargas sewage to the ❑Yes �No � Searched for surface outlet
round surf2�Ce. �Searched for seepfng in yardlbackup in home
System dfscharges sewage to drain ❑Yes �Nv d Excesslve ponding in soil system/D-boxes
tile or sur�ace waters. � Homeowner testimony(See Comme»ts/Exp�anafron)
System causes sewage backup into ❑Yes �$1 No ❑"Black soil"above soil dispersai system
dwelling or esiablishment. I 0 System requires"emergenc�'pumping
Any""yes"a�nswer above indicafes the 0 Per�armed dye test
sysfem is en imminent threat to public ❑ Unable to verify(See Gomments/�xp�anatfon}
f�ealth and safety. ❑Other methods not lisied (See Gomments/Explanatron)
Com mentsJ�xplanation:
2. Yank Inte�rity—Compiiance component #2 of 5
Complpance criteria: verification method{s}:
System consists of a seepage pit, ❑Yes �Na ❑ Probed tank(s)bottom
cesspofll,drywell,or leaching pit. ❑ �xamined canstructlon records
Seepage prfs mesting 7080.2550 may be �ExBmined Tank Integrity Form (AttaChj
compliant iP allowed ln Jocaf ordinartCe,
"'— ""— �Observed liquid le�el below operating dep#h
Sewage tank(s}IQak below their ❑Yes � No
deslgned operating depth. � �xamined empty(pumped)tanks(s) �
If yes,which sewage tank(s)leaks: ❑ Probed outside tank(s)for"black sal"
' � Unable to verify(See Comments/�zplanailon)
Arry "yes"�nswer above indicates the
system is fsiling to prot�ct gro�►ndwater. ❑Othsr methods not�isted (see comments/�xplanatlon)
Gommpnts/Explanatlon. �
3. Other Compliance Cond3tions�-Compliance component#3 of 5
a. Maintenance hole Covers are damaged,cracked,unsecurad,or appear to be struoturally unsound. ❑Yes" �No ❑Unknown
b_ bther issues(elechf�alltazards,er�.)to immecfiat9ly and adversely impact public health or safety. �Yas° �I No ❑unknown
*System fs an imminent thres!to AuWic health and safety.
Expla�n:
c. System is non-protective o4 ground waCer far other condit{ons as determined by inspector. ❑Yes' �No
"System!s falling ro protect grou�ndwater.
Explain;
www.pCa_state.mn.us • 651•Z96•6300 . 800-657-386A • TTY 651-ZSZ-533�,or 800-657-3864 • Avaitabte in alternative formais
wq-wwts[s4-3T • 3J 161 fz Poge 2 of 3
4
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� O�
O �,, O CI'TY OF ORONO
';t`_�,, -�
� � MunicipalOffices
� ,������� �� Street Address Mailing Address:
� 2750 Kelley Parkway P.O. Box 66
'Z �iG Orono, MN 55356 Crystal Bay, MN 55323-0066
�kESH04
To: The Current Owner of Address 125 GOLDEN VIEW DR
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) Pump out Needed
Yes �No
The city recommends the septic tank(s) and/ar lift tank be serviced and pumped out every three
(3) years. City records indicate the tank(s) were last pumped out on '�. ,�► —05—
The tank(s) should be cleaned through the manhole and not through the inspection pipes, this
allows for proper cleaning.
Comments:
^�r ��, P
Insp��.�.��.•�� "�,�'�°��"��� Date of Inspection: � �0 �
Telephone (952� 249-4600 • Fax (952) 249-4616
www.ci.orono.mn.us
- r
• • • •
e
To: Orono residents on mound type septic systems
From: Wiflie Gibbs, ISTS Manager
Date: May 10, 2006
Re: Landscaping Do's and Don'ts for Mound Systems, Quick Reminder
Do plant and maintain a full cover of grass and keep mowed to a normal height, this grass cover aids
in the evaporation of large amounts of effluent (the fiquid 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 probiems.
Do inspect your mound system annually for winter kill, (reseed if necessary) animal damage,
(burrowing)or signs of potential failure.
Do not plant trees or shrubs on the mound system, smaller trees and shrubs may be planted at the
edges. Remember, that sunshine is the key to a healthy mound system.
Do ask questions, if you have any concerns or questions concerning your mound systerr9
please feel free to call me, I can be reached at 952-249�4626.
1
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�( -,,�lr=,::�w��. _ �I'�Y of �RONO
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��l�� 'b�� �� �} `:,� " �C, Municipal Offices
,'� � ii;�� ;�1�°'``\+;�; G~;�� Street Address: �15a:-a4q—ybo O
,,;`,�� g,�,,, Mailing Address:
� kE$Kp .;.;: 2750 Kelley Parkway P.O. Boz 66
���_--�' Orono, MN 55356 Crystal Bay, MN 55323-0066
To Current Owner: Address: /,� :� Cr,��U ��''�•`i �!� (��.�.'
City Ordinance 199 requires that each existing on-site se�vage treatment system in Orono be inspected every rivo 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): �
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 sepazation requirement or nvo 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 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 limitin?soil characteristics.
TAi�TK CONDITION(5-7): �
Tanl:inspection indicates:
5 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 ).
Mzlce sure septic tanks are pumped throuQh manhole and not throuQh white inspection pipes. This allows for the proper
cleaninS ICeep water softner and iron filter dischar�e out of septic svstem to prolonQ 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 tanlc. If
tanlcs have not been pumped out within the last three years,they should be pumped out no�v.
DRAINFIELD CO�tDITION(8-10): ��
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.
�OM��ENTS:
� �
� � �;�
-'� — '
�
! ' � � '`� ;� '� �.4` . �.,:
Date of Inspection Seotic System Inspector
� o� �
0 0
��a���:,;���� ;= CITY of 4RON0
�r�, �u�d�„F���t.>,h� �ti Municipal Offices
�' � rI`�r{�-ti
�,� �'��'�`,,���.�"�� Street Address: Mailing Address:
'9l�Eggp4� 2750 Kelley Parkway P,O. Boz 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
To Current Owner: Address: ��� �'`'''���� �'���� �'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.
!STEM CONFORMITY 1-3 : 0
1 "CODE SYSTEM'� An ISTS which meets a(I the location,design and construction standazds 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 hvo foot requirement for systems installed 1996 or eazlier,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-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 wiUi less than three feet of unsaturated soil or sand between the distribution device and the limiting soil chazacteristics. �
TANK CONDITION(5-7): ..�`�
Tank inspection indicates:
� 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 �7 ' )L-C��. ).
Make sure septic tanks are pumQed through manhole and not through white inspection pipes. This allows for the
proner cleaning. Keea water softner and iron filter discharQe out of sentic 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 : �'
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: /�'�C �r—d c3— 5C�' fi.—� -�-�-��k-� ����� ���,
�
� -1�-�� ��� IJ ,
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 Vansfer of property,be advised that this report does not guazantee
or cercify that an existing system wiil continue to function properly,but is merely an opinion of the adequacy of the system under current conditions based on the available
information.
Telephone(952)249-4600 • Fax(952)249-4616
www.ci.orono.mn.us
. � °� � � � �
O�r�` � O . • .
� ��=�3��-� CITY of �RON
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� � M��� ots��
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��"�'�};;;•�g�i Street Address: Matling Address: -
. k�.'8I'j� 2150 Keiley Parkway � P.O. Box 66
Orono, MN 55356 Crystai Bay, MN 55323-OU66
i
Owner: �aMeS 1-� e�e,� �o,L�� � Address: �as Golae� v;e",- Or. .
Ciry Ordinance 199 requires that each existing on-site se�vage treatment system in Orono be inspected every two yeazs.
The on-site se�vage treatment system at the above address has been inspected and appeazs to fall into the categories checked belocv.
SYSTEM CONFORMITY (1-31: � � �
O "CODE SYSTEM" An ISTS which meau a11 the locatioa,daiga and construction standards ofthe current Orono I�funic�pal Coda
2 "COI�LIANf SYSTEM" An ISTS which does not meet all the locatian,daiga and coastnvction siandazds of the currrnd proao Muaicipal
Code but doa meet tha three foot separation requirement,and wfiich is aot failing or aa immineat thceat to public heatth or saf_Ky.
3 "NON-COMPLIANT SYSTEM" Aprolu'bited ISTS;aa LS'TS located withia a desigiated 100-year flood plaia,any ISTS wfiich may
or may not med all the tocatioq daign,or coashvcticn standards of the current Orono l�fuaicipal Code and which is failing for aay reasoq aad
any ISTS with less than three fed of unsahuated wil oc saad betweea the distn'bution device and the Iimitin3;oi1 characteristia,
TANK CONDITION(�-10): ,�_ � •• ' �
Tank inspection indicates: .. •
� Pumpout not needcd at this time.
6O Tsnk must be pumped out this yeac (city code requira tanks to be pump<d out every 3 years. Tank wu last pumped ��- �b- �� �_
7 Solids accumulation in tanlcs is ac a cricical a criti��al lavaL Tanks should be pumpad out as soon as possibla.
8 Systam is discharging to the surface. Tanks must be pumped aut within 48 hours to eliminata�urface d'uch.uge.
9 Inspectian risers missing-tanks could not be inspected. Irupection risen(4"dia pipe)must be installed in each tank at next pumpout If tanks
Fuva not been pumped out wichin the last three years,they sEieuld ba pumped out aow.
10 Inspe�Kiun pipa is lacated d'ueti:dy over tac�lc ba�le(does not give accurate measuremeat of salids accumulation). If tsnlu have not bern pumped
out�vithin the list three yean,they should be pumped out now.
D IELD CONDITION I1-14 : ��
11 'Drsinfield'u dry,no surfacing evident
12 Some e�tidrnce ofsiufacing,not critical yet � � � . ' ' . -
13 Dcsinfic(d is sa4ir.�ttd and visibly discharginq untreated e�lucut to tht sucface, Contact the City Irupector immediataly.Repairs must be
cromplrud«ithin 90 days, .
1� Drainfield estrnt and condition unknowa.
COM1dENTS: S�St��• � :5 bK. Qv�,p -t'a��CS �� �1.c
��. ca � .�,.� �q -� �vc n�- bce,.
Ye4�5 - .
- � -3 0 - �\ . �1 a�. .
Dace ofInspccaon � .
Septic Systcm Inspector .�`
Notr.: In the event that tfvs asspeciioa repoR u used W satisfy the requiremcats for a mortgage or otha hansfa of property,be adviscd tha!this repaR doa not guaraatae
or certiFy that aa e�sting systzai will eordinue to funecioa properlY,b�u mnely aa opiaion of the adequacy of the rysiem under euaeat eeaditioas baud on th�e avaz'Isble
informatioa
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��`'�
Owner: �.1/4�')'1�� ������r�HL Address: ��S GCJ��P.�� (0��=7.t.� ��2� ( 5�.f'.$'E�
� ,
�
Permit �'s: 3�� Dates: 1� �`t�Fi'� Contractors:_�����j'fc������"f�- ���Jc'�
�
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�j an existing system [ 7 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
uithout 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 sewage input without 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 uhich 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 soil characteristics.
(7he limiting soil characteristic �j 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):
7ank inspection indicates:
Pumpout not needed at this time.
b Solids accumulation in tanks indicates they should be pumped out this year to help prevent future problems.
Solids accumulation in tanks is at a critical level. Tanks should be p�xnped out as soon as possible.
8 System is discharging to the surface. Tanks must be pumped out uithin 48 hours to eliminate surface dischar�e.
9 Inspection risers missing-tanks could not be inspected. Inspection risers (4" dia. pipe) rt�st be installed in each
tank at next pumpout. If tanks have not been pumped out uithin the last three years, they should be punped
out now.
10 Inspection pipe is located directly over tank baffle (does not give accurate measurement of solids accumulation).
If tanks have not bee� pu�ed out within the last three years, they should be purnped out nou.
DRA[NFIELD CONDITION (11-14):
t1f�ilifield inspection indicates:
L,]a� Drainfield 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
irmiediately. 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.): ���v
i / � .�
COMMENTS: S�=/�T�C 7�to�G�S SL'lc-^C��C 1 �Gt '7 C� G(,+ `�Gt, � iZ
�
!
Date of nspection Septic ystem Inspector
Note: ln 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
informatton.
This report must be kept on the pre�nises uith the system tocation and pumping records.
WHI7E COPY/Inspectors File YELLOW COPY/Homeowner
CITY OF ORONO � O�
Municipal Offices O � O
Post Office eox 66
Crystal Bay, MN 55323-0066 � � ON—SITE SEWAGE TREATMENT
r�` � INSPECTION REPORT
�� (J~
9kESH�g'�
� r
Owner• ��.5 Address• � �
Permit #'s: �,�� Dates: f��('O/ Contractors:
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 belou.
(This is f� an existing system [ ] neu 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
uithout discharging any pollutants into ground or surface uaters.
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 soil characteristics.
(The limiting soil characteristic f�, 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 C5-10):
Tank inspection indicates:
5 Pumpout not needed at this time.
6 Solids accumulation in tanks indicates they should be ed out this year to help prevent future problems.
7 Solids accumulation in tanks is at a critical level. Tan s 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. lf tanks have not been pumped out uithin the last three years, they should be purt�ed
out now.
1 Inspection pipe is located directly over tank baffle (does not give accurate measurement of solids accumulation)
!f tanks have not been punped out within the ears, the s ould b p ed out nou. / �pL�
/
DRAINFIELD CONDITION (11-14):
Dr field inspection indicates:
�Drainfield is dry, no surfacing evident.
T2 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 S1TE FACTORS (slope,setbacks.etc.): �
POTENTIAL FOR SYSTEM FAILURE (depends on soils.water table,etc.): �
COMMENTS:
Date o Inspection ept c System Ins ector
Note: ]n 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�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 a � ON—SITE SEWAGE TREATMENT
� � INSPECTION REPORT
ti
���kESH��'�G
Owner: ���� f�y(��Q�� Address: ��� 1�,0/..�1�'/1 ��1`�ir� �./+�
Permit #'s: ���t� Dates: �Q��`"�� Contractors: L��nf� J�EI/
City ordinance nurtiber 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 �1, an existing system [ ] new construction)
SYSTEM CONFORMITY (1-3):
1 "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 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 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 soil 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):
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 �olids 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 lnspection risers missing-tanks could not be inspected. lnspection 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).
!f tanks have not been pumped out within the last three years, they should be pumped out now.
DRAINFIELD CONDITION (11-14):
D�field inspection indicates:
1 Drainfield is dry, no surfacing evident.
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 S1TE FACTORS (slope,setbacks,etc.):
POTENTIAL FOR SYSTEM FAILURE (depends on soils,water table,etc.): �j�
COMMENTS: StP {'.,, �'i � � , � r' ' T� c* ! �=' a ��
1�— a ,.,,,.r�
_ _ _ �tf,� �
Date of Inspection Se tic 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 certtfy that an existing system will continue to function
properlyi but is merely an opinion of the adequacy of the system under current conditions based on the available
informatton.
This report must be kept on the pre�nises with the system loc�tion and pumping records.
WHITE COPY/Inspectors File YELLOW COPY/Homeowner
On the North Shore of
Lakc Minnetorzkn
ON-SITE SEWAGE TREATMENT
INSPECTION REPORT � POST OFFICE BOX 66
1335 S. Brown Rd.
� � � Crystal Bay, MN 55323
473-7357
,l(�1�'>�1 /�Yt� I� ��l �7 !� � /�
OWNER � ADDRESS � � J�'� ✓/Y
PERMIT NO.'S. ��� DATES /������ CONTRACTORS '� � e�
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 fall into the category checked below.
(This is � an existing system ❑ new construction)
�� Meets or exceeds current City standards in all respects relating to design,construction,and location.Appears to be operating
properly.
� 2 Does not meet all current City standards for new construction (1978 Code) 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 relati�g 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 property 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
creati�g 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 contractor 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 measurement 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 prob�ems. should be pumped out now.
❑ Solids accumulation in tanks is at a critical level. Tanks Drai field 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. ❑ Drainfietd 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
at next pumpout. If tanks have not been pumped out within immediately.Repairs must be completed within 90 days.
the last three years,they should be pumped out now. ❑ Drainfield extent and condition unknown.
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 Low ❑ Fair
❑ Lot size �Medium ❑ Poor
❑ Lake,wetland,or stream ❑ High O Inadequate
❑ Drainage ❑ System is causing visible
���� �� , surface discharge.
COMMENTS: . ✓ - ��e �� � �
� 1� Q Z=t'-� ° O►i1� 1� r
����� �
Date of Inspection ptic 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 premises with system location a�d pumping records.
WHITE COPY/Inspector's File GOLD COPY/Homeowner
On the North Shore of
Lake Minnetor:ka
ON-SITE SEWAGE TREATMENT
INSPECTION REPORT • POST OFFICE BOX 66
� _ � � 1335 S. Brown Rd.
Crystal Bay, MN 55323
473-7357
OW N E R rt,l(�YnP� ��la�'� � !`�'l���l�iL"L— A D D R ESS ��� �,/�'/�'•�'� �//l°lA✓ ,v'"�
PERMIT NO.'S. ����' DATES —,��`�� �7 CONTRACTORS ����
City Ordinance No. 210 requires that each onsite sewage treatme�t 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)
� � Meets or exceeds current City standards in all respects relating to design,construction,and location.Appears to be operating
properly.
� 2 Does not meet all current City standards for new construction (1978 Code) 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 creati�g 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 contractor must obtain a permit before work is started.
SYSTEM CONDITION ( m Checked items may require your action)
Tank inspection indicates: o�'�Inspection pipe is located directly over tank baffle.(Does not
❑ Pumpout not needed at this time. give accurate measurement 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 Dra�in,1field inspection indicates:
should be pumped out as soon as possible. {m 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
at next pumpout. If tanks have not been pumped out within immediatety.Repairs must be completed within 90 days.
the last three years,they should be pumped out now. ❑ Drainfield extent and condition unknown.
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 �Low '�Fair
❑ Lot size ❑ Medium ❑ Poor
❑ Lake,wetland,or stream ❑ High . ❑ Inadequate
❑ Drainage ❑ System is causing visible
s rface disch rge.
COMMENTS: � .� � �/ � /Jt—�� G J t�
s' Y !' L � - �% SO}'�.
]�-�9 9c� -��� .�--
Date of Inspection 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 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