HomeMy WebLinkAboutseptic info =o���
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,f�� � � � �ITY of OItU�TO
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,t � t;, `:`ti`�G Street Address: q 5a-a�}q—y 60 � Mailing Address:
'9$E�gH2Og' 2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
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To Current Owner: Ad ress
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 : �
"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 consh-uction standards of the current Orono
Municipal Code but does meet the three foot separation requirement or trvo 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 curren[Orono Municipa]Code and which is failing for any
reason;and any ISTS with less than three feet of unsaturated soil or sand beriveen the distribution device and the luniting soil characteristics.
TANK CONDITION(5-7): _�
Tank inspection indicates:
UPumpout 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 S—\0'�`� ).
Make sure septic tanks are pumped through manhole and not throu�h white inspection pipes. This allows for the proper
cleaninQ. Keep water softner and iron filter discharEe out of septic svstem to prolong life of drainfield. Ask pumper to test
alarm float to verify alarm is still workin�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): �
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: ���:n�-.;c1U � 5���.L �-�,,:kS _.. _ .._._ �polC 6� _ _
�'�'�� � �`�
Date of Inspection Matt Bolterman - Septic System Inspector
Note: ln the et�ent 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 �uarantee or certify that an exis[ing sr'stem will continue to function properl}�, but is merely an opinion of the adequac}� of thz s�stem under cw-rent
cunditions based on the available inlonnation.
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����� �� Mailin Address:
� �� '� �� .' ' r ��:;,;�'�� �;�% Street Address: g
� ����kESH��i��// 2150 Kelley Parkway P.O. Box 66
`� Orono, MN 55356 Crystal Bay, MN 55323-0066
To: The Cunent Owner of Address 1 '�e �J � /C'��� -�r�'E' S
City Ordinance requires that onsite sewa�e treatment systems in Orono be
inspected on a periodic basis. The onsite sewage treatment syste.m 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 ��TO
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 wi11 result in refenal to the Cit�-Attomey for
leQal action.
System Identified as Non-Compliant
Yes ��T 3
If yes, system must be brou�ht into compliance by:
December 31, 2007
December 31, 2010
Other
Septic Tank(s) Pump out INeeded
Yes �No
The City recommends the septic tank(s) and/or lift tai�k be serviced and pumped
out every three years. City records indicate the tank(s) were last pumped out on
��— t�, -��� . The tanl:(s) should be cleaned throu�h the mailhole and
not through the inspection pipes; tlus allows for proper cleanin�.
Comments:
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Inspect�� � � `"' � �,,,, _��� .,�__ Date of Inspection '��' �
Telephone(952') 249-4600 • Far (9�2)249-461(
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, '� Street Address:
� '� Maling Address:
��K�g 2750 Kelley Parkway
Orono, MN 55356 P•�• Box 66
95d-�yq-y600 Crystal Bay, M�y 55323-006E
To Cu.-rent Owner: Address: �� � � ������'� )��Y S
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Ciry Ordinance 199 requires that each existin�on-site sewage treatment system in Orono be inspected every two years.
The on-site sewa�e treatment system at the above address has been inspected and appears to fall into the categories checked below.
SYSTEM CONFORI�IITY (1-31: I
l 1 1 "CODE SYSTEM"An ISTS which mccts all the location,dcsign and construction standards of the currcnt Orono hfunicipal Codc.
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2 "COMPLIANT SYSTEM" An iSTS which docs not mect all the location,dcsign and construction standatds of thc currcnt Orono biunicipa!
Codc but docs mect thc t}uee foot separation rcquircment or two foot rcquircment for rystcros instalicd 1996 or eazlicr,and which is not failing or
an imminent thrcat to public hcalth or safcry.
3 "NO�1-CO�tPLLANT SYSTEM" A prohibited ISTS;an ISTS locatcd within a duignatcd 100-ycar flood plain,any ISTS which may
or may not mcct ali thc location,desigr�or construclion startdards of tjic curnnt Orono Municipa]Code and which is failin�for any ttason;and
any ISTS with Icss than thrce fcet of unsaturated soil or sand bccwcen the distribution dcvice and thc limidna soi]charactcristiu.
TANK CONDIT[ON(5-:71: r:
Tanl:inspection indicates:
� Pumpout not needed at this time.
6 Septic tanks must be pumped out this year (city code requires tanks to be pumped out once every 3 years.
Tank was last pumped �.
I�Ial;e sure septic tanks are pumped throuah manhole and not through�vhite inspection pipes
This allo��•s for the proper cleanina.
7 Inspection risers missin�tanks could not be inspected. Inspection risers (4"dia.pipe)must be installed in each tank.
�
DRAINFIELD CONDITION($-JQ): _�
8 Drainfield is dry,no surfacino evident.
9 Some evidence of surfacin„not critical yet.
10 Drainfield is saturated and visibly dischar�in�untreated effluent to the surface. Contact the City Inspector
immediately.Repairs must be eompleted within 90 days.
CO�iENTS: �:�����C'.�\c� a�c� ���f�� ��kS �ac� c`� �'�►M�� Szp��.
�-����5 5� mh.zr �GC,� _
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Da;c of Inspection I�fatt Bolterman - Septic Syscem Inspector
Note: ln the event that this inspecaon rcport is used to satisfy the rcquiremenes for a moctaa�e orother transfer of prope .ry,be advised�hat this rcgaR does not Su=n.��=
arcc;tify thu an cxisting rystcm will continue m function properly,but is mcrely an opinion ofthe adcquary of the system tmder eurrentconditioru based on thc availabi
information.
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��=�T� CITY of ORONO
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l��"}�t�Og�i " Street Address: Mailing Addrass:
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� � ES�I 2750 Kelley Parkway P.O. Bax 66
Orono, MN 55356 Crystal Bay, MN 55323•006&
95a-�yq-yboo
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To Current Owner: Address: I 4`�� Gc e e� 1 f e eS ��
Ciry Ordinance 199 requires that each existin�on-site sewa�e treatment system in Orono be inspected every two years.
The on-site sewa�e treatment system at the above address has been inspected and appears to fall into the categories checked below.
SYSTEM COIVFORMITY 1-3 : �
1 "CODE SYSTEM"An ISTS which mcets all the location,duign 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 thc current Orono Municipal
Code but does mcet the t}uce foot scparation requiremcnt or two foot requirement for rystertu installed 1996 or carlier,and which ls not failing or
an Imminent threai to public health or safery.
3 "NON-COMPLIANT SYST'EM" A prohibited iSTS;an ISTS locaied within a daignated t00-ycar flood plain,any ISTS which may
or may not meet all the location,desi�n,or construction standazds of tJu current Orona Municipal Codc and which is failing for any reuon;and
any ISTS with leu than three feet of unsaturated soii or sand between the distribution device and the limiting soil chazacteristics.
TANK CONDITION(.ri-:71: 5
Tank inspection indicates: .
S� Pumpout not needed at this time.
6 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. �
Make sure septic tanks are numaed throu2h manhole and not through white insnection pipes
This allo���s for the proaer cleanin�.
7 Inspection risers missin�tanks could not be inspected. Inspection risers(4"dia.pipe)must be installed in each tank.
D INFIELD CONDITION -�Q : ,�_
8 Dninfield 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.
co�rrTs: O�A:��:��J ��� s��fi.-� r���.s I oa(� o� _
`� �6 -oa ��
Date of Inspcetion Matt Bolterman- S�pcic Systcm Inspcctor
Note: In the event that this inspection rcpoR is used to satisfy the rcquicements for a mortgage or other transferofproperty.be advised that this report dou notguarantee
orcertify that an eristing system will continue to function properly,but is merely an opinion oftiie adequary ofthe system under eurnnt condidons based on the availablc
information.
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� ' ' k 1 I "��G i Street Address: Mailing Address:
���CEgKO�'�� 2150 Kelley Parkway P.O. Box 66
- � Orono, MN 55356 Crystal Bay, MN 55323-0066
October 20, 2000
David & Margaret Vergeyle
1485 Green Trees Road
Wayzata, Mn 55391
Dear Mr. & Mrs. Vergeyle:
An inspection of your septic system was conducted on October 20, 2000. A summary of the
inspection is below.
Septic Tank Condition
1. Pumpout not needed at this timeo
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.
Res ectfully,
C ris Penc��
On-Site Systems 1l�Ianager
Enclosures
In the event this inspection report is used to satisfy the reyuirements for a mortgage or other transferof property,
be advised 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
01/31/2�12 14:31 9528733112 PAGE 01106
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�Viidwest Trenchless Technologies, Inc.
1.I30/2012
�A compliance inspection was conducted @1485 Green Trees Roacl in tk�e
city of Orono on January 30th 2012. This inspection was con.ducted during
winter condition and sotne assumption.s about the system had to be mad� due
_ _
to the fact tbat there is 18" o�C frost i.n. the groun .
,,,�'�,�o,c�t�.��eld,;�i,nes cauld n��,be probed. fo.r.;exa.ct 1,ocation,,Qr d�pth,,s� the . , �,,.,�, .
�ocation was determined off the city prvvided as-built. The depth of the
�renck�es is assumed to be 24" or less si.nce the system has a lift tank.
A,n. overall visual inspection was conductad al.ong wi.th on.e soil bo.ring. The
condition of th� ta.nks a.nd pump are basEd off the visual. inspection d.uz�ng
the last pumpin.g by our. company on 6/29/201.0.
According to our records the manhole covers on the 1.9� tank and gum.p tank
' need to be r.ai.sed to surfac� level ta rneet current State Code. This work
. should be conducted in the Spring when the frost �s out of the ground.
"�'���� Raising these covers ma� disrupt some of the existing landscapi.ng.
The estimated cost for raising xhese manholes should b� between. $300-$500.
Tllis does not include adjustrnents to la.ndscaping if required.
Please call with any further comm.ents or questions.
Thaz�k,you,
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Josh.Sv�ed�und
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01/31/2612 14:31 9528733112 PAGE 02/66
. 4 ,
Minnesota Pollution Compliance Inspection Form
Control Agency
5201afayetteRoadNorth Existing SubsurFace Sewage-�Treatment Systems (SSTS)
St.Paul,MN 55155-419� InstruCkionS on page ,
ParCel number: For Local Tracking Purppses
System status: Compllan� � Noncampliant
(based on al1 co pliance requlrements)
Summary Forrn
Property Information
�t�.
Property owner name(sy: ' `1 ��J �� .__.__. ...---..- ...�
Propeny address: �� �•--- • -•• --
Propefty�'s address(If different); —_.._..____ ..••
County n j�� Property owner phone: Permitting authority: __„�,. ,._,,, ,
Oate system constru�d� Reason for inspectlon: _ ___._.., .__....
System Description �?�l�
' i s stem descri tivn; � G � _ T � .��/�T/ (
Bne y p _ - /�����
Local peRnii number: _ Number o(bedrooms; _� esign flow rate: _.C.�/�-`r
Is the sy5tem_
In Shoreland area? �'1Ses ❑ No In Wellhead Protection Area? ❑Yes No
An U,S. Environmental Protection System serving a Minnesota Department
Agency (EPA) Class V Injection Wefl?�Yes �'�- of Heath (MDH) licensed facility? ❑ Yes : o
COt11PI1df1Ce Std'�US(Based on state requirements-add�tional local requirements may also apply,)
Based on the information gathered and reported on attached forms,the compliance status of thls system is(check one�
�ertificate of Compllance-valid until(3 years(rom date of report)� _ __ ________.._
❑ Nolice of Noncomptiance- For Noncompliant systems:
' The reason for noncompllance is: _.-••-•-•-•••• -• -•-
This noncomplfant system is classl�ed as (check one below);
Q Imm�nent threal to publlc health �safety ❑ Failing to protect ground water ❑ Not in compliance witn o{�era��ng perm�'
Ce�tlflCdtlO� (Comp(eted form must be suDmltted to the(ocal unit of government within 15 days,)
1 hereby certily that all fhe necessary information has been gathe�ed to defermir,e fhe compliance status of In�s sysren� �ve
determination ol future system per�ormance has been nor can be made due to unknown conditions during sysrem cor,sir��cr.o��
possible abuse o(the Sysfem,inBd6qu te mainfenanCe, or future wafer usage.
Name' ,,,��_��1���� _ ___ Ce�flffCation number; ����-l_.__
eus�ness license name and number, __ �IC�..S �nL �a�.�__, . _.. _ or
Name of local u � over nt; —. -- --•-• - �
Signature; Date: __�.� - �--- - -
Required ttachments inspec�or comp�o�e;This Inspectlon Report is �pages long.
Check compl' ce forms attached:�ydraulic Pertormanc�lTank Integrl�y [�I Separatlon 0 Operating PeRn��Form��I
applicable stem drawln As•built Orawing ❑An a55855i�enl of any lo�al requir6menls that are Oifferenl from what�s requ�rFd on �•;;,s
form ❑ S Bon g Logs ❑Abandonment form(if gpprop�ate) ❑01her informetion(Ihst)�
Upgrade Requiremants (derived Irom l��nn. Sfat.§ ?15,53)Anlmminent lhreaf lo DubNc hea/fh end aalety(f7PMSJ mvsf De upgradeo,repiacec :
ies use tliSGOndnued wi�hln len moAfAs olroCeJpt ollAis nolice oI wi1hM e snoRer period�f�eqvi�eo by Jncal ordlnanre.!�fAc syslem is la�6ng�a oioiecr�ro��:
waler,Ihe sys/em musl be uppra0ed,ro0leeed,or ifs use GiSCOnNnuad wilhln Ihe lime�o0u��o0Oy loca!orOrn6nce.!f ar1 exisllnp sys�em�s nor/awng as ce`�e.- �•
�aw.and�ss el leasl�wo�e610�d�sipn soll separal+0�,f��n Ine syslem need nol be uD9�Aoea,iepelred, repleced,o��Is use O�scon��nuea.norrv�:�s:3-�c�;.:s-,
loca�ordina�te 1�8f is more strlcl. This Oro��sJon ooes nol apply Io sysrems in snarelend a�eas,wellneao P�olection Areas,0/MOSP uSfd���;on.�r:�,.;,^,��:�•_:_
oe�erapo. ��d/odgmg eslablishmenls rs QeAned in law.
.. � r���ii....�., i.....,.�.:..., c...._. r.., c_,..�..., c:'r:
01/31/2012 14:31 9528733112 PAGE 03106
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Parcel number: System statu�Compliant Q Noncompliant
(as determined by lhis form)
Tank Integrity and Safety Compiiance
Compliance Issue # Qf 4 ��:���
Date of obsc�rvation: f _� Reason for observation: _, . ___„
This form expires on(thr E years): _, ,�„_. .... . .--
CamplianCe questionslcriteria: (Required} Verificatian Method`*: (Optional)
(Check the sppro riafe box (Check the epprQpriato box)
Does the system consist of a seepage pit', ❑Yes �o ❑ Prob�d tank bottom
cesspool,drywell�or leaching_ it?
❑ Observad low liquid level
Do any sewage tank(s)leak below their �Yes �No
designed operating depth? �xamined oonsttuction records
If yes, identify which sewage __ ��xamined empty (pumpod)tank
tank Icaks. ,_ ❑ Probed outside tank for"black soll"
Any"yes"aAswer indicates thaf the system!s failing!o protect � P�essure/vacuum check
ground wafer, �
❑ Other: N �.� T.,
' Seepage pits meeting 7080.2550 may be compliant if allowed
in ordinance by local permitti�g authority. -� •--•••-••�-
'*No sfandard protocoJ exrsts, Th�s/rsf is not exhaustive, �n
sequential ordei, nor daes it indicete which combinafions
a�e necessary to make �hls determinatron.
Safety Check
1, Are any maintenance hole covers damaged,cracked, o�appe�red to be structurally unsound? ❑ Yes' �No
2. were all meintenance hole�overs replaced in a secured manner(c.g..all screws replaced)? �es ❑ Nb'
3. Was secondary access restraint present(safety pan,second�over,or safety netting)-highly recommended. ❑YeS No
4. Was dny other safetylhealth issue present? ❑ Yes' No
Explain: _ .. . -..- -�
"System fs an imminent ihreat to pubfic health and safety.
Certification
This form is to be campleted and attached to the Summary Form of the Minnesota Pollution Control Agency's (MPCA) Compllance
inspectlon Form for Exlsting 5uhsurFace Sewage Treetment 5ystems. Observatlons,interpretations, and concluslons must be
�ompleted by an inspector, maintainer,or service provider, Completed form must be submitted to the local unit of govemment within
15 days.
,
Property owner name(s): _ _ -----.� - �
Property address: _,,, _ . _,s � � - --�—
PropErty own�ddress(if different): .. ... -
� '
County� Phone; , , ._.__..
I hereby cerlrfy that I personally made the observatlons, interpretafions, and conclusions reported on #his form and lhat fhey are
correct.
Name; �� _„ L �l� __ Certification numher: ���.0�_ , ,___.__
Business license name and n ber: Ud,�����5 11��••� _. _ �S�o�. ._....__� or
Name of local un gove ment; .. .._ — - •
Signature: __, Date: ,_ �,.��^
wq-wwisCs4-31 Comp(iance Inspecrion Form /'or Exisiing SSTS
01/31/2012 14:31 9528733112 PAGE 64/06
,�
Pa�cel number: _ System status; Compliant ❑ Noncompllant
(ss datermine y t rs fo►'mJ
Hydrauilc Performance and Other Comp�iance
Compliance Issue 1 of � �
Date of obse►vation: � ��' Reason for observaGon: �° /c!�
This form expires upon next inspection or in three years,whichever occurs first: _. .___________
Compliance questionslcriteria: (Required) VerifiCatfon Method*: (Optional)
Check the a ro rJate box (Check the approprlsfe box)
Ooes the system discharge sewage to the r] Yes No �Searched for surFace outlet
�round surtace?
� PerFormed hydraulic test
Does the system discharge sewage to drain ❑ Yes No
tile or surface waters? �Searched for seeping in yard
[
Does the system cause sewage backup ❑Yes NQ ❑ Checked for backup in home
into dw�llin or establishment?
� Excessive ponding in soil system/p-baxes
Do other situations exist that have the . []Yes No
potentlal to immediately and adversely ❑ Homeowner testimony
impact o�threaten publlc health or safely ❑ Examined For surging i�tank
electrical unsafe covers etc. 7
❑ "Black soil"above soil dispersal system
Any"yes"answer ind/cai�s that the sysiem Is an lmmfneni
threat to publlc healeh and safety. ❑ System requires"emergency' pumping
-- ❑ Performed dye test
Does the system pose a threat oo ground ❑Yes No � pther.
water for any conditions deemed non• ----�--- � � � -- - ��
„protective as determined by the ins ectnr? _ _ _
"Yes"indicates that the 5ystem is fafling tp protecf _�___
ground water. If"yes'; describe the condFt/on nofed:
'No standard protocol exists. This 11st is not exhausfrve,
in sequential order, nor does rt indicate whieh
Combinations are necessary to make this deferminafion.
Certification
This form is to be completed and attached to the Summary Form of the Minnesota Pollution Control Agen�y's(MPCA)Compliance
Inspection Form for Existing Subsurtace Sewage Treatment Systems. Observations, interpretations, and conclusions must be
completed by an inspector, Co pleted form rnu be submitted to the local unit of government within 1�days.
Property owner name(s): � J (��} __�__.__—.—...._.......
T�,._...
Property address; � �7 � _ , _�__ ____,
Property owner' address(li different):
�
County: Phone: ,__„�,_ __^__
1 her�by certify thaf!personaUy made the obscrvations, inte�pretatians, and conclusions reported on this form and fhai they are
correct,
Name: , y�._„ti��1Ll(�� — Certiflcation number: ��_-----------._..
Business license name and number. ���_.�Q,��,'��(�t �Y1L,,^a�Vo� ._._^.__ or
Name of local uni o�er ent:
Signature; _... .�_...__ Date: , � .�� 1.,�.... .. . . .
wq-wwisrs4•31 CompliQn�e lnspectfon Form/`or ExisCPng SSTS
01/31/2612 14:31 9528733112 PAGE 05/06
Parcel number: ___ __ � `�_ System status: f�Compliant ❑Npncompli2ni
(as determined by7his formJ
Soil Separat�on Compliance a�d Other Compliance
tampliance issue #3 of 4 �
Date of observation: � Reason for observation: ' �
rm n ' �
Thrs info at�on o th�s font�does not expire,
Compliance questionslcriteria: (Required) Verification Method*": (Optional)
(Check fhe a�propriate box (Check the appropriate boxJ
For systems bu�lt prior to April 1, 1996, and�ot �Conducted soil obseroation(s)(attach boring logs}
located in Shoreland or Welihead Protection
Area or not serving a food, beverage or ❑ Two previous verificatio�n,,�( ttach boring logs}
lodging establishment: � _ �r�,\ Ib7; � ���J
Other. �
Does the system have at least a two-foot �3� '� - ��
vertical separation distance from periodically �
saturated soil or bedrock? [LYes ❑ No /fjt�
For non-performance systems buflt April .1,
1996,or later or for non-perto�mance systems �"'��'" """
located in Shoreland or Wellhead Protection Soil observaGon does not expire. Previous observations
Areas or serving a food, beverago or lodging by two independent parties are sufficient, unless site
establishment: conditions have boen altered.
Does the system have a three-faot vertical
separation distance fram periodically saturated
soil or bedrock?` Yes ❑ No
For reduced separation distance systems(i.e„
`performance"systems under old 7080.0179 or ' May be reduced by up to 15 percent if allowed in locel
Type IV or V system under new 7080. 2350 or ordinance.
7060.2400)� **No standard protoco!�xists. This Irst is not exhaustive,
Does the system moet the designed vertfca! in soqusntia!order, nor does it indicate which
separation disYance fram periodically saturated combinations are necessary to make thrs
soil or bedrock?' Yes ❑ No detBrminativn,
Any"no"answer iadicates that the system Is failing to protect
ground wafer.
Certification �
This forrn is to be completed and attached to the Summary Form of the Minnesota Pollutlon Control Agency's (MPCA) Compliance
Inspection Form for Existirtg Subsurface Sewage 7reatment Systems. Obseroations,interpret2tions, and conclusions must be
completed by an inspector or designer. Completed fOrm must be submitted to the 1oc21 unit of govemment within 15 days.
Property owner name(s): L.�1�`� 1� �1��Y._..._, ..r.�.- ----� ---....--------...
Propertyaddress: ����Q� � �� ^ � _ . _.___.
Propet'ty owner's address (i4 different?: ___,„ ,,,,,,,,_„ � ,
� ...... . _.._. .__-----•-._._._...._.. ---
Couniy: _ �{� w.r. Phone: --- ---._.. . ... ..
!hereby certify that�persona!!y made the observatlons, Interprelalions, and conclusions rc�ported on�his form and rh�t they are
com:ct ,
Name: �'�p�,���1� __ Certifcation number: �((��j�___
Business license name and numbe�: , 1 ` �t�� __�_ or
Name of local uni ove ent
Signature: , _ _ Oate: ____ _
wq-wwists4•31 Complionce Insvection Form far Exi5ff�1Q SSTS
01/31/2012 14: 31 9528733112 PAGE 06I06
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`1,�,, , k'.°�-n �Fti Municipal Offices
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.� '�"°�_`�''��`.� Street Address: Mailing Address:
•9 �����l'i g,
kE8H0 2150 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
Owner: � �Y �. Address: 1485 Grean Traes Rd.
Permit #'s: 6319 Dates: 8/15/94 Contractors: Dick's Exc.
(This is [�] an existing system [ ] new construction) .
�TEM COMPLIANCE (1-3) : 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.
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 leval [/� ] has or [ ] has not baen identified at this time. If the
saturated soil level has not been idantified, this classification is subjact to revision.)
TANK CONDITION (5-9) : 6
5 Pumpout not needed at this time.
,� Solids accumulation in tanks indicates they should be pumped out this year.
�9� 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.
9 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 tha licansed pumping contractor. If the tanks ware not confirmed to be
watertight, this classification is subject to revision.)
DR INFIELD CONDITION (11-14) : 11
1 Drainfield is dry, no surfacing evident.
Some evidence of surfacing, not critical yet. Repair is not required at this time.
13 Drainfield is saturated and visibly discharging untreated effluent to the surface.
Contact the City Inspector immediately. Repair must be completed within 90 days.
14 Drainfield extent and condition unknown.
POTENTIAL FOR SYSTEM FAILURE: (system age and condition, soils, etc. ) : low
COMMENTS:
11-7-�7 � -�
Date of Inspection Se ic 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 Box 66
Crystal Bay, MN 55323-0066 � � ON—SITE SEWAGE TREATMENT
� � INSPECTION REPORT
ti
���kEsHo�'�G
Owner• � �t� / s �I��.s�(�.
� Address• -��(.�
Permit #'s: L)� Dates: ��_� !`y- Contractors: ��l(J�� ��.-+
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):
"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 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 tnto 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 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 i d, this classification may be subject to revision.>
TANK CONDITION (5-10): "
T� inspection indicates:
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 pixnped 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 punped out within 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 been purtiped out within the last three years, they should be pumped out now.
DRAINFIELD CONDITION (11-14):
Dr field inspection indicates:
(�1 Drainfield is dry, no surfacing evident.
iZ 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 unknown.
LIMITING S1TE FACTORS (slope,setbacks,etc.):
POTENTIAL FOR SYSTEM FAILURE (depends on soils,water table,etc.): ��,✓
COMMENTS:
�
Da e of nspection Sep ic System Inspector
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 uith the system location and pumping records.
WHITE COPY/Inspectors File YELLOW COPY/Homeowner
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T0: Jeanne Mabusth, Zoninq Administr�!itor
FROM: Michael P. Gaffron, On-Site SystE��ms Manaqer
nATE: February 25, 1980
SUBJECT: On-Site Evaluation, Green Trees
Subdivision �541
I have reviewed the soil testing and evaluation report submitted
j, by the applicant and recommend approval of the proposed diviaion
� subject to the items noted below:
; Lot 1 - Percolation ratg and indicated wate:r table depth will allo�r
� a standard drainfield. Extreme car�s must be taken to protect
L, � this area from construct on traf�c and disturbance due to
'L:;� .� its proximity to the existinq road.
s;>r.:
,�,.
,�;� : Lot Z - Percolation rate and water table depth will allow a standard
` k�, drainfield. Depending on final plac�ement of house,
�p��'�`'� additional testinq might be necessa:y prior to issuinq a
'':J�'"Nf'�,
� . buildinq permit.
� :
s���:� Lot 3 - Has existinq house and drainfield. No problems With existinq
��,x>,
,;<.::vl , drainfield were noted. Testinq showed adequate area and soils
�k : � for future drafnfield. A new Well to be located on the lot
��� will not encroach on drainfield areas.
�
���;
�}�� Lot 4 - Existinq mansion - will have neN drainfield installed in
',r tested area. Percolation rate and w,�ter table Mill allow
�,,:;�{�>� atandard drainfield.
�
� ;, � Lots 5 b 6 - Soil testinq indicated fair perc:olation rate for those
holes which did not freeze. Soil te��turea would indicate
� j no problema will be encountered with a standard drainfield
! system, although some additional teat:inq o verify Water
� table depth and extent of qood soils will� r�quired prior
�`;,� to isauance of permits.
�a - .
�_'.� Baaed on the fnformation presented and the aoil ty� indicated, I
� � am confident that adequate area�s of suitable soil exist•on each
� proposed lot to support satisfactory septic syatema. Some additional
� testing Mill be required on certain lots prior to iaauance of permitat
j however, I feel we are justified in approvinq the propoaed lots based
� on the information presented.
Please note that about 67ne-third of the perco:lntion teats on thia
division tailed due to freezing and frost dep�:h. We alNays warn
' prospective developers that perc tests taken in the winter mey very
Well fail due to frost. This case again proves the point.
, r . ..� .., .
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