HomeMy WebLinkAboutseptic info 7 tViinnesata Po!lution Compliance Inspection form
� �� .:
Cantrol Agen�y ,
520 Lafayette Road North E�isting Subsurface Sewage Treatment Systems (SSTS)
St.Paul,MN 55155-4194 Doc Type:Comp/iance and Enforcement
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inspection results based on Minnesota Poilution Controi Agency(MPCA) For local tracking purposes:
requirements and attached forms-additional local requirements may atso appfy.
Submit completed form to Loca�Unit of Government(LUG)and system owner
within 15 days
System Status
System status on date(mm/dd/yyyy): 11J19/2014
❑ Compliant— Certificate of Compliance � Noncompliant— Notice of Noncompliance
(Valid for 3 years from report date, uRless shorter Sme (See Upgrade Requiiements on page 3.)
frame ouUined in Loca!Ordinance.)
Reason(s)for noncompliance (check all appticable)
❑ Impact on Public Health (Comp/iance Component#1)—/mminent ti►reat to public health and safety
❑ Other Compliance Conditions(Compliance Component#3)—lmminent threat to public health and safety
❑Tank Integrity(Compliance Component#2)—Failing to protect groundwater
❑Other Compliance Condifions(C�mp/iancs Component#3)—Failing to protect groundwater
�Soil Separation(Compliance Component#4)—Failing fo protect groundwater
❑ Operating permiUmonitoring plan requirements(Compliance Component#5)—Noncompliant
Property Information Par�ei ia#or secrrwpiRa►,9e:
Property address: 290 Hollander Road Orono, MN Reason for inspection: property transfer
Property owner: ���p jj'/�,�u� Owners phone: (�/a. �,;�.- y�P,77
or
Owner's representative: Jake Ehlers _� Representative phone: 612-720-4987
Local regu(atory authority: City of Orono __ Regulatory authority phone:
Brief system description: 1-125p and 1-1000 septic tank 1-1250 pump tank, rock trenches
Camments or recommendations:
Certification
1 hereby cerfify that a/l the necessary information has been gathered to deteRnine the compliance status of this system.No
dQtsrmination offuture system peiformance has been nor can bs made due to unknown co�diti�ns dunng system c�n�truction,
possible abuse of the system,inad�quate maintenance, or firture wafer usage.
Inspector name: Andrew Kleindf' Certification number: 7927
Business name: Jim's Excavatin LLC License number: 2926
lnspector signature: �%��� � Phone number. 952-442-9282
Necessary or Locatly Req;uired Attachments
�Soil boring logs ❑System/As-built drawing ❑ Forms per local ordinance
❑ Other information(list):
www.pca.state.mn.us • 651-296-b300 • 800-657-3864 . TTY 651-282-5332 or 800-657-3864 • Available in altemative formats
wq-wwists4-31b • 6/4/14 Page 1 of 3
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, Property address: 29(3 Hotlanderl Road Orona,MN Inspector initials/Date: 61'"���
, (n►mldd�l'YYY)
1. Impact on Public He;alth—Compliance component#1 of 5
Cbrtt liance criteria: I VerificatIon method(s):
System discharges sewage;to the ❑Yes � No �Searched for surface outlet
round surface. �Searched for seeping in yard/backup-in'home
System discharges sewage;to drain ❑Yes �No ❑;Excessive pondirig in soil system/D-boxes
tife or surface waters. � ❑Homeowner testimony(See Comments/ExptanaGon)
System causes sewage backup into ❑Yes �No ❑"Bladc soil"above soil dispersai system
dwelling or establishment. ; '
❑System requires�emergency'pumping
Any"yes"answer above indicates the ❑performed dye test
SySfe/Xf%S aR%1l1R3%R@I'�t�'hf�f I'O pUbl%C ❑Unable to verifjr(See Comments/�icplanafion)
health and safety: ❑other methods not listed(see Commenrs/Exp►anarion) '
Comments/Explanation: i
2. 'Tank lntegrity—Com�liance componeni#2 of 5
Com liance criteria: - ` Ver�cation method(s):,
;
System cansis#s of a seepage pit, ❑Yes �No ❑Probed tank(s)boitom
cesspool,drywelt,or leachinq pit. �Examined construction records
Seepage pits meeting 7080.255p may be ❑�mined Tank Integrity Form:(Attach)
com liant if aUowed in local ordihance.
Sewage#ank(s)leak below t�eir ❑Yes �No ��bserved iiquid levef below operating depth
designed operating depth. ; ❑�amined empty(pumped)tanks(s)
ff yes,which sewage#an[c(s);leaks: ❑Probed outside tank(s}for"black soil"
Any"yes"answer abqve indicates the O��bie to veriry'�see eomments�pr8na�on�
system is failing to pr'ptect groundwater. �other metnods not��sted�see comme►�rs�Pra►,anon�
CommentslExplanation: ;
used camera to view upper tank and baffle conditions
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3. Other Compliance,Cqnditions—comp�iance component#3 ot s `
a. hAaintenance hole oovers are damaged,craeked,unsecured;or appear to be strudurally unsound. p Yes* �No ❑Unknown
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b. Other issues(electrical ha�arcls,et�.)to immediate{y and adversely irnpact pubGc heatth or safety. p Yes* �No ❑Unknown
*Systiem is an imminen�threat to public healfh and safety.
Exptain:
c. System is non-protective of ground water for other conditions as determined by inspector. p Yes* �'No
*System is fallfng bo prr�Uecf gr+�trnahv�eter.
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Exptaln:
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www.pca.state,mn.us � b51 296-¢300 • SDO-657-3864 • TFY 65f-282-5332or 800-657-3864 • Avaflabie in altemative formats
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, Pro�erty address: 290 HaUander'.Road Orono,MN' lnspector initials/Date: �� ``''l'7 ��
': (mMdd/YYYY)
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4. Soil Separatian—Co�npliance component#4 0#5
Date of installation: 10/3111990 p Unknown VeMtication method(Q;a
����� Sail observa6on does rrot expi�.Previous soil
ShorelBndlWellhead protectloNFqod beverage �Y� ❑�n observations b fwo inde ende�rt arties aie svh5cien#,
�°dging? i un/ess site conditions have been�ered or/a�a!
Com liance criteria: �quiiements differ
For sys#ems builf pRor to April 7,i 1996,and ❑Yes ❑No �Conducted soit observation(s)(Atfach boRng logs)
not/ocated in Shore/and or Welilhead` ❑Two preVious verifications(Attac6 bori►rg logs)
Protsction A�a or not seiving a�ood,
beverage or fodging establishmer►t: ❑Not applicable(Holdirrg tank(s),rro drainTrek� -
Drainfield has at(east a two-foot�vertical ❑Unabie to verify{See CommenfslExp/anaSon)
separation distanoe from periodi�ally ❑Other(See Comments�Exptanation) :
saturated soit or bedrock. ,
Non�erformance systems 6uilt April?, ❑Yes �.No CanmentslExplanatian:
1996,or fater or for non perfqim�nce
systems located in Sho►aeland oriWeUhead
Protection A�as ocseiving a fiood,
beverage,or lodsing esta6►ishment.-
Drainfield has a three-foot vertic�l
separation distance from periodi�ally=
saturated soil or bedrock" i
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°Expe►rmental", "Othe�;or `Per�ormance": ❑Yes ❑No Indicate de ths or elevatiOns
systems buitt under pre-2008 Rules;Type N
orV systerr►s built under 2008 R�rles(7080_ A. Bottom of distribution media 23 inch
2350 ar7080.2400. (Advanced tnspedor
License requirec� � B. Feriodicau saturated soillbedrodc 38 inch
Drainfie{d meets the designed veatical C. S stem se aration 15 inch
separation`distance from periaiiv�aiiy
saturated soil or bedroek. ;
� D. Re uired com liance se aration" 36 inch
Any"no"answer aboue i�ndicates the system is `May be redueed up to 15 percent if allowed by Locaf
faiting to protect grou�rrhivatee: ordinance.
5. Opecating Permit �nt� Nitl�o�en BMP*—Compliance component#5 of 5 �Not applicable
Is the system operated under�an Operating Permit? ❑Yes �No If"yes",A'below is required
Is the system required to empNoy a Nitrogen BMP? ❑Yes �No If"yes",B below is required
BMP=Sest Managemen#Practice(s)specifisd in the system design
If the answer:to both que,stions is"no'; this section does not need to be comp/eted
Com liance criteria �
a. OperaEing Permit numbec
tiave the O ratin Perr�it r uirements been met? 0 Yes ❑No
b. Is the r uired n' !en¢MP in lace and ro ert functionin ? Yes No
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Any "no"answer indic�tes Noncompliance.
Upgrade RequiremeMs(Minn.'Sfat§115.55)An:imminentihieat to public health and safety pTPHS)mustbe upgraded,`replaced,or its use
discontinueal within ten months of�ceipt of this not�e or within a shorter period if repuiied by loca!ordinance.If�e system is failing to piotect
ground water,the system must be�upgraded,replaced,or its use discantinued wtd�in the time requi,ad by la:a!orsiinance.If an exlsHng system
is not failing as deflned in law,an has at least iwo feet of design soi!separa6on,then the'system need not be upgreded,repairorl,replacecl,or
its use disaontinued,nohaithskan�{'qg any loca!ordinance that i§more stxt This provision does not apply ta systems in Shoreland areas,
Wellhead Protection Aress,'or tho�e used in connectron with food,beverage,and lodying establishmerrts as tlef+rre�in law.
www.pca.state.mn.us • 651-296 6300 • 800-657-3864 • TTY b51-282-5332 or SOQ-65T-3864 • Availabte in attemative formats
wq-wwists4-31b • 6/4/14 ' Page 3 of 3
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. Gsaapter 7080 6 S,ocal Ordi,aa3�ce pe�9,xd gy;,,�c`r�--�. �:,5`',�... �-"'—
Note s Checsk a11. unde�grounfl utilities . ' Oore�1P/1!./� PH.612-497-3SS8
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� `'' Mailing Address:
\��',G�'�, i�'"',;-,;�;�< ;s`���-`� �~� Street Address:
��:: i..' ;'`r>:.''.,' '�:% P.O. Box 66
`�`;�.. <q � ;;:' 275D Kelley Parkway
'�:�. kESK� �; Crystal Bay, MN 55323-OOo6
�� Orona, MN 55356
To: Tl�e Cunent Owner of Address � '�i � �'��St �'��� '��
City Ordinance requires that onsite sewa�e treatment systems in Orono be
inspected on a periodic basis. The onsite sewa�e 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.
lmminent t ublic Heai�� Th�-eat
4'es =�
No
If yes, please contact the Onsite Systems vlanager at 9�2-249-4626 within 1�
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 l�'on-Compliant
Yes �I�;o
If yes, system must be brought into compliance by:
December 31, 2007
December 31, 2010
Other
5eptic T'ank(s) Pump out Needed
Yes �Na
The City recommends the septic tank(s) and/or lift tanlc be serviced aiid pumped
out every three years. City records indicate the ta:�(s) were last punzped out on
e � � � .� �3 . The tanl:(s) should be cleaned throu�h the manhole and
not through the inspection pipes,tlus ailows for proper cleaning.
Con-lments:
Ins ;�or ;y°_� �� � Kd',�`-� Date of Inspection �'C� �
P
P�,_ �
�y,y � ��_ �-�-���,� ���.
Telephone (9��) 249-4<UO • Fat (952j^49-461(
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' �� �`a��`�`� Street Address: °ISa-a�{q-�{bo O
� � Malling Address:
`.�Y'EgHO�' 2750 Kelley Parkway � P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
To Current Owner: Address: �� ��,��hJ t( Ii�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 COIVFORMITY 1-3 : �
1 "COD$SYSTEM"An ISTS which meets all the location,design and construction standards of the cutre.nt Orono Municipal Code.
2 "COMPLIANT SYSTEM" An ISTS which does not meet all the location,design and consiruction standards of the current Orono
Municipal Code but does meet the three foot separation requirement or two foot requirement for systems installed 1996 or earlier,and
which is not failiag or an i�ninent threat to public health or safety.
3 "NON-COMPLIAIVT SY$TEM" 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 stanc�rds of the c�crent Orono Municipal Code and wluch is failing for any
reason;and any ISTS with less than tkuee feet of unsaturated soil or sand between the distribution device and the limiting soil characteristics.
TANK CONDITION(5-71: �
�T k inspection indicates:
Pumpout not needed at this time.
6 Septic tanks must be pumped out this year (city code recommends tanks to be pumped out once every 3 years.
Tank was last pumped �1—�"U3 ). .
Make sure sentic tanks are oamued throueh manhole and not throueh white insnection aiaes This ailows for the nroaer
cleanin¢. Keeo water softner and iron filter discharee out of seotic svstem to arolon¢life of drainfield Ask oumner to test
alarm float to verifv alarm is still workine in vour house. The atarm warns owner that seatase is about to backua into basement
7 Inspection risers missing-tanks could not be inspected. Inspection risers(4"dia.pipe)must be installed in each tank. If
tanlcs have not been pumped out within the last three years,they should be pumped out now.
D INFIELD 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: . . I�S�a:���I�I___ _..�-- S i �,� : �+��5 .. _��a� _ _C� _ �t�� ..: . �,__
��.� c o�'�� °^ :�5�c c�-:r-- D�� a�• J�a:,.�,,cl
�S'-�'L—oy �� ��
Date of Inspection Matt Bolterman - Septic System Inspector
Note: ln the event that this inspection report is used to satisfy the requirements for a mortgage or other transfer of propertti•, be advised that this report does
not guarantee or certifi� that ttn existing sysrem ���ill continue to fimction properly, but is merely an opinion of the adequac�� of the spstem ttnder cw•rent
cunditions bascd on the availablc inlortnation,
.f .�o,�,.. .
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��� CITY of ORONO
!�r�.� f�,
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� � Mnnk[pal Of�Tces
� � � Street Addross: N�lin��ddross:
� � � �g' . 2750 Kelley ParkwaY P.O:Baz�66
� Orono, MN 55356� Ctystal,Bay, MN 55323-0066 :
. . 95d-�49-4600 . • , .�t�..
. . Adaress: a�� ��►) ����e� r�cJ.` .
To Curreat Owner:
City Ordinance 199 requires that each existing on-site sewage treatment system in Orono be�inspected every two yeazs.
The on-site sewage treatment system at the above address has been inspected and appears to fall into the categories checked below.
YSTEM CONFORMIT'Y 1-3 : �
"CODE SYSTEM"M IS'I'S wtdch mats a11 tl►c location,daign and conswction standards of the ewrent Orono Munietpal Code. .
2 "COMPLIANT SYSTEM" M iSTS which does not meet a11 the location,design and construction standards of the cunent Orono Municipal
Code but does mat the three foot separation rcquirement or two foot rcquircment for sysums installed 1996 or earlier,md which is not failing or
an imminent tiu�eat W public health or safety. ,
3 "NON-COMPLIANT SYSTEM" A prohibited ISTS;an ISTS located within a designated t00-year flood plaia.airy ISTS which may
o�may not meet all the location.design,or constcuaion standards of the cuaent Orono Municipal Code and which is faiting for any rcason;and
any ISTS with las than tivee fat of unsanirated soil or sand betwan the distribution devia snd the limiting wii ehacactaistics.
TANK CONDTTION(_.5-:�1: �o �
Taak inspecdon indicates: � . �
5 Pumpout not needed at this tima - ��
6O Septic tanks�must be pumped out this year (city code requires tanks to be pumped out once every 3 years.
Tank was last pumped 11-1 S'0�9 1.
Make sure uotic tanks are pumped throu�h manhole and not throngh white insaection oiaes.
This allows for the oroaer cleaninP. •
7 Inspection risers missing-tanks could not be inspected. Inspection risers(4"dia.pipe)must be installed in each tank.
� DRAINFIELD CONDPfION[$�-IQ�: � .
� Drainfield is dry,ao surfacing evident ' .
�'�Some evidence of surfacing,not cridcal yeL
10 Drainfield is saturated and visibly discharging untreated ei�luent to the surface. Contact the City Inspectoc �
immediately.Repairs must be completed within 90 days.
CO1VIlvIENTS: S�ISi-�� `) ook5 �K- 1"v^,- �:�57' }�� _ 'f�� . .iv K�c J�.,,,
�.�. �tt� ��-�. o••. i- '�°•�KS. N e � ne�., c a� :� .
��`ltic o� d r a:c��-.-t1 - � �
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Date of Inspcction Matt Boltecman- Septic Systaq Iaspector
Note:In the event d�at this inspection apoK is�sed W satisfy the rcqu'uemcnts for a mortgage or othu transfer ofpropecty.be advised that dds teport does aot guarantee
or cutify that an extsting system wip continue to tunction propedy.but is mercly an opinion ofthe adequa�y of the system undecc�nt eoaAi6ons biud on the avatlable
infom►ation.
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� '� CITY of ORONU
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� , ..,� .ry Street Address: Maiiin�Address:
E+ggOg' 2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
October 18, 2000
Dale& Susan Mahaffy
290 Hollander Road
Wayzata, Mn 55391
Dear Mr. & Mrs. Mahaffy:
An inspection of your septic system was conducted on October 3, 2000. A summary of the
inspection is below.
Septic Tank Condition
1. Pumpout needed within one year(last pumpout date 10/8/97).
The septic system is a compliant system, meaning it meets all or most current City and State
Standazds. 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 regazding this report, please contact me at the City Offices at 249-4600.
Res ectfu
< J�%f�'�(./
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s Pence
On-Site Systems Manager
Enclosures
In the event this inspection report is used to satisfy the requirements for a mortgage or other transfer of property,
be advised that tlus report does no guarantee or certify the eaisting 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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A t; � Municipal Offices
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'`�EgH04' 2750 Keiley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
Owner: �a. /P.. /�IQ�hQ7�� l�_ Address: 290 Hollander Rd.
Permit #'s: 3443 Dates: ll/26/90 Contractors: Jerry Johnson
(This is [ �] 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 is� or is not [ ] identified under this septic system. If the
saturated soil level is not i ntified, this classification is subject to revision.)
T NK CONDITION (5-9) : 5
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.
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.
10 One or more tanks are cesspools, which means the septic system is non-compliant.
(The tanks are � or are not [ ] water tight or the condition is [ ] unknown. If the tanks
are not confirmed to be watertight, this classification is subject to revision.)
D INFIELD CONDITION (11-14) : 11
11 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
COL�IENTS: In order to confirm that your septic system meets Minnesota standards, soil borings
were performed to verify a 3 foot separation between the drainfield and the seasonal water table.
The separation is 3 feet and the system is compliant.
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Date of Inspection S ic System Insp ctor
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
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CITY OF ORONO �
Municipal Offices O O
Post Office Box 66
Crystal eay, MN 55323-0066 a � ON—SITE SEWAt3S TREATlIENT
INSPECTION REPORT
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Owner: I�n� ���C��1 Address:��j���/YAQI/� I<[.l•
Permit #'s: Dates: ������ Contractors: �2Y1(V �ri�Yl.�l'�
City ordinance number 700 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 acdress has been inspected and appears to fall into the category
checked below.
(This is �j an existing system [ ] new construction)
S STEM 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 poltutants 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 within a designated 100-year floodplain; any
system which may or mey 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 timiting 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):
Tpnt inspection indicates:
(,y Pumpout rwt needed at this time.
6 Solids accumulation in tanks indicates they should be pumed out this year to help prevent future problems.
7 Solids accumulation in tanks is at a critical level. Tanks should be punped out as soon as possible.
8 System is discharging to the surface. Tanks must be punped out uithin 48 hours to eliminate surface dischar�e.
9 Inspection risers missing-tenks 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 loceted directly over tank baffle (does not give accurate measurement of solids accunulation>.
If tanks have not been punped out within the last three years, they should be punped out now.
DRAINfIELD CONDITION (11-14):
Dr field inspection indicates:
1 Drainfield is dry, no surfacing evident.
�Sane evidence of surfacing, not critical yet.
73 Drainfield is saturated and visibly discharging untreated effluent to the surface. Contact the City Inspector
immediately. Repeirs must be completed within 90 days.
14 Drainfield extent and condition unknown.
�
LiMITING SITE FACTORS (slooe.setbacks,etc.):
POTENTIAL FOR SYSTEM FAILURE (decends on soils,water table,etc.): ��j
COMMENTS:
Date of Inapection e 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 opim on of the adequacy of the system under current conditions based on the available
informatton.
This report must be kept on the premises with the system loc�tion and pumping records.
WHITE COPY/Inspectors File YELLOW COPY/Homeowner
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CITY OF ORONO � O�
Municipal Offices O O
Post Office Box 66
Crystal Bay, MN 55323-0066 � � ON—SITE SEWAQ�E TREATMENT
� . �, INSPECTION REPORT
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Owner: Kf'�'1� f�:S �'Y' Address: �[Q ��/(,�7,C/�� /�(�
Permit �'s:�� Dates: �/��b 9� Contractors:�^� ,��
City ordinance nwnber 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.
(7his 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 uaters.
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 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 [ 7 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):
T inspection indicates:
5 Purtipout not needed at this time.
Solids accumulation in tanks indicates they should be d out this year to help prevent future problems.
7 Solids accumulation in tanks is at a critical level. an s should be punped out as soon as possible.
8 System is discharging to the surface. Tanks must be pumped out within 48 hours to eliminate surface dischar�e.
9 Inspection risers missing-tanks could not be inspected. Inspection risers (4�� dia. pipe) must be installed �n each
tank at next pumpout. If tanks have not been punped out within the last three years, they should be pumped
out now.
10 Inspection pipe is located directly over tank beffle (does not give accurate measurement of solids accunulation).
If tanks have not been punped out within the last three years, they should be p�rnped out now.
DRAINFIELD CONDITION (17-14):
Drp�field inspection indicates:
ay Drainfield is dry, no surfacing evident.
12 Some evidence of surtacing, 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 (deaends on soils,water table,etc.):
COMMENTS:
Date of Inspection eptic ystem 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
properlyi but is merely an opinton of the adequacy of the system under current conditions based on the available
tnformatton.
7his report must be kept on the premises with the system tocation and pumping records.
WHITE COPY/Inspectors File YELLOW COPY/Homeowner
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On the North Shore o f
Lake Miyznetonka
�
ON-SiTE SEWAGE TREATMENT
j INSPECTION REPORT � POST OFFICE BOX 66
1335 S. Brown Rd. ��
� � � Crystal Bay, MN 55323
473-7357
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OWNER ADDRESS �`�"/ '����
PERMIT NO.'S. DATES CONTRACTORS � '� ' �
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.
IThis 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
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 problems. should be pumped out now.
❑ Solids accumulation in tanks is at a critical level. Tanks Drainfield inspection indicates:
should be pumped out as soon as possible. � Drainfield is dry,no surfacing evident.
❑ System is discharging to surface. Tanks must be pumped ❑ Some evidence of surfacing,not critical yet.
within 48 hours to eliminate surface discharge. ❑ Drainfield is saturated and visibly discharging untreated
❑ Inspection risers missing—tanks could not be inspected. effluent to the surface. This condition may require replace-
Inspection risers (4" dia. pipe)must be installed in each ta�k me�t 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 ❑ Inadequate
❑ Drainage ❑System is causing visible
surface discharge.
COMMENTS:
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Date of Inspection `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 functio�properly,but is merely an opinion of the adequacy
of the system under current co�ditions 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
�`'�
^ SEPTIC SYSTEM INFORMATION
STREET ADDRESS _ ��'C� �G�L-L,�}ND�� /� I��
LOT � BLOCK I SUBDIVISION }�LLy ��-�-��
MONTH AND YEAR TESTING DONE_ /`ru Cr�tsT ,���g ,
ITEMS ALREADY COMPLETED_ � �pr2/NG S' C� ��2L T-�"S'/�
NEED TO COMPLETE BEFORE ISSU�ING BUILDING PERMIT -
OBORINGS
OPERC TESTS
�SYSTEM DESIGN
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lX ) SITE PLAN
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O OTHER
TNIS ITEM NAS B ..
��� SUBDIVISION FILE NO. L /�
MICROFItIyED
DATE THIS SHEET FILED �� �S� -���-- BY
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