HomeMy WebLinkAboutseptic info r
Minnesota Pollution SSTS Abandc�nment
Control Agency
520 Lafayette Road Narth Re p o rt i r��g Fo rm
St.Paul,MN 55155-4194
Subsurface SewaBe Tr�atment Systems (SS?P�) Program)
Instructions
This form is offered to meet the abandonment requiremerrts of Minn.R.7080.2500 and Disclosure Requirements of Minn.Stat.
§115.55,subd.6.Future water supply well placement can also be affected by an abandoned SSTS.
The use of this form is not mandatory;however the information on this form must be submitted to the local goverrment unit(LGU)
within 90 days after the abandonment.This form may be completed by a certified SSTS practitioner or by an individual who has
direct knowledge of how the system was abandonetl.
Property Information
Date of abandonment: _ �p��� —IS Reason for abandonment: L w S�/���,.,�._ ,� ;., ' i �
Property owner name(s): ��h n �.��_
Property owner's address: __ .�'3 3 �/�„ �� �•;..,�.
Ciry: U�'iln� --- --- State: /YJ�Y Zip: _ --
Site address(rf different):
--
_._. __ __ _.
Ciry: ___ __ _ State: - - — Z�p� —
Compliance Information
1. All solids and liquids removed from all tanks? �Yes ❑No
Disposal Site: �v.:h �� 5,�,�'f: c
2. All electrical devices and devices containing mercury removed? ❑Yes �No
Disposal Site: _ /�Cn.;�
3. All.underground sewage tanks crushed and filled with soil or rock material? �j Yes ❑No or
Removed and disposed off site? ❑Yes ❑No
Disposal Site:
4. Contaminated materials*removed and disposed off site? ❑Yes j� No
Disposal Site: V1 p i�•z
5. All underground cavities**crushed and filled with soil or rock material? ❑Yes Q No or: �
Removed and disposed off site? ❑Yes ❑No
Disposal Site: _ �����
6. Future discharge to system permanently denied? �7 Yes ❑No
Method(s)used:
'Contaminoted materials= Distribution media,soi(or sand within three feet of the system bottom,distribution pipe��,,geotextile
fQbric/rosin paperJstraw, tanks,contaminoted soil around leaking tenks,arrysotl thatreca_ived sewage
from a wrface fai(ure(7080.2500 subp.3).
"Underground cavities= Cesspoo(s, leaching pits,drywells,seepaqe pi[s,vaulC privies,p)t privies,pump chamber:;
(7080.2500 wbp. 1). Does not include chamber medio,drop boxes,or distri6ution boxes.
www.pca.state.mn.us • 651-296-6300 • 800-657-3864 • TTY 651-282-5332 or 800-657-3864 • Available in altemative formats
wq-wwists4-03 . 11/21/08 Page 1 of 2
Map
Include location�>fnt refe enCe point(s)'and dimensio s'SRersal system, cesspools, seepage pits, and oth��r pits. Also
inc1ude a permar e
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Certificatior�
1 hereby certify tne system wss abartdoned in accadance with M►nn.R_7080250U and any loCa►requlrements.
/� JJ !�i �/�t / � d�����
Name(pieasepiint): ! A ��c:�'�' _ Qd'�' �t':) _ TIUe: /tM f
AddfeSs: �i Y/ ����
r State: /�- Zip: S S 3 7C
S � ,�'!:c/�..��-/ �� ,_..^----
Ciry: _ —
� /�` �,� ,d��� License#'rf appii ble): � 3 �--�
Phone: � rl_ •��"�"
Date: � - 7 L - � 5 Signature: /�L
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� ��� ' Minnesota Pollution
' ControlAgency Compliance Inspection Form
3 Existing Subsurface Sewage Treatment Systems (SSTS)
520 Lafayette Road North
St.Paul,MN 55155-4194 Doc Type:Compliance and Enforcement
SC/�C`__I'\/CI'1
InspeCtion results based on Minnesota Pollution Control Agency(MPCA) !,r For local tracking purposes:
requirements and attached forms—additional local requirements may also apply. I JUL 0 1 2f��:� I
Submit completed form to Local Unit of Government(LUG)and system owner I�
within 15 days ' '
System Status
System status on date(mm/dd/yyyy): 6/26/2015
� Compliant— Certificate of Compliance ❑ Noncompliant— Notice of Noncompliance
(Valid for 3 years from report date, unless shorter time (See Upgrade Requirements on page 3.)
frame outlined in Loca/Ordinance.)
Reason(s)for noncompliance (check all applicable)
❑ Impact on Public Health (Compliance Component#1)—Imminent threat to public health and safety
❑ Other Compliance Conditions (Compliance Component#3)—Imminent threat to public health and safety
❑ Tank Integrity(Compliance Component#2)—Failing to protect groundwater
❑ Other Compliance Conditions(Compliance Component#3)—Failing to protect groundwater
❑ Soil Separation (Compliance Component#4)—Failing to protect groundwater
❑ Operating permiUmonitoring plan requirements (Compliance Component#5)—Noncompliant
Property Information Parcel ID#or Sec/Twp/Range:
Property address: 333 Hollender Road Reason for inspection: _New Installation
Property owner: John& Donnette Tanner Owner's phone:
or
Owner's representative: Representative phone:
Local regulatory authority: City of Orono Regulatory authority phone: 952-249-4600
Brief system description: New Mound System __
Comments or recommendations:
Certification
1 hereby certify that all the necessary information has been gathered to determine the compliance status of this system. No
determination of future system performance has been nor can be made due to unknown conditions during system construction,
possible abuse of the system, inadequate maintenance, or future water usage.
Inspector name: Roger Peitso Certification number: 6683
Business name: Cit of o License number: NA
Inspector signature: Phone number: '�(,Sz—Z �g� ��EZ �
Necessary or Locally Required Attachments
❑ Soil boring logs ❑ System/As-built drawing ❑ Forms per local ordinance
❑ Other information (list):
www.pca.state.mn.us • 651-296-6300 • 800-657-3864 • TTY 651-282-5332 or 800-657-3864 • Available in alternative formats
wq-wwists4-31b • 6/4/14 Page 1 of 3
Property address: 333 Hollender Road Inspector initials/Date: RLP � 6/26/2015
(mMdd/yyyy)
4. Soil Separation—Compliance component#4 of 5
Date of installation: 6/26/2015 ❑ Unknown Verification method(s):
(mm/dd/YYYY)
ShorelandNVellhead protection/Food beverage Soil obse�vation does not expire. Previous soil
lodging� ❑Yes � No observations by two independent parties ar�su�cient,
unless site conditions have been altered orlocal
Com liance criteria: r�quirements differ.
For systems built prior to April 1, 1996, and ❑Yes ❑ No ❑ Conducted soil observation(s)(Attach boring logs)
not located in Shoreland or Wellhead
Protection Area or not serving a food, ❑Two previous verifications(Attach boring logs)
beverage or lodging establishment: ❑ Not applicable(Ho/ding tank(s),no drainfield)
Drainfield has at least a two-foot vertical ❑ Unable to verify(See Comments/Explanation)
separation distance from periodically ❑ Other(See Comments/Explanation)
saturated soil or bedrock.
Non-performance systems built April 1, ❑Yes ❑ No Comments/Explanation:
1996, or later or for non-performance
systems located in Shoreland or Wellhead New System
Protection Areas orserving a food,
beverage, or lodging establishment:
Drainfield has a three-foot vertical
separation distance from periodically
saturated soil or bedrock."
"Experimental'; "Other'; or `Performance" ❑Yes ❑ No IndiCate de ths o�elevations
systems built under pre-2008 Rules; Type IV
or V systems built under 2008 Rules(7080. A. Bottom of distribution media
2350 or 7080.2400 (Advanced Inspector
LiCense required) B. Periodicall saturated soil/bedrock
Drainfield meets the designed vertical C. S stem se aration
separation distance from periodically
saturated soil or bedrock. D. Re uired com liance se aration�
Ally "no"answer above indicates the system is "May be reduced up to 15 percent if allowed by Local
failing to protect groundwater. Ordinance.
5. Operating Permit and Nitrogen BMP*—Compliance component#5 of 5 � Not applicable
Is the system operated under an Operating Permit? ❑Yes ❑ No If"yes",A below is required
Is the system required to employ a Nitrogen BMP? ❑Yes ❑ No If"yes", B below is required
BMP=Best Management Practice(s)specified in the system design
If the answer to both questions is "no'; this section does not need to be comp/eted.
Com liance criteria
a. Operating Permit number: �
Have the O eratin Permit re uirements been met? ❑Yes ❑ No
b. Is the re uired nitro en BMP in lace and ro erl functionin ? ❑Yes ❑ No
Any "no"answer indicates Noncompliance.
Upgrade Requirements(Minn. Stat.§115.55)An imminent threat to public health and safety(ITPHS)must be upgraded,replaced,orits use
discontinued within ten months of receipt of this notice or within a shorter period if required by local ordinance./f the system is fai/ing to protect
ground water, the system must be upgraded,replaced, or its use discontinued within the time required by/ocal ordinance. If an existing system
is not failing as defined in law,and has at least two feet of design soil separation, then the system need not be upgraded,repaired,replaced, or
its use discontinued,notwithstanding any local ordinance that is more strict. This provision does not apply to systems in shoreland areas,
Wellhead Protection Areas,or those used in connection with food,beverage,and lodging establishments as defined in law.
www.pca.state.mn.us • 651-296-6300 • 800-657-3864 • TTY 651-282-5332 or 800-657-3864 • Available in altemative formats
wq-wwists4-31b • 6/4/14 Page 3 of 3
� Property address: 333 Hollender Road Inspector initials/Date: RLP � 06/26/2015
(mm/dd/yyyy)
1. Impact on Public Health— Compliance component#1 of 5
Com liance criteria: 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 ponding in soil system/D-boxes
tile or surface waters. ❑ Homeowner testimony(See Comments/Exp/anation)
System causes sewage backup into ❑Yes � No ❑ "Black soil"above soil dispersal system
dwelling or establishment.
❑ System requires"emergency"pumping
Any"yes"answer above indicates the ❑ Performed dye test
system is an imminent threat to public ❑ Unable to verify(See Comments/Exp/anation)
health and safety. ❑ Other methods not listed (See Comments/Exp/anation)
Com ments/Explanation:
2. Tank (ntegrity— Compliance component#2 of 5
Com liance criteria: Verification method(s):
System consists of a seepage pit, ❑Yes � No ❑ Probed tank(s)bottom
cesspool,drywell, or leaching pit.
❑ Examined construction records
Seepage pits meeting 7080.2550 may be ❑ Examined Tank Integrity Form(Attach)
com liant if al/owed in/ocal ordinance.
Sewage tank(s) leak below their ❑Yes � No ❑ Observed liquid level below operating depth
designed operating depth. ❑ Examined empty(pumped)tanks(s)
If yes,which sewage tank(s) leaks: ❑ Probed outside tank(s)for"black soil"
Any "yes"answer above indicates the ❑ Unable to verify(See Comments/Explanation)
system is failing to protect groundwater. ❑ Other methods not listed(See Comments/Explanation)
Comments/Explanation:
New Tanks
3. Oth21'COmplldtlCe COndition5—Compliance component#3 of 5
a. Maintenance hole covers are damaged,cracked,unsecured,or appear to be structurally unsound. ❑Yes' �No ❑Unknown
b. Other issues(electrical hazards,etc.)to immediately and adversely impact public health or safety. ❑Yes'" �No ❑Unknown
*System is an imminent threat to public health and safety.
Explain:
c. System is non-protective of ground water for other conditions as determined by inspector. ❑Yes* �No
*System is failing to protect groundwater.
Explain:
www.pca.state.mn.us • 651-296-6300 • 800-657-3864 • TTY 651-282-5332 or 800-657-3864 • Available in altemative formats
wq-wwists4-31b • 6/4/14 Page 2 of 3
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;; , .� :_ ;��� CITY o� OIiON�►
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�,,: Municipal Offices
,�,.�,� , � . G,'' ;.;,
Street Address: Mailing Address:
��9�Es:�p4�� ' 2750 Kelley Parkway P.O. Boz 66
�-:: :--.... ...- Orono, MN 55356 Crystal Bay, MN 55323-0066
To: The Current Owner of Address �� ��C��^ �L'-�
City Ordinance requires that onsite sewage treatment systems in Orono be
inspected on a periodic basis. The onsite sewage treatment system at the above
address has been inspected and the following is known about the system. A
sketch of the known components of the system is available for most properties at
the Orono City Hall.
Imminent Public Health Threat
Yes =�No
If yes, please contact the Onsite Systems Manager at 952-249-4626 within 10
days of receipt of this notice. The septic system must be brought into compliance
within 90 days. Failure to do so will result in referral to the City Attorney for
legal action.
System Identif 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 recoirunends the septic tanlc(s) ai�d/or lift tanl:be serviced and pumped
out every three years. City records indicate the tank(s) were last pumped out on
`�'� ����(� . The tank(s) should be cleaned through the manhole and
not tluough the inspection pipes, this allows for proper cleaning.
Comments:
�.
F
Inspecto . � Date of Inspection ��i�
'�'ele��,orce(9�?12�9-�d60� � �'aa (9�2)249-�61�,
1b'VL'S4'.C1.03'Of3G.i1iTl.lgS
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'' ��.:� ..� '� CITYof ORONU
Y�'�i► ,u f.�`}��1t�'.r�a�'�n • � •
, "� i�;���". . � ti . MUD1C1� ��1C�S
,�.^». �F G Street Address: q 5a—�4 q,y 6o O
' '� �� .�:j�^�`F`F°�'�Y Ma�ling Address:
�t'�gHOg' 2150 Kelley Parkway � P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
To Current Owner: Address: �33 ����hn�e< (�
City Ordinance 199 requires that each existing on-site sewage treatment system in Orono be inspected every two years.
The on-site sewage treatment system at the above address has been inspected and appears to fall into the categories checked below.
SYSTEM CONFORMIT'Y (1-3): �
1 "CODE SYSTEM"An LS`I'S which meets all the location,design and construction standards of the current Orono Municipal Code.
2 "COMPLIANT SYSTEM" An LSTS which does not meet all the location,design snd conshuction standazds of the current Orono
Municipal Code but does meet the three foot separation requuement or two foot requirement for systems instatied 1996 or earlier,and
which is not failing or an iQaniaent threat to public health or safety.
[ 3 J "NON-COMPLIANT SYSTEM" A prohibited ISTS;an ISTS located within a designated 1 W-year flood plain,any ISTS which may
�� or may not meet all the location,design,or construction stan�ards of the cu�rent Orono Municipal Code and which is failing for any
reason;and any ISTS with less than three feet of unsaturated soil or sand between the distribution device and the limiting soil characteristics.
TANK CONDITION l5-7�: �
k inspection indicates:
5 Pumpout not needed at this time. -
Septic tanks must be pumped out this year (city code recommends tanks to be pumped out once every 3 years. -
Tank was last pumped C-1'7"U� ).
Make sure seotic tanks are uumoed throueh manhole and not throu¢h white insoection oiaes This allows for the oroaer �
cleamne. Keea water softner and�ron filter dischar¢e out of seotic svstem to nrolon�life of drainfield Ask�umaer to test
alarro float to ver�fv alarm is still workin¢in vour house The alarm warns owner that seota¢e is about to backua into basement
7 Inspection nsers 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.
INFIELD CONDITION 8-10 : ZS
8 Drainfield is dry,no surfacing evident.
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.
COMNIENT : �f°�`�'�t�� .�,-,,,,.:�..5 �p,�_. (:�,,� �,
P ����.. .�ti__� .. r.,,,�— �e:. ._ .
C�' �°��� � — � —ZO\� •
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Date of Inspection Matt Solterman - Septic System Inspector
Note: In the event that ihis inspection report is used to satisfy the requirements for a mortgage or other transfer of property, be advised that this repon does
not guarantee or certify that an existing system �r•ill continue to function properly, but is merely an opinion ot'the adequacy of the s}�stem under current
cunditions based on the available inl'orniation.
o -
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���-� CITY of �RONO
.? �,�
- �' ti'����� ti -
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,� , ;�,� �-�`•i� Gti 14iunlcipal oflices �.,_
l �'�,};��;,g�'y ' Street Addresr. ��
�8�1 2750 Kelle Par1cwa Mailin�Addreu:
. � � Y Y P.O. Bax 66
Orano, MN 55356 Crystal Bay, MN 55323-0066
- 95d-�4q-y600
To Current Owner: Address: 3 3 3 I-�o l�a n d er. ��
Ciry Ordinance 199 requires that each existina 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.
SYSTENt CONFORMITY (1-3): 3
1 "CODE SYSTEM"An ISTS which meets all the locadoo,duign and construction standazds of the curreat Orono Municipal Code.
2 "C0�'LIANT SYSTEM" An ISTS which dces nat meet all the locatian,daian and construction standards of the current Orono Municipal
Code but doa meet the three foot separation requirement or two foot requirement for rystems iiutalled 1996 or earlier.and which 1s not failina or
�.� an imminent threat W pubiic health or safery.
( 3 ) "NON-COMPLIAN?SYSTEM" A prohibited iSTS;an ISTS lacated within a daignated 100.year fload plain,any IS?S which may
�'� or may not meet all the lacation,design,or consuuction standards of t�e current Orono Municipal Code and which is failiag for any ceason;and
any ISTS with less than three feet of unsaturated soil o�sand behveen the d'u�'budon device and the limitina soil characurisdcs.
TANK CONDITION(5:71: 6
Tank inspection indicates: � . .
5 Pumpout not needed at this time. �
� Septic tanks must be pumped outn is yeaz (city code requires tanks to be pumped out once every 3 years.
Tank was last pumpzd 4S�" � ). �
1�Iake sure seotic tanks are aumoed through manhole and not throu;h white insDection gioes
This allo�ss for the aro�er cleaninQ.
7 Inspection risecs missin�tanks could not be inspected. Inspection risers(4"dia,pipe)must be installed in each tank.
DRAINFIELD CONDITION!S-tQ�: �
8O Dninfield is dry,no surfacina evident.
9 Some evidence of surfacing,not critical yet •
10 Dninfield is saturated and visibly discharging un�eated effluent to the surface. Contact the Ciry Inspector �
immediately.Repairs must be completed within 90 days.
C�i�i ��5: �cn,��.c��i ;S C�nt�- Cc�.��:c„�r qr�� t''�uk �� � r�p�5<<d ��
Ia.-�i-2-bio , ��'^-P �CS n�xr S��hcr
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Date of Inspection Matt Boiterman- Sepdc System Inspector
Note:In the event that this inspection rcpoR is used to satisfy the requiremrnts for a moctgage or o�her transfer of propeny.be advised that this npoR does not guarancee
or certit�that an eristing rystem will continue W function propedy,but is merely an opinion ofthe adequary otthe system imderc�rrent wndidorts bastd on the availabie
information.
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,t �r:;�,-., y CITY of ORONO
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� �i� �/ MUIl1C1� D�CCS
\��,tf�,��'�}I�`��`�''.�G~ SVeet Address: MafiinQ Addrou:
`�'Eg'g0g' 2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
October 18, 2000
Gary&Mary Vacek
333 Hollander Road
Wayzata,MN 55391
Dear Mr. &Mrs. Vacek:
An inspection of your septic system was conducted on October 3, 2000. A summary of the inspection
is below.
Septic Tank Condition
1. Pumpout not needed at this time.
The septic system is non-compliant due to a lack of a three foot sepazation distance between the bottom
of the drainfield to the seasonally high watertable. The three foot requirement is a State Code,not a City
Code. A soil boring was conducted to determine the depth of the seasonally watertable. The septic
system must be replaced by December 31,2010.
Enclosed is a list of state licensed septic contractors who work in Orono on a regulaz basis. Also
enclosed is a fact sheet explaining how a septic system functions properly. Finally, an as-built drawing
is enclosed that shows the approximate location of the septic system.
If you have any questions regazding this report,please contact me at the City Oi�ices at 249-4600.
Res ectfull ,
U J .Gt��.�/
Chris 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 this report does no guarantee or certify the ezisting 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.
Telephoae(952)249-4600 • Fax(952)249-4616
www ci.omno.mn.ns
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i� �� � �4-�- -� CITY of ORONO
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,� '� -��-1.�_��'k��"',`yG Street Address: Mailing Address:
9$'��;g4g0g' 2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323•0066
Owner: Address: 333 Hollander Rd.
Permit #'s: 7655 tes: 10/12/84 Contractors: Gene Hayes
(This is [�[] an existing system [ ] new construction) .
SYSTEM COMPLIANCE (1-3) : 3
1 Code System: Meets or exceeds current City standards in all respects relating to desiqn,
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.
� 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 [x] or is not [ ] identified under this septic system. If the
saturated soil level is not identified, this classification is subject to reviaion.)
ANK 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.)
DRAINFIELD CONDITION (11-14) : 12
11 Drainfield is dry, no surfacing evident.
12 Some evidence of surfacing, not critical yet. Repair is not required at this time.
3 Drainfield is saturated and visibly discharqing 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.) : high
CONIMEENTS: 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 0 feet and the system is non-compliant. Repair or replacement of the septic
system is required by 12/31/2005. �
I� ���L- 9�' -
ate of Inspection Se c System nsp 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
CITY OF ORONO �O�
M�micipal Offices O O
Post Office eox 66
Crystal Bay, MN 55323-0066 a � ON—SITE SEWA(�E TREA'1'l�NT
r�,� . �, INSPECTION REPORT
� G�
�`�kEsHo�'�
Owner• Address• �J�..L� �lG�l'Y�
Permit #'s: Dat [J`7�[�ZS`i^ Contractors: ?� ��G.
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 betow.
(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 into ground or surface waters.
3 "NON-CONFORMING STSTEM"-A prohibited system; a system located within a designated 100-year floodplain; any
system which mey 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 identi ied, this classification may be subject to revision.)
TANK CONDITION (5-10):
Tank inspection indicates:
� Pumpout not needed at this time.
/6J' Solids accumulation in tanks indicates they should be p�anped out this year to help prevent future problems.
"7 Solids accunulation in tanks is at a criticat level. ranks should be punped out as soon as possible.
8 System is discharging to the surface. Tanks must be punped out within 48 hours to eliminate surface dischar$e.
9 Inspection risers missing-tanks could not be inspected. lnspection risers (4'� dia. pipe> must be installed in each
tank at next purtipout. If tanks have not been punped out uithin the last three years, they should be pumped
out now.
10 Inspection pipe is located directl over tank baffle (does not give accurate measurement of solids accunulation).
lf tanks have not been pu�out within the last three years, they should be punped out now.
ORAINFIELD CONDITION (11-14):
D�field inspection indicates:
Drainfie[d is dry, no surfacing evident.
2 Sane evidence of surfacing, rat 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 (slooe.setbacks.etc.):
POTENTIAL FOR SYSTEM FAiLURE (deaends on soils,water table.etc.):
COMMENTS:
Date of Inspection e tic Syste Inspector
Note: In the event that this inspection report is used to satisfy the requirements for a mortgage or other transfer of
property, be advised that this report does not guarantee or certify that an existing system will continue to function
properlyi but is merely an opim on of the adequacy of the system �der current conditions based on the available
information.
This report must be kept on the premises with the system locstion and pirnping records.
WHITE COPY/Inspectors Flle YELLOW COPY/Homeowner
CITY OF ORONO � O�
Municipal Offices O O
Post Office Box 66
Crystal Bay, MN 55323-0066 � � ON—SITE SEWA(�E TREATI�NT
r�,� �C�, INSPECTION REPORT
� Gti
�9kESH��'�
Owner: �IVl1�1 .�,�n/��'1,P11 Address: � � �
Permit #'s: ���� Dates: �"��-[S'7 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 tnspected and appears to fall into the category
checked below.
(This is �L an existing system [ ] new construction)
SYSTEM CONFORMITY C1-3): �
1 "CODE SYSTEM"-A system which meets all the location, design, and construction standards of the current City
Codes, and which is operating satisfactorily by treating and disposing of the entire current sewage input
without discharging any pollutants into ground or surface waters.
2 "CONFORMING SYSTEM"-A system 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 ot the entire current sewage input without discharging
any pollutants into ground or surface wat�rs.
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 sotl characteristics.
(The limiting soil characteristic � has or [ ] has not been identified at this time. If the limiting soil
characteristic has not been identi ied, this classification may be subject to revision.)
TANK CONDITION CS-10): �
T�c inspection indicates:
(,�7 Puqwut not needed at th i s t i me.
6 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. 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 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. !f 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).
If tanks have not been punped out within the last three years, they should be punped out now.
DRAINFIELO CONDITION (17-14): �
Drp.�nfield inspection indicates:
(1Y Drainfield is dry, no surfacing evident.
'f2 Sane evidence of surfacing, not critical yet.
13 Drainfield is saturated and visibly discharging untreated effluent to the surface. Contact the City Inspector
immediately. Repairs must be completed within 90 days.
14 Drainfield extent and condition unknown.
LIMITING SITE FACTORS (slope,setbacks,etc.):
POTENTIAL FOR SYSTEM FAILURE Cdepends on soils.water table,etc.): / „- �
S�lk1
COMMENTS:
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 cert�fy that an existing system will continue to function
properlyi but is merely an optnton 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 locetion and pumping records.
WHITE COPY/Inspectors Flle YELLOW COPY/Homeowner