HomeMy WebLinkAboutcompliance inspection 2/2017 �� ,� Minnesota Pollution Compliance Inspection Form
:x,
� Control Agency
520 Lafayette Road North Existing Subsurface Sewage Treatment Systems (SSTS)
St Paul,MN SS155-4194 Doc Type:Compliance and Enforcement
InspeCtion results based on Minnesota Pollution Control Agency(MPCA) For local tracking purposes:
requirements and attached forms—additional local requirements may also apply.
Submit completed form to Local Unit of Government(LUG)and system owner
within 15 days
System Status
System status on date(mm/dd/yyyy): 2/22/2017
� Compliant—Certificate of Compiiance ❑ Noncompliant— Notice of Noncompliance
(Valid for 3 years from report date, unless shorter 6me (See Upgrade Requirements on page 3.)
frame outlined in Local Ordinance.)
Reason(s)for noncompliance(check all applicable)
❑ Impact on Public Health(Compliance Component#1)—lmminent fhreat to public health and safety
❑Other Compliance Canditions(Compliance Component#3)—imminenf fhreat to pub(ic healfh and safety
❑Tank Integrity(Compliance Component#2)—Failing to profect groundwater
❑Other Compiiance Conditions(Compliance Component#3)—Failing to protect groundwater
❑Soil Separation (Compliance Component#4)—Failing to protect groundwafer
❑Operating permit/monitoring plan requirements(Compliance Component#5)—Noncompliant
Property Information Parcel ID#or Sec/Twp/Range:
Property address: 2555 Fox Street,Orono Reason for inspection: Sale
Property owner John Grudnowski _ Owner's phone: 715-865-2243
or —
Owner's representative: _ _ Representative phone:
Local regulatory authority: City , Regulatory authority phone:
Brief system description: 2-1000 Septic&1000 pump,split rockbed at grade
Comments or recommendations:
There is concern that when wetland and creek rise that water will flow into the covers of the septic tanks especially the pump tank.
Snow melt water was close to running into pump tank.
Recommend Raising Covers
Certification
!hereby certify that all the necessary infom►ation has been gafhered to determine the compliance sfafus of this system. No
determinaSon of future system perfonnance has been nor can be msde due to unknown conditions during system constructron,
possrble abuse of the sysfem,inadequate maintenance, or future water usage.
Inspector name: Josh Swedl nd � Certification number: C1659
Business name: Swedlund tic S ce _ License number: 2502
_ _
Inspector signature: __ Phone number: 952-873-3292
Necessary or Local Required Attachments
�Soil boring logs �System/As-built drawing �J Forms per focal ordinance
❑Other information(fist):
www.pca.state.mn.us • 651-296•6300 . 800-657-3864 • T7Y 651-282-5332 or 800.657-3864 . Available in altemative formats
wq•wwists4-3l • 3/16/12
Page 1 of 3
Property address: 2555 Fox Strset,Orono Inspector initials/Date: JS I �2J2017
(mMdd/yyyy)
1. lmpact on Public Health—;Compiiance component#1 of 5
Com Ilance ariteria: Verification method(s):
System discharges sewage to the ' ❑Yes �No �Seardied for surface outlet
round surface. �Searched for seeping in yard/backup in home
System di;,charges sewage to drain ❑Yes �No ❑Excessive ponding in soil system/D-boxes
tile or surface waters. ❑Homeowner testimony(See Canments/Expfanador►)
System causes sewage backup into ❑Yes �No ❑"Black soil"above soil dispersal system
dwelling or establishment.
❑System requires"emergency°pumping
Any"yes"answer above inqlicates the ❑PerFormed dye test
system is an imminent thre�t to publ/c ❑Unabie to verify(See CommentsiExplsnatfon)
health and safety. ❑ptt1e��,�s not iisted�see�menr�xpre,►at�on�
Comments/Explanatlon:
2. Tank Integrity—Complianc� component#2 of 5
Com liance criteria: VeMfication method(s):
System consists of a seepage pit, ❑Yes �No �Probed tank(s)bottom
cesspoof,drywell,or leaching pit. ' �Examined construction records
Seepage pits mseting 7080.2550 may be i ❑Examined Tank Integr(ty Form(At�ch)
c�m lfant if allowed fn local o►clinertce. '
Sewage tank(s)leak below their ❑Yes �No ❑Observed liquid level below operating depth
designed operating depth. ❑E�camined empty(pumped)tanks(s)
If yes,which sewage tank(s)Isaks: ❑Probed outside tank(s}for"black soil"
Any"yes"answer above indlcates the O Unable to verify(see Commenrs�xp�anatton)
systoem fs fal/►ng to protect groundwater. ❑�er methods t�t listed(See CommentslExplenation)
Comments/Explanatlon:
3. Other Comptiance Condltions—compiiance component#3 of 5
a. Maintenar�ce hole covers are damaged,cxacked,unsea�red,w appear to be structurally unsound. ❑Yes* �No ❑Urdcnown
b. Other issues(elec�rica/hazerds,ei�.}to immedia#ely and adversely impad publ�health o�safety. ❑Yes* �Na p Unknown
"`System is an imminerrt�reat dp public heafdr and saiety.
Explaln:
c. System is non-protedive of graand water for other ounditiais as determined by inspeaor. ❑Yes• �No
�System fa fallfng to proUecf groyndwal�er.
Explain:
www.pca.state.mn.us • 651-296-6300 • 800-657-3864 • TTY 651-2$2-5332 or 800-657-3864 • Available in aitemative formats
wq-wwlsts4-31 • 3/16112 PQge 2 of 3
Property address: 2555 Fox Street,Orono Inspector initials/Date: JS I 2!2?J2017
(mm/dd/YYYY)
_4. Soil Separation—Compiian�e component#4 of 5
Date of inatallation: 8l1I2012 ' ❑ Unknown Verification method{s):
fmm/daVYYYy) �'
ShorelandNVellhead proboctioNFood beverage So1!ObseNatiot7 does nof expin9.Previous SOiI
����� �Yes ❑No observaHons by iwo independent parties ene sufficlent,
untess site condfHons have been altered or local
Com Itance criteria: riequi�ments diiler.
For systems built prior to Apri!1, 1996, a�d ❑Yes ❑ No �Conducted soil observation(s)(Attach boring 1ogsJ
not located in Shareland or Wellhead '
Protection Aiea or not serving e food, ❑Two previous verifications(Attach boring�ogs)
beverage or lodging establishment: ❑Not applicable(Holdirrg tank(s),no drafrrf'�eld)
Drainfield has at least a two-foot vertical ❑ Unable to verify(See CommentsiExp/anation)
separation distance from periodicalty ❑Other(See CommentsiExpianatia►)
saturated soil or bedrock.
Non-pertormance systems builtApril i, �Yes ❑No Commenta/Explanation:
1996,or later or for non pe�formance
systems located in Shoreland or Wellhea4l Boring:
Protection Areas orserving a food, 1-16"10 YR 2/2 Loam
beverage,or Jodging establishment:
Drainfield has a three-foot vertical
17-3610 YR 4/4 Clay Loam
separation distance from periodically No Redox
saturated soil or bedrock.*
Experimental; "Othe�; or Perlonnance? ❑Yes ❑No IndIC2lte de ths Or elevations
sysfems builf under pre-20U8 Ruler, Type:N
or V systems built under 2008 Ru/es(70�. A. Bottom of distribution media at rade
2350 or 7080.2400 (Advanced Inspector'
License required) e. Periodical saturated soil/bedrock 3g" lus
Drainfleld meets fhe designed vertical G. S stem se aration 38°
separatiorr dlstsnce ftom periodic�lly
saturated soil or bedrodc.
D. R uired com Gance se aration` 36"
Any"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
►s the system operated under an Oper�ting Permit? ❑Yes ❑No !f"yss",A below is requfred
Is the system required to employ a NitrQgen BMP? ❑Yes ❑No !f"yes",B below is required
BMP=Best Management Practice(s)specl�red In the system design
If ff►e answer to botf�questions!s"no", fhis sectlon does not neeol to be comp/eted.
Com liance cHteria
a. Operating Permit number:
Have the O ratin Permit uirements been met? ❑Yes ❑ No
b. Is the re uired nit en BMP in I�ce and ro rl fundianin ? ❑Yes No
Any"no"answer indicates Noncompliance.
Upgrade Requirementa(Mfnn.Stat.§!1�.55)An fmmineM threat to public hea/d►and sffiety(►7PNS)must be upgraded,replecer/,or��S us�
disc�ntinued within ten months of r�eceipt of thls r►otice or wiq�fn a short+ar period if�equired by loca/o�nar►r�./f the system is failing to prutect
ground water,the system must be upg�ade�t,';rapleced,or lts use discarBnued yviqz)n the dme nsqulred by IacaJ ordfnem;e.li an existing system
Is rrot felling as defrned in law,and has at lea;st two feet of deslgn so!!separation,then the system need not,f�e upg�ader!repaired r�ap/��.
its use disconSnuect,noha/thstanding any loc�i o►r/fnence thaf is mon sMct THis pmvrs�on does not apply to systems in shor�sJend areas,
Weqhead Protectlon Arsas,or thase used in tbnnection wlth food,,bevaerege,and lodgirrg�establishments as deNned in lew.
www.pca.state.mn.us • 651-Z96-63� • $00-657•3$64 • TTY 651-282-5332 or�0-657-38�4 . Avaitabte in altemative formats
wq-wwlsts4-3f • 3/!6/12
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