HomeMy WebLinkAboutSeptic info �
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-�����_�- CITY of OR4N0
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\� �,t i �.,;'��1^�.-,'�,�G Street Address: °15a-a49-y6o O Mailing Address:
� '���p4� 2750 Kelley Parkway P.O. Box 66
�_ Orono, MN 55356 Crystal Bay, MN 55323-0066
C� � \t Ma`�r �-V
To Current Owner. Address: �IO � o
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 CONFORMITY (1-3): �
� "CODE SYSTEM"An ISTS which meets all the location,design and conshuction standazds of the current Orono 3vtunicipal Code.
2 "COMPLIANT SYSTEM" An ISTS which does not meet all the location,design and construction standards of the cuirent Orono
Municipal Code but does meet the duce foot separadon requiremeut or two 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 standuds of the current Orono Municipal Code and wkuch is failing for aay
reason;and any ISTS with less than duee feet of unsaturated soil or sand beiween the distribution device and the limiting soil characteristics.
�
TANK CONDITION(5-7): S
Tank inspection indicates:
5 Pumpout not needed at this time.
6 Septic tanks must be pumped out this year (city code recommends tanks to be pumped out once every 3 years.
Tank was last pumped 5-26-c� ).
Make sure seatic tanks are uumaed t6rough msnhole and not throueh white insaection niaes. This allows for the uroner
cleanin$ Keeu water softner and iron tilter dischar�e out of seatic svstem to nrolon¢life of drainfield. Ask aumaer to test
alarm float to verifv alarm is still workine in vour house The alarm warns owner that septase 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
tanks have not been pumped out within the last three years,they should be pumped out now.
IELD 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 e$luent to the surface. Contact the City Inspector
iminediately.Repairs must be completed within 90 days.
COMMENTS: 1�^a� �� a- 5���.� �G��� ��°K �� -
�-1�-0� '�� _"
Date of Inspection Matt Bolterman- Septic System Inspector
Note: Tn the ev�t 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 U�e adequacy of the system under current
conditions based on the available information.
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���::� :. _ CITY of UR4NO►
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� r�--��r;,•3� Street Address: Mailing Address:
��9x°r'����'�p4��/ 2750 Kelley Parkway P.O. Box 66 .
�����g�� Orono, MN 55356 Crystal Bay, MN 55323-0066
To: The Current Owner of Address � �d� ��o l t ��� c��
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 �,c
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 Attomey for
legal action.
System Identified as Non-Compliant
Yes �”
No 1/ /
If yes, system must be brought into compliance by:
December 31,2007 �
December 31, 2010
Other �
Septic Tank(s)Pump out Needed
Yes
No �
The City recommends the septic tat�k(s) and/or lift tank be serviced and pumped
out every three years. City records indicate the tank(s) were last pumped out on
�- a.�,�p� ( . The tank(s) should be cleaned through the manhole and
not through the inspection pipes, this allows for proper cleaning.
Comments:
�
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Inspector: Date of Inspection
Telephone(9�2)249-4600 • Fax(952)249-4616
�c�ww.ci.orono.mn.us
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# CITY of ORONO
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� ' � a;_.,�`N��`�G Street Addross: Mailina Addross:
�L+ggO�" 2150 Keiley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
July 25, 2000
David & Rocel Kin�an
1100 Knoll Manor Road
Long Lake, Mn 553�6
Dear Mr. &Mrs. Kingman:
An inspection of your septic system was conducted on July13, 2000. A summary of the inspection
is below.
Septic Tank Condition
1. Pumpout needed within one year(last pumpout date 3/12/97).
The septic system is a compliant system, meaning it meets all or most cunent 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
drawin; is enclosed showing the approximate location of the septic system.
If you have any questions regarding this report, please contact me at the City Of�ices at 249-4600.
Res ectfully,
� - -� )
-PM��
C 's Pence
On-Site Systems Mana�er
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 wil!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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07/30/2069 21:14 7634975611 SPTESTINGINC PAGE 02/69
� �w�' T'�S �T'/�C�, INC. Steven s. s�r,�m,a� • nnPCA cart.rvo. s2�
951 Katydid Lane NE • St. Michael, MN 55376 • (763) 49?,3566
FAX (�63) 497�5011
State License #394
� ��
July 29, 2009 �
Dave Kingman ���
1100 Knoll Manor Rd.
Orono, Henn. Co., MN
A Compliance Inspection was completed for the existing on�site sewage treatment
sy�ttem located on this property. The system consists of 2-1300 gallon sepfic tanks, 1-
1300 gallon pumping ahambe�& a pressurized mound system with a 10' x fi2" rock bed
rebuilt in 2002. The mound system was originally built in 1991. In 2002 the rock bed
was hydraulically overloaded. The rockbed & approximately 6" of sand were removed
8�the rockbed was reconstructed. Soil boring #1 found moitJed (redox�tures) at 1.7'
below the ground surFace. Soil boring #3 found the original soil at elev.102.2, 3.7' &
the bottom of the rock bed at elev.104.0 leaving 1.8' of sand below the rock bed 8�a
3.5' separation from the bottom of the rock bed & redox features. Soil boring #2 found
mottled soil afi 2.3' below the ground surface. Soil boring#4�Found the original soil at
elev.102.0. 3.8' &fihe bottom of fhe rock bed at elev.104.0 leaving 2' of sand b�low the
rock bed & a 4.3 separation from the bottom of the roak bed & redox features. This
system is classified as in compliance wi#h Minnesota Chapter 7080 rule�. There was
no evidence of the system being hydraulically overloaded at the time af the inspection.
The tanks were�pumped by �Ime�J. Peterson Co. &were found to be compliant at this
time.
Nothing other than gray water(laundry, showers, etc.) human waste &toilet tissue
should be disposed of into the sep#ic tanks. Garbage disposals are not recommended,
due to adding more solids &fine solids passing through to fihe system. Recommend to
divert iron Trlters out of the system, recommend to divert the water softner also if
diverting the iron fllter. Excessive amounfi� of soaps, antibacfierial soaps, cleaning
agerrts, shower cleaners used every shower�ch�orine agents may kill the bacteria
needed to treat septic effluent. Additives are nofi recommended. Recommend to pump
&clean your tanks through the manhole by a certified pumper �very 2 years. Check
with you�pumper to set up a schedule.
This Certificate.of Complian�e is no guarantee that this system will continue to function
indefinitely.
�z�2�' • �
Steven B. Schirmers
07/30/2669 21:14 7634975011 SPTESTINGINC PAGE 03/09
"'�n:^es°�a p°�,�t�on � Compliance Inspection �orm
• Control ,�gency
Exist�ng Subsurface Sewage Tt�atmen# Systems (SSTS)
S�p l,afayette qoad Norch
St.Paui,MN 55155-4194 • Doc Typo:Compliance and F_nlorcerrlenl
� (nstruction� on page 7
StJ�771'�ary For111 (Completed form must be submitted to the Iocel unit oF governmenl withln 15 day�,)
P�rcel number; ,
Syslem status; �Com�lf2nt ❑ Noncomplianl . For Loce�Tr�cking PurpoSes; � —�'—•�
I
(based on a!!comp!l�nce requiremenlsJ I
, �
Property Information � `—" — �
prQpEr#y owner name(s); .�?����y j��.�,�4
�_.. . � property own�r rhone: ���ed�`���.^
Property address: �,�Q_�M�������g ,�� _ !�
Property owner�ddress(it dl�erent):�,� � �`� . �"�"��' � —
County:�����,1 Penniiting�ulhority: .�� o � . �-
Date system constructed: � �"'������ �
�n 0�_. ,_ Reason fo�Inspectlon_'���.�{ •��5,�
System Descript9on , � � .
Bri�f system description: �,"13d��� �i0��.\�r�, ,�.� .,���W� � 1��Q���, ��
`=`-"-�ra" �4 pJ �-►-�'� „
I.ocal permit number. ^ Number of bedrooms: $� Deslgn flaw rate: �S�} ��
Is the system: � ' , �—�-
in Shoreland aroa? Q Yes � No In Wellhead Protecticn Area? ❑ Yes �No
An U.S,Environmental Protection System serving a Minnesota Deparfinent
Agency(EPA)Class V InJection W�II?Q Ye9 � No of Heath(MDH)Iloensed f�cility? ' ❑Yes � No
COIT1PI1dI1Ce S�dtUS (Besed on st�fe requi'remenls-addition�l locs/roquiremer�s may also apply,J
Based on ihe informallon gelher�d and reported an att2chEd forms,lhe cornplfance status of this systam Is(checlt one):
�Certlflcat�of Compliance-valid until (3 years from datQ ofrepo►7): �
❑Nolice oF Nvncompliance-For Noncompliant systems: T
The reason for nnncvmplianca is':
7hls noncompliant systern is ci�ssifi�d as�heck one belouu);� � ��� "" '
❑ Imminsnl tlir�eat ta public health 8�safery [] Faiiing to protect ground water [j Not in compliance with vperating pErmit
Certif9cafiion
I hereby cerllfy that�II the necessery'inform�flon has been gathered to�efermine lhe comp/lence slatus of this syslem. No
� determi�ation of fuh�re sysbm performance HAs been na can be made due to unknown condltlons during system consln�etion,
possi6le abuse oi the system,inadequate melntenance, ar future water usege.
Name: ����, L .���¢�¢S � Certlfication number: (a a�
. Business license name and number: �-Q������, �,,,� �!+ �
��9�to_3-4°1�-35��or
Name of local unll of govemm�nt�
/�— ,Q .w�
Signature: :��,�1�- ...----- � Dake: �� -ac���,�. .�
��� ��
Required Attachments
� � Hydraulic PerFormance �Tank Integrity . ❑ Operating Permit Form (If applicable)
Soil Boring Logs �Soil 5eparatlon .
�System drawing/As-buill drawing Any Ibcal requlrements that are different from what is required on thfs form
❑Other Infiormation(Ilst): • •
UPOrad�Requirements (derived from Minn. Staf. § 115.55)�In Immthent lhrao�!o publlc heelfh and s�fely(ITPhIS)must be upgnade^d,
repl�ced,or its us�disconNnued withM Isn nronfhs ol receip�of thls nol/c�or withln a shvrler poNod!I requlrod by/acal ordinance.!f fha sysiam!s
fs111ng�o protect Arnund woler,tho sysf�in musf be upgrPded,repleced,or/ts use disconlMued wfthtn the•Nme repu/red by Mcal ordinanco. If an
exlsf/ng��ystam is nof falling os deqned In law,and fies af leasl tvw fee(of cfes/gn soll sopareHon,fhan!ho sysfam nead not be uPBrmded,repalr+ed,
replaced,or Ifs use dlscondnued,no(wqhatand►ng any bcel ordlnence fhaf Is more atMcl. Th)�provision does not epply to systems In shorelAnd
areas, WephaBd nrotecflon Areas,or those used in oonnec�ion wlih food,beverage,end lodging estabNshmenfs as defined In lew, ,
www.pca.state.mn.us � 651•29b•6300 • 800•657•3�6q . TTY 651•28Z•5332 0��00-657•3864 •� A'vailable 1n attemarivP t��mat�
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07/30/2009 21:14 7634975011 SPTESTINGINC PAGE 04/09
Percel numbEr: . _ _ __ System slatus: �Com liant
, . . . _ ....._. ..__........ . . ..._._..,__ _.� P ❑ Noncom�llent '
, (a.a�leterminad by t/�/s formJ
Hydraulic Performance �nd Other Coinpliance - Compliance Inspection Form for Exlsting SSTS
Complrance Issue #1 of �
Dale of ob�orvallon: __7 _a��Dal , ., Reason For observation:
. 1�i�a��-���:���.„�.—.—
This form expirss upon next ins�eclfon or in lhree y e a r s,w h i c h e v e r o c c�r s Fl r s t: �
Compliahce ques#ionslcriterie: (R�qulred) Verification Method*: (pptianal)
_. (Check fhe apprapr/ate box)
- (Ghech the approprlafe bax) �
Dves the systPm dis�harge sewage to lhe � ❑Yes �No
�round surt�ce7 � Searohed for surface oullet 1�L� •
- —� _,.�.� _.,,�_,, .-
Does lhe system discharg�sewAge to drain 1 ❑Yes ❑ No � pertormed hydrt�ulic tesl
�tile` or surf�ee wetere7 � _ � Saarch�d for seeping in yarcl 1yc�
Dve�the system cause sewage bacicup � ❑ Yes I�No� Cl Cheeked for backup in home
into dwelpng or e�lablishrnent? .._���,� •
� Excessive ponding in soll system/D•boxes 1�
Do other slluations exist that hava the � ❑ Yes
potential to immediataly and adver�ely '� N� ❑ Woineowner testimony
impact or threaten public health or safety [] Qxamin�d for su�ging in tank
electr(cal,unsafe covers,etc,)?
Any"yes"answer lndtc�tes th�t the system!s an lmmfnent � "Black soil"2bove svil dispersal syslem hj�
U�reat to public health and safety. O 5ystem requlres"emergenCy"pumping
�• (� Performed•dye te�t
Does Ih�system pcse a threat ta ground� [j Yes � No
waler For any condilions deemecJ non- � 0 Other: �pLy��p�,,, _`�`
,.,nrot` �ctivc�as determined bY the Ins ector? I _ ��_�p,�_
"Yes"indfcAfes that the system!s fa!//ng to protec( �
ground watc�r. !f"yes", describe the condition noted: �'� -•�--�
� "No standard prolocol exisf5. This lisl is not oxhau.st/ve,
-` _ "'� °, ,�— in sequanti�l ader, nor does if lncllca�e which
__., _w�„ , l combinefions�re neCess�ry fo make fhis deferm►natlon.
Certification �
Thls form is lo be compl�ted and atlached to the Summary Form of lhe Mlnnesota Pollution Control Agency's(MPCA)Compliance
Inspectlon Form for Exisling Subsurface 5ewage tre�tment Systems.'Observatlons,interpretations,and conclu�ions must bs
cvmpleled by an inspeclor.Cornpleted form must be submitted'to the local unil oF gov�mment within 19 days.
Properly own�r name(s): ��/� ► y,��,i� y�,j , __-
. PropeRy address: �J�U IGla�7�.1.._,_N���.. - ��
Property owners address(If dlfferw,nl): ' •
Count . ��.��� c �^ � •
y' _��J_���1..1__._._ Property owner phone: ��.� � o�`d al ":t.��
I hereby certify Iha(I personally made the observallons, inferpr�efatians, and eonclu.aions repor1ed on fhis form and that th�y are
correct. -
Name: �{,���, .5 d������_ � . CertificeUon numbe� lo a��,�,
gu�iness licensa name and nurriber. _S�Q�{��1;,l��,�_,,,,,�,����jc,�„ ����,.y9 7„���^ or Y
Name of locel unit oF gavemment: .
. 5ignature: �L� `V�r -�"" , � Dele:---.�'Q'9 „_ , �
wwuv:pca.stat�.mri.us� �•� 651-296-6300 • ' 800-657�Bfr�,; TfY 651•�82-533z or 000-657-3864 • Available in altemactve formac�
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07l3612909 21:14 7634975911 SPTESTINGINC PAGE 65/09
Ju1.29.200� 07:03 AM EI�R J PETER90N CO 76397?7��7 pAC�, 2/ Z
Perc�ll number 9ystem at�ttus� �C�omplionl �Nnnbbmpljqrri
(es d�erif�inad byfhls fbr►»)
Tank Inl��r�and Safely CoenRl�anoe- Co►�pNance/nspec�ion Fonn for Exiating S3T5
Compliance �ssue #Z of 4
Date af obse�valion; 7IZ8/0B Reason tbr obeeNation; Po�t of 9ala
Thfo form e�ires on(three yeere); 7128/12 T.... �~�.
Compliance qubal�JonsJ�HteMac(Requlred) VeMflc�llon Method":(Op�tlonal)
(CJ�eak th�apnr�a'lata b�.,._._ (Chuck tha aPAmOrl9le box)
Does ihe systsm ecnsist of a saepape pit', (a Yes �Nn p proqed tenk bohom
ass o II or laAchi ���
Do sewa tnn s le�k below�hsir ❑ Obsened low liquid leval
arlY p� k( ) r]Yes �No
dnsi ed arenn d� ? CI Examined weelruction receMa
Ityea,idenlify which ~ � Exsmin�d ampty(Pumpa�lank
sewags t�nlc In.aks,
My'yas"enawor Ina�caton ww�e x�e�+at�n�l�f�n�n,p ro protect ❑ �0�d D1J�Ids tank for"black soil"
�aund watar ❑ P�anprp,/vacuum check
� seepega piu�n,a�uno 7aeo,�830 may be complient If allowad � p�e� ""—""""�� —•- �,T
In ordnance by lacal pgrmftting sutho�lqr, _,,. ., , ,.� , .�
'"!Vo afanabrdprofocol�d�ta.7ftfa Neels nor axnsusrlw,fn.y
sequerdlel ord�;nordbsa It wd�coro wMa�h oombrnallona
9re neceasery ib rnake fhls aAtt�nnlnAHo►1.
Safety Check
1, A�e malnlenanae hala e�rer�damagetl,cradeed,or ap�red b be ahucluraly unsound? [J YesR �No
2. Wers meinten�nae no��vara r�plscad h a eecvred n�nne�(e,g,�acrews rpPl�lc�7 �ifee [J No'
3. VVas sacondary acoeas roslrak�t proaen!(sefe�fy pon,semnd covRr,nr eaFdty netHnp)—highy reaorm�ended, Q Yes��[]No
4, Are othar sefely/Itcollh Issub preeenl7 ❑Yec• �No
F�cplein• � ��„ ,. „ �..
"�ysMm l�s an IntMlneAt thrr+�t to pubNc ha�►sed aq/ety.
C�rtific�tian
Thie inrm i�ro bP axnpl�ted and aUached to�he Summery Fam of khe Mlnnespta PdluBon Conqol qgancY'�(MPGA►Gprnpll�nea
la�cdon Fam for Fatlsang Subsutt0op 9owape Trealmont SyeMm�.Obeervqtions,Inteipreta6ona,and cnn�lueiono must be
1�mpleted by an Inspsctor,malntalne►,or seivk�p�ovlder,Compieted form rrwst be submilled 10 Iho loaol unft oP�uvemmenl wilhin
�•
Properfy owner nAmra((s); t�aVe Kingrt�+n
p�ny addross; 1100 Kndl Manor Rd. Orono .
.. ,., ,_.��_.
Proparty owrisrs address(II dlMarenq; , ..
,.,
County: Wennapin.... , Properlyawnerphone: ���-28�-3636
I hergby ce►t(ry thet I per8o�ally m8de the observsNen�,Mt�pr�(Jo�s,and condudans�epolted o►1 th/s/orm snd thst they e�
C0/IBC�
Name: James Braegelmenn � _ CertlAcaUon numb�r.
• _, _..., , .,.,.�..—
Buslneee aoon3s nanr,pncl nurrtbe�: Elm�r J.P�tnroon Co, �.ioen�+#9.�9 _ v �, er
Neme of it povomment• _
.
3lpnature: _. _ Dete: �'/��
www.p�.stete.mn.us • 6S1•�96-6300 • eoo•b9?•38W • TTY 65t•Z82-S3d2 or AOD�697•3861 • Avatlable in altematlwe formab
wq-wwlsnwi-i1 • 4124109 Pone 3 of 0
67130/2e09 21:14 7634975011 SPTESTINGINC PAGE 06109
Ju1.29.2009 n7:03 AM ELMER J P�T��SON CO 7�397�7�17 PAGE. 1/ 2
Tank �ep�rt
��
Date; �1uly 28,2009
E1mer J. Peterson Co.
592� Dague Ave,
Deiano, MN 55328
Phone 763�972-2420
F�x 763-972-7217
Dave Kingman
11U0 Knoli Manvr Rd.
Qrono, MN 56356
Baffles: QN QFF
Tank Capacity: �'13Q0 Gallon Ta�ks
# of Tanks; �
�
Ty�e Qf���k�; Concrete Tanks
�8110f1S: 3500 ✓
M�nholes #o Gra��de; YE� NO
Comments:
On 7I28/Oy, �Imer J, Neterson Co, Pumpad the 3eptic Tanks, No Crecks orVU���r l.eaks at That
Timo,
NOT�: Thls Is only a ta�k report. This is nat a compll�nre i�spectlon fvr point of sale
r�dr does it replace a cnrr�plfanne insp�tion, C��
License #219 �',
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07/30/2009 21:14 7634975611 SPTESTINGINC PAGE 07l09
parcel number; � ._._. 5ystom st�tus: � � Compliank ❑ hioncompli�nl �
....---� .. .__... _ _ ...............__.. ... _.. _._........
(as defe�'mined by Ihis form) .
Soil Separatinn Complian�e and Other Compliance— Compliance Inspection Form for Existing SSTS
Compliance Issue #3 of 4
Date of obsenrakion: 7�a,'��� „� Reason for observatfon_��¢�..�.�!�����
This in�ormalion an fhis fArm does no1 Bxp/re. '—
Compliance questions/critPria: (Required) Verification Method**• (ppllonal)
(CheGlc the appropria�e hox) ppropriale box)
•��--�--- �— (Check Ihe�
For systems built prior to Apr11 1, 1996,and nal I � ConcJucled soil observatlon(s)(attaoh borin lo s
{ocated In Shoreland or Wellhead Prolection 9 9 ) .
Area or not serving a food.heverage or � ❑ Two�revlous verifications(allach boring logs)
lodging establisl�ment: � �
❑ Other: $.����50��., l. • ��4�,�
Does,lhe systsm heve et least a lwo-foot. �
vertical soparation tlistance from periodlcally � �,ra �� �� a� �9,A�p �,V�
saturatod sall or bedrock? Yes ❑ No �, '�, ,��5,�����+
For non-pefformance syslems built Aprii 1, '
1996,or later or f�or non-performance sy�tems �""'"' -•� ' ---�--�-
Iocaled in Shoref2nd or Wellhead Protection Sail obsenration does nol ex�ire. Prevlous�bservaLlons
Areas or serving�a Food,beverAge or lodging by�o independent parlles aro sufficlent, unless slle
establishment: canditions have been all'ered.
DoQs the sy5tem have a three-foot vertical �
saparetion diskance from periodlcally saturated
soll or bedrocic?' . Yes ,No , .
, • .
For reduced separallon distance systems�(i.�.,
"performancs'systems under old 7080,0179 or ' May b�reduced by up to 15 percenl if allowed in local
Type IV or V syslem under new 7080.2350 or or'dinance. �
, �080.2400): ' •'No standa►'d pro�ocol exlsts. Thts lisf is not exhsustive,
Does the syskem meet the designecl veHical , in sequvntlal order, ner does it lndicate whlch
separation distance From periodicatly saturated cvmbinarlons are necessary to make thi.s
soll or bedrock?M .. Yes No deferminaRion.
Any"no"answer indlc�ies that the system/s�fallin�►to protecf
ground water. �
Certification
This form Is to bd compleLed and attached to tlie Summary Form of the Mlnnesota Pollution Co�tro)Agency's(MPCA)Compllance
Inspectlon Form for Exlsting SubsUrface Sewage Treatment Systems. Obsorvatiorts, interpretations,and concluslons must be
aom�leied by an.inRpector or designe�.Completed form must be submllted to the locsl unit vf goverrament within 15 c1ay�.
Pro�aerty owner name(s): y1�AJ+� 141 f,�.NI f�'!J� ,�w , ,,`_
Property address: ,�„�Q 0 1L'�.11�V1,.. M lAr1.1�?������� W .. .,.._
Property owner's address(It.dliferen�): � . �
�. �.._
County: _,�fiG � •. y l.� ,� Property owner phone: ��,p��, ..a�a ^3 S Z �
I hereby certify tha�1 par.sonally made th��observallons, interpretarions, �nd conclua/ons r�sported on thls fnrni and tha(th�y ere
carect
Name:. ,j�`��,��(,�y.���i�,ti�� _ Certffication�umber. r� a�
Buslness license name ancl number. ���{�,fr�la„���„ L� �� 7_
��,.�,�.,�� 3*S c�� _ o�
Name of Iccal ni!af gov�mmerit: � ' ,
Signatur�: � �� ^. �� . � �
_ Date- -� ��_
www.pca.state.mn.us � • 651•�96=6]00 • 800•657-3864 • TTY 691-282-533Y or 800�657•386�1 • Available In altemative formats
wn-wwic�sd-it . A/1A/IM L.
07/30/2669 21:14 7634975911 SPTESTINGINC PAGE 68/99
. '
S"P �������� ���. Steven B. Schirmers • MPCA Cert.No. 627
951 Katydid Lane NE • St. Michael, MN 55376 • (763) 497-3566
FAX • (763)497-50'I 1
State License#394
LOG3 �F S��J.���,��
Dave Kingman
1100 Knoil Manor Rd.
Orono, Henn. Co., MN
Borings completed on 7-28-09, with a hand bucket auger.
�O,�G_,I�.U��R 1- EIev.102.4 - MOTTLED S41L AT 20" - no standing water present in boring.
0 - 10" Topsoii dark brown ivam 10YR 3/3
10" - 16" Gray brown loam 10YR 4/2
16" - 20" Gray brown clay Ioam 10YR 512
20" - 24" Gray brown clay loam 10YR 5/2 - distinc# mottles 10YR 6/8
24" - 32" Pale brown clay loam 10YR 6/3 - distinct mottles 10YR 7/1, 10YR 6!8
&Q.�.NI�IlI,I.B��t.�-EIev,104.0 - MOTTL..ED SOIt,AT 28" - no sfianding water present in the
boring.
0 - 10" Topsoil dark brown loam 10YR 3/3
10" - 18" Gray brown loam 10YR 4/2
16" - 26" Gray brown clay loam 10YR 5/2
26" - 28" Brown clay loam 10YR 5/3
28" - 36" Brown clay (oam 10YR 5/3 - diskinct moitles 10YR 7/1, 10YR 6/8
,B_O.�t),�I..Q.�.t���.3�EIev,105.9 - #hrough the mound.
Q - 12" Fill soil I�am
12" - 44" Fill soil medium sand
44" - 48" Original soil dark brown loam 10YR 3/3
�3.l�lL1.C�,U.�.,�4�.Elev.105.8 -through the rnound.
0 - 16" Fill soil loam
16" - 46" Fill soil medium sand
�6" - 54" Original soil dark brown loam 10YR 3/3
07/30/2009 21:14 7634975011 SPTESTINGINC PAGE 99169
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