HomeMy WebLinkAboutSeptic Compliance Inspection . �
Minnesota Poi�ution Compliance Inspection Form
�� Control Agency
520 Lafayette Road North Existing Subsurface Sewage Treatment Systems {SSTS)
St.Pauf,MN 55155-4194 Doc Type:Compliance and Enforcement
Inspecti��n 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): 4/17/2017
� Coimpliant— Certificate of Compliance ❑ Noncompliant— Notice of Noncornpliance
(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 al!applicab/e)
[] Impact on Public Health (Compliance Component#1)—lmminent threat to public health and safefy
[�Other Compliance Conditions(Compliance Component#3)—lmminent threat to public health and safety
[]Tank Integrity(Compliance Component#2)—Failrng to protect groundwater
❑ Other Compliance Conditions(Compliance Component#3)—Failing to prr�tect groundwater
❑ Soil Separation (Compliance Component#4)—Failing to protect groundwafer
❑ Operating permiUmonitoring plan requirements(Compliance Component#5)—Noncompliant
Property Information Parcel ID#or SeclTwplRange:
Property address: 465 Hunter Pass, Orono _ Reason for inspection: Sale
Property owner: Jennifer Foster Owner's phone: 952-334-2757
or -
Owner's rEpresentative: Representative phone:
Local regulafory authority: City ,_ Regulatory authority phone:
Brief system description: 1300& 1000 Septic with a 1300 gal pump tank 5 bdrm maund system
Comment�or recommendations:
Electric cords for pump and floats is not in electrical conduit,they are just buried in dirt. Tap section of riser should be replaced with
plastic and a 2.5"electrical conduit installed
Certific�tion
J hereby certrfy that all the necessary information has been gathered to determine the compliance status of this system. No
deterrnination 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 fufure water usage.
Inspector name: Josh Swediund Certification number: C1659
Business name: Sewer S ' es I c� �� License number: 2502 �
Inspector signature: _ Phone number: 952-873-3292
Necessary or L cally Required Attachmenfis
� Soil boring logs � System/As-built drawing � Forms per local ordinance
❑ Other information (list):
www.pca.sta.te.mn.us • 651-296-6300 • 800-657-3864 • TTY 651•282-5332 or 800-657•3864 • Available in alternative formats
wq-wwfsts4-31 • 3/ib/1Z
Property address: 465 HuMer Pass,Orono Inspector initials/Date: JS_ ( 4/17/2017
(mm/dd/yYri)
1. Impact on Public Health—Compliance component#1 of 5
Com Ifance criterta: Veriflcatlon method(s):
System discharges sewage to the ❑Yes �No �Searched for surface outlet
round surtace. �Searched for seeping in yard/bacacup in home
System discharges sewage to drain ❑Yes � No ❑Excessive ponding in soil systemlD-boxes
tile or surface waters.
❑Homeowner testimony(See Comments/Exp/anstion)
System causes sewage badcup into ❑Yes �No ❑"Biadc soil"above soil dispersal system
dweifing 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/enation)
heatfh and safety.
❑Other methods not listed(Ses Comments/Explanaaon)
Comments/Explanation:
2. Tank Integrity—Compliance component#2 of 5
Com 8ance criterfa: Verifi�ation method(s):
System consists of a seepage pit, ❑Yes � No ❑ Probed tank(s)bottom
cesspool,drywel(,or leaching pit.
� Examined construction records
Seepage pits meebrrg 7080.2550 may be ❑ F�camined Tank integrity Form(Attach)
c�om liant if alJowed in loca/ordinance.
Sewage tank{s)leak below their ❑Yes �No �Observed liquid level below operating depth
designed operating depth. � Examined empty(pumped)tanks(s)
If yea,which sewege tank(s)leaks: ❑ Probed outside tank(s)for"black soil"
Any"yes"answer above indicates the ❑ Unable to verify(See Comments/ExplenaHon)
system is failing to protect groundwater. ❑Othsr methods not listed(Ses CommentsiExptanation)
Comme�ts/Explanatfon:
3. Other Compliance Conditions—Compliance component#3 of 5
a. Mairrtenance hole aovers are damaged,craGked,unsecured,a�appear tc be structurally unsound. ❑Yes" �No Q Unknown
b. Clther issues(electr�ca►hezerds,etc.)to immediately and adversely impact public health or safety. ❑Yes" �No p unknown
*System is an imminent threat to perbllc health and saNetty.
Explain:
See notes on first page
c. System is non-protective of ground water for other conditions as determined by inspector, ❑Yes* �No
'�ystem!s fafling to probect groundwater.
Explain:
www.pca.state.mn.us • 651-296-6300 • 800-657-3864 • TTY 651-282-5332 or 800-657-3864 • Avallable in alternative formats
wq-ww►sts4-3 t • 3/16/12 _
Property address: 465 Hunter Pass,Orono Inspedor initials/Date: JS I 4/17/2017
(mm/dd/Y'YYY)
4. Soil Separation—Compliance component#4 of 5
Date of Installatfon: 6/11/1998 ❑ Unknown Vertflcation method(s):
�m���� Soi!observation does nof expi�. Pr+�vious soii
����������°�O"�O°d�� ❑Yes � No observa�ons by two indepena�nt parties are sufficient,
g g unless site conditions have been altered or loca!
Com liance criteHa: ►�quirt4ments differ.
�or systems buflt prior to Apri!i, 1996, and ❑Yes ❑No �Conducted soil obse�vation(s)(Attach bw�ng logs)
not located in Shaeland or Wellheed ❑T�p�yious verifications(Attsch boning bgs)
Pr�tection Area or not servfng a food,
bever'age orlodging esfablishment: ❑Not applicable(Ho/dir►g tenk(s),no drair�lel�
Drainfield has at least a two-foot vertical ❑ Unable to verify(See Comments/Exp�anation)
separation distanr.e from periodically ❑Other(See Corrrments/6cp/anation)
saturated sal or bedrodc.
Non-performance systems builtApoll, �Yes ❑ No Comments/Explanation:
1996,or later or ior non perfomaance
systems located In Shoreland or Wellhead Boring:
Prntection Areas orse►ving a food, 1-16 10 YR 2/2 Loam
beverage,or lodging establishment:
17-26"10 YR 4/4 Clay Loam
Drainfield has a three-foot vertical
separation distance from periodicaily No Redox
saturated soil or bedrock."
"Experimental' "Othe�", or "Perfonnance' ❑Yes ❑ No Indicate de hs or elevatlons
systems built under pre-2008 Ru/es; Type!V
or V systems built under 2008 Rules(70�. A. Bottom of distribution media 12" lus
2350 or 7080.2400 (Advanced Inspector
License required) B. Periodicall saturated soiubedrodc over 26"
Drainfield meets the designed verticai C. S tem se aration 36" lus
separation distenoe from periodically
saturated soil or bedrock.
D. R uired com liancs se aration" 36"
A/ly "na"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 af 5 � Not applicable
Is the system operated under an Operating Permit? ❑Yes ❑ No �If"yes",A below is required
Is the system required to empioy a Nitrogen BMP? ❑Yes ❑ Na If"yes", B below ts requlred
BMP=Besf Manegement Pracfice(s)speclned in the system design
K the answer to both questfons fs "no'; thls sectlon does not need to be comp/eted.
Compliance crlteria
a. Operating Permit number:
Have the O ratin Permit r uirements been met? ❑Yes ❑No
b. Is the r uired nit en BMP in lace and ro rl functionin ? Yes ❑ No
Any"no"answer indicates Noncompliance.
Upgrade Requlremen�(MMn. Sfat§115.55)An imminent threat to pubiic health arrd safety(ITPHS)must be upgreded,replec�ed,or ifs use
disconGnued wlthln ten months of r�celpt of this notice or withln a sho�ter period ff requJred by lc�ca/o►dinence.If the syshsm Is feiling to proted
g►ound water,the system must be upgreded,rept�or its us�d/saa►tinued wlth/n the time requinsd by bcaf arllrtance.!f an earlsHng system
is not fslling as def/ned in lew,and has et/east Mro feet of design soi!separetlar,then the system need not be upgraded,repalred,replaced,or
its use dlsContinued,r�tw/thstandln�any Jocaf ordinance that!s more sfric�. This provision does nof apply tp systems in shc�r�larrd aress,
Wellhesd Protection Areas,or those used!n�nnectfon w/th food,beverage,and Mdging establishmenfs as deNrred In law.
www.pca.state.mn.us • 651-296-6300 • 800-657-3864 . TTY 651-282-5332 or 800-657-3864 • Available in attemative formats
wq-wwlsts4-31 • 3/16/l2
n��-e_a�
• 1
�
`��J "`'' �1�,�' f�- <- .- ��
.
.�
.• ,..
,..r
./ rf"
� ., E
; �
� �' �
' ~- �
��;� ,
�
� �
�
,�
��
��
� � ' �
.�, I
��o ��
� � ,
�� �
.�....---�-
1�
li��N � 3�3 ���' �
� �
r�
�1�
� �;"{� �3'C� �-�`'
� ., f�'� �� D .
7���
�
�
,
���
�
�
� _
�`