HomeMy WebLinkAboutSeptic Compliance Inspection 5-30-2017 , � ����, Minnesata �ollution COCp �11C1Ce �IIS CCt10t1 FOr!'1'1
�w Control Agency � p
� ��" � Exisfing Subsurface Sewage Treatment S stems SSTS
520 Lafayette Road North Y ( }
St.Paul,MN 55155-4194 Doc Type:Compliance and Enforcement
InspeCtion reSults based on Minnesota Pollution Control l�gency(MPCA) For local tracking purposes:
requirements and attached forms–additional local requirements may also apply.
Submit complebed form to Local Unit of Government(LUG)and system owner
within 15 days
System Status
System status on date(mmldd/yyyy): 5/30/2017
� Compliant— Certificate of Compliance ❑ Noncompliant— Notice of Noncompliance
{Valid for 3 years from report date, unless shorter fime (See Upgrade Requirements on page 3.)
frame ouflined in Local Ordinance.)
Reason(s)for noncompliance (check all applicab/e)
❑ Impact on Public Health (Compliance Component#1)–Imminent threat to public health and safety
❑ Other Compliance Conditions(Compliance Component#3)–Imminenf fhreat to public health and safety
❑Tank Integrity(Compliance Component#2)–Failing to protect groundwater
❑ Other Compliance Conditions(Complisnce Component#3)–Failing fo p�tect groundwater
❑ Soil Separation(Compliance Component#4)–Failing to protect groundwater
❑ Operating permiUmonitoring plan requirements(Compliance Component#5)–Noncomplianf
Property Information Parcel ID#or Sec/l"wp/Range:
Property address: 4440 Bayside Road, Orono Reason for inspection: Sale
Property owner: David Montecalvo _ . Owner's phone: 952-472-0219
or - - —
Owner's representative: Representative phone:
_... ..—
Local regulatory authority: City Regulatory authority phone:
Brief system description: 2-1000 gal se tic tanks& 1000 gal pump tank with a mound system
Comments or recommendations: �
Certification
I hereby certify that alI the necessary information has been gafhered to determine the compliance stafus of this system. No
deterrnination of future system pertorrnance has been nor can be made due to unknown conditions during system consfruction,
possible abuse of the system, inadequate maintenance, or future water usage.
Inspector name: Josh Swedlund Certification number: C1659
Business name: Sewer S ' es License number: 2502
Inspector signature: Phone number: 952-873-3292
Necessary or Lo ally 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-wwists4-31 • 3/16/12 „___ , _�,
. Property address: 4440_Bayside Road,Orono Inspedor initiais/Date: JS � 5/30l2017
(mMddVyyyy)
1. Impact on Public Heatth—Compliance component#1 of 5
Com Ilance criteria: Veriflcation method(s):
System discharges sewage to the ❑Yes �No �Searched for surFace ouHet
round surfeoe. �Searched for seeping in yard/badcup in home
System discharges sewage to drain ❑Yes � No ❑Faccessive ponding in sflil system/D-boxes
tile or surface waters.
❑ Homeowner testimony(See Comrrrents/Explanation)
System causes sewage badcup into ❑Yes � No ❑"Bladc soil"above soil dispersal system
dwelling or establishment.
❑System requires"emergency"pumping
Afly"yes"answer above indlcates the ❑ PerFormed dye test
system is an Immfnent threat to pubUc ❑ Unabls to verify(See Comments/Fxp/anaHon)
health and safety. ❑Other methods not listed(See Comments/Facplanation)
Commerrts/Explanation:
2. Tank Integrity—Compliance component#2 of 5
Com liancs criteria: VeM�ication method(s):
System consists of a seepage pit, ❑Yes �No ❑ Probed tank(s)bottom
cesspool,dryv+�ll,or leaching pit.
� Examined construction records
Seepage plts meeung 7oso.255o may be ❑ Examined Tank Integrity Form(Attach)
com iant if aMowed!n loca!ordinance.
Sewage tank(s)leak below their ❑Yes �No ��bserved 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"bladc soil`
Any "yes"answer above indfcat��s the ❑ Unable to verify(See Comments/Ex�anat�on)
system is failing to protect groundwater. ❑Other methads not listed(See Comrrrents/Explenatlon)
Comments/Explanatlon:
3. Other Compliance Conditions—Compliance component#3 of 5
a. MaiMenance hole covers are damaged,cxacked,unsecured,or appear to be stnicturally unsound. ❑Y�* �No ❑Unknowm
b. Other iasues(elecbiic�l hazerds,etc.)to immediately and adversely impad public heatth or safety. O Yes* �No ❑UNcnown
"Syst�em!a an lmminent threat to puWlc health and safety.
Explain:
c. System is non-protedive of ground water for other oonditions as determined by inspedor. ❑Yes' �No
*Syat�em fs fal!!ng io protectgroundwater.
Exptain:
www.pca.state.mn.us • 65t-296-6300 • 800-657-3864 • TTY 651-282-g332 or�0-657-3864 • Available in altemative formau
wq-wwtsts4-31 • 3/16/f2 PQge 2 of 3
, Property address: 4440 Bayside Road,Orono Inspecto�initials/Date: JS �; 5/30/2017
(mrNdd/yYYY)
4. 5oil Separation—Compliance component#4 of 5
Date of installation: 8/4/2004 ❑ Unknown Verification method(s):
�m��� Soi!observation does not expire.Previous soi!
ShorelandlWellhead pratecUonlFood beveraae �yes � No observations b two ind ndent afies are su�cient,
lodging? unless sife condiaorts haeve been altered''vr loca!
Com liance criteria: requirBments dif!'er.
For systems built prior to April 1, 1996, and ❑Yes ❑ No �Conducted soil obsenEation(s)(Attach tmring logs)
not located in Shoreland or Wellhead
Protection Area or not serving a i�od, ❑T�p��ous verifications{Attach boring logs)
beverage or lodging establishment: ❑ Not applicabie(Nolding tank(s),no drairrfreld)
Drainfield has at least a two-foot vertical ❑ Unable to verify(See Comments�kp/anatron)
separation distance from peri�ically ❑Other(See Commenta/Exp/anettnn)
saturated soil or bedrodc.
Non pe�formence systems built April 1, �Yes ❑ No Comments/Explana�on:
9996, orlaferorfornony�erforma�ce Borin
systems locai�d In Shore/and or Wellhead 9�
Prr�tection Aress or senring a food, 1-15"10yr 2/2 Loam
beverage,orlodgfng establishment.•
16-26'10 YR 4/4 Ciay Loam
DraiMield has a three-foot vertical
separation distance from periodically Redox�24"
saturated soil or bedrodc"
"Experimental; "Othe�; or "Performance° ❑Yes ❑ No IndiCate de hs or elsvations
systems buflt unafer p►�-2�8 Rules;Type!V
or V systems built under 2008 Rules(7080. A. Bottom of distribution media lus 12"or more
2350 or 7080.2400 (Advanoed inspedor ,
License required) B, Pe�iodicall saturated soiUbedrock 24"
Drainfield meets the designed vertical C. S tem se a�atlon 36"+
separation distanoe from periodically .
saturated soil or bedrock. D. R uired com ianoe se ration* 36"
Any"no"answer above indicates the system Is "�ay be reduoed up to 15 percent if allrnnred 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 Jn fhe system design
If the answer to both questlons/s "no';thls sect�on does not neeal to be comp/eted.
Com liance crtteria
a. Operating Permit number.
Have the O ratin Permit re uiremerrts been met? ❑Yes ❑No
b. Is the r uired n' en BMP in lace and ro e�l functionin ? Yes ❑No
Any"no"answerindlcates Noncompllance.
Upgrade Requirements(Minn. Stat§115.55)An immirrent threat to puWic hea/th and s�fery pTPHS)must be upgraded,rep/aced,or Its use
discontlnued wlthln ten months of r�ipt of this nodoa or withln a shorter period if requl�ed by l�a/o�fnance.If the system 1s fa!ling to protect
grround water,dte system mast be uparader/,rt�plaoBd,or 1ts use dlscontinued within the drtte requfred by/oca/oMMance.lf an existing system
is not feiltng as detrned in/aw,and hes st/esst Mro feef of desigrt soi!separadon,then the system nesd�t be upgred�ed,cepaired,replaoecl,or
its use discaontinued,notwithstanding any/oca!wdlnam,e that is mae sMCt Thls provls/on does not apply to systems In stia+alarrd areas,
WeUhead Protecflon Areas,or those used!n connection►tith food,beveregre,and/odging esteblishments es deNned!n law.
www.pca.state.mn.us • 651-246-6300 • 500-657-3864 • TTY 651-282-5332 or 800-657-3864 • Available in aitemative formats
wq-wwlsts4-31 • 3/f6/12 Poge 3 of 3
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