HomeMy WebLinkAboutseptic info Apr 1715 09:59a Joseph Olson 763-498-8290 p.1
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Fax Transmittal Form
Date: 4/17I2015 Total Pages: I6
To: City of Orono
Phone Number.
Fax Number: 952-249-461b
E-mail:
From: Joseph J Olson
Phone Number. 763-498-8779
Fax Number. 763-498-$290
E-mail: rusty2654(c�corncast.net
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❑ Please Comrnent
❑ Please Reply
Message: This is the septic cert for 10 Myrtlewood Road.
Please file.
Apr 17 15 09:59a Joseph Olson 763-498-8290 p.2
Minnesota Pollutior� Complia�ce I�spection Form
CantroE Agency
S20 Lafayette Road Idorth Existing Subsurtaae Sewage Treatment Systems
5L Paut,MN 55155-4194 ($STS�
Doc 7ype:CompGanoe and Enfa�ement
Instructions: Inspection results based on Minnesota Pollution Corriroi Agency(MPCA) �or local tracking purposes:
requi�ements and attadie�forms-additfonaa�ocaa requirements may a�so app�y. APR � � ZO�5 I
Submit completed form to Local Unit of Governmerrt(LUG)and syst�em owne�
within 15 days
System Status
Sys�em status on date(mm/ddlyyyy): 4H 3/2�15
� Coinpiiant—Certifcate of Compliance ❑ Noncompliant—Notice of IVoncompliance
(Valid for3 years from re�orf dafe,unless shwter time (See Upgrade Requinements on page 3)
frame ouftined in Loca1 Ordinance.)
Reason(s)for noncompliance(check aIl applicabfe)
❑Impact on Public Health(Compliance Component #i)—Imminenf ihreat to pu�c heafth and safe(y
❑ Other Compfiance Condiiions(Compliance Cornponent#3)—Imminent threat to public health ar►d safety
❑Tank Integrify(Compfiance Component #2)—Fa�ing to protect groundwater
❑Other Compliance Conditior�s(Compliance Component#3)—Fairng to profect grounorwater
❑Soii Separation(Compliarrce Component #4)—Failing to protect grocrnafwater
❑Operating permitlmonitoring plan requirements(Compliance Componenf #5)—Noncompliant
Property Information Parcel ID#or Serlfwp/Range: 3611823330009
Properry address: 10 Myrtlewood Road,Orono,MN Rea�n for inspeciion: Property 7ransfer
Property owner: Bryan Freeland Qwners phone:
or
Owner's representative: Gregg Larsen Representative ph�ne: 612-719-4477
Lacal regulatory authprity: �of Orono Regulatory aufhority phone: 952-249-4600
2-1000 gallon septic tanks,l-7Q00 gallon lift station and 380 square feet of mound roctcbed. per aty
Brief system descripUon: records
Comments or recommendations:
Certification
I here6y certily that alJ the necessary information has been gathered to determine the compliance stafus of fhis sys[em.Ab
determination of futwe system perfom�a�rcae has been nor can be made due to unlmown condiGons during system oonstruction,
possibfe abuse of the system,inadequate mainte»ance, or future water usage.
Inspector name: Joseph J Olson Certification nurnber: 1255
Business name: Rus O 's Soil 8� �'estin Lice�se number. 810
Inspector signature: Phone number: 763-498-8779
Necessary o� L.ocally Required Attachrnents
� Soil boriRg iags � System/As-built drawing ❑Forms per local ordinance
❑ Other information(list):
v�rnw_pca.state.mn.us • 651-z96•6300 • 800-657-3864 • TTY 651-282-5332 or 800-657-3864 • Available in alternative formats
wq-wwisGs4-3i • 1124/11 Page 1 of 3
Apr 1715 09:59a Joseph Olson 763-498-8290 p.3
Property address: 1a Myrtlewo� Road,_Orono,MN Inspecior initialslDate: J. O.4l13/15
1. ImpaCt on Pub�iC Health —Complia�ce component#1 of 5
Compliance criteria: Ye�ification method(s):
System discharge sewage to the ❑Yes � No � Searched ior surface outlet
ground su�Face. � Searched for seeping in yard/backup in home
System discharge sewage#o drain ti�e ❑Yes �No � ��ssive ponding in soil system/aboxes
or surface waters. ❑ Homeowner testimony{See CommentslExpranation)
❑ 'Slack soil'above sa!dispersal system
System cause sewage backup irrto ❑Yes 1� No � y�,stem requi�es"emergency"pumping
dwelling or establishment. �
❑ Performed dye fest
Any'°yes'�answer above indicates the system is ❑ Unable to verify(See CommentsiExplanation)
an tmminent Threat to Pub�ic Hea/th and Safety. ❑ p�her methods not listed(See Conn»ents/F_xpJanation)
C o m m entslE�la natio n:
2. Tank Inte�rity—Compliance component#2 of 5
Compliance criteria: Verification method�s):
System consists of a seepage pit, ❑Yes � No � Probed tank(s)bottom
cesspool,drywell,or leaching pit.
� Exarrtined oonstreidion records
SeepagE pirs meeting 7080.2550 may be ❑ Examined Tank Integrity Form(Auach}
compliant if allowed in Joeaf orrlinanCe. I
Sewage tank(s)leak below tl�eir � ❑Yes � No � Observed liquid levef belo�w operating depth
, designed operatinq 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 ❑ �nable to verify(See Comments/Exp�anation)
system is Failing!o Protecf Groundwater: ❑�1her methods not listed(See Comments/Explenation)
C omme�tslExpEanation:
3. Other Comp[iante Conditions—Compliance component#3 of 5
a. Mairnenance hole anrers are damaged,cracked,unsea�red,or appear ta stnidurafty unsound. ❑Yes" �►�o ❑unknown
b. �ther issues(elerxncal hazards,etc.)to irrvnediately and adversely impact public health or safety. ❑Yes" ►8I No ❑Unknown
'�System is an lmminenf lhr+eat to puWic hea/th anaf saf�efy
Explain:
c. System is non-�rotedive of ground water for other condfions as deterrnined by inspector p Yes= �No
'System is faifing to pratect grounahvater
E�lain:
www.pca.scate.mn.us • 651-296-6300 . B00-657-3864 • 77'Y 651-282-5332 or 800-657-3864 • Available in altemative formats
wq-vrwists43 f • iI29!12 Page 2 of 3
Apr 171509:59a Joseph Olson 763-498-8290 p,4
:'ror�erty address: 10 Myrtlewood Road,orono,MN Inspector ini6als/Date: J_ O.4/13/15
4. Soi I Separation—Compliance component#4 of 5
Date of instaNation: 11108/95 ❑Unknown Ve�ification method(s;:
ShorelandNVelihead�ratectioNFood Beverage �YeS ��a Sa!observaaon does not exnire. Previo�s soi(
Lodg�tg?
observa6ons by iwo independent pariies are serl�rcier,.,
Cortl liance criter�a: unless site conditions have been altered orlocal
For s sfetns b W/t rior to �equi►ements differ.
Y p Apri11, 1996, and �Yes ❑I�e
not focated in Shoreland or tR/ellheaaf � Conducted sa1 observation(s)(Aaach baing logs)
Protedion Area ornot senring a foad, ' ❑ Two pre�ious verifecations(At�ach barng/ogs)
beverage or fodging esta,blishment
� Not applicable(Holdirx�tank(s).no drainfreld)
Drainfield has at least a iwo-foot vertical ❑ Unable to verify(See Comments/Explanation)
separation dista�ce from periodica�ly
saturated soil or bedrock. ❑ Other(5ee Conrments/ExpJariatian)
Non performance systems built,4pnJ 1, ❑Yes ❑No ComrnentslExpJanation:
1996,or later or for non-peifom�ance
sysfems bcated rn 5hor�land or Wellhead '
Prntection Areas or serving a food,
beverage, orlodgi»gestablishment:
Drairrfield has a three-foot v�rtical
separation �stance from periodicafly
saturatecf soil ot bedrodc_�`
"EcpeRmenta!" "Ofher';or Pedormance" , ❑Yes ❑No Indicate de ths of elevations
systems bu�7t underpie-2008 RuJes;Type 1V
or V systsms built under 2008 Rules(7080. A. Bottom of distribution media 104.g
2350 or7080.2400 (Advanced Jnspector
License required) 8. Periodicall saturated soiUi�edrock 102.1
brainfield meeis the designed vertical G. S stem se aration 2.8
separation distar�ce from pesiodically
saturated soil or�edrock. •
- I � D. Re�uiied compl�nce separation' 2.D
Any"no"answer above indicates the system is ^ •May be reduoed up to 15 percenE if allowed by Lacal
Failing to Profect Groundwater. Ordinance_
5. Operatir� Permit and Nitrogen BMP*—Campliance component#5 of 5 � Not applicable
Is the system operated under an Operating Permit? ❑Yes ❑tVo If"yes",A below is required
Is the system required to employ a Nitrogen BMP? ❑Yes ❑fVo If"yes",B below is required
8MP=8est Managernent PracfiCe(s)spe�ed in fhe system desigrr
Jf the answer to both questions is "no'; this section does not need!o be comp/eted.
Compliance criteria
a. Operating Perrnit number:
Have the Operating Permit repuirements been met?
❑Yes ❑No
b. Is the required nitroqen BMP in place and properly functionin � j ❑Yes ❑ No
Any"no"ansyrer irrdicates Noncompliance.
Upgrade Req uirements(Min�.Stat.§1?5.55)An immirrent threaf to pvblic heallh and sa/ery(ITFNS)must be upc�r�ded,replaced,a its use
discon0in�ed within ten monttrs of�ec�elpt ofthis nolice pr within a shater period ifr�quirEd by�oca/ornw»ance.!f the sysfem is fai7rrrg to protact
grourni wafer,tfre sysfem must be upgraded,rep/aced,or its use discontinued withrn tlte lime required by loca!wrJinarrce.Jf an existirx,�system
is not faifmg as defined in lat�i,and has at leasf fwo feet ofdesign sa7 separation,thaen the system need not be upgraded,repaired,repfaced, or
its use dfscontinued,rtohvithstanding any locaJ oidinance that rs more stricf. This pro vision does not apply to systems in shoreland areas,
WeNhead Protection Areas,pr fhose�sed ir�coru�ection wlth food,beverage,attd lodging establishmenFs as defined in law.
www.pca.state.mn.us • G51-296-6300 • B00-657•3864 � TTY 651•282-5332 or 80o-657-3864 • Availabte in alternative formats
wq-wwists�-3 f � 1/24!11 Page 3 of 3
Apr 1715 09:59a Joseph Olson 763-498-8290 p.5
Loas of Soil Bor�nas
License#81v
Location or Project: 10 Myrilewood Road
at�rings made by: Rusty Olson's Soil and Perc testing 411312015
��ass�cation S+�stem: AASHO : USDS�USDS�SCS X ; Unifred ; Other
Huger used(check two): Hand�X_, or Power , Flight, Bucket or Probe X
Boring Number_1_Surtace elevation_105.2_ Motlfed Soil at 0.8 feer
0-32"fill in originai soi�s ' !
32"-42"Dark brown�oam 10y�/2 H20�resent at_;;_ �
42"-48"Rusty dark brown loam 10yr3/2
TBM: Top of lift station manhole cover Elv.-1U0.0 assumed
OrigFnal soil under the rockbed Elv.- 102.1
Bottom of rock bed Elv.-�04.9
There is 2 feet plus of sand under the rockbed
Apr 17 15 09:59a Joseph Olson 763-498-8290 p.6
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2/25/02 Water/Wastewater-I$T54.31 .=
. . � Compliance Znspection Form for Existir� � •
Indiv�dual,Sewage Treatment Systems
. . � . Minnesota Pollut�an
Comple�ion of this form fulfills:the minimal requlr"ements ol Minn. s � Control Agenry
to local ordinances for other re utrement�or i�formatfon, es eciallt to com �ance�e)u�e e,nts torrb droom additions. ,
( �• Please refer-
G a �
Date of Inspection: 1��—`l�f—��
_ Reason for inspection: �,�[�„�
Property Owner(s)�- � ,r�o .�.e �^Q as
Person requesttng tnspection ���",� „ Telephbne� (�'O /-. �1?� ,
� �i i' Tc��/ Telephone ( )
site Address 1'D���r„T�,P woo�- R� �
City o No Zip Code________^
Fire No./ Parcei Na County , �{ n.
Legal Description Township
Local Regulatory Authority
Date system constructed_/�I Qg
_ System in Shoreland Area: yes� System in Wellhead
Protection Area: yes � System serving a MDH licensed facili :
ty yes �Local permit# (if any)
Systems built p�ior to April 1, 1996 a�d not located (n Systems located in Shoreland or Wellh
Shoreland or Welihead Protectlon Area or Serving a Food, ead Protect3on
Beverage or lodging Establishment Areas or Serving a Food, Beverage o�lodging
Establishment, or systems Buiit after
Is h s March 31 199Ei
af 7 (a yes answe�is an ITpHs i �-�-�+�eRt an imminent threat�o n�bti�tio����
- Discharge oP sewage to the ground surf�e?m> or safetv? (a yes answer�s an ITPHS system)
- Discharge of sewage to draint�le or surtace waters? YES N� - Discharge of sewage to draintlle or�u aace waters?Y� NO
-Sewage backup into dwelling? Y� YES NO
-5ituation with the potenCfal to immediately and -Sewage backup into dweliing? YES NO
adversely impact or threaten public heaith or -Situatlon with the potential to immediately and �
safety? adversely impact or threaten public health or
YES �� safety? �
._ .:..... .:.... ..: .:.. . ...�YES NO
is the svstem failina� (a y�answeris.a,failin s, t „ ,: ,
- �ess than TYvO feet of vertical s e p a r a ti o n b e t w e e� 9 ��m,� �.the�svs�em ta11t,nd? (a yes ansrueris a f a i l i n g s y s t e r n)
system bottom and saturated soil ar bed�ocki � - Less t han THREE f�et of vertical separadon between:
-A see e �t cess oi d YES�`� ' ',ry�m�tt�;r:,and s`aturated soii or bedrock? YES NO
�9 p � P° � M�+���,or leathing pit? YES N • -A see a d
� page pit,cesspool,dryweil, or leaching pit? y� �p
. ,,,:; .. : :%;..
Is the svs e�*+ � _. . _ ..,., _
.. ..
•. :. : .
, . , ..
IIOn-tomelia.,t� _ =-::.
._.__. . . _�s-tlte.�rstem_
- Is the system regulated under a monitorin lan or `
�1-�omelian#�...._ .
operating permit? (if no,go to a e 2 9 p r ' �s the system regulated under a monitorin
p g ) YES �� operating permit? if no, o to a e 2) 9 Plan or •.
!f yes, . . . . � g p 9 YES NO :
- Has the required manitoring taken lace? �' .~M If yes; ;
(1/no, the system is non-com I rn p Y� ,NO �` - Has the required monitoring taken place? Y�S NO �
p y �} (ll na, the system fs non-com 1 !n '
PY 9I
- Does the monitoring indicate that the system meets + - Does the monitoring indicate,thaC the s stem m
performance expectations? YES NO�� performance expectations? y� ' Bets
(ll no, the system is non-ccmplying) �YES NO
(If no, the system is non-comply/ng) .
":`._ ; rc:,: ::,.
Page i of 2 v wq-wwists4.31 � �
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"""""'�^^.�..�.«...�.....�...:....�....�......�.....+....:-......::�.....�..............:....�.......:�......_...�..�..».«...�.
�em��rnoonents (P/ease descnbe bye sy,stem components and attach s/te skgtch show/ng system/ocat`ion):
�# doo I>--�a�C I loov � � ��,. ]`a
1 D"�� a G��,�,gc�
r (Note:No standard protxal ex/sts
The fol/owing/Ist is not erhaustive, or in sequentia/oro�e�nor lndicates whkh cr�mbl�at/ons may necessary to make a determinadon)
Watertig.ht tank(s) Hydraulic Functioning Vertical Separatfon Distance
� Probed tank bottor� � Searched for su�face oudet O Conducted soil bortngs
� Observed low liquid level O Performed hydraulic test Depth to limiting layer_______
❑ Examined const, records d Searched for seeping in yard Depth to system bottom
� Examined empty(pumped)tank � thecked for back-up in home o Examined records
❑ Probed outside tank for"biack soii" D Excessfve ponding in sall system/U-boxes O LGU Limiting layer Verificatio�
o Pressure/vacuum check �1 Homeowner testfmony ' O �Other
❑ Other � � Examined for surging in tank
!! "Black soil"above soil system
❑ Other
Status of the svsfiem
Based on the compliance criteria,the system status is: (check one) CI failing (to protect groundwater) O an
imminent threat to pubiic health or safety(ITPHS), ❑ non-compliant(monitoring issue) �I compliant(none of the 3
previous conditions). Therefcre,this document is a: � Certificate of�ompliance ❑ Notice of Noncompliance
Is thls s stem an EPA Class V In ection Weil? ❑ es � no
certificarion .
I hereby ce�tify as a state of Minnesota Ilcensed Inspector and/or Designer I or Qualified Emp�oyee Inspector and/or Qualified Employee
Designer I that I conduded an investigaGon that accurately determined the compiiance status of thts system and that my reco�ded
obseroations are accurate as of this date. No determination of future hydraulic performance has been nor can be made due to
unknown conditions during system construc.tion,abuse of the system, inadequate maintenance, or future water usage.
Inspector's name(print)�+��i�✓ R �z�',eym,��,� . � Phone �. -,�-65 7— �s� 8
Ucense and/o�Registration Number_1�� �
—....._....�„� Address l � �t� 2 � ,e
Employed by �. ✓ Address,�f c3 vr �t-t 7�`Z L f'i. ✓Z
Signature
� Date P/� I Y�06
UDQf dde Reauirements rderi,�ed f,r,m Minnesota Starutes t 11Sss> - � �-
An ITPHS must be uPgraded,repl�ce.y,o�iLs use dlscontinued withln ten months of r�relpt of t�5/s n�tice o�withl,h a shori�r per/od!f
repuirc�d by/oca/ordinance. If the system fai/s to.proNde sv�dent groundwater protectlon, then the
rep/aced, o�its use discondnuc�d wfth/n the Gme r�qul�+d by ruk or,the/oca�orr�lnance. If a�.erlsDn �tem must be upgraded,
/aw,and has at/east two fe+et of deslgn soi/seiaaretion, lhen the syaYem ne+e+d not be vpgraded re��pJ���olal�g��as define�d In
disconhnued, notwithstanding any/oca/ordlnance that is more strlct. Thls doPs not appty to,sy#ems in shore/and areas, we//head
protect/on areas, ar those us�d/n connertion w/th h�oa,beveiage�'apd/odging establlshment,as defined in/aw. . . ...
Suaoe�pd Attachmen,,,� _. . . . . . . . .
i) Site sketch coutd.also include:well,well setback to system,dwelling or otherbuildings,qnk(s),reserved.soil treatment area,�.
surface water and soil boring locatlons. Include as•built dra�i ng if availabie.
2) Soil boring logs, showing each ho�izon. Indicate the texture,colo�, redoximorphic features depth to bedrock,.standing water and
whether the makerial(s filF.
.,-_ .
3) A list of any and ail requirements of the iocat ordinance that are different fmm�the st�te requirements referred to on this form.
� A homeowner survey of system performance,signed by the homeowner as being factual. : ' �
) Monitoring data�as appropriate. � . !��:•;.
� � . Pag�,2�of 2
, .
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� MARTY'S EXCAVATING �
_ 7185 Rutz Lake Road • .
Mayer, MN 55360
Ph: 952-657-2548
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of 1%per month(annual percentage rate of 12°/a)
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���::.�� CITY of ORUNO
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�'� �� �0;"�� G qsa-a49—�6o O Mailing Address:
,� Street Address:
�9����p4 2750 Kelley Parkway P.O. �ox 66
Orono, MN 55356 Crystal8ay, MN 55323-0066
M r �-v�� �-�
To Current Owner: Address: �U l� �-
City Ordinance 199 requires that each existing on-site sewage treatment system in Orono be inspected every two yeazs.
The on-site sewage treatment system at the above address has been inspected and appears to fall into the categories checked below.
S STEM CONFORMIT'Y (1-31: 1
1 "CODE SYSTEIVI"`An'ISTS which meets all thelocation,design and consh�uction standards of the current Orono Municipal Code.
2 "COMPLIANT SYSTEM" An TSTS which does not meet all the location,design and construction standards of the cuirent Orono
Municipal Code but does meet the three foot separation requirement 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 construcrion stan�rds of ine curr�t 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(5-71:
Tank inspection indicates:
UPumpout 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 �-1-19"o t-1 ),
Make sure seatir tanks are aumped throu¢6 manhole and not throu¢h white inspection aipes. This allows for t6e aroner
cleanins Keea water softner and iron filter discharge out of seatic svstem to arolone tife of drainfield. Ask aumner to test
alarm float to verifv alarm is still workin¢in vour house The alarm warns owner that seatase is about to backua into basement
7 Inspection risers missing-tanks could not be inspected. Inspection risers(4"dia.pipe)must be mstalled m each tank. If
tanks have not been pumped out within the last three years,they should be pumped out now.
DRAINFIELD CONDITTON(8-10): �
8 Drainfield is dry,no surfacing evident.
O9 Some evidence of surfacing,not critical yet.
I� Drainfield.is saturated and visibly discharging untreated ef�luent to the surface. Contact the City Inspector
immediately.Repairs must be completed within 9U days.
.f4�- SvfFycL o� "�'vP o� 1'`-C�.�J.
COMMENTS: S 1 i 5
. c�-\—U� G1�-�
Date of Inspection Matt Bolterman - 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 tlus report does
not guarantse or certify that an existing system will contiaue to function properly, but is merely an opinion of the adequacy of the system nnder current
conditions based on the available information.
�o�
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'I � - +- CITY of ORONO
I� ��i ���ls .::�' ^
�\�, �' ��y` �� , � ,��4 Municipal Ot�ices
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\�� �, �;� *y Street Address: M'iiina Addrou:
�$+gg0�" 2150 Keiley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323•0066
July 24, 2000
James& Mary Matteson
10 Myrtlewood Road .
Wayzata, Mn 55391
Dear NIr. & Nlrs. Matteson:
An inspection of your septic system was conducted on July19, 2000. A summary of the inspection
is beiow.
Septic Tank Condition
1. Pumpout not needed at this time.
The septic system is a compliant system, meaning it meets all or most current 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
drawing is enclosed showing the approximate location of the septic system.
If you have any questions regarding this report, please contact me at the City Offices at 249-4600.
Res ect ly,
I
� �
C �s 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 eaisting system will continue to function properly,but
is merel�an opinion of the adequacy of the system under current conditions based on the a�•ailable 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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� � ! CITY of ORONO
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� , ,y' . � , l� Municipal Offices
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\�.tl ` � `�`".`yG Street Address: Maiifn� Addross:
��:9$Egg04' 2150 Kelley Parkway P.O. Box 66
'-= Orono, MN 55356 Crystal Bay, MN 55323-0066
/ /
Owner: �Q/J2E'S �..i7�t�Ji'/) Address: 10 Myrtlewood Rd.
Permit #'s: 7505 Dates: il/2/95 Contractors: sullivan
(This is [�] an existing system [ ] new construction) .
�STEM COMPLIANCE (1-3) : 1
1 Code System: Meets or exceeds current City standards in all respects relating to design,
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.
3 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 revision.)
TANK CONDITION (5-9) : 5
5; Pumpout not needed at this time.
� 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 [�j or are not [ ] water tight or the condition is [ ] unknown. If the tanks
are not confirme to be watertight, this classification is subject to revision.)
DRAINFIELD CONDITION (11-14) : 11
1'; Drainfield is dry, no surfacing evident.
�T2 Some evidence of surfacing, not critical yet. Repair is not required at this time.
13 Drainfield is saturated and visibly discharging 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. ) : low
COP'II�IENTS:
�
�C' ��� - �/.�' r � l
-�Date of Inspection ep 'c System Ins ector
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 Date
ADDRESS � Con�ected to
CODE SEPTTC SYSTEM INVENTORY CARD Municipal Sewer
j� �7 WELL DATA
Address �'i°T�-[=r�tsi�b �t� Property I.D. �`���'-�3 �� ('��;��j (
�.Standard trench Lc,�r- > L3 i_, / I
❑ Mound ' o,
System t - �
ype O Other Legal Description Z 7� � p
d
Permit No. ';G L- Date of permit S-i!- �-`1 Installer L'� L P � * �
� k O
No. Bedr ms rbage ` � I
Building type �5;�-j�T,;�C:C= or GPD �_- �. �-:'_� Laundry �( ish as Disposal X � o Q I
E a
d
SEPTIC TANKS: Material C�,�.;r_ h�-e--�_i�_ Capacity 1 C�• 2) '�.S L' ° ¢ ; o
a
Proper outlet and inlet Baffles Liq depth level � �'-
� °«,' �
m
Height of tank bottom above water table �'E' istance nearest ilding � � � N m
�^ O
r
DRAINFIELD: Total length of lines ?°"' `�: umber i es / r�-- Trench width ? `
N
I / \ Y
Total treatment area(sq.ft.) y��� eight o 'nf' d ab e water table 5 � (/-'C••�� 1 � � ��,r, �
. V (' �
Type of filter material %�-,� �•G� a �
il type � f,% ��� • �.
N {, d
Distance from nearest bldg. /�� + Tile size - � Perc rate min/in o � � .c
t� �, d « 0 �
�� ��
Depth of fill over drainfield � "=` Depth of rock r tile / under tile � � a `�'
E c -
p a U 3
N
�\ LOCATION
INSPECTION RECORD PUMPOUT RECORD � SKETCH _
S �
�� � � !�'
DATE COMPLIANCE DATE GALLONS 9
��'���1-^.Su�i'ficr�`C. c;�>���2� �� — /' �� �U(� ro
r 'jJ
�-rA��s 3-y �P 6- o-� �_ .
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�- NO 3���2t*l���va ti��L:JL-: �, . , .,T �X� ,o
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Include: 1) Well location
21 Distance from house to
septic tanks,dist.box,
and drainfieid
C— CONFORMING S—SUBSTANDARD N — NONCONFORMING 3) North arrow and road
CITY OF ORONO � O�
Municipel Offices O O
Post Office Box 66
Crystal Bay, MN 55323-0066 � � ON—SITE SEWA(�E 't'REATMBNT
�ti.
INSPECTION REPORT
��� �G
9kEsH.o�'
Owner �_Address:
Permit #'s: Dates: �1��— /.� Contractors: �//� 1/QY1
City ordinance nunber 100 requires that each on-site sewage treatment system in Orono be inspected on a regular besis.
The on-site sewage treatment system at the above address has been inspected and appears to fall into the category
checked below.
(This is [ ] 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 SVSTEM"-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 sewege in�wt without discharging
any pollutants into ground or surface waters.
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 soil characteristics.
(The limitin� soil characteristic UQ has or [ ) has not been identified at this time. If the limiting soil
characteristic has not been identified, this classification may be subject to revision.)
TANK CONDIT[ON (5-10):
T�i1► inspection indicates:
\S.1 Punpout not needed at this time.
6 Solids accunulation in tanks indicetes they should be punped out this year to help prevent future problems.
7 Solids accunulation in tanks is at a critical level. tanks should be punped out as soon as possible.
8 System is discharging to the surface. Tanks must be puiped 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 Fxmpout. If tanks have not been punped out within 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 accumulation).
If tanks have not been pu�out within the last three years, they should be pumped out now.
ORAINFiELD CONDITION (11-14):
D�field inspection indicates:
11 Drainfie[d is dry, no surfacing evident.
Some evidence of surtacing, not critical yet.
13 Drainfield is satureted and visibly discharging untreated effluent to the surface. Contact the City Inspector
immediately. Repairs must be canpleted within 90 days.
14 Drainfield extent and condition unknown.
IIMITING SITE FACTORS (sloae.setbacks,etc.):
POTENTIAL FOR SYSTEM fAILURE Cdecends on soils.water table,etc.): ��
COMMENTS:
Date of Inspection Septic ystem 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 opinion of the adequacy of the system under current conditions based on the available
informetion.
This report must be kept on the premises with the system locetion and pu�ing records.
WHITE COPY/Inspectors File YELLOW COPY/Homeowner
CITY OF ORONO �O�
Municipat Offices O O
Post Offite Box 66
Crystal Bay, MN 55323-0066 a � ON—SITE SEWA(�E TRFATl�NT
INSPECTION REPORT
ti
ti
��9k o4�G
EsH
Owner• l /i�I!1�.�� l/1/J��� Address•
Permit �'s: Dates: >���' Contractors: •
City ordinance number 100 requires that each on-site sewage treatment system in Orono be inspected on a regular basis.
The on-site sewege treatment system at the above address has been inspected and appears to fall into the category
checked below.
(This is �an existing system [ ] neW construction)
SYSTEM CONFORMITY (1-3):
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 poltutants into ground or surface waters.
2 "CONFORMING SVSTEM"-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.
��NON-CONFORMING SYSTEM��-A prohibited system; a system located within a designated 100-year floodplein; any
system which may or mey not meet all the location, design, and construction standards of the current City
Codes and whic� is failing for any reason; end any system with less than 3 feet of saturated so't or sand
between t e �stri ion i.�.*art�the—timrting so�l characteristics. ���rw/,�<� ���
�I(ll
(The limitin� soil characteristic [ l has or�has not been identified a this time. If the limit ng soil
characteristic has not been identified, this classification may be subject to revision.)
TANK CONOITION CS-10): � � � �
Tank inspection indicates:
5 Pumpout not needed at is time.
�b�, Solids accunulati n tanks indicates they should be o ' ture roblems.
(� ' ' in tanks is at a critical l s ould be punped out as soon as pos
'$ System is discharging to the surface. Tenks mu ' ' ' ' ar�e.
9 Inspection risers missing-tanks could not be inspected. Inspection risers (4" dia. pipe) must be installed in each
tank at next punpout. lf tanks have not been punped out within the last three years, they should be Fxmped
out now.
10 tnspection pipe is loceted directly over tank baffle (does not give accurate measurement of solids accunulation).
If tanks have not been punped out within the last three years, they should be punped out now.
DRAINFIELD CONDITION (11-14):
Drainfield inspection indicates:
11 Drainfie[d is dry, no surfacing evident.
1�Some evidence of surfacing, not critical yet.
T�S � Drainfield is saturated and visibly discharging untreated effluent to the surface. Contect the City inspector
immediately. Jtepeirs must be c�_t_ei� within 90 days.
14 Drainffi�dex�ent�a cor�i 'fi ion �m nown.
LIMITING SITE FACTORS (sloae,setbacks,etc.):
POTENTIAL FOR STSTEM FAILURE (deaends on soils,water table,etc.):
COMMENTS:
Date f Inspection 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 rejwrt does not guarantee or certify that an existing system will continue to fimction
properlyi 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 lxation and pumping records.
WHITE COPY/Inspsctora File YELLOW COPY/Homeowner
CITY OF ORONO �O�
Municipal Offices O O
Post Office Box 66
Crystal Bay, MN 55323-0066 a � ON-3ITE SEWA(�E TREATMENT
„� �, INSPECTION REPORT
ti
'�' G
�9kEsH.o�'�
Owner:��I)1�P_S l/f��� Addres s:���/��� Kd.
Permit �'s: �Og Dates: �'7���� Contractors:�Gn�Lo ���
City ordinance number 100 requires that each on-site sewage treatment .system in Orono be inspected on a regular besis.
The on-site sewage treatment system at the above address has been �nspected and appears to fall into the category
checked below.
(This is ,[N an existing system [ ] neu construction>
SYSTEM CONFORMITY (1-3):
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 wh�ch 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 satisfactority by treating and disposing of the entire current seaage input without discharging
any pollutants into ground or surface waters.
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 soil characteristics.
(The limiting soil characteristic [ ] has or�-has not been identified at this time. If the limiting soil
characteristic has not been identified, this classification may be subject to revision.)
TANK CONDIT[ON C5-10): �
T�q�c inspection indicates:
l51 Pimpout not needed at this time.
b 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. an s should be pumped out as soon as possible.
8 System is discharging to the surface. Tanks �st be punped out within 48 hours to eliminate surface dischar�e.
9 lnspection risers missing-tanks could not be inspected. Inspection risers (4" dia. pipe) must be installed in each
tank at next pumpout. If tanks have not been punped out within the last three years, they should be ptanped
out now.
70 Inspection pipe is located directly over tank baffle (does not give accurate measurement of solids accunulation).
lf tanks have not been punped out within the last three years, they should be punped out now.
DRA1NfIELD CONDITION (11-14):
Drainfield inspection indicates:
y7� Drainfield is dry, no surfacing evident.
e�� Some evidence of surfacing, not critical yet.
'13 Drainfield is saturated and visibly discharging untreated effluent to the surface. Contact the City Inspector
irtn�ediately. Repairs must be completed within 90 days.
14 Drainfield extent and condition unknown.
LIMITING S1TE FACTORS (sloae.setbacks.etc.):
POTENTIAL FOR SYSTEM FAILURE Cdepends on soils,water table,etc.):
COMMENTS:
Date o Inspection eptic 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 certify that an existing system will continue to function
properly� but is merely an op�m on of the adequacy of the system under current conditions based on the available
information.
This report rtwst be kept on the premises with the system tocption and pumping records.
WHITE COPY/Inspectors File YELLOW COPY/Homeowner