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Minnesota Pollution �
Control Agency
��" Compliance Inspection Form
520 Lafayette Road North �isting Subsurface Sewage Treatment Systems (SSTS)
SG Paul,MN 55155-4194 Doc Type:Compliance and Enforcement
r
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 Govemment(LUG)and system owner
within 15 days j
System Status
System status on date(mm/dd/yyyy): 10/15/2012
❑ Compliant—Certificate of Compliance � Noncompliant— Notice of Noncompliance
(Valid for 3 years from iepo�t date, unless shorter 6me (See Upgrade Requirements on page 3.)
frame outfined in Local Orclinance.)
Reason(s)for noncompliance(check a!I applicable)
❑ Impact on Public Health (Compliance Component#1)-Imminenf th�at to public health and safety
❑ Other Compliance Conditions(Compliance Component#3)-Imminent ti►�at to public health and safety
�Tank Integrity(Compliance Component#2)-Failing to protect groundweter
❑Other Compliance Conditions(Compliance Component#3J-Failing to protect groundwater
❑ Soil Separation(Compliance Component#4)-Failing fo protect groundwater
❑Operating permiUmonitoring plan requirements(Compliance Component#5)-Noncompliant
Property Information Parcel ID#or Sec/Twp/Range: 0611723230017
Property address: 4720 NORTH ARM DRIVE WEST,ORONO _ Reason for inspection: PROPERTY TRANSFER
Property owner: Owner's phone:
or — —_——_. _ — .— — — __-- -------- --
Owners representative: _THAI XIONG_ _ _ _ ___ Representative phone:
Local regulatory authority: CITY OF ORONO ___ Regulatory authority phone:
Brief system description: 2) 1000-GALLON SEPTIC TANKS, 1000-GALLON LIFT TANK AND PRESSURIZED MOUND
Comments or recommendations:
Certification
1 he�by cerfify that all the necessary informafion has been gatheried to determine the compliance status of fhis system. No
determination of future system perfom►ance has been nor can be made due to unknown conditions during system construction,
possible abuse of the system,inadequate maintenance, or future water usage.
Inspector name: Ryan Lashinski _ Certification number: 3053
Business name: Lashin i orated License number: 65
Inspector signature: . • Phone number. 612-919-3704
Necessary or Locally 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 formatr
wn-wwists4-31 • 3/16/12 Page 1 of 3
Property address: 4720 NORTH ARM DRIVE WEST,ORONO Inspector initials/Date:�� 10/15/2012
- — __ _-- -
(mm/dd/yyyy)
1. Impact on Public Health—Compliance component#1 of 5
Compliance criteria: Verification method(s):
System discharges sewage to the ,� ❑Yes �No �Searched for surface outlet
ground surface. _ �Searched for seeping in yard/backup in home
System discharges sewage to drain ❑Yes �No ❑Excessive ponding in soil system/D-boxes
tile or surface waters.
------ - - --- - ❑ Homeowner testimony(See Comments/Explana6on)
System causes sewage backup into ❑Yes � No ❑"Black soil"above soil dispersal system
dwelling 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/Explanation)
hea/th and safety.
__ _ ❑ Other methods not listed(See Comments/Exp/anation)
Com mentslExplanation:
2. Tank Integrity—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. �
� Examined construction records
Seepage pits meeting 7080.2550 may be ❑ Examined Tank(ntegrity Fotm(AttachJ
compliant if allowed in loca/ordinance. _
Sewage tank(s)leak below their I �Yes ❑ No �Observed liquid level below operating depth
designed operating depth. ❑Examined empry(pumped)tanks(s)
If yes,which sewage tank(s)leaks:
i �Probed outside tank(s)for`black soil°
A»y "yes"allswel'abOVe iRdlCates the ❑ Unable to verify(See CommentsiEzplanation)
system is failing to protect groundwater. ❑Other methods not listed(See Comments/Explanation)
Comments/Expla nation:
LIQUID LEVEL 1N FIRST TWO TANKS IS BELOW NORMA�LEVEL-TANKS LIKELY LEAKING
3. Oth2�C0111p1tatlCe COrldttlOnS—Compliance component#3 of 5
a. Maintenance hole covers are damaged,cracked,unsecured,or appear to be structurally unsound. ❑Yes* �No ❑Unknown
b. Other issues(e/ectrica/hazards,etc.)to immediately and adversefy impad public health or safety. ❑Yes' �No ❑Unknown
*System is an imminent threat to public hea/th and safety.
Explain:
c. System is non-protective of ground water for other conditions as determined by inspedor. p Yes• �No
*System is failing to protectgroundwater.
Explain:
www.pca_state.mn.us • 651-296-6300 • 800-657-3864 • TTY 651-282-5332 or 800-657-3864 • Availabte in altemative formats
wo-wwtsts4•31 • 3/16/12 Poge Z of 3
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Property address: 4720 NORTH ARM DRIVE WEST,ORONO Inspector initials/Date: � � 10/15/2012
-
!mm/d�YYYY)
4. Soil Separdtion—Compliance component#4 of 5
Date of installation: 8/27/1990 _ ❑ Unknown Verfication method(s)�
(m���y} Soil observation does nof expire.Previous soil
Shoreland/Wellhead protectioNFood 6everage �Yes �No obse►vations b hao ind endent arties are sufficient,
lodging? Y �P P
unless site conditions have been alte�d or local
Compliance criteria: requiiements differ.
For sysfems built prior to Apri11, 1996, and � �Yes ❑No �Conducted soil observation(s)(Attach boring rogs)
not located in Shoreland or Wellhead ❑Two previous verifiqtions(Attach boring�ogs)
Protection Area or not serving a food,
beverage or lodging esfablishment: ❑Not applicable(Ho�ding tank(s),no drair►feld)
Drainfield has at least a two-foot vertical � ❑ Unable to verify(Ses Commer+tsiExplanation)
separation distance from periodicalty
saturated soil or bedrock. ❑ Other(See CommentsiExpranation)
Non-perfomrance systems builtApril 1, , ❑Yes ❑No Comments/Explanation:
1996, or later or for non-pedormance
systems located in Shoreland or Wellhead �
Protec6on Areas or serving a food, I
beverage, orlodging establishment:
Drainfield has a three-foot vertical
separation distance from periodically
saturated soil or bedrock"
"Experimental'; "Othe�; or Performance" , ❑Yes ❑No IndiCate depths or elevations
systems built under pie-2008 Rules; Type I V !
or V systems built under 2008 Rules(7080. A. Bottom of distribution media 99 0"
2350 or 7080.2400 (Advanced Inspector
License required) B. Periodica�ly seturated soiUbedrodc 96'8"
Drainfield meets the designed vertical C. System separation 28"
separation distance from periodically
saturated soil or bedrodc. _D. R uired cornpliance separation• 24"
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
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 Managemenf Prac6ce(s)specified in fhe system design
If the answer to both questions is "no", thls section does not need to be comp/eted.
Compliance criteria
a. Operating Permit number:
Have the O eratin Permit r uirements been met? � ❑Yes ❑ No
b. Is the required nitrogen BMP in place and properly functionin ? ❑Yes ❑No
Any "no"answer indicates Noncompliance.
Upgrade Requirements(Minn.Stat§115.55)An immrnent threat to public health and safety(lTPHS)must be upgraded,replaced,or its use
discontinued within ten months of receipt of this notice or wRhin a shorter period if required by loca/ordinanoe.If the sysfem is failing to protecf
ground water,the system must be upgraded,replaced,or rts use discontinued within the time required by local ortiinance.If an existing system
is not failing as de�ned in/aw,and has at least two feet of design soil separation,then the system need not be upgraded,repaired,rep/aced,or
its use discontinued,norivithstanding any loca!ordinsnce thet is more strrct This provrsion does not apply to systems in shore/and areas,
Wellhead Protection Areas,or those u�d in connection with food,beverage,and lodging establishments as defined in law.
www.pca.state.mn.us • 651-296-6300 • 800-657-3864 • TTN 651-282-5332 or 800-657-3864 • Available in altemative formats
wq-wwists4-31 • 3/f 6/12 Paqe 3 of 3
Compiiance Inspection Attachment for Existing
Individual Sewage Treatment Systems
Client Date 10-15-2012
Address 4920 North Arm Drive City Orono
Borinq#1 Elevation: Borinq #2 Elevation: Borinq #3 Elevation:
0-12 lOYR 3/4 loam fill.
-33 lOYR 5/4 yellowish
brown medium
washed sand(mound
sand).
-49 lOYR 3/2 black clay
loam.
-56 lOYR 5/6 clav loam.
Redoacimorphic
mottling at 46".
Sketc :
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COmmentS: Benchmark=Too of rockbed in mound svsbem. Assumed elevation= 100.0'. Soil borin9#1
indicated redoximorohic mottlina at a deoth of 46". The drainfield does meet the reauired three-foot vertical separation
from seasonal�saturated soils. The svstem conssts of two 1000-oallon ser�tic tanks,a 1000-gallon lift tank and
�proximately 400 sa ft �ressurized mound system Probe samoles taken into the rockbed indicated no signs of wet
conditions and/or oondinq. The lift pum�was manuallv run at the time of the insr>ection and found to be in workina
order. The oum�control float was also ooerable and in workinq order. The svstem was dosed with ap,proximately 300
qallons of effluent with no sigQs of�ondina or saturatlon observed. The house.however.has been vacant and the
plumbinq shut off and winterized. The liquid level in the first two tanks are below normal ooeratina levels.tt�erefore thev
are Dresumed to be leaking. The tanks witl need to be oumoed and insoected to verifv their comoliance. This insoecdon
is not a warranty or guarantee,either written or imaied.of future hvdraullc oerformance. Chanaes ln use can cause any
svstem to become hvdreulicallv overloaded and ultlmatety fail.
, , SEPTIC SYSTEM INVENTORY
Site Address: 4720 North Arm Dr W PID 06-117-23-23-0017
Owner Name: Christopher 8�Laura Guetzkow
Owner Address: 4720 North Arm Dr W Mound MN 55364-
Buildins�Tvpe: residence Installer: E.J. Peterson Co.
Date of Permit: 8/27/90
System Type: mound BR's Designed for 4
In Musa?: No Shoreland?:
SEPTIC TANKS:
Material: precast concrete Capacitv: 1000, 1000, 1000 Tank Filter:
DRAINFIELD:
Treatment Area: 74*36 Soil Boring: no DF Ht above Wt: 3
WELL DATA
Setbacks-Well Tanks: 50 Well DF: 150 Report In File: Depth: 130
INSPECTION RECORDS PUMPOUT RECORDS
Date ; Notes Date ; GallonsOfLiquid i
10/15/2012 non-compliant?Tanks apparently not watertight 10/15/2012 Oi
8/25/2003 no surfacing,mound dug up on west side 7/5/2011 2500�
8/16/2001 no surfacing, pump tanks 6/9/2008 3800i
11/8/1999 no surFacing 6/14/2006 2500!
4/22/1997 no surfacing 10/26/2001 2500!
8/24/1993 no surfacing 9/29/1998 2500�
9/23/1991 no surfacing 4/23/1996 2500;
9/6/1990 replacement installation
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`�'�,t���+ �". ;``;�� ,�r Street Address: Mailing Addre�ss:
:.`q�E�Hp'g'.;; 2750 Kelley Parkway P.O. Box 66
� ��-___:-�..- Orono, MN 55356 Crystal Bay, MN 55323•0066
To: The Current Owner of Address LI��� �o �~�� /-���''1 'i�(: � �
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
If yes, please contact the Onsite Systems Manager at 952-249-4626 within 1 Q
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 Attorney for
legal action.
System Identified as Non-Compliant
Yes �No
If yes, system must be brought into compliance by:
December 31, 2007
December 31,2010
Other
Septic Tank(�Pump out Needed
Yes ���
No
The City recommends the septic tank(s) and/or lift tank be serviced and pumped
out every three years. City records indicate the tank(s)were last pumped out on
I D,.�(p-�� 1 . The tank(s) should be cleaned through the manhole and
not through the inspection pipes,this aliows for proper cleaning.
Gomments:
�' 4" b j
Inspec�e� .� Date of Inspection � r�
'Telephone(952)249-4600 � Fax (952)249-4616
www.ci.orono.mn.us
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=� CITY o� ORONU
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'��'�'��.;�
�y�j lSr Munfcipal Ot�ces
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,� '�;:•�r�'���� Street Address: Mailing Address:
`9$�Hpg' 2750 Keiley Parkway P.O. Boz 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
To Current Owner: Address: ���'� ���� ��'`` ��- � �
City Ordinance 199 requires that each existing on-site sewage treationent 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 SYS'TEM"An LSTS which meets all the location,design and construction standards of the current Orono Municipal Code.
� "COMPLIANT SYSTEM" An ISTS which does not meet all the location,design end construcdon standards of the current Orono Municipal
Code but does meet the three foot separatioa requirement or two foot requirement for systems installed 1996 or earlier,and which is not fatling or
an imminent t6reat to public health or safety.
3 "NON-COMPLIANT SYSTEM" A prohibited ISTS;en ISTS located within a designated 100-year flood plain,any ISTS which may
or may not meet all the location,design,or construction standards of the current 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 dlstribution device and the limiting soii characteristics. '
TANK CONDITION(5-7): �^
Tank inspection indicates:
� Pumpout not needed at this time, ,
6 Septic tanks must be pumped out this year (city code requires tanks to be pumped out once every 3 years.
Tank was last pumped �V"7-{�-��� ).
Make sure segtic tanks are pumped throueh manhole and not throuQh white insoection pipes. This allows for the
proper cleaning. Keep water softner and iron flter discharge out of se.ptic system.
7 Inspection risers missing-tanks could not be inspected. Inspecrion 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.
D INFIELD CONDITION 8-10 : �
8 Drainfield is dry,no surfacing evident
9 Some evidence of surfacing,not critical ye�
10 Drainfield is saturated and visibly discharging untreated effluent to the surface. Contact the City Inspector
immediately.Repairs must be completed within 90 days.
COMMENTS: �'^av^� O�u�..s OIL_ ,�a.. �( �-.Z }�� � �c��. �Z�'�.{
'3 tc.cS_ �..��ri) d a� v ct�. �e1�- 5���. ee a�;ti;.� r�,� �� ,h _
� -�..� -�� �►�r �a�
Date of Inspection Matt Bolterman- Septic System Inspector
Note: In the event that this iaspection report is used to satisfy the requirements for a mortgage or other transfer of property,be advised that fhu report does not guarantee
ot certify that an existing system will continue W function properly,btrt is merely en opinion ofthe adequacy of the system under current conditions based on the available
infomiation.
Telephone(952)249-4600 • Frax(952)249-4616
www ci.orono.mn.ns
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����Y��� CITY of ORONO
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't ''�'"�;.�i��� Street Address:
��Eg�I�4� 2150 Kelle Parkwa Mailing Address:
Y Y P.O. �x 66
Orono, MN 55356 Ctystal Bay, MN 55323-0066
Owner: I�S v � �• U v efi�z.k o� Address: y�a--� /V, /-���.
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Ciry Ordinance 199 requires that each e�dsting on-site sewage treatment system in Orono be inspected every nvo years.
The on-site sewage treatment system at the above address has been inspected and appears to fall into the categories checked belotiv.
SYSTEM CONFORMITY 1-3 : �
1 "CODE SYST'EM" An ISTS which meets ali the Locatioq design aad coastcuction standards of the current Orono btuaicipal Code.
2 "COMPLIANT SYSTEM" Aa ISTS which daes nat meet a11 the locatioq desigi and constcuction standards ofthz cunrnt prono Municipa!
Code but does meet the three foot separation requirement,and which is not failiag or an imminent threat to public health or safety_
3 "NON-CONIPLIANT SYSTEM" A prohibited ISTS;aa LSTS located within a desig�ated 100-year flood plaiq aay ISTS which may
or may not meet all the locatioq desi�a,or cons4vction standards of the current Orono Municipal Code and which is failing for any reason;and
any ISTS with less thaa tlsree feet of unsaturated soii or saad between the distn'bution davice and the limiting soil characteriscics.
:
T.4NK CONDTTION(5-10): �O
Tank inspection indicates: �
� Puinpout not needed at this time.
� Tank must ba pumped out this year (city code requires fanks to be pumped out avery 3 yeats. Tank was last pumpzd 0.�9-a� ).
7 Solids accumu(ation in tanks is at a critical a criticalleveL Tanks should be pumped out as soon as possibla.
8 System is discharging to tha surface. Tanks must be purrtped out within qg houts to eliminate surface discharge.
9 Inspection risers missing-tanks could not be inspected Inspection rise�s(4"dia.pipa)must be installed in each tanlc ae ne.ct pumpaut If tanks
have nut been pumped out within the last three yeais,ihay should be pumped out now.
10 Inspection pipe is located directly over tank baffle(does not give accucate measurement of solids accumulation). If taaks have aot beea pumpzd
out within the last three yeacs,they shauld ba pumped out now.
DRAINFIELD CONDITION 11-14 ; �
11 Urainf eld is dry,no surfacing evident
12 Some evidencz of surfacing,not critical yet
13 Drainfield is saturated and visi'bly discharging wdreated e�luert to the surface. Contact the City Inspector iramediately.Repaus must be
completed within 90 days. �
1-� Drainf eld estznt and condition unkaown.
C�NIl�/�NT$: S�LS�1"C''— �Oi���.5 � ��._ ��.! c�� ��1nIC.5
�5 -16 - 0 \ � �� � �
. Date of Inspection Septic System Inspector '
Note: Ia tha eveat that this iiupection repoct is used to satisfy the requitements for a mortgage or other traa4fer af proPertY,be advised that this repoR does not guaranttee
or cectify that az►asisting system will eontinue to funetion prop�ly,but is merely an opinion of the adeqnacy of Wa system under cuirent coaditions based on the availabiz
infoettatioa
CITY OF ORONO � O�
Municipal Offices O O
Post Office Box 66
Crystal Bay, MN 55323-0066 � � ON–SITE SEWAGE TREATMENT
v�`, � INSPECTION REPORT
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9kESH��'
Owner:�l (3�� — Address: �72L� NG'd?�i l4rL;.+� �� �. ( ����y)
Permit �'s: �2�5 Dates:_ /v`�:�7' � Contractors: L�J' /'�=T "-/1_`�C1j? l_.tl,
City ordinance number 100 requires that each on-site sewage treatment system in Orono be inspected on a regular basis.
The on-site sewage treatment system at the above address has been inspected and appears to fall into the category
checked below.
(This is �j, an existing system [ ] neu construction)
SYSTEM CONFORMITY 1-3 : �
t "CODE SYSTEM"-A system uhich meets all the location, design, and construction standards of the current City
Codes, and uhich is operating satisfactorily by treating and disposing of the entire current sewage input
without discharging any pollutants into ground or surface uaters.
2 '�CONFORMING SYSTEM"-A system which does not meet all the tocation, 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 seuage input without discharging
any pollutants into ground or surface uaters.
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 failiny 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 identi ied, this classification may be subject to revision.)
TANK CONDITION CS-10):
spection indicates:
5 umpout not needed at this time.
Solids accumulation in tanks indicates they should be pumped out this year to help prevent future problems.
7 Solids accumulation in tanks is at a critical level. Tanks should be pumped out as soon as possible.
8 System is discharging to the surface. 7anks must be punped out uithin 48 hours to eliminate surface dischar�e.
9 Inspection risers missing-tanks could not be inspected. Inspection risers (4" dia. pipe> must be installed in each
tank at next p�mpout. If tanks have not been pumped out within the last three years, they should be pumped
out now.
10 Inspection pipe is located directly over tank baffle (does not give accurate measurement of solids accumulation).
If tanks have not been punped out within the last three years, they should be pumped out nou.
DRAINFIELD CONOITION (11-14):
ain'fi Id inspection indicates:
11 rainfield is dry, no surfacing evident.
Some evidence of surfacing, not critical yet.
13 Draintield is saturated and visibly discharging untreated effluent to the surface. Contact the City Inspector
immediately. Repairs must be cortipleted within 90 days.
14 Drainfield extent and condition unknown.
LiMITING SITE FACTORS (slope,setbacks,etc.): _�
POTENTIAL FOR SYSTEM FAILURE (depends on soils.water table.etc.): /o�
COMMENTS:
i
Date of Ins ection 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 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
information.
This report must be kept on the prE�nises with the system locstien and pumping records.
WHITE COPY/Inspectors File YELLOW COPY/Homeowner
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a� CITY o� ORONU
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v�,� y �q�; G�l�r Mwntcipal Offices
� .� Street Addnss: Mailing Addreu:
��C'�;ggOg' 2150 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
Owner: ,� � Address: 4720 North Arm Dr. W.
Permit #'s: ° 3205 Dates: B/27/90 Contractors: E. J. Petersoa Co.
(This is [� an existing system ( ] new construction) .
YSTEM COMPLIANCE (1-3) : 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
code� 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 �] has or [ ] has aot beea ideatified at this time. If the
saturated soil level has not beea identified, this clasaificatioa is subject to revision.)
T K CONDITION (5-9) : 5
5 Pumpout not needed at this time.
6 Solids accumulation in tanks indi.cates 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 rf
have not been pumped out within three years, they should be pumped out now.
/�.
(Duriag the last septic tank Mainteaaace Pumpout the taaks [ ] mere or ( ] were not confirmet3
to be watertight by the licensed punaping coatractor. If tha taaks were aot confirmed to b�
watertight, this classification is sub�ect to reviaion.)
INFIELD CONDITION (11-14) : 11
Drainfield is dry, no surfacing evident. ,
12 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
CONIMENTS:
�/-�-97 - .
Date of Inspection eptic Sy em Inspector
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 .
Y � �°�
CITY OF ORONO O O
Municipal Offices
Post Office Box 66
Crystal eay, MN 55323-0066 a � ON—SITE SEWA(�E TREATMENT
� . � INSPECTION REPORT
ti
��9kEsi�og'�G
Owner:_ _ ��� I/�� Addresa: �"/� 1[S�� 1)r Ull.
Permit #'s: J�v� Dates: 'i�'a7-1� Contractors:__���i 1�°ET�r�C3Y`�'�
City ordinence number 100 requires that each on-site sewage treatment system in orono be inspected on a regular basis.
The on-site sewage treatment system at the above address has been inspected end appears to fall into the category
checked below.
(This is L�l, an existing system [ ] new construction)
STSTEM CONFORMITT (1-3):
� "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 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.
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 (�L has or [ ] has not been identified at this time. If the limiting soil
characterist�c has not been identified, this classification may be subject to revision.)
TANK CONDITION (5-10):
Tank inspection indicates:
Pw�pout not needed at this time.
6 Solids accianuletion in tanks indicetes they should be p�nnped out this year to help prevent future problems.
Solids acc�mwlation in tanks is at a critical level. 'fanks should be p�nnped out as soon as possible.
8 System is discharging to the surfece. Tanks must be pumped out within 48 hours to eliminate surface dischar�e.
9 Inspection risers missing-tanks could not be inspected. Inspection risers (4" dia. pipe) must be installed in each
tank at next p�nnpout. If tanks have not been pw�ed out within the last three years, they should be p�ped
out now.
10 Inspection pipe is located directly over tank baffle (does not give accurate measurement of solids ecc�nnulation>.
If tanks have not been pumpeci out within the last three years, they should be p�nnped out now.
DRAINFIELD CONDITION (11-14):
D�,ep�field inspection indicates:
�7y Drainfield is dry, no surfacing evident.
12 Some evidence of surfacing, not critical yet.
13 Drainfield is saturated and visibly discharging untreated effluent to the surface. Contact the City Inspector
imnediately. Repairs must be completed within 90 days.
14 Drainfield extent end condition unknown.
LIMITING SITE FACTORS Csloae.setbacks.etc.):
POTENTIAL FOR SYSTEM FAILURE (deaends on soils,water table,etc.): �
COMMENTS:
Date of 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 optm on of the adequacy of the system under current conditions based on the evailable
informat�on.
This report must be kept on the premises with the system locetion and p�nnping records.
WHITE COPY/Inspectors Flle YELLOW COPY/Homeowner
� � 1
On the Nortb Sbore o f
Lake Minnetonka
ON-SITE SEWAGE TREATMENT
INSPECTION REPORT � POST OFFICE BOX 66
� _ � � 1335 S. Brown Rd.
Crystal Bay, MN 55323
473-7357
OWNER ��I � �-������ ADDRESS ��� /1��!���'%
PERMIT NO.'S. -� DATES ��7� CONTRACTORS �����"��
City Ordinance No.210 requires that each on-site�wage treatmerit system in Orono be inspected on a regular basis.The on-site sewage
treatment system et the above address has been inspected and ep�ers to fali into the category checked below.
(This is � an existirtg system ❑ new construction)
� � Meets or exceeds current City standards in all respects relating to design,consuuction,and location.Appears to be operating
properly,
� 2 Does not meet all current Ciry standards for new construction (1978 Code) but in most r�pects appears to be designed,
located, and constructed generally in eccordance with previous codes.System appears to be functioning properly;no major
upgrading of the system is required at this time.
� Does not meet current City standards in many respects relating to design,construction,or location.Appears to be operating
3 adequately at this time,but has a relatively high potential for future problems. No major upgrading of system is required at
this time. .
� 4 System may or may not meet current City standards for design,construction ot location,but is failing to properly treat and
dispose of the current input,and is endangering a water supply,or is a source of pollution to surface or groundwaters,or is
creating a safety hazard,or is otherwise areating a public nuisance.Please contect the City Inspector to discuss system repair/
replacement procedures. If drainfield replacement is necessary,soil testing will usually be required,and a design and site plan
must be submitted for review.Your contractar must obtain a permit before work is started.
SYSTEM CONDITION ( m Checked items may require your action)
Tan inspection indicates: ❑ Inspection pipe is located directly over tank baffle.(Does not
�Pumpout not needed at this time. give accurete measurement of solids eccumulation.) If tanks
❑ Solids accumulation in tanks indicates they should be pump- have not been pum�d out within the last three years,they
ed out this year to help prevent future problems, should be pumped out now.
❑ Solids eccumulation In tenks is at a critical level, Tanks Drainfield inspection indicetes:
should be pumped out es soon�possible. '� Drainfield is dry,no surfacing evident.
❑ System is discharging to surtace. Tanks must be pumped 0 Some evidence of surfacing,not critical yet.
within 48 hours to eliminate surface discharge. ❑ Drainfield is saturated and visibly discherging untreated
❑ Inspection risers missing—tanks could not be inspected, effluent to the surfece. This condition may require reptace-
Inspection risers (4"dia.pipe)must be installed in esch tank ment or edditions to drainfield. Contact the City Inspector
at next pumpout. If tanka heve not been pumped out within immediately.Repairs must be completed within 90 days.
the last three years,they should be pumped out now. ❑ Drainfield extent and condition unknown.
SITE CHARACTERISTICS:
Limiting Site Factors Potentiai for System Failure Site Capabilities for `
❑ Slope (depends on soil types,water Future Expansion
❑ Soil table and system condition) �dequate
�High water table �Low air
O Lot size ❑ Medium ❑Poor
❑ Lake,wetland,or stream ❑ High O Inadequate
❑ Drainage ❑System is causing visible
surface discharge.
COMMENTS:
'/ '!��
Date of Inspection Septic System Inspector
Note: In the event that this inspection report Is used to setisfy the requirements for a mortgage or other transfer of property,be advised that
this report does not guarantee or certify that an exisfing system will continue to function properly,but is merely an opinion of the adequacy
of the system under current conditions based on the evailable information.
This report must be kept on the premises with system location and pumping records.
WHITE COPY/Inspector's File • GOLD COPY/Homeowner