HomeMy WebLinkAboutSeptic Compliance Inspection Minnesota Pollution Compliance Inspection Form
Control Agency
520 Lafayette Road North Existing Subsurface Sewage Treatment Systems (SSTS)
Si.Paul,MN 55155-4194 Doc Type:Compliance and Enforcement
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 Government(LUG)and system owner
within 15 days
System Status
System status on date(mm/ddlyyyy): 11/2/2017
® Compliant— Certificate of Compliance ❑ Noncompliant— Notice of Noncompliance
(Valid for 3 years from report date, unless shorter time (See Upgrade Requirements on page 3.)
frame outlined in Local Ordinance.)
Reason(s)for noncompliance(check all applicable)
O Impact on Public Health(Compliance Component#1)—Imminent threat to public health and safety
❑ Other Compliance Conditions(Compliance Component#3)—Imminent threat to public health and safety
El Tank Integrity(Compliance Component#2)—Failing to protect groundwater
❑ Other Compliance Conditions(Compliance Component#3)—Failing to protect groundwater
El Soil Separation(Compliance Component#4)—Failing to protect groundwater
❑ Operating permit/monitoring plan requirements(Compliance Component#5)—Noncompliant
Property Information Parcel ID#or Sec/Twp/Range:
Property address: 2120 Carriage Lane,Orono Reason for inspection: Sale
Property owner: Bonnie Velie Owner's phone: 612-964-7865
or
Owner's representative: Representative phone:
Local regulatory authority: City Regulatory authority phone:
Brief system description: 2-1300 gal septic tanks& 1300.gal pump tank with a mound system
Comments or recommendations:
Certification
I hereby certify that all the necessary information has been gathered to determine the compliance status of this system. No
determination 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 future water usage.
Inspector name: Josh Swedlund Certification number: C1659
Business name: Sewer 4 es I• License number: 2502
Inspector signature: Phone number: 952-873-3292
Necessary or L•cally Required Attachments
® Soil boring logs ® System/As-built drawing ® Forms per local ordinance
El 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
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Page 1 of 3
•
Property address. 2120 Carriage Lane Orono Inspector initials/Date: JS 111/2/2017
(mm/dd/yyyy)
1. Impact on Public Health— Compliance component#1 of 5
Compliance criteria: Verification method(s):
System discharges sewage to the 0 Yes ® No ® Searched for surface outlet
_ground surface.
® Searched for seeping in yard/backup in home
System discharges sewage to drain 0 Yes ® No 0 Excessive ponding in soil system/D-boxes
tile or surface waters.
0 Homeowner testimony (See Comments/Explanation)
System causes sewage backup into ❑ Yes ® No 0 "Black soil"above soil dispersal s stem
dwelling or establishment. P Y
❑ System requires"emergency" pumping
Any"yes"answer above indicates the 0 Performed dye test
system is an imminent threat to public
health and safety. 0 Unable to verify(See Comments/Explanation)
0 Other methods not listed (See Comments/Explanation)
Comments/Explanation:
2. Tank Integrity— Compliance component#2 of 5
Compliance criteria:
Verification method(s):
System consists of a seepage pit, 0 Yes ® No ® Probed tank(s)bottom
cesspool, drywell, or leaching pit.
® Examined construction records
Seepage pits meeting 7080.2550 may be
compliant if allowed in local ordinance. ❑ Examined Tank Integrity Form(Attach)
Sewage tank(s)leak below their 0 Yes ® No ❑ Observed 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"black soil"
0
Any "yes"answer above indicates the Unable to verify(See Comments/Explanation)
0Other methods not listed (See Comments/Explanation)
system is falling to protect groundwater.
Comments/Explanation:
3. Other Compliance Conditions—Compliance component#3 of 5
a. Maintenance hole covers are damaged, cracked, unsecured, or appear to be structurally unsound. 0 Yes* ®No 0 Unknown
b. Other issues(electrical hazards.etc.)to immediately and adversely impact public health or safety. 0 Yes* ®No p Unknown
*System is an imminent threat to public health and safety.
Explain:
c. System is non-protective of ground water for other conditions as determined by inspector. 0 Yes* ® No
*System is failing to protect groundwater.
Explain:
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
Page 2 of 3
•
Property address: 2120 Carriage Lane,Orono Inspector initials/Date: JS I 11/3/2017
(mm/dd/yyyy)
4. Soil Separation —Compliance component#4 of 5
Date of installation: 10/26/1999 ❑ Unknown Verification method(s):
(mm/dd/yyyy)
Shoreland/Wellhead protection/Foodm/ddi beverage Soil observation does not expire. Previous soil
lodging? ® Yes ❑ No observations by two independent parties are sufficient,
unless site conditions have been altered or local
Compliance criteria: requirements differ.
For systems built prior to April 1, 1996, and 0 Yes El No ® Conducted soil observation(s) (Attach boring logs)
not located in Shoreland or Wellhead
Protection Area or not serving a food, ❑ Two previous verifications(Attach boring logs)
beverage or lodging establishment: El Not applicable(Holding tank(s),no drainfield)
Drainfield has at least a two-foot vertical ❑ Unable to verify(See Comments/Explanation)
separation distance from periodically ❑ Other(See Comments/Explanation)
saturated soil or bedrock.
Non-performance systems built April 1, ® Yes ❑ No Comments/Explanation:
1996, or later or for non-performance
systems located in Shoreland or Wellhead Boring:
Protection Areas or serving a food, 1-12" 10yr 3/3 loam
beverage, or lodging establishment:
13-26"10yr 414 clay loam
Drainfield has a three-foot vertical
separation distance from periodically No Redox
saturated soil or bedrock.*
"
"
"Ex erimental, Other" or "Performance"
P ❑ Yes ❑ No Indicate depths or elevations
systems built under pre-2008 Rules; Type IV '
or V systems built under 2008 Rules(7080. A. Bottom of distribution media 12"+
2350 or 7080.2400 (Advanced Inspector
License required) B. Periodically saturated soil/bedrock ! 26"+
Drainfield meets the designed vertical C. System separation 36"+
separation distance from periodically
saturated soil or bedrock.
D Required compliance separation' 36
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 0 No If"yes",A below is required
Is the system required to employ a Nitrogen BMP? 0 Yes ❑ No If"yes", B below is required
BMP=Best Management Practices)specified in the system design
If the answer to both questions is "no", this section does not need to be completed.
Compliance criteria
a. Operating Permit number:
Have the Operating Permit requirements been met?
❑ Yes 0 No
b. Is the required nitrogen BMP in place and properly functioning? 0 Yes 0 No
Any "no"answer indicates Noncompliance.
Upgrade Requirements(Minn. Stat.§115.55)An imminent threat to public health and safety(ITPHS)must be upgraded.replaced, or its use
discontinued within ten months of receipt of this notice or within a shorter period if required by local ordinance.If the system is failing to protect
ground water,the system must be upgraded.replaced,or its use discontinued within the time required by local ordinance.If an existing system
is not failing as defined in law, and has at least two feet of design soil separation,then the system need not be upgraded,repaired,replaced, or
its use discontinued, notwithstanding any local ordinance that is more strict. This provision does not apply to systems in shoreland areas.
Wellhead Protection Areas, or those used in connection with food.beverage, and lodging establishments as defined in law.
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 Page 3 of 3
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Pumping Report
Sewer Services Inc. tic:2502
Date Serviced: (1-2. f fi Driver: _,,f/f\- Type:Residential/ Commercial
Industrial
Scheduled Maintenance Emergency Services: Start time: t4 i S
Stop time: C
C_,,
Name: 1j0111 Y1 k, VCIC“,._ Phone: 6,i2.....(16,(1-
Address: a I go C e YY;Aaye. {.auu City: 6{Og
Did you measure the accumulatifdn of scum and sludge? Yes o pumped regardless
Tank 1 Tank 2 Tank 3 Tank 4 Pretreatment Pump Tank
Gallons Billed ),`304 )13°° 4-x-)
Scum
Sludge
%full
Operating Depth
Access used ,n1qr// N1 f/
Depth to lid ?''C.(.. ,_ 6 /?
1 ,refuse to allow the removal of the solids and liquids through
the maintenance hole.I understand that removal of solids and liquids through other access
points is not considered a compliant method of solids removal and does not fulfill the solids
removal requirements of Minn.R.7080.2450 and 7082.0600
Owner's Signature:
Tank Type Pr ' Block - Come) Plastic - Other 4
Filter: Yes No rte --) Type of system: /Acirj
Type of waste oT) mestic.' Holding - Co mercial - Industrial - Flammable waste trap
Are tanks opera mg t designed depth? e)No,
Did you obserrve sewage discharging onto the ground surface N4Yes,
�(f � Electrical condition: rj
Pump Size:
Are all of the covers securely replace . es No,
Safety concerns:
Disposal site: LO ye C
Next recommended pumping: Ali/.P') Other:
Comments:
Sewer Services Inc.25648 200th Street-Belle Plaine,MN 56011-952-873-3292
Septic tanks should be pumped elJery 1 to 3 years. Billint?Inlformation
Many different variables determine how often Pumping(first 1000 gal.): ,,Og 11
a tank needs pumping: Additional gallons($80.00 per 1000 gal.):__/6/P-v
Exposing Manholes(12"deep or less no charge):
❑ Type and age of system Excessive Distance(more than 120•):
❑ Number of people in the house Excessive Grade(more than 20'total lift):
❑ Garbage disposal Riser:
o Tank history Emergency Charge:
Materials:
PUMP REPLACEMENTS, Labor: awl 1l1Gt11.ee- 399
INSPECTIONS & REPAIR Permit:
Filing Fee: $5.00ao
Payment Method: Total Due:
State Certifie <d None -Cash -Check (# )
Credit Card=
25648 200th St•Belle Plaine,MN 56011 •952-873-3292 Type # Exp.
. - ar Leccrn�
Fl
Daily SlipFlo
6opi_*my__ —
Phone 612-964-7865
Bonnie & Decker Velie Alt-Phone
2120 Carriage Lane Work
Orono MN 55391 Cell (612) 747-5097
System: Mound Pumping Frequency: Every 3 Years
Directions: Pump Size: W0E511
PUMP FROM ROAD
a-1360 Brie k lato 704
Tank:08d0-"gal precast tanks on W side of house. 1st&2nd tank manholes 4"deep. Pump tank manhole @ grade
by mound. 5 hoses.
Comments:
Quad Hennepin County
—---- ---- --------
Notes
Date lime Regarding Record Manager
10/31/2017 12:57 PM Needs a compliance Kirsten Theis
5 Bedrooms
Built 2000
needs to be pumped out as well
CC on file
email report to city and customer
6/20/2017 8:41 AM 6/21/17 Corey checked pump,pump float,cycled pump breaker never tripped. Kirsten Theis
Everything is working properly-billed for servce call$175.00 inv#8508
breaker has been tripping for over a year-doesn't want to pay$85 emergency fee-
havng Corey"bury the fee"for service call.-printed 6,20
6/20/2017 7:40 AM Deker LVM over night saying his breaker keeps tripping-returned his call and got his Kirsten Theis
VM
3/26/2015 7:24 AM Josh pumped 3 tanks 2500 gal thru manhole,pump was running correctly when he Melissa Allen
arrived,water level was normal put a new 6"new cap billed$397.50
11/20/2013 12:56 PM Labor and parts to change out warranty parts billed$150.00 Angie Salonek
10/8/2013 11:33 AM electrical company came out,he thinks that the pumped it is surgin at 32 amps settle Melissa Allen
downs at 18,the electrican thinks that it is the motor in the pump? She has no idea...
Please call..
9/9/2013 8:30 AM Josh tested everuthing alarm,works perfect,electrical problem in house,told to call Melissa Allen
elecrtictian billed$125.00
5/3/2012 9:01 AM Jason pumped 3 tanks 2250 gal wat thru manhole,2nd tank concrete is disintegrating Melissa Allen
around manhole cover and pipe going to the pump tank,customer wants to know what to
do..,billed$346.25
5/13/2011 9:47 AM Alrm going off no braker tripped.Sent Brad out to fix problem Angie Salonek
5/13/2011 8:59 AM Brad replaced bad pump. Billed 915.00 on 5/13/11 Angie Salonek
9/8/2009 10:03 AM Pete pumped 3 tanks thru manholes.Billed$335.00 9/11/09. Angie Salonek
Created 10/31/2017 at 1:01 PM Page 1 of 1