HomeMy WebLinkAboutseptic info 2/25/02 Water/Wastewater-ISTS4.31
compfoance Inspecd n Form ?or E xNstong
Sewage reatimient Sy elms Minnesota Pollution
Control Agency
Completion of this form fulfills the minimal requirements of Minn. tat.§115.55(2001)and Minnesota R. ch. 7080(1999). Please refer
to local ordinances for other requirements or information es eci 1 I for compliance requirements for bedroom additions.
Date of Inspect.l®n: &1A161 Reason for inspect lon: CWX
Property Owners) III Telephone( )
Person requesting inspection Telephone ( )
Site Address .-® A -s-747 /� City Q.QQvD alp Code
fire Noo/ Pardel No. County c•',r.- . .cJ Township
Legal Description
Local Regulatory Authority f
Dat®system construact®d Syste in Shoreland Area: yes no System In Wellhead
protection Area: yes(VSystem serving a MDH lice sed facility: yeF0 Local Permit# (if any) By-9
Systems built prior to April 1, 1996 and not located in Systems located in Shoreland or Wellhead Protection
Shoreland or Wellhead Protection Area or Serving a Foo , Areas or Serving a Food, Beverage or Lodging
Beverage or Lodging Establishment Establishment, or systems Built after
March 31 1996
Is the isstfstem an imminent threat to g ublic health or Ys the sssteun an imminent threat to guub is health
g ? (a.yes answer is an ITPHS system) or saffeV? (a yes answer is an 17PHS system)
-Discharge of sewage to the ground surface? YES NO -Discharge of sewage to the ground surface? YES
-Discharge of sewage to draintile or surface waters? YES NO -Discharge of sewage to draintile or surface waters?YES
-Sewage backup Into dwelling? YES NO -Sewage backup into dwelling? YES IV
-Situation with the potential to immediately and -Situation with the potential to immediately and
adversely impact or threaten public health or adversely impact or threaten public health or
safety? YES NO safety? YES (05
19 the$Xs_teun flailing? (a yes answer is a failing system) Is the VsteM failing? (a yes answer is a failing system,
-Less than TWO feet of vertical separation between -Less than THREE feet of vertical separation between
system bottom and saturated soil or bedrock? YES NO system bottom and saturated soil or bedrock? YES XV
-A seepage pit,cesspool,drywell,or leaching pit? YES NO -A seepage pit,cesspool,drywell,or leaching pit? YES
Is the UsteM non-compliant? Is the est m non-comallant?
Is the system regulated under a monitoring plan or a Is the system regulated under a monitoring plan o
operating permit? (if no, go to page 2) YES NO operating permit? (rf no,go to page 2) YES
If yes, If yes,
-Has the required monitoring taken place? YES NO -Has the required monitoring taken place? -YES NC
(If no, the system is non-complying) (If no, the system is non-complying)
-Does the monitoring indicate that the isystem,meets -Does the monitoring indicate that the system meets
performance expectations? YES NO performance expectations? YES NC
(If no, the system is non-complying) (If no, the system is non-complying)
Pana 1 of lain-tnnnliC>Cd '41
Property Owners) Fire No./Parcel No.
SxateIN Coe000nents (Please describe the system components and attach site sketch showing system location).
02, /00,0IbAv'tv yC S A_j
What methods were used to matte the determinations for the comnliance inspection?(Note.No standard protocol exists
The following list Is not exhaustive, or In sequential order nor indicates which combinations may necessary to make a determination)
Watertight tank(s) Hydraulic Functioning Vertical Separation Distance
❑ Probed.tank bottom X_Searched for surface outlet Conducted soil borings
❑ Observed low liquid level ❑ Performed hydraulic test Depth to limiting layerf�e�0 t
❑ Examined const. records 0( Searched for seeping in yard Depth to system bottom 01ra a
Ex meol emp (pumped)tank ❑ Checked for back-up in home t� Examined records
❑ P�outside t nkror"black soil" ❑ Excessive ponding in soil system/D-loxes ❑ LGU Limiting Layer Verification
❑ Pressure/vacuum check ❑ Homeowner testimony ❑ Other
❑ Other ❑ Examined for surging In tank
❑ "Black soil"above soil system
❑ Other
Lased on the compliance criteria,the system status is., (check one) ❑ failing (to protect groundwater) ❑ an
imminent threat to public health or safety(ITPHS), ❑ non-compliant(monitoring issue)9compliant(none of the 3
previous conditions). Therefore,this document is a: XCertificate of Compliance ❑ Notice of Noncompliance
Ys this system an EPA Class V Injection Well? . ❑ yes no
�erl»d�ca�l®a�
I hereby certify as a state of Minnesota licensed Inspector and/or Designer I or Qualified Employee Inspector and/or Qualified Employee
Designer I that I conducted an investigation that accurately determined the compliance status of this system and that my recorded
observations are accurate as of this date. No determination of future hydraulic performance has been nor can be made due to
unknown conditions during system construction,
abuse of the system, inadequate maintenance,or future water usage.
Altd%)Inspector's name(print) IKIR iiv el/ Phone 762- Y7?- 17j4D
License and/or Registration Number Address &OX ej YB
Employed by� J� Address,�p.t�t7b. �lrv� c����7
Signa e
Date
UllUlrade irements fdadved from Minnesota statutes§115.55)
An ITPHS mustbe 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 fails to provide sufficient groundwater protection, then the system must be upgraded,
replaced, or its use discontinued within the time required by rule or the local ordinance. If an existing system is not failing as definer/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 fs more strict. This 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.
Suggested Attachanents
1) Site sketch could also include: well,well setback to system, dwelling or other buildings,tank(s),reserved soil treatment area,
surface water and soil boring locations. Include as-built drawing if available.
2) Soil boring logs,showing each horizon. Indicate the texture, color,redoximorphic features depth to bedrock,standing water and
whether the material is fill.
3) A list of any and all requirements of the local ordinance that are different from the state requirements referred to on this form.
4) A homeowner survey of system performance,signed by the homeowner as being factual. {
5) Monitoring data as appropriate.
Dana 7 of 7
01
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ITY of OR
Municipal Offices
Street Add ss: Mailing Address:
2750 Kelley Parkway P.O. Box 66
Orono, N 55356 I Crystal Bay, MN 55323-0066
To Current Owner: A dress: 3a�
City Ordinance 199 requires that each existing on-site sewage tre tment system in Orono be inspected every two years.
The on-site sewage treatment system at the above address has bee inspected and appears to fall into the categories checked below.
SYSTEM CONFORMITY (1-3):
"CODE SYSTEM"An ISTS which meets all the location,design and construction standards of the current Orono Municipal Code.
2 "COMPLIANT SYSTEM" An ISTS which does not meet all thlocation,design and construction standards of the current Orono Municipal
Code but does meet the time foot separation requirement or twof of 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 IST located within a designated 1(}0-year flood plain,any ISTS which may
or may not meet all the location,design,or construction standard 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 betw en the distribution device and the limiting soil characteristics.
TANK CONDITION(5-7):
Tank inspection indicates:
5 Pumpout not needed at this time.
OSeptic tanks must be pumped out this year (city code req ires tanks to be pumped out once every 3 years.
Tank was last pumped C\—N\—t) t ).
Make sure se tic tanks are RumRed through manhole and not through white inspection Rives. This allows for the
Proper cleaning. Keelp water softner and iron fil er discharge out of septic sstem.
7 Inspection risers missing-tanks could not be inspected. pection 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.
DRAINFIELD CONDITION(8-10): x
infield is dry,no surfacing evident.
9 Some evidence of surfacing,not critical yet.
10 Drainfield is saturated and visibly discharging untreated a uent to the surface. Contact the City Inspector
immediately.Repairs must be completed within 90 days.
COMMENTS: ®V•� a r� O _ to sk 4--, �-�cm v ti c t
OL—t o'-$ -
Date of Inspection Matt Bolterman - Septic System Inspector
Note: In the event that this inspection report is used to satisfy the requirements fora ortgage 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 o inion of the adequacy of the system undercurrent conditions based on the available
information.
Telephone(952)249-46 - Fax(952)249-4616
JeNY5.2
TY of ORONO
Municipal Offices
Street'Z �►�• g'� Matiiag Address:-
.2750
ddress:
•2750 Keway P.O. Box 66
Orono, 56 Crystal Bay, MN 55323-0066
Owner: A�n md)a N,..RAN Address:_ Sas Old ccys"� &1A ti
City Ordinance 199 requires that each existing on-site sewage treaystem in Orono be inspected every tsvo years.
The oa-site sewage treatment system at the above address has been ected and appears to fall into the categories checked below.
SYSTEM CONFORMITY (1-3): •�
�1 "CODE SYSTEM" An ISIS which meets all the Iocatioa,design and construction standards of the current Orono Municipal Code.
2 "CO;tifPLIANT SYSTEM" Aa ISIS which does not meet all the lmdo�design and construction standards of the current Orono Municipal
Code but does meet the three foot separation requirement,and which is not faBing or as im—neat threat to public health or sri ty.
3 'TION-COMPLIANT SYSTEM" Aprehi'bited Isrs;an ISIS located within a designated 100 year flood plain,any ISIS which may
or may not meet-all the location,design,or construction standards of the Cticrlid Orono Municipal Code and which is failing for acy reasoa;and
any ISTS with less than three fed of unsaturated soil or sand between the distr#bution device and the limiting gaud charaeteristi s.
I
TANK CONDITION(5-10): 6 .
Tank inspection indicates:
5 Puinpout not needed at this time. C�
Tank must be pumped out this year(city code requires tanks to be pumped out c4ery 3 years. Tank was last pumped (� I
7 Solids aaumulation in tanks is at a critical acritical levet Tanks should be pum ed out as soon as possible.
8 System is discharging to the surface. Tanks must be pumped out within 48 ho to eliminate surface discharge.
9 Inspection risers missing-tanks could not be inspected. Inspection risers(4"dia. ipe)must be installed in each tank at next pumpout. If tanks
have not been pumped out within the last three years,they should be pumped out ow.
10 Inspection pipe is located directly over tank baffle(dors not give accurate measueemeat of solids accumulation). If tanks have not been pumped
out within the last three years,they should be pumped out now.
PR4MIELD CONDITION 11-14 ; \\
(--10-Draintield 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. Ca Itact the C' 'Inspector immediate)Y.Repairs must be
completed within 90 days.
14 Drsinfiaid extent sad eonditioa unknown.
COUNTS: 5 Ste,M. ov SCS O
OJT,
Date oflaspecdon Septic S
ysteta Inspector
Note. In the event that this inspection report is used to satisfy the requirements for a mortgage other transfer of property,be advised that this report does net guarantee
or certify that an existing system will continue to tlmctlon properly,but is merely an opinion of*e adequary of the system under MUMA conditions based as the available
infortrtstion
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CITY OF ORONO O O
Municipal Offices
Post Office Box 66
Crystal Bay, MN 55323-0066 ON—SITE SEWAGE TREATMENT
INSPECTION REPORT
O
S 0
Owner• LL Inc, Do we- Address:/ nyJ��'�j�'(/C)
. J�/l�') � G (.. —
Permit #'s: Dates: D Contractors: k7-GATM C,./®,
City ordinance number 100 requires that each on-site sewage tr atment 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 isXan existing system 13 new constructio )
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 tree ing and disposing of the entire current sewage input
without discharging any pollutants into ground or surface
ysce waters.
2 "CONFORMING SYSTEM"-A stem t which does not meet all e location, design, and construction standards of the
current City Codes, but was installed according to t e code in effect at the time of installation, and which
is operating satisfactorily by treating and disposin 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, esign, and construction standards of the current City
Codes and which is failing for any reason; and any s stem with less than 3 feet of unsaturated soil or sand
between the distribution device and the limiting soil characteristics.
(The limiting soil characteristic Whas or 13 has of been identified at this time. If the limiting soil
characteristic has not been identifi , this classifi ation may be subject to revision.)
TANK CONDITION (5-10):
71 inspection indicates:
Pumpout 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. aY nks hould be pumped out as soon as possible.
8 System is discharging to the surface. Tanks must be pumped t within 48 hours to eliminate surface discharge.
9 Inspection risers missing-tanks could not be inspected. Ins ction risers (4" dia. pipe) must be installed in each
tank at next pumpout. If tanks have not been pumped ut within the last three years, they should be pumped
out now.
10 Inspection pipe is located directly over tank baffle (does t give accurate measurement of solids accumulation).
If tanks have not been pumped out within the Last thre years, they should be pumped out now.
DRAINFIELD CONDITION (11-14):
Apa*KfeLd inspection indicates:
rainfield is dry, no surfacing evident.
12 Sane evidence of surfacing, not critical yet.
13 Drainfield is saturated and visibly discharging untreated ffluent to the surface. Contact the City Inspector
immediately. Repairs must be completed within 90 days.
14 Drainfield extent and condition unknown.
LIMITING SITE FACTORS (s lope,setbacks.etc.):
POTENTIAL FOR SYSTEM FAILURE (depends on soils.water table,etc.):
COMMENTS: s'
a— JE7dhd
Date of Inspection S ptic System Inspector
Note: In the event that this inspection report is used to satisfy he requirements for a mortgage or other transfer of
property, be advised that this report does not guarantee or certif that an existing system will continue to function
properly, but is merely an opinion of the adequacy of the syst under current conditions based on the available
information.
This report must be kept on the premises with the s stem location and pumping records.
WHITE COPY/Inspectors File YELLOW COPY/Homeowner
i
i
O
�a
C TY of ORONO
a IVB rZC. A+
A- Municipal Offices
Street Addres : Mailing Address:
2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
Owner: Address: 325 Old Crystal Say Rd. N.
Permit #'s: 8339 Dates: 9/6/96 Contractors: E. J. Paterson Co.
(This is [1j an existing system ( ) new construc ion) .
"STEM COMPLIANCE (1-3) : 1
Code System: Meets or exceeds current City s andards in all respects relating to design,
construction, and location. Appears to be ope ating properly.
2 Compliant System: Does not meet all current ity 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 no 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 fe t of vertical separation between the bottom
of the drainfield and the saturated soil level
(The saturated soil level [ has or [ 3 has of been identified at this time. If the
saturated soil level has not been identified, this lassification is subject to revision.)
t CONDITION (5-9) : 5
5 Pumpout not needed at this time.
6 Solids accumulation in tanks indicates they sh uld be pumped out this year.
7 System is discharging to the surface. Tanks m st be pumped out within 48 hours.
8 Inspection risers missing-tanks could not be i spected. If tanks have not been pumped out
within three years, they should be pumped out a d 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, th y should be pumped out now.
(During the last septic tank Maintenance Pumpout the tanks [./ were or [ ] were not confirmed
to be watertight by the licensed pumping contracto If he tanks were not confirmed to be
watertight, this classification is subject to revisi n.)
NFIELD CONDITION (11-14) : li
QW Drainfield is dry, no surfacing evident.
12 Some evidence of surfacing, not critical yet. epair is not required at this time.
13 Drainfield is saturated and visibly dischar ing 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
COMMENTS: g
Date of Inspection s6pEic System Inspector
Note: In the event that this inspection report i used to satisfy the requirements for a
transfer of property, this report does not guarante that an existing system will continue to
function properly, but indicates the operation of the system under current conditions.
Telephone (612) 473-7357 • AX 473-0510
i
ITY of ORONO
VIA-;
�, r,` ✓ titi Municipal Offices
I•` � Street Ad ress: MailingAddress:
` E+ rJ 11 2750 Ke ley Parkway P.O. Box 66
Orono, N 55356 Crystal Bay, MN 55323.0066
Owner: V_Z&r_� Ad ress:325 Old Crystal Bay Rd. N.
Permit #1x:8339 Dates:9/6/96 Contract rs:E. J. Peterson Co.
(This is [ ] an existing system Jx] new con truction)
STEM COMPLIANCE (1-3) : 1
1 Code System: Meets or exceeds current City standards in all respects relating to
design, construction, and location. A pears to be operating properly.
2 Compliant System: Does not meet all c rrent City standards for new construction,
but in most respects appears to be desi ed, located, and constructed in accordance
with previous codes and is functioning roperly.
3 Non-Compliant System: System may or ma not meet current City standards for design,
construction, or location, but is faili g 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 an the saturated soil level.
(The saturated soil level [ has or [ 1 has of been identified at this time. If• the
saturated soil level has not been identified, this classification is subject to revision.)
ZaIJE CONDITION (5-9) : 5
Pumpout not needed at this time
Solids accumulation in tanks indicates hey should be pumped out this year.
7 System is discharging to the surface. anks must be pumped out within 48 hours.
8 Inspection risers missing-tanks could n t be inspected. If tanks have not been
pumped out within three years, they sho ld be pumped out and risers installed now.
9 Inspection pipe is located over tank ba fle-can not measure solids accumulation. If
tanks have not been pumped out within t ree years, they should be pumped out now.
(During the last septic tank Maintenance Pump t the tanks r� were or [ 1 were not
confirmed to be watertight by the licensed p ing contractor. If the tanks were not
confirmed to be watertight, this classificatio is subject to revision.)
DRAINFIELD CONDITION (11-14) : 11
1 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 disc arging 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 acre and ondition soils etc.) : low
COMMENTS:
-=_
Date of Inspection Se is System Inspector
.Note: In the event that this inspection report is used to satisfy the requirements for a
transfer of property, this report does not guar tee that an existing system will continue
to function properly, but indicates the operati n of the system under current conditions.
Telephone (612) 473-7357 FAX 473-0510
O O
CITY of ORONO
f �!� Municipal Offices
Street Address: Mailing Address:
2150 Kelley Parkway P.O. Box 66
9�CEggO
_8 ,��j Orono, MN 55356 Crystal Bay, MN 55323-0066
k12-LL
Owner: ` Address:325 old Crystal Bay Rd. N.
Permit #1s:2852 Dates:9/13/71 Contractors:E. J. Peterson
(This is A an existing system [ ) new construction)
SYSTEM COMPLIANCE (1-3) : 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 codes and is functioning properly.
3JJ 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 [X] has not been identified at this time. If the
saturated soil level has not been ide tified, this classification is subject to revision. )
TANK CONDITION (5-9) : 7
5 Pumpout not needed at this time
Solids accumulation in tanks indicates they should be pumped out this year.
System is discharging to the surface. Tanks must be pumped out within 48 hours.
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.
(During the last septic tank Maintenance Pumpout the tanks [ ] were or 9� were not
confirmed to be watertight by the licensed pumping contractor. If the tanks were not
confirmed to be watertight, this classification is subject to revision.)
DRAINFIELD CONDITION (11-14) : 13
11 Drainfield is dry, no surfacing evident.
1 Some evidence of surfacing, not critical yet. Repair is not required at this time.
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. ) : failing
COMMENTS: Repairs must be completed by 9/31/96.
r
Date of Inspection S ptic System nspector
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 0 FAX 473-0510
.�o
CITY OF ORONO O
Municipal Offices V
Post Office Box 66
Crystal Bay, MN 55323-0066 Dy ON—SITE SEWAGE TREATMENT
INSPECTION REPORT
G
9k
usHo
Owner: Address: VO
Permit #I s: ®Dates: _ 2 U 7® ontractors: T rJ, rf (tea
City ordinance number 100 requires that each on-site sewage tr atment 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 Kan existing system I I new constructio )
SYSTEM CONFORMITY (1-3): a
1 "CODE SYSTEM"-A system which meets all the location, des gn, 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 sur ace waters.
2 "CONFORMING SYSTEM"-A stem which does not meet all t e location, design, and construction standards of the
ys
current City Codes, t was installed according to t e code in effect at the time of installation, and which
is operating satisfactorily by treating and disposi 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, esign, end construction standards of the current City
Codes and which is failing for any reason; and any s stem with less than 3 feet of unsaturated soil or sand
between the distribution device and the limiting soil characteristics.
(The Limiting soil characteristic [ I has or,1141 has of been identified at this time. If the limiting soil
characteristic has not been identified, this classifi etion may be subject to revision.)
TANK CONDITION C5-10): ��� ��
Tank inspection indicates:
5 Pumpout not needed at is time.
Solids accumutatitanks indicates they should be out this year to help prevent future problems.
in tanks is at a critical Level. a hould be out as ssible.
7
4System is discharging to the surface. Tanks must be u within ours o eliminate s discharge.
9 Inspection risers missing-tanks could not be inspected. Ins tion risers (4" dia. pipe) must be installed in each
tank at next pumpout. If tanks have not been pumped t within the last three years, they should be pumped
out now.
10 Inspection pipe is located directly over tank baffle (does of give accurate measurement of solids accumulation).
If tanks have not been Pumped out within the last thre years, they should be pumped out now.
DRAINFIELD CONDITION (11-14):
Drainfield inspection indicates:
11 Drainfield is dry, no surfacing evident.
N.Some evidence of surfacing, not critical yet.
dischar ing untreated ffl ant to the surface. Contact the City Inspector
immediately. Re c e wi
14 Drainfield extent a condition un nown.
LIMITING SITE FACTORS (slope.setbacks.etc.):
POTENTIAL FOR SYSTEM FAILURE (depends on soils.water table.etc.):
COMMENTS:
Date of Inspection t FSystdm Indiptector
Note: In the event that this inspection report is used to satisfy he 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 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 s stem location and pumping records.
WHITE COPY/Inspectors File YELLOW COPY/Homeowner
.�,o
CITY OF ORONO O O
Municipal Offices
Post Office Box 66
Crystal Bay, MN 55323-0066 ON-SITE SEWAGE TREATMENT
INSPECTION REPORT
ti
G
9kESH
Owner: Address: A
Permit #'s: 23SR Dates: — Contractors: /-. �.
City ordinance number 100 requires that each on-site sewage t eatment system in Orono be inspected on a regular basis.
The on-site sewage treatment system at the above address he been inspected and appears to fall into the category
checked below.
(This is �)•an existing system [ ) new constructi n)
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 tre ting and disposing of the entire current sewage input
without discharging any pollutants into ground or s rface 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 he code in effect at the time of installation, and which
is operating satisfactorily by treating and disposi g of the entire current sewage input without discharging
any pollutants into ground or surface waters.
"NON-CONFORMING SYSTEM"-A prohibited system; a syst 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 ystem with Less than 3 feet of unsaturated soil or sand
between the distribution device and the Limiting
// soil characteristics.
(The Limiting soil characteristic [ I has or P4 he not been identified at this time. If the limiting soil
characteristic has not been identified, this classif cation may be subject to revision.)
TANK CONDITION (5-10):
Tank inspection indicates:
5 Pumpout not needed at this time.
6 Solids accumulation in tanks indicates they should be4(doe
out this year to help prevent future problems.
Solids accumulation in tanks is at a critical Level. hould be pumped out as soon as possible.
8J stem is discharging_to the surface ks must beut within 48 hours to eliminate surface discharge.
inspec t risers miss -tanks- ffta not ach
tank at next pumpout. If tanks have not enut within the last three years, they shou a pumped
out now.
10 Inspection pipe is Located directly over tank baffleot give accurate measurement of solids accumulation).
If tanks have not been pumped out within the layears, they should be pumped out now.
DRAINFIELD CONDITION (11-14): Ja
Drainfield inspection indicates:
11 Drainfield is dry, no surfacing evident.
Some evidence of surfacing, not critical yet.
13 Drainfield is saturated and visibly discharging untreated effluent to the surface. Contact the City Inspector
immediately. Repairs must be completed within 90 day .
14 Drainfield extent a
LIMITING SITE FACTORS (slope.setbacks.etc.):
POTENTIAL FOR SYSTEM FAILURE (depends on soils.water table.etc.):
COMMENTS:
0-7
Date of Inspection erpt&c System Inspector
Note: In the event that this inspection report is used to satisf the requirements for a mortgage or other transfer of
property, be advised that this report does not guarantee or cert fy that an existing system will continue to function
properly, but is merely an opinion of the adequacy of the sys em under current conditions based on the available
information.
This report must be kept on the premises with the system Location and pumping records.
WHITE COPY/Inspectors File YELLOW COPY/Homeowner
On the Nortb Sbore of
Lake Minnetonka
ON-SITE SEWAGE TREATMENT CITY
INSPECTION REPORT POST OFFICE BOX 66
OF� 1335 S. Brown Rd.
NO Crystal Bay,MN 55323
473-7357
OWNER Ad DDRESS
PERMIT NO.'S. an-2 R'S 2 DATES CONTRACTORS /J®
City Ordinance No.210 requires that each on-site sewage treatmeri system in Orono be inspected on a regular basis.The onsite sewage
treatment system at the above address has been inspected and appears to fa I into the category checked below.
(This is 'o an existing system ❑ new construction)
Meets or exceeds current City standards in all respects re ating to design,construction,and location.Appears to be operating
properly.
2 Does not meet all current City standards for new const uction (1978 Code) but in most respects appears to be designed,
located, and constructed generally in accordance with pre ious codes.System appears to be functioning properly;no major
upgrading of the system is required at this time.
3 Does not meet current City standards in many respects re sting to design,construction,or location.Appears to be operating
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 esign,construction or location,but is failing to properly treat and
dispose of the current input,and is endangering a water s pply,or is a source of pollution to surface or groundwaters,or is
creating a safety hazard,or is otherwise creating a public n isance.Please contact the City Inspector to discuss system repair/
replacement procedures. If drainfield replacement is nece ry,soil testing will usually be required,and a design and site plan
must be submitted for review.Your contractor must obtain permit before work is started.
SYSTEM CONDITION S m Checked items may require your action)
Tank inspection indicates: Inspection pipe is located directly over tank baffle.(Does not
❑ Pumpout not needed at this time. give accurate measurement of solids accumulation.) If tanks
❑ Solids accumulation in tanks indicates they should be pump• have not been pumped out within the last three years,they
ad out this year to help prevent future problems. should be pumped out now.
❑ Solids accumulation in tanks is at a critical level. Tanks Drai field inspection indicates:
should be pumped out as soon as possible. Drainfield is dry,no surfacing evident.
❑ System is discharging to surface. Tanks must be pumped Some evidence of surfacing,not critical yet.
within 48 hours to eliminate surface discharge. Drainfield is saturated and visibly discharging untreated
39 In 'on risers missing—tanks could not be inspected. effluent to the surface. This condition may require replace-
InsReCtlon_rlsera 14 is o oe u'sfnsfe a in eac tan ment or additions to drainfield. Contact the City Inspector
at next pumpout. If tanks have not been pumped out within immediately.Repairs must be completed within 90 days.
the last three ye ey should be pumped out now. Drainfield extent and condition unknown.
SITE CHARACTERISTICS:
Limiting Site Factors Potential for System F ilure Site Capabilities for
❑ Slope (depends on soil types,water Future Expansion
❑ Soil table,and system condi ion) El Adequate
❑ High water table 11 Low air
❑ Lot size 0 Medium Poor
❑ Lake,wetland,or stream El High 11 Inadequate
11 Drainage ❑System is causing visible
surface discharge.
COMMENTS:
Date of Inspection OF 7for
ystem Inspector
Note: In the event that this inspection report is used to satisfy the requiretgage or other transfer of property,be advised that
this report does not guarantee or certify that an existing system will continproperly,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 snd pumping records.
WHITE COPY/Inspector's File GOLD COPY/Homeowner