|
Feb 0713 09:O�a �: Joseph Olson 763-498-8290 p.2
<br /> . i �
<br /> � � ��
<br /> ��nneso�;���ut�on � �� Compl��nce fnspection Form _
<br /> . - , - , . , , . .
<br /> ,., n. ._;.rSQn�ro Agen:�x � _�: : ,� �„ , � F��, s�
<br /> � <��� t� � �-�.� • � �t r
<br /> 20 Lafayette Road 1Vovtfi ����ng �ubsurface Sewage Treat�nen`� Systen�s
<br /> SC P8u4 MN 55155-4194 {$$�S�
<br /> Doc Type:Compl'ranoe and Enforr�emen7
<br /> � s..;ti . ! i; Ei.:, 'C+�� t..>):. .
<br /> Ineduchaps:-�Insp�io��+esE+l�s based o�Mirviesota R�1lutlon Co�l Age:iicy{MPGA) For local..trackin9 R�tPQses: .
<br /> requiremepts��¢�a�d't�d fp�ts,,-,add'd'oonal iocaf req�r�ments maY a�aPpIY• , fb ,
<br /> Submyit co�plQ�d fnrm�rc�.4���.Unit of Governmet�t�LUG)and systq�owner , , . � .
<br /> wtthiR 15�d,ays ,ra^�� ,,rrs.-�e �r i���, iV:
<br /> �. :�r.-
<br /> System Status
<br /> System status on da#e mrn/ddlyyyy): 021Q?J13
<br /> � �; E:c�l4„ , �,y�
<br /> �, , ��;. ., �r�: � -.��.
<br /> _ _ Fl„�Cornpliant-Cerbficate of Compliance ❑ Noncompliant- Notice af Noncompliance
<br /> � {�ti%alid for 3,��ai �rrl�r�porf date, unless shorter Srne (See Upgrade��qt�F��rts on page 3) e��
<br /> frame outlined i toca�Ordinance.)
<br /> Reason(s)for n compliance (check all applicable)
<br /> Qhliri�i�'c� . �t�.�1�11kt• �ompliance Com onent# �� ' f� to pu�c�. �a fe �,� 7 F-�, " �-}
<br /> ( P �'���` #3��" ".`� ,�i 1����'� e.��i ` �, � �
<br /> ���!�� .�onditions(Compliance Component ) mmmenf�+reat to pu rc ea and s cy
<br /> ����k}In�(i_, (�n��Ce Compa�ent #2)-;�ai6"tig to`��a'na��tountlw�iter . ,���ga,�� 1'"i'� .....i:.u., .`���c����,.�
<br /> ��F}e�,�(np' r����Onditions(Canp►iance Canponent#3)-Failing to protect groundwater ;:�;�1�,�s�
<br /> ❑Soil Separali n (Compliance Componeni #4)-Failing to protect grormdwater ��cx�,au�--�'�,m��r,�r�rt� ,�,.r nfu�T«�r,,���
<br /> ❑Operating pe iVmonitnring plan requiremerris(Compliance Component #5}-Noncompliant
<br /> . . � r Y� h - . � � �:�'.' �.� � ,.�t:.c'!)fY�.3CH:.i����c��'l��IOSE:"' �.
<br /> A11lS'4''Yi.l�:TI:�i115i: ol+„o�::�G'�'Ct��7 .'ikla't..Jc::�Bi ?i 'rl/'.P"� ,3'�k1G'u'. ...,t�� ., ,y.v,Jl . '''t;
<br /> 1'l.(�l:tfE:, �r,"it;i•'�i'L �S3iidCi�E: i�f7f1TYS- idGi ,u 31!..,: � ,. " i.r�CT'" ..i.^,'i� �Ic_�8l'l�+�j.
<br /> 15t�t�ie,�i���'��0-�i � '���a�a '���n �:� .';{]vc ,3��r�t. ;tp��rl�#:�:�w�l�a�ge_ 32-118•23�34-0004
<br /> Rirt�perl�'-ad�l�ess; 65 bbs Ba Road North, Orono,MN Reason for inspection: Property Transfer
<br /> Property owner. Ameli Kro er Owne�s phone: 952-47B-U012
<br /> or
<br /> ���f���'�e. Representative phone:
<br /> ... .._.�_ �. ,.., _. . .. �� ..__._.. ,._.._,_.._. ..... .. .,_- � 952249-�4600
<br /> Local , �r � f, rono. .. , Regula6oryauthonty or�e: -
<br /> .���°�,�'R�,�:�t . , . >�;. �
<br /> 2-1000 gal on s�t"ic ianks,T='IOOQ galfon lifl station and 3$0 square feet of rnound rockbed.per aty
<br /> Brief s,�ste gs� t� ds Y - . - .. ,
<br /> ,; �..�'a.��rle}�ll�fllapn' l":}' g .. '. , � ' :, � . :� , , , �.�
<br /> Comments,fOf�lcT,<., �r� T��177;:����r� „ . .,. u; .,hs:�F:`�� ;,rne ;.Si � � r � ,�1r�e.rrrE.E t�; x����sc:�i: 3)
<br /> .'r::�rr�� ur.Uone�.�r,L,�ca/G� 1��: r: .�=i
<br /> i�es:�;�.a(��) �:�r ^i�a y:c�s�'��iiar; M. =:hc .,,; ��t,wi. ;:..�i�l
<br /> i,� ('T� �i"i�':'���•J s'IC 5f8�L2'! t ?'1:��.!;� ;.) l�J(:i�;:` �fi' 7�V1!'7J,''I, i1�I if'i�,- �� .��G �7'„2i��'181'���� �'C-'!}� �
<br /> . . • -. .
<br /> T-(f• ..,l.�C:71iJ� i1CG' r.C)1'Cjl� :1".S :`.O, _�..'i �.;il'��, ,J�:,,-f:.,i��. —r�f7L:'tllu .� �. �. t .)�;G IiG'�)� `l�.�� .afllt�i��
<br /> Certifi�att��s� , , ;_: , :
<br /> �T��.':�. f�i f~C'('i)!�',i/li i:l C .' � � ,� i �;f� f�it ('i �r�,::
<br /> !he�by' rti�tha!a/I t?t nece� rnform�'tron has been galrie�d'b c�etemirne the�compliance status of thrs system. lllo
<br /> determina�tr�bf(ut��l�'a ,-' �e�hn�rr�HHs t��eh�hal�c�n be�im2i�1��ire Po'�1nk+iatiJ�rr condrbr�s`�'if4i�tirrg system cor�struction,
<br /> possiblef�btFs��of�e+csJi !1°FrA7i9�8tN�/f181l1f@R8Fl�C�,i9rfiiture wateF,uSag�a:;:,;r;•`.:.:,.
<br /> Inspecta�r-nanle'r�::``D�1 .A�rioru ; ,, r,�r arner_r:. t �,-..�r ;R,�.:e��:.:,:.�3efti�cation m1m��nF�''�96
<br /> " usiness name: us n s oi '�er�c.`TesUn �'���."�_��.License numbe�:�'�""�""�"_.�,_._.........._._.._..___.
<br /> ln�pectar signature: ;r. - Phone number. 763-498-8779
<br /> .
<br /> Q�^~��r�ty lr���� rrtt,� {�n�� .f. �.:� > >�. a� _. __ _ _._._---__
<br /> -�� � ���Il,��a���Xs�
<br /> -� � � �,. t ,� ;,,� �c �-
<br /> �r.��i�S�5� �� ., �"�b�"E�, , � t ,:,.�•, :r, ;, �E ,•� ;,on �o�. �'v �` �.� � _ __
<br /> �c ��
<br /> __ —_ __ ._. - _ _ __
<br /> �.��il_���y iog� E��, �C�Qe�,;�System/As-built drawing ❑Fp�s pe,r locai ordir�c4;-,.p��;.�
<br /> _. . - --
<br /> :erD Other int�ormatio�( ): —
<br /> :v�r:er's ic�,it.�:��tative: `;� ; , ::�. t•.one.
<br /> Cfs^3i'Y �._ .
<br /> _� c� �rx^:.11f"�nrt'�y �c��ae�n ; nnn.r.��_zar,a .
<br /> �-rsre � � 7zM bS1-�A�.;��'l�r,Af1f�/,57-iAF�4�hAR eval,�hle;,iq�ltpenative formats
<br />
|