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Minnesota Pollution Compliance Inspection Farm Control Agency 520 Lafayette Road North Existing Subsurface Sewage Treatment Systems St. Paul, MN 55155-4194 (SSTS) Doc Type: Compliance and Enforcement Instructions: Inspection results based on Minnesota Pollution Control Agency (MPGA) For local tracking purposes: requirements and attached farms — 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 (mmlddlyyyy): 3/27/2020 ® 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) ❑ 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 ❑ Tank Integrity (Compliance Component #2) — Failing to protect groundwater ❑ Other Compliance Conditions (Compliance Component #3) — Failing to protect groundwater ❑ Soil Separation (Compliance Component #4) — Failing to protect groundwater ❑ Operating permit/monitoring plan requirements (Compliance Component #5) — Noncompliant Property Information Parcel ID# or Sec[7wp/Range: 0411723110018 Property address: 2425 Thoroughbred Lane., Orono, MN Property owner: Colin & Julie Davie or Reason for inspection: Property Transfer Owner's phone: Owner's representative: Kevin Stickney Representative phone: 952-250-2015 Local regulatory authority: City of Orono _ Regulatory authority phone: 952-249-4600 Approximately 2-1300 gallon septic tanks, 1-1300 gallon lift station and approximately 680 square feet Brief system description: of mound rockbed. Comments or recommendations: TBM: Top of house block Elv.-1027.4 assumed. The rock bed has 1.5 feet of sand under it. 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: Joseph J Olson Business name: Rusty O 's Soil & Pere. Testing Inspector signature: Necessary or Locally Required Attachments Certification number: 1255 License number: 810 Phone number: _763-498-8779 ® Soil baring 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 formats wq-wwists4-31 • 1124112 Page 1 of 3