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MINNESOTA POLLUTION <br />CONTROL AGENCY Comp p Compliance inspection report form <br />520 Lafayette Road North Existing Subsurface Sewage Treatment System (SSTS) <br />St. Paul, MN 55155-4194 <br />Doc Type: Compliance and Enforcement <br />Instructions: Inspection results based on Minnesota Pollution Control Agency (MPCA) requirements and attached supporting <br />documentation – additional local requirements may also apply. Further information can be found here: <br />hftps://www.pca.state.mn.us/sites/default/files/wg-wwists4-31a pdf. <br />Inspector must submit completed form to Local Governmental Unit (LGU) and system owner within 15 days of f nal <br />determination of compliance or noncompliance. <br />Property information Local trackinc number <br />Parcel ID# or Sec/Twp/Range: Local regulatory authority: City of Orono <br />—.— - -- _. <br />Property address: 2460 Thouroughbred Lane Orono --- <br />Owner/representative: Joe Coianni _ _ Owner's phone: 952-22.1-5711 <br />Brief system description: 2 - 1300 gallon septic & 1300�c anon pump tank with_a mound system <br />System status <br />system status on date (mm/dd/yyyy): 2/16/2922 _ <br />® Compliant–Certificate ofcompliancet' <br />(Valid for 3 years from report date unless evidence of <br />an imminent threat to public health or safety requiring <br />removal and abatement under section 145A.04, <br />subdivision 8 is discovered or a shorter time frame exists <br />in Local Ordinance.) <br />*Note: Compliance indicates conformance with Minn. <br />R. 7080.1500 as of system status date above and <br />does not guarantee future performance. <br />❑ Noncompliant – Notice of noncompliance <br />An imminent threat to public health and safety (17'PHS) must be <br />upgraded, replaced, or its use discontinued within ten months of <br />receipt of this notice or within a shorter period if required by <br />local ordinance or under section 145A.04 subdivision 8. <br />Systems failing to protect ground water must be upgraded, <br />replaced, or use discontinued within the time required by local <br />ordinance. <br />Reason(s) for noncompliance (check all applicable) <br />❑ Impact on public health (Compliance component #1) –Imminent threat to public health and safety <br />❑ Tank integrity (Compliance component #2) – Failing to protect groundwater <br />❑ Other Compliance Conditions (Compliance component #3) – Imminent threat to public health and safety <br />❑ Other Compliance Conditions (Compliance component #3) – Failing to protect groundwater <br />❑ System not abandoned according to Minn. R. 7080.2500 (Compliance component #3) – Failing to protect groundwater <br />❑ Soil separation (Compliance component #5) – Failing to protect groundwater <br />❑ Operating permittmonitoring plan requirements (Compliance component #4) – Noncompliant -local ordinance applies <br />Comments or recommendations <br />Certification <br />I hereby certify that all the necessary information has been gathered to determine the compliance status of this system. No <br />determination of future system performance has been nor can be made due to unknown conditions during system construction, possible <br />abuse of the system, inadequate maintenance, or future water usage. <br />By typing my name bAofsing <br />e above statements to be, true an rrect, to the best of my knowledge, and that this information <br />can be used for the puing form.Business name: Se _ _ Certification number: C1659Inspector signature:_License number: 2502 _asbee lec onically sig ) Phone: 952-873-3292�Necessary or loed supporting documentation (must be attached) —� <br />® Soil observation logs ® Locally required forms ® Tank Integrity Assessment <br />El Operating Permit <br />❑ Other information (list): <br />https://www.pca.state.mn.us 651-296-6300 800-657-3864 Use your preferred relay service Available in alternative formats <br />wq-wwists4-316 • 1/11/21 <br />Poge l of 4 <br />