05-22-22 Septic Compliance Inspection

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MINNESOTA P LLUTION Compliance inspection report form CONTROL AGENCY h' 520 Lafayette Road North Existing Subsurface Sewage Treatment System (SS'T's) St. Paul, MN 55155-4194 Doc Type. Compliance and Enforcement Instructions: Inspection results based on Minnesota Pollution Control Agency (MPCA) requirements and attached supporting documentation - additional local requirements may also apply. Further information can be found here: rhJp�,, / ,ry w,Dca.state._E in.us/site/default/files/wg� 1sts4-31a.pdf. ( r v0C4 for-na f.,.o. err +trf. -.. z of i w s,. �i �tia E rt�;r�- 4...a Property information Local tracking number: Parcel ID# or Sec/Twp/Range: Local regulatory authority: City of Orono Property address: 1520 Tanglewood Road, Orono Owner/representative: Dr.. Roby Thompson Owner's phone: 952-475-1294 Brief system description: 2-1000 gal precast tanks from original system, newer 1000 gal pump tank with a mound System status System status on date (mrn/dd/yyyy): 5/22/2022 ® Compliant -Certificate of compliance* ❑ Noncompliant - Notice of noncompliance (Valid for 3 years from report date unless evidence of An imminent threat to public health and safety (I TPHS) must be an irnminent threat to public health or safety requiring upgraded, replaced, or its use discontinued within ten months of removal and abatement under section 145A.04, receipt of this notice or within a shorter period if required by subdivision 8 is discovered or a shorter time frame exists local ordinance or under section 145A.04 subdivision 8. in Local Ordinance.) Systems failing to protect ground water must be upgraded, *Note: Compliance indicates conformance with Minn. replaced, or use discontinued within the time required by local R. 7080.9500 as of system status date above and ordinance. does not guarantee future performance. Reason(s) for noncompliance (check all applicable) ❑ Impact on public health (Compliance component #1) - Imminent threat to public health and safety ❑ Tank integrity (Compliance component #2) - Failing to protect groundwater ❑ Other Compliance Conditions (Compliance component #3) - imminent threat to public health and safety ❑ Other Compliance Conditions (Compliance component #3) - Failing to protect groundwater ❑ System not abandoned according to Minn. R. 7080.2500 (Compliance component #3) - Failing to protect groundwater ❑ Soil separation (Compliance component #5) - Failing to protect groundwater ❑ Operating permit/monitoring plan requirements (Compliance component #4) - Noncompliant - local ordinance applies Comments or recommendations W. �, � s11 1 hereby certify that all the necessary infonnation has been gathered to determine the compliance status of this systern. No detennination 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. By typing my name below, I certify the above statements to be true and correct, to the best of my knowledge, and that this infonnation can be used for the purpose of professing this,fo n. Business name: Sewer See's ) x Certification number: C1659 Inspector signature: V�License number: 2502 his docrYinent has been electror Cally signed) Phone 952-873-3292 Necessary or locally required supporting documentation at tize,. ❑ Soil observation logs ❑ Locally required forms ❑ Tank Integrity Assessment ❑ Operating Permit ❑ Other information (list): https://www.pca.state.mn.us 651-296,6300 800-657-3864 • Use your preferred relay service • Available in alternative formats wq-wwists4-31b • 1/11/21 Page 1 of 4