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Compliance inspection report form <br />Existing Subsurface Sewage 'T'reatment System (SSTS) <br />Doc Type. Compliance and Enforcement <br />Instructions: Inspection results based on Minnesota i'ol!ution Control Agency (MIDCA) requirements and attached suppor7ing <br />documentation — additional local requirements may also apply. Further information can be found here: <br />Property Information Local trackina number <br />Parcel iD# or Sec/Twp/Range: 3611823310013 Local regulatory authority City of Orono <br />Property address. 280 Wakefield Road. Orono. MN 55391 <br />Ownerlrepresentative. Katherine Batina Owner's phone. <br />Brief system description Pte -cast Septic tanks and rock trench drainfiied <br />System status <br />System status on date (mmiddlyyyy)- 5123/2023 <br />>: Compliant— Certificate of compliance" <br />—j Noncompliant— Notice of noncompliance <br />(Valid for 3 years from report date unless evidence of An immim--mt threat to public health and safety (ITl=HS) must be <br />an imminent Threat to public health or safety requmng upgraded, replaced, or its use discontinued within ten months of <br />removal and abatement under section 145A_04, receipt of this notice or v,,ithin a shorter period if required by <br />subdivision 8 is discovered or a shorter time frame exists local of or under section 145A.04 subdivision 8. <br />in Local 021inancc_) <br />Systems failing to protect ground water must be upgraded. <br />'Note: Compliance indicates conformance with Minn. replaced. or use discontinued within the lime required by local <br />R. 7080.1500 as of system status date above and ordinance <br />does not guarantee future performance. <br />Reason(s) for noncompliance (check all applicable) <br />❑ Impact on public health (Compliance component #11) — lmminent threat to public health and safety <br />Ell Tank integrity (Compliance component #2) — Failing to protect groundwater <br />Other Compliance Conditions (Con.piiance component #3) — imminent tfueat to public health and safety <br />i 1 Other Compliance Conditions (Compliance component #3) — Failing to protect groundwater <br />System not abandoned according to Minn. R_ 7080.2500 iCompliance component #3) -- Failing to .protect groundwater <br />Soil separation (Compliance component #5i - F<riling to protect gr�undc:�ater <br />f Operating permit/monitoring plan requirements (Compliance component #4) — Nom ornptiant - local ordinance applies <br />Comments or recommendations <br />(3) 1000 gallon pre -cast septic tanks. and 400r- Lin feet of Rock Trenches 36 inch depth. Tank baffles on first two tanks are <br />deteriorating and eventually need to be replaced_ Pump tanks every 3 years. <br />Certification <br />hereby certify that alt the necessary information has been gathered to dete[MMO the coanpliance status of this system- No <br />determination of future system peifOlMance has been nor can be made due to unknovvii conditions during system construction, possible <br />abuse of the system, inadequate maintenance. or future water usage. <br />By typing my name below, l certify the above statements to he true and correct, to the best of my knowledge. and that this information <br />can be used for the pufpose-(2fr)-a2 .essir3g this form. <br />Business name. Chip's 'Septic Senhce LLC Certification number: 4761 <br />inspector signature- License number: 2064 <br />(Ti)is ciocwnent !;as beer) electrowcaily s vnec?' Phone: 952-200-3176 <br />Necessary or locally required supporting documentation <br />El Soil observation logs El, Locally required forms] Tank Integrity Assessment Operating Permit <br />Other information (list): <br />rwaw „ !,, 7,-ir eci a 0rvicc, ti.a able ir alternative formats <br />- rge 1 of.; <br />