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M MINNESOTA POLLUTION Compliance inspection report form <br />CONTROL AGENCY p <br />520 Lafayette Road North Existing Subsurface Sewage Treatment System (SSTS) <br />St. Paul, MN 55155-4194 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 />https://www.pca.state.mn.us/sites/default/files/wq-wwists4-31 a.pdf. <br />Inspector must submit completed form to Local Governmental Unit (LGU) and system owner within 15 days of final <br />determination of compliance or noncompliance. <br />Property information Local tracking number: <br />Parcel ID# or Sec/Twp/Range: 0311723220014 Local regulatory authority: City of Orono <br />Property address: 2320 Devin Lane, Orono, MN 55391 _ <br />Owner/representative: Lois Sonstegard _ Owner's phone: (0/2 - <br />Brief system description: Pre -cast Septic tanks and rock trench drainfiled <br />System status <br />System status on date (mm/dd/yyyy). 7/27/2023 <br />❑ Compliant— Certificate of compliance* <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 (ITPHS) 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 permit/monitoring plan requirements (Compliance component #4) — Noncompliant - local ordinance applies <br />Comments or recommendations <br />Drainfield does not meet seperation from season watertable. System will need to be upgraded to meet current septic codes as <br />requried by the City of Orono. <br />Certification <br />1 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 below, I certify the above statements to be true and correct, to the best of my knowledge, and that this information <br />can be used for the purpose of processing this form. <br />Business name: Chip's ptic Servl Certification number: 4761 <br />Inspector signature: License number: 2064 <br />(This docu nt has been electronically signed) Phone: 952-200-3176 <br />Necessary or locally required supporting documentation nust be attached) <br />® Soil observation logs ❑ Locally required forms ❑ Tank Integrity Assessment ❑ Operating Permit <br />❑ Other information (list): <br />https://www.pca.state.mn.us e 651-296-6300 800-657-3864 Use your preferred relay service Available in alternative formats <br />wq-wwists4-31b • 1/11/21 Poge 1 cf 4 <br />