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ON-SITE SEWAGE TREATMENT <br />INSPECTION REPORT <br />OWNER <br />PHONE.. PERMIT NO'S. <br />.ADDRESS. <br />On the North Shore of <br />Lake Minnetonka <br />POST OFFICE BOX 66 <br />1336 S. Brovim Rd. <br />Crystal Bay, MN 66323 <br />473-7367 <br />/SVD <br />_________DATES __________ <br />jAOLfSG -sysre?n <br />City Ordinancs No. 210 requires thet each on-site sewage treatment system in Oror>o be inspected on a regular basis. <br />The on-site sewage treatment system at the above address has been inspected and appears to fall into the category checked <br />below: <br />1 <br />□ 2 <br />□ 3 <br />□ 4 <br />Meets or exceeds current city standards in all respectt relating to design, construction, and location. Appear: <br />to be operating properly. ^ <br />Does not nteet current city standards in some respects relating to design, construction, or location. Appears <br />to be operating properly. <br />Does not meet current city standards in many respecu relating to design, construction, or location. Appears <br />to be operating adequately. <br />Does not meet current city standards of design, construction or location, is being overused, or is failing to <br />properly treat and dispose of the current input and is therefore endangering a water supply, is a source of <br />pollution to surface or groundwaters, is creating a safety hazard, or is otherwise creating a public nuisance. <br />Please contact the inspector to discuss requirements for repairs to your system. Soil testing may be re­ <br />quired. In all cases a design and site plan must be submitted for review. Your contractor must obtain a permit <br />before work is started. <br />WORK REQUIRED:w n Septic tanks must be pumped within 48 hours. <br />[~~| Drainfield must be repaired or replaced within 90 days. <br />r~| Inspection riser (4" diem, pipe) mutt be installed in each tank. <br />Tank inspection indicates maintenance pumpout it needed at soon as pouible. City ordinance requires that <br />tanks be pumped out every three years. <br />SITE CHARACTERISTICS: <br />Limiting Site Factors <br />□ Slope <br />□ Soil <br />□High water table <br />□Lot size <br />^PfLake. wetland, or stream <br />QDrainage <br />Potential for System Failure <br />(depends on toil types, water <br />table, and system condition) <br />JBJ-ovv <br />□ Medium <br />□ High <br />□ System is causing visible <br />surface discharge. <br />Site Capabilities for <br />Future Expansion <br />Hy Adequate <br />□ Fair <br />□ Poor <br />□ Inadequate <br />COMMENTS:./AJ sm^jjLAT70A) <br />Date of Inspection <br />^ I) <br />' Septic System <br />This report must be kept on the premi.es with system location and pumping records. <br />WHITE COPY / Inspector's File GOLD COPY / Homeowner