Laserfiche WebLink
04/08/2016 8: 54AM FAX 9528733112 �0001/0004 <br /> �;��� MinnesoCa Pollution ` <br /> � ControlA�ency Comp��ance Insr�Ct�On FQ["m <br /> 5201.afayette Road North �xisting Subsurface Sewage Treatm�nt Systems (SSTS) <br /> 5t.Paut,MN S5iS5•4194 Doc Fype�Comp/iance and Eoforcemont <br /> Inspectipn YBsults based on Minnesota Pollution Control qgency(MPGA} For loca!tracking purposes: <br /> requlrements and attached forms—additional local requirements may also apply. RE`,E�VE� <br /> Submit completed form to Local Unit of Government(LUG)and system owner <br /> wlthin 15 days � �� �� � <br /> System Sta#us CITY OF ORONO <br /> System status on date(mmlddfyyyy): 4/6/2p16 <br /> � Compliant— Certificate of Compliance ❑ Noncompliant— Natice of Noncompliance <br /> (V8lid for 3 years from roport date, unless sholYer time (See Upg�ade Requlrements on page 3.) <br /> frame outlined in Loca!Ordln&nce.) <br /> Reason(s)for�oncompliance (check a!!app!lcable) <br /> ❑ Impact on Publie Health(Compllance Cornponent#1J—lmminent threat to publlc hea/th and safety <br /> ❑ �ther Compliance Conditions(Comp!lance Component#3)—Imminent th,e�at to public health and sefety <br /> �Tank Integrity(Complianco Componenf#2)—Failing to protect grnundwafer <br /> ❑ Other Gompliance Canditions(Complianee Component#13)—Failing to protect groundwater <br /> ❑ Soil Separation(Campllance Component#4)--Falling to protecf groundwater <br /> ❑ Operating permit/manitoring plan requirements(Compliance ComponEnt#5)—Noncompliant <br /> Property Enformation Parcel ID#or Sec/Twp/Range: <br /> Property address- 140 South Brown Roed,Orono>Mn Reason for inspection: Sale <br /> Property owner poug Coleman Owner's phone: 952-473-7236 <br /> or <br /> owrter's representative: _ Representative phone: <br /> Local regulatory authority: _ Regufatory guthority phone: <br /> Brief system descriptian; � — <br /> Comments or recommendations: <br /> Certification <br /> I hereby eertify that a!I the necessary iniormation has been gafhered to determine the campliance sfatus of thls system, No <br /> determination of future system performance has boen nor can be made due t�unknown canditions during system construction, <br /> possible abuse of the system,(nedequate mAintenaRCe, or future water usage. <br /> Inspector name� Josh Swedlund Certification number: C1689 <br /> Business name: Swedlund Se tic S ice License number: 2502 <br /> Inspactor slgnature: _ Phone number: 952-873-3292 <br /> Necessary or Locally Required Attachments <br /> �Soil boring lags �System/As-built drawin <br /> 9 � Forms per local ordinance <br /> ❑ dther inform&tion(list)� <br /> www.pcastate.mn.us . 651-296-6300 - 800-es�-3864 • TTY 651•282-5332 or800-657-3864 • Availablein alternative formats <br /> wq-wwists4-31 • .3/16/12 Page 1 of 3 <br />