Laserfiche WebLink
May 05 2015 02:35PM HP FaxRusty Olson 7634988290 page 2 <br /> • <br /> ControlMinnesota Pollution Compliance Inspection Form <br /> Agency <br /> 520 Lafayette Road North Existing Subsurface Sewage Treatment Systems <br /> St.Paul,MN 551S5-4194 (SSTS) <br /> Doc Type:Compliance and Enforcement <br /> instructions: Inspection results based on Minnesota Pollution Control Agency(MPGA) For local tracking purposes: <br /> requirements and attached forms-additional local requirements may also apply. RECEIVED <br /> Submit completed form to Local Unit of Government(LUG)and system owner <br /> within 15 days AY 1 1 20' <br /> System Status CITY OF ORONO <br /> System status on date(mmidd/yyyy): 5/1/2015 <br /> ® Compliant—Certificate of Compliance El Noncompliant— Notice of Noncompliance <br /> (Valid for 3 years from report date,unless shorter time (See Upgrade Requirements on page 3) <br /> frame outlined in Local 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 /> ❑ Other Compliance Conditions(Compliance Component#3)-imminent threat to public health and safety <br /> ❑Tank Integrity(Compliance Component #2)-Failing to protect groundwater <br /> ❑ Other Compliance Conditions(Compliance Component#3)-Failing to protect groundwater <br /> ❑Soil Separation (Compliance Component #4)-Failing to protect groundwater <br /> ❑Operating permit/monitoring plan requirements(Compliance Component #5)-Noncompliant <br /> Property Information Parcel ID#or Secrrwp/Range: 31511823340005 <br /> Property address: 40 Orono Orchard Road, Orono,MN - Reason for inspection: Properly Transfer _ <br /> Property owner: David Struyk Owner's phone: 612-9617801 <br /> or <br /> Owner's representative: _ Representative phone: <br /> Local regulatory authority: City of Orono Regulatory authority phone: 952-249-4600 <br /> 2-1000 gallon septic tanks,1-1000 gallon lift station and 500 square feet of mound rockbed. per city <br /> Brief system description: records <br /> Comments or recommendations: <br /> The system should have the trees removed that are growing through it. <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, <br /> possible abuse of the system, inadequate maintenance, or future water usage. <br /> Inspector name: Joseph J Olson Certification number: 1255 <br /> Business name: Rusty Olson's Soil& Pere.Testing License number 810 <br /> Inspector signature: Phone number: 763-498-8779 <br /> Necessary or Locally Required Attachments <br /> Soil boring logs ® : -tern/As-built drawing El Forms per local ordinance <br /> ❑ Other information (list ' s <br /> www.pca.state.mn.us • 651-296-6300 • 800-657-3864 • TTY 651-282-5332 or 800.657-3864 • Available in alternative formats <br /> wq-wwists4-31 • 1124/12 <br /> Page 1of3 <br />