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ON-SITE SEWAGE TREATMENT <br />INSPECTION REPORT <br />OWNER7 ADDRESS <br />PERMIT NO.'S- -- - — DATES <br />On I'hi %or►b .Shore• nj <br />I.ake• Ninnei►onka <br />POST OFFICE BOX 66 <br />1335 S. Brovin Rd. <br />Crystal Bay, MN 55323 <br />473-7357 <br />_37573 P.11 -de - <br />If <br />-- CONTRACTOkb 1 '4tSal^ lid. <br />City Ordinance No. 210 requires Mal eai, on-site sewage treatmertr system in Ororm he inspected on a regular basis. The on-site sawale <br />treatment system at he ]hove address has bet- .respected and appears to fall into the category checked below <br />(This is A an existing system J new construction) <br />jr 1 Meets or exceeds current City standards in all respects relating to design, construction. and location Appears tc be operating <br />of sperly <br />a2 Does not meet all c✓•ent City standards for new construction 11978 Cnde) but in most respects appear to ter designed <br />located, and constructed generally in accordance with previous codes. System appears to be, functioning properls,. no major <br />upgrading of Me system -• required at this time <br />3 Does not men current City standards in many respects relating to design, construction. or location Appears to be operating <br />adequately at this time. but has a relatively h.yh potential for future problems. No major upgrading of system is requited at <br />this time <br />❑ 4 System may or may not meet currew City standards for design, construction or location, but is fading to properly Leat and <br />dispose of the current input and is endangering a water supfdy. or is a source of pollution to surface a groundwaters car is <br />creating a safety hazard. or is otherwise. creating a public nuisance. Please contact the City Inspector to discuss system repair, <br />ferilaceme it procedures. 11 draintield repiacemen! is necessary, sod testing will usually he required, and a design and site plan <br />must be submitted for review Your contractor iriuir obtain a permit before work is started <br />SYSTEM CONDITION 1 [Z Checked items may ie4.­ your achoi.l <br />Tank inspection indicates <br />G Pumpout not needed at this time <br />❑ Solids accumulation in tanks indicates they should be puu p- <br />ad out this year to help prevent future problems <br />❑ Solids accumulation in tanks is at a critical level Taniy <br />should be pumped out as soon as possible <br />❑ System is discharging to surface Tena roust he uurniien <br />Within 48 hours to eliminate surface discharge <br />❑ Inspection risers mining- tanks could not tie insper tf•,1 <br />Inspection risers 14" din pipe) must be installed in each tans <br />at next pumpout If tanks have not been pumped out within <br />the last three years. they should be pumped out now <br />SITE CHARACTERISTICS <br />Limiting Site Factors <br />❑ Slope <br />❑ Soil <br />❑ Mph water table <br />❑ Lot site <br />❑ Lake, wetland, or stream <br />❑ Drainage <br />COMMENTS <br />Date of Inspection <br />- 4 Inspection pipe is located directly over tank baffle. (Does not <br />+s give acruHte maMurensant of solids accumulation I It tanks <br />have not been pumped out within the lest three years. they <br />should be pumped out now. <br />Grainfield inspection indicates <br />ID-snamfield is dry, no surfacing evident <br />1 Some evidence of surfacing, not critical yet <br />Grainfield is saturated and visibly discharging untreated <br />effluent to the surface. This condition may require replace- <br />ment or additions to drasnfield. Contact the City Inspector <br />immediately Repairs must be completed within 90 days. <br />[� G.ainlieid extent and condition unknown. <br />Potential for System Failure <br />(depends on soil types. water <br />table, and system conditronl <br />11 Low <br />%Med.urn <br />(�] High <br />❑ System is carving visible <br />surface discharoe_ <br />is System Inspector <br />Site Capabdtttes for <br />F Mute Expansion <br />[_; Adequate <br />Dk F air <br />❑ Poor <br />(" Inadequate <br />Note. In the event Mat this inspection report is used to satisfy the requirements lot a mortgage or other transfer of property, he advised that <br />this report does not gus.entae or certify that an existing system will con, ore to function properly, but is merely an opinion of the adequacy <br />of the system under current conditions based on the available information <br />This report must he kept on the premises with sysicm location and pumping records <br />WHITE COPY i Inspector's File GOLD COPY i Homeowner <br />