3325 Lexington Ave - Septic Inspection NONcompliant 2017-07-18 Control Agency Pollution Compliance Inspec Lion Form
Control Agency
520 Lafayette Road North Existing Subsurface Sewage Treatment Systems (SSTS)
5t.Paul,MN 55155-4194 floc Type.Co Wiance and Enforcement
Inspection results based on Minnesota Pollution Control Agency(MPCA) For local tracking PL-poses:
requirements and attached forms—additional local requirements may also apply.
Submit completed form to Local Unit of Government(LUG)and system owner
within 15 days
System Status
System status on date (mmlddlyyyy): 7/18/2017
El Compliant— Certificate of Compliance Noncompliant— Notice of Noncompliance
(Valid for 3 years from report date, unless shorter time (See Upgrade Requirements on pag)3.)
frame outlined in Local Ordinance.)
Reason(s)for noncompliance (check all applicable)
❑ Impact on Public Health (Compliance Component#9)—Imminent threat to public health and safety
❑ Other Compliance Conditions(Compliance Component#3)—Imminent threat to public health anq safety
®Tank Integrity (Compliance Component#2)—Failing to protect groundwater
❑ Other Compliance Conditions(Compliance Component#3)—Failing to protect groundwater
❑ Soil Separation (Compliance Component#4)—Failing to protect groundwater
❑ Operating permit/monitoring plan requirements (Compliance Component#5)—Noncompliant
Property Information Parcel ID#or Sec/Twp/Range:
Property address: _3325 Lexirgton Ave S. Reason for inspection: Transi:r
Property owner: Mac Salvielo=Rivas Owner's phone:
or
Owner's representative: Jeff Oman Representative phone: 612-7(,0-2170
Local regulatory authority: City_Of Ea�c an Regulatory authority phone: 6.°1-675 5_6_71
Brief system description: _6 Ft round_ stave tanker.ravity_drainfield _
Comments or recommendations:
Dirt bottom stave tank is an auto fail
Certification
I hereby certify that all the necessary information has been gathered to determine the compliance status of th, system. No
determination of future system performance has been nor can be made due to unknown conditions during sysi;=m construction,
possible abuse of the system, inadequate maintenance, or future water usage.
Inspector name; Matt Mckinley Certification number: 8067 _
Business name: Mike's Sefic�+Mckinley Sewer Services License number; 2899
Inspector signature: Phone number: 952-440-!800
Necessary or Locally Required Attachments
® Soil boring logs ® System/As-built drawing ® Forms per local ordinance
❑ Other information (list):
www.pca.state.mn.us 651-196-6300 800-657-3864 TTY 651-282.5332 or 800-657-3864 Availab.e in attemative formats
wq•wwists4-31b • 614114
Page 1 of 3
Property address: 3325 Lexington Aue S. Inspector initials/Date: M.M,_7/18/2017
(mm/d&yWy)
1, Impact on Public Health — Compliance component#1 of 5
-Compliance criteria: Verification method(s):
System discharges sewage to the ❑ Yes ® No ® Searched for surface outlet
ground surface. Searched for seeping in yard&F,kup in home
System discharges sewage to drain ❑ Yes ® No ❑ Excessive ponding in soil syster SID-boxes
the or surface waters.
❑ Homeowner testimony(See Corr nents/Explanation)
System causes sewage backup into ❑ Yes ® No ❑ "Black soil'above soil dispersal aystem
dwelling or establishment.
❑ System requires"emergency" pi mping
Any"yes"answer above indicates the ❑ Performed dye test
system is an imminent threat to public ❑ Unable to verify(See Comments/l.xplanation)
health and safety.
❑ Other methods not listed (See Comments/Explanation)
Comments/Explanation:
2. Tank Integrity— Compliance Component#2 of 5
Compliance criteria_ Verification method(s).
System consists of a seeoage pit, ® Yes ❑ No E Probed tank(s)bottom
cesspool, drywell, or leaching pit.
❑ Examined construction records
Seepage pits meeting 7080.2550 may be
compliant if allowed in local ordinance. ❑ Examined Tank Integrity Form (F'tack)
Sewage tank(s) leak below their ® Yes ❑ No ® Observed liquid level below oper iting depth
designed operating depth. ❑ Examined empty(pumped)tank:,$)
If yes, which sewage tank(s) leaks: ❑ Probed outside tank(s)for"black soil"
Unable to verify(See Commenls/E planation)
Any "yes"answer above indicates the
system is failing to protect groundwater. ❑ Other methods not listed (See Co.7mentslExplanation)
Comments/Explanation:
3. Other- Compliance Conditions—Compliance component#3 of 5
a. Maintenance hole covers are damaged, cracked, unsecured,or appear to be structurally unsound. ❑1 as* ®No ❑ Unknown
b. Other issues(electrical hazards,etc.)to immediately and adversely impact public health or safety. El 1 as* E No ❑ Unknown
*System is an imminent threat to public health and safety.
Explain:
c. System is non-protective of ground water for other conditions as determined by inspector. Z Yes* ] No
*System is failing to protect groundwater.
Explain:
Dirt bottom stave tank
www.pca.state.mn,us • 651-296-6300 800-657-3864 TTY 651-282-5332 or Sop-657-3864 • Avaitab.e in alternative formats
wq-wwists4-31b • 614114
Page 2of3
Property address: 3325 Lexington Ave S. _ Inspector initials/Date: am- 1.7/18/2017
(mm/d&yyyy)
4. Soil Separation— Compliance component#4 of 5
Date of installation: _ ® Unknown Verification method(s):
(rrrmlddlyyyy)
ShorelandfWellhead protection/Food beverage Soil observation does not expire. Pr�vious soil
lodging? ❑ Yes ® No observations by two independent pa,fies are sufficient,
unless site conditions have been alt. red or local
Compliance criteria: requirements differ.
For systems built prior to Apt!1, 9996, and ❑ Yes XNo ❑ Conducted soil observation(s) (A ach boring togs)
not located in Shoreland or Wellhead
0
Protection Area or not serving a food, Two previous verifications(Attact boring togs)
beverage or lodging establishment: ❑ Not applicable (Molding tank(s), no lrainfield)
Drainfield has at least a two-foot vertical ❑ Unable to verify(See Comments/E,planation)
separation distance from periodically
saturated soil or bedrock. ❑ Other(See Comments/Explanation)
Non-performance systems built April 9, ❑ Yes ❑ No Comments/Explanation:
9996, or later or for non-performance
systems located in Shoreland or Wellhead No sense doing borings when syster i has stave tank
Protection Areas or serving a food,
beverage. or lodging establishment:
Drainfield has a three-foot vertical
separation distance from periodically
saturated soil or bedrock.*
"Experimental", "Other,, or "Performance" ❑ Yes ❑ No Indicate depths or elevations
systems built under pre-2008 Rules; Type IV — r or V systems built under 2008 Rules(7080. A. Bottom of distribution media
2350 or 7080.2400 (Advanced Inspector
License required) B. Periodically saturated soillbedrock
Drainfield meets the designed vertical -
separation distance from periodically C. _System separation
saturated soil or bedrock.
D. Required compliance separation* _
Any "no"answer above indicates the system is *May be reduced up to 15 percent if i Mowed by Local
failing to protect groundwater. Ordinance.
5. Operating Permit and Nitrogen BMP*— Compliance component #5 of 5 N it applicable
Is the system operated under an Operating Permit? ❑ Yes ❑ No If"yes",A below is required
Is the system required to employ a Nitrogen BMP? ❑ Yes ❑ No If"yes", B below is require d
BMP=Best Management Practice(s)specified in the system design
If the answer to both questions is "no", this section does not need to be completed.
Compliance criteria
a. Operating Permit number:
Have the Operating Permit re uirements been met? El Yes El No
b. Is the required niten BMP in place and properly functioninn_E] Yes❑ No
Any "no"answer indicates Noncompliance.
Upgrade Requirements (Minn. Stat. § 115.55)An imminent threat to public health and safety(ITPMS)must be upgr ded replaced, or its use
discontinued within ten months of receipt of this notice or within a shorter period if required by local ordinance. If the sya tem is failing to protect
ground water, the system must be upgraded, replaced, or its use discontinued within the time required by local ordinanc e. If an existing system
is not failing as defined in law, and has at least two feet of design soil separation, then the system need not be upgrade f, repaired, replaced, or
its use discontinued, notwithstanding any local ordinance that is more strict. This provision does not apply to systems it shoreland areas,
Wellhead Protection Areas, or those used in connection with food, beverage, and lodging establishments as defined in aw.
www.pca.state.mn.us 651-296-6300 800-657-3864 TTY 651-282-5332 or 800-657.3864 • Avaitatje in alternative formats
wq-wwists4-31b • 614114 Page 3 of 3
Minnesota Pollution
Control Agency
520 Lafayette Road North
St. Paul, MN 55155-4194
7 1 i/CornpUance
l
rF r
m
E;z5s ng Stu rosmr ace Sewage Urrea r cel t. Sys sans MS 5)
Doc Type: Compliance and Enforcement
Inspection results based on Minnesota Pollution Control Agency (MPGA)
requirements and attached forms — additional local requirements may also apply.
Submit completed form to Local Unit of Government (LUG) and system owner
within 15 days
System Status
For local tracking purposes:
System status on date (mm/ddiyyyy): 7
Cor ploawt -- cerofcate of Compos&ce
(Valid for 3 years from report date, unless shorter time
frame outlined in Local Ordinance.)
1 orrocompHarot — Notice of iM
(See Upgrade Requirements on page 3.)
ncompHaice
Reason(s) for noncompliance (check all applicable)
❑ Impact on Public Health (Compliance Component #1) — Imminent threat to public health and safety
❑ Other Compliance Conditions (Compliance Component #3) — Imminent threat to public health and safety
❑ Tank Integrity (Compliance Component #2) — Failing to protect groundwater
❑ Other Compliance Conditions (Compliance Component #3) — Failing to protect groundwater
❑ Soil Separation (Compliance Component #4) — Failing to protect groundwater
O Operating permit/monitoring plan requirements (Compliance Component #5) — Noncompliant
Property Information Parcel IO# or Sec/Twp/Range:
ict. e L cl-sG=6t Reason for inspection:
Property address:
Property owner:
or
/390- c
Owner's representative:
Local regulatory authority:
t l
Brief system description W'2pj4 ��.
Comments or recommendations: AI&
Owner's phone: SZ— 2.4,C 7 2_ 10
Representative phone:
Regulatory authority phone: - G l — *co 0
s% /41) ./e4it-ck'e5
Cerrtffrication
I hereby certify that all the necessary information has been gathered to determine the compliance status of this system. No
determination of future system performance has been nor can be made due to unknown conditions during system construction,
possible abuse of the system, inadequate maint ance, or future water usage.
Certification number: 92- s
Inspector name:
Business name: _
Inspector signature -
/7'
Necessary or Locally Required Attachments
0 Soil boring logs i!1 System/As-built drawing
0 Other information (list):
License number: 7
Phone number: 4 s—/- Vc 3 - V
0 Forms per local ordinance
www.pca.state.mn.us 651-296-6300 800-657-3864 0 TTY 651-282-5332 or 800-657-3864 s Available in alternative formats
wq-wwists4-31b 6/4/14
Page 1 of 3
Property address:
, `3z x/ inspector initials/Date: � , i 72_2.Z/ '7
(mmlddlyyyy)
1. Impact on Public Health — Compliance component #1 of 5
Compliance criteria:
System discharges sewage to the ❑ Yes
ground surface.
System discharges sewage to drain j ❑ Yes
tile or surface waters. !�
System causes sewage backup into I 0 Yes
dwelling or establishment.
(V No
r''No
E2rNo
Any "yes" answer above indicates the
system is an imminent threat to public
health a safety.
Comments/Explanation:
2. Tank lntegr ty — Compliance component #2 of 5
Verification method(s):
Searched for surface outlet
(g'Searched for seeping in yard/backup in home
0 Excessive ponding in soil system/D-boxes
Homeowner testimony (See Comments/Explanation)
❑ "Black soil" above soil dispersal system
❑ System requires "emergency" pumping
0 Performed dye test
0 Unable to verify (See Comments/Explanation)
0 Other methods not listed (See Comments/Explanation)
Compliance criteria:
System consists of a seepage pit,
cesspool, drywell, or leaching pit.
Seepage pits meeting 7080.2550 may be
compliant if allowed in local ordinance.
Sewage tank(s) leak below their
designed operating depth.
if yes, which sewage tank(s) leaks:
❑ Yes
!'i
❑ Yes No
Any "yes91 answer above indicates the
system is failing to protect groundwater.
Comments/Explanaition:
Verification method(s):
❑ Probed tank(s) bottom
cg Examined construction records
[] Examined Tank Integrity Form (Attach)
❑ Observed liquid level below operating depth
( Examined empty (pumped) tanks(s) 5
❑ Probed outside tank(s) for "black soil"
❑ Unable to verify (See Comments/Explanation)
0 Other methods not listed (See Comments/Explanation)
3. Other Compliance Conditions — Compliance component #3 of 5
a. Maintenance hole covers are damaged, cracked, unsecured, or appear to be structurally unsound. 0 yes**No 0 Unknown
b. Other issues (electrical hazards, etc.) to immediately and adversely impact public health or safety. 0 Yes* 1)2(43 0 Unknown
*System is an imminent threat to public health and safety.
Explain:
c. System is non -protective of ground water for other conditions as determined by inspector . 0 Yes*
*System is failing to protect groundwater.
Explain:
No
www.pca.state.mn.us 651-296-6300 0 800-657-3864 TTY 651-282-5332 or 800-657-3864 Available in alternative formats
wq-wwists4-31b 6/4/14
Page 2 of 3
Property address: /
4. Sol Separation -- Compliance component #4 of 5
Date of installation:
❑Unknown
(mm/dd/yyyy)
Shoreland/Wellhead protection/Food beverage
lodging? ❑ Yes to
Compliance criteria:
For systems built prior to April 1, 1996, and
not located in Shoreland or Wellhead ❑Yes 0 No
Protection Area or not serving a food,
beverage or lodging establishment:
Drainfield has at least a two -foot vertical
separation distance from periodically
saturated soil or bedrock.
Non-performance systems built April 1 Yes 0 No
1996, or later or for non peffonnance 7`'
systems located in Shoreland or Wellhead
Protection Areas or serving a food,
beverage, or lodging establishment:
Drainfield has a three-foot vertical
separation distance from periodically
saturated soil or bedrock.*
"Experimental", "Other", or "Performance"
systems built under pre -2008 Rules; Type IV ❑Yes 0 No
or V systems built under 2008 Rules (7080.
2350 or 7080.2400 (Advanced Inspector
License required)
Drainfield meets the designed vertical
separation distance from periodically
saturated soil or bedrock.
Any "no" answer above indicates the system is
failing to protect groundwater.
Inspector initials/Date. S 1 7--Z2— / 2
(mm/dd/yyyy)
Verification method(s):
Soil observation does not expire. Previous soil
observations by two independent parties are sufficient,
unless site conditions have been altered or local
requirements differ.
1
Conducted soil observations) re l da�.�
❑ Two previous verifications (Attach boring logs)
❑ Not applicable (Holding tank(s), no drainfield)
❑ Unable to verify (See Comments/Explanation)
❑ Other (See Comments/Explanation)
Comments/Explanation: Sc. e
Indicate depths or elevations
A. Bottom of distribution media
y ter
B. Periodical!
saturated soil/bedrock
C. S stem se. aration
D. Re.uired compliance se.aration* 3 /
*May be reduced up to 15 percent if allowed by Local
Ordinance.
5. Operating Permit and Nitrogen BMP*— Compliance component
Is the system operated under an Operating Permit?p #5 of 5 �!� Not applicable
0 Yes 0 No If "yes", A below is required
Is the system required to employ a Nitrogen BMP?
0 Yes 0 No If "yes", B below is required
BMP = Best Management Practice(s) specified in the system design
If the answer to both questions is "no", this section does not need to be completed_
Compliance criteria
a. Operating Permit number:
Have the 0 eratin. Permit re
b. Is the re
uired nitro
uirements been met?
en BMP in
lace and
ro
eri
Any "ego" answer indicates Noncompliancenctionin
Upgrade Requirements (Minn. Stat. § 115.55) An imminent threat to public health and safety (ITPHS)must be
discontinued within ten months of receipt of this notice or within a shorter period if required by local ordinance. If the
to protect
ground water, the system must be u upgraded, replaced, or its use
upgraded, replaced, or its use discontinued within the time required by local ordinance. if an exisis ting system
is not failing as defined in law, and has at least two feet of design soil separation, then the system need not be upgraded,
its use discontinued, notwithstanding any local ordinance that is more strict. This provision does not apply to systems in shoreland areas,
Wellhead Protection Areas, or those used in connection with food, beverage, and lodging estab/ishments as defined
ed, repaired, replaced or
d in law.
www.pCa.state.mn.us 651-296-6300
• wq-wwists4-iib 800-657-3864 • TTY 65i -Z82-5332 or 800-657-3864 • Available in alternative formats
6/4/ 14
Page 3 of 3
❑Yes 0 N
❑ Yes ❑ No
OIC -SITE SEWAGE TREATMENT SYSTEM - INSPECTION REPORT
Applicant and Permit #:
�.
Inspected by: ('):7&-
Municipality/Township: '
/- /771 #
Date of Inspection: 74 2F -i77-‘51
Parcel ID: �J
Site Address: /?9o- / 4 % /�
# Soil Borings
#Perc Test
7 Average Perc Rate
Oar)
Reserve Area:
0
moi' Depth to Restriction
(inches)
Type Mout' Sedro* WaLcr table
�! C 7 Acceptance Rate
(sq- FugPd)
House Type: I II III
Garbage Disposal: Yes / No
# of Bedrooms
# Potential Bedrooms
f Number of Septic Tanks
Capacity (1,000 g. Iviin.)
Pre fab Tank Mode1:(Y—est No
L-7 Outlet Baffle (35% of total liquid
depth- 6" above liquid surface)
1 Liquid Depth (30" min.)
.:1.. 1. �•.Vi
N' .l -
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w !Property Lines (10')
) s Well (75')
Outlet a min. 3" below inlet
Horizontal Dimension (24" min.)
Tank is level
Inlet Baffle (6" below liquid -1"
abo�sc inlet =um)
Watertight Construction
/Buildings (10')
•
/'./. Recreation & Tributary (75')
>?dBundings (20')
to i Large Trees (10')
(Property Property Lines (10')
t:1•.ti.'_:•: _:r_y�l..:::.'.':.�:::.:L:•IJ �.; ti: >•I_
•
/11,41 Recreation & Tributary (75')
‘,) Well (50' or 100')
(Inspection Pipes (4" )
Manhole (24" min.)
Pumping tank Yes f( )
Capacity
} i ` Buried Water Pressure Pipes
(10')
X. . All others except Rec. & Trib.
(150')
M._ All others except Rec. & Trib.
(150')
Buried Water Pressure Lines
(lo')
(-7 Watertight Construction
Inlet Inverts (1" above outlet
invert)
Pipe Connection
Pipe to Drop Box (unperforated)
Outlet Inverts (4" above floor)
yBox is Level
Distribution: ravityJ Pressure
_) Number of Laterals
/2 Rock Under Pipe (6"-24")
/0 Lateral Lengths (Zoo' mac)
`f Rock Over Pipe (2")
/8 Total Trench Depth
inches
re?.. Total Sq. Ft. Trench Area
Site Drawing:
Y
Trench Widths (111" min. - 36"
max) .
Rock is Covered (with walcr
porous mal)
r
I D LateralSpacing (T on arrtcx
>3c q Bottom of Trench to Water
inches Table or Bedrock
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Designer: 4_ c
Installer: ` i
r.“
Approved:Yes /No
Signature:,