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Property address: 3240 Sixth Ave.N.,Orono,MN Inspector initials/Date: J.O.8/15/18 4. SOiI SepdratiOn—Compliance component#4 of 5 Date of instailation: 2/13/97 �Unknown Verification method(s): Shorela�dlWelihead protection/Food Beverage �Yes ❑No Soil observation does not expire. P�vious soi! Lodging? obse�vations by two independenf partres are sulTicient, Compllance criteria: unless site conditions have been altened or local requirements differ. For systems built prior to April 1, 1996, and ❑Yes ❑No not located in Shonalend or Wellhead � Conducted soil observation(s)(ABach boring Jogs) Pratection Area ornot serving a food, ❑ Two previous verifications(Attach boring logs) beverage orlodging establishment: ❑ Not applicable(Holding tank(s),no drainfield) Drainfield has at least a two-foot vertical ❑ Unable to verify(See Comments/E�cplanation) separation distance from periodically , ❑ Other(See Comments/Explana6on) saturated soil or bedrock. ! Non-pedormance systems built Ap�i11, , �Yes ❑No CommentsJ�xplanation: 1996,or/afer or for non-performance � systems located in Shoreland or Wellhead ; Protection Areas or serving a food, ' beverage, orlodging esfablishmer►t: Drainfield has a three-foot vertical separation distance from periodically saturated soil or bedrock* "Experimental" "Othe�;or 'Performance" ❑Yes ❑No Indicate depths of elevations systems built under pre-2008 Rules;Type lV - or V systems built under 2008 Rules(7080. A. Bottom oi distribution media 102.4 2350 or 7080.2400 (Advanced Inspector I ' License required) ; B. Periodically saturated soiubedrock �99.8 � Drainfield meets the designed vertical ' C. System separation ` 2.6 separation distance from periodicaUy — , - -— saturated Soil o�bedrock. D. Required compliance separation` � 2.6 _. _..— ARy "no"answer above indlcates the system is *May be reduced up to 15 percent if allowed by Local Failing to Protect Groundwater. Ordinance. 5. Operating Permit and Nitrogen BMP*-Comp�iance component#5 of 5 �Not 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 required 8MP=8est Managemenf 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 requirements been met? ; ❑Yes ❑No b. Is the required nitrogen BMP in place and prope�ly functioning? ❑Yes ❑ No Any "no"answer indicates Noncompliance. Upgrade Requirements(Minn.Stet§115.55)An imminent threat to public health and safety(lTPHS)must be upgraded,replaced,or iis use discontinued w'rthin ten months of receipt of this notice or within a shorter period if required by/ocal ordinance.!f the system is feiling to protect qround water,the system must be upgreded,replaced,or its use discontinued within the time required by Jocal oniinance.If an existing system is npt failing as defined in law,and has at least hvo feet of design soil seperation,then the system need not be upgiaded,repaired,replaced,or its use discontinued,notwrthstanding any loca/ordinance that is more strict. This prov�'sion does not apply to systems in shoreland areas, Welthead Protection Areas,or those used in connection with food,beverage,and lodying establishments as de�ned in law. _ _— _ _ _— - www.pca.state.mn.us • 651-296•6300 • 800•657•3864 • TTY 651-282-5332 or 800-657•3864 • Available in altemative formats wq-wwisrs4-31 • 1/24/12 Page 3 oj 3