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Ju1051210:15p Joseph Olson 763-498-8290 p.4 <br /> , <br /> Property add�ess: 805 Stubbs BaY Road N_, Orono MN �nspector initialsJDate: J.O.7/2/12 <br /> 4. Soil Separation--Com�liance oomponent#4 of 5 <br /> Date of installation: 12l29l94 p unknown Verlfication meEhod(s): <br /> ShoielaAdNvallhead pnabmefionlFood Be+rerage �Yes ❑No Svr7 observafion does rlo! <br /> i.cdpi�9'? expins•P�svious sor7 <br /> observafions 6y Iwo independe►rt pa�tles sre scrllCier�#, <br /> Compl�ance c�iteria: unless si(e ovrrdrdans have been alfered orbcal <br /> For syslems 6tiilt p�or b Ap�l 7, l996,and ❑Yes ❑ Nfo �qW��"'Onts di�isr, <br /> no?bcafed in Shone/and or Wrellhead � Conduc�ed sa I obsenraaon(s)(q�ach boriny� <br /> Pr�t+ecdion Area ornat senring e fnod. ❑ Two prerio�s verifications(Anach borfn9 Jogs) <br /> 6eve�age or lodging esfablishmer�t: <br /> � Not applicable Moldin9�n�clsl, no drsin�,eld1 <br /> Drai�field has at least a two-fioot vertical ❑ Unable to verify(See ConmenWExplansf/on) <br /> separatbn distanc�fr�m periodically � pW��Ses Gbn►me <br /> satu�aded soil or bedrock. �a��►1 <br /> Narperiormance sysGemsbw7tAprif 1, �Yes ❑ No CommerK�/F�cplanatlon: <br /> 1998,or later or fnr narperfwmance <br /> systsms lbcated�S'horeJand or WeJlhead <br /> Protedion Areas orserving a food, <br /> bevera9e, o�fpdg'mg estabfishme»t: <br /> �rainfield has a fhree-foot verticat <br /> separation dstance irorn periodicaliy <br /> sahrated sal cr bedrodc� <br /> '�iCP��"• "��°, or Perfomrar►ce' ❑Yes ❑Na Indicabe ds hs of e�evations <br /> syatems b[nytunderp�re-2008 Rule�Type IV <br /> or ysystemsbuiftunder20�8 RWes(7080. A eottom of d�stnbution media 101.8 <br /> 2350 or 7080.2400 (Acfvanoad Inspec�or <br /> LicenSe requiCed} B. Periodical saturabed soiUbedrock 98.fi <br /> Drai�'ield rtteets the de�gned vertical C. m se araG'ron 3.0 <br /> separation distanoe froan periodically <br /> saturdted Soil or bedrock. D. u�ed com lianoe ration' 2 G <br /> Ar�y"no"answer above inaf'icates the sysi�em is -p�ay pe reduced up m�c5�ercent if allow�by LL�occai <br /> Failing to Protect'Groundwater. Ordnance. <br /> 5. Operating Permi# and Nitro�en BAAP"`—Compliance cao�rn ponent�,5 of 5 � Not appticable <br /> Is the system operated urtder an Operating Permit? ❑Yes ❑ No If"yes",A below is requlred <br /> Is the syst�n required bo empby a Nitrogen BMP? ❑Yes ❑ No !f"yes".B below is r+equired <br /> BMP=Besf IKenagement Pracdce{s)sFecrfred ai tite sysiem desig� <br /> /i'iEhe answe�r to botf►questions is"no'; thls sectiorr does not need M be complefed. <br /> Com liance criteria <br /> a. Operating Pemrit number. <br /> Have fhe eratin Perrn�t uirements been met? ❑Yes ❑No <br /> b. Is the uired ni en BMP in and ro tl fuodioni ? Yes No <br /> Any"no"'answerindcatas Noncompliance. <br /> Upg�e Requirdnst�s(tifrnn.SYsE§i1�55J M hnrranent tineet[o p�lic heslth and sefety(IiPHS)must be upgraded,replec�d,or ita use <br /> ��continued w�7hFn!en mon�a o�reoelpf�this nofke or wr7hFn a shaterperiod r7requ�od Dy/xa/or�eooe.If fhe syst�n ls feilln�to proted <br /> p�nound weter,tlte system must 6e upgrad�d.►eplsard,or Ks use d'rsaarrttnued n�ln Ehe fime requUed by locaf ortibnaxe.Kan eorlsdng system <br /> is rrot faiGmg es derined in faw,and hes at�M�o I�et of dasign sa1 s�aparslfon,then t/►e system rtsed not be vpgradea reroelred replace�or <br /> ils use disoon[inued,n�ir�g arry locai adfianae that i.s mars sbid This pr�n►sion does not ap�ly to systems M sharelsnd a�19e� <br /> Wei�heed Protection kreas,or tho�used'm oortnectbn v�fooJ,beve�agis,and lod�inq estsblisAmen�s as delFned in lew. <br /> www.pca.s�te.mn.us • 651-296-6300 • 80D-657-3864 • TTY 651 282-5332 or 80Q-657-3864 • Avaitable in�temativoe formats <br />