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May 22 13 08:55a Joseph Olson 763-498-8290 p.4 Property address: 2425 Throughbred Lane Orono MN _ Inspector initials/Date: J.0.05120113 4. Sail Separation—Compliance component#4 of 5 Date of installation: 9/23/96 ❑Unknown Verification method(s): ShorelLodgiin /MVellhead protectioNFood Beverage Lodging? ❑Yes 0 No Soil observation does not expire_Previous soil observations by two independent parties are sufficient, Compliance criteria: unless site conditions have been altered or local For systems built prior to April 1, 1996,and ❑Yes ❑No requirements differ. not located in Shoreland or Wellhead ® Conducted soil observation(s)(Attach boring logs) Protection Area or not serving a food, ❑ Two previous verifications(Attach boring logs) beverage or lodging establishment ❑ Not applicable(Holding tarNc(s),no drainfield) Drainfield has at least a two-foot vertical ❑ unable to verify(See CommenwExplanation) separation distance from periodically saturated soil or bedrock. ❑ Other(See Commenwiaplana6m) Non-performance systems built April 1, ®Yes ❑ No Comrnents/Explanation: 1996. or later or for non-performance systems located in Shoreland or Wellhead Protection Areas or serving a food, beverage,orlodgrngestablishment Drainfield has a three-foot vertical separation distance from periodically saturated soil or bedrock.* 'Experimental" "Other',or Performance" ❑Yes ❑No Indicate depths of elevations Systems built under pre-2008 Rules,Type 1V or V systems built under 2008 Rules(7080. A. Bottom of distribution media 1017.3 2350 or 7080.2400 (Advanced Inspector License required) B. Periodically saturated soiUbedrodc j 1014 Drainfield meets the designed vertical 1 separation distance from periodically J C. S rasion 3.2 saturated soil or bedrock. D. Required compliance separation" 2.6 Any"no"answer above indicates the system is 'May be reduced up to 15 percent if allowed by Local Failing to Protect Groundwater. Ordinance. S. Operating Permit and Nitrogen BMP*—Compliance 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 BM!}Best Management Practice(s)specified in the system design If the answer to both questions is"no"N this section does not need to be completed. Compliance criteria _ a. Operating Permit number. No Have the Operating Permit requirements been met? El Yes El b. is the required nitrogen BMP in place and-Properly functioning? ❑Yes_Q No Any"no"answer indicates Noncompliance. Upgrade Requirements(Minn.Stat.§115.55)An imminent threat to public health and safety(l7PHS)must be upgraded,replaced,orits use discontinued wrlhin ten months of receipt of this notice or within a shorter period if required by local ordinance.if the system is failing to protect ground water,the system must be upgraded,replaced,Grits use discontinued within the time required by local ordinance.If an existing system is not failing as defined in law,and has at least two feet of design sod separation,than the system need not be upgraded,repaired,replaced,or its use discontinued,nolwithstandrrg 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 establishments as defined in law. www.pca.state.mn.us - 651-296-6300 • 1300-657-3864 TTY 651-282-5332 or 80o-657-3864 . Available in alternative formats wq-wwists4-31 • 11241 f2 Page 3 of 3