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Property address: 2600 Thoroughbred Lane,Orono,MN Inspector initials/Date: J.0.4/21/16 <br /> 4. Soit Separation—Compliance component#4 of 5 <br /> Date of installation: 10/05/96 ❑Unknown Verification method(s): <br /> ShoretandANallhead protection/Food Beverage ❑Yes ®No Soil observation does not expire.Previous soil <br /> Lodging? observations by two independent patties are sufficient, <br /> Compliance criteria: unless site conditions have been altered or local <br /> For systems built prior to April 1, 1996,and ElYes ❑No requirements differ. <br /> not located in Shoreland or Wellhead ® Conducted soil observation(s)(Attach boring logs) <br /> Protection Area or not serving a food, ❑ Two previous verifications(Attach boring logs) <br /> beverage or lodging establishment <br /> ❑ Not applicable(Holding tank(s),no drainfre/d) <br /> Drainfield has at least a two-foot vertical ❑ Unable to verify(See Comments/Explanation) <br /> separation distance from periodically <br /> Other(See Comments <br /> saturated soil or bedrock. ❑ /Explanatron) <br /> Non-performance systems built April 1, Yes ❑No Comments/Explanation: <br /> 1996,or later or for non petformance <br /> systems located in Shoreland or Wellhead <br /> Protection Areas or serving a food, <br /> beverage,or lodging establishment: <br /> Drainfield has a three-foot vertical <br /> separation distance from periodically <br /> saturated soil or bedrock.` <br /> Experimental "Other",or "Performance" ❑Yes ❑No Indicate depths of elevations _ <br /> systems built under pre-2008 Rules,Type IV <br /> or V systems built under 2008 Rules(7080. A. Bottom of distributionmedia _ 109.4 <br /> 2350 or 7080.2400 (Advanced inspector <br /> License required) B. Periodically saturated soillbedrock _106._4 <br /> Drainfield meets the designed vertical C. stem separation3.0 <br /> separation distance from periodically <br /> saturated soil or bedrock. _ D, Required compliance separation` 2.6 <br /> Any "no"answer above indicates the system is *May be reduced up to 15 percent if allowed by Local <br /> Failing to Protect Groundwater. Ordinance. <br /> 5. Operating Permit and Nitrogen BMP*—Compliance component#5 of 5 ® Not applicable <br /> Is the system operated under an Operating Permit? ❑Yes ❑No If"yes",A below is required <br /> Is the system required to employ a Nitrogen BMP? ❑Yes ❑No If"yes",B below is required <br /> BMP--Best Management Practices)specified in the system design <br /> If the answer to both questions is"no", this section does not need to be completed. <br /> Compliance criteria _ <br /> a. Operating Permit number: <br /> . . - ---- Q Yes ❑ No <br /> Have the Operating Permit requirements been met? <br /> b. Is the required nitrogen_BMP in place and�ro�er�functioning?_ El ❑ No <br /> Any"no"answer indicates Noncompliance. <br /> Upgrade Requirements(Minn. Stat§115.55)An imminent threat to public health and safety(ITPHS)must be upgraded,replaced,or its use <br /> discontinued within ten months of receipt of this notice or within a shorter period if required by local ordinance.if the system is failing to protect <br /> ground water,the system must be upgraded,replaced,or its use discontinued within the time required by local ordinance.if an existing system <br /> is not failing as defined in law,and has at least two feet of design soil separation,then the system need not be upgraded,repaired,replaced,or <br /> its use discontinued,notwithstanding any local ordinance that is more strict. This provision does not apply to systems in shoreland areas. <br /> Wellhead Protection Areas.or those used in connection with food,beverage,and lodging establishments as defined in law. <br /> www.pca.state.mn.us • 651-296.6300 - 800.657.3864 TTY 651-282-5332 or 800.657.3864 - Available in alternative formats <br /> wq-wwists4-31 - 1124112 Pove 3 of 3 <br />