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08/06/2015 2:44PM FAX Z0003/0004 Property address: 2165 Watertown Road,Orono _ Inspector inhials/Date: JS 1 8/5/2015 (mm/dd/yyyy) 4. Soil Separation—Compliance component#4 of 5 Date of installation: 5/1/1983 0 Unknown Verification method(s): (mm/ddlyyyy) Soil observation does not expire.Previous soil ShorelandNVellhead protection/Food beverage ❑Yes ®No observations by two independent parties are sufficient; ladging7 unless site conditions have been altered or local Compliance criteria: requirements differ. For systems built prfor to April 1, 1996, and M Yes ❑No ®Conducted soil observations)(Attach boring logs) not located in Shoreland or Wellhead ❑Two previous verifications(Attach boring logs) Protection Area or not serving a food, beverage or lodging establishment.• ❑Not applicable(Holding tank(s),no draintield) Drainfleld has at least a two-foot vertical ❑Unable to verify(see Comments✓Explanatlon) separation distance from periodically ❑Other(See Comments/Explanahon) saturated soil or bedrock. Non-performance systems built ApM 1, ❑Yes ❑No CommentslExplanation: 1996, or later or for non-performance systems located in Shore/and or Wellhead Boring: Protection Areas or serving a food, 1-16"10YR 212 Loam beverage,or lodging establishment: 17-24" 10YR 4/4 Clay Loam Drainfield has a three-foot vertical separation distance from periodically No redox saturated soil or bedrock." "Experimental", "Other, or "Performance" E]Yes O No Indicate depths or elevations systems built under pre-2008 Rules;Type IV "or V systems built under 2008 Rules(7080. A. Bottom of distribution media plus 12" 2350 or 7080.2400 (Advanced Inspector License required) B. Periodically saturated soilibedrock over 24" Drainfield meets the designed vertical C. System separation 36"plus separation distance from periodically saturated soil or bedrock. D. Required compliance s9 =ration" 24" Any"no"answer above indicates 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*—Compliance component#5 of 5 ED Not applicable Is the system operated under an Operating Permit? ❑Yes Q No If"yes",A below is required Is the system required to employ a Nitrogen BMP? ❑Yes ❑ 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: ❑Yes ❑No Have the Operating Permit requirements been met? b. Is the required nitrogen BMP in place and properly functioning?, ❑Yes ❑ No Any "no"answer Indicates Noncompliance. Upgrade Requirements(Minn. Stat§115.55)An imminent threat to public hearth and safety(ITPHS)must be upgraded,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 system is failing to protect ground water,the system must be upgraded,replaced,or its use discontinued within the time required by local ordinance.If an existing system is not failing as defined in few,and has at least two feet of design soil separation,then the system need not be upgraded,repalred,replaced,or its use discontinued,notwithstanding any local ordinance that is more stnot. This provislon 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 - 800-657-3864 TTY 651-282-5332 or 800-657-3864 - Avai table in alternative formats wq-wwi5ts4-31 . 3116112 Page 3 of 3