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Nov 12 2015 09:25PM HP FaxRusty Olson 7634988290 page 11 <br /> Property address: 3065 Watertown Road Orono MN Inspector initials/Date: J.O. 10/25115 <br /> 4. Soil Separation—Compliance component#4 of 5 <br /> Date of installation: 5/29/1992 ❑ Unknown Verification methodla): <br /> tlellhead protectloNFood Beverage <br /> Lodging? [1 Yes ® No Soil observation does not expire. Previous soil <br /> Lodging? observations by two independent parties are sufficient <br /> Compliance criteria: unless site conditions have been altered or local <br /> For systems built prior to April i, 1996, and � ® Yes ElNo requirements differ. <br /> not located in Shoreland or Wellhead ® Conducted soil observation(s)(Attach boring kvs) <br /> Protection Area or not serving a food, ❑ Two previous verifications(Attach boring logs) <br /> beverage or lodging establishment: ❑ Not applicable(Holding tank(s),no drainffe►d) <br /> Drainfield has at least a two-foot vertical ❑ Unable to verify(See Comments/Explanation) <br /> separation distance from periodically ❑ Other(See CommentVExplanation) <br /> saturated soil or bedrock. <br /> Non-performance systems built April 1, ❑Yes ❑No CommentWExplanation.- <br /> 1996, or later or for non-performance <br /> systems located in Shoreland or Wellhead <br /> Protection Areas or serving a food, <br /> beverage,or lodging establishment: <br /> i <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 distribution media 95.1 <br /> 2350 or 7080,2400 (Advanced Inspector <br /> License required) B. Periodically saturated soiVbedrodc 92.2 <br /> Drainfield meets the designed vertical <br /> separation distance from periodically C. stem separation 2.9 <br /> saturated soil or bedrock. <br /> D. Required compliance separation' 1 2.0 <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 Practice(s)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 /> Have the Operating Permit requirements been met? ❑Yes ❑ No <br /> b. Is the required nitro en BMP in plaoe and properly functioning? ❑Yes No <br /> Any "no"answer indicates Noncompliance. <br /> Upgrade Requirements(Minn. Stat.§115.55)An imminent threat to public health acrd safety(ITPHS)mustbe upgraded,replaced,orits use <br /> discontinued within ten months of receipt of this notice or within a shorter period a required by local ordinance,it the system is lailing to protect <br /> ground water, the system mustbe 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 desfgn soil separation,then the system need not be upgreded,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 few. <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 Page 3 of 3 <br />