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Nov 071410:47a Joseph Olson 763-498-8290 p.4 IL Property address: 3220 Watertown Road,Orono MN Inspector initials/Date: J.O.11/06/14 4. Soil Separation--Compliance component#4 of 5 Date of installation: 5/11106 ❑ Unknown Verification method(s): ShorelandhNellhead protectionlFood Beverage ©Yes ®� Sall observation does not ex ire.Previous soil Lodging? observations by two independent parb;Ds are suf Beni; Compliance criteria: unless site condWons have been altered orlocal For systems built prior to April 1, 1996,and El 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 tank(s),no drai dW4 Drainfield has at least a two-foot vertical ❑ Unable to verify(See ComraenteExptanation) separation distance from periodically ❑ Other(see CommenwExplane6m) saturated soil or bedrock. Non performance systems built April i, ®Yes ❑No CommentslF_xplana6on: 9996,or later or for non-peftmance systems located in Shoreland or Waffhead Protection Areas or serving a food, beverage,or lodging establishment.- DraMeld has a three-foot vertical separation distance from periodically saturated soil or bedrock.` '1=xpenmentar, `Other; or `Performance" [:]Yes ❑No Indicate depths of elevations systems built under pre-2008 Rules,•Type IV or V systems built under 2008 Rules(7080. A. Bottom of dmtnbution media 10D.3 2350 or 7080.2400 (Advanced Inspector License required) B. Periodicafly saturated soWbedrock 97.3 Draintield meets the designed vertical C. System separation 3.0 separation distance from periodically saturated soil or bedrock. D. uired com liance aration• 26 Any"no"answerabove 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 ®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 BMP=Best Management Practfce(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: Have the O rami Permit requirements been met? Yes ❑No b. Is the required nitrogen BMP inlace and ro ri functions ? Yes No Any"no"answer indicates Noncompliance. Upgrade Requirements(Minn. Stat§115.55)An imminent threat to public health and safety(!TANS)must be upgraded,replaced,or its use discontinued wWn ten months of receipt of this notice or within a shorter period ff required by facet onfxianoe.if the system is falling toprotect ground water,the system must be upgraded,replaced orits use discontinued within the time required by local ordinance.ff an existing system is not failing as defined in law,and has at least two feet of design sW separation,then the system need not be upgraded,repaired,replaced,or its use discontinued,notwithstanaft any local ordinance that is more strict This pmwsioa does not apply to systems in shmakind areas, WeMread Protection Areas,or Nose used in connection with food,beverage,and fudging establishme is as defined in law. www.pca.state.mn.ts - 651-296-6300 - 800-657-3864 - TTY 651-287-5332 or 800.657-3864 Available in attemative formats wq-ww1sts4-31 - 1124112 Page 3 of 3