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Ll•I9 ,"'E+98E2009=N,,/OOE6-aA!sagpy-ta>lsee-pue-Jaggn2{-eouew.lo}gad-q6!H-euaadoaN-W£/_/stonpoad-wE-lle/sn-luedwoo/SD uains/woo•wcwvvvyrsd1}U <br /> Explain: I <br /> j <br /> 4 <br /> Property address: 4990 Sussex Road, Orono Inspector initials/Date: JS 16/18/2019 <br /> (mm/dd/yyyy) <br /> 4. Soil Separation — Compliance component#4 of 5 <br /> 1 <br /> Date of installation: 8/10/1992 ❑ Unknown Verification method(s): <br /> (mm/dd/yyyy) <br /> ShorelandlWellhead�rotection/Food beverage Soil observation does not expire. Previous soil <br /> ElIod to Yes ® No observations by two independent parties are sufficient, <br /> ging? unless site conditions have been altered or local <br /> Corn•liance crit:ria: requirements differ. <br /> For systems built prior to April 1, 1996, and ®Yes ❑ No ® Conducted soil observation(s) (Attach boring logs) <br /> not located in Shor land or Wellhead <br /> Protection Area or riot serving a food, ❑Two previous verifications (Attach boring logs) <br /> beverage or lodging establishment: ❑ Not applicable(Holding tank(s),no drainfield) <br /> Drainfield has at least a two-foot vertical ❑ Unable to verify(See Comments/Explanation) <br /> separation distancerfrom periodically ❑ Other(See Comments/Explanation) <br /> saturated soil or bedrock. <br /> Non-performance systems built April 1, ❑Yes ❑ No Comments/Explanation: <br /> 1996, or later or for'non-performance <br /> systems located inpShoreland or Wellhead Boring: <br /> Protection Areas or serving a food, 1-8" 10yr 3/2 loam <br /> beverage, or lodging establishment: <br /> 9-26" 10 yr 4/6 clay loam <br /> Drainfield has a three-foot vertical <br /> separation distance from periodically Redox @ 24" <br /> saturated soil or bedrock.* <br /> "Experimental, "Other', or "Performance" ❑ Yes ❑ No Indicate depths or elevations <br /> systems built under pre-2008 Rules; Type IV <br /> or V systems built under 2008 Rules(7080. A. Bottom of distribution media 12"+or more <br /> 2350 or 7080.2400 (Advanced Inspector <br /> License required) B. Periodically saturated soil/bedrock 24" <br /> Drainfield meets the designed vertical C. System separation 36"+ <br /> separation distance from periodically <br /> saturated soil or bedrock. D. Required compliance separation* 24" <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 nitrogen BMP in place and properly functioning? I ❑Yes ❑ 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 /> • <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 •sgtl°19/0114ufl W£100E1,eAlsegpv}eNsee pue Jaggnj aouewaoped q6!H eueadoeN „iNE P <br />