12-06-19 Septic Compliance Form - Laserfiche WebLink

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Property address: 1510 Green Trees Road, Orono, MN Inspector initials/Date: J. O. 12/06/19 4. Soil Separation — Compliance component #4 of 5 Date of installation: 11/16189 ❑ Unknown ShorelandlWelihead protection/Food Beverage ® Yes ❑ No Lodging? nee criteria: For systems built prior to April 1, 1996, and not located in Shoreland or Wellhead Protection Area or not serving a food, beverage or lodging establishment: Drainfield has at least a two -foot vertical separation distance from periodically Non-performance systems built April 1, 1996, or later or for non-performance systems located in Shoreland or Wellhead Protection Areas or serving a food, beverage, or lodging establishment: Drainfield has a three-foot vertical separation distance from periodically saturated soil or bedrock.* "Experimental" "Other", or "Performance" systems built under pre -2008 Rules; Type IV or V systems built under 2008 Rules (7080. 2350 or 7080.2400 (Advanced Inspector License required) Drainfield meets the designed vertical separation distance from periodically saturated soil or bedrock. ❑ Yes ❑ No Verification method(s): Soil observation does not expire. Previous soil observations by two independent parties are sufficient, unless site conditions have been altered or local requirements differ. ® Conducted soil observation(s) (Attach boring logs) ❑ Two previous verifications (Attach boring logs) ❑ Not applicable (Holding tank(s), no drainfield) ❑ Unable to verify (See Comments/Explanation) ® Other (See Comments'Explanation) Z Yes ❑ No CommentslExplanation: Attached is the original soil borings and 2013 cert borings Yes ❑ No Indicate depths of elevations Any "no" answer above indicates the system is Failinct to Protect Groundwater. A. Bottom of distribution media 89.4 B. Periodically saturated soil/bedrock I 86.8 C. Svstem separation 2.6 D. Required compliance separation* *May be reduced up to 15 percent if allowed by Local Ordinance. 5. Operating Permit and Nitrogen BMP* — Compliance component #5 of 5 E 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 Practice(s) specified in the system design If the answer to both questions is "no", this section does not need to be completed. criteria a. Operating Permit number: Have the Operatinq Permit requirements been met? ❑ Yes [--]No b. js the required nitrogen SMP in place and properly functioning? � ❑ Yes ❑ No Any "no" answer indicates Noncompliance. Upgrade Requirements (Minn. Stat. § 115.55) An imminent threat to public health 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 law, and has at least two feet of design soil separation, then the system need not be upgraded, repaired, replaced, or its use discontinued, notwithstanding any local ordinance that is more strict. This provision 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 • Avaitable in alternative formats wq-wwists4-31 • 1124112 Page 3 of 3