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Aug 24 13 06:04p Joseph Olson 763-498-8290 p.4 <br /> Property address: 1925 West Farm Road,Orono, MN Inspector initials/Date: J. 0.8122113 <br /> 4. Soil Separation—Compliance component#4 of 5 <br /> Date of installation: 6112/86 ❑ Unknown Verification method(s): <br /> Soodgina?NVellhead protectionlFood Beverage ®Yes ❑ No Soil observation does not expire.Previous soil <br /> Lodging? <br /> observations by two independent parties are sufficient, <br /> Compliance criteria: unless site conditions have been altered or local <br /> requirements differ. <br /> For systems built prior to April 1, 1996, and ❑Yes ❑ No <br /> not located in Shoreland or Wellhead ® Conducted soil observation(s)(Attach boring logs) <br /> Protection Area or not serving a food, ❑ Two previous verifications(Attach boring logs) <br /> beverage or lodging establishment <br /> 0 Not applicable(Holding tank(s),no drainfiekl) <br /> Drainfield has at least a two-foot vertical ❑ Unable to verify(See Comments/Explanation) <br /> separation distance from periodically <br /> saturated soil or bedrock. ❑ Other(See Comments/Explanation) <br /> Non-performance systems built April 1, ®Yes ❑ No Comments/Explanation: <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 /> 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 111 - • <br /> or V systems built under 2008 Rules(7080. A. Bottom of distribution media 103.1 <br /> 2350 or 7080.2400 (Advanced Inspector <br /> License required) B. Periodically saturated soilbedrock 99.5 <br /> Drainfield meets the designed vertical C. System separation 3.6 <br /> separation distance from periodically <br /> saturated soil or bedrock. <br /> D. Required compliance separation` 2.6 <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? 1 ❑Yes 0 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 /> ground water,the sysfem must be 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 design sail separation,then the system need not be upgraded,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 law. <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 • 1/24/12 Page 3of3 <br />