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Apr 17 15 09:40a Joseph Olson 763-498-8290 p.4 <br /> Property address: 2785 White Oak Circle,Orono,MN Inspector initials/Date: J.O.4/17/15 <br /> 4. Soil Separation-Compliance component#4 of 5 <br /> Date of installation: 9/12/96 ❑ Unknown Verification method(s): <br /> Sthoreland/Wellhead protectionlFood Beverage ❑Yes <br /> Lodging? ® No Soil observation does not expire. Previous soil <br /> observations by two independent patties are sufficient, <br /> Compliance criteria: unless site conditions have been altered or local <br /> For systems built prior to April 1, 1996,and CIYes 0 No requirements differ. <br /> not located in Shomland 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 /> ❑ Not applicable(Holding tank(s),no drain5eld) <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_ ElOther(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 /> "Experimenter; "Other,or Performance" ❑Yes ❑No Indicate de sths of elevations <br /> systems built under pre-2008 Rules;Type 1V <br /> or V systems built under 2008 Rules(7080. I A. Bottom of distribution media 102.5 <br /> 2350 or 7080.2400 (Advanced Inspector <br /> License required) B. Periodical) saturated soil/bedrock 99.5 <br /> Drainfield meets the designed vertical <br /> C. S stem se•aratian 3.0 <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 $MP*--Compliance component#5 of 5 ® Not applicable <br /> Is the system operated under an Operating Permit? ❑Yes El No If"yes",A below is required <br /> Is the system required to employ a Nitrogen BMP? 0 Yes ❑ No If"yes",B below is required <br /> SMP=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? ❑Yes ❑ No <br /> Any"no"answer indicates Noncompliance. <br /> Upgrade Requirements(Minn.Stat§115.55)An imminent threat to public health and safety(1TPHS)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 focal ordinance.If the system is failing to protect <br /> ground water,the system must be upgraded,replaced,or its use discontinued within the time required try local ordinance. /f an existing system <br /> 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 <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 • 1124/12 <br /> Page 3 of 3 <br />