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Feb 29 2016 05:06PM HP FaxRusty Olson 7634988290 page 4 <br /> Property address: 1185Wyndamere Road.,Orono MN Inspector initials/Date: J. 0.2/25/16 <br /> 4. Soi l Separation —Compliance component#4 of 5 <br /> Date of Installation: 11/18/84 ❑ Unknown Verification method(s): <br /> Shoreland/Wellhead p►otecGon/Food Beverage <br /> Lodgi ❑Yes ® No Soil observation does not expire. Previous soil <br /> Lodglnp4 observations by two Independent parties are sufficient, <br /> Compliance criteria: unless site conditions have been altered or local <br /> For systems built prior to April 1, 1996, and ®Yes [:] No requirements differ <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 ❑ Not applicable(Holding tank(s),no dra/nfield) <br /> i <br /> Drainfield has at least a two-foot vertical ❑ Unable to verify(See CommentarExplanation) <br /> separation distance from periodically <br /> saturated soil or bedrock. El Other(See CommentarExprenation) <br /> Non-penb►mance systems built April 1, ❑ Yes []No CommentslExplanation: <br /> 1996,or later or fornon-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 IV <br /> or V systems built under 2008 Rules(7080. A. Bottom of distrlbutlon media 99.4 <br /> 2350 or 7080.2400 (Advanced Inspector <br /> License required) B. Periodically saturated soil bedrock 96.4 <br /> Drainfield meets the designed vertical C. System separation 3.0 <br /> separation distance from periodically <br /> saturated soil or bedrock. D. Required compliance separation* 2.0 <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 /> S. 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 Practices)specified in the system design <br /> H 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(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 ordbnence.If the system is failing to protect <br /> ground water,the system must be upgraded,replaced,or its use discontinued within the time required by local ordinance.If an existing system <br /> is rot fairing as dermed in raw,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 • 651-296-63DO • 800-657.3864 TTY 651-282-5332 or BOD-657.3864 • Available in alternative formats <br /> wq-ww1sts4.31 • 1/24112 Page 3 of 3 <br />