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Property address: 1290 French Creek Dr Orono, MN Inspector initials/Date:A�l 8/122020 <br />(mm/ddjM) <br />4. Soil Separation — Compliance component #4 of 5 <br />Date of installation: 1987 <br />(mm/dd/yyyy) <br />Shoreland/wellhead protectioNFood beverage <br />lodging? <br />criteria: <br />For systems built prior to April 1, 1996, and <br />not located in Shoreland or Wellhead <br />Protection Area or not serving a food, <br />beverage or lodging establishment. <br />Drainfield has at least a two -foot vertical <br />separation distance from periodically <br />saturated soil or bedrock. <br />❑ Unknown Verification method(s): <br />Soil observation does not expire. Previous soil <br />❑ Yes ® No observations by two independent parties are sufficient, <br />unless site conditions have been altered or local <br />requirements differ. <br />® Yes ❑ No ® Conducted soil observation(s) (Attach boring logs) <br />❑ Two previous verifications (Attach boring logs) <br />❑ Not applicable (Holding tank(s), no drainfield) <br />❑ Unable to verify (See Comments/Explanation) <br />Non-performance systems built April 1, ❑ Yes ❑ No <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" <br />systems built under pre -2008 Rules, Type IV <br />or V systems built under 2008 Rules (7080. <br />2350 or 7080.2400 (Advanced Inspector <br />License required) <br />Drainfield meets the designed vertical <br />separation distance from periodically <br />saturated soil or bedrock. <br />❑ Yes ❑ No <br />Any "no" answer above indicates the system Is <br />failing to protect groundwater. <br />❑ Other (See Comments/Explanation) <br />Com ments/Explanation: <br />Indicate depths or elevations <br />A. Bottom of distribution media <br />30" <br />B. Periodically saturated soil(bedrock <br />60" <br />C. System separation <br />30" <br />D. Required compliance separation* <br />24" <br />*May be reduced up to 15 percent if allowed by Local <br />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 Practices) specified in the system design <br />If the answer to both questions is "no", this section does not need to be completed. <br />;ompliance criteria <br />a. Operating Permit number. <br />b- Is the <br />BMP in olace and <br />Any "no" answer indicates Noncompliance. <br />❑ Yes ❑ No <br />Yes n No <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 system must be upgraded, replaced, or its use discontinued within the time required by local ordinance. H 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-ww1sts4-31b • 614114 page 3 of 3 <br />