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4 i.00 A <br /> 3. Other compliance conditions — Compliance component #3 of 5 <br /> 3a. Maintenance hole covers appear to be structurally unsound (damaged,cracked, etc.), or unsecured? <br /> ❑Yes' 0 No 0 Unknown <br /> 3b. Other issues(electrical hazards, etc.) to immediately and adversely impact public health or safety?0 Yes' 0 No 0 Unknown <br /> *Yes to 3a or 3b-System is an imminent threat to public health and safety. <br /> 3c. System is non-protective of ground water for other conditions as determined by inspector? ❑Yes' 0 No <br /> 3d. System not abandoned in accordance with Minn. R. 7080.2500? 0 Yes" 0 No <br /> 'Yes to 3c or 3d-System is failing to protect groundwater. <br /> Describe verification methods and results: <br /> Attached supporting documentation: ❑Not applicable ❑ <br /> 4. Operating permit and nitrogen BMP* — Compliance component #4 of 5 ❑ Not applicable <br /> Is the system operated under an Operating Permit? ❑ Yes 0 No If"yes",A below is required <br /> Is the system required to employ a Nitrogen BMP specified in the system design? ❑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. 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 /> Describe verification methods and results: <br /> Attached supporting documentation: ❑ Operating permit (Attach) ❑ <br /> https://www.pca.state.mn.us • 651-296.6300 • 800-657-3864 • Use your preferred relay service • Available in alternative formats <br /> Page 3 of 4 <br /> wq-wwisr54-31b • 1/11/21 <br />