Laserfiche WebLink
5. Soil separation — Compliance component #5 of 5 <br />Date of installation v -}�- 9 e) ❑ Unknown <br />(mmlddlyyyy) <br />Shoreiand/WelIhead protection/Food [1 Yes 0 No <br />beverage lodging? <br />Compliance criteria select one): <br />5a. For systems built prior to April 1, 1996, ❑ Yes ❑ No* <br />and not located in Shoreland or Wellhead <br />Protection Area or not serving a food, <br />beverage or lodging establishment.- <br />Drainfield <br />stablishment:Drainfield has at least a two -foot vertical <br />separation distance from periodically <br />saturated soil or bedrock <br />5b. Non perfonnance systems built April 1, <br />1996, or later or for non-performance <br />systems located in Shoreland or Wellhead <br />Protection Areas or serving a food, <br />beverage, orlodging establishment: <br />Drainfield has a three-foot vertical <br />separation distance from periodically <br />saturated soil or bedrock.* <br />N Yes ❑ No* <br />5c. "Experimental,, ,other,, or Performance" t] Yes ❑ No* <br />systems built under pre -2008 Rules; <br />Type 1V or V systems built under 2008 <br />Rules 7080. 2350 or 7080.2400 <br />(Advanced inspector License required) <br />Drainfield meets the designed vertical <br />separation distance from periodically <br />saturated soil or bedrock, <br />*Any "no" answer above indicates the system is <br />failing to protect groundwater. <br />Describe verification methods and results: <br />Attached supporting documentation: <br />❑ Soil observation logs completed for the report (Attach) <br />Two previous verifications of required vertical <br />separation (Attach) <br />❑ Not applicable (No soil treatment area) <br />S-C�-S��S� �U ti�.tc, , 10-1�-°i '7 �� •� iaR <br />+t�,rk4',.� '�nvU�G 5th lit- • '? - � 5- � � 5'7 <br />Indicate depths or elevations <br />riodically saturated soilibedrock <br />C. System separation <br />D. Required comolian <br />C)'3. ko I. a' Sy6s <br />*May be reduced up to 15 percent if allowed by Local <br />Ordinance- <br />t)<�4r•,. -'0v'�L 3.3` 1- C t <br />Upgrade requirements: (Minn. Stat. § 115.55) An imminent threat to public health and safety (ITPHS) must be upgraded, replaced, <br />or its use discontinued within ten months of receipt of this notice or within a shorter period if required by local ordinance. if the <br />system is failing to protect ground water, the system must be upgraded, replaced, or its use discontinued within the time required by <br />local ordinance. If an existing system is not failing as defined in law, and has at least two feet of design soil separation, then the <br />system need not be upgraded, repaired, replaced, or its use discontinued, notwithstanding any local ordinance that is more strict. <br />This provision does not apply to systems in shoreland areas, Wellhead Protection Areas, or those used in connection with food, <br />beverage, and lodging establishments as defined in law. <br />https://www.pca.state.mn.us <br />wq-wwists4-31b • 1/11121 <br />• 651-296-6300 900-657-3864 use your preferred relay service Available in alternative formats <br />Page 4 of 4 <br />