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Property address: 3010 Somerset Lane <br />4. Sail Separation - Comptiance component #4 of 5 <br />Date of installation: 7/2412018 ❑ Unknown <br />(mrrtidd%W) <br />Shoreland/Wellhead ProtectlonlFood, <br />beverage, todgtng7 <br />Compliance 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 />Non-perlormance systems built April 1, <br />1996, or later or for non-performance <br />systems located in Shoreland or Wellhead <br />Protection Areas or serving food, beverage <br />or lodging establishment. <br />I <br />Drainfield has at least 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 1V <br />or V systems built under 2008 Rules <br />(7080.2350 or 7080.2400 (Advanced <br />Inspector License required) <br />Drainfield meets the designed vertical <br />separation distance from periodically <br />saturated soil or bedrock. <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />[] Yes ❑ No <br />1511.�4 r1tr, iviijo , <br />Inspector Initials/Date I 7/24/2018 <br />(mmlddlyyyy) <br />Verification method(s) <br />Soil observation does not expire. Previous soil observations by two <br />independent parties are sufficient, unless site conditions have been <br />altered or local requirements differ. <br />❑ Conducted soil observation(s) (Attach boring logs) <br />❑ Two previous verifications (Attach boring logs) <br />❑ Not appiicable (Holding tank(s), no drainfield) <br />❑ Unable to verify (See Comments/Explanation) <br />❑ Other (See Comments/Explanation) <br />Comments/Explanation: <br />New system verification done at review <br />Indicate depths or elevations <br />A. Bottom of distribution media <br />❑ Yes ❑ No <br />B. Periodically saturated soil/bedrock <br />C. System separation <br />D. Required compliance separation" <br />"Allay be reduced up to 15 percent if allowed by Local <br />Ordinance <br />Any "no" answer above indicates the system is <br />failing to protect groundwater. <br />5. Operating Permit and Nitrogen BAAP - Compliance component #5 of 5 ❑ Not applicable <br />Is system operating under an Operating Permit? ❑ Yes 0 No If "yes", A below is required. <br />Is the system required to employ Nitrogen BMP? ❑ Yes 0 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. Operating Permit number: LJ Yes ET No <br />Have the Operating Permit requirements been met? <br />b. Is the required nitrogen BMP in place and properly functioning? Yes UNo <br />Any "no" answer above indicates Noncompliance <br />Upgrade Requirements (Minn. Stat. § 115-55). An irnminent threat to public heafth and safety (ITPHS) must be upgraded, replaced, or its use discontinued within ten months of <br />receipt of this notice or within a shorter period if required by local ordinance. If the system is failing to protect groundwater, the system must be upgraded, replaced, or its use <br />discontinued within the time required by tical ordinance. If an existing system is not failing as defined in law, and has at least two feet of design soil separation, then the system need <br />not be upgraded, repaired, replaced, or its use discontinued, notwithstanding any local ordinance that is more strict. This provision does not appty 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 />wq-ww7sts4-31c • &4/14 • wwwpca.state ,mn.us • Available in alternative formats • 651-296-6300 • 800-657-3864 • TTY651-282.5332 or800-657-3e64 Page 3 of <br />