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5. Soil separation — Compliance component #5 of 5 <br /> • Date of installation 11/1/2011 ❑ Unknown <br /> (mm/ddlyyyy) <br /> Shoreland/Wellhead protection/Food ® Yes ❑ No Attached supporting documentation: <br /> beverage lodging? <br /> ❑ Soil observation logs completed for the report(Attach) <br /> Compliance criteria(select one): ❑ Two previous verifications of required vertical <br /> separation(Attach) <br /> 5a.For systems built prior to April 1, 1996, ❑Yes 0 No' <br /> and not located in Shoreland or Wellhead ❑ Not applicable(No soil treatment area) <br /> Protection Area or not salving 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 /> 5b.Non-performance systems built April 1, ®Yes 0 No Indicate depths or elevations <br /> 1996, or later or fornon-performance <br /> systems located in Shoreland or Wellhead! A. Bottom of distribution media 15" <br /> Protection Areas or serving a food, B. Periodically saturated soil/bedrock 21"design <br /> beverage, or lodging establishment <br /> borin_ <br /> Drainfield has a three-foot vertical _C. System separation36" <br /> separation distance from periodically <br /> saturated soil or bedrock* D. Required compliance separation* f 36" <br /> *May be reduced up to 15 percent if allowed by Local <br /> Ordinance. <br /> 5c.'Experimental", 'Other", or "Performance" ❑ Yes ❑ No' <br /> systems built under pre-2008 Rules; <br /> Type IV 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 /> *Arty "no"answer above indicates the system is <br /> failing to protect groundwater. <br /> Describe verification methods and results: <br /> Boring <br /> 1-1-12" 10yr 2/2 Loam <br /> 13-25"10 yr 4/4 Clay Loam <br /> No Redox <br /> Upgrade requirements: (Minn. Stat. § 115.55)An imminent threat to public health and safety(1TPHS)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 /> • <br /> https://www.pca.state.mn.us • 651-296-6300 • 800-657-3864 • Use your preferred relay service • Available in alternative formats <br /> wq-wwists4-31b • 1/11/21 Page 4of4 <br />