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Property Address: 840 North Shore Drive W. <br />Business Name: Ruspf Olson Soil & percolation Tes#gg _ Date: 12/18/2025 <br />S. Soil separation — Compliance component #5 of 5 <br />Date of installation 10/27/1989 ❑ Unknown <br />(mmlddlyyyy) <br />Shoreland/Wellhead protection/Food ® Yes ❑ No <br />Attached supporting documentation: <br />beverage lodging? <br />® Soil observation logs completed for the report <br />Compliance criteria (select one): <br />❑ Two previous verifications of required vertical separation <br />5a. For systems built prior to April 1, 1996, and ❑ Yes ❑ No <br />❑ Not applicable (No soil treatment area) <br />not located in Shbreland or Wellhead <br />Protection Area qr not serving a food, <br />® Original borings included <br />beverage or lodging establishment. <br />Drainfield has at east a two -foot vertical <br />separation dista Ice from periodically <br />saturated soil or bedrock. <br />5b. Non-performanc systems built !®Yes ❑ No <br />Indicate depths or elevations <br />April 1, 1996, orOter or for non- <br />performance systems located in Shoreland <br />A. Bottom of distribution media 103.2 <br />or Wellhead Protection Areas or serving a <br />B. Periodically saturated soil/bedrock 100.3 <br />food, beverage, or lodging establishment: <br />C. System separation 2.9 <br />Drainfield has a t �ree-foot vertical <br />------- -------- _____ _. <br />separation distance from periodically <br />D. Required compliance separation* 2.55 _ <br />saturated soil or bedrock.* <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, 235Q or 7080.2400 <br />(Intermediate Inspector License required <_ <br />2,500 gallons pe day; Advanced Inspector <br />License required > 2,500 gallons per day) <br />Drainfield meets he designed vertical <br />separation dista ce from periodically <br />saturated soil or edrock. <br />*Any "no" answer above indicates the system is <br />failing to protect groundwater. <br />Describe verification methods and results: <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 651-296-6300 800-657-3864 Use your preferred relay service Available in alternative formats <br />wq-wwists4-31b • 412812021 Page 4 of 4 <br />