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Property Address: 460 Orchard Park Road, Orono <br />Business Name: Rusty Olson Soil & percolation Testing <br />5. Soil separation — Compliance component #5 of 5 <br />Date of installation 8/8/2011 ❑ Unknown <br />(mm/ddYYYY) <br />Shoreland/Wellhead protectionlFood ❑Yes ®No <br />beverage lodging? <br />Compliance criteria (select one): <br />5a. For systems built prior to April 1, 1996, and ❑Yes ❑ No' <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 atwo-foot vertical <br />separation distance from periodically <br />saturated soil or bedrock. <br />5b.hon-performance systems built <br />April 11 1996, or later or for non- <br />performance systems located in Shore/and <br />or Wellhead Protection Areas or serving a <br />food, beverage, or lodging establishment: <br />Drainfield has athree-foot vertical <br />separation distance from periodically <br />saturated soil or bedrock.* <br />5c. "Experimental ; "Other; or "Performance" <br />systems built under pre-2008 Rules; <br />Type IV or V systems built under 2008 <br />Rules 7080, 2350 or7080,2400 <br />(Intermediate Inspector License required <_ <br />2,500 gallons per day; Advanced Inspector <br />License required > 2,500 gallons per day) <br />Drainfield meets the designed vertical <br />separation distance from periodically <br />saturated soil or bedrock. <br />® Yes ❑ No' <br />❑ Yes ❑ No' <br />Any "no" answer above indicates the system is <br />failing to protect groundwater. <br />Describe verification methods and results: <br />Daie: 6/4/2025 <br />Attached supporting documentation: <br />❑ Soil observation logs completed for the report <br />® Two previous verifications of required vertical separation <br />❑ Not applicable (No soil treatment area) <br />Indicate depths or elevations <br />Bottom of distr <br />A. <br />ion media j 85.9 <br />B. Periodically saturated soil/bedrock 82.9 <br />C. System separation 3.0 <br />D. Required compliance separation* 2.55 <br />*May be reduced up to 15 percent if allowed by Local <br />Ordinance. <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 focal 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 800-667-3864 Use your preferred relay service Available in alternative formats <br />wq-wwists4-31b 4/28/2021 Page 4 of 4 <br />