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! Property address: 145 S. Brown Rd. Ororw Inspedor irritialslp�ate: ;�A.M. ( 7252017 — �m�� - 4. Soil Separation-Complianoe componerrt#4 of 5 Date of installation: 1/1/1999 __ ❑ Unknown Verfication method(s): (mMddtyyyy) ShorelandNVellhead protectioNFood beverage Sorl o6servation does noi expire. Prc�vious soi! lodging� ❑Yes � No observations by two independent pa ties are suKcient, unless site conditions have been altt�red or local ComplianCe criteria: requirements differ. For systems built prior to April 1, 1996, and ❑Yes ❑ No � Conducted soil observation(s)(At'ach bonng logs) not located in Shore/and or Wetlhead Protection A�ea or not serving a food, ❑Two previous verifications(Anach boring logs) beverage or lodging establishment. '� ❑ Not applicable(Holding tank(s),no �rainfield) Drainfield has at least a two-foot vertical ❑ Unable to verify(See Comments/E��anation) separation distance from periodically ❑ Other(See Comments�Explanation) satureted soil or bedrock. Non-performance systems built April 1, � Yes ❑ No Comments/Explanation: 1996, or later or for non-performance systems located in Shore/and or Wellhead Protection Areas or serving a food, beverage, or lodging establishment.� ' Drainfield has a three-foot vertical separation distance from periodically saturated soil or bedrock.* "Experimental", "Othe�", or "Performance" ❑ Yes ❑ No Indicate depths or elevations systems built under pre-2008 Rules: Type IV , - -- - or V systems built under 2008 Rules(7080. A. Bottom of distribution media 24 inches 50 or 7080.2400 (Advanced Inspector - - --- -- - ___ License�equired) B. Penodically saturated soiubedrodc 60 inches — _ --- , -- _ _._.._ rain ield meets the designed vertical C. System separation 36 inches separation distance from periodically — - - ____ _ _.___ saturated soil or bedrock. � -- - _. D. R uired comptiance separation' i 36 inches __—____ - - AI1y "no"answer above indicates the system is 'May be reduced up to 15 percent if:dlowed by Local failing to protect groundwater. Ordinance. 5. Operating Permit and Nitrogen BMP*— Compliance component#5 of 5 � N�:�t applicable Is the system operated under an Operating Permit? ❑Yes ❑ No If"yes",A below is requi�j Is the system required to employ a Nitrogen BMP? ❑Yes ❑ No If"yes", B below is requir�� BMP=Best Management Practice(s)specified in the system design /f the answer fo boih questions is "no'; this sectlon does not need to be completed. Com Ifance criteria _ --- __ _ a. Operating Permit number: Have the Operating Permit requirements been met? ❑ Yes ❑ No _ __ ____ ---- b. Is the reguired nitro eg n BMP in place and proPerly functioninc�?_ ❑ Yes ❑ No Any "no"answer indicates Noncompliance. Upgrade Requirementa(Minn. Stat.§115.55)An imminent threat to public health and safety(ITPHS)must be upgr�ied, repleced,or its use discontinued withrn ten monfhs of neceipt ol this notice or within a shorter period if required by local ordinance. !f the sy::tem is failing fo protect ground weter, the system must be upqraded,replaced, or its use disoontinued within the time requi�ed by loca/ordinani.e. !/an existing system is not failing as defined in faw, and has at/east two feet of design soil separatron, then the system need not be upgrade.l.repaired,replaCed, or its use discontinued, notwifhstanding any loca/ordinance that is mom strict. This provision does not app/y to systems ir shoreland ar�as, WeRhead Protection Artsas,or those used in connecfion with food,beverage,and lodging establishments as defined in �w. — --- - -- -- __ _ __ --- — . _ www.pca.state.mn.us • 651-296-6300 • 800-657•3864 • TTY 651-282•5332 or 800-657-3864 • Avaitat e in alternative formats wq-wwrsts4-31b • 6/4/14 Page 3 of 3