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Feb 2� 2016 04:35PM HP FaxRusty Olson 7634988290 page 4 <br /> Property address: 2811 Fairview Lane, Orono,MN _ __ Inspector initials/Date: J. O.2/20/16 <br /> 4. Soi) Separation —Compliance component#4 of 5 <br /> Date of installation: 8l06/1987 ❑ Unknown Verification method(s): <br /> Sotlrelan�dlWellhead protectioNFood Beverage �Yes � No Soi!observa6on does not expire. Pr�vious sor! <br /> g 9 observations by two independent parties are sufficient, <br /> Compllance Criteria: unless site Condilrons have been altered orlocal <br /> requirements difi`er. <br /> For systems 6uilt pnor ta Apn/i, 1996, and ', �Yes ❑ No <br /> not(ocated in Shoreland or Wellhead � Conducted soil observation(s){stttach boring logs) <br /> Protecfion Area o�notserving a food, ❑ Two previous verifications {Anacn bonnglogs) <br /> beverage orlodging establishment: ! ❑ Not applicable(Holding tank(s),no d�a,r,field) <br /> Drainfeld has at least a two-foot vertical ❑ Unable to verify(See Comments�xp�anation) <br /> separation distance from periodically ❑ Other{See Comments/Explana6on) <br /> saturated soil or bedrodc. <br /> Non-performance systems built Apn!1, ❑Yes ❑ No Commenfs/Fxplanafion: <br /> 1996, or Iater or for non-perfom�ance <br /> systerns located in Shorelard or Wedhead � <br /> Protecfion Areas or serving a food. � <br /> beverage, or lodging establishmenf: I <br /> Drainfield has a three-foot vertical <br /> separaiion distance from periodically ' <br /> saturated soil or bedrock."' �I <br /> `Expenmenta!", °Other�, or `Performance" I ❑Yes ❑ No Ind'ICate depths of elevations <br /> sysfems built under pne-2008 Rufes; Type IV --� <br /> or V systems built under 2008 Rules(7080. A. Bottom of distribution media ' 92.9 <br /> 2350 or 7080.2400 (Advanced Inspector ! <br /> License required) ', B. Periodically saturated soillbedrock I'I 90.9 <br /> Drainfield meets the designed�ertical ; C. S tem se aration 2,Q <br /> separation distance frorn periodically <br /> saturated soil or bedrock. I D. Required compliance separation" 2.0 <br /> Ally"l10"answer above indieates the system is 'May be reduced up to 15 percent if allowed by Local� <br /> Failing to Protect Groundwater. ordinance. <br /> 5. Operating Permit and Nitrogen BMP*—Compliance component#5 of 5 � Not applicable <br /> Is the system operated under an Operating Permit? ❑ Yes ❑ No If"yes",A below is required <br /> IS the system required to emplay a Nitrogen BMP? ❑Yes ❑ No If"yes", B below is required <br /> BMP=Best Managemerrt Practice(s)speciFed in the system design <br /> If fhe answer to both questions is "no", this section does not need to be comp/eted. <br /> Compliance criteria <br /> a. Operating Permit number: I <br /> ❑Yes ❑ No <br /> Ha�e the Operating Permit requirements been met? I <br /> b. Is the re uired nitro en BMP in lace and ro erl fundioning? ', ❑Yes ❑ No <br /> Any "no"answer indicates Noncampliarrce. <br /> Upgrade Requirements(Minn. 5tat. §915.55)An imminent threat to pub/ic health and safery pTPHS)must be upgreded, replaced,or its use <br /> discontinued wrthin ten months ol receipt of this notice or within a sho�ter period if required by local ordinance.!f the system is failing to protect <br /> ground water,the system must be upgraded, 2placed,or ifs use dismntinued within the time required by local ordinance. If an existing system <br /> is not failing as deh'ned in law,and has at leasf hvo feet of design soi!separation,then the system need not be upgraded,repai�d,replaced,or <br /> its use discon6nued,notwithstanding any loca!ordrnertae that is more strict. th�s provision does not apply to systems in shoreland areas, <br /> Wephead Protection Areas,or fhose used in connectron with food,beverage,and lodging estatrlishments as defrned in law. <br /> www.pca.state.mn.us . 651-296-6300 • 80o-657•3864 � TT`f 651-282•5332 or 800-657-3864 . Available in alternative tormats <br /> wq•wwists4-31 . f124/12 Page 3 of 3 <br />