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Property address: 2755 Copper View Dr, Orono Inspector initials/Date: RGP 3/17/14 4. Soil Separation-Compliance component#4 of 5 1996 ❑ Unknown Verification method(s): Shoreland/Wellhead protection/Food Beverage �odging? ❑ Yes � No Soil observation does not expire. Previous soil observations by two independent parties are sufficient, Com lianCe Criteria: unless site conditions have been altered or local requirements differ. For systems built prior to April 1, 1996, and ❑ Yes ❑ No not located in Shoreland or Wellhead � Conducted soil observation(s) (Atracn boring/ogs) Protection Area or not serving a food, ❑ Two previous verifications(Attach boring logs) beverage or lodging establishment: ❑ Not appliCdble (Ho/ding tank(s),no drainfieldJ Drainfield has at least a two-foot vertical ❑ Unable to verify (See Comments/Exp�anation) separation distance from periodically saturated soil or bedrock. ❑ Other(See Comments/Explanation) Non-performance systems built April 1, � Yes ❑ No Comments/Explanation: 1996, or/ater or for non-performance systems/ocated in Shoreland 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.' "ExperimentaP; "Other", or 'Performance" ❑ Yes ❑ No IndiCate de ths of elevations systems built under pre-2008 Rules; Type IV or V sysiems built under 2008 Rules (7080. A. Bottom of distribution media 95.1' 2350 or 7080.2400 (Advanced Inspector LiCense required) B. Periodicall saturated soil/bedrock 92.0' Drainfield meets the designed vertical C. S stem se aration 3.1' separation distance from periodically saturated soil or bedrock. D. Re uired com liance se aration' 3' Any "no"answer above indicates the system is •May be reduced up to 15 percent if allowed by Local Failin�to Protecf Groundwater. Ordinance. 5. Operating Permit and Nitrogen BMP*-Compliance component#5 of 5� Not applicable Is the system operated under an Operating Permit? ❑ Yes ❑ No If"yes",A below is required Is the system required to employ a Nitrogen BMP? ❑ Yes ❑ No If"yes", B below is required BMP=Best Management Practice(s)specified in the system design If the answer to both quesfions is "no'; this section does not need to be completed. Com liance criteria a. Operating Permit number: ❑ Yes ❑ No Have the O eratin Permit re uirements been met? b. Is the required nitrogen BMP in place and properly functionin ? ❑ Yes ❑ No Any "no"answer indicafes Noncompliance. Upgrade Requirements (Minn. Stat. § 715.55)An imminent threat to public health and sa/ety(ITPHS)must be upgraded, replaced,or its use discontinued within ten months of receipt of this notice or within a shorter period if required by local ordinance. If the system is failing to protect ground water, the system must be upgraded, replaced, or its use discontinued within the time required by local ordinance. If an existing system is not failing as defined in law, and has at least two feet ol design soil separation, then the system need not be upgraded,repaired,rep/aced, or its use discontinued, notwithstanding any/oca/ordinance that is more stricf. This provision does not apply to systems in shoreland areas, Wellhead Protection Areas,or those used in connection with food,beverage,and lodging establishments as defined in/aw. www.pca.state.mn.us • 651-296-6300 • 800-657-3864 • TTY 651-282-5332 or 800-657-3864 • Available in alternative formats wq-wwists4-31 • 1/24/12 Page 3 of 3