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Aug 28 2015 09:18AM HP FaxRusty Olson 7634988290 page 4 Property address: _795 Ferndale Road N,Orono, MN _ __ _ _ Inspecior initialS/Date: J.O.8l25/15 4. S091 Sepal'dti0n —Compliance comp�nent#4 of 5 �ate of installation: 6I17/02 ❑ Unknown Verification method(s): Shoreland/Wellhead protectioNFood Beverage �Yes Lodging7 ❑ No Soil observation does not expire. Prevrous soil observations by two independent pa�fres are sufficienf, ComplianCe C�Iterla: unJess srte condifions have been alfered or local requiremenfs differ. Forsystems bui7t prrortoApri(1, 1996, and � ❑Yes ❑ No not located in Shoreland or Wellhead � Conducted soil observation(s)(Attach bonng logs) Protecfion Area ornot sera�ing a food, ! ❑ Two previous verificalions(AKach boring logs) beverage or lodging establishment: ❑ Not appliCable(Holding tank(sJ,no drainfie/d} Drainfield has at least a two-foot vertical ' ❑ Unable to verify(see CommentslExplanaticn) separation distance from periodically ; saturated soil or bedrock. i ❑ Qther(See Commenis/Expl&nation) ---+- . Non-performance systems builtApriJ 1, � �Yes ❑ No Comments/�xplanation: 1996, o�laterorfornon-performance ' systems located in Shoreland or We!lhead Protecfron Areas or se�ving a food, ; beverage, or lodging establishment: Drainfield has a tnree-foot vertical I separation distance from periodically � saturated soil or bedrock.'` - -----t °Experimenta!", "Other° or "Performance" I ❑Yes ❑No Indicate depths of elevations -- -- _.. — systems bu� under pre-2QQ8 Rules; Type 1V T-- or V systems burlt uncler 2008 Rules(7080. i A. Bottom of distribuGon med,a 96.5 2350 or 7080.2400 (Ad�anced Inspecto� I � License required) B. Periodicall sy aturated_soiubedrock , 93.5 DrainfieJd meets the designed verticai �� � C. System separation � 3.0 separation distance from periodicaUy i — � saturated soil or bedrock. I D. Reguired compiiance sepa�ation` I 2-6 Any "no"answer above indicates the System is *May be reduced up to 15 perceni if allowed by Local _Failing to Protect Groundwater. ordinance. 5. Operating Permit and Nitrogen BMP*—Compiiance component#5 of 5 � Not applicable is the system operated under an Qperating Permit7 ❑Yes ❑ No If "yes",A below is required Is the system requ red to employ a Nitrogen BMP? ❑Yes � No If"yes",B below is required BMP=Best Management Pracfice(s)specified in the system design lf the answer to both questions is "no", this seciion does not need to be compfeted. Compliance criteria a. Operating Permit number: Have the Operatinq Permit requirements been met? , ❑ Yes ❑ No b. Is the required r,itroqen_BMP .n place and properly functionin_�_ ❑Yes ❑ No Any "no"answer indicates Noncompliance. Upgrade RequirFments (Mrnn. Sfat.§115.55}An imminent fh�eat to public health and safety(lTPHS)mustbe upgraded,replaced,or its use discontinued within ten months of receipt ot this notice or w,%thin a shorter penod rf required by loca!ordinance.!f the system is failing to protect ground water,the system must be upgraded,replaoed or its use discontrnued within the time required by bca/ordinance.If an exisb»g system is not faiJing as definea;n law,and has at least two feet of design soi!separation,then the system nsed not be upgraded,repaired,replaced,or its use discontinued,noiwifhstanding any loca!ordinance that is more stncL This provision does not apply to systems in shoreland areas, Wellhead Protection Areas,or those used in connection wifh fooa,beverage,and bdging estabfishmenfs as defined in law. www.pca.state.mn.Ns • 651-296-6300 • 800-657-3864 . TTY 651•282-5332 or 600•657-3864 • avaiiable in altemative formats wq-w,vists4•37 • 1/24/J2 Poge 3 of 3