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Nov 11 2016 09:11 AM HP FaxRusty Olson 7634988290 page 13 <br /> Property address: 1p45 Brown Road S.,Orono, MN Inspector initials/Date: J o. 10/26/16 <br /> 4. SOII Separat1011 —Compliance component#4 of 5 <br /> Date of installation: 7128/03 __ ❑ Unknown Verification method(s}: <br /> Shoreland/Wellhead protectionlFood Beverage � Yes <br /> Lodging7 ❑ N� Soil observation does not expire. Previous soil <br /> obseivariorrs by two rndependent parties are su�cient, <br /> ComplianCe Criteria: unless site condifions have been altered orlocal <br /> For systems built pnor to Apn!1, 1996, and ; �equrr�ments di{fer. <br /> ❑Yes ❑ No <br /> not located in Shoreland or Wellhead � Conducted soil observation(s) (Attach bonng loys) <br /> Profection Area ornot serving a food, ❑ Two previous verificati�ns(Attsch bonrrglogs) <br /> beverage or lodging establishmenf: <br /> ❑ Not applicable(Holdinqfank(s),no drainfield) <br /> Drainfeld has at least a two-f�ot vertical ❑ Unahle to verify(See Comments/Explanatron) <br /> separation distance from periodically <br /> saturated soil or bedrock. ❑ Other(See CommentsiExplanation) <br /> Na�-performar7ce systems built Apnl 1, � Yes ❑ No Comments/Explanatron: <br /> 9996,or later or for non-performance ' <br /> systems located in Shoreland or WeJlhead i <br /> Protection Areas or serving a food, i <br /> beverage,orlodging establishment. <br /> Drainfield has a three-foot vertical ! <br /> separation distance from periodically I� <br /> saturated soil or bedrock.` <br /> °Expenmenta!", "Other° or "Peiformance" , ❑Yes ❑ No (ndicate depths of elevations <br /> systems built under pre-2008 Rules; Type 1V � <br /> ol V systems built under 2008 Rules(7080. A. Bottom of distribution med ia _� 97.4 <br /> 2350 or 7Q80.2400 (Advanced Inspector <br /> LiCense required) ; B. Periodicail satureted soil/bedrock 94.4 <br /> Drainfield meets the designed vehical I C. S stem separetion 3.0 <br /> separaticn distance from periodically --. <br /> saturated soil or bedrock. D. Required compliance separation' � 2.6 <br /> Any "no"answer abave indieai+es the system is •May be reduced up to 15 percent if allowed by Local <br /> Failing to Protect Groerndwater. Ordinance. <br /> 5. Operating Permit and Nitrogen 8MP*—compiiance component#s of 5 � Not applicable <br /> Is the system operated under an Operating Permit? ❑Yes ❑ No If"yes",A below is required <br /> Js the system required to employ a Nitrogen BMP? ❑Yes ❑ No If"yes", B below is required <br /> 8MP=8est Management Practice(s)specifed in the system design <br /> If the answer to both questions is "no", this section does not need to be comp/eted. <br /> Com liance criteria <br /> a. Operating Permit number: , <br /> _ Have the Qperatinq Permit requirements been met? ❑Yes ❑ No <br /> b. Is the re uired niiro en BMP in lace and ro erl functioning? ❑Yes ❑ No <br /> Any"no"answer irrdreates 1Voncompliance. <br /> Upgrade Requirements(Minn. Sfat.§f 15.55)An imminent threat to public health and safery(iTPHS)must be upgraded,replaced, or;ts use <br /> discontinued within ten months otreceipt of thrs notice or wrthin a shoner penod if roquired by Jocal orolfnance.ff the system is farlirx,�to protect <br /> ground water,the System mus2 be upgr8ded,replaced, or its use discon6nue0 within the time required by local ordrnance.If an existing system <br /> rs not faifing as defined in law,and has at least two feef of design soil se,oaraL'on,then the sysfem need not be upgraded,reparred,r�pJaced,or <br /> ris use drscontinued,notwittrslanding any loca!ordinance that is more sUrcf. This provision does nof apply to systems in shoreland arsas, <br /> WeJlhead Protectron Areas, or fhose used in connection wifh food,beverage,and lodging eslablrshments as defined in law. <br /> www.pca.state.mn,�s • 651-296•6300 • 800-657•3864 • TTY 651-282-533Z or 800-657-3864 • Available in alternative formats <br /> wq-wwists4-31 • 1124!12 Page 3 oj 3 <br />