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Property address: 2700 Copperview Drive, Orono, MN Inspector initials/Date: J. 0. 9/02/16 4. Soil Seperation —Compliance component#4 of 5 Date of installation: 5/22/00 ❑ Unknown Verification method�s): Shoreland/Wellhead protectioNFood Beverage Lodging? ❑ Yes � No Soil observatron does not expire Previous soil observations by two independent parties are su�crent, Compliance criteria: unless site conditions have been altered orlocal requirements differ. For systems built pnor to Apnl 1 1996. and ❑Yes ❑ No not located in Shoreland or Wellhead � Conducted soil observation(s) (Attach boring logs) Protection Area or not serving a iood. ❑ Two previous verifications(Attach boring�ogs) beverage or lodging establishment: ❑ Not apptiCable(Holding tank(s).no drainf+eld) Orainfield has at least a two-foot vertical ❑ Unable to verify(See CommentslExplanatron) separation distance from periodically saturated soil or bedrock. ❑ Other(See Comments/Explanation) Non-performance systems burlt Apn! 1, � Yes ❑ No Comments/Explanation: 1996, or later or for non-performance systems located in Shoreland or WeHhead Protection Areas or serving a food. beverage. or lodging esfablishment: Drainfield has a three-foot vertical separation distance from periodically saturated soil or bedrock.' "Expenmental". "Other', or Performance" ❑ Yes ❑ No Indicate depths of elevations systems built under pre-2008 Rules: Type N or V systems built under 2008 Rules(7080. A Bottom of d�s�ribution med�a 105.0 2350 or 7080 2400 (Advanced Inspector LiCense�equifed) B penodically saturated sod/bedrock 101.9 Drainfield meets the designed vertical C System separat�on 3.1 separation distance from periodically saturated soil or bedrock D Required compliance separation' 2.6 Any "110"answer above indicates the system is 'May be reduced up to 15 percent if allowed by Local Failing to Proteci Groundwater. Ordinance. 5. Operating Permit and Nitrogen BMP"`—Compliance component#5 of 5 � Not applicable Is the system operated under an Operating Permrt? ❑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 !f the answer to both questions is "no", this section does not need to be comp/eted. Compliance criteria a. Operating Permit number: ❑Yes ❑ No Have the Operating Permit requirements been met? b. Is the required nitrogen BMP in place and proper�y functioning? ❑ Yes ❑ No Any "no"answer indicates Noncompliance. Upgrade Requirements(M,nn Stat § 115.55)An immment threat to publ,c health and salery j�TPHS)must be upgraded. replaced.or its use discontinued wrthm ten months of recerpt of this notice or within a shorter period if required by local ordinance Jf the system is failing to protect ground water. the system must be upqraded, replaced.or its use discontmued wiihin the time required by Jocal ordrnance. If an existing system is not failing as defined in law. and has at Jeast two feet of design soil separation. lhen the system need not be upgraded.repaired. replaced.or its use discontinued, notwithstanding any tocal ord�nance that is more stnct. Th�s provis�on dces not appty ro systems in shoreland areas, Wellhead Proteclron Areas, or those used in connection with food.beverage.and lodging establishments as defined in law. www.pca.state.mn.us • 651-296•b300 • SOd-657-386a • TTY 651-282•5332 or 800-657-3864 • Avaitable in alternative formats wq-wwis[s4-31 • 1/Z4/12 Poge 3 of 3