02-24-2016 Septic Compliance - Laserfiche WebLink

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02/26/2016 10: 14AM FAX 9528733112 f�0002/0003 � Property address; 2465 French Lake Road, Orono, MIV _ _ Inspector initials/Date: JS � 2I24/2016 (mrNddhYYY) 4. Soi l Separation —Compliance component#4 of 5 Date of installation: 4/23/1984 ❑ unknown Verification rriethod(s): (mm/ddryyyy) Sofl obsen•ation does not expire, Prevlous soil Shorela'd/Wellhead protection/�ood beverage � Yes � No obsen�afions by two independent parties are suffcienf, lodging. unJess site condrtions have been alfered orloca! Compliance criteria: requirements difrer. For systems burlf prror to ApnT i, 1996, and ❑ Yes � No ❑ Gonducted soil observation(s)(Attacn baring logsJ not located in Shoreland or Wellhead Protecfron Area or not serving e food, ❑ YWo previous veri�cations(Attach boring Jogs) beverage orlodging est�ablrshmenf: ❑ Not applicable(Ho1d;nQ rank(s), no drar'nhe�d) Drainfield has at least a two-foot vertical ❑ Unable to verify(5ee Comments/Explanation) separation distance from perlodically ❑ Other(See Comments/Fxplanation) saturated soil or bedrock. Non-performanca sysfems built April 1. ❑ Yes [] No Comments/Explanation: 1996, orlaterorfornon-performance systems located in 5horeland or We!lhead Boring: Protectron Areas or serving a fooG, 1-10" 10YR 2/2 Loam beverage, orlodgrng establrshment: 11-35"10YR 4/4 Glay toam Drainfield has a three-foot vertical separation distance from periodically Motfs�25" saturated soil or bedrock." "Experimental° "Other", or "Pertormance" ❑ Yes � No Irtdicate depths or elevations systems buiR under pr�2008 Rules; Type IV � -- or V systems built under 2008 Rules(7080. A. Battom of distribution media 24" 2350 or 7080_2400 (Advanced Inspector L1Cense reqUifed) B. Periodically saturated solllbedrock __25" Drainfield meets the designed verticaf C. s tam se aration 1" separation distance from periodically saturatad soil or bedrnck. D. Re uired com liance se aration' 24" Atly "no"answer above lndlcates fhe system is "May be reduced up to 15 percent if allowed by Local failing to protect groundwafer. Ordinance. S. Operating Permit and Nitrag�n BMP�— Compliance component#5 of 5 � ►vot app�icab�e Is the system operated under an Operatiny Permit? ❑ Yes ❑ No If"yes",A below is required Is the system required to employ a NiTrogen BM�'? ❑ Yes ❑ No If"yes", B below is required BMP=Best Managemenf Practice(s}specified in the system deslgn If ihe answer to bofh questions�s "nv", this section does not need to be complefed. Compliance criteria a. Operating Permit number: Fiave the Operating Permit requirements been met? ❑ Yes ❑ No b, Is the required nitrogen BMP in placa and properly functionin ? ❑ Yes ❑ No Any "no"answer indicates Noncompllance. � Upgrade Requirements (Mlnn, Staf.§775.55)An imminent th�eef to public healfh and safety(fTPHS)musf be upgraded,replaced, ariis use drscontinued wifhin ten months of recefpt ol fhls notlee ol'wfthln a sho�ter penod if required by local ordinance.If the system!s falling to proteCf ground water,the system mu&f be upgrdded,replaced,orits use discontinued wifhin lhe Hme requlrsd by Jpea!ord/nanee.If an existing sysfem is not failing as defined rn law, and has at laast two faet of design soi!separatron,then the system need not be upgraded,repalred, replaced,or its use dlsContlr+ued,nofwifhstdndlhg any loc�l ordinance that rs morr�stticf. This provlslon does not dpply to Sy5fem5!n Shoreland areas, Wellhead Protection Areas, or those used in connectlon with lood,beverdge, and lodgrng establishments as defined in few. www.pca.state.mn.us • 651-Z96-6300 • 800-657-3864 . TlY 651�282�5332 vr 800-657-3864 • Available in altemative formats wq-wwists4-37 • 3/16172 Page 3 of 3