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May 05 2015 03:14PM HP FaxRusty Olson 7634988290 page 4 Property address� __ 3420 High Lane, Orono, MN Inspector initialslDate: J. O.5J05/15 4. SOl l Sepa�at1011 -Compiiance component#4 of 5 Date of instaflation: 11/11l09 _ ❑ Unknown Verification method(s): Lod renan?/Wellhead protection/Food Beverage �Yes � No Soi!obseivatron does nof expire. Previous soi! 9 9 observations by two independent pariies a�sufficient, ComplianCe C�Ite�ia: unless site conditions have been altered ortocal requirements differ. For systems bi�ilf prior to Apri!J, 1996, and i �Yes ❑ No not located in Shoreland or Wellhead �I � Conducfed soil observalion(s)(Attach baing logs) Protecfion Area ornot serving a food, I ❑ Two previous verifications (Attach borrng logs) beverage orlodging esfab!lshrnent: ❑ Not applicable(Noiding!ank(s),no drarnfield) Drainfield has ai least a two-foot vertical � ❑ Unable to venfy(See Comments/Explanation) separation distance from penodicalty I saturated Soil or bedrock ❑ Other(See Comments/Explanation) Non-performance systems builf Apn!1, �i ❑Yes [ No Comments/Explanafion: 1996, orlater or for non-performance systems located in Shoreland or Wellhead Protection Areas or serving a food, beverage, o�/odging establishment: � Drainfield has a three-foot vertical � separation distance from periodically , safurated soil or bedrodc.� - —+ "Experimenta!", "Other; or "Perforrnance" ' ❑Yes ❑ No Indicate depths of elevations systems burlt under pre-2008 Rules; Type IV � I or V systems builf under 2008 Rules(7080. I A. Bottom of distribution rnedia 101.7 2350 or 7080.2400 (Advanced Inspector ' License requifed) 6, Periodically satureted soiUbedrock I 98J Drainfield rneets the designed vertical II I separation distance from periodically �. System separation _ 3.0 _ saturated soil or bedrock. D Re uired com liance se aration' 2.6 AI?)/ "n0"answer above indicates ti►e sysfem is *May be reduced u to 15 ercent iilallowed b L Failin to Protect Groundwater. p � y oca� 9 _______ __ _ _. _ Ordinance. 5. Operating Permit and Nitrogen BMP�-Compiiance component#s of 5 � Not applicable Is the system operated under an Operating Permil? ❑Yes ❑ No If"yes",A below is required Is tne system req�ired to employ a Nitrogen BMP? ❑Yes ❑ No If"yes", B betow is required BMP=Best Management Practrce(s)specrfred in the system design If the answer to both quesfions is "no'; this section does noi need to be completed. Compliance criteria a. Operating Permit n�mber. ' __ Have the Operating Perrnit requirements been met? ❑Yes ❑ No b. Is the required nitroqen BMP in place and properly functionin9?_ ❑Yes ❑ No Any "no"answer indicates Noncompliance. Upgrade Requfr2r11ents (Minn. Stat §1 i5.55)An rmmrnent threat to public hea/th and safery(ITPHS)musf be upgraded,replaced,orits use discontinued within ten months of receipt of this notice or within a shorter period if required by loeal ordinance. If the system is failing to protect grourrd weter,the system must be upgraded,replaced,or ifs use discon.tmued within the trme reqwred byloeal ordinance.Jf sn existrng system is not fading as debned rn/a�v,and has ar least lwo feet ot desrgn sorl separation,then the system need not be upgraded,repaired,replaced,or ifs use discontinued,nohvithstandinq any locel ordrnancie that is more strict. This provision does not appJy to systems in shoreland areas, Wellhead Protectron Areas,or those used rn connection witn tood,beverage,and loo'ging establishments as defined in law. www.pca.state.mn.us • 651-296-6300 • 8Q0-657-3864 • TTY 651-282-5332 or 800-657-3864 • Available in alternative formats wq-wwists4-3 f . 1/24I 1� Poge 3 o f 3