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Sep 30 2016 06:06AM HP FaxRusty Olson 7634988290 page 4 <br />, Properly address: 280 Hollander Road,Orono,MN Inspector initialslDate: J.O.9/02/16 <br /> 4. Soil Separation—Compliance component#4 of 5 <br /> Date of installatlon: � Unknown Ver�cation method(s): <br /> ShorelandNYellhead protecGoNFood Beverege �Yes �No Sal observetlon does not expire.Previous soi! <br /> Lodping? <br /> obseroations by(wo independent parties are su�c+ent, <br /> COmplienCe Crit8�8: unless site conditrons have been alfered orloca! <br /> r�squir�ments differ. <br /> Forsystems built priorto Apri!i, i996, and ❑Yes ❑No <br /> not located in Shoreland or We!lhead � Conducted soil observation(s}(Attech horing logs) <br /> Protection Area ornot seiving a fooa; ❑ Two previous veritications(Attach boring logs) <br /> beverage orlodging establishment• � <br /> i ❑ Not appliCet�le(Hokling tank(s),no dreinfieid) <br /> Drainfietd has at least a two-toot vertical ' <br /> separation distance from periodicelly i ❑ Unable to verify(Ses Comments�'xp►anation) <br /> saturated soii or bedrodc. � ❑ Other(See CommentslExplananon) <br /> Nonperformance systems built Apri!1, �Yes ❑No Comments/Exp(anallon: <br /> 9998,or later or for non-performance ; <br /> sysiems located in Shoreland or Weflhead j <br /> P�tecHon Areas orserving a fooci, ; <br /> beveraqe,or l0afging establishment. � <br /> Drainfield has a three-foot vertical <br /> separation distsnce from periodically I <br /> saturated soil or bedrodc." <br /> `Experimenfa!" "Other",or Performance" ❑ Yes ❑No Indicate depths of elevations <br /> systems buift under pre-2008 Rules; Type 1V � � <br /> or V systems buiM under 2008 Rules(7080. ; A. Bottom ot distrlbulion media � 102.9 <br /> 2350or7080.2400 (Advanced Inspedar � <br /> License required) B, periodical saturated soiVbedrock 100.0 <br /> Drainfield msets the designed vertical I C. S stem se aration 2.9 <br /> separation distance from periodically j <br /> saturated soil or bedrodc. i <br /> _ D, Required compliance separation' � 2.6 <br /> Any "no"answer above Indicates the system is *May be reduc:ed up ta 15 percent i�allowed by Locat <br /> Faflfng to Protecf Graundwater. Ordinance. <br /> 5. Operating Permit and Nitrogen BMP*—Compliance oamponent#5 of 5 �Not applicable <br /> Is the system operated under an Operating Permrt? ❑Yes ❑ No tf"yes",A below is required <br /> Is the system required to employ a Nftrogen BMP? ❑Yes ❑No If"yes", B below is required <br /> BMP=6est Mar►agement Practice(s}specifred In the sysfem design <br /> If�e answer to both queatlons is"no'; th/s sectlon does not need tn be comp/eted. <br /> Compliance c�lteria <br /> a. Operating Permit number; I <br /> Have the Operatinc Pem�it repuirements been met? ' ❑Yes ❑ No <br /> i <br /> b. Is the required nitrogen BMP in place and properlY functbning? � ❑Yes ❑ No <br /> Any"no"answer indicates Noncompliance. <br /> Upgrade Requirements{Minn.Stat §115.55)An imminent threet to publrc health and se/ety(1TPHS)must be upgreCed,replaced,orlts use <br /> discorRinued wlfhln ten montFrs af receipt of this notiCe or withirt a shorier pertod if roquirad by focal adfnance.!f fhe system is failing to protect <br /> ground water,the system mustbe up,qraded,replaced,orits use discontinued within the time required 6yloca!orUinance.K sn existing system <br /> !s not farGnp as�ned in law,and has at least two fiset o�desrgn Soil separatian,then the system need not be upgraded,repaired,ruplaced,o� <br /> its use disconfinued,notwrthstandJng any focal oniinance tnat is more sirict. This provision does nof appdy to systems in shaefand areas, <br /> WeNhead Prvtection Naas,a those used in connection wrth food,beverage,and lodging estabNshments as defined in Isw. <br /> www.pca.state.mn.us • 651•296-6300 • 800•657-386a • TTY 651•282-5332 or 800-657•38b4 • Availabte in alternative formats <br /> wq-wwists4-3t . 1/24!12 Page 3 oj 3 <br />