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Jul 12 13 06:38a Joseph Olson 763-498-8290 p.4 <br /> Property address: 3680 Jacobs Miil Road,�rono,MN Inspedor initialslDate: J.O.7I03/13 <br /> 4. SOiI Sepdration—Compfiance com�onent#4 of 5 <br /> Date of ir�stallation: 7113f00 ❑Unknawn Yerification me#hod(s): <br /> ShorelandJwenhead probectionlFood 8everage �Yes �No Soi!observa6on does not ex �re. P�vious soi/ <br /> Lodging? observations by fi�vo indepeadentparties a�e swfficier�t, <br /> Com liance criteria: unless srte concfibons have been altsr�d orlocal <br /> requrrements differ. <br /> For systems builtArrortv April l, 1996,and ❑Yes ❑ No <br /> notlocated in 5horeland orWellhead � Cor�ducted soil obsenration(s)(attach boringlogs) <br /> Proteeetion Area or not serving a faod, ❑ Twa previous verifications(Attech ba�ng logs) <br /> beverage orlodging estaWishment.� i ❑ Not applicable{Holding�tank(s),no drair�eeld) <br /> Drainfield has at least a two-fvot vertical ❑ Unable to verify(See CammenisiExplanation) <br /> separaiion distance from periodically <br /> saturated soil or bedrock. ❑ Other(See CommentslEzplana6on) <br /> Non-perforrnance systems built Apn!1, �Yes ❑No Commenfs/Explana6on: <br /> i996, orlaterorfornon-perfoimance <br /> sysfems located rn Shoreland o�Wellhead <br /> Protection Ar�as orserving a food, <br /> beverage, orlodging establishment: <br /> Drainfield has a three-fioot vertical <br /> se�aration distance from periodically <br /> saturated soil or bedrock* <br /> Experimental� "Ofher;or Aerinrmance" p Yes ❑ No Indicate de hs of elevations <br /> systems built underpr�-2008 Rules;Type lV <br /> or V systems built urrder2008 Rufes(70$0. A. Bottom of distribution media 101_D <br /> 2350 or 7080.2400 (Advanced fnspedor <br /> LiCense reC;uired) B, Periodica3lY saturated soiUtredrock ! 98.4 <br /> Urainfield rnePts tt►e designed�ertical � <br /> separation distance from periodiqlly ' C. System separation 2.6 <br /> 38turated soil oa bedrock. � D. Required compliance separatian' 2.6 <br /> Any"»o"answer above indicates the system is �ay be reduc�d up to 15 percent if allawed by Local <br /> Failing tn Protect Groundwater, Ordinance. <br /> 5. Operating Permit and Nitrogen BMP*—comp�iance component#5 of 5 �Not applicable <br /> Is the system operated under an Operating Permit? ❑Yes [3 No If"yes",A belaw is reyuired <br /> !s the system required to employ a Nitrogert BMP? ❑Yes ❑Nto If"yes",B below is required <br /> BMP-BesE Management PracS'ce(s)specrfred in the system design <br /> If the answer ia both questions is"no'; this sectfon does not need to be completed. <br /> Compliance criteria <br /> a. Operaiing Permit number. <br /> Have the Operating Perrnit requiremeMs been mel? ❑Yes ❑ No <br /> b. ts the required nitrogen BMP in place and properly(unctioning? � ❑Yes Q No <br /> My"no"answer indicates IVoncompliance. <br /> Upgrade Requiremerrts(JUJinn. Stat§115.55)An imminent threat to publ'rc heekh arrd sa(ety(ITPHS)must 6e upgraded,replaced, or ifs use <br /> discontrnued wrfhin ten months of�csipt of this notice or within a shorter period if required bylocal ortiinance.!f the system Js fsiling fo protect <br /> ground water,Ure system must be upgraded,replacetl,or its use disaontrnued within fhe trme required by loca/ardinance_!f an existir+g system <br /> is nof faifinQ as defined in law,and has at/east two feet of design soi!s�eparation,then the system need not be apgigded,repaired,repfaced,or <br /> its use Jsoonfinved,nohwitPrsl�nding any kca!adinance�hat is more strrct 77tis provision does not apply to systems in shoreland areas, <br /> Wellhead Protedion A�as,or those used in oonrtecliort with food,beverdge,and lodging estabfishments es clefined in law. <br /> www.pca.state.mn.us • 651•296-6300 • 800-657•3664 • TTY 651-282-5332 or�00-657-3864 • Available in altemative formatr <br /> wq-wwists4-31 . 1l24/i2 Page 3 of 3 <br />