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� Property address: _.575 Kokesic Farm Road, Orono,MN __ _ Inspector initialslDate: J.0. 5/04l'E7 <br /> �, ,� , , - rr �� ..., <br /> 4. Soil SepBratiOn —Compliance component#4 of 5 '°��9�� '"�"''"�"`�° " " <br /> Date of installation: 11/08/02 � Unknown Veri�cation method(s): � <br /> ShorelandlWeiihead protectioNFood Beverage <br /> Lodging? ❑Yes � No Soi!observatior�does not expire. Previous soiJ <br /> observations by two independeni paRies are su�cisnf, <br /> CompGdnce cri4eria: unless site conditions have been altered orloca! <br /> Far systems buiit prior to April�, 1996, and ❑Yes ❑ No �quirernents differ. <br /> nat focafed in Shoreland or Wetlhead � Conducted soii observatian{s)(Artach 6orrng tags) <br /> Protection A�ea or not servfng a faod, ❑ Two previaus verifications(Attach banng�ogs) <br /> beverage ortadgfng esiabiishmer+t: <br /> � Not appiicabie(ttad,ng tank(s),no drainfreld) <br /> Drainfieid has at least a two-foot vertical ❑ Unabie to verify(See CommentslExptanarson) <br /> separation distance from periodicaliy <br /> saturated soil or bedrock. 0 Other(See Commenis/Expianation) <br /> Non-performance systems buiif Apri!1, �Yes ❑ No Comments✓Exptanation: <br /> 1996, or later or for non-perfom►ance <br /> systems located in Shoreland or WeUhead <br /> Protection Areas or serving a food, <br /> beverage, or Jodging establishment: <br /> Drainfieid has a three-foat vee-t6cal <br /> separation distance from periadicaliy <br /> saturated soil or bedrock.'` <br /> "Experimental; `Other; or "Performance" ❑Yes ❑ No Indicate depths af elevations <br /> systems buitt under pre-20(l8 Rules: Type!V ' � "-"�" --����-— <br /> or V sysfems built under 2008 Rutes(7080. A. Bottam of distribution media 104.2 <br /> ___ _ . __ _�_____--- <br /> 2350 or 7080.2400 (Advanced Inspector : <br /> License required) ' B. Periodically saturated soillbedrock 101.6 <br /> Drainfield meets the designed vertical C. System seearation__�_ 2.6 <br /> separation distance fram per'rodicaify .___..._ _ _____ <br /> saturated soil or bedrock. D. Required compliance,separation�. , 2.6 <br /> __.._..___ __. <br /> Any "no"answer above lndicates the system is <br /> `May be reduced up to 15 percent if aliowed by Local <br /> Failing fo Protect Groundwater. Ordinance. <br /> 5. C}perating Permit and Nitrogen BMP*—Comp�iance component#5 of 5 � Not applicabte <br /> !s the system operated under an Operating Permit? Q Yes ❑ No !f"yes",A below is required <br /> (s the system required to employ a Nitragen BMP? ❑Yes � No If"yes", B belrsw is required <br /> BMP=Best Management Pracfice(s)specfied in the system design <br /> If the answer ta both questians is "na", this section does not need ta be compteted. <br /> Com liance criteria <br /> a. Operating Permit number: ' � <br /> - � ❑Yes � No <br /> � Have the Operating Pe�mit requirements been met? <br /> _b. Is the_re uired nitrogen SMP in place anci properi fy unctioning? Yes a No ` <br /> Any "no"answer indicates Noncompliance. <br /> Upgrade Requirements(Minn. Stat.§115.55)Arr imminent threat to public heatfh and safety(lTPHS)musf 4e upgraded,rep/aced,or its use <br /> drscantrnue�`within ten months af receipt of this notice or within a shorter period if requirgd by loca!ordinance. lf the system is failing to protecP <br /> ground water,the sys[em must be upgraded,replaced.or its use disconiinusd withirt the time requirad by locaf ordina»ce.!f an existing system <br /> is not failing as defirted in taw,and has at feast two feet of design soil separation,then the system need nof be upgraded,repaired,replaced, or <br /> its use drsconfinued,nohaithstanding any/ocat ordinanCe that is mae stricf. This provlsion does not appJy to systems in shor8lar�d areas, <br /> Wellriead Profection Aress,or those used in connectron with food,beverege, and ladging establishments as defined in lew. <br /> _.. _.._ _...._. __ __..__.,_—__..._ _ _ ..__ _� <br /> www.pcastate.mn.us • 551-246•6300 • 8�-657-3864 • TTY 651-282-5332 or 800-657-3854 • Available in attemative formats <br /> wq-ww�sts4-3t • 1124/f2 ,.___ , _�, <br />