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Property addrese: 1250 Lyman Ave.,Orono MN inspector in(tials/Date: J.O.02/07/14 ' <br /> 4. Soil Separation—Compliance component#4 of 5 <br /> Date of installation: 9/27/2000 ❑Unknown Verif(cation method�s): <br /> Shoreland/Welihead protecUoNFood Beverage �Yes �No Soil obsenreBon does not explie.Prevlous soll <br /> Lodging? <br /> observaUons by(wo/ndependent parfies arn suf!"iclent, <br /> CompllanCe Crlteria: unless sife condldons have been alter�d orlocal <br /> For systems built prfor fo April 1, 1996,and ❑Yes ❑No �4ulrements dlffer. <br /> not located in Shoreland orWellhead � Conducted soil observation(s)(Atlacb boring logs) <br /> Protecfion Ares ornof senring a food, ❑ Two previous verificatlons(Attach baing/ogs) <br /> beverage orlodging esfabUshment• ❑ Not appUcabie(hlolding tank(s),no dralnHe�d) <br /> Drainfield has at least a iwo-foot vertical ❑ Unable to verity(See Comments/Explanaf/on) <br /> separation distence from periodically ❑ Other(See Comments/ExpJanatlon) <br /> saturated soil or bedrock. <br /> Non-performance sysfems bullt April 1, �Yes ❑No Commenfs/ExplanatJon: <br /> 1996,orlatero�fornon performance <br /> systems located!n Shoreland or Wellhead <br /> ProtecNon A�eas orserving a faod, <br /> beverage,ar Iodg/ng establishment: <br /> Dralnfleid has a three-foot vertical <br /> separation dfstance from periodically <br /> saturated soil or bedrock" <br /> "Experimental; "Othe�',or Pertormance" ❑Yes ❑No Indicate depths of elevations <br /> systems buHt under pre-2008 Rules;Type!V , <br /> or V systems builf under 2008 Rules(7080. A. Bottom ot distrtbuUon media 988.0 <br /> 2350 or 7080.2400 (Advanced Inspector <br /> Llcense requlred) B. Periodical saturated soiVbedrock 996.0 <br /> Dralnfleld meets the designed vertical C. S tem se aratfon 3.0 <br /> separation distance from periodically ti <br /> saturated soil or bedrock. <br /> D. Re uired com Ilance ae ration' 2.6 <br /> Any"no"answer above indicates the system is *May be reduced up to 1b percent if allowed by Local <br /> Failing to Profect Groundwater. Ordinance. <br /> 5. Operating Permit and Nitrogen BMP*—Compliance component#5 of s �Not applicable � <br /> Is the system operated under an Operating Permit7 ❑Yes ❑No If"yes",A below is required <br /> Is the system required to employ a Nltrogen BMP? ❑Yes ❑No if"yes",B below is required <br /> 6MP=Best Manegemenf Practice(s)speclfied!n the sysfem deslgn <br /> If the answer to both questfons 1s"no';thls sectfon does not need to be completed. <br /> Com liance cNteNa <br /> a. Operating Permft number: <br /> Have the 0 eratin Permit ulrements been met? ❑Yes ❑No <br /> b. Is the required nitro en BMP in lace and ro erl funcUonin ? Yes ' No • <br /> Any"no"answer Indicates Noncomp/iance. <br /> Upgrade Requirements(Mlnn.Stat§115.65)An lmmtnent threat to publlc health and safely(ITPHSJ musf be upgreded,replaced,or lts use <br /> discontlnued wlthln ten months of recelpf of fhls noBce or within a ahorter period if required by local oroUnance_If the sys(em!s falling to protect <br /> qround water,the system musf be upgradeai,replacetl,orits use d/sconUnued withTn the time required by local ordinance.Jf en exlsting system <br /> Is not fe111ng as def/ned fn lew,and has at/east two feet of deslgn soil separetlon,fhen the system need not be upgreded,repalred,repleced,or <br /> Its use disoontlnued,nolWllhstanding any local ordinance that is more stdck Thls provls/on does not eppty to systems in ahoreland areas, <br /> Wellhead Protectlon Areas,or those used in connecdon w/th food,beverage,and lodgtng establishments as deflned In law. <br /> www.pca.state.mn.us • 651-296-6300 • 800•657�3864 • TTY 651-282-5332 or 800-657-3864 • Available in altematNe formats <br /> wq-wwtsts4-31 • 1/241 i1 Poge 3 of 3 <br />