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Property ad5lress: 103 Manor Circle,Orona MN Inspector inttials/Date: J.O.5�D2h6 <br /> 4. Soil Separation—Compliance component#4 of 5 <br /> Date of instailstion: �Unknown Veriflcation method(a): <br /> Shorolan�Mlatl�d pro�c�°n�°ad e�r�° ❑Yes �No Sa!observatiar does not expire. P�evious soi! <br /> �� obsenrations by two indeperr�M petties a►te suA'Fcient, <br /> CompliarlCe CHteNs: unless site canditions have been atfered or bcal <br /> For systems buJtf prrvr to Apd!1, 1996, ar�f � ❑Yes ❑No �G!uirements d119�er. <br /> not b�aat�sd in Si�reJand or WellJ�ead � Conduded soil observation(s)(Attach bwtng logs) <br /> Protection Art�a or not ser►ring a ibod, ` ❑ Two previous�erifications(Attech baing/a�x) <br /> beverage or lodging establishrr►snt: ' <br /> � ❑ Not applicable(MoMing tenk(s),no drainileld) <br /> Drai�'ield has at I�aast a twafoot vertical ❑ Unabte to verify(See Comments�xplsneUon) <br /> separation di�t8t�from periodiCally I ❑ Other(See Comments/Exp/anation) <br /> saturated soil or bedrock. i <br /> Nat-periormance systems buiit Aprii 1, �Yes ❑No Comments/ExpJane6on: <br /> 1996, orlat�rorfornon-�rformern:e <br /> sys�tems bcsted in Shor+�lar�d or We�head <br /> Protecctia�Areas or serving a iood. I <br /> bever�ge�or'bdg�in9 estaWishment � <br /> Drainfield has a thnee-fcwt veRlcai i <br /> separation distanCe from�riodically <br /> saturated soii or bedrodc' i <br /> � + <br /> "Experimentel", "Othe�; or P�erformmsnce" ' ❑Yes ❑No Indicate depths of elevations <br /> systems bultt um�er pre-2008 Rules; Type lV � � � <br /> or Y sysQerr►s 6uilt under 20Q6 RWes(7080. A. eottan of diat�ibution media � 98.6 <br /> 2350 or 7080.2400 (Advanced Inspector � <br /> Li�nse required) � 8. Periodicaqy saturat�l soiUbedrodc � 95.6 <br /> Orainfletd meets the designsd verticai j i <br /> seParat[�t distence from peariodically � C. Syatem ser�araiioa � 3.0 . <br /> saturated soi)or I�drodc. D. Required o�npliance separation" I 2.8 <br /> Any"no"answer above fnc�c�tea the systern fs 'May be reduc�d up to 15�rce�t if aliawed by Local <br /> Fal/fng i�o Proteci Groundwai�er. Ordinar�e. <br /> 5. �perating Permit and N9trogen BMP*—Compliance component#5 of 5 � Nat applk:able <br /> Is the system operated under an Operating Permit'? ❑Yes ❑No !f"yss",A below b required <br /> Es tt�system required to empby a Nitrogen BMP? ❑Yes ❑No N"yes",B below is required <br /> BMP=Best Mana�ment Practice(s)specified in the system tlasign <br /> If the answer M both ques�ons Js "no'; th/s secNon daes nat neeaf�be comp/eted. <br /> Compliance c�iteria <br /> ..._ .—,—�_ <br /> a. Operating Permit num�r: j ❑Yes ❑ No <br /> Have the Operating Pertnit requirements been me#? � <br /> _. . , <br /> b. is the required nitrogen BMP in plec�s ar�d properly fur�tio�ing� ' ❑Yes ❑ No <br /> Any"no"answer lndicates Noncomplfance. <br /> Upyrads Requiremsnts(A�inn.Sfat§115.5�j An immJrtent th�e#to publacc heatth and sedety(lTPHS)must be upgreded,replaced,or its use <br /> �sconGinued wdhin ten rr�ths oP r+�[ael�cX thls noti��e or wlMin a shafer period if�qufiod by lo�c�at onaanarxa�.!f tiie system is failir►Q to prohect <br /> grounti wa�ar,th8�m must be upg�adad,replaoeel,w its e�e�sra►Nnued within 1�he tirr�required by bcal adinenoe.!f an exis6inq syshsm <br /> is►at feldng es aRat/»er�in law,end hes at/east two�feet c�ideslspt s�N�paratlon,�n the aystem need not be upgradsd,repeired,replsoed,ar <br /> it�u��ued,ndwibhstan�g any bcal or�na�thst i9 rnors sbfd'. ThTs prrn�ision does not ap�ly to systems in�lertd arees, <br /> Wel�ead P�t�on Arees.or d�+�ed iri ca�+aaction wfth 1bod.bevenags,and lod��g establishments as del�ned in law. <br /> www.pca.staat,e,mn.us • 651-296-6300 • 800-657-3$64 • 'f'TY 651-282-5332 w 840•657•3864 • Avaitabte in altemative formats <br /> wq-wwfsts4-31 • 1/24/12 D,,,,e,„f, <br />