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Data of 1111gal/1001g 1 0 Unknown Vorthcation method(s); <br /> Shoidand1Weilheed protectionrrood Direeraige- yeso No So,/observabon does.not expire.Previous sail <br /> Lodging? • • obeeivatiOns by 11440 independent pieties are sufficient, <br /> Compliance cninda- V. • unless stlecomfdicen have been altered or local <br /> reguirerners differ. <br /> • <br /> For systrinS Wit ptiorteapie tsss,and 0 Yes El No y <br /> - conducted soy 5brairvatian(s)pumice swing togs) <br /> not located in ShoMiand or Kbabeed <br /> Protection Area or not earwig a food 11 Two previous velifications(A homy fami <br /> beverage or bdging estabhshnent itit Not apptigalle(Haft tanks),no cialelat9 <br /> Drain5eld has at least a two4ont insfiCal 0 Unable to verity(Site OsessanniEwienarien) <br /> separation distance kern petiodieelly Ei Other(See iSmeentsiErpienation) <br /> saturated soils bedroSit. <br /> Non-pedormalce sixteens buil Api 1; 0 Yes. OW Commentsecpbriatior <br /> 1995.or later or to r nomeedoenanee <br /> Protection Areas or seiveig bed, <br /> beverage,cc IsOgInaestablIshment <br /> Drainfreld has a thme-fixt inefical• <br /> separation riistance from pediatric:idly <br /> saturated sal or bediode <br /> "Experimenter.'Mart or Test emaaes- - Indicate depths of elevations <br /> . <br /> systems bull under pm-2008 MAW Type IV . <br /> or V sytterte beat under ZOOS Rubs(7080. •• • A. Botta of disbhution made <br /> 2350 or 7080.2400 (Advenced haspeotrs- f <br /> License required) - B. Perham*seemed sobbadroCk <br /> • <br /> Drainfiekl meets the designed vadat • V C. System sepasition V <br /> separation distance from peitiOdically V V <br /> .01/ <br /> saturated soil or beck.• . 13- Regaled conelence separation' .3 <br /> Any"ne"answer above lediCatee the system is Noy holockiceo up to 15 pesuent slowed by Local • <br /> Failing 10 Prettied Grotindatitter. Onfirevice. <br /> 5. Operating Permit and Nitrogen 13PAP*—Cornpiance gomponent 115 of 5 NI Not applicable <br /> Is the system operated under an Operating Permit? ID Yes ID No Ituyes*,A below Is required <br /> Is the system required to employ a Nitrogen BMP? 0 Yes CI No If'yes",B below le required <br /> -V 7-BPJF-41eitt MatieOffillehrPtatTRIIKIPPICNiiad ttl-the Syaretn& M-- "*- -"'If the answer to both questions Is no this section does not need to be completed. <br /> • <br /> Compliance criteria V . • <br /> • <br /> a. Operating Fern*number: <br /> 0 Yes ij No <br /> Have the Operating Pernii requirements been met <br /> b_ Is the reguired_grogen BMP in • met V ? Yes 0 No <br /> • <br /> Any"no°answer imicates Noncompl • <br /> Upgrade Requirements(Iks.Stat S 11556)An invnerent thence a pubes health end=tear(RP )nide De&waded replaced sr Is Ise <br /> diedmill wed*Whin ten eionttie of feat“alibis notice or slide a shorter period inspired by local oitheincs lbe system is fake to protect <br /> grand Water.the slabs was!Is Lids(fetekimnl.ort seeatemilneen 4841M me km maulaid by ksel wness an derberno eyeteen <br /> is not fano eilefinen In les tine his stalest km feel cif design aca asparelicen.then the soros ruse riot be uppadiict iepseed,repassed Or <br /> Is use CliCOntilta4 notrdissining serf km raninanoit bat is more strict ThiC pentsion doee not Apply to miens! aharelend sets• <br /> Wellies!ProtectiOn Anne.areom ia.dS,ooneedbi sib food bevenifis and lotiOing tabiblishmento tee defined in liss <br /> WWw.pa4_stateaunasS - 651-286-6300 • 1130-657-81564 • • TTY 651-232-5332 or 800-657-31164 • Available in abernethy formats <br /> ( <br />