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SEPTIC SYSTEM INVENTORY <br />Site Address: <br />4285 Sixth Ave N <br />PID: 3111823120005 <br />Owner Name: <br />Charles E. Larson <br />Owner Address: <br />4285 Sixth Ave N <br />Long Lake MN 55356 <br />Building Type: <br />residence <br />Installer: <br />Date of Permit: <br />unknown <br />System Type: <br />standard trench <br />BRs Designed for: 2 <br />In Musa?: <br />No <br />Shoreland?: <br />SEPTIC COMPLIANCE INSPECTION <br />Report Date: <br />Compliant <br />Expires: <br />Non -Compliant?: <br />Report in Street File?: <br />SPECIAL NOTES Site Address <br />05/22/08 2008 Septic Maintenance Report Ltr Sent <br />03/16/09 2009 Septic Maintenance Report Letter Sent <br />SEPTIC TANKS <br />Material: <br />DRAINFIELD <br />Treatment Area: <br />WELL DATA <br />Setbacks - Well -Tanks <br />Date <br />12/2/82 <br />8/15/86 <br />9/17/90 <br />8/12/91 <br />10/28/93 <br />8/20/96 <br />10/20/99 <br />11/01/02 <br />10/19/04 <br />09/01/06 <br />4/3/2009 <br />1:03:14 PM <br />Capacity: <br />Soil Boring: yes <br />60 Well -DF: 75 Report in File? <br />INSPECTION RECORD <br />Description <br />no surfacing <br />no surfacing <br />no surfacing -pump tanks <br />DF location unknown -pump tanks <br />owner located system -deep trenches,not verified <br />non -conforming -repair by 12/31/2006 <br />non -conforming, repair by 12/31/2006 <br />non-compliant, replace by 12/31/2007 <br />Non-compliant, replace by 12/31/2007 <br />Non-compliant, replace by 12/31/2007 <br />4285 Sixth Ave N <br />Tank Filter: <br />DF Ht above Wt: 0 <br />Depth: <br />PUMPOUT RECORD <br />Date Gallons <br />04/11/83 1000 <br />11/20/87 500 <br />