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UNIVERSITY OF MINNESOTA OSTP Field Evaluation Form 1.Contact Information Project ID: v 05.13.14 Property Owner/Client Lindsay and Anna Klombies Client Phone Number: Address Same Date Weather Conditions 2. Utility and Structure Information Utility Locations Identified ❑Gopher ate One GII x E::= ❑Any Private utilities Property Lines ❑Determined and Approved W Client Client's Approval(initial) ❑Determined but not Approved ❑Approximate ❑property Lines Surveyed Locate and Verify(see Site Evaluation map) ❑Existing Buildings ❑Improvements ❑Easements ❑Setbacks 3. Site Information Percent Slope 8 Slope Direction Landscape Position shoulder Slope Shape Vegetation type(s) grass Evidence of cut,fill,compacted or disturbed areas ❑Yes No Discuss the flooding or run-on potential of site Identify benchmarks and elevations(Site Evaluation Map)Existing septic tank lid Proposed soil treatment area adequately protected 0 Yes ❑No 4. General Soils Information Original soils El Yes ❑No Type of observation ❑Soil probe Q Soll Boring ❑Soll pit Number of soil observations 3 Soil observations were conducted in the proposed system location 0 Yes ❑No A soil observation was made within the most limiting area of the proposed system ❑Yes ❑No Soil boring log forms completed and attached ❑Yes ❑No Percolation tests performed,forms completed and attached ❑Yes ❑No 5. Phase I.Reporting Information Depth to standing water inches Anticipated construction issues Flood elevation feet Depth to bedrock inches Depth to periodically saturated soil inches Maximum depth of system 48" inches Elevation at system bottom feet Differences between soil survey and field evaluation Percolation rate 15 min/inch Loading rate 0.78 gpd/ft' Contour loading rate 12 gpd/ft Site evaluation issues/comments I hereby certify that I have completed this work in accordance with all applicable ordinances,rules and laws. Swedlund Septic �.J'J'- -k 2502 10/17/14 (Designer) (Signature) (License#) (Date)