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SEPTIC SYSTEM INVENTORY <br />Site Address:2650 Countryside Dr W PID 04-117-23-12-0014 <br />Owner Name:Robert Jorgenson <br />Owner Address:2650 Countryside Dr W Long Lake MN 55356 <br />BuildingType:residence <br />Date of Permit:5/1/97 <br />System Type:mound <br />In Musa?:No <br />Installer:Clover Hill Co. <br />BR's Designed for 5 <br />Shoreland?:No <br />Material:precast concrete <br />Treatment Area:100*42 <br />Setbacks - Well Tanks: <br />Capacity:1300, 1300, 1300 <br />Soil Boring:yes <br />Well DF: <br />Tank Filter: <br />DF Ht above Wt:3 <br />Report In File: <br />SEPTIC TANKS: <br />DRAINFIELD: <br />WELL DATA <br />Depth:204 <br />INSPECTION RECORDS PUMPOUT RECORDS <br />Date Notes <br />5/22/2019 Compliance Certificate Passed Valid until 5-22-22 <br />8/1/2007 OK <br />8/1/2005 OK <br />7/7/2003 no surfacing,pump tanks <br />6/11/2001 no surfacing, pump tanks <br />4/9/1999 no surfacing <br />9/4/1997 installation <br />9/4/1997 installation <br />Date GallonsOfLiquid <br />5/22/2019 3000 <br />11/20/2014 2500 <br />4/11/2012 0 <br />9/24/2009 2500 <br />2/26/2007 2500 <br />11/24/2003 2500 <br />8/15/2000 2500 <br />8/15/2000 2500