07-25-2018 Septic Design - Laserfiche WebLink

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Daycare / In home business ❑ Yes ED No Soil Information Site Information Evidence of site: Existing & proposer! lot ❑ Yes ❑ No Well casing depth 120' ❑ Yes improvements located (see site map) Compacted ❑ Yes ❑Q No Disturbed ❑ Yes Easements on lot located 0 Yes ❑ No Drainfield w/in 100' of ❑ Yes No (see site map) residential well Property lines determined ❑ Yes ❑ No Site w/in 200' of transient ❑ Yes ❑ No (see site map) noncommunity water supply (TNCWS) iteq'd setbacks determined 0 Yes ❑ No Site Win an inner wellhead ❑ Yes Q No (see site map) mgmt zone (CWS/NTNCWS) Utilities located & identified Q Yes ❑ No Buried water supply pipe ❑ Yes Q No (gopher state one call) w/in 50' of system Access for system maintenance ❑ Yes ❑ No Site located in Shoreland ❑ Yes ❑ No (shown on site map) (w/in 1000' of lake, 300' of river) Soil treatment area protected ❑ Yes ❑ No Site map prepared with ❑✓ Yes ❑ No previous items included Construction related issues Soil Information Evidence of site: Cut ❑ Yes Q No Filled ❑ Yes ❑ No Compacted ❑ Yes ❑Q No Disturbed ❑ Yes Q No Original soils 0 Yes ❑ No Soil logs completed and attached 0 Yes ❑ No Soil loading rate (U&ft2) Depth/elev to SHWT Depth to system bottom maximum (or elev minimum) Depth/elev to standing water (if applicable) Deoth/elev to bedrock Survey information 0.45 20.00 -16.00 n/a Perk test completed and ❑ Yes ❑ No attached (if applicable) Percolation rate (if applicable) n/a Flooding or run-on potential ❑ Yes No (comments) Flood elevation (if applicable) n/a Elevation of ordinary high n1a water level (if applicable) Na Floodplain designation and Q Yes ❑ No elev - 100 yr/10 yr (if applicable) n/a