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13-84 ■ SECTION 13: Forms and Reference <br />UNIVERSITY Septic System Management Plan <br />OF MINNESOTA for Above Grade Systems <br />Your Septic Svstem <br />Septic System Specifics <br />System Type:010HQIII " © v" <br />(Based on AN Rules Chapter 70802200-2400) <br />E]System is subject to operating pmniN <br />El System uses uv disinfection unit* <br />Type of advanced treatment unit <br />"AddUional Management Plan required <br />Dwelling Type <br />Well Construction <br />Number of bedrooms: 4 <br />Well depth (ft): <br />System capacity/ design flow (gpd): 1,00 <br />ElCased well Casing depth: <br />Anticipated average daily flow (gpd):2� o <br />11 Other (specify): <br />Con rats <br />Distance from septic (ft): <br />Business? _ What type? <br />Is the well on the design drawing?OY © N <br />Septic Tank <br />One tank Tank volume: gallons <br />Pump Tank & O gallons <br />Does tank have two compartmems?()Y ON <br />77ITwo tanks Tank volume: M 0 gallons <br />IUUV <br />❑ Tank is constructed of <br />❑ Effluent Pump make/model: 1)4, N2• <br />Pump capacity 1�3 GPM <br />IDH 10 Feet ofLead <br />Effluent Screen type: <br />❑ Alarmlocation J-bOJSJ-- <br />- SoB Treatment Area (STA) <br />Mound/At-Grade area (width x length): 4% it x Ba. ft <br />Cleenouta or inspection ports <br />Rock bed size (width x length): to it x 50 ft <br />Surface water diversions <br />Location of additional STA: <br />Additional STA not available <br />2- <br />