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UNIVERSITY <br />OF MINNESOTA <br />Septic System Management Plan <br />for Above Grade Systems <br />Your Septic System <br />Septic System Specifics <br />System Type: (j) I V Il ()1II OIV* () V* <br />O System is subject to operating permit* <br />(Based on AEV Rules Chapter 7080.2200 — 2 '00) <br />F-1 System uses UV disinfection unit* <br />*Additional Management Plan required <br />Type of advanced treatment unit <br />❑ Tank is constructed of <br />TDH Feet of head <br />Dwelling Type <br />Well Construction <br />Number of bedrooms: 4 <br />Well depth (ft): Unknown <br />System capacity/ design flow (gpd): 600 <br />❑ Cased well Casing depth: <br />Anticipated average daily flow (gpd): 464 <br />❑ Other (specify): <br />Comments <br />Distance from septic (ft): 220 <br />Is the well on the design drawing? @Y N <br />Business? : C) Y e N What type? <br />Septic Tank <br />❑ First tank Tank volume: gallons <br />❑ Pump Tank 1260 gallons <br />Does tank have two compartments? oY 0 N <br />❑ Effluent Pump makefmodel: <br />❑ Second tank Tank volume: gallons <br />Pump capacity GPM <br />❑ Tank is constructed of <br />TDH Feet of head <br />❑ Effluent screen: Y V N Alarm QY 0 N <br />1 ❑ Alarm location <br />Soil Treatment Area (STA) <br />Mound/At-Grade area (width x length): 44 ft x 74 ft <br />Inspection portsCleanouts <br />❑ <br />Rock bed size (width x length): 10 ft x 50 ft <br />Location of additional STA: N/A <br />Surface water diversions <br />Type of distribution media: Rock <br />Additional STA not available <br />-2- <br />