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UNIVERSITY Septic System Management Plan <br />for Above Grade Systems <br />OF MINNESOTA <br />Your Septic System <br />❑ -Cleanout <br />_ Manhde <br />Frain {�unq> nmk <br />Mound <br />Ia wal deanuut. _ - <br />&I <br />Goss4"Ilon of mound Ols¢ilw:ion "A <br />h sWden pipe- <br />Sam <br />ipe Sand <br />2 •..'fiagq,rahsdd' 'voLTurtHJ'w+!¢ipa r . <br />Septic System Specifics <br />System Type: (j) I ()Il ()III ()IV* () V* <br />!� System is subject to operating permit* <br />(Based on 1b1IV Rules Chapter 7080.2200 — 2400) <br />❑ System uses UV disinfection unit* <br />*Additional Management Plan required <br />Type of advanced treatment unit <br />Dwelling Type <br />Well Construction <br />Number of bedrooms: 4 <br />Well depth (ft): Unknown <br />System capacity/ design flaw (gpd): soo <br />❑ Cased well Casing depth: <br />Anticipated average daily flow (gpd): 400 <br />❑ Other (specify): <br />Comments <br />Distance from septic (ft): 245 <br />Is the well on the design drawing? eY 0 N <br />Business?: Q Y e N What type? <br />Septic Tank <br />❑ First tank Tank volume: gallons <br />❑ <br />Pump Tank gallons <br />Does tank have two compartments? ()Y ON <br />❑ <br />Effluent Pump make/model: <br />❑ Second tank Tank volume: gallons <br />Pump capacity GPM <br />❑ Tank is constructed of <br />TDH Feet of head <br />❑ Effluent screen:() Y e N Alarm ()Y `:JN <br />❑ <br />Alarm location <br />Soil Treatment Area (STA) <br />Mound/At-Grade area (width x length): 41 ft x 76 ft <br />� <br />Rock bed size (width x length): 10 ft x 50 ft <br />Inspection ports ❑ Cleanouts <br />Location of additional STA: See drawing❑ <br />Surface water diversions <br />Type of distribution media: Rock <br />❑ <br />Additional STA not available <br />-2- <br />