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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: Q I ®II 0III OIV* () V* <br />[:] System is subject to operating permit* <br />(Based on MN 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): <br />System capacity/ design flow (gpd): 600 <br />❑ Cased well Casing depth: <br />Anticipated average daily flow (gpd): 475 <br />❑ Other (specify): <br />Comments <br />Distance from septic (ft): <br />Is the well on the design drawing? OY (F) N <br />Business? : O Y (F) N What type? <br />Soil Treatment Area (STA) <br />Septic Tank <br />� Inspection ports � Cleanouts <br />❑ First tank Tank volume: <br />gallons <br />❑ <br />Pump Tank gallons <br />Does tank have two compartments? OY ON <br />❑ <br />Effluent Pump make/model: <br />❑ Second tank Tank volume: <br />gallons <br />Pump capacity GPM <br />❑ Tank is constructed of <br />TDH Feet of head <br />❑ Effluent screen: Y e N <br />Alarm OY Q N <br />❑ <br />Alarm location <br />Soil Treatment Area (STA) <br />Mound/At-Grade arca (width x length): 50 ft x 86 ft <br />� Inspection ports � Cleanouts <br />Rock bed size (width x length): 10 ft x 50 ft <br />Surface water diversions <br />Location of additional STA: see drawing <br />Type of distribution media: Rock <br />Additional STA not available <br />-2- <br />