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DocuSign Envelope ID: D8AA32DD-94F0-4A26-ACCF-EFE01D862864 <br />13-880 SECTION 13: Forms and Reference <br />UNIVERSITY ,Septic Systeln Management Pian <br />OF MINNESOTA .for Above Grade Systems <br />Maiinte>liance ]Log <br />Track maintenance activities here for easy reference. See list of management tasks on pages 3 and 4, <br />Activity <br />Check frequently: <br />Leaks: check for plumbing leaks <br />Soil treatment area check for surfacing <br />Lint filter: check, clean if needed <br />Effluent screen; if owner -maintained <br />Check annually. <br />Water usage rate (monitor frequency___) <br />Caps: inspect, replace if needed <br />Water Use appliances — review use <br />Other: <br />Notes: <br />Mitigation/corrective action plan: <br />Date accomplished <br />"As the owner of this SSTs, I understand it is my -responsibility to,properly operate and maintain <br />the sewage treatment system on this property, utilizing the Management Plan, zf requirements in <br />this Management Plan are not met, I will promptly notify the permitting authority and take <br />necessarY corrective actions. If I have a new system, T agree to adequately protect the reserve <br />area for .Future use as a soil treatment system." <br />Pro e Owner Si ature: <br />Date <br />Plan Prepared By: S <br />IR <br />Certification # (Da') U)(—t( 3c)k� <br />02010 Regents of the University of Minnesota. All rights reserved, The University of Minnesota is an equal opportunity educator and emptoycr. <br />This material is available in ahernalive formats upon request. Contact the Water Resources Center, 612-524-9282, The Onsite Sewage <br />Treahnent Program is delivered by the university of Miancsola Extension Service and the Ur iversity of Minnesota Water RCaOUTCes Center, <br />