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UNIVERSITY <br />OF MINNESOTA OSTP As -Built Form <br />Owner: Ole Hovde & Carlie Hovde Parcel Number: 3311823430004 <br />Street/City/Zip Code: 2640 Watertown Road, Orono, MN 55356 <br />Lot: 1 Section: 33 Township: 118 N Range: 23 W <br />Installation Date: Installer: Saint Croix Sewer License Number: 3977 <br />Is the system in Shoreland, serving a MDH facility or in a Wellhead Protection area? ❑ YES 0 NO <br />Number of Bedrooms/ Flow Rate: 5 / 750 # / gpd Septic Tanks, No & Size: 2 / 1,250 & 1,000 #/gal <br />Pump Tank Size: 1,250 gal Tank Manufacturer: WIESER CONCRETE <br />Pump Size: 0.4 hp 36 gpm 17 ft of TDH Floats properly set? 121 YES ❑ NO <br />Soil Treatment Area: <br />0 TYPE 1 ❑ TYPE II ❑ TYPE III ❑ TYPE IV ❑ TYPE V <br />❑ TRENCH ❑ BED ❑ MOUND IN AT -GRADE ❑ WARRANTIED ❑ OTHER: <br />Limiting Layer/Depth: 14 " Rockbed Size: 10' x 62.5' Describe: <br />Depth from Surface: <br />Media or Slat depth: <br />" Adsorption Width: 27' <br />Trench Width: ft <br />Bottom Square Feet Area: 625 ft z <br />Design Variances: <br />Other Information: <br />List any further system descriptions: <br />Sand Depth: 22 inches <br />(under mound) <br />List any material testing results (jar test, sieve analysis, etc): <br />List conditions during construction: <br />List who is responsible for establishing vegetative cover: <br />I hereby certify that I have completed this work in accordance with applicable ordinances, rules, and laws. <br />Saint Croix Sewer (Installer) 3977 (license #) $/4/2023 (Date) <br />