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HomeMy WebLinkAbout9-11-2021 septic-asbuiltUNIVERSIT) OF INNESO7 Owner: ' 1, Street/City/Zip Code: Lot: �4 'g U2 Installation Date: Is the system in ShorE Number of Bedrooms/ Flow Rate: 6 gpd Septic Tanks, No & Sizer y 7A#/gal Pump Tank Size: 1,;2 j C gal Tank Manufacturer: 5P 94k Model # Date of Manufacture: 7-?'-Zj Maximum Burial Depth: _4_ Pump Size: (.5- hp_ gpm _ft of TDH Floats properly set? YES ® NO Soil Treatment Area: LTYPE 1 E3 TYPE II ® TYPE III Li TYPE IV © TYPE V Ell TRENCH ® BED ® MOUND U AT -GRADED WARRANTIED ® OTHER: Limiting Layer/Depth: (/K Rockbed Size: f0 (y Depth from Surface: Adsorption width: , Rock or Slat depth: Sand depth: Diameter of travelless: (under mound) Trench Width: iii Bottom Square Feet Area: ft` Design Variances: e 414 6A"R F H (; ak 0/ re 11:�� m�Vcn Q 4% Describe: items to be identified: 1. Septic, holding and pump tanks, piping, and soil system configuration. Label bed or trench width and length or rockbed size, absorption width and final dimensions. Indicate alarm location. 2. Show all setbacks from tank and soil system a. Property boundries b. Buildings c. Wells d. Water bodies e. Road right-of-way 3. Improvements - present and future. 4. Benchmark location and distance of tank and soil system from benchmark 5. Replacement site 6. Abandoned system Reverse Side Other Information: List any further system descriptions: List any material testing results (jar test, sieve analysis, etc): List conditions during construction: Row or-abIC List who is responsible for establishing vegetative cover: I herby certify that I have completed this work in accordance with applicable ordinances, rules, and laws. f (Installer) (' %( � (license #) -//-2 (Date) © 2009, Regents of the University of Minnesota. All rights reserved. For additional copies or for Americans with Disabilities Act accommodations, please call (800) 322-8642. University of Minnesota is an equal opportunity educator and employer. Updated 09/09.