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HomeMy WebLinkAbout10-23-21 Septic Design781 N Ferndale Road Permit: SE21-000026 SP Testing, Inc. 10/23/2021 X OSTP As-Built Form Owner:________________________________Parcel Number: ______________________ Street/City/Zip Code:_________________________________________________________________________ Lot: ___________ Section: ___________ Township: ____________ N Range: ____________ W Installation Date:_______________ Installer:__________________________ License Number: __________ Is the system in Shoreland, serving a MDH facility or in a Wellhead Protection area? YES NO Number of Bedrooms/ Flow Rate:_________________# / gpd Septic Tanks, No & Size:______________#/gal Pump Tank Size:_________________gal Tank Manufacturer: __________________________________ Pump Size: _________ hp _______ gpm _______ft of TDH Floats properly set? YES NO Soil Treatment Area: TYPE I TYPE II TYPE III TYPE IV TYPE V TRENCH BED MOUND AT-GRADE WARRANTIED OTHER:______________ Limiting Layer/Depth:________” Depth from Surface:_________ ” Media or Slat depth:__________ ” Trench Width:______________ft Rockbed Size:_____________________ Adsorption Width:__________________ Sand Depth:_______________________ (under mound) Describe: __________________ __________________________ __________________________ __________________________ Bottom Square Feet Area:____ft 2 Design Variances:____________________________________________________________________________ Other Information: List any further system descriptions: List any material testing results (jar test, sieve analysis, etc): List conditions during construction: List who is responsible for establishing vegetative cover: I hereby certify that I have completed this work in accordance with applicable ordinances, rules, and laws. ________________________________________(Installer) ________________(license #) ___________(Date) Site Drawing: 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 on width and final dimensions. Indicate alarm location. 2. Show all setbacks from tank and soil system including: A. Property boundaries 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. Abandon system © 2020, 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 05/20. North