HomeMy WebLinkAboutSE22-000007 Asbuilt & Pump Form�7kfSHO
Address 2640 Watertown Road,
Installer Saint Croix Sewer
Septic Tanks 1,250;1,000
System Type p I ❑ II
City of Orono Septic Asbuilt Form
Orono, MN 55356
Building Use Residential
License # 3977 Date 8/4/2023
Pump Tank 1,250
❑ III p Mound ❑ Trenches p Pressure Bed ❑ Other
Draw detailed diagram with measurements indicating distances to tank risers using 2 points from a permanent
structure. Show location of drop boxes and length of trenches.
See Attached
UNIVERSITY
OF MINNESOTA OSTP As -Built Form
Owner: Ole Hovde & Carlie Hovde Parcel Number: 3311823430004
Street/City/Zip Code: 2640 Watertown Road, Orono, MN 55356
Lot: 1 Section: 33 Township: 118 N Range: 23 W
Installation Date: Installer: Saint Croix Sewer License Number: 3977
Is the system in Shoreland, serving a MDH facility or in a Wellhead Protection area? ❑ YES 0 NO
Number of Bedrooms/ Flow Rate: 5 / 750 # / gpd Septic Tanks, No & Size: 2 / 1,250 & 1,000 #/gal
Pump Tank Size: 1,250 gal Tank Manufacturer: WIESER CONCRETE
Pump Size: 0.4 hp 36 gpm 17 ft of TDH Floats properly set? 121 YES ❑ NO
Soil Treatment Area:
0 TYPE 1 ❑ TYPE II ❑ TYPE III ❑ TYPE IV ❑ TYPE V
❑ TRENCH ❑ BED ❑ MOUND IN AT -GRADE ❑ WARRANTIED ❑ OTHER:
Limiting Layer/Depth: 14 " Rockbed Size: 10' x 62.5' Describe:
Depth from Surface:
Media or Slat depth:
" Adsorption Width: 27'
Trench Width: ft
Bottom Square Feet Area: 625 ft z
Design Variances:
Other Information:
List any further system descriptions:
Sand Depth: 22 inches
(under mound)
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.
Saint Croix Sewer (Installer) 3977 (license #) $/4/2023 (Date)
2640 Watertown Road, Orono
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Tanks:
1stTank Inlet Invert
1028.7'
2nd Tank Outlet Invert - 1027.9'
0 30
60 120
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I I I Feet
Pump and Alarm Verification Form
Site Address: C q p W.,,+ `"+�►-� (Zoc-j
Company Name: 5 i►, "+ C rb -i x 5"-'c'r License #: 3 q T7
1. That a representative or I of my company has verified that the Indoor or Outdoor Pump Alarm
sounded by lifting the float switch and the alarm light is on and that the pump was tested with
the float switch.
2. If applicable, that myself or a representative of my company has verified that the Indoor or
Outdoor Filter Alarm sounded by lifting the float switch and the alarm light is on.
Date:
Print Name:
Signed:
Please upload to your permit in Citizenserve when completed.
Final Inspection and certificate of compliance cannot be issued until this form is received.