HomeMy WebLinkAboutSeptic System Inventory SEPTIC SYSTEM INVENTORY
Site Address: 520 Big Island PID 22-117-23-42-0021
Owner Name: Dan Austin 327
Owner Address: 4860 Rustic Way Shorewood MN 55331-
BuildingType: sfr Installer: Sons Excavating
Date of Permit: 05/14/08
System Type: mound BR's Designed for 2
In Musa?: Shoreland?: yes
SEPTIC TANKS:
Material: precast concrete Capacity: 1000, 1000, 1000 Tank Filter:
DRAINFIELD:
Treatment Area: 250 Soil Boring: yes DF Ht above Wt: 3
WELL DATA
Setbacks -Well Tanks: 50 Well DF: 50 Report In File: Depth:
INSPECTION RECORDS PUMPOUT RECORDS
Date x r _. Notes �'� l r . �< Date Ga t a ix uid
6/1/2017 Service inspection per MGT Plan 6/1/2017 0€
6/2/2016 Sludge Test- Per Mgmt Plan Agreement with City of Oronc 6/2/2016 0
6/1/2015 Sludge Test- Per Mgmt Plan Agreement with City of Oronc 6/1/2015 0
5/14/2008 Mound system installed 5/14/2008 0
SEPTIC SYSTEM INVENTORY
Site Address: 520 Big Island PID 22-117-23-42-0021
Owner Name: Thomas Judd 327
Owner Address: 520 Big Island PO Box 188 Excelsior MN 55331-
BuildingType: sfr Installer: Sons Excavating
Date of Permit: 05/14/08
System Type: mound BR's Designed for 2
In Musa?: Shoreland?: yes
SEPTIC TANKS:
Material: precast concrete Capacity: 1000, 1000, 1000 Tank Filter:
DRAINFIELD:
Treatment Area: 250 Soil Boring: yes DF Ht above Wt: 3
WELL DATA
Setbacks -Well Tanks: 50 Well DF: 50 Report In File: Depth:
INSPECTION RECORDS PUMPOUT RECORDS
Date Notes Date GallonsOfliquid
6/1/2015 Sludge Test- Per Mgmt Plan Agreement with City of Oron. 5/14/2008 0
5/14/2008 Mound system installed 0i
/
Septic Tank Pumping/Maintenance
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'Method of mews: -- Amanholes 0 itepeakinplpe(holdingtanksw139 - _
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Condition oftindue -
fitter cleaned: Yee ' baffles gnat 4.211 .... slam" ICS
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Septic Tank Pumping / Maintenance
www.SepticResource.com (vers 12.4)
JOwner Information
Date: — / /s-
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Owner: , -s �..,�k C
Property address: Owners address: (if different)
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Tank Information
Reason for(Pumping) ❑ compliance inspection 0 holding tank ❑ maintenance )Q s[,ubC( 1*sr
Method of access: manholes CI inspection pipe(holding tanks only)\
(owner signature req'd if refusing m allow pumping through maintenance hole)
Condition of tanks:
filter cleaned: Yes baffles good: Yes alarm working: Yes \
No No No
n/a n/a n/a
Tank leakage observed: above operating depth: Yes 10 (repairs recommended)
below operating depth: Yes to I (failing to protect groundwater)
Gallons removed:
#1 U #2 0 #3 #4 pump tank U total 0
i
Disposal method:A✓/4 municipal ❑ location:
land apply ❑ location:
Safety concerns:
Recommended repairs:
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Comments:
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I hereby certify t r•I have completed this work in accordance with MN 7083.0770 and any local requirements.
No d nati•j7,r guarantee offuture system performance has been nor can be made
/9/6;is S Pwop; )S1 i_.c..c- 6/.2 —337-35
intainer ignature Company . 334' J Phone number