1365 Rocky Lane - Septic As-Built 2016-10-14 INUIVIDUAL SEWAGE SYSTEM
ABUILT tY OM09
Owner: G✓M h ONvy » r 1N
Project Address 36 5 ,&- z/00,---
House Type, II III Property ID No,(PIN) (7 (A Q Z O L - 0 Y V ;/0(Dak,C.o Tax Info 651-438-4576,or www.co.dakota.mn.us)
it Wp Q q" Installed for Bdrms or
aal/d y Commercial Use? Y
❑New Replace❑Repair❑Addition
Property Transfer Upgrade?C)/N
Bsmt Lift Pump?Y49Future? Y/V
Jacuzzi?YG) Garb Disp?Qaj N
Soil Survey Map Unify.
Soil Compacted?Y ( — 0,v'
Fill Soil? Y
Clrcle Soil Texture:
(Faster than 0.1 mpi)
Coarse Sand I
Medium Sand- ppoc-
Loamy Sand 0.83
FINE SAND 1.67
Loam Our/
Loam 1.67
Slit Loam, Silt 2.00
Sandy Clay Loam 2.2
Silty Clay Loam
Clay Loam �
Silty Clay,Clay 4.2 —1
! - .
(Slower than 120 mpi) 3 tr W v —Ll
Soil dry en ou h for
constructional N
SETBACKS: Prop.Lines 10'
Bldgs 10'to Ta k�&20' to Drnfld�
Well(s) setback ( )not installed yet
Well Depth ( Ori .Well Record ( )Measured
Distance to Lake Creeks Wetland_�-
Buried Water Pressure Lines 10'to Tank& Drnfld? _ Line drawn from Tanks to Pump Truck Access < 100'?67 N
System located by Photos? Y IS GPS? Y 04 RESERVE AREA a/N Fenced Off? Y/CD
SEPTIC/HOLDING TANKS) [A New 0 Existing Owner informed t<o preserve Reserve Area?0/N
Liquid Capacity. 1 compartment oe2? Owner given Septic System:Owner Guide? Y/61
Made by A 2o�i�� Watertight? 6*1 N TRENCHES/BCD OR GRAVELLESS DRAINFIELD:
Baffle Type: a iberglass Sanitary-T Concrete Drop boxes level? Y/N Type concrete/ lastic
No, of Inspection Pipes"��4" 6"�1 lam. Tank Level?'G(/N Trench Depth d S�" Width /�r1 _
No./Diam. Manhole Access r7�f I uth Number of Trenches Trench.Bottom Level G/N
No. & Height of Manhole Risers Trench Lengths Spacing
New Tanks 4 ft or less below Final Grade N
Rock CleanOq 2' !�ipe? Geo Textile Cover�N
Pipes into Tank Sealed. with —_Q'�i N Depth Below-Fipe'? b " Soil Backfill De th l
Riser into Tank Base Sealed? with ra t� V/N p - �
Outlet Effluent Filter? Y/N Type — Gravelless Pipe size? Made by
MOUND / AT(WA Absorption Area:!Sq Ft DE; Chamber Size? Made by _
S Lineal F X
Percent Slope % Scarification Method: Trench Bottom to mottling/bedr ck? inches
Dike Width Up Down Side PUMP TANK Made by P1610121'- Capacity/19ev
Clean Rock? Y/N Depth Below Pipe inches No. & Height of Risers - !o " Sealed? / N
Clean Sand? Y/N Depth Upslope " Dpwnslope Pump Manufa�t'u er Model#�-
Inches to Mottling Pipe ySize/Spacing P 3 ' Horsepower 1" GPM 3 _Feet of Head 17 7
Perf Size/Spacing 3 Final Cover gepth a" C
Day—,'V—Gallons Per Cycle Rock Bed Size Su pp lier: Size of Discharge
Line 1.5
Sand Base Size Supplier: Type of Electrical;'Hookup ost ox b t
Upslope needing drainage/diversion? Y/N Provided? Y/N Alarm Location garag ase
Grading done:Rough/Final Alarm: Tank Alert vet Alar Other
( )Seeding ( )Sod to be done by: Cycle Counter? Yko Water Meter? Y/
I hereby certify,as installer,that this individual sewage treatment system Designated Registered
was Installed according to the appro ed design,and as applicable,this Professional Onsite (7l/y#I
Municipality's Sewage Treat t stem Ordinance,&accurately locates ,�/ r�
all system compo or later ati PCA Lic.No. Company Name_[/(/�t/1f�r ��+C.,�NG.
Installer o�
Sign Date: /7 l Pfi — ;Address o�p g(0
Inspector
Conditions:
a Sign Dat pproved:N s Yes with
White copy: punt Yellow:Owner Pink:lnstaller
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