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4899 Brooklyn Lane - Septic As-Built 2016-07-14 INDIVIDUAL SEWAGE SYSTEM AS-BUILT Date Installed l7'�i ermit No�OI� _� c9vo y Owner: Ci Project Address r/S?9 f3J^Ook'lrn Z4". �.0 House Type: i II III Property ID No.(PIN),[O - (?.3_ t,''�1) - $��_�p (Dak Ca Tax Info 651-438.4576,or www.co.dakota.mn.us) i wp 4 Installed forZBdrms or al! y Commercial Use?o N ! ❑New eplace❑Repair❑Addition Property Transfer Upgrade? Y/O Bsmt Lift Pump?Y Future?Y 10 Jacuzzi?YQ Garb Dlsp?Y/ p Soil Survey Map Unit r 1;53 Soil Compacted?Y Fill Solt? Y 14b Clrcle Soll Texture. (Faster than 0.1 mpi) Coarse Sand Medium Sand amV San 0.8 FINE SAND 1.67 Sandy Loam 1.27 Loam 1.67 tea Silt Loam,Silt 2.00 Sandy Clay Loam 2.2 Silty Clay Loam f 3 g �� Clay Loam Silty Clay, Clay 4.2 (Slower than 120 mpi) Soll dry enoug&for • (� construction /N SETBACKS: Prop.Llnes 10,11 Bidgs 10'to Ta k.�&20'to Drnfid-y Gl80 06D. Well(s)•setback( )not installed yet Well Depth ()Orig.Well Record( )Measured Distance to Lake-,IQ- Creeke_�Wetland Buried Water Pressure Lines 10'to Tank& Drnfid? /V System located by Photos N GPS?Y 1 N Line drawn fr Tanks to Pump Truck Access<i DO'?&N RESERVE AREA? SEPTIC/HOLDING TANK(S) j7� New ❑ Existin (EN Fenced Off? Y/6) Li quid Ca acl / g Owner informed to preserve Reserve Area?�/N q p tY 1 compartment o 40114^� l�t Made by rP<.►sj' Watertight? V N Owner given Septic System Owner Guide? Y I(pb Baffle Type: asti Fiberglass Sanitary-T Concrete ENCHES I BED OR GRAVELLESS DRAINFI No. of Inspect on ipes�-4"/&'dlam. Tank Level?Z/N Drop es level?Y/N Type conc /plastic No./Diam. Manhole Access 1 Trench D Widt No.&Height of Manhole Risers e u Number of Tren s Trench om Level Y I N New Tanks 4 ft or less below Fina Grade o Trench Lengths Spacing Pipes into Tank Sealed?with �—'Y 1� Rock Clean?Y/N 2"over ` Y/N GeoTextiie Cover?Y/N Riser Into Tank Base Sealed? with Pw !r" N Depth Below Pipe? "Soil fill Depth Outlet Effluent Filter? Y/&Type--_____.OU/N Graveness Pipe e? Made p MOUND / ATGRADE: Chamber Si Made by Percent Slope% Scarification Method: OGCr jta. Absorp' Area:Sq Ft Lineal Ft Dike Width.RNUjDP-e-p;t V Down r Bo ttom to mottling 1 be ock? inches Clean Rock? h Below Pipe Side Mp TANK Made by K /NlCapacity�dt� Clean Sand/N Depth Upslope(�' Downs V, N°' & Height of Risers Sealed CSI N Inches to Mottling i S,�ze/Spacing `r 0 Pump Manufac urer Model# t'�1 Perf Size/Spacing k Final Cover 9Qepth „ Horsepower GPM �_Feet of Head Rock Bed Size 0 4ry Supplier: 4NO a Cycles Per Day �/ Gallons Per Cycle of -tow Base Size Supplier: Size of Discharge Line 1 5U I Upslope needing drainage/diversion? Y DV Provided? Y/N Type of Electrical Hog 1 -- _ s .i Grading done:Rough!Final Alarm Location S ltr garage/basement ( )Seeding ( )Sad to be done by.• 71^j fq,l4p .- Alarm:Tank Alert Other C c1e Counter? Water Meter? Yt I hereby certify,as Installer,that this individual sewage treatment system Designated Registered was Installed accordln to the a proved design,and as applicable,this Professional On site Municipality's 5 wa re m t System.Or finance,&accurately locates /�/ / all system co to la ion: _ Company L[44ry11r Installs PC .No.r'} .�Com an Name _,/l4t• Sin Date• ` -f Ph� 1- -dy�7 s Inspector, �!�7'� Address ffv 0111; Sign Date Approved.,No ��Ko`� > White copy:County Yetiow:© ner Pinkanstatier pP s Yes Wlth>✓ondit/ons: o:\emgmtlforms\walm\ists\as-built-form.doc