896 Lakewood Hills Rd - Septic System Records 2022-06-15'"*111
INDIVID 4AL -3 WAGE SYSTEM A -S -BUIL g Date Insfa��
lle�ePermit No.
Owner: �? i a _ Project Address
House Type_ 011. Ill Property 1€J IvR.(PIIv) L� - L S a - ��%,� �(� {Dak Co Tax info B5 i�3& X570, or v nti.co.dakoia.mn.usl
I installed for____Bdrms or
cs o gal ay Commercial Use? Yf
❑Naw 2FR8pl21ce ❑pair ❑Aadltir �a..
Property Transfer Upgrade?0 N _
e,rmt Lr,< pump? YgFuiure? Y
JaCu— i? fist Garb Dls ? f N r
Soil Survey Map Un -
kip", S
Soil Com act ? Y N
Fit Sol/.3
t
Circle Soil Tem ure:
(Faster than 0.1 €npi)
Coarse Sand �!l " `.
Medium Sand � r +'�
Loamy Sand 0.83 J, y ti
Ff AND 1.67 3 `
Sandy Loam 1.2. f
Silt Loam, Silt 2.00 � 1
Sandy Clay Loam 2.2
Silly Clay Logm LV
Clay Loam
Silty Clay, Clay 4.2
(Slower ihan 120 mpf)
Soil dry enough for
Cpn5fRlCiiRr] �
SET SACKS -Prop. Lines 10' 0 l
..� Bidgs 10' to Tank & 20' to Drnfldl-z'
Wells) setb8CI< � ' ( )trot installed yet
Well Depth( )iOdg" Welt Record ( )Measured
Distance to Lake" Creek_ Wetland
Buried Water Pressure Lines 10' to Tank & Drnfld? v r
System located by Photos GPS? Y i
SEPTIC I HOLDING TANKS) ( New ❑ Existing
Liquid Capacity Z2'5"o - Z €compartment in
r0
Made by Watertight?C5 N
Baffle Type: Fiberglass Saniiary-T Concr to
No. of Inspection Pipes— d" / 6' diarpf . Tank Level - IN
NoJDiam- Manhole Access. ���/_Inlet / Outlet I center
No. & Height of Manhole Risers
New Tanks 4 ft or less below Final Grade N
Pipes into T ank Sealed? with„q y N
Riser into Tank Base Sealed? with L Y N
Outle vent F€ter?1 ype A (a.�, „- /z�
MtjUl�i] ATGRA E: '
nt Slope 4�;"_ /a Scarification Method. -
Dike Width -5-/,
ethod:DikeWidth_5-/_ Ue--ZY-fDown�Side
Clean Rock N Depth Below Pipe__2 T1— inches
Clean Sand. N Depth Upslope_ y ” DawnsloijeZ',�!
Inches to MoiEiin �� PipetSizefSpacing'�
Parf Size/Spacin Final Cover Depth_"
Rock Bed Size a w Supp€ier:�
Sand Base Size -� _V -Supplier:
Upsiope needing drat diversiol{ ht Provided? Y®
Grading done_ Roup Final
4LIQSeeding ( )Sod to be done by --
1
y_1 hereby ceriify, as lrisiafler, that this individual sewage treatment system
vras installed accorciing tri trle eutwoved riBsigri_ ano 2S 2005=bfa- this
Municipality's Sewage Treatrrignt System ordinance, & accurately locates
all sr Siem components for i relor,Zbr,
Sian
h da-: pproved: leo es Yes with Conditions:
Line drawn from Tanks t Pump Truck Access < 100'? Y N
RESERVE AREA? Y f) Fenced Off? Y&
Owner imormed to preserve Reserve Area? Y f
Owner given Septic System Owner Guide? Y N
TRENCHES I BED OR GRAVELLESS DRAINVELD,
Drop boxes level? Y 1 N Type concrete I plastic
Trench Depth - Width
Number of Trenches Trench Bottom Level Y IN
i rench Lengths Spacing.
Rock Clean?YIN 2" over Pipe? YIN GeoTextile Cover?YIN
Depth Below Pipe? " Soil Backfill Depth "
Graveliess Pipe Size? Made by
Chamber Size? Made by
Absorption Area: Sq Ft Lineal Ft
Trench Bottom to mottling f bedrock? inches
PUMP TANK Made by Ca aci' o
No. & Height of Risers — Sealed? �; N -
Pump Manufacturer z Model # .2V3- it
Horsepower,GPM Feet of Head _Z!_
Cycles Per Day, =_ Y _ Gallons Per Cycle
Siza of Discharge Line
Type of Electrical Hookup t & box
Alarm LDCBtion para e ; basement
Alarm: Tank gi<i ]Level Alarm her
CY01e CounV? -Y 1 N Wafer me er_ I 1
Prein�a;en�l
PCA Lic. No. :11-1 7 Gomoany
Address /ZU—T/Gff_
While chs. y_Countf Yellow.Owner Pirt1:_lnstaller
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