878 Lakewood Hills Rd - New Septic As Built 2025-06-09INDIVIDUAL SEWAGE SE`STEM AS-SUIL-711- Date installed _ _
Permit No.
Owner: A 'fit �__ Pr,p�ect Address
House Type. i 11 iii Property ID No.(PIN) 1 Q _ " r
City/Twp 1^ Installed for--�LBdrrr
gal/day Commercial Use? Y
❑New]KReplace ❑Repair []Addition.
Property Transfer U grade? Y J�
Bsmt Lift Pump? Ysuwre? Y J
Jacuzzi? YOGarb Disp? Y / N
Soil Survey Map Unitme
Soil Compacted? Y 1V
Fill Soil? Y l0
Circle Soil Texture:
(Faster than 0.1 mpi)
Coarse Sand
Medium Sand
oam San 0.83
FINE SAND 9.67
Sandy Loam 1.27
Loam 1.67
Silt Loarn, Silt 2.00
Sandy Clay Loam 2.2
Silty Clay Loam
Clay Loam
Silty Clay, Clay 4.2
(Slower than 120 mpi)
Soil dry enoug ror
construction?V h?
SETBACKS: Prop -Lines 10'6k
Bldgs 10' to Tank Ok. & 20' to Drnfld 6 JL
Well(s) setbarit YS)not installed yet
Well Depth ()Ono . Well Reco d ( )Measured
Distance to LakecreekVlretland /i7
Buried Water Pressure Lines 10' to Tank.4
System located by Photos'0 / N GPS? Y /
SEPTIC / HOLDING TANK(S) [ 4 New ❑ Existing
Liquid Capacity_ 21;? sb 1 compartment ork
Made by �Fiberg � Vateriight? V[ NiBaffle Type: last' lass Sanitary -T Goncr,e
No. of Inspection Pipes b 4" r r,'• r11;;M. ank rel? �1 N
No./Diam. Manhole Access nl /utl /Center
No. & Height of Manhole Risers oZ 36 a ..
New Tanks 4 ft or less below Final Grade
i N
Pipes into Tank Sealed? with
Riser into Tank Base Sealed? with
Outlet Effluent Filter? Y
MOUND I ATGRADE:
Percent Slop,- Q % Scarification Method: 1 G Z
Dike WidthUp_ (i •5 Down .a Side d
Clean Rock N Depth Below Pipe_ %`___inches
Clean Sand. N Depth Upslope /.da '' Downs open'
Inches to MottiingN Pipe Size/Spacing /,5`Z
Perf Size/Spacin i Final Cover papth "
Rock Bed Size O_ _Supplier:
Sand Base Si; Supplier:
Upslope needing drainage/diversion t N Provided. N
Grading done: Rough I Final
( )Seeding ( )Sod to be done by:
I hereby certify, as installer, that this individual sewage treatment system
was installed according to the approved design, and as applicable, this
Municipality's Se=a Trea ment System Ordinance, & accurateiy rotates i
all system comp- ' is faterreloca€ion. !
Line drawn from Tanks to Pump Truck Access < 100'? Y/ N
RESERVE AREA? Y IN Fenced Off? YI N
Owner informed to preserve Reserve Area? Y 1 N
Owner given Septic System Owner Guide? Y I N
TRENCHES / BED OR GP.AVELLESS DRAINFIELD:
Drop boxes level? Y / N Type concrete / plastic
Trench Depth - Width
Number of Trenches_ Trench Bottom Level Y / N
Trench Lengths Spacing
Rock Clean?YIN 2" over Pipe? YIN GeoTextile Cover?YIN
Depth Below Pipe? _,, Soil Backfill Depth—______
Graveness Pipe Size? Made
Chamber Sizes Made by
Absorption Area: Sq Ft -----Lineal Ft _
Trench Bottom to mottling, b drock? _ inches
PUMP TAMC Made by �P 1' Capacity �d
No. & Height of Risers -,_Seated? &//-N-
Pump Manufacturer ` Model #_
Horsepower -Y,2- GPM 1_ Feet of Head
Cycles Per Day_,__ Gallons Per Cycle �ap_—__
Size of Discharge Line 1.5" ! 2"
Type of Electrical Hookup �Agarage
& box by to
Alarm Location ) asement
Alarm: Tank Alert 1vel Alarm / Other
Cycle Counter? YILO Water Metor? Y�
Professional Onsite
PCA I ic. No. FTs Company Name
Ph 6W �5 7-7SeAddress
Sign(Q 1641 Date/13/202,&pproved: Ido I Yes / Yes with Conditions:
White cooya�o. ur�y Yellow:Ownar Pink:fnstatter
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