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Home My WebLink AboutPermit 2838B11 I 7 0 7 Cf M IJ S If- Tp lrJ,.J R \) 11/ flJ /'f,f# I"'f i( 28 3 8 ,-, 11 .JUAL SEWAGE TREATMENT SYSTEM INSPECTION FORM SCOTT COUNTY, MINNESOTA , "~ "': \j, ~ ",ship ~ti/~ Lt k Date of Inspection /tJr(f/-7/l. Permit number UJs..../-1 Owner W,IIQ~.9 f..4, r........ Installer U6+4~~ ~ Project Address ----1-'70 7q m~}h tz,wl.. Ai Inspection Number /1 City .p/jl/ '- ~ Zip Code )jJ7'- New (i1v Repair r.--- SETBACKS: Buildings to tank(s) ................ Buildings to drainfield ............. Well(s) 50' or 100' .. . . . . . .. . . . . . . . . . Lake/Creek/Wetland . . . . . . . . . . . . . . . I,' .,~ ' qIII! '>7- I AM SEPTIC TANKS: Liquid capacity ........... .... ... .._1 0'0 Manufacturer & type............... ~~ Type of baffle...................... _ f..J/!til-o" I t. . ~-~ nspec Ion pipes .................. ' Manholes access ................ 1- '1AI " MOUNDS: Percent slope.................... Upslope dike width .............. Downslope dike width............ Sideslope dike width ............ Drainfield rock below pipe. . . . . . . . Depth of sand below rock ........ Perforation size & spacing. . . . . . . . Pipe size & spacing ............. Dimensions of rock bed ......... Dimensions of sand base. . . . . . . . Final cover... .................... DRAWING OF SYSTEM ..,t \) ~ r ' ~l t 1b' t t.{J u~ "10' .... AI LId LlD . ,. Inspector's Comments DIST. OR DROP BOX & Type TRENCHES, BEDS, OR GRAVELLESS ~ACHFIELD: Trench depth................ '"2. ,..... Trench length................. S_U~"'fv- Trench bottom width. . . . . . . . . . ,,~ Trench bottom level. .. . . . . . . l.-- Trench spacing.............. \~~- Drainfield rock below pipe. . . ,'1-i'"- Size of graveless pipe.. . . . . . . . A.; ILf Depth of backfill......... ...... ~..;, ....'-. Absorption area: square feet '1 'fJt1 lineal feet (Jt'J ~k\.<<....c.- PUMPS: Tank capacity................ Tank Manufacturer & Type. . . Pump manufacturer & model# Feet of head................. Gallons per cycle ............ Cycles per day............... Size of discharge line ........ Type of electrical hookup .... Type & location of alarm .... Cycle counter (commerciaQ . 74 ,,' .~ <- , c, " rrl#" I , I' IJ~ ~lOo\ \o,kJ \,<I;}I. 1.. r--' '1' 1: /O-W-fern-""'iCt'1U !UN"! t" ~I-.J.....?....... tp...(/,.~ Corrective Action Required Mo..... h~\l. b ( 1'0 I'I1tJf ..{A-b~l .f.o ~l.-/I /J f/JI C,6C1~ .J.t.vJ,.. -l c1 ~II'..A- t;,-,..k lJvkl-,. a...,..., c.,': J........h'uJ. u,U vJ.... ~k 1\ V\..wJ, 1\ Inspector's Signature (~M I ' Installer's Signature \'/~ ~<.\ I White-county Yellow-Applicant Plnk.lnstaller U 01670.2819(10-90 5e) .--" '-.-- ' ---"