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(Nl� <br /> County <br /> Private Onsite Wastewater TreatmentBurnett <br /> IRS Systems ( POWTS) Inspection Report <br /> (Attach to Permit) Sanitary Permit No: <br /> siorr� <br /> Industry Services Division <br /> General Information SAN-24-120 <br /> Personal infonnation you provide may be used for secondary pu oses Privacy Law,s. 15.04 1 (m <br /> Permit Holder's Name: Ij City Village x Town of: State Plan Transaction ID#: <br /> Mike Nightengale Oakland 658575 <br /> CST BM Elev: Insp BM Elev: BM Description: Parcel Tax No: <br /> Nail in 6" white pine 1 33651 <br /> Tank Information setback to: <br /> TYPE MANUFACTURER CAPACITY Prop. Line Well Building Air Intake Road <br /> Septic Norwesco 1000 +2' 40' 17' N/A <br /> Dosing N/A <br /> Aeration N/A <br /> Holding <br /> Pump 1 Siphon Information Elevation Data <br /> Pump Manufacturer Pump Model Demand STATION BS HI FS ELEV <br /> Filter Manufacturer Filter Model GPM Benchmark 5.9 105.9 100 <br /> Lifetime LT1/8 <br /> TDH Lift Friction Loss Head Total Bldg. Sewer 5.3 100.6 <br /> Forcemain Length Dia Dist.To Well Tank Inlet 5.5 100.4 <br /> Tank Outlet 5.72 100.18 <br /> Dispersal Cell Information Dose Tank Inlet <br /> DIMENSIONS Width Length #of Cells Dose Tank Bottom <br /> 3' 90, 1 <br /> SETBACK FROM Prop.Line Building Well OHWM Inst.Contour <br /> +5, +10' 50, NA <br /> Header/Manifold <br /> Type of Cell Manufacturer: <br /> Distribution Pipe 6.4 99.5 <br /> EZ-FLOW Model Number: Infiltrative Surface 10.0 95.9 <br /> Pretreatment Unit Final Grade 7.5 98.4 <br /> Manufacturer: <br /> Model Number: <br /> Distribution System X Pressure Systems Only <br /> Header/Manifold Distribution Pipe(s) X Hole Size X Hole Observation Pipes <br /> Length Dia Length Dia Spac Spacing ❑Yes ❑No <br /> Soil Cover <br /> Depth Over Depth Over Depth of Seeded/Sodded Mulched <br /> Cell Center Cell Edges Topsoil ❑Yes ❑No ❑Yes ❑No <br /> COMMENTS:(Include code discrepancies,persons present,etc.) <br /> Installed per plan. <br /> Plan revision required? ❑Yes 2 No 06 18 2024 - 1565671 <br /> Use other side for additional information. :::Jf6W�� <br /> Date POWTS Inspector's Signature License Number <br /> SBD-6710(R.03/21) <br />