section 13 forms and reference - university of...

Electronic design form instructions (13-1)

Pre-design forms (13-2) Preliminary evaluation (13-2) Field evaluation (13-4) Soil boring log (13-5) Site evaluation map (13-7) Percolation test worksheet (13-8) Class V injection well inventory form (13-9) Homeowner survey (13-11) Design Flow and soil (13-13)

System design forms (13-15) Trench and bed (13-15) Mound (13-17) At-grade (13-21) Pressure distribution – level (13-24) Pressure distribution – non level (13-26) Pump selection (13-30) Pump tank, dosing and float and timer setting (13-32) Single-pass and recirculating sand filter (13-35) Existing dwellings flow determination (13-39) New development flow determination (13-40) Measured flow for other establishments (13-41) Estimated flow for other establishments (13-42) Final permitting flow (13-43) LISTS design flow and system summary (13-44) Loading rates and absorption ratios for effluent treatment Level C using detailed soil descriptions (13-47) Loading rates and absorption ratios for effluent treatment Levels A and B using detailed soil descriptions (13-49)

Inspection forms (13-51) Existing (13-51) New construction (13-59)

Installation forms (13-63) As-built (13-63) MDH Pressure Testing Form (13-65) Abandonment form (13-67)

Maintenance (13-69) Land application (13-69) Management plans (13-79) Septic Tank Pumping Frequency Guidelines (13-95) Service provider forms – (see CIDWT O&M Manual or OSTP Website: http://septic.umn.edu/formsandsheets/bytype/index.htm#maintenance)

Equations and Constants (13-96)

SECTION 13: Forms and ReferenceAll forms are available electronically on the University of Minnesota OSTP website at: http://septic.umn.edu/formsandsheets

The bold forms are interactive on our web page.

http://septic.umn.edu/formsandsheets

http://septic.umn.edu/formsandsheets/bytype/index.htm#maintenance

Section 13: Forms and Reference n 13-1

09/09

1. Preliminary Evaluation 8. Mound 15. Flow Estimate for Existing Dwellings2. Field Evaluation 9. At-Grade 16. Flow Estimate for New Subdivision3. Boring Log 10. Pressure Distribution 17. Measured Flow-Other Establishment4. Site Evaluation Map 11. Non-Level Pressure Distribution 18. Estimated Flow-Other Establishment5. Percolation Test 12. Pump Selection 19. Final Flow Total6. Flow & Soil 13. Pump Tank 20. Flow & System Summary7. Trench & Bed 14. Single-Pass & Recirculating Filter 21. Supporting Information

There are two ways you can utilize this workbook:

Instructions for 2009 OSTPSSTS Design Forms

Yellow cells are user input cells, that is, these are the cells where you as the designer must manually enter the value that the worksheet is requesting.

G ll ll th t ill fill i t ti ll t l i t th ll ll

2. You can print blank copies of the worksheets and fill them out by hand.

1. Your security level must be medium or low (not the default of high). This can be changed under Tools, Macro, Security. In Office 2007, click the Microsoft Office Button, then click the Excel Options. Select the Trust Center, Settings, and then click Macro Settings to enable.

The 2009 Design forms included in this file are intended to meet the new 2008 Chapter 7080 Rules. Due to the many changes there will be updates over the next months and year. Please check back to the website frequently and download the most current version. There are 20 worksheets and additional supporting information in the 2009 SSTS Design Form Workbook, they are:

In each worksheet, you will notice each cell is colored either green (or grey depending on your system settings) or yellow.

These worksheets were created in Microsoft Excel. You must have a software program that can open .xls documents to use these forms. If you do not have Microsoft Excel, you can download a similar program named OpenOffice online: http://www.openoffice.org/

1. You can use the Excel worksheet on a computer and fill in the values on a computer & print out the results or email them. Using this function you must be sure to enable macros if asked this by Excel, or

SECURITY LEVEL & MACROS

This file contains macros which are imbedded formulas to do some of the calculations. In order for these to work:

2. If prompted enable the macros.

INPUTS

The worksheets should display and print at 100%. This makes the worksheets readable and able to be filled in by hand. The worksheets can be printed in either color or black and white. You may need to set your computer/printer to grayscale option or you may wish to change the colored portions of the worksheets. Each sheet that is part of your design must be printed separately as there is not a way to print them all at one time.

CHECK BOXES

Green cells are cells that will fill in automatically as you enter values into the yellow cells.

CREDITS

Developed by the University of Minnesota: Sara Christopherson, Dave Gustafson and Dan Wheeler; Tim Haeg, Watab Inc.; Chris LeClair, Washington County; and the Minnesota Pollution Control Agency. Thanks to the many that provided comments and feedback during thedevelopment process.

Some of the yellow cells have a drop-down menu function. A small arrow pointing downwards will appear in the lower right corner of the cells with a drop-down menu. You MUST choose one of the values in the drop-down menu. To erase the value, simply highlight the cell and press the Delete key on your keyboard.

PRINTING

NOTE: Most of the cells in this workbook have a great deal of complex formatting and formulas in the background. If you alter the formulas, the workbook will not function properly. It would be a good idea to copy this workbook and always work with the the copy, so the original canbe utilized for back-up purposes only.

SAVING

Each time a design is done the file should be saved with a unique file name. Keep an original version of the workbook with no data entered. To have a version which can not be altered you can create at PDF. Creating a PDF requires the full version of Adobe Acrobat which is softwareyou may not have. The other option is to go to "Tools"..."Protection"..."Protect Worksheet" and save the file for that particular job which it what the overall plan for how to do this.

DROP DOWN MENUS

Many of the worksheets have check boxes that one may check on the computer. If these are not working, you are most likely is in "design mode" in excel. To fix this, from the menu, select View, Toolbars, and then select "Control Toolbox". Now a new toolbar will appear in your menu bar. There is a button that looks like a ruler and a speed square. Click it to get out of design mode. Now the check boxes should work.

09/0909/09

http://www.openoffice.org/

13-2 n Section 13: Forms and Reference

09/09

Address

Parcel I.D. Township # Range # W Section

Date Township name Latitude/Longitude

Evaluation for system type Parcel dimensions

Client-Provided Information

Adults Children Teenagers

\

Other (specify )

* Clear water source

Designer-determined Flow Information

A. Estimated Design Flow (gallons per day)

Description:

OSTP Preliminary Evaluation Form

Client Phone Number:

1. Contact InformationProperty Owner/Client:

Unfinished space (ft2)

2. Flow Information

No. of bedrooms* (if applicable)

Type(s) of use (all that apply )

No. of residents in home

Existing flow measurements

Water-using devices (check all that apply)

Any additional current or future uses on this parcel (specify )

Any non-sewage discharges to system (specify )

Water use concerns (check all that apply)

Anticipated waste strength

3. Preliminary Site Information

B(1) W l ll( ) i hi 100 f f b i

Sewage ejector or grinder pump in home

I acknowledge the above is complete and accurate (Client(s) signature and date)

New Construction Existing Dwelling

Residential Commercial Other Use (Specify)

Yes (If Yes, attach readings) No

Garbage Disposal

Dishwasher

Large Bathtub/Jacuzzi

Laundry/Large Tub on 2nd Floor

Water Softener*

Sump Pump*

High Efficiency Furnace*

Hot Tub*

Iron Filter*

Faucet/Toilet

In-Home Business

Multiple Loads of Laundry/Day

No Lint Screen Use of Anti-Bacterial Soap

Long-Term Prescription Meds

Frequent Entertaining of Out-of-Town Guests

Yes No

Domestic High Strength

Yes No

Daycare

Depth of well(s) ft ft Source

Source

List landforms

inches inches

inches inchesMaximum bedrock depth:

Minimum bedrock depth: Minimum bedrock depth:

Maximum bedrock depth:

Parent materials -check all that apply

H. Soil Survey Information (from web soil survey ) Map Units on Parcel

Slope Range

Landscape Position (check all that apply )

Site located in a shoreland district/area

F. Determine property lines (see Site Evaluation map )

E. Floodplain designation and flood elevation

Source

Source

D. Elevation of ordinary high water level (OWHL) - MN DNR (if adjacent to parcel )

B(4). Location of all existing and proposed buildings and improvements on lot (see Site Evaluation map )

C. Location of all easements on lot (see Site Evaluation map )

Source

Well(s) were located

G. Distance of setbacks

B(1). Water supply well(s) within 100 ft of absorption area

Well casing depth(s)

B(2). Site within 200 ft of noncommunity transient supply well

B(3). Site within a drinking water supply management area

B(5). Buried water supply pipes within 50 ft of proposed system

Map Unit Ratings

Septic Tank Absoprtion Field - Trench (MN)

Septic Tank Absorption Field - At-grade (MN)

Septic Tank Absorption Field - Mound (MN)

New Construction Existing Dwelling

Residential Commercial Other Use (Specify)

Yes (If Yes, attach readings) No

Garbage Disposal

Dishwasher

Large Bathtub/Jacuzzi

Laundry/Large Tub on 2nd Floor

Water Softener*

Sump Pump*

High Efficiency Furnace*

Hot Tub*

Iron Filter*

Faucet/Toilet

In-Home Business

Multiple Loads of Laundry/Day

No Lint Screen Use of Anti-Bacterial Soap

Long-Term Prescription Meds

Frequent Entertaining of Out-of-Town Guests

Yes No

Domestic High Strength

Yes No

Direct Observation County Well Index Maps Personal Communication

Yes No

Yes No

Yes No

Yes No

Survey Plat Map Other

Map

Property Lines OHWL Easements Water Supply Pipes Well(s)

Other Buildings

Daycare

Till Outwash Loess Bedrock Alluvium

Colluvium Lacustrine Organic Cut/FillSummit

Depression

Shoulder ToeslopeFootslopeBackslope

ManmadeTerraceStream Plain


09/09

OSTP Preliminary Evaluation Form

Map Unit

Consistence

Map Unit

Consistence

Map Unit

Consistence

Map Unit

Consistence

Structure(s) Other (flooding, ponding, etc.)

4. Preliminary Soil Profile Information (from web soil survey - map unit description & official series descriptions )

Depth Texture(s)

Horizon 2

Horizon 4

Horizon 3

Horizon 1

Horizon 2

Other (flooding, ponding, etc.)Depth Texture(s) Structure(s)

Horizon 5

Horizon 1

Horizon 4

Depth

Horizon 3

Horizon 5

Texture(s) Structure(s) Other (flooding, ponding, etc.)

Horizon 4

Horizon 1

Horizon 3

Horizon 2

Structure(s) Other (flooding, ponding, etc.)

Horizon 5

Depth Texture(s)

Horizon 1

Horizon 2

Horizon 4

Horizon 3

Horizon 5

LGU Contact

I hereby certify that I have completed this work in accordance with all applicable ordinances, rules and laws.

(License #) (Date)

5. Local Government Unit Information

Name of LGU

(Designer) (Signature)

LGU-specific installation requirements

LGU-specific setbacks

LGU-specific design requirements


09/09

Date

Client's Approval (initial)

Proposed soil treatment area adequately protected

4. General Soils Information

Utility Locations Identified

2. Utility and Structure Information

Property Lines

OSTP Field Evaluation Form

Client Phone Number:

1. Contact Information

Address

Weather Conditions

Property Owner/Client

Slope DirectionPercent Slope

Locate and Verify (see Site Evaluation map )

3. Site Information

Discuss the flooding or run-on potential of site

Slope Shape

Vegetation type(s)

Evidence of cut, fill, compacted or disturbed areas

Landscape Position

Identify benchmarks and elevations (Site Evalulation Map )

Original soils

Gopher State One Call # Any Private Utilities

Determined and Approved By Client

Determined But Not Approved

Approximate

Property Lines Surveyed

Existing Buildings Improvements Easements Setbacks

Yes No

Yes No

Yes No

Locate Areas on Site Evaluation Map


(License #) (Date)

Type of observation *Soil pit required if determining loading rate without perc test

Number of soil observations

Original soils

Soil observations were conducted in the proposed system location

A soil observation was made within the most limiting area of the proposed system

Soil boring log forms completed and attached

Percolation tests performed, forms completed and attached

Depth to standing water inches Anticipated construction issues

5. Phase I. Reporting Information

Flood elevation feet

Depth to bedrock inches

Contour loading rate gpd/ft

Loading rate gpd/ft2

Maximum depth of system inches

Depth to periodically saturated soil inches

Site evaluation issues / comments


Elevation at system bottom feet Differences between soil survey and field evaluation

Percolation rate min/inch

Gopher State One Call # Any Private Utilities

Determined and Approved By Client

Determined But Not Approved

Approximate

Property Lines Surveyed

Existing Buildings Improvements Easements Setbacks

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Locate Areas on Site Evaluation Map

Soil Probe Soil Boring Soil Pit*


09/09

Ons

ite

Sew

age

Trea

tmen

t Pro

gram

Soi

l Bor

ing

Log

Cl

ient

/ A

ddre

ss:

Le

gal D

escr

ipti

on/G

PS:

Dat

e:

So

il Pa

rent M

ater

ial(s

):

Till

Out

was

h La

cust

rine

A

lluvi

um

Loes

s

Org

anic M

atte

r Be

droc

k

(cir

cle

all t

hat a

pply

)

La

ndsc

ape

Posi

tion

: Sum

mit

Shou

lder

Back

/Sid

e Sl

ope

Foot S

lope

To

e Sl

ope

Sl

ope

Shap

e:

(cir

cle

one)

V

eget

atio

n:

So

il Su

rvey

Map

Uni

t(s)

:

Sl

ope

(%):

W

eath

er c

ondi

tion

s/Ti

me

of D

ay:

Elev

atio

n:

D

epth (i

n)

Te

xtur

e

Coar

se

Frag %

M

atri

x Co

lor(

s)

M

ottl

e Co

lor(

s)

Re

dox

Kind

(s)

Satu

rate

d So

il In

dica

tor(

s)

(see

bac

k)

St

ruct

ure

Shap

e

St

ruct

ure

Gra

de

Cons

iste

nce

Co

ncen

trations

Dep

letio

ns

Gleyed

Granu

lar

Platy

Blocky

Prismatic

Single Grain

Massive

Weak

Mod

erate

Strong

Loose

Loose

Friable

Firm

Extrem

ely Firm

Rigid

Co

ncen

trations

Dep

letio

ns

Gleyed

Granu

lar

Platy

Blocky

Prismatic

Single Grain

Massive

Weak

Mod

erate

Strong

Loose

Loose

Friable

Firm

Extrem

ely Firm

Rigid

Co

ncen

trations

Dep

letio

ns

Gleyed

Granu

lar

Platy

Blocky

Prismatic

Single Grain

Massive

Weak

Mod

erate

Strong

Loose

Loose

Friable

Firm

Extrem

ely Firm

Rigid

Co

ncen

trations

Dep

letio

ns

Gleyed

Granu

lar

Platy

Blocky

Prismatic

Single Grain

Massive

Weak

Mod

erate

Strong

Loose

Loose

Friable

Firm

Extrem

ely Firm

Rigid

Co

ncen

trations

Dep

letio

ns

Gleyed

Granu

lar

Platy

Blocky

Prismatic

Single Grain

Massive

Weak

Mod

erate

Strong

Loose

Loose

Friable

Firm

Extrem

ely Firm

Rigid

Co

ncen

trations

Dep

letio

ns

Gleyed

Granu

lar

Platy

Blocky

Prismatic

Single Grain

Massive

Weak

Mod

erate

Strong

Loose

Loose

Friable

Firm

Extrem

ely Firm

Rigid

Com

men

ts:

Cert

ified

Sta

tem

ent: I

here

by c

erti

fy t

hat I h

ave

com

plet

ed t

his

wor

k in a

ccor

danc

e w

ith

all a

pplic

able o

rdin

ance

s, r

ules a

nd la

ws.

____

____

____

____

____

____

____

____

____

____

____

__

(Des

igne

r)

____

____

____

____

____

____

____

____

____

___

(Sig

natu

re)

____

____

____

__

(Li

cens

e #)

____

____

___

(Dat

e)


09/09

Textures:

Soil Structure G

rade: Weak ‐poorly form

ed, indistinct peds, barely observable in place Moderate ‐W

ell formed, distinct peds,

moderately durable and evident, but not

distinct in undisturbed soil Strong ‐durable peds that are quite evident in un‐displaced soil, adhere w

eakly to one another, w

ithstand displacement, and becom

e separated w

hen soil is disturbed Loose ‐no peds, sandy soil Landscape Position: 9.09

Soil Structure Shape: Granular ‐the peds are approxim

ately spherical or polyhedral and are com

monly found in

topsoil. These are the small, rounded

peds that hang onto roots when soil is turned

over. Platy‐the peds are flat and plate like. They are oriented horizontally and are usually overlapping. Platy structure is com

monly found

in forested areas just below the leaf litter or

shallow topsoil.

Blocky‐the peds are block‐like or polyhedral, and are bounded by flat or slightly rounded surface that are casting of the faces of surrounding peds. Blocky structure is com

monly

found in the lower topsoil and subsoil.

Prismatic‐ flat or slightly rounded vertical faces

bound the individual peds. Peds are distinctly longer vertically, and faces are typically cast or m

olds of adjoining peds. Prism

atic structure is commonly found in the

lower subsoil.

Single Grain‐the structure found in a sandy soil.

The individual particles are not held together. Massive‐no observable aggregates, or no

orderly arrangement of natural lines of

weakness

Consistence: Loose ‐intact specim

en not available Friable ‐slight force betw

een fingers Firm

‐moderate force betw

een fingers Extrem

ely firm‐m

oderate force between hands

or slight foot pressure Rigid ‐foot pressure

Subsoil Indicator(s) of Saturation: S1. D

epleted matrix (value ≥4 and

chroma ≤2)

S2. Distinct gray or red redox features

S3. 5Y chroma ≤ 3

S4. 7.5 YR or redder faint redox concentrations or redox depletions

If yes to one of the above indicators then: Topsoil Indicator(s) of Saturation: T1. W

etland vegetation T2. D

epressional landscape T3. O

rganic texture or organic modifiers

T4. N 2.5/ 0 color

T5. Redox features in topsoil T6. H

ydric soil Slope Shape ‐ Slope shape is described in tw

o directions: up‐and‐dow

n slope (perpendicular to the contour), and across slope (along the horizontal contour); e.g., Linear, Convex or LV.

c-clay sic-silty clay sc-sandy clay cl-clay loamsicl-silty clay loam

scl-sandy clay loam

si-siltsil-silt loam

* Sand M

odifiers l-loam

co-coarse

sl-sandy loam*

m-m

edium

ls-loamy sand*

f-fine s-sand*

vf-very fine

Summ

it

Foot Slope

Toe Slope

Back/Side

Shoulder


09/09

OSTP Site Evaluation Map

Contact Information

Address:

Property Owner/Client:

List any construction issues:

Mapping Checklist

Map scale: indicate north show slope % direction

Locate Easements Setbacks

Elevations


(Date)(Designer) (Signature) (License #)

Lot Dimensions/Property Lines

Dwellings and other improvements

Existing or proposed system(s)

Replacement area

Unsuitable area(s)Public water supply wells

Pumping access

Inner wellhead zone

Phone

Electric

Gas

Building

All water wells within 100 feet

Pressure PipeWater Suction PiStreams, Lakes, RiversFloodway and Fringe

Borings

Benchmark

Perc Tests

Horizontal & Vertical Reference Points


09/09

Diameter in

* Not required in sandy soils

Soak* endtime:

hrs of soak

Test hole: #1 Location:

Date reading taken: Elevation:

Depth**: inches

Soil texture description:

Address:

OSTP Percolation Data Sheet1. Contact Information

Method to maintain 12 in of water during soak

2. General Percolation Information

Date prepared and/or soaked:

Property Owner/Client:

Is pre-soak requiried*?

** 12 inches for mounds & at-grades, depth of absorption area for trenches &

Soil Texture

Starting time:

3. Percolation Test Data

Soak* start time:

Method of scratching sidewall:

Depth (in)

Reading End Time Start Reading End Reading Perc rate % Difference Pass1 NA NA2 NA NA3

mpi

mpi

(License #) (Date)

Additional percolation test data may be included on attached pages



Chosen Percolation Rate for Test Hole #1

Design Percolation Rate (maximum of all tests) =

depth of absorption area for trenches & beds

Start Time


09/09

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09/09

INSTRUCTIONS AND DEFINITIONS

SECTION 1. DATE PREPARED: Enter date in order of year, month, and day.

SECTION 2. FACILITY ID NUMBER: In the first two spaces, insert the appropriate U.S. Postal Service State Code. In the third space, insert one of the following one letter alphabetic identifiers:

D - DUNS Number, G - GSA Number, or S - State Facility Number.

In the remaining spaces, insert the appropriate nine digit DUNS, GSA, or State Facility Number. For example, A Federal facility (GSA -123456789) located in Virginia would be entered as : VAG123456789.

SECTION 3. TRANSACTION TYPE: Place an “x” in the applicable box. See below for further instructions.

Deletion. Fill in the Facility ID Number. First Time Entry. Fill in all the appropriate information. Entry Change. Fill in the Facility ID Number and the information that has changed. Replacement.

SECTION 4. FACILITY NAME AND LOCATION: A. Name. Fill in the facility’s official or legal name. B. Street Address. Self Explanatory. C. Latitude. Enter the facility’s latitude (all latitudes assume

North Except for American Samoa). D. Longitude. Enter the facility’s longitude (all longitudes assume

West except Guam). E. Township/Range. Fill in the complete township and range.

The first 3 spaces are numerical and the fourth is a letter (N,S,E,W) specifying a compass direction. A township is North or South of the baseline, and a range is East or West of the principal meridian (e.g., 132N, 343W).

F. City/Town. Self Explanatory. G. State. Insert the U.S. Postal Service State abbreviation. H. Zip Code. Insert the five digit zip code plus any extension.

SECTION 4. FACILITY NAME & LOCATION (CONT’D.): I. Numeric County Code. Insert the numeric county code from

the Federal Information Processing Standards Publication (FIPS Pub 6-1) June 15, 1970, U.S. Department of Commerce, National Bureau of Standards. For Alaska, use the Census Division Code developed by the U.S. Census Bureau.

J. Indian Land. Mark an “x” in the appropriate box (Yes or No) to indicate if the facility is located on Indian land.

SECTION 5. LEGAL CONTACT: A. Type. Mark an “x” in the appropriate box to indicate the type

of legal contact (Owner or Operator). For wells operated by lease, the operator is the legal contact.

B. Name. Self Explanatory. C. Phone. Self Explanatory. D. Organization. If the legal contact is an individual, give the

name of the business organization to expedite mail distribution. E. Street/P.O. Box. Self Explanatory. F. City/Town. Self Explanatory. G. State. Insert the U.S. Postal Service State abbreviation. H. Zip Code. Insert the five digit zip code plus any extension. I. Ownership. Place an “x” in the appropriate box to indicate

ownership status.

SECTION 6. WELL INFORMATION: A. Class and Type. Fill in the Class and Type of injection wells

located at the listed facility. Use the most pertinent code (specified below) to accurately describe each type of injection well. For example, 2R for a Class II Enhanced Recovery Well, or 3M for a Class III Solution Mining Well, etc.

B. Number of Commercial and Non-Commercial Wells. Enter the total number of commercial and non-commercial wells for each Class/Type, as applicable.

C. Total Number of Wells. Enter the total number of injection wells for each specified Class/Type.

D. Well Operation Status. Enter the number of wells for each Class/Type under each operation status (see key on other side).

INJECTION WELL CLASS AND TYPE CODES

CLASS I Industrial, Municipal, and Radioactive Waste Disposal Wells used to inject waste below the lowermost Underground Source of Drinking Water (USDW).

TYPE 1I Non-Hazardous Industrial Disposal Well. 1M Non-Hazardous Municipal Disposal Well. 1H Hazardous Waste Disposal Well injecting below the

lowermost USDW. 1R Radioactive Waste Disposal Well. 1X Other Class I Wells.

CLASS II Oil and Gas Production and Storage Related Injection Wells.

TYPE 2A Annular Disposal Well. 2D Produced Fluid Disposal Well. 2H Hydrocarbon Storage Well. 2R Enhanced Recovery Well. 2X Other Class II Wells.

CLASS III Special Process Injection Wells.

TYPE 3G In Situ Gassification Well 3M Solution Mining Well.

CLASS III (CONT’D.)

TYPE 3S Sulfur Mining Well by Frasch Process. 3T Geothermal Well. 3U Uranium Mining Well. 3X Other Class III Wells.

CLASS IV Wells that inject hazardous waste into/above USDWs.

TYPE 4H Hazardous Facility Injection Well. 4R Remediation Well at RCRA or CERCLA site.

CLASS V Any Underground Injection Well not included in Classes I through IV.

TYPE 5A Industrial Well. 5B Beneficial Use Well. 5C Fluid Return Well. 5D Sewage Treatment Effluent Well. 5E Cesspools (non-domestic). 5F Septic Systems. 5G Experimental Technology Well. 5H Drainage Well. 5I Mine Backfill Well. 5J Waste Discharge Well.

EPA Form 7520-16 (Revised 8-01)


09/09

Homeowner Survey –Onsite Septic System

Updated 8/5/2009 Page 1 of 2

These questions help septic system professionals determine the best level of care for your septic system. The questionscan also help troubleshoot problems, address needed upgrades or changes, or other issues.

Name____________________________________________________________ Phone Number____________________

Address____________________________________________________________________________________________

County/Township Permit No._________________

Information about the home and residents:1. The house/cabin is used full time, year round seasonal or part time

2. Number of people living in the home: adults children age 0 – 11 children age 12 & up

3. Current number of bedrooms number of bedrooms in original design

number of bathrooms: full three fourths half

4. Do you have an in home business? If yes – what is it?

Information about the Septic System: italicized answers best protect your system.

5. Number of septic tanks or chambers in tanks: capacity of tanks in gallons unknown

6. Date of last pumping or evaluation: How many tanks pumped unknown

7. Are there risers on the septic tank maintenance holes? yes no unknown

8. Are the risers insulated for freezing protection, and well secured for safety? yes no unknown

9. Is there an effluent screen on the outlet baffle of the tank? yes no unknown

10. If an effluent screen is present, do you maintain it? the pumper checks it yes _____unknown

11. Do you know how old your septic system is? no yes, installed in

12. Are you aware of any problems or repairs? Describe:

13. Has the system ever frozen? Yes, specify where no unknown

14. Do you use septic tank or system additives? no yes, we have added

15. Have you noticed any odors? Where?

16. We have: in ground soil treatment area above ground other

17. We mow the grass over the drainfield regularly yes no

18. We keep all vehicles, snowmobiles, dirt bikes, 4 wheelers, other items off our drain field area yes no

19. Pumps: yes, our system has pumps no unknown Gallons/dose ______ Doses/day

20. Alarms: alarms are present for pumps and/or effluent screen. Alarms do not work

unknown we do not have any alarms.

21. Well: yes no Well casing depth feet Distance from drainfield feet

22. Is this your first home with a septic system?

Are you familiar with the “dos and don’ts” of a septic system?

Do you have a copy of the Septic System Owner’s Guide from the University of Minnesota?


09/09

Homeowner Survey –Onsite Septic System

Updated 8/5/2009 Page 2 of 2

Household product and use information: italicized answers best protect your system.

23. Garbage Disposal: (circle) no yes, and use it often rarely never

24. Dishwasher: no yes loads per week

we use gel or powdered detergents. we read labels for phosphorus content.

Does it discharges to the septic system? _____yes no

25. Clothes Washer: no _____yes, _____and wash loads/week. We wash more than 1 load/day.

We have: an older agitator top loading washer suds saver washer front loading washer

We use liquid or powdered laundry detergents. Lint screen on the washer? Yes no

Amount of laundry bleach used in one week: Type?

Does it discharge to the septic system? yes no

26. Water Softener: no yes, and it discharges to the septic system yes no

27. Other water treatment filter: what: it discharges to the septic system yes no

28. Whirlpool bathtub: no yes, and it discharges to the septic system yes no

29. Sump Pump: no yes, and it discharges to the septic system yes no

30. Floor, roof or other drains: no yes, and it discharges to the septic system yes no

31. Skin care products: bath and shaving oils, creams, moisturizers: yes, we use these, times/week: ______

32. Anti bacterial soaps, cleansers: yes, we use these no, we do not use anti bacterials.

33. Cleaning products: indicate those used: Every flush toilet cleaners after shower door cleansers

drain cleaners bleach based kitchen and bathroom cleansers.

List other commonly used cleaning products:

34. Toilet Paper: number of rolls used per week

35. Prescription Drugs used long term: no yes,

type of medicine

type of medicine

36. We dispose of un needed prescription drugs by

37. Please attach system sketch if available. Include: footing drains, surface drainage and system replacement area

What questions do you have?

© 2009, Regents of the University of Minnesota. All rights reserved. For additional copies or for Americans with Disabilities Act accommodation,

please call(800) 322 8642. University of Minnesota is an equal opportunity educator and employer.


09/09

1.

A. Estimated Design Flow (GPD): gpd

or Measured Flow (GPD) : flow times safety factor

= gpd

Design Flow: Gallons Per Day (GPD)

B. Septic Tank capacity: Gallons

Number of Septic Tanks or Compartments : Effluent Screen & Alarm ?

* Flows for Classification IV dwellings are 60 percent of the values as determined for Classification I, II or III systems.

2. SITE EVALUATION:

A. Depth to Limiting Layer : inches ft

System Type

AVERAGE DESIGN FLOW:

Note: The estimated design flow is considered a peak flow rate including a safety factor. For long term performance, the average daily flow is recommended to be < 60% of this value.

gpd X

OSTP Design Flow and Soil Worksheet

f l d l

Type I Type II Type III Type IV Type V

B. 0

C. 0

D. Landscape Position :

E. Estimated Percent Land Slope : %

F. Calculated Slope = ÷ 0.0

Runor Rise

x 100 =

Trenches Bed At-Grade Mound

Gravity Distribution Pressure Distribution-Level Pressure Distribution-Unlevel

Type of Soil Treatment and Dispersal Area

Type of Distribution



09/09

OSTP Design Flow and Soil Worksheet

3. SOIL LOADING RATES: Use either A. or B. below

A. B.

4. ORGANIC LOADING (if pretreatment is being used)

Grade

Texture Group

Structure

Design Loading Rate: GPD/ft2

Select Soil Loading Rate:

C.

Organic Loading = Design Flow X Estimated BOD in mg/L in the effluent X 8.35 ÷ 1,000,000


DETAILED SOIL DESCRIPTIONS (SOIL PIT REQUIRED)

Consistence

Texture

7080 Table IX

Slowest measured percolation rate:

*Rapidly permeable soils: see 7080.2260

lbs BOD/day


(Signature)(Designer)

gpd X

(Date)(License #)

mg/L X 8.35 ÷ 1,000,000 =


09/09

1. SYSTEM SIZING:

A. Design Flow : GPD B. Maximum Depth : inches

C. Soil Loading Rate: GPD/ft2 C(i). Recommended CLR: gal/ft

D. Required Bottom Area: Design Flow (1.A) ÷ Loading Rate (1.C) = Initial Required Bottom Area

GPD ÷ GPD/ft2 = ft2

E. Select Dispersal Media :

F. Select Distribution Method :

G. Select Dispersal Type :

2. TRENCH CONFIGURATION: (Rock or equivalent media)

A.

6 to 11

Bottom Area Multiplier

1

0.66

OSTP Trench & Bed Design Worksheet

0.8

Design trench

bottom area

12 to 17

34%

Bottom Area Reduction

0%

18 to 23

Initial required trench bottom area

(ft2): (from 1.D)

20%

Sidewall Absorption

(inches)

RockOther Approved Media (Describe):

Pressure (required for rapidly permeable soils)

Gravity-Drop BoxGravity-Other (Describe):

Trench - Rock or equivalent (section 2 below)

Bed (section 4 below)

Trench - Registered Products (section 3 below)

B. Select Sidewall Height : inches = ft

C. Design Bottom Area (2.A): ft2

D. Select Trench Width : inches = ft

E. Total Designed Trench Length: Bottom Area (2.C) ÷ Trench Width (2.D) = Total Required Trench Length

ft2 ÷ ft = ft

F. Select Trench Spacing : ft (typically 5 - 12 ft from center to center)

G. Calculate Lawn Area: Trench Length (2.E) X Trench Spacing (2.F) = ft2 lawn area

ft X ft = ft2 lawn area

H. Calculate Minimum length based on Contour Loading Rate: Design Flow(1A) ÷ CLR (1Ci) =

gpd ÷ ft

I. If using rock or similar substitute media, select Depth Required to Cover Distribution Pipe :

ft (0.33 for pressure, 0.5 for gravity)

J. Calculate Media Volume : (Sidewall Height (2.B) + Depth to Cover Pipe (2.H)) X Bottom Area (2.C) = cubic ft.

( ft + ft ) X ft2 = ft3

Divide ft3 by 27 ft3/yd3 to calculate cubic yards:

ft3 ÷ 27 = yd3

0.66

0.6

gal/ft =

34%18 to 23

24 40%

RockOther Approved Media (Describe):

Pressure (required for rapidly permeable soils)

Gravity-Drop BoxGravity-Other (Describe):

Trench - Rock or equivalent (section 2 below)

Bed (section 4 below)

Trench - Registered Products (section 3 below)


09/09

3. TRENCH CONFIGURATION: (Registered Products)

A. Registered Product: (from MPCA list)

B. Product Absorption Area: ft2 / linear ft

(from MPCA Registered Product List)

C. Req'd Bottom Area (1.D): ft2

D. Total Required Trench Length: Bottom Area (4.C) ÷ Sizing Value (4.B) = Total Required Trench Length

ft2 ÷ ft2 / lin. ft = ft

E. Select Trench Spacing : ft (typically 5 - 12 ft from center to center)

F. Calculate Lawn Area: Trench Length (3.D) X Trench Spacing (3.E) = ft2 lawn area

ft X ft = ft2 lawn area

4. BED CONFIGURATION: (for sites with less than 6% slope)

A. Select size Multiplier :

B, Req'd Bottom Area (1.D): ft2

Designed Bottom Area : ft2

C. Select Bed Width : ft

D. Calculate Bed Length: Designed Bottom Area (4.B) ÷ Bed Width (4.C) = Bed Length

ft2 ÷ ft = ft

E. Select Sidewall Absorption : inches below the pipe = ft

F. Calculate Media Volume : (Media Depth (4.E) + depth to cover pipe) X Designed Bottom Area (4.B) = ft3

( ft ft) X ft2 = ft3

Maximum width = 25 ft. (pressurized) Maximum width = 12 ft. (gravity)

1.0 = pressurized 1.5 = gravity (not allowed in rapidly permeable soils)

+( ft ft) X ft = ft

Calculate Volume in cubic yards : Media volume in cubic feet (4.F) ÷ 27 = cubic yards

yd3

5. ORGANIC LOADING: (Optional)

A. Organic Loading = Design Flow X Estimated BOD in mg/L in the effluent X 8.35 ÷ 1,000,000 (See Table III)

gpd X mg/L X 8.35 ÷ 1,000,000 = lbs BOD/day

B. Calculate System Organic Loading: lbs. BOD/day (5.A) ÷ Bottom Area (2.C) , (3.C) or (4.A) = lbs/day/ft2

ft2 = lbs/day/ft2


(Date)(Designer) (Signature) (License #)

ft3 ÷ 27 =

lbs/day ÷

+


09/09

1. SYSTEM SIZING:

A. Design Flow (Flow & Soil - 1.A) : GPD

B. Soil Loading Rate (Flow & Soil-3.C): GPD/ft2

C. Depth to Limiting Condition: ft

D. Percent Land Slope: %

E. Design Media Loading Rate: GPD/ft2

F. Mound Absorption Ratio (1.E÷1.B):

G. Design Contour Loading Rate: GPD/ft

(From Table I - same as Linear Loading Rate)

2. DISPERSAL MEDIA SIZING

A. Calculate Required Dispersal Bed Area: Design Flow (1.A) ÷ Design Media Loading Rate (1.E) = ft2

GPD ÷ GPD/ft2 = ft2

ft2

B. Calculate Dispersal Bed Width: Contour Loading Rate (1.G) ÷ Design Media Loading Rate (1.E) = Bed Width

ft ÷ ft

C. Calculate Dispersal Bed Length: Dispersal Bed Area (2.A) ÷ Bed Width (2.B) = Bed Length

OSTP Mound Design Worksheet

*Systems with these values are not Type I systems.Contour Loading Rate is a recommended value.

gpd/ft2 =

If a larger dispersal media area is desired, enter size:

ft2 ÷ ft = ft

D. Select Dispersal Media :

3. ABSORPTION AREA SIZING

Note: Mound setbacks are measured from the Absorption Area.

A. Calculate Absorption Width: Bed Width (2.B) X Mound Absorption Ratio (1.F) = Absorption Width

ft X = ft

B. For slopes from 0 to 1%, the Absorption Width is measured from the bed equally in both directions.

Calculate Absorption Width Beyond the Bed : Absorption Width (3.A) - Bed Width (2.B) ÷ 2 = Width beyond Bed

( ft - ft) ÷ = ft

C. For slopes >1%, the Absorption Width is measured downhill from the upslope edge of the Bed .

Calculate Downslope Absorption Width : Absorption Width (3.A) - Bed Width (2.B) = ft

ft - ft = ft

Comments:Slope, CLR Choice, Material issues

Rock

Other Approved Media (Describe):


09/09

4. MOUND SIZING

A. Calculate Clean Sand Lift: 3 feet minus Depth to Limiting Condition (1.C) = Clean Sand Lift (1 ft minimum)

3.0 ft - ft = ft

B. Calculate Upslope Height: Clean Sand Lift (4.A) + media depth (1 ft.) + cover (1 ft.) = Upslope Heightft + ft + ft = ft

(figure D-34)

D. Calculate Upslope Berm Width : Multiplier (4.C) X Upslope Mound Height (4.B) = Upslope Berm Width

ft X ft = ft

E. Calculate Drop in Elevation Under Bed: Bed Width (2.B) X Land Slope (1.D) ÷ 100 = Drop (ft)

ft X ft

F. Calculate Downslope Mound Height: Upslope Height (4.B) + Drop in Elevation (4.E) = Downslope Height

ft + ft = ft

(figure D-34)

H. Calculate Downslope Berm Width: Multiplier (4.G) X Downslope Height (4.F) = Downslope Berm Width

x ft = ft

I. Calculate Minimum Berm to Cover Absorption Area: Downslope Absorption Width (3.B or 3.C) + 4 ft. = ft

ft + ft = ft

% ÷ 100 =

C. Select Upslope Berm Multiplier(based on land slope):

G. Select Downslope Berm Multiplier(based on land slope):

J. Design Downslope Berm = greater of 4H and 4I: ft

K. Select Endslope Berm Multiplier : (usually 3.0 or 4.0)

L. Calculate Endslope Berm (4.K) X Downslope Mound Height (4.F) = Endslope Berm Width

ft X ft = ft

M. Calculate Mound Width: Upslope Berm Width (4.D) + Bed Width (2.B) + Downslope Berm Width (4.J) = ft

ft + ft + ft = ft

N. Calculate Mound Length: Endslope Berm Width (4.L) + Bed Length (2.C) + Endslope Berm Width (4.L) = ft

ft + ft + ft = ft

5. ORGANIC LOADING: (Optional)

A. Organic Loading = Design Flow X Estimated BOD in mg/L in the effluent X 8.35 ÷ 1,000,000


B. Calculate System Organic Loading: lbs. BOD (5.A) ÷ Bed Area (2.A) = lbs/day/ft2

ft2 = lbs/day/ft2

C. Recommended Organic Loading Rate: lbs/day/ft2

lbs/day ÷


09/09

6. MOUND DIMENSIONS`

Comments:Divert surface water away from mound.


09/09

7. APPROXIMATE MOUND MATERIAL CALCULATIONS:

A. Calculate Bed (rock) Volume : Bed Length (2.C) X Bed Width (2.B) X Depth = Volume (ft3)

ft X ft X 1.0 = ft3

Divide ft3 by 27 ft3/yd3 to calculate cubic yards:

ft3 ÷ 27 = yd3

Add 20% for constructability: yd3 X 1.2 = yd3

B. Calculate Clean Sand Volume:

Upslope Volume : ((Upslope Mound Height - 1 ) x 3 x Bed Length ) ÷ 2 = cubic feet

(( ft - 1) X ft X ) ÷ 2 = ft3

Downslope Volume : ((Downslope Height - 1) x Downslope Absorption Width x Media Length ) ÷ 2 = cubic feet

(( ft - 1) X ft X ) ÷ 2 = ft3

Endslope Volume : (Downslope Mound Height - 1) x 3 x Media Width = cubic feet

( ft - 1 ) X ft X ft = ft3

Volume Under Rockbed : Average Sand Depth x Media Width x Media Length = cubic feet

ft X ft X ft = ft3

Total Clean Sand Volume : Upslope Volume + Downslope Volume + Endslope Volume + Volume Under Media

ft3 + ft3 + ft3 + ft3 = ft3

Divide ft3 by 27 ft3/yd3 to calculate cubic yards: ft3 ÷ 27 = yd3

Add 20% for constructability: yd3 X 1.2 = yd3

C. Calculate Sandy Berm Volume:

Total Berm Volume (approx) : ((Avg. Mound Height - .5 ft topsoil) x Mound Width x Mound Length) ÷ 2 = cu. ft.

( - )ft X ft X ) ÷ 2 = ft3

Total Mound Volume - Clean Sand volume -Rock Volume = cubic feet

ft3 - ft3 - ft3 = ft3


Add 20% for constructability: yd3 x 1.2 = yd3

D. Calculate Topsoil Material Volume: Total Mound Width X Total Mound Length X .5 ft

ft X ft X 0.5 ft = ft3


Add 20% for constructability: yd3 x 1.2 = yd3


(Date)

(Designer) (Signature) (License #)

0.5


09/09

1. DISPERSAL MEDIA SIZING:

A. Design Flow (Flow & Soil 1.A) GPD

B. Soil Loading Rate (Flow & Soil 3.C) GPD/ft2

C. Land Slope %

D. Contour Loading Rate GPD/ft(From Table I - Same as Linear Loading Rate)

E. Absorption Bed Width = Contour Loading Rate (1.D) ÷ Soil Loading Rate (1.B)(round up to nearest whole number) Cannot exceed 15 feet

ft

F. Absorption Bed Length = Design Flow (1.A) ÷ Contour Loading Rate (1.D)

ft

G. Required Absorption Bed Area = Design Flow (1.A) ÷ Soil Loading Rate (1.B)

gpd ÷ ft2

2. BERM SIZING:

A. Determine System Height = media height + 12" cover, divide by 12 inches per foot to convert to feet

ft

B. Upslope Mulitiplier based on percent slope (see Table II)

GPD/ft =

GPD/ft =

inches ÷ 12 inches/ft =

GPD ÷

GPD/ft2 ÷

GPD/ft2 =

OSTP At-GradeDesign Worksheet

C. Upslope Width = Upslope Multiplier (2.B) X System Height (2.A)

X ft = ft

D. Downslope Mulitiplier based on percent slope (see Table II)

E. 4 to 1 Downslope Berm Width = Downslope Multiplier (2.D) X System Height (2.A)

X ft = ft

F. Minimum Downslope Berm to cover media by 5 ft = Absorption Bed Width (1.E) + 5 ft

ft

G. Design Downslope Berm: Use the greater of the 4 to 1 berm (2.E) and the Minimum Downslope berm (2.F)

ft

H. Endslope Mulitiplier (usually 4.0)

I. Endslope Width = Endslope Multiplier (2.H) X System Height (2.A)

X ft = ft

J. System Width = The sum of the Upslope Width (2.C) + Downslope Width (2.G) (Minimum of 6 feet)

ft + ft = ft

K. System Length = Sum of the Endslope Width (2.I) + Absorption Bed Length (1.F) + Endslope Width (2.I)

ft + ft + ft = ft

ft + 5 ft =


09/09

3. AT-GRADE DIMENSIONS:


09/09

4. APPROXIMATE VOLUME CALCULATIONS:

A. Rock Area = (Absorption Bed Length (1.F) + additional rock upslope of lateral) X Absorption Bed Width (1.E)

( ft + ft) X ft = ft2

B. Rock Volume in Cubic Feet = Rock Area (4.A) by Depth of Media (Rock) (1 foot) and divide by 2.

ft3

C. Rock Volume in Cubic Yards = Volume in Cubic Feet (4.B) divided by 27

ft3 ÷ 27 = yd3

D. Loamy or Sandy Loam Cover Material Volume: Volume in Cubic Feet = System Width (2.J) X System Length (2.K) X 1.5 ÷ 2, minus rock volume (4.B)

( ft X ft X 1.5 ÷ 2) - = ft3

E. Loamy or Sandy Loam Cover Volume in Cubic Yards = Volume in Cubic Feet (4.D) divided by 27

ft3 ÷ 27 = yd3

F. Add 20% for constructability: yd3 x 1.2 = yd3

G. Topsoil Volume in Cubic Feet = System width (2.J) X System Length (2.K) x 0.5

X X 0.5 = ft3

H. Topsoil Volume in Cubic Yards = Volume in Cubic Feet (4.G) divided by 27

ft3 ÷ 27 = yd3

I. Add 20% for constructability: yd3 x 1.2 = yd3

5. Organic Loading: (optional)

A O i L di D i Fl (1 A) X E ti t d BOD i /L i th ffl t X 8 35 1 000 000 (T bl III)

ft2 X 1 ft ÷ 2 =

A. Organic Loading = Design Flow (1.A) X Estimated BOD in mg/L in the effluent X 8.35 ÷ 1,000,000 (Table III)


B. Calculate System Organic Loading: lbs. BOD (5.A) ÷ Absorption Bed Area (1.G) = lbs/day/ft2

ft2 = lbs/day/ft2

5. Comments:


(Date)

lbs/day ÷

(Signature)(Designer) (License #)


09/09

1. Select Number of Perforated Laterals in system/zone :

(2 feet is minimum and 3 feet is maximum spacing)

2. Select Perforation Spacing : ft

3. Select Perforation Diameter Size inch 0

4. Length of Laterals = Media Bed Length - distance from edge

ft - ft = ft

5.

Number of Perforation Spaces = ft ÷ ft = Spaces

6. Number of Perforations per Lateral is equal to 1.0 plus the Number of Perforation Spaces (Line 5).

Perforations Per Lateral = + 1 = Perfs. Per Lateral

7. Total Number of Perforations equals the Number of Perforations per Lateral (Line 6) multiplied by the Number of Perforated Laterals (Line 1).

Spaces

Check Table I to verifty the number of perforations per lateral guarantees less than a 10% discharge variation. The value is double if the a center manifold is used.

OSTP Pressure Distribution Design Worksheet

Determine the Number of Perforation Spaces . Divide the Length of Laterals (Line 4) by the Perforation Spacing (Line 2) and round down to the nearest whole number.

(1 or 2 feet depending on manifold location as perfs can not be closer then 1 foot from edge)

Perf. Per Lateral X Number of Perf. Laterals = Total Number of Perf.

8. Calculate the Square Feet per Perforation. Recommended value is 4-10 ft 2 per perforation. Does not apply to At-GradesBed Area = Bed Width (ft) X Bed Length (ft)

ft X ft = ft2

Square Foot per Perforation = Bed Area divided by the Total Number of Perforations (Line 7).

ft2 ÷ = ft2/perforations

9. Select Minimum Average Head : ft

10. Select Perforation Discharge (GPM) based on Table III: GPM per Perforation

11.

Perforations X GPM per Perforation = GPM

12. Select Type of Manifold Connection (End or Center):

Determine required Flow Rate by multiplying the Total Number of Perforations (Line 7) by the Perforation Discharge (Line 10).

perforations

End Center


09/09

OSTP Pressure Distribution Design Worksheet

14. Select Lateral Diameter based on Table I: in

15. Volume of Liquid Per Foot of Distribution Piping : Gallons/ft

16. Volume of Distribution Piping =

X ft X gal/ft = Gallons

17. Minimum Dose = Volume of Distribution Piping (Line 17) X 5

Gallonsgals X 5 =

= [Number of Perforated Laterals (Line 1) X Length of Laterals (Line 4) X (Volume of Liquid Per Foot of Distribution Piping (Line 15)]

Gallons

(License #)


(Date)(Designer) (Signature)

gals X 5


09/09

1. Enter soil treatment area (STA) length in order of the Highest Elevation to the Lowest Elevation:

Lateral 1 Pipe Elevation ft ft Highest

Lateral 2 Pipe Elevation ft Length of STA ft



Lateral 5 Pipe Elevation ft Length of STA ft Lowest

2. Calculate Change in Elevation over the laterals

= Highest Elevation (Lateral 1) - Lowest Elevation (Last Lateral above) ft - ft = ft

3. Select Minimum Average Head : ft

Use 1.0 ft for dwellings using 1/4 inch or 3/16 inch holes.

Use 2.0 ft for dwellings using 1/8 inch holes; or, for MSTS or other establishments using 1/4 inch or 3/16 inch holes.

4. Calculate the Total Head = Minimum Average Head (Line 3) + Change in Elevation (Line 2)

ft + ft = ft

5. Calculate Pressure Head for Each Lateral

A Highest trench elevation (Pipe Elevation 1): Pressure Head equals Minimum Average Head (Line 3)

This worksheet cannot be used for a Minimum Average Head of 5.0 feet. Design must be modified or valving must be used to equalize flow.

OSTP Non-Level Pressure Distribution Design Worksheet

Length of STA from manifold

A. Highest trench elevation (Pipe Elevation 1): Pressure Head equals Minimum Average Head (Line 3)

B. All other trenches: Pressure Head equals Minimum Average Head (Line 3) plus the Change in Elevation from Lateral 1.

Lat 1 ft + [ ft - ft] = ft





Elevation of Lateral 1

Minimum Average Head Pressure HeadElevation of Lateral


09/09


6. Determine the Flow Rate per Hole

c=0.60; d=perforation diameter; h=pressure head

or Calculate Perforation Discharge (Q) in GPM:

Lat 1 Pressure Head = GPM FALSE HighestFALSE

Lat 2 Pressure Head = GPM FALSEFALSE



Lat 5 Pressure Head = GPM FALSE Lowest

7. Calculate Flow in Gallons Per Minute for Lateral 1

A. Select Perforation Spacing : feet

B. Length of Lateral = Length of STA (Line 1) - distance from edge (1 or 2 feet)

- ft = ft

C.

ft Perforation Diameter




Select a Perforation Diameter and the corresponding gallons per minute from Table I, interpolating as needed.

Number of Perforation Spaces = Divide the Length of Lateral 1 (7.B) by the Perforation Spacing (Line 10) and round down to the nearest whole number. Check Table II to ensure the maximum number of perforations is not exceeded.


hcdQ 265.19

ft/ ft = Spaces

D. Select Type of Manifold Connection (End or Center):

E. Number of Perforations =Number of Perforation Spaces (Line 11) + 1.

F. Flow Rate for Lateral 1 = Number of Perforations X Flow Rate Per Hole for Lateral 1

X = GPM for Lateral 1

8.

Gallons Per Length = Flow Rate for Lateral 1 divided by Length of Lateral 1

÷ = GPM/Foot

Spaces +1 =

Calculate the Gallons Per Minute Per Foot for Lateral 1. This value will then be used to make sure that the gallons per minute per foot is equivalent in each lateral

End Center


09/09


9. Balance flows for other lateral lengths, spacing, and size.

If you end up with large perforation spacing (3' is max) lower the initial spacing for Lateral 1 (Line 7.A) or the perforation size (Line 6)

Lateral 2 GPM = Length of Lateral X Gallons Per Minute Per Foot (Line 8)

ft X GPM

Number of Perforations = GPM/Flow Rate for Lateral 2 (Line 6.2)

÷ = Perforations Select Type of Manifold Connection (End or Center):

Spacing = (Length of Lateral)/(Number of Perforations -1)

( = ft


ft X GPM




( = ft

L t l 4 GPM L th f L t l X G ll P Mi t P F t (Li 8)

Perforations-1)) ÷ (

) ÷ (

Check Table to ensure the maximum number of perforations is not exceeded.

GPM/Ft=

Perforations-1)


GPM/ft=

End Center

End Center


ft X GPM




( = ft


ft X GPM




( = ft

) ÷ (

GPM/Ft=


Perforations-1)


GPM/Ft=

Perforations-1)

) ÷ (

End Center

End Center


09/09


10. Calculate Total GPM for system - the total GPM need from the pump.

Lateral 1 Flow = GPM





Total Flow GPM

11. Summary

Highest

Lowest

Total Volume to Fill Pipe (gal)

Perforation Size (in)

Lateral 5

Lateral 4

Lateral 3

Lateral 2

Pipe Volume (gal/ft)

Lateral 1

Pipe Size (in)

Enter the minimum pipe size that allows for even distribution and the volume of liquid in the pipe from the table.

Spacing (ft)Pipe Length (ft)

Min. Delieved Dose Volume = Five X the Total Volume of Piping =

(Date)(License #)



Total Volume of Distribution Piping =


09/09

A. 0

1. If pumping to gravity enter the gallon per minute of the pump: GPM

2. If pumping to pressure, is the pump for the treatment system or the collection system:

0

3. If pumping to a pressurized treatment system, what part or type of system:

4. If pumping to a pressurized distribution system: GPM(Line 11 of Pressure Distribution or Line 10 of Non-Level or enter if Collection System)

3. ft

4. ft

5.

NOTE : IF system is an individual subsurface sewage treatment system, complete steps 4 - 9. If system is a Collection System, skip steps 4, 5, 7 and 8 and go to Step 10.

between pump and point of discharge:

1. PUMP CAPACITY

Distribution Head Loss:

Elevation Difference

Additional Head Loss:

OSTP Pump Selection Design Worksheet

2. HEAD REQUIREMENTS

ft (due to special equipment, etc.)

Pumping to Gravity or Pressure Distribution:

Soil Treatment Media Filter Other

Collection System

Gravity Pressure

Treatment System

6. A. Supply Pipe Diameter: in

B. Supply Pipe Length: ft

7.

Friction Loss =

8.

ft X 1.25 = ft

9.

ft per 100ft X ft ÷ 100 = ft

Determine Equivalent Pipe Length from pump discharge to soil dispersal area discharge point. Estimate by adding 25% to supply pipe length for fitting loss. Supply Pipe Length (5.B) X 1.25 = Equivalent Pipe Length

Supply Friction Loss =

Calculate Supply Friction Loss by multiplying Friction Loss Per 100ft (Line 6) by the Equivalent Pipe Length (Line 7) and divide by 100.

Based on Friction Loss in Plastic Pipe per 100ft from Table I:

ft per 100ft of pipe

Soil Treatment Media Filter Other

Collection System

Gravity Pressure

Treatment System


09/09

OSTP Pump Selection Design Worksheet

10. Equivalent length of pipe fittings.

Quantity X Equivalent Length Factor = Equivalent Length

X =

X =

X =

X =

X =

X =

X =

X =

X =

X =

X =

A. Sum of Equivalent Length due to pipe fittings: ft

Valve 11

NOTE: System installer should contact system designer if the number of fittings varies from the design to the actual installation.

Gate Valve

Section 10 is for Collection Systems ONLY and does NOT need to be completed for individual subsurface sewage treatment systems.

QuantityFitting Type

45 Deg Elbow

90 Deg Elbow

Tee - Flow Thru

Equivalent Length (ft)

Equivalent Length Factor

Butterfly Valve

Globe Valve

Angle Valve

Tee - Branch Flow

Swing Check Valve

Valve 10

NOTE: Equivalent length values for PVC pipe fittings are based on calculations using the Hazen-Williams Equation. See Advanced Designs for SSTS for equation. Other pipe material may require different equivalent length factors. Verify other equivalent length factors with pipe material manufacturer.

B. Total Pipe Length = Supply Pipe Length (5.B) + Equivalent Pipe Length (9.A.)

ft + ft = ft

C. Hazen-Williams friction loss due to pipe fittings and supply pipe (hf): Q in gpm L in feet D in inches C = 130

X ( X Total Pipe Length (10.B)

in4.87 ) X ( gpm ÷ 130)1.85 X ft = ft

11.

ft + ft + ft + ft = ft

Total Head requirement is the sum of the Elevation Difference (Line 3), the Distribution Head Loss (Line 4), Additional Head Loss (Line 5), and either Supply Friction Loss (Line 9 ), or Friction Loss from the Supply Pipe and Pipe Fittings for collection systems (Line 10.C)

Hazen-Williams Equation for h

Pipe Diameter4.87 )

(10.5 ÷


GPM (Line 1 or Line 2) with at least feet of total head.

(10.5 ÷ Flow Rate ÷ Constant)1.85

3. PUMP SELECTION

(Date)

NOTE: Friction Loss from the Supply Pipe and Pipe Fittings (Line 9.C) need ONLY be used if system is a collection system.

(Designer) (Signature) (License #)

NOTE: Supply Friction Loss (Line 8) need ONLY be used if NOT a collection system.

A pump must be selected to deliver at least

LCQD

h f *)(*5.10 85.187.4


09/09

DETERMINE AREA AND/OR GALLONS PER INCH

1. A. Rectangle area = Length (L) X Width (W)

ft X ft = ft2

B. Circle area = 3.14r2 (3.14 X radius X radius)

3.14 X 2 ft = ft2

C. Get area from manufacturer ft2

D. Get gallons per inch from manfufacture Gallons per inch

2. Calculate Gallons Per Inch :

(Area X 7.48 gallons/ft3)/(12 in/ft) =

ft2 X = Gallons per inch

3. Enter the Pump Tank Capacity (minimum provided in the table below): Gallons

4. Calculate Total Tank Volume

A. Depth from bottom of inlet pipe to tank bottom : in

TANK CAPACITY

7.48 gal/ft3 ÷

There are 7.48 gallons per cubic foot. Therefore, multiply the area from 1.A, 1.B, or 1.C by 7.48 to determine the gallons per foot the tank holds. Then divide that number by 12 to calculate the gallons per inch.

12 in/ft

OSTP Pump Tank Sizing, Dosing and Float and Timer Setting Design Worksheet

Width

Length

Radius

B. Total Tank Volume = Depth from bottom of inlet pipe (Line 4.A) X Gallons/Inch (Line 2)

in X Gallons Per Inch = Gallons

5.

(Pump and block height + 2 inches) X Gallons Per Inch (1D or 2)

( in + 2 inches) X Gallons Per Inch = Gallons

Calculate Volume to Cover Pump (The inlet of the pump must be at least 4-inches from the bottom of the pump tank & 2 inches of water covering the pump is recommended)

Width

Length

Radius


09/09


7. Gallons

- Line 17 of the Pressure Distribution or Line 11 of Non-level

8. Calculate Maximum Pumpout Volume (25% of Design Flow)

Design Flow: GPD X = Gallons

9. Gallons

10. Calculate Doses Per Day = Design Flow ÷ Dosing Volume

gpd ÷ gal = Doses

11. Calculate Drainback:

A. Diameter of Supply Pipe = inches

B. Length of Supply Pipe = feet

C. Volume of Liquid Per Lineal Foot of Pipe = Gallons/ft

D. Drainback = Length of Supply Pipe X Volume of Liquid Per Lineal Foot of Pipe

ft X gal/ft = Gallons

12. Total Dosing Volume = Dosing Volume (Line 9) plus Drainback (Line 11.D)

gal + gal = Gallons

13 Mi i Al V l D th f l (2 3 i h ) X ll i h f t k (Li 1 2)

0.25

DOSING VOLUME

Minimum Pumpout Volume - 5 X Volume of Distribution Piping:

Select a pumpout volume that meets both items above (Line 7 & 8):

13. Minimum Alarm Volume = Depth of alarm (2 or 3 inches) X gallons per inch of tank (Line 1 or 2)

in X gal/in = Gallons

TIMER or DEMAND FLOAT SETTINGS

Select Timer or Demand Dosing: 0

A. Timer Settings

14. Required Flow Rate :

A. From Design (Line 11 of Pressure Distribution or Line 10 of Non-Level*): GPM

B. Or calculated: GPM = Change in Depth (in) x Gallons Per Inch (Line 1 or 2) / Time Interval in Minutes

in X gal/in ÷ min = GPM

15. Choose a Flow Rate from Line 14.A or 14.B above. GPM

16. Calculate TIMER ON setting:

Total Dosing Volume (Line 12)/GPM(Line 15)

gal ÷ gpm = Minutes ON

17. Calculate TIMER OFF setting:

Minutes Per Day (1440)/Doses Per Day (Line 10) - Minutes On (Line 16)

÷ doses/day - min = Minutes OFF

17. Pump Off Float - Measuring from bottom of tank:

Distance to set Pump Off Float=Gallons to Cover Pump (Line 5) / Gallons Per Inch (Line 1 or 2):

gal ÷ gal/in = Inches

18. Alarm Float - Measuring from bottom of tank:

Distance to set Alarm Float = Tank Depth(4A) - Alarm Depth (Line 13)

in - in = in

*Note: This value must be adjusted after field

measurement & calculation.

1440 min

Timer Demand Dose


09/09


B. DEMAND DOSE FLOAT SETTINGS

18. Calculate Float Separation Distance using Dosing Volume .

Total Dosing Volume (Line 12)/Gallons Per Inch (Line 2)

gal ÷ gal/in = Inches

19. Measuring from bottom of tank:

A. Distance to set Pump Off Float = Pump Height + Block Height (Line 5) + Alarm Depth (Line 13)

in + in = Inches

in + in = Inches

C. Distance to set Alarm Float = Distance to set Pump-On Float (19.B) + Alarm Depth (2-3 inches)

in + in = Inches

in Alarm Depth in

Pump On in

Pump Off in Pump Off in

Distance to set Pump On Float=Distance to Set Pump-Off Float (Line 19.A) + Float Separation Distance (Line 18)

TIMED DOSINGDEMAND DOSING

B.

Alarm Depth

FLOAT SETTINGS


(Signature)(Designer) (License #) (Date)


09/09

A. GENERAL SPECIFICATIONS

1. Design flow - from Flow & Soil or LISTS Flow worksheet:

2. Type of filter (check ):

B. MINIMUM RECIRCULATION/DOSING TANK CAPACITY (if applicable)

A minimum of 24 hours (1 day) of hydraulic retention time is required, but can be greater.

Minimum capacity is equal to the Design Flow (1) multiplied by 1.

gpd X day(s) = Gallons

C. FILTER DIMENSIONS

1. Select hydraulic loading rate: ft2/gpd

Maximum hydraulic loading rate for single-pass is 1.0ft 2 /gpd and 0.2 ft 2 /gpd for recirculating.

2. Filter area based on hydraulic loading rate = flow rate (A1) x loading rate (C1):

gpd X ft2/gpd = ft2

3. Verifty organic loading rate is accectable

OSTP Single-Pass & Recirculating Sand Filter

Worksheet

Single-Pass Recirculating

a.

gpd X lbs BOD

b. Divide lbs of BOD by square feet of filter (C2).

lbs BOD ÷ ft2 = lbs BOD/ft2

c.

lbs BOD ÷ 0.005 = ft2

d.

4. Select width of filter: ft

5. Length of filter = filter area (C3d) divided by filter width (C3) =

ft2 ÷ ft = ft

Number of Zones:

1 zone minimum for single family dwelling, minimum of two zones for anything else.

Organic loading rate must be less then 0.005 lbs BOD/ft2. Divide lbs of BOD (Line 3a) by 0.005 lbs/ft 2

Required filter area is the larger of line C2 and 3c:

mg/l X 0.00000834 =

Take design flow (A1) multipled by estimated BOD5 multipled by conversion factor (0.00000834).

Single-Pass Recirculating


09/09


WorksheetD. DRAINAGE SYSTEM

1. Type(s) of Drainage Media:

2. (a) Total Depth of Drainage Media: ft

(b) Depth of Pea Gravel: in. ÷ 12 = ft

c) Depth of Drainfield Rock: in. ÷ 12 = ft

3.

ft2 X ft = ft3

Divide cubic feet by 27 ft3/yd3 to get cubic yards:

ft3 ÷ 27 = yd3

To protect the liner, 6 in. of 3/8- media must be installed under the liner and 2 in. of pea gravel on top of the liner. Drainfield rock must surround the collection pipe. The upper 2 in. must be pea gravel to limit migration of treatment media into drai

Pea Gravel Volume: Multiply filter area (C2) by drainage depth (2b):

Minimum depth is 1 foot with bottom sloped 1% to drainage pipe unless pump is part of filter drainage.

y

4.

ft2 X ft = ft3

Divide cubic feet by 27 ft3/yd3 to get cubic yards (for sand and gravel only):

ft3 ÷ 27 = yd3

5. Number of Drainage Pipes:

6. Number of Inspection Ports: One inspection port per zone is minimum.

Drainfield Rock Volume: Multiply filter area (C2) by drainage depth (2c):

One drainage pipe per zone or twenty feet is minimum, more are recommended to facilitate system recovery.


09/09


WorksheetE. TREATMENT MEDIA

1. Type (sand, gravel, etc):

2. Depth of Treatment Media: ft 2 feet is required

3. Treatment Media Volume: Multiply filter area(C2) by treatment depth (E2):

ft2 X ft = ft3

Divide cubic feet by 27 ft3/yd3 to get cubic yards

ft3 ÷ 27 = yd3

F. DISTRIBUTION MEDIA

1. Type of Distribution Media:

If other, please specify:

2. Depth of Distribution Media: ft

Minimum depth is 0 67 feet (8 inches = 6 inches below the

3.

ft2 X ft = ft3

Divide cubic feet by 27 ft3/yd3 to get cubic yards

ft3 ÷ 27 = yd3

G. COVER MATERIAL (if applicable)

Is the system covered with geotextile & soil (check box) ?

ft

Single-pass sand filters may be covered with soil while recirculating sand filter must have distribution media to the surface. If soil cover installed, maximum depth of 12 inches of loamy or sandy material with upper six inches of topsoil borrow is required alongwith appropriate vegetation.

Minimum depth is 0.67 feet (8 inches = 6 inches below the lateral and 2 inches above).

If using rock or gravel, media volume: Multiply filter area (C2) by distribution depth (F2):

Yes-Depth:No


09/09


WorksheetH. LINER

1.

ft + ft + ft +

ft = ft

2.

ft + ( ft x 2) + 2 = ft

3.

ft + ( ft x 2) + 2 = ft

4. Liner size/area is then determined by multiplying the width(H2) and length (H3):

ft2 X ft = ft2

Total system height is sum of depth of drainage(D2), treatment(E2), distribution(F2) & cover(G):

Length of liner equals the design length (C5) plus two times the total system height (H1) of the filter plus two additional feet for constructability:

Width of liner is equal to the design width (C4) plus the two times the total system height (H1) plus two additional feet for constructability:

Assumes verticle walls. If sloped additional liner will be

needed.


(License #) (Date)(Designer) (Signature)


09/09

Dwelling#

# of Bedrooms (minimum = 2)

DwellingClassification(see Table IV)

7080.1860Design Flow (gpd)

(See Table 1)

Reduction Factor- 0.45

(if applicable*)

LISTS Flow perDwelling (gpd)

123456789101112131415161718

OSTP Flow Estimation:

Existing Dwellings

192021222324252627282930

* Use 1.0 for the flow from the ten hightest flow dwellings and 0.45 for remaining dwellings

Total Dwelling Flow Estimate


09/09

OSTP Flow Estimation:

New Developments

Dwelling # # of Bedrooms (minimum = 2)Average Daily Flow

(# of bedrooms x 110 gallons)

12345678910111213141516171819202021222324252627282930

Total Dwelling Flow


09/09

Day (1-30)

Meter Reading*

(gal)% Capacity (if exists) GPD

Day (31-60)

Meter Reading*


Day (61-90)

Meter Reading*


1 NA 31 612 32 623 33 634 34 645 35 656 36 667 37 678 38 689 39 6910 40 7011 41 7112 42 7213 43 7314 44 7415 45 7516 46 7617 47 7718 48 7819 49 7920 50 8021 51 8122 52 8223 53 8324 54 84

OSTP Measured Flow:Other Establishments

24 54 8425 55 8526 56 8627 57 8728 58 8829 59 8930 60 90

Minimum Flow gpd

Peak Flow gpd

Full capacity flow from 7 busiest consectutive days (if available): gpd

Average Flow of Days in Operation (without capacity information) gpdDo not include days with no flow

Flow Calculations

* Daily flow data collected during peak season of usuage. Meter calibrated monthly. Data could also be gathered from event counter or running time clock and converted to gallons.


09/09

Establishment 7081 Specified Type of Establishment Unit # of Units

Design Flow per Unit (See

Table I)Total Avg Daily

Flow

1

2

3

4

5

0

Establishment NON 7081 Specified Type of Establishment Unit # of UnitsDesign Flow

per Unit Total Avg Daily

Flow

6

7

8

9

10

0

OSTP Flow Estimation:Other Establishments

Total Flow Non-7081 Establishments (gpd)

Total Flow 7081 Establishments (gpd)

0Total Flow 7081 and Non 7081 Establishments (gpd)


09/09

1. Flow from Dwellings Flow from Dwellings gpd

2. Flow from Other Establishments

Permitting Flow from Other Establishments

gpd

a) Total Length of CollectionPipe:

feet

b) Diameter of Pipe (Minimum of 2 in):

inches

c) Flow from I& I in Collection System:

gpd

gpd

OSTP Final Permitting FlowWorksheet

Design flow must include 200 gallons of infiltration and inflow

per inch of collection pipe diameter per mile per day with a minimum pipe diameter of two

inches. Flow values can be further increased if the system employs

treatment devices that will infiltrate precipitation.

4. Final Permitting Flow

From either existing and new development worksheet

From either Measured or Estimated-OE worksheet

Sum of 1, 2 and 3c.

3. Flow from Collection System


09/09

Permitting Flow (from Final Flow worksheet): GPD

A.

See Assessment and Waste Strength Table

B. If Yes, Estimated or Measured Values

i. BOD5 mg/l

ii. TSS mg/l

iii. FOG mg/l

Facility with potential elevated levels of BOD5, TSS or FOG?

If concentrations of BOD, TSS, and O&G are expected to be higher than 175 mg/1, 65 mg/1, or 25 mg/1 respectively, an estimated or measured

average concentration must be determined.

3. GREASE TRAP

Grease trap required for facilities with high levels of O&G. A minimum of 24 hours (1 day) of hydraulic retention time is required, but can be up 4 days or more.The outlet baffle must extended to 50 - 70% of liquid depth.

OSTP LISTS Design Flow and System Summary Worksheet

1. PERMITTING FLOW

2. ORGANIC LOADING

Yes No

Estimated Measured

A. Design Flow - Grease Trap (kitchen waste only): GPD

Use 70% of permited flow to size the grease trap if using estimated design flows are being used.

B. Minimum capacity is equal to the Design Flow for Grease Traps (3A) multiplied by 1.

X day(s) = Gallons

A. Individual septic tanks at each dwelling (7080.1930 minimum)*:

Septic Tank capacity: Gallons

Number of Septic Tanks/Compartments:

(1/8 or 1/16 inch)

4. SEPTIC TANKS

* When septic tanks are installed at each dwelling

an effluent screen and alarm must either be

located at each dwelling or a the common treatment area. Effluent Screen Minimum Size Slots**

Yes No

Estimated Measured


09/09


B. Gravity collection to common septic tanks:

Minimum capacity is the design flow (1) multiplied by 3 days.

X 3 days = Gallons

Number of Septic Tanks/ Compartments :

(1/8 or 1/16 inch)

C. Pressure collection to common septic tanks:

Minimum septic tank capacity is the design flow multiplied by 4 days.

X 4 days = Gallons

Number of Septic Tanks/Compartments :

(1/8 or 1/16 inch)

D. Septic tank liquid capacity prior to other treatment devices:

** 1/16 inch screen slots must be used when

downstream distribution components utulize 1/8 inch diameter orifices.Effluent Screen Minimum Size Slots**

Effluent Screen Minimum Size Slots**

Capacity set by manufacturer's requirements, accepted engineering principles, or as identified in the product

Gallons

Number of Septic Tanks/Compartments :

A. Depth to Limiting Layer : inches feet

B. Landscape Position :

C. Soil Texture Group Number :

D. Percent Land Slope : %

5. SITE EVALUATION OVERVIEW:

Effluent Screen & Alarm ?

registration recommended standards and criteria.

Yes No


09/09


A. B.

mpi

C. GPD/ft2

DETAILED SOIL DESCRIPTIONS (SOIL PIT REQUIRED)

6. SOIL LOADING RATES: Select method A. or B. below

Design Loading Rate:

Grade

Consistence

*Rapidly permeable soils: see 7080.2260

Slowest measured percolation rate:


Texture Group


7080 Table IX

Texture

Structure

A. Type of Collection System

B.

C. Type of System:

D. Registered Product/pretreatment unit:

E. Distribution Method :

I hereby certify that I have completed this work in accordance with all applicable ordinances, rules & laws.

(License #) (Date)(Signature)(Designer)

Note: Pressure distribution must be used for soil treatment systems with flows greater than 2,500 gallons per day.

Kind of Soil Treatment and Dispersal Area :

7. SYSTEM OVERVIEW

Gravity Pressure

Yes-Type:No



09/09

MoundTexture Soil

Table IX

Loading Rates for Determining Bottom Absorption Area for Trenches and Seepage Beds for Effluent Treatment LevelC and Absorption Ratios for Determining Mound Absorption Areas using Detailed Soil Descriptions

StructureType Grade

Loose - 1.0Weakly Cemented Friable - 2.0Cemented-Firm - -Loose 1.20 1.0Weakly Cemented Friable 0.60 2.0C t d Fi

MoundAbsorption

Structureless1

TextureTextureGroup

SoilLoading

Medium Sand* 2 Single Grain Structureless

Consistence

Coarse Sand*

Structure

Single Grain

Cemented-Firm - -Loose 0.60 2.0Weakly Cemented Friable 0.24 5.0Cemented-Firm - -Loose 1.20 1.0Weakly Cemented Friable 0.60 2.0Cemented-Firm - -

Coarse and Medium Loamy Sand*

4 Single Grain Structureless

Fine Sand 3 Single Grain Structureless

Loose 0.60 2.0Weakly Cemented Friable 0.24 5.0Cemented-Firm - -Very Friable, Friable 0.45 2.6Firm 0.24 5.0Very Friable, Friable 0.78 1.3Firm 0.45 2.6

Weak

Moderate or Strong

Fine and Very Fine Loamy Sand


Prismatic,Blocky,

GranularFirm 0.45 2.6Very Friable, Friable 0.45 2.6Firm 0.24 5.0Very Friable, Friable 0.45 2.6Firm - -Very Friable, Friable 0.24 5.0Firm - -Very Friable Friable 0 24 5 0

Strong

PlatyWeak

Moderate or Strong

Coarse and Medium Sandy Loam

6

StructurelessMassive

Very Friable, Friable 0.24 5.0Firm 0.24 5.0Very Friable, Friable 0.60 2.0fim 0.24 5.0Very Friable, Friable 0.24 5.0Firm - -Very Friable, Friable - -Firm

Fine and Very Fine Sandy Loam

7

Prismatic,Blocky,

Granular

Weak

Moderate or Strong

Moderate or St

PlatyWeak

Firm - -Very Friable, Friable 0.24 5.0Firm - -

Strong

Massive Structureless


09/09

Very Friable, Friable 0.45 2.6Firm 0.24 5.0Very Friable, Friable 0.60 2.0Fi 0 24 5 0

Loading Rates for Determining Bottom Absorption Area for Trenches and Seepage Beds for Effluent Treatment LevelC and Absorption Ratios for Determining Mound Absorption Areas using Detailed Soil Descriptions

Table IX (cont.)

Prismatic,Blocky,

Granular

Weak

Moderate or St Firm 0.24 5.0

Very Friable, Friable 0.24 5.0Firm - -Very Friable, Friable - -Firm - -Very Friable, Friable 0.24 5.0Firm - -

Loam 8

GranularStrong

PlatyWeak

Moderate or Strong


Very Friable, Friable 0.45 2.6Firm 0.24 5.0Very Friable, Friable 0.50 2.4Firm 0.24 5.0Very Friable, Friable 0.24 5.0Firm - -Very Friable, Friable - -

Silt Loam 9

Prismatic,Blocky,

Granular

Weak

Moderate or Strong

PlatyWeak

Moderate or y ,Firm - -Very Friable, Friable 0.24 5.0Firm - -Very Friable, Friable 0.24 5.0Firm - -Very Friable, Friable 0.45 2.6Firm 0.24 5.0


Moderate or Strong

Prismatic,Blocky,

Granular

Weak

Moderate or Strong Firm 0.24 5.0

Very Friable, Friable - -Firm - -Very Friable, Friable - -Firm - -Very Friable, Friable - -Firm - -Very Friable Friable

WeakClay Loam, Silty Clay

Loam, Sandy Clay Loam10

Strong

Platy


Moderate or Strong

Very Friable, Friable - -Firm - -Very Friable, Friable 0.24 5.0Firm - -Very Friable, Friable - -Firm - -Very Friable, Friable - -Fi

Clay, Silty Clay, Sandy Clay

11

Prismatic,Blocky,

Granular

Weak

Moderate or Strong

PlatyWeak

Moderate or Firm - -Very Friable, Friable - -Firm - -Massive Structureless

Strong


09/09

Table XII

Loading Rates for Determining Bottom Absorption Area for Trenches and Seepage Beds for Effluent Treatment Levels A & B & Absorption Ratios for Determining Mound Absorption Areas using Detailed Soil Descriptions

Type GradeLoose - 1.0Weakly Cemented Friable - 2.0Cemented-Firm - -Loose 1.60 1.0W kl C t d F i bl 0 78 2 0

MoundAbsorption

Structureless1

TextureTextureGroup

SoilLoading

M di S d* 2 Si l G i S l

Levels A & B & Absorption Ratios for Determining Mound Absorption Areas using Detailed Soil Descriptions

Consistence

Coarse Sand*

Structure

Single Grain

Weakly Cemented Friable 0.78 2.0Cemented-Firm - -Loose 1.00 2.0Weakly Cemented Friable 0.12 2.0Cemented-Firm - -Loose 1.60 1.0Weakly Cemented Friable 0.78 2.0

Coarse and Medium Loamy Sand*


Fine Sand 3

Medium Sand* 2 Single Grain Structureless

Single Grain Structureless

yCemented-Firm - -Loose 1.00 2.0Weakly Cemented Friable 0.45 5.0Cemented-Firm - -Very Friable, Friable 0.60 2.6Firm 0.45 5.0Very Friable, Friable 1.00 1.3

Loamy Sand*g

Weak

Moderate or

Fine and Very Fine Loamy Sand


Prismatic,Blocky,

G lVery Friable, Friable 1.00 1.3Firm 0.60 2.6Very Friable, Friable 0.60 2.6Firm 0.45 5.0Very Friable, Friable 0.60 2.6Firm - -Very Friable, Friable 0.45 5.0Firm - -

Moderate or Strong

PlatyWeak

Moderate or Strong

Coarse and Medium Sandy Loam

6

StructurelessMassive

Granular

Firm - -Very Friable, Friable 0.45 5.0Firm 0.45 5.0Very Friable, Friable 0.78 2.0fim 0.45 5.0Very Friable, Friable 0.45 5.0Firm 0.00 -V F i bl F i bl 0 24

Fine and Very Fine Sandy Loam

7

Prismatic,Blocky,

Granular

Weak

Moderate or Strong

dPlaty

Weak

Very Friable, Friable 0.24 -Firm - -Very Friable, Friable 0.45 5.0Firm - -

Moderate or Strong


Platy


09/09

Very Friable, Friable 0.60 2.6Firm 0.45 5.0V F i bl F i bl 0 78 2 0

Loading Rates for Determining Bottom Absorption Area for Trenches and Seepage Beds for Effluent Treatment Levels A & B & Absorption Ratios for Determining Mound Absorption Areas using Detailed Soil Descriptions

Table XII (cont.)

Prismatic,Blocky,

Weak

Very Friable, Friable 0.78 2.0Firm 0.45 5.0Very Friable, Friable 0.45 5.0Firm - -Very Friable, Friable 0.24 -Firm - -Very Friable, Friable 0.45 5.0

Loam 8

Blocky,Granular

Moderate or Strong

PlatyWeak

Moderate or Strong

Massive Structurelessy

Firm - -Very Friable, Friable 0.60 2.6Firm 0.45 5.0Very Friable, Friable 0.78 2.4Firm 0.45 5.0Very Friable, Friable 0.45 5.0Firm - -Silt Loam 9

Prismatic,Blocky,

Granular

Weak

Moderate or Strong

Pl tWeak


FirmVery Friable, Friable - -Firm - -Very Friable, Friable 0.30 5.0Firm - -Very Friable, Friable 0.30 5.0Firm - -Very Friable Friable 0 60 2 6

Platy


Moderate or Strong

Prismatic,Blocky,

Weak

Moderate or Very Friable, Friable 0.60 2.6Firm 0.30 5.0Very Friable, Friable - -Firm - -Very Friable, Friable - -Firm - -Very Friable, Friable - -Firm

WeakClay Loam, Silty Clay

Loam, Sandy Clay Loam

10

Granular Moderate or Strong

Platy


Moderate or Strong

Firm - -Very Friable, Friable - -Firm - -Very Friable, Friable 0.30 5.0Firm - -Very Friable, Friable - -Firm - -


Clay, Silty Clay, Sandy Clay

11

Prismatic,Blocky,

Granular

Weak

Moderate or Strong

PlatyWeak

Very Friable, Friable - -Firm - -Very Friable, Friable - -Firm - -Massive Structureless

PlatyModerate or

Strong


09/09www.pca.state.mn.us • 651-296-6300 • 800-657-3864 • TTY 651-282-5332 or 800-657-3864 • Available in alternative formats wq-wwists4-31 • 4/24/09 Page 1 of 8

Compliance Inspection FormExisting Subsurface Sewage Treatment Systems (SSTS)

Doc Type: Compliance and Enforcement

Instructions on page 6

Summary Form (Completed form must be submitted to the local unit of government within 15 days.)

Parcel number:

System status: Compliant Noncompliant For Local Tracking Purposes:

(based on all compliance requirements)

Property Information Property owner name(s): Property owner phone: Property address: Property owner address (if different): County: Permitting authority: Date system constructed: Reason for inspection:

System Description Brief system description: Local permit number: Number of bedrooms: Design flow rate:

Is the system: In Shoreland area? Yes No An U.S. Environmental Protection Agency (EPA) Class V Injection Well? Yes No

In Wellhead Protection Area? Yes No System serving a Minnesota Department of Heath (MDH) licensed facility? Yes No

Compliance Status (Based on state requirements – additional local requirements may also apply.)Based on the information gathered and reported on attached forms, the compliance status of this system is (check one):

Certificate of Compliance – valid until (3 years from date of report): Notice of Noncompliance - For Noncompliant systems:

The reason for noncompliance is: This noncompliant system is classified as (check one below):

Imminent threat to public health & safety Failing to protect ground water Not in compliance with operating permit

CertificationI hereby certify that all the necessary information has been gathered to determine the compliance status of this system. No determination of future system performance has been nor can be made due to unknown conditions during system construction, possible abuse of the system, inadequate maintenance, or future water usage. Name: Certification number: Business license name and number: orName of local unit of government:

Signature: Date:

Required Attachments Hydraulic Performance Tank Integrity Operating Permit Form (if applicable) Soil Boring Logs Soil Separation System drawing/As-built drawing Any local requirements that are different from what is required on this form Other information (list):

Upgrade Requirements (derived from Minn. Stat. § 115.55) An imminent threat to public health and safety (ITPHS) must be upgraded, replaced, or its use discontinued within ten months of receipt of this notice or within a shorter period if required by local ordinance. If the system is failing to protect ground water, the system must be upgraded, replaced, or its use discontinued within the time required by local ordinance. If an existing system is not failing as defined in law, and has at least two feet of design soil separation, then the system need not be upgraded, repaired, replaced, or its use discontinued, notwithstanding any local ordinance that is more strict. This provision does not apply to systems in shoreland areas, Wellhead Protection Areas, or those used in connection with food, beverage, and lodging establishments as defined in law.


09/09

www.pca.state.mn.us • 651-296-6300 • 800-657-3864 • TTY 651-282-5332 or 800-657-3864 • Available in alternative formats wq-wwists4-31 • 4/24/09 Page 2 of 8

Parcel number: System status: Compliant Noncompliant (as determined by this form)

Hydraulic Performance and Other Compliance – Compliance Inspection Form for Existing SSTS

Compliance Issue #1 of 4 Date of observation: Reason for observation:

This form expires upon next inspection or in three years, whichever occurs first:

Compliance questions/criteria: (Required) (Check the appropriate box)

Does the system discharge sewage to the ground surface?

Yes No

Does the system discharge sewage to drain tile or surface waters?

Yes No

Does the system cause sewage backup into dwelling or establishment?

Yes No

Do other situations exist that have the potential to immediately and adversely impact or threaten public health or safety (electrical, unsafe covers, etc.)?

Yes No

Any “yes” answer indicates that the system is an imminent threat to public health and safety.

Does the system pose a threat to ground water for any conditions deemed non-protective as determined by the inspector?

Yes No

“Yes” indicates that the system is failing to protect ground water. If “yes”, describe the condition noted:

Verification Method*: (Optional)(Check the appropriate box)

Searched for surface outlet

Performed hydraulic test

Searched for seeping in yard

Checked for backup in home

Excessive ponding in soil system/D-boxes

Homeowner testimony

Examined for surging in tank

“Black soil” above soil dispersal system

System requires “emergency” pumping

Performed dye test

Other:

* No standard protocol exists. This list is not exhaustive, in sequential order, nor does it indicate which combinations are necessary to make this determination.

CertificationThis form is to be completed and attached to the Summary Form of the Minnesota Pollution Control Agency’s (MPCA) Compliance Inspection Form for Existing Subsurface Sewage Treatment Systems. Observations, interpretations, and conclusions must be completed by an inspector. Completed form must be submitted to the local unit of government within 15 days.

Property owner name(s):

Property address:

Property owner’s address (if different):

County: Property owner phone:

I hereby certify that I personally made the observations, interpretations, and conclusions reported on this form and that they arecorrect.

Name: Certification number:

Business license name and number: or

Name of local unit of government:

Signature: Date:

http://www.pca.state.mn.us


09/09



Tank Integrity and Safety Compliance – Compliance Inspection Form for Existing SSTS

Compliance Issue #2 of 4 Date of observation: Reason for observation:

This form expires on (three years):


Does the system consist of a seepage pit*, cesspool, drywell, or leaching pit?

Yes No

Do any sewage tank(s) leak below their designed operating depth?

Yes No

If yes, identify which sewage tank leaks. Any “yes” answer indicates that the system is failing to protect ground water.

* Seepage pits meeting 7080.2550 may be compliant if allowed in ordinance by local permitting authority.

Verification Method**: (Optional)(Check the appropriate box)

Probed tank bottom

Observed low liquid level

Examined construction records

Examined empty (pumped) tank

Probed outside tank for “black soil”

Pressure/vacuum check

Other:

** No standard protocol exists. This list is not exhaustive, in sequential order, nor does it indicate which combinations are necessary to make this determination.

Safety Check 1. Are maintenance hole covers damaged, cracked, or appeared to be structurally unsound? Yes* No

2. Were maintenance hole covers replaced in a secured manner (e.g., screws replaced)? Yes No*

3. Was secondary access restraint present (safety pan, second cover, or safety netting) – highly recommended. Yes No

4. Are other safety/health issue present? Yes* No

Explain:

*System is an imminent threat to public health and safety.

CertificationThis form is to be completed and attached to the Summary Form of the Minnesota Pollution Control Agency’s (MPCA) Compliance Inspection Form for Existing Subsurface Sewage Treatment Systems. Observations, interpretations, and conclusions must be completed by an inspector, maintainer, or service provider. Completed form must be submitted to the local unit of government within15 days.


Property address:







Signature: Date:



09/09www.pca.state.mn.us • 651-296-6300 • 800-657-3864 • TTY 651-282-5332 or 800-657-3864 • Available in alternative formats wq-wwists4-31 • 4/24/09 Page 4 of 8


Soil Separation Compliance and Other Compliance – Compliance Inspection Form for Existing SSTS

Compliance Issue #3 of 4 Date of observation: Reason for observation: This information on this form does not expire.


For systems built prior to April 1, 1996, and not located in Shoreland or Wellhead Protection Area or not serving a food, beverage or lodging establishment:

Does the system have at least a two-foot vertical separation distance from periodically saturated soil or bedrock? Yes No

For non-performance systems built April 1, 1996, or later or for non-performance systems located in Shoreland or Wellhead Protection Areas or serving a food, beverage or lodging establishment:

Does the system have a three-foot vertical separation distance from periodically saturated soil or bedrock?* Yes No

For reduced separation distance systems (i.e., “performance” systems under old 7080.0179 or Type IV or V system under new 7080. 2350 or 7080.2400):

Does the system meet the designed vertical separation distance from periodically saturated soil or bedrock?* Yes No Any “no” answer indicates that the system is failing to protect ground water.

Verification Method**: (Optional)(Check the appropriate box)

Conducted soil observation(s) (attach boring logs)

Two previous verifications (attach boring logs)

Other:

Soil observation does not expire. Previous observations by two independent parties are sufficient, unless site conditions have been altered.

* May be reduced by up to 15 percent if allowed in local ordinance.

** No standard protocol exists. This list is not exhaustive, in sequential order, nor does it indicate which combinations are necessary to make this determination.

CertificationThis form is to be completed and attached to the Summary Form of the Minnesota Pollution Control Agency’s (MPCA) Compliance Inspection Form for Existing Subsurface Sewage Treatment Systems. Observations, interpretations, and conclusions must be completed by an inspector or designer. Completed form must be submitted to the local unit of government within 15 days.


Property address:







Signature: Date:



09/09



Operating Permit Compliance and Nitrogen BMP Compliance – Compliance Inspection Form for Existing SSTS

Compliance Issue #4 of 4

Applicability: Is the system operated under an Operating Permit? Yes No If “yes”, then complete item A, below

Is the system required to employ a nitrogen BMP? Yes No If “yes”, then complete item B, below

If the answer to both questions is “no”, then this form does not need to be completed.


A. For systems with operating permits:

Has all the required monitoring and maintenance taken place and does the monitoring indicate compliance with the permit thresholds?

Yes No

B. For a system that has a required nitrogen reducing BMP and does not have an operating permit:

Is the nitrogen BMP in-place and appears to be properly operating? Yes No

Any “no” answers indicates noncompliance

Date of observation: Reason for observation:

Operating permit number:

This form expires upon next inspection or in three years, whichever occurs first:

CertificationThis form is to be completed and attached to the Summary Form of the Minnesota Pollution Control Agency’s (MPCA) Compliance Inspection Form for Existing Subsurface Sewage Treatment Systems. Observations, interpretations and conclusions must be completed by an advanced inspector, service provider, or maintainer (maintainer for holding tanks only). Completed form must besubmitted to the local unit of government within 15 days.


Property address:



I hereby certify that I personally made the observations, interpretations and conclusions reported on this form and that they arecorrect.




Signature: Date:



09/09


Instructions – Compliance Inspection Form for Existing SSTS

The Minnesota Pollution Control Agency’s (MPCA) compliance inspection form must be completed for all compliance inspections of existing Subsurface Sewage Treatment Systems (SSTS) (Minn. Stat. § 115.55 subdivision 5a (i)). A compliance inspection is an inspection for the purpose of issuing a certificate of compliance or notice of noncompliance (Minn. R. ch. 7080.1100, subpart 18).Additional local forms may also be required in local ordinance; if this is the case, attach the appropriate local form(s) as well.

The inspection form is divided into five separate pages, each dealing with a separate compliance issue. The pages include: Summary Form, Hydraulic Performance and Other Compliance Form, Tank Integrity and Safety Form, Soil Separation and Other Compliance Form, and Operating Permit and Nitrogen BMP Compliance Form. The following table indicates which sheets need to be completed for which type of systems:

System Classification

Summary Form

Hydraulic Performance

and Other Compliance

Form

TankIntegrity and Safety Form

SoilSeparation and Other

Compliance Form

Operating Permit and Nitrogen

BMPCompliance

Form Type I and old Standard Systems x x x x

Type II and old “Alternative” Systems

x x x x

Type III and old “Other” Systems x x x x

Type IV x x x x x Type V and old “Performance” Systems

x x x x x

ISTS or MSTS with nitrogen BMP x x x x x

MSTS with advanced nitrogen reduction x x x x x

ISTS = Individual Sewage Treatment Systems MSTS = Mid-Sized Subsurface Sewage Treatment Systems

The purpose of multiple forms is to accommodate the different times the system may be assessed and the various individuals thatmay do the assessment. The goal of these forms is to document a continual state of compliance for the system.

The final determination of compliance is determined on the Summary Sheet. This compliance status is based on the supporting compliance forms. Each supporting form has an expiration date (except the Soil Separation form), and, if not expired, will be used to support the Summary Sheet.

1. Summary Form Purpose and Intent This is the form that is completed once all the supporting information is gathered and the supporting forms are completed. Thisform acts as the official “Notice of Noncompliance” or “Certificate of Compliance”. The supporting forms must be attached to the summary form.

Line by Line Instructions (for non self-evident queries)

System Status (top line) - The “Compliant” or “Noncompliant” Section is based on all the required forms for that system.

Property Owner Section - The “Date System Construction” query must be determined from records or owner testimony. If neither of these two sources are available, then a reasonable estimate should be made. The method used to determine the date (records, estimate, testimony, etc… could be provided near the date blank).

System Description Section - The “Local Permit Number”, “Number of Bedrooms” and “EPA Class V Injection Well” queries are optional. An U.S. Environmental Protection Agency (EPA) Class V injection well is any system which serves more than one dwelling, or receives non-domestic waste, or a system which serves an Other Establishment which serves more than 20 persons per day.

The “Design Flow Rate” must be determined or estimated to determine if an advanced inspector is required to conduct the compliance inspection for that system.

Wellhead Protection Areas can be found at: http://mdh-agua.health.state.mn.us/swa/pdwmain.cfm.

http://mdh-agua.health.state.mn.us/swa/pdwmain.cfm



09/09


Compliance Status Section - The compliance status required to be recorded on this form is based on state rule and state statute requirements. The compliance status is based on the supporting compliance forms. If local compliance requirements differ, that can be noted on a separate document, but the state form still needs to be completed based on state criteria.

Certification Section - The final determination of compliance must be done by an inspector (or advanced inspector for a Type IV, Type V, or system with a design flow of greater than 2,500 gallons per day).

Required Attachments Section - The number of supporting compliance forms must be noted to ensure that the supporting information is complete.

If you are filling the form out on your computer, click the “Print Preview” button at this point – this will trigger the automaticfilling of system identification and Inspector information on subsequent pages.

2. Hydraulic Performance and Other Compliance Form (Compliance Issue #1) Purpose and Intent This form denotes compliance for surfacing of sewage or if an inspector is determining that the system is failing to protect ground water other than a leaking sewage tank (septic, pump, cesspool, seepage pit, etc…)


System Status (top line) - The “Compliant” or “Noncompliant” Section is based only on the criteria evaluated on this form, not based on criteria on other forms.

Compliance Questions/Criteria Section - The question in the lowest left-hand box which states: “Does the system pose a threat to ground water for any condition deemed to be non-protective as determined by the inspector?” is meant to allow the inspector to make a determination outside of the obvious non-protective systems (separation distance, leaky sewage tanks, etc…). These systems could include such things as a system covered by an impermeable surface.

3. Tank Integrity and Safety Compliance Form (Compliance Issue #2) Purpose and Intent This form denotes compliance for watertight tanks. Water tightness only refers to water tightness below the tank’s designed operating depth. Non-water tightness above the designed operating depth (i.e., water leaking into the tank) may be harmful for system operation, but is likely not a direct threat to environmental protection.



4. Soil Separation Compliance and Other Compliance Form (Compliance Issue #3) Purpose and Intent This form denotes compliance for the required vertical separation distance to the periodically saturated soil or bedrock. Line by Line Instructions (for non self-evident queries)


Compliance Questions/Criteria Section - The 15 percent reduction in separation distance is further explained by the following table:

System Type Example Required

Separation Distance

Required Separation

Distance with 15% Reduction

For systems built prior to April 1, 1996, and not located in Shoreland or Wellhead Protection Area or not serving a Food, Beverage or Lodging Establishment

Septic tank with trench system, built in 1980 not near a lake or stream 24 inches

24 inches (15% rule does not

apply)

For non-performance systems built April 1, 1996, or later or for non-performance systems located in Shoreland or Wellhead

Protection Areas or Serving a Food, Beverage or Lodging Establishment

Septic tank with a trench system, built in 1980 within a Minnesota Department of

Natural Resources (DNR) Shoreland Area, Or Septic tank with trench system, built in

2001, not in a DNR Shoreland Area

36 inches 31 inches

For reduced separation distance systems (i.e., “performance” systems under old

7080.0179 or Type IV or V system under new 7080. 2350 or 7080.2400)

Septic tank with advanced treatment to a trench system

12, 24 or 36 inches

10, 21, or 31 inches



09/09


Verification Method Section - The vertical separation distance must be determined. This determination can be made by the following:

A. A new soil boring (which does not need to be verified by another for an existing system compliance inspection). B. Previous borings by two independent certified individuals (one can be the original borings by the designer). C. For more complex or difficult site conditions, please refer to MPCA’s fact sheet on determining vertical

separation distance for existing systems.

The soil boring(s) must be attached to this form.

5. Operating Permit Compliance and Nitrogen BMP Compliance Form (Compliance Issue #4) Purpose and Intent This form denotes compliance for proper system operation as determined by compliance with the system’s operating permit, or for systems which employ a best management practice for nitrogen, whether that practice is currently in-place and property operating. These two conditions will only apply to a few systems which are required to have these measures, which began between the years 2008 and 2011.



Compliance Questions/Criteria Section - The assessment of the nitrogen best management practice (BMP) can be a simple visual evaluation if the BMP is still present and whether it appears to be properly functioning at the time of inspection.



09/09

Inspected by # Date

Owner Phone

Address

As-builts

Second site

Certi ed statement Lic. #

System DesignCerti ed statement Lic. #

# Bedrooms Flow gpd

Garbage disposal: Yes No Sump pump: Yes No

Clean water sources

Site Preparati on Same as design? Yes No

Setbacks: Well ft . Water lines ft . Buildings ft .

Surface water ft . Property line ft .

Traffi c Patt erns:

Pressure-tested? Yes No

MaterialsClean sand

Washed rock

Proper cover

Acceptable topsoil

Appropriate pipe specs

AcceptableUnacceptable



New System Inspecti on Report


09/09

Soil informati on Depth to limiti ng conditi on in. Maximum depth of system in.

System elevati on Bench mark

SSF sqft /gpd LLR gpd/ ft

System width ________ ft System length______ ft

System square footage ___________ sqft Absorpti on area _________ sqft

Site drainage: Yes No Swale: Yes No

Building SewerBedding Yes No

Piping Yes No

Slope Yes No

Insulati on Yes No

Clean out Yes No

TankWarning label Yes No

Acceptable Base Yes No

Sealed Penetrati ons Yes No

Manhole grade Yes No

Inspecti on pipes Yes No

Baffl es Yes No

Effl uent screen Yes No

Alarm Yes No

Effl uent screen: Yes No

Tank capacity gal

Compartments? Yes No #

Lift stati on/GrinderTank size gallons % of daily ow %

Timed Dose: Yes No Demand dose: Yes No Piggyback? Yes No

Pump sizing: gpm tdh Alarm : Yes No

Assembly locati on: Wiring Check:

Water ti ght:

�Acceptable�Unacceptable





09/09

Pretreatment DeviceDistributi on pressure: Yes No

Pump sizing gpm tdh

Media _______________ Depth________ ft

Drainage type � pump � gravity

Operati ng Pemit:

Sampling locati on and equipment Yes No

Effl uent quality Yes No

Frequency Yes No

Miti gati ve plan Yes No

Responsible parti es Yes No

Soil Treatment Area

Below GradeExcavati on

Plasti c limit Yes No Compacti on concerns Yes No

Smearing Yes No

Level Yes No

Distributi on �Serial (�drop boxes) �Parallel �Pressure

Drainback: Yes No Lateral locati ons: Unlevel distributi on Yes No

Perforati on size: Number: Perfs / Laterals

Distributi on media �Rock �Gravelless pipe �Chamber system

�Other*

Above GradeScari cati on: Yes No Compacti on concerns: Yes No

Level: Yes No Drainback: Yes No

Lateral locati ons

Perforati on size: _______ Number: ______Perfs / ______ Laterals

Distributi on �Timed �Pressure

Distributi on media: �Rock �Other*__________





09/09

© Regents of the University of Minnesota. All rights reserved.The University of Minnesota is committ ed to the policy that all persons shall have equal access to its programs, faciliti es, and employment without regard to race, color, creed, religion, nati onal origin, sex, age, marital status, disability, public assistance status, veteran status, or sexual orientati on.This publicati on/material is available in alternati ve formats upon request. Please contact OSTP at (800) 322-8642. Updated 09/09.

Site Sketch:


09/09

Owner:___________________________________Parcel Number: _________________

Street/City/Zip Code:_________________________________________________________________________

Lot: ___________ Secti on: ___________ Township: ____________ N Range: ____________ W

Installati on Date:_______________ Installer:_____________________ License Number: __________

Is the system in Shoreland, serving a MDH facility or in a Wellhead Protecti on area? YES NO

Number of Bedrooms/ Flow Rate:_________________# / gpd Septi c Tanks, No & Size:______________#/gal

Pump Tank Size:_____________gal Tank Manufacturer: ____________________________

Pump Size: _________ hp _______ gpm _______ft of TDH Floats properly set? YES NO

Soil Treatment Area:TYPE I TYPE II TYPE III TYPE IV TYPE V TRENCH BED MOUND AT-GRADE WARRANTIED OTHER:______________

Design Variances:____________________________________________________________________________ Site Drawing:

Limiti ng Layer/Depth:________”

Depth from Surface:_________ ”

Rock or Slat depth:__________ ”

Diameter of Gravelless:_______”

Trench Width:______________ft

Bott om Square Feet Area:____ft 2

Rockbed Size:_____________________

Adsorpti on width:__________________

Sand depth:_______________________ (under mound)

Describe: __________________

__________________________

__________________________

__________________________

__________________________

North Items to be Identi ed:1. Septi c, holding and pump

tanks, piping, and soil system con gurati on. Label bed or trench width and length or rockbed size, absorpti on width and nal dimensions. Indicate alarm locati on.

2. Show all setbacks from tank and soil system

a. Property boundries b. Buildings c. Wells d. Water bodies e. Road right-of-way3. Improvements - present and

future.4. Benchmark locati on and

distance of tank and soil system from benchmark

5. Replacement site6. Abandoned system

Reverse Side

OSTP As-Built Form


09/09

Other Informati on:

List any further system descripti ons:

List any material testi ng results (jar test, sieve analysis, etc):

List conditi ons during constructi on:

List who is responsible for establishing vegetati ve cover:

© 2009, Regents of the University of Minnesota. All rights reserved. For additi onal copies or for Americans with Disabiliti es Act accommodati ons, please call (800) 322-8642. University of Minnesota is an equal opportunity educator and employer. Updated 09/09.

I herby certi fy that I have completed this work in accordance with applicable ordinances, rules, and laws.

________________________________________(Installer) ________________(license #) ___________(Date)


09/09

Minnesota Department of Health Well Management Section

P.O. Box 64975, St. Paul, Minnesota 55164-0975 651/201-4600 or 800/383-9808

Certification of Buried Sewer Construction and Testing

This form must be completed and submitted to the Minnesota Department of Health (MDH) for installation of a buried sewer located 20 to 50 feet from a water-supply well, or the installation of a water-supply well located 20 to 50 feet from a buried sewer. NOTE: A 50-foot minimum separation must be maintained between a water-supply well and a buried collector or municipal sewer, an unapproved sewer, or a buried sewer serving a facility handling infectious or pathological waste.

Owner of Property Where Sewer is Located (please print)

Street Address, City, ZIP for Property Where Sewer is Located

County Name Township No. Range No. Section No. Fraction

¼ ¼ ¼

Date of Testing (mm/dd/yyyy) Person(s) Present to Witness Testing

Well Information

Provide Minnesota Well and Boring Number(s) ________________________________ or, if unavailable, provide the following information for each well located within 50 feet of the buried sewer.

Well No./Description Well

Depth Well

Diameter Year of

Construction Well Contractor Company Name

Well Address (if different from above)

Variance Information

Was a variance issued by the MDH for this sewer or well installation? Yes No If yes, please provide the variance tracking number: TN _____________.

Sewer Materials

ABS (ASTM D2661) ABS (ASTM D2751) ABS (ASTM F628) PVC (ASTM D2665) PVC (ASTM D3034) PVC (ASTM F789) PVC (ASTM F891) Cast Iron _______________

Test Methods (check one) Air Test (5 psi constant pressure for 15 minutes). Manometer Test (1-inch water column). Hydrostatic Test (for plastic pipe only).

The portion of the buried sewer system tested is described as follows (please specify each segment of sewer pipe which was tested).

__________________________________________________________________________________________________

__________________________________________________________________________________________________

Please draw a diagram of the sewer system on back and note the locations of any wells and the portions of

the sewer system that were pressure tested.


09/09

Buried Sewer Testing Diagram

Please draw a site diagram of the sewer system and all buried sewer pipes, including those buried beneath buildings (serving floor drain[s], bathroom[s], laundry room, etc.). Please note the portions of the buried sewer pipes that were pressure tested, the location of the well(s), and major landmarks on the property.

I, (name) ______________________________________, certify that the buried sewer(s) described above is/are constructed of the indicated, approved sewer material meeting the requirements of the Minnesota Plumbing Code, Minnesota Rules, part 4715.0530, and has/have been successfully tested in accordance with Minnesota Rules, part 4715.2820, by the indicated method.

In accordance with Minnesota Statutes, section 144.992, persons submitting false information to the Minnesota Department of Health are subject to administrative penalties of up to $10,000.

Name Title

Firm

Street Address

City State ZIP Code

License/Certification Number Signature Date

HE-01488-03 origs/sewer test form.doc 2/09R


09/09


SSTS AbandonmentReporting Form

Subsurface Sewage Treatment Systems (SSTS) Program)

InstructionsThis form is offered to meet the abandonment requirements of Minn. R. 7080.2500 and Disclosure Requirements of Minn. Stat. § 115.55, subd. 6. Future water supply well placement can also be affected by an abandoned SSTS. The use of this form is not mandatory; however the information on this form must be submitted to the local government unit (LGU)within 90 days after the abandonment. This form may be completed by a certified SSTS practitioner or by an individual who has direct knowledge of how the system was abandoned.

Property Information

Date of abandonment: Reason for abandonment:


Property owner’s address:

City: State: Zip:

Site address (if different):

City: State: Zip:

Compliance Information

1. All solids and liquids removed from all tanks? Yes No Disposal Site:

2. All electrical devices and devices containing mercury removed? Yes No Disposal Site:

3. All underground sewage tanks crushed and filled with soil or rock material? Yes No orRemoved and disposed off site? Yes No

Disposal Site:

4. Contaminated materials* removed and disposed off site? Yes No Disposal Site:

5. All underground cavities** crushed and filled with soil or rock material? Yes No or:Removed and disposed off site? Yes No

Disposal Site:

6. Future discharge to system permanently denied? Yes No Method(s) used:

*Contaminated materials = Distribution media, soil or sand within three feet of the system bottom, distribution pipes, geotextilefabric/rosin paper/straw, tanks, contaminated soil around leaking tanks, any soil that received sewage from a surface failure (7080.2500 subp.3).

**Underground cavities = Cesspools, leaching pits, drywells, seepage pits, vault privies, pit privies, pump chambers (7080.2500 subp. 1). Does not include chamber media, drop boxes, or distribution boxes.


09/09


MapInclude location of building sewer, septic tank(s), soil dispersal system, cesspools, seepage pits, and other pits. Also include a permanent reference point(s) and dimensions.

Certification

I hereby certify the system was abandoned in accordance with Minn. R. 7080.2500 and any local requirements.

Name (please print): Title:

Address:

City: State: Zip:

Phone: License # if applicable):

Date: Signature:

↑ North



09/09

Septic Tank Maintenance Reporting FormGeneral Information

This form is offered to meet the reporting requirements of Minn. R. 7080.2450 subp. 2 and 7083.0770 subp. 2. The use of this form is not mandatory; however, the information on this form must be submitted to the homeowner within 30 days after the maintenance work is performed, and to the local government unit as required.

A copy of this information must be maintained by the Subsurface Septic Tank System (SSTS) business for a period of five (5) years from the maintenance date.

For systems installed under ordinances developed before February 4, 2008 (old 7080.0130), the maintenance hole covers:

1. Must be covered by a minimum of 12 inches of soil or be adequately secured.

2. Are not required to be brought up to ground surface. Covers can remain deep once the septic tank has been

pumped.

3. Are recommended, but not required, to be brought slightly above the ground surface.

if brought up to ground surface, the cover must be secured in accordance with the new rule (See Part B)

4. Currently at ground surface are recommended, but not required, to be secured in accordance with the new rule (Part B), or at a minimum, secured to the satisfaction of the SSTS licensee and local government unit if local regulations exist

For systems designed under ordinances adopted after February 4, 2008, the maintenance hole covers:

1. Must be brought to ground surface or slightly above

2. Must be re-secured in accordance with the new requirements

a) cover must be locked, bolted or screwed or must be 95 pounds in weight

b) cover cannot be susceptible to being slid or flipped

c) cover must have a warning label




09/09

Septic Tank Maintenance Reporting Form

Date of maintenance: Reason for maintenance: Property address: City: State: Zip:

Property owner’s name:

Property-owner’s address if different:

City: State: ZIP: Phone: Fax:

1. Access used to remove septage: Maintenance hole Other (Go to #3 below)

2. If maintenance hole was used, were all covers securely replaced? Yes No please explain

Explanation:

3. If owner refuses to allow a Subsurface Sewage Treatment System (SSTS) to be pumped through the maintenance hole, have them complete and sign the following statement.

I, (owner’s name), refuse to allow the removal of the solids and liquids through the maintenance hole. I understand that removal of solids and liquids through other access points is not considered maintenance.

Owner’s signature: Date:

4. Is the tank designed as a leaky tank? example: seepage pit, cesspool, drywell, leaching pit Tank #1: Yes No Verification method used? Tank #2: Yes No Verification method used?

5. Is there evidence of tank leakage from a septic, holding, pretreatment or pump tank below the operating depth or evidence of damaged, cracked or structurally unsound maintenance hole covers?

Tank Leaking out Leaking in Cover damage Septic/holding Tank #1 Yes No Yes No Yes No Septic/holding Tank #2 Yes No Yes No Yes No Pretreatment Tank Yes No Yes No Yes No Pump Tank Yes No Yes No Yes No

6. How many gallons of septage were removed?

Tank #1: Tank #2: Pretreatment Tank: Pump Tank:

7. Is there any sensory (smell and/or sight) evidence of non-domestic wastes?

Yes Please explain: No Disposal site Wastewater treatment plant Land application Other please explain

Explanation:

Other information: List any troubleshooting, minor repairs conducted, tank safety* concerns or other concerns:

8. Certification: I hereby certify as a State of Minnesota-certified SSTS Maintainer that I personally conducted the work and made the observations, or directly supervised others in the performance of this job.

Maintainer’s name and address:

Maintainer’s license #: Maintainer’s phone:

Maintainer’s signature: Date:




09/09

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09/09

OSTP Septage Application Worksheetfor Nitrogen ‐ 08/09/2009

Cropping Year: September 1, to August 31,

EXAMPLE Site Information

Site Code Jones 1 Yield Goal 135 bu/ac Site Code Yield Goal

Crop Corn Acres 20 Crop Acres

Soil OM med. Soil OM

Last year's Crop Soybeans Last year's Crop

Recommended crop N rate 80 Recommended crop N rate

N Credits 20 N Credits

Step 1: Maximum Allowable Nitrogen Application Rate (MANA) Step 1: Maximum Allowable Nitrogen Application Rate (MANA)

Recommended crop N rate 80 lb/acre Recommended crop N rate lb/acre

N credits 20 lb/acre N credits lb/acre

MANA 60 lb/acre MANA lb/acre

Step 2: Maximum Septage Application Rate (MSAR) Step 2: Maximum Septage Application Rate (MSAR)

MANA Rate 60 lb/acre MANA Rate lb/acre

0.0026 0.0026 conversion 0.0026 0.0026 conversion

MSAR 23,077 gal/acre/year MSAR gal/acre/year

Step 3: Maximum Quantity of Septage for this Site Step 3: Maximum Quantity of Septage for this Site

MSAR 23,077 MSAR

Useable Site Acres 20 Useable Site Acres

Maximum Quantity of Septage 461,538 gal/site/year Maximum Quantity of Septage gal/site/year

Notes:N credit is the amount of nitrogen supplied by fertilizer, manure, or other wastes applied on the site.

Recommended rates of nitrogen are from Table 7 in the MPCA guidelines or from "Fertilizer Recommendations for Agronomic Crops in Minnesota"Minnesota Extension Service Bulletin BU-6240-E.

X X

OSTP Septage Application Worksheetfor Nitrogen ‐ 08/09/2009

Cropping Year: September 1, to August 31,

EXAMPLE Site Information

Site Code Jones 1 Yield Goal 135 bu/ac Site Code Yield Goal

Crop Corn Acres 20 Crop Acres

Soil OM med. Soil OM

Last year's Crop Soybeans Last year's Crop

Recommended crop N rate 80 Recommended crop N rate

N Credits 20 N Credits

Step 1: Maximum Allowable Nitrogen Application Rate (MANA) Step 1: Maximum Allowable Nitrogen Application Rate (MANA)

Recommended crop N rate 80 lb/acre Recommended crop N rate lb/acre

N credits 20 lb/acre N credits lb/acre

MANA 60 lb/acre MANA lb/acre

Step 2: Maximum Septage Application Rate (MSAR) Step 2: Maximum Septage Application Rate (MSAR)

MANA Rate 60 lb/acre MANA Rate lb/acre

0.0026 0.0026 conversion 0.0026 0.0026 conversion

MSAR 23,077 gal/acre/year MSAR gal/acre/year

Step 3: Maximum Quantity of Septage for this Site Step 3: Maximum Quantity of Septage for this Site

MSAR 23,077 MSAR

Useable Site Acres 20 Useable Site Acres

Maximum Quantity of Septage 461,538 gal/site/year Maximum Quantity of Septage gal/site/year

Notes:N credit is the amount of nitrogen supplied by fertilizer, manure, or other wastes applied on the site.

Recommended rates of nitrogen are from Table 7 in the MPCA guidelines or from "Fertilizer Recommendations for Agronomic Crops in Minnesota"Minnesota Extension Service Bulletin BU-6240-E.

X X


09/09

Site S

peci

fic R

ecor

d

Reco

rd K

eepi

ng P

erio

d: S

epte

mbe

r 1, _

____

___

to A

ugus

t 31, _

____

____

_ Si

te C

ode:

La

ndow

ner

Nam

e:

Site L

ocat

ion

(pro

vide

one

or

mor

e of th

e fo

llow

ing)

: St

reet A

ddre

ss:

Lati

tude

/ L

ongi

tude

:

/

Lega

l Des

crip

tion

:

Q

uart

er o

f Sec

tion

To

wns

hip

Coor

dina

te

Rang

e Co

ordi

nate

Tow

nshi

p N

ame

Cou

nty

Nam

e

Si

te A

crea

ge:

Cr

op G

row

n:

Yiel

d G

oal:

M

axim

um A

llow

able N

itro

gen

App

licat

ion

Rate (l

b/ac

re/y

ear)

Det

erm

ined

by

usin

g op

tion

1 o

r 2

from

the

MPC

A g

uide

lines

:

M

axim

um R

ate

of S

epta

ge A

llow

ed (g

allo

ns/a

cre/

year

):

M

axim

um G

allo

ns o

f Sep

tage A

llow

ed (g

allo

ns/s

ite/

year

):

A

ttac

h a

copy

of a

soi

l sur

vey

map

or

anot

her

map

con

tain

ing

the

sam

e in

form

atio

n w

ith

the

site b

ound

arie

s an

d un

suit

able a

reas o

f the

fiel

d id

enti

fied.

D

escr

ibe

how p

atho

gen

requ

irem

ents w

ere

met a

t the

sit

e:

Des

crib

e ho

w v

ecto

r at

trac

tion

red

ucti

on r

equi

rem

ents w

ere

met a

t the

sit

e:

OST

P Se

ptag

e A

pplic

atio

n W

orks

heet

for

Nit

roge

n ‐ 0

8/09

/200

9

Cro

ppin

g Ye

ar: S

epte

mbe

r 1,

toA

ugus

t 31,

EXA

MPL

ESi

te In

form

atio

n

Site

Cod

eJo

nes

1Y

ield

Goa

l13

5 bu

/ac

Site

Cod

eY

ield

Goa

l

Cro

pC

orn

Acr

es20

Cro

pA

cres

Soi

l OM

med

.S

oil O

M

Last

yea

r's C

rop

Soy

bean

sLa

st y

ear's

Cro

p

Rec

omm

ende

d cr

op N

rate

80R

ecom

men

ded

crop

N ra

te

N C

redi

ts20

N C

redi

ts

Step

1:

Max

imum

Allo

wab

le N

itrog

en A

pplic

atio

n R

ate

(MA

NA

)St

ep 1

: M

axim

um A

llow

able

Nitr

ogen

App

licat

ion

Rat

e (M

AN

A)

Rec

omm

ende

d cr

op N

rate

80lb

/acr

eR

ecom

men

ded

crop

N ra

telb

/acr

e

N c

redi

ts20

lb/a

cre

N c

redi

tslb

/acr

e

MA

NA

60lb

/acr

eM

AN

Alb

/acr

e

Step

2:

Max

imum

Sep

tage

App

licat

ion

Rat

e (M

SAR

)St

ep 2

: M

axim

um S

epta

ge A

pplic

atio

n R

ate

(MSA

R)

MA

NA

Rat

e60

lb/a

cre

MA

NA

Rat

elb

/acr

e

0.00

260.

0026

conv

ersi

on0.

0026

0.00

26

conv

ersi

on

MSA

R23

,077

gal/a

cre/

year

MSA

Rga

l/acr

e/ye

ar

Step

3:

Max

imum

Qua

ntity

of S

epta

ge fo

r thi

s Si

teSt

ep 3

: M

axim

um Q

uant

ity o

f Sep

tage

for t

his

Site

MS

AR

23,0

77

M

SA

R

Use

able

Site

Acr

es20

Use

able

Site

Acr

es

Max

imum

Qua

ntity

of S

epta

ge46

1,53

8

gal/s

ite/y

ear

Max

imum

Qua

ntity

of S

epta

gega

l/site

/yea

r

Not

es:

N c

redi

t is

the

amou

nt o

f nitr

ogen

sup

plie

d by

fert

ilize

r, m

anur

e, o

r oth

er w

aste

s ap

plie

d on

the

site

.

Rec

omm

ende

d ra

tes

of n

itrog

en a

re fr

om T

able

7 in

the

MPC

A g

uide

lines

or f

rom

"Fe

rtili

zer R

ecom

men

datio

ns fo

r Agr

onom

ic C

rops

in M

inne

sota

"M

inne

sota

Ext

ensi

on S

ervi

ce B

ulle

tin B

U-6

240-

E.

XX


09/09

Site Specific Record

Date of A

pplication Load #(s)

Gallons A

pplied A

creage Used

Rate A

pplied G

allons/Acre

Running Total of

Gallons A

pplied per Site

“I certify, under penalty of law, that the inform

ation that will be used to determ

ine compliance w

ith the pathogen requirements [check one or both of

the following] 503.32(c)(1)[crop restrictions] or 503.32(c)(2) [pH

adjustment to 12.0 for 30 m

inutes and crop restrictions] and the vector attraction reduction requirem

ent in [check one or more of the follow

ing] 503.33(b)(9) [injected], 503.33(b)10) [incorporated within 6 hours], or 503.33(b)(12) [pH

adjustm

ent to 12.0 for 30 minutes] w

as prepared under my direction and supervision in accordance w

ith the system designed to ensure that qualified

personnel properly gather and evaluate the information. I am

aware that there are significant penalties for false certification including the possibility

of fine and imprisonm

ent.”

Signature:

Printed Nam

e:

Title:

OSTP Septage A

pplication Worksheet

for Nitrogen ‐ 08/09/2009

Cropping Year: Septem

ber 1, to

August 31,

EXAM

PLESite Inform

ation

Site C

odeJones 1

Yield G

oal135 bu/ac

Site C

odeY

ield Goal

Crop

Corn

Acres

20C

ropA

cres

Soil O

Mm

ed.S

oil OM

Last year's Crop

Soybeans

Last year's Crop

Recom

mended crop N

rate80

Recom

mended crop N

rate

N C

redits20

N C

redits

Step 1: Maxim

um A

llowable N

itrogen Application R

ate (MA

NA

)Step 1: M

aximum

Allow

able Nitrogen A

pplication Rate (M

AN

A)

Recom

mended crop N

rate80

lb/acreR

ecomm

ended crop N rate

lb/acre

N credits

20lb/acre

N credits

lb/acre

MA

NA

60lb/acre

MA

NA

lb/acre

Step 2: Maxim

um Septage A

pplication Rate (M

SAR

)Step 2: M

aximum

Septage Application R

ate (MSA

R)

MA

NA

Rate

60lb/acre

MA

NA

Rate

lb/acre

0.00260.0026

conversion

0.00260.0026

conversion

MSA

R23,077

gal/acre/year

MSA

Rgal/acre/year

Step 3: Maxim

um Q

uantity of Septage for this SiteStep 3: M

aximum

Quantity of Septage for this Site

MS

AR

23,077

MS

AR

Useable S

ite Acres

20

Useable S

ite Acres

Maxim

um Q

uantity of Septage

461,538

gal/site/yearM

aximum

Quantity of S

eptagegal/site/year

Notes:

N credit is the am

ount of nitrogen supplied by fertilizer, manure, or other w

astes applied on the site.

Recom

mended rates of nitrogen are from

Table 7 in the MPC

A guidelines or from

"Fertilizer Recom

mendations for A

gronomic C

rops in Minnesota"

Minnesota Extension Service B

ulletin BU

-6240-E.

XX


09/09

Dai

ly H

aulin

g Re

cord

Dat

e:

D

rive

r N

ame:

Lo

ad #

So

urce

(s) o

r In

voic

e #

(s)

Se

ptag

e G

allo

ns

Oth

er

Gal

lons

(nam

e)

To

tal

Gal

lons

A

pplic

atio

n M

etho

d1

Te

mpe

ratu

re

of S

epta

ge2

Ti

me

/ In

itia

l pH

(aft

er li

me

adde

d) 2

Ti

me

/ Fi

nal p

H

(aft

er 3

0 m

in.) 2

Des

tina

tion

(s

ite

code

or

POTW

nam

e)

1 App

licat

ion

met

hods a

re I=

inje

ctio

n, S

A=s

urfa

ce a

pplie

d, S

A6=

surf

ace

appl

ied

and

inco

rpor

ated

with

in 6 h

ours

. 2 O

nly

requ

ired

whe

n lim

e st

abili

zatio

n us

ed to

mee

t pat

hoge

n or v

ecto

r at

trac

tion

redu

ctio

n re

quir

emen

ts.

OST

P Se

ptag

e A

pplic

atio

n W

orks

heet

for

Nit

roge

n ‐ 0

8/09

/200

9

Cro

ppin

g Ye

ar: S

epte

mbe

r 1,

toA

ugus

t 31,

EXA

MPL

ESi

te In

form

atio

n

Site

Cod

eJo

nes

1Y

ield

Goa

l13

5 bu

/ac

Site

Cod

eY

ield

Goa

l

Cro

pC

orn

Acr

es20

Cro

pA

cres

Soi

l OM

med

.S

oil O

M

Last

yea

r's C

rop

Soy

bean

sLa

st y

ear's

Cro

p

Rec

omm

ende

d cr

op N

rate

80R

ecom

men

ded

crop

N ra

te

N C

redi

ts20

N C

redi

ts

Step

1:

Max

imum

Allo

wab

le N

itrog

en A

pplic

atio

n R

ate

(MA

NA

)St

ep 1

: M

axim

um A

llow

able

Nitr

ogen

App

licat

ion

Rat

e (M

AN

A)

Rec

omm

ende

d cr

op N

rate

80lb

/acr

eR

ecom

men

ded

crop

N ra

telb

/acr

e

N c

redi

ts20

lb/a

cre

N c

redi

tslb

/acr

e

MA

NA

60lb

/acr

eM

AN

Alb

/acr

e

Step

2:

Max

imum

Sep

tage

App

licat

ion

Rat

e (M

SAR

)St

ep 2

: M

axim

um S

epta

ge A

pplic

atio

n R

ate

(MSA

R)

MA

NA

Rat

e60

lb/a

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09/09

Property Address: ______________________

______________________

______________________

I have chosen to have my system serviced in a manner not meeting the

requirements of Minnesota Rules, Chapter 7080.2450 subp. 3 B

If no maintenance hole exists on a sewage tank, the owner or the owner’s agent shall install maintenance

holes in accordance with Minnesota Rules Chapter 7080.1970, to allow for maintenance to take place through

the maintenance hole. If the owner or owner’s agent refuses to allow removal through a maintenance hole,

the licensed Maintainer must, per Minnesota Rules Chapter 7083.0770 Subp. 2 C, obtain a signed statement

from the owner or owner’s agent that the owner or agent was informed of correct removal procedures and

the reason for refusal.

The reason for this choice is listed below.

I understand that this is my choice and accept responsibility if the system has

problems and also understand that this is substandard as recommended in the

Minnesota Rules Chapters 7080 ‐ 7083.

Stated Reason:

___________________________________________________________________

___________________________________________________________________

Owner or Agent’s Name: _______________________________________________

Signature: ___________________________________________________________

Your Logo Here

We at _____________________________________________

do not recommend the pumping of the tank through the

inspection pipe and cannot be responsible for the quality of

cleaning or inspection of the tank when service is provided

through the inspection pipe. We hope in the future to maintain

your business and stand at the ready to meet your onsite

sewage treatment needs.


09/09

Receipt for Septic Tank Cleaning Tasks performed: Locate Tank Open manhole depth:________ Check:

Tank level Scum depth ____% Capacity Sludge depth ____% Capacity Baffle integrity

Filter: Yes/No Type_________ Tank integrity Manhole/Riser integrity Remove contents Inspection pipes

Close/secure manhole Manhole location and depth

Clean up Locate treatment area System overview Tank Volume: __________gal

Your system has been properly maintained and should be visited again in ______ months/years. This will assure the proper operation and treatment of the wastewater at your site. If you have any questions please feel free to contact us at _______________.

Total amount collected: ____________________________ Additional work necessary: ________________________ Where was the septage disposed? __________________ Company: _____________________ Lic. # _____________

YourLogoHere

Acceptable/Problem _____________________________ Acceptable/Problem _____________________________ Acceptable/Problem _____________________________

Inlet: Acceptable/Problem________________

Outlet: Acceptable/Problem_______________

Acceptable/Problem _____________________________ Acceptable/Problem _____________________________ Acceptable/Problem _____________________________

Acceptable/Problem _____________________________

Acceptable/Problem _____________________________


09/09

Septic System Best Management Practices

Septic systems protect human health and the environment by safely recycling wastewater and returning it to the natural environment. It is your job as the homeowner to be sure this happens effectively and safely. As with your car, regular maintenance and attention is needed to keep it operating efficiently in a cost effective manner.

Septic TankFunctions:��Separates into three layers: scum (stuff that floats),

sludge (stuff that sinks), and the liquid. ��The solids and scum are held until removed by the

maintainer. Anaerobic bacteria work to break down wastes, prepare the liquid for the drainfield.

��The liquid is delivered to the soil treatment area to complete the treatment process.

�� If solids are not removed, they can end up in the soil treatment area, causing (often irreparable) damage.

��Factors that increase frequency of pumping: use of garbage disposal, water treatment unit that discharges into the septic system, in-home daycare or other reason a large number of people are present most of the time, laundry on the 2nd floor, excessive use of water and strong cleaning products.

Best management practices: ��Tanks need to be evaluated every two to three years

and pumped if necessary. Some counties require pumping on a specified basis. New homes—pump within 3—12 months of occupancy the first time.

��Never allow a tank to be cleaned through the inspection pipe. This is not allowed by code, and it does not allow a good cleaning to occur. Scum can plug the baffle, baffles can be knocked off. Tanks should only be cleaned through the manhole or maintenance hole.

��Be sure baffles, effluent screen, pumps and other components are inspected when the tank is pumped.

�� Install risers on the manhole covers to allow easier access. Insulate the cover and secure tightly.

��An effluent screen will prevent most solids from reaching the soil treatment area. Install and clean according to manufacturer recommendations.

��Never use additives. The cleaners are harmful to your system. They do not replace good management practices. Starters and feeders are not effective.

��Warning: NEVER go into a septic tank—there are dangerous gases and no oxygen!

��Do not ignore alarms—troubleshoot the problem.

http://septic.umn.edu

For more information: Order the Septic System Owner’s Guide. Call 800-876-8636 or go to http://shop.extension.umn.edu. Onsite Sewage Treatment Program web site: http://septic.umn.edu. University of Minnesota Extension http://www.extension.umn.edu.

Written by Valerie Prax, Regional Extension Educator, 6/07 ©2008 Regents of the University of Minnesota. All rights Reserved. The University of Minnesota is an equal opportunity educator and employer. This material can be

made available in alternative formats for people with disabilities. Call the Water Resources Center, 612-624-9282.

Septage—the solids from the tank are usually land-applied. Lime is added in the truck to destroy pathogens and help control odors. Septic pumpers must follow strict guidelines to protect public safety and water quality. Septage disposal is managed by the MN Pollution Control Agency (MPCA) and the Environmental Protection Agency (EPA).

Soil Treatment Area: Trench or Mound Functions:��Soil organisms destroy pathogens (bacteria, viruses). ��Remove phosphorus, reduce nitrogen content. ��Recycle clean water into the soil and ground water.

Water and nutrients enter the ground water, evaporate through plants, and are used by plants.

Best management practices:��Maintain vegetative cover (turf grass, native grasses,

flowers). Mow, but do not fertilize, burn or over-water. ��Keep all vehicles, bikes, snowmobiles, etc. off. ��Do not plant trees or shrubs near drainfield. �� Inspect for cracked, missing inspection pipe covers. ��Follow practices to prevent freezing, including

mulching the entire system if needed.

Household Best Management PracticesManage water use:�� Repair all leaking faucets, toilets, fixtures. �� Change to low flow toilets, shower heads. �� Replace appliances with low water use models. �� Spread water uses evenly throughout the day and week.. �� Re-route clean water sources: water softener, treatment

unit recharge water, high efficiency furnace drip, sump pumps to separate drainage area.

Watch what goes down the drain:��The toilet is not a garbage can—nothing should be

flushed except human waste and toilet paper. ��Excess medications—return to pharmacy or land-fill. ��Limit or eliminate drain cleaner use. ��Do not use automatic toilet cleaners, disposable brushes. ��Do not use every-use or automatic shower cleaners. ��No hazardous waste, paints, solvents, chemicals. Use

disposable paint brushes. ��Eliminate or limit use of garbage disposal. ��No chlorine treated water such as from hot tubs.

Manage product use:��Minimize use of anti-bacterial soaps, cleansers. ��Detergents: measure accurately, use as little as possible. ��Limit use of bleach-based cleansers.

Septic System Best Management Practices

Septic systems protect human health and the environment by safely recycling wastewater and returning it to the natural environment. It is your job as the homeowner to be sure this happens effectively and safely. As with your car, regular maintenance and attention is needed to keep it operating efficiently in a cost effective manner.

Septic TankFunctions:��Separates into three layers: scum (stuff that floats),

sludge (stuff that sinks), and the liquid. ��The solids and scum are held until removed by the

maintainer. Anaerobic bacteria work to break down wastes, prepare the liquid for the drainfield.

��The liquid is delivered to the soil treatment area to complete the treatment process.

�� If solids are not removed, they can end up in the soil treatment area, causing (often irreparable) damage.

��Factors that increase frequency of pumping: use of garbage disposal, water treatment unit that discharges into the septic system, in-home daycare or other reason a large number of people are present most of the time, laundry on the 2nd floor, excessive use of water and strong cleaning products.

Best management practices: ��Tanks need to be evaluated every two to three years

and pumped if necessary. Some counties require pumping on a specified basis. New homes—pump within 3—12 months of occupancy the first time.

��Never allow a tank to be cleaned through the inspection pipe. This is not allowed by code, and it does not allow a good cleaning to occur. Scum can plug the baffle, baffles can be knocked off. Tanks should only be cleaned through the manhole or maintenance hole.

��Be sure baffles, effluent screen, pumps and other components are inspected when the tank is pumped.

�� Install risers on the manhole covers to allow easier access. Insulate the cover and secure tightly.

��An effluent screen will prevent most solids from reaching the soil treatment area. Install and clean according to manufacturer recommendations.

��Never use additives. The cleaners are harmful to your system. They do not replace good management practices. Starters and feeders are not effective.

��Warning: NEVER go into a septic tank—there are dangerous gases and no oxygen!

��Do not ignore alarms—troubleshoot the problem.


For more information: Order the Septic System Owner’s Guide. Call 800-876-8636 or go to http://shop.extension.umn.edu. Onsite Sewage Treatment Program web site: http://septic.umn.edu. University of Minnesota Extension http://www.extension.umn.edu.

Written by Valerie Prax, Regional Extension Educator, 6/07 ©2008 Regents of the University of Minnesota. All rights Reserved. The University of Minnesota is an equal opportunity educator and employer. This material can be

made available in alternative formats for people with disabilities. Call the Water Resources Center, 612-624-9282.

Septage—the solids from the tank are usually land-applied. Lime is added in the truck to destroy pathogens and help control odors. Septic pumpers must follow strict guidelines to protect public safety and water quality. Septage disposal is managed by the MN Pollution Control Agency (MPCA) and the Environmental Protection Agency (EPA).

Soil Treatment Area: Trench or Mound Functions:��Soil organisms destroy pathogens (bacteria, viruses). ��Remove phosphorus, reduce nitrogen content. ��Recycle clean water into the soil and ground water.

Water and nutrients enter the ground water, evaporate through plants, and are used by plants.

Best management practices:��Maintain vegetative cover (turf grass, native grasses,

flowers). Mow, but do not fertilize, burn or over-water. ��Keep all vehicles, bikes, snowmobiles, etc. off. ��Do not plant trees or shrubs near drainfield. �� Inspect for cracked, missing inspection pipe covers. ��Follow practices to prevent freezing, including

mulching the entire system if needed.

Household Best Management PracticesManage water use:�� Repair all leaking faucets, toilets, fixtures. �� Change to low flow toilets, shower heads. �� Replace appliances with low water use models. �� Spread water uses evenly throughout the day and week.. �� Re-route clean water sources: water softener, treatment

unit recharge water, high efficiency furnace drip, sump pumps to separate drainage area.

Watch what goes down the drain:��The toilet is not a garbage can—nothing should be

flushed except human waste and toilet paper. ��Excess medications—return to pharmacy or land-fill. ��Limit or eliminate drain cleaner use. ��Do not use automatic toilet cleaners, disposable brushes. ��Do not use every-use or automatic shower cleaners. ��No hazardous waste, paints, solvents, chemicals. Use

disposable paint brushes. ��Eliminate or limit use of garbage disposal. ��No chlorine treated water such as from hot tubs.

Manage product use:��Minimize use of anti-bacterial soaps, cleansers. ��Detergents: measure accurately, use as little as possible. ��Limit use of bleach-based cleansers.


http://shop.extension.umn.edu


http://www.extension.umn.edu


http://shop.extension.umn.edu


http://www.extension.umn.edu


09/09 - 1 -

Septic System Management Plan for Below Grade Systems

The goal of a septic system is to protect human health and the environment by properly treating wastewater before returning it to the environment. Your septic system is designed to kill harmful organisms and remove pollutants before the water is recycled back into our lakes, streams and groundwater.

This management plan will identify the operation and maintenance activities necessary to ensure long-term performance of your septic system. Some of these activities must be performed by you, the homeowner. Other tasks must be performed by a licensed septic maintainer or service provider. However, it is YOUR responsibility to make sure all tasks get accomplished in a timely manner.

The University of Minnesota’s Septic System Owner’s Guide contains additional tips and recommendations designed to extend the effective life of your system and save you money over time.

Proper septic system design, installation, operation and maintenance means safe and clean water!

Property Owner

Property Address Property ID

System Designer License #

System Installer License #

Service Provider/Maintainer Phone

Permitting Authority Phone

Permit # Date Inspected

Keep this Management Plan with your Septic System Owner’s Guide. The Septic System Owner’s Guide includes a folder to hold maintenance records including pumping, inspection and evaluation reports. Ask your septic professional to also:

Attach permit information, designer drawings and as-builts of your system, if they are available. Keep copies of all pumping records and other maintenance and repair invoices with this document. Review this document with your maintenance professional at each visit; discuss any changes in product

use, activities, or water-use appliances.

For a copy of the Septic System Owner’s Guide, call 1-800-876-8636 or go to http://shop.extension.umn.edu/


http://shop.extension.umn.edu/



09/09

Septic System Management Planfor Below Grade Systems

- 2 -

Your Septic System

Septic System Specifics

System Type: I II III IV* V*

(Based on MN Rules Chapter 7080.2200 – 2400)

System is subject to operating permit* System uses UV disinfection unit* Type of advanced treatment unit ______________ *Additional Management Plan required

Dwelling Type Well Construction Number of bedrooms: ______________________

System capacity/ design flow (gpd): __________

Anticipated average daily flow (gpd): __________

Comments________________________________

In-home business? ___ What type? ____________

Well depth (ft): __________________________

Cased well Casing depth: ___________

Other (specify): ___________________

Distance from septic (ft):____________________

Is the well on the design drawing? Y N

Septic Tank One tank Tank volume: _________ gallons

Does tank have two compartments? Y N

Two tanks Tank volume: _________ gallons

Tank is constructed of _________

Effluent Screen type: __________________

Pump Tank (if one) _________ gallons

Effluent Pump type: _________________

TDH _____ Feet of head

Pump capacity ______ GPM

Alarm _____ visual _____ audible

Soil Treatment Area Trenches: ___________ total lineal feet

Number of trenches: _____ at _______ feet each

Drainbed size (length x width): ____ ft x ____ ft

Gravity distribution Pressuredistribution

Inspection ports Cleanouts


09/09


- 3 -

Homeowner Management Tasks

These operation and maintenance activities are your responsibility. Use the chart on page 6 to track your activities.

Identify the service intervals recommended by your system designer and your local government. The tank assessment for your system will be the shortest interval of these three intervals. Your pumper/maintainer will determine if your tank needs to be pumped.

System Designer: check every ________ months My tank needs to be checked every _____ months

Local Government: check every ________ months State Requirement: check every 36 months

Seasonally or several times per year

Leaks. Check (listen, look) for leaks in toilets and dripping faucets. Repair leaks promptly. Surfacing sewage. Regularly check for wet or spongy soil around your soil treatment area. If

surfaced sewage or strong odors are not corrected by pumping the tank or fixing broken caps and leaks, call your service professional. Untreated sewage may make humans and animals sick.

Alarms. Alarms signal when there is a problem; contact your maintainer any time the alarm signals.

Lint filter. If you have a lint filter, check for lint buildup and clean when necessary. Consider adding one after washing machine.

Effluent screen. If you do not have one, consider having one installed the next time the tank is cleaned.

Annually

Water usage rate. A water meter can be used to monitor your average daily water use. Compare your water usage rate to the design flow of your system (listed on the next page). Contact your septic professional if your average daily flow over the course of a month exceeds 70% of the design flow for your system.

Caps. Make sure that all caps and lids are intact and in place. Inspect for damaged caps at least every fall. Fix or replace damaged caps before winter to help prevent freezing issues.

Water conditioning devices. See Page 5 for a list of devices. When possible, program the recharge frequency based on water demand (gallons) rather than time (days). Recharging too frequently may negatively impact your septic system.

Review your water usage rate. Review the Water Use Appliance chart on Page 5. Discuss any major changes with your pumper/maintainer.

During each visit by a pumper/maintainer

Ask if your pumper/maintainer is licensed in Minnesota. Make sure that your pumper/maintainer services the tank through the manhole. (NOT though a 4”

or 6” diameter inspection port.) Ask your pumper/maintainer to accomplish the tasks listed on the Professional Tasks on Page 4.


09/09


- 4 -

Professional Management Tasks These are the operation and maintenance activities that a pumper/maintainer performs to help ensure long-term performance of your system. Professionals should refer to the O/M Manual for detailed checklists for tanks, pumps, alarms and other components. Call 800-322-8642 for more details.

Written record provided to homeowner after each visit.

Plumbing/Source of Wastewater Review the Water Use Appliance Chart on Page 5 with homeowner. Discuss any changes in

water use and the impact those changes may have on the septic system. Review water usage rates (if available) with homeowner.

Septic Tank/Pump Tanks Manhole lid. A riser is recommended if the lid is not accessible from the ground surface. Insulate

the riser cover for frost protection. Liquid level. Check to make sure the tank is not leaking. The liquid level should be level with the

bottom of the outlet pipe. (If the water level is below the bottom of the outlet pipe, the tank may not be watertight. If the water level is higher than the bottom of the outlet pipe of the tank, the effluent screen may need cleaning, or there may be ponding in the drainfield.)

Inspection pipes. Replace damaged caps. Baffles. Check to make sure they are in place and attached, and that inlet/outlet baffles are clear

of buildup or obstructions. Effluent screen. Check to make sure it is in place; clean per manufacturer recommendation.

Recommend retrofitted installation if one is not present. Alarm. Verify that the alarm works. Scum and sludge. Measure scum and sludge in each compartment of each septic and pump tank,

pump if needed.

Pump Pump and controls. Check to make sure the pump and controls are operating correctly. Pump vault. Check to make sure it is in place; clean per manufacturer recommendations. Alarm. Verify that the alarm works. Drainback. Check to make sure it is operating properly. Event counter or run time. Check to see if there is an event counter or run time log for the pump.

If there is one, calculate the water usage rate and compare to the anticipated average daily flow listed on Page 2.

Soil Treatment Area Inspection pipes. Check to make sure they are properly capped. Replace caps that are damaged. Surfacing of effluent. Check for surfaced effluent or other signs of problems. Gravity trenches and beds. Check the number of gravity trenches with ponded effluent. Identify

the percentage of the system in use. Determine if action is needed. Pressure trenches and beds - Lateral flushing. Check lateral distribution; if cleanouts exist, flush

and clean as needed.

All other components – inspect as listed here:


09/09


- 5 -

Water-Use Appliances and Equipment in the Home

Appliance Impacts on System Management Tips

Garbage disposal

Uses additional water. Adds solids to the tank. Finely-ground solids may not settle.

Unsettled solids can exit the tank and enter the soil treatment area.

Use of a garbage disposal is not recommended. Minimize garbage disposal use. Compost instead. To prevent solids from exiting the tank, have your

tank pumped more frequently. Add an effluent screen to your tank.

Washing machine

Washing several loads on one day uses a lot of water and may overload your system.

Overloading your system may prevent solids from settling out in the tank. Unsettled solids can exit the tank and enter the soil treatment area.

Choose a front-loader or water-saving top-loader, these units use less water than older models.

Limit the addition of extra solids to your tank by using liquid or easily biodegradable detergents.

Install a lint filter after the washer and an effluent screen to your tank

Wash only full loads. Limit use of bleach-based detergents. Think even – spread your laundry loads throughout

the week.

2nd floor laundry The rapid speed of water entering

the tank may reduce performance. Install an effluent screen in the septic tank to prevent

the release of excessive solids to the soil treatment area.

Be sure that you have adequate tank capacity.

Dishwasher

Powdered and/or high-phosphorus detergents can negatively impact the performance of your tank and soil treatment area.

New models promote “no scraping”. They have a garbage disposal inside.

Use gel detergents. Powdered detergents may add solids to the tank.

Use detergents that are low or no-phosphorus. Wash only full loads. Scrape your dishes anyways to keep undigested

solids out of your septic system.

Grinder pump (in home)

Finely-ground solids may not settle. Unsettled solids can exit the tank and enter the soil treatment area.

Expand septic tank capacity by a factor of 1.5. Include pump monitoring in your maintenance

schedule to ensure that it is working properly. Add an effluent screen.

Large bathtub (whirlpool)

Large volume of water may overload your system.

Heavy use of bath oils and soaps can impact biological activity in your tank and soil treatment area.

Avoid using other water-use appliances at the same time. For example, don’t wash clothes and take a bath at the same time.

Use oils, soaps, and cleaners in the bath or shower sparingly.

Clean Water Uses Impacts on System Management Tips

High-efficiency furnace

Drip may result in frozen pipes during cold weather.

Re-route water into a sump pump or directly out of the house. Do not route furnace recharge to your septic system.

Water softener Iron filter Reverse osmosis

Salt in recharge water may affect system performance.

Recharge water may hydraulically overload the system.

These sources produce water that is not sewage and should not go into your septic system.

Reroute water from these sources to another outlet, such as a dry well, draintile or old drainfield.

When replacing, consider using a demand-based recharge vs. a time-based recharge.

Check valves to ensure proper operation; have unit serviced per manufacturer directions

Surface drainage Footing drains

Water from these sources will likely overload the system.


09/09


- 6 -

Maintenance Log

Track maintenance activities here for easy reference. See list of management tasks on pages 3and 4.

Activity Date accomplished

Check frequently:

Leaks: check for plumbing leaks

Soil treatment area check for surfacing

Lint filter: check, clean if needed

Effluent screen: if owner-maintained

Check annually:

Water usage rate (monitor frequency____)

Caps: inspect, replace if needed

Water use appliances – review use

Other:

Notes: ________________________________________________________________________ ______________________________________________________________________________Mitigation/corrective action plan: __________________________________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

“As the owner of this SSTS, I understand it is my responsibility to properly operate and maintain the sewage treatment system on this property, utilizing the Management Plan. If requirements in this Management Plan are not met, I will promptly notify the permitting authority and take necessary corrective actions. If I have a new system, I agree to adequately protect the reserve area for future use as a soil treatment system.”

Property Owner Signature: Date

Management Plan Prepared By: Certification #

Permitting Authority:

©2009 Regents of the University of Minnesota. All rights reserved. The University of Minnesota is an equal opportunity educator and employer. This material is available in alternative formats upon request. Contact the Water Resources Center, 612-624-9282. The Onsite Sewage Treatment Program is delivered by the University of Minnesota Extension Service and the University of Minnesota Water Resources Center.


09/09

- 1 -

Septic System Management Planfor Above Grade Systems

The goal of a septic system is to protect human health and the environment by properly treating wastewater before returning it to the environment. Your septic system is designed to kill harmful organisms and remove pollutants before the water is recycled back into our lakes, streams and groundwater.

This management plan will identify the operation and maintenance activities necessary to ensure long-term performance of your septic system. Some of these activities must be performed by you, the homeowner. Other tasks must be performed by a licensed septic maintainer or service provider. However, it is YOUR responsibility to make sure all tasks get accomplished in a timely manner.

The University of Minnesota’s Septic System Owner’s Guide contains additional tips and recommendations designed to extend the effective life of your system and save you money over time.

Proper septic system design, installation, operation and maintenance means safe and clean water!

Property Owner

Property Address Property ID

System Designer License #

System Installer License #

Service Provider/Maintainer Phone

Permitting Authority Phone

Permit # Date Inspected

Keep this Management Plan with your Septic System Owner’s Guide. The Septic System Owner’s Guideincludes a folder designed to hold maintenance records including pumping, inspection and evaluation reports. Ask your septic professional to also:

Attach permit information, designer drawings and as-builts of your system, if they are available. Keep copies of all pumping records and other maintenance and repair invoices with this document. Review this document with your maintenance professional at each visit; discuss any changes in product

use, activities or water-use appliances.

For a copy of the Septic System Owner’s Guide, call 1-800-876-8636 or go to http://shop.extension.umn.edu/


http://shop.extension.umn.edu/



09/09


- 2 -

Your Septic System

Septic System Specifics

System Type: I II III IV* V*

(Based on MN Rules Chapter 7080.2200 – 2400)

System is subject to operating permit* System uses UV disinfection unit* Type of advanced treatment unit ______________ *Additional Management Plan required

Dwelling Type Well Construction Number of bedrooms: ______________________

System capacity/ design flow (gpd): __________

Anticipated average daily flow (gpd): __________

Comments________________________________

In-home business? ___ What type? ____________

Well depth (ft): __________________________

Cased well Casing depth: ___________

Other (specify): ___________________

Distance from septic (ft):____________________

Is the well on the design drawing? Y N

Septic Tank One tank Tank volume: _________ gallons

Does tank have two compartments? Y N

Two tanks Tank volume: _________ gallons

Tank is constructed of _________

Effluent Screen type: __________________

Pump Tank (if one) _________ gallons

Effluent Pump type: _________________

TDH _____ Feet of head

Pump capacity ______ GPM

Alarm _____ visual _____ audible

Soil Treatment Area

Mound/At-Grade area (length x width): ___ ft x ___ ft

Rock bed size (length x width): ___ ft x ___ ft

Cleanouts or Inspection Ports

Surface Water Diversions


09/09


- 3 -

Homeowner Management Tasks These operation and maintenance activities are your responsibility. Use the chart on page 6 to track your activities.

Identify the service intervals recommended by your system designer and your local government. The tank assessment for your system will be the shortest interval of these three intervals. Your pumper/maintainer will determine if your tank needs to be pumped.

System Designer: check every ________ months My tank needs to be checked every _____ months

Local Government: check every ________ months State Requirement: check every 36 months

Seasonally or several times per year

Leaks. Check (listen, look) for leaks in toilets and dripping faucets. Repair leaks promptly. Surfacing sewage. Regularly check for wet or spongy soil around your soil treatment area. If

surfaced sewage or strong odors are not corrected by pumping the tank or fixing broken caps, call your service professional. Untreated sewage may make humans and animals sick.

Alarms. Alarms signal when there is a problem; contact your maintainer any time the alarm signals.

Lint filter. If you have a lint filter, check for lint buildup and clean when necessary. Consider adding one after washing machine.

Effluent screen. If you do not have one, consider having one added the next time the tank is cleaned.

Annually

Water usage rate. A water meter can be used to monitor your average daily water use. Compare your water usage rate to the design flow of your system (listed on the next page). Contact your septic professional if your average daily flow over the course of a month exceeds 70% of the design flow for your system.

Caps. Make sure that all caps and lids are intact and in place. Inspect for damaged caps at least every fall. Fix or replace damaged caps before winter to help prevent freezing issues.

Water conditioning devices. See Page 5 for a list of devices. When possible, program the recharge frequency based on water demand (gallons) rather than time (days). Recharging too frequently may negatively impact your septic system.

Review your water usage rate. Review the Water Use Appliance chart on Page 5. Discuss any major changes with your pumper/maintainer.

During each visit by a pumper/maintainer Ask if your pumper/maintainer is licensed in Minnesota. Make sure that your pumper/maintainer services the tank through the manhole. (NOT though a 4”

or 6” diameter inspection port.) Ask your pumper/maintainer to accomplish the tasks listed on the Professional Tasks on Page 4.


09/09


- 4 -

Professional Management TasksThese are the operation and maintenance activities that a pumper/maintainer performs to help ensure long-term performance of your system. Professionals should refer to the O/M Manual for detailed checklists for tanks, pumps, alarms and other components. Call 800-322-8642 for more details.

Written record provided to homeowner after each visit.

Plumbing/Source of Wastewater Review the Water Use Appliance Chart on Page 5 with homeowner. Discuss any changes in

water use and the impact those changes may have on the septic system. Review water usage rates (if available) with homeowner.

Septic Tank/Pump Tanks Manhole lid. A riser is recommended if the lid is not accessible from the ground surface. Insulate

the riser cover for frost protection. Liquid level. Check to make sure the tank is not leaking. The liquid level should be level with the

bottom of the outlet pipe. (If the water level is below the bottom of the outlet pipe, the tank may not be watertight. If the water level is higher than the bottom of the outlet pipe of the tank, the effluent screen may need cleaning, or there may be ponding in the drainfield.)

Inspection pipes. Replace damaged caps. Baffles. Check to make sure they are in place and attached, and that inlet/outlet baffles are clear

of buildup or obstructions. Effluent screen. Check to make sure it is in place; clean per manufacturer recommendation.

Recommend retrofitted installation if one is not present. Alarm. Verify that the alarm works. Scum and sludge. Measure scum and sludge in each compartment of each septic and pump tank,

pump if needed.

Pump Pump and controls. Check to make sure the pump and controls are operating correctly. Pump vault. Check to make sure it is in place; clean per manufacturer recommendations. Alarm. Verify that the alarm works. Drainback. Check to make sure it is operating properly. Event counter or run time. Check to see if there is an event counter or run time log for the pump.

If there is one, calculate the water usage rate and compare to the anticipated average daily flow listed on Page 2.

Soil Treatment Area Inspection pipes. Check to make sure they are properly capped. Replace caps that are damaged. Surfacing of effluent. Check for surfaced effluent or other signs of problems. Lateral flushing. Check lateral distribution; if cleanouts exist, flush and clean as needed. Ponding. Check for ponding. Excessive ponding in at-grade and mound beds indicates

problems.

All other components – inspect as listed here:


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- 5 -

Water-Use Appliances and Equipment in the Home

Appliance Impacts on System Management Tips

Garbage disposal

Uses additional water. Adds solids to the tank. Finely-ground solids may not settle.

Unsettled solids can exit the tank and enter the soil treatment area.

Use of a garbage disposal is not recommended. Minimize garbage disposal use. Compost instead. To prevent solids from exiting the tank, have your

tank pumped more frequently. Add an effluent screen to your tank.

Washing machine

Washing several loads on one day uses a lot of water and may overload your system.

Overloading your system may prevent solids from settling out in the tank. Unsettled solids can exit the tank and enter the soil treatment area.

Choose a front-loader or water-saving top-loader, these units use less water than older models.

Limit the addition of extra solids to your tank by using a liquid or easily biodegradable detergents.

Install a ling filter after the washer and an effluent screen on your tank.

Wash only full loads. Limit use of bleach-based detergents. Think even – spread your laundry loads

throughout the week.

2nd floor laundry The rapid speed of water entering

the tank may reduce performance. Install an effluent screen in the septic tank to

prevent the release of excessive solids to the soil treatment area.

Be sure that you have adequate tank capacity.

Dishwasher

Powdered and/or high-phosphorus detergents can negatively impact the performance of your tank and soil treatment area.

New models promote “no scraping”. They have a garbage disposal inside.

Use gel detergents. Powdered detergents may add solids to the tank.

Use detergents that are low or no-phosphorus. Wash only full loads. Scrape your dishes anyways to keep undigested

solids out of your septic system.

Grinder pump (in home)

Finely-ground solids may not settle. Unsettled solids can exit the tank and enter the soil treatment area.

Expand septic tank capacity by a factor of 1.5. Include pump monitoring in your maintenance

schedule to ensure that it is working properly. Add an effluent screen.

Large bathtub (whirlpool)

Large volume of water may overload your system.

Heavy use of bath oils and soaps can impact biological activity in your tank and soil treatment area.

Avoid using other water-use appliances at the same time. For example, don’t wash clothes and take a bath at the same time.

Use oils, soaps, and cleaners in the bath or shower sparingly.

Clean Water Uses Impacts on System Management Tips

High-efficiency furnace

Drip may result in frozen pipes during cold weather.

Re-route water into a sump pump or directly out of the house. Do not route furnace recharge to your septic system.

Water softener Iron filter Reverse osmosis

Salt in recharge water may affect system performance.

Recharge water may hydraulically overload the system.

These sources produce water that is not sewage and should not go into your septic system.

Reroute water from these sources to another outlet, such as a dry well, draintile or old drainfield.

When replacing consider using a demand-based recharge vs. a time-based recharge.

Check valves to ensure proper operation; have unit serviced per manufacturer directions

Surface drainage Footing drains

Water from these sources will likely overload the system.


09/09


- 6 -

Maintenance Log

Track maintenance activities here for easy reference. See list of management tasks on pages 3 and 4.

Activity Date accomplished

Check frequently:

Leaks: check for plumbing leaks

Soil treatment area check for surfacing

Lint filter: check, clean if needed

Effluent screen: if owner-maintained

Check annually:

Water usage rate (monitor frequency____)

Caps: inspect, replace if needed

Water use appliances – review use

Other:

Notes: ________________________________________________________________________ ______________________________________________________________________________Mitigation/corrective action plan: _________________________________________________________

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

“As the owner of this SSTS, I understand it is my responsibility to properly operate and maintain the sewage treatment system on this property, utilizing the Management Plan. If requirements in this Management Plan are not met, I will promptly notify the permitting authority and take necessary corrective actions. If I have a new system, I agree to adequately protect the reserve area for future use as a soil treatment system.”

Property Owner Signature: Date

Management Plan Prepared By: Certification #

Permitting Authority:

©2009 Regents of the University of Minnesota. All rights reserved. The University of Minnesota is an equal opportunity educator and employer. This material is available in alternative formats upon request. Contact the Water Resources Center, 612-624-9282. The Onsite Sewage Treatment Program is delivered by the University of Minnesota Extension Service and the University of Minnesota Water Resources Center.


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<Insert logo/address here> Wastewater Treatment andDispersal Operating Permit

Operating Permit No. ____________

Note: To unlock this form for editing, select the Tools Menu/Unprotect Document.

Facility Information Permittee name: Phone number:

Mailing address:

City: State: Zip code:

Property ID number (GPS location):

authorizes the Permittee to operate a wastewater treatment and dispersal system

at the address named above in accordance with the requirements of this operating permit. The attached Management Plan is hereby incorporated as part of the requirements of this operating permit.

Issuance date: Expiration date:

System type: Treatment level:

System design flow: Residential/Commercial:

System components:

Monitoring Requirements

Parameter Target limits Frequency Location Flow CBOD TSS Fecal Coliform bacteria Total Nitrogen Field Tests: Temperature and Dissolved Oxygen Ponding/Surfacing in soil treatment CBOD = Carbonaceous Biochemical Oxygen Demand TSS = Total Suspended Solids

Maintenance Requirements Maintenance requirements shall be performed as specified in the Management Plan as prepared by the system’s Advanced Designer.

System component Maintenance Frequency Septic tank/Trash tank Pump tank and controls Effluent screen Advanced treatment product UV light disinfection device Soil treatment and dispersal Ponding/Surfacing in soil treatment UV = Ultra Violet Light

Page 1 of 4



09/09


Monitoring Protocol Any sampling and laboratory testing procedures shall be performed in accordance with the proprietary treatment product’s protocol,Standard Methods, and at a Minnesota Department of Health approved laboratory. Results shall be submitted to the permitting authority at:

Contingency Plan In the event the wastewater treatment system does not meet required performance requirements as contained in this operating permit, the owner shall notify the local unit of government within 30 days of non-compliance. The owner is responsible to obtain the services of a Minnesota Pollution Control Agency (MPCA)-licensed Service Provider to complete the required corrective measures.

Authorization This permit is effective on the issuance date identified above. This permit and the authorization to treat and disperse wastewatershall expire in year(s). The Permittee is not authorized to discharge after the above date of expiration. The Permittee shall submit monitoring information and forms as required by no later than sixty (60) days prior to the above date of expiration for operating permit renewal. This permit is not transferable.

The owner is required to obtain the services of a Minnesota Pollution Control Agency (MPCA) licensed 1) Service Provider to provide ongoing system operation, maintenance, and monitoring and 2) Maintainer to pump the system’s sewage tanks and components. The owner is responsible to provide the name of the Service Provider business prior to the issuance of this operating permit. The owner has secured the services of as the Service Provider for this system (signed Service Provider contract attached).

I hereby certify with my signature as the Permittee that I understand the provisions of the wastewater treatment and dispersal system operating permit including maintenance and monitoring requirements. I agree to indemnify and hold harmless from all loss, damages, costs and charges that may be incurred by the use of this system. If I fail to comply with theprovisions of this operation permit, I understand that penalties may be issued. If I sell this property during the life of the permit, I will inform the new owner(s) of the permit requirements and the need to renew the operating permit.

The Operating Permit is hereby granted to:

Permittee(please print):

Permitting Authority (please print):

Title: Date: Title: Date:

Signature: Signature:

Page 2 of 4



09/09


Instructions for Completing an Operating Permit

The following instructions provide an explanation for local units of government to complete the operating permit template. This is intended to provide guidance to local units of governments (LGU) in developing operating permits for Type IV and Type V systems,including both residential and commercial systems. The template could be modified for holding tanks. Since the Management Plan is considered part of the operating permit, it needs to be attached to the operating permit. A signed contract, between the owner and Service Provider, should be attached to the operating permit to help ensure the owner has made the necessary arrangements to have the system maintained and monitored.

LGU Name, Department and Address – fill in the name, department and address of local unit of government at the top of the operating permit.

Wastewater Treatment and Dispersal Operating Permit No. – assign an operating permit number to be able to track the system over the years.

Permittee Name, Telephone Number, and Address – fill in the name, address and phone number of the owner.

Property Id. Number (GPS Location) – these are simply identifiers used by local units of government in the event the property address changes over time.

Name of Local Unit of Government – fill in the name of the local unit of government. This authorizes the Permittee to operate the wastewater treatment system at the address named above, according to the operating permit, attached Management Plan and contract with the Service Provider.

Issuance Date – fill in the date the operating permit is issued. The operating permit should not be issued until all required information is submitted.

Expiration Date – fill in the date when this operating permit expires. The first time an operating permit is issued to an owner, it should be issued for one (1) year. This helps ensure the owner actually does the required maintenance and monitoring during thefirst year. If the owner complies, the operating permit can then be issued for a longer period of time as determined by the local unit of government (typically 3 to 5 years). However, if the owner does not comply the first year, the second operating permit could,again, be issued for a period of one (1) year.

System Type – fill in as Type IV or Type V system. Holding tanks also require operating permits (Type II system).

Treatment Level – specify Treatment Level A, B, C, TN or TP. Treatment Level A = Carbonaceous Biochemical Oxygen Demand (CBOD) 15 milligrams per liter (mg/L), Total Suspended Solids (TSS) 15 mg/L, Fecal Coliform Bacteria 1000 per 100 ml; TreatmentLevel B = CBOD 25 mg/L, TSS 30 mg/L, Fecal Coliform Bacteria 10,000 per 100 ml; Treatment Level C = CBOD 125 mg/L, TSS 80 mg/L, Oil and Grease 20 mg/L; TN = 20 mg/L, or TP = 2 mg/L.

System Design Flow – fill in the design flow specified on the construction permit for the system. You may want to note both design flow and average daily flow, if applicable.

Residential/Commercial – specify if the system is residential or commercial. You may specify additional information, such as classification of dwelling, number of bedrooms; or type of commercial establishment.

System Components – provide a brief description of the system components. An example would be the following: 600 gallon trash tank, 600 gallon ECOPOD treatment device, 1 Salcor Ultra Violet (UV) light disinfection unit, 500-gallon pump tank, pump, floatsand controls, and 250-foot shallow trenches using pressure distribution.

Monitoring Requirements (Table)

The monitoring requirements specified in an operating permit are unique to the site and soil conditions of the property (its environmental sensitivity) and system complexity. The monitoring requirements include specific parameters to be monitored, targetlimits and the frequency and location of monitoring. The monitored parameters, at a minimum, would include: 1) wastewater flow -the most basic parameter to know in understanding system performance, 2) ponding in the soil treatment system and 3) surfacing ofthe soil treatment system. Monitoring for CBOD, TSS, fecal coliform bacteria and nitrogen are unique to the site, its receivingenvironment and complexity of the wastewater system. Field tests for temperature, pH and dissolved oxygen can be performed by the Service Provider to serve as general indicators of system performance.

1. Flow – flow to each system needs to be determined as specified in the Management Plan or as determined by the local unit of government. Flow can be determined several ways, using water meters, event counters, and running time clocks. Telemetry can also be used and has the advantage that flow can be determined continually.

The determination for the frequency of flow measurement is done on a case-by-case basis. At first, daily flow monitoring may be needed to determine average flow and peak flows to a system. After a period of time, weekly or monthly flow determination may be acceptable. Flow determinations once a year generally provide limited information.

Page 3 of 4



09/09


2. CBOD – monitoring for CBOD is not typically required for the majority of wastewater systems used for single-family homes generating typical domestic strength effluent. However, monitoring for CBOD may be needed periodically. For example, there may be a need to audit systems as part of the product registration process in Minnesota or if the Service Provider is trying to troubleshoot a system. For commercial systems, monitoring for CBOD is generally necessary to determine CBOD removal efficiencies of proprietary treatment devices and/or organic loading rates to the soil’s infiltrative surface.

3. TSS – monitoring for TSS is not typically required for most residential wastewater systems that generate typical domestic strength effluent. However, turbidity measurements may be taken in the field by Service Providers. Monitoring for TSS may be needed periodically as part of an audit process for the registration of proprietary treatment products in Minnesota. For commercial systems, monitoring for TSS may be necessary.

4. Fecal Coliform Bacteria – monitoring for fecal coliform bacteria will generally be required for systems listed as Treatment Level A and Treatment Level B systems where reduced vertical soil separation is used.

5. Total Nitrogen and Total Phosphorus – monitoring for Total Nitrogen (TN) may be needed in areas identified as nitrogen sensitive environments. Monitoring for Total Phosphorus (TP) may be required in phosphorus sensitive lake environments.

6. Field Tests – these are tests performed by the Service Provider to help ‘monitor’ system performance and identify problems (troubleshooting a system). Although field tests are not a strict monitoring requirement, they are appropriate to list in the operating permit if specified in the Management Plan or in the product’s Operation and Maintenance Manual. The local unit of government will determine if the permittee is required to report field test results as part of the operating permit.

7. Ponding/Surfacing in Soil Treatment – all systems should be monitored periodically as specified in the Management Plan to determine extent and frequency of ponding in soil treatment systems. A check for surfacing is needed.

Maintenance Requirements (Table)

This table lists some of the basic maintenance requirements for each major component of the wastewater system. Since you can’t possibly list all the maintenance requirements in this table, it is best to reference the Management Plan. You could reference theproprietary product’s Operation and Maintenance Manual.

1. System Component – list each system component, including the septic tank, trash tank, effluent screen, pump tank and controls, proprietary treatment product, disinfection device, and soil treatment and dispersal system.

2. Maintenance – briefly identify the maintenance requirements of each major system component. For additional information, you could also reference the proprietary product documents listed on the MPCA Web site at http://www.pca.state.mn.us/programs/ists/productregistration.html.

3. Frequency – briefly identify the frequency of maintenance as per the systems Management Plan and Operation and Maintenance Manual.

Monitoring Protocol – this section of the operating permit states that testing needs to be performed in accordance with approved methods and the results submitted to the local unit of government.

Contingency Plan – briefly describes requirements if the system does not function as intended. The owner must notify the local unit of government when non-compliance occurs. The Management Plan may identify some of the corrective actions required or you will need to consult your Service Provider. The owner is responsible to obtain the services of a MPCA-licensed Service Provider to complete the required corrective measures. More detail could be added here by the local unit of government.

Authorization – fill in the length of time of the operating permit; this is typically one to five years. Fill in the name of the local unit ofgovernment in the second blank space. Next, fill in the name of the MPCA licensed Service Provider identified by the owner in contract; this is needed to help ensure the owner has made the necessary arrangements to have the system maintained and monitored.

The Operating Permits Hereby Granted to – print the name of the owner who signed the operating permit.

Signature of Permittee (and date of signature) – the owner signs and dates the operating permit.

By Order of – signature of the permitting authority, title, and date.

Page 4 of 4

http://www.pca.state.mn.us/programs/ists/productregistration.html



09/09

© 2009, Regents of the University of Minnesota. All rights reserved. For additi onal copies or for Americans with Disabiliti es Act accommodati ons, please call (800) 322-8642. University of Minnesota is an equal opportunity educator and employer.

How often a septic tank needs to be pumped depends on the system design and how your household uses the system. Complete this chart, repeating every few years to gauge how often you should have your tank inspected or pumped. Remember these are guidelines. Your Maintainer or Service Provider can give you a better estimate of your pumping needs. State and local codes may dictate the maximum amount of time between tank cleanings.

Mai

nte

nan

ce a

nd

Car

e

FACTOR POINTSEFFECTS

Add your TOTAL score, enter here. (Compare your score to the risk level chart below)

Do you use a garbage disposal or dishwasher with a food grinder?

Is sewage pumped out of your basement to the septic tank (instead of using gravity flow), and/or is a sump pump connected to the septic system?

Do you have a water-conditioning unit for which recharge water is connected to the septic system? (water softener, iron filter or other devices)

How often do you wash laundry?

Do you have a water-conserving top-loading washer, or a front-loading washing machine?

Do you use low flow showerheads, toilets, not leave the faucet running, and repair leaks quickly?

Do you use few and mild cleaning products and detergents, limiting anti-bacterial products?

Do you have an in-home business that increases water use? (such as a daycare, taxidermy shop, hair salon)

Do you have 3 or more overnight guests at a time, or have large groups visit your house?

When was the last time your septic tank was pumped or evaluated (inspected)?

Is your septic tank (not including pump tanks) smaller than…

Are there more people living in your home than there are bedrooms?

Score Risk Level Outcome

0 - 8 Low Risk Based on your system and positive use habits, your system should be evaluated once every 2-3 years to determine if tank cleaning is necessary. Do not go more than 3 years without an evaluation. Some counties and municipalities require pumping or inspection every 3 years.

9 - 18 Medium Risk Based on your tank size and use habits, your system should be evaluated every 1½ - 2½ years to determine if tank cleaning is necessary.

19 - 26 High Risk Based on your tank size and use habits, your system should be evaluated annually to determine if tank cleaning is necessary.

Number of people Bedrooms 3 2 or fewer 4 3 5 4 6 or more 5 or more

Tank Capacity Bedrooms 1,000 3 or fewer 1,500 4 – 5 2,000 6 or more

more, enter 2

Spread out during the week with no more than 2 loads/day, enter 02

More than 3 loads/day, several times/week, enter 4

0

metimes or have made some changes, enter 1make repairs quickly, enter 0

0

onth, enter 0

large gatherings in your home, enter 4

1

more than 5 years ago, enter 3

Septic Tank Pumping Frequency Guidelines


09/09 1

Equations and Constants

TABLE OF CONTENTS

A. FORMULAS Perimeter/Circumference ........................................................................................ 2 Area ......................................................................................................................... 3 Volume .................................................................................................................... 4 Temperature ............................................................................................................ 5 Velocity ................................................................................................................... 5 Flow/Pumping Rate ................................................................................................ 5 Loading/Pounds ....................................................................................................... 6 Solids ....................................................................................................................... 6 Tanks & Clarifiers ................................................................................................... 6 Filters and Recirculation ......................................................................................... 7 Collection ................................................................................................................ 8 Other Formulas and Constants .............................................................................. 10

B. CONVERSION FACTORS Length ...................................................................................................................... 2 Area ......................................................................................................................... 3 Volume .................................................................................................................... 4 Flow ........................................................................................................................ 5 Weight ..................................................................................................................... 6 Master List ............................................................................................................. 12 C. SYMBOLS AND ABBREVIATIONS ................................................................. 10 D. METRIC SYSTEM ............................................................................................... 11 `


09/09 2

PERIMETER/CIRCUMFERENCE 1. Rectangle or Square: S1 P = S1 + S2 + S3 + S4 S4 S2 S3 2. Circle: C = x D Where: R D = 2 x R D

LENGTH CONVERSION FACTORS 1 inch = 2.54 centimeters = 25.4 millimeters 1 foot = 12 inches = 0.31 meters 1 yard = 3 feet = 0.91 meters 1 mile = 5,280 feet = 1,760 yards 1 meter = 39.37 inches = 3.28 feet 1 kilometer = 0.62 miles = 1,000 meters


09/09 3

AREA L1. Square or Rectangle: W A = L x W 2. Circle: A = x R2 R Where: D = 2 x R D

3. Triangle: A = B x H 2 H B

AREA CONVERSION FACTORS 1 square foot = 144 square inches 1 square yard = 9 square feet 1 square mile = 640 acres or 1 section 1 square meter = 10.76 square feet 1 square meter = 10,000 square centimeters 1 acre = 43,560 square feet 1 hectare = 2.47 acres


09/09 4

VOLUME L

1. Rectangle Volume = Area x Height H V = L x W x H W 2. Cylinder: R Volume = Area x Height H V = x R2 x H

Where : D = 2 x R D D

VOLUME CONVERSION FACTORS 1 cubic foot = 1,728 cubic inches 1 cubic foot = 7.48 gallons 1 cubic yard = 27 cubic feet 1 acre-inch = 27,152 gallons 1 acre-foot = 43,560 cubic feet 1 acre-foot = 326, 000 gallons 1 gallon = 3.79 liters 1 gallon = 231 cubic inches 1 gallon = 4 quarts 1 cubic meter = 35.3 cubic feet 1 cubic meter = 1.3 cubic yards 1 liter = 0.26 gallons 1 liter = 1,000 milliliters


09/09 5

TEMPERATURE 1. Fahrenheit to Celsius: °C = 5 (°F - 32) 9 2. Celsius to Fahrenheit: °F = (°C x 9) + 32 5

VELOCITY 1. Velocity = distance traveled time 2. Velocity(C) = flow rate = Q area A

FLOW/PUMPING RATE 1. Flow Rate (Q) = velocity (V) x area (A) 2. Pumping Rate = volume pumped time pumped 3. Calibrated Pumping Rate (gallons per minute): = drawdown volume (gallons) time to drawdown ( minutes) = (Reading 1 in inches - Reading 2 in inches) x gallon per inch of tank Time (min)

FLOW CONVERSION FACTORS 1 cubic foot/second = 449 gallons/minute (GPM) 1 gallon/second = 0.13 cubic feet/second (CFS) 1 gallon/second = 8.03 cubic feet/minute (CFM) 1 gallon/minute = 0.002 cubic feet/second (CFS) 1 gallon/minute = 1440 gallons/day (GPD)


09/09 6

LOADING and SOLIDS 1. Loading ( lb/day) = concentration ( mg/L) x flow (gallons/day) x 8.34 lb/gallon/1,000,000 2. Organic Loading (lb/day) = population ( people) x population equivalent factor (lb/person/day) Note: Population equivalent factors for: BOD = 0.17 lb/person/day TSS = 0.20 lb/person/day

WEIGHT CONVERSION FACTORS

1 gallon = 8.34 pounds of water 1 cubic foot = 62.4 pounds of water 1 foot of water = 0.433 pounds per square inch 1 pound = 0.454 kilograms 1 kilogram = 2.2 pounds 1 kilogram = 1,000 grams 1 pounds per square inch = 2.31 feet of water 1 liter = 1,000 grams 1 mg/kg or 1 ppm or 1 mg/l = 0.0022 pounds/ton or 0.0001% 1 mg/l = 1,000 µg/l

3. Total Suspended Solids (mg/L) = weight of suspended solids (mg) volume of sample (liter) 4. Organic Nitrogen = Kjeldahl Nitrogen - Ammonia Nitrogen

SOILS1. Percolation rate = min/in 2. Ksat = 3. Contour Loading Rate (CLR) = gal/ft

TANKS & CLARIFIERS 1. Surface Settling Rate (SSR): SSR = flow rate surface area 2. Tank capacity in gallons TC= L(ft) x W (ft) x Liquid depth(ft) x 7.48 gal/ft3 3. Detention Time (DT): DT = volume of tank flow rate to or from tank 4. Percent Removal (PR): PR (%) = influent - effluent x 100% influent


09/09 7

FILTERS

1. Hydraulic Loading Rate (HLR): HLR = total flow to filter * surface area of filter * Where total flow = influent flow + recirculation flow 2. Organic Loading Rate (OLR): (lbs per day per 1000 cubic feet) OLR = pounds per day applied to the filter volume of filter media ( in 1000 cubic feet units) CALCULATING RECIRCULATION RATIOS AT SYSTEM STARTUP To set recirculation at the time of system startup, the flowing information is needed:

Forward flow through the system – this will be assumed from available records and/or interviews or design flow

Pump delivery rate of the pump dosing the media filter (in gallons per minute) Dose volume Amount of pipe drainback to the pump after a dose Desired recirculation ratio, based upon forward flow (usually determined by the designer or manufacturer –

3:1 – 5:1) Number of minutes in a day = 1440

Before media filter startup occurs, it is important that the startup person understand how the regulatory jurisdiction and/or manufacturer determines recirculation volume to the filter. Most proprietary technologies use the following basic formula: [(forward flow) multiplied times (desired recirculation)] plus (forward flow) = volume to the filter. Other entities/manufacturers may calculate recirculation differently, for example [(desired recirculation) multiplied by (forward flow), so always verify before startup. For the following example the manufacturer-determined pump dose volume per pump cycle (15 gallons) will not be altered. The pump off time needed to meet the desired recirculation ratio will be determined. The following values will be assumed for this example:

Forward flow = 200 gallons per day (gpd) -made by assumption Pump delivery rate (PDR) = 30 gallons per minute (gpm) Pump on time = 15 gallons/dose / 30 gpm = 0.5 minutes (min) on Pump dose volume = PDR X Pump run time = 30 gpm X 0.5 min = 15 gallons per dose No pipe drainback is assumed to simplify this example Desired recirculation ratio of 3:1 as required by manufacturer (Using the first formula noted above, the

filter surface will see four times the amount of forward flow or [200 gpd x 3] + 200 gpd = 800 gpd Given the above information, let’s calculate what the pump off time needs to be: Note, that to simplify the example, the entire pump dose volume (15 gallons) reaches the media filter surface with no pipe drainback.


09/09 8

Number of pump dose events needed to meet the 3:1 ratio = 800 gpd ÷ 15 gallons per dose event = 53.3 dose events per day. Because we can’t have a fraction of a dose event, this is rounded down to 53 events. Note that for each dose event there is a corresponding pump rest cycle—or 53 rest cycles a day. Number of minutes per day = 24 hours x 60 min per hour = 1440 min/day Pump off time (minutes) = (number of minutes per day ÷ pump rest cycles per day) minus pump on time. Substituting in numbers, the math is: (1440 min/day ÷ 53 pump rest cycles) – 0.5 min = 26.7 min Answer: 26.7 minutes off time between pump doses To double check the math, the combined pump on and off times multiplied by the number of dose events per day should equal the total number of minutes in a day (or 1440 minutes). Check: (0.5 min + 26.67 min) x 53 dose events = 27.2 min x 53 dose events = 1440 min To double check the math on the timer settings; multiply the pump on time by the dose events per day, and multiply this number by the pump delivery rate (or PDR). The result should equal the total gallons needed to meet the desired recirculation ratio (or 800 gpd). Check: (0.5 min per dose x 53 dose events/day) x 30 gpm = 795 gpd

Note that the answer above is very close to the 800 gpd needed to meet our desired recirculation ratio. The difference is because we could not utilize a portion (0.3) of a dosing event, so earlier in our calculations we decided to round down to 53 dose events per date.

COLLECTION 1. Hazen Williams Equation

V = 1.318*C*R0.63*S0.54

V = Velocity in feet per second C = Hazen-Williams Roughness Coefficient = 130 D = Diameter of pipe in inches R = D/2 S = Hf/L

Hf = Friction head loss (feet) L = Length of Pipe (feet)

Hf = (10.5/D4.87) X (Q/C)1.85 X L

Q = Flow in gallons per minute


09/09 9

2. Manning Equation V = k/n(A/P)2/3S1/2 where k = 1.486, and n = 0.013 n = 0.013 should be used for PVC pipe.

Inserting the constants in the equation: V = 114.3 (A/P)2/3S1/2

A = πD2/4 P = Wetted Perimeter (assume full pipe) = πD

Simplifying the equation by inserting A and P in terms of D: V = 114.3(D/4)2/3S1/2

S = Slope (feet/foot) (usually given, and assumed 1/8 inch per foot, which equates to 0.01 feet/foot) Manning Equation Constants

Other Collection Constants Minimum slope in pipe =1/8 inch per 1 foot ~ 1% Maximum slope in pipe = 0.2 feet/foot = 2%

Maintains velocity below 15 feet/sec

OTHER FORMULAS

1. Convert Gallons Per Minute to Gallons Per Day: Gallons/day = gallons/minute x 1,440 minutes/day 3. Percent Removal (%) = influent concentration – effluent concentration x 100% influent concentration 5. Slope or Grade (%) = rise or drop (difference in height) x 100% run (difference in length)

Pipe Diameter

Velocity (V) ft/s

Area (A) ft2

Qf (GPM)

4” 2.18 0.087 85.2 6” 2.85 0.197 253.0 8” 3.46 0.349 542.2


09/09

10

SYMBOLS/ABBREVIATIONS

A = Area Ac-Ft = Acre-feet B = Base BOD = Biochemical Oxygen Demand C = Circumference CEC = Cation Exchange Capacity CFM = Cubic Feet per Minute CFS = Cubic Feet per Second Cu In. = Cubic Inches °C = Degree Centigrade D = Diameter Ft = Foot or Feet Ft2 = Square Feet Ft3 = Cubic Feet °F = Degree Fahrenheit F/M = Food to Mass Gal = Gallons Gal/Min = Gallons per Minute Gal/Sec = Gallons per Second GPD = Gallons per Day GPM = Gallons per Minute GPS = Gallons per Second H = Height hr = Hour In. = Inch In2 = Square Inch In3 = Cubic Inch L = Length lb = Pound Mi = Mile Mi2 = Square Mile Min = Minute mg = milligrams

ml = milliliters MG = million gallons MGD = million gallons per day mg/kg = milligrams per kilogram mg/L = milligrams per liter MLSS = mixed liquor suspended solids MLVSS = mixed liquor volatile suspended solids N = Nitrogen NH3-N = Ammonia Nitrogen Org. N = Organic Nitrogen P = Perimeter PE = Population Equivalent ppm = Parts per Million ppb = Parts per Billion PSI = Pounds per Square Inch Q = Flow R = Radius RPM = Revolutions per Minute S = Side Sec = Second Sq. In. = Square Inches SVI = Sludge Volume Index SRT = Solids Retention Time SS = Suspended Solids TSS = Total Suspended Solids V = Volume Vel = Velocity W = Width Yd = Yard pi or 3.14 / = Per (as gallon/day) % = Percent µL = Microliters


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METRIC SYSTEM

LENGTH One kilometer (km) = 1,000 meters One meter (m) = 100 centimeters One decimeter (dm) = 0.1 meter One centimeter (cm) = 0.01 meter One millimeter (mm) = 0.001 meter WEIGHT One kilogram (kg) = 1,000 grams One gram (g) = 1,000 milligrams One decigram (dg) = 0.1 gram One centigram (cg) = 0.01 gram One milligram (mg) = 0.001 gram VOLUME One kiloliter (kl) = 1,000 liters One liter (l) = 1,000 milliliters One deciliter (dl) = 0.1 liter One centiliter (cl) = 0.01 liter One mililiter (ml) = 0.001 liter AREA One hectare (HA) = 10,000 square meters One square kilometer = 1,000,000 square meters


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MASTER LIST - CONVERSTION FACTORS

MULTIPLY BY TO OBTAIN Acres 43560 Square Feet Atmospheres 33.9 Feet of Water Centimeters 0.40 Inches Cubic Feet 7.48 Gallons Cubic Feet 28.32 Liters Cubic Feet/Second 449 Gallons/Minute Cubic Meters 35.31 Cubic Feet Cubic Meters 264.2 Gallons Cubic Meters 103 Liters Cubic Yards 27 Cubic Feet Cubic Yards 202 Gallons Feet 30.48 Centimeters Feet 0.31 Meters Feet of Water 62.43 Pounds/Square Foot Feet of Water 0.43 Pounds/Square Inch Gallons 3785 Cubic Centimeters Gallons 0.13 Cubic Feet Gallons 3.79 Liters Gallons water 8.34 Pounds of Water Gallons/Minute 2.2 x 10-3 Cubic feet/Second Gallons/Minute 1440 Gallons/Day Gallons/ Minute 0.06308 Liters/Second Gallons/Day 6.9 x 10-4 Gallons/Minute Gallons/Day/Square Foot 1.604 Inches/Day Grams 2.21 x 10-3 Pounds Grams/Liter 1000 Parts/Million Hectares 2.47 Acres Horsepower 33,000 Foot-pounds/Minute Horsepower 0.7457 Kilowatts Inches 2.54 Centimeters Inches/Day 0.62 Gallons/Day/Square Foot Kilograms 2.21 Pounds Kilowatts 1.34 Horsepower Kilowatt-hours 2.66 x 106 Foot-pounds Liters 103 Cubic Centimeters Liters 0.04 Cubic Feet Liters 0.26 Gallons Meters 3.28 Feet Milligrams/Liters 1 Parts/Million Million Gallons/Day 1.55 Cubic Feet/Second Parts/Million 8.34 Pounds/Million Gallons Pounds 453.50 Grams Pounds of Water 0.12 Gallons Pounds/Square Inch 2.31 Feet of Water Pounds/Square Inch 2.04 Inches of Mercury Temperature (°C) + 17.78 1.8 Temperature (°F) Temp. (°F) - 32 5/9 Temp. (°C)

section 13 forms and reference - university of...

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