Morgan County Health Department

**Septic Installer Information for Trench Systems**

Owner Name: ______________________________ Phone: ____________________________
Site Address:__________________________________________________________________

 
Installer’s Name: ___________________________ Phone: _____________________________
Installer’s Signature: _______________________       Date: ________________________

# Bedrooms: ____           Loading Rate: ____(gpd/sq.ft.)           Total Square Feet: ___________

 
Trench System Type:     Gravity ____           Flood Dose ____          Other ____

 
Sewer Pipe:     ASTM- ____          SDR-____          Length ____(ft)

 
Septic Tank:     Size ______ (gal)          Manufacturer ____________          Material___________

 
Dose Tank:     Size ______ (gal)           Manufacturer ____________          Material___________

Effluent Pump:     Manufacturer ________________     Model _______     GPM ________

                   Static Head _______     Friction Loss _______     TDH _______     Dose _____gal

Force Main: ASTM-____ SDR-____ Diameter _______ Length __________(ft)

Pumping Uphill?     Yes ___     No ____

Gravity Effluent Pipe:      ASTM- ____      SDR- ____       Length ____(ft)

Distribution Box:      # of holes ____     Manufacturer ____________     Material___________

Gravity Header Pipe:     ASTM- ____     SDR- ____

Absorption Field:   Aggregate ____

                               Chamber ____ Manufacturer __________ Model _______

                               Other ____ Manufacturer __________ Model _______

# of Trenches ____     Length ____     Width ____     Depth ____

Drainage:      Site Slope ____%      Water Table Depth ____      Drain Depth ____

Drainage Type:      Upslope Curtain Drain with Aggregate ____

                                  Perimeter Drain Encircling Absorption Field ____