HomeMy WebLinkAbout030-2145-03-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County St. Croix
Safety and Building Division INSPECTION REPORT Sanitary Permit No 633359
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No
Personal information you provide may be used for secondary purposes [Privacy Law, a 15 04 C1 )(m)]
Permit Holders Name City Village Township Parcel Tax No.
Tim & Krista Strand I TOWN OF SAINT JOSEPH 030-2145-03-000
BM Description SectionfTown/Range/Map No
CST BM Elev —7-1� 1 30.30.19.2094
TANK INFORMATION ELEVATION DATA
TYPE
MANUFACTURER
CAPACITY
Septic
Dosing
Aeration
Holding
TANK SETBACK INFORMATION
TANK TO
PIL
WELL
BLDG
Vent to Air Intake
ROAD
Septic
Dosing
Aeration
Holding
PUMP/SIPHON INFORMATION
Manufacturer
Demand
GPM
Model Number
I
Friction Loss
System Head
TCH Ft
th
Dia.
DisL to Well
SOIL ABSORPTION SYSTEM
STATION
BS
HI
FS
ELEV.
Benchmark
Alt. BM
Bldg. Sewer
St/Ht Inlet
St/Ht Outlet
Dt Inlet
Dt Bottom
Header/Man
Dist. Pipe
Bot. System
Final Grade
St Cover
BEDrrRENCH
Width
Length
No Of Trenches
PIT DIMENSIONS
Of Pits
Inside Dia
Liquid Depth
DIMENSIONS
I
like.
I
SETBACK
SYSTEM TO
l -F
-D
ETL G
IWELL
LAKE/STREAM
LEACHING
Manufacturer
INFORMATION
CHAMBER OR
Type Of System
UNIT
Model Number
DISTRIBUTION SYSTEM
Header[Man,fold
joistnibution
Hole Size
Hole Spacing
Vent to Air Intake
11-ength
pipecs)
Dia
Length_ Dib_ Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only
Depth Over
Depth Over
Depth of
Seeded/Sodded
Mulched
Bedr-rench Center
I
BedrFronch Edges
I
Topsoil
I-
Iss
I -- Yes [:] No
1:1 Yes
COMMENTS: (Include code discrepancies, persons present, etc.)
Location: 1399 33RD ST
1.) Alt BM Description
2.) Bldg sewer length
- amount of cover
Plan revision Required? E] Yes E No
Use other side for additional information.
Inspection #1:
Inspection #2
SBD-671 0 (R X97) Date insel Signature
Cent No.