HomeMy WebLinkAbout032-2156-30-000 (3) Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety arid & i Division
"` INSPECTION REPORT Sanitary Permit No: 408230 0
GENERAL I NFORMATION (ATTACH TO PERMIT) State Plan ID No:
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
Permit Holder's Name: City Village X Township Parcel Tax No:
Grand Properties L.P. I Somerset Township -�/ SYp- 30
CST BM Elev: insp. BM Elev: BM Description:
ID I ' y / / • f�p „ �1�7�� 16 . 0
TANK INFORMA ION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Ben F�¢tark
/ O /
DD f mercer 5 /02. / d / -
Dosing / 106 , Alt. BM
Aeration Bldg. Sewer
Holding
St/Ht Inlet
TANK SETBACK INFORMATION St/Ht outlet
TANK TO P/L WELL BLDG. Ven Air Intake ROAD Dt Inlet
0 1�
Septic , d0 / / / / Dt Bottom
Dosing Header /Man.
Aeration °" _ Dist. Pipe
T d� v r3•� -�
Holding Bot. System / 3
- - - - - -- . - 75
Final Grad
PUMP /SIPHON INFORMATION
Manufacturer Demand St Cover
M 7— /o Z . IS-
Model Number OT-pr Y
TDH Lift Friction Loss System Head TDH Ft
rcemain Length
SOIL ABSORPTION SYSTEM I /a A" -4,t, mr
BED /TRENCH Width }. Length q' ' No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS /7,<
SETBACK SYSTEM TO (/ P/L BLDG WELL r - L E /STREA LEACHING M l turer:yl
INFORMATION Type Of System: CHAMBER �J� ��f
Model Number:
� of
DISTRIBUTION SYSTEM
Header /Manifold Distribution C x Hole Size x Hole Spacing Vent Air Intake
Length Dia Lengt Dia Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only bt r
Depth Over Depth Over xx Depth of xodd ed xx Mulched
Bed[Trench Center � , / -„ Bed/Trench Edges Topsoil
5- moo .' X Yes 0 No X Yes [M) No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: IAI (0 Inspection #2:
Location: 1683 89th Street Somerset, WI 54025 (NE 114 NE 1/4 12 T30N R19W) Highlands Lot 3 '� Parcel No: �
1.) Alt BM Description = �y'r4M-, �OCQ '��- `Sl(�l^^ Q / -f t 0 � 1�` s f dA 0 �
2.) Bldg sewer length = Z 21.c5t- t/J -s�- ^AZAJ
- amount of cover
T
Plan revision Required? X Yes No IV
I 'I Use other side for additional information.
SBD -6710 (R.3/97) Date Insepctor's Sig ature Cart. No.
r
Safety and Buildings Division County p �
201 W. Washington Ave., P.O. Box 7162
IsConsin Madison, WI 53707 - 7162 Site Address
— Department of Commerce 7 / (PP3 89' S7
1 Sanitary Permit Application Sanitary Permit Number
In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ❑ Check if Revision � %
se
ma be used for co purposes Privacy Law, s15. l m
I. Application Information - Please Print All Information State Plan I.D. Number
Property Owner's Name - -- . -_. Parcel Number
;. F OIE
Property Owner's Mailing Address Property Location
oaa
(i 2 200`L
—� 'A E 'A; S T N, R
City, State Zip Code t Phone Number Lot Number Block Number
I X C0uu � •l3
Subdivision Name CSM Number
II. Type of Building (check all that apply) / n /j ,� �Ocity
J61 or 2 Family Dwelling - Number of Bedrooms �. ✓ � `'' D � ��.y„ r a
❑ Public/Commercial - Describe Use �`lownstup _
❑ State Owned ® ( j / Nearest Road
a J'L � 3 �x (vZ ` 3' '� . 3' U�
III. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line B if applicable)
A. 1 K New 2 ❑ Replacement System 3 ❑ Replacement of 6 ❑ Addition to For County use
stem Tank Only Existing stem
B. ❑ Check if Sanitary Permit Previously Issued Permit Number Tate ssued
IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use) 8, ode s ssu / &I n (%ham �,_
44 Pq Non - Pressurized In- Ground 21❑ Mound 47 ❑ Sand Filter 50 ❑ Constructed We� EJJ/q - f7rr4
22 ❑ Pressurized In- Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line -3�• / � AA1_
45 11 At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑Other ��
CA
V. Dispersalfrreatment. Area Information: 7'
Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate tystern Elevati n Final Grade
Required Proposed Rate(Gals./Days/Sq t.) (Min./Inch) o ,� BB Elevation
� 9y' c 92 r
SD
K q3 G 03 �/1 - "'``� 8 2,8
VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Tanks /, ,�+ Concrete Constructed Glass
New Existin Tanks Tanks
Septic or Hokling Tank OO E
Dosing Chamber
VII. Responsibility Statement - I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name (Print) is Signature RS umber Business Phone Number
/ _ - _ S
Plumber's Address (Street, City, State, Zip Code)
LG E
VIII. epartmentUse Onl
pproved ❑ Disapproved
Sanitary Permit Fee (includes Groundwater Date Issued suing ent Signa o Stamps)
Surc e Fee) ❑Owner Given Initial Adverse _) � S � 71 1�o
Determination
IX. Conditions of Approval/Re%sons for Disapproval
4 / tu_1•v% 5ys-,, ,u�r4,., -,, 7 tie a
P* 0.'7
Z Se��,z�d �t,i f�lr.. � �. �# vy, Cern�t • �3. � 3 -/ yN�' d/
7 * &*_ sh-n . 40 —k024,,u: ^Ako_ il" - o tr.�l
Attach lete plans (to the County only) for the syst on paper not 1 $1/2 x 11 larches m
Bal���12 7b Pb Me }�i7 p vl�taAJZZ ket ar77in4T�PdW7r /�T /�h -
SBD -6398 . 05/01 t1,S C44Ad f' &e- s0ia
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V ccCriWn Department of Commerce SOIL EVALUATION REPORT Page I of
`bivision of Safety and Buildings
to accordance with Comm 85 Wis. Adm. Code
' County
Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must 1
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D.
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 0 3 Z "' ZO7
Please print all information Re ' by _ M
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).
Property Owner Property Lo cation
Govt. Lot N f' 1I4,(J 1l4 S J Z T N R E (or
Property Owners Mailing Address Lot # Block # Subd. Name or CSM#
135 e Tra _ h
City State Zip Code Phone Number ❑ City ❑ Village [N Town Nearest Road
[9 New Construction Use: (9 Residential /Number of bedrooms Code derived design flow rate 'I GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material nL A1� Flood Plain elevation if applicable
General comments
and recommendations:5�m elev. - top
r
❑ Boring�•�"
a Boring # ;7j a2 r� i6'1\,
pit Ground surface elev. 1 ft. Depth to limiting factor 1((� r' j i i soh (cation Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roo GPD/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2
I
0-1 I c- s lv .5
2 IZ- i Zm r' c _
S - ilp
�f Boring #
❑ Boring at-
pit Ground surface elev. Z • ft. Depth to limiting factor 120 in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh_ *Eff#1 *Eff#2
1
6-1 V Z S i l 2mab G5 �' • 5 .8
2- Y) �i c �5
3 y - 7. l Si C] Zn �
* Effluent #1 = B00 > 30 220 mg/L and TSS >30 < 150 mg /L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg&
CST Name (Please Print) Signatu CST Number
h � Z
Address Date Evaluation Conducted Telephone Number
Q l �'� 50 - ( 15) 241- -loo 8
r - r
Property Owner �) ry t Parcel ID # Page Z of 3
I -S] Boring # Boring ® pit Ground surface elev. Q -0 , 2 6 ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDffF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I 'Eff#2
1 C71 Z Si C 5 I •�
❑ Boring # ❑ Boring
❑ pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. " Eff#1 'Eff#2
F-1 Boring # Boring
❑ pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 "Eff##2
' Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L " Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 -264 -8777.
SBr3 -8330 (R.07 /00)
Property Owner Parcel ID # Page of 3
I—S] Boring # ❑Boring
® pit Ground surface elev. Q� O� ft Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. "Eff#1 'Eff#2
C5 I 5
:5id Z4
F-1 Boring # ❑ Boring
❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary _ Roots GPD/fF
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2
Boring # ❑ Boring
❑ Pit Ground surface elev. ft Depth to limiting factor in.
Soil Application Rate
Horizon I Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. "Eff#1 "Eff #2
Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/L ` Effluent #2 = 1301) : < 30 mg/L and TSS < 30 mg&
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608 -266 -3151 or TTY 608 -264 -8777.
SBr3 -W30 (R.07/00)
PAGE 3 OF
NAME LOT# 3 LEGAL DESCRIPTION Q F YN EZ ,S 12- 1350 ,N,R, 4 E� (org
SCALE: 1 "= �U
BM 1 ELEVATION /00. V
BM 1 DESCRIPTION /-Roj :�f .' t — -I-
BM 2 ELEVATION 99, 3 O
BM 2 DESCRIPTION ,b_ p o 3 lyT v p,�C
S
SYSTEM ELEVATIO $FS'. TO Low cr R
ALTERNATE ELEVATION %Z."o G.w cr q�`0
CONTOUR ELEVATION 9Z, rro, qy. cso y(, • o a
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60
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% GNATLJRE w DATE
ST CROIX COUNTY
SEPTIC "TANK MAINTENANCE AGREEMENT
AND
OWNERS141P CERTIFICATION FORM
Owner/Buyer G—) l 'D Py Y� \e ms_
Mailing Address 1 1 - �NJ R.R.D Sjj Sk(T1' )ba �rJ`('nQYS� ' S�JOZ
Property Address _
(Verification required from Planning Department for new construction)
037-- "'YY -/O —boo
City /State �ome��C Parcel Identification Number
LE GAL DESCRIPTION
Property Location / ! /4, �_ ' /�, Seca T -30 N- R_1.�._W, Town of sOME2T
Sub,. ` �- ��' p� !� �k)c A - - - - -- — to lk 3
Certified Survey Map # Volume , Page #
Warranty Deed # �ulq Volume �Qf r , Page I l (Q ;2
Spec house X yes ❑ no Lot lines identifiable ^yes ❑ no
SYSTEM MAINTENANCE
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance
consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the syster
can affect the function of the septic tank as a treatment stage in the waste disposal system.
The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a
master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system
is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge.
I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards
set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification
stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30
days he three y r expiration dale.
SIGIVATURE 6F APPLICANT DATE
OWNER CERTIFICATION
I (we) certify that all statements on this form arc true to the best of my (our) knowledge. I (we) ant (are) the owner(s) of
the propT c descri b above, by virtue of a warranty deed recorded in Register of Deeds Office.
SIG TfATORE qr APPLICANT DATE
* * * * ** Any information that is mis represented may result in the sanitary permit being revoked by the Zoning Department. • * **
** Include with this application: a stamped warranty deed from the Register of Deeds office
a copy of the certified survey map if reference is made in the warranty deed
ter` 3,1)
Page of
MANAGEMENT PLAN
This Private Onsite Wastewater Treatment System (POWTS) has been designed and is to be installed and
maintained in according to Comm 83, Wis. Admin. Code, the in- Ground Soil Absorption Component Manual for
Private Onsite Wastewater Treatment Systems (SBD- 10567 -P; June 11, 1999),
1. This POWTS has been designed to accommodate a maximum daily flow of
� Y
57U gallons of domestic wastewater -per day.
The quality of influent discharged into the POWTS treatment or disposal component
shall be equal to or less than all of the following:
a monthly average of 30 mg/L fats, oil and grease
a monthly average of 220 mg/L BOD 5
a monthly average of 159 mg/L TSS.
Wastewater shall not be discharged to the POWTS in quantities or qualities that exceed
these limits or that result in exceeding the enforcement standards and preventative action
limits specified in ch. NR 140 Tables 1 & 2 at a point of standards application, except
as provided in Comm 83.03 (4)m Wis. Admin. Code.
2. The owner of this POWTS is responsible for system operation and maintenance. The
following maintenance shall occur within three (3) years of the date of installation and at
least once every three years thereafter:
j 1. The septic tank shall be pumped be a certified septage servicing operator, licensed
under s2.81.48, Wis. Slats, unless inspection by a licensed master plumber or
other person authorized to make such inspection, finds less than (1/3) of
the tank volume occupied be sludge and scum. More frequent pumping may
be necessary to prevent solids from exceeding one -third (1/3) if the volume of the
tank..
Wastes shall be disposed of by the pumper in accordance with ch. NR 113 Wis.
Admin. Code.
At each pumping the pumper must visually inspect the condition of the tank,
baffles, rizers, and manhole cover and verify that any required locks are present.
2. The soil absorption component(s) shall be visually inspected by a licensed master
plumber, certified septage servicing operator or POWTS inspector. Inspection
shall check for evidence of discharge of sewage to the ground surface and for
ponding of effluent in the distribution cell.
3. The tank filter(s) shall be inspected and cleaned to remove any accumulated solids
according to manufacturer's specifications. The filter cartridge shall not be
r
removed unless provisions are made to retain solids in the tank. Cleaning of the
filter at more frequent intervals may be necessary.
4. Any pump, alarm or related electrical connections shall be visually checked for
defects and tested to confirm that they are operating properly.
5. Reports for all system maintenance shall be submitted to St. Croix County Zoning in
accordance with Conan 83.55, Wis. Admin. Code.
3. Defects or malfunctions identified during maintenance described in item #2 above shall
be repaired in conformance with Comm 83, Wis. Admin. Code.
4. Anytime a failure or ntalfi►nction occurs, it shall be reported to the owner of this POWTS.
Repair or connection of such failure or malfunction shall comply with Comm 83, Wis. Adtuin.
Code.
5. No one should enter a septic or other treatment tank for any reason without being in full
compliance with OSHA standards for entering a confined space. The atmosphere within
interior of the tank
k m� contain lethal g ases and rescue of a person from the
these tans may g
may be difficult or impossible.
6. No product for chemical or physical restoration or chemical or physical procedures for
POWTS may be used unless approved by the Department of Commerce in accordance
with Comm 84, Wis. Admin. Code.
7. In the event that this POWTS or a component of this POWTS fails and cannot be
r
repaired, the following contingency plan is proposed:
Po sed:
Lj1&-f,jjlil co s11a1Llz�r�izlas�-
This may require a new soil evaluation to determine where a new soil absorption c
component can tv.
8. If this i is replaced, or its use is disconlinued, it shall tx; abandoned in accordance
will, ('oinm 83.33, Wis, Admin.. Code.
9. Namc and number of local health agencyL-S Croix Co lltlly -ZQllil ' - 5-3 6-468
10. Name of service contractor in case of fa ilure or malf inction :_Schmitt & SOns_ExcayaCutb
715 -549 -6651
�J 1915P `f07 (`
STATE BAR OF WISCONSIN FORM 2 - 1998 G 8 c^ 5 1 4
WARRANTY DEED KATHLEEN H. WALSH
REGISTER OF DEEDS
Document Number ST. CROIX Co. WI
- RECEIVED FOR RECORD
j This Deed, made between 06 -24 -2002 3:00 PH
RICHARD 0 STOUT and JANET P STOUT, WARRANTY DEED
husband and wife,
EXEMPT #
Grantor,
and GRAND PROPERTIES. P REC FEE: 11.00
TRANS FEE: 162.30
COPY FEE:
j CERT COPY FEE:
Grantee. PAGES: 1
Grantor, for a valuable consideration, conveys and warrants to Grantee the following
�i
describedseal estate in St- Croix County, State of Wisconsin:
Recording Area
Lot 3, Plat of The Highlands, Town of
Name and eturn A ress
Some set, St. Croix County, Wisconsin.
I LI A OLD sr2. SuL,T6 ►oa
SN 0�.5
!' 032- 2044 -10 -000
032- 2044 -40 -000
i �
Parcel Identification Number (PIN)
This is not homestead property. "
(is) (is not)
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' I Exceptions to warranties easements, restrictions, rights -of -way and covenants ! I.
of record.
Dated this day of June 2 0 0 2
(SEAL) �� (SEAL)
* Richard 0. Stout * Janet P. Stout
i'
(SEAL) (SEAL)
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) P t /`" v
State of Wisconsin,
�^ day of St. Croix County.
authenticated this 7N i " v �D ?/ Personally came before me this day of
jj June 2002 the above named
Ric hard O . and IanPt P
T �'Y't
St'nut
TITLE: MEMBER STATE BAR OF WISCONSIN LO
Of not, me known to be the person S who executed the foregoing
authorized by §706.06, Wis. Stats.) instrument and acknowledge the same.
THIS INSTRUMENT WAS DRAFTED BY —
Janet P. Stout
1353 Awatukee Tr.
Hudson, WI 54016 Notary Public, State of Wisconsin
My commission is permanent. (If not, state expiration date:
(Signatures may be authenticated or acknowledged. Both are not )
necessary.)
* Names of persons signing In any capacity must be typed or printed below their signature.
STATE BAR OF WISCONSIN Wisconsin Legal Blank Co.. Inc.
WARRANTY DEED FORM No. 2 - 1998 Milwaukee, Wis.
T i!fo"�!�
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W Department of Commerce SOIL EVALUATION REPORT Page of 3
t�v(sion of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code
County Ct
Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 1p
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 0 3Z — v�7
Please print all intformat fon. R by Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ? I�
Property Owner Property Location
�ls� Govt Lot N f= 1 /4,(J 1/4 S jZ T N R E (010
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
1 3 5 e Trc;t I 7The Wa k innd-s
City State zip code Phone Number ❑ city ❑ Village Qj Town Nearest Road
C4 New Constr Use: E4 Residential / Number of bedrooms Code derived design flow rate L 4 _ o GPD
❑ Replacement Public or commercial - Describe: -
:
Parent material dV 1.5{'1 Flood Plain elevation if applicable
General comments l O 1�
and recommendations: 5 �S� M eleV• OP
lower 0 01. %6 � 1 �, ►, � � ?tl�
❑`: ; tax ",• -
# [ :] Boring
❑ 1p+ Pit Ground surface elev. Z • I ft. Depth to limiting factor t in. ;:
t f t Soil &g06atiort Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roo PDM
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
0-1 c lv 5
Sid Z IZ- Zm
+ 4 ' a � r L .
4 1t
5 s r3e 1-- p c�2 e
, - 7 Sft
❑
# Ong
❑ Borng n' I �
Z ®pit Ground surface elev. ft. Depth to limiting factor 1 � in.
Sol Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Efff#2
l
. 6-1 3 Z sil 2mab G5 i v • 5 .8
2 - 5i c �5
7 ! Sic 65
4 4$-1 IN r2ka O — 1 - 7 • 2
' Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg1L • Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L
CST Name (Please Print) Signatu CST Number
Z
Address Date Evaluation Conducted Telephone Number
Q l �'' 540 - o -C' 241 qw 8
Property Owner Parcel ID # Page Z of
Ong # ❑ Boring a �
Ground surface elev. Q(Q OCR ft Depth to limiting factor r � in. [
Pit Sal Application Rate
Horizon I Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2
7 I Ib Sid S
y log ib m b
F � # ❑ Bones
❑ Pit Ground surface elev. ft Depth to limiting factor in. - §WAPPrcauon Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary _ Roots GPM
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 •Eff#2
�9 # ❑ Boring
❑ Pit Ground surface elev. ft Depth to limiting factor in.
F
Sod Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff?
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 5 150 mg/L • Effluent #2 = BOD < 30 mg/L and TSS <_ 30 mg/L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608 -266 -3151 or TTY 608 -264 -8777.
SBD -8330 (807/00)
PAGE 3 OF 3
NAME s c LOT# 3 LEGAL DESCRIPTION.( E YN E t4 ,S I Z T-30 ,N,R, 15 E or�
SCALE: 1"= �U -
BM 1 ELEVATION /00.
BM 1 DESCRIPTION I-po f -4
BM 2 ELEVATION 99, 3 0
BM 2 DESCRIPTION g6_T $
.� jl� �L ,� [
SYSTEM ELEVATION (j $ 8' 4aw cr R ?. , g 6
ALTERNATE ELEVATION ?..f0 L«, cr q�. D
CONTOUR ELEVATION 92, ao, qy. a�, �G • 0 0
I
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tG.
g'"� 3 "� Z � H• o 0
�Z.
b y
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ffi GNATURE �� %� DATE