HomeMy WebLinkAbout032-2055-10-000 -
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
538702 0
GENERAL INFORMATION (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:
Rivard, Anthony Somerset, Town of 032 - 2055 -10 -000
CST BM Elev: Insp. BM Elev: BM Description: SectioNTown /Range/Map No:
/oa 5/Vl 1 GS 7 16.30.19.708A
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER ,� f CAPACITY STATION BS HI FS ELEV.
Septic ' 1 z} Benchmark
W F�l 2. (Cs /t7Z.(c L>�J
Pa I a 5Z 5 wig
Alt. BM I , 661 , d g
'' �•t
Aeration Bldg. Sewer
Holding St/Ht Inlet
TANK SETBACK INFORMATION St/Ht Outlet `I .q t 7 2 7 . 7
TANK TO P/I WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic 5 56 9to � Dt Bottom �\
Dosing Header /Man. q
(0 / /IO(o
Aeration Dist. Pipe
Holding Bot. System /2-(09
Final Grade_ � /� (C 3 3�
PUMP /SIPHON INFORMATION �y! d(_Q,, ,
Manufacturer Demand St Cover
GPM
Model Number
TDH Lift Friction Loss System H H Ft
Forcemain Length Dia. Dist. to Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length o. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS 3 $ Eti� 3
SETBACK SYSTEM TO P/L BLDG IWELL LAKE /STREAM LEACHING Manufacturer: /^ /
INFORMATION CHAMBER OR
Type Of Syste
� 74� C I /D � ( UNIT Model Number: /
O^ue O J �
DISTRIBUTION SYSTEM 31-/3 = .3
Header /Manipid Distribution x Hole Size x Hole Spacing Vent to r Intake
$ Pipe(s) �\ C.. es✓ 4,
Length Dia Length Dia_ Spacin
SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only ��^^
Depth Over / Depth Over xx Depth of xx Seeded /Sodded xx Mulched
Bed/Trench Center Bed/Trench Edges \ Topsoil
S. 3 2 Yes a,, No Yes Ej No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / /
Location: 571 160th Avenue p S� RSET, WI 54025 (NW 1/4 NE 1/4 16 T30N R19W) NA Lot Parcel No: 16.30.19.708A
1.) Alt BM Description �Z L,-, sae-
2.) Bldg sewer length =
- amount of cover =
Plan revision Required? ❑ Yes No =
C
Use other side for additional information.
SBD -6710 (R.3/97) Date Insepc is Signat a Cart. No.
commerce.wi.gov Safety and Buildings Division County
201 W. Washi on Ave., P.O. Box 7162 U
i sco ns i n S ol!47017 D Sanitary Permit Number (to be filled in by Co.)
Department of Commerce 5, Q
Sanitary Permit Application State Trans Number
In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental A�
unit is required prior to obtaining a sanitary permit. Note: Appl' ' s for state -owned WTI are Project Address (if different than mail' dress)
submitted to the Department of Commerce. Personal informatio you dary ��� / /_ IJ ur oses in accordance with the Priva Law, s. 15.04 1 m , Stats. iIT
/ 6 9
1. Application Information -Please Pri 1 Information
Property wner's Name / Parcel #
OCT 0 1 2010
Property Owner's ailing Address ST. CROIX COUNTY Property Location Q
7 / _ PLANNING &ZONING OFFICE Govt. Lot �� O
City, State Z Phone Number 1 ,
(L /,, & /., Section 1
circle one)-
T N; R E o t_.
11. 'Type of Building (check all that appLot #
1 or 2 Family Dwelling - Number of Bedr Subdivision Name
Block #
❑ Public /Commercial -Describe Use ❑ City of
❑State Owned - Describe SM Number El Village of
��ribe Use `�.
Cx� �✓ f..� r S g Town of
III. Type of Permit: (Check only Ae box on line A. Complete line B if applicable)
A ❑ Ne-System
Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain)
B El PermitRenewal El Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued
Before Expiration Owner ::Q"
IV. Type of POWTS System/Component/Device: Check all that a 1 t kr 44 14
Non - Pressurized In- Ground ❑ Pressurized In- Ground ❑ At -Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soilr
❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) ((...•w G�
V. Dis ersal/TreatmentArea Information:
Design Flow (gpd) Design Soil Application Rate pdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sfJ System Elevation
�- . a_3
510 V . Tank Info Capacity in Total # of Manufacturer
Gallons Gallons Units D o g
New Tanks Existing Tanks y y tz
fY U to in rn
Septic or Holding Tank
Dosing Chamber
VII. Respogsibility Statement- I, the undersigned, assume respons' for installation the PO shown on the attached plans.
Plumbe s ame rint) Plumber's MP/MPRS Number Business Phone Number
/ -
Plu er's Address (Street, City, Sta ,Zip Code) qq
VIII. nun /De artme it Use Onl
Approved Ved Permit Fee Date Iss d Issuing nt Signature
❑Owner en Reason o•
�a y �d
IX. Conditisgasons for Disapproval 3,
v�tw C�. O Gtd
1. Septic tank, effluent filter and
dispersal cell must all be services / maintained
as per management plan provided by plumber. M
2: AN setback requirements must be maintained s�. / r t &tr a G
as pa Attach to comp ete p ffl or t e system and submi to the County only on paper fft less than 1/2 11 inches in size,
SBD -6398 (R. 02/09) Valid thru 02/11
/ice
3X 75'
I
Hott3E
I
0
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1, J 9
CONVENTIONAL COMPONENT DESIGN
Residential Application
INDEX AND TITLE PAGE
Project Name: D
Owner's Name:
Owner's Address:
Legal Description: ,�/hJ /</_ /�/� / �,�,, // _ T D.✓ - /9a�
Township:
County:
Subdivision Name:
Lot Number:
Parcel ID Number: Q3-2
Page 1 Index and title
Page 2 Plot Plan
Page 3 System Sizing
Page 4 System Cross - Section
Page 5 Filter Specs
Page 6 Maintenance & Management Plan
Page 7 Septic Tank Maintenance Form
Page 8 Warranty Deed
Page 9 CSM or Plat
1 7
Designer /Plumber: ✓ - zz License Number:
Date: le Phone Number 77
Signature
Designed pursuant to the In- Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD- 10705 -P (N.01/01).
Page 1
3X73
moo
Get
i
�� f4
A4-�
7159)� 7 fit? �,4°•�s�f
L
Soil Absorption System Cross Section
4° Schedule 40
Final Grade
PVC Vent Pipe p
With Vent Cap 9
� ft
Leaching
Chamber _ ft
�- System Elevation
3 ft ft
Soil Absorption System Plan View
ft
Vent Trench 9
Vent Or Observation Pipe � Chambers
4° Dia.
Trench 2 Header
Leachio Chamber Specifications
Manufacturer And Model
EISA Rating sq ft per chamber Soil Application Rate gpd /sq ft
gpd Design Flow = Soil Application Rate ~- ,::;&_ EISA = .375 Chambers
2 rows of --1- _ chambers each.
Page of
PAL Y
to
X nc INSTALLATION INSTRUCTIONS
innovations in Precast, Drainage z PL-525/PL-625 F 1 LT E R
& Wastewater Producfs A Division of Polylok Inc.
I
INSTALLATION INSTRUCTIONS
! i Center filter
with opening I
I -
�
WF '3
J
LL = 9
Atltltfionat pipe or
PolYlok Extend & LokTM Glue
forcenfenng '
Step 1: Step 2: Step 3:
(A) Locate the outlet of the septic tank. (A) Before installation, place the (A) Glue the filter housing on the
(B) Remove tank cover and pump tank filter housing on to the outlet pipe. outlet pipe.
if necessary. (B) Make sure that the housing (B) Insert the filter cartridge in the
is ositioned so the filter an
p c be housing, making sure the filter
removed from the tank for cartridge is properly aligned and
g p p
Y 9
maintenance and service. completely inserted in the housing.
MAINTENANCE INSTRUCTIONS
6 3.
r �r -
- r
Step 1: Step 2: Step 3:
Locate the outlet of the septic tank. (A) Remove tank cover and pump (A) Insert the filter cartridge back
DO NOT USE
if necessary. into the the housing making sure
B the filter is properly ali
hed
I Pull the filter out of the housing. WHEN FILTER IS � () sng. P p Y g
C Hose off the filter over the septic tank. and completely inserted.
USE RUBBER GLOVES Make sure all solids fall back into the (B) Replace septic tank cover
WHEN. CLEANING EIi�TER
se ptic tan
`, p k.
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner
Septic Tank Capacity ga t ❑ NA
�eTnit
Septic Tank Manufacturer ❑ NA
DESIGN PARAMETERS Effluent Filter Manufacturer Ag ❑ NA
Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA
number of Public Facii Units g 19 NA
Facility � NA Pump Tank Capacity al
Estimated flow (average) gal /day Pump Tank Manufacturer IN NA
Design flow (peak), (Estimated x 1.5) gal /day Pump Manufacturer ® NA
r Soil Application Rate gal /day /ft2 Pump Model 21 NA
Standard Influent /Effluent Quality Monthly average Pretreatment Unit A NA
'! Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter
Biochemical Oxygen Demand (BOD 5220 mg /L ❑. NA ❑ Mechanical Aeration ❑ Wetland
Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other:
Pretreated Effluent Quality Monthly average Dispersal Cell(s) i=7 NA
Biochemical Oxygen Demand (BOD 530 mg /L 0 in- Ground (gravity) ❑ In- Ground (pressurized)
Total Suspended Solids (TSS) 530 mg /L is NA ❑ At -Grade ❑ Mound
Fecal Coliform (geometric mean) <10 cfu /100m1 ❑ Drip -Line ❑ Other:
Maximum Effluent Particle Size %$ in dia. ❑ NA Other: ❑ NA
Other: ❑ NA Other:
❑ NA
* Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA
! AVIAINTENANCE SCHEDULE
Service Event Service Frequency
hspect condition of tank(s) At least once every: ❑ month(s) (Ma)imum 3 years) ❑ NA
y ear(s)
°u; :n out contents of tank(s) When combined sludge and scum equals one -third (% of tank volume ❑ NA
.•aspect dispersal cell(s) At least once every: dye m (s) (Maximum 3 years) ❑ NA
❑ month(s)
Glean effluent filter At Least once every: ❑ NA
i 0 years)
! inso =c, oumo, pump controls & alarm At least once every: ❑ month(s) l� NA
❑ year(s)
p st i =-ais and pressure test At least once eve ❑ month(s)
ye ar(s) 0 NA
p n`' ❑ year(s1
At feast once every: ❑ month(s) ❑ year(s) ❑ NA
I P ❑ NA
MAINTENANCE INSTRUCTIONS
inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications:
Master Plumber; Master Plumber Restricted Sewer; POWTS inspector; POWTS Maintainer; Septage Servicing Operator- Tank
inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks,
measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface.
The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding
of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the
immediate notification of the local regulatory authority_
When the combined .accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire
contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113,
Wisconsin Administrative Code.
Alf other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment
units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority within 10 days of completion of any service event.
Page OT
S T ART'UP AND OPERATION
`or new construction, prior to use of the POWTS check treatment tanks) for the presence of painting products or other chemicals
that may impede the treatment process and /or damage the dispersal cell(s). if, high concentrations are detected have the contents
of the tanks) removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be
discharged to the dispersal ce)1(s) in one large dose, overloading the celf(s) and may result in the backup or surface discharge of
effluent- To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring
power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to
restore normal levels within the pump tank.
Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area
-ithin 15 feet down slope of any mound or at -grade soil absorption area.
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the
POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat;
foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil;
painting products; pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is
Properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:
® All piping to tanks and pits shalt be disconnected and the abandoned pipe openings sealed.
® The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator-
0 After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with
soil, gravel or another inert solid material
CONTINGENCY PLAN
il the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant
replacement system:
A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption
system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by
required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will
result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must
comply with the rules in effect at that time.
Q A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS
technology a holding tank may be installed as a last resort to replace the failed POWTS.
0 The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site
evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank
may be installed as a last resort to replace the failed POWTS.
CI Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the
infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time.
< < WARNING > >
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES ANDIOR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
!kDDiTiONAL COMMENTS
POWTS INSTALV POWTS MAINTAINER
Name Name
Phone Phone
SEPTAGE SERVI OPERA T OR (PUMPER) LOCAL REGULATORY AUTHORITY
Name Name
Phone Phone _
- his document v,-as date:: - = -c :ante with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code.
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM 1
OwileI/ B It yer
Mailin8 Address
Property Address
(Verification required from 1'lanuillg & Zottiug Department for new construction.)
City /State Parcel ldentification Number
_� -
LEGAL DESCRIPTION
Property Location ;a , , �/ ! 4 , ,Se , Z Z a -; T _,aL,_N R 2 W, Town of
Subdivision - Lot #
Certified Survey Map # Volume , Page # _
Warrtttkty Uctcf # Volume Page It —...
Spec house yes Lot lines identifiable
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
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 tlu•ev years or sooner, if needed, by a licensed pumper. What you put into
the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance
responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance.
The property owner agrees to submit to St. Croix County Planning & 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
wastewater disposal 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 Plwuiutg &
Zoning Department within 30 clays of the three year expiration date,
1 /eve certify that all statements on this Iurtn arc true to the• best of'my /uurknowledge. I /we am/are the owner(s) of the
property described above, by virtue of a warranty deed recorded in Register of Deeds Office.
Number o • bedrooms
SI A URE OF APPLICANTS)
DATE
***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. � **
nclude with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if
reference is made in the warranty deed.
REV, 08 /05)
U_ 1856P 480
STATE BAR OF WISCONSIN FORM I- 1999 6 7 3 9 5 3
Document Number WARRANTY DEED XATHLEEH H. UALSH
REGISTER OF DEEDS
ST. CROIX CO., W1
This Deed, made between Kenneth A. Erlitz, Shar F. Ri vard, RECEIVED FOR RECORD
Maxine M. Sca nlon, Yvo C. Carlso n and Gat A. Breault, each as fo
an undivided 1/5th interest l 03 -19 -2002 2:10 PH
Grantor, and Anthony 3. Rivard — WARRANTY DEED
EXEMPT # 17
REC FEE: 15.00
TRANS FEE:
— — COPY FEE -t
Grantee. CERT COPY FEE:
Grantor, for a valuable consideration, conveys to Grantee the PAGES: 3
following described real estate in St. Croix County,
State of Wisconsin (if more space is needed, please attach addendum):
E %, of NW '/, of NE V. and NE '/4 of NE '/. EXCEPT Lot I of Certified Recording Area
Survey Map in Vol. 12, Page 3463, All in Section 16- 30 -19. Name and Rettun Address
This deed is given in satisfaction of that original land contract dated August too ',' - yet
14, 1998 and filed September 28, 1998 in Volume 1360 of Records on page D BQQvettl.t milt, w'
306 as Document No. 587854.
032 - 1055 -10
Parcel Identification Number (PIN)
Together with all appurtenant rights, title and interests. This is no t _ homestead property.
Grantor warrants that the title to the Pro d, indefeasible in fee le and free clear
Pet•h' is of encumbrances except
g ood, simple
easements, restrictions and ordinances of record and will warrant and defend the same.
Dated this — 2tO t day of 2002
—.
_ " Kenneth A. Erlitz
" see additional signatures att
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) _ STATE OF WISCONSIN )
) ss.
POL County )
authenticated this _ _day of
Personally came before me this day of
2002 the above named
" Ke eth A. Erlitz
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not, to me known to be the person(s) who executed th; faFSSging
authorized by ¢ 706.06, W is. Slats.) instrument and acknowledged the same.
.4i e
THIS INSTRUMENT WAS DRAFTED BY " Pta Prisci lla R. Dorn Cutler N Public, State of Wisconsin Laux Cutl S.C. fission is perm an j (If not, s ` - , &piration
ate:
(Signatures may be authenticated or acknowledged. Both are not necessary.) G� IJ ��l tL- �( ,)
" Names of persons signing in any capacity must be typed or printed below their signature. UP Intom aUw P or"FSi Fong tiu Lao. VN
STATE BAR OF WISCONSIN •4100-655 -2021
WARRANTY DEED � ...
FORM No. 1 - 1999
II
Wisconsin Department of Commerce P A EVALUATION REPORT Page —I— of
Division of Safety and Buildings 6
in ae8fflVAR& Comm 85, Wis. Adm. Code
County
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must
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. _ J /
Please print all Information. Revi by Date
Personal information you provide maybe use br jecondery Purposes (Privacy Law, s. 15.04 (1) (m)).
P Owner E p r Location
i ot 1/4 1/4 S T N R E (or
Property OwneA Mailing Address OCT 0 1 2010 of # lock # subs. Name M# e
City State PWCUNTY ❑ City Village 0 Town Nearest Road
J NNIN & ZONING OFFICE _
❑ New Construction Use:J Residential / Number of bedrooms Code derived design flow rate .5 GPD
10 Replacement ❑ Public or commercial - Describe:
Parent material Flood Plain elevation if applicable ,N /� ft.
General comments
and recommendations: sy - ��,�7
F-/1 Boring # C ❑rCa� Boring
t al pit Ground surface elev. ft. Depth to limiting factor in.
Soil Applicatim 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
� e
i
a s
I `
!� Boring # ❑ Boring Z
0 Pit Ground surface elev. - Li°�� ft. Depth to limiting factor in.
Sal Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM
In. Munsell Qu. Sz. Cont. Color Gr. Sh. 'EfI#1 'Eff#2
a
3
4 4
/02 �
' #1 = BOPe 30 < 220 rt1gIL and TSd >30 < 150 mglL fflueM #2 = B D < 30 mg& and TSS < 30 mg/L
CST 7 Signature CST Number
G
Address Date Evaluation Conducted Telephone Number
`�� -
Property Owner i per/ �arcel ID # Page of
a Boring # ❑Boring ,
jo Pit Ground surface elev. ft. Depth to limiting factor �/ � in. Soil iaation Re e
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM
in. Munsell Qu. Sz. nt Color Gr. Sz. Sh. •Eff#1 'Eff#2
c
6
E 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
C] Boring
# Ground surface elev . Depth to limiting factor In.
❑ Pit . ft. sw Application Rate
Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/N
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. •Eif#1 `Eff#2
Effluent #1 = BOD > 30 1220 mg/L and TSS >30 1150 mg/L ' Effluent #2 = BODS <_ 30 nglL 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 (8.600)
Property Owner arcel ID # – 10 Page of
a Boring # ❑ Boring v
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
e
JI
Boring # ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
Sal 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 Ong # ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
Sal 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/- • Effluent #2 = BOD 130 mg/- 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.
SBD -8330 (R.6A0)
So
3111 cJKI l
33
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i
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