HomeMy WebLinkAbout038-1082-90-000
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Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: 579094
~
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
Permit Holder's Name: City Village Township Parcel Tax No:
Keith Linneman TOWN OF STAR PRAIRIE_ 1 038-1082-90-000
CST BM Elev: / Insp. BM Elev: BM Description: Section/Town/Range/Map No:
6d l"fj oD
r"4 '4S GSA 20.31.18.3458
;W I
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic /~L,, p
7G rv/ DZ / -5-p Benchmark Z ~ ~ ~~2• ~ (Qa, do
Dosing Alt. BM
Aeration Bldg. Sewer g:47 /
I! 7v
3r
Holding SVHt Inlet 11.15,-
fv. fS'
TANK SETBACK INFORMATION SVHt Outlet ff•5-z
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet ~XZ
Septic 1~ Dt Bottom
Dosing Header/Man.
~ 88 90
Aeration
41 Dist. Pipe
Holding Bot. System
3 V.
O
PUMP/SIPHON INFORMATION Final Grade 20 0 A 9
Ma cturer De nd St Cover 3.5 , 60
Model Numb
TDH Lift ti oss System Head TDH Ft
Forcem ' ength Dia. o Well F J
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS 7 1
SETBACK SYSTI M TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: r
INFORMATION CHAMBER OR
Type Of System: WA I e Z i I UNIT Model Number: ylG v m
DISTRIBUTION SYSTEM t+
Header/Mandold Dis ribution x Hole Size x Hole Spacing Vent to Air Intake
~ I Pipe(s)
Length Dia Length Dia Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Mulched
Depth Over Depth Over xx Depth of 7~0® dded T
Bed/Trench Center -t- 7 Bed/Trench Edges /,q Topsoil Yes ❑No ® Yes ❑ No
y
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: A9 Inspection #2:
Location: 935 210TH AVE (,.Tx
1.) Alt BM Description = I dWC((?)
2.) Bldg sewer length =f/~ ~!'/Q,~d dyt eaG~ r,/ ~Z 4~.Aa I~'`~~ ~~Y✓ "
- amount of cover =
Plan revision Required? Yes No
Use other side for additional informatio . ~G I 4~ ~ /Z
Date Insepctor's Signature Cert. No.
SBD-6710 (R.3/97)
RECEIVED
County 1 , /
Vt'11F71j~.7ti r e f? F i, SEP
U 1 Industry Services Division - A
l 1400 E Washington Sanitary permit lumber (to be filled in by CO.)
ST. CROIX COUNTY P.O. Box 7162
mow
.;,-OMMUN ,?`Y D2V~ ` ' _0"` Madison, WI 53707-7962 T
0A --71,
~071
State Transaction Number
Sanitary Permit Application ~
in accordance tivitlt SPS 38331(2)- «'is COQ- submission of this form to the appropriate governmental unit
is required prior to obtaining a sanitan permit Note: Application faros for stalk owtxed POWTS are subumiued to Prn t Adxlres-(if & fit than mailing address)
rite Department of Safety and Professional services. Personal information you pro-tide inky be used for secondary
purposes in accordance with the Privacy Lacy. S. 15.04(1)(m). Slats. i ,
L Application Information -Please Prin , information Pam l
Property t;tcvne Nance
a a. 34 S ~8
Property Owner's Mailing .Address
Govt. Lot
Zip Code Phone i tunber Sectio`, a one
City, T, R E °
of Buil ding (check all ghat apply) Lot Subdivision Nam
Family D«elline - Number of Bedros
Block
Commerciat -Describe t~sz] City of
❑ State thvned - Describe Use ❑ CS?vI irltage of
'tmmmmbir
Tor<•mm or
~l w I
III Ty e of Permit: (Check only rte box on line A. Comp le#e line B if applicable) A. ❑ Nevv System El Replacement S}strap Q Treatment/Holding Taub Replacement Only ❑
Other Modification to Existing System (explain)
❑ Permit Renetival [:1 Permit Rei ision Q Cltaage of ❑ Permit Transfer to New List Previous Permit Number and Date Issued
-
B.
Before Expiration Plumber Owner L
IV. Typ! of POWTS SyStem/Component/Device: (Check ail that app Uy
Non-Pressun C.i Pressurized In-Ground ❑ At-Grade Q Mound 24 in. of suitable soil ❑ 1=louod < 24 in. of suitable soi1&-,7
Holding Tank: ❑ Other Dispersal Component (explain) Q Pretreatment Device (e&plain)
V. Dis ersaUTru atmeut Area Information:
Design.nou• (gpd) Design Soil :Application Dispersal Area Required (st) Dispersal Area Propos sf) F-E s
*1 , 11111' Rate(gpdsfl y
i
VL Taal: Info Capacity in
Gallons Tote[ = of ylarmfacture:r
Gallons tJrtiis i
~cr Tanks Existing Tanks fIr S v ciJ x n r . a7
Septic or Holding Tank: • ❑ ❑ Q ❑
Dosing Chamber ❑ ❑ ❑ ❑ ❑
m x r , er.trament- I, the undersigtred, assume o€the POWTS shawn an fthe attachplans.
. I€espo S Plumbers Si MPI ORS Nvan ter Business Phone Number
Pkumb~ r amt min / y
r
Plumber's ;address (SlmA, City. State, Zip Code)
pfu)
1 i tar►k, e(th*nt filter j M1,
"disttersal cett'rnusf au be services f'r wr, 66A&
as per manegernent plan provided byplUmbrl.
2 All sgftm rfeg taer~aant ,trntst t d
st t~ tFc Coczu2 r~3t on ,,atcsr not miss Fttn a ti t2 s It tar3ies to size
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CONVENTIONAL COMPONENT DESIGN
Residential application
INDEX AND TITLE PAGE
Project
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Name:
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Address:
::;O::ti?:~~J:iitiiii'-i i\k:: ZJ.':::i::'i+_:S:i::~;:•:i.,.....,..........
::J-.._,'•::: ii'i~:::::•nv'•:?:-t:.+"::::: iv'...... ~ i{:: i:::: !i:-i ~::?::.v?: ;i: iir nl...:::::
<3z~`z>'.;';~:~'~<::.~°s.'.~~•.'.'~'~-~I~>'_' `.?;.ii.,~.~i:•ii:-i::.i•~i.;:<;~,::--ii;::•;:i;~
:;:i~i.,i•:..ii~;?:;_l.rr:•^:'ia.:e-ii:::'<:5:~~:~ai3`-~:y::`;~; :`•::':'.:o-::. .oix-.>.;,?
Legal Description:
Subdivision: Lot #
Town: County:
Parcel ID# - -
Designer/Plumber: License
Signature: Date:
Comments
neeianorl nrirciiani•tn i-ho In_rrniinrl [nil Ahcnrntinn (-mmnnnant Manual fnr Pn1NTS Versinn 7.n
17-1
T,
C
J a
9~Jdtxlt dCX
Soil Absorption System Cross Section
9.1.6 ft
4° Schedule 40 Final Grade
PVC Vent Pipe
With Vent Cap ft
Leaching
Chamber R78 #t
_ System Elevation
-3 r It ft
Soil Absorption System Plan View
ft
ft
~ft Leaching Trench 1
Chambers
4° Dia.
Trench 2 Header
Vent Or Observation Pipe
of ,F~d S
III IN 11111111111111111111111111111111111111111111111111111111 Im I offo-
Trench 3
Leachina Chamber Specifications
Manufacturer And Model
EtSA Ra#inq~_ sq ft per chamber Soil Application Rate , gpolsq ft
gpd Design Flow , 2_ Soil Application Rate .7 EISA = Chambers
3 rows of ^ chambers each.
Page of
INSTALLATION C s -
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L-525 TES
INSTALLATION INS' UCTtONS
wM operft
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Step _ Step 2: sup 3:
(A) Locate the outlet of the septic tank. (A) Bet'ore fr1Staltafion. ptarS fine (A) Glue the OW housing on the
(B) Remove tank cover and pump tank Lifter housing on to fhe outlet pipe. outlet pipe.
if necessary. (B) Make sure that the housing (B) Insert the filW cartridge in the
is positioned so thefit w can be housing, imafdng sure the offer
removed from the tank for cartridge is prgartit aligned and
maintenance and service- completely inserted in the housing
MAINTENANCE INSTRUC-hONS
MIN,
t c
wTz t ~-1; Tcs~ ^F-"'t'tr_. c+ '7.s}"~y R':
'<<:s. '~`=cam' _h !•y -~t.",_,. ;a '.':.r`v~..zt'G, i,o~°ha-- > u ~ ~ .F~ ~s1~fSYF~~N'~fr+'~^r' a*'^'3it'o
{t4~A
Step 1: Step 2 Step 3:
Locate the outlet of the sepfic tank. (A) Remove tank cover and pump (A) matt fw Wder carMge back
eu if necessary. WD the the lousing making sure
M ; (B) Pull the Mier out of the housing. the EMT is prrerly alloed
_ RM and campte#ely inserted
r -
Hose ofrthe fits orter'#e sepric Lark
- R~ tank mw
E7SE iiJS~ . _o-' A Make sure all solids fall back into tfie (B) w septic
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page _"-Cof
FILE INFORM TION SYSTEM SPECIFICATIONS
Owner _ Septic Tank Capacity gal ❑ NA
Permit # Septic Tank Manufacturer ❑ NA
DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA
Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA
Number of Public Facility Units ❑ NA Pump Tank Capacity gal 13 NA
Estimated flow (average) al/day Pump Tank Manufacturer Z NA
Design flow (peak), (Estimated x 1.5) al/day Pump Manufacturer NA
Soil Application Rate , 7 gal/day/ftz Pump Model i IVA
Standard lnfluent/Effluent Quality Monthly average* Pretreatment Unit FA NA
Fats, Oil & Grease (FOG) :_30 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter
Biochemical Oxygen Demand (BODE) :5220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland
Total Suspended Solids (TSS) :_150 mg/L ❑ Disinfection ❑ Other:
Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA
Biochemical Oxygen Demand (BODE) _:30 mg/L )4 In-Ground (gravity) ❑ In-Ground (pressurized)
Total Suspended Solids (TSS) 530 mg/L NA ❑ At-Grade ❑ Mound
Fecal Coliform (geometric mean) :5104 cfu/100m1 ❑ Drip-Line ❑ Other:
Maximum Effluent Particle Size Y, in dia. ❑ NA Other: ❑ NA
Other: ❑ NA Other: ❑ NA
*Values typical for domestic wastewater and septic tank effluent. Other: - ❑ NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
Inspect condition of tank(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA
ear(s)
Pump out contents of tank(s) When combined sludge and scum equals one-third (Y3) of tank volume ❑ NA
Inspect dispersal cell(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA
J9 year(s)
Clean effluent filter At least once every: ❑ month(s) ❑ NA
0 year(s)
Inspect pump, pump controls & alarm At least once every: ❑ month(s) Z NA
❑ year(s)
Flush laterals and pressure test At least once every: ❑ month(s) 19 NA
❑ year(s)
Other: At least once every: ❑ month(s) ❑ NA
❑ year(s)
Other:
❑ 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 (Y3) 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.
All 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.
GMW (4/01)
Page of
START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) 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 tank(s) 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 cell(s) in one large dose, overloading the cell(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
within 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 tie 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 shall 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.
• 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
If 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.
❑ 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.
J$1 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.
❑ 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 AND/OR 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.
ADDITIONAL COMMENTS
POWTS INSTALLE POWTS MAINTAINER
Name Name
Phone l Phone
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name Name
Phone Phone
This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code.
ST. CROIX COUNTY
SEPTIC TANK MALNTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer 7;41,_Z1L44741
Mailing Address
Property Address
(Verification re from Planning & Zoning Department for new construction.)
City/State.tt Parcel Identification Number
LEG 4L DESCRIPTION
Property Location 14/Z_ 1/4, Jh4L_ 1/4 , Sec. , T-ZL_N R /8 W, Town of
Subdivision Plat: , Lot #
Certified Survey Map # , Volume Page T
Warranty Deed # (before 2007)Volume , page #
Spec house 0 yes ono Lot lines identifiable/(yes o no
SYSTEM ALAJINTENANCE 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 three 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 §SPS. 383.2(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.
Itwe, 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 Safety And Professional Services 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 Planning & Zoning Department within 30 days of the three year expiration date.
I/we certify that all statements on this form are true to the best of my/our knowledge. 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 of bedrooms
SIGNATURE OF APPLICANT(S) DATE
***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department.
Include 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. 04/12)
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RECEIVED D
SEP 1 io
7
Wis. Dept. of Safety a AT-ArQQWN11,(s SOIL EVALUATION REPORT Page of
Division of SafeB+CAb"NIT* DEVELOPMENT
in accordance with SPS 385, 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. Q3 " l6Q
p Z, 9Q - cm
Please print all information. Revi ed by Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). i/zz,//
Property ner Property Location
Govt. Lot 1/4 1/4 S T N R E (or
Property Owner's Mailing Address Lot # loc Subd. Name CSM#
City State Zip Code Phone Number ❑ City ❑ Village ®Town Nearest Road
( ) _S ~ ~
❑ New Construction Use: j$( Residential/ Number of bedrooms Code derived design flow rate GPD
Replacement / ❑ Public or commercial - Describe:
Parent materialFlood Plain elevation if applicable ft.
General comments 5. ~ - 878
and recommendations: / "
044XI.- M. Qom! 6d r
❑ Boring
F Boring #
Pit Ground surface elev. 95--l ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ff#1 * ff#2
7
q
q 9
hl~
® Boring # ❑ Boring
® pit Ground surface elev., ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. * ff#1 * ff#2
-7 1-2 A Zj~
a 4
1A - ;,Z I
a 3
S - 4
I
* EfFlue 1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L * E nt #2 = BOD < 30 mg/L and TSS < 30 mg/L
CST Name se Pri ' Signature CST Number
Address ✓ ate Evaluation Conducted Telephone Number
/
SBD-8330 (R11/11)
Property Owner Parcel ID # l1 3S? f~~~9 /S~~ Page _C; -,of
FBoring # ❑ Boring
3 ® pit Ground surface elev. ft. Depth to limiting factor in.
Soil A lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ff#1 . ff#2
~J
q 9
- S
a
1
row-
❑ Boring # ❑ Boring
❑ pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth` Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ff#1 ff#2
❑ Boring
❑ Boring #
Pit Ground surface elev. ft. ..Depth to limiting factor in.
❑
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ff#1 02
* Effluent #1 = BOD 5 > 30 < 220 mg/L and TSS >30 < 150 mg/L Effluent #2 = BOD 5 < 30 mg/L and TSS < 30 mg/L
The Dept. of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to
access services or need material in an alternate format, contact the department at 608-266-3151 or TTY through Relay.
SBD-5330 (RI 1/11)
Property Owner Parcel ID # Page of
[37' Boring # ❑ Boring
® pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2
in. Munsell Qu. Sz. Cqnt. Color Gr. Sz. Sh. * ff#1 V#2
R 4
s l ,
l
❑ Boring
❑ Boring #
❑ pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. * ff#1 * --f f#2
❑ Boring
F1 Boring # Ground surface elev. ft. Depth to limiting factor in.
❑ Pit Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. * ff#1 ff#2
II
s _ 30 mg/L and TSS < _ 30 mg/L
* Effluent #1 BOD s > 30 < 220 mg/L and TSS >30 < _ 150 mg/L * Effluent #2 - - BOD <
The Dept. of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to
access services or need material in an alternate format, contact the department at 608-266-3151 or TTY through Relay.
SBD-8330 (R11/11)
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