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HomeMy WebLinkAbout032-2157-60-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 584707 GENERAL INFORMATION 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 Township Parcel Tax No: Mark & DeAnn Ostenson TOWN OF SOMERSET 032-2157-60-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: Q 2 12.30.19.1358 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic * Benchmark cJ a. I WO /0,5 95 Alt. BM -1 a g 9 to 00, ,Go- je Aeration Bldg. Sewer 7,33 ~d3• Holding SUHt Inlet 7 /ate 5.45 TANK SETBACK INFORMATION SUHt Outlet 5.75 C?9- 7 TANK TO P/L , WELL BLDG. ent t it Intake ROAD Dt Inlet ~ Dt Bottom Septic 6 Il :317 Dosing Header/Man. •Z Z 'j Aeration Dist. Pipe 11 2•S ~ • Holding Bot. System 1 Z ?3. 97 .34 PUMP/SIPHON INFORMAZLIC-UN Final Grade 41- Manufacturer Demand St Cover 1 Cj ~I/ D7 c? 1., L 1 D Z /OZ Model N tuber TDH Lift System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS W (i1ti I A SETBACK SYSTEM TO P/L BLDGW WELL LAKE/STREAM LEACHING Manufactur~~jj.. INFORMATION Ty System . uI CHAMBER OR ,Y1~t"~r ~ea ~QfA j - ~,O J I 19, A)A- UNIT `OMS J - 4 6,, DISTRIBUTION SYSTEM ~•~-1(p c~Z •~•Q, Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air ntake Pipe(s) 10-1 . IL LLength Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx M ed Bed/Trench Center Bed/Trench Edges Topsoil Yes ~ No es L] No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: /I Inspection #2: Location: 893 170TH AVE Of LM . ~ { Oe, 6 1.) Alt BM Description = 1 2.) Bldg sewer length = '16 ~I se WeJ~^' -amount of cover = ' Plan revision Required? ❑ Yes No r b Use other side for additional information. v Date IS ature Cert. No. SBD-6710 (R.3/97) 4, County Safety and Building ' isio 's a S 201 W. Washington Av P.O. 16, Sanitary Permit Number (to be filled in by Co ) P Madison, WI 537 162 s cR0 COUVO ~pptvlEN~ jc? GOMM Sanitary Permit Application late Transact WITIber In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for second 3 I 7 e- ` y A Cc- purposes in accordance with the Privacy Law, s. 15.04(l )(m), Slats. 1. Application Information - Please Print All Informations 111,10 AJ L kv l Property Owner's Name Parcel # Property Owner's Mailing Address Property Location a r. r.. Govt. Lot City, State Zip C,7,/ ode Phone Number v v y, f„' t= y,, Section / -7ON, e A -r (circle one) T C N; R L `j E ordi> II. Type of Building (check all that apply) Lot # I or 2 Family Dwelling -Number of Bedrooms LL Subdivision Name ± / Block 111 I~ L 1{-4 /r/ /-IL,4F/t)5 ❑ Public/Commercial - Describe Use ❑ City of ❑ State Owned - Describe Use /CSM Number ❑ village of Town of ~'te=' L_'iE 1 111. Type of Permit: (Check only ne box on line A. Complete line B if applicable) A k] New System ❑ Replacement System El Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ permit Revision List Previous Permit Number and Date Issued ❑ Change of Plumber ❑ Permit Transfer to New Before Expiration Owner - 11, 6Q,. - IV. Type of POWTS System/Component/Device: Check all that apply) _ 9 Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound ? M it). Of suitable soil ❑ Mound < 2 i f suitable sop ~ Holding Tank ❑ Other Dispersal Component (explain) _ ❑ Pretreatment Device (explain) G~loeTs V. Dispersal/Treat nt Area Information: Design Flow (gpd) Design Soil Application Ra (gpdsf) Dispersal Area Required ( Dispersal Area Prop ed (sf) System Elevation Ci q .3 _ E 1 VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units U New Tanks Existing Tanks Septic or Holding Tank Dosing Chamber VII. Responsibility Statement- 1, the undersigned, assume responsibility for installation ofthe POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signaturq I MP/MPRS Number Business Phone Number a 2 Plumber's Address (Street, City, State, Zip Code) ' VIII ount /Depart tm nt Use Only _ pproved approve Permit Fee Date l sued r _ Issuing ent Signatu en Reason for Denial W ' IX. Condit -easons for Disapproval 1. Septir, ark, elflucirlt filter ~lnd 3) I _ ate dispers;ai cell must all b be seitiic,s ! nrinta'cec 1h,(~, as per management plan provided by plumber. 2. All set" requirements must Oe°maint€inid ae per aW iccable code / : rdinanrm. T d Attach to complete plans for the system and submit to the County ly on pap not-less 1h1l2. 11 inches in size .w E 1eVA1-;CWX 926 (use, SBD-6398 (R. II/11) ~r (Cd C O(AA . P011111- cl~-b b l~ map HARDINA SEPTIC SYSTEMS - MFRS/CST 824825 --p 4CL iL f,, 6L CS (IN J ~T -r o - - - - •_Lt~- L r CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: 5 ii >vwS Owner's Name: ~i)EA A2 L) AL'S C A) Owner's Address: r1 , L (c, `f LL u) WT CL VVI Legal Description: ? Jet - Township: Jr>p,9 r C T County: Subdivision Name: W/111 A,11,)-) Lot Number:, Parcel ID Number: - L. -6-, U[>1.--~ Page 1 Index and title Page 2 Plot Plan Page 3 System Sizing & Cross-Section Page 4 Filter Specs Page 5 Maintenance Information Page 6 Management Plan Page 7 St. Croix Cty Septic Tank Maintenance Form Page 8 Warranty Deed Page 9 CSM or Plat Attachments: Soil Test & House Plans Designer/Plumber:E.r<T License Number. Date: Phone Number C/ - s L t Signature Designed pursuant to the In-Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P (N.01/01). Page 1 HARDINA SEPTIC SYSTEMS MPRS/ -C .T 824825 - oP .,5s~ f- 060-4;Al- 99-6-- 17 T A 1414 v, c,' 3 Z Ca?r.i1IL~~.~/'tuE $~j /!?IL_ i 1?r'~ ~L? I : - x _,l/ i 7.a TV ; i Y } Soil Absor tion System Cross Section ft Final Grade 4° Schedule 40 PVC Verrt Pipe ft With Vent Cap P~ Leaching Chamber 9 1, ,1 ♦ _ I ft System Elevation _ ft .3 ft II Soil Absormtlon System Plan View ft 1 1 ft Leaching Trench Vent Or Observation Pipe Chambers t Vr 4' Dia. Trench 2 Header Leaching Chamber Specifications Manufacturer And Mode( l AA71 tt C frZ o C 0 k EISA Rating© sq ft per chamber Soil Application Rate --j_ gpd/44 ft gpd Design Flow + _7 Soil Application Rate EISA Chambers 2 rows of t chambers each. q 5 I j Page of tiiter Installation and Maintenance Instructions Installation Step 1 Dry fit the filter case onto the outlet pipe going to the drain field. Ensure it is centered directly under the access opening. (if outlet pipe is already in a foxed position, additional pipe may need to be added) Step 2 If utilizing the additional single side support and the two bottom supports: While the case is still dry ft to the outlet pipe, measure and cut 2"schedule 40 pvc pipe to the length needed to extend from the hubs that are pre-molded into the case to the side wall and the inside floor of tank solvent weld pipe into the hubs that are pre-molded onto the case. Step 3 Solvent weld the case to the outlet pipe. Insert the filter cartridge into the case pressing down on the cartridge until it locks into place at the bottom of case. Step 4 if utilizing a vertical read switch: Insert switch into the hole pre-molded into the top of the fitter. Press straight down until it locks into place Maintenance 1) Remove the access lid of the tank. Note: To ensure undesirable solids do not exit the tank and into the drain field, the tank should be pumped out until the level of effluent is below the outlet level of the tank. 2) To-remove the filter cartridge from the filter case, pull up firmly on the handle of the cartridge dislodging it from the case. (if utilizing a vertical read switch, removal of switch is optional) 3) Using an ordinary garden hose, rinse the filter cartridge ensuring all visible septage material is removed. 4) Place the fitter cartridge back into the filter case pressing down on the cartridge until it locks into place. 5) Place the access lid back onto the tank ensuring it is secure. lifetime filter has a lifetime rumted warranty: lifetime filw !!C warrants the.fdter will be free of manufacturing and workmanship defects during normal use for the period of Lime the original purchaser owns the product lifetime fitter will provide a replacement filter in the event that the original filter was not damaged during the installation or maintenance process. Damage to this product caused by accident, misuse or abuse will not be covered under this warranty. Improper care or malfunctions resulting from product not being installed, operated or maintained property will void this warranty. Lifetime filter assumes_po responsibility for labor charges, removal charges, installation or other incidental or consequential costs. Contact mikeWfekimefilterliccom Phone: SM-7242231 PCZ11~J-TS OWNER'S PAANUAL `1 NlANAGENlEtj PLAN - gy;;TEA1 SPECIFIC.1TlOf•i5 r ~ i Septic Tank Lianui2cte rer - / - f_filu=M F-Iter tdianufactufar t { _ i rA r^LA r.:ET=qS -7 p t}.~ cftiUent Fitter ICJ-` ~f r•, S NA Pump Tent: Cepaci. / - _ - .10 tat:P 4i DISC - i iGa r;1, l- - 1'umic Model i'r~traz+fn~6nt Unii ,.t ;r,;,l:~~acn Fate _ C Clthi{ sVCrO~= t ,t.e; /=blue; t Cc,aC,r{ 0 prat i7 Sznd;Gravel NIUX -„1.-,1 I .flue 'i0 mgiL ;,1 ae r7l'Jetla. Grease (FOG) ~ p Paechanic ration i zcs, Q Other: EOC_) :!:-220 m31L (73 i.A t Gxy9=n L~_::~and ( ❑ ;isinf 'ction - - r , :c =z . i otsf ='asFenrled Solids F SS) 51 60 mgiL - LA 3verzu- In-Grcund ru-livl ?v'iOnt Y U ~faVtt'') 53 9 NA d Solids (TS5} S30 mgiW cful I Dorn, t,nean} va in dia. 0 NA !1 N-A nt Paricle ci le 0 NA /FloeI {c.r aorta_.. ;~~+ster and septic tank afilu°ni- ^if1TEi.AfiCESCIJEDULE Service Froqueney months} {raaxlmum -'yQgrs) SetV}Ce Event Qt least once ever"": 1~7 NA - 0 401Urt ,ar.r(s) -third (k} of Uln t ondition of ' - and scum equals one_ J_~--- ~N}t°n combined siudga rkis} p month(s) (N7ax:mum 3 V,2rs) ID Ot!L COn Fn[S e`, to -raar(sl-_ - - - At least once every: G t r.t Iasi ; r;~persa[ cell(s) D month{s} At least o.-,ce every: L i C:'•2-il ?if fj-J F,t filter ❑ rnonth(5) _ I At least cnca avert': -y_---- --i tdr. Dump. rump contras atzrm ❑ month(s) least : nce every: C3 vear(s) - loses At A,-d pressure test O month(s) At least once every: n year{s} 1 ing or+9 of the t,l}0\':ing fice>1585 Or uer:` Vj fr I~ ~i~i SB(Vfc:n~ Cp=rot r.1 .fit N r-l= INSTRUCTIONS losp_ctions of tanks and dispersal coils shalt a made by an eotor; individual carry POWTS Maintainer- Septage n any Craci S Or Ie3+ ;;;aster Plumber; Master Plumber inspgcti°n s(ud9Restricted of Se the wer; tank(s) Pos) w to ys idinspantrfy any missing or broken r round scleac" Ins actions must include a visual e and scum and to check for any back up or ponding of efflUeni to check for any P n;~ asure the volume of combined on the 9 ondinc i na dispers=f call(s) shall be visually insPected to check the effluent oavels in the observation P p85 and identify _ on the ground surface- The ponding of, effluent on the ground surface may indicate a failing condition and rcgvices nn o: 9fi{t,j!nz the en"" i ,.,n)=.diate notification of the local reyulacor~f authority. thz =ark ~'or:'m9' in more of the Se wh chapter NR 113 it ti^,~.en the combined accumulation of tubdge an drage R scum Servicing any tank tank equals one-third dispose(Yd 3) oof or ccncents of the tank shall be removed ! a en~~,r,en Code- urized components, p.~ va mechanical o press Ail oons:n rvi es, i c da, intervals of 51 ? mon s,shall be per }formed filters, a certified POWTS Mai taneS to the Srvicing of :,~r:~i::e report service event. u3:c jos, ahaynd serv any ices, servicing at uthority within 10 days of completion of Y GIVI 0101) r ,sgI;tsiOty shall be provided Yo t ,a ,ot:y , ,T.`.RT UP AND OPERATION Vic r to use of the FO\VTS check treatment .auk(s) for th9 prasencs of psintinfl proc'ucis cr bthcr clt^-::liCi)~S F.- r a constr:ci:en, concenirstions at-3 derect9d have !he car :•~r•i`: may impeda vtie treatatent process and/or danaga the dispersal Cell(s). It high ..f the taak(s) removed by a saptage servicing operator prior ;o use. st :rt up shall not occur when soil condirions are froasn at th9 infiltrative surfrce- s . --hen pow _r is recto:ad the atCess ::asia'::atar :-.i, '-e . a G ° :gag ;io-.ver cautages Pump talks may fill above normal hi3it~+a.er 19':els. re5~1IY In the baaUA CS scr'cC disc arg - ti dispe arsal c fl(s) in one large dose, overioadin:) the calf(s) Zcd ni x/ aan:=d to s._rx ; avoid this situation have the contents of the pump tank removed t by S- ,tinl rt~ n e uali' Servicing opericing 5:in he Ope ster f 1: price ~ is ^C:' re:-'':; To ccv:tr to the affluert pump or contact a Plumber or POWTS Niainiaier to assist I aorrn.al levtis .vhhin the pump tang. the area dispersal cells. Do not drive or park over, or Oth?rvJiSa dis7urb cr co;pw:.t, ;,J not cr:~'o or park vshiclas over tanks and diap_ it;,in 15 feet down slope of any mound or at-grada soil absorption area. , 3 o of tit ,c c "=ducticn :.r °l'.1n0tIQn of i,`ta following from the wastewater stream may improve the performance and Frr ng erg h^ :i`,-3 ers: i cnct f ! ~rJt VTS: ant~+otics; baby vApes; cigarotts butts: condoms: cotton swabs; degreasers; denial floss: diap, i f Gcti n ts; ;ouiyaticn drain (sump pump) tvatec; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps: rr products; pesticides; sanitary napkins; tampons; and watsr softener brine. GB I DO,1tiEfdT l be taken 'N'hen the ?v4JTS faits and/r ►s permanently with chaplet Comm 83h33ol~scr resin Admire lstrativa Code:insure That tie syst'n' _roc-ar:v and safely abandoned 'in All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. o The contents of all tanks and pits shalt ba removed and properly disposed of by a Septage Servicing Operator. A;tsr pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled soil, gravel cr another inert solid martectal. CONTINGENCY PLAN if we PO%IVTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code ori- - t rcF i m.nt system: --A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absa-pikn and not shoul action infring s ire should be protected from structure, lotil•nesn rid wellsmFailure top tectdthe placem nee arupo ean.b}1 reququired setbacks fromex(sting and po r result in the need for a new soil and sitz evaluation to replacement area. Fep(ace- ::c:-t ^ust eat ccmply With the rules in effect at that time. a A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POVJTS technology a holding tank may be installed as a last resort to replace the failed POWTS. rt~ir ble rdG(dCf7lTl get?: erase t.it}On failure of the POtId TS a Sv') and Si:^_ • 'a~ ~ ~flil;T~!~ i-~'•' P` i AAOA ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer ~ Mailing Address /g , _ a ll T , rt t~f~ ~ - ~ J~ i ~ LC dnJiA l f.. iZ t~"C /v~ ~t,1 fj 'JCy'1 ;Y Property Address 70 P A i , t- tL~ E c > t ' t (Verification required from' Planning & Zoning Department for new construction.) City/State s + « ~ ~ + C e Parcel Identification Number 7 G' LEGAL DESCRIPTION Property Location V. , Sec. i - , T _x N R 1 GI W, Town of mac:' r 'T Subdivision Plat: /A L 16 k4 L A A/1r 5 , Lot # Certified Survey Map # , Volume , Page # Warranty Deed # (before 2007)Volume , Page # Spec house n yes n no Lot lines identifiable ri yes n no 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 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 §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. Uwe, 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 Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of a w ty deed recorded in Register of Deeds Office. Number of bedrooms// fj <z Y y ,ems 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. 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J 47i....___.....-.,...,....,F.tl_. ,..J s - - 8w 8w s g~ aN ~ aka haw i i has ~ e .en~.a .e.~o~ dq 2 cd3 am a ~ i ~ cWm~r__,eee ~ : 5 C C ~ ~ C C Y 4 rv . E 8 3 3 3 3 3 3 3 3 3 3 00000000000 F 3 o a 3 3 b b b r b b r e b 3 b o yww 4~ ss~~c y"bY°~ _ w ;<w Y<tl g~i eo a3S~ ~~s;~~ ~ ~ ~ N $ ~ owl ~ 3~p u4 ao U~;;N3Tr 8 F LL ~ i P i i I Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I of Division of Safety and Buildings in accordance with 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 ~ra 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. ,,2 7 - L, o J(-/, Please print all information. Reviewe b i DDaattee/ Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location R Sibo+ Govt. Lot r 1/4 r 1/4 S T N R E (ora Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 353 k e Tr. . I to The H hlctricLS City State Zip Code Phone Number ❑ City ❑ Village & To Nearest Road l>J 54b1 ( ~5 >._5y9-10131 ~ ~-o ~ ~ . New Construction Use: [ Residential / Number of bedrooms Code derived design flow rate Sa ,~Q Ci 6 GPD ❑ Replacement / Public or commercial - Describe: Parent material oC.) -r ici 5 Flood Plain elevation if applicable 19- r, Few 1 ft. General comments 5R vY~ LI v , }p C{ Gt Z. and recommendations: ❑ Boring 4- sd7 t~4 ` Boring # / ® Pit Ground surface elev.?-Z Q ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 p- 13 I Z - 5;1 Zrnab~-- r4r c 5 v 5 .w- 31 Z 13- Z l 5 ~c l Zm~bk ~r L - 3 4Z,)I I m' ~ mL _ .~~1. Z ❑ Boring Fz--] Boring # © Pit Ground surface elev. ft. Depth to limiting factor 1 ZU in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD1ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 I -I Z 3~~ 5 1 Z►->"g~")o C ~r 5 I 5 Z IZ-40 10 Si k ~r cg ~P 3 I ~0 s m - 87 tl * Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg/L CST Name (Please nnt) Signature CS Number 05330 Address Date Evaluation Conducted Telephone Number 2t/ Sf. W 61/6Z ~a-3a-61 C7j,,3)Zq?-yW3 SBD-8330 (R07/00) L r Property Owner ~ou Parcel ID # Page Z. of Boring # E] Boring F31 S Pit Ground surface elev. ft. Depth to limiting factor 1I9 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 I C~ -I 2 I S i l 2-n-)obk- mfr C5 l v~ 5 .9 2 IZ-4 10 5; C_I ZmSbIL rn~ C5 - 3 y1 -119 0 ry 1 - ~1 1. Z qC q0 ❑ 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/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 I I E] Boring F] Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ' Effluent #1 = BOD5 > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODS < 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 (R.07/00) r ~ Property Owner TOU Parcel ID # Page Z of 3 ❑ Boring Boring # ❑ L ]!E Pit Ground surface elev. 9-;?- '16' ft. Depth to limiting factor 119 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I o- z I s~ l 2. n-) 1b~, mfr C-5 lv.~ 5 g 2 ~Z-4~ ID 5;cl ZrnSb, Iy(9 cS - 3 41-lIg I~ ry ~ mS C~ 1 - , ^1 1Z ❑ 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/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 F1 Boring # ❑ El Pit Boring Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD5 > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD5 < 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 (R.07/00) PAGE OF NAME S~c~ f LOT# LEGAL DESCRIPTION NE %u~ i4 ,S /Z T 30 ,N,R, 1 F1(oT y' SCALE: I"= BM I ELEVATION 165.O BM I DESCRIPTION ~ o ~lyT K~ ~~P - - BM 2 ELEVATION L7 e, 30 BM 2 DESCRIPTION ' S e c SYSTEM ELEVATION Q~. Sv l.~W~r qZ Sa ALTERNATE ELEVATION {-o~ R2 co .Gowcr g1.5-0 CONTOUR ELEVATION a57,00 e 1q.00 60J ov gM2 ~,0~ t4 GNATURE DATE /0 PAGE .3_0F_3 NAME 51Uc>-1~ LOT# /(o LEGAL DESCRIPTION it)E XuE 14 ,S 2- T SO ,N,R, 1 E(oo SCALE: I"= O BM I ELEVATION 60.0 BM I DESCRIPTION 4- - 3 h BM 2 ELEVATION 7e, 3U BM 2 DESCRIPTION ~op o 3 - S e -c' _ ~fy ouG SYSTEM ELEVATION w ALTERNATE ELEVATION f t, we CONTOUR ELEVATION gq.oV r7t a ,l-o- d g3 "e lot LA ~o DATE GNATURE Xo~ 'V;.,. ' ~j~-2- O C 1 ~ C.-2f L ✓t U. 1 C CC~-I-c CCC- b V V 170TH AVENUE "VV INE OF THE NE1 /4 s 1318.05' ~ E 71177, -Ak - - H.W.L. = 920.0 928 MIN FFE - 922.0 g2r° MIN. FF = 9 0 / H. = 920. / X 3.1 21 20 DRAINAG IN. F E = 922.0 =2' EASEME .W. = 920.0 / 914.8 IN. FFE R H.W.L = 921.5 E = 923.5 1 J E X 91 .5 edo m ~ 14 N~ 918 X 930,9: