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Parcel 034-1045-70-000 U1i05~2CPO6 03 32
AGE 1 OFr1
Alt. Parcel 20.29.15.311A 034 - TOWN OF SPRINGFIELD
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Cc-Cwner
O -BLOOM, RICHARD & NANCY
RICHARD & NANCY BLOOM 869 280TH ST
WOODVILLE WI 54028
Districts: SC = School SP = Special Property Address(es):
Type Dist # Description 56'~ 3GTI I S
SC 0231 BALDWIN-WOODVILLE AREA
SP 1700 WITC
Legal Description: Acres: 35.000 Plat: NiA-NOT AVAI-ABLE
SEC 20 T29N R1 5W SW NW EXC CSM 511340 Block/Condo Bldg:
35AC
Tract(s): (sec-Twn-Rng 401;4 160114)
20-29N-15W
Notes: Parcel History:
Date Doc # Vol/Page Type
07i23/1997 6921348
2005 SUMMARY Bill Fair Market Value: Assessed with:
82215 240,000
Valuations: Last Changed: 05i2612004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.000 12,950 162,850 175,800 NO
UNDEVELOPED G5 28.000 23,050 0 23,050 NO
PRODUCTIVE FORST LANDS G6 5.000 8,500 0 8,500 NO
Totals for 2005:
General Property 35.000 44.500 162,850 207,3500
Woodland 0.000 0
Totals for 2004:
General Property 35.000 44,500 162,850 207,3500
Woodland 0.000 0
Lottery Credit: Claim Count: 1 Certification Date: Batch M 212
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
A-
i-Liri:t - S T C - 104
t
AS BUI L'f SYSTEM t'L Pt%1:7'
TOWNSHIP SEC. V T N-R~W
A:liMhSS"-~_~-___ - ST. (_l:Olk. ta)I.PJ''Y, t;i_i;:;OCdS1N r
;AjliuIV I ION LOT LUL S~Z['"
PLAN VIEW
Oiutun~:ct-i and din:uu.,ions Co IneeL reyuiremenrs of H 63
>IIOW EVERYTHING WITHIN 100 FEET OF SYSTEM
Lla~t
73
/r
rG .
1
INDICATE NORTH ARROW
bENCHMARK: Di;ticrihe the vertical ruturuncL! point u5ud rU 0 1 j-c~ F
i:levatiut, of VcLtical reference point: Proposed slope aL Site:
1 -
St;P'1LC Ti' NK: MLillufacLULcr' - {4-' S'trZ Liquid Capacity: U U
Nulnbe.r 01 r u u6ud. L~ Tank manhole c•uve•r uI v~3tic)n:
'Tank Inlr-t 1 lev,:tion: 'l'ank OuLlet Elevation:
Nurlbc : u f' 1 , l r : rani nearest Rudd : Front,0 Side', Rear , feet
1
Fri)T I ,'M-t't t I;ruptIrry I Dw Fronr, D Sidt,10Rear,0 - = feet
Numbe r of teeL trout: well , building: .r
(inchide this iniormaLiUL1 of thc, above plot plan)( reverence dimension:, Lo Septic tank)
SEE REVEWW I.;h.
I4. i'', Ih1P Ci1tL~1BLR
Manufacturer: Liquid Capacity:
Pump Model: V a) at Pur,ap/Siphon Manufacturer: Pump Size
E1uvaLiou of inlet: Bot-Lom of tank elevation: J 5
Pump ofI switch elL!vaLion: Gallons per cycle:
Alarm Manufacturer: Alarm Switch Type:
Number of feet from nearest property line: Front, 0 Side, O Roar, Q FL.1.1,_
`lumber of feet from we 11: FS
r
Number of feet from building: 5(o
(Lnclinfo QisLaneus on plot plan).
SUIT. ABSURBI JON SYSTEM
Bed. Trench:
Width. Len1;L1a: Numb,-1- nt Lines: _ Area Built:
Fill depth to rop of pipe:
Number u; Wet tion nearesL property line: Front, OSidi-, O Rear, 0 Ft
Number o: teet f rum well:
Numh(tr oi tuet from hui Iding
(Include distances on plot plan).
J:L:PAGE P1'1+
Size: Number of pits: Diameter:
Liquid depth: _ bottom of seepage pit elevation:
Aica BuilL:
Ilan either a drop box O or distribution box O been used on any of Lhe above soil
nbsorbtion syLems? (Check one).
HOLDINC TANK
Manufacturer: Capacity: _
Number of rings used: Elevation of bottom of tank:
Elevation of inleL:
Number of feet from nearest prupurLy line: Front, O Side, 0Rear, 0Ft.
Number of 1nuL from woll:
Number of Opt from building:
Number of feet from nearest road:
Ai:arm Manut<acL"rer:
Inspector:
r Dated: Plumber on job:
Licenso Number: ?J
i; L'4:iuj
DEPARTMENT OF INDUS( Hy, INSPECTION REPORT FOR SAFETY & 13uILDIN3S
LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION
P.O. BOX 7969 BUREAU OF PLUMB N14
MADISON, WI 53707 _
I _ CONVENTIONAL FMLTERNATIVE PI I D N--,
Holding Tank E In-Ground Pressure XX Mound 84-05410
rv Ar.IL OF PFRMIT HGLDEF :.I:fl!', F..., t-IF ~F RA11T HOLDER rINSF FC.' ,i J .T
Richard Bloom Woodville, W1
JLNC11 hlAliY P.•rr.:-r-il :1 •rriRC ❑C D:.•[IH IBE IF LIF F E RL`, 1 1141 A11' Ar, - - - - REF. Pr E_FV RL: FI F.
SW NW, Section 20, T29N-R15W, Town of Springfield
Via. .1 Pur,J[e, - ~ldP L,:P:.a'>'d. V.. I. -,ntu; P"ni'Ne miner
Steve Aaby 5184 - St. Croix 54953
SEPTIC TANK/HOLDING TANK:
V; %,IF rL14ER It I0111 O CAPAC I T', '.ANk hLL' LI I TANK OVTLET ELL':. %%ARN NI_ LASE_ LOCK ING COVER
FRO'V,OL,E) PPOVIDED
_ YES -NO YES -,'AD
NUMBER OF R- 00 A D PROPERTY WELL BLILDING 1 VE%T TU I HF ;H
m OOWG 'BENT DIA, vLNI M AT( I:iH NATL H IA
ALnP"° FEET FROM NE IHINLLr
IHDYES NO NEAREST
EYES NO
DOSING CHAMBER:
11,14NUFAI_Itll•E12 BEDU NG LL7U C! caFA(:IT': I':1 61P h1(:'rEL lp""1F ~I~V~1_l r. `A .i ^dl!r !~F,T'.IHE1- K4HNINerL LOCKING COVER
rRO.'ID Pvovlr.Fn
_'YES UNO EYENO EYES ENO
GALLONS PER CYCLE: PnnD CONTgcLS OVLH I lovAl NUMBER OF Ifir.E ERTr ~+F 90I.DING AiH JiNI FT RESH
(DIFFERENCE BFTWEEN FEET FROM
PUMP ON AND OFF) _YES NO NEAREST
SOIL ABSORPTION SYSTEM. CheCK -.he so l no sturc at the death of plowing _Er IAnr TFR VATLRIAI AN , raAHKINt
rr excavation. (If soil can be rolled Inlrl n shire, construction shall cease until FORCE
the Soil is dry enough to c.ontirue.I MAIN
CONVENTIONAL SYSTEM: _ -
5'J C'H c: : h;llE Uln aP1T$ LIOUIL`
BED/TRENCH TRENCHES MA T IALI PIT DEVIH
DIMENSIONS J STR PIPE CJ YER
- 7 •':~I CAF 1, T•I FILLUEFITII I :I STq PI~F .-~STR PIFE DISTR. PIPE 61A I F I AI_ 140 CISTH NUMBER OF Pq OPLF'v WELL. BUILOING VENT IU1 1,'•
IET ELE•: END-~- AIR INLET
~IPes ~ FEET FROM 'LINE
FI Fd NL
j NEAREST
(MOUND SYSTEM: - - -
Mound s.te plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM
and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA-
meets the criteria for medium sand. TIONS MEASURED.
EYES ENO
- =Y )E'-•L-1:' I I' I -'!VYF
SOIL COVER r.:r,HL
NO YES ❑ NO
"I rill (-"'FR Tl Er.u BED DEFTH ()VLN IIIFNGH BEO )LPrH OF TOPSOIL `,OUnFFI FEJi-! t, "-YES I:=NTFR ECGES -
EYES GNO EYES LJNO -YES NO
PRESSURIZED DISTRIBUTION SYSTEM-:
I~I~-1 .E`1(UI NO UI -A-RAL SPACING 1H^'%LL ULP I.1 RI Oy. PIP: °ILL L'-F'l l' ARO'dE COVER
BED/TRENCH rHLNCHES
DIMENSIONS
V;•NI°OLD I; PTA+i' %IANIc GLD DISTR. PIPE E111,1117)MAIERIAL NO Uisr_I DISTR. PIPE ill; I: RUTION PIPE MATERIA_$41AI1K Ih:~
FE FV [:I," ELEV. 1'IVES DIA.
ELEVATION AND
DISTRIBUT ION - VLII11l AL LIFTCORRESP^,NDS NO At" 14 :V' II
INFORMATION (HOLE SIZE HCLL SPACINL, DF L_l 1 c HRECTLY ccvER MATER IAL
rl Ar,s M YES 1YES ENO
i I YES NO - IPH UPFRTY rELL: 9UI~UIN1.
COMMENTS: PERMANLNI NA iKERS J oasERVATION v1, I I5 NUMBER OF
FEET FROM uNF
-YES -NO -_'IEo -~NO_ NEAREST-~~----_
Sketch Gystelr or Retain it, county tr.e for audit.
ReVe'"Se v dE. ,.I _,NATURE TITLE
L)Il_HR SOD 6710 (R. 01!821 - -
„ ~r APPLICATION FOR SANITARY PERMIT a
Dc ouvrY
(PLB 67) UNIFORM SANITARY PERMIT
~ oe ocr oc L]
innu ;1cav, r anoca t. rtimrv i ut~~+-ons r"[ , / J 3
Attach complete plans n accord 'vvith s. H 63.05, bNis. Ad m. Code for the system, on paper not less than 8x 11 inches in si7r .
-Sec reverse sire for instructiuns for corn pletimg th s appiicalion. PLEASE PRINT
PROPERTY OWNER MAILING-Al RE S
PROPERTY LOCA I ION r
WA Q
W 1/4 0114, Sp O , T, , N, R 1 S Jl(or To r Floe)
LOT N 1MRER BLOCK NUMBER ISLIBUIVISION NAME EST RC D, 1 AKE OR LANDMARK STATE PLAN I.D. NUMB~-H
TYPE OF BUILDING OR USE SERVED -/D of
l:
I X 1 or 7 Family Number of Bearooms: 3 i Poju, (Specify
THIS PERMIT IS FOR A:
X New System ❑ Tank Replacement [l Repair
Replacement Soil Absnrption System J Revision Privy
Alternate System Reconnection Petition for Modification
IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK.
Seepage Bed _ 1 Seepage Trench ~l Seepage Pit L Holding Tank
System-In-Fill ,l In-Gruund Pressure l- Vault Privy C Pit Privy
❑ Existing, For Which A Previous Permit Is On File, Permit # slued
1 An txisting System That Has Been InspRcted And Is Compliant As Far As Soil Conditions.
Total #of Prefab. Site Steel Fiberylas•; Plastic
Gallons Tarks Concrete Constructed
Seotic T.rk Capacity
Lift Pump Tmil phon Chamber
Ho.dir.y Tan-, capacity _
p,1anulacturer:
IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: ❑ Mound J In-Ground Pressure
Total zp of Pretab. S to Steel Fiberglass Plastic
Gallors Tanks Concrete Constructed
Septic Tank Capacity 01 X
Lift Pump/S Fihon Chamber ~d 1 1 L
Manufactur.!r: r XA-,S G- e- T X
; "A <'a^~✓-Ci f
PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY:
( inutes per inch): REQUIRED (Square Feeti ?ROPOSED ISquare Fectl:
Private ❑ Joint L Public
I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans.
Name Plumber ( n> Signatu DPPIP,1PRS4V No.: Phone Numbe
-
Plumber's Address: Name of Designer:
COUNTY/ DEPARTMENT USE ONLY
Signature of Issuing Agent: Fee: Date: ❑ Disapproved
fit' ~7 7 Owner Given Initial
Approved Adverse Determination
Reason for Di,apprnval:
Alternate Course(s) of Ac:-,ion Available:
:JILHR SDE, 3398 !R. 5'221 D'S-FIAUTION. 0`ic naI 70 C2L.rty, One Copy Tc; Hure,.ni ~,f Plc.mb~ng, Owner, Plurnbrr
INSTRUCTIONS FOR COMPLETING THIS PERMIT APPLICATION, PLB 67 - SBD 6398
f n lip r.rmipL to anC 'ccu'ate the permit appliratinn must ilicl_,de:
1. P-operty ovvii name and complete legal description, please circle the appropriate municipal government unit, (whether this is in
a city, village or towni;
2. Inr'icate specifical y what type of Lisp is served, if public is checked indicate type of use (i.e. 10 unit apartment, 30 seat restaurant,
ctu.),
:1. Cr,ml let the h1uLA for cc)nvtimtienal or alternate N;stem depending on system type, check all appropriate boxes or blanks.
4. Indicate iieSign percnlation rat!. fisted un the 1 15 tps- r_por', tie n_.n er nt sdua-c feet rer:ui-ed by co:1e and the number of
Square feet to be ns,alled,
5. Complete the sectinn on water supuly;
6. PRINT the name of the master plumber m master plumber restricted who will install the system, circle the appropriate lice^se classi-
fication, place your I;cense number in the space provided and sign the permit in the signature block;
7. Please place the plumbers business phone number in the blank provided, if there is a prohlem or question th s skill speed revievv of the
pe, ini t;
8. Change of ownership of plumber requires a San *.ary Permit Trans'er Fo-m (67 T) to be submitted to the co-my :-)rior- to inst.llation.
Failure comp II void the sar-itaiy tir•rrn
9. This permit miiuy h: rcnuv,ed, a•-d at the timra of enc";al arty new crlteria n the Vlis. Adm. Cnde . 11 be apolicahle.
10. A new permit will be needed if ;here is a change in, estir7ated wasleY,ate- fins,, (number of herlroon-s, locatinn of the systcrn.
depth of the system, type o' system.
11. Ali revisions to this permit mu.;r I;u aupro;ed hv' the peg I-- it is;.. ny 'Uwhw TY.
12. A complete plan including a plot plan, drawn to scale or with complete dimens uns•
13. Horizontal and vertical elevation reference points that are permanent and clearly shoe;n.
14. Piping detail including pipe sire, separating rJiste ues, distances hats --ii I, _rds ` al;p-npr a-e• - ,..k to trine r+fl, ~~nt h tr~~-,!r t 1141'
'I
to system, nui'ding sev°'er and gent -l"~ -It 11 :,i
r
TO THE OWNER: This is valid for two years. Changes in your burlrirnq plans or locations may require you to obtain a new permit. Private sewage systems
must be properly maintained. Have a licensed pumper clean your septic lank whenever necessary usually every 2 to 3 years. If you have questions concerning
your system, contact your local code administrator or the Bureau of Plumbing, DI Lli State of Wisconsin.
:\i'P1 LU;v k-OR aAP~~'1't'ili'i PFitMI'1'
I C - 100
Mi., applicaticm loan 15 to bu curii,loti--c iu tulI and sigut_~d by rite owner (s) oI the
Iroperty being; developed. Any inaduquacius will only resulL in delays of Lhe permit
i!;!;uanco. Should LhiS du4elopnucnr he intended for resale by owner/Contractor, ("spec
hv)uSe"), Liien a seConci torm should be retained and completed when the property is
.~)Id and submitted to this office with the appropri-are dee=d recording',.
- - - - - - - - - - - - - - - - - - - - - -
-7)
I,;;.:il it'll of Property r i, is
n s:iil> I\ f-NCA
;ubd i vislou `;:cup
I.uL Number
Provious Owner ot- Property
;'oLal Size of Parc:ul
t,it i'arcel was Created
:',rt• :il 1 corners and lot lines idunti.iiablu" Yes Nu
cli:5 properly being developed for rt•~a Ic (spt=c house) ? Yr-n No
1„Iuu,, f q ,ind Pige Number 3 y 3 as recorded with the Registur of Deed:
I NCLUUh: W1III1 7 Hl1; APPLICATION ONE. OF THE' F01.11,PWANG:
1 . lJa t- r:~n r v u~c,~.t
Land Contract
Other recor.Jin,~_!.:; !iiud with Lilt kct,L:,tur uI U,ed:, (itlice
lr~ addiLion, a certified survey, ii avl';i-lable, would he ht-tptul so as to avoid delays
,It tale reviewing process. If the deed descri;?tion rot,,*rel~ces to a Certified Survey h1;il , the the CUrLil ic'(i Survey Mao .;hat l -L:,u ru(_li_I1r"d.
i lcl,' t't.Attiy ,"i;.c"t cutStall;;me_I'Ltb on tlLi.s +Joluii aAc .thus,. t:,, -the bc'.5t o Illlj ( ~LL~
I;i,ucu edye; that I Iwe) ;gym ta.he) the owne"I(.5) u{y .tire pkiope,` ty de-se'tbe-d .I.n .t6tia i r;ruhn!u.t•io►t Iiv•7m, by v.i,,Ltue_ o6 a wavtanty
deed he.cvhdc.d in the 066.ice a5 the
Cool ty Reg. b.6,h_ o6 D,?-eh a,5 Doc(ario.t No. 3 94 310 arid that I (we.)
I,n(!,scn-tty owrr the ph.)posed sate cwt the sewage disFjcT6a.E •sy.stem (un I (we) have
f).ta.irted an eaherner..t, to imn La)i h the above de,5cA_(.bed p,,LopeAty, 6oh the
~ unVAUCtivit L6 said system, ani the scune, has been duty necohded ~ n the Oj,~,t'c,e
o .the County Reg-1L'•5.t,A o~ Veetts , as Documemt No. ) .
SIGNATURE OF OWNER=AIL- SIG4,vHJRlf. F CO-OWNER (IF APPLICABLE)
ui1 K S 1c:NEIT 0A'i l?_ GNI'N-/
I
J-
L
105
r-,
I-TT I C TANK MA I N'I'LNANCE A(;KLLML;N1
t. CLU1X CuunLy
u
:I-
OW rl I: Ic i li a Yr: 1•: -J\'
KUU'I L / 1SUX NUt1lSI K 1' i rt, Nulnhur
P:0IP1:r.,Y I.r11 I'1 uld
OWIL ul _V"(- N, Cruix C0UI1L1',
if 1)LiI V Ls i.)It L„t If it III CI
I
l Ili l.I CI it ~~t• ~<l Ild il,.i 111 L d[I a II L:e U1 yuur SeI)L lt' sysLe lR t:UUld rc5U1L 111
tts 1)1L~ 1uaLUru 1aitUre to h,indle wa:.i LuS. I'ru1)ur u)aill tuUatlru C011-
r;inLB 0L 1)uIll pirib Out thin s)-l1)t1C Lank every three yeat:~ ur sootier,
if needed, by a licuUsud st•l,I it' tank 1~21 uli)u11- . WhAt- YOU ')UL irltu
I tie sysLuul cull attucL the 1 uUt•t iOil L I l
Ilium s1:d U lu Lltt: waeLU di~,pob.iI sy --~L 1:1,.
SL . Cru 1 x C0LIU11 y L esiduIILt, u1a1 ko 0-11K t
max1Ili u 111 Uf 60% U1 the uo iL of re 1)I aL'elu k- It L .il 1.11.1 Ltt;. :.I
wh1ch wa ti 1n I) if it ratl un 1) 17 iur Lu July 1 , 1978 SL Cru ix Ct)U1i
accul)Led this 1'rL)P,r<lIll lU Aut?it u1 1980, w1LIt Lhu I '(IUtrt'IIJVII
UWif erS 1
111 a 1 11 L. d i l l t: I
1 lie 1)I'u1)I, t I
:rC1t1Catiitll 1 1-111 -1 1)tiuU.d uy Litu awnt!r aii d by a utaL I I,I.till 1)ut ,
ulucynlan 1)1 u1111)0r, re:;trICIL,It 1)1 uulber ,;r' :I Iici'It :ii:d 1)uu)1)0I- vt•I I
Iy1U1, LhtlL (1) Lhe )u - nit_u Was L.ewztLcr Jisposr ,L sysLeIll is in 1)17:, 1)t
I,t raLlUg cuit dILluit null (2) ;II I er ins 1, ccLiL) It ALLd 1)UU11)in1; ( ii UL!c-
ary), tile.. SC1)Lic Lank is I e s than 1/3 full ut slU(lge and scuIll
l:ciLitlcaLLun It)rIll will 11e _iL' uL a 1)Nr0Xitil,irely 30 d I Y I 1)t i1) tt)
Ilruu year cx1)LraLlun
11WG, L I I U U11d2' it,,nL•d, h.tvt Lead Lhu lL,;Vi- ru(I UIIL13eut1, dud I
to ❑I~iLlltaLIi L I I u J) LlvaLc auw.I,,,t dispou al syL~LUill ill 1CL-01d.II-.:t.: with I:
r.
L)r_I,:IrI - u
L. tic Lit aadards scl l ortil, II ciif is se[ I)y Llit; Wiacif rlsill
III euL ut NnLural Resource- s Cc.IL111caLiull ItrrIli I11III ;it L) c coIli1)11 tud
1.1 11 d rt•.LItrLicd LU LIt u SL . Cr.. ix CvltItLy !t)Iti.It1; U1 t il;~t~ t LI-tiU 30 day
o f L If e I I I I' t t' y t- a I U X 1) L I t 1 1. I LV If tl I L L-• .
X U LI II L y e! 0 [1 i U U 1 l i is L
1i:l1uno Id, W1 54015
71.5-7l)6-12311 Or 715-425-5363
:i11'11 , dat it ltd rt_t- Urtl L J ll,.)V IAdl- t•s
X
DEPARTMENT OF' REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
INDUSTRY, , DIVISION P.O. X 796 LABOR AND PERCOLATION TESTS (115) MADISON, W 53707
HUMAN RELATIONS r-•~ (H63-09(1) & Chapter 145.045)
!DOCAI ISECTION: TOWNSHIPiMUNICIPALITY: IOTNO.:BLK.NO. SUBDIVISION NAME
COUNTY: OIVNER'Si S NAME: MAI ING ADDRESS: ref
- -
USE DATES OBSERVATIONS MADE TPTFT- NO. BEDFINIS. TCO` N11ERCIAL DES RIPT10N: _ PROFILE DESCRIPTIONS: COLA f ION TESTS
New -Replace 3 I Residence - S
RATING: S= Site suitable for system U= Site unsuitable for system z
CONVENTIONAL: fv10UND IN-GROUND-PRESSURE:SYST=M-IN-FILLHOLOINGTgV :RECOMMENDEDSYS EM:{optionali
LaSZUINSEIu osZu EIf Per,:olatmn Tests are NOT required DESIGN RATE:
If :my portion of the tested area is m the hinder s.H63.09(5)(b), indicate: Floodplain, indicate Floodpla n elevation:
PROFILE DESCRIPTIONS
BORING TOTAL DEPTH TO GROUNDVVAI FH-INCHES CHARACTER OF SOIL WITH THICKNESS, COI OR, TEXTURE, AND DEPTH IL)VIRER DEPT'1 IN, ,Fl FVATION OBSERVED EST. HIGHEST TO BEDROCK
IF OBSERVED (SEE ABBRV.ON BACK.)
B-
B-
PERCOLATION TESTS
TEST DEP I H WATER IN HOLE TES] I IMF DROP IN 4VA.TER LEVEL-INCHFS RATE MINUTES N1JMFER INCHES AFTERSWELLING INIERVAL-MIV. f'ERIOn PElilop9
PCft PER INCH
P_ _
P-
PLOT PLAN: Show locations of percolation tests, soil borings and the dnnensions of suitable soil anus. Indicate scale or distances. Describe what are the hoi -
zon-al and vertical elevation reference points and show their location o i the alo• plan. Shov, thu surface elevation at all binrijs and the direction and nentent
of land sl ;pc.
SYSTEM ELEVATION 7,5'.0 /
1 I 1
1 i ( 1 I I
I 1 i ,
I I
I r
1 t 1 1 ~ '
)
I, the undersigned, n_,reby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative
Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief.
NAME (print): TESTS WEHE COMPLETED ON:
r'TLr'l~ ti 2~rRII
ADDRESS' CFRTIFICATIO I NUMBER. PHONE NUMBER(optionall: / . i1 Gr ~
.ai.7/ Lam.' l,- ice- - Lie 6 - - r~ r - - CS] S GN URE-
DISTRIBUTION: O•iginal and one copy to Local Authority, Pinperiy Owner and Soil Tester.
71LHR-SBD-6395 JR. 021821 - O`JElt -
x
i ; iLl i li!i`vv t ie r JlYif'LC 1 11` t7 r'UrI vi i lb 660 695
and iii 1 '1
ipl,~te legal desevipti:
he use section must 0
1AXIPAUUI itimher of bedroom jr a~~tnmerclal use Olai ','i s a neva or repl:aa:ment systela;
:>icte the suitability rating boxes. A SITE IS SUiTAL;..
FR SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIO IS;
LASE ust' the abbreviations shov,,n here for wFiting profile rlescrilitions, artd completing the plot I:
F A LEGIBLE diagra.ii accur<atefy locating your test locations. Drawing to scale is preferrc
jte sh^^t may ae trsecf f desired: ✓
sure your benchmark rrnr • + . ;
omplete ail appropriate on, it appropriate;
the informa,..ion (such as
- I he form anti place yo,:
IPCHhI'' COr?iP.S a?d di;tri!)iii, t; rnry'.;mr rl Al I
'rte (over 10".I BR - Bedro
Uble (3 • 10") SS - Sande
Gravel (under 3") L.`,' - Lirncs
Sand HGW - Hioh ( 1parseSarrZi Pe. rc Pin co,
ium Sarn IN - 'APil
Sand Bldg - Build:
,my Sand } Gnsao
idy Loam l Less Ti:,
,nn Er-:
Loam LEI
G y L:~<!m Y _
dy C ny Loam R
Clay Lown n1u,
dy Clay tn!' - writ
Clay fft *r:c
y Cc:
,if teC
I
`d I
s ~y
o rte-; e /
i
w Q ~
a ro o r~ .
TI-
r '
oy ~ ~
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c~ (A4
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r
I
SBD 6678 19!811 (Plb 100x)
ty"'s"L
STATE OF WISCONSIN DI LHR
Detach And Return Upper DIVISION OF SAFETY & BUILDINGS
Portion Of This Form With BUREAU OF PLUMBING
201 E. WASHINGTON AVE. RM 178
Any Return Correspondence P.O. BOX 7969
MADISON, WI 53707
• ; . 608-266-381 b
DATE: 00 R v
o~~°~ PROJECT:
os
"o. -
p~ .n Springfiel
PLAN ID.
DETACH HERE
PROJECT NAME PLAN ID.
This is to acknowledge receipt of your plans and specifications for the above-indicated project.
Preliminary review indicates the required fee is $ Fee Received is $
❑ Underpayment - Please submit the additional fee. ❑ Overpayment Refund forthcoming.
❑ Plan accepted for review. ❑ Plans being returned.
❑ No fee has been remitted. Plans submitted with no fees will be ❑ Additional information required. SEE BELOW.
held in abeyance.
1. Plan Submission ❑ Complete data relative to anticipated use of bldg.
L] Additional information shall be submitted in duplicate un- ❑ 2 copies of PLB 60 enclosed.
less specifically noted. ❑ Deed restriction required (1 copy).
❑ Plans not clear, legible or permanent. ❑ Condominium declaration. (1 copy)
❑ All information submitted shall he signed, dated and sealed
or stamped in accord with Section H 63.08(2) (a) Wisconsin
Administrative Code. L_ Affidavit enclosed. IV. Holding Tanks
Profile of holding tank showing vent, manhole alarm and
manufacturer if precast. Complete construction details if
H. Pressurize Distribution Systems (Mound or In Ground Pressure) site constructed.
Application for use of an alternative system signed by owner ❑ Holding tank agreement signed by owner and local unit of
and notarized. (1 copy) government (sample enclosed).
❑ County onsite required (1 copy). ❑ Design calculations ❑ Reason for installing holding tank. Soil test or statement
for pressurize distribution. ❑ Soil boring & percolation from county (1 copy).
test data. E71 Plot plan showing location of holding tank with lateral dist-
Cross section of system. ❑ Pipe lateral layout. antes to any building, wells, water service piping, water
❑ Plan view of system. ❑ Plot plan. course, lot lines, swimming pools, all weather service road,
71 Verification of Exception Status Form by County. (1 copy) Etc. Provide benchmark with elevation reference point.
III. Private Sewage Disposal Systems V. Lift Pump
Ground slope with 2' contours in entire area of soil absorp- ❑ Calculations for total lift pump discharge, head and gallons
tion system extending 25' on all sides. pumped per cycle.
❑ Elevation of permanent reference point (benchmark). F7 Size, length & depth of force main.
Location of area suitable for replacement system - provide ❑ Detail & model of pump or automatic siphons including
soil data. size, pump curves, drawdown and average flow rate GPM.
❑ Plot plan showing lot size and all lateral distances from ❑ Cross section of lift pump tank showing pump(s) or
sewage disposal system to buildings, lot lines, well, water siphon(s).
course, swimming pools, water service piping, Etc.
L1 Construction detail of septic, holding or lift pump tank if
site constructed or tank manufacturer if precast. VI. Systems In Fill (Fill must be placed prior to plan submission)
L] Construction detail and cross-section of soil absorption ❑ Total area filled (fill to extend 20' beyond edge of trench
system. before side slope begin).
Soil boring and percolation test on 115 completed by cer- L~ Depth and type of fill.
tified soil tester (1 Copy). ❑ Copy of onsite report by county or district staff.
Safety and Buildings Division
DPLAN APPROV , Bureau of Plumbing
L . P.O Box 7%9
Madison, Plumbing - s nn wl 53707
Private Sewage P 4, 4G,~/t!s Telephone: (608)266-3815
O ivy%, ~9OFFICE USE ONLY
Plan Identification No.
Gallons Per Day
PRIORITY PLAN REVIEW ONLY
Plan Review
S
1
Petition I or Modification.
Project Name Project Location - Street No. or Legal Description
County
LJ City ❑ Village D Town of:
The plumbing plans and specifications for this project have been reviewed for compliance with applicable code requirements. This approval i,,
based on Chapter 145, Wisconsin Statutes and the Wisconsin Administrative Code. The plans are stamped "conditionally approved". This approval
is contingent upon compliance with any stipulations shown on the plans. All items that are noted must be corrected. All permits required by the
city, village, township or county shall be obtained prior to construction. The licensed plumber responsible for this installation shall keep one set of
plans with the dopartrnenC; approval stamp at the construction site The installer shall notity the appropriate inspector vvhen inspections can be
made.
L- FOR GENERAL PLUMBING PLANS:
This approval will expire two years from the date approved below. If construction ha; not curnmenced before the expiration date, new plan
approval must be obtained.
L FOR PRIVATE SEWAGE PLANS:
This approval will expire two years from the date approved below or if a sanitary permit is obtained, it will expire the day the initial sanitary
permit expire.
Comments:
By.
James Sargent
Bureau Director _
If Questions Plans Approved By: Date Approved:
Contact
cc: J OWS O DPS C' H&R & Rec. Sari. Section
1-1 County r Local PI Facilities Need Analysis Section
LIW-55W\1P Plumber - Department of Agrirulttir~
C'dl1: 1;I~ 6u'r) a rt a Ov.,ner 1)t1, cr
"""°CI'"' SANITARY PERMIT
Iu
C0° - -•C- GROUNDWATER SURCHARGE
.u,.,W~,L.~.a..cr~unrr,wawrv~ Sanitary Permit No.
9-53 _T Y On May 4, 1984, 1983, Wisconsin Act 410 was signed into law. This legislation is more com-
monly known as the groundwater protection law. This change in statutes was the result of over
2 years of steady negotiation and public debate. The groundwater bill included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater.
The
surcharge took effect on July 1, 1984. All of the water that is used in your building is returned to
the groundwater through your soil absorption system or the disposal site used by your holding
tank pumper.
The monies collected through these surcharges are credited to the groundwater fund adminis-
tered by the Department of Natural Resources. These funds are used for monitoring ground- water, groundwater contamination Investigations and establishment of standards. Groundwater,
it's worth protecting. Ground a*t'
S1 n re of Iswing Avant: Groundwater F«: Wisco ti's , l ,7' buried .1
p~pgr 9 DILHR SBD-Y= (N. 05164)
1
r,
I
PLAN APPROVAL Bureau B1rmin s Division
Ji D'~~~ Bureu of Plumbing
P.O Box 7%9
J General Plumbing Plans Madison, WI 53707
Private Sewage Plans Telephone: (608)266-3815
OFFICE USE ONLY
Plan Identification No. o,:.
Gallons Per Day
lie W PRIORITY PLAN REVIEW ONLY
Plan Review
Petition I or modification
S
Pro ect Name pp Project Location - Street No. or I egal Description
County
City f Village ,Town of:
the plumbing plans and specifications for this project have been reviewed for compliance with applicable code requirements. This approval
based on Chapter 145, Wisconsin Statutes and the Wisconsin Administrative Code. The plans are stamped "conditionally approved". This appro,-i
is contingent upon compliance with any stipulations shown on the plans. All items that are noted must be corrected. All permits required by tt e-
city, village; township or county shall be obtained prior to construction. The licensed plumber responsible for this installation shall keep one set
plans with the department's appmv,il ~,L~;mo at tl-c, ci ri,lruclio n site. The instiller shall ratify the gi;mupriate inspector when inspections ran oe1
made.
FOR GENERAL PLUMBING PLANS:
This approval will expire two years from the date approved below, if construction has not c-om i-enced hefore Lhe expiration (!ate, new p~cil
approval must be obtained.
FOR PRIVATE SEWAGE PLANS: J ex.
This approval will expire two years from the date appro%cd hdkw e:~r it'll sanitary peJrrut 1, ')[It 01110d, it tiv ll ('Vwe~ Lhr cla,, I -ii ini: ,II sanitan
permit expire
comments
By:
James Sargent
Bureau Director
If Questions Plans Approved By Date Approved:
Contact ♦ J/-- / r
c: X OWS C DPS ❑ I I&R & Rec. Sari. Section
County U Local PI ❑ Facilities Need Analysis Sector
C:~ti' S5Wti1P ❑ Plumber F7 Department of Agricultrtre
Jn IR sl+tJ ni•r<;;: ui r,4: l)wncr )ther
loom
_ L~IJ IZ~S~
X x --jt - -T('---------- x~---- - it - li x x -
d
,1p S`opG. rin}e
of \
t„
' ~ v C E~ f I J
1 <
\ \ 1
rl Q 3
Z U ~ C r~ h-ticl:r~Vr
i y
PLUMBING
APPROVED:
OF WOUSTRY LABOR r,N1 HU:Ur~ """o"
Of Sl14TY V40 BL4LONCS
SEE t;~EZ~~; POi`FDEs l:;E~
' N<tyc: ` Ut
t'~rfuraled f lp• Dstull
j L nJ_Viuw
CPo lug uIell
tno 1. UU~ "-~I J.
1 v C f'.pe
Hulu L ucuuo Un but tom,
4#• Louully Spui.eu
k_
i
Yv %wal > i
From Nurnp Htut.IVEU
j:il_ 1 i IBS
N v c
Munlulo f ya PLUS,^~lld~ GI 1_
rl N
Nlleinut• Position Ot
' ~(Julbuhon ~ -
pope -~y/- Force Moan f I f1m Pump
Lott Hole :3houjo a.
Nell To End Cop aayy//
tno (-Op DittrlDullon Pipe Luyout
S r
x
y /Q] l1
Signed: Hole Oiameter Inch
G Ldteral I, Inch(es)
License. Number. Manifold
Inches
Date: Force MFt i n Inches
PLUMBING /
A
P P W'"I".1VED
DEPARTMENT Or INDUSTRY, LAFOR AND HU'.+A'1 RELATIONS
DIV,I(SION 0 SAFETY AiJD BVILDItN6
SEE CORRESPONDENCE
Page _ Ut
Straw, Marsh Hay, Or
Synthetic Coverinp`\
-Distribution Pipe
Modlum Sand
Topsoll Lc
F
I
3 E D
b
Slope
t:- Bed Of ' 2
I b~, z 2 Force Main Plowed
AQyreyote - From Pump La er
0~ l•.iDWz PV, lq..~c cy-i ilr Y
ii'i~ E -ii L!.~I`rJ~J 0' n
Cross Section Of A Mound System Using E I .
A Bed For The Absorption Area F ' '
G I. o
i gned : o'` - -
Q
Ft.
License Number: y
Date. '7- J - Ft.
Alternate Position
of L Ft..
Force Main W Ft
-
7bservot,o n Pipe
I(-`-- _ III
AI~----------- - - -
yy - .I Force Main
- ----I-- ~J From Pump
~UIstribution Hed Of
r 2
Pipe
I Agyreyate
Observation Pipe Permanent Markers -
View Of Mound Using A Bed For The Absorption Area
l I'fLt.l .r
i'UN11' I HA^^~t,F I( ikl~•,~, , C I iiJf`I f~.nll) ~,I'I r II I( •n, uJnl,
vL I,,_ I c_h.N
l 1~
VI rJl Y;YI
WI AI 111 K VKUUI
- - - JL,AJC I IU►J LUX f°kP.u{uI k VI h
WIWL)LJW c,K t KL Sri IZ mtu_
AIII( IIUTAKL
I l
C.KAOIL
~ ~ 1 t 5r1J
LC)UDUIr -
ki.
I
VKL)V,U)L I S
AIKTilsil F SLA I
AI YK1~71 4 JCllul A ~ I I I AVPKOVLL
W% C A rI rL •r31.r.. i l I I I W/c 1 r,l•L
GICI LNUIL,(. i' I I I ALAKM LxI CLIUIU;.
`J I I~ )I l l u ~UL i t
uuTO '.EJLIL.J •_t,il ~ rf ~7 ~c tivEJ
CL'EF,~
'l ILD,
PLU"
S"t ( L r'U~I- ;,CL III I ,,t1
- L - C0KICKE-I IL GLJLrt
Kl l K L_ XI I 1'L KMI-II LU 6k1~ 'J r I J,IJK MAUUFA"- I UKL K rIA•, !L-H ki I'I. L, V AL
A I I (1KA j
/ AAJLJI At. I- UKL Ll Q( fl - fur/ IJ,JMHLK 1_rF DUS► _-L L K LAJ
IAAJK ,ILI ----I -'~~1-------._.- (,Ai L.O"z, btj',C VOL LAME: Z I.AL L.u~JI.I',
T OS
Nl AKM h1A►JUFAf.-1 UK6_14
. LAVA I'-I Irk- A IkA,ACJK LiALI
MOULL KJUMbLK b - ~~jZ~ Iw1 Nl~ uK 3C_ GALLUU~
W I T i- H I J I E f ! 2e, i_ INLNL~ UK I( t.AL.LUA1':,
a X79
_AL L t,u,
L AJUMbI K Nt~ I ► I'IIMY AlAt, hL.AK.M AIAI 1,, bi
~)WIIC.li TJPL: IAJ~IAL_LVU UW tLVAKAIL i_IKCLJII_l,
PUMP UiSL_HAHI,L KAI L 1'M it ~ "1r•( / ~ Cl( ~
VLKI ILAI UItLcKLFJt_L bL I V4LLA1 I'UMI' l)II AA_jU UISIKII'SUlIU,, I-IrL - _ FE I I l 1
t M,AAIh1L1M AlL 1 WOKK ,UI'I l- y YKL/L L KE_ H EC 1
r' (•7t}' ..L~
i tLt 1 OF i UKLL MAIN k IKICIIG►.J IAC-ruK._. ' FLL I
I GTAL UUIJA.rllt H LAD f LL 1 1 1 L
IIJ79. 4L
1 LKIJAL GIMk ►Jj1U1J» ~F I A►JK: L LAIC, I tt _ ;WIDTH _ LiL4UIU LAV I I1
.l. l
` Bulletin CL2.1A
July 8, 1983
For Horses
Farms -
Trailer courts r
Motels Model 3885
' y.
ISuperPdes PA1x1ei 38i0i
Schools •
Submersible
Hospitals
trwa,, PuPV Effluent Pumps
ndustry
qq
Effluent Systems
r
anywhere effluent
or drainage must be disposed of quickly.
and efficientl X
quietly y
Heavy-Duty Solids Handling
Dependable Capability to 3/4" •
1 1 ~ ,
'/3 1/2 H. P. 60 Hz , L
Single Phase 115, ~i". r~
30 Volt.
1/2, N, 1, 1'/2 H.P. 66Hz
Single Phase 230 Volt_ Three Phase 208-230, 460 Volt.
' -o T,.
90 -f~
HO
F 70 MODEL 3885
w RPM 1750/3450
WE10H -
_
LL 60
O
i
a WE07FI -
= 5tt
L)
Q 40 WEU5H t
Z I_~
30 WE03M - - -
20 WE03L_- - - -
- i -
10 - - • Pc If ic'. nT U~N-: Afif ~,i it;.Y ~ ~ rl ~ -.I r-..tt
IM-fl, Ill rJi u.r,f
1-
0
~NH
0 10 20 30 40 50 60 70 HO 90 100 Ito 120 ~ GOU LDS PUMPS. INC.
GALLONS PER MINUTE t• .
STATE OF WISCONSIN DILHR
taILHR PRIVATE SEWAGE SYSTEMS BUREAUNOFFPLUMBING BUILDINGS
Rm 41
1
PLAN APPROVAL APPLICATION 201 E. Washington Avenue,
P.O. Box 7969, Madison, WI 53 53707
7
608-266-3815
INSTRUCTIONS: Please fill in all applicahle data and submit this form with plans. Plans will not be reviewed until all fees are received.
The back side of this form describes required plan information. Plumbing codes can be purchased from the Department of Administration,
Docurnent Sales, 202 Suuth Thornton Ave., ;Madison, Wisconsin 53703, Telephone (608) 266-3358.
1. PROJECT INFORMATION (Type or print clearly) Revision To Plan Number:
Name of Submitting Party lRans returned to same) Project Name
Street & No. or Rural Route Project Location - Street & No. or Legai Description
City or Village State 1 - - -
71p City F1 County
Village ❑ OF:
Town L
Telephone No. (Include area code) Designer Telephone No. (Include area code) Owners Name Telephone No. (Include area code)
Street & No. Street No.
i
City or Village State Zip City or Village State Zip
2. APPLICATION FOR: ❑ New Mound System (3a) ❑ Groundwater Monitoring (7)
U Conventional System - Public Building (1) ❑ Replacement Mound (4a) L Holding Tank (2)
❑ Replacement Pressurized System (4b) ❑ System in Fill (1) ❑ Petition For Modification (6)
❑ New Pressurized System (3b) _I System in Flood Fringe (1► ❑ Other Alternatives (5)
3. FEE COMPUTATIONS (Include existing tanks) 4. r
MAKE ALL CHECKS PAYABLE TO DILHR
3a. 750- 1,500 gallon septic tank - 50.00 4,:
3b. 1,501 - 2,500 gallon septic tank - 60.00 4(:.
3c. 2,501 - 5,000 gallon septic tank - 80.00 4c.
3d, 5,001 9,000 gallon septic tank - 100.00 4d.
3e. 9,001 15,000 gallon septic tank - 150.00 4e.
3f. Over 15,000 gallon septic tank - 250.00 4t.
3g. 500- 1,000 gallon dose chamber - 30.00 49.
3h. 1,001 - 2,000 gallon dose chamber - 50.00 4h.
31. 2,001 4,000 gallon dose chamber - 70.00 4i.
3j. 4,001 8,000 gallon dose chamber - 90.00 4j.
3k. 8,001 - 12,000 gallon dose chamber - 110.00 4k.
31. Over 12, 000 gallon dose chamber - 150.00 41.
3m. 500 - 5,000 gallon holdinq tank - 30.00 4m.
3n. 5,001 - 10,000 gallon holding tank - 55.00 4n.
3o. Over 10,000 gallon holding tank - 100.00 4o.
3p. Revisions - 20.00 4p.
3q. Groundwater Monitoring Per Lot - 32.00 4q.
(other than a proposed subdivision) Subtotal
3r. Priority plan review: walk through! 41. _
Submittal of plans in person,
by appointment, with dnuhle fee
3s. Petition for Variance
Setback - 15.00 45.
Site evaluation - 50.00
Total Fee
Note: Fees pursuant to Wis. Adm. Code, Chapter Ind. 69
may be subject to change annually
Nfl S(1 6-,1F R U; L4! Effective July 1, 1984 -OVER
Tha fo, n,v ng irforn- atJ m i~. reriJired tnr Iii ii. i'dlew,, A.n index paga nr each 7agr' n' I'ie: p a t;. n'uts' h: s1:1.1 .(I e.:lpd and dated by the d ••apr-.r
5. MOUNDS & IN-GROUND PRESSURE DISTRIBUTION SYST EMS
Eta- Aopl,cation fcr Use o'' a'i Aln:n r. ve Sistem (I)II HR-SOC-b'r31_`:, ;nlrieil ow-a=r and I)w I, zad.
5h. County on-site.
5c. Verification form signed by : wiiiI:y IDI_HF SK D-6 1 5a),
5d. 115 photocopy.
5,. Plot plan show ng lot size and all lateral deranges from the system to hailoings, wel's, w+rtei cr,urses, Shovv permannt reference points. Direc-
tion and percent of slope or two foot contours must be Included. Provide system elev.,nur for n•ground presscre, shoe; for replacement if
for new construction. (TWO COPIES).
511. Plan view of System with observation pipes and permanent lateral markers (TWO COPIES).
5q. System cross section (TWO COPIES).
5h Pipe lateral layout (TWO COPIES).
5 . Construction detail of septic tank if site-constructed, or manufacturer if Prefabricated (TWO COPIES).
5,. Dosing Chamber cross section with construction details if site-constructed (TWO COPIES).
5k. Pump or siphon model, performance curve, total dynamic head calculations and minimum dose volume ITWO C^t' I F,'
.-rl c I r t•ir, :'i~t air nn r~;~ .
51. If the s to is suitable for a conventional privates t c
6. CONVENTIONAL PRIVATE SEWAGE SYSTEMS
Ga. Photocopy of soil tes' (115) by CST, ncludlne dat. to rep~acetn=_nt Sy'sn~iri, ! a w
Gh. Project Detail Data Sheet providing all sizing information (TWO COPIES).
Plot lar showirig location of septic tank, soil absorption system and replacement area. Indicate lateral data ices to any buildings, well, water
courses, lot lines, etc. The plot plait must also show the location of permanent horrzotional and vertical reference points (benchmark). A so Indicate
ground slope with 2 foot contours in entire area, extending 25 feet on all sides of initial and replacement systems. (TWO COPIES).
6,1 P an view of soil absorption system showing all dimensions, pipe lengths, spacing, etc. (TWO COPIES).
6e. Cross section of soil absorption system showing system elevation, aggregate, cover rnateria , depths, etc. (TWO COPIES).
Gf. Construction Beta l of septic tank if s 1e- constructed, or manufacturer if prefabricated ITWO COPIES).
6g Detail of lift pnmo sank or awomatrc siphon, tank s z diem, gallons per cycle, vertica ift, fri:i on loss, etc. ITWO COPIES:-
HOLDING TANKS
?a. Photocopy of soil test 15; by CST. A ful evaluation rnuf.t r.e made to et,m,nate az~ pL,.sir, tty of arv Othe- syste r being rn,miled,
7h. Agreement document between owner and local unit of government, notarized and tecoirfed in reference to the deed. This agreement must incl.ide
a statement about the quarterly pumping report.
?c. Plot plan showing location of holding tank with lateral distances to any buildings, viell, water service piping, water courses, lot lines, etc, Provide.
horizontal onrd vertical reference points. Include all-weather service road within ten feet of the service port. (TWO COPIFS).
;d. Holding tank pwifide showing vent, manhole, alarm and manufacturer if prefabricated. Complete construction deanls f si'e-const'ucted. (TWO
COPIES).
?e Prolrtct Detail Data Sheet provichng all Sizing info-•natinr (TWO COPIES). Th r; is rot iegaired for -esioential installat nn; vdhere the camber of hed-
rooms is indicated on the plans.
h SYSTEMS IN FILL
,nsa. Systems nt 'ill must include an on site invest gation f::rm IDILI IZ-SEID-61561, as %e l as all of t`ie appropriate items listed in sections 6.
9 GROUNDWATER MONITORING
9,a 115 photocopy (TWO COPIESi.
9w Groundwater Monitoring Report (DILHR SBD-64121 (TWO COPIES).
Pc. Verification of data and procecures front (:aunty ITWO COPIES).
9d Precipitation data.
10 PETITION FOR MODIFICATION
1 0a. Predate coce,aqu Pei itio -t'or fvlcciftcatnn Form (DILHR-SBD-6689).