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HomeMy WebLinkAbout040-1227-10-000 W:scorsin Department of Commerce PRIVATE SEWAGE SYSTEM Counnc St. Cr~iX Safety and Building Division INSPECTION REPORT Sanitary Pent, Nq: f5 n /y 1 7 GENERAL INFORMATION (ATTACH TO PERMIT) State Pian ID Na: r}`~Jy~~ y Personal information you provide may ire used for secondary purposes )Privacy Law, s 15.D4 (1)(m)). /V Permd Holder's Name: / ~ /la City ViIYaae X Township Parcel 7a;. Ng: - Vol, /7 P~~~///yyy zl& z8 I 1;L1 6 0 CST BM Elev: Yrsp- BM Elev: BM Description: SecuonrTown/Range/Map No M: l3. 2 TANK INFORMATION a• ELEVATION DATA TYPE MANUFACTURy \ CA. ( STATION BS HI FS ELEV. Septic / Benchmark 2. Alt. BM /sits ~J BYda. Sewer ' 4 _ .y _ .l0 831 t Inlet .D 80.0 9 TANK SETBACK INFORMATION Ist/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air intake ROAD ~Dt inlet 'NU [A 01 Septic 1 6 } D'. Bottom Dosing t Head rf lian. J r A ration Dist. Pip= 5 0 833. y Holds Bot. System (ir 5'5 $3l 5 , -71 832. 3 Final Grade p~ p PUMP/SIPHON INFORMATION 2. / 3 (0, I Manufacturer i~ Demand St Cover I G r / -I I z GPM J . J l"o Model Number N 553 ~TDH Lift Friction Lo System Head TDH ^ Ft n S .-I .!i ~ . &E'~ ef 16 -0d iForcemain Length D~J f/ Dist to Well n' n ' I \VI S ` 1 SOIL ABSORPTION SYSTEM 't Z BEDITRENCH Width , Lengt, j No. Of trenches PIT DIMENSIONS No. Of Pits Inside Liquid Deptiy DIMENSIONS L/--- re .r , M. SETBACK SYSTEM TO ' P/L BLDG WELL LAKE/ST EAM LEACHING vR INFORMATION T pe Of System CHAMBERO UNIT M Numbed, BUTION SYSTEM heap flid Distrioution x Hole Size x Hole Spacing Vent to Air make Pipe(s) Length Length D;a 0 )d SOIL COVER z Pressure Systems Only xx Mound Or At-Grade Systems Only Depf'n Over Depth Over xx Depth of xx Seeded;Soodec b Mulched Bedrrench Center Bed. i-rop^q Edges Topsoil J Yes No J Yes No COMMENTS: (((IIncliIu\}de code ddiiscrepe(n~cli~eysy, jP~e~rs~ons(~present, eta. Inspection #1: inspection ~2: Location: j ~ Y VS) o I um l I Vl AI `a IDs `lX lk Pey ~I q Parma / i-) Aft BM Description W 1 n~~ ~S 'lea C/ ►N~ 2.) BYog sewer length C Y~ II~UYVt ~ - amount of cover = v ` V CWtf o~n o,11 e~ I Plan revision Required? Yes No 6~41- AH/a j Use- other side for additional iniorrnation. I Date Yrnsepctor's Signature Cent, No. SBD-6710 (8.3/57) PLOT PLAN PROJECT Ben Hanke ADDRESS 230 Monroe St. N Hudson Wi 54016 1/4 1/4S 13 /T 28 N/R 20 W TOWN Troy COUNTY ST.C.,10?X SYSTEM ELEVATION 832.0/931.8' 4.5' below grade 6/1 /16 Mti. DATE BEDRC,: ~M CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANI; MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE765 DOSE TANh` tZE HOLDING TANK SIZE LOAD RATE •7 ABSORPTION AREA 891 # of chambers 4' BENCHMARK V.R.P. Top of spike in tree ASSUME ELEVATION 1001 Filter Lifi ie Filter ❑ BOREHOLE O WELL *H.R.P. sameasbenchmark All piping shall be ASTM SDR 30/34, within Scale _ 1 4u = 10' 10' of tank, piping shall be ASTM F891 Vent M. 100' >6" Quick4 Standard of Cover Leaching Chamber with 20.0 ft2 of Area 12„ 5.6ft^2/pair of end caps 60' 4' Long 3 4" Grade at System Elevation Vents B-1 40' 1% Slope 50' 2-3 X 90' Cells with >3' spacing 100 B-3 Huffcutt Combo Tank 90' 20' Pro 3 B-2 Not enough slope Bedroom to establish house contours To Salishhan Drive i PLOT PLAN~ PROJECT Ben Hanke ADDRESS 230 Monroe St. N Hudson Wi 54016 1/4 1/4S 13 /T 28 N/R 20 W TOWN Troy COUNTY ST. CRC., SYSTEM ELEVATION 832.0/931.8' 4.5' below grade 6/1 /1 6 BEDROOM DATE CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK :MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE630 DOSE TANK SIZI` HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32 BENCHMARK V.R.P. Top of spike in tree ASSUME ELEVATION 100' Filter LifetimE 'fter ❑ BOREHOLE O WELL *H.R.P. same as benchmark ` All piping shall be ASTM SDR 30/34, within Scale _ 1 4 u= 10' 10' of tank, piping shall be ASTM F891 h 40' Vent txl.* 100' ~6» Quick4 Standard of Cover Leaching Chamber with 20.0 ft2 of Area 5.6ft^2/pair of end caps 60' 4' Long 12" 3 4" Grade at System Elevation Vents B-1 40' 1% Slope 0' 100, B-3 Huffcutt Combo Tank 90' 20' Not enough slope to establish contours Pro 3 B-2 Bedroom house To Salishhan Drive Wisconsin Department of Commerce SOIL EVALUATION RT Division of Safety and Buildings Pag of in accordance with Comm 85, Wis. Adm. Codel CC,ill[i~c, Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must Coun 1 X include, but not limited to: vertical and horizontal reference point (BM), direction and 7 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. O'! ( Q - 1.~ Z ` /ease print all information. Re e ~ 7 Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (m)). 2407 [Plyo perty Owner `'D ~ 1 .,,r~~ _ Lm .1 SR c~ rro r t, Prop y Location ~`~t. ~.'3ovt. of Z. 1/4 1/4 S T ZS N R E (orIW, operty Owner's Mailing Address Lot Block # Subd. Name CS 1DGC 200 I ~1 State Zip Code Pone to ber ` ❑ ❑ Village [Town Nearest Road v eR, PAUS 1,i ti ® New Construction Use: Residential / Number of bedrooms ❑ Replacement ❑ Code derived design flow rate q0 O GPD Public or commercial - Describe: Parent material G L Al. OUT VA -S M Flood Plain elevation if applicable fV General comments ft• and recommendations: p cL-1jL , L U 0" L.U ~6 W lTl~ 1 n.l F-1 t_1l;~ll(> Sun-o-i or- cxz~S -Vu BL. ~ 1 , S 3 3 . S / F-1 I Boring #❑y Boring r hbl Pit Ground surface elev. g ~O. 3 ft, Depth to limiting factor '2 ct6 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 1 0 2 i. [ - L 'j s bh v~~,~- as z -P Z 0 -1g LOy6Z 31b y 98)0 _ S os9 mI - t.z E Boring # t❑ Boring f CSI pit Ground surface elev. 3 b O g, Depth to limiting factor R 1) in. Horizon -Depth Soil AppD Rate Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 -10 t 0-1.2 ZZ Z L 2 s-P CS- S 2- S . `d Z to -!b JbItz alb - S. a1~ C.S 3 1 -y.2 -I.Slip3ly G~ s o S9 Y'1 CS L/ qZ-90 try fz sr~ - S o s~ m - r t, Z Effluent #1 = BOD5 > 30 < 220 mg/L and TSS >30 150 rng/L ' Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signatur CST Number Arthur L. Wegerer CD 3-! 220254 Address W e g e r e r Soil Testing & Design Service Date Evaluation Conducted Telephone Number 421 N. Nain St. River Falls, t•II 54022 6 -30 -011 715-425-0165 a i 11 ULL - 2Z:7-10 -00-o Page 2 of 0toperty'gwner S or") Parcel ID # 7-~] Boring F f Boring # 83 S ft. Depth to limiting factor 9 3 in. ® Pit Ground surface elev. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/tt' In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. -Eff#1 -Eff#2 I ©-10 I p1.1 ft 312. - L 2s b ~ `F c-S Z`~ • 5 Z i :r-1. . toys 3/6 - Si I Z S d M`{'11- CS -S 3 1-7 -Z& 5`1 fZ3I Vs OS9 ) CS ~-1 t, Z ' 3! o~t2 VI S d g m I • Z. Boring # ❑ Boring 2 Pit Ground surface elev. ~JJ, ~ ft. Depth to limiting factor ,Z3 Z2 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 / qu) / r i T r~ a Boring # BPitoring G nd surface 4ec ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Do in Color Redox Description Texture Structure Consistence Boundary Roots GPD/tt' In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. -Eff#1 -Eff#2 Effluent #1 = GODS > 30 < 220 mg/L and TSS >30 < 150 mg/- - Effluent #2 = BODS < 30 mg/L and TSS < 30 mp/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. i SBD-6330 (8.6/00) a F3Toperiy Owner' ► r-1~ `S Parcel ID # U LL 12Z:7-- 10 -000 Page 2 of 3 t Boring Boring # ~3 • S ®pit Ground surface elev. ft. Depth to limiting factor > l 3 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft= In. Munsetl Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 I o-l0 ~SJ`1 R312 - L 2~zb 'YY) fl ~S Z~C •5 Z i Ij Lo-m, 3/6 - s% I Z YS 10k Yvi.'{~- c s , S g 3 17-?$ ~•S`i231 - \s OS9 ) cS ~ -DI 3 ! 0`L2 - .S d g m I ~ - `t 2 Boring # ❑ Boring e7 _ Pit Ground surface elev.0 JJ ft. Depth to limiting factor-Z3.2 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsetl Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 1 pj Q r--- C i -22 ' e -,2 F-1 Boring # Boring Pit G nd surface a tt. Depth to limiting factor In. Soil Application Rate Horizon Depth Do in Color Redox Description Texture Structure Consistence Boundary Roots GPD1ft2 in. Munsetl Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 Effluent #1 = GODS > 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. i seo-8330 (Raroo) ' PLOT PLAN Page 3 of Scale 1' =50' iJ ` S)TIE -X ~-e$T CoV ~ D 1'~ 11ZOtJ G') Pr- l.pT Bra it-1 Cu2r.,~`cz z P bs6 g3b~ nzz-E3 3f~ t3-1 L4 I I UIT t Rt Prk I H LR-~1~ cis 'o ~o to ° -Tt A 8.3' ~..~3~ 5 J U, c d I 9.7 L4 0' Lam. 4-3 6 ` iT0 S Pt L.I S ttf~ tJ X3 6 I li"> \Z.I U C ~w`'ucw►,L, d~'~,~ ~ - 3 C~ - 0 3 715-425-0165 220254 C)3-1)v CST Signature Date Telephone No. CST No. Job NO. WsconsinDepartment ofIndustry, SOIL AND SITE EVALUATION REPORT Page! of 3 and Human Relations / 1. Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code CO s T= (2. Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but PARCEL I.D. # not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or Aa-7 dimensioned, north arrow, and location and distance to nearest road. ' ~(f nD APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED B~ ATE 7 PROPERTY OWNER: \AKA? p~ GvDp tl CuOp PROPERTY LOCATION jo S~~ t~N CUp G T Z 1/4 1/4,S l3 T 8 N,R -.0 E (00 C BLOCK # SUED. NAME OR CSM # Sf'tl.lSN PrN PROPERTY OWNER':S MAILING ADDRESS OT # \\ZO Pt1~~ ~~OGI: t~P_-l~C" I [ - i'~POSL4 PST OF CITY, STATE ZIP CODE PHONE NUMBER ❑VILLAGE ®fOWN NEAREST ROAD R~V QFSt T-_ftL-L w sclOZZ (71s) qZ.S- u)G-7 11Z0`( 1121~5" C41)G R4RO New Construc ion Use p(j Residential / Number of bedrooms L4 Additi f to e>asting building Replacement [ ] Public or commercial describe Code derived daily flow 6 o o gpd Recommended design loading rate o 7 bed, gpdM2 0 `a trench, gPd/ft2 Absorption area required $ S B bed, ft2 - S y ° trench, ft2 Ma)omum design loading rate bed, gpolft2 !2 ' R trench, gpdt2 Recommended infiltration surface elevation(s) S aL8 'PINGE 3 of 3 ft (as referred to site plan benchmark) Additional design/ site considerations 'DdS~ZD 'C'C>~~JC1F~S NRS CZ~CO►~1wfElui~~`D . Parent material s+~-n Sewma it o u e 5 ►Mc, 0 r--"U0_ Flood plain elevation, if applicable t--) - A . ft S = Suitable for System CONVENTIONAL MOUND IN4GROUND PRESSURE AT-GRADE SYSTEM IN FU HOLDING TANK U = Unsuitable for Stem (0 S ❑ U ® S O U [9 S ❑ U 19S ❑ U ®S ❑ U ❑ S ® U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Sere Consistence qw dary Roots GPD/ft Boring # Horizon in. Munsell Qu Sz. Cont Color Gr. Sz. Sh. Bed IerKtt 0_11 ~o~-t2 %1 L Z~sbk m' l- c S o-s o,6 ti... 2 \I-I>3 10 4 Q 316 ~ Z ~Sbk v,) CS D.S o•[. Ground 3 I P4 Z_ `i.S R 3)y - G►, VS O SO) v~ 1 cS o - o S elev. I O Y 2 ~ v r9 ~ ~ g3~.s fL y uZ-qo ~ : o.a Depth to C~ CCAQ AJ S P )'t o 1= )h v 1- 5 limiting factor Remarks: o•so•6 Boring # p. l O t o y2 z l Z L Z S bk l+~'~1~ 5 Z Z le-Is 1-1 R. 3~ L 2 `~shk m~~- ~S o,S 0.6 3 3- L12. VvW GI'-ks o S &C' o.s Ground elev. yt.g tv /y ,sf <p 5 O S9 M 1 9 3b-3 fL ~t Depth to limiting ca " factor 9 LLJ Remarks: CST Ntme:-PleasePrint Phone Arthur L. We erer 715-425-0165 eg~rer Soil Testing & Design Service-P.O. Box 74 River Falls,WI 54022 Signadrre: Date: CST N M00576