HomeMy WebLinkAbout026-1294-26-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
ATTACH TO PERMIT) 592116
GENERAL INFORMATION State Plan ID No:
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. ~ j
T Village Township Parcel Tax No:
Permit Holder's Name: City
Oevering Homes TOWN OF RICHMOND 026-1294-26-000
CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No:
h0. , v-~') 28.30.18.1508
TANK INFORMATION, 0, A ELEVATION DATA
TYPE \ ACTItI V CAPACITY STATION BS HI FS ELEV.
Septic ~UD Benchmark Q I_ 1 I_ I u u C(CA ~]D9- lJ Alt. BM <`(rAefatteff Bldg. Sewer
Held+ng.' - - - Ht Inlet
TANK SETBACK INFORMATION Ht Outlet LO U
~ 7
TANK TO ' iP/Lt WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic Dt Bottom
p g 'v eade Man.
Aeration Dist. Pipe 113 .3 /3.2 cll.,, 3 ~o, l
lding Bot. System I '7 ~•Z 5 /
Final Grade
PUMP/SIP ORMATION / D d
Manufaeturer Demand St Cover
GPM l / V L
Model Number
TDH ift Friction Loss System, He TD - Ft
Forcemain a. Dist. to Well
SOIL ABSORPTION SYSTEM
BEDfTRENCH Width Length No. Of Trenches PIT DIMENS NS No. Of Pits Inside Diae Liquih
DIMENSIONS
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM EACHING Manufacturer
INFORMATION m CHAMBER OR J
TYPO DY Y M~ UNIT Model Number:
RIBUTION SYSTEM `f \UI ~j D6tY~ 11 I V rJ/
Header/ anifold tl Distribution x Hole Spacing Ve t to Air Intake
n
Length Dia Length Dia. Spacing n L11 447 e
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over th Over xx Depth of xx Seeded/Sodded Mulched
Bed/Trench Center LA qDe
Bed/Trench Edges > / J Topsoil El Yes E] No E] Yes :E] No
COMMENTS: (Incl de code discrepencies, persons present, etc.) Inspection #1: Inspection # /
1.
Location: 11 34THUi
~7 1
i
1.) Alt BM Description = 11ir, C
2.) Bldg sewer length =
- amount of cover = LAI, f
> ~ V o-~ coy ~v m Nil
Plan revision Required? ❑ Yes Q No
Use other side for additional information.
Date Insep tor's Signature Cert. No.
SBD-6710 (R.3/97)
- o~ County I ?
fir' Safety and Buildings Division
K 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit N (to be ed in by Co.)
r PS_ A SEP 1 Madison, Wl 53707-7162
ST. CROIX COON J~~Z /
h.
COMM e~Tll App1iG TY4 StateTransactionnN~ r
In accordance with SPS 383.21(2), Wis. Aden Code, submission of this for QZ O' V 8 H 93 V W /
is required prior to obtaining a sanitary permit Note: Application forms for stale-ownea rvw r o m~ ,
the Department of Safety and Professional Servies. Personal information you provide may be used for secon project Address (if different than rnaiIin~ address
ores in accordance with the Privac Law, s. 15.44(1) m), Stats.
L A Gcation Information - Please Print All Information / t -
Property Owner's Name ( y
/`j r PazceI
( (9 (rt_ Qa6_~~~~~a~-cJU
Property Ownerr'ss Mailing Address
1 %a Property L ovation a C ( v
C r ~ q ~n u-f'
City, Stare _ Zip Code I Govt_ Lot
} _ Phone Number
~n , t ) J ` I'~ 'ii Section
v~J~JJ~ -R-ZJJJ L~J _ Ic o
II. Type of Building (check all that a ly) T C__) R-aE W
Family Dwelling - Number of Bedroo Subdivision Name
i loc
ok aD f
❑ Public/Commercial -Describe LJse r^ ~ I
❑ City of
❑ State Owned - Describe use CSM Number ❑ Vi of
t~T C ,~.'9 wn of~ 7
III. Type,of Permit. (Check only on box on line A. Co``mplete line B if applicable)
A.
ew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain)
B- ❑ Permit Renewal ❑ Permit Revision List Previous Permit Number and Date
❑ Change of Plumber ❑ Permit Transfer to New Issued
Before Expiration Owner ~ w
IV. of POWTS System/Com onent/Device: (Check all that a 1 ~ /rjl
n-Pressun7zd In-Ground ❑ Pressurized In-Ground ❑ At-Grade a
❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil l /x
❑ Holding Tank ❑ Other Dispersal Component (explain)
❑ Pretreatment Device (explain)
V. Dis ersal/Treat t Area Infor ation:
Design Flow (gpd) Desi Soil lication Ra ds
F tc(gp f} Dispersal Area Required (sfl p persal oposed (qf) ystran levalion
~z.0 7
VL Tank Info Capacity in Total # of Manufacturer
2vew Tanks Gallons Gallons units o
~--s Fxistmg Tanks
C U v.
a 'V r ti N
J C/] v v] C. L
Septic or Holding Tani;
e
Dosing Chamber
VII. Responsibility Stateme - the undersigned, assume r o sibility for installation of the POWTS shown on the attached plans
p~, s Name (Prim
( ' Plumber's MP/MPRS Number Business Phone N bet
Plumb ; s dr s (Street, City, S Zip Code) ~ ' . ~ ~ ~ ~ ' ~J ~ ~ ~ ~ ~ %
,lam ''t r
VIII. ountylDe artment Use Only V
Approved ❑ Permit Fee Date ueedd Issuing , t Signature
❑ r Given Reason or Denial S / V ✓ • i ~rJ
IX Conditi 13sons.for n pproval
1. ep.. P ar. , et a .,g ulte* pit, 1i1 nC~
tlisper-. a, cell must all be ~fiq icps,! n>eiPAg t
as per management plan provided by plumber. w~ i S YIAt~ w~ ~
2. AU ale r A requirerode / dnane maint~ fined ` ~ O 1
as Per IAPF cam / ~narroea. ~~CG
t0 ~mP plans £or the system and submit to the Conn my on paper not 1 n 8 rP_ z I1 inches in size
SBD-6398
I 1/11
P~
r"• ~ r v ra~ •r~l ~O i
4, Zjl
System PLOT PLAN
PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017
NE 1/4 SW 1/45 28 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX
SYSTEM ELEVATION 98.0/97.6/97.2 4' below grade 9/13/16 BEDROOM 3
DATE
CONVENTIONAL XXX CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .4 ABSORPTION AREA 1 157 # of chambers 57
BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter Lifetime Filter
❑ BOREHOLE O WELL *H.R.P. same as benchmark
Scale = 1/4" = 10'
134th Ave
~i
s
;30' ST
261'
leidroom 60'
House ~
a
0
B-2
50'
N 3-3' X 78' cells
with >3' spacing
5'
Vent 100,
>6" Quick4 Standard 3
of Cover Leaching Chamber
with 20.0 ft2 of Area
5.6ft^2/pair of end caps 5
Long 12 '
Grade at System Elevation
34"
B-1
ents
All piping shall be ASTM SDR 30/34, within
10' of tank, piping shall be ASTM F891
135'
203' Property Line
B.M.*
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 9/13/16
Owner:Oevering Homes
Location: NE1/4 SW1/4 S28 T30 N,R18W 1147 134th Ave Richmond
Manuals Used: In-ground absorbtion system (version 2.0)
Page#
1. Cover Page
2. Plot Plan
3. Chamber Cross S ion
4-6. Maintanance and ntingency Plan
7.Filter Cross Sectioyl
Signature
License n er #226900
System PLOT PLAN
PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017
NE 1/4 SW 1/4s 28 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX
SYSTEM ELEVATION 98.0/97.6/97.2 4' below grade 9/13/16 BEDROOM 3
DATE
CONVENTIONAL XXX CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .4 ABSORPTION AREA 1 157 # of chambers 57
BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter Lifetime Filter
❑ BOREHOLE O WELL *H.R.P. same as benchmark
Scale = 1/4" = 10'
134th Ave
30' ST
261'
Pro 3
Bedroom 60'
House
B-2
50'
3-3' X 78' cells
with >3' spacing
50'
Vent 100
>6" Quick4 Standard B-3
of Cover Leaching Chamber
with 20.0 ft2 of Area
12 5.6ft^2/pair of end caps 5% Slope
4' Long
34" Grade at System Elevation
B-1
Vents
All piping shall be ASTM SDR 30/34, within
10' of tank, piping shall be ASTM F891
135
203' Property Line
B.M.*
Cross Section of Quick 4 Standard Leaching Chamber
Typical cross section for 2 of 3 cells
Quick 4 Standard
Leaching Chamber with
20.0 ft2 of Area per
Chamber 5.6ft^2 pair of end plates To be >1' above grade
Finish grade elevation
Typical Installation 102.0'
Len Vent
G rade
4'
4 Septic Tank
4' L5' 4' Log 1
Grade at System Elevation
3 4 Grade at System Elevation 3411
Spacing 5'
3-3' X 78' Cells
Observation tube/Vent
Same on other end To be located on end of Cells
~%A
B
System elevations: C
A-98.0'
B-97.6'
C-97.2'
19 chambers per cell
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of
ILE INFORMATION SYSTEM SPECIFICATIONS
Owner ( t' r` Septic Tank Capacity DNA
Permit # it
Septic Tank Manufacturer ~
t
IGN PARAMETERS Effluent Filter Manufacturer
E3 NA
.1 Number of Bedrooms ❑ NA Effluent Filter Model " ❑
NA
Number of Public Facility Units ;i~ M Pump Tank Capacity
Estimated flow
= L ~ Pump Tank Manufacturer i Design flow (peak), (Estirriated x 1.5) al/ Pump Manufactures Sal Application Rate aV ~ Pump Model
i Standard Influent/Effluent Quality Monthly average' Pretreatment Unit
INA
Fats, Oil & Grease (FOG) 530 Biochemical O SandtGravel Fitter D Peat Filter
Oxygen Demand (BODS) 5220 nVIL ❑ NA O Mechanical Aeration ❑ Wetland
Total Susperided Solids (TSS) 5150 mgtL O Disinfection D Other:
Pretreated Effluent Quality Monthly average D' I Cell(s)
Biochemical Oxygen Demand (BODE) 530 ❑ NA
mgt -Ground (gravity) ❑ In-Ground (pressurized)
Total Suspended Solids (TSS) <30 mgtt.. ID At-Gro C3 Mound
Fecal CoGforrn (geometric mean) 5104 cfcrh 00MI ❑ drip-Line ❑ Other:
IMaximum Effluent Particle Size 3l3 in dice. ❑ NA Other.
Other: ❑ NA
Other.
13 NA
*Values typical for dornesfic waStMatar and septic tank effluent Other.
❑ NA
NTENANCE SCHEDULE
Service Event Service Frequency
gnspect condition of tank(s) At least once every: ❑ rnor sr(s) (Maxirmnn g years) ❑ NA
Pump out corrlents of tank(s) When cornbined sludge and scum equals one-third ()6) of tank vbturne
❑ NA
hnspect dispersal cep(s) At least once every: ❑ month(s) (Maximum 3 r(s) years)
❑ NA
Olean effluent filter At least once every. / r O month(s) O NA
I nspect pump, pump controls & alarm At least once every: 0 month(s)
❑ year(s) ❑ NA
f=lush laterals and pressure test At least once every: ❑ month(s)
❑ year(s) NA
At least once every: ms( s)
r. E NA
NA
MAINTENANCE INSTRUCTIONS
!Inspections of tanks and dispersal ells shall be madeby an individual carving one of the following licenses or certifications: Master
Plumber; Master Plumber Restricted sewer POWTS inspector, POWTS Maintainer, Se a Servicing O
include a visual inspection of the tank(s) to identify any missing or broken hardware i l r. Tank inspections
the io volume must
combined sludge and scum and to check for any back up or ponding of effluent on th ` any cracks or leaks, he measur e the volume of
Visually inspected to check the effluent levels in the the ground surface. The dispersal cell(s) shall be
The pondng of effluent. on the ground surface may observation indicate a ng and to check for arry ponding of effluent on the condom and requires the immediate notificadon of the
local
regulatory authority.
6%= the combined accumulation of sludge and scum in any tank equals one-thins
(36) or more of the tank volume, the entire contents of
}fie tank shad be moved by a Septage
Administrative Code. Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin
All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, preteatrnent units,
end any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority within 10 days of completion of any service event
Page of
START UP AND OPERATION other chemicals thFjt
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or
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 oo= 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 ble
discharged to the dispersal cep(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluenlt.
To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to thle
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 ceps. 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 pedbrrnanc a and prolong the life of the POWT$:
antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; dlsinfedants; fat; foundation drain
(sump pump) water, fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products;
pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly
and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Cade:.
• Ail 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 fined with soil,
gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS falls and cannot be repaired the following measures have been, or must be taken, to provide a code compriont
replacement system:
-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 requitied
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 rule..i in
effect at that time.
❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technologW a
holding tank may be installed as a last resort to replace the failed POWTS.
❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a sal and site evaluation
must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed) <i
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 TAN UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE O~ A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINER
Name r Name c u `
Phone Phone f > ,
SEPTAGE SERVICING OPERATOR (PUMPIER1 LOCAL REGULATOR AUTHORITY
Name p~, Name
Phone
El I I I Phone `_71) J 3C~~i -
z y
This docWWA was drafted in =mplianoe with chapter SPS 383.22(2)(b)(1)(d)&M and 383..54(1), (2) & (3), Wisconsin AdminWeartive Code.
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ST. CROIX COUNTY
SEPTIC TANK MA NTENANCE AGREEMENT
AND
('-NMRSHIP CERTIFICATION FORM
Owner/Buyer
Mailing Address
Property Addr~ Z
(Verification required from Planning & Zoning U ✓ _
partment for new construction.)
City/State
- Parcel Identification Number
LEGAL DESCRIPTION
Property Location ax/, A4, - PC.
T ~S c7N R W, Town of
Subdivision i -
Certified Survey Map # Lot#
Volume
Warranty Deed # - - Page # - -
, Volume Page
Spec house yes no I_ot lines identitrabl yes no
SYSTEM MAINTENANCE
AND OWNER CERTIFICATION
Improper use and maintenance of
maintenance consists of u yaur Septic system could result in its re
the system can affect the fan bon of the Sept ~ every three a P e failure to handle wastes. Proper
responsibilities are specified in C p tank as a treatme t etas e or sooner, if needed, by a licensed pumper
-
the waste disposal system, Owner What you put into
§ anon. 83.52 l g in
and in Chapter 12 - St. Croix County inamtenance
The property owner agrees to submit to St. Croix County planning Sanitary Urdinuance.
Owner and by a master plumber , 3otirne tY nning & Zoning De
wastewater disposal system is in u e ~ plumber, restricted plumber or a licensed Pant a certification fo
less than l/3 p p operating condition and/or pumper n signed by the
full of sludge. (2) after inspection and Ong that ar the on-site
pumping (if necessary), the septic tank is
j/we, the undersigned have read the above re uir
standards set forth here 4 emenis and agree to
Certification Srtng ~ as set by the Department of Commerce and a De maintain the private sewage disposals stem >of Natmal
Zonip D that your septic system has been
maintained must b p~ment and recur d Resources, State of Wisco in. the
8 eP~ment within 30 days of the be completed and re
three year expiration date. turned to the St_ Croix County Planning &
I/we certify that all statements 0
Property described above b virtue form are true to the best of my/Our knowledge. I/we am/ere the owner(s)
Y irtue of a arrauty deed recorded in Register of Deeds Office.
Of the
NUVaber of bedrooms
IGNAT OF APPLICANT(S) ;?~07 DATE i
***Any formation that is misrepresented may result in the sanitary Permit being revoked by the Planning &Loning Department-
Include with this application a recorded warranty deed from the 1Zegister of Deeds Office and a copy of reference is made in the warranty deed,
f the certified survey map if
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w Wisconsin Department of Commerce SOIL EVALUATION REPORT Page - of
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code ,
e_---- unty S-~ C ~R~ ►
Attach complete site plan on paper not less than 8 1/2 x 11 inches in si Pd', t iEr ,
include, but not limited to: vertical and horizontal reference point (BM), directiorfbnd° P rcel I.D. it Z 6_/ a9 ~b~
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. f/
Please print all information. ; 0Llf vie ed by Date
Personal information you provide maybe used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ~ f
Property Owner LQ N , e1 FIC ton
Gerald, • i'~~ ~ o " 4~L`'1/4 Sa~ T~(~ N R E(or
Property Owner's Mailing Addrel Lot # Block # Subd. Name or CSM#
i 90-11 Ve. N W a ~o afi o f is m6 crc
City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road;
HK K*`/C- R KIN 30 ( ) 1- $ K;ic~ti M a N c .~e..
New Construction Use: Residential / Number of bedrooms Code derived design flow rate s GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material GI Flood Plain elevation if applicable _ _ fl.
General comments S v S 5a 5t 3 rt r •f v as t i U
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and recommendations: T-
-T,4 S;fe. ' 1.a (47 V5') S;~G T 5 q~•3$') ^ i~ fi i a F~ ~~c `+~G'
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Boring 1
Lj J Ground surface elev. ft. Depth to limiting factor - 5 in.
L __l J Boring # 54 Pit -
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
l
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sit,
Boring
® Boring # 3 •
Pit Ground surface elev. Depth to limiting factor Soil A lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
4
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Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 /L a d TSS < 30 mg/L
p~ Signature l -k ` CST Nu j
T Name (Please Rd'
1 Lt. I r~~"~~
-Add ss C ate Evaluation Conducted Telephone Number
3588
a
Property Owner Gera' i y r 5M,411 Parcel ID # Page of
137 Boring # ❑ Boring r -
P6 Pit Ground surface elev. Az!~•1~7 ft. Depth to limiting factor ! in.
- Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 -Eff#2
14
AD
F-T
F-1 Boring # ®Boring -
❑ Pit Ground surface elev. ft. Depth to limiting factor _ in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
® Boring
I p Boring # Ground surface elev. Depth to limiting factor - in.
(L-~~ ® Pit Soil A lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2
Effluent #1 = BODS > 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.
S1313-8730 (R.6/00)
s
Property Owner Gervd e9 .SyY, ,4k Parcel ID # Page C~_ of -Y-
a Boring # ❑ pit Boring t
Ground surface elev. L O - , f ft. Depth to limiting factor a~ in.
Soil lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
V U
oring -
orin Pit Ground surface elev. I W ~ ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft?
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 Eff#2
s 2.~
F
F-1 Boring
Boring # Ground surface eliv. ft. Depth to limiting factor in. ❑ Pit Soil A lication Rate
Horizon Depth Dominant Color Redox Description Texture LStrmucture Consistence Boundary Roots GPD/fg
in. Munsell Qu. Sz. Cont. Color 'Eff#1 `Eff#2
Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD, < 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.
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