HomeMy WebLinkAbout040-1312-12-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: 592206
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:
Delta Construction TOWN OF TROY 040-1312-12-000
CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No,
X19. 8 ' U GST 04.28.19.2042
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER , A l CAPACITY STATION BS HI FS ELEV.
Septic w / • 6 , Benchmark dic
",d- F~ ~1.... 3a /Z 66 /t y, 6 4T T. 'Two
Alt. BM 64 Fa 41C.A , Z ldj.7
1 J- Aeration Bldg. S er
3•$ /OO,1S
Holding St/Ht Inlet
1..3:5
TANK SETBACK INFORMATION St/Ht Outlet $ °J g !
TANK TO P/L WELL BLDG. en Air Intake ROAD Dt Inlet
w ea4- 44rw
Septic 32 Dt Bottom
Dosing /tJ Header/Man.
Aeration Dist. Pipe 7. q& 3
Holding Bot. System 1W. ~S
PUMP/SIPHON INFORMATION Final Grade
Manufacturer Demand St Cover//
_ GPM f,~~ CO✓ Z' S
Model Numb
TDH Lift Friction Loss System Head H Ft
Forcemain Length Dia. a Dist. to Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length / No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS 47CJ ` z 1
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufact r:
INFORMATION CHAMBER OR
Type Of System: /7 Z 7 UNIT Model Number: /
(jOr4aJ2K~+go O✓, L SI-i.~~~~ /7dJ
DISTRIBUTION SYSTEM Qy1- 7,4.11,- 4/
Header/Manifokjr Distribution Ix Hole Size Ix Hole Spacing Vent to Air Intake
Pipe(s) d/
Length T Dia T Length Dia Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over xx Dept of 1xx Seeded/Sodded xx Mul hed
Bed/Trench Center Z Bed/Trench Edges Topsoil
.41 - Yes n No es No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2:
Location: 527 OLIVIA CT 1 /
CAD 1~.. C/ Ir _ e d d
1.) Alt BM Description = I~
2.) Bldg sewer length = S WAXI Ab+--- rr q~- 4tri,4- 414
- amount of cover = "
Plan revision Required? ❑ Yes No s
Use other side for additional information
SBD-6710 (R.3/97) Date Insepct Signatur Cert. No.
MN ~0)16
y County f
2~j y( rt~~d Safety and Buildings Division r .
< o 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.)
P C '00(cou" Madison, W1 53707-7162
COMH11JI41V DEV'ELO (SENT 2Zb `p
Sanitary Permit Appl; awTransa o4Number
in accordance with SPS 383.21(2), Wis. Adm. Code, submission of this 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 secondary
purposes in accordance with the Privacy Law, s. 15.04(1 m), Stats. `
L Application Information - Please Print All Information r 1 ✓ ! C~
Property Owner' Name Parcel #
-A A
Property Owners Mailing Address Property Locationl I ` I
G Govt. Lot t,
City, S Zip Code Phone Number li, Jy. Section
r _ / ; l ,(cycle onr1
ZFN; R 7`/_7_ E ori~V`/)
II a of Building (check all that apply) Lot
r 2 Family Dwelling -Number of Bedroo / Subdivision Name
Block f✓C
❑ Public/Commercial - Describe Use a~
aV^ - ❑ City of
U
❑ State Owned -Descri~be Use ~r 16,0 CSM Number ❑ Village of -
2
l~C'.tr~ fZ.1-1-Z Town of
III. Type of Permit: (Check only o box on line A. Complete line B if applicable)
A. System ❑ Replacement System ❑ Tr eatment/Holding Tank Replacement Only CJ Other Modification to Existing System (explain)
B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued
Before Expiration Owner r 1 /111 IV of POWTS System/Component/Device: (Check all that apply)
-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil Mound < 214 in. of suitable soil
❑ Holding Tank ❑ Other Dispersal Component (expwn)_ ❑ Pretreatment Device (explain)
V. Dis ersaIlTreat ent Area Information: '
Design Flow (Rd) Design Soil Application c(gpdsf) Dispersal Area Required (s Dispersal Area oposed (sf) nation
VT. Tank Info Capacity in Total # of Manacturer
Gallons Gallons Units o
New Tanks g Tanks 'y c y m
Septic or Holding Tank , oZ S i
Dosing Chamber
VII. Responsibility Statement- I, the undersigned, a e responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name (Print) PI Signature MP/MPRS Number Business Phone Number
Plumber's Address (Street, City; State, Zip
321
VDIeCounty/Department Use Only
pproved ;=**6 Permit Fee Date Isson for Denial Pu1 $ I V~ ' 'v 1
IX Conditins_ ns, or Dis pproval a E tm f /
alspen:: i cell must all be sptok ~s r m 'n
as :per Management plan prodded by plumber, k~
2. t+Nl a~et c k req irer.~ ft must be rtai t iced
as per oRka+ble coda 1 i.rdinattow. I
Attach to complete plans for the system and sub;i' the Rnty, only OR paper not s than XSE 1 in ch~ - m sift
1ua., pr~,ser
I
SBD-6398 (R. 11/11)
System PLOT PLAN
PROJECT Delta Construction ADDRESS 206 2nd St. Hudson Wi 54016
NE 1/4 SW 1/4S 4 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROIX
SYSTEM ELEVATION 95.3/95.1 47 below grade DATE 12/7/16 BEDROOM 4
CONVENTIONAL XXX CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 891 # of chambers 44
BENCHMARK V.R.P. 1/2" iron pipe ASSUME ELEVATION 100' Filter Lifetime Filter
❑ BOREHOLE O WELL *H.R.P. same as benchmark
1~calle 10'
i
Olivia Court
233' Property Line
Vent
>6" Quick4 Standard
of Cover Leaching Chamber
with 20.0 ft2 of Area
5.6ft^2/pair of end caps
4' Long 12
Grade at System Elevation
34"
B-2
Pro 4
10' W Bedroom
ST House
100'
60'
-3 "'M10 too,$
0% Slope 2-3' X 90' Cells with
>3' spacing
0'
B-
B.M. All piping shall be ASTM SDR 30/34, within
Vents 10' of tank, piping shall be ASTM F891
32'
54' jr- 71' 387' Property Line
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 12/7/16
Owner:Delta Construction
Location: NE1/4 SW1/4 S4 T28 N,R19W 527 Olivia Court Troy
Manuals Used: In-ground absorbtion system (version 2.0)
Page#
1. Cover Page
2. Plot Plan
3. Chamber Cross Se 'on
4-6. Maintanance and o tingency Plan
9
7.Filter Cross Section
Signature
- -
License number #2 6`900
System PLOT PLAN
PROJECT Delta Construction ADDRESS 206 2nd St. Hudson Wi 54016
NE 1/4 SW 1/4S 4 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROIX
SYSTEM ELEVATION 95.3/95.1 47 below grade 12/7/16 BEDROOM 4
DATE
CONVENTIONAL XXX CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 891 # of chambers 44
BENCHMARK V.R.P. 112" iron pipe ASSUME ELEVATION 100' Filter Lifetime Filter
❑ BOREHOLE O WELL *H.R.P. same as benchmark
Scale = 1/4" = 10'
Olivia Court
233' Property Line
Vent
>6" Quick4 Standard
of Cover Leaching Chamber
with 20.0 ft2 of Area
5.6ft^2/pair of end caps
4' Long 12"
Grade at System Elevation
34
B-2
,~--r`i bm- Pro
C
0, Be oom
ST Ho se
1
6'
-3
14 10 2-3' X 90' Cells with
>3' spacing
0'
B-
B.M.* All piping shall be ASTM SDR 30/34, within
Vents 10' of tank, piping shall be ASTM F891
32'
54' 71' 387' Property Line
Cross Section of Infiltrator Quick 4 Leaching Chamber
Typical cross section for 2 of 2 cells
Quick 4 Standard Leaching Chamber
with 20.0 ft2 of Area per Chamber To be >1' above grade
5.6ftA2 pair of end plates
Finish grade elevation
Typical Installation 100.0'
Vent ~ Grade Vent
3, 4„ 13'
A~30134 Septic Tank
5' Long 1 57 4 5 Long Grade at System Elevation
36" Grade at System Elevation
Spacing- 5'
2-3' X 90' Cells
Same on other end Observation tube/Vent
At end of cell
A
B
22 chambers per cell
System elevations:
A-95.3'
B-95. 1'
ST. CROIX COUNY Y
SEPTIC TANK MAINTENANCE.ZWREEMENT
AND
OWN_ERSHIP CERTIFICATION FORM
Owner/Buyer (
- ~ W S
Mailing Address 7 Dn 5~~ L~.<_0~
•
Property Address A (42 L z
(Verification required from Planning & Zoning Department for new construction.)
City/State Parcel Identification Number ~ 7
LEGAL DESCRIPTION
Property Location V. '/4 , see. , T 7-, YN R~ W, Town of
Subdivision Lot # -
Certified Survey Map # , Volume , Page #
Page
Warranty Deed # c r , V o time , # e
Spec house 6P no Lot lines identifiable yes 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, ii: 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 wastt 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.
Vwe, the undersigmcd have read the above requirements and agree to maintain the private sewage disposal system with the
standards set forth, herein, as set by the Deparunent of Commerce and the Department of Natural Resources, State of Wisconsin.
Certification stating that your septic system has been maintained must be completed and retinmed to the St. Croix County Planning &
Zoning Department within 30 days of the three year expiration date.
Uwe certify that all statements on form are true to the best of my/our knowledge. l/we am/are the owner(s) of the
property described above, by virtue of a deed recorded in Register of Deeds Office.
Number of bedroo
O&AtURP, OF APPLICANT(S) DATE
***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department"
Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if
reference is made in the warranty deed.
(REV. 08/05)
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of
PILE INFORMATION SYSTEM SPECIFICATIONS
Owner
V ,1 Septic Tank Capacity al ❑ NA
Permit # Septic Tank Manufacturer ❑ NA
3ESIGN PARAMETERS Effluent Filter Manufacturer 13 NA
Number of Bedrooms 0 NA Effluent Filter Model 0 NA
Number of Public Facility Units )"A Pump Tank Capacity al NA
j Estimated flow (average) gal/day Pump Tank Manufacturer NA
Design flow (peak), (Estimated x 1.5) gal/day Pump Manufacturer NA
Soil Application Rate al/da tftz Pump Model NA
i Standard InfluentlEffluent Quality Monthly average* Pretreatment Unit NA
Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter
Biochemical Oxygen Demand (BODs) 5220 mg1L ❑ NA ❑ Mechanical Aeration ❑ Wetland
Total Suspended Solids (TSS) !_l 50 mg/L ❑ Disinfection 0 Other.
Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA
Biochemical Oxygen Demand (BODs) 530 mg/L -Ground / (gravity) 0 In-Ground
(pressurized)
Total Suspended Solids (TSS} 530 mg/L -,LLNA ❑ At-Grade ❑ Mound
Fecal Coliform (geometric mean) 5104 cfu/100ml \ ❑ Drip-Line ❑ Other:
iMaximum Effluent Particle Size Ya in dia. ❑ NA Other. ❑ NA
(Other. A Other: 0 NA
'Values typical for domestic wastewater and septic tank effluent Other. ❑ NA
IAINTENANCE SCHEDULE
Service Event Service Frequency
linspect condition of tank(s) At least once every: ~ month(s) ear(s) (Maximum 3 years) 0 NA
(Pump out contents of tank(s) When combined sludge and scum equals one-third (36) of tank volume 0 NA
_1 71
(inspect dispersal cell(s) At least once every: 0l month(s)
year(s) (Maximum 3 years) ❑ NA
1--lean effluent filter At least once every: month(s) 0 NA
ear(s)
Inspect pump, pump controls & alarm At least once every: ❑ month(s) NA
❑ year(s)
1:lush laterals and pressure test At least once every: ❑ month(s) NA
0 year(s)
Dther. 0 month(s)
At least once every: C1 year(s) NA
13ther:
NA
MAINTENANCE INSTRUCTIONS
!Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master
(Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must
!include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of
icembined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be
!visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface.
The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local
regulatory authority.
When the combined accumulation of sludge and scum in any tank equals one-third (X) or more of the tank volume, the entire contents of
f:he tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin
Administrative Code.
N1 other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units,
13nd 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 thot
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 thO
tank(s) removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will by
discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of eftiuent.
To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to ttye
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 yehkA* over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within
15 feet down slope of any mound or at-grade soil absorption area.
Reduction or elimination of the foikwAng from the wastewater stream may improve the performance, and prolong the We of the POWM
antibiotics; baby wipes: cigarette butts; -condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain
(sump pump) water, fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products;
pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is propetly
and safely abandoned in Compliance with chapter Comm 83.33, Wisconsin Administrative Code:.
• Ail piping to tanks and pits shall be disconnected and the abandoned pipe openings seated.
• The contents of all tanks and pits shall be removed and property disposed of by a Septage Servicing Operator.
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil,
gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS falls and Cannot be repaired the following measures have been, or must be taken, to provide a code cornpront
replacement system:
-;6-4 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 infrincjsd upon by requirled
setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the rmW
for a new soil and site evaluation to establish a suitable replacement area. Replacer rt systems must comply with the rule;) in
effect at that time.
❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technologl/ 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 sail and site evaluagon
must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed) as
a last resort to replace the failed POWTS.
❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative
surface. Reconstructions of such systems must comply with the rules in effect at that time.
<<WARNING>>
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TAN UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE 0 A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS _
POWTS INSTALLER POWTS MAINTAIN PR
Name J Name
Phone`, Phone j~- ' - l
SEPTAGE SERVICING OPERATOR (PUMPOIJ LOCAL REGULATORY AUTHORITY
Name Nama E -7
Phone Phone
This doasnent was drafted in compliance with chapter SPS 383.22(2)(b)(1)(d)&M and 383..54(1), (2) & (3), Wisc onsin Administrative Code.
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CERTIFIED SURVEY MAP
VOL. 3 PG. 720
e are no objections to this plat with respect to
n^sr 4 e n11e' 1-11 1117x' 111df III £90 --A E'l'i
1Nscorsin Department of Commerce
'.G / LUATION REPORT Page / of
3
Division of Safety and Buildings
in ~ arjcelwit#~ . '~dQ m Code
County S?. G k>Q 1 X
Attach complete site plan on paper of less than 8 1/2 x 11 inches in ze. n _
include, but not limited to: vertical a d horiibntaKblWdbi'"T (BM) direction panel I.D.
percent slope, scale or dimensions north a16f6W*@ rand dis nce to neares d. 4 b -
Please print all information. Review y Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ~b /L ds
Property Owner Property Location ZD
~O Z> D 13J EIS - rc-D -1- Govt. Lot 4 G 1/45 W114 It T 2 N R al E (1r)e5
Prope Owners Mailing Address Lot # Block #
Subd. Name or CSM#
-1
3`Z 0MAH/I C 7 12- - C o??'A c--T 6- M6fiPowS
City State Zip Code Phone Number
U~~ Al w l C] City ❑ Village ~`fown Nearest Road
c ) -TROY Soi,6 G-.4
New Construction Use: (0 Residential ( Number of bedrooms 3 - 5 Code derived design flow rate ! 5 d - -750 GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material Flood Plain elevation if applicable t4 I^- v ft.
General comments
and recommendations:
Area X Wt Tested Double klir o S S l
a comentiona ground system (P.O.W.T.S.) % r r
a Boring # n Boring a
pit Ground surface elev, ft. Depth to limiting factor > 95 in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 -Eff#2
i o-I `f IurR2/i - 3m,5bK m--r c s 3V4 8
2 14•Zb IDYR4/4- - $Cl Zm5b'k mfr QW Z~~
3 A-q5 10 R 5 OS dl .7 I.~
{
~ if
F-T
Boring # 0 Boring 9
Fz-1 FA pit Ground surface elev. 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
l 0-18 I u ors 2/1 - 2 2-W5bx m-f r 9S ;?V--f to
2 16-36 10YA ' ScAlr'?511K
Mfl ail 2 V-, 4- ~ ell ~f 3 3 8- 9l 10 YR 114 n 115 d 1 - - --7 1. G L If 5 ITIt Po K~~
` S/CL I n,5 mf/
roU14 14T 3 gn_ .g
r ~
Effluent #1 = SOD > 30 < 220 mg/L and TSS >30 < 1 YL& ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L
CST (Please Print) Signature CST Number
0~i UL L-r R IL ti-T e5913-,
Address Date Evaluation Conducted Telephone Number
Z I2- /724 -A'j10 S pRi~Jq VAL.UFY,WI
MAY- 10 - goof ~~l l s) 772 - 3'~}Z
=oY issuance of permits and designing
Contact: Ulbricht &Associates g:;ltit~lates
Registered private wastewater consultant and 0UMbW Private Sewage Co fe
~'?sul:te
2812 10th Ave. 2812 1 Qth Ave.
Spring Valley, WI 54767 54767
715-772-3442
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Property Owner Parcel ID # Page 2 of 3
Boring # Boring
Q ® Pit Ground surface elev. /00.06ft. Depth to limiting factor 93 ✓
Sod Applicatim Rate
Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPDff
in. Munseli Qu. Sz- Cont Color Gr. Sz. Sh. `Eff#1 `Eff#2
0-13 ~4fz 7-1 - Zr*517X mfr a 5 3 ✓-F • (o S
2 13.35 jVfR`t/9- - 50-l 2m5b,X M~; Ct
2of b
3 3 5 93 i v'f r~ 5/S f 5 0 5 cl I - - -7 to
F] Boring # ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
Sod Appli Rate
Horizon Depth Dominant Cotor Redox Description Texture Structure Consistence Boundary Roots GPf7AF
in. Murrell Qu. Sz Cont Color Gr. Sz. Sh. -Eff#1 -Eff#2
Boring # ❑ Boring -
❑ Pit Ground surface elev, ft Depth to {inciting factor in.
Soil Rate
Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPDlfF
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. `Ei1#1 'Eff#2
I
F-1 Boring # El Boring Ground surface elev. it Depth fp limiting factor in.
• Sod Application Rate
Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPDftf'
in. Mures Qu. Sz. Cont. color Gr. Sz. Sh. `Eff#1 'Eff#2
` Effluent #1 = BODY > 30 < 220 rngit. and TSS >30:S 150 mg1L ` Effluent #2 = BOD$ < 30 mgt and TSS < 30 mglt.
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.
SB"334) 0L6M) r
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Property Owner Parcel 10 # Page -2 of 3
F I Boring # t~ Boring
tJ Pit Ground surface elev. JC>d-eft. Depth to !uniting !actor 93 in.Soil r Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM
in. Munsell Qu. Sz. Cont. Color Gr. Sz. SK `Eff#1 `Eff#2
0-13 16 rrR 7-1 - -0 2,,7 5121( M fr C s 3 ✓-f . to S
2 13.35 10fR t/+ - SC! 2msbl~ M*, a
3 35'93 f urz 5/8 r 5 2of 4-
0 b
5 cl ! - -
❑ Boring # ❑ Boring
❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Redox Description Texture Structuna Consistence Boundary Roots GPD/lf
in. Munseil Qu. Sz. Cont Color Gr. Sz. Sh. `Eff#1 `Eff#2
F Boring # ❑ Boring
❑ Pit Ground surface elev. It. Depth to limiling factor in.
Soil 'cation 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 `Efif#2
F] Boring # ❑ Boring
❑ pit Ground surface elev. ft. Depth to limiting factor in.
Soft 'cation Rate
Horizon Depth Dominant Color Redox Description. Texture Stuctw.- Consistence Boundary Roots GPDM
In. Munsel Qu. Sz Cont. Color Gr. Sz- S h. `Eff#1 'Eff#2
I I 1
` Effluent #1 = BODS > 30 < 220 mg& and TSS >30:E 150 mg1L ' Effluent #2 - Bobs < 30 mg& and TSS < 30 mgn-
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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ro, Issuance of permits and designing
C ontact: Ulbricht & Associates
Registered private wastewater corsulM Plump,-,",
U1b -=b°ht & Associates 2812 10th Ave,
Private Sewage Go;9sultants Spring Valley, WI 54767
2812 1 Oth Ave. 715-772-3442
Spring Valley, I'll 54767
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