HomeMy WebLinkAbout042-1077-20-011
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
(ATTACH TO PERMIT) 592249
GENERAL INFORMATION State Plan ID No:
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
Permit Holder's Name: City Village Township Parcel Tax No:
Benjamin & Laura Orne TOWN OF WARREN 042-1077-20-011
CST BM Elev: Insp. BM Elev: BM Description: ' Section/Town/Range/Map No:
28.29.18.440A-11
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER ` xt.. CAPACITY STATION BS HI FS ELEV.
Septic t ; r Y Benchmark
]A J
Dgsing - Alt. BM 777
Ae~atieti Bldg. Sewer r
` x.
f-010i,n9 St/Ht Inlet ✓
TANK SETBACK INFORMATION St/Ht outlet 1 _i
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
C"3
Septic T-Y Dt Bottom
Dosing Header/Man.
3
Aeration
Dist. Pipe
Holding` - - Bot. System
PUMP/SIPHON INFORMATION Final Grade
Vf
Manufacturer Demand St Cover
GPM t,;' / • j 3 [oa a 6
Model Number -
TDH Lift Friction Loss System Head TDH Ft
Forcemain Length Dia. Dist. to Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length t No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS
r.
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: .
INFORMATION CHAMBER OR I,' c
Type Of System: f i
UNIT Model NumberiN t~.
DISTRIBUTION SYSTEM 0, (9- Jd
Header/Manifpld Distribution x Hole Size ix Hole Spacing Vent to Air Intake
.fir < Pipe(s)
Length f_? Dia ' Length Dia Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over } Depth Over xx Depth of Seeded/Sodded =N. ulched
Bed/Trench Center ff Bed/Trench Edges Topsoil r Yes Yes No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2:
Location: 780 112TH ST f
1.) Alt BM Description ';'_k i~p2?r 2
(t~~• Q4 ~a 3~~1,
2.) Bldg sewer length 6~+- amount of cover
I
Plan revision Required? U Yes ❑ No ;
Use other side for additional information. J
SBD-6710 (R.3/97) Date Insep`ctoe"I nalu Cert. No.
RECEIVED SA N -19~; i-? L/.3
County _ 1
l
S (
U MAR O Safety and Buildings Division
$ Ia 201 W. Washington Ave., P.O. BOX 7162 Sanitary Permit Number (to be filled in by Co.)
p$ ORO%00 Madiso 15 7-7%62
1OMM NITY pEVELO ENR
Sanitary Permit Al State Transac Number
In accordance with SPS 383.21(2), Wis. Adm. Code, submission ofthis form to the appropriate govc....... . -..it
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), Stars.
~y r.~-
1. Application Information - Pleas rint All Information v
Property Owner's Name Parcel # ~
Property Owner's Mailing Address ~ Property Location a c+ . 1 q q G
~X JJ / t Govt. Lot 7
City, state
Zip Code Phone Number A;q Section
j 5 ~fJy W S/ ~G~ "~7 7 ircle one
H. Type of Buildin check all that apply) Lot # T Jt N; R E
0-1 or 2 Family Dwelling - Number of Bedrooms - M Subdivision Name
Block #
❑ Public/Commercial - Describe Use
❑ City of
❑ State Owned - Describe Use CSM Number /b - ❑ Village of
N1 W ~Z~ZZ V Town of
III. Type of Permit: (Check only one ox on line A. Complete line B if applicable)
A. New System ❑ Replacement System
❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain)
B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previ us Permit Number and Date Issued
Before Expiration Owner
I I 14~tm,~ Q,-444
IV. Type of POWTS S stem/Com onent/Device: Check all that apply)
XNon-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil S
❑ Holding Tank ❑ Other Dispersal Component (explain ❑ Pretreatment Device (explain)
V. Dis ersal/Treat entArea Information:
Design Flow (gpd) Design Soil Application Rate( dsf) Dispersal Area Required (sf) Dispersal Area Proposed System Elevation
07 Sy7 ~ ~S, oC-
VI. Tank Info Capacity in Total # of Manufacturer
Gallons Gallons Units n p o o
New Tanks Existing Tanks /'w / 2 IS 'R
p D nGf/~ a v ~ w r7 a
Septic or Holding Tank • -1,
Dosing Chamber C /
VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
Plumber's N me (Print) Plumber's ~atore MPRS Number Business Phone Number
Plum Address ~(Street, City, State, Zip Code)
X 04
VIII. ,;aunty)Department Use Only
pproved roved Permit Fee Date sued Issuing A V Signature
T05~~ 3 ~g 0
en Reason for ial
IX. Condit easons for Disapproval
1 Septif. tank, erfh gin: Bite v nd Iqe~,
6;sire cell must all be sN It e__
as per maG3 emen'. plan !u liderl by Iwrbe:. L I b
2 . 9 AefWdt (ek;t.jlwt n:s mtr;t k e r ai ti it e s Q 7 lbi a ( ;
as per ApFil rbh! w6f I .'rdinancup. c
Attach to complete plans for the system and submit to the County only paper not less th s 1/2 x I I inches in size
SBD-6398 (R. 1111 1)
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CONVENTIONAL COMPONENT DESIGN
Residential Application
C~ INDEX AND TITLE PAGE
Project Name: 0/` u/E ,
Owner's Name: 254) Z,~) Xlu a
Owner's Address: :3 7 oZ ~ ox
t14 oo Y) 13
Legal Description: Cs l U y J 5 UD~
Township:
County:
Subdivision Name:
Lot Number:
I
Parcel ID Number: U
Page 1 Index and title
Page 2 Plot Plan
Page 3 System Sizing & Cross-Section
Page 4 Filter Specs
Page 5 Maintenance Information
Page 6 Management Plan
Page 7 St. Croix Cty Septic Tank Maintenance Form
Page 8 Warranty Deed
Page 9 CSM or Plat
Attachments: Soil Test & House Plans
Designer/Plumber: 07_&-J License Number: o~rj7h~
Date: Phone Number 7/,5 - 7~C➢ ° (D
Signature
Designed pursuant to the InfG and Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P (N.01/01).
Page 1
711
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Soil Absorption System Cross Section
16 ft
4" Scee pie 40 Final Grade
PVC Ve^t Pbe G1
Wt`, Ve-*. Cap 1 ft
Leaching U
Chamber 2,5,6Uft
-J System Elevation
.3 ft 3
Soil Absorption System Plan View
ft
ft ~
ft Le I
,caching Trench i
Vent Or Observation on Pie
o p ~.7ambers
4 Dia.
Trench 2 Header
Leaching Chamber Specifications
Manufacturer And Model
EISA Rating sq ft per chamber Soil Application Rate -44W gpd/sq ft
C~ gpd Design Flo v,, : o. 7 Soil Application Rate = 0 EISA =
V2,Khambers
2 roves of 9(~-
chambers each
do - Ll ~'6 ~ Xa -7~- goo
s~
Page of
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(EFFECTIVE IENG FH!
,.2
8° INVERT X5.3" INVERT
S;^ VERT f~~ 13"
182,
J ~
6..
E Er
2 1v`JERT 1( Q~~~ Ali-
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Plus Standard Chamber Specifications
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221.=436
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POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page I of 2
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner Septic Tank Capacity gal ❑ NA
Permit # Septic Tank Manufacturer ❑ NA
DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA
Number of Bedrooms ❑ NA Effluent Filter Model `A `?5 ❑ NA
Number of Public Facility Units ❑ NA Pump Tank Capacity gal ❑ NA
Estimated flow (average) gal/day Pump Tank Manufacturer ❑ NA
Design flow (peak), (Estimated x 1.5) 4X00 gal/day Pump Manufacturer ❑ NA
Soil Application Rate d 7 al/day/ft2 Pump Model ❑ NA
Standard influent/Effluent Quality Monthly average* Pretreatment Unit NA
Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter
Biochemical Oxygen Demand (BOD5) 5220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland
Total Suspended Solids (TSS) 5150 mg/L ❑ Disinfection ❑ Other:
Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA
Biochemical Oxygen Demand (BODS) 530 mg/L kin-Ground (gravity) ❑ In-Ground (pressurized)
Total Suspended Solids (TSS) 530 mg/L ❑ NA ❑ At-Grade ❑ Mound
Fecal Coliform (geometric mean) <104 cfu/100m1 ❑ Drip-Line ❑ Other:
Maximum Effluent Particle Size Y. in dia. ❑ NA Other: ❑ NA
Other: ❑ NA Other: ❑ NA
*Values typical for domestic wastewater and septic tank effluent. Other ❑ NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
Inspect condition of tank(s) At least once every: t, El yea (s (s) (Maximum 3 years) ❑ NA
Pump out contents of tank(s) When combined sludge and scum equals one-third (Y) of tank volume ❑ NA
Inspect dispersal cell(s) At least once every: ❑ month(s) (Maximum 3 ears) ❑ NA
421- 1J~ year(s) y
Clean effluent filter At least once every: f .9 month(s) ❑ NA
❑ year(s)
Inspect ❑ month(s)
pump, pump controls & alarm At least once every: NA
❑ year(s)
Flush laterals and pressure test At least once every: ❑ 13 m year(s) r(s) } NA
(s) i ❑ NA
Other: At least once every: ❑ ❑ m year(s)
Other: ❑ 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 combined 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 or more of the tank volume, the entire
contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113,
Wisconsin Administrative Code.
All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment
units, and any servicing at intervals of <_12 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
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals
that 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 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 be
discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of
effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring
power to the 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 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 following from the wastewater stream may improve the performance and prolong the life of the
POWTS: 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
property and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:
• All 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 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 fails and cannot be repaired the following measures have been, or, must be taken, to provide a code compliant
replacement system:
❑ A 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
required 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 rules in effect at that time.
❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS
technology a holding tank may be installed as a last resort to replace the failed POWTS.
T .
aluati / a o mg~ank
mAy be e . ?RD{-/IB T(i~ SDP- A/6~% ~NS'T9UC-- lO
❑ 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 TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINER
Name
Name O- 12
Phone r7~ _ ?~.L7 Phone
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name 7 NamT-71':-- s-`- G ( U 201W ~ f
Phone FPhon3g(`1_ 41&9,fD
This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code.
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer r'`
Mailing Address Z- C)X O"
Property Address
(Verification required from Planning & Zoning Department for new construction.)
City/State"/ Oy)- , 6, `"k) Parcel Identification Number 1~~Z~ (7 ~7 zCiC' i
LEGAL DESCRIPTION
Property Location K;'~V 1/4 , 1/4 , Sec. 'Ze~ , T _2f_-I N RA W, Town of tQcc i~rU'1
Subdivision Plat: , Lot #
Certified Survey Map # Volume Page #
'S
(oz
before 2007)Volume , Page #
Warranty Deed #
(
Spec house ❑ yes ;Cno 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, if needed, by a licensed pumper. What you put into
the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance
responsibilities are specified in §SPS. 383.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance.
The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the
owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site
wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is
less than 1/3 full of sludge.
Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the
standards set forth, herein, as set by the Department of Safety And Professional Services and the Department of Natural Resources,
State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix
County Planning & Zoning Department within 30 days of the three year expiration date.
Uwe certify that all statements on is form are true to the best of my/our knowledge. I/we am/are the owner(s) of the
property described above, by virtue of a w anty deed recorded in Register of Deeds Office.
Number of bedrooms I
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L-1 E T/_~~ 2- / i t2 A I
y SIGNATU 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. 04/12)
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RECEIVED
MAC1 y
\/V/;s. Dept. of Safety an'! P o ~sional -e
Division of Safety an$Uyn~ Code
nee with S PS 355. 0/,s. 1~.. County
30mmuNIN -
Attach comp~.:te site Plan nn paper less -ian i x 1
nn ('arcel i f~_
lnetude but not hmltec o: vertical and , , « ta! .ice
percent slope. ;cafe c~ dig rensionS. r at o•v a - - ~i Dale
P~ease p~-:~ Revi ed by ~r. ~~f~ 3 zq 1
!'cr>on?I ,n`ormarn. ic, ~~ride n .s 1 r. -
peri;r Owner
GnOLot 4q{t,,,,71/4 ` 114 S T,~ N R a E (or/ W
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-property Owner's Mailinq Address l r Block # Subd. ddame or
19a
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^jy ataie 7_IpCade Pt7one Number I,uy aV!dlage ,own Nearest Road
a?1,
od,. aorive:c, design flOW rate y S GPF)
Ne v Ccnstruction Use: P _sider- ~I ! c~ n beI co~»' _
Pi,hlrr ^
cr , Plain cl va`ior ii applicable
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1 Parent nlr rial
J
General comments 61
and recommendations.
wi
Boring #
Gri . ~i, ace b~ , b Depth to Illrliting factor
ci, ounct s °le,. Soil A lication Pate
-
Horizon Depth D ! r,an ~ C P cx rest n-Ire Structure consistence ~oundary Roots GPD/ft '
o1o1 - °nsPlc
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loli7on Depth ?Dominant Colo, I ed Des,c o lnur re lonsistence. oundary Roots ~ _GPD/ft
r.. !`;#1 0#2
S Cont. Color _ I,
L k
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-
Effluent #1 = BOP . -S r ~c /L C f (rent #2 = BOD _ < 30 ma/L and TSS <30 my/I_
i CS-1 Name (Please Print' jr, eery
D .tc Evaluation Conducted Telephone Number
SfiF)-8330 (R I I /I I 1
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Borina
Boring
it Grain s ,ac ev~~~~ ~rtl° tr, n°ruiing fac ►AD
to, in.
- - Soil Application Rate
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in. i/lunsell r"i- Sz. Con'- Color ff#1 ff#2
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Soil Application Rate
! Horizon Deoih j Dominant Cola ed Y. D r r.° r io ,dare Structure "onsistence [Boundary Roots GPD/fl
a n iVi.nsell U. S cn`- of r r. Sz Sh.
1 ff#2
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-IOYIZOn Depth i Dominant o!c edc . F rn 'oh, _xtui ;,,cture =~OIISSlstenc-leoundary Roots GPD/ft
pp Ulursell noi. Color 4 . Sh. ff#1 ff#2
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7 he Tnch~ oi Saf nd i i° ,w~si~ , C,jwr nrtl tel: ;;r. ice piovid r aicl cnnployer- tfyou need assistance to
u cep. Scrr illc cici>,,9rimcnt it 60-766-? 1-51 or TTY through Relay.
Property Owner ar o i+ Parcel 11D#
Page a ~ of
Boring ~ Boring
Pit Ground surace elev_0 y ei
Depih to limiting factor in.
Soil A lication Pate
Horizon Depth Dominant Color Redox Description i Texture Structure onsistence Boundary Roots GPD/ft
r,. ; Munsell ; Ou. Sz. ^ont. coior { Gr. Sz. Sh, f.#1 ff#2
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Soil Application
Rate
1 Horizon I Depth t Dominant Color Redox Description -e;<ture I Structure onsisfence oundary Roots GPD/ft
in. Munsell t nu. Sz. Cont. Color
Gr. Sz Sh. ff#1 ff#2
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- Soil Application
Rate
Horizon Depth Dominant Color ~edcx Description -exture Str~,~ciure consistence oundary Roots GPD/ft
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in. j Munsell f du. S.. Cont_ Color Gr. Sz. Sh,
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Effluent #1 = BOD t > 30 < 220 mg/L and T SS %30 < 150 mg/L ` Effluent #2 = BOD s < 30 mg/I_ and TSS < 30 mg/,
The Dept. OFSaicty and Pro`essiona; Sol- cos is c 1r1-r ier and employer. If you need assistance to
access scM°ices o? .iced Ulc depart,-rent at 6U-266-3151 of TTY t:hz'ough Relay.
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Wis. t o~yS~fr hYl Professional Services Oa'. 1=,`~/A!-_U/-, "ION RE M H K7COBNJA000 Page of
Divis'Nv.t Safety and 3 if ings "
GOUNW in accordance with SPS 385, AVfis. Adm. Code
ST CRO 1.OPMENT County 'a U t 7G
~O + 1_ r site plan on paper not less than 8 1/7 x 11 inches in sire Plan must /tt a
include, but noi Prnited te: vertical and horizontal reference poin 'M), direction and Parcel I. D.
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peicent slope. ;c:ale or dimensions, north arrow, and location and li Lance, to nearest road. O 1577- 26 • ~
Please print all information, Revi ed by : Date
Personal infrrmaticr ycu provide may h;. used °or secondary nu-posr, (Prhwacy Lave, s. 1S.04 (1) (m)).
Property ,rJn~ r { Property Location Ole
Govt. Lot/ y~ l14 /4 S' - T j N R 1 E (o (W
Properly Owner's Mailirg Address Lot # ~i3lock # SUM. Name or SM#
_.[10- ~ c.. w t c - . S o `1 _ ,/n I o a -1 to
City State Zip Code Phone Number I ❑ City ❑ Village Town Nearest Road
Lo,Y(g-Lrgw I Mn) <,Soq3 953 L a rre- I } t a~~' s4.
New Construction Use: 1% Residential / Number of bedrOnMS Code derived design flow rate J~ a GPD
J ❑ Replacement ❑ Public or commercial - Describe:
Parent material- 0 t' Pa r -!t? C-
Rood Plain elevation if applicable ft.
General comments VcJ,5e,-5-t oZ-"Crehr.,•'5 1,-7
and recommendations
E] Boring
Boring # rr,,-,,1~ c q Cv~ ~1
Ld Pit Ground surface elev. Depth to limiting factor in.
_ Soil A lication Rate
Horizon Depth Dominant Color Redox Description 1 Texture Structure onsistence Boundary Roots GPD/ft
f in. (unsell Qu. Sz. Cent. Color 1 _ Gr. Sz. Sh. 'I f#1 ff#2
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177.
Boring
Boring
Pit Grounci cu„ace elev. Depth to limiting factor
_ Soil A lication Rate
Horizon Depth i Dominant Color Redox Description - ex'il~u'e Structure ,onsistence oundary Roots GPD/ft
in. _ Mansell Chu. Sz. Cont. Colorer, Sz. Sh, ff#li w ff#2
. T Sz
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Effluent # i BOD > 30 < 22r,, ^,c/L andJ TSS i0 = x r. /L (f lucnt #2 _ BOD < 30 mg/L and TSS < 30 mg/L
CST Name (Please P°u-`)
cii atuie. r - -
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r. ~ CST Number o I)Ptc -valuati tf7
dqs Q1 .t on Conducted Telephone Number
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