HomeMy WebLinkAbout004-1055-60-100 (2)
PRIVATE SEWAGE SYSTEM "u St. Croix
Sa L+M and -na, In rtr i
INSPECTION REPORT
SAN-2019-088
GENERAL INFORMATION k/,-TACI- TO PER1017no P;, I: W
:•erscna -torn'aaer ve, e. »oe rta. i uses for scccr::llvri owpo. >tr.:rcv .N _i.4'1
writ FolOe•s Name ry thllace iuw:AUb =acrtl -;u NO
Nate Sorenson TOWN OF CADY 004-1055-60-1001
C;o 11.1 Flea msp FN -uw RE1 CC=chat or. 5^cuer 7ewMRanpc/Nap lda
24.28.15.376A
TANK INFORMATION ELEVATION DATA
Ty,_ htANUFACTURCR CAPACI IY SIA.II IN 35 HI FS E_EV.
S`pnc 3enonn:ark
Dosing All BM
4crallorl Rldg Sevmr
•told:ng SUHI Inlet
SUHI Outlet
TANK SETBACK INFORMATION
-ANK T. -!L -AIL LL D-DG. ent tc 4.' i ROAD D! ii
Lr Sutton.
D:s:ing Heatlerilvtan
Aeranor Dist Pqw
II IOIaing Rnt System
=mat ;;rude
PUMPISIPHON INFORMATION
Ivlanufaoturer Dernann 51 !:ove'
;rr~t
i~l ~Uc'~. Number
TDH L. itt FnGUon Loss 2iySer'r i lead 'Utt F1
OrCeamrn Length Una. '-list t[ Avil
SOIL ABSORPTION SYSTEM
BED:TRENCH :1:1b _eny:f: PIT DIMENSIONS ib::. Fm: mono Aa ..ndCrpt-
DIMENSIONS
Sh1BACK SYSTEM T t_1 _ B_:)f; 11 1 AKFai-REAM L[ACTING bfa':rtacnrc-
INFORMATION T,,,,- 'x Cr CIIAMBER OR
UNIT `ecao i
DISTRIBUTION SYSTEM
caom Rd::uAnW t' .."h...I err w Hal¢ 5¢C s yr..:., ianp -nt c. dr Intanr.
Prpc .
-enptr L'na_ LenGih
SOIL COVER x Pressure Systems Only xx Mound Or AT-Grade Systems Onty
Dep% Over L,r :t ;?•.c: •s C-W.t.:d _ o:•d:~:":o:ltlnt xx. Mulcoca
Hetl 'renC Gen:er h,C lIr,d6I dre:: T::.. -
' ves No NG
COMMENTS: firwiti e none rlis:aetwncres persons presert. ea i Insocdiort 011 Irmpe: non 1i
Location: 2113:;]: A:,
I_i AL' b" Gese'Ipl: ul -
2 , Bldg sewer Ienpln =
- amount o' cower -
?tar revision Required" Yes Nu
'.Ise other side for addieonal inlnrtnxia•:
L to I. sep :ors Srmiatwf ~.r. Nr.
County Sanitary Permit Applic 'on ST. CROiX COUNTY WISCONSIN
vil
Gp In accord v l S C > olz Cn Im Sat i.ary an;-l, ZONING OFFICE
Furs-.Iw r•'Inrt a o,, ;nu tr ^.•!e m+y tr rases '-HOIXW~N'."G„' ERNt.'LNI CLN I Lii
. IP•rvc.r; 1 aw S t T t l I Ca m cnael R ad
r~^ mild ~'1 1 $C if '1C'
h~//1"/~~ 1r ` l!o)JO,r 463.. 'ax l't u',EEG GEEti
Attach Complete plans for the system ar paper n(l: less than `ylr2 ni r, - in site
C" I ly Sanitary Pennt 8 L.l Check if re,r i.'r to o•evieus app' ' i.orr ' - -
F}A-) - 7-61`t- 68 5
I Appticabon Information - Please P all Information Location
-
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I5,6 n T ,2 N. R 11VI, grj f,
Property Owne's faa I:ng llcdrvss LOt Nb r Block Nr.mber
ph fiv-e City State Z p Code Phone Numbor r;JC.i': Sion Name or CS'd NbmOcr
4J. -7 7J6 - T-/Z 17
It T~ype of Building: ;check ore} bk ha rl _ -y ❑'V,Nage j$To•w-t of
y`I 1 er y FaTJy U';cellmg Nc o! i (L ;D
ii C: n'r~e'Cidi I;Oescnpe usej Imo Jk_ I0.v` CO
^Iufe-o'w'ned _.-N=crest toad
It Type of Permit: ll-hto:k only one nox on iire A. Check box on ire B f app icobly:
parcel Tax Nbmbersj
~1 Re,^'rv 9 31(i Re crnoc!ion 91 ~•on pl t,r ibiry a. 3kele'rahlri
Af~
At 00
Sa°i.atl "I
131 !°FrTL J ITt." 5 Date ISS"ed
~ S:ate Sar•.c. Pe'm t was ore': oust, ),Sued b (o zz ( L67
IV Type of POWT System- (Check all that apply) _ 2c , - x
❑ Non-presal.rzee in-ground - - 'h10und ^ Sand Filter ❑ Ccr-trjCavd Ydc7a,d
P•ess.rr:ed Ir:-yrCdr'C--hol+anP Single Pass ❑ Drp _ne
-1 A:.bane Aerob':r Trea:rnert ~„rII RCCirClf. a: o'; Over
Oispersa,rreatment Aroe information.
1 tics, i uw (ypc 1. Dlspoaai Area 3. Dispersal ArFa 1 r.ppli-,:i~r -:.iie ; Percnia:.on Hate 10. .`.vs a, m~ Elvval-on ' Fina 'Jra,;c
II ~egalred PfCpOSed `GalS.lda,+se `..1 +Mir tir~ci Flevat on
~lv' r rs~ `~7, 7`l
Tank Information Capaic;, it Gallons Total # or t.'anufacnrer Prwa:o S.to Con- Stvvi Fiber Pl asl i6
New Exisling Gallons Iar•.ks r- _ C<v,:rote structed 01055
Tanks TanKS f✓/(~ ✓ ~-i
cot' OIJV 7PJ I L.l ❑
_ D ❑ D ❑ ❑ C
R .Jp n,ibdity Statement
I, t: w ..,ours yn+.d, assvwe rvsporc,ip.f:y' !Cr •epair:rCCOnnenc:-wVrel.+venalwn: )stal ation of nor) -plumping f0' :ne PCIAITS sr:own on the attached flans. A
G,-e^se 5 not :egwre" for Ieval.C •e.. air or Ine irslal'a7on of nonpl.:ni sa^i:a:on -',stem
Pli.mbe'S Name IP:ht ' P'umoSq;na:.ue (ro ."arr-i A1r:i'lli NO / Wmness Phone Nuntl:ur
77L - SZ
Plr.vrtr] ° i.ddruss is:roe:, Cr'y' State, Zip' Cod l
Aolh
VIII County Use Orly
'bay d Sdyn}llali rein it Fou at Is? n :n: L ^r a' v ;t aTpsl
I.Iroeer. C 'rer on Ir crsc Z5b Ott 6 -
17L1P(T,19 ath'ir `K d
IX. Ccndrtwns of Approval*vasons for Disapproval:
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2- Ail -,that k reef r en.s ,11))yy{{ rKl e. rti in-,,t oe „ r r:L ire -
as px~pFdc-bl'. cnF~ !`Tt1'.,:+y;.✓J J.S-;: o per ti'Fdccbli uY..•: ; :rr1':aloe:.
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Ryan Yarrington
From: the Timnis -:rbjt,,@wwt-net
Sent: Tuesday, May 2019 8,40 AM
To: Ryan Yarrindton
Subject: Nathan Sorenson mound inspection
May 7, 2019
1 inspected the mound sewer systern for Nathan Sorenson, at 3211 30th Ave. Wilson, WI 5402 All
components were in working order, with no water ponding in the mound system, as of 5/1/2019.
IDH 226524
Roger Timm
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$ Y 1 l 25
Wsconsin Department of p Commerce PRIVATE SEWAGE SYSTEM County*
safety aid BW" INSPECTION REPORT a l
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit NO-:
Personal inkSmsabon you pro'nca may be used for secoindery purposes TrIvacy Law, 6.15.04 (1)(m)(.
Permit Holder's Name: City Vi age Town o : State P an ID No,:
l\M Elev.; sp BM E ev.l BM Deifnionon: Paris Tao No.:
TANK INFORMATION ELEVATION DATA )y d t%- 1S•.3 C
TYPE MANUFACTURER CAPACITY STATION 85 HI FS ELEV.
Septic Benchmark j~ IU~T` f
Dosing
l In _ Bldg. Sewer l
Holding T-)5 _w'C7 L.-k- . )1141 St /Hit Inlet ~ I
TANK SETBACK INFORMATION St/ Ht Outlet j r 1
TANKTO P/L WELL BLDG. gvhitake ROAD Dt Inlet
_7
Septic 4- Lamj Ix+ NA Dt Bottom
Dosing (r;•t NA Header/Man. )D t3
Aeration NA t. sqq ipe k_(. aj y• J (j-do /Y.J-n 3E3
Holding Bot w em L-1- b3 , g Y
PUMP/ SIPHON INFORMATION Final Grade y~ y
Manufacturer , It Demand -Putiv!) t' 'r ~
Model Number 1,4,0 `30• -GPM
TDH Lift 3o. ri Friction y ; 5 emG S Tdti3S• S
Forcemain Length %t1' Dia. Dist.TOWe01~O~ c
SOIL ABSORPTION SYSTEM Cs
BED/TRENCH width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
Menu atturer:
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM( LEACHING
CHAMBER ode Num r.
INFORMATION ype
5ymm:~~)'i1U(~ Oft UNIT
DISTRIBUTION SYSTEM 4ef S-~ e /►h ur'
He r/Mani ~~sr D- ion Pipe s (i v Hole Size a Ho 5pacing vent To Air Int e
Lengm Lo -_7\ Oia I ~ r T Length Dia- 1 r Y Spacing : ~ i 3.3
SOIL COVER It Pressure Systems Only xx Mound Or At-Grade Systems V
Depth Over Depth Over ax Depth Of n Seeded / Sodded Mu
Bed/Trench Canter Bed/Trench Edges Topsoil ❑ Yes ❑ No Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.) = Y'7 /
v~d ~1~1 u*c 7if
, f ~luc~
k I ~ / A L~ ,5' ~Ir-d Ca, i0 52 A
J -
Plan revision required? ❑ Yes NO
Use other side for additional informatfon-
CRnm1n na iaT Dad lnspactor's Signatwa Cert No.