HomeMy WebLinkAbout036-1002-95-000
'.us:-omm~ Dnn:um-.vr of Cammere PRIVATE SEWAGE SYSTEM St. Croix
Sn'n'y :re: P.uildlny pruis:on
INSPECTION REPORT nvn r,v
GENERAL INFORMATION !AT-A-r I -O PERM r 607094
cnr pia- Ir: •,r,
~nr.:nna -fn,manon ve_ p':., en r.rv he. .::vd for e.: rontlary Purp: c:r'+ lonra" y Law s 1S . I li'n'I
I'e rr: I HOWtl Nx--n „ VIII: pe Iownsn,p Paco Tar NC
Darrin & Ashley O'Flanagan TOWN OF STANTON 036-1002-95-000
- Hbt Elev mr SRI Elev nhl Cc?cr. olnr. eG Om'iawnlRanpc!Mao NC
~ri0.~ rtu~a~' 1 02.31.17.26
TANK INFORMATION ELEVATION DATA
TYPE MAN JFA;;TURL N. r; 4PACIT" STATIIDN BS HI rS ELEV
rpl !A
Septic ` Bernamlark `
cc,~ It cl,.><t 1.91 ~b4. S 97.E
Alt BM r(~ L~ 1 ~17.~L
(aeration - Bldg. Sewer 1 f- ~a
N-414 q`{.`f7
Hr,Id nq Sl Ht lnle' 11.4 `t3.~c7
TANK SETBACK INFORMATION Sr•1l Owlw* 11.16 5-15
TANK 'O PA Vs_LL BI ITI; 'v,mlIc Ar nwke ROAD D: Inlet
`SCUIn: 1 I D: Bottom
f intirtKl 7f • uaavu Man t2.Z~
I~" V ( q Z.70 -76
i,erahor 7111. Pipe t-L-A qL
HnIJm° But. Syslem
~ .l k
PUMPISIPHON INFORMATION Flna grade 7
~.q
N'.3nutdCiUrP' Dm nc St Cova'
4,47- IM
GPIvt W
ldudol Nuu, I 1QJ r L t
l I
TDH alt . ns?. SvW .111 Heac TU: k•
'ol CClrtam xnglE )I Jut to l:'el
SOIL ABSORPTION SYSTEM
DIMENSIONS oPI n rn+ 1 Nc Of T,,,-,s PITnIMENSIONS No :'•t 'ts ms:tle L; I:q.. rl Den
IMENSIUNS [J /lO
SETBACK SYSIEN P.•L 9. JG AC-_ IAK'-.rSTRFAA! L ACHING h'anuramte,
INFORMATION CHAMBER OR 4 1`rc;AIor
ivy JI 3 slrn
~•~~`1 ~.I D I!X -•71 At~ wl` UNIT Llcoel Numuer (1
DISTRIBUTION SYSTEM W 1 1• I° 77.,v- 7.-7_
Ica oenlJan/clc Dice DUbon r. Ilor Size ,:Ile, iL,a:aw
Q~ r t( F m I 'went tc ArIntaAe
SOIL COVER X Pressure Systems only xx Mound Or At-Grade Systems Only
li=F ! - DeF;h p••cr ieoth c' zr Sas+tlvd3ooocd 1ax Mulches
rice I _ ,r^ler ~ Q [te<L'Trrn.i =,;ir=. ,I
COMMENTS: i;nr ,.Je _ooc dlscrerx:nc,es. person;, Present. cl:: Inspection u1 nspecuon r.;
Location:. ~al5N1 (~I~ CA, M In.b `T}' D
I.: All HNI Uescnplion-
2.1 BIJg sewer length - 31 I
amount UI uovur = I
U
se t er side Yes /Nn
Use other de for additional Intol nlgtlOn 1 G I ~I1 I1 Y l!/TJI
J?II I 7 11. iFa Uffie-___ Ins yo: - ewe .,eG tJc
_ 5~\Y`l - - ~SA0-20(9-095
Indmry >enlre I)ids..,:. e,ucr, ,
' 14011) \4'ishinvrcn Arc
of SP fits 6 St titarv P.nni: \u nta. I , be rll,i in'r; C.::.f
f baadl. VI 111 - 2
Sanitary 11c mit Applic l
In rtncc with SP S ~S:i. I 2.."V'.. :..h ..Iru r 1 Ili' f tt I" dt yq.r tl. 't _ r - -nacn d unit -
♦ •.pp..,tut In ur. r I.I1, ,1. .i POW1S&t.. sobtnit-.cd to Pro:cct Addm,s(ifdt9*cwnt lb at n':aiLng address)
11 r It I :al t uti.: 111 . t rv'. d.:..lie, used I n'sccenday
u u a; I n ,tih th V, I e• I I1jur ♦ it.,
~
III em,m Infra manna 6,_ lrunt_ M Information Naim _4 p ,a
f~acC
r 1 sly lTa:. r 1 :lu 1,A 31 I I } I, lu.nlion W3 n, dl~
~.CGaI t , r L.:
/ 4LL f~~1
7
UI 5tdte 7•1) C'\{e Ptnre \eri.rr iLti Section y
{circle On
II Icpe n(IiwldmL'(chrd all lh.lt apply) Lnt' -
..f Sabdl a Seuu: .
ll~/JJ-t:"F.;nule Uvll:.::--~tmh'~ra(IJCdr:ys ` ^^~~L
6)e- 616 p~
❑FcbhcC,r.;uncn::;d I)cvcrib,rll.;
uC tcf "
! r Sate O:mud } sa'fic Use
Z &s~- CeWt, w ZZ+-ZZ ;
Ill. 'Type of 1lermil: (Check only on. I1or on line N. 4 wnplcte line 13 if applicablel
n
ISI St r.m I f w ,m t S•; -t: n. If h r, .o: li I ru< tt On y .J Ulhe hludiC. rtrn to Fxis:in S)U -tt texplainl
If. L Fcant. uxv:a. L u 1 rrrr l i ?'rtmn \rmhcr td U lc rssacd
U I<, I R;.r.r. ai ❑.I n c"i n Ia .1 tau, lransier (eAew
3.:-ac Fi.trt,: I Cper I -r-_/t t I~
'I,\y l y aC-p(-N~ ki' 1 tun Contpulent Devict.• IChed, all th tr apply)-_
`irN,•.`I s.daolc soil ~~(n
I,. t I :.a ....I It rt I n :'assn, i J lit tr. ar.d U r•;-0rnd. J \tuu-.i , a i:l. of x:ntablt soil ❑ WI;nd'- 24
IL
fa tk Crln.r U sf:r sd Cn y .neat vpl::.rfl ❑ Prclreahnen: Drrice (explain)
A I)ispcrsal It a and Uta Information:
I1 t r FL, , I. pai IRsien S .,ppa:a t lia;c(ePc]t I):. pe-sn lira mr.q,.imJ /s~ DI penal Aree Pr.~ 1-t,sil S}Nlem Elev t:on
y'1 Tank Info Tat. :'r.. rrc
< rIl n [all n; Coil,
V V.
VII. Responsibility SlateIncllt 1.11 r rut I nr d a wpu r, .pa l Jrh fi installation mf the P OM IS siroan un the attached plasm
I uI,/y4m it t) II m-~' S tlrsrliu- I 'MI'li Au -t,n Ru Ira- Phol. Number
\I I .m lilt )cp IrumenI Ilse (1111}
ov.::~C UL. f .SdDe.oo ~r9~c~9 Icsuim. .cal S- 'dare
I\. CmnlitwareAII]O GRRett"Ins for Dieepprnval
1. Sepl-o tart, r Yb. • n. Al,,r ;'n•l
a'I',- 'I ' . .I All lie .a NP -2 - : 4.
as per 61ar agement plan pw+iffM W ylumot,
2. All tle!bv:k mcvirar.^arr.'s mr.)t w r. .^..rf: it f
"per Pxiorbh f,1ri; l:re: res.
w pn. :npd ,p. p:uu Ibr rpm "ua :ura .r.lr ~i, Ip.Unxr ntv v+t• -.,al, arh.mxtr .11 in,Lv o.,c-
SI31 >>-i':•i ,S (R; ~S' 14,
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CONVENTIONAL COMPONENT DESIGN
Residential Application
INDEX AND TITLE PAGE
Project Name'
Owner's Name
r:
Owner's Address:
Legal Description: j -
Township
County
Subdivision Name.
Lot Number:
Parcel ID Number`
Page 1 Index and title
Page 2 Plot Plan
Page 3 System S zirg & Cross-Sectio•1
Page < Filter Specs
Page 5 Maintenance Wormat on
Page 6 Management Plan
Page 7 St. Croix Cy Sep:ic Tank Maintenance Form
Page 8 Warranty Deed
Page 9 CSM or Plat
Attachments: Soil Test & House Plans
Designer;Plumber ; ,A; t License Number.
Date: y Phone NUrnber
Sicrature
Cesignec pursuant to the In-Grounc Soil Absorptior Comoonert Manual `o• POWTS Version 2 0 SBD-10705-P (N.01;01 }
Page 1
' ~ ~
'f-
--S~A.~Yci✓
- i~.N~ i _
-
~ -
{
r
'I 1
~
2c
_ ~ _ ' F~
t- _ ~ f ~ ~ - -
_ ~ 1 , _
fir- ~ _ 1~'
i f /
I
i
11~'
I ~ 1~ ~
11 111 ' ~ LI
~ 1 i
111
i 1 ~IIi
I 11
11
X11 ~
X11
f ~ f
f _
X ~
1 ~
~
Sod Absorption Systwn Cross -secfiot,
~ft
47 Sdedde 4o Feiel Grade
PVC nerd Vqq
VAM Vert cup -ft
l Chamber
- J - system awafim
Soil Absotption.SVStern Plan view
ri
ft vent (h Observatfion Pipe C C~+h l
OJ Fi(os
4' Dia
CTrenc3h 2 Headcs
?~dhihha G - -
ManufactmerAnd Mode
EISA Raf6hg - sq R Per dwrrdx-r Soil Appliculion Rate
_ 9pd/scj ft
gPd Design Flow Sol Applimfim Rate : S EISA =
Chambers
2 tows of Chambers each.
Page of
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page _of_
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner Tank Manufacturer 0 NA
Permit tt Gh Septic Fl Dose ❑ Holding Volume: (gal)
DESIGN PARAMETERS Tank Manufacturer g NA
Number of Bedrooms. ❑ NA ❑ Septic ❑ Dose ❑ Holding Volume: (gal)
Number of Public Facility Units: NA Vertical Distance Tank Hottem(s) to Service Pad: (R)
Fsfirnated (average) Flow (gavday) Horizontal Distance Tank(s) to Service Pad: (R)
y Specific Servicing mechanics must be provided if vertical is >15 feet or
Design (peak) Flow = (estimated x 1.5): (galfday) if horizardal is >150 feet Specific instructions to be provided on back.
A 11 L.
In Situ Soil Application Rate: (gayday/fe) Effliamt Filter Manufacturer
- ❑NA
Standard (Domestic) InfluenUEtfluent Monthly average Effluent Filter Model:
Fats, Oil & Grease (FOG) X10 mg& pump Manufacturer.
Hiorhemical Oxygen Danand (BOD,) x220 mgrL ❑ NA Ej NA
Total Suspended Solids (TSS) -:150 mgll. Pump Model:
High Strength InfluentlEftluent Month -
ty average Pretreatment Unit
(FOG) >30 mglL Manufacturer:
(BOD') >220 mg/1- ❑ NA ONA
(1 ss) >ISO mgA. ❑ MAeration ❑ Peat nFilter it
_ U Disinfection ❑ Wetland
Pretreated Effluent Monthly average ❑ SandfGravel Filter ❑ Other.
(BOD,) -30 mgrL Soil Absorption System
(fSs) -30 mg/L jj NA
Fed Cofform (geomolric rnmi) 1.70' .0 In-Ground (gravity) ❑ In-Ground (pressure) ❑ NA
Maximum F1Ruent Particle Size lt3 in d ia. F1 NA [I At Grade ❑ Mound
❑ lhp4 ine ❑ Order:
Other: ❑ NA Other. ❑ NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
Pump out contents of tank(s) When combined sludge and stun equals one-tlvrd (Y3) of tank volume
❑ When the high water alarm is activated
Inspect condition of tank(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA
_ 0 year(s)
Inspect dispersal cell(s) At least once every: _ ❑ month(s) (Maximurn 3 years) ❑ NA
_ PJ year(s)
Clean effluent fitter At least orice every [Q month(s) ❑ NA
W year(s)
Inspect ptrnp, pump controls & alarm At least once every: ❑ mon0i(5) LT NA
❑ year(s)
Flush laterals and pressure test At least once every: ❑ moth(s) ❑ NA
❑ year(s)
Other: - -
At least once every: ❑ year(s) El (s) ❑ NA
Other,
❑ NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and soil absorption systems shall be made by an individual carrying one of the following licenses or certifications:
Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector, POWTS Maintainer or Seplage Servicing Operator (pumper).
Tank inspections must include a visual inspection of the tank(s) to identify any missing or broker hardware, identify any cracks or leaks,
measure the volume of combined sludge and scurn and a check for any back up or pondng of effluent on the ground surface. The soil
absorption system stall 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 pending of effluent on the ground surface may indicate a failing condition and requires the immediate
notification of tine local requlalorv authurity.
When the combined aocumulation of sludge and scum in any treatment tank equals one-third (Y) or more of the tank volume, the entire
contents of the lank shall be removed by a Septage Servicing Operator (pumper) and disposed of in accordance with chapter NR 113,
Wisdxmsin Administrative Code.
All other services, including but net limited to the servicing of effluent fitters, mechanical or pressurized components, pretreatment units,
and any servicing at intervals of -512 months, shall be performed by a certified POW TS Maintainer.
A Service report shall be provided to the local regulatory authority within 30 days of completion of any service event.
GMW-005 (02105)
START UP AND OPERATION Page of
For new construction, pnor to use of the POW I'S check treatment tank(s) for the presence of painting products, solvents or other
chemicals or sediment that may impede the treatment process and/or damage the soil absorption system. If high concentrations are
detected have the contents of the tank(s) removed by a Septage Servicing Operator (pumper) prior to use
Pump tanks may fill above normal highwater levels prior to startup or due to pump failures. Start up or restoration of power under these
conditions is not recommended, as the excess wastewater will be discharged to the soil absorption system in one large dose causing an
overload that may result in the backup or surface discharge of effluent and damage to the system To avoid this situation have the
contents of the pump tank removed by a Septage Servicing Operator (pumper) prior to restoring power to the pump or contact a Plumber
or POWTS Maintainer to assist in manually operating the pump controls until normal effluent levels are restored within the pump tank.
System start up shall riot occur when soil conditions are frozen at the infiltrative surface.
Do riot drive or park vehicles over tanks or the soil absorption systern. 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 treatment
tanks and soil absorption system acids, antibiotics, baby wipes, cigarette butts, condoms, cotton swabs, degreasers, dental floss,
diapers, disinfectants, fats, foundation drain (sump pump) discharge, fruit and vegetable peelings, gasoline, greases, herbicides, (neat
scraps, medications, oils, painting products, pesticides, sanitary napkins, solvents, tampons, and water softener brine discharge.
ABANDONMENT -
When the POW I S 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 compliancewith s. Comm 83-33, Wisconsin Administrative Code.
• All piping to tanks, pits and other soil absorption systems 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 (pumper).
• After pumping, all tanks and pits shall be excavated and removed or their covers retrieved 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 hecn. or must be taken, to provide a code compliant
replacement system:
L] 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 riot be infringed upon by requiied
setbacks from existing and proposed skucuie, 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 the time of their permit issuance.
❑ A suitable replacement area is rot available, due to setback andfor sod limitations. If the soil absorption system cannot be
:ehabilitated and barring advances in POWTS technology, a holding tank may be installed as a last resort.
U The site has not been evaluated to identify a suitable replacement area Upon failure of the POWTS a soil and site evaluation
must be performed to locate a suitable, replacement area. If no replacement area is available a holding tank maybe installed as a
last resort to replace the failed POWTS.
❑ Mound and at grade soil absorption systems may be reconstructed in place followng removal of the biomaf at the infiltrative
surface. Reconsvuctions of such systems roust comply with the rules in effect at that time.
WARNING TREATMENT TANKS, PUMP TANKS, AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES OR LACK
SUFFICIENT OXYGEN TO SUSTAIN LIFE. NEVER ENTER ANY TANK UNDER ANY CIRCUMSTANCE. DEATH MAY
RESULT. ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK MAY NOT BE POSSIBLE.
ADDITIONAL INSTRUCTIONS:
POWTS INSTALLER POWTS MAINTAINER , I [
rNaine
Name
hone - Phone
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name Name
Phone
Phone
'I his document was drafted by the staffs of the Green I ake, Marquette aril Waushara County POWTS'(ogulatory agencies in corn iiance with sections
Comm 83.22(2)(b)(1)(d)&(f) and 83.54(l),(2) & (3), Wisconsin Administrative Code.
91', 4CROIX COUNTY
SEPTIC TANK MAINTENANCE AGRFENENT
AND
OWNERSHIP CERTMICATION FORM
Owner/Buycr-DwxtY1 ~{-UEan- 4(2snn-..
Mailing Address ]~.~~1Q~1C t! `ILw tiLllY~pY1C~,W ` ~4~ }Z--
Property Addre
(verification required lion Planning & Zo Department for now construction.)
City/State )Dff po,r) Panel Identification Number (a- )QQz_01s, OCO_. _
LEGAL DESCRIPTION
Propcrty Location _ '14 > ° , Sec. OZ , T_5A_N R- W, Town of Shnbn
Subdivision Plat: Lot ti
CeriiFied Survey Map # Volume Page #
Warranty Deed # (before 2007)Volume Page
I
Spec house ! yes 0 no Lot liners identifiable 0 yes 0 no
I
SYSTEM MALNTENANCE AND OWNER ChRTI1!CATION
improper use And maintenance of your septic system mull result in its ptnmanne Worn to handle wastes. Proper
maintenance consists of pumping out the septic lank every three yeas or sooner, it needed, by a licensed pun per. What you put into
doe system can afferttile binction of the septic lank as a treatment say; in the waste disposals . tem. Owner maintenance
responsibilities are specified in §SPS. 383,52(() and in.Chapicr 12 i St Croix Coonty Sanitary Ordinance.
t
The property owner agrees to submit to. St Croix County $ +Ianning & Zoning Department a certification fora, signed by the
owner and by a masterPlumber, i0aroeyntan plumber, restricted . Zbex or a licensed pumper veuiCyiag that (1) the. or"ite
wastewater disposal system is in proper operating condition and/or (2) after inspection and pouiping (if necessary), the septic lank is
less than 113 full of sludge.'
Uwe, the rmeki5tgrred have toad the above requirements mmmmyyyy'ii agree to maintain the private sewage disposal systort with the
standards set forth, herein, as set by the Department of Safety Aud Bxsiemal Services and the Department of Natural Resources,
Stare of Wisconsin. Certification stating that your septic system h been maintained must be completed and returned to the St Croix
County Planning & 7auuing Deparunant within 30 days of the three year expiration date.
Uwe certify that all statements on tbisfiarm are true to the ¢esrofmylour knowledge. I/we am/are the otmra(s) of the
property described above, by virme~~ of a t ty deed recorded in Register of Deeds Office,
Number of bedrooms Z- `1
SI AT I OF APP ICANl(S) DATE
s
***Any information that is misrapresented may result in the semitary permit being revoked by the Plartnwg & Zoning Depattment ssa
include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey n. tp if
mference is made in the ivamroty deed.
mnp n.fml
C 3o CST--ao'q ^ 03
'^rs. Depl. of S.ifwy and Professional Service, SOIL EVALUAI ION REPORT page T o,
Division of Sa'ety and Bindings
in accordance wi!h SIPS 385. Wis. Adni. Code
County
Mach ociinplete site plan on papcN not less Ihan 8 1:2 x 11 inches in s2c. Plan must -
nclare, but not I roiled to vertical and horizontal retcmnce point (BrAu direction and Parcel I D.
p onxnt rici :e. scale or d. riensions. north an o•.:, aid locat'o. sl di rce ne load. - 1 4'
Please print all information. Revi ed by Date
Vrisc-al I^fomlahan ynu pr~yids rcav Ot _zr:[ •scor tla•y anr:ro-r ..^r
Property Owner - Properly I oration
Go'a I of 14% S - 7 N R E (orIi
4 4 Property Owne.!s Madrig Address nl ;r Block # Sutid Nanw or CSMI
1
Y
City ; State lip Code Phuce Number ❑ City ❑ Village ElTown Nearest Road
New Construction Use: Z Res-denliaU Numhe, of bedrooms - - Code derived design noa; rate GPp
❑ Replacement ❑ Public or annwercial - Describe
Parent material Flood Plain elevation it applicable ,y7zl
fl.
General comments
and recommendations. - -
Boring ,y Bonng
Pit Gro.urcl sudacc elev ft. "leplh to limitirg facfnr in-
_ Sc I A I cation Rate
Horizon Depth Dominant Color Redcx Descrtpt on Texture Structure ,onsiste•re Boundary Roots (;Pihft'
in. htunsell Q~ Sz. Cont Color Gr. Sz. Sh. ff~1 1162
l Ir ~ ~r
/ n
L Boiaa # ❑ During
J Pit Giounc! surface oleo. _ ~t. Unpth to limiting factor in
Sv.)d Application Rate
I lonzon Depth Dominant Colc' Redox Description lextare Stnictwe 'onsistenee Boundary Routs GPDr1t -
ia Fdunsell Qu, Sz. Cont. Color Gr. Sz. Sh. ifiti ftk2
a q
' Fffluerit k1 = 30D > 30 < 220 mg;L and f SS >30 11501,19:1. ' Effluent 4; - HOD 30 mg+L and TSS < 30 ing;:
CST Namd (Please Pun , / Sianefl re3 j,. CST Number -
Address - Date Evaluation Conducted Telephone Number
i
1111)i~(ii tl2l ::'Iii
I'•c: el1`r rJw^er Parrr'I II: , _ page._ _-If_
❑ Boring
Ronng#
Pii Grourci su•`at:e elev. % ! h. Deph to Prniiiny fn: to hcahon Rnto
Horizon Dept'r Dcminart Color Redox DescripN:tn Texture StrtlClure 'cr sisroncc oundary Rents GI'DTl '
'.n. P41 uosell Qu. Sz. Con'. Color G. Sz. Sh ff#I ff#2
n {
- a v
Honrg
&ninc#
❑ Pi[ C!nourt9 scdace elev. _ f•. Depth lc I1*1 i7•;q !attar 'r
Sod A•r dica:ion Rate
Ilorzor Ileplh Dominx?l Cul:)r Raaox Doscnplicn Tex:~rc Slru !,uc ,onsisterco co.nd.ary Roots GPD9t
ir. 6Aunscll 0... Sz Ccrl. Color Gr. Sz. Sr ' IWO ff#2
❑ Boring
❑ Horiny S Gn.md surta.e elev. fl DePIP. In Lon tiny fnGOr _ P.
❑ Pit Soil A 'hC'rlicn Ra:c
HC-von Depth :hnnlcani Color Re.Aox Descrq:hun -extwe S:rtloturc 'onsistence mwilwy Rrols t}PIA
in. Pdursoll Ou. sz. Cont. Color Gr. Sz. Sh. ' :fL'ft ff#2
• HIWen: 91 - 307 :+ir 220 mgrs vt:! T"S >3C h!: •ry+L ' I-flluent 42 - BOD • < 30 mg:L and TSS < 30 rnyil,
1'hr Dept- ol'Sulch and Prol'cssunrtl ticrciccs a an egn:d opportunity service proeidcr and rntployer. If you need assistance in
tcce>.'el civc, Or need material in ar allerIIAC fortn tt. cunrael the depurtmeul at 61Ig-266-31 i 1 of I'TS' Through Relay.
Property Owner _~'/)fh ParcelID# Page " of
❑ Boring
Boring #
Pit Ground surface elev. 7 / it Depth to limiting factor in. Sail A Xcatian Rate
Horizon Depth Drrninant Color Redox Description Texture Structure onsislence Boundary Roots (,PDift '
in. Munsell Or. Sz. Cont. Color Gr. Sz. Sh/. ff#1 ff#2
Is - All
L
yy-
1
Boring # ❑ Boring !n5
❑ Pit Ground surface elev. IIVV Depth to limiting factor in.
Soil Application Rate
Honz-on Depth Dominant Color Redox Description texture Structure onsisterim Boundary Ronk GPD#t '
in. Munsell Qu. Sz. Curt Color Gr. Sz- Sh. ff#1 ##2
Boring At Boring
❑ pit Ground surface elev. ft. Depth to limilmy factor in.
Soil Application Rate
Horizon Depth Daminanl Color Redox Description Texture Structure .crnislrnov loundary Roots GPD/ft '
in. Munsell (I Sz. Cant- Color Gr. Sz. Sh. ff#1 V#2
Cfllucxu flt -ROD > 30 < 220 roWl arA TSS >30 < 150 mg/L ' 1-(fluent #2 - BOD 30 mg/L and TSS < 30 rtglL
The Dept of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to
access services or need mater ial in an alternate fermi, contact the department at 608 266 - 1151 or TTY thtnugh Relay. .
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