HomeMy WebLinkAbout020-1016-07-000 (2)
^nsconsm Depaa•nc^t cf Cocrorcc PRIVATE SEWAGE SYSTEM c.oun.1. St. Croix
Safety and Bc tlino ]ivltu:.n
INSPECTION REPORT sanitary Pe "+ru;,
!ATTACH TO PERrdl t f 615322
GENERAL INFORMATION Sta:c Plan m
Pe-sc-ai mlannaaml'r>u prcrlde ma,Y .see'c- svc~nda-, p,wws IPnvary 1..^.'r• s 15 J: 11`: 11:1
Fernnt Hoce(5 Valle n9e Tuna cAnp; 'amed Tax Na,
Timothy Weiskopf TOWN OF HUDSON 020-1016-07-000
Bbt Ile, ri EM E c: BM Cescr of or S,ctc--cA., n nue:Nap ra
/ 00 16m 1 12.29.19.71 F-20
TANK INFORMATION ELEVATION DATA
TYFF M1•A\UFACTURCR r CAPACITY SIA 1^N BS HI FS FI FV.
Septic 6_K. "enchmark a / 110 /61.1 /
Alt. nM h' Q..... (-a if 6.9 q7• Co
SCNCr
Al+etidn \ 3 Cu.
Hold inn S'U11:.nlet 1
G
TANK SETBACK INFORMATION SUI It Cuter 7 7 / L • $
TANK TO PiL ^:6LL U_CG. \+cn; 1 ryake Ri)AU
st:pl' Sd 45 4 cd s~uwo- it d,✓-
aV Ilk 9. L 95. 03
GR~eqJ 7 a J& y 2 ea:tcrrn4an. 1,5 42.
Aeration :)ISI. Pipe
Holding
L Hal. System
a le." L'i
_ _ 1 1777'1 H•ia! Grade
PUMP/SIPHON INFORMATION
Manufacture, Gen-ard St Cev^
C'PAd : I Art b •9 et-7, W
rdeoel Number
UI I n I lead TCH Ft I ' q ,A elf,
=e¢:urrain Le Dist 10 '.^;e'.. .~-s • r /b • 0 qo t d
SOIL ABSORPTION SYSTEM / O
BEWTRENCH V,09, Lenyt^ Mp. C' -'unchos PI I D 1ENSIONIS Vc UA is u..1de. La . Lie...d Depth
DIMENSIONS 9JL 3 ~Q k
SETBACK SYS 16M 10 v P:L ELCG H.t LAKE:STRFAIA LEACHING `Aa-.1'
INFORMATION ~ CHAMBER OR
Ty. '-If S?stem oq UNIT !ACCrI N. rot
Sz
DISTRIBUTION SYSTEM -•',-7 ZZ~LZ }-ZZ I✓S
heaven'1.tanlfoifl C s',nF,„.t.r x If:fle n"e x Iloe pacing Ven: to n r n' Ic
paein~ ~
SOIL COVER X Pressure Systems Only xx Mound Or At-Grade Systems Only
_m It t :meth v x. Depth cf x F.ee 7cdr'3e.eced xx Nulrned
:Je °,ter '.'-dr , I:1nc r: -cpsai vcs PIo Yes No
lef V1101
COMMENTS: ;Include ecde d ~crepenc es persrrs present. etc.; Inspect or. $1. Inspeclign 112.
Location: 1016 MOON BEAM RD/ G • , a
t f r'! t 0%1 DesCfipt'on =
-7 Z 4-a
i Hlou se'.ver Ienoth = T ~d
-amount cf cover = ! 1 t I /
1 ~ [v tee, t 'lf.'a!I LQ/ EOtk
J l , ti4 al ~r o
Dian revision Required? "es X/o 13 /G .y Cjl T5
-se a19ef SI:11? I::I accllmral vilorlral01) 1
Daly nscpcl SSona:u Ce9 No.
SEG-0?'2 P, 315?
aolh - X31
cnnnn J~ .L
- et}' and 6Jfaings DMSIUr.
`U L~ , i 1 3 [L lg i Di l1 '0:1asninglort ye, Box
Ivt 7162 SMian Perini: Nunbct (to be cilcd in b)
PS adlson. V4 'C7 181
v,
u\ `
Uja Numz
tanPcrluit application
y "wrdao.~ wabt SPS ,R3 I I 4L =-da• C o nfs i of dv. iou•, ;c the upprcgnac em•:mven.el unit Alt+
rry,tircd Pow W I'aininr a cvii.ary petnu Not. Appit abort 'orals lot suite ow.W4 f'(JUTS are sunmincd u> f ?IF Admees -'If difin..c o~ wltoss;
A:pwm= o- Saicn and P< tcssioml Si ne. -rconal of naauon r.+u p,ovidu ma) be used for sr~.ndan. I D C R y~~
I!
UUlicauun lnforma r
non - Please Print All Into) S~
1 A fo) roatiolif
rr ~+cr} V» "Nam, .^a J..pw: l6
i _k oa n --P~p
r .a•u 1 la s 1.1 art A,i(_rss N,)pc«v ;
1 i:y.'• I /tPk-me / 1;b c VOxlbcr fL(/ '•I Sr_uoc.
_ Z ~ /jlrem n i
p-q~~. ~Jv 1
T
If. ype of Budding (check all that apply]_I L d _ NI fi ~'J L N'
utllbi'~7'Ihv<~iug NueiSc, ,~t Bcdr ra Subd vi iu: Name T
Fanh< is i -i -i J - Lrs-ibr l z:. -
~Lnle U»n-d biaibc I. a l I Deli
~a...loe3 9a _ vl~~s dry
/Q I
I I I ype of Permit: (Chet old n Tine A. Complete line B if applical,10
a
.J Nea stect - ' •mea Svsu.--, }a 7rcami n :-lo u 'C :i. P.< I ro n ~ulr _Cnl.u Nwu::atior. 1~ i:x;nuk. Ssstrm Iczp:auy
N . 1'e h --wa: f -mit ri-n tc_ t m Litt Yrrtiws Ye: tan vttmber and fhh issuee(f/
o! ,
r r Ytu•-b r I _ Penn ttva , h. w / ~~[[_,IIyJIIffjj//
rrfl. -1:u ant r lwua
/ pc of 1 UR M tiv<tsoi (.rain oU oene'Decice ICbeck all that apply l
Yrez ur a to a i1i lI i'rezso ved Iu-vumad ] Atr«ss J ?,n»u:l -'4 C. of surabl t,.t Mour. N in
in rr .enk ,o'.I _
i dwas 1 vi L nnc Di ry t al n rn///,,,fff-xplairyi_ _ _ _ Prrncartmw t Uc i.e .l Iau., _
1 UlspcrsaiTreaqg1 nt Area Infra mah i P
lYSr Aow d / ..o r Sppbc:ru aln;gPiSSft Cssycnal At-ca itc eir:a - Us}rral P.;u Proposed a t -irra oc
VL Torok Info Capaaty a, - I- local =of Mmufactum
~ -
G..Il.ns Cijonc L-na% z Z:
\,ew Tmk• r - - , .
um<f.7aaL o
Y
f-.x Holdu<Saok
0 44r; -T
VII. Responsibility' Sutcin Lth<undrrvigncd,x n ratyousibnin far installation of the Pf1R'I\yhuwn an the attached plans I
?lumha Att»arss Rlcn<Numh- -
F f.u tb.l a\; n_`YttaR pls. r ^na-u:e _ - r__
tt, tip etc. Gp Co' < x
A1Z~I w~ !
kA
Lll uunh Ucpatrrrien [u Onlc__ _ - 'I
umu itc ~).:k sto Ltsu.l 4 ci Sigiaturc
cruet ~ ~ ns:.n >R ~ _ 5~ , oa ro 3 i9 - -
IX.Condi awns rUe apprn.'al 7~ A,'-~ S t~ /
E cbn.', a In J '/w f
Uispat V:a Eell d11 be , is ~s ntl_ eS I
+s par .marayemen'p4nr Moen.,ipltknoe;. n.~~-F+`•e--~-
2 AI nelMrk Fft-.Uear..NwUi Met w 1-at.nhi.1 ~
Y Pat tpPkCrbl+ use}: i Cfd, :A.1CLf 'F~ L ra yr Wta wtA a% ~ _ ~Li01ew lyV v ro W`
>nacb w eampletc plain j..< the asst<m sad aobmir u net C uaot) orals a pope, nor kss Man a t.r a I I .lies m sw<
:RDti?9g r{.::r': 1
SvsLe1D PLOT IT
-1\
PRQIEci Tirr WQiSKOn` ADDRLSS ICY8 [000nneeTr -in-I I fU':Siir 4G1
SVV 1?4 SE 1!4S 12 ?I 20 N!R 14 v4 TClv~'N HLCSDn C'OIyTl' Cz CROIX
SYSTtiM ELEVATION 1.28 4.5 bcb,V., grace- S'L9"G 6
HATE BEDROOM
CONV'EN'19ONAL XYa' C'ONVFNTI0\A1. LIIJ HOLDING 'PANE
AIM ND SITIR TANK SIZE 2100 Lt -R D-* LIFT TANK SIZE DOSE TANK SIZE.
HOLDING TANK SIZI LOAD RATE ARSORI'TION 4RLA '336 r of chwnbecc66
RENCH YLA RK R.P. Base O' GD'ncr DOS- ASSLAI F: I:LEVA TIO\ 1110•
Filter laia[imc F:Iter
RORELH>LI N'li1.L '11.lt. P. samr,:IS b0'm'lc ire.
M17arn~b~ali. Ra;,d
Scale = 1/4" = 10'
enr
(1teC n4 9tan a:C
L:.aehln2 Chan m
~l ~.6PL pair of end C:"ms
=.Long
Grade a' S\ sten; F.a anon job
I
F.ztsur~ r,
6,dn:~ rn
A alve is to Ix
I nstalled it possible CT
B. M.'`
ti
j'
R Vents
-
96'
9>'
\`❑t - - l 94 f.'
R I S:R
,n
\ p m~ i tal_',c .AS 1 vI SDF it`11'.
p p'n, silatl be -\S I'M Fsr}l
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 5128'19
Owner:Tim Weiskopf
Location: SW114 SE1'4 S12 T29N,R19W 1016 Moonbeam Rd Hudson
Manuals Used: In-ground absorbtion system (version 2.0)
Pageu
1. Cover Page
2. Plot Plan
3. Chamber Cross Section
4-6. Maintance and Contigency Plan
on
7. Filter /mber#226900
SignaturLicense
System PLOT PLAN'
I'R(>.IEci Tim Wniskonf :(UDRr.ss 1016 Moonbeam Road Hudson Wi 54016
SW Ir4 SE 1/4s 12 rr 29 NIR 19 lAr V)WN Hudson
COI: N'I'A' ST. CROIX
SYS 1'EN1 ELEVATION 91.2;90.5,''89.8 4.5' bW v (Trade 5/29,19
DATE Bt:uRO(mt
C ONVE,NHONAL XXX
~C'ONVEN'I'IONAL LIP'I' IIOLDING 'TANK
MOUND SEPTIC "TANK SIZE 21000 gahOns 1.111"1 INK SIZE DOSE "LANK SIZE
HOLDING 'TANK NIZE LOAD RA'rlc .7 :1BSORPTION AREA 1336
# of chambers 66
BE.NCIINIARK V.R.P. BaSe 0! Comer nos!
ASSUME D:LFNA'TION 100' Filter hletime hilicr
❑ BORF11OLF, O Wta,1. , II. R.I'. Same, as benchmark
iA9oonhCam Road
Scale - 1/4" = 10'
Vent
0- Quick-1 ` IMAIl'd
of Cover I.cachm Chamber
with 20.01`12 of Area
4' 5.6f1^2/pair of end Caps
Lon,
~4„ Grade al Svstem Elevation WCII
Exlsii1 6
Bedroom
House
A valve is to be
installed it possible '-1` IU'
15'
IN
Sr I
40'
15' B vents
96'
911' MIM
pqVent
94'
4 45' 30'
B-I 'S Slope 13 ' 9„
:111 Piping shall he AS 1'M SDR 30/34, within
10' of tank, pipin" sh:111 be E891 50'
- 3' \ 90' (ICIIN v, III) spacing,
Property Line
Cross Section of Quick 4 Standard Leaching Chamber
Typical cross section for 2 of 3 cells
wick 4 Standard
Leachin-, Chamber with
20.0 112 of Area per
Chamber 5.611^2 pair of end phitcs To be >1' above grade
Finish grade elevation
Typical Installation 95.8'
Vent Vent
Grade
4' .A~30f34 Septic Tank 4
d' Lon, 5' 4' Loner I
(iradc at S stem Rlc~ation
1 ° Gradc a[ S"Iem Ho at,on 14
Spacing 5'
3-3 X 78' Cells
Observation tube/Vent
Same on other end To be located on end of Cells
22 chambers per cell
A
B
System elevations: C
A-91.2'
B 90.5'
C 89.8'
i
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page _of.-
FILE INFORMATION SYSTEM SPECIFICATIONS
' [Owner -I-!J K Septic Tank Capadry NA
Septic Tank Manufacturer
i)ESIGN PARAMETERS Effluent Fitter Manufacturer U NA
Number of Bedrooms J
-
r NA E`fluent Filter Model U NA
Number of Public Facility Units _ '1_NA Pump Tank Capacity qaI NA
Estimated flow (average) (t G U dal/day Pump Tank Manufacturer NA
i Design flow (peak), (Estimated • 1.5) gal/day Pump Manufacturer NA
Soil Application Rate aVdaYJff` Purnp Model - - - NA
Standard Influent/Effluent Quality Monthly average' Pretreatment Unit NA
Fats, Oil & Grease (FOG) ' s30 mg/L ❑ Sand/Gravel Filter ❑ Peat Fitter
Biochemical Oxygen Demand (BOD;) <220 mq& Cl NA :3 Mechanical Aeration ❑ Wetland
I otal Suspended Solids (TSS) 1150 mg/L C Disinfection ❑ Other:
Pretreated Effluent Quality ~ Nonthly average Dispersal Cell(s) U NA
Biochemical Oxygen Demand (BODe) <_M rng/L n-Ground (gravity) ❑ In-Ground (pressurized)
1 otal Suspended Solids (TSS) 1530 mg/L 7,d5.NA a At-Grade ❑ Mound
- Fecal Colifonn (geometric mean) •'104 cfu/100m1 f _ ❑ Drip-Line ❑ Other:
Maximum Effluent Panicle Size Jk India. ❑ NA Other- _ -
G NA
A Other. NA
'Values typical for domestic wastewater and septic tank offluerr. Other Z NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
inspect condition of tanks month(s)
At least once every: 3 ar s - (Maximum 3 years) U NA
(Pump out contents of tank(s) When combined sludge and scum equals one third (k) of tank volume O NA
'Inspect dispersal l oell(s) At least once every: 0 month(s) (Maximum 3 years) O NA
- 3 -Y~ ear(s)-- -
;lean effluent fitter month(s) least once every: month(s) U NA
/ar(s)
nspect pump, pump controls & alarm, At least once every: - Mont (s) - 0 NA
year(s)
i
lush laterals and pressure lest At least once every: L month(s) 0 NA
- ❑ year(s)
tither: EI month(s)
At least once every: El year(s) N'°
)thee -
NA.
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells snall be mace by an individual carrying one of the following licenses or certifications: ;ter
Plurnoer; Master Plumber Restricted Scwer, POVV; S inspector. POWTS Maraamen Septage Servicing Operator. Tank inspection must
nclude a visual inspection, of the tank(s) to identify any missing or broken l;,udwaie, identify any cracks or leaks, measure the vol 1, of
combined sludge and scum and to check for any barge up or ponding of Pfflue•ii on the ground surface. The dispersal cell(s) shall be
visually inspected to check the effluent evels in the observation pipes and to check for any ponding of effluent or the ground surface.
The pondmg of effluent on the ground surface may incieate a failing condition and requires the immediate notification of the local
-egulatory authority.
When the combined accumulation of sludge and scum in any tank equals one-third (Y) 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.
M other services, inciuaing 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 purformed b; a certified POWTS Maintainer.
A service report shall be provided to the local regulatory edti :,i% vrlthln 10 nays of completion of any service event.
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer I i I,l )C ~~n P
I Y
Mailing Address I y 1 01-rc pJbQry~
Property Address _ c--Q,
(Verification required from Planting & Aming Department for new construction.)
City/State Parcel Identification Number 0d0 - / 0 j lo- 07- h7R )
LEGAL DESCRIPTION
Property Location T Z N R jqq
_W, Town of
Subdivision Lot #
Certified Survey Map # J ag
Warranty Deed ,Volume Page # _
Spec house yes (y~ nd Lot line!. identifiable yes no
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Iagaoper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper
rnamtataaee consists of pumping out the septic tank every three years or sooner, it 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 §Conmm 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance.
The property owner agrees to submit to St. Croix County Planting & Zoning Department a certification form, signed by the
owner and by a nmster 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.
I/wc, the undersigned have read the above requiremems and a&vx: to maintain the private sewage disposal system with the
standards set forth, herein, as set by the Department of Commerce and the Department of Naturai 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 stab:ments on this 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 7"uty deed recorded in Register of Deals Office.
Number of bedrooms
SI , A ME OF APPLICANT(S) DATE
***Any information that is misrepresented may result in the sanitary permit being rk-voked 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 tap if
reference is made in the warranty deed
(REV. 0&05)
Page _ of
START UP AND OPERATION ducts or oftrer cFnernicals tht t
For new construction, prior to use of the POWTS Check treatment tank(s) for the presence of painting pro
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 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 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 vahln
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 PONIf$:
antibiotics; baby wipes: cigarette butts: condoms; cotton swabs: degreasers; dental floss: diapers: disinfectants; tat; 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 prope(y
and safety abandoned in compliance with chaptbr 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, ail 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 systelm.
The replacement area should be protected from disturbance and compaction and should not be infringed upon by requii0d
setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the neod
for a new sal and site evaluation to establish a suitable replacement area. Replacement systems must comply with thei rules in
effect at that time.
~.d,A suitable replacement area is no 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.
❑ The site has not been evaluated to identity a suitable replacement area. Upon failure of the POWTS a sal and site evaluation
must be pertomed 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 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
Phone 71-L phone /!S !Y rJ - `7.~~ 6--
SEPTAGE SERVICING OPERATOR P MPER LOCAL REGULATORY AUTHORITY
Name Name s / _
Phone l- Phone 71 % ' ` 6 6 h
This doaanent was drafted in eompuaooe wtth chapter SPS 383.22(2)(b)(t)(d)S(f) and 383.54(1), (2) 8 (3). Wisconsin Adrninstrative Code.
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ST. CRo=:t COUP;TY ZoNTBiG OF.'ICE
CERTTF'ICATION S'T'ATEMENT
Foil UTILTZATION OF AN EXISTING SEP'T'IC TANK
uc:'tirl that I i;ave inspected the se is tank
pt preser:r__:
t;:e ~s - lt/qu tC D _f
j _ residence located
1~✓ c
> Section ~ N W, To'.-:!. ~
Upon inspection, i certify that i Fac._
tank and baffles to be in good condition, and it. appe-ire t., be
r.inctioninq properly.
t tine serviced:
C_ow back occur from :bsorpt.icn systcr..%
- Yes !ao I f no, :;ki.p nev. t. 1 i r,e i
1=n17ov.imate volume or Lt:gt.h of tim(.,:
g,zl lams nu r,cc~s:
acity:~L9t~CJ - -
n:-.truction: Prefab Concrete--)(,- Steel Cther
r„fa t.:rex: (If known', : Z,,YL40r11,-1 - -
c lank (TC known): 7ypy{1/y
nature) .S~
(Name) case prin
t
t
itiej
(Liccnsc- A'un:ber)
_crm to bi= completed by licensed plumber (s.145.Gc, isC::
statutes) or Licensed Disposer (NR 113 Wisconsin Adninistrat'.:
ode;
:'Lumber (applying for sanitary permit) Certification:
accepting the above statement regardi q existing sepCic t
-oral=lion, I certify that the tank to the
tog
t. of my knowiedce w'_!1
conform to the requirements of ILHR 83, Adm. Code (except
nspec`tti/o{n oper.irg ver outlet baffle)
Na! c
signatur. - - MP/ MPRt. 72 `~v
';ER
T0w^JSHIP;
1. ADDRESS SF,C. T g~ R W
S'I, CROIX COUN- i , 'dISCONSIN
iD1VISION
LOT_ LOT SIZE
Distances 6 dimensions to meet requirements of H62.20
SHOE' EVY:RYTTANG *,;I;HIN 100 FEET OF SYSTEM
- r • -
- 1-j. I
i
TIC TANK(S) MFGR. '
NO. of rings on cover CONCRETE_ STEEL
NCHES NO. Of width Depth DRY WELL
no. of lines length area
width' length area
depth to top of pipe
'RECATE
RATE'S` AREA REQUIRED AREA AS BUILT
claimer: The inspection of this system by St. Croix County does not imply complete
liance with State Ac:❑in1stro[i•je CQ(ies. There are other areas that it is not passible
inspect at this point of construction. St. Croix County assumes no liability for
tem operation. However, if failure' is noted the County will make every effdrt to
ermine cause of failure.
-ASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
t
INSPECTOR
DATED' PI,VMBFR ON JOB
LICENSE NLIMER ' .
Parcel ID # Pago of _
Properly Omer -
❑ Etnnny
Bonny It
pit Ground surface elev. ~ 5 • ~ K. Depth to limiting facto in. Soo licetinn Rate
Henzon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD#f
in Munsell Ou Si. Cont. Color Gt. Sz Sh. 'EB#1 'E11#2 V! ~ ~rf
I ❑ Sonng
~J Boring # ❑ Pit Ground surface elev. I1. Depth to limiting factor in. 8a1 licahon Rate
F b on Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDHf
in. Munsell Ou. Sz. Cent- Color Gr Sz. Sh. 'Eff#f 'Eff#2
Bering
Boring # Ground Surfaceelev. Depth to limiting factor _ in.
IIL~~JJJ ❑ Pn Soil ApVibon Rate
Roots GPDlff
FHorizon ']epdr Dominant Color Rodox Description. Texture Structure Consistence Boundary
n. Munsell Do. Sz. Conn Color Gr. Sz. Sh. 'Eff#1 'E11#2
Effluent #1 = BODE > 3i) 221' nxgL and TSS >30 ' 150 m91- ' Effluent #2 = BODr < 30 mryt 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
[iced matcnal in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
see a~ro M 11.1.
Property Owner Parce' ID R _ Page o'-
-
Bonng P ❑ Boring
pit Ground surface elev h. Depth to limiting factor y"2 in.
Soil -AnPi"bon Rate
Horizon Depth Dommant Color Redox Description Texture Strixxure Consistence Boundary Roots GPDK-
_m. ! MunseO Ou. 5.. Con;. Cola Gr. Sz. Sh. 'E"l 'EAk2
1 -7 . Z S n 4
3 - G~ ! ( 1✓i/I4
i
E7 Boring ir ❑ Boring 1
❑ Pit Ground surfaceelev ft. Depth In limiting tactor In.
Soil ADNe;ation Role
Honzon Depth Dominant Color Repay Description Texure Struclure Consistence Boundary Roots GoDfff
in. Munsell Ou. Sz. Con; Color Gr. Sz. Sh. 'Et1*1 'EfHi2
I ~
I
I
i
Boning R Boring Pit Ground surfaceelev. Depth to hmihng factor in.
❑ - -
Sol Application Rate
Honzon -)epth Domnant Col Redox De ption. Texture I Structure Consistence Boundary Roots GpDlff
.n Munsell a. Sz. Cont. Color Gr. Sz. Sh. -EN#1 'Effk2
i
i
I ~
I i I
Effluent #1 = BODr > 30 < 22C rtxyL and TSS >3C < 1K mgnL ' Effluent 62 = BOO, < 30 axWL 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 608-2h6~315I or TT 1• 60S-264-S-7.
Cn6xi1:(x Aryl
Soil Test Plot V/29/1 Project Name Tim Weiskopf
d
Address 1016 Moonbeam Road
Hudson Wi 54016
26900
Lot 7 Subdivision DatS W 1/4 SE 1/4S 12 T 29 N/R19 W
- - Township Hudson
Boring O well PL Property Line County ST. CROIX
Ri\1 or VKt' Assume Elevation 100 ft. Base of corner post
System Elevation 91.2/90.5/89.8 *HRPSame as Benchmark
~toonbcum Road
Scale IS F = 40'
unless othel•\visc
noted
Well
L-sistint, 6
Bedroom
House
1. 10•
100
13.M.*
Vent 11 B-3
96'
90'
95'
94'
45' '0
+0
B-I ? Slope B 2 9.+
4 7; 50'
Property Line