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HomeMy WebLinkAbout020-1345-20-000 (2)Crunia "s PRIVATE SEWAGE SYSTEM St. Croix $Wdl enl fal III INSPECTION REPORT siammn xo. 615453 GENERAL INFORMATION (ATTACH TO PERMIT) ell well I xa. Alen ad, Law. v soa (PIT A mimwrmamnye. wame mar n•Law roraeaenearvoaa TRACI rennr Robert 3, ll &Danielle R. Petricka �� ����KK TOWN OF HUDSON 020-1345-20-000 law uaa. "a`3.48 um ..a a.I.u� �-' w.m a..ea'n,11a.29. 19A852 TANK INFORMATION ELEVATION DATA TYPE MPNOFACNPEA CAPACITY STATION Bid NI As El£V. Send, W;nialfillial /ZG6 ,hma. 7. 161 9546 1I La Alt M 3. I 98 3 u Bldg sea, 044 PRIOR SYH, Inlet 1 TANK SETBACK INFORMATION um Oman 79 9W.3 48 TANKTO ^I'L , WELL SLW. na POPO Ol Iola, \ $e"" >zs G'7 ZI 37 ,me _ meM.e. 8.6 93 4 Ar g.D qs. w��s �.. -- I.sW,.�,� cl all 4 PUMPISIPHON INFORMATION Owe 3,eW q'A mm`" ICED I °" 3a I 9s 3 Been Carl I FP PC Add Pan Head Syd� SOIL ABSORPTION SYSTEM , Em B ITVI=10 ON 9 W�em3 z.—IFAA,aal oM`.. _ a. SYSLEM TO Pa LOG WELLCHAMBEIR Bio INZOInM, °". s,m.m:IAia2 55 �.�. we,}L ... edT DISTRIBUTION SYSTEM 5 M Z AJ ,Lau: p . a vm_,gMCi' dealVAIL Over "AR, I � wallo :�aa:a, S.5`i �F ., a 2NO COMMENTS: Iinawe cme a�sveperciee, cenans ureeem, nc.l all 21PACKER DR�I� , J All BM Oeevrouon- e� 2IBldg ee m m Real PI IamR,Pmree, ❑Y 9 I CAPo0.1 AIR III nAl �„ Ideal9 Raga AC V. n Cl a a,o. cAn, u, ti EC EYED \ � mml�ta..vdrir b PDD. Ikm sT uol Pu1tWrU . Qe) r Iw®uvn srrm-n�z 1 2019 &/5# 53 P«�gltA licet'i '��m e®r...S.E,,,wxnr...®.e. A1R E/ LS�Aa� TL' I Kl L YY�IY— ewa.UYr�r2.� E E:LLE -. It1RIeK'K 02D—/345'-SD.-pB0 7zl IACAK lC)wv& W.er ze +lugseN s1+W K �1 K ffi It � stcl6 r s9 a l�.�r r'nr..rr+ss(s.aarwb) K �s3Pagn,ec'q_xrtr Z, , Os.ar-n.�eu. V a r,a � w 11}22 45113 nrr N�— mrrv..rtire ♦ rrrarwwxx ❑Ir.v olvw no�a...l. ors..,,. rv.In< r .om a,�.mmco,. ❑..m. ol...... raa.a offi.v.rra.w ❑mwarr ucod�.,ol J p awu. - yir.mP�+M neoi.w 5wm7 0,7 37 .: 94 n.rru 4m. .37// � !! AA55 • E. CiNTTr sy Ym ly 0- ' 3) kL e,F P• a prrt z. rm.ek Ru9... mm UL fJ P. Plot Plan page Lofy PROPERTYO NER: 17 waL'E F.R-TKICKA- r 40 FT. I�) o�npma Lutz {ILM£S{CT9 w%4 sF n+E s�%u p_ba we rzqe R14w T DF Hdp 4 RSY eau + Ul's py Z.Izo RGRE> 0io-IS45.ye-poo 72l rxwe �xive North Site location: 09� t� COPY Plot Plan Pap 2-ofy PROPERTY OWNER: ^OBERT S, £ DAwtEU.FR. ?�TRI[KA- r=40 FT. Uxreptvg, Wtm) V wa 'Piticn: poi z HW+t£x wi4 eF T sw�4 siiit. II Q a b me Pit rzgg P.19w Tow,ij OF HNbo.J . "x G4N ry WI CMSIAI- z 72'Pne tRvE Z.Izu RGRES T North Site location: a i1Bfi: so?q wcaouwoa�vm osaShwKW"w �r <•,•>r°%.7•F' •� u�r �rauw,wm�aita s)m,amaw 3RTgM�(ew.naltl,g oaR) IG�f _r —w _w ®vme x� T/PltN-la@fJi s Ai0l7 CR�mi1rMV6M A+rs�rr•72� w•rr..r� bF�E �� __ rys�avanaw,arw.�.swnn.., �� RANVEW / lMa Pob) alu'O.aWu r v F—e: u�noIe w.s.u.�.marID' •a�.r�.ewr.....8f&rg�0�rr.r.$Z�r amwr�m+ae s 2 boa nCP rT" -Akr &Uutllm mulirYeJ bmy*' 0.7 LR = W 1Y'P'RA)9?96n 957�H07-20&s/w,Tr W. 9c 'T u¢kh'>aT^� 43�s x Y' M. _ loz' Nl AMM TOTAL az gy 98 vs -nT� In -ground Gravity Management Plan PAGE 4 OF 4 131P0110i ribe Omer a Mierground ymHy mslem shall as rtap bM arils Wholly oilerlion and malMepards pumvmR to mquimmenhe a SPS 362 W. None ad in. COW Pursuant a SPS Sic U(2), lash Admin. Code MIS "Shall Shall W Wnsldared a human) health haaaN arawre If not mannered it anShall his awmved management pan. FWI'mml ,, all inspecAm are maintenance adde ies Mail as Potential by a mgNtw•II PoWIS MYIMehnr in xmNsnis Ait SIPS 3W 52 (3), New; Admin. COW MAmum Dismmal ArN Chweratfinto Liberal: Design Flow• 600 gild; SODr52201112I TSSSViorl FOGS30rai IMdaceon CheCliftit INSPECT EVERY 3 YEARS o tyre a uea a ega of System absence factors (le, wont, uwr mmpame RAI medial maMul (i.a., Wal valvq Assumes apes, Ai mat a intgue (re., Islas, Creaks, wnwan. mu1 • mlitla volumeinasam•de 0eabnmt t"(s)end Wry d&filuti^n appuaew (s)(I.e., dig "Cuten f Crop gyps) n�lad or Impmrerum (1.e., Wasedhlp dery n rape-'uea, Prohibited as vits%etc.) extent or pending In duenbudm call per 10 dai obyslan it g�ulantas-W applicable pa., pump mdytlsg float mach War WS, 00) 0 Steil c lrmadr pn -ff o' � e (i.>r ., - ng minxppna. sµ g wn1MaanTea, genre, &a) p mn�e dlwwmad dnuml area :�gaa(.fpinm a�p�da,ad�nlae re-comperembeNgn xearlrauon) lsalnfenawe Critical MAINTAIN EVERY 3 YEARS(orwTen nx"ua ) 0 9eorlc •nE Mesta shall be Pummed By rental mpsge mniarg Werear Grgnaeal undw 5. 281.Q She stag_ win•^ 1M VGume ofaolids in a• Al l "x ft me.alN (113) this lewd volume ofine Wallis) 0r Wrepulmdbylxelominancia. oimoe9l otwllgXs ghee l»gnaumRa rvlx it3. wi x. Ndnin. CCOe. 0 MMt naMa shall be Mspened every, 3Mass And and W deri VAI•n necessary to mnwe am a Ustedxliwxmdirptomenuac WsgRen one Aaervitlng Parisd rtiu tlwera ebalaitg Menu months SYN•m maimawn npow aM1aB ba eubmmM to Ind paowrloul gowmmam War In Amsterdam" MN SP63•].66 NBC. Admin. Cow. am any agnponam fallen or mallunHlan th: Name dlMNmwl or danreny: ADVANCED SEPTIC INSTALLAT Andre. 715-703-8337 L«m goemmem unit ST. CROIX COMMUNITY DEVELOPMpflem, 715-386-4680 reel aovenmam umaaeresa HUDSON,Vy1 Z1P; 54018 Any wsdiae pan d MNaystem Nwp W MpMW repewd, dmmpmd pureueM a 6PS 383.51 Ili), Vex Mrrvn. Code. Rewlror m1.Verarnlmt Mtmled wmelan limin8 rvmporrenUehell mply Wlh 6P6333, N1x. Adnln. Cow. Nopm]udarMwnlcmoroydmlrea wnmMe POWFSmaybew uxunkea appovw Cy MedewMlmn amNanm BarSP53M,, wx. pal code [.Ongnawroor Plan in Me avem Aw any tailed bealmem romrerent altar p0I Cannot ba reported, It shall Ce repeated pumueM to a Mere�� Plan "MAN come appmpnaw MIAMI reviawandappovm. Afailed Ihyr^YM OlaPersalwmPaxnl lnmy CB Madhpd eng di"ll mmsananl In a padeternrlmd area of III mils. Sv Assndonment If use Of "a POV?& Is diamrrill It Small be abandoned in aanaanm warn SPS W,00. No, Admin COW. Quick4 INFILTRATOR The Quick4® Plus Standard Chamber a sl Plus Standard Chamber am m a mngm thi has winner structural cobras. a chamber can M installa0 M a -man -wide trench. Like the Mesatl with its contour Barrel maii todry wbn its Comour a Man to 15 dn^r which permits Wms tot&degrees,u wlend Iris as sonde In rwr-M1wt IerglM1e ro rvitle Wlimal inamlmli:n flexibiMly. 1oap, are the l]ukkl Periscope accounts WI this chamber, bases increased flexibility, in :lam configurnmons. Maximum Strength 12^H 08'(1219 con) mnew used F tier corm d] ga111]a U 15 ( Gim mm5.9'(1 35 Man),8.0-15 p' (2m1 mm), 12.7' raze mm1 APPB m Buicka Plus Standard Chamber Benefits: • Two center structural calumet Wlar Increased arability and superior strength • Adancetl cmlwlVg connwTarre • latching mechanism allows for quick insla:Aallon • Four-ball chamber Imgms are eery to M1VMIe war irosll • Suppose; wFred Icwk of 16,000lesions earth 12- of cover nuick4 Plus All-iri 12 Endcap Benefits: May M used at the and of chamber may for an InleVoulld or ern be Insm16N mid-trenM • Mid m nM aonrectkn becWre slkµ5 conatruchon of chamber cows Wm center red, as an alterative to adding at the Made of chamber come Center -fee connection allows for easy Installation of renal distribution systems and, connection options Include aides, ends or tap nuickl Plus AIIHmnlm Periscope Benefits: Maws for bake Invert insWlatlo:s, • ten' directlond sterling 12'based invert h ideal for serial applications c Ibad by Me dammora Fso,si at Montana d Media cal / onlclwa Vam+91 \�� W cM4 No MUM #Wck4 yypV/1 I III4h11�11 'S�p 'I'Cy ian�u®wwe e� u-- -- iWalter monrviEw sioE MIM Wina nua u4x.am wnsw.MWlVATNR WATERTICHAMNOVEM UC DRALTRITTAI _ 1 a, wd=m .�....,l 1 w as W _ - wdraftr,a.. NadNRell ..,�a���"" Res addreddeeefaEARN , w....nem,.e,d.". "am." IM�nnm we�f ah,,ed,, INvdpw Id µ'NI M,wioru ww"'I INFILTRATOR aa.Unem`Fe: neI°ME"w',1".0Meedd M:"..:+ 12 9 70MM Q It l.k V_14PLATTED :ve. LANDS WCPTION REnll 'M SEC. II, T29N, RI9w IN E g NW ` from' a IS LE �7Ea •�.� Ih SEP= TANK MAIIJiIIiIxCB AGRRQ.ffi.IT A!ID O WN®tSE� �ThTCATllIN FORM � �Ror=�ou»r s �7�ws � Perrc,cKR Moline A"m 7ZI y ii P q AdNm LSAMR (Yvmeua aa9odlml6mbC! PAi e9apel0 aw wmoa#m) ores Re i-ilet�51N1 l.a� P*WM-f` - N®be OLO-Iz45_�0-000 Awrwia�l�1 u. 5n�w,ss, I�T�NR�w, Tow at fFunson) Subdivmoa Pbe y-16ME5(Fit)7 W#_z wamub DpE# (Iwfda2=)Vo Fag# s�ac.MrOr�' a tm�im I�q�vpvm W,mmmo(MQa91�9'emmd#ewle:iBP®Nelilaeehodbvapor OeO�ualm�fm��"r Mlle �mkawYrh�eeamezm.EoeNd.Mali®tlw�m. Wsm Wieb eNCIW rrYn�ip#a®berablewlal4ie ow®:ko®¢ ae�.tii+u. wvJem:9�l zos�)�emt�ypiz.saoouGmb#ebra�®m _ Tse#ewbe�raReb Nmt63[fim Cu®bM®6!T CLaWp®amtiGemm6 ��dMmle�:'�mai�v.�mCbvlpl�Naa4®{pmpvWtlll Wemaaa ytlC �wmp In tmar#ae#., ewww�amle®mef2)er:wr•®ar�a(#ae®nx b.aplua 'ma.a'r��vyl�e ro"eo°°.�r�rwrvs.b.r:.ra.+maw�a2pewe. �.er�,®.°�w®a�re#.anes..asmm�arnwmvorxpd �rb®#t�sanem�iayamei# w#ae+rrlm.:r.a�rwr+:e#emaro.0 � lnrtrrr2wwbm.er Ine eob!laoarwom!'ss�eq +/ merrerwbel.a.biya v.vm..l.we.)psr ba.be.ar<ev b.lsamm:lyl000toeb0®m nulp lam, 6U/�✓s&�llfd� �z� �i DAlB ^Mrmumr.:�,rel.vl:rwbaromrs�wneyl.r�glvu.#ga.�l,l ••, .�aa�.e�.rbl�.oy.� �'rsal�a.lwm�a.a.o�ea.rn=em.m##e+�wr�#a I ST. CROIX COUNTY TONING OFFICE FOR �UTILIZATION JOF EXISTINGSEMC TANK(S) r1DBPKT 1 DAAI kEUS ROTPWC('7�C This is to cetify that I have inspected the mating septic and/or dose teak presently serving the following residence: (Street address) 7zl PIXKK DoxIVE located at 5w '/y 5 Ys Secbm )/ Town_jW_N, Renge/%--W, Town Of�a—b5&J St. Croix County Wisconsin. Upon bispectlm, I certify that I have found the tank(sh to the best of my knowledge, will conform to the mwimmeata of SPS. 39425, and it (they) appear(s) to be flmctiowng properly. Most m m date of inspection or service Did flow back occur from absorption system? Yea_ No — (if W, skip next line.) Approximate volr®e or length of time: gallons_ minutes Tank Capacity: ZfcD Ccattmction: Prefab Conmem W Steel Other Mmof ank(iffkaown): Wf Age of Tank (if known): OH -a -pZ Penitntmhr('dknown) :no5gz lI C ps Kent--(�rflRl46 s (LiccAsed Pl ber Signadhe), (Print Name) ➢i AtB 4R, zzYp 31 (Title) (Lionise Numbm)� � 1( 19 (Dace Prom to be completed by licensed plumber (Dept of Safely and Professional Services Chapter 305 and s. 145.06. Wisconsin Statutes) or licensed dispoaer (NR 113 VViccoosin Admirdsnative Cade) Rev. M012 xmN.0 n.NNNeumew •INSPECTION REPORT �`M.&9ies-maro I Rmalny r ---r SUM INK lir.6 93 :W, TAN[ SETBACA INFORMATION st/M ONNet 93. 0' T/NKTO F/L I WELL I NLW. [ a MIRD Lit INK NVv[ 1 NA MCOvgn DOYFg M1 Neaaer/Man. i' 93.48' Matim NP USL. RPe R. .ST xxaing am sysum O. usi' PUMP/SIPNONINFORMATION FItiN G[vaN S.q ga.yro' linKilwaurer I MOtlW vn - oem,m GPM 9t W[ TON LiQ- FL MgN Ma NRL�._.L1_ SOIL ABSORPTION SYSTEM/Ireb e imwoaN��. Wwavrov sYSTEMTO PANLOG WELL TAKE/Slfl $t yn Sfl9RIX IxFDNMnnox I%k+` . ( 23' Y3' (a() � OROMT DISTRIBUTION SYSTEM w4v6i/-F•i. 7 u SOILCOWR aPFa[[wsyamu OnF/ vMwMO[At{n+M1 syatemFONy nepW (nn OgUOwr vi[ehtllSVMtl vYWwa eN/inixn femer vei/ira.xn Fapn Tn=m iqW ❑r.. ❑Fw Dim ONO COMMENTS: Ilnaux[naeai:�Pnn<in, gr[m[Prexnt.tcJ mmecN�Pliy/DI Lvntivv: ]21 Pecka Drirc. Nudpp. Wl LO�f _ f (SEW I/411 T19N K19WJ-1139191B52 NOW-LNS IJ nugai>mm/gbn �(eP•F iw.Ad1>^ aeru�� 2.) BW86[wewtofcvverofm ILO ♦ ' n = >q1 S^''w/ 3j Go6jL b—IDn E V, 4r*t[V. 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Sy l04 Ce Atr- Tuv of Ir°n p.A•- onozms a2. TP°s1 r�a4keD w/ ticllo� R166a��as°% p°s}