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2005/01/07 - SANITARY - SAN - Other
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TOWN OF SCOTT
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18792
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2005/01/07 - SANITARY - SAN - Other
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Last modified
3/6/2020 9:06:39 AM
Creation date
9/30/2017 12:14:29 AM
Metadata
Fields
Template:
Property Files v2
Document Date
1/7/2005
Document Type 1
SANITARY
Document Type 2
SAN
Document Type 3
Other
Tax ID
18792
Pin Number
07-028-2-40-14-34-5 05-005-013000
Legacy Pin
028413403603
Municipality
TOWN OF SCOTT
Owner Name
NICHOLAS B & ANDREA L RIEDELL
Property Address
27422 PEPIN RD
City
WEBSTER
State
WI
Zip
54893
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Visconsin <br /> VATE ON ITE WASTE TREAT EN S Bumett County <br /> ( POWTS) Property Address:0 -Nas <br /> Department of Commerce INSPECTION REPORT pc(, <br /> Safety and Buildings Division (ATTACH TO PERMIT) <br /> Sanitary Permit No: <br /> GENERAL INFORMATION / eq <br /> Personal information you provide nay be used for sewn Pun oses Privacy Law,s. 15.04 I m)IT <br /> Perm' Holder's Name: 0 City U Village Tam cif: State Plan Transaction ID*: <br /> S <br /> CST BM Flow Imp BM Eley: BM Description: <br /> Parcel Tax No: <br /> /00-0U 5AAA15- NAIL. JtJ TRIo(.r~ 088- Da`b-y►3y o3=rte <br /> TANK INFORMATION ELEVATION DATA <br /> TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV <br /> Sept SKAVV gpp LOA Benchmark 3-(,e5 103.1p <br /> Dosing <br /> Aeration Bldg.Sewer r 470 9 <br /> 9. 93 <br /> Holding St/Ht Inlet ,5,,�$ 9 . 35 <br /> TANK SETBACK INFORMATION St/Ht Outlet S 99./7 <br /> TANK TO P/L WELL BLDG AIR I T°NTac� ROAD Dt Inlet <br /> AIR <br /> Septic x26 tyN — NA Dt Bottom <br /> Dosing NA Installation <br /> Contour <br /> Aeration NA Header/Man. <br /> Holding Dist Pipe S <br /> 97,82 <br /> PUMP I SIPHON INFORMATION Infiltrative <br /> Surface 6,516 97 o <br /> Manufacturer Demand Final Grade <br /> Model Number . GPM &40A /6 e O 3 <br /> TDH Lift Friction Loss System Head TDH Ft <br /> Forcemain Length Dia Dist To Well <br /> DISPERSAL CELL INFORMATION <br /> DIMENSIONS Width (p Length 7Z No of cera L Type of System Manufacturer: <br /> SETBACK OHWM of Nav G a rwe rbonal ACHING <br /> INFORMATION P/L Bldg weY waters Zn,9 rU� CHAMBER Model Number. <br /> CELL TO (o'+ AJ/A- m/A ? (00 <br /> DISTRIBUTION SYSTEM X Pressure Systems Only <br /> Header/Manifold Distribution Pipe(s) X Hole Size X Hole Observation Pipes <br /> Length Dia Length Dia_ Spac Spacing 10Yes ❑No <br /> SOIL COVER <br /> Depth Over Depth over Depth of Seeded/Sodded Mulched <br /> Cell Center Cell Edges Topsoil ❑Yes ❑No ❑Yes ❑No <br /> COMMENTS: (Include code discrepancies,persons present,etc.) <br /> Permit Posted? N <br /> Schedule 40 Vents and Observation Pipes?C N <br /> Cover Material: TypAk <br /> Effluent Filter Manufacturer Az5L Model 530b <br /> Components Not Inspected: <br /> Plan revision required.❑Yes CTlo � 1 171011 13 1 <br /> Use other side for additional information Date POWTspector's Sig re Cert No <br />
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