Laserfiche WebLink
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR /Q� SAFETY&BUILDINGS <br /> LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS �— DIVISION <br /> P.O.BOX 7969 BUREAU OF PLUMBING <br /> MADISON;WI 53707 <br /> 60NVENTIONAL ❑ALTERNATIVE slalePM^LD.Numee,. <br /> III asir9^aBl <br /> ❑Holding Tank ❑ In-Ground Pressure ❑Mound <br /> NAJ 1RESOF PERMIT Hobe rc0s� 6 � drlcj VVV\ INSPECT O <br /> BENCH MARK PeTO— .elereporml DESCRIBE IF DI RENTFROM PLAN <br /> REV. CST REF PT EFy� <br /> Vo 1/66 a <br /> Na1m�e I PI I,I. MPIMPRSW N, Cuurr S,I-1,V 1—a Number <br /> �l r� iii a ( -l9 6 a�9c� <br /> SEPTIC TANK/HOLDING TANK: <br /> MANUFACTURER LIOWD CAPACITY TANK INLET ELEV LANK OUTLET ELEV WARNIN LABEL LOCKING COVER <br /> Q PROVIDED PROVIDED <br /> � &) I 7s I L S ❑NO -]YES -�NO <br /> BEDDING. DIA./YJr y TMALI 'HIGH WATFH NUMBER OF ROAD. PROPERTY/ ELLTU/ BW LDI�G. AV FRN TN LOT RESH <br /> 1 r ALARM FEET FROM s LI /V / <br /> ❑YES XNO y /}S t L-]YES NO NEAREST I,e <br /> DOSING CHAMBER: p (f i <br /> MANUFACTURER BEDDING LIIID UU <br /> I:APA(:111 PMP"I'IIEI PMP SIPII(IN MANVI AI_TLIHL 11 WARN, GLABEL LOCKING COVER <br /> IO <br /> PROVID DPROVIDED. <br /> EYES ❑NO OYES ❑NO ❑VES ❑NO <br /> GALLONS PER CYCLE: PUBEANO CONTROLS OPERATIONAL NUMBER OF PEPIPIFFITI wFILL BVILDwF, VENT TO FRESH <br /> (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET <br /> PUMP ON AND OFF) ❑VES ❑NO NEAREST -0 <br /> SOIL ABSORPTION SYSTEM.Check thesoil moistureat thedepthofplowing IFQIINom olAMnul Mnn1IAE nrvuMARKINIr <br /> or excavation. (If soil can be rolled into a wire,construction shall cease until ..MAIN <br /> RCE <br /> the soil is dry enough to continue.) <br /> CONVENTIONAL SYSTEM: <br /> WIDTH LENGTH Nn or ulsni PlVE svnCwo COVEN INSwL011 =PITS LI00I0 <br /> BED/TRENCH III1 UI U, Fs / NlAT /Cl� PIT DEPTH <br /> DIMENSIONS <br /> V. .57 H FILL DEPTH Illtilli i'IPk UISTH PIPE DI$TR PIPF MATERIAL NO OI$LH NUMBER DF. PROPERTY WELL tlVILOING VENT TO FRESH <br /> BELOW PIPES, ABOVE COVEN EIFV INLII ELEV ENO /� P'Pt 1 LINE (� AIR INLET. <br /> It- i/ /1 qq o ///P FEET FROM - >I'� r <br /> -d 7%s �J s b��_, V`� NEAREST---s J-� CBBS l S� <br /> MOUND SYSTEM: Be -5 <br /> Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDEA DIAGRAMOFSYSTEM <br /> and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE.SHOW ELEVA- <br /> meets the criteria for medium sand. TIONS MEASURED. <br /> 1-1 YES ❑NO <br /> SOIL COVER TEXTURE P I Hn1ANI Ni MAHKI It', LBSEIrvATION wF LLS <br /> ❑VES 1-1 NO ❑YES 1:1 NO <br /> DEPTH nvrR TRENCH BED EDGES LIVE R TRENCH nr Ptll nE IuvsnlL xEu lnuuEu $LIUIn MULCHED <br /> CENTER EDGES <br /> ❑YES. ❑NO El YES C NO DYES ❑NO <br /> PRESSURIZED DISTRIBUTION SYSTEM: <br /> ..WIDTH LENGTII NO.OF LATE HAL SPACING D <br /> ,;HAVE L EPTH RE L OW PIPE F It L D.PTH ABOVE COVER <br /> BEDITRENCH.. TRENCHES <br /> DIMENSIONS '. <br /> MANIFOLD PUMP MANIFOLD DISTR PIPE MANIFOLOMATEHIAL NI 'IS", DISTR PIPE DIBTHI LJUON PIPE MATERIAL&MARKING <br /> ELEV. ELEV DIA ELEV PIPES DIA <br /> E LE V ATION'AND <br /> DISINFORMATION HOLE HOLF SFACINC. eRULFD COHHECT lv COVER MATERIAL VERT 'At UFT CORRESPONDS TO APPROVED <br /> INFORMATION. PLAm <br /> DYES ❑No DYES ENO <br /> COMMENTS: PERMANENT MARKERS OBSERVATION WELLS NUMBEROF. . PROPERTY WELL BUILDING <br /> FEET FROM'. LINE. <br /> yV 7r/j� �3i d+ <br /> EYES 1:1 NO EYES DIS <br /> fJEAREST <br /> 7 A <br /> fie el Dree <br /> (� �/ 3� 9S, S s3 0/ r^ T� C J (iA1J� <br /> D GJ o g7,ls w, To <br /> " CDue <br /> a <br /> f�r I <br /> Sketch System on Retain in county file for audit. <br /> Reverse Side. <br /> 51(iNA R TITLE. <br /> DI LHR SBD 6710 (R.01/82) <br />