Laserfiche WebLink
��S PRIVATE ONSITE WASTE TREATMENT SYSTEMS coNnty 3,rne{(- <br /> ` <br /> Wisconsin ( POWTS) A4— �7 A <br /> Department of Commerce INSPECTION REPORT ZT4608 fiaft fiord <br /> Safety and euudings ONSIon (ATTACH TO PERMIT) Sanitary Permit No: <br /> GENERAL INFORMATION ,$5$835 <br /> I'cannal ndiannmfon you provide mavbc used for senmJam a -[Pnvaev Isw.s-15,14 fI$n0I <br /> Pered Holder's Name: .�City❑ Village ovm ol: State Plan Transaction ID#'. <br /> SOe( Mal Gfonis 3Ac.KSO4 �,,,.r6y (sCU1Cc� <br /> CST BM Elev: Insp BM Us, BM Descriplion: Parcel Tar No' <br /> OT p/2�2''F0>5'Z7'S <br /> /oo. Same Nail in Paou Pale. os-ooz- 029eno <br /> TANK INFORMATION ELEVATION DATA <br /> TYPE MANUFACTURER CAP I STATION BS HI FS ELEV <br /> Septic SKAW e? ii Benchmark —/,20 98.80 i00.00 <br /> Dosing <br /> Aeration Bldg.Sewer (, <br /> Holding St I Ht Inlet 4.&0 <br /> TANK SETBACK INFORMATION StIHtOutlet <br /> TANK TO I P/L WELL I BLDG vENiio ROAD Dt Inlet <br /> RIR INTAKE <br /> Septic >/pp• >35• 26' 'NA Dt Bottom 8.10 $515 <br /> Installation <br /> Dosing >30 NA Contour <br /> Aeration NA Header l Man. <br /> Holding Dist.Pipe s-%T aT 93Z3q/93 <br /> PUMP/SIPHON INFORMATION Infiltrative 91.E <br /> Surface6-YO <br /> _I 7L9 <br /> Manufacturer �fZ - Demand Final Grade <br /> S Pp Ys <br /> Model Number /52 + 53 GPM TP - gS5 93.45 3..20 96115 <br /> TDH Lift 8,C Friction Loss ZG System Head I TDH/l.(,Ft <br /> Forcemain Length Dia I Dist,To Well <br /> DISPERSAL CELL INFORMATION, <br /> DIMENSIONS Width /o Length 3!o Noof Ceus .Z Type of System Manufacturer. <br /> LEACHING —r <br /> SETBACKp/L Bldg Well 0HWIv of Nav CHAMBER <br /> INFORMATION g wales In 9la.eQ Model Number: <br /> CELL TO �/'f0' <br /> wfh HF? <br /> DISTRIBUTION SYSTEM X Pressure Systems Only <br /> Header /Manifold I Distribution Pipe(s) X Hole Size X Hole Observation Pipes <br /> Length= Dia= Length 0D0Dia -i' Spac Spacing I Ed Yes 0 N _ <br /> SOIL COVER <br /> Depth Over Depth Over Depth of Seeded/Sodded I Mulched <br /> Cell Center Cell Ef es Topsoil ❑Yes D No D Yes D No <br /> COMMENTS: (Include code discrepancies,persons present,etc.) <br /> BfA>2 EFF/pert �i/�'r /al><,lLFi( - . <br /> Plan revision required?D Yes O No <br /> Use other side for additional information q Date /POVV�JjA-$�ylnspector;Iq:� Cert No <br /> V <br />