Laserfiche WebLink
1EPARTMENT qF INDUS1ftY, INSPECTION REPORT FOR SAFETY&BUILDINGS <br /> .ABORT&+HUMAN RELATIONS DIVISION <br /> .0.BOX,7969' PRIVATE SEWAGE SYSTEMS BUREAU OF PLUMBING <br /> IADISOIVt,WI 53707 <br /> • 'ONVENTIONAL ❑ALTERNATIVE State Plan 1.D.Number: <br /> Of <br /> ❑Holding Tank ❑ In-Ground Pressure El Mound <br /> Sec• 3 c D U') /'1 <br /> VAME OF PERMIT HOLDER ADDRESS OF PERMIT HOLDER INSPEIVION DAyE <br /> ,ho)I4241 ja%•••Abev 3U67 IVgL Lie 1.swi., 14. 5-76;&)To ,,, WA to <br /> 3ENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN. / REF.PT.ELEV.: CST REF.PT.ELEV. <br /> n a S ".ate K 5, 1,,L• ,. C`t f 10 O <br /> term of Plumber: MP/•PW3V•No.: County Sanitary Permit Number: <br /> w l l.t,j 4--, to-46,.so N 54 I S" --.... a'-fl p te9—0 go o q <br /> EPTIC TAN K/M6t91N6-TANK: <br /> dANUFACTURER: LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV. WARNING LABEL LOCKING COVER <br /> RO IDED. PROVIDED -�� � <br /> STQ tL1� )a°� ES ❑NO DV 8t4O <br /> 'EDDING: VENT DIA.: VENT MATL.. HIGH WATER ROAD: PROPERTY WELL BUILDING: VENT TO FRESH <br /> ALARM LINE. _ AIR INLET <br /> bh`ES ONO CI �S »s �c . <br /> *SING CHAMBER: <br /> MANUFACTURER BEDDING LIQUID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER <br /> ROVIDEO: IDED: <br /> QtL•P NYES ONO _ 5V0 SB1ao Amd,..�.^.•-qT) G YES ONO 1�lYES ONO <br /> 3ALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL PROPERTY WELL BUILDIN VENT TO FRESH <br /> (DIFFERENCE BETWEEN LINE AIR INLET Co <br /> 'UMP ON AND OFF) OYES ►- • 0 s yP s 'S dag <br /> AIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowin r 7 la`LENGTH DIAMETER MATERIAL AND MARKING • <br /> Fr excavation. (If soil can be rolled into a wire,construction shall cease until -r I - <br /> he soil is dry enough to continue.) , ., t 1 C. r.e ` h <br /> :ONVENTIONAL SYSTEM: <br /> WIDTH. LENGTH <br /> NOE.OF HES DISTR PIPE SPACING. MATERIAL*IALt .:•;•,,,. ".':_INSIDE DIA *PITS • LIQUID <br /> DEPTH <br /> L) JC t ' � <br /> L FILL DEPTH DISTR <br /> PIPE DISTR.PIPE OIS R.PI{PE MATF_RIAL. NO DIST• PROP •TY �J BUILDING V NT TO FRESH <br /> 3ELOW PIPES BOVE COVER ELEV.INLET ELEV.END) Sc..a'. LJ V PIPES LINE: AIR INLET <br /> Gtn..„► K ii/AnaX Ae.� 191`$.Ib lCr.'s). 1 L' <br /> ROUND SYSTEM: _ <br /> Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM <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 /> ❑YES ■ 0 <br /> SOIL COVER'TEXTURE PERMANENT MARKERS OBSERVATION WELLS <br /> DYES ONO EYES III .. <br /> DEPTH OVER TRENCH BED DEPTH OVER THE /BED DEPTH OF . • SODDED SEE. • MUL D <br /> CENTER EDGES <br /> OYES ❑ : EYES OW OYES ONO <br /> 3RESSURIZED DISTRIBUTION SYSTEM: <br /> i WIDTH LENGTH NO.• LATERAL SPACING GRAVEL DEPTH BE • PIPE FILL DEPT •:OVE COVER <br /> TR 'C <br /> MANIFOLD PUMP MANIFOLD DISTR PIPE MANIFOLD MATERIAL NO.DISTR. DISTR.PI' DI' RIBUTION P 'E MATERIAL&MARKING <br /> ELEV.. ELEV. DIA. EV. PIPES DIA.: <br /> ■ HOLE SIZE HOLE SPACING. DRILLED CORRECTLY •COVER MATERIAL / VERTICAL LIFT CORRESPONDS TO APPROVED <br /> PLANS <br /> OYES ❑NO ❑YES ONO <br /> COMMENTS: PERMANENT MARKERS OBSERVATION WELLS PROPERTY WELL BUILDING <br /> OYES ONO OYES ONO <br /> • <br /> Sketch System on Retain in county file for audit. <br /> Reverse Side. <br /> SIG TU � TITLE. • , 'A <br /> DILHR SBD 6710(R.01/82) <br />