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HomeMy WebLinkAbout008-1090-90-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)], Pennit Holder's Name: JoAnn Lavelle Estate City Village Township TOWN OF EAU GALLS CST BM Elev: insp. BM Elev: BM Description: TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Weil SOIL ABSORPTION SYSTEM ELEVATION DATA County: St. CI"OIX Sanitary Permit No: 617844 State Plan ID No: PWTS-032000273-C Parcel Tax No: 008-1090-90-000 Section/Town/Range/Map No: 32.28.16.479 STATION BS HI FS ELEV. Benchmark Alt. BM Bldg. Sewer St/Ht Inlet SUHt Outlet Dt Inlet Dt Bottom Header/Man. Dist. Pipe Bot. System Final Grade St Cover BEDfrRENCH DIMENSIONS Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth SETBACK INFORMATION SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING CHAMBER OR UNIT Manufacturer: Type Of System: Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipes) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil 0 Yes 0 No 0 Yes 0 No COMMENTS: (Include code discrepencies, persons present, etc.) Location: 61 220TH ST 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Inspection #1: Inspection #2: Plan revision Required? � Yes � No Use other side for additional information. 1 Date Insepctor's Signature Cert. No. ���4y¢enatai� � ' . o � � �' D � �� Safety and Buildings Division � ty Coun d �'I St. Croix ;n �r. " ,� � 201 W. Washington Ave., P.O. BOX w 7162 Sanitary Permit Number (to be filled in by Co.) �� 05 2024 Madison, W �707 716 � MAR ���kt pN 46`i�` //n I � � �� �L`� nt• AppllCat10I1 � Y/ State Transaction Number In accordance with SP 1'(i); Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: A lication forms for POWTS pWTS-032000273-C Pp state-owned are submitted the Department of Safety and Professional Services. Personal information you provide ay be used for to secondary Project Address (if different than mailing address) u oses in accordance with the Privac Law s. 15.04 1 m Stats. Same I. A lication Information -Please Print All Information Property Owner's Name Parcel # JoAnn Lavelle Estate —John Lavelle Executor From 008-1090-90-000 Property Owner's Mailing Address Property Location '� � ^ � � ,' 'Z 61 220a' St. Govt. Lot S W '/<, NW %, Section 32 City, State Zip Code Phone Number Baldwin, WI 54002 715 684-2699 . (circle one) T 28 N; R 16 w II. Type of Building (check all that apply) Lot # ®1 or 2 Family Dwelling —Number of Bedrooms 3 � 1 Subdivision Name Block # ,�/ ❑ Public/Commercial -Describe Use Na � � CSM -�? rC tBe�O� /.�%�jp ❑ City of ❑ State Owned -Describe Use CSM Number ❑ Village of � j Oq �' -I � ®Town of Eau Galle III. Type of Permit: (Check only one, box on line A. Complete line B if applicable) `�' ❑New System ® eplacement System ❑ Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System (explain) B• ❑Permit Renewal ❑Permit Revision ❑Change of Plumber ❑Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner 1V. Type of POWTS System/Component/Device: (Check all that apply) � x C• � • ��� ❑ Non -Pressurized In -Ground ❑Pressurized In -Ground ❑ At -Grade �vllound > 24 in, of suitable soil ❑Mound < 24 in. of suitable soil ❑ Holding Tank ❑Other Dispersal Component (e plain) ❑Pre tment Device (explain) V. Dis ersal/Treatment Area Information: PL-525 effluent filter at ST outlet Design Flow (gpd) Design Soil Application R (gpdsf) Dispersal Area Required (sf) Di ersal Area Proposed (sf) System Elevation 450.0 Gpd 0.4 Gpd/sq. ft. native soil 1,125.00 sq. ft. 1,367.09 sq. ft. 103.50' at 12" above 1.0 G d/s . ft, ASTM C-33 102.50' contour VI. Tank Info Capacity in Total # of Gallons Gallons fa rer �O Units ���,r � o 'b �/�/ New Tanks Existing Tanks iii���"'LLL _� `��" U U � � N ' � o :.' � Y a n. U cn v, � w C7 G�, Septic or Holding Tank ��� 1,000 1 Wieser Concrete Heavy X Dosing Chamber (!pp 600 1 Duty Combination ST/PC X VII. Responsibility Statement- I, the u ersigned, as ume responsibility for installa ' he POWTS shown on the attached plans. Plumber's Name (Print) Plumb 's Signature MP/MPRS Number Business Phone Number James K. Thom son ''�-- MPRS 30021 715 248-7767 Plumber's Address (Street, City, State, Zip Code) 340 Paulson Lake Lane, Osceola, WI 54020 VIII. Count /De artment Use Onl — Approved ❑Disapproved Permit ee ate Is ued �D sui Agent Signature I � 3�o ❑ Owner Given Reason for Denial Zoe IX. C nditions of A roval/Reasons for Disapp va �" SYSTEM OWtJp�R: 3 �i:yC �- QA 1. Septic tank, effluent filter and (- — dispersal cell must be serviced /maintained 1 n / , ` „(fir _�,/ � as per management by � C O+�d�G�1 � �� �� plan provided plumber. l-'T�` 2. All setback requirements must be maintained l� C'�, `�,t`S �`�--- � . EA @ j�la(d�lASsc for the system and submit to the County only oo p er of less than 8 1� x 11 inches in size�.�,� SBD-6398 (R. 11/11) s) QI r ,V, "�{,� �p��i. �G� : To An 4%Ilc rs6cae -A=.dcsm c�tr s�n� 6kocro;rCw, izzo �J lobo%� y III Will III Ito I r at S.tJ Grritr ilow; Vv Tf Ar'ca,a� a•� �E Noeta ,A�91' , r;/... /i ica c � tar 6;� rarr:w dr'we `` "yIt`�` Residential Mound POWTS Index & Title Sheet Project Name: Lavelle 3 Bedroom Replacement Residential Mound Owners Name: JoAnn Lavelle Estate -John Lavelle, Executor Owner's address: 61 220th St., Baldwin, WI 54002 Site address: Same Project Location: Subdivision: Lot O1, Proposed CSM Legal Description: SW1/4 NW1/4, Sec. 32, T.28N., R.16W., Town of Eau Galle, St. Croix Co., WI. Parcel ID #: Pending from 008-1090-90-000 Mater Signature: Page 1 Index and Title Sheet Page 2 State Approved Mound Design Plans Page 3 Treatment Tank Cross Section Page 4 Filter Specifications Page 5 Septic Tank Maintenance Agreement Page 6 Proposed Certified Survey Map Page 7 Warranty Deed Attachments: None Service: James K. DSPS Credential #30021 Page 1 of 7 Design pursuant to In -Ground Soil Absorption Component Manual for POWTS, version 2.0 SBD-10705-P (N.01/01) DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL GREEN BAY WI 54304-5211 Contact Through Relay http://dsps.wi.gov/programs/industry-services wwwmisconsin.gov Tony Evers -Governor Dawn Crim - Secretary March 4, 2020 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 2022-03-04 Plan Review: PWTS-032000273-C JAMES K THOMPSON 340 Paulsen Lake Ln Osceola WI 54020 SITE: �.iIYC��e 22 220th St., Baldwin, WI 54002 Town of Eau Galle Saint Croix County Total Amount: $250.00 Pressure Distribution Component Manual — Ver. 2.0, SBD-10706-p (N.01/01, R 10/12) EZFIow Mound Component Manual —December 2017 Version Description: 450 GPD (3 Bedroom — Replacemer:tl Maintenance Required The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. ' The following conditions shall be met during construction or installation and prior to occupancy or use: • Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site. • Any tall grasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to prevent matting underthe dispersal area. All loose organic material to be removed from POWTS Dispersal Area. • Prior to construction of the dispersal area check the moisture content of the soil to a depth of 8 inches Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil Proper soil moisture content can be determined b ry oiling a soil sample between the hands. If it rolls into a 1/4- inch wire the site is too wet to prepare. If it crumbles, site preparation can proceed. If the site is too wet to menare. do not roceed until it dries. • Abandon Existing System per SPS 383.33 • Pump Floats to be set and verified per approved plan. Any changes may result in pump resizing to meet TDH and GPM Sme fications. • Divert surface water from POWTS Area. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) • Tank Installation to follow all manufacture's recommendations. • Verify property Ime(s) prior to installation. • Well setbacks to meet chs. NR 811 & 812. • Areas that are occupied with rock fi•agmeuts, tree roots, stumps and boulders reduce the amount of soil available for proper treatment. If no other site is available, trees in the basal aria of the POWTS Di persal Area must be cut off at ground level. A larger till area is necessary when my of the above conditions are encountered, to provide sufficient infiltrative area. Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/install ation/operati on. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2)3 nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. TrrhTTa--nks, POWTS Plan Reviewer —Wastewater Specialist Department of Safety &Professional Services � Division of Industry Services email: tim.vanderleest a wisconsm.gov Cell: 608-51&6134 EZflow®MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Lavelle 3 bedroom replacement residential mound Owner's Name: JoAnn Lavelle Estate Owner's Address: 61 220th Ave. Baldwin, WI 54002 Property Address: Same Legal Description: SW1/4 NW1/4, Sec. 32, T.28N., R.16W. Township; Eau Galle County: St. Croix Subdivision Name: Proposed CSM Lot Number: 1 Block Number: Na Parcel I.D. Number: From 008-1090-0000 Plan Transaction No.: Date: 02/27/2 Signature: Page 1 Index and title Page 2 Data entry Page 3 EZflow mound drawings Page 4 Lateral and dose tank Page 5 Distribution media Page 6 System maintenance specifications Page 7 Management and contingency plan Page 8 Pump curve and specifications Page 9 Site Plan Page 10 Attached Soil Evaluation Report License Number: Phone Number: 30021 (715) 248-7767 Designed Pursuant to the FZilow Mound Component Manual Ver. August 20, 2007, SSVVMP Publication 9.6 Design of Pressure Distribution Networks for S 1-SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706=P (N. 01/01, k. 10/12) EZflow Mound Version 3.0 (R. 3/1/12) 0age 1 of 10 (r or c) (c ore) Mound and Pressure Distribution Component Design Design Worksheet Site Information R Residential or Commercial Design 300.00 Estimated Wastewater Flow (gpd) 1..50 Peaking Factor (e.g. 1,5 = 150%) 450.00 Design Flow (gpd) 7000 Site Slope (%) 102.60 Installation Contour Line Elevation (ft) 24.00 Depth to Limiting Factor (in) 0.40 In -situ Soil Application Rate (gpd/ftz) listribution Cell Information 6.00 Cell Width (ft) 3, 4, 5, 6, .7, 8, 9 or 10 Only 0.95 Dispersal Cell Design Loading IRate (gpd/ft2) 1 Influent Wastewater Quality (1 or 2) Pressure Disribution Information E 3 2 0.125 162 2900 90400 85650 0.00 6.50 17,50 1.22 25.22 Center or End Manifold Lateral Spacing (ft) Number of Laterals Orifice Diameter (in) (e.g. 0.25) stimated Orifice Spacing (ft) _ Forcemain Diameter (in) Forcemain Length (ft) Inside Pump.Tank Elevation (ft) Forcemain Filter Loss (ft) System Head (ft) x 1, 3 Vertical Lift (ft) Friction Loss (ft) Total Dynamic Head (ft) Lateral Diameter Selection in. dia. o tions choice 0, 75 1000 1.25 x x 1,50 x 2A0 x 3.00 x 120.00 Contour Length Available (ft) 80.00 =Dispersal Cell Length (ft) Are the laterals the highest point in the distribution F Ynetwork? Enter Y or N If N above, enter the elevation ft of the highest point. . 8.00 ft2/orifice Does the forcemain drain back? �Y Enter Y or N 50.08 64.76 24.72 Forcemain DrainbacK (gal) 5x Void Volume (gal) Minimum Dose Volume (gal) System Demand (gpm) Manifold Diameter Selection in. dia. o tions choice 1.25 x x 1.50 x Z00 3.00 Gallons/Inch Calculator (optional) Treatment Tank Information 592.00 .Total Tank Capacity (gal) 1000.00 Septic Tank. Capacity (gal) 37.00 Total Working Liquid Depth (in) Wieser Concrete IMainufacturer 16.00 gal/in (enter result in cell B49) Dose Tank Information 592.00 -Dose Tank Capacity (gal) 16.00 Dose Tank Volume (gal/in) Wieser Concrete 01 Manufacturer Effluent Filter Information Poll.ok Filter Manufacturer PL525 Lfilter Model Number Project: Lavelle 3 bedroom replacement residential mound Page 2 of 10 Mound Plan View /10 64 :Observation Pipe It a 12 •' K. 5 '• o ♦[v ♦6 14 r[i=4 xe[x rY •1[!r> }}xi ix4[}[i B [}a}xi r[AxF[Fx1•y•}[}x!v}x>xi"i xi rr[i A •!♦yr[[, x, a,Z vkx;[x [, x'.}.'♦ `.Aa4a kx}[x[xa,r.,x[N[fix'[[x[Tx [ [MA y. L Mound Component Dimensions A 6.00 ft E 17.04 in H 1.00 ft K 9:63 ft B 80.00 ft F 12.00 in z 11.09 ft L 99.26 ft D 12A0 in G 0.50 ft J 6.20 ft W 23.29 ft 480.00 (ftz) Dispersal Cell Area 1 1367.09 (ft) Basal Area Available 5:63 (gpd/ft) Linear Loading Rate 8.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View EZflow Dispersal Area Finished Grade 105[50 (ft) ---► ..� ..,.,to. H «xrsrriar 2 +WE war, •rv... G. I F k.. Dispersal Cell 104,00 (ft) Lateral 103.50 (ft)--► — 6" Invert Elevation Dispersal Ceil s ',„. `[ :sg go go : _ :r's is D[ Elevation ;[., Shading Key To soiF Ca 0 Project:. 7.0 %Site Slope 102:50 (ft) Contour Elevation Typical Dispersal Cell See Page !i Tilled Layer EZtlow Media be. .i See details on page 4 for number, size, and spacing of laterals, Laterals are located in the 4" gravity distribution pipes as shown on page Lavelle 3 bedroom replacement residential mound Page 3 of 10 Project:. 7.0 %Site Slope 102:50 (ft) Contour Elevation Typical Dispersal Cell See Page !i Tilled Layer EZtlow Media be. .i See details on page 4 for number, size, and spacing of laterals, Laterals are located in the 4" gravity distribution pipes as shown on page Lavelle 3 bedroom replacement residential mound Page 3 of 10 no Connection Lateral Layout Diagram Place Appropriate Lateral Diagram From Right Below . 1�• I.Y f f t' . "r . 1 � 1 . 1 Number of Laterals 2 Orifice Diameter Lateral Diameter 1.25 in Orifice Spacing (X) Lateral Length (P) 79.30 ft Orifices per Lateral Lateral End (Z) 0.70 ft Orifice Density Lateral Spacing (S) 3.00 ft. Manifold Length Lateral Flow Rate 12.36 gpm Manifold Diameter System Flow Rate 24.72 gpm Forcemain Velocity Dose Tank Information Electrical as per NEC 300 and —� SPS 316.300 WAC Tank component is properly vented Wieser Concrete �Manufacturer Capacff 1 592.00 Gallons Volume 16.00 gal/inch Dimension Inches Gallons A 18.95 303.24 B 2.00 32.00 C 4.05 64.76 D 12.00 192.00 Total 3 .001 592.00 And Disconnect. As Per Manufacturer Alarm Manufacturer SJ Rhom_ bus Alarm Model. Number JBJB PIu��L�� Pump Manufacturer Zoeller Pump Model Number BN152 Pump Must Deliver I 24.72 gpm at F 25.22 ft TDH 0.125 2.71 30 8.00 ft 3.00 .25 2.52 E 1 ft in ft 2/orif in ice ft /sec Locking cover with warning label and locking device and sealed watertight 4 in. min. F— Alternate outlet location Note: Switches. containing mercury may not be used in this system: Forcemain diameter Weep hole or anti - siphon device Puff elevation (ft) 86.50. Dom se tank elevation (ft) • 85.50 Project: Lavelle 3 bedroom replacement residential mound Page 4 of 10 C Project: EUlow® Distribution Cell Media Layout, 6.00 Cell Width (ft) 1.50 Sidewall to Lateral (ft) Distribution Cell Cross-section Arrangements Com SR1-7A Bundle - 5 ft or 10 ft lengths end SR1-12A or EZ 1201A in 5 ft or 10 ft lengths , Perforated Distribution Pipe With Pressure Lateral Inside Tumup Enclosure — — - — — Pressure Laterel Bundles are covered with approved geotextile fabric as per the their product approval. Distribution Cell Plan View Layout -Typical 6.00 Cell Width `- A (ft) 80:00 Cell Length - B (ft) Center Connection Lateral Layout Diagram Lavelle 3 bedroom replacement residential mound Page 5 of 10 Mound System Maintenance and Operation Specifications Service Provider's Name lJmaes K. Thompson — Phone 715 248-7767 POWTS Regulator's Name St. Croix CountyZoningDe 't Phone 715 .386-4680 Design Flow -Peak Estimated Flow -Average Septic Tank Capacity Soil Absorption Component Size Type of Wastewater Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Other System Flow and Load Parameters 450 Man 300 1000 480 Domestic gpd Maximum, Influent Particle Size gpd Maximum BOD5 gal Maximum TSS ftz Maximum FOG away Maximum Fecal Coliform Service Frequency, 1/8 . Malay 220 150 Van 30 mg/ service once eve 3 ears Ins ect and clean as necessaryof least once eve 3 ears Test once eve 3 ears Should test periodically Laterals should be flushed and pressure tested eve 3 ears Ins ect for ondin and seepage once eve 3 ears in g g f/0L Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap and are secured in as shown in the EZflow Mound Component Manual Ver, August 20, 2007. 2. Dispersal cell media conforms to EZflow products approved for use with the EZflow Mound Component Manual Ver. August 20, 2007. Media is covered with an approved geotextile fabric. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board+or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral. Turn -up Detail Finished Grade 6-8" Diameter Lawn Threaded Cieanout Sprinkler Valve Box Plug or Ball Valve x P•: Lateral .Ends at<Last Orifice Where Variable length Cleanout Begins in g g f/0L Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap and are secured in as shown in the EZflow Mound Component Manual Ver, August 20, 2007. 2. Dispersal cell media conforms to EZflow products approved for use with the EZflow Mound Component Manual Ver. August 20, 2007. Media is covered with an approved geotextile fabric. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board+or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral. Turn -up Detail Finished Grade 6-8" Diameter Lawn Threaded Cieanout Sprinkler Valve Box Plug or Ball Valve x P•: Lateral .Ends at<Last Orifice Where Variable length Cleanout Begins •P •P•P• •I•P•R•P•P P P• IF A A P• P•/•1 P i•Py 1•P F at Distribution Lateral Lateral• bedroom_ ------_• Lon Sweep 90 or Two 45:�e ree Bends Same Diame�er as Lateral Page 6 of 10 Mound System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382-84 Wis: Adm. Code, and shall maintained in accordance with its' component manuals [EZflowMound Component Manual 8/20/07, Pressure Distribution Component Manual Ver. 2.0 SBD=10706-P (N. 01/01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. Septic and pump tank abandonment shall be in accordance with SPS 383.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers; access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be. sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater•than 84nches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in. accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the -filter when removed from its enclosure. if the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 113 the liquid volume of the tank. If the.contents of the tank are not removed of the time of a triennial assessment, maintenance personnel shall advise the owner as to when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septictank use by the Wisconsin Department of Commerce. Pump Tank The dosing (pump) tank shall be Inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary, if the force main has a weep hole, it should be noted if it is functional during pump operation, and if not, it should be cleaned. *****No one should ever enter a septic or dose tank since dangerous gases may be present that could cause death.' Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (OctobervFebruary) dictate that the mound be heavily mulched as protection from freezing, Influent quality into the mound system may not exceed 220 mg/L BOD6, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODS, 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent: Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 3 years. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the.dispersai cell. Observation pipes within the dispersal cell shall be checked for efflu'entponding. Ponding levels shall be reported to the owner, and any levels above 4.inches;considered as an impending hydraulic failure requiring additional, more frequent monitoring.' Continaency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or -replaced -to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component falls to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its'.present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing sold components as deemed necessary to bring the system into proper operating condition. See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Lavelle 3 bedroom replacement residential mound Page 7 of 10 T D //. " 16 4 >,. tc I t3.OW � •t11lIlE 64a40•A . oZg612 PM M:4trnaMalPSna4gL�'�Qod. CONSULTFACTORY FOR 0 SPECIAL APPLICATIONS 77A i. • Ipop fi„ 151I152/153 Series titM62N63 M0t7Ete cowttw ta�liaN•n liw.l vele,.Pr lion -iris o N1 1 115 t NO:=342i 2 or 3. ON151 115 1 Aub . 2 or3 E151 230 1 N8n2or3 BE151 230 1 A* 2 or 3 N162 115 1 Nm2or3 OM52 I% 1 Aub 2cr3 E152 230 1 Natt 4.3 1 2 or 3 OEM 230 1 Aub 4.3 k kWd 2 or3 N153 115 1 Nan 105 1 2or3 SM 115 1 1 Aub `10.6 kxkxbd 2 or 3 E153 230 1 Nan &3 1 2 or3 W1531 30 1 Aub 5.3 kftxbd 2 ar 3 All: Inat,lDatloit of oonhol•, prot•a5on d•vic.• •nd rilriny should b• eon• ey . qurllkd Ilceriied rsettid•n, All �i♦otricr anal •N•ty cod••.hould b• tolla•ted Inciudinp the most rgaenMWWH W Elachlc Code INEC) od (h• OcouP•6onr ti•bty t!nd HoWth Act (08HA). TOTAL DYNAMIC HEADIFLOW PER MINUTE EFFLUENT AND DEWATERING MODEL 151 152 153 F.•t u•rn (K ttrn GA UWm cats. urn 6 to 50 tee 66 261 n 2p1 10 3D 4e 17D ei 231 70 M 15 IA 36 1" 63 2Dt e1 23) 20 6.1 Zo 110 44 IN 52 W 26 1*0 16 61 31 12e 42 IN 30 ta.1 23 a >a IN36' 10.7 - - 1D 122 _ 11 42 9k*MHud: 301ti .1t,t^ 361E 1Uk„ 44ft LAAM Model 151 43• m Models 152 / 153 3DA7 SELECt10N GUIDE. *am Po Box Iv4? r n : 4AWy i. d r Allow .j. wwd�c/ a rat s.w. CAr"^'r. 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Provide SharePoint User name below: Hayward DSPS For plan status, check our website at http://dsps,wi.gov Several counties have been delegated certain.authority to review plans in lieu of Division of Industry services, For a current list of those counties and their designation check our website at h ://ds s.wi: ov 1. Project Information - Fill in all known information. Confirmation of assignment to a reviewer. Project/Site Name: Lavelle 3 bedroom replacement residential mound Transaction ID: Location, Number & Street of project (if unknown, indicated nearest road) Previous Related Trans. ID: 6122011 SIN Baldwin WI 54002 Estimated Completion Date: Legal Description: Lot 01 of proposed CSM SW1/4 NW1/4 Sec 32 Assigned Reviewer: T.28N.. R.16W.. County Tn. of Eau.Galle, St. Croix Co., WI, Office: Mail Mail to your office of choice below: ❑ 9,ty ❑ Village ® Town of Hayward, LaCrosse, Waukesha NOTE: We reserve the right to remdlstrlbute plans to another office If 2. After plans are reviewed, please: (check all that apply) 171 Call customer 1, 2 (Circle number) needed to reasonably balance turnaround"times. Check ❑ Requesting party will pick up http://dsas.wi.aov for office availability and next available review date - ® Mail plans to customer 1, 2 (circle number)* *Refers to customer number from below. 3. Complete the following designer/owner/requesting information. Utilize the check boxes when designer, owner or requesting party is the same to avoid repeating Information. Designer Information (Customer 1) . DSPS First Name Other Please Specify Below (Customer 2) DSPS Last Name Customer Number Jim Thompson First Name Last Name Customer Number 30021 Company Name Company Name A.C.E. Soil & Site Evaluations LLC Address Address 340 Paulson Lake Ln. City State Zip+4 (9 digits) Osceola WI City State Zip+4 (9 digits) 54020 Phone Number E-mail address Cell phone (area code) Phone Number E-mail address Cell phone (715) 248-7767 acesoil frontiernet net (area code) Check if applicable ❑ Owner Check if applicable or specify relationship Information and Plan Submittal Checklists. POWTS pre -scheduling ❑ Owner ❑ Other — s eciN relationship is not available. Plans will be assigned to a reviewer after receipt at a DSPS office. Submittals received may be assigned to offices other Submittal than the receiving office depending on reviewer availability. checklists can be -found in each applicable component manual appearing on the POWTS Publications page, http://dsps.wi.00V/php/sbtp aloop/prodcode result php/POWTSM/POWfS COMPONENT MANUAL. You -may email technical code uestions to DSPSSBPowtsTech wi. ov: 10541N Ranch Rd Hayward WI54843 71"34-4870 Fax: 715-634-5150 Email: D§psSbPIanScheduIe0,wI gov LaCrosse Area DSPS 3824 N Creekside Holman WI54636 (NOTE CHANGE) 608485-9334 Fax: 608-785-9330 Email: DsysSbPlanSCt Waukesha DSPS 141 NW Barstow St 4`" Floor Waukesha WI53188-3789 262-548-8600 Fax: 262-548-8614 Email: DspsSbPlanSchedule0wi ov Make Checks Payable to: Division of Industry Services OR ❑ Ch@Ck bOX t0 If11VOIC@ desigtl@I' a"u Sigh b@IOW TOTAL AMOUNT DUE 250 00 Designer signature Review Code 7633 SPS-10577 (R 10/15) N m m us ` c as I I W 1N I I I 'p 0 0 0 v 0 0 0 c 0 0 0 ~ M 0 0 0 O O G L� c > No �" C OODt3 'l'n O.O O 0 0 to p' E m to NMtT O to) OWN tp Z O y O O. a 0 O. tto12s -' � m t/l coW m tel}7 N O {A IA - p• fA to b9 ~O v a O.' O. j v► v9 w T� N Y v> d9 to c .N^.. 0 vk 69 fA E9 e} fA m c C rn u sW C s8 mA$'o E o °; 0 rn 'O mw � � E N OI o v o Z t O c C W L z 57 AS 84" N REQD m 45" z 72„ r D - z C D 0 r---- ,. E! II F N I' co ej D I. 61 O -n m ;o (00 I I o< mVl D . I �� �— L .r-37MT ' n '.I '.I v p eI m - m C o y 431) c� co 0 0 o o <>m r z o z cn Amz-T, I m(nw— D I m;urD� N 0 m oz > mo z� Dv o F m m D -i --I �)mDoocD0ZZmKZno omoy� Mj c� mmZ� v m oo 0co >X° o o A I Fzz n= me 46 o CC , rn O DN zZ 0 D m N 01vFj (n� (n� �r�O a� ZnD n� o Nmy m w�oppp.� p > ,� �r O oN D rn00vtn o D 0 oz � m 0 00 mrrnn;n r 00 �o 0 0 O) D 0 O m m z err- mDr'' 0 00 0 D O < m :E -zi mrri W 00 0 a LQ zz OF> o W� � =-i O m D o O H n rn D4k 0 (A (n D O r o m -I ..� D A Nmn �O� D M z o D l!1 m v ° F D 0 rTlr 0 Cn j In m z D o 0 �� -m-( �C 0 0 0K m D H 0 D� 0 rn _ ; D N m O z� v, WEHD1000/600 � DRAWN BY: WCP SCALE: 1 4"=1'-O" PRE -POUR: MIERER conccETE REV. mi SEPTIC MANUAL DATE: 00 00 00 DATE: POST -POUR: \ z W3716 US HWY 10 MAIDEN ROCK, WI 54750 800-325-8456 FILE: WEH01000/600 13 P�. 3ofT Innovations in Precast, Dratnage & Wastewater Products PL-525 Filter Zabel• A Division of Polylok Inc. PL-525 Effluent Filter The PL-525 Filter is rated for 101000 GPD (gallons per day) making it one of the largest filters in its class. It has 525 linear feet of 1/16" filtration slots. Like the Polylok PL422, the Polylok PL-525 has an automatic shut-off ball installed with every filter. When the filter is removed for cleaning, the ball will float up and temporarily shut off the system so the effluent wori t leave the tank. I ,, Features: • Rated for 10,000 GPD (gallons per day). • 525 linear feet of 1/16" filtration. • Accepts 4" and 6" SCHD 40 pipe. • Built in gas deflector. • Automatic shut-off ball when filter is removed. • Alarm accessibility. • Accepts PV.0 extension handle. PL 525 Installation: Ideal for residential and commercial waste flows up to 9.0,000 gallons per day (GPD). 1.. Locate the outlet of the septic tank. 2. Remove the tank cover and pump tank if necessary. 3. Glue the filter housing to the 4" or 6" outlet pipe. If the filter is not centered under the access opening use a Polylok Extend & Lok or piece of pipe to center filter. 4. Insert the PL-525 filter into its housing, 5. Replace and secure the septic tank cover. PL-525 Maintenance: The PL-525 Effluent Filters will operate efficiently for several years under normal conditions before reqng cleaning. It is recommended that the filter be cleaned every time the tank is pumped, or at least every three 4. years. If the installed filter contains an optional alarm, the owner will be notified by an alarm when the filter needs servicing. Servicing should be done by a certified septic tank pumper or installer. 1. Locate the outlet of the septic tank: 2. Remove tank cover and pump tank if necessary. 3. Do not use plumbing when filter is removed. 4. Pull PL-525 cartridge out of the housing. 5. Hose off filter over the septic tank. Make sure all solids fall back into septic tank. 6. Insert the filter cartridge back into the housing making sure the filter is properly aligned and completely inserted, 7. Replace and secure septic tank cover. 1/16" Filtration Slots Accepts 4" & 6" SCHD 4U pipe Outdoor SmarkFitterCR) Alann .Polylok, Zabel &Best filters accept the SmartFilker® switch and alarm. Alarm Switch (Optional) Accepts 1" PVC Extension Handle Rated for lo,000 GPD 525 Linear Ft. of 1/"l6" Filtration Slots CertilFed to NSF/ANSI Standard 46 Gas Deflector Automatic Shut -Off Ball Extend & LnkT�� Easily installs into existing tanks. Polylok, Inc. 3 Fairfield Blvd. Wallingford, CT 06492 Toll Free: 877.765.9565 Fax: 203.284.$514 www.polylok.com ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer JoAnn Lavelle Estate - John Lavelle Executor Mailing Address 61 220th St., Baldwin, WI 54002 Property Address 61 220th St., Baldwin, WI 54002 (Verification required from Planning &Zoning Department for new construction.) P�d— Baldwin, WI _ 00&1090060Cit /State parcel Identification LEGAL DESCRIPTION Property Location SW %4 , Sec. 32 , T 28 N R 16 W, Town of Eau Subdivision Plat; Pending CSM Certified Survey Map # Warranty Deed # 941950 Spec house �yes�►o Galle Volume ,Page # (before 2007)Volume ,Page # Lot lines identifiable �yes�no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Lot # 01 Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §SPS. 383.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The properly owner agrees to submit to St. Croix County Planning &Zoning Department a certification form, signed by the w owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site astewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Safety And Professional Services and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms 3 IGNATURE OF 03/04/20 DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning &Zoning Department. *** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 04/12) .. ,.: =-z> Certified Survey` Map Joann Lavelle' Estate Part of the Southwest % of the Northwest % of Section 32, Township 28 North, Range 16 West, Town of Eau Galle, St. Croix County, a g Z 33' 33' 6 6' NW Cor. Sec. 32, T 28 N, R 16 Wm15✓16" O.D. Iron Pipe Found) d Ito 0 U Legend; O Indicates 16/16" O.D. x 18"iron pipe set; weighing 1.88/bs., Iin✓fr. _p0 3 � }' U�Q~N��ii �a v� mNCO O 1.Z -o Ulafted Lands Dwelling CenterlJne Driveway o r Shed Z 80.00'00"W 42.31' 33.02' 9.29' 3 n ti CA 4 Z 1 o N 89051'34"E 607.97' 474.96' Garege Shed O SCALEINfEET !" ■ 100' 60 50 1 0 Lot' 6.083 Acres or 264;959 Sq. Ft. 5.T34 Acres or249,756 S46 Ft. Exciuding Road Right Of S 89°51'34"W 447.90' Unplatted L a»ds W 1/4 Cor. Sec. 32, T 28 N, R 16 W, (3/4" O.D. Iron Bar Found) RIVER FgLLS APPLICATION FOR THE TERMINATION OF DECEDENT'S INTEREST AND CONFIRMATION OF APPLICANT'S INTEREST IN PROPERTY DECEDENT'S NAME DATE OF DEATH JOHN J. LAVELLE APRIL 16, 2011 ADDRESS OF DECEDENT AT DATE OF DEATH CITY ST ZIP 61 220T" STREET, aALDWiN WI 64002 PRESENTATION OF DEATH CERTIFICATE I certify that I have viewed a certified copy of the decedent's death certif ate. ,19, --slam_ �----------- 71111---- REGISTER OF DEEDS SIGNATURE DATE THE INTEREST OF THE DECEDENT IN THE PROPERTY NOTED HEREIN IS HEREBY TERMINATED/CONFIRMED UNDER THE FOLLOWING STATUTE: (please check appropriate statute) ® s. 867.045 which pertains to real property in which the decedent was a joint tenant, had a vendor's or mortgagee's interest, or had a life estate. (You must provide a copy of the document establishing interest in the real property.) ❑ s. 867.046 which pertains to property of a decedent specified in a marital property agreement; survivorship marital property; or a third party confirmation; or a nonprobate transfer on death as described in s.705.10(1). You must provide a copy of the document establishing interest in property.) Presentation of recorded document establishing interest In real estate. DOCUMENT# 314663 VOLUME/REEL �t••Z� Description of the real estate. PAGE/IMAGE RECORDS/DEEDS F�:�:�TtE7 ® See Attached V�IIIVIIIIVnIIIIINIiVIII 941590 REGISTER OF DEEDS STo CROIX CO., WI RECEIVED FOR RECORD 09/16/2011 11:12 AM EXEMPT #: REC FEE: 30.00 PAGES: 8 Recording area Name and return address: Robert J. Richardson Bakke Norman, S. C. Box 54 Baldwin, WI 54002 See Attached Parcel Identification Number SEND TAX STATEMENT TO: JoAnn Lavelle 61 2201" St, Baldwin, Wi 64002 Description of personal property (if any) being transferred. You may list savings accounts, checking accounts and securltles on attached pages. Indicate persons) receiving property. DECLARATION: I(We) declare that this document is, to the best of my(our) knowledge and belief, true, correct and complete and is in conformity with the provisions and limitations of the Wisconsin Statutes. Name and Address Applicant's Applicant Signature ;List all remaindermen/ Interest in Property (Notarized) Date beneficiaries. If more apace is (le: spouse, remaindermen, (Print or type name below signature) needed, attach pages.) beneficiary) JoAnn Lavelle Surviving 61 220" St. Spouse and . 44h> � Baldwin, WI 64002 Joint tenant � J 3 JoAnn Lavelle �zoq IniS tlOCUment was dratted STATE VF WISGVNSIN, county of St. Croix by:(print or type name below) .Subscribed and sworn to before me on: September 13, 2011 Attorney Robert J. Richardson by the above named person(s): JoAnn Lavelle NOTE: SEE DIRECTIONS. Signature of Notary or other person Vi4sconsin Register of Deeds authorized to administer an oath (as per ; Association Form HT -Ito s 706,66, 706407) ( Rile Webeite Version 05/2010 Print or type name: ' = er 4l. Richardson Title: Notary Public. '•• IS grigowj siren'#Expires:ts permanent THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FO 9Ij0ULD 5 rPL.EARLY IDENTIFIED. ,f of 1 of 8 ��, Joe Certified Survey Map Joann Lave//e Estate Part of the Southwest '/. of the Northwest '/+ of Section 32, Township 28 North, Range 76 West, Town of Eau Galle, St. Croix County, Wisconsin. 0 1098146 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 03/03/2020 03:14 PM CERTIFIED SURVEY MAP VOLUME: 30 PAGE:6762 REC FEE: 30.00 PAGES: 2 m� NW Cor. Sec. 32, T 28 N, R 96 W, o � � 1 5/16" O_D. Iron Pipe Found) .-.. c � � °� Legend: m � N s � o Indicates 9 S/96" O. D. x 98" iron pipe sef, o �' b N weighing 1.681bs., lin./!t. c m � � I � � � o �o m ti c"'o Z a 3 0 33' 33' I 6 3 z :� 3 U�/atted Lands N 89"5134"E 507.97' SCALE IN FEET _ 1"� 100' 50 0 .50 1 0 33.o1T 474.96' I I I o •a I I o Dwelling � O � � � Rf � N J � Centerline Driveway ❑ 6.083 Acres or264,959 Sq. Ft. :L _ � Garage 5.734 Acres or 249, 756 Sq. Ft. o y,�,i � Shed � Excluding Road Right Of Way � � .�. y = I I Shed 0 O Silo I 90'00 00"W 42.31' 12, 9.29' � N „a. �' O �� w ti � N m 3 0 N 4 z S 89"5134"W447.90' Unplatted Lands W 1/4 Cor. Sec. 32, T 28 N, R 16 W, (3/4" O.D. Iron Bar Found) Owner's Address: 80 230Th St. Baldwin, WI 54002 Dated: November 96, 2099 muRPFty ; � S 1713 ' O RIVER FALLS �y WI '' .� •` ��LANp`S.,Q``• i Sheet 1 of 2 Sheets �a-���� St. Croix Countv '1098146 Page 7 of 2 .,► �04s Ta v as 3 S' 2FIl" tonal Services � � Page 1 of 3 SOIL F.VAUJ TION_R�P� . In accordance with SIPS 385, Wis. Adm. Code County Attach com Rlete site plan on paper not less th n 8 1/2 x 11 inches in size. Plan must include, St. Croix but not limited to: veqjFatjapd�h16rJ± NfaI ref re ce point (BM), direction and percent slope, Parcel I.D. Pe ro of 4'scale or dim nso pf Rot�rrpwyahtl) nd distance to nearest road. From 008-1090-90-000 Ref #2563 Please print all information. Review Personal information you provide may be used for secondary purposes Privac Law, s. 15.04 1 m . Property Owner Property Location ❑ JoAnn Lavelle Govt, Lot SW '/4 NW '/. S 32 T 28 N R 16 E (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 61 220TH St, 01 Na 4 Proposed CSM City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road Baldwin WI 54002 7 1 1 Eau Galle 1011 Ave. ❑ New Construction Use: ®Residential/ Number of bedrooms 3 Code derived design flow rate 450 GPD ❑ Replacement ❑ Public or commercial — Describe: Parent material Glacial till Flood Plan elevation if applicable na ft. ZOkcN General comments and recommendations: Site suitable for mound POWTS. Recommend infiltrative surface elev. to be 103.50' at 12" above 102.50' contour. 1❑ Boring # ❑ Boring ® Pit Ground surface elev. 102.50 ft. Depth to limiting factor 46" in. Soil A lication Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 1 0-9 10yr3/3 none sil 2fgr mvfr cs 2fm1c 0.6 0.8 2 9-15 10yr4/4 none sil 1msbk mvfr cw lfm 0A 0.6 3 1546 7.5yr4/6 none cost 1csbk mvfr cw 1fm 0A 0.6 4 46-52 7.5yr4/6 f2f 7.5yr4/4 scl Om mefi - 0.0 0.0 2❑ Boring # ❑ Boring ® Pit Ground surface elev. 102.4?_ ft. Depth to limiting factor 31" in. Soil A lication Rate Horizon Depth In, Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 1 0-9 10yr3/3 none sil 2fgr mvfr cs 2vf,f 0.6 0.8 2 9-25 10yr4/4 none sil 2fsbk mvfr cs lvf,f 0.6 0.8 3 25-31 10yr4/4 none sll 1msbk mvfr cw 1vf,f 0A 0.6 4 3143 7.5yr4/6 f2f7.5yr5/8 cost 1msbk mvfr cw - 0.4 0.7 5 43-50 7.5yr4/6 I f2d 7.5yr4/6 scl Om mefi - 0.0 0.0 * Effluent #1 = BOD. > 30 5 220 ma/Eland TSS > 30 it 150 ma/L *Effluent #2 = BOD_ > 30 < 220 mo/I. and TSS > 30 5 150 mn/I CST Name (Please Print) Signatur CST Number James K. Thom son �� 30021 Address ate Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, WI 54020-5413 January 6, 2020 715 248-7767 SBD-8330 (R04/15) 3 Boring # ❑ Boring ® Pit Ground surface elev. 100.95 ft. Depth to limitingractor"in. Soil Application Rate Horizon Depth In, Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ftz *Eff#1 *Eff#2 1 0-8 10yr3/3 none sil 2fgr mvfr cs 2fm1c 0.6 0.8 2 8-24 10yr4/4 none sil 2msbk mfr cw 1fmc 0.6 0.8 3 24-30 10yr4/4 f2f7.5yr5/8 sil 1msbk mvfr cw 1vf,f OA 0.6 4 30-49 7.5yr4/6 m2d.7.5yr5/8 cos] Om mfi - 1 of 0.2 0.6 L-j Boring IF ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil A lication Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 _ *Eff#2 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil A lication Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu, Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 * Effluent #1 = BOD, > 30 <_ 220 mg/L and TSS > 30 5 150 mg/L *Effluent #2 = BOD, > 30 s 220 mg/L and TSS > 30 5 150 mg/L A1140 A. i eye � 401 004 a/ua4prvJ; E �ws�1 S'� eAce 15r.3 .Tv/mn Matte E"66ate 6/?o&• �/dkOI0i .syaaz Ig'%tdS��CS M, Goal, SSW �� .See,, O.f' 0 �c .Cry xCo,, 'SOn•ce {secs �\ i r r o ode 6,iCi5b� EIW _ �aa. Ave$ r mwA `Jeolrwq At S.tv. Cornw� E,1��►,+q �' p ko,vte- TjoArdV,ei'c;e a640ir 4AOfOX-/0co6or? •F e,3� Cm^ne/oF S/a✓/ Sep�%aba-.c! To b�a6&lvew Jae t.V /� ' ✓ Port w , �� q SC®dt. •. 3 c 3'