HomeMy WebLinkAbout008-2017-03-000SOIL ABSO
BED=N
Width
Length
No. Of enches
PIT DIMENSIONS
No. Of Pits
Inside Dia.
Liquid Depth
DIMENS NS
SETBA K
SYSTEM TO
PIL
BLDG
WELL
L.AKE/STREAM
LEACHING
Manufacturer:
INFORMA N
-�
Type Of System:
CHAMBER OR
- .UNIT
Model Number:
DISTRIBUTION SYSTEM
Header/Manifold
IDistribution
x Hole Size
Icing
Vent to Air Intake
Pipe(s)
Length Dia
Length Dia-Spsclol�. _
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only
Depth Over
Depth Over
m Depth of
to Seeded/Sodded
m Mulched
Bed/Trench Center
Bedlfrench Edges
Topsoll
Q Vas Q No
Q Yes Q No
COMMENTS: (Include code discrepancies, persons present, etc.) jj Inspection #1`:t Inspection #2:
Location: 258125TH AVE I �1P tAJ Sr'�V�
1.) Alt BM Description
2.) Bldg sewer length = 751
- amount of cover = �J6
Plan revision ad7 ❑in Yes No for
—
Use other side for additional informatio
SBD-6710 (R.3/97) Date Insep is Signature Cert. No,
Cd AI __l.n , i%cA
aQ�q.4
Camty
�����
Safety and Buildings Division
201 W. Washington Ave., P.O. Box 7162
St. Croix
Sanitary Permit Number (to be filled in by Co.)
' MAR 16 ZON
Madison, WI 53707-7162
„-
I �-gs-(
1-1 t
y
Co rt ° t t A,pplieatlon P
Slate Transaction Number
IG�
In accordance with SPS 38321(2), Wis. Adm. Code, submission of this fn rrlemal unit
Na
is required prior to obtaining a sanitary permit. Note: Application forms for scat "ed OWl'S are submitted to
protect Addeess(if different than mailing address)
the Department of Safety and Professional Services. Personal information you provide may be used for secondary
purposes in accordance with the PrivacyLaw, s. 15.04 1 m Slats.
A , _ .
1 — �/ Z mat/( Ave,
S `� ame 2 `j �' i'C-
L Application Information - Please Print All Information
Property Owner's Name ou
Parcel #
Carrie Timmers
008-2017-03-M
Property Owner's Mailing Address
property Location a
2379 Rose Ln.
'
GovL Lot
City, State
Zip Code
Phone Number
NE /., SE v., Section 23
Woodville WI
54028
715 684-9364
(circle one)
T 28 N; R 16 E m W
11. Type of Building (check all that apply)
Lot #
® 1 or 2 Family Dwelling - Number of Bedrooms 3
Subdivision Name
03
❑ PubliclCommereial -Describe Use
Block #
Plat of Rolling Meadows Farm
❑ City of
Na
❑ State Owned - Describe Use
❑ Village of
CSM Number
Na
® Town of Eau Galle
111. Type of Permit: (Check my one box on line A. Complete line B if applicable)
A-
❑ New System
® eplacement System
❑ Treatment(Holding Tank Replacement Only
❑ Other Modification to Existing System (explain)
Move existing holding tank
B.
❑ Permit Renewal
❑ Permit Revision
❑ Change of Flambe
❑Permit Transfer to New
I.rs[ Previous Permit Number and Dale Issued
Before Expiration
Owner
IV. Type of POWTS S stem/Com onent(Device: Check all that apply)
❑ Non -Pressurized In -Ground ❑ Pressurized In -Ground ❑ At -Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil
Holding Tank ❑ Other Dispersal Component (explain) ❑ Prereaunent Device (explain)
_V.-D'ispersaffrestatentAreainformation:
Design Flow (gpd) Design Soil Application Rate(gpdsf)
Dispersal Area Required (st)
Dispersal Area Proposed (so
System Elevation
450 Gpd Na
Na
Na
Na
V1. Tank Info
Capacity in
Total
# of
Manufacturer `
Gallons
Gallons
Units
a /Q
New Tanks
Existing Tanks
Septic or Hording Tank
3,000
Na
3,000
1
Wieser Concrete
){
Dosing Chamber
VII. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name (Print)
Plumber's Signature
MP/MPRS Number
Business Phone Number
r
I
Dale Hudson
R�- GS i
MP 220853
715 684-3378
Plumber's Address (Street, City, State, Zip Code)
820 Main St., Baldwin,W154002
VIII. County/Department
Use Only
Approved
❑Disapproved
aermit Fee 3/�'e Issue I
I at A�t Signa[u
❑ Owner Given Reason for Denial
/ ` ZO
y�+� �
MC for Disapproval 3 Kt 41
1. Septic tank, effluent filter and ere ��.ank f
dispersal cell must be serviced / Maintainedylamb r� (�: CP-A
es per management plan provided by plumber, wP� �-6 ,gyp
�1>�S
a cuy
�e 2, All setback requirements must be maiMaieed < 2S
at per applicnhl, C
Attach to eompkr ptaas for the system dad submit to the Cmmty poly pp upper not Ips�a 8 is x It es in
11 fJl 1 r 1. a V 1� -.. n _i.e. i tT v� i/Va/YN[l7
rt'x`11
J / r II.M.wtYet �tn�^-� r•-�.-t ts+++ty ••
SBD-6398 (R 11/11)
CONCRETE HOLDING TANK DESIGN
Single Tank Option
INDEX AND TITLE SHEET
Project Timmers 3 bedroom Residential Holding Tank
Owner Caroline Timmers
Address 2379 Rose Ln., Woodville, WI 54028
Site Address: 2581 25th Ave.
Legal Description NE1/4 SE1/4, Sec. 23, T.28N., R.16W.
Township Eau Galle County St. Croix
Subdivision Name Rolling Meadows Farm Lot No. 3
Parcel ID Number 008-2017-03-000
Plan Transaction ID Number
Designer Dale Hudson
Signature
License Number
Index and title sheet Page 1
Holding tank specifications Page 2
Site plan Page 3
Maintenance and contingency plan Page 4
Holding Tank Servicing Contract Page 5
Holding Tank Agreement Page 6
Attached Soil Evaluation Report Page 7
DSPS Credential #220853
G�CC�C�OMC D
MAR 2 3 2020
St. Croix County
Phone No. (715) 684-3378
Date 03/23/20
Designed pursuant to:
Holding Tank Component Manual For POWTS (Version 2.0)✓
SBD-10855-P (N. 03/07, R. 01/12)
Version 7.0 (11/12) Pagel of 7
HOLDING TANK SPECIFICATIONS
3 Number of bedrooms
0.0 Non-residential estimated flow (gpd)
2000.D Minimum holding tank volume required (gal)
3000.0 Proposed holding tank capacity (gal)
Wiese Concrete Tank Manufacturer
W3000-MR Tank model number
JH Rhombus Alarm manufacturer
SJE 1011421 Alarm model number
Tank Dimensions and Data
- IX for round tank
junction
box _
conduit
blind plug
to seal
outlet
depth below inlet invert (in)
lum de th of soil cover (ft)
: (in) Outside
1 (in) Dimensions
(in) Only
IRIEC IENIEDD
MAR 2 3 2020
St, Croix County
Community Development
Tank Anchor Calculations
24827
Ibs Weight of tank and cover
1.50
Safety factor
41698
Ibs Weight of anchor required
41.7
in Soil cover req. for anchor or
10.3
yd4 Concrete counter weight
HOLDING TANK CROSS SECTION
manhole cover with
locking device and finished vent cap
warning label grade ,
4" min. .1. 12" min.
23 in.
Manhole and vent locations
vent pipe
18" min.
i tetherweight _
service
alarm on
Electrical as per
NEC 300
and SPS 316
iParllil
41.0 in.
Note: All tankjoints, and
joints between tank
openings and piping are
sealed watertight. All
pipe and vent materials
comply with SPS 384.
building sewer
inlet
3 in. bedding under tank. Tank is anchored as necessary to negate buoyancy.
Project: Timmers 3 bedroom Residential Holding Tank
Transaction Number. Page 2 of 7
IRECEHDD
MAR 2 3 2020
St. Croix County
Community Development
z6`A/4✓z.
iprepos dc.//k
access
Idefvec Y
�o-a
i.,,i d 6l)
El 44,
_ Qesidcntf
0
�ExtsE werl
6i 9
63
CX,3iir.S �l�C t/e%
cd
yse/ ss"-eAvr.
Lo -03, P/a,�ol Q//,
»(eado,at Ow"5��-M,, YgsF�y
,del. a doh -1°,7- 03 •-dOO
be; i% 3.70 a e/eS
r zC
_ (�ropwee�cJ: csci Cc.c� tEt
� 9B'� / Ek.3f.•Hq SePElc�C'
aba„ dr„cd¢s /4r- ev✓as
`X67,Y- 7J /78S
-�-4. ao P.✓,e_
54cd
Eledad'ons
�ornsreP/i,euSl.Assamcd ems` ' ��•�
�o�rvl qc'�/efNr�-Ean�7Ho:So'
•
ez-
pl.3 of -I
MAR 2 3 2020
HOLDING TANK MANAGEMENT PLAN
St. Crmx County
This Private Onsite Wastewater Treatment System (POWTS) has been designed, and is to be i tv Development
maintained according to SPS 383, Wis. Admin. Code, the Holding Tank Component Manual (SBD-10855-P J� 2,0�
N. 03/07, R. 01/12), and the St. Croix County Sanitary Ordinance.
1. This POWTS is designed to accommodate a wastewater flow of 600.0 gpd.
2. The owner of this POWTS is responsible for system operation and maintenance, including all provisions in
the attached holding Tank Servicing Contract and Maintenance Agreements.
3. Each time the wastewater in the tank reaches 90% of the tank(s) capacity or a level of 12" below the inlet
(at which time the alarm will activate), the pumper listed in the current Service Contract must be called to
empty the tank's contents and dispose of them in accordance with NR 113, Wis. Adm. Code.
4. At each service event, the service provider should visually inspect the condition of the tank, risers and
manhole cover(s) and verify that the alarm system functions and manhole locking devices are present.
Discrepancies are reported to the owner in a timely manner for corrective action*. All corrective actions
shall comply with the county sanitary ordinance and SPS 383 and 384 Wis. Adm. Code.
5. All service events or inspections of this POWTS shall be reported to the county within 30 days.
6. The owner may not remove any of the wastes from the holding tank(s), or cause such wastes to be
removed by any person not authorized to do so under Ch. 281, Wis. Statutes. The discharge of wastes
tank to the ground surface, including intentional discharges and discharges caused by neglect, constitutes
a failing POWTS and may result in issuance of correction orders or a citation by the county or state.
7. No one should enter a holding tank for any reason without being in full compliance with OSHA standards
for entering a confined space. The atmosphere within these tanks may contain lethal gases, and rescue
of a person from the interior of the tank may be difficult or impossible.
8. In the event that this POWTS fails and cannot be repaired, a code compliant replacement holding tank
may be installed in the same location (a new sanitary permit is required for such a replacement). Con-
nection to municipal services would also be considered at this time if they are deemed available to the
property.
9. If this POWTS is replaced, or its use discontinued, components no longer in use it shall be abandoned in
accordance with SPS 383.33 Wis. Adm. Code.
10. If there is a problem with, or question about this installation, the following persons may be contacted:
a. Installer ......................... Dale Hudson Phone: (715) 684-3378
b. Service Provider ............... ABC Septic & Sewer Service Phone: (715) 665-2112
c. Co. Zoning or Health Dept. St. Croix Co. Zoning Dep't. Phone: (715) 386-4680
11.
Project: Timmers 3 bedroom Residential Holding Tank
Transaction Number. Page 4 of 7
SEPTIC or HOLDING TANK SERVICING CONTRACT
Contract Date
This contract is made between the
Tank Owner(s) Name(s) and
Pumpers Name
=moo/,.0 ev-s
1,46c, "e,- ✓io,
We acknowledge the installation of (a) septic/holding tank(s) on the following property:
(P rovid e legal descript ion): Co:<o4y 41a4 o /- Ac) /I40Y1Fi'3/ e-.23�
�
T. 30If- e. /6 a).y 2r,-. a C,, roa/k, 56.Crolk do. � )1.✓0c/ G�3-Zo/7
--1—. --o—n—r —gr—ee—o—fi—a—co—yo—f—i—c—ont—rac—t w—ith—the—lo—cal—go—ve—n—me—ntal—un—it—(St—C—roi—x County --------
Planning & Zoning Department) to document maintenance by a certified septage servicing operator as
required in Comm 83.52(1)(c)2. Wis. Adm. Code and the approved Component Manual.
2. The owner agrees to have the septic/holding tank(s) serviced by the undersigned pumper and guarantees to
permit the pumper to have access and to enter upon the property for the purpose of servicing the
septic/holding tank(s). The owner agrees to maintain the access road or drive so that the pumper can
service the septic/holding tank(s) with the pumping equipment. The owner further agrees to pay the
pumper for alt charges incurred in servicing the septic/holding tank(s) as mutually agreed upon by the
owner and pumper.
3. The Pumper agrees to submit to the local governmental unit (St. Croix County) a report for the servicing of
the septic/holding tank(s) on a monthly basis. The pumper further agrees to include the following in the
monthly report:
a: The name and address of the person responsible for servicing the septic/holding tank;
b. The name of the owner of the septic/holding tank;
c. The location of the property on which the septic/holding tank is installed;
d. The sanitary permit number issued for the septic/holding tank (if known); -
e. The dates on which the septic/holding tank was serviced;
f. fhe volume in gallons of the ^ontents pumped from the septic/holding tank for each servicing;
g. The disposal sites to which the contents from the septic/holding tank were delivered.
4. This agreement will remain in effect until the owner or pumper terminates this contract In the event of a
change in this contract, the owner agrees to file a copy of any changes to this service contract or a copy of a
new service contract with the local governmental unit named above within ten (10) business days from the
date of change to this service contract.
a,r r,cr(s) Narre(s) (^rint)
Owner's SignatUie(s)
Subscribed and sworn to me on this date:
Date
QToday's
Pumper's Name (Print)
Pumper's Signature
Notary Public Signature
Pumper's Registration Number V Commission Expiration
p�, sod 7
Replacement Holding Tank POWTS
Index & Title Sheet
Project Name: Timmers 3 bedroom Replacement Conventional Dispersal Cell
Owners Name: Caroline Timmers
Owner's address: 2379 Rose Ln., Woodville, WI 54028
Site address: (42581 25th Ave.
Project Location:
Subdivision: Lot 03, Plat of Rolling Meadows Farm
Legal Description: NEIA SETA, Sec. 23, T.28N., R. 16W., Tn. of Eau Galle, St. Croix Co., WI.
Parcel ID #: 009-2017-03-000
Page 1 Index and Title Sheet
Page 2 State Approved Holding Tank Design
Page 3 Holding Tank Cross Section
Page 4 Parcel Map
Page 5 Warranty Deed
Attachments: None
Mater Plumber Restricted Service: Dale Hudson, DSPS Credential #220853
Signature:
Date:
Page 1 Of 5
Design pursuant to Holding Tank Component Manual for POWTS, SBD40855-P (N.03107; R O1/12)
aa"
cc
0
�n d
a w
K
INLET —
OUTLET
n
0 N
2j„
a
TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS
IiTlyl0liIIll aLACi
TANK SPECIFICATIONS
DIMENSIONS:
WALL: 2 1 /2"
BOTTOM: SEPTIC 4"
COVER: 6"
MANHOLE: 24" I.D. PRECAST CONCRETE RISER
HEIGHT: 71" O.D.
LENGTH: 186" O.D.
WIDTH: 93" O.D.
BELOW INLET: 57" O.D.
LIQUID LEVEL: 50"
WEIGHT: 12,260 LBS. SEPTIC
COVER 8.350 LBS.
INLET AND OUTLET:
4" CAST -A -SEAL BOOT OR EQUAL
GASKET, CAST -A -SEAL BOOT OR EQUAL
INLET AND OUTLET BAFFLE AND FILTER:
WISCONSIN, SEE DETAIL #10
(OTHER STATES SEE CHART)
LIQUID CAPACITY: 58.94 GAL/IN
LOADING DESIGN: 8' 0" UNSATURATED SOIL
HOLDING TANK:
OUTLET HOLE PLUGGED
ACTUAL CAPACITY: 3,183 GALLONS
TANK CAN BE USED AS:
SEPTIC/ HOLDING/ PUMP OR SIPHON
COVER: MIX DESIGN y8 (NO FIBER)
TANK: MIX DESIGN N9 (SMALL FIBER)
CUSTOMIZED TANKS:
FOR CUSTOM TANKS CONTACT WESER CONCRETE
IIDRAFORGAPPROVALTEDII
APPROVED BY:
APPROVAL DATE:
PRODUCTS NEEDED BY:
W
Lo
W
Y
C�Lo
z00
z ro
o I
a �
� N
�io
k CD
N
joF
m
— —
wHr weaT«.xn.n,lEc.u.� — —
— — — — —
— —
n nR
s.
NOO't O'23'E 1360.01'
,MIX
PR�ppp5[1p�
3401
Ml A
I
I1
I
1
I
I
1
1
I
I
�
%r
1
.
Y
y�
® 1
Iw
i.J,1
I
e.a
1
i5
�
Y
I
�
jlll
qyy
I r
`
1O l.awlN#
Jd T
iC
I IA
I
�m
I
1
ru 1
'
I
8
TI
i
i
N
co
v
W`OMW ,
1
-----------------
q
Spa
.3
1
4��
A
sarloawwa
a
a�a
mv,oaw
b
.................
pg■
�q
'
p
0
tom;,
St Croix County
Holding Tank Agreement
Permit Number-
�t.r0/int IP T-rMAltrhS
Name — (Owner) Typed or printed
being duly swom, stoics. ®der oath, that
1. He/she is the owner/part owner of the following parcel of land
located in St Croix County, Wisconsin, recorded in Volume -
Page Document Number/ O S t Croix County Register
of Deeds Office: -RecordlrgArea
A parcel of land located in theme'/. of the y. of Section
z3 , T Zo' N - R / 4 W, Town of
451ta 62 /IG , St Croix County, Wisconsin, being
duly described as follows (include lot no. and subdivision/CSM or
detailed legal description):. E o/ 3 P rrF' //, %erg 00
lr+ UN:$ Parcel Wentlfin6on Number (PIN)
/%1 Q4
Agras ..vt Date:
We arhrnowledge that application b being made.for the installation of (a) holding tank(s) on the above descrDed property or Mat rentiwed use of
the roasting prermses requaes that a holding tank be Installed on the property for Ina purpose of proper containment of swage. Also, the property
cannot now be served by a municipal sewer, or any other type of pdvale onahe wastewater treartment system as permitted under Ch. SPS 383, We.
Adm- Cede, or Ch. 145, Wis. Stats.
As an Inducement b the county to issue a sanitary parent for the abovadesaEad property, we agree to do the fol ai g:
I- c wmer agrees to contonn to ale applicable requirements etch. SPS 363. Was. Adm. Cods Mating to holding tanks. ache wear fags to lhnre
me holding tank property serviced in response to orders issued by the gow:mmental unit or the Deparmaent of Commerce, W prevent or abate
a hums, health heian u described N s. 254.59, Stale., the govemmantai unit (Town) may enter upon the property and sevvira Me bNe or
cause m have the lank to be serviced and charge the owner by Mating me verges on Ma tale bill as a special assesamerrt for current
services rendered. The charges will be assessed as prescribed by a. 66.0703. Sits,
2 The owner agrees. pursuwd to X. SPS 363.54 (2), and SPS 3 40(3xe), Wb. Adm. Cade, toluea a wales meter Installed it the strudwe.
Tho water meter shag be Installed by a plumber auftdmd by the Department to make such Installations. with said Installation canplying
with State regulations ad manufachrrere specifications, The owner agrees to be financially responsible for the purchase, installation,
mainfeance, and repair of the water meter, and ages to allow the 1F'e^urre^lal unit or 6w Daparthert of Cormurm le Wer me abar
desvaed property on a regular bash b read anNor Instead Me water meter.
3. Owner agrees to pay all charges and coats Named by the governmental unit or county for Inspection. pumping. hauling, or dherwse
urvicig sad maintaining the holding took in such a marmr as to prevent or °bete any humanheWi hazard caused by the tooNNg tank
The 9ovemmental unit shag nobly the owner of " costs which shag be Paid by the owner within thirty (30) days from the date of notice. In
the event the carer does not pey the costs within thirty (30) days, the owner spedfieally agrees that all the costs and charges may be Placed
.. on the tax roll as, a spewl asseaanwnt for!he abatement a a human health haxand, and the tax shag be, collected as provided by law.
4. lte owner agrees to contract wait a person whoa licensed under Ch. NR 113, We. Adm. Code. In have the holding tank serviced and to file
a copy of On contract with the govemrtralal unit. The wmer fortune agorae to file a copy of and charges to he saMm contact or a copy of
a new service corAuct, with the govenmtmtal unit within ten (10) business days from the date of change to the service contract
,5. The owslx af)es to contract win a. person Arerscd under Ch, NR 113. Ws. Aden. cope. who shin submit fo the warty on asemiannual
tam a aspot detaking the saMcig of the hotlaag tan. The goromnenhi mk or rounry may enter upon the property b Investigate the
r _ c rldtion o the hok&V tank when Wmpkg reports and.,refer readings naay fiats coal Ora laolehg Wk k What baND property maIntained.
6. The agreement will remain in effect only until the county office nespo,siole for the repdation N pMate osite wastewater Irealment syslema
pennies that the property h served by either a municipal sewer or a private orwae wutewater treatment system that compiles With Ch. Corm
_ $3. Wis. Adz, Code. In addition, this agreanvsd may be cancelled by esaang and seconding said oaldhcaaon with reference to this
spreemnn in such manner Which will permit the edstence of the certification to be rleten,ined.by rebrence to doe Property.
7. This agreement shag be binding upon the ownar, the heirs of the owner, and aasgnees of Ire Amer. The caner shag submR this agreement
to the register of deeds. and the agreement shall be recorded by the register of deeds In a manner which WE Permit the exhlenoe of the
agreement to be delemtned by reference to its property where the hoping tank is Inslaaed-
Owners) Name(s) - Please Print
Sag ribediind s`wn to bqm me on this date.
/ d
i 20 rr wee Is
demo i4te' e T` .s
{'Groltr,¢ 7uimcrs «.. .
Nrtartad o.ner. SWnWAMN ..:. _
PILtc -. .
cool FE
.. t>KOI6r,IMlNalfe:Tkk-PF.'aePrit
nExpko STATE OFINI
�l
s;�+tc.wgd-Ea..-WltTew,C'W
Ufak.OMrdal sanabaa ..
Droned by:
< a•ersarm anoaaamon yap Prwm rtwy oe uses ao aemraury Wrpesea t�rw+uy aa.r c ,a..vt,nrun _
'(NIS PAGE IS PART OF THIS IEOAL DOCUMENT —DO NOT REMOVE'
.. .. RJsirdamallonmu#bcomplaa+dbystMWlsr.'document bVe.nem,&return ad3'eas&1d8N(tlr*gUVv). OdWWo MdonauhWVW
9ramWg ryeusea bagN descrUdnri, Inc. nayW placed m ales first page of de docu,ert armsybe placed w ad&iOfulpegss aft
daveraert [. v�si' Use carter mverpape adds are page byordoraarertaMd200bMe reLnrlrrq/ea Hlamrshl Sbtub;51./1
4
NE
`'.
;
I
Wisconsin Department of Safety and Professional Services Page 1 of 3
k Division of Industry Services
OCT 08 2019 SOIL EVALUATION REPORT
In accordance with SPS 365, WIe. Adm. Code County
Attach complete site plan on paper not less than 8 1Y2 x t 1 inches in size. Plan must inducts, SL Croix
but not limited to: vertical and horizontal reference point (BM), direction and percent slope, Parcel I.D.
scale or dimensions, north arrow, and location and distance to nearest road. 008-2017-03-000 Ref #2548
Please print all information. t�Asd by �) _ A._ aD to /
Property Owner Property Location i[:PSf 2.S' AWC ❑
John & Caroline Timmers Govt. Lot NE % SE '% S 23 T 28 N R 16 E (or) W
Property Owner's La.,fingAddess Lot # Block # Subd. Name or CSM#
2379 Rose Ln. 03 Na I Plat of Rolling Meadows Farm
City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road
❑ New Construction Use: ® Residential/ Numberofbedrooms 2 Code derived design flow rate 450 GPD A&WdA n AW
® Replacement ❑ Public or commercial - Describe: _ pe Pee UM& py&
Parent material Glacial driftl Flood P n e v on if applicable na ft. P"'
General comments and recommendations: Site re uuires Hoklin Tank install ti n.� ��
a 7 k VaL2 Va-g
1❑ Boring # El Boring
® PR Ground surface elev. xx.xx ft. Depth to limiting factor Q' in.
Sal Annlir Linn Rate
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/Ft'
'Eff#1
,Eft#2
1
0-5
10yr3/3
none
sit
2fgr
mvfr
cs
2vrf
0.6
0.8
2
5-8
10yr3/3
m1d 7.5yr4/6
sit
2fgr
mvfr
cw
2vf,f
0.2
0.3
3
8-15
10yr4/3
cld 7.5yr5/8
Sid
imsbk
mvfr
gw
2vf,f
0.2
0.3
4
15-22
7.5yr4/4
m2d 7.5yr5l8
sd
lmsbk
mill
gw
1vf
0.2
0.3
5
22-36
7.5yr4/4
m2d 7.5yr5/e
Sid
I imsbk
mvfr
-
-
0.2
0.3
2❑ Boring # ❑ Boring
® Pk Ground surface elev. xx_xx ft.
Depth to limiting factor 0" in.
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/Ft2
'Etf#1
I 'Eff#2
1
0-6
10yr3/2
none
sit
21gr
mvfr
cs
2vf,fm
0.6
1.0
2
6-10
10yr3t3
m1d 7.5yr4/6
sl
2fsbk
mvfr
cs
2vf,f
0.6
1.0
3
10-19
10yr4/3
f2f 7.5yr518
all
2fsbk
mvfr
gw
1vf
0.6
1.0
4
19-30
10yr4l4
c2d 7.5yr5/8
sl
imsbk
mvfr
ON
lvf
0.4
0.7
5
30.39
7.5yr4/6
m2d 7.5yr5/8
sc
0m
mfi
-
0.0
0.0
' Effluent #1 = BOD. > 30 S 220 ma/L anti TSS > 30 5 150 mdL - F luarm 22 = ROD_ > 305 220 mall- and TSS > 30 5150 mdL
CST Name (Please Print)
' not
CST Number
James K. Thom n
Z
30021
Address
ate Evaluation Condu
Telephone Number
340 Paulson Lake Lane Osceola, WI 54020-5413
August 21, 2019
715 248-7767
SBO-0330 (R04/15)
Boring # ❑ Boring
® Pd Ground surface elev. xx_xx ft.
Depth to limiting factor Q in.
And Annlirarinn Rarn
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont- Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/Ft2
'Eff#1
'Ef#2
1
0-5
10yr3/2
cif7.5yr4/6
all
2fgr
mvfr
cs
2vf,f
0.6
0.8
2
5-11
10yr5/4
m1d 7.5yr4/6
sit
lfsbk
mvfr
rw
2vf,f
0.4
0.6
3
11-19
10yr5/4
m2d 7.5yr5/8
sit
1fsbk
mvlr
ow
1vf
0.4
0.6
4
19-30
1 10yr4/6
m2df.5yr5l8
ad
imsbk
mfi
-
-
0.2
0.3
4❑ Boring # ❑ Boring
® Pit Ground surface elev. xx_xx ft.
Depth to limiting factor Q in.
Soil ADoI lication Rate
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD1Ft'
'Eff#1
'Eff#2
1
0-12
10y2/1
m1f7.5yr4/6
sit
2fgr
mvfr
cs
2vf,f
0.6
0.8
2
12-17
10yr4/3
m1d 7.5yr5/8
sit
lfsbk
mvfr
cw
2vf,F
0.4
0.6
3
17-24
10yr4/4
mid 7.5yr5/8
sit
Om
mvfr
ow
tvf
0.0
0.2
4
24-30
1Oyr4/4
m2d 7.5yr5/8
sicl
Om
mfi
aw
-
0.0
0.0
5
30-38
10yr4/6
m2p 7.5 yr5/8
sc
Om
men
-
-
0.0
0.0
5❑ Boring # ❑ Boring
® Pit Ground surface elev. xx.xx ft.
Depth to limiting factor 0' 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/Ft'
•Eff#1
•Eff#2
1
0-12
10yr3/2
c1d 7.5yr4/6
all
21gr
mvIr
as
2vf,f
0.6
0.8
2
12-17
10yr314
m2d 7.5yr5/7
sid
Imsbk
mfi
cw
1vf,f
0.2
0.3
3
17-31
10yr4/4
m2p 7.5yr5/8
sit
Om
mfi
0.0
0.0
Effluent #1 = BOD, > 30 5 220 mg/L and TSS > 30 5 150 mg/L ' Effluent #2 = BOD, > 30 5 220 mg/L and TSS > 3015 150 mg/L
Se,% a✓a/aad a��/6
ca r � �Qt!• a�sNd
.Tolvi � C'.va/.�. T•'n„nrc
yse/ ss�.wi.
Ced a3 l�/afOF�//.�j
r!(taWok)s �in,�Ky13�
Src.13,T. 1fl t. A° 74.
0 Crau Q Ar, SE. Crox eel cJ/.
AsdOd-fo I7-03-40d
bt,7.5.70 QCie4
.ZS44,{-
R,