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Home My WebLink About026-1149-00-007Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM -y St. Croix Safety and Building Division INSPECTION REPORT Sanitary Penntt No: GENERAL INFORMATION (ATTACH TO PERMIT) 617884 State Plan ID No: Personal information you provide may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)] Permit Holder's Name: City Village Township Parcel Tax No: ALEX & TARAH MUNTER I TOWN OF RICHMOND 026-1149-00-007 CST BM Elev. Insp. BM Eley: I00 BM Description: I j 1 Section/Town/Range/Map No: 1530.18.1112 TANK INFORMA TYPE MANUFACTUR ;w,,,, CAPACITY Septic �Q r +vim �OfidvILq` Z-50 Dosing Aeration F1 5 TANK SETBA6K INFORMATION LoG kz5 fLk��`►� ! M�Mm® e.a M®MM�W a. . �l W—�M ®■,---MI1--,-' mmmmu = PUMP/SIPHON INFORMATION Manufacturer Dirlinand M el u ber 7D Lift ricti n Loss Sy tem H d TDH Ft For main ngth D' . to Well SOIL ABSORPTION SYSTEM ELEVATION DATA STATION BS HI FS ELEV. Benchmark /Jr ��'�• �]] (bo Alt.' 1.15 103.11 Bldg. Sewer ,$1 % . q S St/Ht Inlet 83 C 15 Q 01 SVHt Outlet /7 ' 81 Of Inlet Dt Bottom Header/Man. I p� Dist. Pipe Bot. System �y Final Grade 11 b St / o,rcr 15 103, 4 +-A Ea 111OL-is BED/TRENCH DIMENSIONS Wdlh , Le3 1 46 No. Of Tres PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth SETBACK INFORMATION SYSTEM TO P/L k BLDG IWELL LAKE/STREAM I LEACHING CHAMBER OR UNIT Manufacturer Yt it Ty p Of System: }O„��'� j 1 7 ?'2 ` a __ Model Number' DISTRIBUTION SYSTEM Header/M n,o Id r Distribution x Hole Size x Hale Spacing Vent to Air Intake Ll Pipes) LengN Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over BedrTrench Center / Depth Over Bed/Trench Edges �I 11 xz Depth of Tops xx Seeded/Sodded xx Mulched r r 0 41 Ves ®No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: i k Location: 1262152ND AVE �VE / CO vv V 6 K V-CO4 vl jt- ry% 1.) Alt BM Description = r/I r VV.< - DbScr v,L-}-t 1 0I -e-,( to .fl TT ' � b v, V rr � � E J `-7r L 2.) Bldg sewer length = 2 LI -amount of cover =71g1` ,1 ho�' !h lk,f�-eGC911_ ,�/�') Plan revision Required? Yes �[ No Use other side for additional information. Date Cent. No. Insepctor's ignatu 580.6710 (R.3/97) . f Cc ®P_A_T S4,v —zCzo -o&fi l a APR 2 1 Z0' Safety and and Buildings Division ST CROIX d= 201 N. Waehlrtpton Ave., P.O. Box 7162 Sanhuy, Permit Number (m be filled in by Co.) a vy, : � Croix Count Community Develol Madigan. WI 53707-7162 T o b anent (p Sanitary Permit Application State Transaction Number In accordance with SPS 383 2](2), W is. Adm. Code, submission of this form to the appropriate govemmeatel unit ---------�• u required prior m obtaining a emihry permit. Note: Application forms ter steteowned PO WTS are submitted to Project Address (if different than mailing addrees) the Deperomeat of Safety ad Prolmericad Service. Potential information you provide may be used for secondary accordance with the Privacy Lew, a. 15, I) m , State. 1262 152NDAVE NEW RICHMO Min t. 1lcatlonInformation-PWAsePrintASlnformaden - Property Owner's Name N Plead N ALEX AND TARAH MUNTER 026-114 -oo —cc } Property Ovner's Mailing Address Progaty Location GovL Lett SW W. SE a, Section$ ' City. son, i Zip Code Phone Number X �eaekone T � N; R �-N"• I I I L> D. Type of Building (check all that apply) Lot g 61or2Farmill,Dwelling -Number ofBe" ' 4 7 Subdivision Nunn GfLa IMY KuOLf_s Blockg ❑ PubtiMCommmcial-Describe Use ` �• ❑ City of ❑ State Owned- Desmbe Use ❑ vinep of CSM Number 19 Town of RICHMOND DI. Type of Permit (Cheek only one box on Ilse A. Complete line B If applicable) A. System ❑ Replacement System ❑ TresimmUkioldmg Tank Replacement Only ❑Other Modification to Existing System (explain) B. ❑ Permit Renewd Beale Eupomioo ❑ Permit Revision ❑ Change ofm Phber ❑ Permit Tramfa m New Owns Lin Prevrom Permit Number and Date leaned IV. Type of POWTS S Com eaNDewlce: Cheep all that v Ow 0 In -Grand ❑ Pressur¢ed InGround ❑ At Grade ❑ M 24 in. of suikbk soil ❑ Mound < 24 in of suitable sotl Ho-Prees:.d _ lding Teak ❑ Other Dispersal Component (explain) _., _ ❑ pretreatment Device (explain)__._ V. DispenaVIrreatiottat Area latormatlog: . c Design Flow (gpd) Design Soil Application Ra f) DrspetW Aces Required (at) Diapeteal Area Proposed (at) System Eleva: 600 .7 857 900 c VI. Task Info Capacity is Tomi g of Manofiouuer Cations Gallons Unin /P•(�1w� �j�•' ) u u New Tontortbtg axlTech —d - 6U i`�i. 0. vwi 8epticerlfoldmg Tank X 1250 WIESER X Mites Chamber VIL Responsibility Statement- 1, the oaderdped, assume responsibWty, for installation of the POWn ehowa as the attaehed plane. Plumber's Name (Prim) Plumber's ignet MP/MPRS Number Bumess Phone Number PAUL R KOEHLER 225410 715-246-2660 Plumber's Address (Street, City, State, Zip Code) f/ 321 WISCONSIN DRIVE NEW RICHMOND WI vul. Conn ent Use Onl IR Approved ❑ Disapproved Permit Fx $ Da Issued Agent Siputuro � �a/0 — 4 ClOwnerGives Reasam fan Daniel .�`� "Y IX. Coa dons of ApprovalfRessom for Disapproval 3 YSTEM OWNER: Septic tank, effluent filter and �) R y. -�a pvw' AP- 5-4 �t w. MP-' arls+u.e._ dispersal t cell must b-qser cod I maintain t nr f �y � 11 b as per management plan provided by plumber. r Ca II setback mouirements must hp. maintained as per applicable codefE4'dIR r"P"m or sae syaes ass esbma m tee a:mry sesy on paper seta teesmas a to r a a nenea wrier SBD-6399 (R. 1111 I) I] 310.62 BOREING 3 O BENCH MARK 100.00 BORIN I - . •.� S ® N1 O RK14-_IJ. 31S �o"f I 163.02 0 SCALE V 40 FT SYSTEM ELVATION 93*c%y0 ET I WIESER CONCRET - BENCH MARK 1 TOP OF IRON 100.00 --F'T 1250TANK I - BENCH MARK TWO TOP UTILITY PIED 107.75 525 POLY LOCK SYTEM TO RIN WITH CONTOUR i63-/00.0 FILTER SCH 40 PVC FROM HOUSE TO TANK APPROX3dFT V �O SCH 3034 TO DRAIN FILED APROX 60 FV - o m BOREING 1 ` PROYOS�O A8 ------------ �26 ` y COP: No PROPOSED WELL BENCH 1U-- -0S'% M CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Alex and Tarah Munter Owner's Name: Alex and Tarah Munter Owner's Address: APR 18 2020 St. Croix County. Legal Description: SW1/4 SEIA S 15 T 30 R 18 W r Township: NEW RICHMOND County: ST CROIX Subdivision Name: CHERRY KNOLLS Lot Number: 7 Parcel ID Number: 026-1149-00-007 Designer/Plumber: Date: Page 1 Index and title Page 2 Plot Plan Page 3 System Sizing & Cross -Section Page 4 Fitter Specs Page 5 Maintenance Information Page 6 Management Plan Page 7 St Croix Cty Septic Tank Maintenance Form Page 8 Warranty Deed Page 9 CSM or Plat Attachments: Soil Test & House Plans PAUL R KOEHLER License Number. 225410 04/10/2020 Phone Number (715)246-2660 Signature Designed pursuant to the In -Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P (N.01/01). Page 1 @3 310.62 ' BOREING 3 O BENCH MARK 100.00 BORIN S o 0 N1 �00 O� I If 163.02 FAO 0 SCALE 1" 40 FT o I SYSTEM ELVATION 93-.4,'Fyo WIESER CONCRETE - BENCH MARK 1 TOP OF IRON 100.00 1250 TANK BENCH MARK TWO TOP UTILITY PED 107.71 ISYTEM TO RIN WITH CONTOUR �94+/pp,p 525 POLY LOCKFILTER SCH 40 PVC FROM HOUSE TO TANK APPROX 36T SCH 3034 TO DRAIN FILED APROX 60 FT.: 0 m ` BOREING 1 a9-01,000NO�� PO , 16 ` 'sl '-• :.:-•"'•.... PROPOSED WELL ` l BENCH MARK 107.75 SOIL ABSORPTION SYSTEM DETAIL / GRAVELLESS LEACHING UNIT Pegs_o1_ Project Name: 2 No. of Cells 3 ft Cell Ndth 90 ft Call Length 3 ft Cell Spacing 9 Per cell 18 Total No of 1203H-1 450 sq ft EISA Per Cell 900 sq ft Total EISA Manufacturer Model Lavino L.enaer EISA Raana Inftaraw Q1203H-5ft 5.0' 25.0 E21203H-10ft 10.0' 50.0 Greveliess Leaching Unit Manufacturer: EZ FLOWS Gravelless Leaching Unit Model: EZ 1203H-10FT Finished Grade ft a IV in I .................::::: Plumber/Designer Signature: License s: 225410 Typical Cross Section n �- —Observation Pipe with approved cap or vent Soil Backfill .Geotexbie Fabric _ft Infiltrative Surface _ft Limiting Factor / Slotted and Anchored Vent/ Observation Pipe with Cap ............................................... PAUL R KOEHLER Date: APRIL 10 2020 A A 6.5" (16.51cm) SEALED BALL MATERIAL - HDPE 33.02183.9 cm 1 7-- 20.71152.6cmI 4" (10.16 cm) BALL HOUSING TRAVEL FILTER CARTRIDGE MATERIAL -POLYPROPYLENE � 5.7p[14.7cm1 -� MATERIAL -FILLED POLYPROPYLENE POLYLOK PL- 525 - 625 CUTAWAY BALL PUSH ROD SECTION A-A� FACTORY INSTALLED MATERIAL - FILLED POLYPROPYLENE 4" AND 6" FACTORY — OPTIONAL BUSHING INTALLED PIPE OUTLET (FOR 4" THIN WALL PIPE) MATERIAL -PVC PART NO, 30142-R OR OPTIONAL FLOAT SWITCH (FOR 110 MM. PIPE) PART NO.30142-EUR 0 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page I of 2 FILE INFORMATION Ownar Alex and Tarah Munter —� Permit # DESIGN PARAMETERS Number of Bedrooms 4 ❑ NA Number of Public Facility Units ® NA Estimated flow (average) 450 gal/clay Design flow (peak), (Estimated x 1.5) 600 gal/day Soil Application Rate al/da /ft' Standard Influent/Effluent Quarts Monthly average* Fats, Oil & Grease (FOG) 530 mg/L Biochemical Oxygen Demand (BODs) 5220 mg/L ❑ NA Total Suspended Solids (TSS) 5150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BOD.) 530 mg/L Total Suspended Solids (TSS) 530 mg/L ❑ NA Fecal Colrform (geometric mean) 510' cfu/100m1 Maximum Effluent Particle Size Y, in dia. ❑ NA Other: ❑ NA 'Values typical for domestic wastewater and septic tank effluent. MAINTENANCE SCHEDULE SYSTEM SPECIFICATIONS Septic Tank Capacity 1250 al ❑ NA Septic Tank Manufacturer WIESER O NA Effluent Fitter Manufacturer poly lock ❑ NA Effluent Filter Model 525 ❑ NA Pump Tank Capacity al W NA Pump Tank Manufacturer 93 NA Pump Manufacturer ® NA Pump Model Z) NA Pretreatment Unit ❑ Sand/Gravel Filter ❑ Mechanical Aeration ❑ Disinfection ❑ Peat Filter ❑ Wetland ❑ Other: ❑ NA Dispersal Cattle) ® In -Ground (gravity) ❑ At -Grade ❑ Drip -Line ❑ NA ❑ In -Ground (pressurized) ❑ Mound ❑ Other: Other: ❑ NA Other. 11 NA Other: ❑ NA Service Event Service Frequency Inspect condition of tank(s) At least once every: 3 months! ear(6) 1' (Maximum 3 ears) O NA Pump out contents of tank(sl When combined sludge and scum equals one-third (Ys) of tank volume ❑ NA Inspect dispersal calls) At least once every: 3 ❑ monthls! (Maximum 3 years) la yearls) ❑ NA Clean effluent fitter At least once every: ❑ month(s) 1e1 jp year(s) NA Inspect pump, pump controls & alarm At least once every: ❑ month(s) ❑ year(s) N NA Flush laterals and pressure test p At least once every: �': ❑ month(s) ❑ year(s) jP NA Other: At least once every: ❑ month(s) ❑ year(s) IR NA Other. ® NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector, POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tanks) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cellls) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Y) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent fitters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer, A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. Page of 2 START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cellls). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwatar levels. When power is restored the excess wastewater will be discharged to the dispersal cellist in one large dose, overloading the cellist and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist In manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or.must be taken, to provide a code compliant replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, tot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. T alua o ing .�� ank be e al �1?D}{19 T7S2�DQ-h%§l� COh1S7R(J�7l p>� ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply wnh the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name COUNTRYSIDE PLUMBING AND HEA IN Name PAUL R KOEHLER Phone 715-246-2660 1Phone 715-246-2660 SFPTAGE SERVICING OPERATOR (PUMPER) Name DARRLES SEPTIC Phone 715 426 1025 LOCAL REGULATORY AUTHORITY Name St. ( 2.D ilk) Phone —7lS— 3F/,— qll This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d)&M and 83.540). (2) & (31, Wisconsin Administrative Code. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Alex and Tarah Munter Mailing Address Property Address 1262 152nd ave (Verification required from Planning & Zoning Department for new construction) Cit /state New Richmond 026-1149-997 - �� -�� 7- Y Parcel Identification Number LEGAL DESCRIPTION Property Location SW 1/ , SE ,'/, Sec S T 15 N R30 W, Town of RICHMOND Subdivision Plat_ (, ii��Y joL L S _ , Lot # 7 Certified Survey Map # _ _ �— Volume _ Page # Warranty Deed# 10-'T-4e%B Spec house Dyes lno (before 2007)Volume _ ___ , Pagc #_ Lot lines identifiable Byes[jno SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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 arc specified in §SPS. 383.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater 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. 1/we certify that all statements on this form are true to the best of my/our knowledge. Uwe 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 4 SI RE OF�APPLICA�NT(S) 4/ 10 / 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) Building Location 310.62' Fuhre B&Ading MW MW Xa15 Alex & Tarah Munter Lot 7, Plat of Cherry Knolls Town of Richmond 1262 152nd Ave New Richmond, WI 54017 St Croix County (026-1149-007) '""�'" LEET ELEVA710N • xoi[ m.e wrt w wn o....o wm ao.�+..,.. REAR ELEVATION 0 •DT[ . C J M Wf W+ R..tL Y s ----------------------- NIYI Ito_ 1 a24 I� I w I I Y a I I I I • I a I Y II mim I o35 aNh a. 9 � aI 1 I I I I I' a "aTa ' """Ow` "^"'^""w w" •• •w• m""'"'"' MOSSAORX DESIGN INC. uE%! TRH PUNTER n ......si�w n.. �..ww.ww..r. -- .,1E ARWYORs REPcRr Av ims AREA - N00'12'WW 5288.14' N0012054•W 696.15' MX11W.M'r M82' �w MESr LAVE CF LANQ C RACr, KZUAif On PACE 293 I YqLrm& IS ! irz-K- Ln/xN.J nACRn+-SOVn+ E:m 1/* Loo- FA N00'12'54'W Ar J NOOW34" C 1225.07' r 0 '((_ 10 y %r® six f j IRS fWK lk If n/ Wisconsin Department of Commerce Divisio&bf Safety and Buildings SOIL EVALUATION REPORT ?� 3�j3 I Page_of - in accordance wnn Comm oo, vms. mom. -oae complete site plan on paper not less than B 1/2 x 11 inches in size. Plan must irhu. - but not limited to: vertical and horizontal reference point (BM), direction and perce,- lope, scale ordimensions, north arrow, and location and distance to nearest road. Please print all information. Peremal information You provide may be used for w dary purposes (Privacy Law. a. 15.04 (1) (m)). County Sf. Cro/x Parcel I.D. D 6 // q / Reviewed by We Property Owner Properly Location Govt Lot S r.rJ 1I4SC 1/4 S ,S T -5;� N R /g E (or)W Properly Owners Mailing Address Lot # I Block # Subd. Name or CSM# City State zip Code Phone Number ticwLrzk—.k I Lv t (7S-)adb- 20 ❑ city ❑ village [P Town Nearest Road .!�k. -Acj NewConstruction Use: (9 Residential / Number of bedrooms Code deriv/a/d flow rats S� / G d ❑ Replacement El Pubic or commercial - Describe: � Val Parent material n- 1 Flood Plain elevation if applicable General comments ./{re\ e�-e ✓. q8. 00 RECEIVED and recommendations: MAR 1 3 2002 _ GPD Boring (, O ST. CROIX COUNTY Boring ® pit Ground surface elev. -((,D.O ZO INGOFFICE _� ft. Depth to I'unitirg factor Application Rafe Horizon Depth in. Dominant Color Munseu Redox Description Ou. Sz. Cont Color Texture4Gr.!Sz. StructureConsistence Boundary Roots GPD/tl? -Eft#1 -EW - I )z — Si I c „-C .5 ID z) sit 4 10 L5 — — - 1 1 Z Boring # El Boring (''� �. Pit Ground surface elev. `f 7• 16 ft. Depth to tanning Wor in. Soil Rafe Horizon Depth in. Dominant Color Munsell RedoxDesciption Ou. Sz. Cant Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDW 'Eff#1 'Etf#2 I 2 ld 2> — i I ZrLsb� rr�rr c 2 Z- I I � <Sil c — .5 •� 3 -48 10 —� Sicl rnsbk c� — `l u 1214 y It n L--3 rnFr — I, .BL Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg1L and TSS < 30 mg4 CST Name (Please Print) - - Signature �CST Number .. ZS3 3dg Address Date Evaluation Corduad Telephone Number d Zir-Pliaf. 50 + 1 .$SdZS / -/ -a C715 2N7--y4`61 s PAGE 3 OFF SCALE: 1"= Rio BM 1 ELEVATION /Oo , o BM I DESCRIPTION pia p o a P �c �P e BM 2 ELEVATION qf.. 3 O BM 2 DESCRIPTION ,bP c( (z 2 cR,'Q e SYSTEM ELEVATION Yt�• ALTERNATE ELEVATION CONTOUR ELEVATION 4 od -3 16.Y° q0= SIGNATURE Q c, 1-r I A /Z - 3 c — c/ wiscon`sinDepartment ofCommerce SOIL EVALUATION REPORT Page I of 3 Division of Safety and Buildings in acwmanue wnn Comm od, vvie. Min. Code Attach complete site plan on paper not less than 8112 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all inforlination. Personal Infamatlon you provide may be used for secondary purposes (Privacy law, s. 15.04 (1) (m)). minty St. Croix Parcel I.D. �/Q �2 �� (/ — O� Reviewed by Date ecr— / d Property Owner Steve Derrick Property Location rl Coot. LotSW 1/4 SE 1/4 S 15 T 30 IN 18 E (or)W Propnuty Owner's Maifing Addrass 1438 County Road G Lot # 7 Block # Subd. Name or CSW Cherry Knolls City State Zip Code Phone Number New Richmond i Wl 1 54017 1 ( 715-246-3120 o Village L!jTown Nearest Road Richmond County Road G E) New Construction UseE] Residential / Number of bedrooms 3 to 4 Code derived design flow rate 450 to 600 GPD []RsplarsmeM ❑ Pubficormnmerrial,pescirl Parent material t ne48 ^yPr till Flood Plain elevation If applicable Genes comments Site suitable for a conventional below grade syster and recommendations. a w/ alternating bands of s, 7.5yr5/6, Osg, ml O C T 2 8 2002 T ST. CROIX COUNTY Boring# ❑ onng P 0' Pit Ground snataca also. 142.04 R Depth to limiting facts �� lo. Soil Application Rate Horzon Depth in. Dominant Color Wrisell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Rods GPDAP 'Eff#1 I 'Eff#2 1 0-9 10yr3/2 ail 2msbk mfr cs 2f 4 .8 2 9-24 7.5yr4/4 sicl Imsbk mfi cs if ,2 .3 3 24-62 7.5yr4/4 - *at Om mfi cs - 'k --'4: 4 62-110 7.5yr5/4 s Osg ml .7 1.2 2 13odrg# Boring 100.00 >110 �lr, E] pit Ground surface elev. It. Depth to limiting factor I Shc Applicsficin Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/IP -Eff#1 'Ef1#2 1 0-9 10yr3/2 sil 2msbk mfr cs 2f -f* .8 2 9-24 1 4/4 - aid lmsbk mfi cs if .2 .3 3 24-65 7.5yr4/4 *at Om mfi cs _ A, %i ' 4 65-110 7.5yr5/4 s Osg ml .7 1.2 93•S o D - Effluent #1 = BOD > 30 < 22Ci.Mgklaand TSS >30 < 150 mg/L' ' Effluent #2 = BOD < 30 mWL and TSS < 30 mg4. CST Name (Please Print) Signature o CST Number Thomas C Nelson 227387 Address n Conducted Telephone Number 1432 120th Street, New Richmond, WI 9-25-02 715-246-2454 Steve Derrick Parcel ID # 2 3 Page —Of 3 Boring V Boring # El pit Ground surface elev. 100.40 ft Depth to limiting factor >1�in. Sop Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Ou. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/fF 'E##1 I 'Efr#2 1 0-10 1Oyr3/2 sil 2msbk raft cs 2f .8 2 10-25 7.5 4/4 sic] lmsbk mfi cs if .2 .3 3 2547 7.5yr4/4 •sl Om mfi cs T3. So w: 4 47-108 7.5yr5/4 s Osg ml .7 1.2 1-1 Boring # Boring Pit Ground surface elev. R Depth to limiting factor in. Soil Application Rate Horizon Depth in. Dominant Color Munsall Redox Description Ou. Sz Cont Color Texture Structure Gr. Sz. Sh. Consistence Bourxlary Roots GPD#F 'Eff#1 'Eff#2 ❑ Boring # Q Boring Pit Ground surfaceelev. fl. Depth to limiting factor in. SoII�Rate ®MIMI Redox Qu.Sz. Cont. Color®®®®® Effluent #1 = BOD, > 30 < 220 mg1L and TSS >30 < 150 mg/L ' Effluent #2 = BOD, < 30 mglL and TSS < 30 mg& The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format; please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-83]Qrw(Fl.tl M) 4VI'LZZ 14 = «I a1ea% uoslax Newoy.L 19/ Qh•oo I £� 00,00f a0 `rp SZ'Lol dad '��'i,t� 00'00! ad, Z d boil iC, do ir^ �TT ?I wT Ox A t w M ss�j'�%�d� y�rykOt►� M�•MMM y$iSaQ � d y �YyI gFy S y �1 \".:fir d. \ V1 \.. CHERRY KNOLLS :m.a n pr ar m. uWlnn.r aWrW m u. saaln.mt a.t can w u. sa 1o W el m. W .a,t W Wt . pl w 1. OwrW a rn. Seuuwn aWIW ma M •t tn. ,nu..a a.,t.r •t ra eauxnr aanW, a n seum r� �..,nh eo ,wus nWre. re wex, r _ _ _ a XNmm4 SY Gtl. Cwnl% Wxm,F. r A Sf. CFIOIX CgMIY PLAT er v xwxac a � eer v. I nan «v%a Jar w s«sorga / ware%an --- u_aaa / L0/M TS6SIId Ws� t01. I e ral, � W+�zeeW� I�Ihri✓1K3P. 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