HomeMy WebLinkAbout014-1051-20-000Wisconsin Department of Commerce
Safety and Building Division
PRIVATE SEWAGE SYSTEM
INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT)
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]
TANK INFORMATION ELEVATION DATA
TYPE
MANUFACTURE
CAPACITY
Septic
)( .1 f�-L v t
�f
1 D O
Dosing
Aeration
l , IwW.
4 r' r If-0*1 1 'Y--`.fl
TANK SETBACK INFORMATION
M�Mm®
•.•
®or—M==�=
MM__�11-
'®M.AMMI
NAM
PUMP/SIPHON INFORMATION
Manufacturer
Demand
GPM
Model Nu I
er
TDH
Lift
F do Loss
S tam ad
H Ft
Forcemain
ength V
Dia.
IDist.toWall
SOIL ABSORPTION SYSTEM
STATION
BS
HI
FS
ELEV.
Benchmark
a .-t
Alt. BM
Bldg. Sewer
3. Z
1.7 yq
SU'Ht Inlet
3.7
l t .' 8�
SVHt Outlet
. c(
% . 7 �l
Dt Inlet
Dt Bottom
Header/Man.
0rn
I
Dist. Pipe
Bat. System
i, 2
8•
Final Grade
3.5
97. IV
St Cie
cr
I.D
%9.G
BED/TRENCH
DIMENSIONS
Width 1
Length-7
`
No. Of Trenches
3
PIT DIMEN IONS
No. Of Pits
Inside Dia.
Liquid Depth
SETBACK
INFORMATION
SYSTEM TO
P/L
BLDG
WELL
LAKE/STREAM
LEACHING
CHAMBER OR
UNIT
Manufacturer^t
i of
Of System
Type : 22
���
l�,
/1 I
/v^
Model Number
DISTRIBUTION SYSTEM - CJ. ^aLr 1 T
Header/Manifold
'
x Hole Size
x Hole Spacing
IVent to Air Intake
1
/�
Length b Dia I
Pipebution
Length Ea Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only
Depth Over -7
Bedrrrench Center q (,' r
./
Depth Over 11
Bedrrrench Edges r 7
!�
xx Depth of
Topso'
xx Seeded/Sodded
xx Mulched
o
COMMENTS: (Include code discrepancies, persons present, etc.) f 'I_nnspection #1: ' 1 `Inspection #2:
Location: 3132200TH AVE Lwo<5 d—tib.�trzJ� / vtq-' ek-% w f j� �
1.) Alt BM Description= ) iJlur Gvtt _. BILy? H(eM4.N7�57At hJJ-0"4p4_ 0�14r�xl�
2.) Bldg sewer length - 7-0
Flo'-�s
-amountofcover=7r8 Z
Plan revision Required? NkYes 0 No .
Use other side for additional information. ` _ _
SBD-6710 (R.3/97) DInsepcto Signature
Cart. No.
g�
F. tq
SM 2269 a —►y3
(i*
Safety and Buildings Divis'an
Con""
/� 'f—
a
$ 2 2020
2. W.` Washington Ave., P.O. Box 7162
Ssnvsy Pa®it Ntunber (w be Med m by Co.)
Madison, WI 53 07- 162
62` 6
• U
rotx County -
Communit Deve permit Applic
Sue Transaction Number
In aeoardma with SPS 383212), Wis. Adis. Code, submission f this the piropnme gm-arneatal unit
ProjectAddress (if t iftentthan mailing address)
is regoved prtor to obtaining a sanitary petmrt Note: Appkcationforms for niYbpdn:d w
the D�aA of Safety and Professional Semies. P=eW information you Provide may be used for a
srs m accoNmce with the Law, s. 15.04(l m Suns.
3 Z
'ation
L Information- Please Print All Information
Property Owner's Name ( l`
Feed k
014—IOSI- -
Pmperty owner[ Mailhrg Address
Pmpcm Lamson a N. 3) • 5• o
GpvL LatTj ),
a
Code Phone
N=ber
ma's 'k Set
t r
T N, or
pe o is ding (check all that apply) Lot
k
3S. �Zeae.tt
2 Family Dwelling -Number of
Q$�
Block
k
❑ PubliclComokrcial - Describe Use
�_
0 �y of
❑Stake Owned -Desmbe Use CSM
❑VHMP of
Number
Town of�--
III. Type Permit: (Chock only one box on line A. Complete Roe B if appliable)
A.
System
Replaoammt System
❑ Tseaunmt/Holdmg Took Replaoema t only
❑tithe Modification to Existing System (explain)
B.
❑ Permit Reoewal
❑ Permit Revision
O []stage ofPlumber
❑ Pa nit Transfer to New
List Ptevioos Permit Number and Date )saved
Before Exphation
owner
of PO W'I'S S stem/Com nent/Device: Check all that apply)
;KW•Pressmiaed In-Grormd ❑ Pressmiaed is -Ground ❑ iu arsde ❑ Mouod> 24 io. of suitable soil D Mound<24 a e '
Holding Took ❑ OtherDispersal Component tam) Pretreatrn )
V. Du Vrreatment Ara Information
Ded� Flow (pd) Design Soil Applic�on &o
Dispeanl AW Required (at) Proposed (st)
S
VL Tank Info
Capacity in
Gallons
Total
Gallons
a of
Units
Mao
,_ /�i �_1.,r _ (b tJ.._�) S
All
u
Nun Tub
Erimog Snob
ss'!-�*K•'!'vl�^ Y
_
'
s
erevs
aO
swac or Holding Tank
Naas Cbwba
VIi RespomibBity Slafem - I, the oadersgm!!
a mponsibility for installation of the POWTS shown as the attached plans
's Name(Print) S
MPMfPRS Ntunber
Business PhoneN
Pbmsber'a Address (StraS City. Stem; LP Code) � 11 f
VIB. Co /De asmsent ere On
ts4 _, �s
�sp�Os'O°
Permr�it�yFFeeee
/ all L�sjoed
Iss' Aga[si
(0��/Z'20
❑Uwa�� On forDrnial
M Coadidons of Approval/Reasons for Disapprais"3` p� S e _
) fl GteK 45
EM OWNER: ` L +�
I tank, must Alter and
e',- �+� tS 36 su--a
I pereel cell must be eervlr&d / nlelnSained � S ���� �
er l
"^
per management plan provided by plumber.
a
2. AI a. as►shmthe carry wympper.seka ra:Ii aatrorta earn /
as per applicable code/ordinances. my�`/�J
SBD-6398(IL II/In
OR
v4r-KAL-
K
System PLOT PLAN
PROJECT Matthew MohauDt ADDRESS 1504 Twin SDrinas Road Houlton Wi 54082
SE 1/4 SW 1/4S 24 /T 31 N/R 15 W TOWN Forest COUNTY ST.CROIX
SYSTEM ELEVATION 92.5/91.5/90.5 3.6' below grade 5/30/20 BEDROOM 3
DATE _
CONVENTIONAL XXX AT -GRADE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE _4 ABSORPTION AREA 1125 # of EZ-Flows22.5
�"ENCHMARK V.R.P. Nail in box elder
ASSUME ELEVATION jQQ; Filter Lifetime Filter
❑ BOREHOLE O WELL .H.R.P. same as benchmark
�Nco �
M
Vents
l_
-, av
Pro 3
Bedroom
House
94'
35'
93' 6W >500'
10% Slope 1 -��
>500' 3-3' X 75' cells with >3' spacing
OXYTITI.VNI
r�� ,0?
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 5/22/20
Owner:Matthew, Mohaupt
Location: SE1/4 SW1/4 S 24 T31 N,R 15W 3132 200th Ave Forest
Manuals Used: In -ground absorbtion system (version 2.0)
Page#
1. Cover Page
2. Plot Plan
3. EZ Flow Cross Section
4-6. Maintance Contigency Plan
7. Filter Cross a ion
Signature '---�
License nurrIzer #226900
System PLOT PLAN
PROJECT Matthew Mohauot ADDRESS 1504 Twin SDrinas Road Houlton Wi 54082
SE 1/4 SW 1/4S 24 /T 31 NIB 15 W TOWN Forest COUNTY ST. CROIX
SYSTEM ELEVATION 92.5/91.5/90.5 3.6' below grade 5/30/20 BEDROOM 3
DATE
CONVENTIONAL XXX AT -GRADE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .4 ABSORPTION AREA 1125 # of EZ-Flows22.5
C�ENCHMARK V.R.P. Nail in box elder ASSUME ELEVATION bQo° Filter Lifetime Filter
❑ BOREHOLE O WELL sH.R.P. same as benchmark
Cross Section of Quick 4 Standard Leaching Chamber
Typical cross section for 2 of 3 cells
Quick 4 Standard
Leaching Chamber with
20.0 ft2 of Area per
Chamber 5.6ft^2 pair of end plates
Typical Installation
Vent A/ Grade
4
.A"�30/34 Septic Tank
m
4' Long
Spacing 5'
System elevations:
A 92.5'
B 92.1'
C 91.7'
5'
at System Elevation
!i
To be >1' above grade
/ Finish grade elevation
�( 96.0'
Vent
1"
at System Elevation
3-3' X 78' Cells
Observation tubeNent
Same on other end To be located on end of Cells
19 chambers per cell
%A
O°
Cross Section of a Three Cell EZ Flow In -Ground Dispersal Component
Design Flow t Loading Rate = Required dispersal areaSq Ft
Required dispersal area 50 (EISA) (number of units)
Cell #1
System Elevation:�r�• Ft
0
Final Grade:% / Ft
Geotextile fabric to meet Comm 84.30(6)(g) Wis. Adm. Code
Minimum of 12" of cover over top of cell
Two observation/vent pipes to be provided per cell
Not to scale
Cell #2 /
System Elevation(// 5
Final Grade: Y 1 Ft
Cell #3
Ft Y!i
System Elevation. (' Ft
Final Grade:& Ft
ST. CROM COI INT'Y
SLPI')C'I'ANK MA1Nf'1'13NAN("Ii itURHEM) NI
AND
M
OWNURS111P Cigt'1*11r1C'ATk: N FORM
owller/Bnyt:r _flPCA4VleW PAACkve# - F'SSc\ _f�r(7014
Mailing Address. I 5d-I . TW f /�. _S 1r_ 1 �t ei }�Ot) i4on w� S�C
!.
Proputy Addie%313 Z 2 oot'A wCX)fA
(Vcuificatio0 regomd riont Planning & Zoning oupatit ttelm fillnew ell . 11hion.)
City/State (evk..... 1 Irvxel Idculilicalina Nw�hel (� 1 y - �C��1 - 2 V - U�i�
LEGAL D1,SCIUIYI'ION
Property bwaiion SE %„ , 5b) 1/ ,Sea ? -I- ? I- N R, Is W,,'I'own of
Subdivision - - 3 .. Z. aue-_ Oelce - - -- IA#
— --- � f ..
Certified Survey Map # _. IV i \Rdunlc Page 1t ...._..._...
Warranty Deed #._..._. t QO O G5— Voluule. _-' Page l/
Spet house yes 1 tit lilac identifiable yes 11710
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use and inaintsuauce of your septic system could iesull in its prnmalore failure to handle wastes. Proper
maintenance consists of plumping out Ili: septic tank every three yearx or souner, it needed, by a licensed pumper. Wlmt you put into
lite syslunl unit 101bul tho limc:tion 01'01e septic: tank as it treatment stage in the waste disposal systeM. C)WnCI Maintenance
ICxpOtlsihilitiea are apOCi$Cd ill §Conlllr. 83 S2(1) all([ in (:11aplel 12 St. Croix C:o'Imy Sanitary Ilydinxncc
The property owuel agl e(z Ill submit to SC Croix C:ounly Planning & Zen my, I )oparlolunt a ccrtifiwtiorl linui, signed by the
owner and by a master phlmbor, journcyrnan plumhcl, rushiclad plumber or it liceusedl pumper vrri tying that (1) the on -site
wastewater dispersal system is in proper operating condition and/or (2) allet inspection and pumping (if necessary), file septic tank is
loss Elton 1C3 AM ofliludge..
t/we, its' underssiglled have read the above requvclnrnAs unit ap9a• to mnuvtun. it.. private xew,.yc atixposad systvul will, Ihr
xumdmuAx xet tin tit, lu:uciq in xe1 by the Ucparlua;nl of Cnumrolce and ill(! Department of Nati ial Rcsom ms, Solo of Wisconsin.
Certification $filling that your septic system has been nutiutained muss he complehal and retained to the St. Croix Courtly Planning &
Zomug Dopmtuxot within 30 days of the dance year expiration date.
l/we cerlity that all stalernents on dos farm au: live to the best of m}•/our it nowledge. ]live su✓are the owner(s) 01,111e
property described above, by virtue of a wiltrality deed 1 ecotded In Register of Dec. is Office.
Numb r f b dr s
l _ S /3I1 Zcizo
i UR DAT)^,
°/Any information that is misrepresented may result ill the saailary poi nail being winked by the Planning & Zoning Depaltmeut. *F+
Include with this application a recoided wariauty deed from the Regnslm of I )ocds Office and it copy of the cortifted survey rump if
refcrcra a is made in the rvafranly deed.
(REV. 08/05)
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page _of_
41-
9LE INFORMATION
Owner n
Permit #
)ESIGN PARAMETERS
Number of Bedrooms
^ ❑ NA
Number of Public Facility Units
i
0-bCA
I Estimated flow (average)
CTZ2 gavday
Design flaw (peak), (Estknated x 1.5)
gal/day
i
i Soil Application Rate 1
aVda /flz
i Standard Influent/Effluent Quality
Monthly average"
Fats, Oil & Grease (FOG)
s30 mg/L
Biochemical Oxygen Demand (BODs)
5220 mg/L ❑ NA
Total Suspended Solids (TSS)
<750 mg/L
Pretreated Effluent Quality
Monthly average
Biochemical Oxygen Demand (BODs)
:= mg/L
Total Suspended Solids CTSS)
G30 mgfL ❑ NA
Fecal Coiform (geometric mean)
510" cfu/100ml
iMaximum Effluent Particle Size
lk in dia. ❑ NA
Other
A
'Values typical for domestic wastewater and septic tank effluent
MAINTENANCE SCHEDULE
SYSTEM SPECIFICATIONS
Septic Tank Capacity
al
0 NA
Septic Tank Manufacturer
❑ NA
Effluent Filter Manufacturer
❑ NA
Effluent Filter Model
t l
❑ NA
Pump Tank Capacity
gej
NA
Pump Tank Manufacturer
NA
Pump Manufacturer
NA
Pump Model
NA
Pretreatment Unit
❑ Sand/Gravel Filter
❑ Mechanical Aeration
❑ Disinfection
O Peat Filter
❑ Wetland
0 Other.
NA
Dispersal Cell(s)
Ground (gravity)
• At -Grade
• Drip -Line
O NA
❑ In -Ground (pressurized)
❑ Mound
❑ Other:
Other.
0 NA
Other:
El NA
Other.
❑ NA
Service Event
Service Frequency
(Inspect condition of tank(s)
At least once every:
r°O (s) (Maximum 3 years)
❑ NA
(Pump out contents of tank(s)
When combined sludge and scum equals one-third of tank volume
❑ NA
(inspect dispersal cattle)
At least once every:
o r(S)(s) (Maximum 3 years)
❑ NA
Clean effluent filter
At least once every:
month(s)
❑ NA
Inspect pump, pump controls & alarm
At least once every:
El yeaarr((ss))) ❑ m
NA
-lush laterals and pressure test
At least once every:
❑ month(s)❑ year(s)
3 NA
)tiler.
At least once every:
[3 mom years)s)
NA
()tiler
NP:
MIAINTENANCE INSTRUCTIONS
!Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: actor
IPlumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer, Septage Servicing Operator. Tank inspections must
iinclude a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of
rombined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) she$ be
ivisuatly inspected to check the effluent levels in the observa8on pipes and to check for any ponding of effluent on the ground surface.
The ponding of effluent on the ground surface may indict ie a failing condition and requires the immediate notificetlon of the local
regulatory authority.
When the combined accumulation of sludge and scum in any tank equals one-thi.d (%) 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.
lbil other services, including but not limited to the servicing of effluent filters, medrianical or pressured components, pretreatment units,
lend any servicing at intervals of <12 months, shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority within 40 days of completion of any service event
Page _ Of _,
START UP AND OPERATION
For new construction, prior to use of the POWrS check treatment tank(s) for the presence of painting products or other chemicals thEt
may impede the treatment process antdfor damage the dispersal celf(s). 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 highwater levels. When power is restored the excess wastewater will be
discharged to the dispersal ceil(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluentt.
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 yehides over tanks and dispersal cells. Do not drive or park over, or otherwise disturb of compact, the area within
15 feet down slope of any mound or al -grade soil absorption area.
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWT$'
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; oft; Painting produces;
pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS fails and/or a 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 opeangs sealed.
• The contents of all tanks and pits shall be removed and property 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 falls and cannot be repaired the following measures have been, or must be taken, to provide a code compliOnt
replacement system:
"A-sullable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption systelm.
The replacement area should be protected from disturbance and compaction and should not be infringed upon by requiried
setbacks from existing and proposed structure, lot lines and welts. Failure to protect the replacement area will result in the meted
for a new soil and site evaluation to establish a suitable replacement area. Replacement Systems must comply with the ruled in
effect at that time.
17 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.
❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation
must be perfomred to locate a suitable replacement area. If no replacement area is available a holding talc may be installed as
a last resort to replace the failed POWTS.
❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the blomat at the infiltrative
surface. Reconstructions of such systems must comply with 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 O� A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE
COMMENTS
POWTS INSTALLEt
Name
Phone
IT
SEPTAGE SERVICING OPERATOR
L _
This document was drafted in compliance with chapter SPS 383.22(2)(b)(1)(d>&(f) end 393.54(1), (2) & (3). Wisconsin Adminmtrabw Code.
20140048A
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9.8164 9X59
9.4356
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a �
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SECTION A -A .
NORTH
49.5'
oae
4
BEDROOM i Seaioom FRONT ENTRY whys i Bathroom eeanan BEDROOM 2
9' x 14' Closet £ 9' x 10.5' 9' x 9' eiwd 9' x 13.5'
Sxwer
E
N
�1H1
xiWm xnnim KA&en 6 Dining Room Woos Score Living Raom
smw IWM 15.5'x 24' 15.5'x24'
TOTAL SQUARE FOOTAGE = 1.287 i
SOUTH
r» x
;t
t,�r l�,
tr�'wM'i
t� ,{l,V�f f�erlf •'t�b ,Li7j�'r!f I ! � r_
R7�0" ttYpyylv"f: ,i �
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- ';,j, j.
'S I
ARRcc- E0�PD
.+.9 SOI EVALUA N EP R
�. �1,,(�ddyy qq �p99��
\ =8 Department of afetyaRyofegiwtl86rVices Ir
, Jt , Division of Saf ty and 4}''Ild'otq,,ix (ftetwordanoe ith Cownm 85 ex
0125
Page 1 of 3
Northland Plumbing, Inc.
Commune
nt Cou
Attach complete site plan 31 ches in size. Plan must
St. Croix
include, but not limited to: vertical and horizontal re ere point (BM), direction and
Parcel I.D.
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
Please print all information.
a owed By -�at
Personal information you provide may be used for seoondary purposes (Privacy Law, s. 15.04 (1) (m)).
Property Owner
Property Location
Matthew Mohaupt
Govt. Lot SE1/4, SW1/4, 524, T21 N, R15W
Property Owner's Mailing Address
Lot #
Block #
Subd. Name or CSM#
1504 Twin Springs Road
City Stale Zip Code Phone Number
City [� Village `� Tam Nearest Road
Holten WI 54082 612-968-1719
Forest 200Th Ave
New Construction Use: (A Residential / Number of bedrooms 2 Code derived design Flow rate 300 GPD
Replacement ❑ Public or commercial - Describe:
Parent material Glacial Till Flood plain elevation, if applicab ft.
General comments_G 5s•w1•- oH¢aN 1r4` •�n'/ mcrL
and recommendation 1 SSA•1��ssa�,lf�
040
7�F�, Nr/so+o
rtai }e GiT en a+ - 04— X
,. '. Boring l2 , =' `� `
-"7>80
a
Boring #
❑ Pit Ground surface a 96.07 R. Depth to limiting factor in. Soil Application�Rate•
Horizon
Depth
Dominant Color
Redox Description
Texture
Structure
Consistence
Boundary
Roots
GPDM
vte
in.
Munsell
Ou. Sz. Cont. Color
Gr. Sz. Sh.
•E1181 'En#2
Ice
1
0-7
10YR3/2
sit
2msbk
mvfr
rs
2m
.6
.8
re
2
10YR5/4
sicl
2msbk
mvfr
cs
2m
.4
.6
0Q
3
30YR6/8
Cos
Osg
mfr
cs
.7
1.6
4
48-80
10YR5/8
s
Osg
ml
cs
.7
1.6
92.,y-a
a17
2]
Boring # Boring
Pit Ground surface elev. 94.07 fL Depth to limiting factor >84 In. Soil Application Rate
Horizon
Depth
Dominant Color
Redox Description
Texture
Structure
Consistence
Boundary
Roots
GPD/W
•Eff#1
•EIM
in.
Munson
Ou. Sz. Cont. Color
Gr. Sz. Sh.
1
0-11
10YR3/2
sit
2msbk
mvfr
cs
3f
.6
.8
2
11-30
10YR5/4
sit
2msbk
mvfr
cs
im
.6
.8
3
3q�50
10YR5/4
ski
2msbk
mvfr
gs
if
.4
.6
4
50-63
10YR6/8
Cos .
Osg
mfr
a
.7
1.6
5
63-84
10YR5/8
s
099
ml
cs
.7
1.6
3•bd
ee,1 srn-
(?. 7"t
Effluent #1 = BODS> 30 < 220 mg/L 9nd TSS >30 < 150 mg/L ' Effluent #2 = BOD5 < 30 mg/L ar. TSS <30 mglL
CST Name (Please Print) Sig re: CST Number
Michael J. Myers 267985
Address Northland Plumbing, Inc, Date Evaluation Conducted Telephone Number
2943 130th Ave Glenwood City, WI 54013 4/23/2020 715-265-4115
saaesao(punr)
Property Owner Matthew Mohaupt Parcel ID #
Page 2 of 3
3]
Boring # E Boring
rj Pit Ground surface elev. 92.54 ft. Depth to limiting factor >80 in. Soil Application Rate
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description
Qu. Sz. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPDRt'
'E8#1
TM
1
D-12
10YR3/2
sil
2msbk
mvfr
cs
3f
.6
.8
2
12-36
10YR5/4
sid
2msbk
mvfr
Cs
.4
.6
3
36-45
10YR6/8
Cos
Osg
mfr
Cs
.7
1.6
4
45-80
10YR5/8
s
Osg
ml
cs
.7
1.6
at 3 6d
Boring
4 Boring # Pit Ground surface elev. 96.23 ft. Depth to limiting factor >84 in. Soil Application Rate
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description
Qu. Sz. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPDIR'
1E101
•C-a#2
1
0-12
10YR3/2
sil
2msbk
mvfT
Cs
3f
.6
.8
2
12-60
10YR6/8
cos
Osg
mfr
cs
lm
.7
1.6
3
60-84
10YR5/8
s
Osg
ml
Cs
.7
1.6
Ayz. Sd
3. v
r
...�
`/`1O
3•z
z
5
Boring
Boring # �, P8 Ground surface elev. 94.64 ft. Depth to limiting factor 68 in. Sob Applioeli0n Rate
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description
Qu. Sz Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPOfR'
'EW1
I -Eea2
1
0-14
10YR3/2
sill
2Msbk
MVfr
rs
311'
.6
.8
2
14r42
10YR5/4
sicl
2msbk
mvfr
Cs
if
.4
.6
3
42-68
10YR5/8
d
lsbk
rntr
cs
2
Effluent #1 -BOO? 30 < 220 mgfl- and TSS >30 � 160 mgA- . Effluent #2 = BOD5 < 30 mgA- and TSS < 30 mgrL
The Department of Safety and Professional Servicese is an equal opportunity service provider and employer. If you need assistance to
access services or need material in an alternate format, contact the department at 608-266-31 S 1 or TTY through Relay.
SBD8330Tm (R.31/11) aard"W KmAb gr Im.
d
CHECK e0X AS APPLICABLE.
0 SOIL EVALUATION Scale: l"=49
SITE MAP o
PROJECT NAME (10nyia) 10,
Matthew Mohaupt
CHECK BOX AS APPUCABLE.
SYSTEM PAGE 2 OF
PLOT PLAN
DESIGN FLOW: GPD
Attach design Now caludations for commercial plans.
PROJECT ADDREss: 200th Ave, Glenwood City, NA, Forest Town. Pipe Wwrial / ASTM Standard (Tables 384.303 & 384.30-5)
100.0 N Sanitary s/
BM aymbot: BM lsevation; FT Force Main:
eM Deacnpe M Nall in box elder tree 12 off ground
awram no.m by
ShtWGM= i 0 Well Syntd (e aPWc"M 0 an Mg aPpanp
ite In,
a rK*t-r =lbe .0 1
n/Ilur 1tom. Yell 6(0) el"-tvtt-c
( W f
gM�y ; 99./9y11'
tze eFFrAroA+A�
>'5*",
aY8'
IMPORTANT:
Show ground elevation contours at s0table intervals.
.Cno-Cx (IVA./y
t or+St �tNs p
ss yy 6&&3yy 5-1 1-,- R�5"�
7/L
4Y.•j 91� 'y'
�- 4s•SY'
B( :
9G.o7'
e-Z :
qaf• 07'
ss :
92.5r'
(35 :
9It. bY'