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Home My WebLink About012-1064-10-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM I County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: 624834 Personal information you provide may be used for secondary purposes [Privacy Law, s 15.04 (1)(m)] Permit Holders Name: City Village Township Parcel Tax No: Shirley Mayer/SKM Interest LLC I TOWN OF ERIN PRAIRIE 1 012-1064-10-000 CST BM Elev: Insp. MElev: BM Descriptioppo. CIA wszc„-t Section/Town/Rangellvap No: 30HO "► Jf SCd (mom 30.30.17.449 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER ;A S CAPACITY Septic w I -ec r T y. 4- �Z�J d Dosing Aeration ; Po ( /oK 6`Z5 TANK SETBA& INFORMATION MW�w�A, AM ®■I,I-,,.■,.-„- ®"MWLN�v M PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model IN TDH L' Fricti Los S to Hea TD Ft Forcemain L ngth I Dia. ist. to We STATION BS HI FS ELEV. Benchmark •' /OO AILBM �e1 16, �q I?1' l Bldg. Sewer DJ'� St/Ht Inlet 9.Ig 1 J 40-q5 1 S1/Ht Outlet 9.q0 qo.G-:_ Dt Inlet Dt Bottom Header/Man. 1p,Z V 1 Dist. Pipe Bot. System t.75 8 Z� TJ Final Grade I ,� stcoief Cvvtr 3" f1(.I9 SOIL ABSORPTION SYSTEM % -)- C) F2 1=40W5 BEDITRENCH DIMENSIONS WidtFy., t 13 Leni ` Na. Of Trenches 3 PIT DIMENSIONS No Of Pits Inside w ep SETBACK INFORMATION SYSTEM TO P/L JBLDG IWELL LAKE/STREAM LEACHING CHAMBER OR UNIT Manufacturer. --``/f �L4(1 Tyy//ppe Of System: A COYI1ystem coil �It7p0 sir• N�i n /flU, Model Number DISTRIBUTION SYSTEM ct-� r e. (oroo Header/M nifold r ` Length "Y��/ Dia - IDIstribution Pipes) Length Die Spacing x Hole Size x Hole Spacing Vent [o Air Intake SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over r/ Bed/Trench Center / /�, 5-% Depth Over Bedfrrench Edges' 1.7 T t xx Depth of Topsoil xz SeededlSodded xx Mulched ® Yes Na COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: Location: 1563140TH AVE�� C�.^r �`S c--�Jy1•Yr1't%,•�-�'+c�vt 1.) Alt BM Description = ICI L "r L&,-eC _ 11�em 0 ,� V 2.) Bldg sewer length = 15 1 - amount of cover = 7101 — /� p 1�I14-- V� A6y Y�(� oc"Ce UI rc,i Plan revision Required? ® Yes [No r^ '7 Imo, _ - IK Use other side for additional information. L �,/ !� 11 (-� SBD-6710 (R.3/g7) Date Ins pc[ors Signature Inspection #2: ?-tPcs ) Q-�+ 1#1. Cede, Cert. No. sprv-010ao _ 10 Uv Safety and Buildings Division County ST CROIX 201 W. Vrhington Ave., P.O. Box 7162 M dison, WI 53707-7162 S,oitery Points Number (m be teed in by Co.) I=94"JUN 0g 2020 PA �2 4f 83 Jr ft. St. crn�l it Applicat' te Tesmacrton Number I to attor wish r,ata. a Adm. Code, submission of this form to the t is top= mg a sanitary permit. Note: Application forma for nate-owued PO WTS aresu to the Department of Safety and Profmiemal Servies. Personal information you provide may be used for secoodmy Project Address (if different then mailing address) .�tL 3 purposes inaccurdmce with the Privacy Law, s. 15. ] m) Stets. /7 `r 4668-140TH AVE NEW RICHMO _ I, Application Information— Please Print All Information Property Owner's Name E Parcel N SHIRLEY MAYER / SKM INTEREST LLC 012-1064-10-000 Property Owner's Mailing Address Ply wpm 17 STACY LANE Govt. tot NW X NE u Sam 30 City, Sure Zip Code Plmse Number MADISON 53718 608-709-1218 (CiroemXV�,o�1 T30 N; Rsr T` 1fr1VJJ Q. Type of Building (cheek all that apply) La N I9 1 in 2 Family Dwelling -Number of Bedrooms 4 Subilivisim Name 13 Publinice®acul-Deseribe use Block N ❑ City of ._... ❑ Suer Owned -Destnbe Use ❑ Villago of CSM Number 0 Town of ERIN PRAIRE M. Type of Permit: (Check only one box on Bne A. Complete line B if applicable) A. ❑ New System serene System ❑ Treatment/Holding Teak Replacemant Only ❑Other Modification to Existing System ("plain) a• ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Tramkr m New List Previous Permit Number and Date Issued Before Ezpuatioo owner e of POWTS S atem/Com nent/Device: Check all that apply) ® Pre»mized 1n-Gro®d ❑ Pressurized li. )ra and ❑ A,-C.& ❑ M>ouud24 m of eumdAe soil ❑ Mound <24 in. of auirable soil Holders Tack ❑ Other Dapetsal Component (explain) ❑ pretreatment Device (explain) _ _ __ V. D)s ersaUTrestment Area Information:hi Design Flow (gpd) Design Soil Application R Dispersal Area Required (sf) V Dispersal Am Proposed (sf) E1.1111tor e 600 .7 857.14 900 87.5 �s V1. Tank Info Capacity in Gallons Toed Getters Nof Units Manufacturer lwf 1 D � �f D-yf lot 7Z�\•l•� r (• g �U yC New Tusks Existing 7aab U i�A SeprkmHoldtng Tale 1250 Z,,jO ♦ L Dosing chamber VII. Responsibility Statem s t- I, the umkrd led, name responsibility for iasullatloa of the POW TS ckowe on the attacked puss Plumber's Name (Print) Plum MP/M %S Number &nines Phone Nomber COUNTRYSIDE PLG AND HEA NG 664713 715 216-2660 Plrmher's Add— (Sued, City, Slate, Zip Code) 321 WISCONSIN DRIVE NEW RICHMOND VUI. Countv/De artmeot Use Only Approved ❑ Duoppmved PeFee Date Issued 6//b/L,p Issum Agora Sigoa ❑O erGi forDeai.l 00.00rmit $11 IX. Conditions of App val/Reasi as for Dimipproval 3 n - �O Teol; OWNER:` t1 ntD49/ 5 crank, effluent end�wr � . - 7fJ ,, „n�, t lga4,`t�.t Dlsperaln qnn must oeva.eu r lawn nmrnar asper management poa *ovided by plumber. 2. All setback *uiremefils mud be atsiiMflr" as per applicable code%ordinaftbeS. SBD-6398 (R. I1/11) h] 140TH AVE SLOPE 4.5% CHICKEN COUPE GROUND SURFACE CORNER,,' HOUSE WELLO I BENCH TWO OF HOUSE .9 81 FT OFSIDEING CORNER . ! SAX Nt rfi , dD , �, WIIESER 1200 TANK Al- _ LP TANK �,___, i POLY LOCK 525 FILTER B3 95.16 )I ' �i ROW OF TREES ' 0• „ CONTOUR FT 112 FT B193.3 2 90 FT TRENCHES OF EZ FLOWS SYSTEM ELEVTION 87.5 SCALE 1"=40FT i�T CORNER OF CHICKEN COUPE 100 S °' B2 90 84 BM 2 CORNER OF SIDEING AT HOUSE 1 95� � ABORING 195.16 BORING 2 93.3 BORING 3 90.84 CONTOUR LINE 93.0 CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: SMK INTERESTS LLC Owners Name: SHIRLEY MAYER Owners Address: 17 STACY LANE MADISON WI 53716 Legal Description: NW/NE/ SEC 30 T30NR17W Township: ERIN PRAIRE County: ST CROIX Subdivision Name: Lot Number. Parcel ID Number. 012-1064-10-000 Designer/Plumber: Date: Page 1 Index and title Page 2 Plot Plan Page 3 System Sizing & Cross -Section Page 4 Filter 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 06/01/2020 Signature License Number. 225410 Phone Number (715) 246-2660 Designed pursuant to Me ImGmund Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P (N.01101). Page 1 140TH AVE HOUSE BENCH TWO BO OM OF SIDEING CORNER N1 WEILO OF HOUSE .9 f200T:NI( C� � $' 1pdp �jQWIIESER LP TANK POLY LOCK 525 FILTER O (5)(o 0 0 0 0 0 0 o O o o Q o q o J O g o ROW OF TREES SLOPE 4.5% \ B3 95.16 CHICKEN COUPE GROUND SURFACE AT CORNEI,119' 81 FT CONTOUR FT 112 FT Bl 93.3 2 90 FT TRENCHES OF EZ FLOWS SYSTEM ELEVTION 87.5 SCALE 1"=40FT /BM 1.4T CORNER OF CHICKEN COUPE 100 82 90 84 LBMM22 CORNER OF SIDEING AT HOUSE 99�9�5� � BORING 195.16 BORING 2 93.3 BORING 3 90.84 CONTOUR LINE 93.0 SOIL ABSORPTION SYSTEM DETAIL / GRAVELLESS LEACHING UNIT Page I Of Project Name: SKM INTERESTS LLC 2 No. of Cells 3 n Cell Width 90 n Cell Length 3 ft Cell Spacing 9 Per Cell 18 Total No of 10 50 sq ft EISA Per Cell 900 sq ft Total EISA Manufactunw YM.I I..,— 1 e....M. Infiltrate EZ1203H-5ft 5.0' 25.0 EZ1203H-10ft 10.0' 50.0 Gravelless Leaching Unit Manufacturer: INFILTRATOR Gravelless Leaching Unit Model: EZ1203H-10FT. Finished Grade 99— It �...... ones 12 In 10 •. Yin ...............:::: Typical Cross Section RAI Observation Pipe with approved cap or vent Backfill :extile Fabric 3111 Infiltrative Surface Limiting Factor / Slotted and Anchored Vent/ Observation Pipe with Cap ............................................... Plumber/Designer Signature: v>I License u: 225410 Date: 8/10/2017 A A 6.5" (16.51cm) SEALED BALL MATERIAL - HDPE 33.02 183.9 cm] 20.71 [52.6cm) — _ 4" (10.16 cm) BALL HOUSING TRAVEL FILTER CARTRIDGE MATERIAL -POLYPROPYLENE r- 5.7 [ 14.7 cm] MATERIAL - FILLED POLYPROPYLENE POLYLOK PL- 525 - 625 CUTAWAY - BALL PUSH ROD FACTORY INSTALLED SECTION A -A 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 I'Al• a 4' CAST -A -SEAL N a g INLET - — — OUTLET N � e 2} Sn TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS WLP1250—MR TANK SPECIFICATIONS DIMENSIONS: WALL: 2 1/2" BOTTOM: SEPTIC 3' COVER: 5' MANHOLE: 24" I.D. PRECAST CONCRETE RISER HEIGHT: 52 1/2- O.D. LENGTH: 120 1/4' O.D. WIDTH: 84" O.D. BELOW INLET: 41" O.D. LIQUID LEVEL: 360 WEIGHT: 8,810 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: 34.81 GALAN HOLDING TANK: OUTLET HOLE PLUGGED ACTUAL CAPACITY, 1.323 GALLONS LOADING DESIGN: 8' 0' UNSATURATED SOIL TANK CAN BE USED AS: SEPTIC/ HOLDING/ PUMP OR SIPHON COVER: MIX DESIGN /8 NO FIBER) TANK: MIX DESIGN /10 STRUCTURAL FIBER) CUSTOMIZED TANKS: FOR CUSTOM TANKS CONTACT WIESER CONCRETE II DRAWINGS SUBMITTEDII FOR APPROVAL APPROVED BY: APPROVAL DATE: _ PRODUCTS NEEDED BY: W C awe � lmd J K Q I z N U F a Lu SHEET NO. OF/ i POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page I of -I- FILE INFORMATION Owner SKM INTERESTS Permit 0 DESIGN PARAMETERS Number of Bedrooms 4 0 NA Number of Public Facility Units X7 NA Estimated flow (average) 40 al/der Design flow (peak), (Estimated x 1.5) 600 al/der Soil Application Rate al/der /ft' Standard Influent/Effluent Quality Monthly average* Fats, Oil & Grease (FOG) 530 mg/L Biochemical Oxygen Demand (BODs) 5220 mg/L 0 NA Total Suspended Solids (TSS) 5150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BOD6) 530 mg/L Total Suspended Solids (TSS) !C30 mg/L ❑ NA Fecal Coiiforn (geometric mean) 510' cfu/100m1 Maximum Effluent Particle Size Ys in dia. ❑ NA Other: ❑ NA Values typical for domestic wastewater and septic tank effluent. KAAI uau rrc cr•ucnr uc SYSTEM SPECIFICATIONS Septic Tank Capacity 1200 al ❑ NA Septic Tank Manufacturer WIESER) NA Effluent Filter Manufacturer POLYLOCK ❑ NA Effluent Filter Model model 525 ❑ NA Pump Tank Capacity al XI NA Pump Tank Manufacturer A NA Pump Manufacturer XI NA Pump Model N NA Pretreatment Unit ❑ Sand/Gravel Filter 0 Mechanical Aeration ❑ Disinfection ❑ Peat Filter ❑ Wetland ❑ Other: ❑ NA Dispersal Cellls) ❑ In -Ground (gravity) ❑ At -Grade ❑ Drip -Line ❑ NA ❑ In -Ground (pressurized) ❑ Mound O Other: Oder. ❑ NA Other. 0 NA Other. ❑ NA Service Event Service Frequency Inspect condition of tank(s) At least once every: p( earl3 0 ymXs)hIs) (Maximum 3 yews) ❑ NA Pump out contents of tank(s) When combined sludge and scum equals one-third %) of tank volume ❑ NA Inspect dispersal cell(s) At least once every: 3 monthIs)(Maximum 3 years) ❑ NA Clean effluent filter At least once every: 0 mli4 yearonths)(a) 0 NA Inspect pump, pump controls & alarm At least once every: 0 month(s) ❑ year(S) NA Flush laterals and pressure test At least once every: 0 monthis) ❑ yearls) X NA Other' At least once every: 13 Y arm) s) 1X 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 Maimainar; Septage Servicing Operator. Tank Inspections must include a visual inspection of the tank(s) 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 call(s) 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 filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shag 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. START UP AND OPERATION Page z of 2 For new construction, prior to use of the POWTS check treatment tankls) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cells). 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 calls) 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 Isump 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 safety 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 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 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, lot 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. fj//� alu t g t b e ai �fZD415 TT;� i&iDQ-'-Jl a('1STRU«'t Uank Cl 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 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 OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL POWTS INSTALLER POINTS MAINTAINER Name COUNTRYSIDE PLUMBING AND H ATI G Name PAUL R KOEHLER Phone 715-246-2660 Phone 715-246-2660 SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY/AUTHORMY Name NamSe , ( 2 J/AJ Phone Phone —7/57— 39'&— &p a This document was dratted in compliance with chapter Comm 83.22(2)Ib)(1)Id)&(fl and 83.54(1), (2) & (3), Wisconsin Administrative Code. Owner/Buyer ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM SMK INTEREST LLC Mailing Address 17 STACY LANE MADISON WI Property Address 1563 140TH AVE (Verification required from Planning & Zoning Department for new construction.) City/State NEW MCHMOND N parcel Identification Number 012-1064-10-000 LEGAL DESCRIPTION Property Location NW '/4 , NE y4 , Sec. 30 T 30 N R 17 W, Town of ERI N PRAIRE Subdivision Plat: .O Certified Survey Map # , Volume , Page # Warranty Deed # ("'� p `Z,3 (before 2007)Volume Page # Spec house 13yesdto Lot lines identifiable❑yesOno SYSTEM MAINTENANCE AND OWNER CERTIFICATION Lot # �— 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 pm 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 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. 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 4 SIGVkTURP OF PPLICANT(S) t/� 41 �D ATE ***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) Nis. Dept. of Safety an Professi r S�e�020 ON- EV � �' S v p� 1 of 3 Division of Safety and uildirps in accordance vri SPS 385, Wis. Adm. Code Attach complete site 5`-Croix Ccunty Coady ST CROIX I�,t6�pt na2li 1 inches in size. Plan must include, but not limit re erence point (BM), direction and Parcel I.D. 012-1064-10-000 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. R viewed by I {n A Date Personal information you provide maybe used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). n .... RJ i Aid, (//& /' SHIRLEY MAYER /SKM INTEREST LLC I Govt. Lot NW 1/4 NE114 S 30T 30N R 17E 17 STACY LANE �.... y...w.o rirwe r.urnusn LFsy Uvillage Mown Nearest Road MADISON I W1 1 53716 1( 6g8-709-I218 ER -IN 1?RAIRL I 160THST ❑ New Construction OseQ Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD a❑ Replacement ❑ Public or commercial - Describe: Parent material LOESSES OVER LOAMY DRIFT OVER SANDY Flood Plain elevation A applicabe ft. General recommendations: GRAVEL OUTWASH . anddrecommendatioro: _k i w 6h �Je-..Ql1� X �g � St1g S.a•: ��a,tr 1❑ Bodng it 0 Boring r Q Pit Ground surface elev. 93.3 ft. Depth to smiling factor 112 in. Sol Application Rate Horizon Depth in. I Dominant Color Mundell Redox Description Cu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. aonsistence Boundary Roots GPD/ft ' fiY1 1RY2 A 0-12 10 YR 3/3 -------- — -- - SL 2MSBK MVFR CA 2F .6 1.0 B 12-28 7.5YR414 •------------ SCL 2MSBK M91 CA 1F .4 .6 C 28-40 7.5YR4/4 --•------------ S OMSG ML CA -- .7 1.6 Cl 40-I12 10YR5/4 ---- ---- - S OMSG ML ---- ------- .7 1.6 2 Borig# Boring 90.84 112 ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Horizon Depth in. Dominant Color Munl Redox Description Ou. Sz. Cart. Cola Texture Structure Gr. Sz. Sh. onsistence Boundary Roots GPDAI tff02 A 0-17 10 YR 312 ------- -- SL 2MSBK MVFR CA 2F .6 1.0 B 17-38 10 YR 5/4 ---------- SICL 2MSBK MFI CA IF .4 .6 C 3&52 10YR4/6 --------- S OMSG ML CW _ .7 1.6 Cl 52-112 10 YR 514 ----------------- S OMSG ML - .7 1.6 • Effluent R1 - BOD , > 30 < 220 mg& and TSS >30 1150 mg4. • Effluent 02 = BOD , < 30 mg lL and TSS ! 30 mg/L CSTName(Please Print) SignatureCST Number PAUL R KOEHLER 225410 Address Dale Evaluation Conducted Tebphone Number 321 WISCONSIN DRIVE NEW RICHMOND WI MAY28TH2O20 715-246-2660 SBD-8330 (RI 1/I 1 Property Owner SKM IN3 TEREST LLC parcel ID # 1563 140TH STREET page of Borg ❑ Bonng It ❑ pit Ground surface elev. 95.16 ft. Depth to limiting factor 112 in. sMAt . Horizon Depth in. Dominant Color Munsell Redox Description Ou. Sz. Cont. Color Texture Structure Gr. Sz. Sh. onsistence Boundary Roots I GPD/fl ' M#1 ff#2 A 0-13 10YR3/2 ------- ------------- SL 2MSBK MVFR CA 2F .6 1.0 B 13-30 IoyRS/4 ------- —------- ----- SICL 2MSBK MFI CA 1F .4 .6 C 30-40 10YR5/4 -------------- ------- S OMSG ML CA -- .7 1.6 Cl 40-112 I0YR4/4 -------- --------------- S OMSG ML CA --. .7 1.6 ❑ Boring # Boring pit Ground surface elev. ft. Depth to limiting factor In. Sol Applicaton Rate Horizon Depth in. Dominant Color Munsell Redox Description Ou. Sz. Con(. Color Texture Structure Gr. Sz. Sh. 7.onsistence, Boundary Roots ' GPDM ' R#1 ff#2 7 Boring # Boring Pit Ground surface elev. A. Depth to Gmiing factor in. Snll�k�rrLvr ' Effluent #1 - SOD , - 30 < 220 mWL and TSS -30 < 150 m91L ' EMuent #2 = BOO , < 30 mglL and TSS 130 nV& The Dept. of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to access services or need material in an altematc format, contact the department at 608-266-3151 or TTY through Relay. SBn-9330rm(Rn111) 140TH AVE HOUSE WELD I BENCH TWO BOOM OF SIDEING CORNER OF HOUSE .9 3Ac z = 5?. 9 i Nt 0 0 0 0 0 0 0 0 0 0 0 o g o 0 �- 0 0 0 0 0 0 e o ROW OF TREES CHICKEN COUPE GROUND SURFACE AT CORNER.95 81 FT B3 83(5.16 ) / CONTOUR 93 SYSTEM ELEVTION 87.54 SCALE 1'=40FT 105 FT BM 1 AT CORNER OF CHICKEN COUPE 200 _ QB2 ,( gq> BM 2 CORNER OF SIDEING AT HOUSE 99.95 (� BORING 195.16 �~ • 122 FT BORING 2 93.3 BORING 3 90.84 CONTOUR LINE 93.0