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HomeMy WebLinkAbout040-1005-95-001 (2)Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: Kent &Deana Lindahl City Village Township TOWN OF TROY CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM ELEVATION DATA County: St. Ct'OIX Sanitary Permit No: 624845 State Plan ID No: Parcel Tax No: 040-1005-95-001 Section/Town/Range/Map No: 03.28.19.34C-01 STATION BS HI FS ELEV. Benchmark Alt. BM Bldg. Sewer SUHt Inlet SUHt Outlet Dt Inlet Dt Bottom Header/Man. Dist. Pipe Bot. System Final Grade St Cover BEDffRENCH DIMENSIONS Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth SETBACK INFORMATION SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING CHAMBER OR Manufacturer: T e Of S stem: DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipes) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched BedlTrench Center Bed/Trench Edges Topsoil � Yes � No � Yes � No COMMENTS: (Include code discrepencies, persons present, etc.) Location: 653 DEERWOOD DR 1.) Alt BM Description = 2.) Bldg sewer length = -amount of cover = Inspection #1: Inspection #2: Plan revision Required? 0 Yes � No Use other side for additional information. Date Insepctor's Signature Cert. No. �I n 2 &�amp ere plans for the system a sub ` t a t �c C )� only n pap thin 8 )rz x I I inc Ies in size as per applicable cowdeiorSBD-6398 (1103/14) C:�OctGw `Vn`�A , county _- r;5 •� VI1 D Industry Services Division �^ st.Croix daa JO D S A` 1400 E Washington Ave � 1 P [D✓9 P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) S Madison, WI 53707-7162 1 0 $ Sa 1ttp it Application State Transaction Number In accordance with SPS 383`1 r me it ( It qaM t mission of this form to th '4Powvrs Are PWTS-062001014—G is required prior to bt 1) miit. Note: Application forts for state-ownedu ed to the Department of and Professional Services. Personal informatiA you prd"10 r secondary Project Address (if different than mailing address) purposes in accordance with the Privacy Law, s. 15.04 1 (m), Stats. 653 Deenvood Drive t 1. Application Information — Please Print All Information Property Owner's Name Parcel # pent K Deanna Lindaltl (Zvi\, 040-1005-954K11 Property Owner's Mailing Address Property Location 912 5"' Street Govt. Lot NW %<, NE'i4, Section 3 City, Stale Zip Code Phone Number Hudson, WI 54016 r le one) T28N R 19Eofo l II. Type of Building (check all that apply) Lot # Subdivision Name ® 1 or 2 Family Dwelling— Number of Bedrooms l NA ❑ Public/Commercial — Describe Use Block # [I City of ElState Owned — Describe Use ❑ Village of 10 3:o SM Nunt erDpC : Town of Troy 11I. Type of Permit: Che one box on lino A. Complete line S if a licabte A• ❑ New System ® R lacement System ❑ TreatnienUHolding'fank Replacement Only ❑ Other Modification to Existing System (explain) Q. ❑ Perrot Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before; Expiration Plumber Owner IV. Type of POWTS System/Component/Device: Chethat apply) ❑ NonTressurized In -Ground ❑ Pressurized In -Grow ® AtZrade�)o Mound > 24 in, of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) Pretreatment Device (explain) t V. Dispersal/Treatment Area Information D CCU Design Flow (gpd) 450 Design Soil Applicau ) Rate(gpdsO Dispersal Area Required (sf) 750 Dispersal Are 803 r se (sf) W Sys m ton / 0 CT6 p 0.6 VI. Tank Info Capacity in Gallons o 10 �v�,}_ _\ ('let c Total # of Manufacturer J A e w u U rJ400 New Tams Existing Tanks Gallons Units `oa U zr (� H Septic or HoldingTank 1000 1000 1 Unknown ® ❑ ❑ Dosing Chamber 750 750 1 Wieser Concrete ❑ VII. Responsibility Statement- 19 the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plum .'ign sire i MP/MPRS Number Business Phone Number John Schmitt (� l �/ ` ��� 223760 715-760-0486 Plumber's Address (Street, City, State, Zip Code) 586 Valley View Trail, Somerset, Wl 54025 Vlll. County/De artment Use Only Approved )rov fee, PeZP2 Dale L ug Age Si at r RDis cr Given eason for Denial IX. Conditions of Approval/Reasons for Disapproval 3� i6� is STEM OWNER: ^�r � lle�i, - �- 5y{ w "" l Septic tank, effluent filter and dispersal cell must be serviced / maintained 1LLUAMA�r&L 1kimo-M Ob Ce t AWras per management plan provided by plumber.All setba& SYSTEM PLOT PLAN Lindahl 3 Bedroom At -Grade Project Address: 653 Deerrrood Drive BM1 Symb 1: BM Elevation: ' BM Descd B 2 ymbol: Q BM Elevation: 100.00' BM Description: Comer of concrete patio Slope Gradient of Tested Area: (16%) Well Symbol (if applicable) Notes: See Plat Map for complete map 21'x100' At -Grade w! 11'x90' Cell 7% Delection Effective Length =84' 91.50 80' PVC force � m 61 � JT L N Q Q n. 1 97.50' Design Flow: 450 GPD Attach design flow calculations for commercial plans: Pipe Materials / ASTM Standard Tables 384.30-3 & 384.30-5 JUN 24 St. Croix Co ty Communitv Devi 4" SCH 40 PVC pipe ASTM- D2665 2" SCH 40 PVC pipe ASTWD1785 1 112" SCH40 PVC pipt ASTWD1785 Ei.=96.00' R/W Deerwood Drive Existing in field to be abandoned Proposed WLP750-MR Pump an Existing 1000 gal Septic Tank BM2 Driveway Existing 3 Bedroom Garage House I o III Deck over Concrete Patio Fenced Area NOTE: A soil application rate of .55 gpd/ft2 was used to force an effective length of 84 feet to ensure the At -Grade was sufficent in length. Juue 35 2020 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 2022-06-O3 Plan Review: PWTS-062001014-C JOHN F SCHMITT 616 150th Ave Somerset WI 54025 SITE: Lindahl 3 Bedr•ootn At -Grade 653 Deerwoud Drive Town of Troy Saint Croix County Total Amount: $250.00 FOR: Description: 450 GPD Maintenance Requited DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL GREEN BAY WI 54304-5211 Contact Through Relay htip://dsps.wi.gov/programs/industry-services www,wisconsin.gov Tony Evers - Governor Dawn Crim - Secretary Conditionally APPROVED DEPT, OF SAFETY AND PROFESStONAL SERVICES DIVISION OF INDUSTRY SERVICES i SEE CORRESPONDENCE At -Grade Component Manual -Ver. 2.0, SBD-10854 (N.03/07, R. I/12) Pressure Distribution Component Manual — Ver. 2.0, SBD-10706-P (N.01/011 R 10/12) The submival described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. he o owing conditions shall e me during construction or installation an pnor to occupancy or use: • Any tall grasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to prevent matting under the dispersal area. • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil. Proper soil moisture content can be determined by rolling a soil sample between the hands. If it rolls into a 1 /4- inch wire, the site is too wet to prepare. If it crumbles, site preparation can proceed. If the site is too wet to prepare, do not proceed until it dries. • It is recommended to cut as short as possible and remove ground cover prior to tilling the ground surface for the dispersal area. • Remove and maintain woody vegetation on or near the dispersal component to minimize root infiltration into the dispersal cells • Abandon the existing system components per SPS 383 33 • All piping shall conform to SPS Table 384.30.3 and SPS Table MUM • Insulate building sewers beyond 30 feet per SPS 382.30 (11)(c) A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/instal lation/operation. In granting this approval the Division of Industry Services reserves the right to requite changes or additions should conditions arise making them necessary for code compliance. As per state stats 101 a 12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, dit2aia (il/it8r�e�I Travis Wagner POWTS Wastewater Specialist, Division of Industry Services (608)598-0715 travis.wagner@wi.Qov AT -GRADE AND PRESSURE DISTRIBUTION COMPONENT DESIGN INIJF_X ANiO TITLE PAGE Project Name: Lindahl 3 Bedroom At -Grade t..,vtltJatoU11ci Iy Owners Name Al ROVED Kent &Deanna Lindahl DF12 0F= SAEErY AND PROFESSIONAL Owner's Address 653 Deerwood Drive SERVICES DUSTRY SERVICES Hudson, WI 54016 Legal Description. NW1l4, NE114, S03, T28N, R19W Township County T St. Croix Subdivision Name: NA Lot Number: 1 Block Number Parcel I.D. Number 040-1005-95-001 Plan Transaction No. SEECORRESPON©ENCE Page 1 Index and title Page 2 Data entry Page 3 At -Grade drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Dose tank specifications Page 8 Effluent filter information Page 9 Pump specifications and curve Page 10 Plot plan Page 11 Septic tank maintenance agreement Page 12 Existing Tank Certification Page 14 CSM Attachment Soil evaluation report Designer John Schmitt License Number Date: 5/25/2020 Phone Number: Signature Designed Pursuant to the At -Grade Component Manual for POWTS Version 2 0 SBD-10854-P IN 223760 715-760-0486 03/07) and both SSWMP Publication 9.6 Design of pressure Distribution Networks for ST-SAS IOtI$1 i and Pressure Distribution Component Manual Vey 2.0 SBU- 10706-P IN 10/0112) Version 7.0 (R 11/2012) Page 1 PRESRIZED ATADE DESIGN r�r.�iJs 1', 11(�U t. Flaws and Site Data Entry. -• r Kesidenpai 0r commercial'' 300.0':Estimated wastewater flow igpd) 450 0 Design wastewater flow (gpd) 16.00j% Site slope 96.00?Contour elev. below lateral (ft) 36.00 Depth to limiting factor (in) 0.56'In-situ soil application rate (gpolft^2) Distribution r_ eIi information 1', Influent wastewater quality 10.00! Linear loading rate gpolft 9.00 Effective absorption width (ft) 10,00 Max effective width permitted (ft) 90 00 Aggregate length (ft) Pressure Distribution Data Entry �---mac' Center or end lateral connection t� Number of laterals 0.188' Orifice diameter (in) e g 0 25 2.00' Estimated orifice spacing ift) 2.00 Forcemarn diameter (in) 3 10 Forcemarn flow velocity (ft/sec; 80.00 Forcemarn length (ft) 86.00 Pump tank elevation tftl 3 25 9 50 1.59 0.50` 14 $4 i T System head (ft) x 1.3 F Vertical lift (ft) riction loss (ft) nAne Filter Loss (ft) otal dynamic head (ft} Lateral Diameter Selection Pipe diameter Desrirn opt.+���. Desun cnarde 1 in 1 5 in X X 2 rn X 3 in I X Effluent Filter Information Polylok ',Filter manufacturer 525 Filter model number Project Lindahl 3 Bedroom Transaction Number Y Y 130 40 5 Does forcemain drain back? Are laterals at highest point? NA x Forcemarn drainback {gal} 5Lateral void volume (gal) MlnimUm dose volume (gall Systen, demand (gpm) Gallonsllnch Calculator '.Total Tank Capacity (gal) 'Total Working Liquid Depth (in) Treatment Tank Information 1000,Septic tank capacity (gal) Manufacturer Dose Tank Information 750.0, Dose tank capacity (gall 20.3Dose tank volume (gaUrn) Wieser Concrete Manufacturer Page 2 A l "GRADE PLAN VIEW Observation pipes i2 typical) D �; =Total aggregate cell A x B = Plowed area L x W Synthetic fabric cover Lateral Invert elev. 96.50 ft urtace contour - 96.00 and system elevation A B 1 /6 B C D E L t IV AxB 9.00 90.00 15.00 Typical obs oipe Slotted in the tower 6' and anchored securely AT -GRADE CROSS SECTION E C 0 L ► = 12 in. topsoil and subsoil Q`ler ar�gfPf�afP anti t8r'PfPd f!) tnefi 0 = 6 in. aggregate below pipe(s). and 2 in. above pipe. Project: Lindahl 3 Bedroom Transaction Number: Finished grade elevation ft ft ft^2 ft ft ft ft Observation pipe Plowed layer i)C10':.L '1 `,V Page .s PRESSURE DISTRIBUTION AND DOSE TANK Lateral Diagram 11 Center Connection 6' xe Y Lateral Specifications 0.188 Orifice diameter (in} X 1 25 Orifice spacinq (ft! 23 Orifices/lateral P 15.2 Lat. discharge rate (gom) 30.41 Sys. discharge rate (gpm) 14.84 TDH (ft) F�nai grade UUeather-proof ji+rt0?. SJ n � _ . rank component is Frope�ly +tented Elecincal as per NEC 300 and SPS 31� 30G WAC o q ^N B E C a D Totals Inches Gallons 203 4123 2.0 406 26 12.0 535 2436 36 9 750.0 Center 43.88 1.50 �.00' 80.ao Lateral connection point NUmrar litera+� Lateral length (ft) La diameter (in) FOi�emat+l diameter (in, Forcemaln Length (ft) Typical Pump Chamber Layout Tank fi+3f '— A Alarm on Pump on B a7 00 ft C Pump off D �_ s rseaamg unaer tanK - Zoeller PUrnp manufacturer 98 Pump model number Protect Lmdahl 3 Bedroom Transaction Number disconnect Approved manhole cover with �,rarn,ng abet and tock+ng device 4 Alternate ��_, Outlet location I Approved ouliet joint Provide 1 4 weep huge of anhs+phvn device SJE Rhombus Alarm manufacturer 1036378 Alarm model number Page 4 At -grade System Maintenance and Operation Specifications Service Provider's Name John Schmitt Phone`715-760-0486 POWTS Regulator's Name St. Croix County Community Develop Phone,715-286-4680 Design Flow -Peak Estimated Flow - AvArme Septic Tank Capacity oil Absorption Component Size Type of Wastewater S Septic and Pump Tank ElfluF;nt Fiiier Pump and Controls Alarm Pressure System rVI ' <t i :d Systeirt Flow and Load Parameters 450 _300 10DU 803.E Domestic gpd Maximum Infl�ient Particle Size anti M�rimiim 13(lD5 gal Maximum TSS ftz Maximum FOG Maximum Fecal Coliform Service Freauencv l Ins ect and/or service once eve 3 ears (nE, i, 3r' Test once ever 3 ears Should test month) Laterals should be flushed and pressure tested ever 1.5 ears Misceltaneous Conslructiun alto 1Viaterials 5tali�ial�is 4 mnjL mg/ mg/ cful100 mL i t�i,s;.,V.ihrri I,p�� :�r�- s�, ;t ! i ;�::ls :ofr,n_�. E ��'S �F,i _`i 1, av• �, �: ittr;h'. +:,up and 8re sP.cored in as Shown in the eqt-(grade component nlanlial ? nlcpersal cell aggregate conforms to ;P. 0184 30 (6)(0 Wis Arim r.orte J. mli gla'vliy and p(eSSUie plpIng mateiiais t oidoin, to iht rt4Wit i,mcnta it JP %j o64 Vvis %-Will trOoe. 4. Tillage of the basal area is accomplished with a mold board or chisel plow 5 The at -grade structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration 6 Areas within 15 feet of the downslope toe will be protected from compaction 7 All other construction details are as per the at -grade component manual SBD-10854-P (N. 03/07). Lateral Tura-ui� r�etait Finished • . � , , , ....... • Grade sir F-8" Diameter L awr ----i Distribution 96 50 ft Project Lindahi 3 Bedroom Transaction Number ............... '"---�4--- Threaded Cleanout Longg Sweep 90 or Two 45 De tee Bends Same Diameter as Lateral Page 5 At -grade System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382-384 Wis Adm Code. and shall maintained in accordance with its' component manuals (SBD-10854-P IN 03/07. R 01/12) SSWMP Pub. 9 6 (O1r81) and Pressure Distribution Component Manual Ver 2 0 SBD• 10706 (N 01101 R 10/12)j and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death �aptii.Ifi tf. a, ., + ',i.. _.. 1V PUVVTS components rq Septic or pump tank manhole risers. access risers and covers should be inspected for water tightness and soundness Access openings used for service and assessment shall be sealed watertight upon the completion of service Any opening deemed unsound defective or subject to failure must be replaced Exposed access openings greater than 8•inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s 281 48, Slats The contents of the septic tank shall be disposed of in accordance with NR 1 13, Wis. Adm. Code The operating condition of the septic tank and outlet filter shall be The outlet filter shall be cleaned as necessary to ensure proper operation the filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. if the filter is equipped with an alarm. the filter shall be serviced if the alarm is activated continuously Intermittent filter alarms may indicate surge flows or an impending continuous alarm The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1 r3 the liquid volume of the tank If the contents of the tank are not removed at the time of a triennial assessment maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank The addition of biological or chemical additives to enhance septic tank performance is generally not required However if such products are used they shall be approved for septic tank use oy the Department of Commerce Pumu Tank The pump idosinyi tank shall be inspected a1 least once every 3 years Ail switches alarms and pumps shall be lested to venfy proper operation If an effluent filter is installed within the tank it shall be inspected and serviced as necessary At -grade and Pressure Distribution 5vstem No trees or shrubs should be planted on the at -grade Plantings inay be made around the al grade's perimeter and the at•to shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration Traffic (other than for vegetative maintenance) on the at -grade is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter vrrll promote frost penetration Cold weather inatallaizns iOctober•February) dictate that the at- grslrle hP heavily mitwheri AS rmtprtinn frnm frPP71nn .�e!„y.7d�tJ i1D7 at a! aoa mg(L BOD5 30 mgrl TSS 10 mglL FOG and 10' cfu'100 mL for highly treated effluent Influent flow may not exceed maximum design flow specified in the permit for this installation The pressure distribution system is provided with a flushing point at the end of each lateral and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell Observation pipes within the dispersal cell shall be checked for effluent ponding Ponding levels shall be reported to the owner and any Iavels shove 4 inches considered as an impending hydraulir failure requiring additional morp frequent monitoring Corittngr-ncy Flan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition If the dosing tank pump, pump controls alarm or related wiring becomes defective the defective componentist shall be immediately repaired or replaced with a component of the same or equal performance If the at -grade component fails to accept wastewater or begins to discharge wastewater to the ground surface it will be repaired or dispersal media. installing new piping. and replacing other components as deemed necessary to bang the system into proper operating condition See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider Project. Lindahl 3 Bedroom Transaction Number Page 6 L Ln J en-Mm :3113 SbB—S7S-00� c \ df10d-1SOd 31V0 00 00 00 31v0 OSLtIS .R '.a %0 N]HlVW O1 iwti q sn 9l4iM Z \ �— "38 313d�l10� �vnNVN DI1d3S enOd-3Md „0-,1=„4 t 3lVOS d0M �8 NMVaO 13531M r 21W-09LdIM N X. Lij Li F j Vt of Z _H < j O O z > i w 0 ' z c> t� 0 w Jw O O m C� 1 j O 4 0 Of Z 0 N m U) I m I r U W F LLJ J OJ J 3 /1 Q p F- p X o Li O 1- J Q Q r w Q w Qt O O m o' Q Z_ 0 d � U � W a w cr LLJ to �O Ow dU Q 0)� N a LLn ZO LL a y v 0 oC p m to J 1— w Ca C9 Z O U a o D I L�ww (� O \ zN a Q o p0w�Mm Wa W�N �J c V) Y ® a FF-- a( V) Z LLJWW a O Q (p O Q Z ¢ ct t �. r, O 1 V1 m (n F- N d W "Co o yk:� �Ul �oW>t0 FaU �ZN i d0 U) o 0Z Y jIIIIIIU z 0 Zo WLJ ZLLJJ OInW Ozo U z JF- V1 w U oW fQ—O �OCYz=�000= o�vYi oUw p <j?Ly o m Fti. LL) �¢ooQw�wc�i��.1 zt d z�'o Zdc z � �o �3mUmYOmD d<tc� Q� 1? F 1- O o s 1 O it J d YZ o Z O OJ H 0 H U w d I d � s � f z w w LLJ LLJ {{ tY, m - v i p w o Li w i w o U a t � „V9 u3b1;1C332i Sb „t: z d w va Y z d F- Page 7 a FILTER PRESSURE FILTER INSTALLATION & SERVICE INSTRUCTIONS L.ttit,,,4"\.,,,v-,_nP ,u,,„_ n,r.nrt'�i1.III»4-i. I,t�_Ei.: � =J �. INSTALLATION: When installing an STF-100, screw filler into discharge port of any pump that has a 2" National Pipe Thread. Pumps with a smaller discharge port may be adapted to fit. When installing an STF-100A2 a tailpiece and male adapter will need to be added to the inlet end of the filter fend opposite of the cap) to the desired height and a 2" union will need to be added to the outlet end (the end closest to the cap & on the side of the filter). Always install the filters in a position where they can be easily serviced. '"Always use caution when starting threads to avoid cross threading". Plumb force main into the 2" sch 80 PVC union. "We recommend that the union remain together during gluing to insure that glue or cleaner does not ruin O-ring or sealing surface'- 5ERVICE: Service of filter screen is dependent on usage as every system is unique. For most residential systems we recommend inspecting the filter within the first year to determine the necessary service intervals for the filter. In high volume systems we recommend inspection within the first 6 months to determine necessary service intervals for the filter. Once the service interval is determined it should be consistent unless something changes in the system. Always inspect the filter screen for any damage or corrosion and replace if necessary. If our STF-101 service alarm switch has been installed and adjusted property it will alarm when the filter requires service. it should be serviced no less than when periodic pumping of the septic tank and pump chamber is performed. Servicing will be more frequent if using any one of our optional filter socks (600 micron, 150-190 micron, and 100 micron). Check your local health department for septic system servicing recommendations. If the screen becomes clogged before the periodic pumping requirements, a high level alarm or light will indicate the need for service. If system is equipped with a 'pump on lightthat stays on longer than normal, this also may indicate a need to service filter. To service filter screen, unscrew the =t' cap. Pull filler screen from canister and wash out thoroughly in appropriate location with proper protection. In some cases an additional filter screen allows quicker service allowing the dirty filter to be washed later at the shop. Note that in cold conditions the filter cap may be difficult to remove. Keep the filter in a warm area or pour warm water over the cap before removing. Once the filter is installed in the tank it maintains a stable temperature and removing the cap will not be a problem. If the system IS equipped with our Service Alarm Switch, the biter screen does riot need service until the Service Alarm Switch activates a light or audio alarm. We s I recommend that the filter be inspected once a year for damage or corrosion. NOTE: The total dynamic head loss of the system must be increased by 0.5 feet of Plead to overcome traction loss through the filter. SERVICE ALARM SWITCH The alarm switch is available rn three pressure ranges, low head, medium head, and high head Installation is simple. on SIMITECH FILTER systems, remove'/." plug from base of fitter chamber and connect tube fitting. Next, run the tube up into the tank riser and connect to service alarm switch. The alarm switch is fastened to the side of the riser via the nylon strap provided. Run alarm wire to alarm box. The service alarm switch can be wired with its own alarm or with the high water alarm, turn equals approximately 3 PSI. The low (read alarm switch comes factory preset at 8 PSI and is completely field adjustable within it's range (3 to 24 PSI i. We recommend the rise of a Batt valve when using an alarm switch Once you have installed the filter and alarm switch, the ball valve can be closed off to simulate a phrgged filter so that you can make sure the alarm switch is working correctly. "`"TRY OUR LIDlSCREEN REMOVAL WRENCH. Our wrench holds filler lid firmly and hooks screen for easy removal and installation Made of PVC plastu.. WARRANTY All products are warranted against defects rn material and workmanship for a period at two years from the dale of purchase. in no event shall GAG SIM(TECH FILTER• INC. be liable (or any consequential damages or any labor, material, freight or expenses required to replace. correct or reinstall the product. GAG SIM/TECH FILTER. INC 's liability is limited to repair or replacement of the part. All warranties are void if the product has been improperly modified, applied or installed, subjected to misuse or abuse. Except as stated herein, there are no warranties expressed or implied, including the warranty of merchantability or warranty of fitness for a specific purpose. EFFECTIVE September 13, 2005 ar w It At {t vr,t�o i TERS ii $'J 3fiti F ti;+ PER MINUTE Electrical alternators. for duplex systems, are available: and supplied with an alarm Mechanical alternators, for duplex systems, are available with or without alarm switches 98 Series Mode! Volts•Ah _ Modes _ Au,6 N'sb Woi -- DbfiYLdU + AJ!o Ly,, z sn _ Non Control Selection _ _ Amps-� Simplex Duplex b 1 integral float operated mrschantcai switch. no extersat cunUol requ,red For automatic use s!nyle p�yggbark ,arr;�bie revel float switch or douGte Piggyback variable level float slmu,! Refer to FM0477. 3 Soo FM1228 for correct model of simpler uwlrot panei d Sr.0 FM0712 for correct model of dupietc conlrol pane' or r' IKE,a for a residennai altornawf systen! c�.:,.; ire 8a4,,,, FMr14R7 �:qgt• Ph3�r' S!�r':3pf ?'.tin;, r,:r,n, s.. �kesr,4, ld,u'r' q;:rs.,3,3 F�4't,"31 7A CAUTION TnTAL DYNAMIC HEADIFLOW PER MINUTE EFFLUENT AND DEWATERING MODEL 98 Kcal hleten Gal' L+le+s t 7? —7d --�-- q it - + read -- ' !t r :;m �lariable level float switches are available for conlroiliny single and three phase systems Dry ibie piggyback variable level boat switches are available for variable level long cycle controls Refer to FM 1922 and FMO806 for temperatures above 130 F i 'Easy as�etifbl�r" d ,b Reduc-es r>ntent+al r:+nggtn,a by debris Maoe c' durable nr_auorrnsh;a r,SS Pa+se, out=r+ 2' :�H brtt{rm o! hasty; Prov+des the abl'!ty % raise Intake b., adding sections of t �r 2' PVC piping ritt30nes sZ;:U{elt `,0 pW A+�cr,!=,rnudafes Sunlit). deNaleong and effluent appitcat!on, NOTE: Make sure float is tree front obstruction For unusual conditions a reserve safety factor is enyuieered into the design of every Zoeller pump. MAIL TO %r7, SHIP TO r 41JJ! n PUMP ;j,.!� Ui t <'M1',,7 1GY rill �t www.zoelreccom t;upyrryht 74.'oeliir Cu All r;ghls reserved ST. CROIX COUNTY � � � � � �� D SEPTIC TANK MAINTENANCE AGREEMENT AND JUN 2 4 2020 OWNERSHIP CERTIFICATION FORM St. Croix County Kent &Deanna Lindahl Community Development Owner/Buyer _ -- Mailing Address 9 � 2 5th Street, Hudson, WI Property Address 653 Deerwood Drive - - - .- - _ (Verification required from Planning &Zoning Department for new construction.) City/State Hudson, WI parcel Identification Number 040-1 ��5-95-��1 LEGAL DESCRIPTION Property Location N W %a , N E'/4 ,Sec. 03 , T 28 N R 19 W, Town of Troy Subdivision Plat: Certified Survey Map # _ Io3 O, j �i ,Volume _c��" Warranty Deed # _ IO 3�� Spec house I]yes�to (before 2007)Volume Lot lines identifiable dyes❑no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Page # �ZZ.�_ Page #. Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §SPS, 383.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance, The 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 ays or the tnree year expu•atron date. I/we certify that all statements on this form are true to the best of my/our knowledge. I/we am/are the owners) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedroums j 3 SIGNATURE OF APPLICANTS) .._/_/� DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning &Zoning Departement. *** 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) Page 11 SI . k- RMA k- M ANTlzO ING OFFICE CERTiFICATlO� S'I'ATE�IENT FOR U'i'I LIL:1TION OF EXISTING SEPTIC TANK(S) This is to certify thal 1 llLII%W IIl;illeeted the existitl�f scptii anchor dosc tank presently serving the following residence: (Street address) 653 Deerwood Drive _ _ _ _ located at: NW 'i�i, NE 1 /4 Sect1011- -03- — . l 0��11 28 N. Ra114`c 19 [ 0\%411 of Troy _ , St. Croix County Wisconsin. Upon inspection, 1 ccrtily that I have Blond the tank(s), to the hest ol'im knowledge, \1'III conform to the reclulrements of SPS. '184.25, and it (tile A) appear(s) to be functioning properly. Must recent �Irttc ofinspection ur service Did flow bael: occur from absorption system:' tif'no, skip next line.) Approximate volume or length ut'tinlc: _ - Tallk Capacity: 1000 Construction: Prefab Concrete Steel Iatlll tacttlrel" (i f known ): - ---� — Age of Tank ofknown): ---- __ Permit nunlher (if known) {Licensed Plt.rmber Signature) ("[�itle) (Hate) Yes No _ gallons Of her John Schmitt. (Print Nillllt',) L nlinutcs (License Number) MP/MPRS Form to be completed by licensed plumber (Dept of Safety and Professional Services Chapter 305 Auld s. 1=)a.Ob. Wisconsin Statutes) ur- licensed c[ispuser (NR 113 Wisconsin Administrative Code) Rey•. �AIM,012 Page 12 1037070 State liar of \\'isconsin Form ti-?003 PERSONAL REPRESENTA'ffWS DEED llurumrnf tiumiui THIS DEED, made bt vveen Keith \\'. 1 rank t )Ui Un1C111 Vamc as Personal Representative of the estate oi' Donald A. Uobis {•'Decedent" }. ("Grantor," whether one or More), and Kent 1. Lntdahl an(I Deanna L. Lind toll. as inarilal prow with rights of surwi\`urshin ("Grarnee." twhether unc or more}. Granlor conveys to Grantee, \cithuut %%arraim, the following described real estate, together with the rents, profits, fixtures and other appurtenant inlerests, in St, Croix Counry, State of "lisconsin ("Propert}1(if more space k needed, please attach addendum): Lot of Certified Survey Map recorded in the Register of Deeds Uftice for St. otx County. \\'I, an ,tune 10, 2016, in Volume 27 of Certified Survey Maps. Page 6221. as Document No. 1030376. located in the Northwest 1 !4 of the o� rtl)ea;t 1114 of'Section 3, fotwnshi1) 28 Nt rth, Range it) \Pest, -frnwn (A 17m. St. Croix Count-\. Wiscollsirl, BETH PABST REGISTER OF DEEDS T. CROIX CO,, WI RECEIVED FOR RECORD 10/11/2016 10:S9 AM EXEMPT#: REC FEE: 30,00 TRANS FEE: 390.00 PAGES: 1 ' •The above recording information verifies that this document has been electronically recorded & returned to the submitter Rcr;�rding r\era \nmr and I(etum Addrc4s 1\ illiam J. Iladoscvich 502 Second Street I Judson, \VI 54106 O�10- I OUi-y5_OIl ) 1' rnl Idoniifiranon Number 111I14) hunr.par;td prupert) !a) rrs nau Personal Re)orescntatiwr by This Uecd diva t:unwe} to (iraluee all of the estate and interest in the Pruprrt� wilit:h Decedent had immediately prior to Decedent's death, and all of the estate and interest in the I'ropem which the Personal Representative has since acquired. Dated Cltaober 10. 201 b Pe160N,vL RCPKESEN'r.al'lvr:: t! j1� �10 /i..ti * Keith \\'. Frank AUTHENTICATION Sit,nature(s) Keith W. Frank, Personal Rcnrest nlie Estate of t)conald A Uobis authenticated on (.)etolier 110 . 2016 " \Villiam J. Radosevirh 1'ITL.F: MF,�•ilii-,R ST�V`ff:' (_3AR OF V't'ItiCt�NSiN (1f not, Wisconsin Slate 13ar # I U 1281 authorized by is. Stat. § 706,06) �tl 11S 1NSTRLiMEN F' DFLAFJCLU t3ti': William J. Radosevich S02 Second Street, Hudson. Wisconsin 54U16 ACKNU\�+�LEnctiFEN r ti1N S I A"fl� CIF \L'ISC'r)N cot)NTv' lath came before me on the above -named to me known to be thL persun(sl who e\el'ute<i the li,rcgoing instrument and <trknowirdged the s<unr. N ntar•. Public. Slate of \1'isrnf)sin [�`tv ���nnnissiun is permanent (Nil;nafarrs Ilia) hr authenticated or rtrl.nm,Irdl;ed. 131ifh ;ere not nt•cessrtr'ti.l COI C:'ftl151'+:5 51.511►:\liU rt)Itll. :►V5' S10U1f1'1tU\ti 10 fills FtiR51 SIIUI'Ln QG ('Lt•:AKLS II)EN'fIPIEU. t'Ii11�0i:5L REPItE51:N"I'.1l'15'E'ti Uta:!) i :p113 ti 1':5T[, BARBARtOF51`15('r)\S1\ F'Ott11 \'O, i.?rI11J ' I ype nnmc belos+ sipmures St Croy! Count/ tGj7U7C7 Page t rat 1 Page 13 CERTIFIED SURVEY MAP LOCATED IN PART OF THE NW1/4 OF THE NE1/4 AND PART OF THE SW 1/4 OF THE NE 1/4 OF SECTION 3, T28N, R19W, TOWN OF TROY, ST, CROIX COUNTY, WISCONSIN; BEING LOTS 1 AND 2, CERTIFIED SURVEY MAP VOLUME 11 PAGE 3137, DOCUMENT NO. 547248, I IF } FIFO, I C 1 ---N82"5219 E 78.39 — -- - -- — — LOT 2 f08,883 SO. FT. 2, i00 ACRES 1qJ CIEAR wI IJ►I�, f 06/01/16�n��Np suF� s >c bpi �, i:, r ,•p:,t. O o LO f f2, Ise SO. FT. Z 575 ACRES 11RAI' .. 13T68' N89' 58'39"�^J ;15ti {F9' 5590'00'OOW 3565T) - — — — — SCALE ! = F;?0 "*mrmn+w.•.- x, BEARINGS ARE BASED UPON THE ST CROIX COUNTY COORDINATE SYSTEM 1030376 BETH PABST REGISTER OF DEEDS ST. CROIX CO„ WI RECEIVED FOR RECORD 06/10/2016 12:35 PM CERTIFIED SURVEY MAP VOLUME: 27 PAGE: 6221 REC FEE: 30.00 PAGES: 2 I (S88'54'00`E I �815 00 t..E i,t. fir. � PREPARED FOR: ,N,00 KEITHFRANK 00 651 DEERWOOC DRIVE HUDSON WI54022 oD z SURVEYOR: TY R DODGE S 8 N LAND SURVEYING um 2920 ENLOE ST STE 104 HUDSON WI54016 �I I NE CORNER _ SEC 3,T26N.R19W ALUM IRON LEGEND W U 'I FOUND COUNTY SECTION o c 0 1 w v 2 " W CORNER MONUMENT AS NOTED S ` FOUND 1•',4 UUT$(OE N DIAMEIER IRON PIPE _ N89'57'31 W , SET 1'OUTSIDE DIAMETER BY t8` 76.29' 1857 10' —� LON L85 G IRON PIPE. WEIGHING ' 13 NSW57'31'W N PER LINEAR FOOT S90'00 W VJ rn PREVIOUSLY RECORDED AS Z Vote, IhrS (Crti''1'd Sufvey N1al) r` 0 1 w v 2 " W CORNER MONUMENT AS NOTED S ` FOUND 1•',4 UUT$(OE N DIAMEIER IRON PIPE _ N89'57'31 W , SET 1'OUTSIDE DIAMETER BY t8` 76.29' 1857 10' —� LON L85 G IRON PIPE. WEIGHING ' 13 NSW57'31'W N PER LINEAR FOOT S90'00 W VJ rn PREVIOUSLY RECORDED AS Z Vote, IhrS (Crti''1'd Sufvey N1al) r` Stale Number DRAFTED BY Radws Len !h Central An 1e Chord Beanng Chord Len 1h ?Arc Len th ,Tangent in Tangent Out Cr 273.5 57 08'164OG' N87'004290E 394 ;w' ' 194 68' N82'52'29'E S8R"51 31'E 1.0T 2 2735 52 0410539 N84'55 18 5'E '95 41 1"47 N82`52'29"E � N86'58 GB E LOT 1 273552 04`t021' N89'03105'E 19917 19921' N85`58'00It: 588'5V3VE 7)'hrrlltiL' PROJECT NO 7479.001 GATE Oaj29Fi0+E SI-IEET 1 OF 2 Page 14 Wisconsin Department of Safety and Professional Services Division of Industry Services SOIL EVALUATION REPORT In accordance with SPS 385, Wis. Adm. Code Attach complete site plan on paper not less than 8 112 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 ail information. Property Owner Kent & Deanna Lindahl Property Owner's Malting Address 653 Deerwood Dr. City State Zip Code WI 1 54016 i Pag� 1 of � County St. Croix Parcel I.D. i 04O-1005-95-001_ Ref #2553 Reviewed by- Date / Law, s. 15.04(1)(m)). Property Location Go 4. Lot NW Y. NE X S 03 T 28 N R 19 E (or) >�V Lol # ,._ 01 Phone Number ❑ City (239) 888-5191 Block # ❑ Village Subd. Name or CSM# CSM Vol. 27, Pg. 6221 ® Town Nearest!Road New Construction Use: ®ResidentiallNumberofbedrooms 3 Code derived design flow rate 9�Q GPD ® Replacement ❑ Public or commercial - Describe: Parent material Glacial driftl Flood Plan elevation if applicable Da It General comments and recommendations: Dispersal call infiltrative surface cannot be installed in cemented soils as per SPS 383.44 (4)(a)l d., eliminating suitability of site for in -ground POWTS Site suitable for AT -Grade or 6" mound. Design contour = 96,00'. I 1 I Boring # ❑ Boring ttLLL � ®Pit Ground surface elev. 91.95 ft. Depth to limiting factor 36" in. Soil A lication Rate i Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 In Munsell Qu, Az, Cont. Color Gr Sz. Sh j "Eff#1 eEfi#2 1 0-10 10yr3/2 none sit 2fgr mvfr cw 2fm1c '0.6 0.8 J 2 i 10-15 1Oyr3/4 none sicl , 2fsbk mfr gw lfmc ;0A 0.6 3 15.27 t0yr414 none sicl ifsbk mfr cw 1vf,f V2 0.3 4 27-36 7.5yr4/4 none cost lmsbk mvfr cw 1vf,f 0.4 0.7 5 36.69 7.5yr4/6 & 10 r4/4 none is w/ Ifs bandin osg/Om mllcemented ow 0.0 0.0 6 69.98 & c2d 7.5yr5/8 is Ifs Osg/Om ml/cemented 0.0 0.0 1Oyr4/4 10 r4/4 - _ ban I 2 � Boring # ❑ Boring ® Pit Ground surface etev. 96.80 ft Depth to limiting factor 4Q" in. ._ 'Soil A IicaGon Rate orizan Depth Dominant Color Redox Description Texture i Structure Consistence Boundary Reots � GPD/Ft`" in. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. •Eff#1 ( 'Eff#2 1 0-15 10yr3/2 none sit 2fgr mvfr gw 21mic '0.6 0.8 2 15-30 10yr4/4 i none scl lmsbk mfr gl 2fmc iO,2 0.3 3 3040 7.5yr4/4 I none sicl 1msbk mfr cw 2fm1c 10.2 0.3 4 40-55 7.5yr4/6 f2f 7.5yr5/8 sills mix Om/Osg mfr/ml ew 2fm 10.2 0:6 15 55-71 10yr5/6 m2d 7.5yr5/8 LSBR/0 na na ; - ``'0.0 0�0 >50 1' I j - tmuent 81 = rsL)u, > jo s zzo m / an r ss 3o s 15u m /L ?Effluent #2 = BOD > 30 5 220 mgil. and TSS > 30 � 150 mg/L CST Name (Please Print) Sign ure CST Number ( James K. Thompson �-- 30021 � Address o06ate Evailuaiion�ConducWd i Telephone Number 340 Paulson Lake Lane, Osceola, WI 54020-5413 September 26. 2019 ! (715) 2484767 I SBD•8330 (R04/15) 3 ! : Boring # ❑ Boring ® Pit Ground surface elev. 93.66 ft. Depth to limiting factor 45" in. i r— aou Hppncauon mate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 In. Munseil Qu. Az. Cont. Color Gr- Sz Sh. i --_ 'Eff#Z 1 0-23 1Oyr3/2 none sit 2fgr mvfr cs 2fm1c P0.2 0.8 2 23-31 10yr4/4 none sicl 1fsbk mfr cw 2fmc 0.3 �3 31-39 7.5yr4/4 none sicl 1msbk mfr cw 1fmc 10.2 0.3 (; 4 3945 7 5yr4/6 nnone cost lmsbk mvfr Cw 1fm 0.4 0.6 5 45 76 10yr4/6 & 10 r4/4 f2d7.5yr4/6 Is w/ Ifs bandingOsglOm MI/ cemented 1vf 0.0 0.0 Boring # ❑ Boring ❑ Pit Ground surface elev. —, ft. Depth to limiting factor in. -- Horizon Depth In Dominant Color Munseil I Redox Description Ou. Az. Cont. Color Texture ! Structure Consistence Boundary Roots Gr. Sz. Sh GPD/F112 Eff#1 11 i 'Eff#2 i Boring # � Boring ❑ Pit Ground surface elev ft. Depth to limiting factor in. r I Son A lication Rate Horizon Depth � Dominant Color Redox Description Texture Structure 1 Consistence Boundary Roots ' i GPDlFt2 In. i Munseil Qu. Az. Cont. Color Gr Sz. Sh. 'E(f#1 4Eff#2 - — i i I ' Effluent #1 = BOD, � 30 s 220 mg/L and TSS > 30 s 150 mglL ' Effluent #2 = BOD, > 30 s 220 mglL and TSS > 30 s 150 mglL Jai/ p✓R/c(0.�'an/oid �EXis�n9 �r ode eltr! 'e�„edW ea,101,G'4da(l 1G5p3betrwCocize6 !,/udjrr% v?/, 5vmo (� � Lobo; C-srn,/,l• z7iJ,G21✓, ll `J /1�vYyr,A�fi.sc�. o,�� T,ze�tr Ve oyl PC% Igos!o-loos-9s-�i bt,nj 2.57�acr«s �.1 � f r l; i� � �ot /i•C r I /t r! I� 1� E,Y.36nt% CtenEr't�[ d 1�44,�� 82 r Qcsew d.yJ Axe E,tjs+✓'rt y Corncro f cAmcr w!/1 J �af,'o. 4 6samGd BJtlh = /049•Q9; LC.oncireAe�ki�,'o a E ;- ^,��f �� oc! 32 b Wisconsin Department of $afe�y and Professi nal Services V Page 1 of 3 kt�� g Division of Industry Services . DEC 3 2019 SOIL EVALUATION REPORT in accordance with SPS 385, Wis. Adm. Code County County St. Croix Attach complete site plan on �� er rio�,l g,1hrdn_ 1/2 x 11 inches in size. Plan must include, 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. 040-1005-95-001 Ref #2553 Please print all information. R viewed by ate Personal information you provide may be used for secondary purposes Privac Law, s. 15.04 1 m /p . d 24 Property Owner Property Location ❑ Kent & Deanna Lindahl Govt, Lot NW %< NE '/, S 03 T 28 N R 19 E (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 653 Deerwood Dr, 01 Na CSM Vol. 27, P . 6221 _ City State Zip Code Phone Number ❑ City El Village ®Town Nearest Road Hudson WI 1 54016 239 888-5191 I I Troy Gilbert Rd. ❑ New Construction Use: ®Residential / Numberof bedrooms 3 Code derived design flow rate 450 GPD ® Replacement ❑ Public or commercial - Describe: Parent material Glacial drift) Flood Plan elevation if applicable na ft. General comments and recommendations: Dispersal cell infiltrative surface cannot be installed in cemented soils as per SPS 383.44 suitablilty of site for in -ground POWTS. Site suitable for AT -Grade or 6" mound. Design contour = 96.00'. Mt4t . (402.) s.,, OgLt., ( WL,C2 ) 1❑ Boring # ❑Boring ® Pit Ground surface elev. 91.95 ft. Depth to limiting factor 36" in. eliminating Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 In, Munsell Qu. Az, Cont. Color Gr. Sz. Sh. *Eff#1Eff#2 1 0-10 10yr3/2 none sil 2fgr mvfr cw 2fm1c 0.6 _ 0.8 2 10-15 10yr3/4 none sicl 2fsbk mfr gw 1fmc 0.4 0.6 3 15-27 10yr4/4 none sic[ 1fsbk mfr cw 1vf2f 0.2 0.3 4 27-36 7.5yr4/4 none cos[ 1msbk mvfr cw 1vf,f 0A 0.7 5 36-69 1 Oyr4/4 & 10 r4/4 none Is w/ Ifs banding Osg/Om m[/cemented cw 0.0 0.0 6 69-98 1 Oyr4/4 & 10 c2d 7.5yr5/8 Is w/ Ifs Osg/Om ml/cemented - 0.0 0.0 r4/4 banding ❑ Boring # ❑ Boring ® Pit Ground surface elev. 96.80 ft. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture 1 0-15 10yr3/2 none sil 2 15-30 10yr4/4 none scl 3 3040 7.5yr4/4 none sic] 4 40-55 7.5yr4/6 f2f 7.5yr5/8 sl/Is mix 5 55-71 10yr5/6 m2d 7.5yr5/8 LSBR >50 /o * Effluent #1 = BOD, > 30 5 220 ma/V and TSS 30 5 150 ma/L Depth to limiting factor 40" in. Structure Consistence Boundary Roots Gr. Sz. Sh. 2fgr 1 msbk 1 msbk Om/Osg mvfr gw mfr gi mfr cw mfr/ml cw na - 2fm 1 c 2fmc 2fm 1 c 2fm *Eff#1 I *Eff#2 0.6 0.8 0.2 0.3 0.2 0.3 0.2 006 0.0 Ov0 2fm 1 c 2fmc 2fm 1 c 2fm *Eff#1 I *Eff#2 0.6 0.8 0.2 0.3 0.2 0.3 0.2 006 0.0 Ov0 CST Name (Please Print) SBD-8330 (R04/15) 3 I Boring # ❑ Boring ® Pit Ground surface elev. 93.66 ft. Depth to limiting factor 45" in. r _. _. Soil A lication Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ftz *Eff#1 *Eff#2 1 0-23 10yr3/2 none sil 2fgr mvfr cs 2fm1c 0.6 0.8 2 23-31 10yr4/4 none sicl 1fsbk mfr cw 2fmc 0.2 0.3 3 31-39 � 7.5yr4/4 none sicl 1msbk mfr cw 1fmc 0.2 0.3 4 39-45 7.5yr416 nnone cost 1msbk mvfr cw 1fm 0.4 0.6 5 45-76 10yr4/6 & 10 r4/4 f2d7.5yr4/6 Is w/ Ifs bandin Osg/Om ml/cemented _ 1 of 0.0 0.0 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil A lication Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil A lication Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots _ GPD/FtZ *Eff#1 __ *Eff#2 * Effluent #1 = BOD, > 30 _< 220 mg/L and TSS > 30 5 150 mg/L * Effluent #2 = BOD, > 30 5 220 mg/L and TSS > 30 5 150 mg/L .Pc�c�a�d Dr \ .Epp�dX. /ecabo,,e f' Soil a1Q1kab*on/a!6 • kis6/118r•dOle e/l✓. „02 $0r AC"rzss /i d50V , r v/..5W/(a (� Lobo; cs.rt ✓o%z7/�,G2/, A044f ; Sec. 04 T. "A, —o Q -l. Ifk)., 774�. 40,ere0/, S6•Croi,Y�'p W4 /oepJ, amovo-iaoS- 6trno 2, 57Socra5 1\yIL. �I r 5 ,W eeX# toca�ibn -of baered 5as /ioe 1 Sc�oL'c � 0 ru' � 3 b�o[.-� [Ples: damor i I F •cpncr�e�a.E�o a•E 8r•ou..,d let/"a