HomeMy WebLinkAbout030-2123-30-000 r
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No: 430326 0
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No:
Personal information you provide may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)].
Permit Holder's Name: City Village X Township Parcel Tax No:
McCormick, Dennis St. Joseph Township 030 - 2123 -30 -000
CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No:
• (e S �q•�i C 5 A-1-1 gllokk UU 33.30.19.1001
TANK INIFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELE
Septic £� Benchmark 3.w 63,10
Dosing J Alt. BLA,--
lol•bo'
Aeration Bldg. Sewe t 8
96
Holding St/Ht Inlet
� •go `�S.(o0 f
TANK SETBACK INFORMATION St/Ht outlet
`� 10 g5.V
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic t / Dt Bottom
Dosing Header /Man. 'ZD 9S ZO
Aeration Dist. Pipe ,02
Holding Bot. System rrt9.3
I�•3o 93
Final Grade r
PUMP /SIPHON INFORMATION
Manufactur r GP St Cover r O /
Model Number
TDH Lift F ' n Loss System Head TDH Ft
Forcemai Length Di . Dist. to well
SOIL BSORPTION SYSTEM
/TRENC Width ' L gtp No. Of Trenches ?IT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIM S 5 z�I'"`
SETBACK SYSTEM TO P/L LDG WELL LAKE /STREAM LEACHING Ma
nyufa r r:
INFORMATION CHAMBER OR — AA
Type System: t
UNIT
p� .�� Model Number: it
DISTRIBUTION SYSTEM
Header/ ifo if Distribution x Hole Size x Hole Spacing Vent to Air Intake
Pipes '
Length Dia Length Dia g
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
Bed/Trench Center Bed /Trench Edges Topsoil r- Yes j No Yes No
COE M TS: (Include code discrepencies, persons present, etc.) Inspection #1 1 Inspection #2:
t } vas
Location: 580 128th Avenue Hudson, WI 54016 (NW 1/4 NE 1/4 T ON R1 W) Perch Lake E sta Lot 3 Parcel No: 33.30.19.1001
1.) Alt BM Description = G) ,;Vw- `� -b " O°� h s fe
2.) Bldg sewer length = 2 3 6) tj � c &r4v ta,-v'w'C r+.
- amount of cover = �, L f � l 00 6s&44 40 6 ejs
Plan revision Required? Ye No
Use other side for additional information.
- 6710 (5.3/97J � (� f " Date Insepctor's Signature Cert. No.
Safety and Buildings Division County
Nvi m 201 W. Washington Ave., P.O. Box 7082
sconsin Madison, WI 53707 — 7082 Sanitary Permit Number (to be filled in by Co.)
Department of Commerce
(608) 261-6546 0?
Sanitary Permit Application State Plan I.D. Number
In accord with Comm 83.2 1, Wis. Adm. Code, personal information you provide
may be used for secondary purposes Privacy Law, s15.04(1 xm) oct Address (if different than mailing address)
I. Application Information - Please Print All Information gr 1 s °r . - '
Pro Owner's Name Parcel # g t Block #
4 u
LI
Property Owner's Mailing Address Property ation
City, Slate Zip Code Phon "^ �, Section
Ai N 5� f yd 3
r715- Q ,� E or one)
v T R or W
II. Type of Buildfig (check all that apply)
Wnr 2 Family Dwelling — Number of Bedrooms 3A .L A _ .. Subdivision Name CSM Number
11 � Public/Commercial — Describe Use
❑ State Owned — Descri - 130 ❑Vil ownship of
t /010
III. Type of Permit: k%_11eCKomyoneD0X01VIIncA. CompleyennYMP1201DRICam 096 — Z 12 t7p
A ' gew System ❑ R Replacement System -,
ep ys ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System
B. List Previous Permit Number and Date Issued
Permit Renewal ❑Permit Revision ❑ Change of ❑Permit Transfer to New
Before Expiration Plumber Owner
IV. Type of POWTS System: Check all that appl
11� on - Pressurized In -Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑
Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑
Recirculating Synthetic Media Filter Leaching Chamber ❑ Drip Line ❑ vel -less Pipe ❑ Gliher (ex 'n
V. Dispersal/Treatment Area Information:
Design Flow (gpd) Design Soil Application Rat f) Dispe 1 Area Required s Area Propos yttem Elevation
`l,5 - C� 0 R , So
VI. Tank Info Capacity in Total Number Manu acturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Units Concrete Constructed Glass
New Existing
Tanks Tanks
Septic or Holding Tank oDb Q /
Aerobic Treatment Unit
Dosing Chamber
VII. Responsibility Statement I , the undersigned, assume responsibility for i allation of the POWTS shown on the attached plans.
Plumber's Name (Print) Plumb Si tore Busies
PRS Number ns Phone Numb5
Plumber's Address (Street, City, Stat Zip C e
N tJ
I. Coun /De artment Use Onl
A Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued I ss ng Agent Signatu (No Stamps)
Surcharge Fee) ❑ Owner Given Reason for Denial z 5 0-- PA - /
IX. Conditions of Approval/Reasons for Disapproval
SYSTEM OWNER:
1 Septic tank, effluent filter and
dispersal cell must all be serviced t maintained
as per management plan provided by plumber.
2. All setback requirements must be melftined
as per applicable code/ordinances.
Attach complete plans (to the County only) for the system an paper mot less than 81/2 s 11 inches is size
SBD -6398 (R. 08/02)
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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3
Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Steel Soil Service
Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County St. Croix
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. Parcel I.D.
Please print all information sewed By I Date
Personal information you provide may be F sed for ss p gr�ur gs( Law, s 15.04 (1) (m)).
Property Owner property Location
McCormick, Dennis (Govt. Lot na NW 1/4 NE 1/4 S 33 T 30 NR 19 W
Property Owner's Mailing Address ' a e Lot # Block # Subd. Name or CSM#
6800 3RD Ave SO 3 na Perch Lake Estates
City State 4ip Code Phone NUnop { _J City _j Village pe Town Nearest Road
Minneapolis MN 554 -� St.Joseph I 60TH St
New Construction Use: PI Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD
J Replacement —J Public or commercial - Describe:
Parent material Glacial Drift Flood plain elevation, if applicable na
General comments
and recommendations: Conventional System. System elevation 93.50ft, trenches spaced and depth to code 5.00ft below grade.
a Boring # I Boring
Pit Ground Surface elev. 98.50 ft. Depth to limiting factor 109 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 -11 10yr3/3 none sit 2msbk dfr gw 1 c12 .5 .8
2 11 -36 10yr4/4 none sicl 2msbk mfr gw 1vf .4 .6
3 36 -49 7.5yr4/4 none scl 2msbk mfr gw na .4 .6
4 49 -109 7.5yr4/4 none sl 2msbk mfr na na .5 .9
Boring # I Boring
llI Pit Ground Surface elev. 98.50 ft. Depth to limiting factor 102 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft'
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 -12 10yr3/3 none sit 2msbk dfr gw 1 c .5 .8
2 12 -29 10yr4/4 none sicl 2msbk mfr gw 2f .4 .6
3 29-44 7.5yr4/4 none scl 2msbk mfr gw na .4 .6
4 44 -102 7.5yr4/4 none sl 2msbk mfr na na .5 .9
* Effluent #1 = BOD? 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg/L
CST Name (Please Print) )Signature: - CST Number
David J. Steel 248956
Address Steel Soil Service Date Evaluation Conducted Telephone Number
1564 CR GG, New Richmond, W154017 8/15/2003 715 - 246 -5085
Property Owner McCormick, Dennis Parcel ID #
Page 2 of 3
3] Boring # Boring
01 Pit Ground Surface elev. 97.6 ft. Depth to limiting factor 105 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 -9 10yr3/3 none sil 2msbk dfr cs 1 c .5 .8
2 9 -34 10yr4/4 none sicl 2msbk mfr gw na .4 .6
3 34-44 7.5yr4/4 none scl 2msbk mfr gw na .4 .6
4 44 -63 7.5yr4/4 none sl 2msbk mfr gw na .5 .9
5 63 -105 7.5yr4/6 none Is osg mvfr na na .7 1.2
F-1 Boring # I Boring
; J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots D
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
I
F-1 Borin Boring #
Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
i
* Effluent #1 = BOD? 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS <30 mg /L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 - 264 -8777.
Page 3 of 3
STEEL'S SOIL SERVICE INC.
David I Steel 1564 Cty Rd GG
CST - POWTSM Dennis McCormick New Richmond,WI 54017
JL Lic. #248956 NWl /4,NE1 /4,S33,T30N,R19W Bus.(715) 246 -6200
Town of St. Joseph, St. Croix Co. Fax (715) 246 - 9372
Lot 3, Perch Lake Estates Legend
1" = 40'
♦ = Benchmark Ele. 100.00Ft
Top of 1/2" PVC pipe
3 }/p G rp • = Alt Benchmark Ele. 99.65ft
9 6a Top of 1/2" PVC pipe
❑ = Borings
Boring Elevations
B 1 = 98.5017t
B2 = 98.5017t
B3 = 97.60ft
B4 = 00.00ft
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POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page , of 2
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner L
Septic Tank Capacity Lit al ❑ NA
Permit # D 32�P Septic Tank Manufacturer ❑ NA
lyra DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA
Number of Bedrooms ❑ NA Effluent Filter Model _ a0 ❑ NA
Number of Public Facility Units 93A Pump Tank Capacity al OA
Estimated flow (average) 30 al /day Pump Tank Manufacturer A
Design flow (peak), (Estimated x 1.5)� j` al /day Pump Manufacturer A
Soil Application Rate t, gal/day/ft 2 Pump Model I MA
Standard Influent /Effluent Quality Monthly average* Pretreatment Unit ILIA
Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter f
Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland
Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other:
Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA
Biochemical Oxygen Demand (BOD _ <30 mg /L Ground (gravity) ❑ In- Ground (pressurized)
Total Suspended Solids (TSS) :530 mg /L ❑ NA ❑ At -Grade ❑ Mound
Fecal Coliform (geometric mean) 510" cfu /100ml ❑ Drip -Line ❑ Other:
Maximum Effluent Particle Size Y. in dia. ❑ NA Other: 12114q
1 4
Other: ❑ Nq Other: A
*Values typical for domestic wastewater and septic tank effluent. Other:q
MAINTENANCE SCHEDULE
Service Event Service Frequency
Inspect condition of tank(s) At least once every: — ❑ ear( '(s) (Maximum 3 years) ❑ NA
Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA
Inspect dispersal cell(s) At least once every: ❑ month(s) (Maximum 3 years) 11 NA
[year(s)
Clean effluent filter At least once every: ❑ month(s) ❑ NA
!4 year(s)
Inspect pump, pump controls & alarm At least once every: 0 year '(s1
Flush laterals and pressure test At least once every: p yea�(s)(s) A
Other: ❑ month(s) q
At least once every: ❑ year(s)
Other: A
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications:
Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank
inspections must include a visual inspection of the 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 cell(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, shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority within 10 days of completion of any service event.
Page 2 of 2
START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s)'for the presence of painting products or other chemicals
that may impede the treatment process and /or damage the dispersal cell(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 cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of
effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring
power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to
restore normal levels within the pump tank.
Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area
within 15 feet down slope of any mound or at -grade soil absorption area.
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the
POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat;
foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil;
painting products; pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is
properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:
• All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator.
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with
soil, gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired the following measures have been, or:must be taken, to provide a code compliant
replacement system:
�A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption
system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by
required setbacks from existing and proposed structure, 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.
T he PG. US
ey. alua ' a o ing nk
TIC �� - I�I�✓ a&,s 7Zu4Ao#J a
f1D4d1 B
❑ 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 COMMENTS
POWTS INSTALLER POWTS MAINTAINER
Name LCQ;j,wZ -ID Name
Phone S ��! S� Phone
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name Name ST. ckb ( d 2Dll� "
Phone Phone "] /S—
This document was drafted in compliance with chapter Comm 83.22(2)(b)0)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code.
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer :F—)t� of rj / S
Mailing Address (.O<i
/c 7V Vic:
Property Address BIZ GJ,/
(Verification required from Planning Department for new construction)
City/State /�j I���� O, Parcel Identification Number 03 — 'off .3'
LEGAL DESCRIPTION
A) W a ll
Property Location Ah-:� I /., NE�' '/., -3, T N -Rj?_W, Town of
Subdivision Po;a-, &_. 2-_-,oe_ Lot #
Certified Survey Map i11 1�6Z ) 2. P �� Volume P #
,� �L _ g
Warranty Deed # _ . :7 - 3 Volume Page # W
Spec house ❑ yes Lino Lot lines identifiable L ❑ no
SYSTEM MAINTENANCE
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 sal system
g dispo Y rn.
The property -owner agrees to submit to St. Croix 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 wastewaterdisposal 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.
Uwe, 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 Commerce 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 Zoning Office within 30
day f the three year expiration date.
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SIGNATURE OF APPLICANT DATE
OWNER CERTIFICATION
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 roperty described above, by v of a warranty deed recorded in Register of Deeds Office.
SIGNATURE OF APPLICANT
DATE
* * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department.******
** Include with this application: a stamped warranty deed from the Register o
p ty g f Deeds office
a copy of the certified survey map if reference is made in the warranty deed
I
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Front Elevation
VO 23'78 PAGE 79 7 3 6 1 5 6
STATE BAR OF WISCONSIN FORM 2 - 1999 KATHLEEN H. WALSH
WARRANTY DEED REGISTER OF DEEDS
Document Number ST. CROIX Co., WI
RECEIVED FOR RECORD
This Deed, made between Delwin R. Magsam 08/18/2003 02:45PZy
Grantor, and Dennis L. McCormick Grantee.
Grantor,lo conveys and warrants to Grantee WARRANTY DEED
the following described real estate in St. Croix County, State of Wisconsin EXEIPT #
e space is needed, please attach addendum): REC FEE: 11.00
Lot erch Lake Estates, St. Croix County, Wisconsin. TRANS FEE: 297.00
COPY FEE:
CC FEE:
PAGES: 1
Recording Area
Name and Return Address
- r -, Q
L ot.
030 - 2123- 30-000
Parcel Identification Number (PIN)
This is not homestead property
(is not)
Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any.
s>
Dated this — day of August 2003
_ 2
* * Delwin R. Magsam
* *
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN )
) ss.
ST. CROIX _ County )
authenticated this day of
s,
Personally came before me this day of
August 2003 the above named
Delwin R. Magsam
*
TITLE: MEMBER STATE BAR OF WISCONSIN _
(If not, _ _ _ _ o n to be the person(s) who executed the foregoing
authorized by § 706.06, Wis. Slats.) Briar ScottP I t umen and acknowledged the same.
Notary In
THIS INSTRUMENT WAS DRAFTED Y State of is
Attorney Kris Ogland * lir � a✓
Hu dson, WI 54016 Notary Public, State of 30v. s .
My Commission is permanent. (If not, state expiration date:
(Signatures may be authenticated or acknowledged. Both are not necessary.) f- - , > 0�1" .)
* Names of persons signing in any capacity must be typed or printed below their signature. Information Professionals Co., Fond du Lac, WI
STATE BAR OF WISCONSIN 500 -655 -2021
WARRANTY DEED FORM No. 2 - 1999
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` WiisconsinDepartment ofCommerce SOIL EVALUATION REPORT Page_ of 3
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code
County S
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. din
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. pen din g
Please print all information. Reviewed by Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).
Property Owner Property Location
Del Ma S Govt. Lot NW 1/4 NE 114 S 33 T 30 N R 19 31Z (or) W
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
950 N. Knowles Ave. 3 1 na jPerch Lake Estates
City State Zip Code Phone Number ❑ City ❑ Village [RTown Nearest Road
54017 ( 715) 246 -6707 1 St. Joseph
® New Construction Use: ® Residential / Number of bedrooms _ 4 Code derived design flow rate ✓ ti GPD
El Replacement El Public or commercial - Describe: `
Parent material glacial dri Flood Plain elevation if applicable l na t ' "` ft•
General comments i ek
and recommendations:;a ,
mound @ el. 103.00', based on contour line of el. 102.00'
F Boring # Z.
Boring 102.20 60 `
® Pit Ground surface elev. ft. Depth to limiting factor In `~`
-Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft=
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 - Eff#2
1 0 -9 10yr4/3 none sil cs 2f .5 .8
2 9 -34 10yr4/4 none sil 2msbk mfr QK if .5 .8
3 34 -48 7.5 4 4 none sl 2csbk mfr
4 48 -60 7.5yr4/4 none is Os
5 60 -90 7.5yr4/6 c2d 7.5 5/6 sil j
❑ Boring # F1 Boring 102.20 60
2 0 Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft°
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ' 'Eff#2
1 0 -10 10yr4/3 none sil 2f 5
2 10 -28 10yr4/4 none sil 2msbk mfr 1f 5
. yr none sl 2csbk mfr 9w na 5 .9
4 48 -60 .5yr4/4 none cos .7 11.2
5 60 -80 .5 4/6 c2p 7.5 4 6 sil JE1101 mfr na 2
Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg /L Vuent #2 = BODa 30 mg/L and TSS 5 30 mg/L
CST Name (Please Print) Signature . CST Number
Gary L. Steel 02298
Address ate Eval ation Co ducted Telephone Number
1554 200th. Ave., New Richmond, WI. 54017 6 -13 -2001 715 - 246 -6200
Property Owner Del Macl Parcel ID # pendim Page 2 _of 3
1 Boring # ❑ Boring
ele 101 .5O ft. Depth to limiting factor ()o Pit Ground surface e m. Soil �Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2
1 0 -8 10 4 3 none Si 1 2tnsbk 5
2 8 -25 10yr4/4 none sicl .4 .6
3 25 -60 7.5yr4/4 none
4 60 -90 7.5yr4/6 none
F-1 Boring # ❑Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in. =oil plication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft=
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I *Eff#2
Boring
❑ Boring # Ground surface elev. ft. Depth to limiting factor _ in.
El Pit Soil A lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *Eff#2
Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg /L ' Effluent #2 = BOD S 30 mg /L and TSS < 30 mg/L
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SBD -8330 (R.6 /00)
STEEL'S SOIL SERVICE
Gary L. Steel 1554 200th Ave.
CSTM2298 Del Magsam
New Richmond WI 54017
MPRSW -3254 NW4NE4 S33- T30N -R19W (71.5) 246 -6200
town of St. Joseph
P
lot #3 -Perch Lake Estates
This soil evaluation was conducted to satisfy a zoning requirement, it may or may
not be suitable for your use. The location of the test may or may not be as shown
as permanent lot lines were not established at the time the test was conducted.
N
1 " =40'
BM.= t p of mid -lot survey stake el. 100.00'
alt. .- top of 1" pvd pipe @ e 101.50'
i � v
h
Ati �
i
70 r
I
Gary L. Steel
6 -13 -2001