HomeMy WebLinkAbout020-1035-70-050 (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 Holders Name City Village Township
Hudson Business Park LLC--Hunt Elect TOWN OF HUDSON
CST BM Ele'v Insp BM Elev BM Description
TANK INFORMATION ELEVATION DATA
TYPE
MANUFACTURER
CAPACITY
Septic
) Z
J a
Dosing
Aeration
Holding
TANK SETBACK INFORMATION
PUMP/SIPHON INFORMATION r p ?,..p _Zt, orrlt
Manufacturer
�//��
b''S 3SH }'
Demand
GPM
Model Number
l.J S to
TDH
Lift
izaction Loss
System Head
TDH Ft
Forcemain
Length
Dia
Dist to Well
SOIL ABSORPTION SYSTEM
BEDITRENCH
Width
Len th
No Of Trenches
PIT DIMENSIONS
% Of rl s
Inside Dia
Liquid Depth
DIMENSIONS
SETBACK
SYSTEM TO
PIL I
DG
WE
LAKEISTREAM
LEACHING
Manufacturer
INFORMATION
CHAMBER OR
UNIT
Type Of System
Model Number:
DISTRIBUTION SYSTEM — L J /
Header/Manifold
❑istriution
x Hole Sae
e Hole Spacing
Vent to Air Into
Pipets)
Length Di a —
Length Dia Spacing
SOIL COVER x Pressure Svstems Only xx Mound Or At -Grade Svstems Only
Depth Over
Depth Over
xx Depth of
xx Seeded/Sodded
rx Mulched
Bed/Trench Center
Bed/Trench Edges
Topsoil
O Yes No -�
Yes No
C - _ CQM MXTS: (Includcode discrepancies, persons �present, etc) � In_sJp_ecction #1: 3�1$ ZOZI
_ocati. 6 BAE �t�ta� � I� A VL4Ja�e� 5�5 �s'ti , it
Location: qg6 BAER DR l p I, y� �^ �
1.) Alt BM Description = l �yr . li n..no _ �p ¢J,�.,��y�i ,
2.) Bldg sewer length = ` n ((���, jj.�},,, r
-amount of cover = S�hA �t wr '7L t�•Oh,'�'�
Plan revision Required? Yes IY
Use other side for additional inform on
Inspection #2
ro i
11v� 4P_re44tl —; -t
SBD--6r6710(R 3/97)`�tp, V.f
'hv�-_'■7cGL�5�'k�-{ems ., rv-"wllt.tw� "'!CQ-�—JAtil, '' �p rL'pC
rOS
County t '
Safety and Buildings Division
St. Croix �'ad I I — o`3 8
0 5 2�Zti
201 W. Washington Ave., P.O. Box 7162
Sanitary Permit Number (to be filled in by Co.)
M qR
Madison, WI 707-7162
63I268
Sanitary Permit Application
State Tmnsattion Number
er
In accordance with SPS 38321(2), Wis. Adm. Code, submission of this forte to the appropriate govenanemal unm
µl — 032- et 291 — C-
is required prior to obtaining a sanitary permit Note: Application forma for state-owned POWTS are submitted to
the Depamant of Safety and Professional Services. Personal inf ximation you provide may be used for secondary
Project Address (if different than mailing address)
purposes in accordance with the Privacy Law a. 15. 1 m Stats.
486 Baer Dr., Hudson, WI
I. Application
Property Owner's Name
Parcel #
Hudson Business Park LLC — Hunt Electric CDIV E
020-1035-70-050
Property Owner's Mailing Address
Property Location
715 St. Croix St.
Govt La
SE '/y SE /., Section 17
City, State
Zip Code
Phone Number
River Falls WI
54022
(fie one)
T 29 N; R _ 9 E or W
IL Type of Building (check all that apply)
Lot #
Subdivision Name
111 or 2 Family Dwelling— Number of Bedrooms
02
CSM Vol. 23, Pg. 5508
Block #
® Public/Commercial — Describe Use Electrical Contractor
Na
❑ City of
❑ State Owned — Describe Use
❑ Village of
CSM Number O
8 0189
® Towne£ Hudson
IQ. Type of Permit: (Check only one boa on line A. Complete line B if applicable)
A'
❑ New System
❑ Replacement System
❑ Treatriscritutkilding Tank Replacement Only
Modification m Existing System(explain)
existing Pump Chamber
B.
❑ Permit Renewal
❑ Permit Revision
❑ Change of Plumber
❑ Permit Transfer to New
List Previous Permit Number and Date Issued
Before Expiration
Owner
83815 issued 7/29/96
IV. Type ofPOWTS System/Component/Device: (Check all that apply)
❑ Non -Pressurized In -Ground ❑ Pressurized In -Ground ❑ AWG de ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in, of suitable soil
❑ Holding Tank ❑ ONe Dispersal Component (explain) ❑ Rouugnbnr Device (explain)
V. DisperrissVilreatment
Area Information: Sim/fcch STF-100A effluent Biter a[ effluent disch e
Design Flow (gpd)
Design Soil Application Rale(gpdat)
Disperse! ! A=ItTired (sl)
7T
Dispersal Awe Proposed (at)
System Elevation
1,297.5 G
0.29 W . Ft.
Na
4 452.0 Existin . Ft.
94.41'
VL Tank Info
Capacity in
Total
# of
Gallons
Gallons
Units
/Manufacturer
! r ■n! e (S
New Tank,
Existing
Tanks
'
4AL
Septic or Holding Tank
Na
7,000, 1,000,
4,500
3
Wieser Concrete
X
2,500
Dosing CBambm
Na
2,500
2,500
•1
Wieser Concrete
X
VH. Responsibility Statement- 1, the ed, aaaame responsibility m
ibility for installation of the POWTS shown on e attached planes.
Plumber's Name (Pry) Plumber's Si `7 MP/MPRS Number Busiass PhoneNumber
G Z
MPRS 222373 715 386-2850
Plumber's Address (Street, City, State, Zip Code)
715 Gh St. N Hudson WI 54016
Coun /De artment Use OnlApproved
rVIII.
ElDi
PermitFa
Dale Issued
Si
tasui Ahem
❑ Owner en Reason r Denial
S 2a--
'3//D ?t12
IX. Conditions otApprovaV aarfiF O reval 3
SYSTEM OWNEp (Ylr
1. Septic tank, effluent filter and
dispersal cell must be serviced /maintained
as per management plan provided by plumber.
2. All setback requirements must be maintained r
_q � �.( � a,..,0 ; �-?ta.,r � C-�nCt�. den,,
as per a pp Iicable cod 2 aPFfiGplete plan Nrthe ryaersa wbs the■tZ111e���---��}}}'''111���,,,���one �n}(`Pgst.�o�r is ougrrz:ff te�ke� �-~.n V
SBD-6398 (R. I I /11) i u� iA�t►2 `��tt`•' — "��"
b . T' GGGI//
' Form -STC- 104
AS BUILT SANITARY SYSTEM REPORT
OWNER �d[te o. /'/.a,..u. TOWNSHIP /Vuntor/ SEC. TN-RW
�y ADDRESS kTF_ f lVzlpro,, _ ST. CROIX COUNTY, WISCONSIN
G
SUBDIVISION IVA - LOT ///Q LOT SIZE
PLAN VIEW
Distances and dimensions to meet requirements of ILHR 83
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
q.4M1 /.10 T. A,mw /ii. /YnfY
t:rvr
cE
I.iftr /'nave2r/ Ls..,c
�'� iEMLE
IV,
Y J/teN
, ELraaoam
sl7 j
x ws.wrs.c, u.+aw
OJED AREA LrvvNa \
69,N6E -
. 4 t ASPYRLr
Oven /Say CkZSiSMa ,
rc So,?IJ AAtO FI(.IrorAtE
64DG
LZEv. 99.0j
oo
�wR v ' ro E..sr
/9.Pr .rV Lx�r
Av Z: WELL SS /00�6gtr
E%tr11rv6 sel"Cr.
INDICATE NORTH ARROW
tiv SCALD
9
BENCHMARK: Describe the vertical reference point used /y ?/tom p..r,_ti. r,_ 4i c
Elevation of vertical reference points /)O. U0 Proposed slope at site: 1.70
SEPTIC TANK.: Manufacturer: �g_ Liquid Capacity: dSOO w
Number of rings used: _ Tank manhole cover elevation: C Y
Tank Inlet. Elevation: Tank Outlet Elevation:
Number of feet from nearest Road: Front 10 Side 0 Rear, O aoo t._ feet
From nearest property line Front.0 Side,ORear,® J004 feet
Vt
JD •T.
Number of feet from: well /,�o , building: /0
(Include this information of the above plot plan)( 2 reference dimensions to septic tank)
SEE REVERSE SIDE
POWTS Index & Tilte Sheet
Project Name: Hunt Electric Corporation
Owners Name: Hudson Business Park, LLC
Owner's adress: 715 St. Croix St., River Falls, WI 54022
Site address: 486 Baer Dr., Hudson, WI
Project Location:
Subdivision: Lot 02, CSM #870189, Vol. 23, Pg. 5508
Legal Description: SD/4 SE« 4, Sec. 17, T.29N., R,19W., Tn of Hudson, St. Croix Co., Wl.
Parcel ID #: 020-1035-70-050
Page 1
Index and Title Sheet
Page 2
State Approved Design
Page 3
Filter Specifications
Page 4
Sanitary System Ownership/Address Form
Page 5
Certified Survey Map
Page 6
Waranty Deed
Attachments: None
Mater Plumber Restricted Service: Gary Zappa, Dep4. of SPS Credential #222373
Signature: Date:
Page 1 Of 6
Design pursuant to In -Ground Soil Absorption Compuawl Manual for POWTS, v sion 2.0 SBD-10705-P (N.01/01)
March 4, 2021
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 2023-03-04
Plan Review: PWTS-032100281-C
GARY T ZAPPA
715 6th St N
Hudson WI 54016
DIVISION OF INDUSTRY SERVICES
2331 SAN LUIS PL
GREEN BAY WI 54304-5211
Contact Through Relay
http:lldsps.YA.gov/programstindustry-services
v .wisconsin.gov
Tony Evers - Governor
Dawn Crim - Secretary
Conditionally
APPROVED
DEPT. OF SAFETY AND PROFESSIONAL
SERVICES
DIVISION OF INDUSTRY SERVICES
SITE: Hunt Electric existing POWTS modification
486 Baer Dr., Hudson, 11 I
Town of I-IUDSON
St. Croix County
Total Amount: $325.00
FOR:
Descrindon: 1,297.50 GPD
Maintenance Required
SEE CORRESPONDENCE
Pressure Distribution Component Manual — Ver. 2.0,
SBD-10706-P (N.01/01, R 10/12)
The submittal 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.
The following conditions shall be met during construction or installation and prior to occupancy or use:
• With construction; it is recommended not to activate the pump in the dose tank until the tanks are pumped
prior to homeowner occupancy.
• Wastewater generated from contractors cleaning of equipment and tools and/or left over construction
products shall not be discharged into the drains discharging to the private onsite wastewater treatment system
(POWTS). Waste generated shall be properly disposed of on -site or off site.
• Divert surface water from all POWTS Areas.
• 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.
• All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5
/ '6;0 1� lv�`b'
• Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c)
• Well setbacks to meet chs. NR 811 & 812
• Tank Installation to follow all manufacture's recommendations.
• Verify property line(s) prior to installation.
• Pump Floats to be set and verified per approved plan. Any changes may result in pump resizing to meet
TDH and GPM Specifications.
Owner Responsibilities
• The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating
to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and
maintenance manual and/or owner's manual for the POWTS described in this approval SPS 383ZA(1).
• In the event this soil absorption system or any of its component parts malfunctions so as to create a health
hazard, the property owner must follow the contingency plan as described in the approved plans.
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/installation/operation.
In granting this approval the Division of Industry Services reserves the right to require changes or additions should
conditions arise making them necessary for code compliance. As per state stats 101.12(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.
Thanks,
POWTS Plan Reviewer— Wastewater Specialist
Department of Safety & Professional Services I Division of Industry Services
email: um Nandai le,<r.r �� i,L o_n_si:,-m
Cell: 608-516-6134
POWTS Index & Tilte Sheet
Project Name:
Hunt Electric Corporation
Owners Name:
Hudson Business Park, LLC
Owner's adress:
715 St. Croix St., River Falls, WI 54022
Site address:
486 Baer Dr., Hudson, WI
Project Location:
Subdivision: Lot 02, CSM 45508, Vol. 23, Pg. 5508
Conditionally
APPROVED
DEPT. OF SAFETY AND PROFESSIONAL
SERVICES
DIVISION OF INDUSTRY SERVICES
SEE CORRESPONDENCE
Legal Description: SEm SEua, Sec. 17, T.29N., R.19W., Tn of Hudson, St. Croix Co., Wl.
Parcel ID it: 020-1035-70-050
Page 1
Index and Title Sheet
Page 2
Job Descrioption & Daily Flow Calculations
Page 3
Pump Chamber Calculations & Cross Section
Page 4
Distribution Network Calculations
Page 5
POWTS Management Plan
Attachments: State Approved POWTS Design
& Sanitary Permit Info. for Existing POWTS
Mater Plumber Restricted Service: Gary Zappa, Dept. of SPS Credential 0222373
l'
Signature: r /fin , �� �� Date:
Page 1 Of 5
Design pursuant to In -Ground Soil Absorption Component Manual for POWTS, version 2 0 SBD-10705-P (, 7.01101)
Form -STC-104
AS BUILT SANITARY SYSTEM REPORT
OWNER TOWNSHIP lVien.ronY SEC. _LZ T O'Z? N-R_,j W
ADDRESS k7-f / 1✓iiluaN �.__ ST. CROIX COUNTY, WISCONSIN
SUBDIVISION IVA- LOT 114ZA • LOT SIZE
PLAN VIEW
Distances and dimensions to meet requirements of ILHR 83
SNOW EVERYTHING WITHIN 100 FEET OF SYSTEM
' q.Gn ISO Y• n,n.0 li,. P[nrY
t Y
Herr Pnoiel<>r ZS - >
1i� /07� � tip rAu"4
L {5
ffrv�t
ff O 47 �t �S
' ' � ffrc, Ei.rr.aoaao
sl �,o ys'
T I/YfeAcf MI,Sn/
/iT` St"(7�Sn CLIIl3W
C.rZ3ttrv4 '� \
WO /1RFA 50rtwfe i ?
A ASPN\Jtf
Ps lul T �l
avert�/So' Exur=�x.
To Swnu iAwbo'/� /iGrof,. cC
�uno �G
CSLDr;
Eta = 99.060
,^ Yam' ro Enlr
i rm,i LSMF
^Y Z�'ELL at )oo'EAT r F.
E%trlZ"G SL•l{SCTANra'
INDICATE NORTH ARROW
/1/0 '%-4LE
9
BENCHMARK: Describe the vertical reference point used /V1Yr e �-rr _ ,s -RLL"f
Elevation of vertical reference point: 00. v0 Proposed slope at site: 2p_
SEPTIC TANK: Manufacturer: 1'Inrrg - Liquid Capacity: iu pU
Nmber of rings used: _ Tank manhole cover elevation:
Tank Inlet Elevation: Task Outlet Elevation:
Nmber of feet from, nearest Road: Front 0 Side Rear, O aoo r feet
Prom nearest property line Front 10 Side jo Rear, ® J00+ feet
/D T
Number of feet from: well J,'o , building: /0
(Include this information of the above plot plan)( Z reference dimensions to septic tank)
SEE REVERSE SIDE
Hunt Electric, Inc.
Non -Residential ATU POWTS
In accordance with Pressure Distribution PO4VrS Component Manual, Version 2.0, SBD-10708-P (N.01101)
JOB DESCRIPTION:
Hunt Electric is proposing to take occupancy of the former Duro Bag facility. The structure has not been occupied for
several years. Hunt Electric will operate one shift per day, Monday — Friday with no show room, no sales and no customer
walk-ins anticipated. There are no kitchen facilities on site, no meals will be prepared or served and no shower facilities
are available. The daily design wastewater flow of 1,297.50 Gpd will be generated by 55 full time employees and six
floor drains.
The existing POWTS was installed in August of 1986 and was designed and installed to accommodate 150 employees and
3,500.00 GPD. The Soil & Site evaluation report of record indicates class I soils as determined under the now outdated
perc test method. The dispersal cell area was designed and installed using 0.8 gpd/sq.fL/day. The soil description indicates
that the soils will accept effluent at a rate of 0.7 gpd/sq.ft./day under the soil morphological evaluation procedures now in
place. The POWTS consists of three septic tanks in series - two (2) 1,000 gallon tanks and a 2,500 gallon tank, two (2)
2,500 gall pump tanks in series that were plumbed and installed to function as a single 5,000 gallon pump chamber, and a
42' x 106' dispersal cell with effluent distributed evenly throughout the dispersal cell by use of a pressurized distribution
network.
PROPOSAL:
The installation of a new overhead garage door in the existing structure will require truck traffic to pass over a component one of the existing pump chambers - of the existing POWTS. This design seeks approval to remove the component to
prevent safety concerns associated with the tank. The design proposes to remove the eastern most pump tank and install
new lumbun between the 2 500 Ilon tic tank ane remammg ,5 g on pump chamber with the f
the exng FOWTS left in service as installed. All system componenM including electncal components, control floats,
alarms and effluent pump will be tested and proper operation confirmed Any defective components will be replaced as
needed. The pump control and alarm control floats will be reset to comply with this design. A new Sim/'rech STF-100A
effluent filter will be installed at the effluent pump discharge located in the existing 2,500 gallon septic tank.
Existing POWTS Certification:
The existing POWTS was inspected on 2/1 li'2021 by Crary Zappa, DSPS Credential # 222373 and found to be sound and in
good operating condition. All system components are in place and appear to be fully operational. The hydraulic operating
condition of the dispersal cell cannot be determined at this time due to the lack of recent use, but is believed to be fully
operational. The hydraulic condition of the dispersal cell will be evaluated at 6 months from system startup. Any and all
defective system components that may be found upon startup of the POWTS will be replaced or repaired as needed.
Design Wastewater Flow: 1,297 50 Gyd Design Daily Flow
(55 employees all shifts) (13 gal./employee) = 715.00 gpd
(6 floor drains) (25 gal./drain) = 150.00 eod
Estimated wastewater flow = 865.00 gpd x 150% = 1,297.50 gpd
Dispersal Cell Calculations:
1. Daily Design Wastewater Flow: = 1.297.50 God
2. Infiltrative capacity of natural soil = 0.7 gpd/sq. ft.
3. Absorption area required: 1,853.574. ft (1,297.50 GPD / 0.7 gpd/sq. ft.
4. Existing Absorption area 4,452.00 sq. R (42' W x 105'L x 18" D)
5. Soil loading rate as installed relative to proposed Daily Design Flow: 0.29yad/so. ft.
Septic Tank Capacity Sizing Calculations:
Existing Septic Tank Manufacturer & Capacity: 4,500 gallons existing cwoci
(Two 2 Existing W 1 000-MR Wieser Concrete and one (1) W' 500-MR Wieser Concrete all three in series)
Minimum Capacity Required:_ 2,709,18 gallons
(1,297,50) + (11.61 x 1,297.5/75x3•) + ((46.77x1,297.5)/75) = 2,709.17
*(Requires a three year maintenance cycle) Pg. 2 of 5
Dose Chamber Capacity & Dose Volume Calculations:
Manufacturer & Capacity: Existing Wieser Concrete W2,500-MR (50.00" @ 49.46 gal./inch = 2,473.00 gal. actual)
1. Pump Chamber Calculations:
A) 24 It. reserve capacity: 29.00" — 1,434.20 gal.
B) Alarm setting: 2.00" = 98.92 gal.
C) Dose volume + flow back: 9.00" = 445.16 gal.
(1,297.5 gal./5 doses per day) - (.65)(305') = 457.75 gal. max, dose volume
(.064 gal./lineal foot of 1 W' latera1)(50.Ox14x5) = 224.00 gal. min. dose volume
D) Reserve storage: 10.00" = 494.60 gal
TOTAL: 50.00" = 2,473.00 gal.
2. Pump selection:
Manufacturer.
Model number.
Min. discharge rate required:
Pump discharge:
Gould's
3887 WS10B
131.04 gpm
140 ± gpm 0, 18.26' TDH as installed
Dose Chamber and Float Setting Cross Section:
Dose Tank Information
9ectrical as per NEC 300 and —r
Comm 16.28 WAC
Tank cornponent is property vented
Wieser Concrete
Capacityl
2473.00
Volume
1 49.46
Manufacturer
Gallons
gal/Inch
Dimension
Inches
Gallons
A
29.00
1434.32
B
2.00
98.92
C
9.00
445.16
D
10.00
494.60
Total
50.00
2473.00
Alarm Manuafecturer LenelArm
Alarm Model Number DVL
Pump Manufacturer Goulds
Pump Model Number 3887 WS10B
A
B
Locldnp cover w lth w arniq
label and lockcrg device and
sealed w starlight
4 in. min.
F— Alternate outlet
location
Forcenwri diaine r
--111 3 in.
Weep tole or entk
siphon device
Pimp off elevation (ft)
86,23
-d Dose tank elevation (ft)
85.40
Pg. 3 of 5
Pressure Distribution Network: (As per original system design and approval)
Distribution pipe sizing:
Laterals per cell:
Lateral spacing:
Lateral length:
Lateral size:
Orifice size:
Orifice spacing (x):
Orifices per lateral:
Network discharge rate:
2. Manifold sizing:
Location:
Length:
Diameter:
Friction loss Manifold:
3. Force Main
Diameter:
Length:
Flow rate:
Friction loss - Foncemain:
4. Total dynamic head•• 18.26'
Min. supply pressure:
Vertical lift:
Friction loss-Forcemain:
Friction loss - Manifold:
Effluent filter head loss:
Total dynamic head:
14
6.00'
50.00,
N/s"
1/4"
84"
8
131.04 salJminute (141ateralsx8 orifices/lateralx1.17 gal/orifice)
Center
37'
4"
0 94' (36 X5.30ft./100ftJ = 1.90 ft.
4"
16
140.0 gal./min.
3.99' (305')(1,31 ftJ100ft.) = 3.99 ft.
2.50'
9.37'(high point of forcemain = 95.60', pump off- 86.23)
3.99'
1.90,
0.50
18.26
5. Fluid Flow Calculations: 3.57 ft./second
Pump discharge rate = 140 gpm f at 18.26' TDH
Effluent velocity = L.408)(140 eom) = 3.57 ft./second (flow through PVC pipe to be 2 - 10 ft./sec.)
16
Pg. 4 of 5
In -Ground Pressure Septic System Management Plan
Pursuant to SPS 383.54, Wis. Adm. Code
General
The septic system shall be operated in accordance with SPS 382-384 Wis. Adm. Code, and shall be maintained in accordance
with component manual SBD-10705-P (N.01/01) and SBD-10706-P (N.01/01). All local and/or state rules pertaining to
system maintenance and maintenance reporting shall be complied with. all inspection and maintenance activities shall be
performed by a registered POWTS Maintainer in accordance with SPS383.52 (3), Wisc. Admin. Code. Questions on the
operation or maintenance of the system should be directed to the installing plumber, Gary Zappa at (715) 386-2850 or the St.
Croix County Zoning Department at (715) 3586-4680.
S_ytic Tank
Septic tank servicing mechanics comply with SPS 383.54(])(e). The septic tank is located within 150' of service pad, with
the bottom of tank <_ 15' below service pad elevation. The operating condition of the septic tank and outlet filter shall be
assessed at least once every three years by inspection. The septic tank contents shall be removed when the sludge and scum
in the tank exceed 1/3 the liquid volume of the tank. The contents of the septic tank shall be disposed of in accordance with
NR 113, Wis. Adm. Code, by an individual certified to service septic tanks under s. 281,48, Stats. If the contents of the tank
are not removed at the time of a biannual assessment, maintenance personnel shall advise the owner of when service will be
needed to maintain less than 1/3 scum and sludge accumulation in the tank. 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. Septic tank manholes 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 the tank.
No individual should ever enter the septic tank as dangerous gases may be present that could cause death. Septic tank
abandonment shall be in accordance with Comm83.33, Wis. Adm. Code when the tank is no longer used as a POWTS
component The addition of biological or chemical additives to enhance septic tank performance is generally not required. If
such products are used, they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings
Division.
Pump Tank
The pump (dosing) tank shall be inspected annually. All switches, alarms, and pumps shall be tested to verify proper
operation. Distribution lateral pressure shall be flushed every three years.
Soil Absorption Cell
Trees or shrubs should not be planted directly on the soil absorption system. The area above and around the system should
be seeded and mulched as necessary to prevent erosion and provide some degree of frost protection. Traffic (other than for
vegetative maintenance) over the system is to be avoided. Soil compaction may hinder aeration of the infiltrative surface
within and above the system and will promote frost penetration during cold weather months. Cold weather installations
(October -March) dictate that the system be heavily mulched for frost protection.
Influent quality into the system may not exceed 220mg/L BOD5, 150 MG/L TSS, and 30 mg/L FOG. Influent flow may not
exceed maximum design flow specified in the permit for the installation.
Observation pipes within the dispersal cell shall be checked for effluent ponding annually. Ponding levels above 6 inches
indicate an impending hydraulic failure requiring additional, more frequent monitoring.
Contingency Plan
If any POWTS component becomes defective, the component shall be repaired or replaced to keep the system in proper
operating condition. Excessive ponding within the dispersal cell will be eliminated by alternating the diversion valve
between dispersal cells to bring the system into proper operating condition. If alternating cells does not result in a properly
operating system, a new dispersal cell will be installed.
Pg. 5 of 5
-E APPLICATION FOR SANRARY PERMIT
COUNTY
(PLB 87) UNIFORM SANITARY PERMIT #
—Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than B14x 11 inches in size.
—See reverse side for instructions for completing this application. PLEASE PRINT
PROPERTY OWNER
&ON
MAILING ADDRESS
p
ERTV
E 1 �1/4, S /% T N R E (or
TOWN* or n/
LOT NUMBER
BLOCK NUMBER
SUBDIVISION NAME NEAREST ROAD, LAKE OR LANDMARK
STATE PLAN I.D. NUMBER
TYPE OF BUILDING OR USE SERVED
1 or 2 Family Number of Bedrooms:
X Public (Specify):
THIS PERMIT IS FOR A:
❑ New System Q Tank Replacement ❑ Repair
X Replacement Soil Absorption System ❑ Revision ❑ Privy
❑ Alternate System ❑ Reconnection ❑ Petition for Modification
IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK.
❑ Seepage Bed ❑ Seepage Trench ❑ Seepage Pit ❑ Holding Tank
❑ System -In -Fill D In -Ground Pressure Q Vault Privy ❑ Pit Privy
❑ Existing, For Which A Previous Permit Is On File, Permit # issued
❑ An Existing System That Has Been Inspected And Is Compliant As For As Soil Conditions.
Septic Tank Capacity
Total
Gallons
of
Tanks
Prefab.
Concrete
Sitt
Constructed
Steel
Fiberglass
Plastic
Lift Pump Tank/Siphon Chamber
'
Holding Tank capacity
Manufacturer:
IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: ❑ Mound In -Ground Pressure
Septic Tank Capacity
Total
Gallons
of
Tanks
Prefab.
Concrete
She
Constnittetl
Steel
Fiberglau
Plastic
I AySbp I
Zj'
Litt Puny/Siphon Chamber I
CDP*j
Manufacturer:
PERCOLATION RATE
IMinu per inch):
ABSORPTION AREA
REQUIRED (Squis Faetl:
ABSORPTION AREA
PROPOSED (Square Fact):
WATER SUPPLY:
'�' Private El Joint ❑Public
I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans.
Name of Plumber (Print). Signature: /MPRSW No.: IlPhone Number:
I
P umbees Address, Name of Designer: '
COUNTY/DEPARTMENT USE ONLY
Signature of Issuing Agent: Fee: pate: Dbassigaroved
Reaso for 0' r 1:
Alternate course(s) of Action Avalloble:
Of LHR-SSD-6398 (R. e/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing, Owner, Plumber
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR r SAFETY & BUILDINGS
LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION
P.O. Box 7969 X BUREAU OF PLUMBING
MADISONEWI 53707
❑CONVENTIONAL DMI-TERNATIVE
❑Holding Tank UIn-Ground Pressure ❑ Mound
P. KIM to. EMPIPP:
...M3'654
NAME OF PERMIT MOLDER
ADDRESS OF PERMIT HOLD"
IN ECTION DATE
DX Bag Manufacturing
Rt. 1, Cty Trk11A11, Hudson, WI 54016
M x -Vil -.NF 00.10 IaE If DEFF ERENT FROM PLAN
REF PT.ELEV.
CSa MEf PI HEV
VE of the SEA of Section
17, T29N-R19W, Town of Hudson
H.nr Mn.iiMw.
1NMRAV Ne
CwnlF
u.Y rmX Nu.nIX.
Gary Zappa
3300
St. Croix
83815
SEPTIC TANK/HOLDING TANK:
NANV ACTURER
LIOUIOCAPACITY TANKINLETILEV
TAM[OUTLET [LEV
AM IN
LOCKINU COVEN
PROVIDED
OVIDED
OYES LINO
DYES ❑NO
BEDDING
VENT DIA
VE N T NAT L,
N
NUMBER OF
JMOAD
ROFIRTY
Ell
V
`ARM
FEET FROM
LM'E
[W.I.I.Iiiiii
Am MLEr
DYES ONO
❑VES
NEAREST
DOSING CHAMBER:
MANUFACTURER EEDUWG
LIDUIDOAPACITY P'Llm, 1UEt %➢W SIh10N MANUI AC IUNEN
WARNING LANE
LOOMING COVER
MOVIDFO
MOVIOto
❑YES ❑NO
❑YES LINO
❑YES ONO
GALLONS PER CYCLE:
A 1 AL
NUMBER OF R 1011II
1
aUIL x v
(DIFFERENCE BETWEEN
FEET FROM LINE
AIM INIEI
PUMP ON AND OFF(
DYES NO
NEAREST
SOI L ABSORPTION SYSTEM.ChMok the Wit moisEunt Et the depth afski—i.Fp
or excavation, (11 wil can be rolled into a Write,
construction shall call until FORCE
the snit is dry enough to continue.)
MAIN
ONV NTI NAL SYSTEM:
BEO/TR EMCN rwo M %D rN[rFCNes unrw wr srAla e
u MIA` PIT
min nw
'
.Pun nrr u
DIMENSIONS
luV ) 1 IlL 1
lnw ilrts BOVE cm
IN 1 N ! STR RIAL
luvIN.II tLe, ENU
NU 1
i'"Es
OF
`Wr
L
BUILDINfi
V 11 b,
A,I INItr
FEET FROM
NEAREST
MOUND SYSTEM:
Mound site plowed perpendicular to slope
Check the texture of the fill material for
PROVIDE A Of AGRAM OF SYSTEM
and furrows thrown upslope:
mound systems to make certain that it
ON REVERSE SIDE. SHOW ELEVA-
meets the criteria for medium sand.
TIONS MEASURED.
❑YES ❑NO
Y Ti1L1UN!
EN NI IX IIF
iXIy 11VA 1I��N Wl 11\
❑YES LINO
❑YES UN
Uf PT11UVfk I"ENf.N NFU
Ul Yll,ln
II Y Il fl IWtfNI
WIbIM II
i ilk,,
UII'INU
[NIEN
fIM•ES
❑YES LINO
DYES FIND
❑YES LINO
BED/TRENCH
DIMENSIONS
Yt AMs
Retain in county file for audit.
X
1. 01 A321
OWNER:
03.654
PROJECT INDEX SHEET
� tl R O l3h(T Af4Vj), iKyvP/AlG— !f/'// 4
ADDRESS: / Hwr filvvsov GUis
sYa'G
SITE. LOCATION:
t,Kr yi ►f sjr% uc .i7" TjIN, o°/rw • ;?vN 0 f Hv/�fo.v
PROJECT DESCRIPTION: ST C,PO/X 40OA17,y .
/f f11ea1' ,ta,P, AVA� Y w//k /J22 t 2 7'/aa� A-4lhUS
arm NEw
�N f,PO0u0 �/E� tS u�, t j� S fE•y iS ��PiffOl�O� s or,2 P z rx) 404.0
Ow, 170 fOiQA.4ihl EnpIOyeEr .z -FloaR oeAlAj5, �ESiG,1
IDAPIPS PAtEs , RlKm ft, Si+r sal -rtsYffl AS CiA.sS -T "ll
:F5TlmA-T&v P*ILY &PAs1E w,TEQ f►ow � 3,960
�VKe- / fLoT Ae4w p"'CW5
Pi/E A,►rEorc t,4your=
I/,y/1 5jr/7ie
AwP 644,V&rX <idoss 5ce77o v 1-T4"
G�igy Alvs 330 o
yby ?J-
NeR4, yvP..So,J, was. A016,
DATE: G
SIGNATURE
S.4�S
SITr rVALUATM. or DESIGNER
Xow�ane acme nuMwo ca
RT. f O'IRIt RA, XIU R1t 61BM
in Rtm PLUMBER LID. NO, my MAU
WK RdMUIR 6OESWER: t X0.0=
¢EooVEo
PWM��a OUBgpU
� y �} A1sWppEo �. �wy�� fii3ovE
�v�' ?'� iwyrsTzii/ lv�jeS sir// .en f� �(t S ►�i�
A.W Cis .7�6 f// x",O�vdyets
SAf// efr- vN�tr �oR
lAwpovorr, f,C%f►ir PevxervTiw.U.
ki�s� A,�s f/i�,�,���En � o�•s�,os�a m,� �
�. N. R. hppRo�e ('; ��«as�,t►rr- ,a-fe /bv►11.ti�. �`
'DrspaS�L sr-rF .
Aor PL4N
"a
SO
I�
= soil TEi Tc.Pl .Bj�CI(-/iGE
AORE$
`/BADE E/c vA7io�7S
(EKrls.vb�
�40
I fA�EsT cal^ 4'r� t
N.i rv.PA L �
NAROnw '.= � ,fRr,trNC�
RAaoo a �� .. x.NP. AP�a�v�o i vvto i/�o7Q��
�i�rt /vAf1E QROBurff POP7 I �
2 F/aok OrPA/rUVs
of. o -
i
apce
Iy scA s%
I fMjw,frso / COOL
f/EVA�onl =/00.0 fT ta./,. Ac.r,e-lo* iA/cj
C,f.vfsr/-*5 So r,tt
yy 5so do.?.
f
li COAI�'"�v
i CL� EYi51 f �
7
2o[K rm,c
J V
--
D.oC
pecc r
co Y..tIL
yo^/Yy1' _
SEA fG �
'A
w/[fc(Lbiva(
Asvhnctru
�N G.ROOVO PRE550RE Ct4>55 SECTJv c)
g6-03 6 54
n� Fr
t Vi u 1�yi
e A
e �tAP
olsseRue� AlAr PeR sat
A);-K %S Holes F�L�Ai/W
'WhED w LAST
1 Fr a F PIPE-.
�LIRfzEY
('S717.
F"
�� r SC;{EOGt�E
7&sr ' y0 /°VC
of acp ��.r10 /cafL)
,% fr, oisT��snne..
I/�E /NVERr �
1N4-RD(AND PRE55vfLF BED
/" - 20
r--------------------------------------------
.y-- rARrrus ;.
i o � oGle,OMfAV/
D 1
I' I
' 0 I
---
IWI,MeAl 33eo •F 34,
S.I EW,41s 4fffA6-,jsF
PE Y� 4 AdMi{+/D
3os eP
s<Av lr Yo 7k
ti.YE /Hwu
skAtp & Yp• JAAC44r RAee To
PUMP clq.4m4d�,
RECEENED
�UL 171986
IFAM
view
'NR F40F AT£ P f
IFE -DtTAI(/
LAsT Hcls- PUG .:,; .
s<r 2[P.fil4y-
C'OfCUArb,J
.usx?' Ta
eAA!% r f
l�
?I PE LATERAL LAyo OT-
7 o%s7.P;/f oTro., .
zf L^-- 7rw ^4,vi,-ozo
D��TAi.BuTiO,U Pi�l O/SCRA.P(� �cil7E " %7� A�S nn iv ,
Al'/I/ o;s A jp
fso
R
9AbE 3 at 5
R
p SO fr.
38 sr
S 6 -r.
X 7 fT
y _- -5-fr.
1,
}bir 'Du,,.,er6e f
A r&.R4 yy ,
# /Aa&5/1,= 8
Se,?TF 41IWooeO OCAfr I
8so;1
Pilaf
�hAH/3E/C
n mn
5ee
FdR
nerds
1.
9. . 2 9
Niw .2Sco fa.
ARr C Kr ri.w.�i=
sWr%c. I�'•fSte Peuac(!f `a
ode, : Iy'. 13'y'
.ors
�. STAB A/plotlED Toiv/f -Fo,t:�ffe J P; fr
SCT (�' Flon+ BDY.HM of Trio y,5ooSAI
P pRC�A$7 putif -rANt.S PT WKSER Cotl4df2
pROOV<TS fpeTOitY, N��DcA Rbek WAS
� ^ FIfuATieN of [o�A1 ec7raG- /irJF
AMIS '7 ye,✓ o /ochVb
y..
57.42C �ppPoJ£O /NS c�v lnP
;S' - — 1,
/nt. y0�0
_T-,
57
s
emw�
/goo
fAA
,tcPl.�
P.Piqur
ce.+atix-
Note,
99• o
u � . a,r 4•. B/04
I
1.0�
IAIWA
girls'
Its I
B�1�p�
93A
Fri 57'.
r�Cra
/co Q^ .
Ael *,+r r
rv� "f0-
�p�i
. 41/ -,yI A4v#,e rowps eAj e4eA o` 3
,vEw 3Oo Selr4A*, 5 AG+cw- 5OV41/ 4c 13.
^ttouf 5PACE.Wid-. ST.Rc aWWfo fo<KNv
eouces.
PUMP CHAM/3ER ; sFpTic 74tik PLgA/ 1//4EN/
SLAIE : / N:/0'
Tof4L G44.1 m4s7EleV Q -3,6100
RAi7k .V vas,>< &r ,{,E,.
V01'D t/o/u/Lt foRr�M�iN (y" . yo I0LS- TAL 3a5'
—gat rc . Ai"&Ft_Ao5/LYf---107y /�3F .
A1la RVNAtAV&_ i�HE = g '*.OAvvre4 , pU - _ 0 g 6 5 4
PUMP CAM6E5 CR055 SECTIOW AND 5PECIFICATf01J5
-
PC, I
aa�gq,o
i1rVCWT CAP
4'C.I. VENT PIPC
2: ZS' FROM ODOR, It
WINDOW OR FRCS14
AIR INTAKE
iY
,p,&ArjbAj �%, 23``.
APPROVED LOCKIIJG
MANHOLE COVER
Y' AU
7.6. Ff
- ...
PROVIDE
._. .... ..
AKTILHT UAL
AFIROV[D JOnAT'
A 1 (
hNn� ���� I
III
I I
AP►ROVLD JOOIIf
MvC.Z. PIP[
W�C.I. Pipe
LLTCNDIWO 3'
I. /N St,�iEi i
1
I ALARN
OWTD lOLID WL
oWro SOLID sDlt�
R S(
A, Pun I
1
I 061,
D 'l
CLEKof
c ,
1
PUMP-` --
Elg�Y swk
01►
'
g90�
�
F/�1/fnnN
yes
r," f" coA¢RETE elacll
RI&OR LRIT PLRAIIFLD OUL9 If TANK MAWIPACTURER HAS
&UCH APPROVAL
SEPTIC I P[LIFIC.ATIOUS
DOSS
TANK4 MAYUFACTURCR: /F'� �OA '{E�
WRMkOE 04, DOLLS: -PIER DAN; �
TANK SIZE: 1-If 9ioo &ALLOUSf"
DOSS VOLUME
/M1>A�
&LARA AL"FACTURLR% LopeL ^/ARC}
ILICLUDIUG LRPLOM 1
"io
mOOCL u"iER% •R rIF'
CAPAcmul t CALLOUS
SWITCH TL►L: MASPeUAJ F/OAT
D. 1• IUCMLL OR ' 'Y OALLOUS
PUMMUUCR: P AFACTUIt(>'OL LZ7 U/F/�1 SNC •
(,. /_Z rrNi[ OR / OALL�77
MODEL UUMDER: 3PA7 /M P' 0S10'6 Bf
SG iCS 0-JIL? INCHES at'� GALLOUG
. SWITCH Ty►L: 1 PINY RAtK,HA URy IeAtf
WTC: PUMP AWO ALARM ARE TO WE
ATE �:. ko rPK
- MIUIMUK DISCKAROL R/
INSTALLLO OU SEMRATL CARCtATL
VLRTICAL DIFFLREUCL DETWELU PIMP OFF AWO OUITRIOUTWU PIPE.. PuT 'J,(N.(' V-1eY '
+ MINIMUM NETWORK SUPPLY PRESSURE ...........
L.+.a FEET Cif 1&44 g :2
*�
+!MQ ►EtT Of ►ORC[ MAIN X / Z' /{N nPRICT10N FACTOR. 6 PELT ( TOfNf-0 IN S4,O&S
TOTAL DWAMIC HCAO /''• / FELT '401A
1((II
I ✓
�'3 y
,
IUTERUAL OIMLUt101J[ Of TAUK% LCU&T11 :WIDTH
,LIQUID IDE*TM�
A
RECEM
JUL 17 1986
S
.'z T,Wyt f ��`� 40*111 P (74AAG.t 7/.c- 44 71 AAA '•e_
57/v7- /y/dm004y f, ' C'T. 1,NcE7- C.fsT fT Y'*M01 r
AOf 7.I uK T�, L S�ooc:A/ av1 tc� GIST / E Ti Ajk
AS S*wA// (3oCL �.. -FRoA, /NS,AF Ro77em .
wi
c
r.•v— , v
INDUSTMENTOF REPORT ON SOIL BORINGS ANO SAFETY$BUILISIOS
INDUSTpY, LABOWANDp�► , w DIVISION
HUUMAN RELATIONS PERCOLATION TESTS (115) MADISP.O. BOX 7969
ON, WI 53707
(H63A9(1) Q Chapter 145,045)
It MATION
x P`arto P*f&e At& Af4V&t er 1 ywy � .tr. / NuccoN w is . rs�afo
OATS OBSERVATION$ MADE
70pA,/ o/s, 2 'f'/oo,t 1LA AvS .
iN
r NOT rpyired I O EBI ON RATE I! any porOon of eM t_ W Oe If In tire
hwwte: CJ/i/SS Z— Floodpbm, Irgkero F lood Asm elevatlOn
PROPILFOESCRIPTSONS . 'IM0..'. Al Z..
BORINGG
ND
UMBER
A
IN.
/..vo*
ELEVATION
DEPTH
IL WITH THIGMESS�LOR, TEXTURE, K f OBSERVED E 31IRV, N BACK.) N
6 /
/OfQMEEMMO
B-
?ee—
r /O O
rfu uE er s G e
Ar --
iv.v
,ahar Ai .
' T E Cf 4 $_R{
ffa
d" G.
t/ ff•
'PSI/
l�u vtier CS i s p
cs j 6 4 .
PERCOLATION TESTS
��.:OPIrP'/Aetla1131i11`[N`I1'�
iv.eli11
i:7t/_7��IJd.R.).i�
1
I�JA:n.lsaL♦ e�� adlq.x�
�iwio
�i
��■
�^%�
z�r
E�--i�=�T�aY—'�e.�"��
L`��TALliis��/
PLOT PLAN: $hew bDOdOIO Of Percobbon teete, -11 bO lrW end Ow dimes of wlbbb .oil wee. IrWio.b ,W or dwnea. DeeciW .Met em the horF
t'alOI bl ere! vHtltal ebwrtpn nfwbea Painb end 4yg'vf ItyM'lf loo bn 0' 'he qPt Pbw n. Sr " Wflq ebgtbn et all be" eats notlon the diend m ae,
IeM dPpe. �.
SYSTEM ELEVATION
AN
s.
MIN
■■■
TN
I• the -derWVP . h.mby y fy thet de Poll t,,. rpMW On thie farm slate me by ms In e M e " tM INaOedelee a,d meMOde eneb/hd in dr PiNCDndll
AOMMRIeaN Cade, and Met dre deb retarded end tlr Meefbn of tM taw en o -Ot W tW bet of rr,v kn-- WO a end belts.
DISTRIBUTION: Of qln l Pro one copy to Lotml Ayt rry. P• tv Ovmar,M Soil Teter,
DILHA-SO04399 M. 02412) —OVER —
'REPORT ON SOIL BORINGS # PERCOLATION TESTS IT
VPLor PLAN PizosEcr z.o. A4- !-
DArr 6' /�7sry E)L sip r2y, j
.TT. CRorx ter,
NOW -SITE SEPUC PLL&GIC M BOB ULCXIC",
rr. i OVIL M HtMWN. Ms sauROM UBROT
L's r 1 ypZ
,. Ft MSTER RIMBER UC. M3 3M MJPU
sCAIE = SQ MdIM. IO AW i BEWAR ac Mo Rosa
PROPOSED ftoE mor i. r 2f Pr• of MOdE rWH A« rrfr AAC45.
pRopowo weu ► osr Wr ,So'r et Alefr Am,, 4t4 Mrl A"s,
r swow o/f3 ®� sX,lTIAI (r wrLL
X •PEAL lee4r/ay -A ` NANO 409r,040 Of s4orl �glEs
. ' A4w;z. BM' Is ; vrpricet erooA er Polar iY-y j>flll*,;4 P/sz
,� ° yR�o� F/ev�tiavf sa><� csT Ar rapAm,o- o^ rout /-A.,&
LEGEND 0,0 IIAWf ffO pf ioo,o '
wesrf- 1w&s
Awv
o►pob"
sa�E.e
o'pv4 Stv A6,
iy. s,�iE �;ago
sfo�
pdE� F'q�T°Qli
AlLJj
a
Asp//4b-Eo
LoMovk I /
4&4-
ST. CROIX COUNTY
WISCONSIN
ZONING OFFICE
7W2230 (HAMMOND)
425-83M (RIVER FALLS)
HAMMOND, WI 54015
June 25, 1986
Di.v.c.6i.on o6 Satiety and &utding6
Bwteau o6 Ptumb.cng
P. 0. Box 7969
Nad.L6on, WI 53707
VeaA S.ih
An on 6.ite invatfg"Zon jot the 11wco Bag paopehty, Located
at .the E-� o6 the SE14 o6 section 17, T29N-R19W, Town o6 Hudbon, '
St. CAo.<x County, Aeveated 6udtabte 6oitA at a depth o6 10.5 beet,
betow which 6ea6onabte high grtound water. wa6 noted.
Th.i.6 site should be 6u.r,tab Ce. boa an .in -ground ptuzuAe 6y6tem.
Shouts you have any quebti.onb, pieabe beet 6Aee to contact
thi.6 office.
SinceAeCy,
VAOXI/-?*�
Thoma6 C. Nee6on
A66.i6tant Zoning A&Lnl6tAatoA
TCN/mf
Pam -STC-1G4
AS BUILT SANITARY SYSTEM REPORT
OWNER 4:Z2�. / TOWNSHIP ntol/ SEC. Z T �N-R�N
ADDRESS 127F_ / Sri cyo T_ ST. CROIX COUNTY, WISCONSIN .
SUBDIVISIOH N.A - LOT eVA LOT SIZE
PLAN VIEW
Distances and dimensions to meet requirements of I3.HH 83
SHOW.EVEEYTHING WITHIN 100 FEET OF SYSTEM
9
BENCNNARR: Describe the vertical reference point used rn011w,
Elevation of vertical reference points 9, do Proposed slope.at site: 1�
SEPTIC TANK: Manufacturer: 1'('.8(Fp Liquid Capacity: .9bOO
Number of rings used: _ Tank manhole cover elevation:
Tank Inlat.Elevation: Tank Outlet Elevation:
Number of feet from nearest Road: Front.0 Side,® Rear, O .-J O t.. feet
From nearest property line - Front 10 Side IoRamr,® ,� O Or- feet
i Number of feet from: well building. /D
L (Include this information of the 'above plot plan)( y reference dimensions to septic tank)
SEE REVERSE SIDE
St. Croix County Planning and Zoning
Taesday, December 07, 2010 N 9:15710 AM
Detail Sanitary Information Page 2 of 1
Computer A:
020-1035-70-000
Sub/Plat metes 8 bounds
section:
17
Parcel /:
17.29.19.155A
Lot
TNIRNO:
T29N R19W
Municipality:
Hudson, Town of
CSM:
1141M
SE 1/4 SE 114
Owner: -
Duro Bap Mamdectuft 488 Baer Drive
Hudson, WI 54018�
-----
�—-------------- — =--------
Stab Permit
83815 Issued:
07/29f1986
POWTS Dispersal:
Pressurized In -ground
Parmit Replacement
County Permit
0 InaWted:
O8107l19M
POWTS DahN:
IGP (In -Ground Pressure)
Bedrooms: 0 WI Fund:
POWTS Pretreatment
NA
Notes
lssueNlnsoedw As Bual
Mary Jenkins Yes
Ton Nelson Signed Off: No
Maintenance
sobcduled Puma E)ate Pumped
WV2006 5t2r2"
5/2/2009 5115=8
5MM1011 6192W9
6K"12
Plumber Moo: Requirements
Zappa, Amhory MPa1
commercial system replacement - Inspector $0-00
sdxxkdod W186, but noMing completed on report
form. Tom may have written rod readings on
folder. Found 1986 permit in crarsnt fee folders -
now onpinel and reptacemeni pennas are in 1986
arctrrvas-
APPLICATION FOR REVIEW
Private Onsite
J -Complete all pages. Wastewater Treatment
a/ NOTE: Personal information you provide may be used for secondary purposes stems
[Privacy Law s. 15.04(1)(m), Slats.] Systems
Division of Industry Services
❑ Plans to be E-filed. Provide SharePoint User name below: I For plan status, check our website at htto://dsos.wi.gov
Several counties have been delegated certain authority to review plans in lieu of Division of Industry services. For a current list of those
counties and their designation check our website at httaJ/dsos.wi.aov
1. Project Information - Fill In all known Information.
Project/Site Name: Hunt Electric existing POWTS modification
Location, Number & Street of project (if unknown, indicated nearest road)
486 Baer Dr., Hudson WI
Legal Description: Lot 02, CSM 65508, Vol. 23, Pa. 5508. SE1/4 SE114
Sec.17. T.29N. RA9W Tn. of Hudson
County St. Croix
2. After plans are reviewed, please: (check all that apply)
❑ Cali customer 1, 2 (circle number)'
❑ Requesting party will pick up
® Mail plans to customer 1, 2 (Circe number)*
*Refers to customer number from below.
Confirmation of assignment to a reviewer.
Transaction ID:
Previous Related Trans. ID:
Eadmated Completion Date:
Assigned Reviewer:
Assigned Office:
Mail to your office of choice below:
Hayward, LaCrosse, Waukesha
NOTE: We reserve the right to re -distribute plans to another office If
needed to reasonably balance tumaround tines. Check
Mtn://dspe.wi.noy for office availability and next available review daft
3. Complete the following dosignedownedrequesting Inforutlon. Utilize the Deck boxes when designer, owner or requesting parry is the game to
avoid reputing Information.
Designer Information (Customer 1)
DSPS
First Name
Last Name
Customer Number
Gary
Zappa
222378
Company Name
Zappa Brothers Excavating
Address
715 6' Street North
City
State
Zip+4 (9 digits)
Hudson
WI
54016
Phone Number
E-mail address
Cell phone
(area code)
(715) 386-2850 ZappaBrothers®SBCGlobal.Net
Check if applicable
❑ Owner
Other Please Specify Below (Customer 2)
DSPS
First Name
Last Name
Customer Number
James
Thompson
30021
Company Name
A.C.E. Soil & Site Evaluations, LLC
Address
340 Paulson Lake Lane
City
State
Zip+4 (9 digits)
Osceola
WI
54020.5413
Phone Number
E-mail address
Cell phone
(area code)
(7151248.7767 aossoi0frordlemetnet
No
Check if applicable or specify relationship
Information and Plan Submittal Checklists. POVVTS pre -scheduling is not available. Plans will be assigned to a reviewer after receip
at a DSPS office. Submittals received may be assigned to offices other than the receiving office depending on reviewer availability.
Submittal checklists can be found in each applicable component manual appearing on the POWTS Publications page,
f http://dap9 wi cioy/DhL/sb-ppalopD/orodoode resuft ohp/POWTSM/POWTS COMPONENT MANUAL. You may email technical code
Hayward DSPS LaCrosse Area DSPS Waukesha DSPS
10541N Ranch Rd 3824 N Creekside 141 NW Barstow St
Hayward WI 54843 Holman Wi 54636 41" Floor
715-634-4870 (NOTE CHANGE) Waukesha WI 53188-3789
Fax:715-834-5150 608-785-9334 262-548-8800
Email: DsosSbPlanSchedukeawi.00v Fax: 608-785-9330 Fax: 262.548-8614
i Email: OspsSbPlan6chedule0wi.aoV Email: DsosSbPlanSchedule(dimd W
Make Checks Payable to: Division of Industry Services OR
® Check box to invoice designer and sign below
Designer signature
TOTAL AMOUNT DUE $ _
Review Code 7633
5. Pows SUBMITTAL (check all that apply — incomplete forms may result in processing delays)
❑ NEW — . ❑ Aerobic Treatment Unigs) ❑ Chlorinator ❑ Tank Replacement Only
[]REPLACEMENT ❑ Commercial System ❑ UV Disinfection Unit ❑ Add Effluent Filter
SYSTEM TYPE($) NOTE: Submit separate sheets for each system if submitting multiple systems on the same site Enter Fee
❑ Revision to previously approved plan S65.00
® Miscellaneous Review (i.e. replacement of a septic tank, addition of an effluent filter or prebeabnant device to an existing system, etc.) $SWhr
—
® Component Manual
DesAll
�^
treatment components are previously approved
❑ At -Grade Component Manual -Vac 2.0, SBD-10654 (N 03/07, R. 1/12)
Wastewater Flow in
under s. SPS 384,10 (2) or (3)-
❑ in -ground Component Manual - Ver. 2.0, SBD-10705-P (N.01/01, R 10/12)
❑ Mound Component Manual — Ver. 2.0, SBD-10691-P (N 01101, R 10/12)
Gallons Per day
Design wastewater flow of the proposed system:
® Pressure Distribution Component Manual — Ver. 2.0, SBD-10706-P (N.01/01, R 10/12)
1,297,
1,000 gpd or less $ 250.00
❑ Other - Please specify
GPD
1,001 — 2,000 gpd $ 325.00
2,001 — 5 000 400.00
❑ Sod Based Individual Site Design`
One or more treatment components are not
❑ Grade
previously approved under s. SPS 384.10 (2) or (3):
(Individual site design/deviation from component
❑ Non -Pressurized In -ground
Design
manuals and use of components without product
❑ Pressurized in -ground
Wastewater Flow in
approval):
❑ Mound
❑ Drip -tine
Gallons Per day
Design wastewater flow of the proposed system:
❑ Constructed Wetlands
GPD
1,000 gpd or less $450.00
' Documentabon must be provided to support treatment and dispersal claims. In a separate
1,001 — 2,000 gpd $600.00
statement provide rationale for the project and attach supporting documents (code sections, test
2,001 — 5.000 gpd $750.00
reports, technical papers, research articles, etc.)
greater than 5,000 gpd $900.00
plus $0.08 for each gallon over 50DO gpd
State-owned facilities:
Den
Design
Holding tanks previously approved under s. SPS
❑ Holding Tank Component Manual, Ver. 2.0, SBD-10855-P (N.03/07, Rt/12)'
Wastewater Flow in
384.10 (2)(3). Design wastewater flow of the
proposed system.
Gallons Per day
' Non -state caned Commercial and Residential Holding tanks that completely utilize this manual
5,D00 gpd or less $ 90.00
and have an estimated dairy flow of less than 3000 gallons per day must be submitted to the
GPD
5,001—10„000 gpd $150.00
appropriate governmental unit for review instead of the Department. [see SPS 383.32(3)(a)j
greater than 10,000 gpd $225.00
❑ Holding Tank Individual Site Design*, (i.e. she constructed, <5 day holding capacity, Co-
Design n
Holding tanks Including site constructed tanks NOT
mingled wastewater, etc.)
Wastewater Flow in
previously approved under s. SPS 384.10 (2) or (3).
Please apeciff
Gallons Per day
Design wastewater flow of the proposed system:
' Documentation must be provided to support the rationale for the project. In a separate statement,
5,000 gpd or less $180.00
5,001 — 10,000 gpd $300.00
please include all code sections, test reports, technical papers, research articles, etc.)
GPD
greater than 10,000 gpd $450.00
❑ Sol Saturation Determination Report (using observation pipes) ❑ Interpretive Detemristlon $240.00
---
❑ Experimental System (One time additional fee). Submit fee for individual system as per appropriate above system type) Experiment Number _ $400.00
Prix approval from a section chief Is required for a priority review.
If approval is granted, the priority will be reviewed within 5 days of receipt.
Priority Review (enter same amount as normal review fee listed above)
l✓111 ' I: Lv 11: :I. li.'
SPS-10577 IR 11 W1 S1
Einar Total (rounded to the. nearest dollar)
$
Manufacturer: JlTyT"_ Liquid Capacity: _ 4e000 G+el
Pump Model: -2'r /0/ Pump/Siphon Manufacturer: "T� Pump Site
Elevation of inlet: 90,,I _ Bottom of tank elevation:
Pump off switch elevation: ��/Gallons per cycle:
Alarm Manufacturer: 2Z ✓ELALa.,,a l% Alarm Switch Type:AZo
Number of feet from nearest- property line: Front, O Side,Rear, f V ) Ft.9S6
Number of feet from well:
Number of feet from building: �d
(Include distances on plot plan).
SOIL ABSORPTION STOT4W
Bad: %Fr a,r.. Tronch:
7 a/
Width: y f Lenpehf /b% Number of Linear Area suilt:-�KloL
Fill depth to top of pipe: ? ii � yR
Number of feet from nearest property line= UFrornt,/ O Side, ® Rear,OFt .J_
N:mber of feet from wall: )/i]
Number of feet from building:
(Include distances on plot plan).
SEEPAGE PIT
Site: Number of pits: Diameter:
Liquid depth: bottom of seepage pit elevation:
Area Built:
Has either a drop box O or distribution bo1O been used on any of the above soil
absorbtion syteme4 (Check one).
MOLDING TANK
Manufacturer;
Number of rings used:
Elevation of inlet:
capacity:
Elevation of bottom of tank:
Number of feet from nearest property line:
Number of feet from well:
Number of feet from building:
Number of feet from nearest road:
Alarm Manufacturer:
Dated:
Front, O Side, 0Rest, 0Ft.!
Inspector:
Plumber on job:
License Number: , -V122 l . 2:?00
3/84:mj
Wsconsin Department of Safety and Professional Services Page 1 of
Division Of Industry Services
SOIL EVALUATION REPORT
In accordance with SPS 385, Wis. Adm. Code County
Attach complete age plan on paper not less than 8 112 x 11 inches in size, Plan must Include, St. Croak
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. 020-1035-70-050 F ef#2610
Please print all Information. Reviewed by late
Personal Information you provide may be used for seconds Prtv Law, s. 15.04(11(m)).
Property Owner Property Location
Hudson Business Park, LLC - Hunt Electric Corp. GovL Lot SE '% SE '% S 17 T 29 N R 19 E (or) W j
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
715 St Croix St. 02 Na CSM #5508 Vol. 23 P . 5508
City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road
River Falls W 54022 ( ) I I Hudson �_ PG Add:466 Beat Or, Hudsc
❑ New Construction Use: ❑ Residential! Numberof bedrooms _ Code derived design flow rate 1,297.50 GPD
❑ Replacement ® Public or commercial — Describe: Hunt Electric
Parent material Glacial Outwash Flood Plan elevation if applicable na R
General comments and recommendations: Evaluation completed to verify soil suitability to allow the alteration and continued use of existing POWPS serving
former Duro Bag facility. Soils suitable for In -ground POWiS with 0.7 gpd/sq/ft. design loading rate. Existing dispersal cell infiltrative surface elevskon = 94.4
1❑ Boring # El Boring
® Pg Ground surface elev. 100.15 ft. Depth to limk V factor 4M
Soil Apo
in.
ication Re
Horizon
Depth
In.
Dominant Color
Munsetl
Redox Description
Ou. Az. Cont. Color
Texture
Structure
Or. Sz. Sh.
Consistence
Boundary
Roots
GI
5DfFt2
"Eft#1
•EfW
1
0-12
10yr2/1
none
all
2fgr
mvfr
cs
2fmc
0.6
0.8
2
12-26
10yr314
none
sicl
tmsbk
mfr
ow
2fmc
0.2
0.3
3
26-50
10yr5/4
none
a
O69
dl
aw
-
0.7 I
1.6
4
60-103
10yr5/4
none
cos&gr
089
dl
flw
0.7
1.6
5
103-163
10yr6/4
none
s
Ogg
dl
0.7
1,8
2❑ Boring # ❑ Boring
® Pit Ground surface elev. 100.39 ft. Depth to limiting factor >
Soil Application
" in.
Ra
Horizon
Depth
In,
Dominant Color
Munsell
Redox Description
Qu. Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
Gi
ID/Ft?
'ER01
"Eff#:
1
0-14
1Oyr2/1
none
sil
2fgr
mvfr
ce
2fmc
0.6
Os
2
14-36
1 Oyr4/4
none
sl
1 msbk
mvfr
Cw
2frn2
0.4
07
3
36-46
1Oyr5/4
none
its
039
dl
Cs
tfm
0.5
1.0
4
46-70
10yr4/6
none
a
Ogg
dl
aw
-
0.7
16
5
70-116
10yr5/4
none
cos&gr
Ogg
dl
aw
-
0.7
1.6
6
116-184
10yr6/4
none
s
Ogg
dl
-
0.7
1.6
Effluent #1 = BOD > 30 s 220 and TSS > 30 s 150
mgA. Effluent
02 - BOD > 30 s 220 ni and TSS > 30 5150 mj
11-
CST Name (Please Print)
James K. Thompson
Sgnat re
Fs"-
CST Number
30021
Address
340 Paulson Lake Lane Osceola 1M 54020.5413
ate Evaluation Cdu
on
March 3 2021
Telephone Number
715 248-7767
JCu-7 (Ku4
3❑ Boring # ❑ Boring
opt Ground surface elev. 100.26 ft. Depth to limiting factor
Soil App
tn.
ication Rat
Horizon
Depth
In.
Dominant Cobr
Munsell
Redox Description
Ou. Az. Cont. Color
Texture
Structure
Gr. Sz Sh.
Consistence
Boundary
Roots
G
D/FP
'Eff#1
'E111#2
1
0-25
mufti colord
none
Is/sllsil
fill Om
mfi
aw
2fmc
0.0
0.0
2
2535
tOyrlN
none
sit
3mpl
mill
aw
2fmc
0.0
0.2
3
35-44
10yr4/4
none
sl
3mpr
dh
as
1vf,fm
0.8
1.0
4
44-77
1Oyr5/4
none
s
Osg
dl
aw
0.7
1.6
5
77-119
10yr5/4
none
cos&fr
Qsg
dl
aw
0.7
1.6
6
119-186
10yr6/4
none
s
Osg
di
-
0.7
1.6
❑ Boring # Boring ❑
❑ PH Ground surface elev. _ R. Depth to Idrritlrg factor
_ __ Soil A_p
Horizon Depth Dominant Cobr Re;w Desen tion Texture Structure Consistence Boundary Roots G
In. Munaell Qu. Az. Cont. Color Gr. Sz. Sh. 'Eff#1
in.
!cation Ral
/Ft'
'EfW2
I
I
❑
❑ Boring # Boring
❑ Pit Ground surface elev. _ ft. Depth to limiting factor
Soil
in.
licaoon Re
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
G
D/Ft'
'Eff#1
'Eff#:
Effluent #1 = BOD, > 30 5 220 mg& and TSS > 30 5150 rrg/L ' Effluent 02 - BOD, > 30 5 220 ng/L and TSS > 30 s 150 mg/L
Form -STC-104
AS BUILT SANITARY SYSTEM REPORT
OWNER Y/unn &o %y% .. TOWNSHIP /VLnro.J SEC. T gjN-E_.) LW
ADDRESS Tf l AL",, 1 ST. CROIR COUNTY, WISCONSIN
SUBDIVISION 111A . LOT IVA . LOT SIZE
PLAN VIEW
Distances and dimensions to meet requirements of IIMR 83
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM:
Aa.gnrY
Lzr.E
7.�e:-r �nuvrarY L.wa
B2-
�� Logy' �I
ICE
MA.wIFncTMrl3n/G
/31I�G
E.rc u,.6 rlFv = 99. 0J,
Pw.,o
PSG u«en Yoo� �° EA,r
/�r--j 1 Norf � Nf4 SS /Oo EWT A:�, far
,UYOL't �� ENSIzn-6 Sk'rl2c rAw�[
M°A y,•
ED /!/tEA
AS T
y Ps' \
LT-
aa/,ior frzrrs..n�, INDICATE NORTH ARROW
� N AAA f{LSSOr.+tE /LO`_�'�%1�,�.''�4i
'+V /
BENCHMARK: Describe the vertical reference point used y ra.y „s ;,,.,,_,, la-r
Elevation of vertical reference point: JV,9oo Proposed slope at site: ,_
L�]]
SEPTIC TANK: Manufacturer: 1'/r'erEA; Liquid Capacity:
Number of rings used: _ r Tank manhole cover elevation:
Tank inlet Elevation: Tank Outlet Elevation:
Na ber of fear from nearest Road: Front 0 Bide.® Rear. O fast
From nearest property line Front o side,ORear,® J004 feet
Number of feet from: well /.�O building: /O
(Include this information of the above plot plan)( 2 reference dimensions to septic tank)
SEE REVERSE SIDE
3 06
FILTER B❑DY
23182
J761
1/4' NPT F❑R
PRESSURE
ALARM SWITCH
CSTF-101>
5
FILTER SCREEN;
PERF❑RATED METAL
22 GA. STAINLESS STEE
TYPE 347 WITH 0.062
H❑LES
6.3aA
ST C:x SANITARY SYSTEM File Offtce Use Only
```" " - OWNERSHIP/ADDRESS FORM Creaftef 212021
Community Development Department will utilize this information to provide the property owner with
information regarding operation and maintenance of your new or replacement sanitary system! This
information will be provided as part of our ongoing efforts to protect public health, your well, groundwater,
surface water, property values, and county resources. Once approved, this completed form and educational
information will be sent to you by email.
Owner/Buyer
Hudson Business Park, LLC
Mailing Address 715 St. Croix St.
--
City/State/Zip River Falls, WI 54022
Phone Number (required) (651) 646-2911
Email Address (required) CShieffer@HuntElec.Com
Parcel Identification Number 020-1035-70-050
(found on the property tax bill)
Property Location ?t
Subdivision Plat: Na
28 N R 19 W,
Lot # 02 .
Certified Survey Map # 0 /�c% Volume 23 Page # 5508
Warranty Deed # tl�35 Z8 (before 2006)Volume . Page #
Number of bedrooms Na Spec house 13 yes 0 no Lot lines identifiable ■ yes 0 no
New Property Address
(Verification of new address required from Community Development Department for new construction.)
1
(Staff Initials) (Date)
This form must be submitted with all Private Onsite Water Treatment System (POWTS) applications.
New System: Include with this form 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.
Community Development Department — Land Use Division
715-386-4680 St Croix County Government Center
cdd0sccwi.aov 1101 Carmichael Road, Hudson, WI W16
715-245-4250 Fax
kYWW.5CCW.- y
'5. dX6
Wisconsin Depart 61 t �r4f� 'ar'S ices L .J T d0� I Pag 1 of 3
Division of Indust ���J
MAR U g 2p21 SOIL EVALUATION REPORT
In actor nce with SPS 385, Ws Adm. Code County
unto St Croix
Attach complete site pl on papgf hbfP sLt @1bfItMa inches in size Plan must include,
but not limited to vertic an gotr3Nr oint (BM), direction and percent slope, Parcel I D
scale or dimemions. no ocatlon and distance to nearest road 020-1035-70-050 Ref#2670
Please print all information. Rgweweij by , ! , Date
Property Owner Property Location I ❑
Hudson Business Park, LLC - Hunt Electric Corp. Govt Lot SE % SE % S 17 T 29 N R 19 E (or) W
Property Owner's Mailing Address Lot # Block # Subd Name or CSM#
715 St. Croix St. 02 Na CSM #5508, Vol 23, Pq 5508
City State Zip Code Phone Number ❑ cit
y El Village ®Town Nearest Road
River Falls W 54022 Hudson Pcl Add.486 Baer Dr, Hudson)
❑ New Construction Use ❑ Residential / Number cf bedrooms _Code derived design Flow rate 1.297.50 GPD
❑ Replacement ® Public or commercial — Describe Hunt Electric
Parent material Glacial Outwash Flood Plan elevation if applicable na ft
General comments and recommendations: Evaluation completed to verify soil suitability to allow the alteration and continued use of existing POWTS serving
former Duro Bag facility. Soils suitable for In -ground POWTS/Iwit'h' 0 7 gpd/sq/ft design loading rate Existing dispersal cell infiltrative surface elevaton = 94 41'
Rvr1�"OA+ S D4.Ktl'Yfa SO.itC
711 1 Boring #
❑ Boring
®Pit Ground surface elev 100 15 ft
Depth to limiting factor >163" in.
rHorizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az Cont. Color
Texture
Structure
Gr Sz. Sh
Consistence
Boundary
Roots
GPD/Ft'
'Eff#1
'Eff#2 1
1
2
0-12
12-26
10y2/1
10yr3/4
none
none
sit
Sid
2fgr
1msbk
mvfr
mfr
cs
civ
2fmc
2fmc
0.6
0.2
_
0.8 {
03
3
26-50
10yr5/4
none
s
Osg
dill
aw
0.7
1.6 1
4
50-103
10yr5/4
none
cos&gr
Osg
dl
aw
07
1 6 1
5
103-163
10yr6/4
none
s
Osg
dl
-
-
07
1 6
2 Boring# ❑4onng
®pit Ground surface etev 100 39 ft Depth to limiting factor >184" in.
i ��. ti r..1.3L F c
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az Cont Color
Texture
Structure
Gr Sz. Sh.
Consistence
Boundary
Roots
GPD/FP
'Eff#1
'Eff#2
1
0-14
10y2/1
none
sit
2fgr
mvfr
cs
2fmc
0.6
0.8
2
14-36
10yr4/4
none
sl
imsbk
mvfr
ow
2fm2
0A
07
3
36-46
10yr5/4
none
Ifs
Osg
dill
cs
lfm
05
10
4
46-70
10yr4/6
none
s
Osg
all
aw
0.7
16 1
5
70-11
10yr5/4
none
cos&gr
Osg
di
aw
-
0 7
6I6
116-184
10yr6/4
none
s
Osg
dill-
-
0 7
�11 6
I —
CST Name (Please Print)
Signature
CST Number
James Thompson
Ste—
30021 J
Address
ate Evaluation Condu ed
Telephone Number
L340 Pauison Lake Lane, Osceola, WI 54020-5413
March 3, 2021
715 248-7767 —
bbU-63W (KU4/1 b)
3 Boring #
❑ Boring
® Pit Ground surface elev. 100 26 k Depth to limiting factor >186 in
Soil Application Rate
Horizon
Depth
In
Dominant Color
Munsell
Redox Description
Qu Az. Cont Color
Texture
Structure
Gr Sz Sh
Consistence
Boundary
Roots
GPD/Ft2
•Eff#i -EfNt�
1
0-25
mufti colord
none
Is/sysil
urn
mfi
aw
2fmc
00
00
2
25-35
10yr2/1
none
sit
31MI
mfi
aw
2fmc
00
0 2
3
35-44
1Oyr4/4
none
sl
3mpr
dh
as
1vf,fm
06
1.0
4
44-77
10yr5/4
none
s
Osg
dl
aw
-
0.7
1.
5
77-119
10yr5/4
I none
I cos
I sg
I dl
aw
0.7
16
6
119-186
10yr6/4
none
s
Osg
dl
-
-
07
1 6
Boring #
❑ Boring
❑ Pit Ground surface elev.
k Depth to limiting factor _ in
Sod Application Rate
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/Ft'
•Eff#1
'Eff#2
❑ Boring #
❑ Boring
❑ Pit Ground surface elev. _ It
Depth to limiting factor in.
Soil Application Rate
Horizon
Depth
In
Dominant Color
Munsell
Redox Description
Qu. Az Cont. Color
Texture
Structure
Gr. Sz Sh.
Consistence
Boundary
Roots
GPD/Ft°
' _ 1
'Eff#2
' Effluent #1 = BOD, > 30 5 220 mg/L and TSS > 30 5 150 mg/L ` Effluent #2 = BOD, > 30 5 220 mg/L and TSS > 30 s 150 mg/L
C
Form -STC- 104
AS BUILT SANITARY SYSTEM REPORT
OWNER 6^0- / � TOWNSHIP Niinto.✓ SEC. _,j T _'Z? N-R_2y W
ADDRESS )? f / ly'Upfor ST. CROIB COUNTY, WISCONSIN
SUBDIVISION LIZA. LOT ///q . LOT SIZE
PLAN VIEW
Distances and dimensions to meet requirements of ILHR 83
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
P/EM1 /SO -lo n.TM /JIu AnTY
[ZnC yy� y�
FEncE UuaO /J/�G
—1✓frr PAoaenrr Lz.,,E /'/prv✓FN crvnl r./G
8 /SL1�G
d5 /
. yJ RxeAEn-rY Lzn.F
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SLOPE
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//tlFeKE Alwrni 0 e O C
WZ�H L+L.IMT JN
*ED NltFiq
GAM6E
' I I ASPrYn�r �
y Ps �
r
OvEa / Exu,x...c, INDICATE NORTH ARROW
To Sw%N Ai.Awfi AfnoE«ci /LO SCALE
LS
BENCHMARK: Describe the vertical reference point used /y T d„ - F r,
Il r
Elevation of vertical reference point: 00 00 Proposed elope at site:
SEPTIC TANK: Manufacturer: k.i TElF�_ Liquid Capacity: �9'�; 00
Number of rings used: �_ Tank manhole cover elevation:
Tank Inlet Elevation: Tank Outlet Elevation:
Number of feet from nearest Road: Front Side,® Rear, O ZU O * feet
From nearest property line Front,0 Side,O Rear,® -3U O + feet
Number of feet from: well L.CO building: /D
(Include this information of the above plot plan)( 2 reference dimensions to septic tank)
SEE REVERSE SIDE
6. 3 CqC 3
• G(Zo ► X COUNTY NO. 631268
STATE SANITARY PERMIT
PLUMBER
TOWN OF_
SEC t4 ,
AN
pkt
PREVIOUS
/OR LOT BLOCK
1104w3 . 'MR)Doi a. 8'T01 ? 9 SUBDIVISION
CHAPTER 145.135 (2rWISCONSIN STATUTES
(a) The purpose of the sanitary permit is to allow installation
of the private sewage system described in the permit
(b) The approval of the sanitary permit is based on regulations
in force on the date of approvaL
(c) The sanitary permit is valid and maybe renewed for a
specified period.
(d) Changed regulations will not impair the validity of a
sanitary permit.
(e) Renewal of the sanitary permit will be based on regulations
in force at the time renewal is sought, and that changed
regulations may impede renewal.
(f) The sanitary permit is transferable.
History: 1977 c. 168; 1979 c 34,221; 1981 c. 314
Note: If you wish to renew the permit, or transfer ownership of
the permit, please contact the county authority.
UTHORIZED ISSUING OFFICER - DATE
THIS PERMIT EXPIRES 'Z0u0 ( e0AZeSUNLESS RENEWED BEFORE THAT DATE
POST IN PLAIN VIEW
VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION
SBD-06499 (R. 10/11)
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