HomeMy WebLinkAbout020-1106-90-200Wisconsin Department of Commerce
Safety and Budding Division
PRIVATE SEWAGE SYSTEM
INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT)
Personal information you provide may be used for secondary purposes (Privacy Law, s.15 04 (1)(m)l
rchin L
TANK
TYPE
MANUFACTURER
CAPACITY
Septic
FI= Gt•JI'T
� �
Dosing
Aeration
Holding
TANK SETBACK INFORMATION
TANK TO
P!L
WELL
BLDG
Vent to Au Intake
ROAD
Septic
, 3-01
Z21
Dosing
Aeration
Holding
PUMP/SIPHON INFORMATION
SOIL ABSORPTION SYSTEM
RENC Width f Lengt
DI S 61
SETBACK SYSTEM TO
INFORMATION
Type O System
G�l�a
DISTRIBUTION SYSTEM
GPM
>yo,IOo!
x_ o • I L` bsv c-
TOWN OF
ELEVATION DATA
STATION
BS
HI
FS
ELEV.
Benchmark
q�
Alt BM
ST. M
ow, Cal
Bldg Sewer
SUHt Inlet
SUHt Outlet
Dtlnlet
Dt Bottom
Header/Man
Ze
Dist Pipe
Bot System
y,J
, 2c
Final Grade
4.8D
s Co
Of Pits
CHAMBER OR
UNIT
Header/Manifold, u
S 0
Dlsten(sution — _
x Hole Size
x Hole S�
Vent to Air Intake
Length Dia
LengtS—� Dia Spacing
SOIL COVER x Pressure Svstems Only xx Mound Or At -Grade Svstems Onlv
Depth Over
Depth Over
xx Depth of
m Seeded/Sodded
m Mulched
Bed/Trench Center
Bed/Trench Edges
Topsoil
Yes 0 No
M�EfNTS: Include code discrepencles, persons present, etc) Inspection #1. Sl /�ZI Inspection #2.
Location: No Address Available (/.' 1\y ( , p
wcQ decYY'( �s�� „Y^'Gh �. {s be �J�r�c.�'�i�{ r'ta•r � ih5 ��� /
1.) Alt BM Description =� � Ake--(v Ayzotvl ✓ret'ft.Rri+ 4�e'�
2) Bldg sewer length o5 P�'P (tom
-amount of cover = 7 j�" fn I r� ��Z4 iio 21 TO
3) o tis • Q` Vt^ via, $ r��us Ls �^ l� b e1� �t„e,.#-•
Plan revision Required? Yes No �,I 7-1
o ear $LdGe.�f'or adds io I infonnat n. "/-Jl�n`r�•"i-1_."._
-6�0(RP/97) �� -Z•Ot — t� OW �% In Actor's ignat4re e
i✓t' u,R„(,y ` = O . d ` rL SArf — L' C[ � ta�e..Q • 5 t_� e k
S56Ai -Qflao — Nn(-/
2.
Safety and Buildings Division201
Sanitary Permrt Number(to be filled in by Co.)
g!j-FNOV
Wi'Washington Ave., P.O. tnx 7162
04 2020
Madiso WI 53707-7162
it Appiic�
State Transaction Number
In accordance with SPS 3832112), Iris, Adm. Cod., submission of this form to the app a emcmnental smn
is required prior m ch+�;, +ro a sanitary Permit- Note .4pphcanon forms for smtr~owned POV'TLS�� Lenbmated to
Project Address (if different than mailing address)
the Department of Safety and Professional Servies. Peramal information you provide may be used for secondary
/fit
purposes in accordance with the Privacy Law, s 15,04 1)(m), Stars. -
��/ /t..� /J f//
1
L Application Information- Please Print All Infa matt
1�(
Property Owner's Name
Parcel'
Property Owners Mailing Addr
Pruplerty Locattn
^
ez,
Gout Lot
, }
3
C, _
ZIP Phone Number
!
T N; R / Y E W
II. of Building (check all that apply) - ! Lot b
ype
2Famdy Dwcllmg-Numbs of/jicarcoacs 131
Subdivision Name!`
Block if
/
❑ Pubhc/Cmi mercial-Describe Use❑City
of
❑Stare Owned - Describe Use CSM Number
❑V-Mage of
.---
I
Town of
Ill. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A.
❑ Replacement System
❑ai Tr.ment/Pioldmg Tank Replacement Ody
❑Other Modificanw toExisting System (explain)
B.
❑ Permit Renewal
❑ Permut Revision
❑ Change of Plumber
❑ Permit Transfer to New
List Previous Permit Number and Ike Lssued
Before Exphnnon
Owner
IV. T of POWTS S stem/Com onent/Device: Check all that apply)
Non-Pressi¢iuA In-Gound ❑Pressurized In-Gromd ❑ Atfirade ❑ Mound > 24 m of suitable soil ❑ Mound <24 in of suitable soil
❑ g Tart ❑Other Dispersal Comp®ent (explain) ❑ eatmem Device (explain)
V. Dis rial/Treatment Area Information: f
Design Flow (gpd) Desten Sml Application dsf)
Dispersal Aria Regnhed (sf)
Dispersid Area Proposed (sf) SwernElevano
elsv _'5�o-72
3
S�
VL Tank Info
Capacrry in
ToW
II of
Manufacco er
Gallons
Gallons
U.
1 f/,,� E'tC.Y
�
New Tanks
Ev g Tanta
!
"
1.- V •
—
SU
APlE,—
Sepoc or Hold,og Tank
Dosing Chamber
VII. Responsibility Statement -Star undersigned, c responsibility for instaRaaon of the POWTS shown on the attached plans.
Pl mine (Print)
PI tgoature MP/MP Number
Brmness Phone Nrwbee
- n
l�7
7
Plumber's Address (Street, City, State, .
3 Z lac? l
Coun apartment Use only
&{App�,� ❑ Di
Permit Fee
Da Lt5
Lssum Agent Sigrua[me
3 /�
Jam-
L
❑ ven for Denial
z3 2ozo
IX Conditionsrov 3)
aAll a
TEM OWNER' A
eptiC tank, effluent filter and f� .. • rY�- — t fir-'
cell must be serviced / maintained �) �.oK
ispersai
;
s management plan provided by plumber. +)-cr—(tKXs
per
ned
as per applicable Code/D p�P�for the aTatem and mbm'vw the County oWy apepv aaf ImstWa8 tox11 iarhesmsize
SBD-6398(K 11/11)
°!+Xwre
��,a�aa `,49�
sr; � , �
�.
System PLOT PLAN
PROJECT Urchins LLC ADDRESS 1353 Awatukee Trail Hudson Wi 54016
N 1/2 NE 1/4S 35 /T 29 N/R 19 W TOWN Hudson COUNTY ST.CROIX
SYSTEM ELEVATION 95.0/94.5 4'below grade DATE 11/1/20 BEDROOM 3
CONVENTIONAL XXX CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE
DING TANK SIZE LOAD RATE .5 ABSORPTION AREA 933 # of chambers 46
ENCHMARK V.R.P. Top of power box ASSUME ELEVATION 100' Filter Lifetime Filter
[:]BOREHOLE O WELL *H.R.P. same as benchmark
Scale = 1 /4" = 1 0' Magoo Road
95' 20
110, B_2 20'
V B 1 „ I
"X ,7 f. eot — a p par 6&r
97' — _ `` 1
Pro 3
r c Bedroom
" TT_--__
All piping shall be ASTM SDR 30/34, within
10' of tank, piping shall be ASTM F891 Vent
>6., Quick4 Standard 4
of Cover Leaching Chamber 203' Pr�QpOVhe
with 20.0 ft2 of Area 1✓
5.6fM2/pair of end caps
L4' Long 12
Grade at System Elevation
Ql
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 10/31 /20
Owner:Urchins LLC
Location: N1/2 NE 1/4 S 35 T29 N,R 19W 751 Magoo Road Hudson
Manuals Used: In -ground absorbtion system (version 2.0)
Page#
1. Cover Page
2. Plot Plan
3, Chamber Cross Section
4-6. Maintance and i ency Plan
7. Filter Cross Secti
Signature
License nur6o/r #226900
System PLOT PLAN
PROJECT Urchins LLC
ADDRESS 1353 Awatukee Trail Hudson Wi 54016
N 1/2 NE 1/45
35 /T 29 N/R 19
W TOWN Hudson
COUNTY ST.CROIX
SYSTEM ELEVATION
95.0/94.5 4'belowgrade
11/1/20
3
DATE
BEDROOM
—
CONVENTIONAL XXX
CONVENTIONAL LIFT
HOLDING TANK
1000 gallons
LIFT TANK SIZE
DOSE TANK SIZE
MOUND SEPTIC
TANK SIZE
TANK SIZE
LOAD RATE .5
ABSORPTION AREA 933
# of chambers 46
HDING
ENCHMARK V.R.P. Top of power box ASSUME ELEVATION 100' Filter Lifetime Filter
❑ BOREHOLE O WELL 'H.R.P. same as benchmark
Scale = 1 /4" = 10'
Pro 3
Bedroom
House
Magoo Road
95'
110,
B - 1
97'
20'
ST
B
20' -3
All piping shall be ASTM SDR 30/34, within
10' of tank, piping shall be ASTM F891 Vent
>6"
of Cover
4' Lonell2"
Quick4 Standard
Leaching Chamber
with 20.0 ft2 of Area
5.6ftA2/pair of end caps
,LGrade at System Elevation
20
20
Vents
— 99,
7% Slope
203' Property Line
Cross Section of Infiltrator Quick 4 Leaching Chamber
Typical cross section for 2 of 2 cells
Quick 4 Standard Leaching Chamber
with 20.0 ft2 of Area per Chamber
5.6ft^2 pair of end plates
-/ Typical Installation
Vent i Grade
4"
_ A�30/34 Septic Tank
5' Lonai t 5'
Grade at System Elevation
Spacing 5'
5'
To be >1' above grade
/ Finish grade elevation
�( 99.0'
Vent
t"
at System Elevation
2-3' X 94' Cells
Same on other end Observation tube/Vent
At end of cell
A
B
23 chambers per cell
System elevations:
A 95.0'
PI OWNER'S MANUAL & MANAGEMENT PLAN Page_of_
lr�ILE INFORMATION
Owner
Permit #
13ESIGN PARAMETERS
Number of Bedrooms
❑ NA
Number of Public Facility Units
NA
1 Estimated flow (average)
gal/day
1 Design flow (peak), (Estimated x 1.5)j"'fl
al/da
Sal Application Rate
aidda /ft'
Standard Influent/Effluent Quality
Monthly average"
Fats, Oil & Grease (FOG)
530 mg/L
Biochemical Oxygen Demand (BODE)
Q20 mg/L
❑ NA
Total Suspended Solids (TSS)
5150 mg/L
'Pretreated Effluent Quality
Monthly average
Biochemical Oxygen Demand (BODs)
530 mg/L
Total Suspended Solids (TSS)
530 mg/L
;?(J�A
Fecal Coliform (geometric mean)
510° cfu/100ml
Maximum Effluent Particle Size
t%in dia.
❑ NA
Other
NA
zt
"Values typical for domestic wastewater and septic tank efliuenL
M11Au1T1=11dAurc Cl"YGP1111 C
SYSTEM SPECIFICATIONS
Septic Tank Capacity
gai ❑ NA
Septic Tank Manufacturer
❑ NA
Effluent Fitter Manufacturer
�t!
❑ NA
Effluent Filter Model
❑ NA
Pump Tank Capacity
gal NA
Pump Tank Manufacturer
ItiNA
Pump Manufacturer
NA
Pump Model
III NA
Pretreatment Unit
NA
❑ SandlGravel Fitter
❑ Peat Filter
O Mechanical Aeration
❑ Wetland
• Disinfection
❑ Other.
Dispersal Cell(s)
❑ NA
AlGround (gravity)
❑ In -Ground (pressurized)
❑ At -Grade
❑ Mound
❑ Drip -Line
El Other
Other.
0 NA
Other.
El NA
Other
❑ NA
`
Service Event
Service Frequency
]inspect condition of tank(s)
At least once every:
❑ moMh(s) ears (Maximum 3 yB8rs)
NA 1
I
(Pump out contents of tank(s)
When combined sludge and scum equals one-third II of tank volume
❑ NA
inspect dispersal ceN(s)
At least once every:
morlrt(S�s) (Maximum 3 years)
❑ NA
Clean effluent filter
At least once every:
Ev month{s)
earls)
❑ NA
rspect pump, pump controls & alarm
At least once every:
0 Y �>s)
❑ NA
-lush laterals and pressure test
Pre
every:
At least once eve
At least once every
❑ )
yea s)
❑ year)
❑ month(s)❑ year(s)
NA
NA
Other
xher:
MAINTENANCE INSTRUCTIONS
inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Maa(ef
(Plumber, Master Plumber Restricted Sewer: POWTS inspector: POWTS Mainta per; 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
Irombined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be
ivisually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface.
The pointing of effluent on the ground surface may indicate a fading condition and requires the immediate notification of the local
Iegulatory authority.
When the combined accumulation of sludge and scum in any tank equals one-third (%) or more of the tank volume, the entire contests of
!'he tank shah be removed by a Septage Servicing Operator and disposer; of in accordance with chapter NR 113, Wisconsin
4dministrative Code.
iNI 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 b, a certified POWTS Maintainer.
A service report shaft be provided to the local regulatory authooty Mth;r 1 O days of completion of any service event.
Page __ of
START UP AND OPERATION or dher chemicals d*t
ctl
For new construon. Prior to use of the POWTS dnedk fcell s).tank(sIf
the p am he" Ina cot tents of the
may impede the begin ant process and/or damage the dispersal () _
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. will
be
power outages pump tanks may fAI above nomrei highwater levels. When Power is restored the excess tew wasaW
discharged to the dispersal cell(s) in One large dose, overloading the Cell(s) and may festllt In the backup or surtaoe disdlerge of sAfluent.
To avoid this situation have the contents of the pump tank removed by a Septege Servicing Operator Prior to sestorirg Power to title
affluent pump or contact a Plumber or POWTS Maintainer to assist in mama* operating Rump controls 10 restore normal levels
within the pump tank.
Do not drive or park Yehides over tanks and dispersal calls. Do not drive or park over, or otherwise disturb or comps the area within
15 feet down slope of any mound or at -grade soil absorption area. Kid
Reduction or elimination of the following from the wastewater stream may improve the Performance adle P the NO of the P n drat
antibiotics; baby wipes: Oigaratte butts; condoms; cotton swabs: degreasers; dental flu diapare; dbinfedants; tort toiling on drain
(aumP pump) water; fruit and vegetable peelings; gasdf W gam; herbicides; meat sasPs; madicallons; 00; Painting Produciiii;
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 propejty
and safety abandoned in complience with dtiapter Comm a3.33, Wisconsin Administrative Code:
• Ail piping to tanks and pile shall be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and pits shall be removed and property disposed of by a Sepfage Servicing Operator.
• After pumping, ail tanks and Pits shag be excavator) and removed or their covers removed and the void space filled with soil,
gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS fags and cannot be repaired the following measures have been, or roust be taken, to provide a code compliant
replacement system:
�A suitable replacement area has been etrakratad and may be uWaed for fhe location of a replacement soil absorption sYsteM
The replacement area should be protected from disturbance and compaction and amid not be irdrYuged upon by raquirled
setbacks from existing and proposed structure, lot limes and wells. Failure to protect the raplBCernent area will result in the need
for a new soO and site evaluation to establish a suitable replacement area. Replacement systems must comply wllh the ruled in
cited at that time.
❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a
hddfng tank may be installed as a last resort to replace the failed POWTS.
❑ The site has not been evaluated to identify a suitable raplaoemertt area. upon faiture of the POWTS a soil and site evak0*01 n
must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as
a last resort to replace the failed POWTS.
❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of fhe biorret at the infigretive
surfao. Reconstructions of such systems must con" with the rubs in effect at that tine.
«WARNING»
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES ANOIOR INSUFFICIENT OXYGEN. DO NOT
ENTER ASEPTIC, PUMP OR OTHER TREATMENT TANIF UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE & A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS
POWTS INSTALLER POY4TS MAINTAINER
Name t ri..✓`✓j
Phone I 7o —
SEPTAGE SERVICING OPERATO PUMPER LOCAL REGULATORY AUTHO
Narrxe Name S1
Phone ,,-�� Pf 7i� - 5 2 C
Thb doaanerdwas dralmd In compliance with chapter SPS 383.22(2)(b)(1)(d)8.(t) and 3a3.S1(t), (2) & (3), Wigoonsi+Pdnhistrafive Code.
?0140048A
0t,5200
SECTION A -A
1921
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer I- %cjy)c 1^
Mailing Address
Property Address %Jf-
(Verification
OR
f-ktkso(A t
City/State N,\-�keSO h NkA!)iISC-, Parcel Identification Number
LEGAL DESCRIPTION
new
Property Location Az— A AE Y4 , Sec. T L N R W, Town of
Subdivision Plat: i Lot # �
Certified Survey Map # Volume ^ Page #
Warranty Decal # 10'W 2 > Z (before 2007)Volume --- , Page #
Spec house 0yes*o
Lot lines identifiable)(yesQno
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
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(I) 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.
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 Safety And Professional Services and the Department of Natural Resources,
State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix
County Planning & Zoning Department within 30 days of the three year expiration date.
I/we certify that all statements on this form are true to the best of my/our knowledge. I/we am/are the owner(s) of the
property described above, by virtue of a warranty deed recorded in Register of Deeds Office.
Number of bedrooms
SIGNATUM OF APPLICANT(S)
lz /2/i�v
DATE
***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department •**
Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if
reference is made in the warranty deed.
(REV. 04/12)
mD
m
m C
___ _ ------ ZL7_-___.
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t
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(715)2,*-301O
I BRACED WALL LINE
PANEL DETAILS
® ...�.........,...... Oevering Home:
t3-JJ
r FOUNDATION
I
I I
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o
ai!
+'•
.vvv.ox
t
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I
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rou w.w
�49j•9 (715)24e-3010
ol
---------
Y ' '
a. NOTICEI
as .Np.�v'wRM.'Yl
mioriivev�n
��� • Y wwmurunw..n
{
BRACED WALL LINE
PANEL DETAILS
MSG PT.
MAIN LEVEL
8 8 ENTRY
Oevenng HDmBS
i]-M
MAIN LEVEL
A3
�tK ..
BENCHMARK
TOP REBAR \
ELEV = 97773' O
qR0 \ i
I
r lgs9 C7
4WATER EASEMENT
O. F.'97700
ON
L „ -L23 -
HWIJE,O.F. = 978.30
STORMWATER
EASEMENT 2315'-
0
4-
�-
BENCHMARK
BENCHMARK 1
STOP REBAR +j
ELEV. = 977.32'
249 42' — - -
-I-� L 20' STORMWATER
EASEMENT
i 1a
N6
- MAGOO
_ _ _ —
- —'
_ - - - - -
+
DEDICATED
___--SB-
GZ 260 85'
-- 708,31' ---
223 73
91i ,'
} N88°1627"W 261 34' _
_
B_ENCHMARK
TOP REBAR
ELEV == 980 85'
L0T14
mm
A
�p
p,
88,045 S0. Ff,
/V L.B0.=98150'
m
n
m
1
('n
,
S87051
AT OF LOT 2 - CSM VOL. 29, PG. 6614, DOC. # 1077822
)R, USER, LICENSEE OR OTHER PERSON MAY HAVE ANY
IHWAY LYING WITHIN THE RIGHT-OF-WAY OF INTERSTATE
A RESTRICTION FOR THE BENEFIT OF THE PUBLIC AS
DEPARTMENT OR ITS ASSIGNS, ANY ACCESS SHALL BE
�ECIAL EXCEPTION SHALL BE CONFIRMED AND GRANTED
HITS ARE REVOCABLE"
434.42'
III
0
LOT 13
2.98 ACRES
�n
129,661 S0. Fr.
�+
v
Q
I � u
Wiscons:. i Department of rcef UN 2 9 �0 soil- EV " T
Division of Safety and Build igs
St. �: M� axordance with Q mm85, Ws. Adm. code
C«nN
Attach complete site plan es in size. Plan must
include, but not limited to. vertical and horizontal reference point (BM), direction and parcel I.D. ��
Percent slope, scale or dimenvons, north arrow, and location and distance to nearest road.
Please print all information. Reviewed by
Person•I roforrnaeon You ti o mey be used for secondary f>urvwaa (Prnoc/ Law, s. 15 04 (1) (m))
6ST--2,02,0- �tiY
IMOM
lure
Page__ of_
Govt. Lot N t 114 114 s 3_- T N R E( W
Property Owners Mailing Address Lot # Block # I Subd. Name or CSM# F n i
i
"'/ � State Zip Code Phone Number city ❑ Village Nearest Road
6� 1Ar15aUG9011 Usa,*J�Sesidenbal i Number of bedrooms /i` Code derived design now rate `��?7//, tii GPD
❑ Replacement ❑ Putil/�l,/p r commercial - Describe/7
Parent material Flood Pla elevaabon if aGeneraipp/L/cable
grid recommendations.
ec t SQH of
wl�.1ue VOIL t �ryD s
�1� xr v �ce,r,�. T3D
�-
System Type System Elevation
Boring # 4 ring Ground�/'
$-:It surface elev. 51 5-
ft Depth to leniting factor LI J in, --�
- LrKMM 91 = 50U. > 3U < 2Z0 mgeL and TSS >30 < 1 — AfMuerd #2 = BOD. < 30 mg/L and TSS < 30 ngfL
CST Name (Please Print) Ignature CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address ate Evaluation Conducted Telephone Number
1432 120th St, New Richmond, WI 54017 �'02� 0, 0 715-246-4516
:.1""rPl�'r57
Parcel ID #
Page —of
• _ _ _ �� • > AFT}!
WOU
Boring # [rv1)Boring ii!,
L-Tpil Ground surface elev. -{� t 'J ft. Depth to lirrunng factor �� v in
Shc�4on Rate
Boring # ❑ Boring
❑ Pit Ground surfaceelev. ft. Depth to limitug factor in.
Snip
Etffuml #1 = BODE > 30 1220 mg/L and TSS >30 1150 mgA- . Effluent #2 = BODr < 30 mglL and TSS < 30 mgll
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.
s Mla.soot
Soil Test Plot PI
Project Name Urchins LLC
Address 1353 Awatukee Trail
Hudson Wi 54016
Lot
N
14 Subdivision Summer Prairie 1st. Add
Bird
>TM #226900
6/24/20
1/2 NE 1/4S 35 T 29 N/R19 W T h• Hudson
Boring Q Well PL Property Line
` BM or VRP Assume Elevation 100 ft.
owns ip
County ST. CROIX
Top of power box
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