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Home My WebLink About008-1056-20-300 (3)Wisconsin Department of Commerce Safety and Building Division GENERAL INFORMATION Personal information you provide may be used for secondary Joan Insp BM TANK INFORMATION PRIVATE SEWAGE SYSTEM INSPECTION REPORT (ATTACH TO PERMIT) [Privacy Law, s 15 04 (1)(ri City Village Towne TOWN OF EAU GALLE TYPE MANUFACTURER CAPACITY Septic Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG Vent to Air Intake ROAD Septic Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift Faction Loss System Head TDH Ft Forcemain Length Die. Dist to weu SOIL ABSORPTION SYSTEM LEVATION DATA STATION BS HI FS ELEV Benchmark Alt BM Bldg Sewer St/Ht Inlet SUHt Outlet Dt Inlet Dt Bottom Header/Man Dist Pipe Bot System Final Grade St Cover BED/TRENCH Width Length No Of Trenches PIT DIMENSIONS No Of Pits Inside Dia Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L IBLDG IWELL LAKE/STREAM LEACHING Manufacturer INFORMATION CHAMBER OR Type Of System Model Number UNIT DISTKIEWTION SYSTEM HeaderiMamfoltl iDistribution x Hole Size x Hole Spacing Vent to Air Intake Pipes) Length Dia Length Dia Spacing SOIL COVER x Pressure Svstems Only xx Mnund Or AGr of Svetnme Aril, Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center BedlTrench Edges Topsoil ❑ Yes ❑ No ❑ Yes No COMMENTS: (Include code discrepancies, persons present, etc) Inspection #1 Inspection #2 Location: 2149 30TH AVE 1 ) Alt BM Description = 2 1 Bldg sewer length = - amount of cover = Plan revision Required? ❑Yes ❑ No L �I Use other side for additional information SBD-6710 (R W97) Date Insepctor's Signature Can No <AAI -N,AI— 2,ct \Vvl Safety and Buildings Division St. Croix I 201 W Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co ) Madison, WI 53707-7162 R, 6 3 3 98(v State Transaction Number g rOiX psi p it Applicatio In accordance wdh . _ . Wis Adm. Code. submission ofthis forth to the appropriate governmental unit 2986465 is required prior to obtaining a sanitary permit. Note Application torms for state-owned POWTS are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Services Personal mlormation you provide may be used for secondary purposes in accordance with the Privacy Law, s 15 04 I (m), Stals 2149 3011 Ave. 1. Application Information -Please Print All Information Property Owner's Name Parcel d Joan Larson >✓ 008-1056-20-300 Property Owner's Mailing Address Property Location 2149 30" Ave. 6ovt Lot NE Y.._NE_''/., Section City State Zip Code Phone Number _19_ (circle one) Baldwin. WI 54002 715 220-8306 L 28 N, R 16 E or W If. Type of Building (check all that apply) Lot d ®Ior 21-amdy Dwelling- Number of Bedrooms 3 Subdiv ision Name 03 Block a CSM ❑ Public/Commercial - Describe Use - Na ❑ City of __- ❑ State (honed - Describe Use CSM ❑ Village of Number ® 1 own of Eau Galle Vol. 28, Pg. 6372 III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ❑ New System ®Replacement System ❑ I reatmenVNoldmg Tank Replacement Only 1 ] Other Modification to Existing System (explain) B. Permit Renewal u ❑ Permit Revision n Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Daze Issued Before Expiration Owner 600241- 10/24/17, 617719 - Renewal I r] / 019 /f / IV. Type of PORTS System/Corn onent/Device: Check all that a I / = ❑ Non -Pressurized In -Ground ❑ Pressurized In -Ground ❑ At -Grade ® Mound > 24 m of sortable sod ❑ Mound < in of suitable sod Hulduig Tank ❑ Other Dispersal Crlmn lam) retre vice exp a r —Dispersal/Treatment V. Area Infop ill„)' Design Plow (gpd) Design Sod Appgpdst) Dispersal Area Required Dispe al Area Proposed (st) Sys[em�EIev n 450 Gpd 1,125-00 sq. ft. at 6" above S(o / i 104.00' contour VL Tank Info Total p of MGallons Units� 1_Newranksting 4ex-Septic Tanks or voiding Tank 1,000Na 1,000 1 Wieser Concrete WLP X nosing Chamber 600Na 600 1 Combination ST/PC X V 11. Responsibility Statement- Elthe undersigned, assume responsibility for installation of the POyi'TS shown on the attached plans. Plumber's Name I. Print) Plumber's Squutur MP/etPRS Number Business Phone Number James K Thompson MPRS 30021 715 248-7767 y� Plumber's Address (Street. City, Statc—e Code) 340 Paulson Lake Lane, Osceola, WI 54020 VIII. County/Department Use Only A Approved ❑ DS oved Permit e 9�e /� Da[v [Qss�� Issm Agent Slgnat ❑ Owner Given for Denial V IX. Conditions Appro I I 3 1blk c YSTEM OWNER: �� tJs(,SIA�t.� . Septic tank, effluent filter and pkx 11"24-e t L ' x -t'p�e c,Q,�.ptY�-LRd,� dispersal cell must be serviced / maintained fl S p.¢.c t l ( W tJ�,� �t�A as per management plan provided by plumber J G)! T t� J plumber. .All setback requirements must be maintained R-C rid.t - I to plans for the system gnd sphmn to the Cgyn`iq my on pap�`t less sap 8 i�� inches io size a6- c e&-e r� J\ �'/Lu.;/�L/ lfA'11.1�s �er�tt-I—r fIX, CIA-L t.Vk U ,eComity Safety and Buildings Division St. Croix OCT 08 01�01 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Cc ) Madison, WI 53707-7162 77/7 Sanitary Permit Application — State Transaction Number In accordance with SPS 383 21(2), Wis. Adm Code, submission of this form to the appropriate governmental unit 2986465 is required prior to obtaining a sanitary permit Note. Application forms for state-owned POWTS are submitted to reject Address (if different than mailing address) the Department of Safety and Professional Services Personal information you provide may be used for secondary purposes in accordance with the Privacv Law, s 15 04 1 m , Suits / 2149 3011 Ave. ✓ 1. Applicationjlnfaion —Please Print All Information Property Owner's N e/ Parcel # Joan Larson 008-1056-20-300 Property Owner's Mailing Address Property Location 64.28. lea- 279$ 2149 30' Ave. Govt Lot NE '/., Section 19 , City, State Zip Code Phone Number Baldwin, WI 54002 715 220-8306 _NE_'/., (circle one) T 28 N, R 16 E m W IL Type of Building (check all that apply) Lot # ® t Dwelling—Numbe Bedrooms 3 Subdivision Name 0 I4�LtL CSM Block# ❑ Purcial —Describe UseNa ❑City o❑StaIkscnbe Usel ❑ Village CSM Num r too I ®iown o£ u Gall jf O� / / is As .28, Pg. 6372 III. Trmit: (Ch a Complete line B if plicable) 'Astem ® Replacement System ❑ atmcnUHoldmg k Replacement Only ❑Other a[ion [o Ezisnng System (explain) Renewal ermit Revision ❑ Chang f Plum r ❑ Permit T t ew List P o Permit Number and Date Issued iration Owner 241 issued 10/24/7 I S Component/Device: Check all tha Oft.J ❑ Non -Pressurized In -Ground ❑Pressurized In -Ground EllA[- Mound > 24 in. sit s and 124 in of suitable soil and El Holding Tank ElOth Dispersal Component (explain) Pre at a l V. Dispersal/Trealryint Area Information: Nal X, 6 Design Flow (gpd) Design Sod Application Rate(gpdsf) D persal Area Re q it (sf) Disper'MWea Proposed (sly s evasion 450 Gpd 0.4 1.125.00 sq. 1,51V&77 s . ft. 104.50' 6'-Wove VI. Tank Info Capacity in Total # of Menu ac urcr Gallons Gallons Units a 0 9 0 New Tanks Existing Tanks U " Septic or Holding Tank 1 AvieseXoncrete WLP X Dosing Chamber 1V� ttOhe 1 Combin on ST/PC X V IL Responsibility, , umder gned, a me responsibility [or installation of the POWTS own on the attached plans. j Plumber's Name (Print) Plumber's Signa re PfMPRS Number Business Phone Number I James K. Thompson 5--- MPRS 30021 715 248-7767 Plumber's Address (Street, City. State, Code) 340 Paulson Lake Lane, Osceola, WI 540 VIII. oun /Dapartment Use Only Approved ❑ Permit Fee Date sued Issmng ent Sign re 'rven $ ' 16 Y7 Reason for Denial /f� r IX. Condi Reaswis for Disapproval 1. S ll tut u tsrkt t b ulsl.Tei::�, cell ^,ust all be sn_ic •s '_ Ttz _ ec 4ape ,, c ae per ,ilaragemen' plan ^ o'we! liv alwnne . (� f�1 ^ w� f 1 `. p��,i,i �•, 2. AM neftwk recl.irai ^ems mual i et, It as per pFikrAils oytf / : rd', ' �✓ tlCn� c�tO4. > Amen to compiete pians Tor the system and suhfvit to the County only on [Pi 1 s thy, Sin x I I inches to size SBD-6398 (R. 11/11) C"It" � J 66A,-•1 County t /+�N�� Safety and Buildings Division St. Croix __�,.,, -5r RECEIVED VV 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co ) 1 O Z017 Madison, WI 53707-7162 OCT G� 7Z1 IFFY YeYlu� lt API Slate Transaction Number MUN ECC In accordance w;hh S38321(2), Wis ArlonArlonCode, SWRTJS MOCKVT submission of t 2986465 • is required nor to obtaining a sane forms nn o...,_ _ q p g Sanitary permit Note Application Project Address (if different than mailing address) the Department of Safety and Professional Services Personal mfonnanon you provide may be used for secondary information purposes ni accordance with the Privacy Law, s. 15 04(t)(m), Slats 2149 30'" Ave. 1. Application In rmation - Please Print All Information Property Owner's am k iaSG_ 20— 3oa Joan Larson 008-1947MIT-TIO" Property Owner's Mailing Address Property Location ' V 2149 30" Ave. Govt. Lot NE '/4, _NE_'/4, Section _19 City, State Zip Code Phone Number (circle one) Baldwin,W1 54002 (715)220-8306 T 28 N; R 16 EorW 11. Type of Building (check all that apply) Lot 4 ❑ I or 2 Family Dwelling- Number of Bedroom 3 Subdivision Name �a Block 4 ❑ Pub] w/Commercial -Describe Use Na ❑ City of ❑ Slate Owned- Describe Use t Ll VV 11 ge of CSM Number + lr^ou f L Town of Eau Galle (Q v a Z ! III. Type of Permit: (Check onl one box on line A. Complete litalliq i applicable) ZC A ❑ New System Replacement System ❑ "frea[ment/Hol ank Replacement Only El Other Modification to Existing System (explain) B• ❑ Permit Renewal ❑ Perini[ Revivo ElCh lumber ElPertnrt Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV. Type of POWTS S stem/Coin onent/ e: trpwall that a 1 ❑ Non -Pressurized In -Ground ❑ Pressurized In ❑ At -Grade ound > 24 in of suitable soil ❑Mound <24 m of suitable soil ❑ Holding Tank ❑ er Dispersal Component (ex m) Pretreatment vice (explain) �r V. Dis ersalfrreat ent Area Information: Design Flow (gpd) Design Sod Application Rate(gpds Dispersal Area Required (sf) Dispersal Area Proposed (s0 Sowm6lalevation 450 Gpd 0.4 1,125.00 sq. ft. I ft. 104.5 ' t6" ffbin, VI. Tank Info Capacity in Total d of Manufacturer Gallons Gallons Units t v o o New Tanks Ex� Septic or Belding Tank r „plys 1 ieser C crete WLP X Dosing Chamber Na &D@^ I Combination ST/PC X V 11. Responsibility Statement- , the undersigns , assume responsibility installation of the POWTS shown on the attached plans. Plumber s Name (Print) Plumber's anature MP/MPRSNumber Business Phone Number James K. Thom son �4_— MPRS 30021 (715) 248-7767 Plumber's Address (Street, City, State, 7 ode) 340 Paulson Lake Lane, Osceola, WI 54020 Vlll. oun[ /De artment Use Only Approve Permit Fee Date ssued Z' "T Issum of Signature /0 ! iven Reason for Den IX. Condi ]Reasons for Disapproval I Al +n,i 3 .Is, erOtxrn • rt6YA FAsper ai cefl ^wet all be - si_ic ,s i t +. nta r ec t �A^. I e� as per Tarsagemeni plan pit, nael by plumber. r ^ -AN P /" 2. eelbltlone Uftmentsmust berrartrire1 V 1l n ,.1 aspwslapklbMead=/:Mineln ti. �} �tvlSllnq Po�� If/ Gf�J Gt�IIV(A LOGUC e Attach to complete plans for the system and submit to the G6uoty, only on paper not less than 8 1 a x 11 inches in size SBD-6398 (R. 11 /11) wwL:T �f 51ap< CIAr As3� .uc efuo e[D.co Qre� 83, _ J —�' l Preposedwres��e.�cr,.fe � wl� (oCoMQCuK6,hwFiy-, "taw Ei¢eLAC EobePicbccEcd 11�11/S f ;or r5L lawn EX/Sf-�i wed ✓✓� d'%IsTm3o35rburld;., .Sux. (y Cs..yo/Y w/ OSRs 382. 3o i'��c�. SEE CORRESPONDENCE /J.yd..ue (- 64 r=xaA 9BE REfi.Ar-Eb w1llvME v tAf il7o 6REmtc -,:H z 3 e&P Rm.v f m x ®Aci/. f2YbS So a.+ Lnrson Pr°P- z/sr9 Awr�rJEYySee iy, T. sBn., fac% 8ca9-iaS7-Go-ace J69,�S yo o/l vcs Ce, Or"r Mound POWTS Index & Title Sheet Project Name: Larson 3 Bedroom Replacement Mound Owners Name: Joan Larson Owner's address: 2149 30th Ave., Baldwin, Wl 54000 Site address: Same Project Location: Subdivision. Na Legal Description: N WYNEY, Sec. 19, T 28N., R.16W., Town of Eau Galle, St. Croix Co., W L Parcel ID #: 008-1057-60-000 Page I Index and Title Sheet Page 2 State Approved Mound Design Page 3 Septic Tank Maintenance Agreement Page 4 Septic TanldPump Chamber Cross section Page 5 Filter Cross Section Page 6 Certified Surve) Map Page 7 Warranty Deed Attachments: None Mater Plu er Res cled Service: James K. Thompson, DSPS Credential #30021 Signature: Z-G{- Date' e6z.6,12e17 Page I of 7 Design pursuant to In -Ground Sod .Absorption Component Manual for POWTS. version 2 0 SBD-10705-P (N 01/01) DS 1 PS.. August 23, 2017 CUST ID No. 30021 JAMES K THOMPSON ACE SOIL & SITE EVALUATIONS 340 PAULSEN LAKE LN OSCEOLA WI 54020-5413 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/23/2019 SITE: Joan Larson 2149 30TH Ave Town of Baldwin St Croix County NW 1/4, NE1/4, S19, T28N, R16W FOR: DIVISION OF INDUSTRY SERVICES 3824 CREEKSIDE LN HOLMEN WI 54636-9466 Contact Through Relay http.//dspswi gov/programshndustry-services www wisconsin gov Scott Walker, Governor Laura Gutierrez, Secretary ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1 101 CARMICHAEL RD HUDSON WI 54016-7708 Identification Numbers Transaction ID No. 2986465 SiteID No. 841463 Please refer to both identification numbers, above, in all correspondence with the agency Description- Three Bedroom EZFlow Mound System 1 Sloping site Object Type, POWTS Component Manual Regulated Object ID No . 1721474 Maintenance required, Replacement system; 450 GPD Flow rate; 30 in Soil minimum depth to limiting factor from original grade; System(s): EZflow Mound Component Manual, (R. 7/12), Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01,01, R. 10/12), Effluent Filter 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. CONDITII The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code APPRI requirements. DEPT OF SI No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145 06, PROFESSION stats. DIVISION OF IND The following conditions shall be met during construction or installation and prior to occupancy or use. Reminders • A sanitary permit must be obtained from the county where this project is located in accordance with the SE RI requirements of Sec. 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • A state approved effluent filter is required Mamtenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. • The existing POWTS shall be abandoned per SPS 383.33, Wis. Adm. Code. • The area within 15' downslope of the dispersal cell shall remain undisturbed. Vehicular traffic, excavation or soil compaction is prohibited in this area. • A copy of the aeoroved clans, specifications and this letter shall be on -site durine construction and ouen to inspection by authorized representatives ofthe Department,. which may include local inspectors. JAMES F THOMPSON Page 2 8/23j2017 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. • The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. SPS 383.54(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. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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. Sincerely, raid M Swim POWTS Plan Reviewer, Division of Industry Services (608)789-7892, Mon - Fri, 7:15 am - 4 00 pm jerry.swim@wisconsin.gov Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm 1AMES K THOMPSON Page 2 8/23/2017 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. • The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. SPS 383.54(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. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance hacking purposes Reports shall be submitted at intervals appropriate for the componem(s) utilized in the POWTS. In granting this approval the Division of Industry Services reserves the right to require changes or additions should f� code ^ ••, ance. A_ per state oats 101.12(21, nothing in this review conditions arise making 'Wen, necessai j r' �o••�p•• P-- shall relieve the designer of the responsibility for desiming 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 nthers who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, rard M Swim POWTS Plan Reviewer, Division of Industry Services (608)789-7892, Mon - Fri, 7 15 am - 4:00 pm jerry.swim@wisconsin.gov Fee Required $ 250 00 Fee Received $ 250.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm EZflow` MOUND AND PF ESSURE DISTRIBUTION COMPONENT DESIGN ResideAgt 6Applic?p97, INDEX AND TITLE PAGE 3 r taf�: tr" Project Name: Larson 3 bedroom replacement mound Owner's Name Joan Larson Owner's Address: 2149 30th Ave. Baldwin, WI 54002 Property Address: Same Legal DescriptionNW1/4 NE114, Sec. 19, T 28N , R 16W Township Eau Galle County St Croix Subdivision Name. Na Lot Number Na Block Number Na )NALLY WED Parcel I D Number 008-1057-60-000 .FETY AND XL SERVICESISTRY Plan Transaction No. SERVICES Page 1 Index and title Page 2 Data entry r Page 3 EZflow mound drawings (J-CID Page 4 Lateral and dose tank CEEN Page 5 Distribution media Page 6 System maintenance specifications Page 7 Management and contingency plan Page 8 Pump curve and specifications Page 9 Site Plan Page 10 Attached Soil Evaluation Report Designer: J s K Thompson License Number Date. 6/13/17 Phone Number Signature' 30021 (715) 248-7767 Designed Pursuant to the EZflow Mound Component Manual Ver August 20, 2007, SSWMP Publication 9 6 Design of Pressure Distribution Networks for ST-SAS (01/81) and Pressure Distribution Component Manual Ver 2 0 SBD-10706-P (N 01/01, R 10/12) EZflow Mound Version 3 0 (R. 3/1/12) Pagel of 10 Mound and Pressure Distribution Component Design Design Worksheet (r or c) Site Information Residential or Commercial Design Estimated Wastewater Flow (gpd) Peaking Factor (e g 1 5 = 150%) Design Flow (gpd) Site Slope (%) Installation Contour Line Elevation (ft) Depth to Limiting Factor (in) In -situ Soil Application Rate (gpd/ft`) R 300.00 1.50 50.00 P 13.00 104.00 30.00 0.40 -: el 105.00 Contour Length Available (ft) Distribution Cell Information 6.00 Cell Widtn (ft) 3 4, 5, 6, 7, 8 9 or IQ -On 80 00 = Dispersal Cell Length (ft) 0.95 Dispersal Cell Design Loading Rate (gpolft) 1 Influent Wastewater Quality (1 or 2) Pressure Disribution Information Center or End Manifold Lateral Spacing ifti Number of Laterals Orifice Diameter (in) (e g 0 25) Estimated Orifice Spacing (ft) _ Forcemain Diameter (in) Forcemain Length (ft) Inside Pump Tank Elevation (ft) Forcemain Filter Loss (ft) System Head (ft) x 1 3 Vertical Lift (ft) Friction Loss (ft) Total Dyramic Head (ft) Lateral Diameter Selection in dia. options choice 0 75 1 00 1 25 150 x x 200 x 3 00 x Are the laterals the highest point in the distribution F Y network? Enter Y or N If N aoove. enter hie elevation !ftl of the highest po nt ( 8 28 ftziorifice Does the forcemain drain back? Y Enter Y or N 8 16 Forcemain Drainback (gal) 71 93 5x Void Volume (gal) 80 09 Minimum Dose Volume (gal,, 31 23 System Demand gpm) Manifold Diameter Selection in dia options choice 125 x 150 x x 2 00 3 00 Gallons/Inch Calculator (optional) Treatment Tank Information 602 82 Total Tank Capacity (gal) 1000 00 Septic Tank Capacity (gal) 51 00 Total Working Liquid Depth (in) Wieser Concrete IManufacturer 11 82 gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 602 82 Dose Tank Capacity (gal) PolLok Filter Manufacturer 11 82 Dose Tank Volume (gal/in) PL525 Filter Model Number Wieser Concrete Manufacturer Project. Larson 3 bedroom replacement mound Page 2 of 10 Mound Plan View Observation Pipe tJ K rt B ❑3 1_ 1 L Mound Component Dimensions E 15 72 in F 12 00 in G 0 50 ft 48000 (ft2) Dispersal Cell Area 5 63 (gpd/ft) Linear Loading Rate Finished Grade 104 50 (ft)--O-• Dispersal Cell Elevation H 1 00 ft K[Aft ft 14 17 ft Lft J 4 27 ft W 161345 (ftz) Basal Area Available 8 00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View EZflow Dispersal Area 106 50 (ft) 13.5 % Site Slope I H 105 00 (ft) Lateral Invert Elevation 104 00 (ft) Contour Elevation Typical Dispersal Cell Shading Key See Page 5 C -� Topsoil Cap > m o- 7 2 0 Subsoil Cap o o a Approved Geotextile Fabric Cover 3 ASTM C33 Sand "A4 w ' 2 0 ft 1 t :.. �' 0 Tilled Layer 9 'v 5 �, ..... F E EZflow Media L c ." :: .;,;..:.,.;;.�..?ii:i:`;aaaa: 0ti 05ft -�- __ A See details on page 4 for number, size, and spacing of laterals Laterals are located in the 4" gravity distribution pipes as shown on page 5 Project. Larson 3 bedroom replacement mound Page 3 of 10 End Connection Lateral Layout Diagram Place Appropriate Lateral Diagram From Right Belnw r— p • : Turn-u p rdGe ll vii ba or l as n out pl u q — z -4 t st orifice boated at Z It- X�) Orifices pant up except every Sit-, one pords down for drainage Force main crm: ieCtiCYr lKa tee w crp„ t4 mdnd010 ][ Xiy pOxd. Laterals 61or<r main of PVC 4h 40 Ad laterals identical vv8h onta:es equaPy spaced pa SPS Table 384.30L Number of Laterals Latera Diameter Latera' Lencth ;P) Lateral End (Z) Lateral Spacng (S) Latera. Flow Rate System Flow Rate 2 1 50 in 79 20 ft 0 80 ft 3 00 ft 5 62 gpm 31 23 gpm Orifice Diameter Orifice Spacing (X) Orifices per Lateral Orifice Density Manifold Length Manifold Diameter Forcemain Velocdy 156 in 2 80 ft 29 828 `t"orifice 3 00 ft 1 50 in 3 19 `Lsec Dose Tank Information Lo�;, r.: o,r v: th v.�rnna laces arc I,c. in deace and sealed .v atertign, Elezt,icaas per NEC 200 and 3P5 316 }rD J'.'AC Tanh ccrnpone It F properly Vend Wieser Con.rc:e Capacity o02 82i Volume 1182 Manufacturer Gallons gaUinch Dimension In hes Gallons A 31 22 369 07 B 2 00 2364 C 6 78 80 09 D i 11 00 130 02 Total _ 51 00 602 82 And o sconnec: A I B C D �- Ahemate outer aria^or F):_e7a l : ame:e n Weer. hole ,r 31:U- siPncn drnce Pump off e,e Jetlun ;ft; -- — 9817 'Jose fay:k e;ajavon (ft) As Per Manufacture, 97 25 Alarm Manufacturer WSJ —Rhombus Alarm Model NJmber'SJE 1011421 Pump Manufacturer 'Zoeller Pump Model N imber BN151 Pump Must De ever 7 31 23 gpm at 12 43 ft TDH Note Switches containing mercury may not be used in this system Projee: Larson 3 beJrcom replacement mound Page 4 of 10 EZf/owC Distribution Cell Media Layout 6 00 Cell Width (ft) 1 50 Sidewall to Lateral (ft) Distribution Cell Cross-section Arrangements Component Legend SR1-7A Bundle - 5 ft or 10 ft lengths `< SR1-12A or EZ 1201A in 5 ft or 10 ft lengths t SR3-12H or EZ 1201 P orewe SR3-12H in 5 ft or 10 ft lengths 0 4" Perforated Distribution Pipe With Pressure Lateral Inside ® Turnup Enclosure - - - - - Pressure Lateral Bundles are covered with approved geotexhle fabric as per the their product approval Distribution Cell Plan View Layout - Typical 6.00 Cell Width - A (ft) 80 00 Cell Length - B (ft) Center Connection Lateral Layout Diagram Force Main 6ftWide ---------------- --- ---- End Manifold &--- -- -- ------- ---- - --- - - Project Larson 3 bedroom replacement mound Page 5 of 10 Mound System Maintenance and Operation Specifications Service Provider's Name lJmaes K. Thompson Phone 1 (715) 248-7767 POWTS Regulator's Name ISt Croix County oning Dep't Phone (715) 386-4680 System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mgr'L Septic Tank Capacity 1200 gal Maximum TSS 150 mg; L So I Absorption Component Size 480 ft2 Maximum FOG 30 mglL Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfur'100 mL Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Other Service Frequency Inspect and/or service once every 3 years Inspect and clean as necessary at least once every 3 years Test once every 3 years Should test periodical) Laterals should be flushed and pressure tested every 3 years Inspect for ponding and seepage once every 3 years Miscellaneous Construction and Materials Standards 1 Observation pipes are slotted and materials conform to Table SIPS 384.30-1, have a watertight cap and are secured in as shown in the EZflow Mound Component Manual Ver. August 20, 2007 2. Dispersal cell media conforms to EZflow products approved for use with the EZfow Mound Component Manual Ver. August 20, 2007 Media is covered with an approved geotextile fabric 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis Adm Code 4 Tillage of the basal area is accomplished with a mold board or chisel plow 5 The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn -up Detail Finished Grade 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Lateral Ends at Last Orifice Where `Variable Lengtn Cleanout Begins `may �� f:2 Long Sweep 90 or Two , 45 Degree Bends Same jDiameter as Lateral EZflow Synthetic Media :a;� `r<: _ 11 Feet Distribution Lateral Lateral Cleanout —� Project Larson 3 bedroom replacement mound Page 6 of 10 Mound System Management Plan Pursuant to SPS 383 54, Wis Adm Code General This system shall be operated in accordance with SPS 382-84 Wis Adm Code and shall maintained in accordance with its component manuals [EZ/low Mound Component Manual 8/20/07, Pressure Distribution Component Manual Vol 2 0 SBD-10706-P :N 01,01 i an SSWMP Publication 9 E 101/81j] and local or state rules pertaining to system maintenance and maintenance reporting Sept : and pump tank abandonment shah be in accordance with SPS 383 33, Wis Adm Code when tme'anks are no Ion3er used zs POWTS components Sept.; or pump rani, manhole risers, access risers and covers should oe Inspected tot Water lightness and soundness A:r'ess openings used for service and assessment shall be sealed watertight upon the completion of service Any opening deemed unsound defect ve, or subject to failure must be replaced Exposed access openings greater than 8-Inches in diameter shall be seared by an effective licking device to prevent accidental or unauthorized entry into a tank or component Septic Tank The septc tank shall be maintained by an individual certified to serv,ce, septic tanks under s 281 48 Slats i he contents cr the se: tic to Is shall be disposed of in accordance with NR 113 Wis Adm Code The operating condition of one septic tank and cutlet fitter sell be assessed at leas' on:e every 3 years by inspection Tr e outlet filter shall De cleared as recessary to ensure proper operation The filter cartridge st ould not he 'moved u r ess pro asions are made to retain solids in the tank that may slough off the filter when removed froth its enclosure If the Idler is edcrpFe�= m,tn an z1arm the filter shall be ser: iced if the alarm Is activated continuously Intermittent trier alarms gray ncicate surge tUws or an ,mFen:rig continuous alarm —re septic tartk shall rave i s contents removed when the volume of sludge and scum to the lank ex_ee-s 1 3 'he leuic ✓_lucre of ire tar k f the contents cf ;he :aril are not removed at the time of a triennial assessment mainternce perscrrel smirk adv se tine c e,rer as o v.re,r the next se^nee reeds to be performed to maintain less than maximum sour and sludge a:-rhula r in in :re tars Tre audition of biological o chemical addrt ves to enhance septic tank performance its generally not re4c.irec However if sucn crodocts are used they shall be app rovec for septic tank use by the Wisconsin Department of Commece Pump Tank —tie r sing Ipum.pi 'ark snai be inspected at least cnoe every 2 years All seyhches, a.,rms and purTrs Sn3l, ce tested to ver'y .. _: er cc_laaon If an erfwert'dte is lusts led w thi t tr e tank It shall be inspected arc serviced as ne:;essa'y If t-e zrce r,�a n Pas a ,,ye-, re e it snood be ric-ee If t is funotienal during pump operation and if hot it should to cleaned ""'No one should ever enter a septic or dose tank since dangerous gases may be present that could cause death Mound and Pressure Distribution System 03 r es cr shrubs sho.,ld be started on the mound Plantings may be made around :he mound'a Penn ee and the mo.nh snag De woos, ar c mulcreo as necessary :o prevent erosion anc to provide some, rotedtron from tresr penetra-io t Trarr0 i tithe' tr ar .ugeiati E Tamtenati 31 tre mujnd is nDt recommended since soil rompaction may tlnder aerator 0"ne i 11 hrati.,e sLrta Ce .v Ih, i 're meu u arc snow carractien in the winter wl I primate frost peretration Cold weather nstallaticns iJetober-Fecrcar;l di ,ate that 're me u'u ce heavily and clei as r otecoor frcT freennc rzlue tr q-wiry nit tee mein] system may no e. ceec 220 mg BOD. ' 50 mgrL TSG, anc 30 rig L I=UG t: r sup: c to ri e' LOn: or 2'J mg L 3OG. SC Mg, L `SS 11 mg: L FOG and 10-cfu!' Co mL for highy !rea:ed effluent Inruent t]c.o nay its exceec maomtn tie or f u.v specified in the permit fir this instalaror The rressure distnbu: cn systerr is provided v.ith a flushing point at the end it each lateral, and it ie rae,mrieneec too' soot aleral ce'lusnec of accumu sled solids at least once eoery 3 years When a pressure test is performed t she ulc be OrnpareJ •c it e in rat test .vn-n the s/stem was installed to d,9ermine if entice aoggirg has occurred and it orifice cleaning is recur ec to maintain do, a1 1.a, not ,- w thin :he dispe's3l Lell Obse- caner pipes wchir the drspersar _e I shah be checked for effluent pending Pending levels shall ue reported to tyre r.vrer an: one. Ie�e s bdve 4 inches cors,Jered as an impending hyd aulic failure requiring additional, more frequent monituring Contingency Plan :f tire s.ptc tark or any of its components become detective the tank or component shall be repaired it replaced to Keep :he syst=-rn n rrupe' cperating cond dun if *he :using tank pump, pimp controls ala,m or related wiring becomes defective the detective romponr-misl shot be rrnnieolate y =_p,ired or replaced with a ccmaonent of the same or equal performance the round component fads to 3ecept wastewater or begins to discharge wastewater to the grounc sdrfaz, t vall be rem 3uad or e, aces in .ts' present ocahoo by increasing basal a ea if toe leakage occurs or by removing bielog'cally cicgged shad of on and Lspersa media, and related piping, and replacing said components as deemed necessary to bring the system into proper d.ier34ng oral tics See Page 6 0;this plan =o, the name and telephone number of you local POVVTS regulator and i provider Project Larson 3 bedroom replacement mound Page 7 of 1 a TD PUMP PERFORMANCE CURVE MODEL 1511152/153 R.Cw PERMIAfrE ou5 I //gg yo.M. rN � of i m u m CONSULT FACTORY FOR O SPECIAL APPLICATIONS 374 • Tmed dosong panels avar[We. • Electrical allmatm, for duplex systems, are available and supplied Math an slam. • Vaiai level control snatches are evadable for controwng sutgle phase systems. • Double pWAack variable level float svnmhes are evadable forvalacle level long and short cycle controls • Sealed Qv& -Box available for outdoor installstons. See FM1420. • Over 130•F. (54•C.) speaal quotation required 15111521153 Series _ 151115N153 YODELS control Selector, Yodel WltsPh I Mode Am Sandi" Duplex 1,151 1'.5 1 Nm 60 1 2a3 614151 115 1 Aub SR IMuded 2 a 7 E151 230 1 Non 31 1 2 a 3 BE151 230 1 Zip 31 Irsiuded 1 a 7 h152 ti5 1 Non 85 1 2a7 EN152 t15 1 Auto 65 IaJuded 2a3 E 152 130 1 Non 47 1 1 2or3 6E152 230 1 Auto 4.3 Included 2 a 3 N153 115 1 Non 1J5 1 2a3 6Nt 53 1:5 1 Pub 175 Muded 2a7 E153 230 1 Nm 1 53 1 2a7 BE153 20 1 Auto 7 5 3 1 h surfed 2 a 3 TOTAL DYNAMIC HEAD/FLOW PER MINUTE EFFLUENT AND DEWATERING MOD$53 51 152 153 Feel U. Gal titers cal Uit's 5 le 65 261 77 291 10 170 61 231 70 265 15 144 53 201 61 231 20 it0 44 167 52 197 25 61 34 129 42 150 30 236] 33 45 35 - - 22 65 40 121 S1ut-otl Head 301L191m1 38'r111Sun) tt 11(1341,) Model151 Models 1521153 414 5113444 F`I7lXNQ9.[a31D�li Single pggybacK variable level foul sMtch a double p ggyoack vanac;a la�ul 1G.1 a cAU7lON Swtich Petato FM0477. AN instasaion of controls, protect on dsvlos and wumg should be done by a t uahfed 2 Sae FM0712 for coned model 01 Eloctrcai Alarnata E-Pak hcnsad elecmaan. At a'aclncal and safety codas should bar followed including the most recentltsuanxi Elaamc Coca (NEC) and the occupaficnal Safety and Heel th Act(OSHA), 3'Aflablelavel CGn7olwdch IM225usedasa LOnVoladivalof,Spec[lydup�ex(5) a (4) Moat system. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered Into the design of every Zoeller pump. fi 1WE70: PO BOX 16341 / louanlb, KY 40211-0317 / AlanuhcWrers of i' SHIP 70' add Ca eRn ROW r Loulsrilla, KY 40211-tisYf qq PUMP !O. (502) 7782731. 1(600) 08PUMP hvp7Mww.zoadlelcom FAX (502) 774-3624 ® Copyright 2004 Zoeller Co. All rights reserved � � q�Ee:05/ond j I r: r1.(SJ�i.J.t -0y. ars�'so. jof �, 3cb A4• B �J ■ sue. � P.✓.c. u+.s-t- a f E � I � h ! 3 0�A✓(. 63— _ _ h� o- PrapoJed J>exi Gncn Ee ^`C ` �w/wo�6CoMQCc..�6.'ha�ElN-+ fief loc 6o be ea Ucbfd law, EXi3�^5 wed V J ,4s7m 3031Fbu! )d;,—')C. 60 C. ,O/y W/ dsRs 3's2-sc( )(c) SEE CORRESPONDENCE /J.idcnce � He r4��r A BE R6Pv.Af- yy�Ho gE V AI A3o hie tC-j{iyA1 -3 SEDKcn.v j .50.% H✓Q/4a.T�ir��i� Ex,sE•-�✓. �rad� crud man /a-. 2/d9 3o�,gJ< uJ/ SYa0.7- Awv�rlEYy, ,See /y rsen., P. rG w r,,. e c E¢u 6. Me I� p foC/ uca4- as7-Go-ow Crl �e,i= y0ai4cics � m x Fy.9�/c 0 A okc: 05 /cu.+ — ad750 AA. 3ob. 8d ■ 4 3 o Avt. Ec rf3lu..a-d 3 ■ o �■ .%moo. - ioi�if• i�i i.jo 33 --- ---- �r Ijtlft /,nc fs, be ProEtcEtd 1 IaWK EX1:5t;, i �o EXsE% yiude eli✓ S� Lcus� �ap- L'�o/dw;�, uJJ. sYooz i1c.Y/�i1EYy ,SeC i9T. 1e�(., ,f . iG Eau 6 a!(e N n locJ aca9-1c6'7-Go-ocv �O m x Py - 3 YrJ Owner/Buyer Mailing Address ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Joan Larson 2149 30th Ave., Baldwin, WI 54002 Property Address Same (Verification required from Planning & Zoning Department for new construction.) City/State Parcel Identification Number 008-1 05;-64-0000— LEGAL DESCRIPTION Property Location NE '''A Subdivision Plat: Na NE 'ASec. 24 T 28 N R 16 W, Town of Eau Galle Certified Survey Map # Na Warranty Deed # Spec house l]yesElno Volume Na . Page # (before 2007)Volume . Page # Lot Imes identifiablel]yes[:]no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Lot # Na Na Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §SPS. 383.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that ( I ) 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 Ii, full of sludge. Iiwe, 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 le tic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within ' days of the three year expiration date. Uwe certify that all statements on tIn form are true to the best of my.%our knowledge Uwe am,,are the owner(s) of the property described above, by virtue of a warn my deed recorded in Register of Deeds Office 3 Number of bedrooms SIG ATURE OF APPLICANT(S) / 6'fl /7 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 wartanty deed. (REV. 04112) P� 3 W 7 0 1146. k4" (III T-A-SEALlill ORFLE TOP VIEW SIDE VIEW 4" CAST A SEAL 4" VENT TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS W1000/60 ' MR TANK SPF (CATIONS z DIMEN S: a a WALL: 2 1/2" w ,� BOTTOM: 3" a a COVER: 5" MANHOLE: 24" I.D. PRECAST CONCRETE RISER HEIGHT: 69 1/2" O.D. - LENGTH: 114 7/8" O.D. c WIDTH: 93" O.D. BELOW INLET: 57" O.D. w LIQUID LEVEL. 51" < > WEIGHT: 12,380 LBS. o INLET AND OUTLET. 4" CAST -A -SEAL BOOT OR EQUAL CASKET, CAST -A -SEAL BOOT OR EQUAL 3Ell 0 INLET AND OUTLET BAFFLE AND FILTER: r m WISCONSIN, SEE DETAIL /j10 � 0 � (OTHER STATES SEE CHART) LIQUID CAPACITY: 19.61 GAL/IN (SEPTIC) LL Lao 11.82 GAL/IN (PUMP) ~ LOADING DESIGN- 8' 0" UNSATURATED SOIL W cz O Ln K OD O Z OD I TANK CAN BE USED AS: a Ln SEPTIC/SEPTIC, SEPTIC/PUMP N OR SEPTIC/SIPHON 0 Lu _ r O COVER: MIX DESIGNS NO FIBER) � TANK: MIX DESIGN #10 STRUCTURAL FIBER) � CUSTOMIZED TANKS: n FOR CUSTOM TANKS CONTACT WIESER CONCRETE 3 � Q Z o C o U o � O a - DRAWINGS SUBMITTED 3 w FOR APPROVAL nongOVrp '": SHEET NO. . APPROVAL DATF: 1 PRODW IS NEEDED BY: / F 74 M 1 Lj- W N Iii I I a �Ll �+ • a � Y ? ems.. l 0 1 1 1I ) 1 rc i ' ./� .din, ��Clr mrxra•ra.Yxns�»v rf .i VE'0 CSC Wisconsin Departm� Professional Services Page 1 of 3 Division of Industry Ices GCS Q2` its( _ SOIL EVALUATION REPORT R0�(�`,tV�✓1OIPrdancewithSPS385 A - County Attach complete site plan o S. Gii t7es" s than 8 1/2 x 11 inches in size J� St Croix but not limited to verti orizontal reference point (BM), due an r 0 Parcel D scale or dimensions, north arrow, and location and distance to near d _AD 008-1 7-60-000 Ref #2465 Please print all information. `,��• Rev ed by Date s/ Personal information you provide may be used for seconds u o, .*I,?- Law s 15 04 1 m IQ z ! Property Owner V� Property Location ❑ Joan Larson Govt Lot NW % NE Y. S 19 T 2 N R 16 E (or) W Property Owner's Mailing Address Lot # Block # Subtf Name or CSM# 2149 30" Ave. na na na City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road Baldwin WI 54002 _ (715) 220-8306 1 I Eau Galls 220" Street ❑ New Construction Use ® Residential! Numberof bedrooms 3 Code derived design Flow rate 450 GPD ® Replacement ❑ Public or commercial — Describe Zo�Ai x Parent material Glacial Till Flood Plan elevation if applicable na ft General comments and recommendationsSite suitable for mound POWTS Recommended infiltrative surface elev to be 104 50' at 6" above 1G4 00' contour ❑ Boring # ❑ Boring ® Pit Ground surface elev 104 02 ft Depth to limiting factor 30" in Rml AnH,.hnn Rnfo 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 1 0-8 10yr3/3 none Sit 2fgr mvfr M 2vf,f 06 08 2 8-22 75yr4/6 none sl imsbk mvfr cw 1vf,f 04 0.7 3 22-30 7 5yr4/6 none cost icsbk mfr M - 04 0.7 4 30-46 7 5yr4/6 f2f7 7yr5/8 cost icsbk mfr M - 04 07 5 46-52 7 5yr4/6 c2d 7 5yr5/8 scl Om mfi - 0.0 00 ❑ Boring # ❑ Boring ® Pit Ground surface elev 104 00 ft Depth to limiting factor 31 in ✓ Rnd A —I— i— Rofn 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 1 0-10 10yr313 none sil 2fgr mvfr cs 2vf,fm 06 08 2 10-24 75yr4/5 none sl imsbk mvfr gw 1vf,fm 04 1 3 24-31 75yr4/6 none cost imsbk mvfr cw 1vf,f 04 1 4 31-41 7 5yr4/6 f2f 7 5yr5/8 sl icsbk mfr ow ivf- 0-4 06 5 41-56 7 5yr4/6 f2d 7 5yr5/8 scl Om mfi - - 0.0 0.0 - f=nwenr #1 = fiUu > all < JJO ni and rSS > 3n < 15n mn/l ' Pfnuanf R9 = i > 3n < 99n mn/i .od TCs > in < 1 sn mnn CST Name (Please Print) Signature CST Number James K. Thompson — yq 30021 Address ate Evaluation Conducied Telephone Number 340 Paulson Lake Lane, Osceola, WI 54020-5413 December 21. 2106 (715) 248-7767 SBD 8330 (R04/15) ❑ Boring If ❑ Boring ® Pit Ground surface elev 101 38 ft. Depth to limiting factor 35 in Rnil Annlicahnn Rafe Horizon Depth In Dominant Color Munsell Redox Description Qu Az Cont. Color Texture Structure Gr Sz Sh Consistence Boundary Roots GPD/Ft2 'Eff#1 -Eff#2 1 0-12 1 Oyf3/3 none sit 2fgr mvfr cs 2vf,f 06 08 2 12-24 10ry4/4 none sl 1msbk mvfr gw 1vf,fm 0.4 07 3 24-35 7.5yr4/6 none sl 1msbk mfr cw lvf,fm 04 0.7 4 35-47 7.5yr4/6 f2f 7 5yr5/8 sl 1 m&csbk mfr aw 04 07 5 47-55 7.5yr4/6 f2d 7 5yr5/8 scl Om mfi - 00 00 4 Boring # ❑ Boring ® Pit Ground surface elev. na It Depth to limiting factor)—sYn Soil Aoolication Rate Horizon Depth In Dominant Color Munsell Redox Description Qu Az. Cont Color Texture Structure Gr. Sz Sh Consistence Boundary Roots GPD/Ft2 'Eff#1 -Eff#2 1 0-8 1Oyr3/3 none sil 2fgr mvfr cw 2vf,fm 0.6 0.8 2 8-18 75yr4/6 none sl 1msbk mvfr cw lvf,fm OA 0.7 3 18-32 75yr4/4 none cosl 1csbk mfi M 1vf,f OA 0.7 4 32-46 7 5yr4/6 f2f 7.5yr5/8 scl 1 m&csbk mfl - - 0.2 0.3 5❑ Boring # ® Boring ❑ Pit Ground surface elev na it Depth to limiting factor <8 in '� I Soil Aooli Horizon Depth In. Dominant Color Munsell Redox Description Qu Az. Cont Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 'Eff#1 I 'Eff#2 1 0-3 10yr4/4 none sil 2mpl mfi as 2vf 0.0 02 2 3-8 10yr3/3 none sil lfsbk mfr cs 2vf 04 06 3 8-24 7 5yr4/6 mfd 7 5yr5/8 sil Om mfr cw - 0.0 02 4 24-53 7 5yr4/6 c2p 7 tyr5/8 & c2 10 re/2 slot Om mfi - 00 00 Effluent #1 = BOD, > 30 5 220 mg/L and TSS > 30 5 150 mg/L ' Effluent #2 = BOD, > 305 220 mg/L and TSS > 30 <- 150 mg/L 3 tc (L�0%�✓te �K d. ■—•,—da---icj;q. ill 63-__---- ----__ \`r fief /,I(- (y 6e ro/oiLctcd JAWN C.W t;,S wL!l �/ 0 EX��E%K �/�2clL Litz! tea„ Lasoh z/y9 30 Ad<. L/dwin, uJ(. 55100z Awi�IIEYySec /f'T1B�., hoc-/ a�9-�7-Go-om O m x rated 111�C CS��" 01- 6 cou rvo. 6 986 STATE SANITARY PERMIT KTRANSFE NEWAL PREVIO OWNER PLUMBED TOWN OF SEC ) q T J N, R LIC.# ' ems/ BLOCK NO. CHAPTER 145.135 (2) WISCONSIN 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 may be 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. (1) 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 V. SUBDIVISION the permit please contact the county authority. L • Aye PORIZED ISSUING OFFICER —DATE 'E IT EXPIRES 0 UNLESS RENEWED BEFORE THAT DATE POST IN PLAIN VIEW VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION SBD-06499 (RI1/20)