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HomeMy WebLinkAbout034-1037-30-075 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 479487 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). Permit Holder's Name: City Village X Township Parcel Tax No: Richardson, Steve Springfield, Town of 034 - 1037 -30 - 075 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range/Map No: ( 16.29.15.250A30 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ' lie Z MOO Benchmark /I � 16 W Dosing Wt.l J Alt. B� ` J ' • $5 � C.IJ Yv- Aeration eo Bldg. Sewer •$ �, f Holding St/Ht Inlet I$ ,07 $3 , $3 �\ TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 7 ZS J / f Dt Bottom Z� b$ $Q • Z Z Dosing 725 ` /� / /5 Header /Man. ��• Aeration J `J Dist. Pipe 74. o-7 Holding Bot. System � GC Z 1 /1 PUMP /SIPHON INFORMATION Final Grade '-S• 91 ' Manufacturer Demand St Cover t0 GPM ' Model Number 7 • 94J 7 C.dvl�0u� Z TDH j L2 , , ,,,,Friction 1 Loss SystemH51d J TDH Z ` Ft N�c ,. 5.37 c 33 �.�� ,115 Forcemain Length Dian Dist. to Well 1 1 I dk Z A SOIL ABSORPTION SYSTEM 7• Z BEDITRENCH Width y Length No. Of Tre s PIT DIMENSIONS No. Of Pj Inside Dia. Liquid Depth DIMENSIONS w 79 J � _\ _� SETBACK SYSTEM TO P /L BLDG WELL LAKE /STREAM LEACHING Manufacturer. INFORMATION CHAMBER OR Type tem: f 1 . 1 UNIT Model Number: DISTRIBUTION SYSTEM,�,,Q� � Header /Manif ld 1 it Distribution C4 ; r � f x Hole Size f � I x Hole Spacing I Ven�,tp Air In ke Pipes) 3 �+ Length J � Dia z Lenglh Dia Spacing �� 'Tc� SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over F-Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center , 1 `1 1 Bed/Trench Edges oil r es No No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 101 / / y5 Inspection #2: Location: 915 290th Stree i ' son, Wj, 54027 (SW 1/4 SW 1/4 16 T29N R1 5W) NA Lot 3 C �I Parcel No: 16.29.15.250A30 1.) Alt BM Description = " ' C, �- pe✓�5 a v� I a %_j d r 2.) Bldg sewer length = /!, G IPri cn- ` - 0 - amount of cover 1 Plan revision Required. Yes � `10 i j �S — _.- _- ._. - -- - - -- - -- _� Use other side for additional information. - -- ` Date Insepc Signat Cert. No. SBD -6710 (R.3/97) Safety and Buildings Division City lvia ashi n �70� x 7162 r 4/lo m iso WI ' °w F nary 't Number to be filled is by Co.) cans�n Department of Commerce State Sanitary Permit Applica i _` I.D. Num ter ������ In a000ed with Comm 83.21, Wis. Adm. Code, personal information you provide maybe used for secondary purposes Privacy Law, s15.04(1�m) Project (if different than mailing address) L Application Information - Please Print All Information - "' -- _ 9 j' .?9a Property Owner's Name 1 # # Mook # ��"Ev� fCiGNA/LDso.✓ (i.-o Oetft�, ( 3) — Property Owner's Mailing Address Property Location y � �_�_ aD City, S I Zip Code Phone Number t� y`' SL✓ '/s, Scotian le (� t y� ,W� ouole arse) IL Type of Bull check all that apply) Ml or 2 Family Dwelling - Number of Bedrooms . 3 au S9 CZ )Vi f ��c CS ❑ PubfidCammeroiel - Describe use ❑ State owned - Describe Use ZTownship of IIL Type of Permit: (Check only one box on line A. Complete line B if applicable) p - 0 3 7 - 3b - o , 2 S OA - 30) A- XNew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modifioatim to Existing system B. ❑ Permit Renawal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner t i IV. Type of POWTS System: Check all that apply) 6..t,t i.� = O 2 ❑ Non - Pmumized in- Ground Mound> 24 in. of suitable s 7 ❑ Mound <24 in. of suitable soil ❑ At -Grade ❑ Single Pan Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobio Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic, Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. DispersaVrreatinent Area Wormation: Design Flow (gpd) Design Soil Application Rate(gpdsf) pe-al Area Required (af) persal Area Proposed (sf) System Elevation 5/Sa a yso s��8 9s 3 s� J �r �. VL Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units w - coo -1 Concrete Constructed Glass New Existing / 1 Talcs Taub for Reldisg4ask loo — L✓ /�sE.c �o,�c ssrr Aerobic Treatment Unit Dosing Clamber �60 �, d 0 / r r r r ✓ VIL Responsibility Statement- I, the underskppd, Wurne resp%siblilty for Installation of the POWTS shown on the attached Phoms. Plumber's Name (Print) PI ji T MP/NRW Number Business Phone Number Plumber's Address (Street, City, State, Zip Code) VIIL County/Department Use Oil Sanitary Permit Fee (includes Groundwater Date Issued Issuing t Signature (No Stamps) Approved a Dis provW von Reason for Denial 2C 7� IX. Conditions pro e SYSTE WNER: 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code%rdinances. Attach complete plans (to the County only) for the system on paper ant less than 81a x 11 inches is aim SBD -6398 (R. 01/03) a 0 o { 1 F' a w A a h ' O � V4� p a O c •t N � �C a a� wa w 0 a { No A . IA o C; P Safety and Buildings commerce.wi. OV 4003 N KINNEY COULEE RD g LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 i sco n s i n www.w www.commer isco govsb, isconsin.gov Department of Commerce Jim Doyle, Governor Mary P. Burke, Secretary September 13, 2005 CUST ID No. 3412 ATTN: POWTS Inspector HERB J PELKE ZONING OFFICE PELKE PLUMBING ST CROIX COUNTY SPIA N6298 STATE HWY 25 1101 CARMICHAEL RD DURAND WI 54736 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 09/13/2007 Identification Numbers Transaction ID No. 1193399 SITE• Site ID No. 704397 Steve Richardson Please refer to both identification numbers, 290th Street above, in all correspondence with the agency. Town of Springfield St Croix County SWIA, SWIA, S16, T29N, R15W Lot: 3, FOR: Description: Three Bedroom Mound System P Y Object Type: POWTS Component Manual Regulated Object ID No.: 1039180 Maintenance required; 450 GPD Flow rate; 31 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 101), Pressure Distribution Component Manual -Version 2.0, SBD- 10706 -P (N.01 /01); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. COQ 1 No person may engage m or work at plumbing in the state unless licensed to do so by the Department per s. 145.06, �t1 stats. APFA i The following conditions shall be met during construction or installation and prior to occupancy or use: EP RT?.4" NT of Reminders • This system is to be constructed and located in accordance with the enclosed approved plans and with the SEE CG; ,RE "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01 /O1) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD- 10706 -P (N.01 101). • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, activities that impact the treatment and dispersal action excavation vehicular traffic and other similar ctt p P p are prohibited. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. I • Inspection of the POWTS 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. Stat HERB J PELKE Page 2 9/13/2005 • Comm 83-22(7) A copy of the approved plans specifications and this letter shall be on -site during construction and open to inspection by authorized rWresentatives of the Department which may include local inspectors. Owner Responsibilities: • Comm 83.52 Responsibilities. 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. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 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. 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 Safety & Buildings 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 to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Charles L Bratz POWTS Reviewer II, Integrated Services WiSMART'code: 7633 (608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday cbratz@commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 Private On -Site Wastewater Treatment System (POWTS) Index and Title Sheet Owner: . Sy-E -vE bG /�.✓.o,ra sd,✓ Project Name and System Type: srd-.V�e Zlely 4,0.r,.y - .? ,4. Location: e?9c r.� 15�n Street Address x64 P Legal Description ocJ.✓ F /.ti,✓tfi! o fir. C oix Co Township /County Contents: Page 1 Page 2: r Page 3: Rots - .5�rc A,.✓ G/r.✓ .f C6 .,o Page 4: li'ioe 1A r`iti� Lwr„ r Page 5: -Pr.� . ,�x /�ur� Ci6�.0i'J.OI'.t C/lOJJ • �� a re .� Page 6: �✓uyr �sirF ®�.y,..r,� Cu.►�� 'o t��►lly D AD Page 7:. OD A.' r.S O.y.✓ 1 �.i.✓a,�a �,o.✓ASl�rl.✓r oi�•✓ �CMMERCE cs Page 8: y� Jr r� r• rr SPQNDENCE ,Page 9: Attachments: RECEIVED iii rl.� /y,�i,✓ rc,✓.�,✓e .✓f•. S E P 0 7 2005 SAFETY & BUILDINGS Plumber/Desioner: , o�t ,<,r Signed: 410-,� Credential Number: Date: G1SC0 .SBA ' Joy 9 /•P /yiu,v CO�YPo.�t'.�r /% i0.✓u AL (�f�tSie�J .l D �S?'.O � .SQQ - � /f ��i✓NA6 /d 70l -i � Q� itlJ S ae! �i1 r.,.oN r..r C oroPr.+�t.✓r �� !/F.t s�i.✓ a.o c- o i w a Y � a 0 , ' x IK o c � � Z, IA I 0 • ^ p ib a � a � IN - - - ao o 1-4 ! r� e 0 I�o i" .� t � t t _ _ _ ( �, gyp � o, tom. . pC . ►�! t4 d 1� I I„ Inl i M' �►y �M tA rt• R rt n tt n. n t w b . ph 'd o o b 1 . • P4 • 0 '1 .t M ct• '�1 r M .. h �£ r e' n ,b w H. V n o • t; • g • ►�C M. M M M M d R R M [T x f7 ii i � a „ N �^ \ M A� Y � t Ch h R � o 0 IV a o • Page S Of J SEPTIC TANK E'PUMP CHAMBER CROSS SECTION SPECIFICATIONS VA d44. 4" CI VENT PIPE 12" MIN. ABOVE GRADE E WEATHERPROOF ?• /p' FROM DOOR, WINDOW OR JUNCTION BOX APPROVED FRESH AIR INTAKE WITH CONDUIT MANHOLE COVERS W/ PADLOCK E fiaijNdo WARNING LABEL -.J_ " MIN. 18 " IN. i INLET i► WATER TIGHT SEALS GAS - ZgQ�c. T TIGHT i �ppROYED Fic rE.t A. /oo } SEAL JOINTS WITH APPROVED ; ALM APPROVED PIPE PIPE 3' B ON 3' ONTO OUTO SOLID SOLID SOIL SOIL' PUMP OFF ELEV . 8sa FT. -I- OFF RISER EXIT D PERMITTED ONLY IF TANK MANUFACTURER HAS APPROVAL 3 APPROVED BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS SEPTIC./ DOSE' TANK MANUFACTURER: 1, Ggw_ NUMBER DOSES PER DAY: TANK SIZES SEPTIC /0o6 GAL.' DOSE VOLUME INCLUDING DOSE Goo GAL.. FLOWBACK: 109, ,� GAL. ALARM MANUFACTURER: , E ll,.r s ' CAPACITIES: A = _,?,o_ INCHES = _ �3L ' GAL. MODEL NUMBER: 4zrtr _z SWITCH TYPE: /yE�16vAr B = 2 INCHES AL. PUMP MANUFACTURER: /b'y,0.tv/Y./ric �^' C = C .S INCHES = o/ s, z GAL. MODEL NUMBER: SWITCH TYPE: D . = X s' INCHES = 2 GAL . REQUIRED DISCHARGE RATE ,n. GPM PUMP E ALARM WIRING AS PER ILHR 16.23 WAC /VERTICAL'DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE /d 9 FEET + MINIMUM NETWORK SUPPLY PRESSURI; . . . . . . ,3 3 FEET + � FEET FORCEMAIN`X /.S FT /100 FT. FRICTION FACTOR . FEET TOTAL DYNAMIC HEAD = • FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH Sa ; WIDTH 7,* ; DIAMETER — LIQUID DEPT ,. • i t HYDROM I SD33 VS33 SW5 SW/SD/V$33 SW/SD/VS50 Typical Application' Sump /Effluent pump Typical Application' Sump /Effluent pump Capacities SW/SD/VS33 - to 48 GPM (3.0 IN Capacities SW /SDNS50 to 44 GPM (2.8 I /s) Heads SW/SD/VS33 - to 26 ft. (1.9 m) Heods SW /SD/VS50 - to 24 h (1.3 m) Electrical SW /SD/VS33 - 115V, le, 10.0 FLA, 60 Hz Electrical SW/SD/VS50 • 115V, le, 8.0 FEA, 60 Hz Motor SW /SD/VS33 - 1/3 HP shaded pole w /thermal Motor SW /SDNS50 1/2 HP shaded pole w /thermal overload overload 1550 RPM 1550 RPM Minimum Recommended SD/VS33 = 12" (304.8 mm) Minimum Recommended SD/VS50 = 12" (304.8 mm) Sump Diomerer SW33 = 18 "(451 mm) Sump Diameter SW50 = 18" (457 mm) Automatic Operation SW = Wide -angle float switch Automatic Operation SW = Wide -angle float (manual available) SD = Diaphragm pressure switch (manual available) SO = Diaphragm pressure switches VS = Vertical float switch VS = Ve rtical float switch Mmerials of Consiruction Cast iron and engineered thermoplastic Materials of Construction Cast iron and engineered thermoplastic Impeller Thermoplastic vortex Impeller Thermoplastic two vane semiopen - — - -- - -- Disc Sae 1 -1/2" NPT (38.1 mm) Discharge Size 1.1/2" NPT (38.1 mm) Solids Handling 3/8" (12_8 mm) Solids Handli 3/4" (12.8 mm) Power Cord 10' , SJTW,(20' optional) Pow er Co 10' , SJTW,(20' optional) _ Superior features • Carbon /Ceramic mechanical seal Superior Features • Carbon/Ceramic mechanical seal • Oil- filled motor w /automatic reset • Oil- filled motor w /automatic reset thermal overload thermal overload • Uses single row ball bearing construction • Uses single row ball bearing construction • Piggyback plug available for easy maintenance and • Piggyback plug available for easy replacement maintenance and replacement 9 30 40 i 1 D33, SW33, VS33 30 6 W 20 - -- — - -- SW /SD/VS50 tf _ I t a ►- 20 o W j U. 10 Tr i (opacity -U.S. G.P.M.O 10 20 30 40 so 10 20 30 40 50 60 70 Liters/Second 0 I 2 3 GPM � Switch A ll l l rT 1 PI POWTS OWNER'S MANUAL AND MANAGEMENT PLAN FILE INFORMATION SYSTEM SPECIFICATIONS Owner sy-Edp• Go ,tD o.✓ Septic Tank Capacit o00 E3 NA Permit # Septic Tank Manufacturer L,/ sxr [3 NA Effluent Filter Manufacturer Z4,04 ❑ NA DESIGN PARAMETERS Number of Bedrooms 100 room ,3 ❑ NA Effluent Filter Model —iao [3 NA Number of Commercial Units .— NA Pump Tank Capacity G ao 1 ❑ NA Estimated flow (average)* _ . 300 g al/day Pump Tank Manufacturer !✓iarrrc [3 NA Pump Manufacturer NA Design flow (peak), estimated x 1.5* yso g al/da y Pump Model gyp/ s-o ❑ NA Soil Application Rate / D gal/day ft Pretreatment Unit ANA Influent/Effluent Quality (NA❑) Monthly Average** ❑ Sand/Gravel Filter ❑ Peat Filter Fats. Oil & Grease (FOG) < 30 mg/L ❑ Mechanical Aeration ❑ Wetland Biochemical Oxygen Demand (BOD5) < 220 mg/L ❑ Disinfection [3 Other: Total Suspended Solids (T SS) Manufacturer: Model: <_ 250 m Dispersal Cell(s) Pretreated Effluent Quality [3 Monthly Average * ** E3 In ground (gravity) ❑ In- ground (pressurized) Biochemical Oxygen Demand (BODD 30 mg/L I ❑ At -grade j' Mound Total Suspended < ended Solids (TSS) < 30 mg/L 0 Drip-line ❑ Other: Fecal Coliform (geometric mean) <10 cfu/100m1 ❑ Leaching Chamber Manufacturer Maximum Effluent Particle Size 1/8 inch diameter Model Laying Length/Chamber *Wastewater Flow Verification and Calculations: Soil Application Rate_gpd/ft Area Req. ft (Other than bedroom based) Infiltrative Surface/Chamber- ESIA Rating ft2 Minimum Number of Chambers ❑ Aggregate Design Flow/Loading Rate= ft min ** Values typical for domestic (non - commercial wastewater Materials: all materials must comply with WI Aden Code and septic tank effluent. COMM84 and be installed per manufacturers specifications ** *Values typical for pretreated wastewater. I and approval letters. DESIGN CRITERIA ❑ "Wisconsin At -grade Soil Absorption System, Siting, Design & Construction Manual" (Converse et.al.1990) ❑ "Wisconsin Mound Soil Absorption System: Siting, Design & Construction Manual" Converse, J.C. and E.J. Tyler. Publication 15.22 ❑ "Design of Pressure Distribution Networks for Septic Tank -Soil Absorption Systems" Publications 9.6 ❑ "Design of Conventional Soil Absorption Trenches and Beds ". R.J. Otis — ASAE Publications 5 -77 and "Design Manual — Onsite Wastewater Treatment and Disposal Systems ". EPA 625 /1 -80 -012 October 1980 ❑ SBD — 10570 —P (8.6/99) "At -Grade Component Manual Using Pressure Distribution" ❑ SBD — 10567 —P (R.6/99) "In Ground Absorption Component Manual" ❑ SBD — 10705 —P (N.01/01) "In Ground Soil Absorption Component Manual" Version 2.0 ❑ SBD — 10628 —P (N.6/99) "Recirculating Sand Filter System Component Manual" ❑ SBD — 10656 —P (N.6/99) "Split Bed Recirculating Sand Filter System Component Manual" ❑ SBD - 10572 —P (R.6/99) "Mound Component Manual" XSBD - 10691 —P (N.01 101) "Mound Component Manual" Version 2.0 ❑ SBD - 10595 —P (8.6/99) "Single Pass Sand Filter Component Manual" ❑ SBD - 10657 —P (8.6/99) "Drip -line Effluent Disposal Component Manual" ❑ SBD - 10573 —P (R 6/99) "Pressure Distribution Component Manual" ,k SBD - 10706 —P (N.01/01) "Pressure Distribution Component Manual" Version 2.0 ❑ Drip -line Effluent Dispersal Component Manual for Multi -flo Onsite Wastewater Treatment Units MAINTENANCE AND MANAGEMENT MAINTENANCE MONITORING SCHEDULE Service Event Service Frequenc Inspect condition of tank(s) At least once every ❑ months 3 Id year(s) (Maximum 3 yrs.) Pump out contents of tank(s) When combined sludge and scum equals one -third (1/3) of tank volume Inspect dispersal cell(s) At least once eve ❑ months 3 ear(s) (Maximum 3 s.) Clean effluent filter At least once eve months ❑ ear(s) Inspect pump, pump controls & alarm At least once every ❑ months 3 ear(s) ❑ NA Flush laterals and pressure test At least once every ❑ months -3 0 year(s) ❑ NA Valves At least once every ❑ months ❑ ear(s) g NA Other: At least once every ❑ months ❑ ear(s) ❑ NA Page of i 1 START UP For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products'or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. OPERATION The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity and quality of the wastewater stream will affect the performance and longevity of your POWTS. The installation of water - saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water softeners, iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground surface whenever possible. Note: this does not include laundry waste, showers, dishwater, etc. This system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable /fruit peels and seeds, bones, and food solids such as those produced by a garbage disposal should be minimized. Toilet tissue is the only paper that should be discharged into the system. Other non - biodegradable items such as baby wipes, tampons, sanitary napkins condoms, cigarette butts, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, paint, disinfectants, pesticides, antibiotics, solvents, etc., should not be flushed into the system as they can seriously damage your POWTS and contaminate your drinking water supply. Maintain a regular steady flow by spreading laundry washing throughout the week. Avoid vehicle traffic over all system components. Compaction of snow over the dispersal unit may cause it to freeze up. ❑ Valves Valves shall be operated in the following manner: [ Alarms Alarms should be tested on a regular basis by the home owner. If an alarm sounds, contact an individual licensed to service POWTS, There is normally a 1 day reserve under regular operating conditions, however water should be conserved until any problems with the system are corrected to prevent back -up of sewage into the dwelling or surfacing. INSPECTIONS Inspection shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule). X Septic Tanks Component Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any backup or ponding of effluent to the ground surface. Access openings used for service or assessment shall be sealed and/or locked upon completion of service. Any defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective locking device to prevent accidental or unauthorized entry into the tank. When the combination of sludge and scum in any tank exceeds one -third (1/3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with Chapter NR113, Wisconsin Administrative Code. The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. Provisions are to be made to retain solids in the tank. Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating. X pump Chamber/Treatment Tanks Component The inspection must include a test of all electrical equipment such as pumps, alarms and floats. A visual check must be made for leaks, backups, surfacing, missing or broken security devices and other hardware and the condition of any filters. Any service needs or repairs shall be promptly taken care of. ❑ In- Ground Gravity Component Dispersal Cells The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding at depths greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. Page$of 9 (M ound, At- Grade, In- Ground Pressure . / The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. The pressure distribution system is provided with an opening at the end of each lateral to be used for flushing. The laterals should be flushed at least once every three (3) years. Pressure checks of systems with multiple laterals should be done to ensure that equal distribution of effluent is occurring to promote the longevity of the system. REPORTS Reports for maintenance, inspection, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin Administrative Code. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is properly and safely abandoned in compliance with Ch. COMM 83.33, Wisconsin Administrative Code. - All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. - The contents of all tanks and pits shall. be removed nd properly disposed of by a Septrige Se.T :cirg GPCrator. - After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or other inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. and/or soil limitations. Barring advances in POWTS technology a ❑ A suitable replacement area is not available due to setback holding tank may be installed as a last resort to replace the failed POWTS. The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation 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 the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTIAN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE L'qTERIOR OF A T:! NK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name � .ft,��' /yid- .>'y�2 Name E?!G lL.K! EL.CE Luir.Qi✓s Phone y d7,7-524'41 Phone 7/5 7.? -S LG SEPTAGE SERVICING OPERATOR (Pumper) - G/,,,,r vow.; LOCAL REGULATORY AUTHORITY Name A en J; Cit��x �o. Zovi.✓c E ::� Phone Phone 7 1.5' .384 8D KAWPDATMEMPOWTS OWNER'S MANUAL.doc Page_? of 9 a` =F rv- r Maintenance The interval for servicing septic tanks is set by state and local code. Throughout the United States there is a wide difference of opinion on what this interval should be, but most regulatory agencies suggest two to five years. The Zabel'" filter, which does not increase the frequency of servicing for the tank, should be cleaned when the septic tank is normally inspected and pumped. However, our filter is virtually self- cleaning. The continued action of the anaerobic organisms on the Zabel filter causes lodged particles to disintegrate and fall to the bottom of the tank. If your filter contains a SmartFilter"' alarm, you will be notified by an alarm when the filter needs servicing. To service the filter: 'Servicing any Zabel filter should only be done by a certified septic tank pumper or installer. Locate the outlet of the septic tank. ; Firmly pull the filter hat'tidla . and slide the cartridg Remove the tank of the and pump the 'Note: A tee handle may . necessary to pr to be used It the titter Is ti> any solid below ground level to escaping to th Contact Zabel for info 1 when the f handles rem s 4 While holding tiye °Crtrid a rtvtF:. the access opert.(ft x ' Insert the flI 6 d f} ° ' cartridge with fir ilf� back in the w� careful to rinse all sure the filt b properl *Note: It is not neces completely i `spotless". The blom aides in the pretreatme be felt on the litter. (11n maybe dtsass iii. Replace t MADE IN USA The product(s) shown are covered by one or more of the following patents: U.S. 5,762,793, 5,580,453, 5,591,331, 5,759,393, 5,683.577, 5,562,716, 5,779,896, 5,593,584,5,795,472,5,736,035, 4,710,295, 5,382,357, 5,482,621 U.S. Des. 386,241, 349067, 4605501,5098568, Des. 309007, Australia: 134440; Canada: 2,135,937; Israel: 111574; New Zealand: 264824, Other Patents Pending Call for a free ZABEL ZONE An Onsite Wastewater Magazine 1- 800 - 221 - 5742 - Website http: / /www.zabeLcom A100/300.1- M•61499 Wisconsin Department of Commerce SOIL EVALUATI T Page / of 3 Division of Safety and Buildings in accordance with Com 85,11 Cou l Attach complete site plan on paper not I han /2 x inc in size. Plan must J �R include, but not limited to: vertical and h a ren of M), direc(ion and 'r+ 1 Pa I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please prillf viro wiluritivIrml. 1 ( R(jix CC)t�N Revi ed by Date Personal information you provide may be used for secondary purposes (Pri cy Law, ( IC 5 T-, ZZ 7q}a Property Owner Property Location y"Ed� iC /G.y.4irDt.,.✓ Govt. Lot fAl 1/4 1/4 S f T 9 N R /,S # (or& Property Owner's Mailing Address Lot # Block # Sabd -idioms or CSM# ' ✓ �9 D JSce�J.ri.� .Sr �a�rd /o y' 3 6✓oi.+ # �S City State _ Zip Code Phone Number [, jy [.3 �FiHege ® Town Nearest Road a �..✓ I u2" I S I ( 71-�') ,? 72 -Z 5 �.4l+%l fitso .? 90 r New Construction use: Residential/ Number of bedrooms Code derived design flow rate GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material 1 o &r x, F'/L a Flood Plain elevation if applicable ft. General comments and recommendations. 1!; ,2 o Alrj x.4.ri LifY� 71vleA Y .fJ.tvrNrD fiTf� Rd'ceis,r�,�D .SYf 7 Goy ro-Z. F-/1 Boring # Boring © Pit Ground surface elev. ?4 7 ft. Depth to limiting factor J in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 a S .T rR,9 -<e. 7 C F Boring # E) Boring ® Pit Ground surface elev. 9.3 .? ft. Depth to limiting factor in. Soil pccation Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftx in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I *Eff#2 L �. Gf 7 /Q -?/.P s t/ 0 S 'V't f'/ 'd Ra/ /o - ' -4't s d X4 * Effluent #1 = BOD > 30 220 mg /L and TSS < 150 mg/L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) i natur CST Number Address Date Evaluation Conducted Telephone Number So 3 '6 1.4A'0 Y ,fir, E•vcr Z-"f A 8 - -oS /S 83lr Air /o Property Owner �rEy� i� /GN�/AeJ Parcel ID # Page - of '3 Boring # ❑ Boring , ® pit Ground surface elev. 9.rO ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Ef1#1 'Eff#2 / D -7 loAt 1/s -1Y .rA. B a Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fl' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 "Eff#2 Boring F-1 Boring # Ground surface elev. ft. Depth to limiting factor in. 1:1 pit Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider anqr"loyer. If you need assistance to access services or need material in an alternate format, please contact the depwb n8nt at 608 - 266 -3151 or TTY 608 -264 -8777. SBD-8330 (R07/00) _ - w v cn n ro ro r H O O i [ L4 =1 :0 CS1 QR C C~"I 1 IA H ti o z � e IL IL n � a C • A 1p n sk c a � < , y a 1j y 9 A • a sa � v � N h � g L I \ 4 �u ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer Mailing Address °4 '� C. tt ('A —, L� iJ chi 'z) .. Property Address I LEN J C xT (Verification required from Planning & Zoning Department for new construction.) \ City /State L�L�,x�ot� C.r� _ L..) ..) Parcel Identification Number LEGAL DESCRIPTION d3� _ /a3 } _ 30 `-�� 1 /4 , Sec. � T �N R I S W Property Location Slt� /4 , , , Town of Subdivision , Lot # Certified Survey Map # �� 8 �� �Q , Volume , Page # -4-9-)( Warranty Deed # T D to , Volume , Page # 3 3 I Spec house yes (9) Lot lines identifiable yes 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 §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County 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. Uwe 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 9/ OJ SIGNATURE OF APPLICANT(S) 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. 08/05) - 7 s4B - 7 rz>?�_R V 2_� S P 33 STATE BAR OF WISCONSIN FORM I - 2000 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS Document Number ST. CROIX CO., WI 116*Deed,spade Theodore E. Bergum and RECEIVED FOR RECORD Shirley Bergum, Husband and wife 03/03/2005 10:00AN Grantor, WARRANTY DEED and Stephen D. Richardson, a single person EXEMPT 11 REC FEE: 11.00 TRANS FEE: 132.00 Grantee. COPY FEE: Grantor, for a valuable consideration, conveys to Grantee the following PAGES: 1 described real estate in St. Croix County, State of Wisconsin (the "Property") (if more space is needed, please attach addendum): I Part of the West One -half (V14) of the Northwest Recording Area Quarter (NI04) of the Southwest Quarter (SW-4) and Name and Return Address Part of the West One -half (W►t) of the Southwest Stephen D. Richardson Quarter (SW of the Southwest Quarter (SW4) of 206 Wisconsin Street N., #103 Section Sixteen (16), Township Twenty -nine (29) Hudson, WI 54016 North, Range Fifteen (15) West, TOWN OF SPRINGFIELD, St. Croix County, Wisconsin described as follows: Lot Three (3) of Certified Survey Map filed October 26, 2004, in Vol. 19, Page 4867, Doc. No. 778156. t) 1 - 310 ` b� (.ZSol� - 3a� 034- 1037 -60 -000 (pt) Parcel Identification Number (PIN) Together with all appurtenant rights, title and interests. This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions and roadways of record. Dated this day of 2005 * * Theodore E. Bergum of * * Shirley rgum AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN ) Signature(s) ) County. ss. authenticated this day of Personally came before me thi y of QT -1 He ed Theodore E. Beram an x` * Sh:Lrlgy A. r TITLE: MEMBER STATE BAR OF WISCONSIN husband and wife $ ' A. *.k3 (If not, to me ktpWn to be the person Z� '^ cq authorized by §706.06, Wis. Slats.) the for goinlki n the J THIS INSTRUMENT WAS DRAFTED BY Michael H. Forecki, Attorney No Eau Claire, Wisconsin k rErllll2(ffioftlt, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) F es of persons signing in any capacity must be typed or printed below their signature. RANTY DEED STATE BAR OF WISCONSIN FORM No. 1 -2000 Attorney Michael H Forecki 3452 Oakwood Hills Pkwy Ste I. Eau Claire WI 54701 -7928 Phone: (715) 835 -3029 Fax: (715) 8354112 Marge Stafford T4399185 ZFX PrMstrar1 with 71nFrvmw by RF FnrmeNPt I 1 r.. 1A(MS FiftwPn MOP Read r:Gntnn Tnwnchin Mirhimn 4An35 (Rnn) 3R3 -AAOS www 7infnrm rnm FORM NO. 985 -A Y er 7 7 8a 1 5 Es Stock No. 26273 VOL 19 PAGE 4867 REGISTER OF DEEDS CERTIFIED SURVEY MAP NO M/79VE R4 4E34pK VOLUME , PAGE CERTIFIED SURVEY KAP REC FEE: 13.00 THE WEST HALF OF THE NORTHWEST QUARTER OF THfOPY FEE AGES: 2 SOUTHWEST QUARTER, AND THE WEST HALF OF THE SOUTHWEST QUARTER OF THE SOUTHWEST QUARTER. SECTION 16, TOWNSHIP 29 NORTH, RANGE 15 WEST, TOWN OF SPRINGFIELD, ST.CROIX COUNTY, WISCONSIN. N89'39'1 9"E 660.71' .a � o • O I w 627.71' �C D E Jo m T N 00 ; rn OT - ' (!1 Cl _< of W r-+ N a r c or < 1 ;i L+ $ o o_ rc M a ^� w' Oo I 1 rn 1 3 1 o r w M N 3a rn x rD r I I b j I w m' ni �" 00 r r `� v� a I rn c fID r � rrl Iy I I I r w `"' ZI Io I IOl ro a I I I Iz _ I 1 N89 28'35 "E 659.06' IN 1 um i I 1 630.01 • Q N� (n I d 33 3 o Oi O - - - n I S 2 4gw^ v o f p o i g IA b o n I �o c a 1 I N 1 a fl R1! E fD ro _.. _.I ...1 m 40 line ............................ �L...,....:T...........,..... " � ............... I....... ... � ., � s � a � j i........i" I N89'28'35 "E ` 658.08' • a c a m Z I 1 p 631.45' m _ N n !^ y .c ro L' 1 N c 1 p 9 ' O I f y,, n3 _. T _ n, Oo 9 N n D. ..`J O ?� C' N { c,l .i M X 5 n rp In ,a ^ i o 3' �o ^ W O YN� a� n 1 x cn �= O m == ro r I I A I r- 4. 0 D + E O z c w N' I o c o � N� 11 I =r 1 J i I `) i O r �' N -i c 1 N89'28'35 "E 656.91' c In N „ z o ro l I z 628.41' 11 o m o ro o a rn a° 1 1 N = W w g• !O 1 I b rn (/l " '°' -�• o° c I 1 OC L CL .°. 2wcn O Iz I� r I o a `rte a , 1U i� aoo NA rn z v� 1 `� !r I t �'m 3 It I.ti w 1 * �—•� o `� • t .A . T fl) o y rn' I Z I w I ( e 9D ro CO 00; co 1 r3 tr to 1 ` 4 `\ O1 Cr: 3 y c E D7 d 1 I o '' r 1 SecGack n c: a �•�' Z 4A Im ° > v v _ 622.99' CL g - --- - - - - Y - -- 1967.12'N a,$ 90th - A - c S89'17'46 "W 655.70' "' j N Page 1 of 2 Vol 19 Page 4867 �FORM NOO.�983 -A H�1rLller E..,.......,.. 7 7 8 1 =i 6 Stock No. 26273 VOL 19 PAGE 4867 KATITEEM K. ALSK REGISTER OF DEEDS RECEIVED FOR'hECORD CERTIFIED SURVEY MAP NO. ?A 2004 04: d VOLUME , PAGE CERTIFIED SURVEY K AP REC FEE: 13.00 D THE WEST HALF OF THE NORTHWEST QUARTER OF THE ACesFEE. SOUTHWEST QUARTER, AND THE WEST HALF OF THE " - 4 20� SOUTHWEST QUARTER OF THE SOUTHWEST QUARTER . SECTION 16, TOWNSHIP 29 NORTH, RANGE 15 WEST, TOWN OF SPRINGFIELD, ST -CROIX COUNTY,WISCONSIN. ST. CROIX COUNTY SURVEYOR'S RECORD' m N89'3 19"E 660.71' ;T S� • o � 1 ( 627.71' rn N f D D fD O Z g �7CD E o �o I N a -1 =n rn cv I _ — o rT+ C ' � .i �o � p (+ a a � _ I 1� i� iN � ��� r c wr �rD =r �-"� N -�` � 1—" I C I 1 w I ✓� � r - - rn 4- - I 1 2 1 1 ru �1 m v'+ r� .r+ rD D C) °° o^ 111 in -no Id to rD rD r j I I _ i? N z o I I� I f '� 1 U 1 I Id la i I N89'28'35 "E 659.06' 1c " I- an i 1 I 630.01' o 'W Iv 333 1 O 1 A I _4ZZ Ln >E s 2 v,2 I� g� o�w_�� �O y a 1 0 O c0 OD W I M Z f1I ' ....m 40 line .............................. °......... ^................... R a• I N89'28'35 "E � 658.08' • a `K to I 0 m 631.45' O 1 nNa 1 g �S ^ ? Ca. n) j j 1l ITS I � � 4 O i d N D Oc p U m QCVC (A O b rD 'O `C = O rD r I p c" Q1 c " O ,-. V, N b x m c ro o i O I �- of nrD'c w N 1 °i i< o f , N89'28'35 "E 656.91' Z m ro Z 528.41' 1 o n r _ a iD T rn �I 1N �oow � Ip ; 1 ro N f° a c o ° i�l o °�'c�i L� c+'cr I a o I w- z O ` .a -r O I I I. 6 p N p O IC7 Iy C3- ,--� ? t o I 2^ iii p1 R rn 1 I'-3 �c 3a I� Ib t I f o i �' �- -A w : IC � rD rD 01 ° rD v in v� 1 `� to 1 1 1 4 1 . p� �' 3 -' c �'o� I Im 1 I ca a rDcu Ib I IC) 17rti -,c7!buck nc N um' o 522.99' $ 1967.12' ------ - - - - - <„ 90th Aye �o N C3. - - - o — S89'17'46 "W — 655.70'- - Page 1 of 2 Vol 19 Page 4867 i ANN 'wiiisoonsinDepartmentofIn" try, SOIL AND bii'E EVALUATION REPORT Pape -Lot Labcr and human Relations DivWor> - safety & sulk ings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but 'S� not limited to vertical and horizontal reference point (SM), di and % of slope, scale or PARCEL I.D. NN dimensioned, north arrow, and location and distance APPLICANT INFORMATION- PLEASE PRI REVIEWED BY DATE PROPERTY OWNER: ,✓�, ERTY LOCATION , 'Tr•e,d c r �� l e �. i �. i LOT 5 µ; IN J w IN.$ T q NCR I PROPERTY OWNER :S MAU AQDRESS 4 BLOCK r SUED. NAME OR CSM 8 9 10 1 5 — ,, - SAcezt V 1 �_ N A N A CITY, STATE ZIP CODE • QVILLAGE OWN. NEAREST ROAD lenw� � U11 4 0 1 q s:) - 7v •. n :� t r4V (� New Construction Use tKj Residential / Nu r 'oi () Addition b existing Duildiftq j) Replacement O Public or oanrner Code derived daily flow go Recommended design loading rate G S bed, gP(W WW Absorption area required _ bed 0 +rtxtch ft2 k I ..)drn r► �'°= i irn ;airy r, M U S .,"t? CI' a;,;; '- Recommended infiltration surface elevation , IO .-4. 3 -t /i 1. .7 ' Ccn -, rs ft (as referred to site plan benchmark) Additional design / site considerations P16W k IS -4v d i s cu rb p & 5& c �u(f . Parent material E^ck ( WO i'0.' n e.S Flood plain elevation, if applicable Al A ft S - Suitable for system CONVENT MOUND IN-GROUND PRESSURE I AT-GRADE SYSTW W F1.L I HOLDING TAW U- Unsuitable fot s stem ❑ S 119 U ®S ❑ U ❑ S ®U ❑ S ®U ❑ S E U ❑ S Jeri I SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consislenoe Bounda y Roots GPD /ft in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed Tiench t ) (v 10(fe 31 AJ 3 0 .5 - 0.49 /DYr2of 1, t& j m s mJ e4,) o.S o. (o Ground 3 i- a0 o YW- !o N c S► a m S b k iM d k I O s D• to elev. J0 11 IL Nesj1 ms — DS 0- (0 Depth to 6�5- 40 0 V ` l cW c �. `�s j /. i� rt, e i Nt III limiting fac tor , Remarks: Boring # .2 1 o-7 /0 YK 3/a AlCr sbk r yes 0S (, '7- s - 11 )U��y -Pjt I mbK ✓ a D }v Ground 3 11 /S 1D y/1 5 `� Pi CKe i 1 m v (�1 NP a- l dev.� 4 4 i5 Iq it Y 41- AJ CW b t;) M S k m Cti.1 Depth to `l 1, Aj (mr r I 4 1 0 limiting fac Remarks: to e.i s T Name:— Plaase Print Phone: o 6 u � m S- S Add ress: 1 34 90 ee tv) A ubNr n w X fLi 7 5'7 Spnature: Date: CST Number: 3 31 - m-3 1 - -- J PROPERTY OWNER - TC - kV I Le n SOIL DESCRIPTION REPORT Page D 3 PARCEL LD. e Y Boring P Horizon Depth Dominant Color Mottles Texture Structure Cor>S�Oenoe� GPD /ft in. Munsell Clu. Sz. Coat Color Gr. Sz. Sh. Bed Twich `1 2 (o f�c ` i � rn 10k m J�r �v am U'S d "lv Ground 3 U M c a m s b k m y r-r Lw I v S d• to elev. �Nc rn k m 5 d �v Depth to P Ong factor Remarks: Boring Ground elev. ft. Depth to - kniting factor Remarks: Boring P ............. . Ground elev. � u l io uniting factor Remarks: Boring P _. Ground elev. fc Depth to uniting factor Remarks: SB04MR.OM2) CF ez" © C-0 cn tp .... ........ ......... .. ........ .. . q 0 c `*s __ _ _ _ __ _ - -_ __ __ __ __ _ _ - __ _. __ _ _ __ __ _ __ - _ _ _ _ __ __ __ ____ _ _ _- __ __ __ __ __ __ __ __ _ _ __ __ _ __ - _ -_ _ __ _ __ _ __ -_ _ _ __. __ _ _ _ _ __ _ ____ __ __ _ __ -- _� _