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County. nt of Commerce PRIVATE SEWAGE SYSTEM S Croi Division --j INSPECTION REPORT Sanitary Permit No ;105188 0 INFORMATION (ATTACH TO PERMIT) State Plan ID No: i ,ation you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. s Name: City Village X Township Parcel Tax No: tbly of God Church Springfield, Town of 034 - 1076 -30 -025 �M Elev: N'} t,. BM Elev: I BM Description: Section Town /RangelMap No: I' �� QM ► ct 33.29.15.513810 TANK INFORMATION S ELEVATION DATA 26 TYPE MANUFACTURER CAPACITY STATION BS f S ELEV. , 10D • 0 [`?.eptic 5 05 7 Benchmark 45 / f c�S t�'� G7C� Dosing Alt. M �4VbYn 0� '4 h4 1 Bldg. Sewe� a S1 Holding SUHt Inlet ��y (�� (I , y N ?, / TANK SETBACK INFORMATION SvHtOutlet at, / 3• l � Z • Z �b `� TANK TO PA. WELL BLDG. Ve to Air Intake ROAD Dt Inlet ,*VI o / Septic i Dt Bottom • / (� u 7 `Jd < 6 - 4 4 36 r ks. 1 / [Aeration os 7 66 Z 8 ' 7 �a� ! �. Head an Dist. Pip . p is ✓ / Holding Bot. Syste 0� /Jai' th �t I C- e t S ' ti /0 30 7 PUMP /SIP I NFORMATION ` j n, Manufacturer Zo�i,l Demand t Cover GPM � 3 (�'S 1 4 Model Number /qL�p ITD i't Friction Los:: System Head TDB ` Z + ` " /b0 For .emain t- engtyl Dia. + I Dist to weil 2 (0!`� SOIL ABSORPTION SYSTEM ¢mod S) O = 1 74 Liquid Width � / Length I No. Of Trenches T DIMENSI . Of Pits Inside Dia. Liquid Depth DIMENSIONS — T• 5 Z QS ~ SETBACK SYSTEM TO P/L / tBLDG WELL I LAKE /STREAM LEACHING Manufacturer: � INFORMATION CHAMBER OR Z Type Qf S Jtem 4 / / / I �� UNIT Model Number 1 , / L 'I DISTRIBUTION SYSTEM 1,JcaSj- Head Manifoi Distribution I/ x Hole Spacing �� �Ver \ir Intake b Pi,,'( length_ Dia Lenyunj Dia J,, Spacing Z• / SOIL COVER x Pre Sy s t ems Only xx '7r At -Grade Systems Only Depth Over / Depth Over x Depth of x Seeded /Sodded xx c / BedlTrench Center J + / Bed /Trench Edges Topsoil !u // Yes Ye tom COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:�P / ' � / � 7 Inspection #2:____/ ! Location: 2988 60th Avenue Wilson, Wl 54027 (SE j 1/4,SfE,-1/4 33 T29N R1 5W) NA,ot Lot 1 Gt^'� , l P arc�No: 33.29.15.513810 1.) Alt BM Description = !/ 6( 0 Sj' i s le _ l ' `d..,,1 j Pl aw t J5td( ph 2.) Bldg sewer length = r amount of cover AF 4�tn, PIV - _ b -- - -- - -- - -- - - -- L "— Plan revision Required? Ys s No Use other side for additional information. - - - - -- Date Insepctor' 8lgnantre Cert- No _SBD -6710 (R.3/97) commerce Safety and Buildings Division County M 201 W. Washington Ave., P.O. Box 7162 St Croix sc o n s n Madison, WI 53707 -7162 Sanitary Permit Number (to be filled in by Co.) L Department of Commerce 50 Co I S Sanitary Permit Application 1` 6 T ransaction Number .n accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate go unit is required prior to obtaining a sanitary permit. Note: Application forms for state -o POWTS are Address (if different than mailing address) Department Commerce. submitted to the tment of C Personal informatio purp oses in accordance with the Privac Law, s. 15.04 1)(m , Stats. I. A lication Information - Please Print nformation Property Owner's Name Parcel # Assembly of God Church Pastor Rick Marmon MAY 0 7 2007 0 '' 3 � • b ZS Property Owner's Mailing Address Property Location s�. CROW cot.IN�rr P.O. Box 56 Govt. Lot City, State Zip Code Phone Number SEA /<, SE %, section 33 Wilson, WI 54027 715- 7724764 T29N; R15 W (circle one) II. Type of Building (check all that apply) ZgCj Lot # ❑ 1 or 2 Family Dwelling - Number of Bedrooms :5EAk% �, Subdivision Name Block # X Public /Commercial - Describe Us Church Assembl ❑ City of ❑ State Owned - Describe Use CSM Number ❑ Village of Z. 13 2— / i (o J,� ?6 35 Z O Town of Springfield III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A ' X New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner t7� s �� • � - � J W. Type of POWTS System/Component/Device: Check all that appl ❑ Non - Pressurized In- Ground ❑ Pressurized In- Ground ❑ At -Grade ❑ Mound > 24 in. of suitable soil X Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dispersal/Treatment Area Information: a , Design Fl w (gpd) Design Soil Application Rate(gpdsf) Dispersal Area wired (sf) Dispersal Area Proposed (sf) System Elevation 1164 2 �, D 1164 5 � Z jj 1164 10 t BW2 10 104 -43 Q , g VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units New T7 (, Existing Tanks 2 )) Q1Cl�tl� �Jt, r U v� v w U CL Septic or Holding Tank 4%;U 2750 1 Skaw Pre -Cast X Dosing Chamber 1000 1000 1 Skaw Pre -Cast x VII. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number Thomas D Gustum 715- 658 -1344 MP227618 Plumber's Address (Street, City, State, Zip Code) N13450 937` Street New Auburn WI 54757 V111._County /De artment Use Onl Approved lsapproved Permit Fee Date I ssued Issuin gent Sign re ven Reason for eniai $ 6AA. 00 5 /J7 a7 IX. Conditions of Approval/Reasons for Disapproval �1c�� ; SYSTEM OWNER: n max. Le.t+! -r✓c� 1. Septic tank, effluent filter and ,� PA"t~G a� 1.x.1 ..... dispersal cell must all be services / maintained as per management plan provided by plumber, 2. All setback requirements must be maintained `f �� AO tl loe� a„l off( . ti- as per 1Cedma4iNtI1r11d10!/pr the system and submit to the County only q u paper not less than 8 1/2 x 11 inches in size f ~ Safety and Buildings PO BOX 7162 commerce .Wl.gov MADISON WI 53707 -7162 TDD #: (608) 264 -8777 isconsin www.w www•commer isco n sin.go / Department of Commerce iscosin.gov Jim Doyle, Governor Mary P. Burke, Secretary January 08, 2007 CUST ID No. 227618 ATTN: POWTS Inspector THOMAS GUSTUM ZONING OFFICE GUSTUM SEPTIC SERVICE ST CROIX COUNTY SPIA N13450 937TH ST 1101 CARMICHAEL RD NEW AUBURN WI 54757 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 01/08/2009 Identification Numbers Transaction ID No. 1356235 SITE: Site ID No. 721621 Wilson Assembly of God Church Please refer to both identification numbers, 60TH Ave above, in all correspondence with the agency. Town of Springfield, 53176 St Croix County SE1/4, SETA, S33, T29N, R15W FOR: Description: Mound Object Type: POWTS Component Manual Regulated Object ID No.: 1113482 Maintenance required; 1,164 GPD Flow rate; 6 in Soil minimum depth to limiting factor from original grade; System(s): 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) 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 the component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, `o stats. CDla The following conditions shall be met during construction or installation and prior to occupancy or use: 4 tP t 1. On pages 4 and 7, the distribution pipe diameter shall be 1 `/4 inch. D1VJSl i�9EN1 2. On a es 5 and 8 the um switch settings shown do not apply to this design. Refer to page 9 for the / ` P g � pump g PP Y h 1 g P g E4 � actual pump switch settings. EE CQRr A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of 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. i THOMAS GUSTUM Page 2 1/8/2007 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 $ 225.00 Fee Received $ 225.00 Balance Due $ 0.00 Peter E Pagel Private Sewage Plan Re ewer , Integrated Services WiSMART code: 7633 (608)266 -2889 , M - F, 0630 - 1500 Hrs pete.pagel@wisconsin.gov cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726 -2544 i x ASSEMBLY OF GOD CHURCH PASTOR RICK MANNON P.O. BOX 56 WILSON, WI 54027 715- 772 -4764 TOWN OF SPRINGFIELD ST. CROIX COUNTY C. SE,SE,SEC.33,T29N,R1 5W JAN 0 2 2D1 DESIGN FOR DUAL MOUND SYSTEM SAf�' {� 1. COVER SHEET 2. SIZING PROBLEM V 3 . BED 1 MOUND SIZING CALCULATIONS 4 Q BED 1 P R E S S U R E D I S T R I B U T A T I O N CALCULATIONS BED 1 TOTAL DYNAMIC HEAD Q 6. BED 2 MOUND SIZING CALCULATIONS O BED 2 PRESSURE DISTRIBUTATION CALCULATIONS O BED 2 TOTAL DYNAMIC HEAD V 9. P U M P CHAMBER CROSS SECTION AND c SPECIFICATION S 1 0 . CONTROL PANEL SPECIFICATIONS ii. PUMP CURVE 12. PLOT PLAN 13. MANAGEMENT PLAN GUSTUM SEPTIC SERVICE flp� MP 227618, DESIGNER 1201 y Q: .�j. TOM GUSTUM o0 cn o THC D. 0• N13450 937TH STREET M� GUSTUM ✓ t �P4 u F 1201 NEW AUBURN, WI 54757 j Gs Phone and Fax #: 715 - 658 -1344 �is►' %1`9E� N�FNc� Page 1 of 13. 212 6� 2.aa,C ASSEMBLY OF GOD CHURCH PASTOR RICK MANNON P.O. BOX 56 WILSON, WI 54027 715 - 772 -4764 SIZING PROBLEM 1. SEATING FOR 299 @ 2 GPD PER SEAT = 598GPD 2. 6 FLOOR DRAINS @ 25 GPD = 150 GPD 3. 2 EMPLOYEES @ 13 GPD = 26 GPD TOTAL GPD =774 USE 776 GUSTUM SEPTIC SERVICE MP 227618, DESIGNER 1201 TOM GUSTUM N13450 937TH STREET NEW AUBURN, WI 54757 Phone and Fax #: 715 - 658 -1344 Page 2of13 Mound System pq=zacr Mound Sizing Calculations Project Name: Assemblys of God Church 338 GPD Mound Bed 1 Site Conditions Design of Entice Pitt Project Type: commercial Building • Cell depth at upslope edge (D): =Oi % Slope: 1 1 Cell depth at downslope edge (E): 30.6 in. L Estimated Daily Flow: 388 Distribution cell depth (F): 10 in. Depth to limiting factor: 6 in. Cover thickness over edge (G): 6 in. Absorbtion rate of fill material: 1 gal /ft /day Cover thickness over center (H): 12 in. Absorbtion rate of in -situ soil: 0.2 gal /ft /day End slope width (K): 13.1 ft. Effluent quality Eff #1 . Fill length (L): 158.2 ft. Max BOD effluent value: 220 mg /I Upslope width (J): 11.2 ft. Max TSS effluent value: 150 mg /I Downslope width (Toe) (1): 17.6 ft. Fill Width CM: 33.2 ft. Design of the Distribution Cell Basal Area �z System Design Flow: 582.0 gal /day Basal area required: 2910 ft Distribution cell width (A): 4.41 ft Basal area available: 2910 ft Distribution cell length (B): F 132.0 ft Area of Distribution Cell: 582.0 ft Observation Pipes Contour Elevation of Mound: 100.74 ft— Location from end of cell (Z): 22 ft System Elevation of Mound: 103.24 ft Final Grade of Mound: 105.07 ft Mound Plan View _� �Obsetvation Pipes � z� vV K — Cell A B K Tilled Area/Fill Material L Mound Cross Section Final Grade – Observation Pipe Synthetic Fabric H G Distribution Cell System Elevation % s 1 Cover Material Lateral p 3 Fill Material Invert Tilled Area System Slope Forcemaln S y Contour Notes: Fill material to consist of ASTM C33 Sand Distribution cell aggregate to comply with Comm 84.30(6)(1) Synthetic Fabric covering on cell per Comm 84.30(6)(8) Distrbution corto'nave minimum b' aggregate beiow'laterdl and Y above. a 3 0 13 L5 Mound System Page 3 of a Pressure Distribution Calculations s o Project t Name: Assemblys of God Church 338 GPD Mound Bed 1 Latema Uaywt UaklwaWa"5ftAd Lateral elevation: 103.7 Lateral diameter: ft In. Y s � Rows of Laterals: 2 • Laterals sp acing : p 9( S ) 2.94ft Manifold type: . Lateral to cel edge: Yp Center I dg 0.7345 ft Orifice diameter: 0.125 • I In. Lateral discharge rate: 11.53 gpm F # of Laterals: 4 System discharge rate: 46.14 gpm Distal Pressure: 5 ft Manifold diameter: Z In. Lateral Length: 65.5 ft Manifold length: 2.94 ft Orifice Spacing /Distribution Forcemain Friction Loss Orifice spacing (X): 28.58 Inches Forcemain length: 220 ft Orifices per lateral: 28 Forcemain diameter: 3 In. Avg. €t?�L1rrf�ee: 5.20 €f F rja.LRO Jfcs in 1.3P.5 €t Lateral Side View Manifold Lateral \Lateral x x x x x --T-X--Tx x x x x x 2 2 Lateral Length r Lateral Length Lateral Plan View ' PVG MarNTOlcf onricas o., bottom or PVC laterals, forcemain and manifold to co mply racarai quauy sr�oaa ply with ` specifications per Comm 84.30[2] I Forcemain connection via tee or cross to manifold at any point Clean Out Detail Observation Pipes Clean -out plug Final Grade or ball valve Water tight cap or plug 9 „/ —Lawn Sprinkler Box Slot Note: Closet Collar 6” Minimum may be used in Long Sweep 90 place of 3YO" bar or two 4a s Lateral 3J$" Bar Mound System Page 4of 4 Septic, Pump and Dose Tank Project: Assemblys of God Church 338 GPD Mound Bed 1 Tank Information Dosage Volume Pump tank manufacturer: Skaw Precast Does forcemain drain Pump tank size /model: 1000 back to tank? Pump tank gal /inch: 28.32 Lateral void volume: 4„5.8 � Tank bottom elevation (inside): 93 ft Dosage to absorbtion Cell: 116.4 gal Septic tank manufacturer: Skaw Precast Forcemain volume: 84.4 gal Septic tank size /model: 2570 Total dosage: 200.8 gal Pump and Filter Total Dynamic Head Pump Manufacturer: Zoeller Are laterals highest point? y Pump Model: 140 if not, enter highest elevation: 0 ft cffibent RYer. I S" bid-fu l Salem heart Wits x ?.3) 6.50 ft Vertical Lift ( "D" to lateral) 9.74 ft Note: Access opening of sufficient size to be provided to allow removal of filter Opening to terminate at or above grade. Friction loss in forcemain: 1.32 ft Pressure loss from filter: C �ft - T otal dynamic lead (T DH): 17.56 ft Pump Tank Diagram Vttateftight Locking Cover Dose Tank Levels 4 inch �VJRh warring Label .-Finis&A Minim , Grade In. al erve 402.7 Aft —� B Pump o rm 2.0 56.6 Location C Total Dosage 7.1 200.8 Elect. per Comm 16.28 and D Effluent d for pump�o 339.8 Forcemain NEC 300 T Capacity: t��0 w\ Ct ` 35.3 1000. Weep Hole A Siphon B Oevice C v J �� D Pump must be capable of: 46.1 GPM and head pressure of: 17.6 Feet 13 Mound System Page 2of 4 Mound Sizing Calculations Project Name: Assemblys of God Church 338 GPD Mound Bed 2 Site Cortditions Qesign of Entire RU Project Type: Commercial Building Cell depth at upslope edge (D): 30.0 in. % Slope: 1 1 Cell depth at downslope edge (E): 30.6 in. YL Estimated Daily Flow: 388 Distribution cell depth (F): 10 in. Depth to limiting factor: 6 in. Cover thickness over edge (G): 6 in. Absorbtion rate of fill material: 1 gal /ft /day Cover thickness over center (H): 12 in. Absorbtion rate of in -situ soil: 0.2 gal /ft /day End slope width (I): 13.1 ft. Effluent quality Eff #1 . Fill length (L): 158.2 ft. Max BOD effluent value: 220 mg /I Upslope width (J): 11.2 ft. Max TSS effluent value: 150 mg /I Downslope width (Toe) (1): 17.6 ft. Fill Width (W): 33.2 ft, i Design of the Distribution Cell Basal Area Y Design Flow: 582.0 gal /day Basal area required: 2910 ft' Distribution cell width (A): 4.41 ft Basal area available: 2910 ft' Distribution cell length (6): F - 1 - 32 - - 0 ft Area of Distribution Cell: 582.0 ft Observation Pipes Contour Elevation of Mound: F 1 ft Location from end of cell (Z): 22 ft System Elevation of Mound: 102.83 ft Final Grade of Mound: 104.66 ft Mound Plan View ,Observation Pipes W K C 4 A i B K Tilled Area/Fill Material L Mound Cross Section Final Grade 1— ► Observation Pipe Synthetic Fabric H G Distribution Cell dF System Elevation a a, &� F sd � I � 3 Lateral Cover Material � D Fill Material Invert Tilled Area S s #em Slope Forcemain Y Contour Notes: Fill material to consist of ASTM C33 Sand Distribution cell aggregate to comply with Comm 84.30(6)(1) Synthetic Fabric covering on cell per Comm 84.30(6)(g) Dlstnbution Geri to have minimum Fi" aggregate below lateral and ' above. 13 I Mound System Page 3 of 4 Pressure Distribution Calculations �; 6 "0, Project Name: Assemblys of God Church 338 GPD Mound Bed 2 t� `Lzkwa1 �a�so t �atesatif4dSa�5 #drd �estig� ��� � Lateral elevation: 103.3 ft Lateral diameter: 1 Y In. Rows of Laterals: z Lateral sp acing (S): ft 2.94 , � Manifold type: Center Lateral to cell edge: 0.7345 ft Orifice diameter: o.i2s • In. Lateral discharge rate: 11.53 gpm # of Laterals: 4 System discharge rate: 46.14 gpm Distal Pressure: 5 ft Manifold diameter: Z In. Lateral Length: 65.5 ft Manifold length: 2.94 ft Orifice Spacing /Distribution Forcemain Friction Loss Orifice spacing Q 28.58 Inches Forcemain length: 175 ft Orifices per lateral: 28 Forcemain diameter: 3 In. z Avg. � ; �r� €gee: �.2a f: z Frac�� kw in fi�ce.►xaali�: ?.A4fi €t Lateral Side View Manifold Lateral Lateral .x .x .x x .x 11 �2L x .x .x Lateral Length Lateral Length Lateral Plan View 0 I � PvC Manifold 0 PVC laterals, forcemain and manifold to comply with lateral a luallY spacaA ` specifications per Comm 84.30[2] I Forcemain connection via tee or cross to manifold at any point Clean Out Detail Observation Pipes Clean -out plug Final Grade or ball vahre Water tight cap or plug --Lawn Sprinkler Box r, Slot Note: Closet Collar 6" Minimum MY be used in Long Sweep 90 place of W" bar or two 45 's 318" Bar Lateral Pc5 e 7d /3 Mound System Page4of 4 Septic, Pump and Dose Tank Project: Assemblys of God Church 338 GPD Mound Bed 2 Tank Information Dosage Volume Pump tank manufacturer: Skaw Precast Does forcemain drain Pump tank size /model: 1000 back to tank? C Pump tank gal /inch: 28,32 Lateral void volume: 45.6 qaJ Tank bottom elevation (inside): 93 ft Dosage to absorbtion Cell: 116.4 gal Septic tank manufacturer: Skaw Precast Forcemain volume: 67.2 gal Septic tank size /model: 2570 Total dosage: 183.6 gal Pump and Filter Total Dynamic Head Pump Manufacturer: Zoeller Are laterals highest point? y Pump Model: 140 if not, enter highest elevation: 0 ft Effluent iFRer. i 6" tiro- tube l swem heard OWN x ?.3) 6.51 � Vertical Lift ( "D" to lateral) 9.33 ft Note: Access opening of sufficient size to be provided to allow removal of filter. Opening to terminate at or above grade. Friction loss in forcemain: 1.05 ft Pressure loss from filter: ft - T otal bynarrilcbead (DH): 16.88 ft Pump Tank Diagram k 1 •a 5 V Meftht Locking Cover Dose Tank Levels 41hcd With Warring Label —Fini &..d Minim Grade <3, A rve anerra� B Pump o larm Outlet Location C Total Dosage Elect. per Comm D Effluen th for 1s28and P Forcemain NEC 300 otal Capacity: Weep Hole A si lrm B O � C D @ pow Pump must be capable of: 46.1 GPM and head pressure of: 16.9 Feet g o� 1 3 PUMP CHAMBER CROSS SECTION AND SPtG I t l l.H I I un� WITH DUPLEX PUMPS PUM P MIAQUFAC.TURER— MODEL. kiUMBER __�1`� O ___! . _ - - - -- FRICTON LOSS WITHItJ FORLE AAAIkl -- ---- MEASUREMEWT BETWEEAI PUMP OM AND PUMP OF'F GALLONS PUMPED PER GyCLE_.- -- -- LIFT PUMP TANM C MAIUUFAGTURER _ — — — SIZE OF TAkltil___ VERTICAL. HElf-%HT FROM PUMP SASE TO DISTRIBUTIOU 6E:D OR TPZUC-M_ =7? - - -- WEATHERPROOF JUNCTION BOX APPROVED LOCKING MANHOLE COVER, 4" MIN. ABOVE GRADE NO TE*. IMSTALL AUDIO OR VISUAL ALARM IIJ 4" VENT -12 "ABOVE GRADE ALTERLIATIM& CONSPICUOUS LO- as FROM DOOR, -SWITCH CATIOLI WIIJOOW OR FRESV4 AIR IUTAKE PROVIDE AIRTIGHT SEAL MANHOLE ( i MIRIIMUM 2y" I.D. j I FORGE MAINS I 1 { I MI Al IMUM 2'' I. D. 141414 WATER IVAKUIIJG DEVICE 1 •�1 r E i j i i - --° - 71�I 3:ULET E OUTLET 4 APPROVED PIPE i CXTEUOIIJba - 5 FEET ;, r - - J UUTO UIJDISTURBEO 211 GRDUNID_ ( ( JOIAITS PUMP fm { 1 { I 5 7&.10 Sat. CIA P P FF C QoS�,5e I F 1J ar �(7,�y"r�y, SUBMIT COMSTFIUGTION DETAILS OF TANK IF SITE CONSTRUCTED 9 �! / p FM2094 , KIA I /�l/MPu 515fer /Y�c/ 0402 L' supersedes Product information 'i ® NEW here reflects V presented h e c conditions at time of Pl1MP !O. publication. consult factory visit our web site: regarding discrepancies or MAIL TO. P.O. BOX 16347 • Louisville, KY 40256.0347 inconsistencies. SHIP TO. 3649 Cane Run Road • Louavft, KY 40211 -1961 http. 1Avww.zoeIIer.com (502) 778.2731.1(800) 928-PUMP • FAX (502) 7743624 Zoeller Programmable Advanced Control Panels Zoeller Company Programmable Advanced Control Panel is a programmable control designed to interface with a PDA (Personal Data � Assistant) to monitor and log system events such as: pump cycles, doses, elapsed time, high water alarms, power outages and invalid sensor readings. Control Panel Features: • NEMA U thermoplastic enclosure • Magnetic motor contactor' • Circuit breaker(s) for pump power disconnect ti -,- • 360 visual high water alarm beacon • 83 -85 db rated high water alarm hom • Terminal blocks for easy wiring • Hand /off /auto (HOA) switch , • Exterior alarm test(normaUsilence switch • Alarm and control circuits are fused • Spare control /alarm circuit fuse • Pump specification and installation labels • UL listed •Ground lug • 20' float switches included PDA not included. Part Number Application Voltage Amps Enclosure Size 10 -1423 Simplex control, on- demand system - includes on, off and alarm 115V 0-20A 12" x 10" x 6" sensor float switches 10 -1424 Simplex control, on- demand system - includes on, off and alarm 115/200/230V 0-20A 12" x 10" x 6" sensor float switches 10 -1425 Duplex control, on- demand system - includes on, off and 115/200/230V 0-20A 14" x 12" x 6" override /alarm float switches 10 -1426 Simplex timed dosing control - includes low level cutout, timer 115V 0 -20A 12'x 10'x 6" override, and high water alarm float switches 10 -1427 Simplex timed dosing control - includes low level cutout, timer 115/200/230V 0-20A 12" x 10"x 6" override, and high water alarm float switches 10 -1428 Duplex timed dosing control - includes low level cutout, timer 115/200/230V 0 14" x 12" x 6" override, and high water alarm float switches Dual pump timed dosing control - includes low level cutout, 10 -1429 timer override, and high water alarm float switches for dose tank. 115/200/230V 0-20A 14" x 12" x 6" On /off and high water alarm floats provided for secondary application. Pc5 �o a �' 3 HEAD CAPACITY CURVE TOTAL DYNAMIC HEAD /CAPACITY 3 7/6 6 1/4 w w PER MINUTE MODELS "140/4140 EFFLUENT AND DEWATERING �a 5/6 Ft. Meters j Gal. Ltrs. 14 45 5 1.52 91 344 0 0 3 7/8 10 3.05 84 318 + o 12 40 15 4.57 76 288 0 4 1 40 20 6.10 68 257 1 1/2 - I1 I/2 NPT 35 25 7.62 59 223 10 30 1 9.14 49 185 30 35 10.67 38 144 40 12.19 21 79 8 25 45 13.72 5 19 72 5/e LACk Valve: 46' 41 z 6 20 U_ 4 5/16 I z 15 r SK1524A J 4 0 10 5 3 7/8 6 1/4 - 9 e 4 5/6 0 O 3 7/8 U.S. GALLONS 10 20 30 40 SO 60 70 80 90 100 110 0 LITERS + 80 160 240 320 400 0 0 FLOW PER MINUTE 010904 0 1 1/2 - 11 1/2 NPT CONSULT FACTORY FOR SPECIAL APPLICATIONS • Electrical alternators, for duplex systems, are available and supplied with 16 13/32 an alarm. • Mechanical alternators, for duplex systems, are available with or without �- alarms. 4 5 /16 • Control alarm systems are available for 1 phase pumps used in simplex _� SK7524e system. See FM0732. - • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long cycle controls. SELECTION GUIDE • Sealed Qwik -Box available for outdoor installations. See FM1420. 1. Single piggyback variable level float switch or double piggyback variable level float • Over 130 °F. (54 °C.) special quotation required. switch. Refer to FM0477. • Refer to FMO806 for 200° F. applications. 2. Mechanical alternator M -Pak 10 -0072 or 10 -0075. 3. See FM0712 for correct model of Electrical Alternator E -Pak. 4. Variable level control switch 10-0225 used as a control activator, specify duplex (3) 140 Series - 53 lbs. 4140 Series - 73 lbs. or (4) float system. 14014140"" MODELS Control Selectio Model Model Volts-Ph Mode Amps simplex Duplex N140 N4140 115 1 Non 15.0 tort &5 2 or 3 & 4 E140 E4140 230 1 Non 7.5 tort & 5 2 or 3 & 4 O CAUTION BN140 BN4140 115 1 Non 15.5 1 or 1 &5 2 or 3 & 4 All installation of controls, protection devices and wiring should be done by a qualified BE140 BE4140 230 1 Non 7.5 1 or 1 & 5 2 or3 & 4 licensed electrician. All electrical and safety codes should be followed including the most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL To: P.O. BOX 16347 L , Louisv*, KY 40256-0347 Manulasturers of. . SH 3649 Cane Run Road Louw ® Louisville, KY 40211 -1961 Qu4urrPuWveS,vc /9m9'� httpJfwww.zoeller.com to/Mo A (5o2J 778- X (502) 7800) 24 PUMP FA X (502) n4 -3s24 © Copyright 2001 Zoeller Co. All rights reserved. I 5 r � ' h Mound System Management Plan pursuant to comet 83.54 W. A. C. page =297 3 0 .x' 13 Owner's Responsibility: The component owner is responsible for the operation and maintenance of the component. The county, �,naskmeAt as POINTS Cdr- ersnKKarf r wa%j waka �.�r rAr i. sWJ.�s � tkva c_+w,vss+ k%, �hRrJE frys surface discharge, treated effluent levels, etc. The owner or owner's agent is required to submit necessary maintenance reports to the appropriate jurisdiction and /or the department. Septic Tank: ap%ti� t�kts) are ti a .tiRS,�e�ts�+ rs.�tkne�j� �!ti+ .�t�ta%� �y� c artme�t }r<��� .1. 1 Ad- s � 4�?�t? necessary in accordance with their approvals. The use of chemical /biological "treatments" is not required or recommended. If such additives are used, make sure they are approved by Department of Commerce, Safety and Buildings Div.. Effluent filters are to be removed & cleaned as necessary, with provisions to keep solids from passing the septic during removal. No more than 1/3 of the usable tank volume may be occupied by sludge /scum. 3 year inspection: If tank has greater than 1/3 volume sludge, tank contents must be emptied and disposed of in accordance with NR 113 Wisconsin Administrative Code by an approved individual. If the inspector does not recommend pumping of the septic tank, then the owner must be notified of when pumping should be done as to not exceed 1/3 sludge volume. Septic tank should be routinely inspected to be watertight and of good repair. Rump/Dose rank If an effluent filter has been installed in the pump /dose tank, it must be removed & cleaned as necessary, with provisions to keep solids from passing to the mound component during removal. The pump, float switches and alarms must be inspected at least every three years for proper operation. Pump /dose tank should be routinely inspected to be watertight and of good SP.I . Mound and Lateral System The mound system component must remain free of ponded surface water prior to pump operation. if 4 inches or more water level is detected in the observation pipes, the owner must be notified of possible prahkL.r.rG1fakUrE TrPPs and any other deep rooted vegetation should never be planted, or allowed to grow anywhere on the component. Activities OTHER than mowing /maintenance (i.e. excessive walking, pets, vehicles, etc...) could compress the component and reduce it's absorbtion capabilities and /or possibly cause it to freeze in winter conditions. Lateral distribution pipes should be flushed out/tested every 18 months using the cleanout points at each end of the component to remove scum that may clog orifices. Performance Monitoring: Performance monitoring must be done at least once every three years following the installation or at the time of a problem, complaint, or failure. Contingency Plan: If the septic tank, pump tank or any of their components therein (including floats, alarms, pumps, etc) become defective, the defective tank or component must be replaced immediately to ensure that the system can operate as designed. If the mound component cannot accept wastewater or ponds wastewater to the surface, the component must be repaired or replaced in it's current location by either: extending basal toe to provide added absorbtion area; or by removing the clogged bacterial mat,aggregate cell, and distribution piping within the mound and replacing said components in order to return system to proper working order as required. has e 13 of /3 r i Safety and Buildings • ' 10 SUNSHINE CIRCLE commerceml.gov R- EPEIVED CHIPPEWA FALLS WI 54729 TDD #: (608) 264 -8777 i scons i n www.commerce.wi.gov /sb/ Department of Commerce Ida 2Q www.wisconsin.gov i . CROIX COUNTY Jim Doyle, Governor ZONING OFF Mary P. Burke, Secretary August 03, 2005 CUST ID No. 224832 ATTN: POWTS Inspector MARY JO HOLLISTER ZONING OFFICE HOLLISTERS SOIL TESTING ST CROIX COUNTY SPIA W9875 690TH AVE 1101 CARMICHAEL RD RIVER FALLS WI 54022 -4011 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/03/2007 Identification Numbers Transaction ID No. 1154255 SITE: Site ID No. 701810 Assembly of God Church Please refer to both identification numbers, Town of Springfield, St Croix County above, in all correspondence with the agency. SE 1/4, SE 1/4, S33, T29N, R15W FOR: Object Type: Soil Saturation Determination Regulated Object ID No.: 1029637 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. The following conditions shall be met during construction or installation and prior to occupancy or use: 1. Approval is hereby granted pursuant to s. Comm 85.60(2) Wis. Adm. Code, to estimate the depth to seasonal soil saturation based on an interpretive determination process. Approval of the interpretive determination negates the requirement in s. Comm 85.30(2)(b), Wis. Adm. Code to designate the ground surface as the higest level of soil saturation when redoximorphic features are less than 4 inches below the bottom of the A horizon. 2. The estimated highest level of prolonged soil saturation approved under this determination is 6 inches below grade. At least 30 inches of sand lift on top of 6 inches of unsaturated, in -situ soil is required for adequate treatment and dispersal. 3. The basal soil application rate for the mound shall be S 0.20 gpd /sf, and the linear loading rate < 4.5 gpd/ft. 4. Chisel plowing to a depth of 12 -I6 inches immediately prior to sand placement is required to improve vertical water movement into the soil solum. 5. Landscaping up slope of the mound shall be incorporated into the POWTS design to prevent surface water from concentrating along the up slope edge of the mound and to divert surface water drainage away from the system. 6. This approval shall remain valid unless the site is altered in such a way that the depth to soil saturation would change or if saturated conditions are observed for seven consecutive days at depths less than 3 feet below the infiltrative surface of the POWTS distribution component. 7. This approval in no way relinquishes the use of color patterns to estimate the depth to high groundwater on any other parcels or portions of parcels. 8. A copy of this approval letter and attachments must accompany the mound system design for this site for purposes of plan approval and sanitary permit issuance. ' MARY JO HOLLISTER Page 2 8/3/2005 This approval applies only to those specific areas as referenced and recorded by the CST. Reports dated 7/18/05 for Lot 1, and 6/25/05 for Lots 2 -4 show the locations of suitable areas for mound installation. In addition, the enumerated conditions apply to all four proposed lots (1 -4). If the Interpretive Determination Report was accompanied with a plan and an expiration date is shown on this letter, the expiration date only applies to the plans for the design, not to the decision on the Interpretive Determination Report. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. If plan index sheets were submitted in lieu of additional full plansets, a copy of this approval letter and index sheet shall be attached to plans that correspond with the copy on file with the Department. 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. Sinc rely, Fee Required $ 100.00 Fee Received $ 100.00 — Balance Due $ 0.00 Leroy G. J sky, PS . Wastew t r Specialist Integrated Services Bureau WiSMART code: 7633 (715)726 -2544 Voice Ijansky@commerce.state.wi.us ,Jul 26 05 10:52a owner 7154284827 P.3 Mart Jo Hollister W9875 6Yd"Avenue River Falts, WI 54022 (715)+24 7 775; fax:426 - 4827 Interpretative Determination Report R 0.W. S.. 6 jul 2009 Conditionally APPROVED Property Owner: Robert Leaf DEPARTMENT OF COMMERCE DIV SION OF SAFETY AND BUILDINGS gui9ers: Cal vary A ssem6ly of God and brucc trenc If 44 L ocation: L Sr W of the 5r S4, 5cction 33 T �9N R 1 5W, SEE VORRE S NDEN Town of Springfield, 5t. C roix Count, W isconsin INTRODUCTION: On 25 June 2005 a site and soil evaluation was completed forfour new Private onsite wastewater treatment system (PO 6, th is soil tester on a twenty acre p arce l that is for sale. During this evaluation it was determined that there is not a clearfour inch horizon below the A horizon without redo features. In fact, it appears that the redoxirnorphicfeatures are in the A horizon in most soil Pits that were observed. - ( - he buyers were informed at this time that the State of Wisconsin, Dept. of Commerce will have to approve the site for depth to seasonal saturation. GEOLOGICAL 1 This area in f �lisconsin is an area of the Glaciated 1zegion, which occurred 1 2,000 to 1 5,000 years ago. This caused erosion, deposition, stream erosion and other processes. Wisconsin is divided into five natural regions, which are related to land 6, the use of Plants, animals an b man. Also th 6oundaries are determined 69 soil texture and structure in the underlying rocks. 5t. Croix County is located in th Western Upla which is underl b O rdovician dolomites. (Martin, L. ( ►965)• The Physical Geology of Wisconsin. university of Wisconsin Press, Madison, Wisconsin.) This part of 5t. Croix Jul 26 05 10:52a owner 7154264827 p.4 Page 2- L.1 =Ar, Robert County was formed 69ground moraine deposits from the Wisconsin stage ofglaciation. The parent material at this site is loess over glacial till and the topography is gently rolling. LOCAL AND SITE. HYDROLOGY= This land area is located within the Lower Chippewa }liver basin which.includes F,au Galle River, Wilson Creels, Cady Creek and several small creeks. (St. Croix County Development Management Plan Physical features Analysis pg. 2 -i t .) This site is near the headwaters of the Wilson Creek that flows northwesterly and near the headwaters of the Cady Creek that flows southerly. (5ce attached copy of St. Croix County Soil Survey, Page 72.) The attached topographic map from the State of Wisconsin Geological and Natural History Survey shows the site to be two feet higher than the surrounding land area. The slope drainage at all the sites are linear and convex which is good for moving water away from the site. All surface waters drain from these sites and there are no wetland areas nearby or areas of ponding water. SOiL MAPPING= This area is indicated on the copy of the Soil Survey map as a Santiago series which are on ridges of ground moraines or on pitted glacial drift that are gently sloping to steep and well drained with moderate permeability and as a rrecon Series which are of gently sloping and sloping, moderatel well drained soils formed from sand loam till. Well drained soils removes the waterand does not have redoximorphic features and moderately well drained soils remove the water somewhat slower and are wet for only a short period of time. This would imply that the site appears not to stay saturated for a long period of time. As indicated in the Soil Survey of c jt. Croix County, Wisconsin published 6, 9 the National Cooperative 5oil5urvc3 the area tested is mapped as Santiago silt loam with 2 to ,6 percent slopes and Frecon silt loam. goth of these soil series belong to the soil order i I Jul 26 O5 10:53a owner 7154264827 p.5 page 3 - LF_Ar, Robert Alfisols and are further classified as Typic Glosso6oralfs that have properties of tongued and cool. These soils are formed mostly under broadleaf deciduous forest and where drainage is not restricted from the water table with an odic, ustic, or xenic mositure regime. (Keys to Soil Taxonomy (soil 5urvc Staff} U5DA -NRC5.) 501L CONDFFION5 AND 5URFACr. WATFR rLOW: The soil evaluations completed by this certified soil tester encountered an A horizon of 9 to 12 inches of silt loam with redoximorphic features starting at 7" inches in a few Pits to ,9 inches in most of the Pits. Root and worm action was present in all pits to depths of 36 inches. This indicates that there would be greater than 6 inches of in -situ soil to accommodate a prop erly,, designed MW I75• The subsoil colors are more of a grayish brown than a gleyed color that is associated with wet conditions. In the lower Part of the A horizon and into the glacial till redoximorphic features are observed. The 5 horizon consists of a sandy loam with gradual heavier conditions and had some sand and loamy sand pockets with many sand coats present. /{any other pits were observed that were similar as far as rcdoxiphoric features, texture, structure and consistency. A few pits had few, fine, faint redoximorphic features in the A horizon at 4 to 6 inches. These areas were not considered for that reason. cjurface water does move into the horizon which may be perched in the g horizon as indicated b the redoximorphic features and some water havingto be a6sor6ed into the A horizon due to tension saturation. The redoximorphic features in all the pits were few, fine, Faint then becoming common, medium, distinctive or many, medium, prominent_ This indicates that Perching does take place, but not fora long period of time. It also indicates that it is wetter longer atgreater depths and probably not so wet and for shorter durations near the surface. The surface and subsurface drainage from the site appears to flow away from the site in three directions as indicated on the topography map as this area is the highest elevation. .Jul 26 05 10:53a owner 7154264827 p.6 Fage 4 - LFAF, Robert An existing dwelling, approximately 400 feet on the west side of the 20 acres has a replacement mound systcm. According to the soil survey map, similar soils exist at this site. CON CWSION/RECOMMENDATION5. The landscap at this site, gen rolling, shows the water movement away from the tested areas with drainage to the south and southwesterly. `f `(here there are slight depressions in the topography where surface water can collect, there will be redoxiphoric features forming at shallow depths which were observed at four inches in some of the pits that are not being used for a PO Redo xiph oric features in the lower part of the A horizon are pro6a61y due to th tension saturation above the saturated subsoil. fjas on the l ac k of the redoxiphoric f eatures in the upper 7 inches of the topsoil, these sons will properly accept and treat the wastewater with a long and narrow mound system as per Comm 8 5.++(3)(6) 1, and 2., Wis. Adm. C ode. Ejased on all this evidence the recommendations shall 6e: J The h h do t of the a pprove d sa nd b a treatment P d c at least 2.50 feet for a t. PF � 2.) The mound system be designed long and narrow with a maximum linear loading rate 4.5 gpcl /ft. and the basal soil application rate shall be 0.2 gpd /ft.2 for adequate dispersal into the natural soil. 5.) Increase the downslope area around the mound system to increase the basal absorption area. 4.) Surface water is to be diverted from the mound system with either a grass diversion or upslope area of mound system designed with a greater side slope. Res ectfully submitted, Mara. Jo ollister, CS`( 224832 Dated: b July 2005 (Revised 2, ,jul_ 2005) I J,ul eb ut iu: bja owner ria -rco -roc r N. r Kr-FF KF.NCE5= 1.) Martin, L. (1960. The Pkusical eolo o{ isconsin_ (Jniversify of Wisconsin Press, Madison, Wisconsin, 2.) Soils. Universit of Wisconsin r Jucation Courses. 3.) st. Croix County Development Plan. Volume Two; bacl ground jtuJies. F gsical Features Anal9sis. 4.) soil survey of 5t Croix County (1978). (Anitcd States Department of A griculture Soil Conservation jervice and Research Division of tke College of Agriculture and Life jciences, tAniversity of Wisconsin. I r owner 7154264827 P _1 4- CERTIFIED'° SURVEY MAP NO. VOLUME PAGE-.. THE SOUTH -HALF OF THE E AST QUARTER OF THE SOOTHE A - �S j 0 SECTION 33, TIWNSHIP- 29 NORTH, RANGE 15 WEST ESst 114 TOWN OF SPR!NGFIELD; ST:CROIX COUNTY, WISCONSIN Section on. PREPARED BY: Joel A Brandt JB SURVEYING LLC 966 Rustic Road 3 r of - UNPLARTETi, LANDS - � o•m Glenwood City_ WI i NI 220.66' 220.3 220.33' 628.80' J N ' ' Z O Z sal tesis sod ie5is — 100� � lc Z LOT ) $ 1� 1z LOT 4 N L OT LOT 2 N 435.020s incl. r -o -w Ln 01 a u N 92.57E sq. ft U � ua � - a w i incl, r - o - w L.0 let c ro o 33.00' 33.0 33.00' 33.00' $ I �ceo:er.�re 1_324:47' 220.66' 220.33' AA 220.33' 630.08' V /-589'28'50 'w_ 220.66'— _ 220.33 — 720.33' _ 663_15 60th Ave_ - P.O.B. 5V1 cornea - - - S o uth 119 � — -- - -- 1 r SE St S89 28'50 "W 1324.47' . Section 33 -29-15 S "W 2615.91, c enterline - • � - � - Southeast Corner Found Aluminum rye. Sec 33 - -15 UNPLATTED LANDS Found Aluniriurl Nor. PREPARED FOR: LOT ¢ IBuyer of Lot 44 LOT 3 LOT 2 Calvary Assembly of God 145.230 sq ft 1 44,933 sq ft 144,850 sq.ft. 310 LaPointe Rd S 3 33 acres 3.33 acres 3.32 acres Wilson. WI 54027 lncl- r -o -w incl r -o -w Incl. r -o -w PREPARED FOR: OWNER: (Buller or Lots 1 -31 137,949 sq It 137.662 sq. ft 137.579 sq ft. Robert Leaf Br%- French 317 acres 316 acres 316 acres 3026 60!h Ave not ind r - o - w not mcl r - o - w -lot Incl r -o -w Wilson. Wt 5402? Note: Each parcel on this map is sub)ect to State and County laws. rules and regulations 1 • t .�_�Yx- +tea.... -�� _ � _ ,� �':`:ur^:'•�— ' & x �t�^�_•_ �i4 3 y fog WE 5 7�7 fl t _ .y .'"'mss OTT - r' _ I - 4 f �!g ' m !' t 10 1 O Ore N l tt i �,: ✓ � _ r..., rte_, i � '� f r -: � '""'� � "� , , r• : o f v A ° o lil� �Lt 1 v — •.!.J � — 1 O 4 ' 1 7iv 9 MrMOTe'9 S s a aD 2m M P1 N N ie 39vci Cw T?n - -"TC*l'4 N C4r /C7bCT/ T e :7T CQA7 / /Q /!p .Jul 19 05 09:33a owner 7154264827 p.2 Wisconsin Department of Commerce SOIL EVALUATION REPORT page I of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County ST. CROIX Attach complete site plan on paper not less than 8112 x 11 inches in size, Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. (Pending) percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print art inforvnation. Reviewed by Date Personal irrror radon you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Q E] ROBERT LEAF (Buyer. Calvary Assembly of God) Govt. Lot --- SE 114 SE 114 S 33 T 29 N R 15 E (o* W Property Owners Mailirig Address Lot # I Blod(# Subd. Name or CSM# 2928 C.T.H. DD 1 — (Pending) City to p Code Phone Number O VII ge Town Nearest Road Glenwood City, I WI 54013 715 265-4964 Spfingfield i 60th Avenue E New Construction Use[B Residential / Number of bedrooms Code derived design flow rate GPD Replacement o Public or commercial - Describe: char eb Parent material glacial till Flood Plain elevation if applicable NA ft. General tents Mound System — 0.2 loading rate — 2.50 ft. sand fill and recornmendatiorrs. SEE INTERPRETIVE DETERMINATION REPORT --on -site w/Leroy Jansky, State of Wisconsin Wastewater Specialist To be designed by designer . or installer F 1-1 Bo" # � Boring o Pit Ground surface elev. 100.14 ft Depth to limiting factor 10 in. SoN Applicabon Rabe Horizon Depth Dorrrinant Color Redox Description Texkxe Stnkbure Consistence Boundary Roots GPD/ff ar. Munsal Qu. Sr- Cont. Color Gr. Sz. Sh. 'Eff#i1 'Eff#2 1 0-4 10YR313 — sil 21gr mvfr ' cs 3vf-co 0.6 0.8 2 4 l0YR3/3 _ sil 2fabk ds as 2vf-m. 0.6 0.8 3 10-13 10YR4/3 m2d 10YROW0YRb/1 sil 2fabk ds - 2vf-m 0.6 0.8 Some gr; gobbles. t3orirhg # Boring 100.14 10 • pit Ground surface elev. it. Depth to timifing factor in. Soil Application Rate Horizon Depth Nn olo Redox Description Texture Structure Consistence Boundary Roots GPDA'f in. Qu. Sz. Cont. Color Gr. Sz. Sh. 'Etf#1 'Efi#2 l 0-4 — sil 3fgr mvfr cs 3vf-co 0.6 0.8 2 4-10 - sil 2fgr&abk ds as 2vf-m 0.6 0.8 3 10-14 IOYR4/3 mU IoYR4 /6&IOYR6r1 ail 2rnabk ds - 2vf-m 0.6 0.8 Some gX; few cobbles. Effluent #1 = BOD 30 220 mg& and T5S >30 < 150 mgrL ' Effluent #2 = BOD < 30 mg1L and TSS < 30 rrrg►L CST Name (Please Prino Signature tu CST Number M Jo Hollister 224832 Address Evaluation Conducted Telephone Number W9875 6" Avenue, River Falls, WI 54022 07-18-05 (715) 426 -1775 ,Jul 19 05 09s33a owner 7154264827 p,3 Property Owner _ LEAF, Robert (Lot 1) Parcel ID # (fending) Page 2 of 3 B oring Boring pit Ground surface elev. 100.74 ft_ Depth to limiting factor 9 in. Sod AWicafion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots . GPD/if in. Munsed Qu, Sz. Cont. Color Gr. Sz. Sh. 'EW1 •042 1 0-3 I0YR3/3 sil 3fgr mvfr cs 34-co 0.6 0.8 2 3 -9 10YR3/3 — sil 2fa &sbk ds as 2vf-m 0.6 0.8 3 9-13 IOYR4 /3 m2d IC4R sil 2mabk ds -- 2vf- 0.6 0.8 wv�a Some gr; cobbles. F - 1 Boring # Boring Pit Ground surface env. ft. Depth to limiting factor in-j A Rate Horizon Depth Dominant Colo Redox Description Texture Structure Consistence Boundary Roots WON in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'E8#1 'Etl#2 a Boring # � Boring El Pit Ground surface elev. ft. Depth to limiting factor in. Sod 8pe§20on Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/tf in. Munsefl Qu. Sr- Cont. Color Gr. Sz. Sh. "Etf#1 'Etf62 * Effluent 91 = BOD > 30 220 mg& and TSS >30 < 150 mg/L " Effluent #r2 = BOD, 5 30 mg/L and TSS 130 nxjL 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. SOD -833MA pto1M) + Jul 19 U5 09:42a owner T 7154264827 P.1 rAff LEM 1s i . w sue• - F 7W e cea to one oa: aoswuv aiour� cnw��c�aet�s L i, �PttPDSE.D q.0 AeFzr--S F - C5Z ) y' J SL IUD 4. rte- J EL Ito. r o da . z Lmr 60- rkAjp-?` Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Ms. Adm. Code Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must RO include, but not limited to: vertical and horizontal reference point (BM), direction and p I.D. (Pendi ) percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. vie Date Personal information you provide may be used for secondary purposes (Privacy Law, a. 15.04 (1) (m)). ST. CROIX COUNTY Property Owner Property Location 11 S ROBERT LEAF (Buyer: Calvary Assembly of God) Govt. Lot -- - -- SE 1/4 SE 1/4 S 33 T 29 N R 15 Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 2928 C.T.H. DD (Pending) -- � City State Zip Code Phone Number icy Village Town Nearest Road Glenwood City, I WI 1 54013 ( 715 265-4964 601111 Avenue E] New Construction UseE) Residential / Number of bedrooms Code derived design flow rate GPD 13 Replacement Public or commercial - Describe: church Parent material glacial till Flood Plain elevation if applicable NA ft. General comments Mound System -- 0.2 loading rate -- 2.50 ft. sand fill and recommendations: SEE INTERPRETIVE DETERMINATION REPORT - -on -site w/Leroy Jansky, State of Wisconsin Wastewater Specialist To be designed by designer or installer F-71 Boring # Boring Q Pit Ground surface elev. 100.14 ft. Depth to limiting factor 10 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Efr#1 `Eff#2 1 04 10YR3/3 — sil 2fgr mvfr cs 3vf-co 0.6 0.8 2 4 -10 10YR3/3 - sit 2fabk ds as 2vf-m 0.6 0.8 3 10 -13 10YR4 /3 m2d 10YR4/6 &10YR6/1 sit 2fabk ds -- 2vf -m 0.6 0.8 Some gr; cobbles. Boring 100.14 10 2 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/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `092 1 0-4 10YR3/3 — sit 3fgr mvfr cs 3vf-co 0.6 0.8 2 4 -10 10YR3 /3 — sit 2fgr&abk ds as 2vf-m 0.6 0.8 3 10 -14 10YR4 /3 rn2d 10YR 4 /6&10YR6/1 sit 2mabk ds -- 2vf -m 0.6 0.8 S ome gr; few cobbles. ' Effluent #1 = SOD > 30 220 mg/L and TSS >30 < 150 mg/L ` Effluent #2 = BOD < 30 mg/L and TSS < 30 ffKA CST Name (Please Print) — _ Signature CST Number Mary Jo Hollister 224832 Address Evaluation Conducted Telephone Number W9875 690th Avenue, River Falls, WI 54022 07-18-05 (715) 426 - 1775 Property Owner _ LEAF, Robert (Lot 1) Parcel ID # (Pendin Page 2 of 3 Boring ❑ Boring # ❑ Pit Ground surface elev. 100'74 9 ft. Depth to limiting factor 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 1 0 -3 10YR3/3 -- sil 3fgr mvfr cs 3vf-co 0.6 0.8 2 3 -9 10YR3/3 _ sil 2fa&sbk ds as 2vf-m 0.6 0.8 3 9 -13 10YR4/3 m2d IvIK4 /y% sil 2mabk ds -- 2vf-m 0.6 0.8 IaVRV 1 Some gr; cobbles. Boring # 1__ I 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/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 •Eff#2 F-1 Boring # Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil Applica tion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 "Eff#2 ' Effluent #1 = BOD > 30 < 220 mg/L and TSS >30:5 150 mg& ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. SHW330Test (8.07/00) X QD _ Sq Ir 5P , Lcrr 1, �Rnpo�D q.oi f}eRbs .Z F SL 6 00 . J C` IM '4 LIVE o w - 2 sue-• �� ,� - - r� FORM NO. 985 -A Stock No. 26273 VOL 20 PAGE 5044 KATHLEEA H. . -- REGISTER OF DEEDS gap. eltafm e15. , WT CERTIFIED SURVEY MAP NO e 5L�0 VOLUME 20 , PAGE 5044 C. RTIFIED SURVEY MAP REC FEE: 13.00 THE SOUTH HALF OF THE SOUTHEAST QUARTMES FEE:: OF THE SOUTHEAST QUARTER, SECTION 33, TOWNSHIP 29 NORTH, RANGE 15 WEST. East 114 TOWN OF SPRINGFIELD, ST.CROIX COUNTY,WISCONSIN Fd vey Ma k PREPARED BY: Nail Joel A. Brandt JB SURVEYING LLC 966 Rustic Road 3 oI, Glenwood City, Wt UNPLATTED LANDS 1`j 01 - - - co 00 N I N SW/SE SC /SF N89'34'45 "E 1323.12' ^' in 661.80' I I 220.66' 220.33' 220.33' 625.02' 1 > 36.78' I I -nI� N LOT 2 I ° Z S Z LOT 1 -,00 ' Ix 12 Z LOT 4 =s zo° S 435,020 sq.ft. o l� N I� I�I"o c; LOT ✓ i3 9.99 acres o� l =, a m I u o u cn MCI. r -o -w VJ I - N A y A I o I o " g 389,788 sq. ft. ril N lz I I o I r cn rn rn 8.95 acres v 10 A N not Incl. r -o -w �) E 6 I tO � I building setback line 33.00' 33.00' 33.00' 33.00 $ 52492, centerline , r 132 226.33 220.33' (7) 663 5,___ ✓ 589'28'50 "W - 22 _ _ 220.33 _ _ _ Y _ _ - - - C - 220.33 �sw corner S89'28'50 "W 1324.47' l 1 1 South 114 SE/SE S "W 26 8. center ine Section 33 -29 -I5 4 94 Southeast corner Section 33 -29 -15 Found Aluminum Mon, UNPLATTED LANDS Fd Survey Mark Nail PREPARED FOR: (Buyer of Lot 1) LOT 4 LOT 3 LOT 2 Calvary Assembly of God 310 LaPointe Rd S 145,230 sq.ft. 144,933 sq.ft. 144,850 sq.ft. Wilson, WI 54027 3 -33 acres 3.33 acres 3.32 acres PREPARED FOR: incl. r -o -w Incl. r -o -w incl. r -o -w OWNER: (Buyer of Lots 2 -4) 137,949 sq. ft. 137,662 sq, ft. 137,579 sq. ft Robert Leaf Bruce French 311 acres 3.16 acres 3.16 acres RR1 Glenwood City,Wl 3026 60th Ave not incl. r -o -w not incl r -o -w not incl. r -o -w 54013 Wilson, WI 54027 Note: There will be no access to State Highway "128 Note: Each parcel on this map is sub to State and County laws, rules and regulations (i e. wetlands, minimum lot size, access to parcel, etc.). Before purchasing or developing any parcel, contact the St. Croix County Zoning Office for advice. LEGEND 4ry Government Corner (as noted) JOWL A, o...... .... Set 3/4" x 18" Iron rebar weighing ' r woT » 1.502 lbs. /lineal ft s ' otbAMpgp dtY� soil tests ►K North is referenced to the SCALE: 1" - 250' South line of the Southeast f 0 Quarter of Section 33- 29 -15, 0" � which is bears S89 °28'50 "W 250' 500' 4 4 (St Croix County Grid Systeml Page 1 Of 2 Vol 20 Page 5044 FORM NO 985-A 11[�lrl�ller Stock No. 26273 CERTIFIED SURVEY MAP NO 5044 VOLUME 20 ) PAGE 504 THE SOUTH HALF OF THE SOUTHEAST QUARTER OF THE SOUTHEAST QUARTER, SECTION 33, TOWNSHIP 29 NORTH, RANGE 15 WEST, TOWN OF SPRINGFIELD, ST.CROIX COUNTY,WISCONSIN SURVEYOR'S CERTIFICATE I, Joel A. Brandt, Wisconsin Registered Land Surveyor, hereby certify that I have surveyed. divided, and mapped the south half of the Southeast Quarter of the Southeast Quarter of Section 33, Township 29 North, Range 15 West, Town of Springfield, St. Croix County, Wisconsin, more particularly described as follows Commencing at the Southeast corner of said Section 33, as the point of beginning of the parcel herein described: Thence S89 °28'50 "W, along the south line of said Southeast Quarter, a distance of 1324.47 feet; to the east line and Southwest corner of the Southeast quarter of said Southeast Quarter; Thence N00 °21'15 "W, a distance of 658 -37 feet, along said east line, to the north line of the south half of the Southeast Quarter of said Southeast Quarter; Thence N89 °34'45"E , along said north line, a distance of 1323.12 feet, to the east line of said Southeast Quarter Thence S00 °28'21 "E, along said east line, a distance of 656.09 feet; to the point of beginning. The described parcel contains 870,033 square feet (19.97 acres). Said parcel is subject to the right -of -way of State Highway 128 to the east and 60th avenue to the south and to the easements of record and as shown. That I have made such survey, land division, and map at the direction of Rick Mannon, and the Assembly of God Church, Owner, 310 LaPointe Rd S, Wilson, Wisconsin, 54027. That such map is a correct representation of the exterior boundaries of the land surveyed, and the subdivision thereof made. That I fully complied with the provisions of Chapter 236.34 of the Wisconsin State Statutes and the subdivision regulations of St Croix County in surveying, dividing and mapping the same. Dated this _ day of 3 uL_ 1 q 2005. r .nost A. (LJ A . + ate: y sas. ait�+w000 Cary, Joel Brandt, R.L.S. #2603. � '"� z _ Approved this 5 day of ��c jf - 2005. / /f -�� // �j iT. CAOp[ COIA11*'Y P ! � 'J ( Ci GK � ✓r' �� � =aaiiq Cena�Mlaa St. Croix County Zoning Admi ato. AUG 1 5 Zoos G1<, tz f , if not recorded within 30 days of approval data approval shall be null and void Vol 20 Page 5044 Page 2 of 2 !1 ' I I � O LL rTif z � iu }11 u J j Y RECEIVED P.O. Box 56 MAY 1 6 2007 Wilson, WI 54027 ST. CROX COUNTY Phone: (715)772 -4625 May 15, 2007 St. Croix County Zoning Attention: Ryan Greetings, This letter is a folluw -up to our telephone conversation and to inform you of our intentions concerning the serving area of our new church building. We do not plan on preparing food there, but just use it as a serving area. The.food would.be brought be prepared elsewhere and brought in. It is also our intent to serve on and with paper products. Thank you. � %J' / Pastor Rick Mannon i i 1i 8 1 0393 2 g 6 P 1 2 `I KATHLEEN H. WALSH REGISTER OF DEEDS State Bar of Wisconsin Form 2 -2003 ST. CROIX Co., W1 WARRANTY DEED RECEIVED FOR RECORD Document Number Document Name 18/26/2085 10:15AN WARRANTY DEED EXEMPT # THIS DEED, made between Robert Leaf aka Robert E. Leaf, a single person REC FEE: 11.00 TRANS FEE: 428.00 ("Grantor," whether one or more), COPY FEE: and Calvary Assembly of God Church CC FEE: PAGES: 1 ( "Grantee," whether one or more). Grantor, for a valuable consideration, conveys and warrants to Grantee the following Recording Area described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ( "Property") (if more Name and Return Address space is needed, please attach addendum): Scenic Title and Abstract, Inc. Lots 1,2,3, and 4 of Certified Survey Map filed August 15, 2005 in Volume 20, Page 220 Locust Street 5044 as Document 803520. Located in part of the S 1/2 of the SE 1/4 of the SE 1/4 Hudson, WI 54016 of Section 33, Township 29N, Range 15W, Town of Springfield, St. Croix County, File # 24193 Wisconsin. 034 -1076- 30-000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Exceptions to warranties: Easements, Restrictions, Covenants, and Rights -of -way of record, in any. Dated August 31, 2005 (SEAL) (SEAL) * * Robert Leaf (SEAL) (SEAL) * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) - I m STATE OF WISCONSIN ) authenticated on '� `' ' ' ) ss. St. Croix COUNTY ) * Personally came before me on August 31, 2005 , TITLE: MEMBER STATE BAR OF WISCONSIN the above -named Robert Leaf aka Robert E. Leaf, a single person authot, to me known to be the person(s) who executed the foregoing authorized by Wis. Stat. § 706.06) instrument and acknowledged acknowledged the same. THIS INSTRUMENT DRAFTED BY: * Brian Scott Eckholm Robert Leaf Notary Public, State of Wisconsin 3928 CO RD DD, Glenwood City, WI 54013 My Commission (is permanent) (expires: 9 -11 -05 ) (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED ® 2003 STATE BAR OF WISCONSIN FORM NO. 2-2003 • Type name below signatures. r ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner /Buyer C 1/C1! V kS S Q wt � J"� &� 6-o Gi( Mailing Address - P U. �o X s — to Property Address 6 0*i x A v_e .. (Verification required from Planning & Zoning Department for new construction.) City /State �I I S oo CVT Parcel Identification Number D34 - io 74o - 30 -. 07-5 LEGAL DESCRIPTION Property Location S 6 i /4 , s 1= '/ , Sec. 3 T a9 N R S W, Town of V1 G �Gi Subdivision , Lot # Certified Survey Map # ?0 "� , Volume cL O , Page # SOS/ _ Warranty Deed # (Sc/ o 3 9 3 , Volume (3 , Page # f ay Spec house yes no Lot lines identifiable yes no 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 Nt v S / 7 /aPP SIGNATVRE 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) Parcel #: 034 - 1076 -30 -025 0510812007 10:31 AM PAGE 1 OF 1 Alt. Parcel M 33.29.15.513B -10 034 - TOWN OF SPRINGFIELD Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 08/15/2005 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - CALVARY ASSEMBLY OF GOD CHURCH CALVARY ASSEMBLY OF GOD CHURCH PO BOX 56 WILSON WI 54027 Districts: SC = School SP = Special Property Address(es): ` = Primary Type Dist # Description ' 2988 60TH AVE SC 0231 BALDWIN - WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 9.990 Plat: 5044 -CSM 20 -5044 034 -05 SEC 33 T29N R15W S1/2 OF SE SE CSM Block/Condo Bldg: LOT 01 20 -5044 LOT 1 (9.99 AC) (CHURCH) Tract(s): (Sec- Twn -Rng 401/4 1601/4) 33- 29N -15W Notes: Parcel History: Date Doc # Vol /Page Type 10/26/2005 810393 2916/124 WD 08/15/2005 803520 20/5044 CSM 2007 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 04/14/2006 Description Class Acres Land Improve Total State Reason UNDEVELOPED G5 9.990 9,000 0 9,000 NO Totals for 2007: General Property 9.990 9,000 0 9,000 Woodland 0.000 0 0 Totals for 2006: General Property 9.990 9,000 0 9,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 1 Wisconsin Deparfrrrent of Commero e \ OlL t 31 R ORT g 1 of Division of Safety and Buildings in 85 Wis. Adm�� ��Code county ST. CRAIX 'Attach complete site plan on paper not less than 81/2 rriuij include, but not limited to: vertical and horizontal refere (BM), direction and Parcel I.D. (Pending) Percent slope, scale or dimensions, north arrow, and I arrisfarit�k2s piF #hlload. Please print all informs ' ZONINGUFFiC Re 7 by Date Personal intbrmlion you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Z 1? 0 Property Owner Property Locatron ROBERT LEAF (Buyer: Calvary Assembly of God) G L — SE 1/4 SE 114 S 33 T 29 N R 15 E( Property Owner's Mailing Address Lot # Block # Subd Name or CSM# 2928 C.T.H. DD 1 — (Pending) City State Zip Code Phone Number []Village DFown Nearest Road Glenwood City, I WI 1 54013 715 ) 265 S.T.H. 128 New Construction UseE] Residential l Number of bedrooms Code derived design flow rate GPD Replacement Q Public or commercial - Describe: church Parent material glacial till Flood Plain elevation if applicable NA ft. General comments Mound System — 0.2 loading rate — 2.50 ft. sand fill and recommendations: SEE INTERPRETIVE DETERMINATION REPORT To be designed by designer or installer FT] Boring # ❑ Boring Q Pit Ground surface elev. 100.69 ft. Depth to knitirg factor 8 in. Sol Appl ication Rate Horizon Depth Dominant Cdw Redox Description Texture Structure Consistence Boundary Rods GPDfff in. Munsell Qu. Sz. Cart. Color Gr. Sz. Sh. - Eff#1 "Eff#2 1 0-4 10YR3/3 — l 2fgr mvfr cs 3vf-co 0.6 0.8 2 4-8 l0YR3/3 1 2fabk mfr as 2vf-m 0.6 0.8 3 8-12 10YR3/3 flf 10YR4/6 I 2fabk mfr as 2vf-m 0.6 0.8 4 12 -18 10YR4/4 c2d 10YR5/6&10YR6/l A 2f -msbk mvfr as lvf-m 0.6 1.0 5 18 -36 7.5YR4/4 m3p 7.5YR5/6 sl 2f -msbk mvfr — lvf-m 0.6 1.0 Some gr; cobbles. ❑ 2 Boring # ❑ Borin 99.75 9 Q Pit Ground surface elev. ft. Depth to limiting factor in. Sod Applicatiori Rye Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 '002 1 0-5 10YR3 /3 _ 1 3fgr mvfr cs 3vf-co 0.6 0.8 2 5 -9 10YR3/3 _ 1 2fgr&abk mfr as 2vf-co 0.6 0.8 3 9 -12 l0YR3 /3 flf 10YR4/6 I 2fgr&abk mfr as 2vf-co 0.6 0.8 4 12 -18 10yR3 /4 c2f10YR5/6&IOYR6/1 sil 2fa&sbk mfr as 2vf-m 0.6 0.8 5 18 -27 7.5YR4/4 m3p7.5YR5 16 sl Imsbk mvfr — Ivf-f 0.4 0.7 Some gr, few cobbles. ' Effluent #1 = BOD > 30 220 mg& and TSS >30 150 mg& ' Effluent #2 = BOD < 30 mg& and TSS < 30 mg& CST Name 0 Print) attre ` / CST Number Mary 3o Hollister / 224832 Address Dale Evalcratio n Conducted Telephone Number W9875 690(11 Avenue, River Falls, WI 54022 06-25-05 (715) 426 - 1775 1 Pm;mV Owner LE Robert (L ot 1) Parcel ID ( fending) Page 2 3 3 Boring # L3 Boring 99 1 Q Pit Ground surface elev. ft. Depth to WrMing Factor in. S A Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsed Qu. Sz. Cont. Color Gr. Sz. Sh. Tff#1 "Eff#2 1 0-5 IOYR3/3 — sil 3fgr mvfr cs 3vf-co 0.6 0.8 2 5 -10 10YR3 /3 — sil 2fa&sbk mfr as 2vf m 0.6 0.8 3 10-11 IOYR3 /3 flf 10YR4 /6 sil 2fa &sbk mfr as 2vf-m 0.6 0.8 4 11 -18 IOYR4 /4 m3dlOYR5 /6&IOYR6/1 sit 2fa&sbk mfr as 2vf-m 0.6 0.8 5 18 -26 7.SYR4 /4 m3d 7.5YR5/6 st If- -msbk mfr - ivf-f 0.4 0.7 Some gr, cobbles. F Bori # Bori Pit Ground surface elev. fl. Depth to limiting factor in. Sod Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/tf in. Munsed Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 Boring F-1 # BBoring ❑ Pif Ground surface elev. fl. Depth to limiting factor in. Sod Rate Horizon Depths Dominant Color Redox Description Texture Structure Consistence Boundary Roofs GPQW in. Munsed Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 " Eti#2 Effluent #1 = BOD, > 30 220 mg& and TSS >30 150 mg& ` Eflluent #2 = BOD, < 30 mg& and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 -266 -3151 or TTY 608- 264 -8777. SOD- 833OTesl (P- 07100) I — F M. MAN 3 3 &2 d WAR =Box= A ELM, LOCA-60 kid agr, 65 . - U2464 - Yom! .bli �RAPO�D 4• �t .hr�.es CIV?Re � ! �gz. ; ti► k 4 M I ca: tb ' �4WMQ6" N 7►. 3 _ W 3 - �le see.'S� _ at - X � - a . a Leroy G. Jan State of Wisconsin INSPECTION Department of C/ Department of Commerce 13 E . Spruce Safety & Buildings Division REPORT Bureau of Field Operations Chippewa Falls. i (715) 726 -_ Inspection Date 1 1 =, ) `) J C_ Personal information you provide maybe used for secondary purposes (Privacy Law, s.15.f)4(1)(m)]. Name of Premises Address or Legal Description f dy/Township County i l \ I--�u C^ P� - •y. _ N .� .� 7 `y ! 7 `tiJ -� t �. ;, [` 1' _ L Master Plumber Name and Address Master Plumber Firm Name and Address Plan I.D. No. Sanitary Permit No. Journeyman Plumber /Soil Tester Licensed Person's Names) and License Number(s) Owner's Name and Address 4. � , i t r� � ; • S t a + , ', L•t� , j ., a : F -( t J t, . ,a, . _ I ._ 1 '. ` t � i,� A a • e , J � J I , 1 , 1 W jj p n , J . , ,' ; /, .. ,. -. r - , �.. •(.' .- .. _. (. s Page of i Signature of Responsible Licensed Person (only one needed) Signature of Plumbing ConsultanVPrivate Sewage Consultant 1 Check all Original: 1 Copies to: `that appl y J sso -6192 (R.tzres) District 0 S &B 0 Plumber 0 Owner 0 County /Local Insp. 0 Other 1 1 I I I I 1 # - 1 I I I 1 I 1 n ' i n Cn m PC? Fri r F6 = G7 m 4 y I I �w SL I CD Q� C7 I o » ' c � cfl g 07 I I cn 73 I ^. 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