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018-2001-01-000
Wis Safety an Deilding ntol Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law. s.15 04 (1)(m)I Permit Holders Name City Village Township Bob & Nan McMurrin TOWN OF HAMMOND CST BM Elev linsp. SM Elev IBM Description TANK INFORMATION ELEVATION DATA r TANK SETBACK INFORMATION TANK TO P/L WELL BLDG Vent to Art Intake ROAD Septic Dosing Aeration Holding PUMPISIPHON INFORMATION Loss QVIL AOAVKr I IVIV Zi T51 tM STATION BS HI FS ELEV. Benchmark Alt BM Bldg. Sewer St/Ht Inlet SUHt Outlet Dt Inlet DI Bottom Header/Man. Dist Pipe Sol. System Final Grade SI Cover BEOrMENCH DIMENSIONS Width Length No Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth SETBACK INFORMATION SYSTEM TO JPIL BLDG WELL LAKE/STREAM LEACHING CHAMBER OR UNIT Manufacturer Type Of System Model Number Header/Manifold Distnbution x Hole Size x Hole Spacing Vent to Air Intake Pipes) Lengtat Die Btu e�w�� Length Dia Spacing Depth Over Over xx Depth of xx SeededrSodded xx Mulched Bed/Trench Center 7BO&TrenchEdges Topsoil .. Yes � No Yes No I.VMMtfV 1,: (Include code discrepancies, persons present. etc.) Inspection 1k1: Location: 994 193RD ST 1.) All BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? ^1 Yes No Use other side for additional information. SBD-6710 (R.3/97) Date Insepctofs Inspection #2: Cart No c,AM-ZoZZ—�3Zv (�EE) G)GC E M I � Industry Services Division 4822 Madison Yards Way County St. Croix .) f ;C OCT 1120 Madison, W 153705 P.O. Box 7302 Madison, W15 11 Sanitary Permit Number (to be filled in by Co.) 2 & L46 q5J ssar - it Application — In accordance with P ' ev o u mission of this form to the appropri mental unit State Transaction Number PWTS - 102202501-C is required prior to obtaining a sanitary permit. Note: Application forms for stateoWned PWWTS are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Services. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. 15.04(1 xm). Slats 994 193`d St., Hammond, Wl 54015 Iltletr Parcel H Propem 0%%ner's Name Bob K Nan McMurrin 018-2001-01-000 Property Owner's Mailing Address W2858 776d Ave. ProPy�.ny Location o vt. La �' f �- NE y, N W %, Section 14 City, State Zip Code Phone Number Spring Valley, Wl 54767 (651) 324-9380 ][e.. Lot M T 29 N R 17 W Subdivision Name �3 I or 2 Family Dwelling- Number ofBedrooms 3 01 Forest Ridge Estates. Block a F ohl i.'Commercial -Describe Use ❑ City of ❑ Statc Owned - Describe Use ❑ Village of CSM Number ® Town of Hammond III. Type of mA, iine C i a pliable. A 0 New System ❑ Replacement System ❑ Other Modification to Existing System (explain) ❑ Additional Pretreatment Unit (explain) B' ❑ Holding Tank ❑ In -Ground �rade r (conventional) e Z T� ®Mound ❑ Individual Site Design ❑ Other Type (explain) C. ❑ Renewal Before ❑ Revision ❑ Change of Plumber Expiration t ❑ Transfer to New Owner Z List Previous Permit Number and Date Issued N. Dis Design Flow (gpd) 450.00 Lok drhriadM y`�r ' _ Des' Soil Ayypl�ication Rate(gpdrsr) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation I.0 ASTM-C33 sand fill 450 ft. 99.00' at 6" above na ve basal area 1 090.91 kQ71T> 98.50' contour Tank Information xity in Gallons o Gallons a of Units anu acturer P lvr6 !)'L5 r o U o $ y in U to iL 3 f1. New Tanks Existing Tanks Septic or [folding Tank 1,000 1,000 1 Wieser Concrete X 650 650 1 Triple X V. RaponaibiliW reaprrtlbility for 1 tYe POW" lumber s Signal MP/MPRS Number Business Phone Number Plumber's Name (Print) Plumber)ure James K. Thom n 30021 (715) 248-7767 Plumber's Address (Street, City, State, Zip Code) 340 Paulsen Lake Lane, Osceola, Wl 54020 Vl. County Approced ❑Disapproved Permit Fee Dale Issued Issuing Agenl ure El Owner Given Reason for Denial S W. ov /0 z:1 Conditions of Approval/Reasons for Disapproval 2 9 I I �pno//'�����jpt,.� / 1 dt e SYSTEM OWNER: filter arW V i f)`P 5 ✓3 Nit n i r. 12C t1Q n t. st l er rank. er must dlslxnalallmust� �IUYVI %x,r. j1�fj�.� s. MI Por Kkrevu �ntteen sprmistbe nlad �rh 7�,^M64 4r ), `%D ��b �l'► [J Br, �1^er. w Per aophcable coga/ordinances, G\ L "'nac to co etc plans for the system and submit to t�ounty only y on pa t; than 8 112 s 11 inches in sue J�acytM- -t -a ril�s7- sflbl;''^4 SQ a '5; 8 ,02�22) _rh�d 39. 777 ,v,,m olo j •` ? A Y. _i•_ -1 I. ___y- I , !!! � ark d " � � p , . �/ • 6 y --r--_ , € -00 - - - - jp� I I Residential Mound POWTS Index & Title Sheet Project Name: McMurrin 3 Bedroom Residential Mound Owners Name: Bob & Nan McMurrin Owner's address: W2858 776th Ave., Spring Valley, WI 54767 Site address: 911 193rd St., Hammond, WI 54015 :•.,;act Location: 994 193rd St., Hammond, WI 54015 Subdivision: Lot 01, Plat of Forest Ridge Estates Legal Description: NEl/4 NW IA. Sec. 14, T.29N., R.17W., Town of Hammond, St. Croix Co., WI. Parcel ID #: 018-2001-01-000 Mater Signature: Page I Index and Title Sheet Page 2 - 18 State Approved Mound Design Plans Page 19 Septic/Pump Tank Cross Section Page 20 Filter Specifications Page 21 Ezflow 1203H Distribuution Media Cut -Sheet Page 22 Sanitary System Ownership & Address Form Page 23 Parcel Map Page 24 Warranty Deed Attachments: None Service: James K. Thompson, DSPS Credential #30021 Date: bc' . //' Z&2_Z Page 1 of 24 Design pursuant to In -Ground Soil Absorption Component Manual for P(IWTS, version 2.0 SBD-10705-P (N 01/01) Wisconsin Department of Safety and Professional Services Division of Industry Services 4822 Madison Yards Way PO Box 7302 V13dison_ WI 53707 October 10, 2022 CUST ID NO.: 30021 \VFS K THOMPSON ,4,i P-vl'I_SEN LAKE LN OS( I{OLA. WI 54020 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/10/2024 ML'NICIPALITY: TOWN OF HAMMOND ST. CROIX COUNTY �2�FpnatyfyTG R 3 � �Rsm��L SITE: MCMURRIN 3 BEDROOM RESMENTIAL MOUND 994 193RD ST. HAMMOND. WI 54015 LOT 01. PLAT OF FOREST RIDGE ESTATES, NE I /4NW 1 /4, SEC. 14, T.29N., R.17W. FOR: Design Wastewater Flow Value: 450 Bedrooms: 3 Limiting Factor(s): 43" Maintenance Required: Effluent Filter Phone 608-266-2112 Web hun //dsns. H_i eu% Finatl dsysifwisconsmgw Tony Evers, Governor Dan Hereth, Secretary Identification Numbers Plan Review No.: PWTS-102202501-C Application No.: DIS-092247799 Site ID No.: SIT-107625 Please refer to all identification numbers in each correspondence with the Department. Conditionally APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES SEE CORRESPONDENCE Mound Component Manual - Version 2.1 (May 2022-2027) Pressure Distribution Component Manual - Version 2.1 (May 2022-2027) SITE REQUIREMENTS • A full size copy of the approved plans, specifications, and this letter shall been -site during construction mid open to inspection by authorized representatives of the Department, which may include local inspectors. A Department electronic stamp and signature shall be on the plans which are used at the job site for construction. The following conditions shall be met during construction or installation and prior to occupancy or use: • Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site. • With new construction; it is recommended not to activate the pump in the dose tank until the tanks are pumped prior to homeowner occupancy. • Wastewater generated from contractors cleaning of equipment and tools and/or left over construction products shall not be discharged into the drains discharging to the private onsite wastewater treatment system (POWTS). Waste generated shall be properly disposed of on -site or off site. • Any tall grasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to prevent matting under the dispersal area. All loose organic material to be removed from POWTS Dispersal Area. • Divert surface water from all POWTS Areas. • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil. Proper soil moisture content can be determined by rolling a soil sample between the hands. If it rolls into a 1/4- inch wire, the site is too wet to prepare. If it crumbles, site preparation can proceed. If the site is too wet to prepare, do not proceed until it dries. • All piping shall conform to SPS Table 384.30-3 and SIPS Table 384.30-5 . I n.ulate building sewer beyond 30 feet per SPS 382.30 (1 1)(c) • Well setbacks to meet chs. NR 811 & 812 • Tank Installation to follow all manufacture's recommendations. • Verify property line(s) prior to installation. • Pump Floats to beset and verified per approved plan. Any changes may result in pump resizing to meet TDII and GPM Specifications. • � real that are occupied with rock fragments. tree roots, stump's and boulders reduce the amount of soil available tur proper .rcaunent. If no other site is available, trees in the basal area ofthe mound must be cut off at eround level. A larger till area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. Owner Responsibilities The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval SPS 383.54(I). In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. OWNER RESPONSIBILITIES • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owners manual for the POWTS described in this approval and Wis. Admin. Code & SPS 383.54(l). • in the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval, the Division of Industry Services reserves the right to require changes or additions, should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. The Division does not take responsibility for the design or construction of the reviewed items. Inquiries concerning this correspondence may be made to me at the contact information listed below, or at the address on this letterhead. Sincerely, Fee Required: $250.00 .� 1011 Fee Received: $250.00 7/.4�.1 Balance Due: $0.00 l im \ ander Leest Refund Expected: $0.00 i10%%-1 S Plan Reviewer Division of Industry Services Phone: 608-516-6134 Email: tim.vanderleest@wisconsin.gov EVIOW' MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Conmuon.uy APPROVED Project Name: McMurrin 3 bedroom replacement mound DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES Owner's Name: Bob & Nan McMurrin Owner's Address: W2858 776th Ave., Spring Valley WI 54767 ,EE CORRESPONDENCE Property Address: 994 193rd St Hammond WI 54015 Legal Description: NE1/4 NW1/4, Sec. 14, T.29N., R.t7W. Township: Hammond County: St. Croix Subdivision Name: Forest Ridge Estates Lot Number. 1 Block Number: Na Parcel I.D. Number: 018-2001-01-000 Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 EZflow mound drawings Page 4 Lateral and dose tank Page 5 Distribution media Page 6 System maintenance specifications Page 7 Management and contingency plan Page 8 Pump curve and specifications Page 9 Site Plan Page 10 Attached Soil Evaluation Report Designer. ames . Thom son License Number. 30021 Date: 09121 Phone Number: (715) 248-7767 Signature: s.. Designed Pursuant to the EZflow Mound Component Manual Ver. August 20, 2007, SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01, R. 10112) EZftow Mound Version 3.0 (R. 3/1/12) Pagel of 10 Mound and Pressure Distribution Component Design Design Worksheet (r or c) Site Information Residential or Commercial Design Estimated Wastewater Flow (gpd) Peaking Factor (e.g. 1.5 = 150%) Design Flow (gpd) Site Slope (%) Installation Contour Line Elevation (ft) Depth to Limiting Factor (in) In -situ Soil Application Rate (gpd/ftz) R 300.00 1.50 450.00 4.00 98.50 43.00 0.60 (c or e) Distribution Cell Information 6.00 Cell Width (ft) 33 4, 5. 6, 7, B. 9 or 10 Only 0.95 Dispersal Cell Design Loading Rate (gpdW) 1 Influent Wastewater Quality (1 or 2) Pressure Disribution Information Center or End Manifold Lateral Spacing (ft) Number of Laterals Orifice.Diameter (in) (e.g. 0.25) 110.00 Contour Length Available (ft) B0.00 = Dispersal Cell Length (ft) Are the laterals the highest point in the distribution I Y network? Enter Y or N If N above, enter the elevation ft of the highest point. Estimated Orifice Spacing (ft) = 8.89 fe/orifice Forcemain Diameter (in) Forcemain Length (ft) Inside Pump Tank Elevation Ift) Forcemain Filter Loss (ft) System Head (ft) x 1.3 Vertical Lift (ft) Friction Loss (ft) Total Dynamic Head (ft) Lateral Diameter Selection in. dia. options choice 0.75 1.00 1.25 1.50 x x 2.00 x 3.00 x Does the forcemain drain back? I Y Enter Y or N Forcemain Drainback (gal) A 5x Void Volume (gal) Minimum Dose Volume (gal) System Demand (gpm) Manifold diameter Selection in. dia. options choice 1.25 x 1.50 x x 2.00 3.00 Gallonslinch Calculator (optional) Treatment Tank Information 1 653.131 Total Tank Capacity (gal) 1000.001 Septic Tank Capacity (gal) 41.00 Total Working Liquid Depth (in) Wieser Concrete IManufacturer 1 15.93 gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 653.131 Dose Tank Capacity (gal) Pol Lok Filter Manufacturer 15.93 Dose Tank Volume (gal/in) PL 525 IFilter Model Number Wieser Concrete Manufacturer Project: McMurrin 3 bedroom replacement mound Page 2 of 10 o �Em© to U-), i 3 r (off 3gwn w m m m B.- wm v v a � a 3 ? Schedule 40 PVC 3 m 4 in. dia. slotted R m o observation pipe A 7 T m O �C c 7 n 'm' N T11 ut o O. 5 m I c p. oco 0 m v n m $m �i v N 7 a Co �0 a m n m CSCD _ m N m m LinF T n CJ v 7. O O n F` O T I m A O se v� m CD 0 O 7 O C m 41 0 0 m R 0 8 A v+ o wo v r m _ r 0 0 m D_ 7 CD � m 4) 9 5• -V ;* C H 2 3 r I Project: End Connection Lateral Layout Diagram Place Appropriate Lateral Diagram From Right Below P •- Turn -up z -W 1 ttt Wttim looted it z IE x—>J arlfk:se pout up except every ft one poM"b down for drnrle9e, rcrwm ocxwwoam W tw or , j r 4t to marliof0 at"P*L Latwak k fora@ Mon or PVC 9 A 40 AI hterde *,', Hr wih artlbes 0*X*V elpeoed. pw WS Tah 364ao4 Number of Laterals Lateral Diameter Lateral Length (P) Lateral End (Z) Lateral Spacing (S) Lateral Flow Rate System Flow Rate Orifice Diameter Orifice Spacing (X) Orifices per Lateral Orifice Density Manifold Length Manifold Diameter Forcemain Velocity Dose Tank Information Electrical as per NEC 300 and —� SPS 316.300 WAC "DLqcwn: Tank component is properly vented Wieser Concrete Capacity653.13 Volume 15.93 Manufacturer Gallons gaUnch Dimension Inches Gallons A 21.45 341.75 B 2.00 31.86 C 5.55 88.36 D 12.00 191.16 Total 41.00 653.13 And -r A B C As Per Manufacturer Locking cover with warning label and kx9dng device and sealed watertight i 4 in. min. Alarm Manufacturer JSJ Rhombus 77-1 Alarm Model Number JJB Plugger XL Pump Manufacturer Zoeller Pump Model Number IBN151 Pump Must Deliver 29.08 gpm at F 14.88 ft TDH Note: Switches containing mercury may not be used in this system. McMurrin 3 bedroom replacement mound Alternate outlet location Foroemain diameter ---1 2 in. Weep hole or anti - siphon device P4 ump off elevation (ft 91.00 Dose tank elevation (ft) 90.00 Page 4 of 10 Is EZHowe Distribution Cell Media Layout 6.00 Cell Width (ft) 1.50 Sidewall to Lateral (ft) Distribution Cell Cross-section Arrangements Component Legend SR1-7A Bundle - 5 ft or 10 ft lengths SR1-12A or EZ 1201A in 5 ft or 10 ft lengths SR3-12H or EZ 1201 P or SR3-12H in 5 ft or 10 ft lengths 4" Perforated Distribution Pipe With Pressure Lateral Inside Tumup Enclosure — — — — — Pressure Lateral Bundles are covered with approved geotextile fabric as per the their product approval. Distribution Cell Plan View Layout - Typical 6.00 Cell Width - A (ft) 80.00 Cell Length - B (it) 6 ft Wide End Manifold Center Connection Lateral Layout Diagram Force Main .Y•Y.-t'f Y\Y.YriY>Y>t•riY>Y.YriY>YI't''riY.Y.}`ry Protect McMurrin 3 bedroom replacement mound Page 5 of 10 Mound System Maintenance and Operation Specifications Service Provider's Name Jmaes K. Thompson Phone 715 246-7767 POWTS Regulator's Name ISt. Croix County Zoning De 't Phone (715) 386-4680 System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 480 ftz Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Other Service Frequency Inspect and/or service once every 3 years Inspect and clean as necessary at least once every 3 years Test once every 3 years Should test periodically Laterals should be flushed and pressure tested every 3 years Inspect for pondin and seepage once every 3 years Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap and are secured in as shown in the EZflow Mound Component Manual Ver. August 20, 2007, 2. Dispersal cell media conforms to EZflow products approved for use with the EZflow Mound Component Manual Ver. August 20, 2007. Media is covered with an approved geotextile fabric. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn -up Detail Finished Grade 6-8" Diameter Lawn � Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Lateral Ends at Last Orifice Where Variable Length Cleanout Begins Long Sweep 90 or Two 45 Deeggree Bends Same Diameter as Lateral 44Distribution flow S nthetic Media 1.98 Feet Lateral —► Lateral Cleanout —I. Project: McMurrin 3 bedroom replacement mound Page 6 of 10 Mound System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382.84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [EZf1dwMound Component Manual 8120107, Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. Septic and pump tank abandonment shall be in accordance with SPS 383,33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 84nches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic kanK shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 113 the liquid volume of the :ank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner as to when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Wisconsin Department of Commerce. Pump Tank The dosing (pump) tank shall be inspected at least once every 3 years All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent fitter is installed within the tank it shall be inspected and serviced as necessary. If the force main has a weep hole, it should be noted if it is functional during pump operation, and if not, it should be cleaned. ""Wo one should ever enter a septic or dose tank since dangerous gases may be present that could cause death."" Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mounds perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other then for vegetative Maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October -February) dictate that the mound be Heavily mulched as protection from freezing. Influent quality Into the mound system may not exceed 220 mg/L BOD„ 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODB, 30 mg/L TSS, 10 mg/L FOG, and 10k ctu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 3 years. When a pressure test is performed it should be compared to the initial teat when the system was installed to determine if orifice togging has occurred and it orifice cleaning is required to maintain equal distribution within :he dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an Impending hydraulic failure requiring additional, more frequent monitoring. Contlnaencv Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shag be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by Increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider Project McMurrin 3 bedroom replacement mound Page 7 of 10 T ROWPIRMAR E z 9.ed�on i3r:e,%xeeAet aL��e /e�,d� ref d. CONSULT FACTORY FOR SPECIAL APPLICATIONS • Teed doming panak to awa. • Elserted dwnal M for 410m sytlkms, NO WWI" and supplied veil+ an alarm. • • Variable level oonliml aaRchee ale wmk bk ft eonhoing single phasesyelerne. Double piggyback veie' 'a level lbmt ailehaa me mvdable for variable level long and WW cycle cmrdh*, Sealed Qwk-Box even" tar m a, Imm imlllIki , 9es FM1420. • Over 130'17. (546C.) spedal gemeran required. 15111521153 Series 16eK3ryp amoeu OW" md.aroe MOM Mmetrr Yoe. N151 t15 t Nlo 6.o 1 293 BN151 16 1 Awe 0.0 l Amw 2 a 3 E751 230 1 Non 9.2 1 2a3 BE161 230 1 Aule 3.2 ktdtldle 2 a 3 N1 92 115 1 Nm• t6 1 2a3 BN152 11b 1 Awl ib ktdtrd.d 2 a 3 H52 230 1 allot 43 1 2a3 WI-5-2 1 4.3 lded 2 N153 351 01 BN1 116 t A o5 kdLbd E3 : 230 1 Non 5.3 1 30 L Ab dedB5. Incl 2a 31on TOTAL DYNAMIC HEAD/FLOW PER MINUTE FaFFLUENT AND DEWATERNG MODEL 151 152 153 F.al Male. Oal. ran ()Il Ulm Gal. l3hn b 1a 6a tee 00 221 77 2e1 10 3o As 17o e1 231 70 28e 16 4A 3e 94 53 21" 61 231 20 6A n 110 1 4e 1 19 32 w 25 7a 1e M 1 34 1 12e u to 30 e.1 - 23 sr 33 t25 3e 1o.7 1 _ 22 IS 11 e2 8711oI1N••d 30t .tn 3et t16n 41l 134• SELECTION GUIDE 1. Sktmle pppyback viable level hat ewlch or double pwyheak van bb Wm lad All in•tWebon of contra., proactlat�h. RNab FMOM. on rine.Aouk be elon• 6Ya quallhW eaneed Nut ici•n. All electrical land safety cod., Should be %NM d iWUdine th• mo•1 2. See FM07121or oorted model or Ebctrloal Akrnator E pale reem'N•eond ENctdc Cod. (NEC) and the OmupaeanM 1d* •rid H•alth Aet (OSHA). 7. Variable MWI"gN1Ch 104= wed Be a cost fdjyelpr 11M1,11y Dylmc (3) . or (4)1bd syslatl. RESERVE POWERED DESIGN For unusual co imm a reserve safely %clor is engineered inb the deeial of every Zoelar marm ME 30: P.O. BOX 1e347 :O aM111"M 3"11COMRte Road eenatercaew d.. h9rp-4w r.2eeem.roere PUWNW /(W 7784 M a~ Ar" saw Aw C COPYrlya 2004 Zoeller Co. Al rWft m enred. A,• Aof la �..4 APPLICATION FOR REVIEW Private Onsite -co pieta all pages- Wastewater Treatment NOTE: Personal information you provide may be used for secondary purposes [Privacy Law s. 15.04(1)(m), State.] Systems Division of Industry Services ❑ Plans to be E-filed. Provide SharePoint User name below: For plan status, check our webShe at hfto://dsps.W.Gov Several counties have been delegated certain authority to review plans in lieu of Division of Industry services. For a current list of those counties and their designation check our website at httol/dsos wi oeu 1. Project Information - Fill in all known information. IConfirmation of assignment to a reviewer. Project/Site Name: MoMUrtin 3 Bedroom Resklene el M Lcca:ior., Number 8 Street of profed (If unknown, indicated nearest road) 994 193rd St Hammond WI 54015 Legal Description: Lot 01. Plat of Forest Ridge Eatates NE+r4 NW1/4 Sec. 14. T29N., R.17 N. County Tn. of Hammond, St. Croix Co., W. 1_.J k rrY LJ village IN Town of 2. After plans are reviewed, pkaase: (check all that apply) Cal! customer 1, 2 (circle number)* gequesting party will pick up ® Mail plans to customer 1, 2 (circle number)' 'Refers to customer number from below. Transaction ID: Previous Related Trans. ID: Estimated Completion Date: Assigned Reviewer. Assigned Office: Mail to your office of choice below: Hayward, LaCrosse, Waukesha NOTE: We reserve the right to re -distribute plans to another office if needed to reasonably balance turnaround times. Check htip://daos.wl.Gov for office availability and next available review date 3. Complete the folbwing deslgner/ovm0drequesting Information. Udltm the check boxesiAhen designer, owner or requesting party is the sum to avoid repeating Information. Designer Information (Customer 1) DSPS First Name Last Name Customer Number James Thompson 30021 Company Name A.C.E. Soil & Site Evaluations LLC Address 340 Paulsen Lake Lane City State Zlp+4 (9 digits) Osceola WI 54020 Phone Number E-mail address Celt phone rarea code) (715) 248-7767 ace"NUrontiemet net Check ifapplicable ❑ Owner Other Please Specify Below (Customer 2) DSPS First Name Last Name Customer Number Company Name Address City State Zip+4 (9 digits) Phone Number E-mail address Cell phone (area code) Check if applicable or specify relationship —••••���•• -••� vuaarnuar %.nacruram. t-uvvl s pre -scheduling is not available. Plans will be assigned to a reviewer after reosip at a DSPS office. Submittals received may be assigned to offices other than the receiving office depending on reviewer availability. Submittal checIdists can be found in each applicable component manual appearing on the POWTS Publications page, h#V://dsDs.wi.aoy/Dhp/sb-DDalgpp/prmdcodg resuk Ghp/POWTSM/POWTS 9OMPONENT MANUAL. You may email technical code questions to DSPSSBPowtsTachobud nnw Hayward DSPS 10541 N Ranch Rd LaCrosse Area DSPS 3824 N Creekside Waukesha DSPS Hayward WI 54843 Holman WI 54636 141 NW Barstow St 0 Floor 715-634-070 Fax:715-634-5150 (NOTE CHANGE) Waukesha WaukeWaukesha WI 53188 3789 Email: DgpsSbPlanSchedukwi aov 608-785-9334 Fax: 608-785-9330 -8600 Fax: 262-548-8614 Email: t§psSbP18nScheduIeil5wi Gov Email: DWSSbPlanSchedUle0wi aov Make Checks Payable to: Division of industry Services OR ❑ Check box to invoice designer and sign below FTOTAL AMOUNT DUE $250.00 Designer signature Review Code 7633 SPS-10577 (R 10115) Co ed. Gne --rr Cam. r i In / ` 1�,N'71aJoL�iorinT%Ls x �2G'"y -- �d 1 slt✓ w 1rod f { { : _ 1 VNsaonWn De w"m of Cam wm SOIL NIVdATI N REPORT pope _� a 0rriw, a Sde1y"arraotnp h (:OQ�157yy1kAdm. ode Caudy Agadi campbb sM plan on papr not kss !) 1 _mindi�e. lsn induds, taut not MduK ta: veAael ene ( } ^ percort slope. mob or dh modw ,Rab road. P �. pt D 0t�00/ Pfwaa p'fnt all /n/orrndtlun. e Dow .wa..rm.r ya.r.rs la...y e. w.e.W Mcc-A .n Pu.yaw. (►ar y L.w. 4. ta.04 t+) (")I. Mw� 3� Pmpertyoww Pn)palyLocadm A � AM 1N JJJIM S if T Zq N R I7 New P mriy O~s Maft Address La M 9b it Sea Name or CSW I)1-4 W. ChJ)s)Om Isc j — i�0 �acffllES Gry SWe Cade N~❑ p)y ❑ V&mps $I Town NerM Road R\\)e)2 FAi.L.s wrI Syoz I is '}2b-48o N Aw art: E New Consavtltm User ReMdrWal / Nisrbr olOedroons __ Cods rrdvsd design Raw rats (,QQ _—. - GPD ❑ ReWccemom Cl PRtic or eomnwdd - Dew*c Prod material _ �f4 � _ Flood Plain WwWon it eppacaela _.'AO R. Gerwst COfre)ter)!S andrecoomr,daaan: qr &meAcoe 94s-reM as "hoWCo czATE Boring p p,1 i❑t &*v ph Ground aurbw ebv. _ 1i.] A, Depfr to kWN rclar n —1 M =A. •.MOM MM. MMMIMr� ©olmols �-M +rffowt m U BWUV x U B06V PU omww me*" ww. ALk 9/ -it. oaoth to terraria roar 7 re% In. r-----, ml� .4 ••v �•• •w ..wr rev mpti - WRIAGN a¢ • am < 30 mpll, and TSS S D nVtL CST Name (Pwse PMp aitss CST PAA bw Address E"k"WCa Au%d TOWWWNWbr `w94�5 �40�~A�EQ FALLSIwI S402Z 0$-09-OZ. LEIS H16-VI (LM pm wty Oww SILL ^ _ r--1 n Bol zvF3 nro.Inr�P�NDWGZ_ __ wc. n swim 10241 ' pg GrwWsurlaoaOWY_ . ih. OM'J+bIWA bM__—fn gd AXkbkn POO HDrizon DWM OW*BM COW AoWx Onm0kn Texan Struclu.e Boutdwy Roofkt. Mutant Ou. Sz. CaK Cebr Gr. Sz. SA. 'ENt 'Err2 0-f0 =iZLZ�-L WCons"Wwma ►{ m3 1449 2 - L -mSbKas Z 44 -24 10vRWS - S11 mfr es Z*( 5 O. 0%3W r �s -t19 W-V 7.3 YA SI *K ...I ► -m og 0. 3fr IeYR �t . 3 104A © • P1 moo= �� a • i�luYia►�����® y 01 - BOO, > jp t 27D nWL wW TSS >3D < 1S0 mp0. , ERubN 02 • BOD� wW TSS I 3D M90L The Mputment of Commerce is an equal opponunity service provider and employer. if you need assistance tO access satviccs Or need material in an alternate romut. please contact the department at 608-266-31 S 1 or TTY 6011-2644777. sfusllalasA71 L. '3:��LY�'1Fi_ ' I : ...l'SZT►�T•3.�_.S�II;��71 M ■ CP u LoT i 45 oa 5. POWTS SUBMITTAL (check all that apply —incomplete forma may resuR In processing delays) ® NEW ❑ Aerobic Treatment Units) ❑ Chlorinator ❑ Tank Replacement Only ❑ REPLACEMENT ❑ Commercial System ❑ W Disinfection Unit ❑ Add Effluent Filter SYSTEM TYPE(S) NOTE: Submit separate sheets for each system if submitting multiple systems on the same site Enter Fee ❑ Revision to previously approved plan $86.00 ❑ Miscellansotn Review (i.e. replacement of a septic tank, addition of an effluent fitter or pretreatment device to an existing system, etc.) S80/hr — ❑ Component Manual All treatment components are previously approved ❑ At -Grade Component Manual - Ver. 2.0, SBD-10854 (N.03/07, R. 1112) Design Wastewater Flow In under s. SPS 384.10 (2) or (3): ❑ In -ground Component Manual - Ver. 2.0, SBD-10705-P (N.01/01, R 10/12) ® Mound Component Manual— Ver. 2.0. SBD-10691-P (N.01101. R 10112) Gallons Per day Design wastewater flow of the proposed system: ® Pressure Distribution Component Manual — Ver. 2.0, SBD-10706-P (N.01/01, R 10112) 45Q 1,000 gpd or less $250.00 250, � ❑ Other - Please specify GPD 1,001 — 2,000 gpd $325.00 2.001 — 5,000 gpd $400.00 ❑ Soil Based Individual Site Design* One or more treatment components are not approved under a. SPS 384.10 (2) or (3): El At Grade (Individual (Individual site design/deviation from component ❑ Non -Pressurized In -ground Design manuals and use of components without product ❑ Pressurized In -ground Wastewater Flow in aoprovap: ❑ Mound Gallons Per day ❑ Drip -line Design wastewater flow of the proposed system: ❑ Constructed Wetlands GPD 1,0D0 god or less $450.00 ' Documentation must be provided to support treatment and dispersal claims. In a separate 1.001 — 2 ODO gpd 5600 00 statement, provide rationale for the project and attach supporting documents (code sections, test 2,001 — 5,000 gpd $750.00 reports, technical papers, research articles, eta) greater than 5.000 gpd $900.00 plus $0.08 for each gallon over 5000 god State-owned facilities: DeDesignsly Holding tanks previouapproved under s. SPS ❑ Holding Tank Component Manual, Ver. 2.0, SBD-10855-P (N.03/07, R1/12)• Wastewater Flow in 384.10 (2)(3). Design wastewater Now of the proposed systera: Gallons Per day • Non -state owned Commercial and Residential Holding tanks that completely utilize this manual 5,000 god or less $90.00 and have an estimated daily flow of less than 30DO gallons per day must be submitted to the GPD 5.001 — 10„000 god $150.00 appropriate governmental unit for review instead of the Departrnent. [see SPS 383.32(3)(a)) greater than 10,000 god $225.00 ❑ Holding Tank Individual Site Design*, (i.e. site constructed, c5 day holding capacity, Co- Holding tanks including site constructed tanks NOT mingled wastewater, etc.) Design Wastewater Flow in previously approved under s. SPS 384.10 (2) or (3). Please specify: — Gallons Per day Design wastewater Now of the proposed system: • Documentation must be provided to support the rationale for the project In a separate statement, 5,000 god or less $180.00 great—10,000 50.00 please include all code sections, test reports, technical papers, research articles, etc.) GPD greater than 1D,0000 $40 gpd 5450.00 ❑ Soil Saturation Determination Report (using observation pipes) ❑ Interpretive Determination $240.00 ❑ Experimental System (One time additional fee). Submit fee for individual system as per appropriate above system type) Experiment Number _ $400.00 — Prior approval from a section chief Is required for a priority review. If approval is granted, the priority will be reviewed within 5 days of receipt. Priority review fee is double the normal review fee. Priority Review (enter same amount as normal review fee listed above) Enter Total (rounded to the nearest dollar) S $ 250.00 SPS-10577 (R 10/15) 4" CAST -A -SEAL WLP1000/650—FDL TRIPLE 13•-4" TANK SPECIFICATIONS DIMENSIONS: 4" CAST -A -SEAL WALL: 3" BOTTOM: 3" Is -____= 1==�F=====_===1=____`-___-� COVER: 5" II I I Iltl �I MANHOLE: 24" I.D. PRECAST CONCRETE RISER l f t it li a a F HEIGHT: 57" O.D. mjptp•PI L .'-'.\ iIt ,U LENGTH: 13'-4' O.D. I ~ o I II I i WIDTH: 6'-0" O.D. ` llj BELOW INLET: 46' O.D. LIOUID LEVEL: 41' WEIGHT: 15,000 LBS. t 10"XIS I FILTER OR II I FLOW T_RU II B_AFF_L_EII II INLET AND OUTLET: - T 4' CAST -A -SEAL BOOT OR EOUAL GASKET INLET AND OUTLET BAFFLE AND FILTER: TOP VIEW WISCONSIN, SEE DETAIL #10 (OTHER STATES SEE CHART) LIOUID CAPACITY: 12.37 GAL/IN (SEPTIC) 12.37 GAL/IN (SEPTIC) 15.93 GAL/IN (PUMP) LOADING DESIGN: B'-0' UNSATURATED SOIL 4" VENT J L J OUTLET It ]:,tLJ t 1 I e fl Il J i a v u t Q - U I d V L3-�D � PUMP PAD 43}" 42j"JL57"-- TANKS ARE MANUFACTURED TO C-1227 TANK CAN BE USED AS: SEPTIC/SEPTIC, SEPTIC/PUMP OR SEPTIC/SIPHON COVER: MIX DESIGN /B (NO FIBER) TANK: MIX DESIGN #10 (STRUCTURAL FIBER) CUSTOMIZED TANKS: FOR CUSTOM TANKS CONTACT WIESER CONCRETE REVIEWED BY REVIEW DATE DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCTS NEEDED BY: It a 0 - o a W ; ✓� U O G J 0 w W J J Q a � z Q O � N U � F o w o to IL OF 7 rA �e V - IM !1Aft0Vj!9SWDr#i,WLTKlnC. el• & Wan"it" Prod m of Puy ok Inc. PL-525 Filter PL-525 Effluent Filter The PL-525 Filter is rated for 10,000 GPD (gallons per day) making it one of the largest filters in its class. It has 525 linear feet of 1/16" filtration slots. Like the Polylok PLr122, the Polylok PL-525 has an automatic shut-off ball installed with every filter. When the filter is removed for cleaning, the ball will float up and temporarily shut off the system so the effluent won't leave the tank. I A Features: • Rated for 10,000 GPD (gallons per day). • 525 linear feet of 1/16" filtration. • Accepts 4" and 6" SCHD 40 pipe. • Built in gas deflector. • Automatic shut-off ball when filter is removed. • Alarm accessibility. • Accepts PVC extension handle. PL-525 Installation: Ideal for residential and commercial waste flows up to 10,000 gallons per day (GPD). 1. Locate the outlet of the septic tank. 2. Remove the tank cover and pump tank if necessary. 3. Glue the filter housing to the 4" or 6" outlet pipe. If the filter is not centered under the access opening use a Polvlok Extend & Lok or piece of pipe to center filter. 4. Insert the PL-525 filter into its housing. 5. Replace and secure the septic tank cover. PL-525 Maintenance: The PL-525 Effluent Filters will operate efficiently for several years under normal conditions before requiring cleaning. It is recommended that the filter be cleaned o� ery time the tank is pumped, or at least every three years. if the installed filter contains an optional alarm, the owner will be notified by an alarm when the filter needs servicing. Servicing should be done by a certified septic tank pumper or installer. Locate the outlet of the septic tank. 2. Remove tank cover and pump tank if necessary. 3. Do not use plumbing when filter is removed. 4. Pull PLr525 cartridge out of the housing. 5. Hose off filter over the septic tank. Make sure all solids fall back into septic tank. 6. Insert the filter cartridge back into the housing making sure the filter is properly aligned and completely inserted. 7. Replace and secure septic tank cover. IA6" Filtro 10,000 Accepts 4" & 6" SCHD 40 pipe Outdoor SmartFilter'4- Alarm Polylok Zabel & &rst filters accept the SmartFilter® switch and alarm. Extend & Lok^ Easily installs into existing tanks. Polylok, Inc. 3 Fairfield Blvd. Wallingford, CT 06492 Toll Free: 877.765.9565 Fax: 203.284.8514 www.polylok.com �� �0e) ESTABLISH VEGETATIVE COVER FILTER FABRIC 12" EZflow BUNDLE (TYP.) Mow 1203H - GEO 36" MIN. TRENCH WIDTH NOTE: PRODUCT CONFIGURATION AND INSTALLATION DEPTH MUST COMPLY WITH APPLICABLE REGULATORY REQUIREMENTS. NATIVE BACKFILL 6" MIN. COVER OR PER CODE 4" PERFORATED PIPE 05 , 21 o Fz s1 ST. VNTY SANITARY SYSTEM File At:OryiceUseOnly OWNERSHIP/ADDRESS FORM Crcored212021 nunity Development Department will utilize this information to provide the property owner with ^formation regarding operation and maintenance of your new or replacement sanitary system! This information will be provided as part of our ongoing efforts to protect public health, your well, groundwater, surface water, property values, and county resources. Once approved, this completed form and educational information will be sent to you by email. Owner/Buyer OWNER/BUYER INFORMATION Bob & Nan McMurrin Mailing Address W2858 776th Ave. City/State/zip Spring Valley, WI 54767 Phone Number (required) (651) 324-9380 Ernail Address (required) mbcsports@svtel.net Parcel Identification Number 018-2001-01-000 (found on the property tax bill) NEW SYSTEM: LEGAL DESCRIPTION Property Location NE t/4 , NW t/4 , Sec. 14 1 T 29 N R 17 W, Town of Hammond Subdivision Plat: Forest Ridge Estates Certified Survey Map # Warranty Deed # 1156827 Volu Page # (before 2006)Volume . Page # »cer of bedrooms 3 Spec house O yes ■ no ' Lot lines identifiable ■ yes Cl no Lot # 01 OFFICE USE ONLY c�q New Property Address ` `q lqst� 15�—1 (&A n.P-r& (verification of new address required from Community Development partnt for new 0/11 ZZ (5 ff 'tials) (Dat 1 This form must be submitted with all Private Onsite Water Treatment System (POWTS) applications. New System: Include with this form a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. Community Development Department - Land Use Division 715-386-4680 St. Croix County Government Center cdd@sccwi.goov 1101 Carmichael Road, Hudson, WI 54016 715-245-4250 Fax www.sccwi.gov 6 'Z'Z oFzc/ rw IIIIIIIIIIII� �L TIE BATH FMb ARE SO ON V H 4 ROUND SM DUCE ALL SMEWAU 1EAMS PR POSE WA-DSAl ICBM 563A5 APPROVAL PUW Wisconsin Department of Safety and Professional Services Division of Industry Services SOIL EVALUATION REPORT In accordance with SPS 385, V05, Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 11 inches insize. Plan must include St. Croix, F. b_t not limited to: vertical and horizontal reference point (BM), direction and percent slope, Parcel I.D. scale or dimensions, north arrow, and location and distance to nearest road. 018-2001-01-000 Please print all Information. Reviewed by Page 1 of 1 Ref #2690 Date Personal information you provide may be used for seconds Prtv Law, s. 15. 1 m . Property Owner Property Location ❑ Bob & Nan McMurrin Govt. Lot NE % NW '/. S 14 T 29 N R 17 E (or) W Property Owner's Mailing Address Lot # I Block # I Subd. Name or CSM# City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road Spring Valley Vill 154767 1 (651) 3249380 1 1 Hammond Co. Hwv E & 193i0 St ® New Constru tion Use: ® Resick"Wl / Number of bedrooms I Code derived design flow rate 4450 GPD ❑ Replacement ❑ Public or commercial — Describe: Parent material Glacial till Flood Plan elevation applicable na R. General comments and recommendations: Site does not comply with A+4" requirement as specified In DSPS 335.30(2(b)l and is unsuitable for mound POWTS. DSPS interpretive approval is unlikely. 11-1 Boring # [1Boring ® PH Ground surface elev. 98.82 R Depth to limiting factor 4T in. Horizon — Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 •Eff#1 'Eff#2 1 0-8 10yr3/2 none I 2fgr mvfr aw 3fmc 0.6 0.8 T 2 B-21 IOyr4/6 none at 2febk mvfr cw 2fmc 0.6 1.0 3 21-40 10yr4/6 none Is osg ml cw 1fm 0.7 1.6 4 40-59 7.5yr4/4 f2d 7.5yr5/8 fs On ml 0.5 1.0 ❑ Boring # ❑ Boring — ❑ PR Ground surface elev. R. Depth to limiting factor _ in. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 •Eff#1 •Eff#2 CST Nerhe (Phase Print) ignatu CST Number James K. Thompson 30021 Address ID6 Evaluation Conducted Telephone Number 340 Paulson Lake Lane Osceola WI 54020-5413 June 30 2020 715 248-7767 stsu-easu trtuarrol REC I Vfg vvlsconsinDepartrlwntofConrnerce SOIL EV ATI N REPORT Pepe --of Division of Salary and BuedWV9 p��� in. nr�s)seYCo�rr�S�WlarAdrn. ode County Atlach compete site plan an Paper not less n e 7 I Jrlchos5lnn size. Plan I PMOBI i r' wlcluds. W not IW*od to: v9dical.M horizon rel BcSlik'�� =ru tom. off— -7 00/ �.1Y percent slope. scale or dirnenslons. noM err (p pf"" print all Information. R oat. Pv.ow.. •A•.m.noe tw go.tl. m.7. a v.ee br..tone.ry pwpos•+ (P/n•rr Lw, •. IS M l r) (m))I� i( l / Ply Owner Properly Location a� A `� A •` -/ JOG ifs,Aja1H S / r T Zq N R 17 1N Property Owners Us" Addreu Lot a WockwvXT Slbd. Name or CS W 11l9 VJ, U'sJtStom ST. Cey State Zip Code Phone Number [3 City ❑ Village X] Town Nearest Road AWEA FALL--, I Wr 1 5402 (115) 4Z Io—L180 HAMAWVQ i 0 Lk: E J4 Now Construction User Reeldental i Number of bedrooms ___ _ Code derived design now rare Replacement ❑ Plbec or canrrneroal - Describe: _ -- Perent matenat _ill Sl+ Flood F1aaI elevation it oppsr'.aiNrr General comments and recommandadons: AT C.at AnE 94sTe^ as "ADW6 RATE JBoring �u awng a Pit Ground surface elev.. It. oeolh to kvWWV factor _Zfob n Soil RMs Horizon Depth in. Dominant Color Hansel Redos Description Ou. Sze Coll. Color Toxhre Structure Gr. Sz Sh. Consistence Boundary Roots G "1 'EBd2 l 0- 10 10,4001Z L m*A L& 3 -0E Z to- _. - 5 d a_ 5 Z 8 -c Ail I 1 _ -2 c u..mL. c f% �. -1 1 l u-C_' ®Bwwve 0BOWN � of �L IfS7 Pit Gramm surface alw. _.'Is" 7_+ _ n. D.pel b Molting lector _�, In. c„e�Rnal . �M vim t7El" r , =1n! EldUent el • DGO > 30 c 22D rngfL and TSS >30 < 150 rrlgll ' Effluent 02 - tJVV 7D nlgrL ano I JA � JIr rrr7L. n CST N.a (Please Pf" _ -Qi^nsture CST Ntrnbar M AHLLSE zz Address EVIU111 n f; mdWed Tele WO Nufft ilf 1-49175 64D�``Atle,Fp�(tlEft,F^L1Sf WI 5402Z 0$- -0Z 1%S y16-1-17,S LA-0 E� EL- : 04-zb-C115- � rommCyo�>w w Z OF3 Parcel t0 r �_—. rt = SOD%> 30 1 2Z0 rnWL " I SJ am < t�myr� The Department of Commerce is an cqual opponuntly service provider and employer. If you need assistance to access services or need material in an alternate formt. pleaao contact the dcpanmcnt at 609-266-31 SI or -fTY 609-264-8777. all.allat"m n w �' `" �qb• CP E Lo-r I oo AT / \ ! 115- �- UNPLATTED LAND&15 $ x \ / ll' / x / ;3n3"& x 1145.6 ZONED AG. -RESIDENTIAL / , ��' NORTH SINE OF /fIHE NW 1 — — — — - ---— v-- --- _____- —�— —____--_---_�----_=--f _ — — — — =ST 1 r w ---- — ---�—3630'-------- SECTIOW w / / �288.84' o I �1 \ o J, R17W, I 1 ; O O �o L o i" COUNtY p 3s / o AS � � c / o 912 w — � �-. F Nai o m 2.23 }1\C.`- / N.B. 51308 S.F. \ l N.B. 1.17\ C. x I „Xz. z 1 = 114s.5a' 1146.8 �M 2 /i � I i Fr_ \� 121097 2.78 Al �/ yy �/ yy / IM5 A �m �� IU�m Re /Z 1 m m �, Om 0 D 1 2 I- D �m 1 m 1 m 1 � N O V J ly'x 1145.2929a8-SF.672 Ac.LFE _ 44.00'N.B.\151636 S.F.N.B. ,3.48 Ac/r! / /96—€ L)T/i LFE - 11 o4.00' 1 /' r / / 1 i 2170P7 S4F. / 4. 8 ACi 1143.3 x / / / / i t I 1� B. 53993 N1e5).24 1A /J. F _ ?1146.5 yNPlergoi.e�L----------------- ----- -- w NORTH LINE OF THEN '33'E 1178.58' N 89322Y E 117&85' N89' rF— & ------------------------148. 8.85' 06" I 385 52' 95 90' 170.00=L0_T_2_800`y�,98226 S.F. - /--------�-i5^�� i , I 1 \ \ 2.25 Ac. �'K.,,••'° �AN) �/ LOT 29 LOT 3C� Im r el /s 118933 S.F. I 137528 S.Fi I Iz 2.73 Ac. I`" 3.16 Ac. LOT 27 I IK Ln - 1150 I I ,n . ttaaoo' I R.A. 1\ 130024 S.F. N 89 \HK Q 2.98 Ac. I I I IE I Ln -11".W- i YL \ \ \ \ 1144.50' LOT 1 € 294113 S.F. 6.75 Ac. /� `� \ `\ \ 254.23' 22.3.50' 31&50' uE . na4.W IF y ` \ r — —_ N 8939'06' E 834.03' —_ —_ —_ 2Qa b\ iaj `� U LOT 26 O Qr C + }, — — — — — -- \ q{* �°*• �`\ \ "W 251982 S.F. 5.78 Ac. a'7 1i[ - 11lu.00' 1100 LOT 2 r \ \\ m +� 217087 S.F.-------- 4.98 Ac. i N r Ln-1144.00' 1 --------------------- ' p - 8 9978.8T W 480.78' 70 — — — — 5 89'2O'18' W 780.80' — — — — — — —1 4 It N 8938'S7' E 479 22' — — — m-------------------- Z 14LW------------ ----I i r- i ST. CROIX COUNTY WISCONSIN PLANNING & ZONING DEPT. ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 FAX (715) 386-4684 April 25, 2005 Ms. Mary Jo Hollister, CST #224832 Hollister's Soil Testing W9875 690'hAve. River Falls, WI 54022 Re: Revisions for Soil Evaluation Reports - Forest Ridge Estates, Hammond Twp. Dear Ms. Hollister: On April 21" I performed on -site verifications of data reported for lots 27, 28, 29 and 30 to determine the cause of discrepancies between the engineer's preliminary plat elevations and those on the soil reports. There was an error in your method for calculating the benchmark elevations in relation to mean sea level contours, which resulted in the contours not matching the elevations described for soil borings and test pits. While on the site, I walked all four lots and found that some of the distances between test pits and hand borings did not match measurements represented the scale used for their associated plot plans. In order for mound systems to be designed, corrections need to be made. To summarize my findings: 1. All lots whose reports used mean sea level elevations need to be revised so that the benchmarks are based on an assumed 100.0 ft elevation. This will require using your field notes and, starting with every BM #1, add the back -sight rod reading to 100'to give a new height of instrument. Then re -calculate (subtract from HI) all the foresight rod readings to obtain test pit and/or boring elevations related to the BM #1 and draw u nevv�plot plans to correspond with the new contours. Lots reported using mean sea level re 1, 21 3, 4, 6, 8, 10, 17, 21, 24, 26, 27, 28, and 29. 2. Do not exclude any previously reported test pits. They must be included in revised evaluations and shown on the plot plans. This will help avoid confusion when locations for mound contours are being established. The distances between test pits within tested areas need to be updated from the original 2002 plot plans. 3. Original signed and dated revised reports must be submitted to our office so that they can be attached to the previous submittals to track changes made. 4. I evaluated a hand boring on lot 28 that was next to a test pit that had been marked with a lathe labeled "29A" (from the original lot numbering). It was approx. 95' southwest of the corner benchmarks and 20 ft. west of the test pit you now show as "A". The original site was an excavated pit, not a hand boring, as evidenced by backfill. Regardless, both test pits were Hollister — Page 2 described as having redox features within 3 inches of the A -horizon. I found mottling in the sample I examined just below the A -horizon boundary, so am requiring that any mound design be restricted to the northerly test pits B, C, and E. 5. Based on the soil evaluation for lot 28, all four lots fronting on Cty. Rd. E appear to have serious limitations for POWTS installation other than the tested areas already documented. This means that any damage to existing tested areas may eliminate the possibility of POWTS installation, unless an A+0" mound design is approved by the Dept. of Commerce after the requisite on -site evaluation by Leroy Jansky. I will send a copy of this letter to the current owner of the lot to forewarn him of this situation. Would you please re-establish the marking tape to indicate the locations of these areas, since you are more familiar with the terrain? Sanitary permits cannot be issued for the lots referenced above until the soil reports in question have been corrected and/or completed. If you have any questions regarding the above requested changes and/or additions to the soil reports, please feel free to contact me at the Zoning office number and schedule a meeting to discuss the soil data for Forest Ridge Estates. Sin c ` Pamela Quinn,qCST665054 Zoning Specialist Cc: Mark Sylla, Developer Kernon Bast, Edina Realty Leroy Jansky, Dept. of Commerce POWTS Wastewater Specialist Subdivision file 0 Wisconsin 0eparonantofCommarce SOIL EVALUATION REPORT Page __L—of OtvW lofSafetyandBuildings In seoortlonce with Gomm 85. Wls. Adm Code ronfit A11e011 oompoe stie plan On Paper not Iloss than 6 1t2 s 11 Incnas In Md. Pion must sr. CROLX Include. bullnot I1111e0 tu: comical and horizontal reference Do" (BM)• dlredmn and en perct stops. scale or dir"nslons. north snow. and locallon and distance to nearest road. 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NILt Doolh to umlenlg odor _ZAP— ++ _ soy Rots Horizon Depth Dwninant Color Rados Description Toature Strlxture Consistence Boundary Roots r3pom m. Munsell Ou. St. Coral Cole, Gr. St. Sh •Eller 'Efm2 0 0 It N4 K.'5JZ - L rv\* d •5 _ ^� 3 a 5 Y Z to- 5A 9-rn - _l• z I 1-1-31 Bo rg a p Boning pit Orprrld surface allow. h Depth to Smiting lector —Z _ In. Horizon Depth M1. Do mant wor Munsot Redoa Description Clu, St. Cent. Color Texture Structure l Gr St. Sh. Consistence I Boundary I_ Roots --- - GPDRF - - 'EfMI •F"2 ! Q- t 1 z .- - _ L flit.d 1rf o •S 0.1 2- 1 11 -Z-y - ll I 3jr3Lais as o • 0•io -- 5 0 • t.z . Z I sa wA _ lm mg& ' E@wnt 02 w 000 a 30 ffgk and TSS 130 mgfL CST Noma (Plaose Pnrd) Signature 0 /" �" CST Nunbor M O N t, t-1STtc K 7�1OL1,(S 22 Addtsu Date Eviluslim Conducted Telephorls Number W9t75 690"\Ay�pjuE�FjkLLS, WI _5402Z 01-Oj-OZ. -its L416-V175 REvIlseo, 04-MOZ �j (L= % ) 7- -oF3 Properly Owner SAIL ^ _. _ Parcel10 s �t 0 W ti __.. _ Pape ;r'-•_ W __ U manp h:u BOhg IC? _ ._...... ...w.....t... 110.52 h Death to I1(mm Acts _ -- N. a-„ .f ...di..rw, R.r.1 vier zon Deem Dominant Color Redox Description Textue SlNcture Consistence Boundary Roots _ GP00 6002 M. Mused Ou. Ss. Coat Color Gr St. Sh. E"i L 24-molb 0,5 I 0- 0 y to-t r�t�%i f b 3 l w -f6 v 2 — L m 5WC z m VZ4 Io4R4% - S11 2(_ K Ce ZJi 5 0• 4 Y�3 _ .mid( m r �s m 0.4 TI ri7•T4 v ro -ier t0 `r��Ilr - --J G u -- ---- it Depth to Urnev Acts - - h Sol A lcawn Rate (ltrT in) IA it MR1ten Dominant Cola Radox Descrlpton Texture Stricture Consistence Boundary Room C wElwl E in. Mue4 Ou. Ss. Cont. CCowGr. St. Sh. t Z -if is v sl _. - rVOWA1 1 m� !!'../ _ L SN t f. 2. sb t�-mablc rnafr r � S 1v�- O.S 0, S ,$ o g 3 -1 to e4 S wI m ZJ�.rI o.t 0.7 0 1 2 .Ltr _q 1L'K ...if- � 12J�-ev\ 0.7 t• 2 _. e t • 600% > 30 1220 n4k end TSS 1-30 1150 rng& - Effluent 02 • DOD,1 Oft " TSS 130 mart. The Uepsnrneat of Commeree is an equal opponunily service provider and employer. if you need assistance to access sorviccs or need msterial in an shamble formal, plesxe contact the depanment at 609-266.3151 or TTY 609-264•8777. -S'T'A -P sac. w w 0 MtA 10 0. .9 rW 3!� C*: taw CFf%Qk Z" C6 4A BM*Z z pvc- 1ptpL ABOU V EL W14. sx L) 5z , la �= \\. �.- I d LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF HAMMOND COMPUTER NUMBER 018-2001-01-000 Parcel Number 14.29.17.865 OWNER NAME: First CHARLES R & REBECCA J Last PACE PROPERTY ADDRESS: Hse # 1/2 PD --Street Name-- Type SD Apartment 994 193RD ST SECTION 14 TOWN 29N RANGE 17W Y.160 NW '/,40 NE Line Description Line Description TOTAL ACREAGE 6.750 PLAT FOREST RIDGE EST 1/30 018/03 LOT01 BLK 01 SEC 14 T29N R17W PT NE NW 15 02 FOREST RIDGE ESTATES LOT 1 16 03 (6.750AC) 17 04 18 05 19 O6 20 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1-General, F4-Prev. Parcel, F5-Next Parcel, F7-Valuations, F8-History, F10-Exit 3 &,�drww� 54--6i?i ' couNn No. 645453 STATE SANITARY PERMIT OTRANSFER/RENEWAL PUNO. 1 AW- ' PLUMBER ct V4 TOWN OF#*WAomrj- SEC 9T_!N, R, AND/OR LOT / LICa# 300 BLOCK -- SUBDIVISION 00iAC X CHAPTER 145.135 (2) WISCONSIN STATUTES (a) The purpose of the sanitary permit Is to allow Installation of the private sewage system described in the permit (b) The approval of the unitary permit 6 based on regulations in force on the date of approval. (c) The sanitary permit 6 valid and maybe renewed for a specified period. (d) Changed regulations will not Impair the validity of a sanitary permit. (e) Renewal of the unitary permit will be based on regulations in force at the time renewal 6 sought, and that changed regulations may Impede renewal. (f) The sanitary permit 6 transferable. History: 1977 c. 165; 1979 c. 34,221; 1991 c. 314 Note: If you wish to renew the permit, or transfer ownership of the permit, please contact the county authority. �AU T OR I ED ISSUING OFFICER - DATE 0� Z3 Zt THIS PERMIT EXPIRES Z UNLESS RENEWED B O THAT DATE POST IN PLAIN VIEW VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION SBD-06499 (R11/20)