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HomeMy WebLinkAbout032-2149-30-000 (4)Wisconsin Department of 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 (Pnvacy Law, s.15.04 (1)(m)( 'ermlt Holders Name: City Village Township Andrew and Alexandra Yarosh I TOWN OF SOMERSET ST BM EktY I Insp. BM Elev: BM Description: I00. a 1fl o, D I o 0 2 t Ql/L Mnr% 11711ir VrRItr1A I IVri TYPE MANUFACTURER NUA 5Zs CAPACITY Septic L[: S C 2 50 Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P(L' WELL BLDG. Vent to Air intake ROAD Septic ~ 2 'f/ r Dosing A!%Uerr Hok ng PUMPISIPHON INFORMATION Manufacturer Demand PM Mode umber TDH LIR on Loss System Head T Ft Fo in Length Dia. ist. to Wall SOIL-A8$ORPTION SYSTEM CLCYA 1 ium L11% I A County St. Croix Sanitary Permit No: 645498 State Plan ID No: Parcel Tax No: 032-2149-30-000 SecGonrfowrdRange/Map No. 02.31.19.1299 STATION BS HI FS ELEV. Benchmark (3.�aZ I13.6Z fb,o/ Alt. BM Bldg. Sewer St1Fi1 Inlet SVHt Outlet [o_6Z 1o3.D' DtInlet Dt Bottom Header/Man. Dist. ripe 1 gb,�8 Bot. System f? 93 2- r gs.ro 9 Final Grade ri ) St Cover 5 1g0 Ion g2 BGEW,MENCO Width Length / No. O( riches PIT DIMENSIONS No. Of Pits inside Dia. Liquid Depth DIMEN S q ! 2 SETBACK SYSTEM TO PIL JBLDG IWEEL LAKE/STREAM LEACHING Manufactur r INFORMATION CHAMBER OR 7 t f",a6— t UNIT Type Of System: D [D� { / r00 Model Num_ ben Header(Manifolfi I ( D Dia Distribution Ptpe(s h Dia_ Spacing x Hole Size x Hole Spacing Vent to Air Intake I'Length , I �('� SOIL COVER x Pressure Svetems Ontv xx Mound Or At -Grade Svstems Only Depth Over , Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bedrrrench Center ?� r p Bedrrrench Edges Topsoil jAu Yes ®No [� Yes p� s COMMENTS: (include code discrepancies, persons present, etc.) Inspection #1: /t� / Inspection #2: Location: 2336 fi 1ST ST 1.) Alt BM Description = 2.) Bldg sawer length = 10 571 - amounl of cover = .�7) 3, 5-On —than. Plan revision Required? ❑Ie Yes )(No Use other side for additional information. I SBD-6710 (R.3197) Dale Insepctoes Signature Cert. No. S'AW --2ADZ3 OD Z r Industry Services Division 4822 Madison Yards Way County 12-111 ' _lp Madison, Wr 53705 be'filled l Sanitary Pirrinit Numb Ito in by co.) >� I P.O. Box 7162 Madison, WI 53707-7162 �,fr q I0 ! 8 1 7 - StatcTraaxctionNumber Sanitary Permit Application In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit Note: Application forms for sm Addreas if different than mailing address) the Department of Safety and Professional Services. Personal information you 72 purposes in accordance with the Privacy Law, s. 15.04(1 xm), Stats. S� L laftr rkow Pr AN Isfonutb. odes - Property Owner's Na JAN 12 ZUZ3I a OWfiW5 M"iBg A00reM Community Development 99 Gov[t. of ,��� _ -sG City, State Zip Code Pbone Number ScJ '%icl. '.., Section ss- .. T N R E o EL Type of 2~dkoWsd1lI apply) Lot 4 101 or 2 Family Dwelling -Number ofBedraoms _. Subdivision Name Gc/Commercial - Describe Use B1odc It) ily or rtatwc Owned -Describe Use illage of CSM Number / down of `— -;; pi f` M. Type of POW73 Cbak eider "NW or "Rephoeme.t" mW otia appBeAk on line A. Cbeck om box o. Ow B. Cet piece U.e C If amOmbile.) A, ew System � aceinern System U -ep1 1300'er Modification to Existing System (explain) dditional Pretreabnent Unit (explain) B Holding Tank R[hi-Ground �AAt (parade Mound Individual Site Design Type (explain) ono! Revision C. Renewal Before an ge of Plumber [:]Transfer to New Owner ism Previous Permit Number and Date Issued Expiration 1 TV. t Area rind Tank i brmollo.: Design Flow (gpd) Design Soil Application Ratc(gpolsf) Disoujdl Areaa�Roquirod (sf) Disprnel sf) Sys Elevation C1a-�p• -- -- - — -- - Capacity in --- TOW q of Manug r Tank Information Gallons Gallons Units oQ ` yffiSp{+p- (` E o Ta u� New Tanis Exist Tanis Septic or Holing Tank 5 ` Dosing Clime. H ILJ H V. Respopludw sfffibeaaeat- 4 tare saderidEN4 ,uaeee I V M tie seethed Plana. PI ) 1 Plumber's / MP/MPRS Numbcv Busuxm Phone Nembcr u 'a A41dress (Street ity, Zip Code) '0�) VL CNaty/Deporbacit Uae Only Approved ❑ Disap roved� Permit Fee s Issued Age it Signature ❑ Ow v�for Denial Conditions of "Imp 1�1 3 9. Septic tank, effluent filter and dispersal cell must be serviced / maintained as per } LLAS IN management plan provided by plumber. «,ti a.d All setback requirements must be maintained as per applicable code 1 ordinances. (,q Attach to compiete plan For the system sed sab.lt to the County o* so paper sot less tbaa a to % I I fades in site SBD-6398 (R.03/21) 0 �. 9 �- ®t6, I regal DemajOW Toiwnsw cotaw- sebtldsim NOWAL Parcel 10 Munibw-. Page 9 !lrrierr aM wb Papa 2 Plat pbm . Paae'3 ajok w 8kke & comweadbn PMW4 Fisrspew Page 6 AftbOunme Wounaion PSW 6 t Plea Pape 7 SL (mbtCV21rlrie Tank XlmW4 r Form pqp a WMINW ©eed P-w S Gwyrpi* Aihsdfmalll� b'�i T/bet� Hume Pkrre - _ , / liorfne iiuiaraer Qebs` Pburw 1�1un6er' %J.5 =,,� /- 7`i/ 7 fls.��.s pr�tw>tr �Aw���N�wMon �t�wraK r+Onrra br.hwZo seD•tgr16� 1N��� - pmw 7 -906 ._.. 8f6 o c O v � b � 5 12 - iv �6 aY 11renF{:aq� charAer Y .= B Hr. y e vim Fmcbm es And hbxkA� � F SSA eq � per c�ezaber Sol RMo gpel1� �L _ Appire�on _ f7nrir : Sd App p�! haft '7 = hers 2s of-,LZ-2_ dmWtmm eedk "aw of r 111111 GE Too Ina knevoo m in h$UK Drsinap+ Zabel• 4 titer asur hoaFxu A g�r� an d POO* trr- 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 PL-122, the Polylok PLr525 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. If 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 Polylok 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. The PL-525 Effluent several years under normal conditions before requiring cleaning. It is recommended that the filter be cleaned every 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. 1. Locate the outlet of the septic tank. 2 Remove tank cover and pump tank if necessary. 5 4. Pull PIr525 cartridge out of the housing. 5. Hose off filter over the septic tank. Make sure all solids fall back into septic tank, not into filter housing. 6. Insert the filter cartridge back into the housing making surf' the filter is properly aligned and completely inserted. 7. Replace and secure septic tank cover. 1/16" Filtration Slots WAS 1W Acm" 4- & 6- SCHD 40 pipe m Switch tional) }eepts 1" PVC tension Handle Rated for 10AW GPD 525 Linear Ft. of 1/16- Filtration Slots Certified to NSFIANSI Standard 46 ' Gas Deflector r Automatic Shut -Off Ball Outdoor SmartFilte0` Alarm Fxtend & Lokr" Polylok. Zabel & Best filters accept Easily installs the SountMerO switch and alarm into exrstutg tanks. Polylok, Inc. 3 Fairfield Blvd. Wallingford, CT 06492 7bll Free: 877.765.9565 Fax: 2032M.8514 www.polylok.com POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION Owner I 411-)4 i Permit DESIGN PARAMETERS Number of Bedrooms ❑ NA Number of Public Facility Units 19 NA Estimated flow (average) gal/day Design flow 1peak), (Estimated x 1.5) gal/day Soil Application Rate aUd /fe Standard Influent/Effluent Quality Monthly average` Fats, Oil & Grease (FOG) 530 mg/L Biochemical Oxygen Demand (BODs) 5220 mg/L ❑ NA Total Suspended Solids (TSS) 5150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BODE) 530 mg/L Total Suspended Solids (TSS) 530 mg/L M-NA Fecal Coliforrn (geometric mean) 510` cfu/100ml Maximum Effluent Particle Size Ya in dia. ❑ NA Other: ❑ NA "Values typical for domestic wastewater and septic tank effluent. RRAI iTE NArWE SCHEDULE SYSTEM SPECIFICATIONS Septic Tank Capacity al ❑ NA Septic Tank Manufacturer ❑ NA Effluent Fitter Manufacturer 7 ❑ NA Effluent Filter Model �- El Pump Tank Capacity al 19 NA Pump Tank Manufacturer 1i NA Pump Manufacturer NA Pump Model ON4 Pretreatment Unit ❑ Sand/Gravel Filter ❑ Mechanical Aeration ❑ Disinfection ❑ Peat Filter ❑ Wetland ❑ Other: WNA Dispersal Cell(s) 0In-Ground (gravity) ❑ At -Grade ❑ Drip -Line ❑ NA ❑ In -Ground (pressurized) ❑ Mound ❑ Other: Other: ❑ NA Other. ❑ NA Other. ❑ NA Service Event Service Frequency Inspect condition of tank(s) At least once every: ' month(s) (Maximum 3 years) ear(s) ❑ NA Pump out contents of tank(s) When combined sludge and scum equals one-third (Y) of tank volume ❑ NA Inspect dispersal cell(s► At least once every: 13 [3 months) (Maximum 3 years) year(s) ❑ NA Clean effluent fitter At least once every: �3 months) yea(s) ❑ NA Inspect pump, pump controls & alarm At least once every: 0 mont j(s) year(Flush ONA laterals and pressure test At least once every: ❑ month(s) ❑ yearW R1 NA Other' At least once every: ❑ month(s) ❑ year(s) ❑ NA Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following llcanses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintalner; Septage Servicing Operator. Tank Inspections must Include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or pending of effluent on the ground surface. The dispersal call(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any pending of effluent on the ground surface. The pending of effkient on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third %) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the focal regulatory authority within 10 days of completion of any service event. GMW (4101) START UP AND OPERATION Page -L of For new construction, prior to use of the POWTS check treatment tankls) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cellist. If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cellist in one large dose, overloading the cell(s) and may result In the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the fife of the POWTS: antibiotics; baby wipes; cigarette butts, condoms; cotton swabs; degreasers; dental floss; diapers: disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, pravei or another inert solid material. CONTiNGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement syatem: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be Infringed upon by required setbacks from existing and proposed structure, lot fines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. 0 A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to Identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the lnfihxathre surface. Reconstructions of such systems must comply with the rules in effect at that tine. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR WSUFFIC(ENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT_ RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTs wsmu# 4 POWTS MAINTAINER EPhme Name one _ Phone SEPTAGE SERVICING OPERATOR 041MPER) LOCAL REGULATORY AUTHORITY Name Name > >1 Phone Phone This document was drafted in compliance with chapter Comm 83.22f2)lbl0)(d)lk(0 and 83.5411), 42) & 131, Wlaaonsin Admirstrathm Code. STT. CRO [v-rY SANITARY SYSTEM File 5(YN y Office use only OWNERSHIP/ADDRESS FORM GeaW212021 Community Development Department will utilize this information to provide the property owner with information 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 INFORMATION Owner/Buyer Andrew & Alexandra Yarosh Mailing Address 2199 Vining Drive Unit L City/State/Zip Woodbury, MN 55125 Phone Number (reouired) 507-954-4091 Email Address (required) ayarosh444 a@gmail.com Parcel Identification Number 032-2149-30-000 (found on the property tax bill) Property Location Sw NEW SYSTEM: LEGAL DESCRIPTION ,1, , NW 1A , Sec. 02 T 31 N R19 W, Town of Somerset Subdivision Plat: Grandview Estates Certified Survey Map # Warranty Deed # Volume Page # (before 2006)Volume . Page # Number of bedrooms 4 Spec house 0 yes ■ no Lot lines identifiable ■ yes 0 no Lot # 03 . New Property Address (Staff Initials) O USE ONLY 113 e (0I s 5T Ifs, a�f G(�5 Nerifition of new address required from �Iza Zz (Date) Department for new construction.) 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 mode in the warranty deed. Community Development Department— Land Use Division 715-386-4680 St. Croix County Government Center 715-245-4250 Fax cddPsccwi.gov 1101 Carmichael Road, Hudson, WI 54016 vvww.sccwi.9ov Qlimi Qr~nq Rex—. LLC 2022 !' I 9 E d E : �' e✓ccn ? loh's Ora hlg Room-. ' � Andrew � Alexar�dro Yaroah k a [ � 1' 2S]6 4lst ftroel Jomerxt L�'I 34023 - Lot S, GmWvlev [stotm u ;\ L ld� ■`� � \�� Mt \ 2\~]% \�• | /_oo so-Grm- ]]`I\� a. &n_±oAma\q _ 0 Uidp Drawing Roan. U.0 2022 L L iRs� �y iIlk q; t� [i Z -n 0 0 4 70 00 7o Q Q 0� 1� 0 4 Z C � C) Q Z lA T ows Dr" Room Andrew 6 Alexandra Yorosh E afi4' 23M 6tstj*tmejan aW wl 54=1 - Lot 5. Grandview [states �� .� 01mn� Dr~f4 Room. LLC 2n22 i _IZi 1�rs. M ' i t 4/rXX xa 4 P 4 IddS Orwkg Room - I '1 Andrtw 6 Alexandra Yoro3h y a r i la s 2356 61st jtreet-fmw et VI 34025 -lot ]. ldandvieu [states & \70 00 O z \/ 2 0 z a■1 ��� & &em*o� mk ^�t0ln,~aw" Room � 11!9�� �emz_� _tu,«23-m%Gr_aw�W� \2 z�_ State Bar of Wisconsin Form 1-2003 WARRANTY DEED Document No. Document Name THIS DEED, made between Scott Bohnen, a married person ("Grantor," whether one or more), and Alexandra R.H. Yarosh and Andrew J. Yarosh ("Grantee," whether one or more). Recording Area 1138236 BETH PABST REGISTER OF DEEDS ST. CROIX Co., WI RECEIVED FOR RECORD 09/01/2021 01:57 PM EXEMPT#: REC FEE 30.00 TRANS FEE 228.00 PAGES: 2 **The above recording information verifies that this document has been electronically recorded & returned to the submitter Grantor, for a valuable consideration, conveys to Grantee the Name and Retum Address: following described real estate, together with the rents, profits, Alexandra R.H. Yarosh and Andrew J. fixtures and other appurtenant interests, in St. Croix County, State Yarosh of Wisconsin ("Property")(If more space is needed, please attach 2199 Vining Drive, Unit L addendum): Woodbury, MN 55125 032-2149-30-000 Parcel Identification Number (PIN) This is not homestead property. Lot 3, Grandview Estates, Town of Somerset, St. Croix County, Wisconsin Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: Dated: 23rd day of\August, 2021 Scott (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. 1-2003 `Type name below signatures St. Croix County 1138236 Page 1 of 2 AUTHENTICATION Signature(s): Scott Bohnen, a married person authenticated on TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by Wis. Stat. 706.06) THIS INSTRUMENT DRAFTED BY: Edina Realty Title, Inc. Mary Kay Long 520 Commons Drive Woodbury, MN 55125 STATE COUNTY Personally came before me this \,� Y R> I� the above, Scott Bohnen, a married person, to me known to be the person or persons who executed the foregoing instrument and acknowledged the same. 9 Notary u lic. State of Minnesota r.-1- MARY KAY LONG Notary Public -Minnesota N - My Con r !"on Exmitia Jan 31. 2025 (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. 1-2003 'Type name below signatures St. Croix County 1138236 Page 2 of 2 �. ORA ND VIEW ES TA TES I. v.. WEST LOCATED IN PART OF THE SOUTHWEST QUARTER OF THE SOUTHWEST QUARTER AND THE NORTHWEST QUARTER OF THE sour+ ' QUARTER ALL IN SECTION 2, TOWNSHIP 31 NORTH, RANGE 19 WEST, TOWN Of SOMERSE i, ST CROIX COUNTY. WISCQNSIN. 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Adm. Code Tom Schmill County Oa,WW5E�451on"w . Pier: moat St. Croix aid est rood. Parcel I.D. irO3Z — Z(49— —�(- 1294By Dabtir t,i+}s o4 itl i+xl►. 1 g 2 uJ.Property Location Sovt. Lot na NW 1/4 SWIM S 2 T 31 N R 19 W io1 i Bbdc i Subd. Name or CSQAi - — 3 na I Grandview Estates Number _ j City J Village lidTown Nearest Rood L 1 Somerset I Cty.Rd. I New Construction Use: 16 Residential / Number of bedrooms 3 Cade derived design flow rats 450 GPD J Replacement J Public or commercial - Describe: Parent material OutwaSh - -. -- _--- Flood plain elevation, if applicable na General conxnents and rowrim, mWanons: Suitable far a conveothmel system with a 0.7gpd/sgR rating. Possible system elevation for Area 1, step trenches, (high trench) 95.07 (law trench) 95.11. Based on a 8% slope. Boring 4 J Boring 101 Ad Pit Ground Surface elev. 100.90—_ fL Depth t0 limiting factor _? _ in. Sol AppM Wm Rate Haritm Depth Domlro Color Redmilwtlion Texhae Stnrc4as CorataN Dwdwy Root h M urrel ou. Sz. Coro. Color Or, Ss. Sh 1 0-8 10y13/3 none sil 2mgr mfi cs 1f .5 .8 2 B-19 10yr4/4 none sd 2msbk mfr dw I .4 .6 3 19- 4 10yr4/4 none sl 2msbk n* 9w -- .5 .9 4 34-42 10yr4/6 none Cos 069 ml Ca .7 1.8 6 42-101 10yr5/4 none me 089 ml — — .7 1.2 F2 ]Bodnq S J Boring A Pit Ground Surface elev. 100.90 R. Depth to IirnMV factor >120 in. Sol Applca i Rob Horizon Depth im Oonbat Color Muned Redox Deadiption 0u. SL Cant Color Texture Sbuchoe Gr. SL Sh Caneigerroe Baedary Roots GP Nrirm- 1 1 0-6 10yr3/4 none sid 21sbk mfr Ca I .4 .8 2 6-15 10yr4/4 none sd sl 91 ms 2119k 2msbk mfr 9w I .4 .8 3 15-38 7.5yr4/4 10yr4/4 none mfr 9w -- .5 .5 `@ 4 38-42 none 2msbk 089 mfr ml Cs -- 5 48-120 10yr514 none — — .7 1.2 i S7. 9 3• Effluent 91 - BOD? 30 < 220 mgA. and TSS >30 < 150 mWL • Effluent 02 . BOD 130 rag t and TSS <30 mg/L CST Name (Please Pried) Signature: CSTNumber Thomas J_._Schmitt 227429 Address Tom SdvnM Dab Evaluation Conducted Talsphone Nunber 585 Valley View 7raY WI 54025 5421/01 715-549-8651 Plop" owner M & G Inc Psroel [DO Paps _ -2_ of _ 3 L.._! �i * J �ng IdPR Ground Sudsce ekv. 98.06 rt. Depth 10 limiting fscW > 102 __ in. Sal AppYcef m Rate Halton Depth n. Dm*M Cdar Mu $ RWw Deepip m Qu. Sz Cat Cdor I Tens Sbw" Gr. U.SIL CanbMixe BMEWNY Rook 'EfW1 'EfW2 1 0-12 1oyrm none i 2mgr ; n* ce If .5 .s 2 12-34 10yrW4 none sd 2fsbk n* 9W It .4 .B 3 4 3446 48-72 10yr414 none sl 2msbk MR cw -- .7 1.8 10yrSM none Coe ms psg 089 rnl cs 5 72-102 1oyrm none lTd — -- .7 1 1.2 ; 5 � Boring J Boring _j Pit Ground Surface else. ft- Depth to limiting factor in. Hod= 080 h DanitwoCalor Wed Radar Qu. Sz Cod. Color TW*M Stnrdlna Gr. Sz. Sh Col bftrw Botinbry Rack aE 1 'EfltE2 I 1 r_1 Boring 0 J Bourg Sol - _j Pin Ground Surface elev. ft. Depth to limiting factor in. Sol Applidltlon RMe Horkwn Do* in Oer *wd Color AkMd Raft Deear"m Teshne Qu. Sz, Cod. Color Strlchn Gr S¢. Sh Ca bbrce Rook GMr TAM aERS2 i I ' Effkwm 91 a SOD? 30 -c 220 mgll and TSS >30 < 150 rrg& ' Effluent 02 a B00, <_30 mplL and TSS <_30 nV& The Department of Comrtwrxo is an ogaal opportunity servioc provider and mWfo+yer. If you mad assistance to access swAm or n. l mat"al in an n1w r—t—,4 rig► Awn "' + of N14_' "-I1 191 n.7'CV 0;AQ_1AA_*777 ty 1,0T 3 OD a 961, 79' M. I.39% rd co. , kve Z.O t 3 G�il•eo Zs4gs nrw SW� sz ����9w /V /C-V Ale 3d A3 p rdA^� —/Ap v • ?, Scj•.,1f e57>rl .22 ? y.19 S -C 4/alley f/o,w To► 1.fr- 57/0.25- 11710 rW- wl6s`/ W ON qrst L l • 0 z rm�' O w a a- F CAM Alb, At CA Q w a R a LO pY CL tl Iw, CIO V V w e yq CY li;% 2L no u Y. a .r Y Y Y O Of R q Y O p w Ye w Z'9 a w 0 w z w a z 4