HomeMy WebLinkAbout018-1078-00-000Wisconsin Department of Commerce
Safety and Building Division
PRIVATE SEWAGE SYSTEM
INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT)
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)],
Permit Holder's Name:
City Village Township
Round Hill Farm Trust/Kirstin Thompslo
TOWN OF HAMMOND
CST BM Elev:
Insp. BM Elev:
BM Description:
Ioo-OD
A--r ar Po c
TANK INFORMATION
TYPE
MANUFACTURER
• S
CAPACITY
Septic
S�
Dosing
Aeration
H^!d:li 19
W
TANK SETBACK INFORMATION 1—.ks
TANK TO
P/L
kk\
WELL
BLDG.
Vent to Air Intake
ROAD
Septic
,
�
71%
Dosing
I
?
Aeration
Holding
PUMP/SIPHON INFORMATION %Mitc.Xo 1411thmi A
Manufacturer
V
lfe�mand
GPM
Model Number
TDH
L
System He d
TD Ft
RFrictilLos
5
Forcemain
Length
Dia.
Dist. to Well
-7
p
0
SOIL ABSORPTION SYSTEM
ELEVATION DATA
County: St. Croix
Sanitary Permit No:
651331
State Plan ID No:
Parcel Tax No:
018-1078-00-000
Section/Town/Range/Map No:
35.29.17.542B
STATION
BS
'A
HI
FS
ELEV.
The - 0
Benchmark
102.2
.a-D
Alt. BM
Bldg. Sew r
. ku&,V,
.�Iq.3
St/Ht Inlet
St/Ht Outlet
Dt Inlet
Dt Bottom
Header/Man.
Dist. Pipe
Bot. System
Q�
l'
Final Grade
Qcd-over
coo -roof"
(q
BED/TRENCH
DIMENSIONS
Width
Length
25
No. Off
9-
�, S
PIT DIMENSIONS
No. Of Pits
1
Inside Dia.
1
Liquid Depth
1
SETBACK
INFORMATION
SYSTEM TO
P/LA{I
BLDG;r
WELL LAKE/STREAM
LEACHING
CHAMBER OR
UNIT
Manufacturer:
T e f S st
y y
' I
I
�
�1 0
I
Model Number:
DISTRIBUTION SYSTEM
Header/Manifold
i
Distribution
Pipe(s)
x Hole Size
x Hole Spacing
1
Vent to Air Intake
Len th Dia
9 -
Len th32� Dia S acin
g p g
IV*
2
SOIL COVER
x Pressure Svstems Only xx Mound Or At -Grade Svstems Only ("Olt/
Depth Ove
Bed/Tre h Center ,
(,
Depth Over
Bed/Trench Edges
xx Depth of � i
Topsoil
xx Seeded/Sodded
xx Mulched
\,
.1
Yes ❑ No
❑Yes ❑ No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: itlN1'23 Q2 Inspection #2:
Location: 1920 60TH AVE
1.) Alt BM Description =• Jl u "6w ... w 4bm V\00-C4 �kvv+
2.) Bldg sewer length =vluo ;ftsillA�qk
er�t siout �air r�.-c �- amount of cover - n� �
7, too,"
Plan revision Required? ❑ Yes No It
Use other side for additional information. 45 q
SBD-6710 (R.3/97) Date V Insepctor's Signature Cert. No.
in(iustT-y ::>ervices uivision
4822 Madison Yards Way
kULP11Ly
c !�A)V-2v234
T 9 2023
Madison, W1
Sanitary PetT-nl( Nuniber (to bey filled in by Co.)
0C 2
53705
P.O. Bo % 7161
W] 53707-7V2
33l
41
IMadisoji.
Saii'itary Permit Application
State Transaction Number
W1111 M-IS 383.2](2), WIC, Adm, Code, subaiission of this fGn-n to the appropfiatc goveTwental unit
i$ rCQL1 Nd prior to c�bt,,iining ,i swiitary permit. Note: Applic,'itwn fornis for sc-iic-owned POWTS are SUbmitted to
Project Address (i F chi fferent th api ma i I in address)
the Del.iartineni of Sal'co, and Professional Scrvices. Jlersonal infomiation you provide may be used for secondary
Purposes L r I i �`i) r d, i i I k: c w I di the Pr 1 vac y 1, mv, s - 15.04(1 )(m), .5
A-ucez-
it 1 i
A 1) 1) cat"i u ri.,.] n fo r- nia. ti o n — Plea se P r i a I -A 11 I ti Fo r ma t i o n
11roperly Oivrl�r's N"mic
TL (h--
L-A
I J r Q. 11 y =C� Murk lig A(-Wfcs
11roperty Location
Govt. of
City. Sun Zip Code Phoile Number
chon -345
T N R E o Pru"N
_1�. � �Vz
1TVpe of Building �clleck��all t'll'."It apply)
e
Lot #
. SSubdivision
Lk I [)welling — Number of'Be(J r ot ni is
Name
F1 " ti IL- 'I ic/C.'o in rn crc i al — De s c r 1 be Use
Block
LIC i ty o f
Slate O%Aied — Describe Use
V i I I age of
CSM Ntimber
I _A__.-1__.-A411 - —
K own 0i, _-M--1- —,akj--
1111. Type {jITOWTS Permit: (Check cutter "New" or "Replacement" and other 1,1pplicable on 11ne A. Check one box on line 13. Con qflee e line. C 11
3plien ble.)
A.
W tell]
RCptgaCCj11k:,11C System
Mlcr MuLlificat loll to 17,xisfing systay) (explaill)
ound
Z4
-1 (explain)
EIVILlitional Pretreatment Uni
F�l.. o l d ing T{ill :
Individual Site Design Othcr Type (explaiii)
P
el ,,, c v� a I I � c fore
n (coventional)
)
O T ev ision
Ey.hange r PI uni 1:),er
TF8nSfCI IONew OwneT
List Previous Perniii Numher and Date Issued
IV 1) i s 1) e rs -Et I/` Yt-ea t ni e gi t Area rind T-ki I i k- I n fo r j ii a ors: x -4 S" ea
D Flow (g;id) DeS1611 ,Oil A[iplic-l.'11011 Dispersal Area Requir�A (sif) I perstfl Area 11roposed (so Sys1cm Elevatioll
N
fV
W U Le" If 1, 7
Capacity III
ToWl
# of
Manti fad ctitrcr
4 60
Tank Information
Gallons
Gallons
tJiii(s
64.e_ kx-
or- M
U
New'ranks
ExislHig Tanks
iq
7 V)
177, 711
SCIVi[C 0( 1101dillg TRuk
A
Dosing Chamber
V. Respon Si h i I ity State M ell t - 1, h v ii ridersigned, asS tri Sj)JjTjSjbjj1ty f0]'jnSt8jlRtj0ji (if lhli 1101VTS -shnivu on the atcriched plans.
PI L I 11, tl Q Cs N am e (P ]glut) lu) Htirlib I'll- , ILI H2 NIP/MPIRS Number litisiness Phone Number
AWL& VA/
Plumbei's A(Wens (Street, City. stag: Zip Code) . .........
mail
,('.o u nty/De 1) a rt ni en I I I se Oil. ly
Permit Fee Dale k�tied [s,�ujnv Awrit S11
AApproved vmhlre
er "Is )n If
itj
I I I U1 I:s yj t-WIlro va 3 kou� kao bam revw0\/d.
"YSTEM "VM-R: S Ca.0
I Sc P %f i c t a n ',11 ul e r IL fi I r a n d dis p r-, rs a ( ce, I I WL
must be serv-cc-d i aril;-itane('1 2s per e - c��1r� fie.
rnanap-me,r)i .I.,,r providc-114 hy r_-4umhar.
I
2. A II s e t I!, a c, k r ( 2', �ql L i i rements must be inaintained
ras pef apphr,,a�,k�-:. V,ode / cjrdin-;�ri,,,.. cio QS
Allack to cl-mWeliv 1)1.� For f;c rem nand submit 10 tlljz County only on paper I e..SL' it than Rf4/2 % 11 inches in size
S -
H 1) -�),; 9S (R. 03/2 1
System PLOT PLAN
PROJECT Ili rsti n Themosen ADDRESS 1920 50th Ave. Hammond Wl 54002
SW 1/ 4 SW 1/ 4 S 35 / T 29 NI R 17 w TOWN Hammond COUNTY ST. CRGIX
SYSTEM ELEVATION 99.7' 1.7' Sand Lift DATE 1 0f 3f 23 BEDROOM 4
CONVENTIONAL AT -GRADE CONVENTIONAL LIFT HOLDING TANK
MOUND
xxx SEPTIC TANK SIZE 1200 Gallons LIFT TANK SIZE DOSE TANK SIZE 801 Gallon
HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 500 # of ChambersNcne
BENCHMARK V.R.P. Top Nail in Utility Pole 1002 Lifetime
ASSUME ELEVATIONra'ter L�fetime
0 BOREHOLE(DwI:LL * H . R . P , same as benchmark
Area 15'
below Mound
is to remain
undisturbed
B - 2
11
971
� w �
Scale 1 "=40'
. --- I
01 401 80'
Wieser
Combo
0 Septic
Grading to be done to�
divert runoff away
from system
6% Slope � I
Pre 4
Bedroom
House
Well
0
r � f}ppmx . E'E'
h
N B. M. l t ,� s�rcn t ass ue.
60th Ave/
W isconsi n Departmen I o IF Sa fee y an d Pro fcssi ona I Servi ces
Division o r I ndwitry S c mri ces
4822 N,13dlwn Yards Way
PO By 7302
Madison, W1 53707
October 20, 2023
CUS]"11) No-: 226900
Sil--%L�N R BIK)
n
143 2 1210111 ST
COND Irl, IONAL APPROVAL
1"LAN APPRO�",kL E\.PIRES: l.o,--'_1(j.,-__1025
MUNICIPALITY:
TO �k- N OF f1 A N-1 NI() N L)
Sjr I'L:
KIRSI'IN THOMPSON
60TH AVE
BA1.11)WIN, WI 54002
S W 1 -`4 S NVI /4 S 3 5 1-27 9 Ni, R 17 W
FOR:
Design Was(eivater Ylcm, Valuv:, 600
Bedrooms: 4
Limiting Factor(s): 16"
INTaintenance Required: Efflucrit Filter
Nit 14p.A. J?4
L
41-
N
Phone: 60-266-2112
Wcb: Imp.
Email. d41 '4i i �k' ( I I LII gpv
Tony E%crs, G)N,ernor
Dan Hereth, Secretary
Identification Numbers
1111an Review No.: PWTS-102302395-C-
Ak i . pplication No.: DIS-102343589
Site I D No.. SIT-! 11347
Please refer to all identification numbers in each
correspondence with the Department.
Mound Compomit Manual - Version 2.1 (May 201-2-2027)
PrOSNUre DiatnNjriiorl ( omponent Manual - Version 2.1 (,May 201-' Il 7)
SITE. REQUIREMENrrs
full size copy of the approved plans, specifications, and lotcrxhall be on -site dUrillg Cofl-,trllclion and opelf 10
lip authorized represcmatives of the Department, which may InCILKL: local inspWors. A DC-p-,Artmet? t elcaronic stJm[l -Lmd
ilature Shal I be on th e r lane, which are used at the jol) site for constniction.
The follms-ii'143 Condjfjojj� Slijil t)V JJJCJ (juring Coils[ rticl ioll (w i[IN(Allatioll and Prior to occupancy or use:
JJCF "I
_'S `3_� 3 SI 3
0 Preser%c dispersal area Prior and during coast rUdiiiii to avoid distar bante, compaction and use of the site.
0 011 nc�� Consti-tiction; il IN l-i%%:oi11mCF1dCd iwl 41 -LILAII'ate the PUMP 'ill t1w dose tank until the tanks are pumped prl�)r to
hunicowner OCCUPancy.
a Wasl ewater general eti rro n, coo, I rac I ors c lc -Lair I ng of equ ipment and tools an&or le ft over construction products sha I I not be
'Ite UnSIte W, Ll rtreatilacritsystcrii(POWTS). Waste generatcd shall be
.�JLC�1�'o
d'NchLin�yed into (lie (Iniins dischargino to the jlrivi LIte
;11_0j)eTiV 01'011 NIlk: 01- 011)�Itc.
-
-kn% tall grasses, lea-ses and shrubs shall be cut sliorl ;md remov-,A] prior 1(..-i tfllmw-- the surface lor installation to prevent matting
Jm%
1111d'Ll" 1111: dl:�,PCFS,d 4-irca. All loose organic niam-ial k5 11C FLTILjk\ k:kI Irom 1 0\\ FS Di�,persal Area.
• ,
Dk-erl stirface Nvaler from Ill POW T` �rc�
• Prior to construction ofi,h%_ th'-,iNk i�;d ii c--i, check lire moisture canteen offlik-- io, -ki (.kpfli of inclics. Snicaring and
compaoing ol"wei soil -v, Ill result [it veduciii5_, the Er filirmi�Pll C.'Li.Ncity of the sell. lli,oper soil mol�lffl'C content k:�Lm bc LIctermined
by rolling. A -�Oil sainple between 1111C 11.�Ltll.Lk. 1'i'it r()1k 1111to Li 1/4- inch wire, the site is too wet to prepare. If it crunibles, site
- r # I ,
p rcpa ri i -. o n �k L r I [) l'(1 1.- 0 t le s, 'i I ,: , -, i o � � %v �: I to p i - k: 1) L. -C d(1 11
I I L L 1, .,� il I - % I 8 �Xll A)1114) �;,IiL% L,:�inflnr it, Sp T�th' 'S4.30-3 and SPS T,ihle 3, I I pn -
0 1 rv� I 11:11 L, 1) 11 N d i t I c vk t. r 11Q v� I il (I I () I'cct per I'S 3 1,30 0 1 )(0
• Well setbacks to meet chs. NR 811 & 812
• Tank Installation to fallow all manufacture's recommendations.
• Verify property iine(s) prior to installation.
• Pump Floats to be set and verified per approved plan. Any changes may result in pump resizing to meet TDH and GPM
Specifications.
• Areas that are occupied with rack tragments, tree roots, stumps and boulders reduce the amount of soil available for proper
treatment. if no other sitc is available, trees in the basal area of the mound trust be cut off at around 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 and Wis. Admin. Code SPS 383.54
• 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, scats.
All permits required by the state or the local municipality shall be obtained prior to commencement of
cons truction/instal lation/operati on.
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
Fee Received: $250.00
67� Balance Due: $0.00
Tim Vander Leest Refund Expected: $ o. o0
POWTS Plan Reviewer
Division of Industry Services
Phone: 608-516-6134
Email: tim.vanderleest@wisconsin.gov
Shaun bird
Bird Plumbing Inc.
1432 120th St.
New Rchmond VVI 54017
'713'-'-246-45,16
I I
Sato: 10.,-'3..-2 0 2 3
Owner- Kirstin Tliampson
Locatiom SW1/4 SVV1/4 S35 T 29 N,R 17W 6001 Ave, Haniniond
M,antjals Used: Mound Cwiponent Manual Version 2.1 (May 2022-27)
Pressure DistribUlicy tl Manual Version 2.1 (May 202?-;)7)
pagO
1. Cover Page
2. Mound Plot Plan
3. Mound Cross Section
4, Pipe Cross Section/Pipe Layout
5. Pump Chamber Cross Sects 011
6. Pump Curve
7. Filter Specifications and cross secflors
8-9. Main1an,.-.,ero f ontin enr,�y pinn
Attachments:
AMEE=
S i o n ait u re
License num
Page 1 of 9
System PLOT PLAN
PROJECT Ili rsti n Thomason ADDRESS 1920 50th Ave. Hammond wl 54002
SW 1/ 4 SW 1/ 4 S 35 / T 29 NI R 17 w TOWN Hammond COUNTY ST. CRGIX
SYSTEM ELEVATION 99.7' 1.7' Sand Lift DATE 1 0f 3f 23 BEDROOM 4
CONVENTIONAL AT -GRADE CONVENTIONAL LIFT HOLDING TANK
MOUND
xxx SEPTIC TANK SIZE 1200 Gallons LIFT TANK SIZE DOSE TANK SIZE 801 Gallon
HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 500 # of ChambersNcne
BENCHMARK V.R.P. Top Nail in Utility Pole 1002 Lifetime
ASSUME ELEVATIONra'ter L�fetime
0 BOREHOLE(DwI:LL * H . R . P , same as benchmark
Area 15'
below Mound
is to remain
undisturbed
B - 2
11
971
� w �
Scale 1 "=40'
. --- I
01 401 80'
Wieser
Combo
Septic
Pre 4
Bedroom
House
Grading to be done to
ell
divert runoff away VlJ 0
from system
6% Slope
B.M.*
5oth Ave
4
Motn'd system Cross Section and Plan View
6b.6 poop moo
qL
j
A
W
'j..M � 40M moo b&* -F= MOM pop
ft.. Wj 6MI MW MW
K B
L
T
Dimension Feet
A
7
G
H 4�7
4
31
K if y
W
Z
Slope 00
4 *n. sch. 40 Pvc
-1 Topsol I ASTNI C-33 Clean aggregate
Cap tcrl1/2 to 2 V2in. dia. observation pipe Mai� sand, fill 1,
Slope Directioii
I{-: NFAIAL INSTALLA'HON: The mound area is staked out alono the design contour. Existing
vegetatioii is TDOW led -'111�A raked ofl'the Nita. The riound bawl 'Lire'a (L x W) is plowed with a moldboard or
-t-ijj is wet at Oic plow depth to form a 1/4 inch soil wire
chisel plo" r. Plowing iiiay not proceed if the
wlien a sample. is rolled M%vceii the paln)s ofthe 11"Inds. ASIANI C-33 qtiality sand is placed MiniedlZuely
after plowing. and is placed witli a tj�,Icjl-c�j 11jachille I(ccping 12 or niore inches of sand under the tracks or
is placed overliead by a backhoe, SpCC.E,.jj C�ITC IIILIst be Wised when placil'19 SWIct of less than oric foot
i ound
thickness to minimize compaction ofthe plowed sUrfiWe. After the to I c4al) is placed, the entire m
is setided and njutched to promote vegetatjvL� growth, limit crosion and protect from freezing. The
observation pipes are slotted in the lower 6 inches yin d secured in place vvith rebar or a closet flange.
Kim I I
Page . of
Pressure Lateral Layout
Two Laterals — End Manifold
Force Main=
i L / L lam" /�`- 1 � ✓
Distribution Net -Rork S
Lateral Diameter
Manifold Diameter
Orifice Diameter
(Orifice S ng)
L Lateral Len th
M Manifold Len th
Force Main Diameter.
Forcd Main Length
03/05 lgio
)ecifications
,�. In.
.:1513 z ,. In.
In.
2cZ
Ft,
..� In.
'j F
-T-
Pressure System Construction
ded
,out
9
ng
Sweep
90
Bend
Laterals are constructed of Schedule 40. PVC
pipe. Orifices are drilled perpendicular to
the pipe with a sharp drill fait and face down.
Lateral turn -ups terminate with a threaded
cleanout plug and are enclosed in a 64 inch
diameter lawn sprinkler valve box accessible
from finished grade.
Page of .�
0 00
noof-x.Tank Cross
"rank,Mmiufactureor
�_ ..
Ygnk Model � i�
, �7 q_i
ctpaulty
B
fool filter Mw1uFacturely
Model'NumbU
Inlet
r
Mimmuin Pump Verformwwe, Rr'Lluired
I Ft"FDB
4V d
Ouflot o1\4nnhole, Min. 47' Abk,)ve Gra(loc With
�Lookiug Duvice. Inlet Mallhoole
< 6" Below Cira'de Seated )ATalertight
Fitj'slied Graile
�7 to,
lCe S i olls
Section -And- P Peiforniffl
Numbcr
Alumi Nlftnvlfkloct�'Ire"
A1a,rmMode_1Nu,m.be)'
switei, otrype
'or Ota IL D y c d CrD 11) Floe el
Network LO-5.8
Ttt'orce Main Loss
- r I
F0
6 'IMajilwie in. 4" Above Grade
With Lacking Device
7. , 1% .4 to &I * int I
1)iscomlect
Baffle
0 d i
A
-.d ■e lit
wid Reserve C.,apaeity T
1: d 15witch U L
q4i weep
1'rmik Volume
r
Ar 14.,
7, I
4 + i
Dimemqimi Inches Volume 0
00 CIO"
(rewrve) k 2, Z
0 ff Elevation, C
2
41. Warm) 2,
B
Tt
IL It roll o 0 111
p 1.
1p r
d) F . 'Icvatiull
j D
Y;l I ' FI,0
P ro Ud 7 F
Z
.1-T F r-r-V h r'l' T-;- FT-F-N-] F, r I -r I I -7� b-'T��77; 1 :"!1"+. 77T p
p T F ;
4 4 ll I'F L' 41' 4
L 4 11 p I % 3 IL - d I'M 11 1 '1! to, 4 4 1 1.1
i2�L I I !q. : 4 a
INSTALLATION
C I 'J"N L"Jseptichfoe tank is bed(lcd wid back filled iri accordawx with t1w r EAL IP
-n tif ctiaer may 11ot alw -
prOduct aipproval spocifications. Maxrinmin dep-11i of bury �js spvcffiod by tho i ai
llk� OXLOC1:1i&(J 'WitNOUt pTiur xIpproo-%rm. %'Iazilmie �;ovooers ouxposiud to grade have mi offective iaukij)�4 dcvLcu (vmcilm'16
4, p watertiot fittings, �'Ifid
1118(alled. piping at the III -lot mid -outlet is of approvc6 matorml, co to tho tank with . ,
Iftid on stRbl( so'll lo pi -event seffling or s�4ggiugo, Tliv, fol-cuo tritiin is solcoved with 4" Sch. 40 PVC to britige ILhe. tanl%
cx(;avation n Nd the .04u,Svc Is sealed waterlight. 'Flectrical service complies Nvith NEC 300 and Cmi'll 1 6.2$r
02/05 U' Page . _ of
280MSERIES
112 hp Submersible EffluentlSump PumPs
The Liberty 280-Series provides a cost effective "mid-
range" purnp for on -site +vaste viater systems, liquid
�%ast e trallisfor and c o m m c rc 1 all heavy- d uty G u ii-ip PUmP
ajipilcations that require higher Bead or more f
Designed around Liberty's uniqUe "Uni-Body 11 Casting!
t',-Jo 260-Serles will provide years of reliaUe peilot-mance,
Vortex style impellej- permlttin.o pa.ssaoe of su`ilds
416 stail,floss steel rotor shaft
Pe?rmanantly ILA)r1cated 11.11)PIO!" E1171d lower ball beai,lng
Ep oxy 13mivd et' Goat' fin i sh
A I I fasteners - c a rrosli on,- re si st it stain less stool
V/2" Discharge
Staiiiiess sto-el bottom screen - easily removable
Mai rnuir fluid tomperatL,11-13: 140' F. '
260-Series Cord Leiigtfis
280 Standard 0[,itional Optional oj)ftnal
281 Stajidard 00,1011W Optlo;I)a1l
283 Standard 01�tllo.,Ial 0i.*1.0rial. N/A
287 S t an,,i. a r d Op*llcnal NI/A NIA
10' cord length standard orl, all r-n odels. For optin nal lengths,
add "-2, -3 or -5" suffix to modol siu mber.
Example: for model 280 Mth 35' cord, ordor 280-3
,1 .1
1,4 lip 60 Hz 3450 RPM
0 i I f illed , therm -,1,11,y p rot ected
(PSQ PerMaTlet-It Split Capacitor
8.0 amps (11 5V)
4.0 amps (208/23OV)
Moclel 28 1
f Model 280
W
manuall de angle
fl,O-;�It Switch
no switch wit[i quick-
d1sconnect
Ab A� A
Em EENEN11__1 I
35
0
5
0
9
2
0
LA j IV I'd Lw �_ — — — -
U.s. Gauons Per Minuto
78
J 156, 192 228 270 1 4F
U t o r,,:-,- P o r M I n � i to
Dimensional Data:
Weight: 29 IlDs.
Holght; 1311
PA aj or 'id th P. 10" �m Qd e 1 287)
Minimum Sump Diameters:
Model 281, 263...1411
Model 287 VMF...1011
2
Factory switch Model 2811 a3 'Model 287
settIngs VMF
Turn on lovel 13 9.5
Turi-i off level 711 4.011
Tho Modol 21'3 foatu rozs, a fully adjustable w1de-angle float. Differential
adjUstme-m-ts call 13i3 r11ado oasily by tethering the float to the d19-
charge piPe or o1hQ r motintIng poInt. Vertloal f [or.1 ,,ii odol �87 Ir, not
adjustalk-,,0110.
Mcdel283
Wide angle
float switch
with series
(piggy -back)
Plug
rviodel 287
M-Series
VF
Vcj-+jcal rnag-
1ieflc float for
:911.1aller pits -
�
vjf
will operate. i i i
alo diamotur
sumj�
SSP
CL�1.1`11- D
C us Certified
Spiacilloal Ian n ra tublooll 10 c 11,0 rig B w 111 Ou l A01 I Co,
Liberty Pumps .9 7000 App to Tree A vo,ii ue * Bo rqaii, No v., Yoi'k 44 1 Copyr I u ht C� Ob erly P411.NP 14, In a. 2017
tvvv w. I ib ed yp (i j i) i) S , c ( - I All rfglita ro:5Qrvoo. LIT 200OR05/17
C3
P14
l4q
co
i.
m
Fli .
0
. ,
Jo
LU
LqV)
Page �- Of
START UP AN[) C)PERATION 3 (, cts or other help thf.-it
,hq�A for ttla presenCe Of Painting produ hake the contents of thl)
`iOr tO L'se of the POD cell(s), if 1,,iqh concentr0ons are 61atected
For nevi constructlon, Pr aTldlor darrage t�ia dL
may impede the ireatmant process
WO(S) feffloved by a septS96 servlcl'-19 oparatOr P60r tO
ysterT) start Ljp shr, j)0jj Cond1110TIS rim. frozw-) at t�10 hlfihr8t'�Va ALIrfaCe- %water W111 Lip
11 not occur wh 841 norrnsi InIghwater to gel.
WtIer, 1power is rostor-ed the exCess ,,IqstL
Duhng poWer OLItages Punip tanks mIry 11,11 above, and may reault in the k)ackup or surface discharge of effilJODIt,
d1scharged to the dispeirsal celll(S) in ore large dose, ()v.aT1cad1ng the cell(s) n a 0
of the pump tanK reMorVed by a take ServIcing der tar pr1or to '.Iestcrl 9 pow r tot
is
To avold tills s1luatic)n 1-kave the r'orltenta operatIng t)je pkirnp ccntrols to restore norrn;81 IP.vcll
effluent Pump Of Contact a plurnher or poV�78 [VIalrite lner' M sssi5t It) (flallually
within the pul-np tank, efsal cell, Do not drive or par' K over, or otharwjd se l-StLJFb Of com, psell the area �rv)tllln
Do not drive or park vand dispabsorption area.
ire Over to
-gsol[
15 feet dm%ln slope Of arY MOUTIC! Or atrade y Improve the Qerjofrnance and prolong the fifr,' Of the POW15.
Reduct[or) or e�lmlniaflcn of the fojjav��qg frow, the Wastev�ajer streaffl M3 oundat'�,on dralln
I viats; dogreasers; dental floss: diapers', di:9lnf6Ct-5ntS�, fBI,' f
Iga.rettiB buttA+ ccndomsi cOtt0l) 8 ns, oi�; palinflng produci's'.
antiblotio-o', baby w1pas', c �h qlea,� scraps, nedicat1c)
, grease', hP,.rblc1des,
(suqnp pump) water-, fruit and vagOtO`0110 109elill9s'.
tnj-n�,)Ors; jalic] water softener L�rine-
1y
ABANDONMENT nenq taken oLit of serviic�e the f01lDV,.!ng steps snall i)e taken to jr1sure to the system is �]ropc"l
NA�rien tlie PCWTS Ells anWor Is porria
and safely abandoned In COmplianc;e vrlth chaptsIr Comt-n 83.33, V�qsconsln Adoilnistretve Code'.
pjqIT)g to tanks and pits sha!1 be dlisiaarwec,ted and the abandoned pipe openings sealed,
'y disposed of by 0 SePtaqe qef,vl(;,.rjg operator -
shall be. reiroved and pfoper
• The contents of all iankz; and p1ts - [je void f
a, 5 removed Evid I space filled with
�cii qrrd fenjoved or thelr cover
• After pumping, all, Link and P';t
gravel or another inert solid MMOdal,
CONTINGENCY PLAN iEl-asures have bee'), or must ho taken, to provide a code C01-InPlif',1111
If (he POWTS falls and uannot be i-epaired the follOW1119 p
replaceme"t sYstPlll: 118y be utilized for tl�ie location of a repliacement soll, absorption syste0l.
r] A suitable replace,-nellt area has beerl eVal,Uated and f I
The replaceniont area stiould be protected fTc3m disturbance and compaction and st)oi,ild not be infringed upon by rcqUil'ed
ent area vjjij result In the rdled
rid proposed structure� lot 'Jno$ and wel[s. Failure to protect the replacem . k
setbaLcks from exiStI119 E ri to a �Ilabllsh a suitablle replacernent area. Replacement systems. must ccmply with the rulefl in
fDr a new B011 and site evaluatlO
affect at that time, not aval�jable clue to .9.atback anther soli lirnitati-ons. Barring advs(IC-es Inpo��ffS technoloq,( le
11 A suitable reDlacefflent area Is
holdIng lark inay be Installed as a last resort to replactie the failed PO�ArTS, P()�VTS a soil arid 511te eva),drefl.,or
placement area, U0011 tlilufe 01 Ille
The site has not been eValUBted .to [deqtIfy ri su'llahie re
%ing tarnk mcly be installed' a.,
Ctst be pel-fXfTled to `iccate a Suitable replacurneill area- if no replace rnant area is avlzi'lble a 1)old
M resort (c replaCe the failed PUArrs. 11vi
a last i it att the fflfftra
Mound sno at-gTado soil absorpton systel-na may be reconstructed in place fallowIng ramovqj o-P tll�e bicriLitc
must coi -nply �vqjj jhc- rj.jIeLs 1n effect at that Unin.
yotems
Recons,fuotlnns of such5
<<WARNING>> Tel MAY CONTAIN LETHAL GASSES AN Di INSUFFICIENT OXYGFN, 00 NO'
SEPTICI PUMP AND OTHER TREATMENT Tj -SULT. RESCUE
ENTER A SEPTIC., PtJrAp on OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RF
PERSON FROM THE INTERIOR OF A TANK MAY 13E 01pFICULT OR IMPOSSIBLE.
FR
Alli)DITIONAL COMMENTS
POS INSTALLER
Name
a C_
P Phon hone.
P0VVT8 MAINTAINER
Name
Phone
Ift
WCAL REGULATORY A1JTH0.'1TY__,_
->ERATOR PUMPER)
Sr-PTAG5 SERViCING 01
R P 'ERA O� Name
Nan
Phone '21.9
r P horie
) I elm tr tiv Crd
I I a [i ce Wjtj,, chapter S P S 38 3.2 2 (2) (b)(1) (d) f) a, el), VJ:-srcn--,�A inis a e
This docuMent was djaAed Ir, r.omip
POWTS OWNER'S MANUAL & MANAGEMENT PLAN p2ge — of
�µl t_E INFORMATION
Owner
iZziL=2
Permit#
�1kM7±1V.--7ALTj lAdA.MV
Number of Bedrooms
0 NA.
Number of Publi-c. Fa6lity Uni[,5
Estimated flovv (average)
Design ffuv (peak), �Estirnatied x 1-5) galiday
Soil Application Rate
'Standard Influent/Effluent Quality
Monthly average*
Fats, Oil & Grease (FOG)
rng/L
Biochemical Oxygen Demand (B01)5)
5,220 Mg/L L1 NA
Total Suspended Solids (7SS)
s 15 0 rng/L
'Pretreated Effluent Quality
Monthly average
Biochemical Oxygen Derrand (00Ds)
�30 mg/L
Total Suspended Solids (TSS)
30 mg(L �<NA
Fecal Coliform (geornetric mean)
104 cfu/1 00 m I
lmaxirnum Effluent Particle Slze in die. D NA
L
I
mVaiues typical for dornestIc" waste%-,�alei and sept;c tank, effluent.
MAINTENANCE SCHEDULE
ISeptic Tank C;apaciity
/:),(7V al
—
E NA
Septic Tank Manufacturer
0 N
Effluent Filter Manufacturer
r -1 NA
Effluent Filter Model
0 NA
Pump Tank Capacily��
� Aa
NA
Pump Tank Manufacturer
12 NA
P u m p IM a n,J fac I u ro r
EJ NA
Purnp Model
(�7��''
0 NA
Pretreatment Unit
NA
0 Sand/Gravel Filter
0 Peat Filter
CA Nlechanlcall Aeration
El Welland
0 Other,
Dispersal Cell(s)
El N A
C3 in -Ground (gravity)
0 In-Grourd (Presaur;zedl,
11 At -Grade
�lcund
0 Drip -Line
0 Other:
Other:
C1 NA
Other:
0 NA
they
ZJ NA
Service Event
Servlco Froquency
linspect conditlon of tank(s) every-
mont) -n 3 years)
rf s) (Maxliniut
El N A
IPLAMP oLit contents of tank(s)
When combinad sludge and scum equa
ts one-third uf tank volume
0 NA
lInspect dispersal cell(s)
At least on
once every-,
rn o n th (s) (Ma xiii-num 3 yoa_,. rs)
�.e a r� s)
LJ NA
lw.lean eff,Uent Wer
At least once every:
a a r (s)
:3 N A
aspect purrip, pump controls & allarm
At least once every:
mont
D h"s)
El NA
1--lush laterais and pressure test
At least once every:
At east once every:
�
month(s)
f
III ear�s)
D month(s)
0 yoar(s)
13 NA
6 A
Qther'.
15-t 0-9
MAINTENANCE INSTRUCTIONS 4
ilnspedloris of tarks and dispersal cell s shall be made by an individUall carrying one of the following licenses or certl.fica',icns: Ivlastar
PILJF11�0r' Master Plumber Restricted Sewer; POINTS Inspector POANTS klaintainer; Septa qe Servicing Operator. Tank inspec.,t,or5 must
linc[ude a visual inspection of the ta,ikls) to 'Kfentil,y any missing or' broker, hardware, !donl,ify any cracks or leaks, measire the volume, of
c,ornbined sludge and -SCUM and lo &eck for any back up or pondIng Of Off%jerjt on the ground surface, T'he di5per-sal cello's) shall be
lvis�.jally inspected to check the efrhuent levels in the observatlor, pipes and to chec'� for nny ponding of effluent on the groUnd surface.
The pond�nql c)f efflLerat on the gfk)LJ.rid surface n',ey Incicate a failing condition and requires the immediate notification cif the local
[,egulatory authority.
lhhefi the co[Tibined acc1JML1V,JW of sludge and scorn in any lank equals one-th:rd () or more of the tar* volume, the entlre contents of
the tank shall ba removed by a Septage Servicing Oplarator and disoo8etkd of In accordance with chi pler N-R 113. V,-11sQons1rj
Administrative Code,
All other services, including but not lirailed ic !h,e servicing of effluent filters, mechanical or pressurized components, pretreatment units,
[arid any serilcing at iintervals of l 2 months, shall be performed by a certified PODS Malintainer.
A service repoFt shall be provided to the loca! regu!ato7y au�hority within 10 days of completion of any service event.
Sr. CROJ y SANITARY SYSTEM File 4:
Office Use Only
OWNERSHIP/ADDRESS FORM Created 212021
Community Developn-ient Department will utilize fliis inforrnaticn to provide the property owner with
information regarding operation and rnaintenance of your new or replacement sanitary systern! This
information will be provided as part of our ongoing efforts to protect public health, your well, groundwater,
surface water, piropert y values, and county resources. Once approved, this completed forrn and educational
inforii'iat-lon will be sent to you by email. If you would like to view your issued sa�litary per1rit Dnline, you can
Flo so by using the Propert -Fi.les Icanreed vveblink.
Owner/Buyer
pri
Mailing Address _0
city/statc/zip —1
Phone Nunibor (required)
Email Address (required)
V`11'11 E R/ UUT E R I il F 0 R I
�Pm
-1
Parci-fl Idea ti'fication Number
(fOLLincl on the prc)pe
r1y tax bill)
NEW SYSTEM: LEGAL DESCRIPTION
Propery Locat 7 1011 1/4 Sec, ),/-,T N R W 7 w n of
Subdivision Plat: Lot
Certified Survey Map # volume Page #
Deed # 92_QI S 9 —(before 2006%ValLjrne Page 4
Number of bedrooms Spec house ® yes I o Lot lines identifilable "* yes 0 no
New Property Address
(Staff Initials)
OFFICE USE ONLY
C'
A.VCR
'I
(Verl fica [ion of new address required from Comma niter Developme fit kep 11111 er'it f r�r I)e'.V C 011 StJ UC'Li","" 1.11)
0
(Date)
Tl�is form oicisr be st&7.3itted w(th all Private O.site Water Treatment .system (POWTupp S) lic(iboll s.
N CW Sy Stei'll - �i) c hde whi? this (of f � � a recorded warn at7 ty deed froin the Regis tcr of Deed5 Office ail d a copy of th e certified
survey map if reference is roade ii� thp wnrranty deed -
Ccimm.unity Development Department — Lat-id Use Division
715 - 3 8 6-4 1580 St- Croix Coun-1,6y Government ,'-'enter 715-2-45-4250 Fax
1101 Carmichael Road, 1`ludson, Wl 54016 VVV1W_5CCWi'a0
Siate Bar oi'Wisconsin Form 5-2003
SPECIAL ADMINISTRATOR'S DEED
Document Number Documcni. Name
Tf11S DELL), mlidc hotween Fa it E. Sp ec 1) t as Spada I A dui in ist ra r
JUK"9 M-&Arh Y S.Nxo f the estate of Sandra Ru n d h a ug
whether one or more), and Hound Ilill f-arin 'Furst
("Grantec." whether one oi, inon�).
Grantor conveys to Granice, without viarranty, the following described real estate,
togeilier with the rents, profit, fi,\t°irvs and other apPLINenant interi..-its. in
I'L Croix COLD!,%, Staie of Wisconsin ("PropL:riy") (if more spacLis
necdcLl, pk,irc attach
See Exhibit A attached.
3 1 5
Ty :40124 1
929578
BETH PABST
REGISTEFZ OF DEEDS
ST. CROIX CO, WI
12/29/2010 1:36 PM
EXEMPT#: 17
REC FEE: 30-00
TRANS FEE: 35.10
PAGES: 2
RL�i�ordiiiv Alva
N'-Linx and Relum Addtuss
_Fhomas A. McCormack
PO Box .2120
Bald"in XVI 54001
Thk deed is given in futl satisraction or that certain Land Contract dated N-Lirch
'2V9. 1974. recorded April 2. 1974, in VoL 509 of Records, Page 226, as Document 018-1075-70-000, 018-j()77-70--0(M.
No. 321 t03. Vendor's interest (if Gvm-�Zc A. Rtin(jhaug was acquir-cd bandra 1) 1 8-1078-(K)-000
Rundhaug, as his sufV[Ning spouse h� 1'eraiination of Decedents 11roper(y Interest Parcel ldenflf1L:;vwn Number (PJN)
dated July 20, 1988, recorded JuK 20, 1088, in Vol, N [ 7 of Records, Piape 180, as 'Flits is not h,omestead propenv
Document No. 439624. Purchaser's ]Ater est in said Land ('ontract ".as av-iigned
to Round I {ill Fa rni 1'ru ; t by Ass ig n m en I () f Land Contra cl dated Dec C11 I be r 11'.
1989, record vd D-cce Fit ber 27, 1989, in Vo L 859 of Ile co rd s, Va ge 533, as Docu nlent N (�. 454-1 l
Special Adinirdst_n.it_or
b, this Deed does c,,� ii to CY r{iriwe all o I` th LL7 estate and interest in the Propcqrty �� h I ch D....'Cedent had
111IFT7#1edialeFivi to 1)ect*ate nt's death, ailcl Lal [ of' t L,state atic. 1 Merest in (he Properi%Yhich 'the
ha,..; si-icc acquired,
Special )v-1-nini-str.tor
"J
Gaii E. Spec 6, Special Adniinistrawr
AUTI]ENTICATION
Ak KNONVI-VIDGMEN1'
(SEA[.)
Signature(s) STA 'IL'E OF WISCON �, I N
SS,
jC I(LI
authent 1-d 011 S1'. CROIX
Pcr7c)r,k,a1'1\ canic hcforc rr,,,
[tic -Abo�,c-rijmcd ()-ail
I I'YLE 10 EMBER S]"A _TE B A R OF WISCONSI �J
'If not.
I C kno �1, I t%,t� t ed the forei.Toi7o'
is. S tat. N� 706.06 11 JS T t L
authorized by W" �1 1'1( wle ed the --,.�ML'
"T'Fi I S I NISIR U %1 l''INT D R A F'1-1 1) 1) Y
1k e
fA jh rv,�,� 4
A. N1J'm-rnack
Ptihlic. State Ot' WISCONSIN
flald,whi W1 540021 1
AY Corninission (1SPeM1iiT1C11U
11 �t t it r vs� MOB Incaitifficn flesi led or t�i� ri� �v� I e(jr-eil. lioth are nest cwcv-,isarv.)
No -MKPVOR�1, ANY 1()1111�1V0RN1I Sili tTDH1A.LFAR1_1 IDENI]VIFI),
NO3STA UE MAR OF %k JS('(jNSjF-0K\1 No 5-2003
naine Kdtlw slgnulurcNVO -PRO "I f 8001655-2021 - ml.-4,f oforrs -4
wo
f6
The Southeast Quarter of the Southeast Quarter ( SEA of SE'n'), of
Section Thirty-four (34) , Township Twenty-nine (29) North, Range
Seventeen (17) West, except the North 91--� rods thereof, in St. Croix
County, Wisconsin, and
The West Half of the Southwest Quarter (W'--� of SW'4) of section Thirty-
five (35), Township Twenty --nine (29) North, Range Seventeen (17) West,
EXCEPT the West 300 feet of the South 200 feet of the Northwest
Quarter of the Southwest Quarter (NW'.-4 of SW'--4,) , and also EXCEPT the
West 300 feet of the North 90 feet of the Southwest Quarter of the
Southwest Quarter (SW14 of SW14)■ all in Section Thirty—five (35),
Township Twenty—nine (29) North, Range Seventeen (17) West.
2 of 2
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Wisconsin Department of Safety and Professional Servioes
Division of Industfy Services
SOIL EVALUATION REPORT
C —202, —V
0
1-1 1 2023In a=ordance with SPS 385, Wis. Adrn Cade County
ST Croix
Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must include,
but not limited to: vertical and horizontal reference point (BM). direction and percent slope. Parcel I ID
scale or dimensions, north arrow. and location and distance to nearest road 018-1078-00-000
rmPlease print all information.Y Revie d by Dal
Personal intoabon you provide may be used for secondary p ur oses Privac Law s- 1 5.0� ' m . � )726120Z
Property Owner Properly Location
Scutt & Kirstin Thorrlpson (Buyers) Round Hill Farm Trust (Seller) Gcvt. Lot. SW 'l1, SW /4 5 35 T 29 N R 17 VV
Property Address Lot # Black # Subd- Name OF C:SM#
1920 60TH AVE 3� f GtC.12'S
City State Zip Code bane Number ❑ City ❑ Village ® Town Nearest Road
Baldwin IWI 154002 (715) 307-1377 1 Hammond � 60TH AVE
0 New Construction Use: ■�] Residential/ Number of bedrooms 3-4 Cade derived design flow rate 600 GP❑
Replacement ❑ Public or commercial - Describe:
Parent material Loamy drift ano or mess over loamy till (Santlago sil) Floodplain elevation if applicable NA fi
General comments and recommendations: Recommend rstOf3lMUM 20sand-lift POWTS mound on 100 00 coraour with 0.6gpd`Q loading'Lxe X
LF = 16' {Redoxirnorphrc Will irHs) 1
17 ❑ Boring Baring # ❑■ Pit Ground surface eiev f17,4f] ft. ®ef�l� t4 li€- ,jinn ractor 1� in.
Soil Application Rate
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu Az- Cont. Color
Texture
Structure
Gr. Sz, Sh
Consistence
Boundary
Roots
GPDIFt2
*Eff#1
`Eff#2
1
0-10
1 10YR 3/2
-
sil
2mgr
mtr
cs
3m-vf
0.6
0.B
2
10-18
10YR 414
-
sil
2mahk
ds
gs
2m-vf
0.6
0.8
3
IA-,2 7
10YR 414
P2f 1oYR 518 & 1OYR 611
sil
2niabk
ds
gs
1m-vf
0,6
0.8
4
27-42
7-5YR 414
c2d T5YR 5re a 10YR 512
51
1 csbk
dh
-
1 m-vf
0.4
0.7
F2 ]
Boring
# ❑■ Pit Ground surface elev 96.2Q � Depth to limiting facto 16 in,
Annlinntinrt R�fn
Horizon
Depth
In.
Dominant Color
Munsell
Redox Uescr€ption
Cu. Az, Cont. Color
Texture
Structure
Gr. Sz Sh
Consistence
Bourutaiy
Runts
GPD/Ft2
*l ff#1
'Eff#2
1
0-9
10YR 3,2
-
sil
3mgr
mfr
cs
3m-vf
0.6
0-8
2
9-16
10YR 4/3
-
sil
2mahk
mfr
gs
2m-vf
0.6
0-8
3
16-23
1 OYR 414
fed 7..5YR 5 8 & 10YR 511
I
2f-mabk
mfr
gs
1 m-vf
0-8
0,8
4
23-42
7.5YR 414
c2d 7.5YR 518 & 10YR 512
SI
l csbk
mfi
-
1 m-vf
0.4
0.7
C111urr IL +t . - 0r�J1J. - ov -ztcv 11r t- t7r iU -, - -- --
CST Name (Please Print) Signature CST Number
Ryan Bechpl (Advancec Environmental LLC.) 1330832
Address Date Evaluation Conducted Telephone Number
W 11932 560TH AVE, Prescott, VVI 54021 09126J23 (651 ) 327-0074
SBD-13330 (R04115)
Boring # ❑ Boring ..
0 Pit Ground surface elev. 98.55 ft. Depth to limiting factor 18 in.
Horizon
1
Depth
In.
0-9
Dominant Color
Munsell
1OYR 3/2
Redox Description
Qu. Az. Cont. Color
-
Texture
sil
Structure
Gr. Sz. Sh.
3mgr
Consistence
mfr
Boundary
cs
Roots
2m-vf
Soil Application Rate
GPD/Ft2
*Eff#1
0.6
*Eff#2
0.8
2
9-18
10YR 4/4
-
sil
2mabk
mfr
mfr-mfi
dh
gs
gw
1m-vf
1 m-vf
0.6
0.4
0.8
0.6
3
18-27
7.5YR 4/4
7.5YR 4/4
f2f 10YR 4/6 & 10YR 6/1
c2d 7.5YR 5/8 1 YR 5/2
I-sl
sl
1 msbk
1 msbk-Om
4
27-44
-
1 f-vf
0 2
0 6
Boring # ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Soil Application Rate
Consistence
Boundary
Roots
GPD/Ft2
*Eff#1
*Eft#2
Boring # ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
Soil Aeplication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2
In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh.
*Eff#1 *Eff42
* Effluent #1 = BOD, > 30 s 220 mg/L and TSS > 30 s 150 mg/L * Effluent #2 = BOD, > 30 s 220 mg/L and TSS > 30 s 150 mg/L
VVisconsin Department of Safety and Professional S
Divisl o n of I n duntry S e i-vice s
SCIL EVALUATION REPORT
Ire aocorda n 17* with SP S 385. W S - Ad m. Code
Attach complete site plan on pa per no t I ess th an 8 112 x 11 I n�� he s i n size. PI a n m us I; i ncl ude,
but not lirnited to: vertical and horl.-ontal reference po-r-li. (81M), direction and percent slope,
scale or dirnens,ions, north arrow, and locatior', and dl!sr�ric� to nearest road.
Please print all information.
Personal informalion you prqvide ma , �e aset for secx)n6ary punp—p- nVa. y 11 w,
Property Owner Prop-orty Location:
Scold & Kirstin Thompson (Buyers) Bound Hill Farm Trust (Seller) Govt. Lot:
Property Address Lot N Block 11
1920 60TH AVE
aunty
ST Croix
Parcel I.D.
018-1078-00-000
Re,viewud by Date
S W 1/4 S W 1/4 S35 T 29 N R 17 W
Sul)d. Name or CSM#
jCity State zip Code Pnone Number city ViViaep-1, 9 Town Nearest W.)ad
Baldwin 540C12 (715) 307? - 1377 Hanimond 60TH A%*'E
781 New - Construction Use: R-esidentiall Nuirinberofbedrooms Code derived design flow rate 600 GPL)
0 Replacement P'Li �! Ic or cornmem! al - 0 es cr i b o.
Parent matedb[ Loa drift and/or over loamy till (Santiago sill) Floodplain elevation if applicable - NA ft-
General comments and rLeC0MM0j'jdL3t
Ions: Refxillmorld rT�nimum 2W'sand-1111 POWTS mound on i oo-oo contour wiih a.6gpdfli:2 Ireng rate.
L F '= '16" (Redoxjmofphic le ature:5)
Boring Boring
Pit Ground surface 0[ev. 97,40 ft. Depth to Urnifingiac-tor In,
H onzo n
Depth
In-
0.10
Dominant Color
munsell
10YR 3/2
Redox Dos rrlptiro t)
Qu. Az. Cont, Color
Texture
iI
it
2
4
10-18
18-27
27-42
1 OYR 414
10YR 414
7.5YR 414
121' 10YR & iO,YR 611
c2 d 7.5Y R 5r3 & 1 DY n 5/2sl
Structure c
Gr, Sz. Sh.
2mgr
2mabk
2mabk
1 c:sbk
Soil Application Raly,
isistence
Boundary
Roots
GPD/Fl?
"Eff # 1
'Eff#2
mfr
CIS
3m-vf
0,6
0.8
gs
2m.vf
0-6
0,6
ds
gs
0,113
1 M-V(
0,4
07
dh
Boring ft
Boring
Ground surface elev,
Dcp1i to 11miting facw,r 16 in,
Soil. A ulication Rafe
Hod�'On
Depth
In.
Dominant Color
munsell
Redox Description
Qu- Az- Cont. Color
TexLure
Structure
Gir., Sz. Sh,
Consistence
BOUridary Roots
GPDIFt
"Eff#1 F-- ffo 2
1
0.9
1 OYR 3!2
Sill
3mgT
mfr
3M-Vt
o.6 0,13
2
9-16
1 CYR 413
-
2mabk
MIF
gs 2m-vf
o.6 0.8
3
16-23
10YR 4M
f2d'7-5YR 5'8, & 10YR 6/1
1
f-mabk
Mir
1 M-0
0.6 0.8
4
23-492
'7.5YR 414
c2d T5YR 17.-5 6 1 UYR 512
Sl
1 csbk
Mfl
1 M-0
0.4 0,
-n-
' Ef Muent 9 1 = BOD. > 30:5 220 rr)ql!-' a! 0 TS S > 30 S I �gjpq�L M.Yent #2 = BOD. !� 30 mg]L and TSS !; 3U i
CST Name (Please Print) Signilura CST Number IL
Ryan Bechet (Advanced Environmental LLC.) 1330832
Address Date EV,-1ILJa60n C09dUVI-r-1 Telephone Number
W1 1932 560TH AVE, Prc-5c,-tt, 11.1154021 109,12&23 (651)327-0074
SBD-8330 (R04/15)
3 Boring #
C:1 Boring
® Pit
Ground surface elev. 98.55
ft.
Depth to limiting factor 18 in.
Sail Appllcation Rate
Horizon
Depth
Dominant Color
Redox Description
Texture
Structure Consistence
Boundary Roots
GPD/Ft'
In.
Munsell
Chu. Az. Cont. Color
Or. Sz. Sh.
*Eff#1 *Eff#2
1
0-9
10YR 312
-
SO
3mgr
mfr
Cs 2m.�
0.5 0.$
2
9-1 S
10YR 4/4
-
sii
2mabk
m#r
gs 1 MM
M 0.8
3
15-27
7.5YR 4/4
f2f IoYR 416 & 1 OYR 6/1
i-sl
1 msbk
mfr-mfi
gw 1 m-vf
M o.5
d 1
27-44
7.5YR 4/4
c2d 7.5YA " & 10YA 612
sl
I msbk-Om
dh
- 1 f-vf
0.2 o.5
Boring # ❑ Boring
❑ Pit Ground surface elev. �ft. Depth to limiting factor __.�_.. in.
5 Boring # ❑ Boring
0 Pit Ground surface elev. A. Depth to limiting factor In.
Soil lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfF?
In. Munseli Qu. Az. Cont. Color Gr. Sz• Sh• *Eff#1 *Eff#2
Effluent #1 = BC D, > 30 s 220 mg/L end TSS > 30 5 150 mg1L * Effluent #2 BC D, > 30 5 220 mgfL end TSS > 30 5150 mg/L
Designer. Ryan Bechel
Certified Soil Tester. 1330832
Designer of Engineering Systems: D 2263-7
SCALE
Qt t
1 1
O 2023 Advanced
Enviruninental LAC, A M N C E D i
All rights reserved.F4�p�ENVIRONMENTAL
*AU property !rues not
dram are >704ft from
syste►"*
�� Existing system
'C (outlet unknown)
V�>
Benchmark _ _ ._ S'STEM NOTES
c Tank:
Soil Bering N '
E
..._....... I 'F�9 5�e�r io �B ab�r�do►� per' SAS 383.33
i
i
t
Barn
Pump_ Tun :
� 4
BM2 = 100.00 +- +- - -- � `� �`� Ste 3
So8 Trrstment Area:
Tap nail in 30" Maple +- +- +- + --,_ ��2VS PaWs�o
(8" above graded —� ,—�__, 100.00CM o Wi1b 0.6Wm� � r,
_ .— { •.Dept�t resor� -'l6' �Re�ooari�arptac ��
-Con ax= 98,W
-�-- -sbpe =694
err + + • d s F
'� •• r It
eyo +-
�+- New 3 4 B R _
��► pta• % �� Distribution:
+ +- +- ! Home f • 4YS W VA req n Pima dobhm
s� f+ + + +
+, +, + +, i +.. +.+ + + + A 0 It+ + +
` I
LOCATION MAP (not to scow)
1 Cu+Tent gale Welt'
IFJ
C� (1) 1 + 4102.56-
+ + +- + + 1(lo+ + +
C�) +� � -f,,xisbngFhome40otpnqtCD
BM1 — 100.00 + + + + + - i + �D rerrved + ; �
Tap nail in utility pole
'� 1 i '�'""��E
v + + +- + +- IU- + + + + +Z
(2above graded f 1 ; ; : AVE
-+ -+ + -+ + + 1 + -+ + +- ��T�
PREPARED FOR:
!�/a +b + j + + + +
��
i Scott #t Kirstin Thompson }
site Address:
1920 60TH AVE
J I Baldwin, WI 54002
PID: 018-1078-00-000 39.32 Acres
60-TH-AVE-
S35 T29N R17W
Town of Hammond
Cer red 9bet�r�r& This n twr bsa� deigned and aMduatsd to ac�orticaraas wily rand l000{ erode . 'iM ��t araa must r�arnoin froes� d� aridfar coenpoe�iart bsFON ar+d r�fker �,
No WAMWW 15 WADE Dw Im sfsTm WLL � To n*cn m rcaW Y: 9t"n . nvAt be._�+�uper!�'. - Review raw. sy4 v man�ra�nt pion tar �nda�rradon on e�'ePsr a" aW Vie. _ �___ �.._-__..........:........._.-...�..... _. ......�
- Scale: 1" 40` Date: 9/26/ 3
4ILL F) EAk FROIALSI
., ?>I R-L
TOWN OF }rat iM,NA,D,v��
sr-ju 3SO000 Nq
AND/
htme.
CHAPTER 145.135 (2) WISCONSIN STATUTES
(a) The purpose of the sanitary permit is to allow installation
of the private sewage system described in the permit.
(b) The approval of the sanitary permit is based on
regulations in force on the date of approval..
a renewed f c The sanitarypermit is valid and m be renew or a
P y
specified period.
(d) Changed regulations will not impair the validity of a
sanitary permit.
(e) Renewal of the sanitary permit will be based on
regulations in force at the time renewal is sought, and that
changed regulations may impede renewal.
(f) The sanitary permit is transferable.
History: 1977 c. 168; 1979 c. 34,221; 1981 c. 314
Note: 1f you wish to renew the permit, or transfer ownership of
# ca authority.
t e erm�t lease contact he uu h
permit, P ty
ID
ri
TAIS _rr-.,RMI'l'l' EXPIRES U NL lrj S S RENT" WE
. .. . .. ......... . . ...... ... ... ... . ...... . ... .. .............
I all
SBD-06499 (RI 1/20)
" . .. .. ..... M