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HomeMy WebLinkAbout010-1046-50-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 538863 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Milligan, Lee & Debra Emerald, Town of 010-1046-50-000 CST BM Elev: In . BM Elev: BM Descriptio Section/Town/Range/Map No: 9 2.73 a 73 14rj~otl3m ► CST 19.30.16.282B TANK INFORMATION ELEVATION DATA bj1l/48p~e' TYPE MANUFACTURER CAPACITY STATIANM S HI FS ELEV. 4 17,21 -12, -3 Septic it--tf, Benchmark Dosing G«l J - -7 s-z> Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet gm 2.3 (p2 T-410 TANK TO P/L WELL BLDG. Vent^ toy it Intake ROAD Dt Inlet kJ- art 7- Septic / Dt Bottom r W IF ! Hea r/Man Dosin -76 1A ( s' eration Dis,~ Pi-°e 2 3 9lJ Holding Bot. System t~ 70 r: R3 • B l Final Grade 'r > PUMP/SIPHON INFORMATION }3 It ttrxi ?A ~4- b", ✓ Manufacturer 11 Demand tCover N1S _ s5 7,SV 9;2 W`k GPM Model Number Z f r, ~j 9S 3 Z TDH Li Friction Lo System Head WJ~' TDH I IO~vFt w/ t35 p. (o.. 1 For rain Lent Dia. 2 rf Dist. to well 6 4e A s 61L ABSORPTION SYSTEM BEDITRENCH Width Len h No. Of Trenches PI IMENSI NS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS I W, SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM L CHING Manufacturer: INFORMATION Tq~Of System: r I C UNIT OR I Number: yY/Vll UinlY_~„'l x0o g >100" DISTRIBuT N SYSTEM / ,Ir% GCQSS c nw,124 HeadedManifol 2 ( rLpelpn tributior~rj 5w Ix Hole Size x Hole Spacing Ve\nEto Air Inta e f D k I gS) U ~rf -2,5 t-Z / ~8 1 Length Dia gth ti, S pacing SOIL COVER x Pressure Systems Only xx Moun r At-Grade Systems Only Depth Over Depth over of~ xx eedgd/Sodded lxoAulched Bed/Trench Center Bed/Trench Edges Topsoil p( [2 Yes No] Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: A /31 /-1 Inspection #2: __LL/ /j_L .2 Location: 2132 140th Ave Baldwin, WI 54002 (SW 11_/4 SE 1/4 19 T30N R16W) NA Lot 1 CL-144- Parcel No: 19.30 1.) Alt BM Description = 2.) Bldg sewer length= - amount of cover = Plan revision Required? Yes No r Use other side for additional information. I f 4Signa Date InsepctCert. No. SBD-6710 (R.3197) oti m commerce.wi v Safety and Buildings Division County W. Washington Ave., P.O. Box 7162 St. Croix ' O n Madis 13. ONINNV-Id San itary Permit Number (to be filled in by Co.) tlespas en t of Commerce ,,I.NnOo xiow + C G g Cc I p ' Z ° ` , State Transaction Number Sanitary Permit Applic tior~ Oi' In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this f to the appropriate govelnmental~ 4 unit is required prior to obtaining a sanitary permit. Note: Application rms for state-owned PO TS areks Project Address (if different than mailing address) submitted to the Department of Commerce. Personal information you p vide ' ndary Same purposes in accordance with the Privacy Law, s. 15.04(l) (m , Slats. ' 2132- 111/-1 ~ e- I. Application Infor ion - Please Print All Information TL/ Property Owner's Nam Parcel # 010-1046-50-000 Debra Milligan Property Owner's Mailing Address Property Location ~V ( Z (17 2132 140th Ave. Govt. Lot City, State Zip Code Phone Number SE'/.,SW'/<, Section 19 Baldwin, WI 54002 715-684-2993 (circle one) II. Type of Building (check all that apply) Lot # T 30 N; R 16 W ®1 or 2 Family Dwelling - Number of Bedroo s 3 Subdivision Name P4 1 CSM ock # ❑ Public/Commercial -Describe Use Na ❑ city of ❑ State Owned - Describe Use CSM Number ❑ Village of Vol. 3, Pg. 716 ® Town of Emerald III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ❑ New System ® Replacement ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) System B. ❑ Permit ❑ Permit Revision ❑ Change of ❑ Permit Transfer to List Previous Permit Number and Date Issued Renewal Before Plumber New Owner Expiration IV. Type of POWTS System/Component/Device: Check all that apply) ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil ® Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dispersal/Treat ent Area Information: Design Flow ( Design Soil Application Rate(gpdsf) Dispersal Area Required t) Dispersal Area Propose f) System Elevation 450 1.00 3!' 0.00 sq. ft. 450.00 sq. ft. 94.50 ' @ 20" above • 7✓~ 13~ 92.83' contour VI. Tank Info Capacity in Total # of Manufacturer w Gallons Gallons Units Z W U H a~ U U -l New Tanks Existing Tanks j o H W a a I-IJ Septic or Holding Tank 0 1000 1000 1 UnKnown ❑ ❑ ❑ ❑ Dosing Chamber 760 - 750 1 Wieser Concrete ® ETI= 1:1 ❑ VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) P 's Signatu MP/MPRS Number Business Phone Number 00, Dale Hudson ate,nl^-- 220853 (715) 684-3378 Plumber's Address (Street, City, State, Zip Code) 820 Main Street, Baldwin, WI 54002 V . Coun /De artment Use Only Approved Permit Fee Date sued Issuing nt Signatur C Owner Give anon ial $ /O / IX. Condi~~~efA4WAWIReasons for Disapproval i s "Septic tank =ltitlottl w and 3) ; ~~-r~rY~ (•v` ~v dispersal 9 mt15t ali be servtces / maintaineg_, as per rear ! eme>7t plan provided by plumber. 6"f lees ~1 2_. Al setback requ rants must.be maintained / l f II as per applicabls`Cod! I ordinances. 0 4010 r ~ c Attach to complete plans for the system and bmit to the County only on paper not 1 than 1/2 x 11 inches in . 1, 1 SBD-6398 (R- 01/07) Valid thru 01/09 / 3s0 So;l etla/u4l~iol16;-6 ~m ~/i/off /iI)e 6',r grc-i e e 1tcA -'-2-2 117 UE~~a 7.~i-✓f, a., ~i oar uw,L- cad = 9s.9y' L3~./d~~, S`'/ooz , Lod / SM t/v~ 3 /c • 716 P; rles /d, 6- :610 ;X Cam, c nc%/o-/of(/,-SG''CGU 3.92 acres ~L~ I ~ d%ManS~?Yl•S K/aea.z:on cc•'IK-r16w~j. / \ ~ ~ i %~l 6C•c~ r] ' ~ l K ti ;hp \ / z n3c~ !(0 it rri ; \ 3 r e/et{ric lr'Vtes P.ine-L-ee I 1 I C ~ ~ I /f'lrS,Tiy. 3o3S/ I f S/o t~ I 97.74' P~~/acrr~ /iae C~ 1\ - E J )Iz v , 0 I ~ 1 F. v _ - - - - _ FY.'sinq Cus~iran ou ~GeE MQt°iF Z i i J.G. ~i/~~ .6rca h ~N u o, v !>ana5,e j 31ae~frer~.» Q ~ r ~O~~r,-, o~'.S,a;-+t f~"r7/~%e'~eE;s ✓ I .~a i i dPi.~it.C I a Ql~. r3., : To~,o~ Cpncrc ` P~cNosec /y~ou„a' SYstP„, rl ~ y~.~i c S (a5 = 92, 73 : ~ a.f <.3.2G;t• G8 ~ S X 9G ; S~r{~ce e/¢v = 9y'sz at 20 cf ~e'-~rf 1 prf r-iC~ ~ce.d"a~2•S,j~ v Q zoo ~o 3SO' COPY r , 3`~ernnTtirF;vT Safety and Buildings 3824 N CREEKSIDE LA D HOLMEN WI 54636 3 S Contact Through Relay ry S www.commerce.wi.gov/sb/ 2G www.wisconsin.gov ~0 SS1 NN Scott Walker, Governor Dave Ross, Secretary October 07, 2011 CUST ID No. 220853 ATTN: POWTS Inspector DALE E HUDSON BOLDT'S PLUMBING & HEATING, INC. ZONING OFFICE 820 MAIN ST ST CROIX COUNTY SPIA PO BOX 78 1101 CARMICHAEL RD BALDWIN WI 54002 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/07/2013 SITE: Identification Numbers Debra Milligan Transaction ID No. 2004494 2132 140TH Ave Site ID No. 772523 Town of Emerald, 54002 Please refer to both identification numbers, St Croix County above, in all correspondence with the agency. SW1/4, SETA, S19, T30N, R16W FOR: Description: Three Bedroom Mound System / 3% slope Object Type: POWTS Component Manual Regulated Object ID No.: 1338530 Maintenance required; Replacement system; 450 GPD Flow rate; 16 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD-10691-P (N.01/01), Pressure Distribution Component Manual - Version 2.0, SBD-10706-P (N.01/01); Effluent Filter 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`' 21 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 '.a. requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06i stats. b i . The following conditions shall be met during construction or installation and prior to occupancy or user Reminders • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • The area within 15' downslope of the dispersal cell shall remain undisturbed. Vehicular traffic, excavation or soil compaction is prohibited in this area. • A copy of the approved plans specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department which may include local inspectors DALE E HUDSON Page 2 10/7/2011 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. • The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. 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 owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 ~ Balance Due $ 0.00 Gerard M Swim POWTS Plan Reviewer, Integrated Services (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WISMART code: 7633 jerry.swim@wisconsin.gov MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN ;-,,,CFF Jv~ Residential Application C INDEX AND TITLE PAGE 2 Z ZOJ> Project Name: Debra Milligan 3-bedroom residential mound Owner's Name: Debra Milligan Owner's Address: 2132 140th Ave. Baldwin, WI 54002 Site Address: Same Legal Description: SW1/4 SE/4, Sec.19, T.30N., R.16W. Township: Emerald County: St. Croix Subdivision Name: CSM Vol. 3, Pg. 716 Lot Number: 1 Block Number: Na Parcel I.D. Number: 010-1046-50-000 Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications • eV,O Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Site Plan Page 9 Attached Soil Evaluation Report Designer: Dale Hudson License Number: 220853 Date: 09/15/11 Phone Number: (715) 684-3378 Signature: ~y--~ Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and both 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) Version 5.1 (R. 06/06) Page 1 of 9 Mound and Pressure Distribution Component Design Design Worksheet Site Information (R or C) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 300.00 Estimated Wastewater Flow (gpd) Table 83-44-3 in-situ soil treatment for 1.50 Peaking Factor (e.g. 1.5 = 150%) fecal coliform of 36 inches. 450.00 Design Flow (gpd) 3.00 Site Slope 92.83 Contour Line Elevation (ft) 16.00 Depth to Limiting Factor (in) 0.601 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 90.001 Dispersal Cell Length Along Contour (ft) = 5.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest_point in the distribution Y Pressure Disribution Information network? Enter Y or N (C or E) C! Center or End Manifold 2.50 Lateral Spacing (ft) If N above, enter the elevation (ft) _ C Number of Laterals of the highest point. , 0.125! Orifice Diameter (in) 2.50; Estimated Orifice Spacing (ft) = 6.25 ft2/orifice 2.00_1 Forcemain Diameter (in) 40.00! Forcemain Length (ft) Does the forcemain drain back? Y 86.00, Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 6.52 Forcemain Drainback (gal) 8.08 Vertical Lift (ft) 56.42 5x Void Volume (gal) 0.76 Friction Loss (ft) 62.95 Minimum Dose Volume (gal) 0.50'1 In-line Filter Loss (ft) 29.66 System Demand (gpm) 15.84 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x _.x 1.00 x 1.50 x 1.25 x x 2.00 1.50 x 3.00 2.00 x 3.00 x Gallons/inch Calculator (optional) Treatment Tank Information 750.36; Total Tank Capacity (gal) 1000.00 Septic Tank Capacity (gal) 37.00' Total Working Liquid Depth (in) Existing Concrete Manufacturer 20.28 gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 750.36 Dose Tank Capacity (gal) S r-m Tech Filter Manufacturer 20.28 Dose Tank Volume (gal/in) STF 100-A Filter Model Number !Wieser Concrete Manufacturer Project: Debra Milligan 3-bedroom residential mound Page 2 of 9 Mound Plan and Cross Section Views 1 1/10B J Observation Pipe 5 A W a: B I . :•Q•::•: : 41 e L Mound Component Dimensions A 5.00 ft E 21.80 in H 1.00 ft K 10.54 ft B 90.00 ft F 9.25 in 1 10.18 ft L 111.08 ft D 20.00 in G 0.50 ft J 8.08 ft W 23.26 ft 450.00 (ft2) Dispersal Cell Area 1366.07 (ft2) Basal Area Available 5.00 (gpd/ft) Linear Loading Rate 9.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 96.27 (ft) G1 I F Dispersal Cell 95.00 (ft) Lateral 94.50 (ft) - ► - Invert Dispersal Cell Elevation D Q - = ' 92.83 (ft) Contour Elevation 3.0 % Site Slope Geotextile Fabric Cover Shading Key 2- Dispersal Cell See lateral details on 10 ®Topsoil Cap o 1.5 ft Page 4 for number, size, Subsoil Cap y o andspacing of laterals. Laterals are equally 0 ASTM C33 Sand , F Tilled Layer y 0.5 ft Typical spaced from the Lateral © 0 gg g distribution cell's A re ate o 4 I1 centerline in the T - A distribution cell (AxB). Project: Debra Milligan 3-bedroom residential mound Page 3 of 9 Center Connection Lateral Layout Diagram Forte main connection via tee or cross to manifold at any point. Laterals are identic al I If P S 0= Turn-up V W11 valve or <-X--+X12 x/23l Laterals & force main of PVC Sch 40 cleanout plug per COMM Table ;4.J0.5 Holes drilled on the bottom of the lateral Number of Laterals 4 Orifice Diameter 0.125 in Lateral Diameter 1.25 in Orifice Spacing (X) 2.53 ft Lateral Length (P) 44.28 ft Orifices per Lateral 18 Lateral Spacing (S) 2.50 ft Orifice Density 6.25 ft2/orifice Lateral Flow Rate 7.41 gpm Manifold Length 2.50 ft System Flow Rate 29.66 gpm Manifold Diameter 1.25 in Total Dynamic Head 15.84 ft Forcemain Velocity 3.03 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and ► Comm 16.28 WAC 4 in. min. Disconnect Tank component is properly vented E- Alternate outlet location Forcemain diameter Wieser Concrete Manufacturer 2 in. Ca acit 750.36 Gallons T Volume 20.28 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 20.90 423.77 B 2.00 40.56 C Pump off elevation (ft) C 3.10 62.95 _t 86.92 D 11.00 223.08 D Total 37.00 750.36 Dom se tank elevation (ft) 3" Bedding under tank. 86.00 Alarm Manuafacturer SJE Rhombus Alarm Model Number Tank Alert SJE1011421 Pump Manufacturer Goulds Pump Model Number EP04 Pump Must Deliver 29.66 gpm at 15.84 ft TDH Project: Debra Milligan 3-bedroom residential mound Page 4 of 9 Mound System Maintenance and Operation Specifications Service Provider's Name Dale Hudson Phone (715) 684-3378 POWTS Regulator's Name St. Croix County Zoning Dep'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 450 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once eve 3 ears Effluent Filter Should inspect and clean at least once eve 3 ears Pump and Controls Test once eve 3 ears Alarm Should test month) Pressure System Laterals should be flushed and pressure tested eve 1.5 ears Mound inspect for ponding and seepage once every 3 years Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, 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 Distribution Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Debra Milligan 3-bedroom residential mound Page 5 of 9 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, 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 8-inches 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, Stats. The contents of the septic tank 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 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of 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 Department of Commerce. Pump Tank The pump (dosing) 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 filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than 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 BODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODS, 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/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 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the 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 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Continciency 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) shall 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 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. Project. Page 6 of 9 XGOULDS PUMPS Submersible Effluent Pump EP04 Ago 3871 1 EP05 APPLICATIONS • Fully submerged in high ■ EP05 Impeller: Thermopias- ■ Bearings: Upper and lone! grade turbine oil for tic enclosed design for heavy duty ball bearing Specifically designed for the lubrication and efficient improved performance construction. following uses: • Effluent systems heat transfer. ■ Casing and Base: Rugged • Homes Available for automatic and thermoplastic design provides AGENCY LISTING • Farms manual operation. Auto- superior strength and corrosion SP Canadian Standards Association resistance. • Heavy duty sump matic models include • Water transfer Mechanical Float Switch ■ Motor Housing: Cast iron for efficient heat transfer, Goulds Pumps is ISO 9001 Registered. • Dewatering assembled and preset at the factory. strength, and durability. SPECIFICATIONS ■ Motor Cover: Thermoplastic FEATURES cover with integral handle and • Solids handling capability: float switch attachment points. '/4 maximum. ■ EP04 Impeller: Thermoplas- E Power Cable: Severe duty • Capacities: up to 60 GPM. tic Semi-open design with rated oil and water resistant • Total heads: up to 31 feet. pump out vanes for mechanical • Discharge size: 1'h" NPT. sea! protection. • Mechanical seal: carbon- rotary/ceramic-stationary, BUNA-N elastomers. • Temperature: 104_F (40 C) continuous METERS FEET - 140-F (60'Q intermittent. • Fasteners: 300 series 0i stainless steel Cable of running dry withot,t damage to a 2 5 FT / J components, I 25 - Q _ Motor: • I: _P04 Single phase: 0.4 HP, 0! 20 115 or 230 V, 60 Hz, 1550 /S 01 RPM, built in overload with?-a> 15 automatic reset. a 4 EPOS • EP05 Single phase: 0.5 HP, o 115 V or 230V, 60 Hz, 1550 1 3 10 RPM, built in overload with EP04 automatic reset z • Power cord: 10 foot 5 standard length, 16/3 1 SJTOW with three prong 33: ,q ac~ua/d,e/'a grounding plug. Optional 20 0 0° 10 20 0 (9p 40 so GPM foot length, 16/3 SJTW with three prong grounding plug - 3 (standard on EP05). c' 4 r 0 1 m m CAPACITY Goulds Pumps ITT Industries c 2002 Goulds Pumps Effective September 2002 83871 3s0' t So,l erta/u4tro„Fi;~ /7~^Ed/oE /ne ~'krsb,~ ~~e~e elegy uwrE ca = 95.97 Lo>f Pi n eS 1 V /(o u~y T . off' Eit ~i'a /d, ' ,'{pPrq~. /occt~~ of J fi cii,9 3.92 ¢er d; rn~r~sr ~vu ~ /acccz:-cn lc.~ Krl o~ •;cl . y ~ ~ ' we acN n ~ Ja' / ~ ~ I-a Gw h / / ~''a. i + 5l~PE Q , l ~~~,/Rv.C~occcmG:h ~ tkrou..~ 5Y5~ t j j cq/ `J eon crr /~C. I I lcv It ra easE F-6F/K~.•rCfi/~.a.~ UCa /'i ~t tG~ j i O S~'~S.Tir/ 3o3S1 i i 0` S/off Xisfi n~ 97.7G' ~F~/ucitL /iy~ C✓ i h~b~ 5~1. r i ~ ~ EY.'s ~ CtcSfironor..EG~ MkI°IF ~ i r f i y Gainyt I 3be~rrr, r ~p{~~~hvFS~c(n fkf7/~CJees I ~ ~2es:d~.~ae a~K,~; Co~ner~Fkouse. ~r_ y X SScc.n~ d clcr/ . /C6. I 0, CPnGi'Ctc. +1 CPOSCcv, Me Lo na' SyS'~rm ~.~;o~(a,5 c 92.73: ~ a--t7.3.2G;C ///Uf3~w/SX9C, SCC/{wi ce e /¢v' 0 9¢~ Q-t r~ 20 "asodt 9-0.93 l /a Es~o.-/S a /,%4' ter' S/5!1:$ , fl Sf'a cedar` 2. SG 'u-y% ct ~wr, l o~~'{i'C~.S SPa~eaa•bz.53' v l L? Z.~IJ'~ to r r 1 3SD ' p~.8eF9 2247 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code A.C.E. Soil & Site Evaluations County Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. 010-1046-50-000 Please print all information. Reviewed By Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Debra J. Milligan Govt. Lot SW 1/4 SE 1/4 S 19 T 30 N R 16 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 2132 140th Ave. 1 CSM Vol. 3, Pg. 716 City State Zip Code Phone Number J City I Village 1J Town Nearest Road Baldwin WI 54002 715-684-2993 Emerald 140Th Ave. J New Construction Use: 1/1 Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD 0 Replacement J Public or commercial - Describe: Parent material Glacial Till Flood plain elevation, if applicable Na General comments and recommendations: Site suitable for replacement mound system with 20" sand lift placed on 92.83' contour. System elevation to be 94.50'. Boring # Boring Pit Ground Surface elev. 92.94 ft. Depth to limiting factor 16" in. Soil Application Rate Horizon Depth Dominant Color I Redox Description Texture Structure Consistence Boundary Roots GPD/tt= in. Munsell ! Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 "Eff#2 1 0-9 10yr4/2 i none sil 2fcr mvfr as 2fmc 0.6 0.8 2 9-16 10yr4/4~- none ~ sil 2fsbk mvfr cs 2f,1mc 0.6 0.8 3 16-20 10yr4/4 f2f 10yr4/6 sicl 2fsbk mfr cw 1 1vf,f 0.4 0.6 4 20-30 7.5yr4/4 f2f 7.5yr5/8 sl 1 csbk mfr cw 1 of 0.4 0.7 5 30-43 7.5yr4/4 c2d 7.5yr5/8 sl Om mfi 0.2 0.6 I Boring # Boring ✓J Pit Ground Surface elev. 92.11 ft. Depth to limiting factor 16" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-8 10yr4/2 none sil 2fcr mvfr as 2fmc 0.6 0.8 2 8-16 10yr4/4 none sil 2fsbk mvfr cw 2f,1mc 0.6 0.8 3 16-20 10yr4/4 f2f 10yr4/6 sicl 2fsbk mfr cw 1vf,f 0.4 0.6 4 20-32 7.5yr4/4 f2d 7.5yr5/8 sl 1csbk mfr cw 1vf 0.4 0.7 5 32-60 7.5yr4/4 f2d 7.5yr5/8 sl Om mfr - - 0.2 0.6 ' Effluent #1 = BOD? 30 < 220 mg/L an TSS >30 < 150 mg/L " Effluent #2 = BOD5 <30 mg/L and TSS <-30 mg/L CST Name (Please Print) Signatur : CST Number James K. Thompson S-L_ 3602 Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, WI 54020 5/19/2011 715-248-7767 Property Owner Debra]. Milligan Parcel ID # 010-1046-50-000 Page 2 of- 3 a Boring # Boring - Vf Pif Ground Surface elev. 93.26 ft. Depth to limiting factor 32" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-12 10yr4/2 none sil 2fcr mvfr as 12f,1m 0.6 0.8 2 12-20 10yr4/4 none sil 2fsbk mfr cw 1vf,fm 0.6 0.8 3 20-32 7.5yr4/4 none sl 1msbk mfr cw 1vf 0.4 0.7 4 32-40 7.5yr4/4 f2d 7.5yr5/8 sl 1 csbk mfr cw - 0.4 0.7 5 40-58 7.5yr4/4 f2d 7.5yr5/8 sl Om mfi - - 0.2 0.6 ,7 Boring # Boring - _J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' _ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ~ I I I i I ❑ Boring # J Boring - Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 I I * Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS <_30 mg/L and TSS <30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (R.07/00) A.C.E. Soil & Site Evaluations /oE /,'ne L?xrsb,~ c~ic~c~e ~I erg, 401 E/ecl ~E~ °F x/32 /S/O vv "k- ca-to = Ys.9~ L o / e 5.ri v'o-~ 3 7/~ p 5wPy ice. /y T 30. / h -~.~n r~~cs ~ c.✓ h o ni c/. ~l D /O - / USA- SU - GGG p~prt~l. /UC2tibv~ of P;~-,`Jt~J~ ~jeirtcy 3.92 acid i 3 ~acrrSal 5/~eG ~-c / ~ I d; rncn.S.7)~s C /oCa ficn Lc: I ~naw7. / ~ I I ~ I I I hlcw r) i k I I i I c5 I l i /G~ t~ eaS6 Ap/~~o~'. /aco~'o~ of i~ i I '1 t el¢ctr~c L'vteS ~!„r E/rQ I 'j I I v 97.76' I f ox S/a e XrS~i'~~ ~O /'(CUnn~C.. ',DYE. 47r'fX 1 p 7 C1 1 EX<5ti nq r] a` AS C.{ / Ganag,[ j 36r.~reY~.r, r ~p~vr,-, o-~.SYC/,-.i /zP~~e'~JeES I .Qs s ~ de.-tcG I a~H.~'. Co~n¢~OFkauS¢. y rt ssa.n~ d ~lcrr . /CC, c6. _a ~ ,41~. t_3.r>7 :T~o{'Cpncrc~c. ~Xii,o-Slab = 92,93.' ,r ,r d ~ cJ ri ~t ne,5 3 v Q G~nE~/~nC J v p LA-9 ~ " of DOCUMENT NO, STATE. BAR OF WISCONSIN FORM 1 1953 TH14 O-Z RESERY6O FOR RrcoRCfna onrw '"sA.RRANTY DIMECD per...-.. ~ 4 4- XL Gi r` • 7 REGISTER'S OFFICE This Deed, made between ST. CROW Co., Vitt ReC£CfarRecord James___G1_eason-and__i,inda._lslea snn-,.__husb.and..and_----•- Kif-e MAR 1311 Grantor. 10-50 AM and.-Lee--.an2d.__ue3ara_._i...... Mii~`'~ ga33- hus_ba~'±d - and __wife_.as__surv3vor.ship"*±tax=i.t.a 3 ROGWO Of Vftdii Grantee, Witnesseth, That the said Grantor, for a valuable consideration...... e~ren Ly__.tbss~__.thflzwand RETURN TO conveys to Grantee the following describers real estate in County, State of Wisconsin: Tax Parcel No: Part of the SWa of the SE' of Section 19 T30N R16W described as follows: Lot I of Certified Survey Map filed October 26, 1973 in Volume "311, page 716. 40 FEE This •_-15--_-...___----- homestead property. (is) (ism) Together with all and singular the hereditaments and appurtenances thereunto belonging; And.................................... warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except and will warrant and defend the same. 19...8. 1.. Dated this 3-1-------------------------- day of t\l.ar.ch........ ..I........ (SEAL) (SEAL) - James--/-G_1.ea.son---------•- ....(SEAL) (SEAL) Linda Gleason AUTHENTICATION ACXNOWLEDGMENT - Signature(s) 3ames___Cn.l_ea_son------------------ STATE OF WISCONSIN 1 Linda Gleason-- St. ( `s. Ir T G i X County. ----...I------- . authenticated this -3-1-day o£..Mzg_,-h------ 19 S9 Personally r carne before me this . 30- y of M,ircn "O , 19..`.'. jae bbve named James Gleason and Li no a - - _____Thomas..K. Schumacher Gleason TITLE: MEMBER STATE BAP. OF WISCONSIN (If not. - c• authorized by 5 70605, Wi3. Stat8•, to r•a k,, n Cc 2A thc• nrrGntt wiin executed the i(+rrfroin;.; rr,ar um~-; ~ ..:y.: . THIS r.`rSTRUr.f Ef-.fT WAS CRA1-rtU trr nt1[I7,3_C it r C J . v • L_ C~ - ~J . • . . - - l Sir++»atn roe may hr :nrthr nrtoarrri rrr ac•i. rr.,i l WARRANTY 'lvwmrq ..r L r+..... F.... - _ ~ f•- .1 r.. .I n FFn STATE. fi.11; (71- K f~/ !)~~1♦ ~ 1.•."•~ I:i:.,~'.. i DESCRIPTION A parcel of land located in the SW1/4 of the SEI/4 of Section 19, T30N,R16W, Town of Emerald, St. Croix County, Wisconsin, described as follows: Commencing at the S1/4 corner of said Section 19; thence S89°44'41"E 150.25' along the South line of said SEI/4 to the point of beginning; thence N3°03'08"W 488.061; thence S89°44'41"E 350.001; thence N3°03'08"W 250.001; thence S89°44'41"E 814.371; thence S3°05'23"E 738.09' along the East line of said SW1/4 of the SE1/4; thence N89°44'41"W 1164.85' along said South line of the SWI/4 of the SE1/4 to the point of beginning. Contains 17.70 acres, more or less, including Frog Pond Road right-of-way and 16.68 acres, more or less, excluding Frog Pond Road right-of-way. I certify that the above description and map are correct and that I have fully complied with the provisions of Sec. 236.34 of the Wisconsin Statutes and Section 5.4.2 of the St. Croix County Zoning Ordinance. Date: October 23, 1978 jgrse.- J ads T. Swanson S-1492 Job No. 78-1082 Ogden Engineering Co. ,`,,ths~GOq~~~. 123 E. Elm Street River Falls, Wisconsin 54022 V V JAMES T. SWANSON z S-1482 = RIVER FALLS, I Wis. W4.10. Al s U R`IE *tt ~~rrraasssais+sw I hereby certify that this map has been approved by the Town Board. Date SURVEYED FOR: George Hop 1370 9th Avenue Baldwin, Wisconsin 54002 OWNER: James Geraghty R. R. #2 Baldwin, Wisconsin 54002 APPROVET ~ 2 ~ 1Q~g A!'PKOVAL U!' iHaZz,. MIN Ai SUbU'VISIGI-4 ST. Cgol)L DOES NOT MEAN APPROVAL FOR ~pNpyt"jE14SW rp s . BUILDING SITE OR SEPTIC SYSTEM. 2~nr+ REFER TO H62.20. ~Cf ~t FORM NO. 985-A wcr u..co.o...®m 352641 CERTIFIED SURVEY MAP 8 A_ N w c To ~o (D TRUE BEARING 6 8~ Q • N west line of the SE1 /4 z l_a-t -ted Iands v, Z un T. Z - - p owi O n al J fND f° O n -os c 488.06' c ' 70 tO I N 3° 03' 08"W (D M $i w 450. 00' z w `.nab g p ~ 7 I ~ m t4 m 45`'~ N ~ d ~ 3 cQ I 61 CL -I m o t ~ei SCALE IN FEET Ln H U1 r ` a i o x n m 4,~" J Q' 200' I ° n o., o. 5' 450.00' 250.00' A N3003'08"W ' IC I~ I oR Ia c I 738.06' to LEGEND 1"x24" IRON PIPE WEIGHING I" ro O 1.68#/LINEAL FOOT, SET. C-n o o ~j N l~ O z fu 0 m r 0 Im COUNTY SECTION CORNER IQ CA >z e ns z wc_ I- ml~ 07 0 N N v_ I- I m M I m x n r,,-> I~ CL ;0 0 CL - 2 I~ I ~ ta• ~ 0 sm oQi fl. CL w I ~ 0 J16'61! ,0east tine of the SW1 /4 of the SE1 /4 ~ 7 0 0. 0 S3°05'23"E 738. 09' N I i u n p I a t -t e d l a n d s m M W Pr1 N 3 z 0 n o CD Volume 3 Page 716 This instrument drafted by James T. Swanson t~ Jul-29-2011 11 25 AM St. Croix County Plan/Zoning 715-386-4686 1/21 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer e t'u Mailing Address -L/Q / L t,~l fk- property Address E, (Verification required from Planning & Zoning Department for new construction.) City/StateSc? I r_ 0i Parcel Identification Number 010-10-114-5o-000 LEGAL DESCRIPTION Property Location s'/o , ,Sec., T N R./W, Town of G Y' /0/ _ Subdivision Plat: , Lot H Certified Survey Mar # , Volume , Page H Warranty Deed # (before 2007)Volume , Page Spec house 0 ye590 Trot lines identifiablxyes D no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put iwo the system can affect the function of the septic tank as a treatment stage in the waste disposal system, Owner maintenance responsibilities are specified in §Comm. 83.52(l) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & zoning Department a certification form, signud by ilia owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 113 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my/our knowledge. I/we am/are the owner(s) ul'the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Nu r of bedr s SIGI T OF APPLICANT(S) I)ATFi ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed fl'om the Register of Deeds Office and a copy of the certified sl MN. map it' reference is made in the warranty deed, (REV. 09/07) G~ ~t1w 2247 Wisconsin Department of Commerce OIL EVAL ATION R OPtl A I Page I of 3 Division of Safety and Buildings in accordance ' h;~n 85, is. Adm. Co ou A.C.E. Soil & Site Evaluations `D Attach complete site plan on paper not I than 8'%9V incl i St. Croix include, but not limited to: vertical and ho ' ntal referen percent slope, scale or dimensions, north a w, and o nearest road. Parcel I.D. N~ 010-1046-50-000 Please print all Rf~tr Re ewed B D~{at p Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Gw I ` l ~0 Property Owner Property Location Debra J. Milligan Govt. Lot SW 1/4 SE 1/4 S 19 T 30 N R 16 W Property Owners Mailing Address Lot # Block # Subd. Name or CSM# 2132 140th Ave. 1 CSM Vol. 3, Pg. 716 City State Zip Code Phone Number J City J Village r/J Town Nearest Road Baldwin WI 54002 715-684-2993 Emerald 140Th Ave. New Construction Use: 0 Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD & Replacement Public or commercial - Describe: Parent material Glacial Till Flood plain elevation, if applicable Na General comments and recommendations: Site suitable for replacement mound system with 20" sand lift laced on 92.83' contour. System v elevation to be 94.50'. 01fo 0 q P77 a 1D ✓ Boring r? ism ❑ Boring # i/ Pit Ground Surface elev. 92.94 ft. Depth to limiting factor 16„ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-9 10yr4/2 none sit 2fcr mvfr as 2fmc 0.6 0.8 T7-2 9-16 10yr4/4 none sit 2fsbk mvfr cs 2f,1 me 0.6 0.8 3 16-20 10yr4/4 f2f 10yr4/6 sicl 2fsbk mfr cw 1vf,f 0.4 0.6 4 20-30 7.5yr4/4 f2f 7.5yr5/8 sl 1 csbk mfr cw 1 of 0.4 0.7 5 30-43 7.5yr4/4 c2d 7.5yr5/8 sl Om mfi - - 0.2 0.6 Boring # Boring Pit Ground Surface elev. 92.11 ft. Depth to limiting factor 16" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-8 10yr4/2 none sit 2fcr mvfr as 2fmc 0.6 0.8 2 8-16 10yr4/4 none sit 2fsbk mvfr cw 2f,1mc 0.6 0.8 3 16-20 10yr4/4 f2f 10yr4/6 sicl 2fsbk mfr cw 1vf,f 0.4 0.6 4 20-32 7.5yr4/4 f2d 7.5yr5/8 sl 1 csbk mfr cw 1 of 0.4 0.7 5 32-60 7.5yr4/4 f2d 7.5yr5/8 sl Om mfr - - 0.2 0.6 * Effluent #1 = BOD5> 30 < 220 mg/L a TSS >30 < J50 mg/L * Effluent #2 = BOD5 <30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signatur : CST Number James K. Thompson 3602 Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, WI 54020 5/19/2011 715-248-7767 . Property Owner Debra]. Milligan Parcel ID # 010-1046-50-000 Page 2 of 3 3] Boring # Boring ✓f Pit Ground Surface elev. 93.26 ft. Depth to limiting factor 32" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-12 10yr4/2 none sil 2fcr mvfr as 2f,1m 0.6 0.8 2 12-20 10yr4/4 none sil 2fsbk mfr cw 1vf,fm 0.6 0.8 3 20-32 7.5yr4/4 none sl 1 msbk mfr cw 1 of 0.4 0.7 4 32-40 7.5yr4/4 f2d 7.5yr5/8 sl 1 csbk mfr cw - 0.4 0.7 5 40-58 7.5yr4/4 f2d 7.5yr5/8 sl Om mfi - - 0.2 0.6 ❑ Boring # -1 Boring -1 Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F-1 Boring # - J I Boring _ Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (8.07/00) A.C.E. Soil & Site Evaluations 35O • soil e ckl/uu~io~ ~orEd /oE /irye ♦ ex,,a6,,v grime el eri 40' F7;7I A=9 x./32 /s/O ~ .`tvt• t7e%aE p~~ 65,ldu ,,rJi, SS/oa2 tfg,, ca10 = 95 97 z o 6 / e 5n1 t/o~' 3, F~ 7/l0, swyy5ey 5<e. /y, T. 30. /f•, P;nes ~ ~./low,T.oy'E.n~ra/d, t - 0 5E cro?X Lo, w (tih~E,nC1.C'O ~-~•✓t'1 ~CG~ i`{O/d-/Uf!!v- SU-CIiU /OCa-tz"Z7 , o~p~-, j \ being} 3.92 ctc~~ iSper'.snlts/~ Spec+~'~ / ~ { d%rn..,•,s,rru a/oCa.fic~ ~~ew7. ` I ~ I L-k,-6 LL / I it t Icy' 1~ II I /ct7'r e4St ~ ~ I \ I ~ B,2 /off /,'tie > g eleetrfc (,nos r/ (~ine'E/Ce I~ Xi S ~i_i+q 97.74 c U 1 ~O' ~ I ~ar~ h rv / ~ ~ ~o~~ I 1 3 s EX%SEing Ca»crv1x3tPdG pi • ~ ) I ~ ~ ~ / 5~/uC{u .i CDnC,~f~yr I ( ~ I~ / _ _ _ - Syr s6 ~1~ ~,~co~~p~lo~ I 4i ~ I fo ~tCUnnc Ct,'cr. 6rrt~ t 81 N' 4jt a c9 Garag,t i 3 be~lr•er~.r, t ~p~Jern o-F'S,d,- ~p~01~~eE-s I .Qe s r ~.-ttt I a•E,H.E Cnr~ne~lJF1tauSQ• y sE SSu Meal G/e~I` _ /CrY7• G8: d Ql~. PJ oi ConuCfc ^ l'a.ko.51ab = 92.73: ,r ,r d 3 G~/.nC r O. LA2. -0 C) o a I M; ao II a~ o c a I N N i .o I d c II d o Z c ~ m LL C O Q M Z y p w E E f° cn = o ~ v I E ~ z d 4) E C) a m v C O Z:!t c c U o d Z c 4? c hh~~ N m N Q. r+J N N N O O O IL o C C O N O r t~ O O N Q N O Z H Z Z Z o N (D (D a a M y N N O j o c a -o U 7 Z > v I-- I-- f- n ~i 0 0 0 a = •N ~an.a CL 7 G N co W (a m -j U m a } ~n o0 0 a~ o o o Q O E N N N 04 O a N N m (D O O N U~ d 7 +U+ v 0 O O I, y tll U) U) C }V r"~ O C y O E 00 00 M O O IM O N C U a rn o 0 0 0 r CO O = -p N N N N m CID LO c Ca -6 c O O N y y "O Z v v 0{ O FBI M N f6 c0 v a > O C_ N O E aoo c0 O ul m O R U • O W U M Z 2 I- cn ~ ~ r II V a a L a CL Id • ~w _1 A 0 a 0 m U REPORT OF IJISPECTIO.;1--INDIVIDUAL SEWAU DISPOSAL SYSTEM Sanitary Permit Al • - r State Septic r 1E T61II1SHIP ` t. Croi;; County SEPTIC T.A'?Y ' Size gallons . ber of Compartments l Distance From: Well /t/ ~ ft. 12% or greater slope ---~L Building ` ft. Wetlands ft Iiigti later eft. DISPOSAL SYST:Z Tile Field or Seepage Pit(s) Distance From: hell a 640 12%.or greater slope ft Building ft. Wetlands f;. t. i FIELD r;ghwater; Total length of lines Oft, dumber of lines 15 Length of each line L -ft. Distance between lines ft. Width of the trench ft. Total absorption area sq. ft. Depth of rock below the /Lin. Depth of rock over the Z= in. Cover -.over .rock,, Depth of tile below grade in. Slope of trench min Der 100 ft. Depth to Bedrock ft. Depth to g and water PITS Number of nits 0 id Yes ter ft. Depth below inlet ft. Gravel aroun : t: no. Total absorption area t• sq. ft. .Square feet of seepage trenc area required :square feet of seep pit a a duired Inspected by: Title:. Approved Date 197 PLB67 State and County State Permit # Permit Application County Per it # --K for Private Domestic Sewage Systems County } Q *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: ,3,q),a J-A M EnS _ 16'4 011 S c i ✓ : c «o J1 a B. LOCATION: .5 '/4 '/4, Section T 31, N, R /t' E (or) W Lot# City _ Subdivision Name, nearest road, lake or landmark Blk# Village l L~~ Township C. TYPE OF OC PANCY: *Commercial *Industrial *Other (specify) *Variance Single family L Duplex No. of Bedrooms 3 No. of Persons 2-- D. TYPE OF APPLIANCES: Dishwasher YES NO Food Waste Grinder YES NO # of Bathrooms ~ Automatic Washer RYES NO Other (specify) E. SEPTIC TANK CAPACITY lece Total gallons No. of tanks ~ *Holding tank capacity Total gallons No. of tanks New Installation J( Addition _ Replacement _ Prefab Concrete *Poured in Place Steel Other (specify) F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) .30 2) 3-1 3) Total Absorb Area 960 sq. ft. NewX Addition Replacement *Fill System Seepage Trench: No. Lin. Feet J ) oo Width Depth 10 Tile Depth Y~ No. of Trenches 3 Seepage Bed: Length Width Depth Tile Depth No. of Lines Seepage Pit: Inside diameter Liquid Depth Tile Size Percent slope of land 70 Distance from critical slope I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared by the Certified Soil Tester, NAME Rc 8z ,i.'T-- LIA.a A i < ; C.S.T. # .SS•- Z YY and other information obtained from e~2.p ,,w,' (owner/builder). Plumber's Signature MP/MPRSW# A ~Ly Phone #40- Plumber's Address PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20, including well). T s .000 4 ~ T/i .*,-r rk-c n r^aw ySr s~ ° ~~Q ~~Av,lcte'd jy d}+di+«,,f ~`ye EH 115 • WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH r. P.O. BOX 309 MADISON, WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION TESTS LOCATION:f r 'I, 5W% Section Lt T-30N, R& E (or)_W, Township or Municipality j MReALZ> A pytRtEo f , eo t~ • OPJAJEO 131V T R Count 57~ GiPCy!)( i '11,y Lot No. Block No. y 49 n Subdivision Name Owner's Name:(PCCIt~~~~j OSPy~ ~ IE'c 45204 SDI ~EO,QC~E D/9 Q.~J-S Mailing Address: !D / TYPE OF OCCUPANCY: Residence x No. of Bedrooms 3 Other EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT oC116 / C/ 75? PERCOLATION TESTS ~G /ViP DATES OBSERVATIONS MADE: SOIL BORINGS SOIL MAP SHEET I JrCZ 1-5'0 SCS SOIL TYPE '5 ~ rlrl'G-U 16'81 PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST.TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL MIN/IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P_ Si4-725J.20110, /4 51 26 0" 30 7& P_ /0'~ G~'ytit BIV . SQL • Ts i~ 13 13 14 ll" Ziyht B*. S'<. TS 13 P -j 3 0. s,'L., l4 1151 26 D 30 SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) '12 /I~Dif/E 7 7Z " A74A I 42" S/ B Z /o" 57 Ts, -2 /0 14 - , 3y " V It 42o#,51 3 k" 5/4 75., .22 4 i, h a /1" 5,'1- TSB .2- p " /a A M, 40 B s w " 5,L. T5, 47- S/ Co " " ` /0"Sri 75.E 221" Lf 13N IWL PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy. T-60 FOR TA4FMC# Fie gFD Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. 1A I-= • o Ti RfeE e - - - N O X t N E P~ of L XN) 11Nw ~ EH 115 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES i DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH ♦ P.O. BOX 309 MADISON, WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION TESTS LOCATION: 54-71/4, S/a,, Section J1, T PN, R 1O E (or) W, Township or Municipality C Lot No. Block No.1?ber0F aw mw /q/ U. C~.-M,h~y County ✓ ~~O~,r Subdivision Name T Owner's Name: TCOSeD ocvE (2 - KrAM£ S G LE' $Otil Mailing Address: C~ 'J~b' d-L7o B4LDW IN W I S TYPE OF OCCUPANCY: Residence- No. of Bedrooms 3 Other EFFLUENT DISPOSAL SYSTEM: NEW X ADDITION REPLACEMENT DATES OBSERVATIONS MADE: SOIL BORINGS 0L7' 157!14 MOM PERCOLATION TESTS SOIL MAP SHEET 26~ ZY0 SCS SOIL TYPE 6?5--40 1 PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE SINCE HOLE INCHES THICKNESS IN INCHES HOLE AFTER INTERVAL MIN/IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P_ io" g v. 51L_ TS, If "4-/• 13iV tl/0 ~ c ? S T A r wi ix v 19 MOt, s L . 13~ Vi 0E- f,~~4S iVA L 2 L , 9QJI v P- /b'~M 5iL 7's lg L7• /3N wiA o t 9y. Mod 2'' st, . Z0A,7 S of S ~4TvR ioN. P 13 '7 '6A i-A D 3Gy.'*Ot- /2" s SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) 671,51, -Wit O LINE' /3w $°iL TS, 2l" L7/• l3~v L 42" S i 30" Cl_ 3 " '£A'RED G ~6ti 3/L T5 Z-1,11 7- 6V L , 20 f Z2 cL B tSv S;Z Ts, iS' 15V L , 2.P- S1, zs' 40 eL " CL r " /Z" Piv. SiL ?s, /G "6f !3N L, 60" 536 6~6 PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy. NOT 51"M Ale- fog TZ'_6 'eA .0 /$Et7 Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. Z - O Iv = 1 ' 3 s O E / • ?Q:7-CA Zu MA o N L9 O