HomeMy WebLinkAbout020-1317-80-000
STC - 10 4
RcE(vE0
AS BUILT SANITARY SYSTEM REPORT ~1
--I JA. m 2
OWNER Ke-4gj C Od Rb~ LAP-S ON ST
CROI
COUNTY
ZMINCiOFFICE
ADDRESS
~d~m we s~o~ 1~' SUBDIVISION / CSM#_ 54>j ~iIC III LOT #
SECTIONT al N-R. ~W, Town of HunSolJ
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
[ BeDR.OU M
r .3o,
IaoayAl 31' 58
lo'
h~bNt~ele OW
YO
30S -rap>v Jl-t s
4Seb Y) t* NC~IL
^ I
~l,n~le S~~)S ►V
T
INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form.
- Provide a- dimensions to center of-septic tank-manhole cover:
BENCHMARK:, 1 I~Q ~~V = ' U 0. Q
ALTERNATE BM:
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: t_ek S Liquid Capacity: UU GA)
Setback from: Well Q~ House 361 Other
Pump: Manufacturer Model# - Size
Float seperation Gallons/cycle:
Alarm Location
SOIL ABSORPTION SYSTEM
Width: 3 Length 7,S_ -Number of trenches o~ "lASep Siiv2W~N~M1 S14«f
Distance & Direction to nearest prop. line: om SO'
Setback from: well: House S ~1 Other
ELEVATIONS ~oVe~
Building Sewer - ST Inlet: 99.Q(0 ST outlet: Qj?
PC inlet PC bottom Pump Off
94,•3 ~ gS.ou
Header/Manifold L- 9L.3) Bottom of system M_. o 4" fa gj,OU
Existing Grade S f4rv\,Q Final grade L-L 49.2
DATE OF INSTALLATION: la i-47
PLUMBER ON JOB: Qyh. I>aW
LICENSE NUMBER: 31Vl
INSPECTOR:
3/93.: Jt.
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County:
8T. CROIX
Safety anti Buildings Division INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary-PU1tJ
Personal ilInfformation you provice may be used for secondary purposes [Privacy L S.15.04 (1)(m)].
LARSONer's VViN & DEBORAH f7_CitY L1 Village Town of: State Plan ID No.:
CST BM Elev.: r Insp. BM Elev.: BM Description r:r tfi s .c) Parcel Tm!-131'7-80-000
/00 too ~o cAr Pr Pr'_ ~U
TANK INFORMATION ELEVATION DATA A9700234
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septi 2.0 O Benchmark 3.71 /0 l00
Dosi ng
Aeration Bldg. Sewer 77.916
Holding Dt * Inlet 17.7-c/
TANK SETBACK INFORMATION St 41t Outlet Vent TANKTO P/L WELL BLDG. AirItontake ROAD Dt Inlet
Ar
Septi sp'` sQ~ ~~r .Spy NA Dt Bottom
'
Dosing NA Header / Man. 74
Aeration NA Dist. Pipe 7.112, 9'G Z.o/'
Holding Bot. System 73' 7qg"
PUMP / SIPHON INFORMATION Final Grade rn d 3 ~q. y7
Manufacturer Demand S~. M.hti ~Cov /Yf' 102.210
Model Number GPM
TDH Lift Friction stem TDH Ft
Forcemain Length Dia. Dist.Towell
SOIL ABSORPTION SYSTEM
BED RENC width r Length P No. Of Trenches PIT No. Of Inside Liquid Depth
E-ff 9019-S- 75- DIMEN I
SYSTEM TO P / L BLDG WELL LAKE / ST M LEACHI nu adurer:
SETBACK MBER
INFORMATION Typeo t ~7. * OR UNIT Mode
Systemp onV
DISTRIBUTION SYSTEM 2S' r,/ larr
Header/Manifold Distribution Pipe(s~ / x Hole Size x Hole Spacing Vent To AirI take
Length Dia Length 75 "r2b 3,L rTl Spacing yo
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over xx Dept xx Seeded/ Sodded xx Mulched
Bed /Trench Center Bed / Trench Edges oil ❑ Yes ❑ No ❑ Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, e
LOCATION: HUDSON 24.29.19,SW,NE 874 JANE CIRCLE LOT 63
12 t t> per -~~✓►~~h - S;tJ f vJ'tv1dC*-
2)
Plan revision required? ❑ Yes J@ No
Use other side for additional information. 'LI ~Yc~ /~~~t
SBD-6710 (R.3/97) Date Inspecto s Signature C4N,
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
"Safety and Buildings Division
v~C~riR SANITARY PERMIT APPLICATION Bureau of Building water systems
201 E. Washington Ave.
In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969
Madison, WI 53707-7969
• Attach complete plans (to the county copy only) for the system, on paper not less County
than .8 112 x 11 inches in size. K~O'
• See reverse side for instructions for completing this application State Sanitary PPe~erm~it Number
The information you provide maybe used by other government agency programs E] Check if revision to previous application
[Privacy Law, s. 15.04 (1) (m)]. A r p State Plan I.D. Number
1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION
Prope y Owner Nam Property Location
~2v~iN 'i 4bej (,•g 1/4 Nj~ 1/4,SQ Tag N,R 9 E(or W
Property Owner's Mailin Address Lot Number(43 Block Number
City, State Zip Code Phone Nmber Subdivision Name or CSM Number 5 (v V01 .b
ovo S 0 IP4 W i SC • j 6 ( k 4
II. TYPE F BUILDING: (check one) ❑ State Owned ❑ it Nearest oa I
❑ Public 1 or 2 Family Dwelling - No. of bedrooms ❑ To~a9 OF DI e~' v^'NC . C► Rc.l'Q
III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 11j. ^ p . 1q. /(eI p
1 ❑ Apartment/ Condo o Q V 80 O
2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility
3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/Bar/Dining
4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash
5 ❑ Hotel/ Motel 9 ❑ Office/Factory 13 ❑ Other: specify
IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable)
A) 1. }.New 2. ❑ Replacement 3.. ❑ Replacement of 4. ❑ Reconnection of 5• ❑_Repair of an
-----System System Tank Only Existing System ---------Existing System
B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non-Pressurized Distribution Pressurized Distribution Experimental Other
11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank
12 Meepage Trench 22 ❑ In-Ground Pressure 42 ❑ Pit Privy
13 ❑ Seepage Pit 43 ❑ Vault Privy
14 ❑ System-In-Fill
VI. ABSORPTION SYSTEM INFORMATION:
1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade
Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) I{ 173.0 E149 ti
6o
1 7S
7 SO V L c~V 6 Feet r Feet TANK Capacity
VII. in Total # of r Prefab. Site Fiber- Exper
gallons Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App
INFORMATION -
New Existing strutted
Tarioks Tanks
❑ ❑ ❑ ❑ ❑
Septic Tank or Holding Tank 1 i ~V~i W t~ J R I
Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ El F1
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name: (Print) Plumber's Signature: (No Stamps) MP/MPRSW No.: Business Phone Number:
Plumber's Address (Street'?4; CState, Zip Code):
1616 Hw- xn .01., U~ rc. S~I~Oi
IX. COUNTY / EPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (Induces Groundwater ate Issue Issuing A nt N tam s)
Approved ❑ Owner Given Initial/L) SurchargeFee) Adverse Determination
X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
SBD-6398 (R. 05194) DISTRIBUTION: Original to county, One copy To: Safety & Buildings Division, Owner, Plumber
INSTRUCTIONS _
1. A sanitary permit is valid for two (2) years.
2. Your sanitary permit maybe renewed before the expiration date, and at a time of renewal any new criteria in the
Wisconsin Administrative Code will be applicable.
3. All revisions to this permit must be approved by the permit issuing authority.
4. Changes in ownership or plumber requires a Sanitary Permit Transfer / Renewal Form (SBD-6399) to be submitted to the
county prior to installation
5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever
necessary, usually every 2 to 3 years.
6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of
Wisconsin, Safety and Buildings Division, 608-266-3815.
To be complete and accurate this sanitary permit application must include:
1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the
system is to be installed.
II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling.
III. Building use. If building type is public, check all appropriate boxes that apply.
IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair.
V. Type of system. Check appropriate box depending on system type.
VI. Absorption system information. Provide all information requested for numbers 1 through 7.
VII. Tank information. Fill in the capacity of every new/or existing tank, list the total gallons, number of tanks and
manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and
holding tanks for this system. Check experimental approval only if tanks received experimental product approval from
DILHR.
VIII. Responsibility statement. Installing plumber isto fill in name, license number with appropriate prefix (e.g. MP, etc.),
address and phone number. Plumber must sign application form.
IX. County/ Department Use Only.
X. County/ Department Use Only.
Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must
include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic
tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon
tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served;
B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume;
elevation differences; friction loss; pump performance curve- pump model and pump manufacturer; D) cross section
of the soil absorption system if required by the county; Q soil test data on a 115 form; and F) all sizing information.
GROUNDWATER SURCHARGE
1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can
effect groundwater.
The monies collected through these surcharges are used for monitoring groundwater contamination investigations
and establishment of standards.
s, rn ~3 a ~ s t~
NAME K v'• d _ a, b c rzP'~ Lr, K:6 NAME---
11L O C A 1 0 N__.5 ~....~?i A - I C E N S E 3~a _
P L 0 -1: MAP
~j~ 6 S AQCD off
p 11,
T'~ pal
• ~d~~ : ~p~~ 1 S ~14121 Rfll~ '
y n
J r 9
N c
fR ills
r St Ewrn eI 1
NI/
3)4~'~~~ ~B:0 ~a~4o ab13 7q of ~l-cv~ 4 g,?S Iop~ U_~ 'U
_ l03
FRESH AI1Z INLETS AND OBSERVATION PINE
C110-S SECTION
Approved Vent Cap
1 1Mgl ~KP 0-9
e'
Minimum 12" Above g9
Final Gra~~__ r 1 ' 3
4" Cast Iron
Above Pipe Vent Pipe
To Final Grade
Wisconsirl Department of Industry, =hrda SITE EVALUATION
'Labor and Human Relations Page of
Division of Safety and Buildings % with s. ILHR 83.09, Wis.
County
Attach complete site plan on paper not le It 81/2 Fee"n size. Plan must c,Po~
Include, but not limited to: vertical and h tal refer (M), direction and
percent slope, scale or dimensions, nort (dk w, a
ll, location and distanceyto-merest road. Parcel I. D. #
199 i 026 - 1317 QO
APPLICANT INFORMATION - prinatio / Reviewed by Date
Personal information you provide may be used fo a a4PN#JQ L ~s. 1 .04 (1) (m)).
Property Owner Property Location
l~ V/~ ~Ef3D,Qq~, t 2 Govt. Lot 1/4 Af 1/4,S T ?-f N,R E cr)
Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# 5,7,fOV6
6P .3 -7 -ff, S T Ito
- 3 Svv if~~~ IP • yf~
Iciity State Zip Code Phone Number Nearest Road
f f V P.5d^D W 1 5qoIe! ( 7(5 )3410 '/y2 61 ❑ City El Village Town
New Construction Use: EY-Residential / Number of bedrooms _141, Addition to existing building
❑ Replacement ,~1S ❑ Public or commercial - Describe:
Code derived daily flow ~U v gpd 7d Recommended design loading rate bed, gpd/fit trench, gpd/tt2
Absorption area required bed, ft2 trench, it 2 Maximum design loading rate bed, gpd/ft2 ' b trench, gpd/ffz
Recommended infiltration surface elevation(s) *5 Joe I? el . .3 y~ it ((,as referred to site plan benchmark)
r 'A
~r`sT~~•~
Additional design/site considerations use- A
Parent material -:5r1fiVPY,0&rVj'} Flood plain elevation, if applicable ft
S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank
U = unsuitable for system (cs ❑ u D-s- ❑ U Ch's ❑ I. ❑-8 ❑ U UK ❑ U ❑ s
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/1112
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
l k /oY LS vie e.5 3 . S . G
2L- e 2X, 160 f-044 <1 el sil eY -7 .8
Ground 3 _ d S s Q -7, . S
9Q elev.
Depth to
limiting
factor
Remarks:
Boring # 51-10 / SL C f • q • 5
Z •z o 3/ /7rS Cs a~f • Z ' 3
Ground
elev.
J 0~~ 3A9-ft
Depth to
limiting
~~in. Remarks:
CST Name (Please Print) Signature Telephone No.
10094 - Z(LQR I d4T' ~1' 71.5.3$6 • e18-5
Address Date _ CST Number
Associates
SOIL DESCRIPTION REPORT
PROPERTY OWNER Page of
PARCEL I.D.#
Boring # Horizon Depth Dominant Color Mottles Structure 2
TexturA Consistence Boundary Roots
in. Munselt Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
Ground
elev.
ft. ,
Depth to -
limiting
factor
in.
Remarks:
Boring #
Ground
elev. - - - -
ft.
Depth to
limiting
factor
Remarks:
Horizon Depth Dominant Color Mottles Structure GPD/ft2
Texture Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
in. Remarks:
Boring #
a y' ~rtcy
Ground'
elev. fi `e
ft.
Depth to
limiting
factor
in.
Remarks:
~+onw Donn in nn u.~. - '
/ eF S
50A) RIO
oll
la3 rl
A
sysr yysa 1
D = ~xc'ST~0 G- PpPos~
psED l0 3, 8 y / 9 `~o } ' i i i y0~ ~ ~i
i_i 1 i 1
s'~Gl,-~ ehKS ~l 13 I
/S I
/99
FX TES T-~ E
f~p,~ l trQs
evE-S T Go 7- L, 3
0 13 I 3 y I(- t5-f5
~~poei
/Vf
SST.
76p-/
y" ~sd~ yep.
8 T C - 100
This application form is to be completed in full and signed by the
owner(s) of the property being developed. Any inadequacies will
only result in delays of the permit issuance. Should this
development be intended for resale by owner/contractor, (spec
house), then a second form should be retained and completed when
the property is sold and submitted to this office with the
appropriate deed recording.
Owner of property CF v/N d .DCbc*e.4f{ !.4-R 6>,Y
Local ion of property , aW 1/4 NE 1/4, Section 2, T 29 N-R(17_W
Township YAPS 6'q Mailing address LAG Ira ST. 6/0.
Address of site K7¢ \T-.+A/E C,EGGE
Subd i vision name Scc~y~/,pGe~ Lot no.
Other- homes on property? Yes_ ~C No
Previous owner of property 64trAlwoy-D =1V'ro4Pe1sz - T/M Rt'CS
Total size of property 2. U3 .4c is
Total size of parcel
Date parcel was created J~¢N. 2, ~99d
Are all corners and lot lines identifiable? Yes No
Is this property being developed for (spec house)? Yes _X _No
Volume 6- and Page Number 4-6 as recorded with the Register
of Deedf;.
INCLUDE WITH THIS APPLICATION THE FOLLOWING:
A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE
NUMBER AND THE SEAL OF THE REGISTER OF DEEDS. In addition, a
certified survey, if available, would be helpful so as to avoid
delays of the reviewing process. If the deed description
ref.or nnces to a Certified Survey Map, the Certified Survey Map
shall also be required.
PROPERTY OWNER CERTIFICATION
I (we) certify that all statements on, this form are true. to the
best of my (our) knowledge that I (we) am (are) the owner(si of the
property described in this information form, by virtue of a
warranty deed recorded in the office of the County Register of
Deeds as Document No. S'3 gQ 46 , and • that I (we) presently
own the proposed site for the sewage disposal system or'F*,X (we)
obtained an easement, to run the above described property, for the
construction of said system, and the same has been duly recorded in
the office of the County Register of. Deeds as Document No.
Signature of A plicant Co-Applicant
- 7`3.7
l'Itt, cit i(matmre Date c,wf gignature
ST(' - 1115
S,1'TIC TANK MAIN'TEINANCE, A(:ItEENIENT
St. Croix Counly
MAILING ADDRESS T~ $ 7', _ (1l0 •pp~t/~- Gl-_~ O /V _
PROPE111T ADDRESS ~T¢ \7-,4N-E CIRCLE 5¢016
(location of septic system) Please obtain from the Planning Dept. -
CITY/STATE L(~S~V W
PROPE.R'TY LOCATION S G!/ 1/4, _/E 1/4, Sec(ion 2¢ T 2.9 _.N-lt 19_
TOWN O ~UPSdA/ ST. CROIX COUNTY, WI
SUBDIVISION SWAI&IDGF -ZL~- LOT NUMBE.11 3
CERTIFIEDSURVEY MAP 53g046, VOLUMrPAGE , LOTNUM13EIt 3
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 licensed septic tank pumper. What you put into the system can affect the function of the septic tank
as a treatment stage in the waste disposal system.
St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost
of replacement of a failing system, which was in operation prior to July I, 1978. St. Croix County
accepted this program in August of 1980, with the requirement that owners of all new systems agree to
keep their system properly maintained.
'the property owner agrees to submit to St. Croix Zoning a certification foim, signed by the owner
and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1)
the on-sire wastewater disposal system is in proper operating cooditicm ,met (2) alicr inspection and
pumping (if necessary), the septic lank is less than 1/3 full of sludge and scum
I/We, the undersigned have read the above requirements and al,rce to maintain the private sewage
disposal system in accordance with the standards set faith, herein, as scl by the Wisconsin DNIt
Cell Ificatloll slating; that your septic has been maintained must he con►pleted and teturord to the St (:roix
County I-ming Officer within 10 days of the three year expiralion dale
SIGNED
DATE 7-3-17
tit Croix ( oollIy 4ooinl, (flirt.
(;over nmvn1 t 'i•ntci
1 101 1 ':utnncharl It,rid
1111(koll, W1 '111016
STATE BAR OF WISCONSIN FORM 1 - 1982 1;
T WARRANTY D,ED I
DOCUMENT NO. REGISTERS C. , .
_ 1168PA~~ 11 - -
ST. CROIX C
Roc'd for 1•i:;+•, ! i
This Deed,, made between Greenwood Enterprises,
Inc'..:, a Wisconsin corporation MAR 2 2 1996
11:55 M
rant any,
I w2vr.. i~•.. t 1
' ;Kevin E. Larson and Debora 0. Larson , u's~an~
p.r}dy wife with right of survivors ip
THIS SPACE RESERVED FOR RECORDING DATA
orrn one
Wltnesseth, That the said Granto for a valuable cop ideratiop
'do' lar and other good and vatluable consideration - -
NAME AND RETURN ADDRESS
St. Croix
co~ eys to Grantee the following described real estate in Greenwood Enterprises, Inc.
County, State of Wisconsin: 1416 Third Street
Hudson, WI 54016
i;
ii
(Parcel Identification Number)
Lot 63 of the Plat of SunRidge III, filed in the Office of the Register of Deeds for
St. Croix County, Wisconsin, on January 2, 1996 in Volume 6 of Plats, at Page
46 as Document Number 538046.
Y A gFER
ICI
it
This is not homestead property.
{do (is not)
Together with all and singular the hereditaments and appurtenances thereunto belonging; I~
And Greenwood Enterprises, Inc.
II
warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except
ii
easements, restrictions and reservations, if any, of record
li l
l i.
and will warrant and defend the same.
Dated this a-1 ss t day of March 19 96 . Ii
GREE OD ENTER ES, GREENWOOD ENTERP ; I
B (SEAL) B SEAL)
*j u h its resident * Mar usch its cretar
j~ (SEAL) (SEAL)
i~
l
Ij i!
li AUTHENTICATION ACKNOWLEDGMENT it
I'
Signature(x) Names R Rnsoh, its president STATE OF WISCONSIN
i
ss.
~i
ST. CROIX County.
II
Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of 3
Labor and Human Relations
Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code
COUNTY
'57, C4>0
Attach complete site plan on paper not less than 0 '#1 Plan must include, but
not limited to vertical and horizontal reference Iirectioit slope, scale or PARCEL I.D. #
dimensioned, north arrow, and location and ' t to neart road. " f
REVIEWED BY DATE
APPLICANT INFO RMATION-PLEASE/PAt~IT INP FF ATIO
_ n.
PROPERTY OWNER: Q w PROPERTY LOCATION
114Ae y /l USG Lt G qIT. LOT $E 114 NE 1/4,S27 T 2-9 N,R E
PROPERTY OWNER':S MAILING ADDRESS rF BLOCK # SUED. NAME OR CSM #
/ylll 3R0 Sr-. 4r. 3 SUu R r D(rE
CITY, STATE ZIP CODE I tH E NUM R []CITY []VILLAGE OWN NEAREST ROAD
ft U PJ o,J W1, 9q0 1(0 ( 134'< " U OS
o
(q'New Construction Use (t 'Residential / Number of b6drooms 3 -to ~ Addifion to existing building
Replacement yS6 _ [ ) Public or commercial describe
Code derived daily flow (Q o o gpd Recommended design loading rate bed, gpd/ft2 trench, gpd/ft2
Absorption area required bed, ft2 7_y trench, ft2 Maximum design loading rate -bed, gpd/ft2 00 trench, gpolft2
Recommended infiltration surface elevation(s) 5-2-¢_ P q '3 ft (as referred to site plan benchmark)
Additional design/ site considerations cv~pv~ 7,*k 44-t S TO . M A T- c,6- e 0,~Jo uR 3, 5 / o ~.Q s
Parent material 5C-5 .59 - /.3 01P e111tRV7_ oorw Flood plain elevation, if applicable N A- ft
N
S - Suitable for system C VENTIONAL MOUND INN--G D PRESSURE AT-GRADE SSYYS1P IN FILL HOLDING T
U = Unsuitable fors stem CTS El U ❑ S p't'1 LA'S p U El S CL GAS O U O S
~K ~e s' j/o S SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
In. Munsell tau. Sz. Cont. Color Gr. Sz. Sh. Bed tertdt
0-7 /D yle 313 s/ .t f 164- ~-6 e s 2-•,,. , s .
2 7-100 /OO 31s/ sIe 1w f/e acs 2 f , S G
Ground s l/~ y/lo !S //M ,p Ge S C~ . -7
elev.
9a,3o ft. y 7, sY1 y o s
Depth to
limiting
tor
il
Remarks:
Boring #
/ 0-3 o yp 3/3 zfS ke /w,fk V.S
z Z 3-11 ~OV't 31 ~ ~7 XX& 4"-6e 't S. A) f
Ground 3 1 -,?o 7.5 xe y ~S ~iyyl ~s as elev.
d ' 09 it.
Depth to
limiting
factor
Remarks:
CST Name:-Please Print R o I3 ER T- U Z_ Q R I-C L,7- Phone: 716= 3 *06 . S7100.5-
Address: Signature: a-am r.nnsultants Data- CST Number:
tqw
PROPERTY OWNER S1 3 ?US CtA- SOIL DESCRIPTION REPORT Page? of 3
PARCEL I.D.t /-0 T- C 3 SU,v/2iDG~5-
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bwxi3y Roots GPD/ft
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
o-g io
Y/e 1/3 o M 2-~ Sb~ .~,f,e es ice, , s ,
Z -1610 /G %2 3/ 1 f S U- /of 's
Ground 3 4 -37 7,5 R S
elev.
Cl q' / ft. 7-a to /e 5(o,0
Depth to
limiting
factor ~r
Remarks:
Boring #
o-7 io y V 3 Sb~ f~ c s I
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SERCO Laboratories
1931 West County Road C2 Phone (651) 636-7173
St. Paul, Minnesota 55113 Fax (651) 636-7178
LABORATORY ANALYSIS REPORT NO: 83159 Page 1 of 3
09/04/98
St. Croix County Zoning DATE COLLECTED: 08/24/98
1101 Carmichael DATE RECEIVED: 08/25/98
Hudson, WI 54016 COLLECTED BY : CLIENT
DELIVERED BY : CLIENT
SAMPLE TYPE DRINKING WATER
Attn: Mary J. Jenkins
CLIENT'S ID: Lot 63 Sunridge III
SERCO SAMPLE NO: 88048
SAMPLE DESCRIPTION: Lot 63
Sunridge
III
ANALYSIS:
Dichlorodifluoromethane, ug/L (Freon 12) <2.0
Chloromethane, ug/L (Methyl chloride) <3.5
Vinyl chloride, ug/L <0.5
Bromomethane, ug/L (Methyl bromide) <1.7
Chloroethane, ug/L (Ethyl chloride) <0.6
Trichlorofluoromethane, ug/L (Freon 11) <1.0
1,1-Dichloroethene, ug/L 0.1 A,C
Methylene chloride, ug/L <3.0
(Dichloromethane)
trans-1,2-Dichloroethene, ug/L <0.2
1,1-Dichloroethane, ug/L <0.3
2,2-Dichloropropane, ug/L <0.5
cis-1,2-Dichloroethene, ug/L <0.2
Chloroform, ug/L <0.5
Bromochloromethane, ug/L <0.3
1, 1, 1-Trichloroethane, ug/L 1.1 B, C 1, 1-Dichloropropene, ug/L <0.2
R t
Carbon tetrachloride, ug/L <0.2 -.r
1,2-Dichloroethane, ug/L <0.1 ! ED ;t
(Ethylene dichloride) err; 1
Trichloroethene, ug/L 0.6 i sT f9.g8 +
1, 2-Dichloropropane, ug/L <0.1
~AOrx `f f
Bromodichloromethane, ug/L <0.2
Zavr a'o rice Dibromomethane, ug/L <0.3
cis-1,3-Dichloropropene, ug/L <0.1
trans-1,3-Dichloropropene, ug/L <0.2
< means "not detected at this level". 1 mg = 1000 ug.
SERCO Laboratories
1931 West County Road C2 Phone (651) 636-7173
St. Paul, Minnesota 55113 Fax (651) 636-7178
LABORATORY ANALYSIS REPORT NO: 83159 Page 2 of 3
09/04/98
SERCO SAMPLE NO: 88048
SAMPLE DESCRIPTION: Lot 63
Sunridge
III
ANALYSIS:
1,1,2-Trichloroethane, ug/L <0.2
1,3-Dichloropropane, ug/L <0.5
Tetrachloroethene, ug/L <0.3
Dibromochloromethane, ug/L <0.3
1,2-Dibromoethane, ug/L <0.4
(Ethylene dibromide)
1,1,1,2-Tetrachloroethane, ug/L <0.1
Bromoform, ug/L <2.0
1,1,2,2-Tetrachloroethane, ug/L <0.3
1,2,3-Trichloropropane, ug/L <0.5
1,2-Dibromo-3-chloropropane, ug/L <0.5
Hexachlorobutadiene, ug/L <0.3
Benzene, ug/L <0.2
Toluene, ug/L <0.5
Chlorobenzene, ug/L <0.2
Ethylbenzene, ug/L <0.5
Total Xylene, ug/L <0.5
Styrene, ug/L <0.5
Isopropylbenzene, ug/L, (Cumene) <0.2
n-Propylbenzene, ug/L <0.2
Bromobenzene, ug/L <0.2
1,3,5-Trimethylbenzene, ug/L <0.2
(Mesitylene)
2-Chlorotoluene, ug/L (o-Chlorotoluene) <0.2
4-Chlorotoluene, ug/L (p-Chlorotoluene) <0.2
tert-Butylbenzene, ug/L <0.5
1,2,4-Trimethylbenzene, ug/L <0.4
sec-Butylbenzene, ug/L <0.4
4-Isopropyltoluene, ug/L <0.4
(p-Isopropyltoluene)
1,3-Dichlorobenzene, ug/L <0.2
(m-Dichlorobenzene)
< means "not detected at this level". 1 mg = 1000 ug.
J SERCO Laboratories
1931 West County Road C2 Phone (651) 636-7173
St. Paul, Minnesota 55113 Fax (651) 636-7178
LABORATORY ANALYSIS REPORT NO: 83159 Page 3 of 3
09/04/98
SERCO SAMPLE NO: 88048
SAMPLE DESCRIPTION: Lot 63
Sunridge
III
ANALYSIS:
1,4-Dichlorobenzene, ug/L <0.5
(p-Dichlorobenzene)
n-Butylbenzene, ug/L <0.4
1,2-Dichlorobenzene, ug/L <0.2
(o-Dichlorobenzene)
1,2,4-Trichlorobenzene, uq/L <0.2
Naphthalene, ug/L, (volatile method) <0.5
1,2,3-Trichlorobenzene, ug/L <0.2
This sample's analytical results are below the US EPA's SDWA maximum
contaminant level of 1/30/91 for those requested compounds which are
also on the SDWA MCL list.
See addendum for additional information.
All analyses were performed using EPA or other accepted methodologies.
Samples that may be of an environmentally hazardous nature may be
returned to you. Other samples will be stored for 30 days from the
date of this report, then disposed of by SERCO Laboratories. Please
contact me if other arrangements are needed. This report may not be
reproduced, except in its entirety, without prior written approval
from SERCO Laboratories.
Report submitted by,
6k>71--
Carol Davy
Project Manager
< means "not detected at this level". 1 mg = 1000 ug.
SERCO Laboratories
1931 West County Road C2 Phone (651) 636-7173
St. Paul, Minnesota 55113 Fax (651) 636-7178
Addendum to SERCO Laboratories Report #83159
St. Croix County Zoning
September, 1998
A: Detected in lab blank at a concentration of 0.4ug/L.
B: Detected in lab blank at a concentration of 1.1ug/L.
C: Overall calibration was acceptable, but % recovery for
this calibration standard was above the QC acceptance
limit.
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