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Home My WebLink About026-1105-50-000 0 o 4 ° O e» a N ~ f0 n II O - N O O N p QZ C H O N tl I N O O N N d Co 4 N co co Y E ~ a3 3 ~ f6 N N ~T co Er L c O L (n 3 6 p U (6 E 'O ~ d N-0 E W c N O U 00 C(0m ; O O C R U O O O C it LL O 6) N N N I~ o 9 E N zo Q>NV'iE3 I 0 3 Z in 00 ~cwn E o d ` Zo a m Cl) w o~ U) O Z d c N O CL c E CD U E CD ` N O ~ L CL O Z Z E N E Co E ° a V N co LO S c w y a~ 3 CD N I G G CL EI 4 co U) U) c a >m 0 333 O O O •►w Uaaa FY ~ N z z N J U Q i U ~ o a - 7 to Ci O N N O O C I W C ~O R O Q O I,I a N C 06 w T . w ° E a`s W -a rM U N vi O O C, z i I E CL a i o 3 3 o A vat 0 U)t) ST. CROIX COUNTY I~ r WISCONSIN vM~dk . ZONING OFFICE ST. CROIX COUNTY COURTHOUSE JriM'T 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 SEPTIC INSPECTION / WATER TEST REQUEST FORM Specify desired test(s) & remit appropriate fee with application. Outside water lines are often turned off during winter months, making access to the home necessary. Please make arrangements with this office to insure a time when entry can be gained. N Water (VOC's) $185.001 ❑ Septic $25.00 Water (Nitrate & Bacteria) $5.00 ~ (Visual inspection) 5tLLEk.S 8,ye/L NN. Owner STEPHFnj 'R. 10/TVVA,-) Requested by: D14VID s, mE~srE2 Address: t904 CouN ; r 2t -d A Address: 9 ci 14o+` (gw k_ City & State: Nc,,) R~,oAn.ND , w► City & St.Neu r2,Gr}n,oND , 4./ Zip Code: .S4ot? Zip Code: s-toi-7 Telephone N4: (71s) -_4ca- s-3 i5 Telephone N4: (-7,~ ) Property address (Fire N4 & Street) : i '4oy Co✓wTY i2oq- A Location: Sec. , T _N, RW, Town of "RD St. Croix Co., WI. Tax ID N4 Parcel ID N° House color: G.'-o Realty firm: - Lock Box Combo: t Water sample tap location: ' O TO BE COMPLETED BY PROPERTY OWNER I PROVIDE A SKETCH OF HOUSE & SEPTIC SYSTEM ON REVERSE OF THIS FORM 0 Is the dwelling currently occupied? r4Yes ❑ No If vacant, date last occupied: I Septic system installed by: ' Year: Septic tank last serviced by: Date: <y Previous Owner's Name(s): Q Have any of the following been observed? DY ❑N Slow drainage from house. ❑Y ON Sewage Back-up into dwelling. tca ❑Y ON Sewage discharge to ground surface, - road ditch or body of water. ❑Y ON Slow drainage from the dwelling. cM ~`t44 ❑Y ON Foul odors. pf $ ~ n Other comments relative to system operation: N• I certify that the above information is complete a d truee best of my knowledge. OWNERS SIGNATURE: DATE:- 4/93 r F ~ OWNERS DRAWING OF HOUSE & SEPTIC SYSTEM LOCATION t N TO BE COMPLETED BY INSPECTION AGENCY System design &/or permit on file? ❑Yes ONo Soil series per SCS Soil Survey: sheet # Type of soil absorption system: OBelow grd OAt-Grd OMound Approx. size 'X OGravity ❑Dose OPressurized Ft.2 OBed OTrench ODry Well ❑Holding Tank OOutfall pipe OBSERVED DEFICIENCIES 00ther OUnknown Septic tank Setbacks: OHouse OWell OProp. line OOther Dose tank Setbacks: OHouse OWell OProp. line OOther. OLocking cover OWarning label OPump/Floats OAlarm OElec. wiring Soil Absorption Svstem Setbacks: OHouse OWell ❑Prop. line OOther OPonding: ODischarge: General comments: ccµ - { c~ ~s vwew~ INSPECTORS SKETCH OF SYSTEM OCATION N d O CA Inspe for ~ Titl w~ d ST. CROIX COUNTY WISCONSIN =41 ZONING OFFICE M M N N p M r N rrr~ ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 January 20, 1998 David J. Meister 917 140th Avenue New Richmond, WI 54017 RE: Water Test Results for Stephen R. Pittman located at 1404 County Road A, Tn of Richmond, St. Croix County, Wisconsin Enclosed you will find the test result for the water sample that was collected on December 30, 1997 at the above referenced property for a VOC (Volatile Organic Chemical) water test. If you have any questions regarding this, please call our office at (715) 386-4680. Sincerely, &"e Rod Eslinger Assistant Zoning Administrator Enclosure 7 SERCO Laboratories 1931 West County Road C2 Phone (612) 636-7173 St. Paul, Minnesota 55113 Fax (612) 636-7178 LABORATORY ANALYSIS REPORT NO: 74334 Page 1 of 3 01/15/98 St. Croix County Zoning DATE COLLECTED: 12/30/97 1101 Carmichael DATE RECEIVED: 12/31/97 Hudson, WI 54016 COLLECTED BY : CLIENT DELIVERED BY : CLIENT SAMPLE TYPE DRINKING WATER Attn: Mary J. Jenkins CLIENT'S ID: Stephen R. Pittman SERCO SAMPLE NO: 141177 SAMPLE DESCRIPTION: 1404 Co. Rd A New ANALYSIS: Richmond 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 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 <0.3 1,1-Dichloropropene, ug/L <0.2 Carbon tetrachloride, ug/L <0.2 1,2-Dichloroethane, ug/L <0.1 (Ethylene dichloride) I t4' Rocs Trichloroethene, ug/L <0.4 a UN 1, 2-Dichlorcpropane, ug/L <0.1 Zocc; Bromodichloromethane, ug/L <0.2 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. J SERCO Laboratories 1931 West County Road C2 Phone (612) 636-7173 St. Paul, Minnesota 55113 Fax (612) 636-7178 LABORATORY ANALYSIS REPORT NO: 74334 Page 2 of 3 01/15/98 SERCO SAMPLE NO: 141177 SAMPLE DESCRIPTION: 1404 Co. Rd A New ANALYSIS: Richmond 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 di bromide) 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. ~ SERCO Laboratories 1931 West County Road C2 Phone (612) 636-7173 St. Paul, Minnesota 55113 Fax (612) 636-7178 LABORATORY ANALYSIS REPORT NO: 74334 Page 3 of 3 01/15/98 SERCO SAMPLE NO: 141177 SAMPLE DESCRIPTION: 1404 Co. Rd A New ANALYSIS: Richmond 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, ucj/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 U.S. EPA's SDWA maximum contaminant level of 1-30-91 for those requested compounds which are also on the SDWA MCL list. 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, &iW) 1- Carol Davy Project Manager < means "not detected at this level". 1 mg = 1000 ug.