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HomeMy WebLinkAbout006-1052-30-000 Wiscon:ii+ Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety anc Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 515082 0 GENERAL INFORMATION 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: Hawksford, Francis & Sharon I C Ion, Town of 006 - 1052 -30 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 23.31.16.353 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head r DH Ft Forcemain Tengt7 Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil 0 Yes 0 No ❑ Yes E] No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 2450 200th Avenue Deer Park, WI 54007 (SE 1/4 SW 1/4 23 T31 N R1 6W) 40 acres Lot Parcel No: 23.31.16.353 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? Yes [�] No Use other side for additional information. Date Insepctor's Signature Cert. No. SBD -6710 (R.3/97) cmmett.wi.gpy Safety and Buildings Division County Q. 201 W. Washington Ave., P.O. Box 7162 �^ O i al t h s pa o p o n s n Madison, WI 53707 -7 anitary Permit Number (to be filled in by Co.) ent o f Commerce J� 5 a s Z- Sanitary Permit Application tate Tra�,s�c� Number In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental N unit is required prior to obtaining a sanitary permit. Note: Application forms for state -owned POWTS are Project Address (if different than mailing address) submitted to the Department of Commerce. Personal information you provide may be used for secondary ��� purpo in accordance with the Privacy Law, s. 15.04 1 m , Stats. I. Application Information - Please Print All rmation RECEIVED Property Owner's Nam V.4,,hI5 / Parcel # r AAIcls A 2 2 2009 O - 1 p5a - 36 -6vo Property Owner's Mailing Address Property Location 35 3 �1 � �_ ST QRO NING OFFICE Govt. Lot City, Statev / Zip Code Phone Number S� �/4 �/4, Section 2 3 ?ACV- to( �qOr�� `7 )$'a.q &. - '7W circle one H. Type of Building (check all that apply) Lot # T 1 N; R E orGD %-I or 2 Family Dwelling - Number of Bedrooms Subdivision N / ee d� Block # /7'U 4e, d ❑ Public/Commercial - Describe Use ❑ City of ❑ State Owned - Describe Use CSM Number ❑ Village of Z J► (, (,✓ '�' Z I own of I-6 AI III. Type of Permit: (Check only o# box on line A. Complete line B if applicable) A. Y � P Y g P Y g Y (explain) El New S stem a lacement System ❑ Treatment/Holding Tank Replacement Only El Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV. Type of POWTS System/Component/Device: Check all that app l Non- Pressurized In- Ground ❑ Pressurized In- Ground ❑ At -Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil t�i��e► ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis ersaUTreat ent Area Information: Design Flow (gpd) Design Soil Application R (gpdsf) Dispersal Area Required Dispersal Are oposed (sf) System Elevation �o J //R5 11 1 lo;a5 VI. Tank Info Capacity in Total # of Man acturer Gallons Gallons Units j , � o New Tanks Existing anks c g l✓ Qom GF /Z� CZ . w 0 rn m w C7 a Septic or Holding Tank /000 Dosing Chamber VII. Responsibility Statement - 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plum ' Si na a MP/MPRS Number Business Phone Number TO 1-1 t� t A `7 �S Q Plumber's Address (Street, City, State, Zip Code) 41 1 `70 V u E '1' LL L Ak.0 tJl 54 VIII. County /De artment Use Onl Approved tsappro Permit Fee Date sued Issuing eat Signa tt en Reason vial y s. a� � �ZZ /b� IX. Conditi tJO easons for Disapproval 3 1. Septic tank,.eftent filter and (J dispersal cell must all be services / maintained GO as peg management plan ust a maintained plumber. Z. Ali a ck#+gtnretttents must be maintained wxr Attach to complete plans for the system and submit 4 the Coot* my on paper not less than 8 vi x 11 inches in size SBDa6398 (R- 02/09) Valid thru 02/11 IN GROUND SOIL ABSORPTION DESIGN - -- - - - -- - - - -- -- INDEX AND TITLE PAGE - -- -- — - Project Name: Dwher"s Name: Owner's Address: so Legal Description: 6 61�t,J a 3r 31 Township: T� County: Subdivision Name: Lot Number: - Block Number: Parcel I.D. Number: lb5d- " 30 000 Plan Transaction No.: Page 1 Index and We Page 2 P Lo Page S d eesS age 4 M,oA)A6 Y LA &AI Fig 5 5oi� �)rx ( a B c� age Page 7 Designer: License Number: Date- ©miff— Phone Number, Signature: tlfsigned pursuant to the In -ground Soil Absorption Component Manual for POWTS Version 2.0 SBD- 10705 -P (N.01 101), Page I of .� ' v HARDINA SEPTIC SYSTEMS MPRS /CST 824825 y qj a _ ( INJ .o to iA a_ r f3 d � y ti. 10 LA E co l p y ( t � a ga n v HARDINA SEPTIC SYSTEMS MFRS /CST 824825 y o IA a � 4 eT _ of �' A 1 � r - 1 _ o I` a ` J (A f i � oar s Soil Absorption System Cross Section 17,7 ?r t T7 -- ,rial Grade 4" Schedule 40 PVC Vent Pipe 9 fft With Vent Cap Leaching Chamber . ds — ft System Elevation a ft 3_ft Soil Absorption System Plan View I/3 ft ft { ft Leaching Trench 1 Vent Or Observation Pipe Chambers 4" Dia. Trench :2 Header Leaching Chamber Specifications Manufacturer And Model l x/ Fi L -k eprVoQ @ uIL IL q EISA Rating o D sq ft per chamber Soil Application Rate gpd/sq ft gpd Design Flow : Soil Application Rate = R EISA Chambers 2 rows of oZ chambers each. 4 Page of 3 b S INGROUND SOIL ABSORPTION 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 be maintained in accordance with its component manual [In- ground Absorption Component Manual for POWTS Version 2.0 SBD- 10705 -P (n.01 /01) and SSWMP publication 9.6 (01/81) and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic tank 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 and 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 the triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maxium 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 Dept. of Commerce. Pump Tank The pump tank shall be inspected at 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. Soil Absorption System No trees or shrubs should be planted on the absorption area. Plantings may be made away from the cell's perimeter, and the area shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than foot or for vegetative maintenance) on the area is not recommended since soil compaction may hinder aeration of the infiltrative surface within the system and snow compaction in the winter will promote frost penetration. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency 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 shall be immediately repaired of replaced with a component of the same or equal performance. If the dispersal area fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. Replacement in a suitable area nearby is also an option at which point a diversion valve will be installed between the old and new systems to allow dispersal cell rotation at a schedule to be determined at the time of cell replacement. Wisconsin Department of Commerce " SOIL EVALUATION REPQRT p age 1 of 2 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code i County ST. CROIX Attach complete site plan on paper not less thap4l 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 006- 1052 -30 -000 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. PleRse print all information Rev" ed b Date Q Personal 'information you provide may be used for secondary purposes Pri s. 15.04 (1) (m)). "' 0 / Property Owner Property Location • FRANCIS HAWKSFORD Govt. Lot SE 1/4 SW 1/4 S 23 T 31 N R 16 E (or) W Property Owner's Mailing Address Lot # I Block # Subd. Name or CSM# 2450 200th AVE. � N/A N/A City State Zip Code Phon ity [:]Village ■ Town Nearest Road DEER PARK WI 1 54007 ( 7j5- 246 -7444 200th AVE New Construction LlseE] Residential / Number M bedrooms 3 Code derived design flow rate 450 GPD E] Replacement ❑ Public or commercial - Describe: Parent material O ASH Flood Plain elevation 0applicable _ft. General comments / RECOMME ED SYSTEM ELEVATION 89.42' (p 9 67 4� v. and recommendations: I / Or r 7 t a Wo`j 30 -45% COBBLE IN ALL BORES a " 0 '� IA ,i ar.- 1 oYk ,stfir, Sac. Boring # Boring Pit Ground surface elev. 92.42 ft. Depth to limiting factor "�5 Q in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roars GPD/fg in. Munsell +Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 I "Eff#2 1 0 -8 10YR3/3 -0- SIL 1MSBK MVFR GW 2M .4 .6 2 8 -28 10YR4 /6 -0- SIL 2MSBK MFR CW 2F .6 .8 3 28-40 10YR5/6 -0- SL. 2MSBK MFR CW N/A .6 1.0 r 4 40 -75 7.5YR5/6 -0- SL 2MS8K MFR N/A N/A .6 1.0 5 75 -96 7.5YR5/6 F2D10YR5 /3SL J SL 2Tv1SBK MFR N/A N/A N/A N/A D.Z F I M 2 Boring # ❑ Boring 91.7 80 Q pit (Round surface e[W. ft. Depthib limiting factor in. Soil Application Rate Horiaplf D th Dominant Color Redox Description Te trre Wucture Consistence Boundary Rafts GPDtlf in. Murtsell Ou. Sz. Corrt. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-9 10YR3/3 -0- SIL IMSBK MVFR OW 3M .4 .6 2 9 -30 10YR4/4 -0- 3IL 2MSBK MFR CW IF •5 • 3 30-48 7.5YR4/6 -0- SL 2MSBK_ MFR CW N/A .6 1.0 r 4 48 -80 7.5YR5/6 - GkLS USG ML N/A N/A 7 1.6 1 ' Etllhrent #1 = BOD > 30 220 mg/L and TSS >30 1 60 ' Effluent #2 = BOD S 30 mg/L and TGS < 30 mg4. Cat Nrwm (plesw Print) Signatures CST NumW R ERT J HARDINA 824825 Address OatelE valuation Conducted Telephone Number 477 1 AVE, TURTLE LAKE W1. 54889 5 -22 -0-# 715,986 -2-40& Property Owner HAWKSFORD Parcel ID # 0 - 1052 -30 -000 Page 2 of 2 3 Boring Boring g 0 Pit Ground surface elev. 91.67 Depth to limiting factor 80 in. Soil Applicatim Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fr? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -8 10YR3 /3 -0- SIL 1MSBK MVFR GW 3M .4 .6 2 8 -30 10YR4 /4 -0- SIL 2MSBK MFR CW IF .6 .8 3 3046 7.5YR4/6 -0- SL 2MSBK MFR CW N/A ..6 1.0 4 46- 7.5YR5/6 -0- GRLS OSG ML CW N/A .7 1.6 5 60-W 7.5YR4/6 -0- SL 2MSBK MFR N/A N/A 6 1.0 �•� �J F1 Boring # 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 GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I *Eff#2 F-1 Boring # Boring Pit Ground surface elev. it. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I *Eff#2 * Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 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. SM- 8330Test (R-07/00) . v HARDINA SEPTIC SYSTEMS MPRS /C.ST 824825 ' a 4 ;z ct Ocm iA a / N g _ N _ ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer 1- ! P"Adn e' ' A'J zItr � Mailing Address 67 o1 DD Property Address (Verification required from Planning & Zoning Department for new construction.) City /State D6E9- Vkg, o ( Parcel Identification Number py SO - 0 00 LEGAL DESCRIPTION Property Location 5 E '/4 , S w '/4 , Sec. - 3 , T 3_N R 1] Town of Subdivision , Lot # Certified Survey Map # , Volume , Page # Warranty Deed # , Volume , Page # Spec house yes no Lot lines identifiable yes 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 into 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(1) 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, signed by the 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 1/3 full of sludge. Uwe, 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. Uwe am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms _ SIGNATURE OF APPLICANT(S) DATE ** *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 from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) �elu s� 3 '.l s r- -_r t I304,r�UME - r NO. St Bar of % isconsm t°arrn 2 - 19$2 111+ "'A_FtRA.a'�TTY DEED RLGI5. S DFF-It✓ _ ST. �R 1X Co.. W1 Marion Hawksford aWa klarian Hawksford afk/a Marion L. APR 3 1998 Hawksford by Mary L. Johnson her agcn' and attorney -in -fact 8: aq L4 conveys and wG rants to Francis E. Hawksford amd Sharon K_ — �k 4,3.1ct Hawks -ford, husband and %Afe as survivorship marital prop+, the �_- followi ge, described real estaxe in St_ Croix County, Wisconsin: TR ANSFE R 006-90 t- 3n;curs- 1e- 1 -:50; Fee 006-1052-30 t t'srrr! lr t a1,a1 - z2:z Numb rssl East one— haiT(E-°V) ofthe Wrest ortG- i:atCl45°;zi of Section 2:3, Township 31 North, Range 16 West - Thus deed is given in full satisfaction of that certain land contract berween Ed Hat. -A- -ford wwa Edward F. Haxvksicrd and Mar_on Hawksford alkia Marian 14awksford, husband and wrife, (Vender) and Francis E. d°iaw sford and Sharon K. Hawksfard (Purchaser) dated June 1, 1977- and recorded in Volume 657 a. page 373 its Document No. 381954. Said land ccntxacl <vass amended by Agreement dated Dmesnber 31, !982, recorded in Volume 657 at page 377 as Document No. 391954 and by Extension dated October 7, 1992 and recorded in Volume 973 at page 369 its Document No. 489636. The interest of El Kawksfore aW a Edward F. Hawksford was deeded to Marion L. 1 -fawksford by deed dated August 25,1993, and recorded in Volume 1030 at page 329 as Document No. 50 "1 land contract is not yet clue. Vendor has agreed to discount the remaining unpaid amount to 550,000.00 in exchange for Purchaser's Agreement to Ray off the land contract early. This is not homestead property. Exception to warranties: municipal and zoning ordin :ncm casements and restrictions of record and any lien created by act or omission of Grantee. Dated this g day of March 1998. Marion W�Avksford iviary x. Joihnsoit her Agent and Attorney - m - Fact ,TA T G OF WISCONSIN ) ) ss. clr CR OI X CO R4Ty 1 Personally cane before trc this S :_ day of March. 1998- the above -named Mary Lj ). dhnson to sire known to be the person who exec&e' d the foregoing THIS DOCUMENT DRAFlZD BY. instrument and ack nowledge the same. Judith A. Remington �_ � / � REMrNGTON LAW OFFICES J h A. Remington P.O. Box 177 Notary Pub)ic SL Croix County, tiff is. New Richmond, WI 54017 My commission is permanent Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I of 2 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County ST. CROIX Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 006 - 1052 -30 -000 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 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 ❑ )W FRANCIS HAWKSFORD Govt. Lot SE 1/4 SW 1/4 S 23 T 31 N R 16 E(or)W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 2450 200th AVE. N/A N/A N/A City State Zip Code Phone Number []City Village own Nearest Road DEER PARK WI 1 54007 1 ( 71 5-246-7444 200th AVE New Construction User Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD E] Replacement ❑ Public or commercial - Describe: Parent material OUTWASH Flood Plain elevation if applicable General comments RECOMMENDED SYSTEM ELEVATION 90.25' and recommendations: 3045% COBBLE IN ALL BORES 1❑ Boring # 0 Boring El pit Ground surface elev. 92.42 ft. Depth to limiting factor 75 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -8 10YR3 /3 - SIL 1MSBK MVFR GW 2M .4 .6 2 8 -28 10YR4 /6 -0- SIL 2MSBK MFR CW 2F .6 .8 3 28 -40 10YR5 /6 - FSL 3MSBK MFR CW N/A .4 • 4 40 -75 7.5YR5 /6 -0- FSL 3MSBK MFR N/A N/A .4 .8 5 75 -96 7.5YR5/6 F2D10YR5 /3SL SL 2MSBK MFR N/A N/A N/A N/A 2 Boring # ❑ Boring 91.67 80 Q Pit Ground surface elev. ft. Depth to limiting factor in. Soil Applicatio n Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -9 10YR3 /3 -0- SIL 1MSBK MVFR GW 3M .4 .6 2 9 -30 10YR4 /4 -0- SIL 2MSBK MFR CW IF .6 .8 3 30 -48 7.5YR4/6 - FSL 3MSBK MFR CW N/A .4 .8 4 48 -80 7.5YR5/6 - GRLS OSG ML N/A N/A .7 1.6 * Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signatu CST Number ROBERT J HARDINA 824825 Address M Oatevaluation Conducted Telephone Number 477 170th AVE. TURTLE LAKE WI. 54889 5 -22 -09 715- 986 -2508 4 o$ ; � Property Owner IIAWKSFORD Parcel ID # 006 - 1052 -30 -000 Page 2 2 of 3 Boring Boring g pit Ground surface elev. 91.67 ft. Depth to limiting factor 80 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 *Eff#2 1 0 -8 10YR3/3 -0- SIL 1MSBK MVFR GW 3M .4 .6 2 8 -30 10YR4 /4 -0- SIL 2MSBK MFR CW IF .6 .8 3 3046 7.5YR4/6 -0- FSL 3MSBK MFR CW N/A .4 .8 4 46 -60 7.5YR5/6 -0- GRLS OSG ML CW N/A .7 1.6 5 60 -80 7.5YR4/6 -0- FSL 3MSBK MFR N/A N/A .4 .8 4] Boring # ' Boring 92.0 80 ❑ 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/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -9 10YR3/3 -0- SIL 1MSBK MVFR GW 3M .4 .6 2 9-28 1 /4 SIL 2MSBK MFR CW IF .6 .8 3 28-46 7.5YR4/6 -0- FSL 3MSBK MFR CW N/A .4 • 4 46 -80 7.5YR5/6 -0- FSL 3MSBK MFR N/A N/A .4 .8 Boring Ground surface elev. ft. Depth to limiting factor in. F Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 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- 9330Test (R07 /00) S7 0� s v HARDINA SEPTIC SYSTEMS j• MFRS /CST 824825 a D R