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010-1062-20-100
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building~ivisior~ INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Schwartz, Kenneth Emerald Townshi CST BM Elev: Insp. BM Elev: BM Description: ov. ~ QUO .v o-fta 5~ ~ 8~ TANK INFORMATION ELE ION DATA TYPE MANUFACTURER CAPACITY Septic _ ~~ l~'~/L / ~ O 7 Poste ~ ~ Sir S-~ Holdin •/o -fu' TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ',~U , ~ ski ~ Desing ) ~ ~ 7 r~, ~.~r r ~ / Holding PIIMP/SIPHnN INFnRM~TInN County: $t. CroiX Sanitary Permit No: 430541 0 State Plan ID No: Parcel Tax No: 010-1062-20-100 Section/Town/Range/Map No: 26.30.16.3906 STATION BS HI FS ELEV. Benchmark m az, oo,a Alt. BM Bldg. Sewer ex ~ -~ 7. SUHt Inlet B.O,~ SUHt Outlet 8. zy 9' ~ Dt Inlet ~~ Zd 9 Dt Bottom 11• ,Z Header/Man. 3' l Dist. Pipe Bot. System ~`~~ Final Grade 5 ~• Z..(J~ ~ //-- ~ () U l~ St~;ddc.~ ~ 3.by `3 . i .d3 9 . 2 S.S `t7•v BED/TRENCH DIMENSIONS Width ~ ~ Length ~ / '' 7 No. Of Trenches (~~ ~ PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth ` SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION MBER OR Type Of System: 1 y ~ ~, ~ 1 D b ~ UNIT Model er: ' DISTRIBUTION SYSTEM Header/Manifold ~~ 2 2 Length J Dia Distribution c( ~~ / Pipe(s) ~ '~ 3 Length ~ ~' Dia I Z Spacing x Hole Size fl ~ x Hole Spacing ~D ~r Vent to Air Intake SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over ee ed odded - xx Mulched Bed/Trench Center B Yes L] No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 1 f /~/D 3 ~'L Inspection #2:1L/~/ () 3 Z .a~~ Location: 1341 250th Street Glenwood Ci~ty/,~,WI~54013 (NW 1/4 SW 1/4 26 T30N,r/R''16~~W--) NA Lot 1 1( ~ o J ~~ Parcel No: 26.30.16.390B~~ 1.) Alt BM Description = ~'C~ ~ "'~" \ ' TI ~ ~tl~ Vut'Fh T"~' ~ ' ~ ~ dLl/ ~ ~"_" (9'-1 GOyt,'f U.vt 2J Bldg sewer length = I /~ y ~ ttiT P' = O ~ ~ ~,~ ~ ~/ U - amount of cover = ~ U - - __- ---, --- - ~ - Plan revision Required? ~ Yes o / ~-~~ i ~ ' .CCi 'her side for additional information. ` ~ -- --~-- ~ l - ----- ~ - - - ---------- ~ Date (~,,~ ® Inse ctor'/s Signature ~//, Cert. No. 0 (R.3/97) ~ ~~ n~u~ ~ ~ C/l ')'4-(ft !~ ~ l~ ~~// ~ ~~ l C /M ~~ ~~/ / _,, r to ~~ ~• ~~ ~; ,. T',~S SOIL ABSORPTION SYSTEM ~~~ C.' Safety and Buildings Division ~~tY s~ ~ C j ` ~ ~ 201 W. Washington Ave., P.O. Box 7082 . ~-A ~ ~scons~n Madison, WI 53707 - 7082 Sanitary Permit Number (to be filled in by Co.) De artment of Commerce (608) 26I-6546 1.113 0 ~~ Sanitary Permit Applica ionRECEIVED S . Number to Plan I.D ` ~~ ~yc Q ~ ~ In accord with Comm 83.21, Wis. Adm. Code, personal info ion you provide / t / rosy be used for secondary purposes Privacy Law, sl 04(Ixm)O V ~ 0 2~~3 NN P oleo Address (if different than mailing address) I. Application Information -Please Print All Information ~SGt,,,,,~1 ST. CROIX COUNTY Property Owner's Name ZONING OFFICE P cel # Lot # Block # Property Owner's Mailing Address Property Location /'1 ~~ Section ~ ~ s- ~~` ~~ ~~ City, State /7 ~~,!^- ttJO~(~ C ~~ l.~j i Zip Co~dej / ~- F d/ ~ Phone Number ~~~' O ~~1~J ~ . ti V T3Q N. R~6(cE ot~W~ ! ~~~36 II. 'I~pe of Building (check all th t apply) ~/ ~' / 1 or 2 Family Dwelling - Numbs of Bedrooms ~ ~ `S~ ~X'" "7f Subdivision Name Number ~ ~ O ~~ ^ Public/Commercial -Describe Use ^ State Owned -Describe Use ~ 1-ST ~ C ~(-' l0 )(~ ~'1. C~YI. CI n.0 ^City ^Village ownship of M e~' CA III. T ype of Permit: (Check only one box on line A. Complete line B if applicable) A' ^ New System Replacement System g ep y ^ Treatment/Holdin Tank R lacement Onl ^ Other Modification to Existin S stem g y B• ^ Permit Renewal ^ Petrttit Revision ^ Change of ^ Permit Transfer to New Iast Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. T e of POWTS S stem: Check all that a 1 ^ Non -Pressurized In-Ground Mound > 24 in. of suitable soil Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^ Recirculating Synthetic Media Filter ^ Leaching Chamber ^ Drip Line ^ Gravel-less Pipe - ^ Other (explain) V. Dis ersaUTreatment Area Information: 2 .Design Flow (gpd) Design. oil Application e(gpdsf) s ' Dispersal Area R qui f) Dispersal Area Prop sed (sf) ~ System Elevation /, t`]~ 3 988 ~5l 0 ~ ~5 50 ~ ~~O13s . VI. Tank Info parity in Total Number anufacturer P cfab Site Steel. Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Exisliag Tanks Tanks Septic or Holding Tank ~0 ~ ~ ~~•? ~S' Aerobic Treatment Unit Dosing Chamber ~v _~,- ~!' ~ ! Z VII. Responsibility Statement- 1, the undersigned, assume responsibility (or installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number Plumber's Address~(yStreet, City, State, ZipysCoyd~^e) /j,~ /l G ~ / ' ~Gt~,k~... !J r ~ ~G~ C~GtI /,Y~. !~`~ rn.~ ~~Ol~~i VIII. Coun /De artment Use Onl ,~.,,,, ~~ UYApproved ^ Disapproved Sanitary Permit Fee (includes Groundwater ~~ Date issued (1 uing A t Sign ture mps) Surchar a Fee 8 ) ~~ ~Q ~ 3 ^ Owner Given Reason for Denial IX. Conditions of ApprovaVReasons for Disapproval ~ ~ ~'`~ f ~/ 3 - ~ STEM OWNEF~: ~ ~. ~+ -~~C~ (,~~ G~~it'~' ~3.5~ nd d t filt er a w vn Septic tank, effluen dispersal cell must all be serviced !maintained as er management plan provided by plumber All set ac requlreme as per applicable code/ordinances. ~ ~ ~ 3~~("3-1 wrraca comprece peas lra me a:oanry Dory[ ror rae aysrem ow paper w«~ K.= .«_« «,.... . SBD-6398 (R. 08/02) ~3 ~03~ r ~ a~ 9s3 ~ ~ ~ v~ l mocc,~j '~, ~ ~ fbn /a-Eerta.ls at I~~X 3G.G9 Vd '~ori~'ce.f /Clcr /cs~ra-/ ~ z• s3.' ~Confou/ A,oPfcX bur; ea ~8.0, 2 so ~' Sf+"e c.~ ~i IOW ked d ri I/~t~. v ~ Soi/ edal'ua~io~ P; t ~ E'/2da~u'an Sca/e : / '= s~0 ~ 5~ ~ P o ~ lam; GSIr' C'.o•'1 CfCL~. ~O'S~ W: CSG/ Conc~~e P t, crap/(,W - wt iQ Cp...b;nafi7~r/ ~f.'C-'~',n~~/i~dbt~st-/GO PF{l..cc.:t r ~~i- a ~vu..E/cQQ~ . f1G~ h'(4Y~ ~ Ud~O/-7 Of^ ~l,-~~ Assumcr~ete~ -~~.~~ ~~cfc~e slab. E/ev,~- 98~. isconsin Department of Commerce Safety and Buildings 2331 SAN LUIS PL STE 150 GREEN BAY WI 54304 TDD #: (608) 264-8777 www.commerce. state.wi. us/sb www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary November 03, 2003 CUST ID No.220853 DALE E HUDSON BOLDT'S PLUMBING & HEATING, INC. PO BOX 78 BALDWIN WI 54002 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 11/03/2005 SITE: Ken Schwartz 1341 250TH St Town of Emerald, 54013 St Croix County NW1/4, SW1/4, S26, T30N, R16W ATTN.• POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD ~ HUDSON WI 54016 ~'f' ~ Y3o ~~// Identficati om Numbers .Transaction ID No. 939407 Site ID No. 202103 Please refer to'both identification numbers, above, in :all comes ondenee with-the a enc . nndl~ FOR: Description: SCHWARTZ MOUND Object Type: POWT System Regulated Object ID No.: 929615 APPF DEPAR7M ISION OF SAF ,)~. c ^EE R The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation an prior to occupancy or u e: to on the plan. #1. The existing POWTS must be properly abandoned per s. Comm 83.33 Wis. Adm. Code. 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. All permits required by the state or the local municipality shall be obtained prior to commencement of construction installation/operation. 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 to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Wesley C Grube Plumbing Plan Reviewer ,Integrated Services (920)492-5613 , M-r 7:00 - 16:30, F 7:00 - 11:00 wgrube@commerce. state.wi.us Fee Required $ 350.00 Fee Received $ 350.00 Balance Due $ 0.00 WiSMART code: 7633 DALE E HUDSON Page 2 11/3/03 cc: Boldts Plumbing and Heating Inc Leroy G Jansky, Wastewater Specialist, (715) 726-2544 RECEIVED MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Ken Schwartz 3 bedroom residential mound Owner's Name: Ken Schwartz Owner's Address: 1341 250th St. Glenwood City, WI 54013 Site Address: 1341 250th St. Legal Description: NW1/4SW1/4, Sec. 26, T.30N., R.16W. OCT292003 SAFETY $ BLDGS,-DIIf; Township: Emerald Tonally County: St. Croix ~~~D Subdivision Name: Na of COMM RCE TY AND LDINGS Lot Number: Na Block Number: Na _SPONDENCE Parcel I.D. Number: 010-1062-20-000 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 Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Site Plan Page 9 Soil Evaluation Report Designer: Dale Hudson License Number: Date: ~, 10/24/03 r~ Phone Number: Signature ~„ <> ,. r~~C~~=P!"Y~-~ 220853 715-684-3378 Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SD(3-10691-P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) Version 3.0 (03/01/01) 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 fecal 1.50 Peaking Factor (e.g. 1.5 = 150%) conform of <= 36 inches. 450.00 Design Flow (gpd) 5.00 Site Slope (%) ~ 97.00 Contour Line Elevation (ft) ' 14.00 Depth to Limiting Factor (in) 0 50 lication Rate ( In-situ Soil A d/ft2) . pp gp Distributio n Cell Information 75.00 Dispersal Cell Length Along Contour (ft) = 6.00 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 ore) ~ c Center or End Manifold 3.00 Lateral Spacing (ft) If N above, enter the elevation ft 4 Number of Laterals of the highest point. 0,125 Orifice Diameter (in) (e.g. 0.252 2,53 Estimated Orifice Spacing (ft) = 7.50 ft2/orifice Forcemain Diameter (in) ~~ 5 rcemain Length (ft) Does the Forcemain drain back? t_.__ .50 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 6.83 Vertical Lift (ft) 0.68 Friction Loss (ft) 14.01 Total Dynamic Head (ft) Lateral Diameter Selection in. dia. options choice 0.75 1.00 x 1.25 x 1.50 x x 2.00 x 3.00 x Treatment Tank Information 1600.00 Septic Tank Capacity (gal) Wieser Combination Manufacturer Dose Tank Information _ 760.50 Dose Tank Capacity (gal) 20.28 Dose Tank Volume (gal/in) Wieser WLP750-MR Manufacturer 8.16 Forcemain Drainback (gal) 67.32 5x Void Volume (gal) 75 8 Minimum Dose Volume (gal) 2 ystem Demand (gpm) Manifold Diameter Selection in. dia. o tions choice 1.25 x 1.50 x x 2.00 3.00 Gallons/Inch. Calculator (optional) 760.50 Total Tank Capacity (gal) 37.50 Total Working Liquid Depth (in) 20.28 gal/in (enter result in cell B49) Effluent Filter Information Zabel Filter Manufacturer A100 ~ Filter Model Number Project: Ken Schwartz 3 bedroom residential mound Page 2 of 9 Mound Plan View 1 /10 B • •Observation Pipe ' 3~.• . ;.r; :; .. J--~ r . .•. ti •. •'• r L`' 1 ' -f J ~l TA I -f- L - 1- I Mound Component Dimensions A ~ 6.00 ft E 25.60 in B 75.00 ft F 9.50 in D 22.00 in G 0.50 ft H 1.00 ft K 11.33 ft I 12.09 ft L 97.65 ft J 8.15 ft W 26.24 ft 450.00 (ft2) Dispersal Cell Area 1356.62 (ftz) Basal Area Available 6.00 (gpd/ft) Linear Loading Rate / 7.50 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 100.63 (ft) ~I H I F , .:: ; : Dispersal Cell 99.33 98.83 (ft) --+ - Dispersal Cell ;[~: '•'' t Elevation E • ~ D ~ ; ~: • .. .. ...• ... .• .~ .... ..... .. Y ...... 5.0 % Site Slope Shading Key 1~ Topsoil Cap © ~~»~ Subsoil Cap © ~~ ASTM C33 Sand -~' ~'~~. Tilled Layer ^5 Aggregate ~ a I 0 1.5 ft h O N 0.5 ft 0 `" ~ --1-- Dispersal Cell ~..ti,ti,ti,ti~.,;~..ti : •,. r~° .•.: ._ _Y : :: ::::~:..._ rwical Lateral ~--- A Project: Ken Schwartz 3 bedroom residential mound (ft) Lateral Invert 97.00 (ft) Contour Elevation Geotextile Fabric Cover See lateral details on Page 4 for number, size, and spacing of F laterals. Laterals are equally spaced from the distribution cell's centerline in the distribution cell (AxB). Page 3 of 9 Center Connection Lateral Layout Daigram Force main connection via tee or cross to manifold at any point. P ' •=Turn-upwtball valve or ~f.X--~IExl2~-xl2~l cleanoutplug I') Holes drilled on the bottom of the lateral. Laterals are identical Laterals & farce main of PVC Sch 40 per COMAA Table 8#.30-5 S ,L Number of Laterals 4 Lateral Diameter 1.50 in Lateral Length (P) 36.69 ft Lateral Spacing (S) 3.00 ft Lateral Flow Rate 6.18 gpm System Flow Rate 24.72 gpm Total Dynamic Head 14.01 ft Orifice Diameter Orifice Spacing (~ Orifices per Lateral Orifice Density Manifold Length Manifold Diameter Forcemain Velocity 0.125 in 2.53 ft 15 7.50 ft2/orifice 3.00 ft 1.50 in 2.52 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 Wieser Combination Ca acit 760.50 Volume 20.28 Manufacturer Gallons gal/inch Dimension Inches Gallons A 18.98 384.95 B 2.00 40.56 C 4.52 91.63 D 12.00 243.36 Total 37.50 760.50 3" Bedding A B C D er tank. Alarm Manuafacturer LevelArm _~ Alarm Model Number DLV ~~^~ Pump Manufacturer Goulds _ Pump Model Number 3871 EP04 ~~ Pump Must Deliver 24.72 gpm at 14.01 ft TDH Project: Ken Schwartz 3 bedroom residential mound E--- Alternate outlet location Forcemain diameter ~ 2 in. Weep hole oranti- siphon device P' u~elevation (ft) 92.50 Dom se tank elevation (ft) 91.50 Page 4 of 9 Mound Svstem Maintenance and Operation Specifications Service Provider's Name Boldt's Plumbing -Dale Hudson Phone 715-684-3378 POWTS Regulator's Name r St. Croix County Zoning ~ Phone 715-386-4680 Svstem Flow and Load Parameters Design Flow -Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow -Average 300 gpd Maximum BODS 220 mg/L Septic Tank Capacity 1600 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 Freauencv Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Other Ins ect and/or service once every 3 ears Should ins ect and clean at least once every 3 ears Test once eve 3 ears Should test month) Laterals should be flushed and ressure tested eve 1.5 ears Ins ect for pondin and see a e once eve 3 ears Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Cornm 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. Adrn. 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 -~" Plug or Ball Valve Sprinkler Valve Box Distribution Lateral ~~, Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Ken Schwartz 3 bedroom residential mound Page 5 of 9 ~~ d ~ ,, ~ r~ y r`g ~ ~L b * t ; f F y ;~ j k ~' ~~ R t ~ s ~ ~. F t ~~ ` ~aj ~S r + ~ ~ t~s ~~ J ~~ 1 GOUT US r 5.~~~ t "~)~ !~~ 'fj { ~'' i ~ 1. ¢ ~ ~ A ' fR¢ ~ ~ r ~~ i'Y I ~ j ~. Pump Sp,;cifications ',', H F i Up tc ~, uP~VI ', Discl~~~ ~e ~i~, 1y," IVPT " f/iCfor ~: 5~ngl~ ~has~~ 115V ~~~ IJl~ten.ils of Construction ~ Fea'~~a~~es anti Benefits ' ` ~~.~ i~~e ~ t,llCr a~llrinal~s ~ ~' r~~ ~l r ~ o~~ging. ~~rrc~ on r-.sisiant ~ " ~ ~~ t r cal ~~ ~ " ~~ ~~ rtu. t~~~~ s~~.vi~ct. _ _.____.~__._..~_.r __ ~~ ~i ~ ~~ __~__.__.~_____._.__._ IJ; ii :if ' .._ ~ r~cue~ ~ ~ ~~~s I -`` ` i _ _ _ ~ - -. ~ Ali ~. ~ _ I _ ~ __ I ,_ ,_ _ ~ ~~ i~ zc _ i so ~ s ~ us«n ~ a ~ F u,'m~ '~ L 1?kC,l ~ I iIC ~H; FFf f - _ _ _ i yti o~~ a -- , - ~ r r -- -~ - z~ - - --;- - -,) ~ --. ~. ~ ~ 6. 20 ___ ~ _.. ~ __ ~ _ __. _ 5! .\ ~ io .__ _ _. _ _ _ _ _ _ _,t_. 9. i0 .. _.I_ _ - - - -\ _. _... .. i _ ~- - F - - -- - ~, __ - ,o..- i --j .~- --;~ a s~r;~ C__ z.__ _ _ .__ _____F ___. ,,___. _____L:. jf ;, A i, l" C F'.ir,tp Spe~ifc~~:i~r~5 ll ~~ '7 )'' M M r r~et-tuies dr~~~~~rl~fl,s '~~ b~l~l ~!> I I~ ° ~f'~4 I'1N',3"- ~ ~ili-C1 ' C? ~~CII I~ O (j (a-~) t'/i',fl ;Uil) Ol't / n~':: i. r''Ci~ C1 1~-1X nla!11 1, l(1 lC i; ' III~~C~,;~J ~' li i'~i~. ~~IiC'l~iICIC ,IZ'' '/' ~~'~ '°~f'~: ( i~ ~'~~ . ~ Il;FO`:C i;: ~~, ~C ICS 9~7 rCX till ~ '0 11'J ~ ~~ i LI'~r ~l< iC I~lotur ° R~,9~ rC ~ a~.-iil,~ ~Ir_, r (I, st~c 41. m~clors ~c~ t a .E L~ I ~a ;irk n I ir,.sE lE~lq~ ~ i ~e~~ ~earn~, corst u~ti~n su~~e~~c ~lr:;~rg I ara .o ~so~~, ~l rg~e ~~ha: c': ~ .5~i re a ~u cE. ~i_3tr:r18iSC,l(;U~1SfIUaIOr; ~~`~" rC 11J'GI Oi,~N) 0 ;~Sl IC~II ef1Cl~"1 h'9~ J~ f Std "ft''(t I ~'~?rll(liil: il( ~In'_I (llr ll; i11~ ~C.llll~,5° S uE "COI( `I ail ~r;3,(i;[ h'~.I~ ;C~_C ~Av,iil,~.~l, ~~o~ ~ku~~,C Ir:~~.ti~_ II_~,I nr,~nt,,l ol~erthci . f;~~ ~1~ iC~c~3c'I =' C'~: ~ ~(IB(~ FC(C Gr.'1. )UU~ S C~~' "<7'6:/~ a'~cl ~t ~ )it;/? ='i J~ , ~E' :S _ 1'c?! Ali! 'C ~ l ~%; ~. ~~~~ 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) 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 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 fitter 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. Puma 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 Svstem No trees or shrubs should be planted on the mound. Plantings maybe 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 10° 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. Contingencv 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 v~ith a component of the same or equal pertormance. 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 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Ken Schwartz 3 bedroom residential mound Page 6 of 9 ~ .So,% eda~uau~'v.~ P,~t • E/eda~u'or~ N tee. ct mou.~(af. ,Z L.z~ X 97, l,S' ! a.~ .z• s3.' A,~»~ou~ ,2 ~-o ~- 5fr'e c.~ AioP~~' bcci,'ec u~; ~/ouJ hed t d ri vee,.~ty v n ~- ~,Y%5 ~r'iX~ WC l S~ rd q8.o' o/ao5eC1 WicSCr'Concrc{~ oPoS~ W.'CSC.i Cancr?~e ~L P t, ago/G cn - .n R Goanbinafi7~v) /bt/' a~vu.#/c~. ,C ^Mctim~ ~ dL`~o~ of ~. i~~-nCj f~ SSuiltf~ 2 ~Q~`.' = /CC~.00 ? Co~~f~ slab. E/ec!~= 9v',~. ~. ~°.~' 9 ~ a~ 9s 3 , ST CROIX COUNTY SEPTIC TANK MAIN~ANGE AGREEMENT OWNERSHIP CERTIFICATION :FORM Owncr/Buyer _~~ ~'I~ t~~``- J C h u~ Mailing Address _ ~-~ ~~ .~~~,~~ `~"> Property Address (Verification rcquir+cd from Planning Dcpartrncat for new - City/State ~t- r-~l (~! L,~c~>' , Parcel Identification Ntunber ~'~o~/Q6 G- `~~-' T~EGAL DF;SCRZP'~ON 390 Property Location ~ '/<, %~~a ~/,, Sec. ~~ . T -SL~N-R /~ W, Town of ~ ~ r'~ Subdivision Lot # Certified Sarvey Map # (v0 7 ~ S~ .Volume ~ -3 ,Page # 3 ~ ~3 ~~G~f `~ 5 Warranty Deed # `~~~ f ~ -~ Volume % Page # /O 6 Spec -hoase ^ yes Cd no Lot lints identifiable C~' yes ^. no SYSTEM~~VIA.IN9CINANCE - - Imp~o~Crusc and mainicaaa~ocof your septic systcmeould rtisvlt is its far7utC to handle wastes. PropcrarainLcnarboc of pam~g oat the septic taa>c every throe years or sooner; if nacdcdby a licensed pamper. What you put into the system caa~affoct~;fun,aioa of the sc~isc tanlCSS-a trcatmcat stag~c is See '~y~- - _- The., pmpaiy-owner agrees to sabmit-to St. Ck+oac Zoning i ceriificatioa fear, signed by the owncc and by a - PPh~ t~oictodphmrbcror i ~Casodpaarlxxrrtfying that (Ij cfx oaaito ~dssposal system is is proper operating ovtyditioa:ad(or (2) after iaspodi~ and .Cif aiy), the septictank~is Less tlraa 1/3 full of iludgr.. -Uwe„ Sre ua~derxigaed have read the above roquircmca~ and sgrx to maintxia fire private sewage disposai system with the standards . set fartf~, hcirm,'as set by the Ucpartalcot of Commare and the Dgsarimcat of Platural Rcsour~ State of Wisconsin.- Cutifi<xtion that y+oar septic system has Boca maintained nnnst be oomplctod and rcmmed to the St. (~oix.Coemty Zoning Office within 30 days~of Sic tlrix ~. 0,9~,a3 GNATURE OF APPLICANT DATE OWNER CERT'>~ZCATtON ~ (we) oatify that all rtat~ts on this form arc true to the best of my (our) l~aowlcdge. I (wc) am (arC) flit own«(s) of the property 'bed abo virtue of a warranty deed rrcordcd is Register of Deeds Office. GNATUI F APPI:I DATE s•««ss ~.„, mformatioa that is mLS-PGprCSCaiOdmay Ir~lllt lII the tdnrtaiy perIIlit bCtng revOlCCd by the ZOarrlg DCparflIICnt. 4s<sRs •• Indade rvlth this application: a stamped wacxanty decd from the Register of Dads office a copy of the. certified survey map if r~efct+cuce is made in the warranty deed r~RIGIRlAL SOIL EVALUATION REPORT Wisconsin Department of Commerce Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code 1201 Page I of 3 Certified Soil Testing ounty 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 Parcel I D. percent slope, scale or dimensions, north arrow, and loca' i q crest road . . 010-1062-20-000 (CSM from) Please print all infor i ..1 ' R e Dat \ Personal information you provide may be used fors da rposes (Priv~Law, s. 15.04 (iy(m r' ~ ~. Q ropey caner WQ ~ ~ . .. rope ~Y- ca ion Schwartz, Ken ~, ~~ Go .Lob ...~ NW 1/4 SW 1/4 S 26 30 N R 16 W Property wner's atling ress 1 ~ 4 M # --- - lock # Subd. 1341 250th St. ~+ gT CROsX ~ 12 A. CSM From Above 40 City State Zip o ~ ne Numb8t3U ~ ; it Village Town FF Glenwood City ~ WI 54013 '~ -E7t~-356 w r` ~ Emerald 250Th St. ~ ~ - ~~~ ~ 5 `~ ~' J ~j, ~b New Construction Use: Residential / Nu r~offb~drbam~...-~ 3 Code derived design rlow rate 4cu ~ru _~ yi Replacement a Public or commercial -Describe: Parent material loess over till Flood plain elevation, if applicable NA General comments ~ y ~y.~}/S'~ and/ recommendations: install 7.5' x 60' rock unit mound on .97.3 contour as do4vnslope edge of~r"ock w/ 1.9' sand fill d'~Pr~ Cl/1.~ ~~~'~/ H~O~ 4 ~ ,~`~" ~°r'Q `~~(,r~ G>'' '72fl f~~.a~o ~- ~ f Boring # _j Boring y Pit Ground Surface elev. 97.8 ft. Depth to limiting factor 14 in Soil Application Rate Horizon De th Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP Dift' p in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0-7 10YR 2/2 - sil 2 rt ,gr ds cs 1 f/m .5 .8 2 ~ 7-14 10YR 4/3 - sl 2~sbk dsh cs 1m 5 _9 3 ` 14-36 7.5YR 4/4 c2p 7.5YR 5/8,5/3 sl 2 m sbk dh - - .5 ', 9 ~'~ ~ . _ - -- ~ ~ - Boring # _,.,i Boring ~ Pit Ground Surface elev. 96.0 ft. pepth to limiting factor 20 in. Soil Application Rate Horizon ' Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DIft' , ~~ in. Munsell Qu. Sz. Cont. Color ___ 1 ~, 0-4 10YR 3/2 ~ - sil 2 m gr ds cs 1f/m .5 I .8 2 '~ 4-12 10YR 2/2 - sil 2 f sbk ds cs 1 m .5 ~ 8 3 '. 12-20 10YR 4/3 - sl 2 m sbk dsh cs 1 '~~.~~ ; .. __ 4 4 20-52 7.5YR 4/4 c2p 7.5YR 5/8,5/3 sl 0 m dvh - ~ ~ ~i , ' S ,~ , i - ' -~' e b k vev s ~ ~ - wccl~c r - re ,~-~e n 0 ~ ~ i s. i STV ~~ ±..-_~ }~` ;' 11r ~;,~s . Effluent #1 = BODs> 30 < 220 mg/L and TSS > 0 < 150 mg/L ffluent #2 = BOD < 30 mg/L ' ~ _ g/L ~ ~;': ~,f ame ease not igna ur : _ ~ ' ~ . . 222 i. _• J.,,, ,.r! Henry F. Grote t ~ I ! r,} ,~ `' Address Certified Soil Testing Date Evaluation Conducted Telephone Number E. 4366 353rd Ave., Menomonie, WI 54751 9/21/2000 715-233-0398 • ~ ,^A~i I V `~k0 I-n~ V/ ~~ ~k~ ~~, Property Owner Schwartz, Ken Parcel ID # 010-1062-20-000 (CSM from) Page 2 of 3 ^ Boring # Boring Pit Ground Surface elev. 94.2 ft. Depth to limiting factor 12 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots = in. Munsell Qu. Sz. Cont. Color Gr. h. yQ, 1 0-4 10YR 2/2 _ sil 2 m gr ds cs 1f/m .5 ~ 8 ~( 0 2 4-12 10YR 2/2 S~~l _ d ~ `T 2 f s k ds cs 1f .5 j .8 3 12-40 7.5YR 4/4 c2p 7.5YR 5/8,5/3 sl dvh - - .3 5 1 I m - r ~' sh ~ ~s r~ d ~ - acs +4 ^ Boring # Boring Pit Ground Surface elev. 95.2 ft. Depth to limiting factor 11 in. Soil Application Rate Horizon ~ Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots = in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0-4 10YR 2/2 _ sil gr ds cs 1f/m 5 g 1 2 4-11 10YR 2/2 _ sil 2 f sbk C ds cs 1f .5 I 8 3 ! 11-30 7,5YR 4/4 c2p 7.5YR 5/8,5/3 sl 0 m .dvh - _ .3 T 5 ~- i acs + Boring # ~ Boring Pit Ground Surface elev. 96.5 ft. Depth to limiting factor 15 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots = in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 ~ i 0-3 10YR 3/2 _ sit 2 m gr ds cs 1f/m .5 '; g 2 i 3 3-8 8-15 10YR 2/2 10YR 4/3 _ _ sil sl 2 f sbk 2 m sbk ds dsh cs cs 1 m 1 m ~ 5 8 5 I 9 4 ' 15-28 7.5YR 4/4 c2p 7.5YR 5/8,5/3 sl 0 m dvh - - .3 .5 I "Effluent #1 = BODS> 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-8330 (RA7/00) Certified Soil Testing t f 12.y J C.K w e-~v ~ ~ ~ 0 1. o V J~ 1 av~ 1 ~ ~ ~-tt'~-t 2 s 2~}~ ~ L o l~.p o '~-~-0- ,6.0' - f i, (~~. r,as3 R4.z~ y ~. 2( w ~~.~ ~o K 1 ~ ~~~. tobZ,- Zo -moo N~w_ ~w _ Lla•~ -1dw - ~ ~ "` to ; ~ w f(LV o~,tY~ ~ ~ 4 . C.+~ y-t iv o •.. w~ 134-1 ~.~s-o ~ ~1, C~~,~ w~ /' ~y.~'~ a ~Z•1~ -~,- 5~ ~~ Cwt1 w.+4bl~ C ~ ~~/; 5 s w• ~... e. ~+w:~ ~~ - ~: 3, S'~ r" S~. 1~ `i ~ •~ ~Y.a.~' w. ire,.,. ~- 3eS.? 1 ,~ h~,.; ~3-~ "-_~l r `y L r. lLt P( ~' ~ ~ ~ ~, a:~ ~ Z"`~'' stn isconsin Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LACROSSE Wl 54601-1831 TDD #: (608) 264-$777 www.commerce.state.wi.u6/SB Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary December 13, 2000 OUST ID No.22277~ !~ SS 4 ~u,,rt(re VOGEL GROT .~'Gl~s 3RD AVE MENOMONIE WI 54751 ,..-_-.n _.r_.. r~ BE: CONDITIOl~1AL APPROVAL /~. ~ %' ~ F ATTN.• POWTS INSPECTOR ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD SON WI 54016 ~' , l` -0~ .~°; PLAN APPROVAL EXPIItES:1Z/1312+1~G f , ~~.,, w i s~,,y, f SITE: ' - `~ 6~ '-~ r Site ID: 202103, Ken Schwartz ` ` -r•~ St. Croix County, Town of Emerald ~ o NWl/4, SWl/4, S26, T30N, R16W ~'`'~ FOR: Description: Three Bedroom Mound System ~ _ _ j`/ Object Type: POWT System Regulated Object ID No.: 771364 Identification Numbers saction ID No. 451960 ~,,ID No. 202103 se refer to' both identification numbers,..: The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD-10572-P (8.6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD-10573-P (R.6/99). • In the event this soil absorption system or any of its component parts malfiinctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • An 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. • 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 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. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. VOGEL GROTE Page 2 12/13F00 Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, Gerard M. Swim POWTS Plan Reviewer -Integrated Services (608)-789-7892, Mon. to Fri. 7:15 AM to 4:00 PM jswim@commerce.state.wi.us DATE RECEIVED 11/08/2000 FEE REQUIRED $ 175.00 FEE RECEIVED $ 175.00 BALANCE DUE $ 0.00 'WiSMART code: 7633: GENERAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR01 REAL ESTATE TOWN OF EMERALD COMPUTER NUMBER 010 - 1062-20-100 Parcel Number 26.30.16.3908 Claimed 1 Date Re-certified 12/04/1998 Relate Number: OWNER NAME: First KENNETH D & LILA Last SCHWARTZ CO-OWNER Mailing Address 1341 250TH ST City GLENWOOD CITY State WI Zip 54013 - Type Vol Page Doc # Rec.Date Type Vol Page Doc # Rec.Date HISTORY 759/ 106 07/23/1997 563/ 482 07/23/1997 PROPERTY ADDRESS: Hse # 1/2 PD --Street Name- Type SD Apartment Post Office 1341 250TH ST School District: 2198 - GLENWOOD CITY Special District: (1) 1700 - (2) - (3) - WITC Plat Code: Last Changed on: 07/27/1999 Book Number: 1 SECTION 26 TOWN 30N RANGE 16W '/+160 '/.40 Map Number: 00 - Sales Area: Parcel Control 0 TAXABLE Number of Units: ZONING: Permit Number: Type: Bank Numbers F4-Prev, F5-Next, F6-Legal, F7-Value, F8-History, F10-Exit, F12-More ~~ j ~A~ATION REPORT in accordance with Comm 85. Wis. Adm. Code 1201 Page 1 of 3 Certified Soil Testing Wisconsin Department of Commerce Divi ion of Safety and Buildings ounty 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 Parcel I D percent slope, scale or dimemsions, north arrow, and location and distance to nearest road . . . 010-1062-20-000 (CSM from) Please print all information. Reviewed By Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ropey yvner ropey oca ion Schwartz, Ken Govt. Lot NW 1/4 SW 1/4 S 26 30 N R 16 W Property wner's Mai ing ress Lot # Block # Subd. Name or CSM 1341 250th St. 12 A. CSM From Above 40 City State Zip ode Phone Number Cit Village Town Nearest Road Glenwood City ~ WI 54013 715-684-3565 Emerald 250Th St. -___ _; New Construction Use: ~ Residential /Number of bedrooms 3 Code derived design flow rate Replacement Public or commercial -Describe: Parent material loess over till Flood plain elevation, if applicable General comments and recommendations: install 7.5' x 60' rock unit mound on 97.3 contour as downslope edge of rock w/ 1.9' sand fill GPD NA ~ Boring # Boring ~ Pit Ground Surface elev. 97.8 ft. Depth to limiting factor 14 in• Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 I 0-7 10YR 2/2 - sil 2 m gr ds cs 1f/m .5 .8 2 ~!i 7-14 10YR 4/3 - sl 2 m sbk dsh cs 1 m .5 I 9 3 14-36 7.5YR 4/4 c2p 7.5YR 5/8,5/3 sl 2 m sbk dh - - .5 .9 I I - --- -- - --i- ~ I I Boring # Boring Pit Ground Surface elev. 96.0 ft. Depth to limiting factor 20 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. 1 ~ 0-4 10YR 3/2 - sil 2 m gr ds cs 1f/m .5 .8 2 i 4-12 10YR 2/2 - sil 2 f sbk ds cs 1 m .5 ~ 8 ---, 3 12-20 ~ 10YR 4/3 - sl 2 m sbk dsh cs 1 m .5 j 9 I 4 ' 20-52 7.5YR 4/4 c2p 7.5YR 5/8,5/3 sl 0 m dvh - - 3 ' 5 _ __ '~ i " Effluent #1 = t30D5> 30 < 220 mg/L and TSS > 0 < 150 mg/L 'Effluent #2 = 80l 5 < 30 mg/L and TS5 < 30 mg/L ame ease not igna ur : um er Henry F. Grote ` 222774 Address Certified Soil Testing Date Evaluation Conducted Telephone Number E. 4366 353rd Ave., Menomonie, WI 54751 9/21/2000 715-233-0398 .l, Property Owner Schwartz, Ken Parcel ID # 010-1062-20-000 (CSM from) Page 2 ~ of 3 ^ Boring # ~ Boring Pit Ground Surface elev. 94.2 ft. Depth to limiting factor 12 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots = in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0-4 10YR 2/2 _ sil 2 m gr ds cs 1f/m .5 .8 2 4-12 10YR 2/2 _ sil 2 f sbk ds cs 1f .5 .8 3 12-40 7.5YR 4/4 c2p 7.5YR 5/8,5/3 sl 0 m dvh - - .3 5 i acs +4 Boring # "Boring Pit Ground Surface elev. 95.2 ft. Depth to limiting factor 11 in. Soil Application Rate Horizon ~ Depth in Dominant Color M Redox Description Texture Structure Consistence Boundary Roots = . unsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0-4 10YR 2/2 _ sil 2 m gr ds cs 1f/m 5 ', 8 2 4-11 10YR 2/2 _ sil 2 f sbk ds cs 1f .5 I 8 3 ~ 11-30 7.5YR 4/4 c2p 7.5YR 5/8,5/3 sl 0 m dvh - _ .3 5 i i i acs +4 -- ^Boring # ``mil Boring ~j Pit Ground Surface elev. 96.5 ft. Depth to limiting factor 15 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. 1 0-3 10YR 3/2 sil 2 m gr ds cs 1f/m .5 I 8 2 3-8 10YR 2/2 _ sil 2 f sbk ds cs 1 m 5 ', 8 3 8-15 10YR 4/3 _ sl 2 m sbk dsh cs 1 m 5 g 4 i 15-28 7.5YR 4/4 c2p 7.5YR 5/8,5/3 sl 0 m dvh - - .3 .5 i I 'Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L s _ _ `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 608-266-315 I or TTY 608-264-8777. SBD-8330 (R.07/00) Certified Soil Testing DOCUMENT NO. ~E .4i89~ STATE BAB OP WISCONSIN 1'ORl[ ]l - ifs11 w~RAlrnr oEEo _ This Deed, ,naa. b.c..ell ....Doris M...Sct~rarta~..a.aingle ..Flersoa?~ ..........................._............._.._........___._..___.._......._.....---........... aad..... t}I..Sc~iwartz••aa~d Lila sctsaartzR- t}usba~~d_ --,as surviwrs?lip..n~rit~1..P?n?P.?rtY.~.._...-•----.-•-•-.--.-.--•--• .................................................................................................. (isanteey Witneiseeth, That the said (irsator, foe a ~alnabis eoasiderstion..--•- of cne dollar and other valuable oonsideraticn~_.___.,,,,,,•... ooaveys to Grantee tM following described real estab iB ..$~*..5~'.4~C ............. Cotulty, State of Wisconsin: TMIe MACe ReetllYeA IuR aeGOR°INO DATA r~e+~r~s office ST. CAOIX OD.. WIS, Rse'd. bir Reiaord Nlla ~ rd doy of__A.0.19 86 ~~ 11: 40 A , stir w A N ~/2 of the W ~/2 of Section 26-30-16, N 7,/2 of I~ ~/~ Ta: Paml No: of 1W1 ~/4 of the same section, gown and range, E ~/2 of the SW 1,/4 of Section 26-30-16 EST the E 330.0 feet of the W 544.5 feet of the S 297 feet of the SE 1,/4 of tike SW i/4 of Section 26-30-16s ~~: µ a r T ~XE2 This ............................ homestead property. (is) (is not) Together with all sad singular the hereditamenta and appurtenances thereunto belonging; And:.~~_ M..-Scl~raaxtz warrants tha! the title is good. indefeasible in tee simple and free end clear of encumbrances except recorded covenants, easements and restrictions of record, if any, and will warrant end defend the ssrre. .}~ 1 ~ Dated this .....1~....Lr.N .............................. day of --- -. ............................................... 19.86... ........._.(SEAL) -~/.A:~i.L1-- ,,. ..(SEAL) !I • ..............................................................•--- Doris M'...........•------. ...... ............. ....-•-• ..............°----•-•------.._..._........----••-------..._(SEAL) --•---...--•-••--••---.......-----....._..._.......°---.._.._...---(SEAL) AV?BHNTICA?ION ACHNOWLHDdl[HN? j 1 Sigastare(s) .» .............................°---.----.-____.__»..~» STATT Gvy' WISCON9IN ~ ~~ .»..---..»-------------°-..._.._...--------.....------...._...____.___.__ ~rLtr~ll........_....._......_.Connty. ~ ~ ~ antheMiested this .....---day of .....................---• 19----- ersonally came before ms th' .--- ~ ~..--day o! t ~.~l:.t.t. .. 19r.~~_ ~9 Sbgw named ...................................•----._...----------------.._~~------°° Doris M. :iC114JdrtZ •' 5; • - TITLE: MEMBER STATE BAR OF WISCONSIN s wthorIzed by ~ 706.06. Wis. State.) • . i to me known to be the person .....,.;t.~ '~ E1le foregoing inatrnment and acknowledge. TH1a INSTRUMENT WAS DRAFTED BY - '•.•...• Ibbert F. Wall , •` ,_---•-- -• RIQ~A)~&,--~1g1LT.--i~-~7S•---------------__----------- • -----l~_.:::~' .~~._.....U~?.x:=~„~c ~c-J 52 Second S , P.O. Box 151 -- --- -/}~ ...- ............... -- ~..~....` ............................------------ Notary Public ..C.,4~:~_.._....._._......_....County, Wis. (Signatures may be authenticated or acknowledged. Both 'My Commiesion is permanent. (if not, state ezpiration ~ are not necessary.) _// • ~ / " date: .+,eti~l,~t'..:~~ ................••-•---..........19_~t:?.) 1 ---.._~ ---~_~.. ___ ___ _ ._ _ _------- - - ---- __.. __ 'Namr a[ Dsrsons .kaiai is aaT pDacity should hs t7D.d or Driated bebw their sifaaWr.s. 1, WA1tAAt11?! DsiD QATE BAS 0I wIaCONatN Wiseonsia Leta) Hhiak Cap Ia4 MBY Nw t - bq Liilwwkee, Wis. r ~ r,' SOIL EVALUATION REPORT Wisconsin Department of Commerce Division of Safety and Buildings in accordance with Comm 85. Wis. Adm. Code 1201 Page 1 of 3 Certified Soil Testing Dun y 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 Parcel I D percent slope, scale or dimemsions, north arrow, and location and distance to nearest road . . . 010-1062-20-000 (CSM from) Please print all information. Reviewed By Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ropey caner ropey oca ion Schwartz, Ken Govt. Lot NW 1 /4 SW 1 /4 S 26 30 N R 16 W roperty cane s ai ing ress Lot # Block # Subd. Name or CSM 1341 250th St. 12 A. CSM From Above 40 City State Zip o e Phone Number Cit ~ Village Town Nearest Road Glenwood City ~ WI 54013 715-684-3565 Emerald 250Th St. _~ New Construction Use: Residential /Number of bedrooms 3 Code denvea Design now race 4~u ~ru _/~ Replacement Public or commercial -Describe: Parent material loess over till Flood plain elevation, if applicable NA General comments and recommendations: install 7.5' x 60' rock unit mound on 97.3 contour as downslope edge of rock w/ 1.9' sand fill Boring # Boring Pit Ground Surface elev. 97.8 ft . Depth to limiting factor 14 in. Soil Appliption Rate H i th D min t Color D tion Redox Descri Texture Structure Consistence Boundary Roots GP D/ft' or zon ep in. o an Munsell p Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0-7 10YR 2/2 - sil 2 m gr ds cs 1f/m .5 .8 2 7-14 10YR 4/3 - sl 2 m sbk dsh cs 1 m .5 .9 3 14-36 7.5YR 4/4 c2p 7.5YR 5/8,5/3 sl 2 m sbk dh - - .5 .9 ^ Boring # Boring Pit Ground Surface elev. 96.0 ft. Depth to limiting factor 20 in• Soil Application Rate Horizon Depth in. Dominant Cobr Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GP D/ft' 1 0-4 10YR 3/2 - sil 2 m gr ds cs 1f/m .5 .8 2 4-12 10YR 2/2 - sil 2 f sbk ds cs 1 m .5 .8 3 12-20 10YR 4/3 - sl 2 m sbk dsh cs 1 m .5 .9 4 20-52 7.5YR 414 c2p 7.5YR 5/8,5/3 sl 0 m dvh - - .3 .5 'Effluent #1 = BODS> 30 _< 220 mg/L and TSS > 0 < 150 mglL 'Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L ame ease not igna ur : _ um er Henry F. Grote ` 222774 Address Certified Soil Testing ate Evaluation Conducte Telephone Number E. 4366 353rd Ave., Menomonie, WI 54751 9/21/2000 715-233-0398 1 r_ Property Owner Schwartz, Ken Parcel ID # 010-1062-20-000 (CSM from) Page 2 of 3 `' ^ g Boring $ Borin # ~ Pit Ground Surface elev. 94.2 ft. Depth to limiting factor 12 in. Soil Applicetan Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0-4 10YR 2/2 - sil 2 m gr ds cs 1f/m .5 .8 2 4-12 10YR 2/2 _ sil 2 f sbk ds cs 1 f .5 .8 3 12-40 7.5YR 4/4 c2p 7.5YR 5/8,5/3 sl 0 m dvh - - .3 .5 acs + ^ Boring # Boring Pit Ground Surface elev. 95.2 ft. Depth to limiting factor it in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0-4 10YR 2/2 _ sil 2 m gr ds cs 1f/m .5 .8 2 4-11 10YR 2/2 _ sil 2 f sbk ds cs 1f .5 .8 3 11-30 7.5YR 4/4 c2p 7.5YR 5/8,5/3 sl 0 m dvh - - .3 .5 a s + ^ Boring # Boring Pit Ground Surface elev. 96.5 ft. Depth to limiting factor 15 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0-3 10YR 3/2 _ sil 2 m gr ds cs 1f/m .5 .8 2 3-8 10YR 2/2 _ sil 2 f sbk ds cs 1 m .5 .8 3 8-15 10YR 4/3 _ sl 2 m sbk dsh cs 1 m .5 .9 4 15-28 7.5YR 4/4 c2p 7.5YR 5/8,5/3 sl 0 m dvh - - .3 .5 'Effluent #1 = BODS> 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) Certlfied Soil Testing F. ~' 4 ~ t9~~o~.`.`e 'fir o tC4o~' p~+..e, ~. S2M J C~"l W. e-~V ~ ~' ~ ~'O~ V~ ` sy~ t pp ~~ ~ zo 4Q ,~ as. S~ ~ ~, / (~~ , z) mow.. ~w-2.1e•~-It.w 1 ~ 4 , ems, ,,.~ ~, o .,. o.,~ ~ +3 / ~S-3 (~~.z~ ... 2(w ~,l a~n o C~-~~ ~- ~t - lT. ~ - 19.~.3~ - ~4b-r) ~-~ / _ ~~+ ~~~ S~o~ ~s.t~e ,~3 ~~~: Ca.i 1 w.. Gam) ~ ~ o v v.+. ~ ~~.,,~. .. 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