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014-1017-90-000
I I I I ~ d I ~ ~. M ~ C ~ @ 3 N O- ~ I o ~ m I ~ I ~ c I ~ O I I g' 7 N I 7 n I Z 0 I =ti O 7 I W I n Z I o =f o. 7 I I' I I I I I I I I N O n~ O ~ O N °' ~ m m ~' n p 7 n CD y ~ o ~ v n •~ ~ ~ ~ 01 fD ~ ~' ~ N ~ ~ O N n 7 3 m ~ `° 7 ° c ~ n c o S a o ~~ 0 (n Z Cn Z D m cfl D ~ D ~' m a a W ~ r. ~ 0 o i o m N ~ ~ ~_ N N C o in a ~ ~ m o ~ ~ ~ O 3 O .Z7 (D C (D 7 V7 D U1 Ul N v N ~ 7 `G G1 7 ~~= O S D n nNCO7y v , =y a _ ~m7occ°1i 0 ~c 7 v m ~ m --o ~' 7' O y o 0) fD 7 CD ~ N ~ N (D ~ ~v'D`< N fD D O 7 n ~ N ~ ~ N ~1 y n S vi a n N ~, j O p W ~ ~ ~ a ~ (D ~ N S'O O ~ 7 ~ O paj ~ O ti N O' ^! S . O p y j~ 7 (D O (p TI -" fD L11 N CO ~,D°~ m O cnv, ~.m am f . fD ~ S n ~ p O [) () O O ~- N Z 0 v o" 7 N 7 a Z ~i o' 7 W d Z o_ M N O 7 d O ~ O N m c O ~ ~ p 7 ~ N y (D N (D 7 7 ~ ~. ~ N 7 7~ m (O 7 n a ~ a o (n Z (n Z D D D ~ W O O r. o m c ~ `~ CD 3 o in 3 ~ m ~ ~ o ~ ~ ~ O s N .(1 CD C fD (D 7 N DN cn v v ern ~ 7~ m 7 0 ? -o,? D a n N C 0 7 N d= fA n _ ~~7mccoi 0 ~~ 7 m n..n~ zm m c~ o ~-o ~ N n ? N Z o , ~ ~ N O D. P 73~ O ~. 7 7 N D N m'~ ~ m d N D O 7 n (7D N ~ ~ 3d-,vv, vi aO 0 ~s N , ~ V aO - O ~ ~~ _ O j m ~ m ~ cn (p ~~ O p n d 7' j ~ O. O 7 O N ( ~ N TI -~' (D N N (~ ~,D°~ m O fn N ~. d am ~ ~ O N O ' ~ = a p 7 O O O O O ~ o Nom 3 o Cy ; ~ ~ d ~ ". ~1 ,7 ~ ~ ~ ~o c . ?" ' ~ '9 ~ ~ ~ ~ ^ ~ ~ ~ ': ,~ gc ~ ` 1 ~ ~ 0 car, ~ '', m oT °a ° ~ ~. fD W a (/f r ..a ~ -J (a ~ v ~ .+ ' O ~ j v O lAl ~ 3 ~ co ~ 1 0 ° 7 N -• ' '' .Ni C O `~' N , a o a 7' I ° o c n m ' ~v , ~ 0 0 ~ A A ~ ti O Q • * 3 ~ ~' ' ao ~ Ul Ul fA O ', ~f ~vv,° ~ ~ N ~ - ~ ~ ~' M N D D 0 o a • N N ~ y 7 Cr 7 N a ' ~ ~ N c A ? n J Q A ~ ~ N .. ~ ~ O W ~ C < ~ d ~ ~ Z ~ ~ ~ O'•' Z C C CC C < f/1 Z O W ~ A ~_ c a fi A A tr ti a N O a A h M N W VV ~ b N W,is'~onsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide maybe used for secondary purposes [Privacy Law, x!15.04 (1~j(m)]. 'ermit Holder's Name: City Village X Township Kre er, Jim Forest Townshi SST BM Elev: Insp. BM Elev: BM Description: .a ~ G TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic t ~~~'L. ~~.~ Dosing ~ ~ ~ ~~ Aeration /~~c, G ~ K, Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ~ /0~3~ ~ J/~ / ~( ~ ~ J71 /VtJ" ~ )~ /v ' - Dosing ~/~ - ~ ~ ~ Aeration Holding PUMP/SIPHON INFORMATION Manufacturer ,,1' ,t ~ ¢~ a Demand GPM Model Number ~~~ ~ ~ ,~ TDH Lift 1~ ~~~ Friction Loss ~ ~ f ~ System H d • ~ TDH Ft zZ •~ ~ Forcemain Lenfgth r Dia. ~~ Dist. to Weil l~ N SOIL ABSORPTION SYSTEM ELEVATION DATA county: St. Croix Sanitary Permit No: 453237 0 State Plan ID No: Parcel Tax No: 014-1017-90-000 Section/Town/Range/Map No: 08.31.15.119 STATION BS HI FS ELEV. Benchmark Icy 9~ ~~ c ' Bldg. S wer , •]~ SUHt Inletnlet X3.5 9i.y~ SUHt Outlet \ Dt Inlet \ Dt Bottom (.7 ~ ~~ ~7• ~ 5 Header/Man. tr • ° i,J 5.e5 Jr, ~3 /9- C/~o Dist. Pipe 5 . a 9~. 9(0 Bot. System S 70 79. z9 ~J,7b cn 7 7 ~ Z Final Grade ~ '~ . D3 /o~ ~ 9~ St Cover ,~ ldtr~ ~.7~ `~$ .L 1 BED/TRENCH Width ~ Length ~ No. Of Tren hex PIT D ENSIGNS No. Of Pits In ide Dia. Li uidq Depth DIMENSIONS ~ /~ ~~ \ SETBACK SYSTEM TO P/L BLDG WELL LAKE/BYRE LEACHING Manufac er: INFORMATION CHAMBER OR T e Of tem: yp ~ j , ~~ /~ ~~ ~ UNIT Model Num r. ~ ~ ~ DISTRIBUTION SYSTEM Header/Manifold ~ ~ ~ ~ Distribution /k ~ t I ~ ~ ~ Pipe(s) ~y C (, ~ ~ 3 ~ x Hole Size fl ~[ 1~ x Hole Spacing / f Vent to Air Intake / ~ Dia Length I ' `~ Dia Spacing ~ Length 0 ~P ~Z ~ ( J~ ~-• d SOIL COVER Y pYPSSIII'P SVA}PmS Anly YY Mound Dr At-Grade Systems Only Depth Over Bed/Trench Center / Depth Over Bed/Trench Edges xx Depth of Topsoil (~I xx Seeded/Sodded - xx Mulch e, I ~ l97 \ I ,~..~!- es [f No ^ ~ es L, No r ~~ Ok COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~ / Zoo/~ ~~Inspection #2: / / Location: 2261 270th S reet Deer Park, WI 54007 (SW 1/4 NW 1/4 8 T31N R15W) 40 acres Lot ~C~ ff~` Parc I No: 08~. 1.15.119 1.) Alt BM Description = ~~ ~ ~..,..~ CaJ ~^"` ~~~ S~ ~ /7dC~'~y~~ ~~ 2.) Bidg sewer length = i'V t7r~ ` 1 u ~ ~~~ra~~•... ~~ G~.,~`~.~ ~La~ ~ ~ - amount of cover = ~S ~ ~ ~ r~ ~~~: Use otherls de foruadditional n Yes o ~ ~ 7 ~ ~(,, ~~1 ~ ~~ ~ ~_- ' formation. L___ ~ __-__ i _ 1 J i _ _ SBD-6710 (R.3/97) Date Insep is Sig ure Cert. No. Mound System Septic, Pump and Dose Tank Project: Mound K/r.~E~ Tank Information Pump tank manufacturer: Wieser Concrete Pump tank size/model: wiooo/6so-MR Pump tank gal/inch: 17 Actual Pump Tank Volume: 646 gal Tank bottom elevation (inside): . S ft Septic tank size/model: wiooo/650-MR J Pump and Filter Pump Manufacturer: Little Giant Pump Model: 9EH Effluent Filter: Zabel A1OO Note: Access opening of sufficient size to be provided to allow removal of filter Opening to terminate at or above grade. 4 Inch Minimum Alternate ~ Outlet Wished Location Eled. per Comm 16.28 and ~n ~ NEC 300 Weep Hole ~` or Anti- Siphon 8 Device C D Page 4 of 6 Dosage Volume Forcemain drains back to tank? QQ Yes O No Lateral void volume: ~frgal ZO. y Dosage to absorbtion Cell: ~$2 gal ~O. C Forcemain volume: ~3~3 gal 2l0. / Total dosage: •9~z'Lgal //(,./ Total Dynamic Head Are laterals highest point? y if not, enter highest elevation: 0 ft System head (distal x 1.3) 6.50 ft Vertical Lift ("D" to lateral) -}364 ft / $. /Z. Friction loss in forcemain: .~2e-ft 3 ./S~ Pressure loss from filter: ~ft Total dynamic head (TDH): 22.~ft Dose Tank Levels In. Gal A Reserve 22.6 383.8 B Pump off to Alarm 2.0 34.0 C Total Dosage 5.4 92.2 D Effluent depth for pump 8.0 136.0 Total Capacity: 38.0 646.0 FLOW- LITERS/HOUR W W W Pump must be capable of: and head pressure of: A Q ~ GPM 3l •'~ ~ Feet 2Z.~' 10 N 7.5 W r W I S ~ A 6 2.s 0 Pump Tank Diagram Watertight Locking Cover ~j With Warning Label Little Giant FLOW- GALLONS/MINUTE 9EH PUMP PERFORMANCE CURVE 11sV 60HZ Safety and Buildings Division County ` ~ ~ 201 W. Washington Ave., P.O. Box 7162 ~'~ ~ ~' ~scons~n Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (~8) 2Cb-3151' ~. 3 ~-3 ~. Sanitary Permit Application Pao ~ State Plan I. .Number ,~ g ~ ~ ~ In accord with Comm 83.21, Wis. Adm. Code, rs rovide may be used for secondary purposes Pr' acy L>i~ ~~~~'~d"".. "~ ~ Project Address (if different than r~[~iling address) , ~ ~~ l ~ ~Q ~T' I. Application Information -Please Print All Info ation ; ~~ Property Owner's Na me / ~ ~ Parcel ;y Lo[ N Block k I ~; ci,1,/, t,! I Property Owner's M ailing Address / ~ "'~-~--•--=-~.,..,,,.,„; _ Property Location ~ ~ ~ ~O ~ a N.J~/ ~L~ S ( ta ~k S don City, State Zip C Phone Number , , , ~T ~iA-t.t~ t __~11 ~/~l ~ISS~ 2 I ucle R~E~ T N ; ~ II. Type of Buil ng (check all that apply) /J~ L ~ ~ ~ ~1 or Z Family Dwelling -Number of Bedrooms Subdivision Name CSM Number ^ Public/Commercial -Describe Use ^ State Owned -Describe Use ~ST vt/v~. y..$r ~(~~ ~•2 ^City ^Village Township of PO III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A' New S stem y ^ Replacement System ^ Treannent/Holding Tank Replacement Only ^ Other Modification to Existing System B. ^ Permi[ Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner 1V. T of POWTS System: ( C heck all that a 1 ) ~ r r ^ Non -Pressurized In-Ground ,cli 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 Synthe[ic Media Filter ^ Leaching Chamber ^ Drip Line ^ Gravel-less Pipe ^ Other (explain) V. Dis ersal/Treatment Area Information: 2 ,~ Design Flow (gpd) Design Soil Application te( sf) Dispersal Area Re 'red (sf) Dispersal Area Pro sed (sf) System Elevation ~~~ ~ ~ -U ~s~ S~ o ~9 e , VI. Tank Info Capacity i Total Number Manufacturer Pr fab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank ~d c_'`~L Aerobic Treatment Unit c Dosing Chamber ~ ~ ~ __ I /pY VII. Responsibility Statement- I, the undersigned, assume responsibility for ' tallation of the POWTS shown on the attached plans. Plumber's Na me (Print) Plumber's Si nature /MPRS Number Business Phone Number e -~ t, ,~-s o ~~ ~G l~ 7/ ~ ~ ~.~~5'~U ~ Plu is Addre ss (Street, ity, State, Code / /` /o/~f r7 VIII ount /De artment Use Onl Approved ^ Disapproved Sanitary Permit Fee (includes Groundwater Surcharge Fee) O U Date Issued uing Age Signature ( ps) ^ Owner Given Reason for Denial ~ 3 S ~~ ~ S t7 IX. Conditions of Approval/Reasons for Disapproval ~ S~-~ ~ ' ~ ~.2 Gs~ c~0 ~ ~ f ~YSTEM OWNER: U 1 Septic tank, effluent filter and ~~ Urr~~l ~'L t.o ~~~%4~m.~~~ dispersal cell must all be serviced /maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code/ordinances. Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size SBD-6398 (R. 01/03) ~~~°~ ~ tr1 a - r- ~ ~ k' d0 ~ a ~ ~. ~ v r 3 '~ Y~~ N ~ a V ~ 3 ~ h v j - J .~ 2 c n ~Y NZ < a ?~ ?%~ ~ ~ ~ p' ~ . W (L ~ ~ - n- Q N ~ ~ ~9 ~ '.,. 1F~ 4` ~ .~ 0 M K ~ 0 ttc O Q - ,i `~ ~ ~ N ` 11 N m, ~ ,~ ~ ~ °° ~ a- o ,~ ~ ^ ~o ~ ~~ w 0 ~_ n ~ t1. ~` _~ ~7 N ~, N N N commerce.wi.gov isconsin Department of Commerce Safety and Buildings 141 NW BARSTOW ST FL 4TH WAUKESHA WI 53188-3789 TDD #: (608) 264-8777 www.commerce. state.wi. us/sb www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary May 06, 2004 CUST ID No.224617 LYLE J MYERS NORTHLAND PLUMBING INC E1556 STATE ROAD 64 BOYCEVILLE WI 54725 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/06/2006 SITE: Jim Kreyer 270TH Street Town of Forest, 54012 St Croix County SW1/4, NW1/4, S8, T31N, R15W ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 Identification Numbers Transaction ID No. 995097 Site ID No. 682865 Please refer to both identification numbers, above, in all corres ondence with the a enc . FOR: Description: Mound, 3 Bedroom Object Type: POWTS Component Manual Regulated Object ID No.: 956057 Maintenance required; 450 GPD Flow rate; 12 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual -Version 2.0, SBD-10691-P (N.O1/O1) 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. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. 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 Private Onsite Wastewater Systems VERSION 2.0" SBD-10691-P (N.O1/O1) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD- 10706-P (N.O1/O1). In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must comply with the operation, maintenance and monitoring duties as described in section VIII of mound component manual. A copy of this information must be given to the owner upon completion of the project. ~• O The pump chosen for the design is at the limits of its capacity. If the total dynamic head is cafe t~-t~,1~, at the time of construction, a pump that meets or exceeds the system flow will need to be ins~ll ~ ~ ; ~ ~j Raj FAQ Maintenance information must be given to the owner of the tank explaining that per' dic clea~i'~g~'P~~~ter is required. Access to the filter for cleaning must be provided per Comm 84 product appro cond~tt~Od~~ SF A Sanitary Permit must be obtained from the county where this project is located in accorda~ the requirements of Sec. 145.135 and 145.19, Wis. Stats. q 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. LYLE J MYERS Page 2 5/6/04 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/instal lation/operation. Owner Responsibilities: Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Julia ALewis-Osborne POWTS Reviewer 2 ,Integrated Services (262)548-8638, Fax: (262)548-8614 j lewis @ commerce. state. wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 Mound System Cover Page pg 1 of 6 ~~~~~~~ Project Name: KREYER-MOUND Owner's Name Jim Kreyer Owners Address 2280 Indian Way St. Paul, MN 55109-1555 Legal Description sw • y4, ~ Nw , ~ /, Sec~~ T 31 N, R 15 ~w ~ ~ Township Forest County Saint Croix Subdivision N/A Lot# ParcellD# Pending Table of Contents pg• 1 Cover page 2 Mound Sizing Calculations 3 Pressure Distribution Layout and Dynamics 4 Dose Tank 5 Management and Contingency Plan 6 Plot Map total # of pages: 6 Designer Name: Lyle J. Myers MP/License #: I.D.# 224617 Date: 4/23/04 Ph. #: 7156432520 Signature: Mound System Design Methods Used per "Mound Component Manual For Private Onsite Wastewater Treatment Systems" (Version 2.0) SBD-10691-P (N.01/01) per" Pressure Distribution Component manual for Private Onsite Wastewater Treatment Systems" (Version 2.0) SBD-10706-P (N 01/Ot~S, ``~~ _~~~I~ ~~* /yFCOM qN~e IONc S ~ Spreadsheet provided by: 3bAdvisement N12486 220th St, Boyceville, WI 54725 Ph: 715-643-6068 email: 3bat~3badvisement.cdfia.~C \ I ~ , j 1 N N ~ ~~ ~~ b v 0 / U j / ~W ~ ~/ ow ~~ GW N I N ~-J ~_ 1 ~ ~ n SCI N -1 C ~ ~ • ~ Z m _ k ~ ~ ~~ ~ ~ ~ C L ~ OD -C 2 ro W z A t~ `'' GQ '~..f ~~ ~' zd ~' 0 0 m~ v n J rn ,~ e w ao ~ ~ 1 ~~ W N ~ ~ N ~ n c 11 1' ~ S O ~ 7r Ga f ~~~ ~ .~N .a ~ ~ ~,° ro . ~ ~m ~~ '~ > y ~~ v >v ~ ~ O + ~ L~ ~ x CO ~r 1 Mound System Mound Sizing Calculations Project Name: KREYER-MOUND Site Conditions Project Type: 1 or 2 Family Dwelling Slope: # of Bedrooms: Depth to limiting factor: Absorbtion rate of fill material: Absorbtion rate of in-situ soil: Effluent quality Max BOD effluent value: Max TSS effluent value: 12 in./ 1 gal/ft2/day 0.6 g I/ft~/a~0~ Eff# 1 ~ 220 mg/I ~°~ 150 mg/I Design of Entire Fill Cell depth at upslope edge (D): Cell depth at downslope edge (E): Distribution cell depth (F): Cover thickness over edge (G): Cover thickness over center (H): End slope width (K): Fill length (L): Upslope width (J): Downslope width (Toe) (I): Fill Width (W): Page 2 of 6 24.0 in. 25.7 in. 9.5 in. 6 in. 12 in. 11.6 ft. 123.2 ft. 9.1 ft. 11.4 ft. 25.0 ft. Design of the Distribution Cell Basal Area System Design Flow: 450.0 gal/day Basal area required: 750 ftZ Distribution cell width (A): 4.50 ft Basal area available: 1590 ftz Distribution cell length (B): 100.0 ft Area of Distribution Cell: 450.0 ft2 Observation Pipes Contour Elevation of Mound: 97.29 ft Location from end of cell (Z): 16 67 ft yste~tion of Mound: 99.29 ft . Final Grade of Mound: 101.08 ft Mound Plan View ~ ~Dbservatian Pipes Z~ '.' ~ ~ ~' ~ K=- ^'~ J Distrib~_Ifiion C~II ~~ I U ~K Tilled ArealFill Material Final Grade Synthetic Fabric-, Distribution Cell-~, System Elevation-~~-- Cover Mate Fill Material L Mound Cross Section ~--L-~ ____C ~t, F~ ~ 4 °.~ ~' -_ t~ ' ' ' z __ P b 1 Lote~~~1 ~ L ~ Ir~~"'~~ bservation Pipe r G~~ Tilled Area u Slope ~Forcemain System Contour Notes: Fill material to consist of ASTM C33 Sand Distribution cell aggregate to comply with Comm 84.30(6)(1) Synthetic Fabric covering on cell per Comm 84.30(6)(g) Distribution Cell to have minimum 6" aggregate below lateral and 2" above. Mound System Pressure Distribution Calculations Project Name: KREYER-MOUND Lateral Layout Lateral elevation: 99.8 ft Rows of Laterals: ~ I ~ Manifold type: i Center '; • Orifice diameter: ~ o.1zs • In. # of Laterals: 4 Distal Pressure: 5 ft Lateral Length: 49.5 ft Orifice Spacing/Distribution Orifice spacing (X): 32.11 Inches Orifices per lateral: 1 g Avg. ft2/Orifice: 5.92 ft2 Lateral Side View ~ Lateral n Manifold Lateral Plan View Lakeral Length Orifices on bottom of lakeral equally spaced Forcemain connection via tee o~ cross to manifold at any paint Clean Out Detail Clean-out plug Grade ,-or ball valve Jdater tight cap or plug Sprinkler Box Long Sweep 90 ortwo 45's--~ Page 3 of 6 Lateral/Manifold Design Lateral diameter: 1'iZ ~ In. Lateral spacing (S): 3 ft Lateral to cell edge: 0.75 ft Lateral discharge rate: 7.83 gpm System discharge rate: 31.31 gpm Manifold diameter: (z ~ . In. Manifold length: 3 ft Forcemain Friction Loss Forcemain length: 150 ft Forcemain diameter: ~ 2 ~ m, Friction loss in forcemain: 3.146 ft Lateral Turn-up wlball valve or cleanout plug PVC laterals and forcemain to comply with specifications per Comm $4.30(2J(eJ Observation Pipes 6" Minimum Note: Closet Collar may be used in place of 318" bar X318" Bar Mound System Septic, Pump and Dose Tank Project: KREYER-MOUND Tank Information Pump tank manufacturer: Wieser Concrete Pump tank size/model: I wiooo/65o-MR _ • Pump tank gal/inch: 17 Actual Pump Tank Volume: 646 gal Tank bottom elevation (inside): 84 ft Septic tank size/model ~wiooo/65o-MR Pump and Filter Total Dynamic Held Pump Manufacturer: Zoeller Are laterals highest point? ~ y Pump Model: BN152 if not, enter highest elevation: ~ 0 ft Effluent Filter: Zabel A100 System head (distal x 1.3) 6.50 ft Vertical Lift ("D" to lateral) .15.12 ft Note: Access opening of sufficient size to be provided to allow FrlCtlon TOSS In fOrcemaln: 15 ft 3 removal of filter. Opening to terminate at or above grade. Pressure loss from filter: . C~ft Total dynamic head (TDH): 24.77 ft Pump Tank Diagram Dose Tank Levels Watertight Locking Cover ~ In. Gal 4 Inch With Warning Label Finished A Reserve 21.2 359.9 Minimum Grade g Pump off to Alarm .2.0 34.0 Anerr,ateJ C Total Dosage 6.8 116.1 outlet cation L D Effluent depth for pump ' 8.0 136.0 o Eled. per Comm 1628 and Total Capacity: X38.0 646.0 t. NEC 300 Weep Hole p` or Anti- Siphon 8 Device C D Page 4 of 6 Dosage Volume Forcemain drains back to tank? ~ Yes O No Lateral void volume: 20.9 gal Dosage to absorbtion Cell: 90.0 gal Forcemain volume: 26.1 gal Total dosage: ~ 16.1 gal 0 w __ U Z Y O Pump must be capable of: 31.3 GPM and head pressure of: 24.8 Feet ;~ Mound System Management Plan pursuant to comm 83.54 W. A. C. page 5 of 6 Owner's Responsibility: The component owner is responsible for the operation and maintenance of the component. The county, department or POWTS service contractor may make periodic inspections of the components, checking for surface discharge, treated effluent levels, etc. The owner or owner's agent is required to submit necessary maintenance reports to the appropriate jurisdiction and/or the department. Septic Tank: Septic tank(s) are to be inspected routinely and maintained by department approved individuals when necessary in accordance with their approvals. The use of chemical/biological "treatments" is not required or recommended. If such additives are used, make sure they are approved by Department of Commerce, Safety and Buildings Div.. Effluent filters are to be removed & cleaned as necessary, with provisions to keep solids from passing the septic during removal. No more than 1/3 of the usable tank volume may be occupied by sludge/scum. 3 year inspection: If tank has greater than 1/3 volume sludge, tank contents must be emptied and disposed of in accordance with NR 113 Wisconsin Administrative Code by an approved individual. If the inspector does not recommend pumping of the septic tank, then the owner must be notified of when pumping should be done as to not exceed 1/3 sludge volume. Septic tank should be routinely inspected to be watertight and of good repair. Pump/Dose Tank If an effluent filter has been installed in the pump/dose tank, it must be removed & cleaned as necessary, with provisions to keep solids from passing to the mound component during removal. The pump, float switches and alarms must be inspected at least every three years for proper operation. Pump/dose tank should be routinely inspected to be watertight and of good repair. Mound and Lateral System The mound system component must remain free of ponded surface water prior to pump operation. If 4 inches or more water level is detected in the observation pipes, the owner must be notified of possible problems/failure. The designed daily flow capabilities of the component should never be exceeded. Trees and any other deep rooted vegetation should never be planted, or allowed to grow anywhere on the component. Activities OTHER than mowing/maintenance (i.e. excessive walking, pets, vehicles, etc...) co~iid compress the component and reduce it's absorbtion capabilities and/or possibly cause it to freeze in winter' conditions. Lateral distribution pipes should be flushed out/tested every 18 months using the cleanout poi its at each end of the component to remove scum that may clog orifices. Pertormance Monitoring: Performance monitoring must be done at least once every three years following the installation or at the ti, ne of a problem, complaint, or failure. Contingency Plan: If the septic tank, pump tank or any of their components therein (including floats, alarms, pumps, etc) become defective, the defective tank or component must be replaced immediately to ensure that the sys em can operate as designed. If the mound component cannot accept wastewater or ponds wastewater to thy: surface, the component must be repaired or replaced in it's current location by either: extending basal toe to provide added absorbtion area; or by removing the clogged bacterial mat,aggregate cell, and distribution ~ piping within the mound and replacing said components in order to return system to proper working order ~s required. ST CROIX COU~I'll'Y SEPTIC TANK IviAINTENANC"E AGREEMENT AND OWNERSHIP CERTIFICA'T'i~~N FORM OwnerBuyer ~l -ti, l~f+c,~Ye~. - Mailing Address 22g~ i'~ ~ ii°"j w ~t7 T sr, i°.arc ~ /1[~/ 55/a 9- /SS5 Property Address - ~ Z ~ / ~ 7C~ ~~ S'~ (V. erificatioa required from Planning Department for nf:w constnictioa) City/State ~ ~ ~l! A - _ r~ Parcel Identif cation Number '~ !~- /D / `7 " > ~ ~ ~,EGAL DESCRIPTION Property Location Sup "/<, nI t~c.J `/., Sec. ~ . T 3 / N-R /S W, Subdivision .//~- ~~~ Town of ~,~ES T Lot # ._ Certified Survey Map # ,Volume _ _, Page # _--- . Warranty Deed # 7~s~6 .~ ~ .Volume ~~ Paso # 1 l S Speo house ^ yes ,ono Lot lines identifiable j~yes ^ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result ixi it:;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 disposai system. The property owner agrees to submit to St. Croix Zoning Deparhncat a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the onsite wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if pecessary), the septic tank is less than l/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maixttain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Deparmycat of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed a-id roturned to the St. Croix County Zoning Office within 30 da f the three year expiration date. X ,r y ia~i oY SI ATURE OF APPI,IC DATE ****** ****** Any information that is mis-represented may result in the sanit;iry permit being revoked by the Zoning Department. OWNER CERTIFICATION I (we} certify that ail statements on this form arc true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the roperty dcscn'bed above, by virtue of a warranty deed recorded is Eteg.istcr of Deeds Office. X ,~ ~a31 Gs~' (}NATURE OF APPL ANT DATE ** Include with this application: a stamped warranty deed from the Rrgistor of Deeds office a copy of the certified survey mag if refereaco is made is the warranty deed Wisconsin Department of Commerce Division of Safety and Buildings Page / of In a~raance •.v~tn ;,omm ac, vrs. H;, m. tJoce eoy~ ~^~ Sr ~ I er not less than 8 112 x 11 inches i lete site lan on a Atta h m n size Plan must , . p p p p c co . „~ludg n~_~t „ct ur.,ired to' verica! end horzdnta! reference point ;B^:!;, direction and I Per%i~i i.D. Q/y.' "~ ' / ' Q percent slope, scale or dimensions, north arrow, and location and d istance to nearest road. f ( W Please print all information, view Date t Personal information you provide m ( y l.aw, s. 15.04 (1) (m)). )/ i ,... D(/~~' /~a Prnpath, (lw,nor - - ... ~.. , . t-. •..-.-..:'~' Property Locat'lon i J/ rn ~~ ~ E Govt. Lot .S~,c~ 1 /4 /~/ff/1 /4 S O T 3/ N R /S W I Property ~::n,;, s h"ad'ng Addras ~ „ ~ ~ ^t ° CSP „lock # u~. Na^~ or ,/l# City State io • • r ~~ ^ City ^ Village Town Nearest Road •S'T ~iQ UG /h/~ ~ -0N I FF .~ ~0 R-EST 2 ~f~ 5 New Consvucrion Use: ~}testdential /Number of bedrooms _ ~ Code derived desi n fbw rate 9 ~~ GPD ' _ ^ Public or commercial -Describe: ^ Replacement _ n Parent matenai (T~Q ~ ~ 7/~~ Flood Plain elevation rf applicable _ ft. General comments I and recnmmandations __ I I i ~~ A~'~ ~~ U uGriny I / I DVl li ly k ^y SOIL EVALUATION REPORT r g/_ i. / / 9 l-J kSl Pit ~roune sunace elev. _ • ~ •_ n. ~aNui w unuwry iauvi ~ - -_ ~~~. Soil A ication Rate I lorzon I Depth I Cominani Cclort Redox Desaipiion 1 Texture Structure Consistence Boundary Roots GP C/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff3t2 ' / ' a - are ~Z ' ' si / 2 s6~i ~ ~ ,- ,~ ~' . ~ . 8 2 ~-/2 o ye s/ si'/ 2sS ~ V~r ~`S /~ - ~ - ~ 2-8 /aY~es/ ~•sye/ ~2d si/ Zs6lf rn/~'r cs /~ ~ ~ , fl I ./8.2/ ' /d YR G~3 ~'.2dS ~'I ' ~. Sf~2 ~ ,5'+/~ ~s.6~ N~ r C,5 - ~ 2 ~ . 3 .s 2 /- 3(, 5 ~q 'f ~ / ~. Sy,~ 7 ~'ZdS ~$ r~J /sit ~'r- c S - ~ /. 4 ~ ^ Berin; I I Bcrjng Q~ 72 /il t ~ I ,+~,J pit c~rouno surrace elev. ____ n. veprn w mrnurn,~ ~nuur i r _ gyn. Soil Application Rate I tlnnZnn I Uenth I Upminant (~plnr l Rerlox UesCripbon I I PxtUfP, I StnarUUe I (~OnSiSlent~ I tinundary I i~rx>lt (;PUltt I in. I Munsell I Qu. Sz. Cont. Cobr I I Gr. Sz. Sh. I I I 'Eff#1 I 'Efftt2 ' / 'O-8 ' b RZ~L ' ' S'•/ 2S.6K ' /ytV r CS .~~ ' .ls ' 8 1 / -2d /d ~24~G ~•SYre%8 C/d SC ~S r C,S /~' 2 3 1 . Zo 321 .5Y1e9 1 ~r5 ,e e ld s /yt CS -- I . ~ t /, 1 '~ i 'Effluent #1 = BOD > 30 < 220 mg/L and T55 >30 < 150 mg/L " tmuent #"1 = t3UU < 3U mg/L and I SS < 3U mg/L CST " T12 (P'eas2 Prnt) Signature CST Number /yip ~~./ r t.~.-~ v?G ~ 85 Address Gate Evaluation Conducted Telephone Number 2 9f3 13e~,c. ~ ~ ~~~a~aoct ~~,,Cciisfa~.~ 9- /~-!~ ¢ his- 2G S- ~i~ 2, .,. _ __ ~,~ Propbrly Ownbr~~ ~ ~~y~~' Parrxil (D N ^ Boring Boling # ~~ ~-pit Ground surface elev. ~ ~ / ft Depth to Limiting factor ~2' in. Page ~ of Soil Annliralion Rate Horizon Depth Dominant Cobr Redox Description Texture Structure Consistence Boundary Roots GPD/fF I in. Munsell Qu. Sz. Coot Color Gr. Sz. Sh. 'Eff#1 'Eff#2 / v-~ /uy~e2/Z s/'/ 25/~f ~V~r e.S' 3~ •l ~ , 8' Z - 2 o ye s/ Si / ZS,5k /h (/~'r C S / ~' ~ !o . g ' ' /Z-2d e G ,G'1d sc / /s.6K /j-r~ r cS /~ 2 • 3 ~ I I I I I I I a..r.n3 # ^ Boring L~ l_1 Pil Ground surface elev. __ FL Depth to iirniting factor _ in. Soil Annliratinn Rate Horizon Depth Dominant Cobr Redox Description Texture Structure Consistence Boundary Roots GPD/FF in. Munsell Qu. Sz Cont Color Gr. Sz. Sh. I I `Eft#1 'Eff#2 I ~ ~ I I I I I I I I I I i I I I I Boring I?nrino # UJ LJ Pit """'~"'"'~~~`'°°~°". ,•`~~~ •v ~~~,,,,.,.y .Y~V. - Soil A ication Rate Horizon th De Dominant Cobr Redox Description Texture Strur~ture Consistenr~ Boundary Ror~ts GP D!ff p in. Munsell Qu. Sz. Coot Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I I I I ' Efttuent #1 =RODS > 30 < 220 mg/L and T•SS >•30 < 150 mg/L ' Effluent #2 =BUDS < 3U nx,}ILa.M TSS < 30 ^''0~ The DC~art111Cl1t Uf CUII1fIlelCe 19 all egllal U~pUI~tUlllty SeIVIC;e ~1'VVldel' alld CIII~IVY01. {f YUU n@Cd aJJlJtal]CC tU aCGCSJ JCIVICCS ur need material in an alternate fotmat, please contact the department at 608-266-3151 or TTY 608-264-8777. t ~ y ~~C ~ + i a /^\ ---- 3 ~ ~ ~ ~.,, a ~ o -__ . ____ ~ ~ ~ ~ ~0. ? ~ 4 Q -• ~ N O ~ a ~ 0 ~ ~ 3o ~~ y,~ o aw s ~ ~ o` ~, o- ~ ,~ ~ ~ ~~ ~ w3 ~ J ~w; M~ a~r _ M m~~ r ~ ~31~. 0 ~a~' ~ o0 ~ ~ ~ ~ ~ Cl a. a' ~ a ~ pQ j{. N n' Q~ ~ / ~ ~ ~ ~ / / ~ % / M / oq d ~ / I I // ~~ ~~ ~ ~ _ i~ ~~ ~ / /. ~ ~ ~ // ~ ~ ~ w ^ /~ P 0 ~~ u~ w V 1 ___ 1 ~~ ~ ~~ N ti ~~ ~' ~v _, ~I ~i ~a ai o- ~J2187P 115 STATE BAR OF WISCONSIN FORM 1 - 1998 WARRANTY DEED Document Number ~ ~ ~ This Deed, made between ~n/~RSUJ ~ /41VD~r2SOnJ _ Grantor. and~AME`~' -~- REYc R k~0 t^.4RD[. L, ~OlfNSorJ __ I Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in ST• C/20 / X County, State of Wisconsin ~ (the "Property"): i 7 1 5 0 5 9 KATHLEEN H. MALSH REGISTER OF DEEDS ST. CROIX CO. , NI RECEIVED FOR RECORD 03/28/2003 02:15P![ MARRAHTY DEED EXERT * 17 REC FEE: 11.00 TRANS FES: COPY FEE: CC FEE: PAGES: 1 Rrcorp~r.q area $W ~L/ OT Nitl f`y p~ SEA/O~.! $-31- IS ST eCZOiX Cou/JT'yl WISCoiJSl~1 °T't((S ~ Ft~ j 5 C: 1 ~ c- ~ / n! art L C. SA-si SFA~~o ~U ~e~~l turn tltlr ss ((o a ~U E, w ~~ ~ OGToBr~ Zt~e~ ~ _pw_ Ior7- 90 ~~ ~ j~-T ~ /V~ ~` N'7'KHGT .1)ffT ~ , p . Parcel Identification Number (PIN) ~I R/~ RcCd RDC~ O N ~.TdFjEQ ~ ~~~ L~ / ~N VO~u~~ ~/9~O This 15 NAT homestead property. (is) (is not) O~ RE~oRllS cvN PHd~' .S~/ RS ~aLurrrE7Jr ,Nu/-1,9P?q Ic 9aS.~ /~/ •~' rft oFFtc~ of TlfE /2cG/.s i ~JE; o ~ D~~oS /sn/ A.vo Fob Together with all appurtenant rights, title and interests. Grantor warrants chat the title to [he Property is good, indefeasible in fee simple and free and clear of encumbrances except Dated this ~$"~ day of ~/4JQC~ o~}b03 * RnIDReIA! F AaDEKSor~) (SEAL) (SEAL) * AUTHENTICATION Signa[u re (s) authenticated this day of , 111 LC: 1VlC1VItlCK JIH1C ISHK VC WIJI.V IV JIIV (If not, authorized by §706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY R-sDR€i~ F. ~ND~'RSonJ (SEAL) __ (SEAL) ACKNOWLEDGMENT State of Wisconsin, ~a ss. ©~ x Count. Personally came before me this ~~ day of Irn ~ . ~°3~ •~~ti. . c~ to me known to be the person wh ~ecuted ,~ f goirt~g ins~~ent and acknowledge the same. Lr+~ ~ f~.~ ~ ~~ `~i4 U •. t 'S't71 X ~ ~ ^.- (r -4 . * Q .. ...?.ei ~ - - - ~ I Notary Public, State of Wisconsin !I My commission is per anent. (If not, state expiration date: !~ (Signatures may be authenticated or acknowledged. Both are not __.__ ~ __.. ~ a~_.) necessary.) Names of .. _- _ _____ __ . _ .._.__ _ .. _._. persons sgn;ng In any capaclt t be t ~ ~ ~~~~ _- ~ ~~~~ ~~~ y mus yped or panted below their signature S1'A'I'E BAR OF WISCONSIN W~sconsn Legal Blank Co.. hc. WARRANTY DEED FORM No. 1 - 1998 Milwaukee. wis. 0 x a a s 0 \` Q r n~~ ~~~~,~ ~p ~ ~ K i ~. ~Q ~.. ~.~1y~'~~ ~~ ~?i!?7 a k '~ ~~. ~~y~~4. ~ y F ~ ~ ~~ F ~~. :r._f.,~I Yl `-. ~e :I~VLI'~'. ~. 5 !~ \~ ~^,jV 4 ~? c- isconsin Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www.commerce.state.wi. us/sb www.wisconsin.gov Scott McCallum, Governor Phili Edw Albert Secretary p , August 29, 2002 CUST ID No. 227618 THOMAS. GUSTUM GUSTUM SEPTIC SERVICE N13450 937TH ST NEW AUBURN WI 54757 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/29/2004 SITE: Andrew Anderson Town of Forest, St Croix Co SW 1/4, NW 1/4, S8, T31N, R15W i rl..a3 ~;~~F c... _ -- ATTN: POW7'S Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 Identification Numbers ~ Transaction ID No. 783082 Site ID No. 649536 Please refer to bofh! identif cation numbers, above, in all correspondence with the FOR: Object Type: POWT System Regulated Object ID No.: 867592 450 gpd Mound System and Biomicrobics Micro FAST 0.5 Aeration Unit 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 and prior to occupancy or use: 1. This approval is based in part on an interpretation determination approved under transaction number 783074. Conditions of the interpretative approval also apply to this mound system approval. 2. Plowing must be done with a chisel plow to a depth of at least 12 inches to promote infiltration into the subsoil. 3. The maximum basal loading rate is 0.2 pgd/ft^2, and the maximum linear loading rate is 4.5 gpd/ft. 4. Landscaping around the mound shall divert surface water away from the mound perimeter. 5. A maintenance plan for the aeration unit shall be attached to the plans prior to sanitary permit issuance by the county. 6. Pursuant to Comm 83.21(2)(c)5, Wis. Adm. Code, and prior to sanitary permit issuance, documentation shall be submitted to the county indicating that maintenance requirements for the proposed aeration unit have been recorded with the deed to the property. 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. THOMAS GUSTUM Page 2 8/29/02 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, eroy G sky Wastewater Specialist , Field O ions (715)726-2544 , ljansky@commerce. state. wi. us cc: Leroy G Jansky ,Wastewater Specialist, (715) 726-2544 Thomas Gustum , Gustum Septic Service Gustum Septic Service Andrew Anderson Fee Required $ 175.00 Fee Received $ 300.00 Refund Amt $ 125.00 WiSMART'code: ?633 isconsin Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www.commerce.state.wi.us/sb www.wisconsin.gov Scott McCallum, Governor Philip Edw. Albert, Secretary August 29, 2002 CUST ID No. 227618 THOMAS GUSTUM GUSTUM SEPTIC SERVICE N13450 937TH ST NEW AUBURN WI 54757 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/29/2004 STTE: Andrew Anderson Town of Forest, St Croix County SW 1/4, NW 1/4, S8, T31N, R15W ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 Identification Numbers ~ Transaction ID No. 783074 Site ID No. 649536 Please refer to!hoth ident~cation numbers,: above, in all correspondence with the FOR: Object Type: Soil Saturation Determination Regulated Object ID No.: 867589 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 and prior to occupancy or use: • Approval is hereby granted pursuant to Comm 85.60 (2), Wis. Adm. Code to estimate the depth to seasonal soil saturation based on an interpretive determination. This approval and determination negates the requirement of Comm 85.30 (2) (b), Wis. Adm. Code to designate the ground surface as the highest level of saturation when redoximorphic features are less than 4 inches below the bottom of the A horizon. • Recommendations by department or county staff that must be considered during plan approval for this project and include using a linear loading rate of 4.5 gpd/ft or less and a highly treated effluent basal soil application rate of 0.2 gpd/ft^2 or less to improve hydraulic performance of the mound system. • At least 30 inches. of sand lift on top of 6 inches of unsaturated in-situ soil for adequate treatment is required. • Chisel plowing to a depth of at least 12 inches immediately prior to sand placement is required to improve vertical water movement into the soil solum. • Landscaping up slope of the mound shall be incorporated into the mound design to divert surface water drainage around the up slope toe of the mound structure. • This approval shall remain valid unless the site or sites are altered in such a way that the depth to soil saturation would change or if saturated conditions were observed for seven consecutive days at depths less than three feet below the infiltrative surface of the POWTS distribution component. • This approval letter and attachments must accompany the mound system plans for this project. This approval in no way relinquishes the uses of color patterns to estimate the depth to high groundwater on any other parcels or portions of parcels. THOMAS GUSTUM Page 2 8/29/02 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. Sincerely, roy G. J ky, Wast ter Specia Field Operations Bureau (715) 726-2544 Office (715) 726-2549 Fax (715) 577-8078 Cell ljansky@commerce. state. wi. us Fee Required $ 100.00 Fee Received $ 100.00 Balance Due $ 0.00 `~"iSM~~T e~de: 7633 RECEIVED SAFETY AND BUILDINGS DNISION • Field Operations Bureau 13 East Spruce Street SPECTION REPORT Chippewa Falls, wl sa~2s r~ 2 4 2002 www.commerce.state.wi.us I ~~O ~~~ Scott McCallum, Governor Department of C mm~~c~e`~oiX COUNTY Philip Edw. Albert Secretary Date of Inspection: ~ June 18, 2002 Project Name: Ande Use: New Residential Legal Description ~;~1~' ~;•:~~,;°~~1 Site Number: Subdivision: Municipality: Town of Forest County: St. Croix Plumber Name and Address: Certified Soil Tester Name and Address: Tom Gustum, CST 227618 et al N13450 937th Street New Auburn, WI 54757 Plan Transaction Number: Sanitary Permit Number: Wastewater Fiow: 450 gpd Persons Present: K. Grabau Owner Name and Address: ~-~ ~ ~ ~< `~ ~~ Clear Lake, WI 54005 An onsite soils verification was conducted at the request of the county because of questionable soil conditions that they felt would not allow a standard A+4" mound installation. It is my understanding that several other certified soil testers had previously failed to locate a suitable mound area on the property. It is unknown where on the property the other CST's conducted their evaluations since no reports were filed. The USDA NRCS has mapped this area as Freeon silt loam, a moderately well drained (3-5 ft) soil series. However, there are inclusions of somewhat poorly drained (1-3 ft) Magnor silt loam. Both series exhibit a perched zone of seasonally saturated soil, and are taxonomically classified as glossoboralfs which means albic material often extends (tongues) into lower horizons. Albic horizons are inherently associated with illuvial spodic material in lower horizons that may appear as redox features, but are not indicators of wetness. A hand constructed soil boring in the area evaluated by CST Gustum revealed the following soil profile: 00-06" 10YR 3/2 sil, 2mgr, mfr, cw. 06-09" 10YR 4/3 sil, 2mpl, mfr, cs, w/f1f 10YR 4/6 & 5/3 redox. 09-14" 10YR 4/4 sil, 2msbk parting to pl, mfr, c2d 7.5YR 5/6 & 6/2 redox. Estimated highest level of soil saturation is 0 inches. Possibilities exist for an evaluation under Comm 85.60 (2), Wis. Adm. Code, which allows an int retatio features that may negate certain soil color features as indicators of seasona sol saturation Backhoe pits are recommen ed to better view t e soi pro I e If further work Is done. However, today's evaluation Indicates that onl a holding tank installation would meet soil and site conditions speci ie y omm 83, Wis. m. Code. Contour and si-ope information should also be verified to ensure system oven a Ion Is a equate.~~~ ~_ Recommendations for this site include the possible use of a mound system designed to overcome limitations of a high level of seasonal soil saturation and moderate permeability present in the soil solum A coil saturation determination pursuant to Comm 85.60 must be corn leted b a CS d a roved b the department to certi that this site has at Inc es of soil free of saturated conditions for seven or more consecutive ays. If there are any questions reg rding this report please contact me. roy G ansky, Wa water S alist Ljansky commerce. tate.wi.us E- ail 715/726-2549 Fax 715/72 544 Voice cc: County ^ Plumber ®CST ~ Owner ^ Other Wisconsin Department of Commerce SOIL EVALUATION REPORT Division of Safety and Buildings in arrnrrianrp with r:nmm Rai Wic Aram (:rxiP 1544 Page 1 of 3 Gustum Septic Service Attach complete site plan on paper not less than 8'/2 x 11 inches in size. Plan must i l t li d b t it d t ti l d h ri l f t i BM di i County St. Croix nc no m u e, u e o: ver ca an zon re erence po o a nt ( ), rect on and percent slope, scale or dimemsions, north arrow, and bcation and distance to nearest road. Parcel I.D. ~"'I "' Please p~~q P l i f id ti ~uifeRneUo71: ~ d f d~ P~~` 04 ~ 1 1 b Reviewed By ~~ Dat _ ersona n orma on you prov e may use o gpurpbsc ( ) (m)). a%ses s ( acy Law, s. . Property Owner operty Location Anderson, Andrew ~.~ u~ vt. Lot n/a SW 1/4 NW 1/4 S 8 T 31 N R 15 W Property Owner's Mailing Address L t # Block # Subd. Name or CSM# 2711 County Road Q n/a n/a N/A City State ip Code Phone Ntrmbek ., J City J Village ~/ Town Nearest Road Clear Lake ~ WI ~ 715-263-2162 Forest 270Th Street 1~ New Construction Use: /~ Residential /Number of bedrooms 3 Code derived design flow rate 450 GPD J Replacement ~ Public or commercial -Describe: Parent material glacial til Flood plain elevation, if applicable n/a General comments and recommendations: Part of 40 acres. Recommend mound system with treatment unit along 94.7' contour. BM. #2= 91.35'. Boring # -~ Boring JY Pit Ground Surface elev. 94.4 ft. Depth to limiting factor 9 in. Soil Appication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DIftZ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-5 10yr2/2 none sil 2mcr mvrf as 2f,2m 0.5 0.8 2 5-9 10yr4/4 none sil 2msbk mvfr cvv 2m,1co 0.5 0.8 3 9-19 10yr4/6 c2-3p 10 7/2 7.Syr5/8 sil 2msbk mfr cvir 1m 0.5 0.8 4 19-30 10yr4/6 ii3~'S~~'jg/2 gr. scl 2msbk mfr - - 0.4 0.6 a Boring # ~ Boring 1/ Pit Ground Surface elev. 95.1 ft. Depth to limiting factor 10 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *EfF#2 1 0-7 10yr2/2 none sil 2mcr mvrf as 2f,2m 0.5 0.8 2 7-10 10yr4/4 none sil n - • • ~^~~r ~ cw 2m,1 co 0.5 0.8 3 10-20 10yr4/6 c2-3p 10yr7/2 sil i ~ ~ Y, ~ °~' • "} Y'~re-y 1 m ~/ 0.5 0.8 4 20-32 10yr4/6 ~7 5yr5/g/2 gr. scl ~--" '" "E ~~ ~«-~-~-c~. - 0.4 0.6 ~- eZ~ `~ ~-w~ /~ ` fi ~r~ ~/- s - e2. - cmuenr ~~ = rsws> su <_ zzu mgrL and 15s >3U < 15U mg/L ` Emuenc ~~ - ~,,.~ _ and TSS <_30 mg/L 5= _._ CST Name (Please Print) Signature: CST Number Tom Gustum 227618 Address Gustum Septic Service Date Evaluation Conducted Telephone Number N13450 937th St., New Aubum, WI 54757 4/5/02 715-658-1344 m)v V Property owner Anderson, Andrew Parcel ID # Page 2 of 3 Boring # ~ Boring 1/ Pit Ground Surface elev. 94.4 ft Depth to limiting factor $ in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description (~u. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots ' *Eff#1 'Eff#2 1 0-5 10yr2/2 none sit 2mcr mvrf as 2f,2m 0.5 0.8 2 5-8 10yr4/4 none sit 2msbk mvfr Lwv 2m,1 co 0.5 0.8 3 10-17 10yr4/6 c2-3p 10yr7/2 7 gyrg/g sit 2msbk mfr cw 1 m 0.5 0.8 4 17-30 10yr4/6 map 10yr7/2 7 5 5/8 9r. scl 2msbk mfr - - 0.4 0.6 ^ Boring # ---~ Boring J Pit Ground Surface elev. ft Depth to limiting factor in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Du. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots 'Eff#1 "Eff#2 ^ Boring # --~ Boring _J Pit Ground Surface elev. ft. Depth to liming factor in. Soil Application Rate Horizon Depth in. Dominant Cobr Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots z 'Eff#1 'Eff#2 'Effluent #1 = BODS> 30 < 220 m9ft 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, vlease contact the deoartment at 608-266-3151 or TTY 608-264-8777. Local Topographic Map SCALE =1":40' a S b ~ Z ~ ~ ~ ; ~ {(~ { y b ~ r ~ W •C 1 ~ I f 1 ~ r 1 .~ Q / 1 ! k / ~ C o I .L 1 1 1 3 i 1 ~ i i 1 1 ~ 1 _ `~ ! i r 1 i i 1 1 ~ 1 ~ ~ ~ 1 i i I 1 _ ~ ~ i i i 1 1 W O ~ `/' /° F i f 1 i i 1 1 f6 y 1 1 r r 1 1 ~ U ~ 1 1 1 1 1 m C -p 7 1 t tr 1 ~ r I~ I ~ 1 ~ ~--' ~ ~ E 1 1 1 1 1 ~ 1 \ 1 Z O _ ~ ~~ l 4 1 1 O ~ m ~ 1 ~ ~ ~ ~ ~ C acq= 1 ~ r~ 1 ~ `~ I ~ . u u a : 1 1 ~ ~ 1 ~ ^ ~ ~ ; ' 1 1 ' 1 1 1 1 1 r N ; 1 ~ 1 m m ' ~ i i ~ ' ~ m i» ' 1 1 1 / 1 t '~ I 1 1 ~ / I 1 i / I 1 I I ~ ~ I I 1 1 1 1 1 b rn i I I i / / / I / / / i / / / I f I I 1 I 1 1 1 1 I 1 1 1 1 1 1 , 1 / 1 , 1 1 , 1 , 1 , 1 1 1 I 1 1 1 1 ~ 1 / i~ 1 F / 1 % / 1 1 1 1 / / _ I I I 1 / / ~~~~ 1 1 / 1 l ~ -'~ l I ~ 1 I / ~ '~~ ~ ~ ~ I t 1 i i / / / 1 j t ~ % / % / 1 1 i ~ ~ ~ ~ ~ i r ~ / 1 i ~~ i~ / 1 1 ~~ ~ 1 1 I r ~ / ~ ~1 i // 1 i ~ ~% ' % / ~ / ~' _ ' ~~ ' / ____- ___----' __. ' - 3~4S 4~OL~iW2f ----------------------------------------------- ------ -_ --------------- -------- ---- + ---= ~ n o --------------------------------------------- • E3 N o'i ~~~ f~ 3~~1S 4a0LZ z s r ~ s a ~ a ~ ~+ ~$ ~ S 0! TS ~= o c $ g ~ ai ZZ 7 Y LL { p ~(~J ~ ~ b ~ ~ c Q N ~ tl N j U ~ ~' u ~. ~ Q ~ a O o ~ rn cN ~ G m Page 3 8€ 3 r_ R RECEIVED ,544 SOIL EVALUATION REPO 1 0 2~~2 Wisconsin Departrnent of Commerce Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. ode ST. CROIX COUNTY Gustum Septic Service aIDdllt¢G OFFICE Attach complete site plan on papa rat Ins than 8'h x 11 inches in size. Plan muss roix indude, but not limited to: ~rlical and txxizontal reference point (BM), direction and percent sbpe, scale or dimemsbns, noM snow, and bcetbn and distance to nearest road. r' Parcel I.D. Please print all iMormation. ~ ~ 1 ~ ~ "' Reviewed By Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Properly Owner Property Location Anderson, Andrew Govt. Lot n/a SW 1/4 NW 1/4 S 8 T 31 N R 15 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 2711 County Road Q n/a n/a N/A City State Zip Code Phone Number J City J Village i/ Town Nearest Road Clear Lake WI 54005 715-263-2162 Forest 270Th Street !JI New Construction Use: M" Residential /Number of bedrooms 3 Code derived design flow rate 450 GPD J Replacement ~ Public or commerdal -Describe: Parent material glacial til Flood plain elevation, if appligble Na General comments and recommendations: Part of 40 acres. Recommend mound system along 94.7' contour. BM. #2= 91.35'. Boring # -f Boring t~ Pit Ground Surface elev. 94.4 ft Depth to limiting factor 11 in• Soil Application Rate Hodzon Depth in. Dominant Cobr Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GP 'Eff#1 D!(t~ *E 1 0-5 10yr2/2 none sil 2mcr mvrf as 2f,2m 0.5 0.8 2 5-11 10yr4/4 none sil 2msbk mvfr cw 2m,1co 0.5 0.8 3 11-19 10yr4/6 02 ~ S~yr7/2 sil 2msbk mfr cw 1m 0.5 0.8 4 19-30 10yr4/6 m3p530yrg/2 gr. scl 2msbk mfr - - 0.4 0.6 Boring # ~ Boring Pit Ground Surface elev. 95.1 ft Depth to limiting factor 13 in. Soil AppicaUOn Rate Horizon De th Dominant Cobr Redox Description Texture SWcture Consistence Boundary Roots P D p in. Munsell Qu. Sz. Cont. Cobr Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-7 10yr2/2 none sil 2mcr mvrf as 2f,2m 0.5 0.8 2 7-13 10yr4/4 none sil 2msbk mvfr cw 2m,1co 0.5 0.8 3 13-20 10yr4/6 c2 ~ S~ yr7/2 sil 2msbk mfr tw 1 m 0.5 0.8 4 20-32 10yr4/6 m3p510yrg/2 gr. scl 2msbk mfr - - 0.4 0.6 Effluent #1 = BODS> 30 <_ 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 =GODS < 30 mg/L and T5S < su mgn_ SST Name (Please Print) Signature: CST Number tom Gustum 227618 4ddress Gustum Septic Service Date Evaluation Conducted Telephone Number N13450 937th St., New Aubum, WI 54757 4/5/02 715-658-1344 !- . , _z, Property Owner Anderson, Andrew Parcel 10 # Page z of 3 Boring # -~ Boring ~/ Pit Ground Surface elev. 94.4 ft Deptli to liming factor 10 in. Soil Applicagar Rate Horizon Depth Dominant Cobr Redox Desaipgon Texture Structure Consistence Boundary Roots in. Munsell C~u. Sz Cont. Cobr Gr. Sz. Sh. *Eff#1 'EfF#2 1 0-5 10yr2l2 none sit 2mcr mvrf as 2f,2m 0.5 0.8 2 5-10 10yr4/4 none sil 2msbk mvfr cw 2m,1co 0.5 0.8 3 10-17 10yr4/6 c2-3p 10yr7/2 7.Syr5/8 sil 2msbk mfr cw 1 m 0.5 0.8 4 17-30 10yr4/6 °13p 10yr7/2 7.5 5/8 r. scl 9 2msbk mfr - - 0.4 0.6 Boris®# J Boring ~ Pk Ground Surface elev. ft Depth to limiting factor in. ~ ~ ~~ Horizon Depfh Dominant Color Redox Desaipgon Texture Structure Consistence Boundary Roots in. Murrell t]u. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 Boring # J Boring J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Cobr Redox Desaiplion Texture StnKture Consistence Boundary Roots in. Munseq ilu. Sz. Cont. Cobr Gr. Sz. Sh. 'Eff#1 'Eff#2 * Effluent #1 = BODS> 30 < 220 mglL and TSS >30 < 150 mg/l * Effluent #2 = 8005 <_30 mgll and TSS <30 mg/L The Department of Commerce is an equal opportunity service provider and employer. 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