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Home My WebLink About018-1001-40-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building,Division INSPECTION REPORT Sanitary Permit No: 563831 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Delon g, Jeffrey J. Hammond, Town of 018-1001-40-000 CST BM Elev: Insp. BM Elev: IBM D ription: Section/Town/Range/Map No: /o 5-S/ / OS. S/ Z l I 01.29.17.7A TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER , CAPACITY STATION BS FS ELEV. Septic r.• Ben mark Dosing f Alt. BM ff GO., . `fib 6 6 o ? ' 11,,- Go a /O Z . . Aeration Bldg. Sewer ~•s 9l• ~s5 Holding St/Ht Inlet -7Q 49 3 -TANK SETBACK INFORMATION d c7~S St/Ht Outlet TANK TO P/L WELL BLDG. Vent t it Intake ROAD Dt Inlet Septic /Q L /6-(, ~ ~ .1 ~ Dt Bottom J 9S Dosing O Z/ Header/Man. 3 S /Zj Z. U Aeration Dist. Pipe r Holding Bot. S 4. z7 /67. PUMP/SIPHON INFORMATION Z6 el s~v; ~f l3aX Final Grade z 5 / 63 y Manufacturer Demand St C r O GPM ~I Gc /d2 . < Model Number -T 0 ZcJ 1~ cC~ TDH Lift / Friction Los System H ad TDH Ft I < ( .77 6. t JS /Z. Zz> f f Dist. to Well Forcemain Ill i IDia. Z' I SOIL ABSORPTION SYSTEM l0 BED/TRENCH Width Length No. Of renches PIT DIMENSIONS No. Of Pits Inside Dia. T id Depth DIMENSIONS / _ 75 9 C SETBACK SYSTEM TO P BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION p CHAMBER OR UNIT Model Number: Ty1 ~l rte _ System 33 ~ 57 /57 /lf i- DISTRIBUTION SYSTEM 4b oP Header/Manifold Distribution x Hole Size x Hole Spacing V to Air Intake i~ Pipe(s) l 'T Z:5 '7 Length Dia • ZS Length 3~ Dia Spacing ✓ 3Z 3 t SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over / Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center 1 , ' 7 Bedfrrench Edges Topsoil 1 ~L Yes No Yes No COMMENTS: (Include code discrepencies, persons pres tt, etc. Inspe 7/ Inspection #2: Location: 1165 200th Street Baldwin WI '51002v (SW 1/4 NW 1/4 1 T29N R1 7W) N Lot 1 J' parc_el N 01.29.17.7A CQ 1.) Alt BM Description =96 ~~~J Xjl / '"1 54~_ 2.) Bldg sewer length = Lo d y 644 ~n _ -amount of cover = u Z f I ✓12 ~•t=G(Q Iil~I~ ~ 12, ~Lp/ V~ Plan revision Required? Q Yes No Use other side for additional information. / 2 " I SBD-671 0 (R.3/97) Date Insepctor' Signatur Cert. No. Plot Plan, Page S of 8 Property Owner ~E~VYJ-ZGLONG I"=40ft. Legal Description sw'/y c F r ft A j w l/y, s i► (except where noted} Tzig., R i7yJ . -7o-au of moNp-, sg-. cgotx cc Packhoe pit tMAIP wise-oAsW North ~lr-2~f ~C'o0~ ~'ltrln.0~~ . 5 ~ 2Ge ssa.U~ ~ex-~ ' ~ 1~,P'~')~~ ~ z . F s~o►t~b SE'S 3 8 ~'cC`, CG, 2 3'~-govt 6Rnun~ W a1 V ~ ~t~t/A1lo 1' f!t/t1 fST/AJC~ 7v g o New w~ES~I ~ ® COMBD 7~AlJK f L;t V'~ A STM Rill a Y-~"~ M G 5 ~M fz 2~ iCi (+~L V. r 99 p ~~s ~ v id TIME /.dt ° ABOA G0eOU•'1D t c►o, OtJ' a Rj"'W Derr- t W I PRAW -roc ~ x Site Location: rr~~ h Pam Quinn From: Taylor, Edwin - DSPS <Edwin.Taylor@wisconsin.gov> Sent: Friday, July 19, 2013 10:25 AM To: Pam Quinn Subject: RE: Revised Mound Design Trans. ID 2260783 Hi Pam, I'm glad that the installer caught the elevation error. I should have but obviously didn't. I spoke with Matt Janzen regarding an appropriate administrative procedure to rectify the problem. He advised that I issue a revised approval letter noting that an error was made in issuing the original approval letter once corrected plans have been received. I apologize for any inconvenience that my oversight may caused. Please contact me with any additional questions or concerns. (Whenever I attempt to call your office, I get a busy signal. Is that typical?) Thanks, Ed Taylor -----Original Message----- From: Pam Quinn fmaiIto: Pam.Quinn@co.saint-croix.wi.us] Sent: Thursday, July 18, 2013 3:47 PM To: Taylor, Edwin - DSPS Cc: Janzen, Matthew A - DSPS Subject: Revised Mound Design Trans. ID 2260783 Here are Mary Jo's revised contour elevation and subsequent corrections for this mound. She included the 6" depth to limiting factor and 30" sand at "D". Pam Quinn, Land Use Specialist (POWTS) St. Croix County Community Development Dept. 1101 Carmichael Road Hudson, WI 54016 715-386-4680 pam.guinn@co.saint-croix.wi.us -----Original Message----- From: Administrator Sent: Thursday, July 18, 2013 2:41 PM To: Pam Quinn Subject: Message from "RNP15651F" This E-mail was sent from "RNP15651F" (MP 6001/LD360). Scan Date: 07.18.2013 15:40:50 (-0400) Queries to: administrator@co.saint-croix.wi.us 1 r m ~N1 Q u I~nl Mound and Pressure Distribution Component Deign VFW Design Worksheet C 18 2013 Site Information sr ERo (R or C) R Residential or Commercial Design Note: Sand fill (D) calculations 999u 300.00 Estimated Wastewater Flow (gpd) Table 383-44-3 in-situ soil treatment for 1.50 Peaking Factor (e.g. 1.5 = 150%) fecal coliform of 36 inches. 450.00 Design Flow (gpd) 4.00 Site Slope 99.64 Contour Line Elevation (ft) 6.00 Depth to Limiting Factor (in) 0.40 In-situ Soil Application Rate (gpd/ft2) Distribution 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 or E) 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. 0.156 Orifice Diameter (in) 3.19 Estimated Orifice Spacing (ft) = 9.38 ft2/orifice 2.00 Forcemain Diameter (in) 68.00 Forcemain Length (ft) Does the forcemain drain back? y 93.00 Pump Tank Elevation (ft) Enter Y or N 4.55 System Head (ft) x 1.3 11.09 Forcemain Drainback (gal) 8.73 Vertical Lift (ft) 46.90 5x Void Volume (gal) 1,D 1.00 Friction Loss (ft) 57.99 Minimum Dose Volume (gal) 0.00 In-line Filter Loss (ft) 25.85 System Demand (gpm) 14.28 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x x 1.00 x 1.50 x 1.25 x x 2.00 1.50 x 3.00 2.00 x 3.00 x Gallons/Inch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1000.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Wieser Manufacturer gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 600.00 Dose Tank Capacity (gal) [ PolyLok _--]Filter Manufacturer 16.76 Dose Tank Volume (gal/in) L 525 Filter Model Number Weiser Manufacturer Project: JEFFREY J. DELONG Page 2 of 8 Mound Plan and Cross Section Views T 1/10 B : J Observation Pipe + T K• r.l•l.1•l.f•P•. r•r•r•r.r•l•l.J•J•1• J`f•J•r......•. •J•l•l r J l r J J J J J: J r J J • '.•L•1•L•L•L•1.1•L•1•L•L•1.1.1.1.1• L~ti•L L•L•L•1.1•L•1.1.1.1.1.1.1.1.1`L•L•L: 5.1.1.1' r•l'•J•l.u r.r.r•r•J•r.r.J•J.r.r_~ -_rr l•l•J•l.l•!•J•r•l•J•J•l•l•l•J•J•J•J• l•l.t•J 1.1.1.1.Y 11.•..1.1.L•1.1.1.1.1.1.'•~ `L:ti.1 1.1.1.1.1.1•'.•1.1.1.1.1.1.1.1.1. 1.1.1.1• A r•l•l•l• l•l•l•l•J•r•r•r•J•J•r J•J•J•J•r.l'r•r•r•r•r•r•J•l•l•J•r•J•J` r.J•r.l•r • '..1.1.1.1. 1.1.1.1.1.1.••.1.1.1.1. JLj1`1 1.1•L•L•1.1.1.1.1.1.1.1.1•L•1.1.1. 1.1.1.1••.• r•r•J•r•r•r•r.J•J•J•r•J•l•J•J•r•r•J• 1.J•r•J•r•J•r•J•l•l•r•r•l•l•J•r•r•r•l•J•r•r•l•l•l • 1.L•1•L•1.1.1.1.1•L•L•1.1•L•L•L•1.1•L•L•ti•'. 1.1.1.1.1.1•L•1.1.1•L•L•L•L•1.1.1.1.1.1•'.•L•1• W :I. I• - • • . B .fTTTTT1.e • • I L Mound Component Dimensions A 6.00 ft E 32.88 in H i1ft ft K 13.17 ft B 75.00 ft F 9.25 in z ft L 101.35 ft D 30.00 in G 0.50 ft J W 29.77 ft 450.00( ft2) Dispersal Cell Area 1475.50 (ft) 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 103.91 (ft) ..,lrllJ.l,.... ♦ H 111 A G 1 • ft) Lateral F Dispersal Cell 102.64 ( 102.14 (ft) - Invert Dispersal Cell ( Elevation D 4 4 99.64 (ft) Contour Elevation 4.0 % Site Slope Geotextile Fabric Cover Shading Key d c. -T Dispersal Cell See lateral details on 1 Topsoil Cap 1.5 ft Page 4 for number, size, r.J.r.r•r•J.J.r•r•r.r.l.r`r.J Y 0 1.1.1.1.1.1 1•L 1.1.1.1.1.1• Subsoil Cap r•r.J•J.J.J.r.r•J.r.J.l.r`r.r and spacing of laterals. _1. 1 L•1 L 1.1.1.1• ~.•Y 1 ham. 1 '4.1.1 b1 L• ti .1 Laterals are equally '..1.1.1.1.1.1 •1•L•1.1.1•L•1• ASTM C33 Sand r.J J r r r J r r r r r J•J•r. r, r.r r, r, r•J r`r•r•r Llti f1 1.1.1. F spaced from the f•r.l•J 1.1.1. C m 0.5 ft 0 :f1f. Typical Lateral`r_l; r.r•r•r ti•L`1 ;1. 1.1.1.1•:•1•-.`L•L.ti distribution cell's ® Tilled Layer r•}•J•J•r.r r•r•r•J.r r r•r•J•l 1.1.1.1•L•1•L•L•L•L•L•1.1•L•L © ® r•J•J.r•r•r•r•l•r•r•r•J•r.J• r S•L•1.1• ~ o L•1•..1.1.1.1•L•ti centerline in the Aggregate . J•r•J•r• •J•J distribution cell (Ax6). Project: JEFFREY J. DELONG Page 3 of 8 Center Connection Lateral Layout Diagram Force main mv*cdon via tee of cross to MW*om at an point. Laterak are identsa al dw- P S im Turn-upwtbsllvsWeor I+X- W2 Laterals &forCemain Sch40 PVC olesnoutplug per SPS Tale 35430-6 Holes dried on the bottom of the Weral. Number of Laterals 4 Orifice Diameter 0.156 in Lateral Diameter 1.25 in Orifice Spacing (X) 3.20 ft Lateral Length (P) 36.80 ft Orifices per Lateral 12 Lateral Spacing (S) 3.00 ft Orifice Density 9.38 ftz/orifice Lateral Flow Rate 6.46 gpm Manifold Length 3.00 ft System Flow Rate 25.85 gpm Manifold Diameter 1.25 in Total Dynamic Head 14.28 ft Forcemain Velocity 2.64 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical aL316.300 r NEC 3010 and SPS WAC 4 in. min. Disconnect Tank component is properly vented -E- Alternate outlet location Forcemain diameter Weiser Manufacturer 2 in. Capacityl 600.00 Gallons Volume 16.76 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 19.44 325.81 B 2.00 33.52 C Pump off elevation (ft) C 3.46 57.99 93.91 D 10.90 182.68 D Total 35.80 600.00 11 Dose tank elevation (ft) 3" Bedding un er tank. 93.00 Alarm Manuafacturer SJE Rhombus _ Note: Switches Alarm Model Number Tank Alert containing mercury may not be used in Pump Manufacturer Zoeller this system. Pump Model Number 98 Pump Must Deliver 25.85 gpm at 14.28 ft TDH Project: JEFFREY J. DELONG Page 4 of 8 Wisconsin Department of Commerce l `--SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County ST. CROIX Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 018 - 1001 - 40 - 000 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). i Property Owner Property Location ❑ JEFFREY J. DELONG Govt. Lot SW 1/4 NW 114 S 1 T 29 N R 17 EE((or)W Property Owner's Mailing Address ;Lot TIBIlock Subd. Name or CSM# 530 C.T.H. M V4, P996 CityState Zip Code Phone Number llage ■ Town Nearest Road River Falls, WI 54022 ( ) 200th Street New Construction LlseE] Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement Public or commercial - Describe: Parent material clay loam till Flood Plain elevation if applicable NA ft• General comments An Interpretive Determination Report approved by the State of Wisconsin Department of Safety and Professional and recommendations: Services (DSPS) is required before a POWTS is allowed on this site. A mound system with a 28" sand lift would be required with a 0.4 loading rate. PROPERTY ADDRESS: 1165 200th Street Boring # 0 Boring Q Pit Ground surface elev. 100.00 ft. Depth to limiting factor I I in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fg in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 `Eff#2 1 0-10 l0YR3/2 sil 2fgr mvfr as 3vf-co 0.6 0.8 2 10-11 10YR5/3 sicl 2fgr mfr as 2vf-co 0.4 0.6 3 11-16 10YR5/3 c I d IOYR4/6 sicl 2f-mabk mfr cs 2vf-co 0.4 0.6 4 16-23 10YR5/3 m2p7.5YR4/6&10YR6/2 cl If--mabk mfi lvf-m 0,2 0.3 Water ob- served at 23" (drain tile from base- ment was 20 ft. from pit) Boring # ❑ Boring 98.90 10 I Q Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate F Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-9 10YR3/2 - sil 2fgr mvfr as 3vf-co 0.6 0.8 2 9-10 10YR5/3 sicl 2fgr mfr as 2vf-co 0.4 0.6 3 10-16 10YR5/3 cld7.5YR4/6&10YR6/2 sicl 2fabk mfi lvf-co 0.4 0.6 One stone; some gr/cobs. * Effluent #1 = BOD > 30:< 710 mg/L and TSS >30:5 150 mg/L * Effluent #2 = BOD < 30 mg/L and TSS 130 mg/L CST Name (Please Print) 2V~ ST Number Mary Jo Hu ert Hollister's Soil Testing & Design) 224832 Address Date ECe phone Number W9875 690th Avenue, River Falls, WI 54022 05 - 14 - 13; revised 06-11-13 (715) 426 - 1775 nnr~ n~~n mnn,nm f 1 e DELONG, Jeffrey J. Parcel ID # 018 - 1001 - 40 - 000 Page 2 of 3 Properly Owner Boring Boring # a Pit Ground surface elev. 98.80 ft. Depth to limiting factor 8 in. Soil Mplication Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/ft' in. Munsell cu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 "E1102 1 0-8 1OYR3/2 - sil 2fgr mvfr as 3vf-co 0.6 0.8 2 8-14 IOYR5/3 cId 7.5YR4/6&IOYR6/2 sicl 2fabk mfr cs 2vf-co 0.4 0.6 3 14-19 10YR5/3 m2d7.5YR4/6&IOYR6/ cl 2fabk mfr as 2vf-m 0.4 0.6 4 19-26 10YR3/6 m2p7.5YR4/6&10YR6/ sl Om mfr cs Ivf-m 0.2 0.6 5 26-30 10YR3/5 m3p7.5YR4/6&10YR6/ scl Om mefi cs - 0.0 0.0 6 30- chill Some gr (1-5%); few cobs. Pit left open for 1/2 hr. and no water was ob- served RPH Boring 4 ] ng F Bon # Ground surface elev. 920 - ft. Depth to 6rnbV factor 9 in. SoN Awficatim Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDff in. Munsell Ou. Sz. Cont Color Gr. Sz. Sh. -EW1 -EM02 1 0-9 IOYR312 - sil 2fgr mvfr as 2vf-co 0.6 0/8 2 9-11 IOYR5/4 sicl 2fabk mfr - lvf-m 0.4 0.6 F-1 Boring # Pit Boring Ground surface elev. ft. Depth to limiting factor in. Sofl Rate Horizon Depth Dominant Color . Redox Description Texture Structure Consistence Boundary Roots GP in. Munseli Ou. Sz. Cont. Color Gr. Sz. Sh. `EMOI *002 Effluent #1= BOD$ > 30 1220 mg& and TSS >30:< 150 mg7L " Effluent #2 = BOD, < 30 m9 L and TSS 5 30 mg1L _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 608-2648777. sn3D433"e& (807/00) r` Plot Plan for Site I and `Soil Evaluation Page 3 of 3 Property Owner kO ~Ta LM6- 1 = 40ft. Legal Description 3W 41 of 71At (e wept where noted)- TzgAi ,217 , 'TawAJ or innoN ST- C1411- Com 44U1ISCONSIn~ gq,?z a4O~ North 6 R0,0 tA ~~Wa1 Oz , 8rrr~ oM o F sta\~b r C I 2, 3,* oUE GRONnu~ 1~7 1 / o.5..s~ F 2 J / AVI ~ fig, 99 OA . I --FPM= l s Sf tK£ jtj N Misr o0- ' aOO oo D RP W+`~C•~ Ll \'f C t 14 Y, - 7R~ t \N T - ~~NCt. L.xNL Site Location: N h ~ 1 ~ 4yf. Ey . County a~~'°Ar4~ Safety and Buildings Division S'7- C (7 I X p;S 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) P 5' Madison, WI J6 83 State Transaction N Permit Application In accordance with SPS 3 (2 , Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Pr*a Address Cirdigbrent than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary CRpt purposes in accordance with the Privacy Law, s. 15.04 1 (m , Stats. V! I. Application Information - Please Print All Informatio ` Property Owner's Name Parcel # Kerrey 1 0e10k1 ~t8~(oa l - ~a -060 Property Owner's Mailing Address Property Location (D S ~ 6501 /7 ,5 7- Govt_ Lot ' \J City, State 3,q jW'9 y y1 l Zip Code Phone Number S W L! Section p~ ~C' ' W S [ -(/00,2 71S luo - 0q17 T N; R tJ circleoon H. Type of Building (check all that apply) Lot # 3 I El 1 or 2 Family Dwelling -Number of Bedroo Subdivision Name Block ❑ Public/Commercial - Describe Use - ❑ City of CSM Number & ( ❑ Village of ❑ State Owned - Describe yTse /~U Town of Pa Ill m6nd 3/f~^ 7`'Z X C~ III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ❑ New System Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. Permit Renewal El Permit Revision ❑ Change of Plumber El Permit Transfer to New List Previous Permit Number and Date Issued ❑ / Before Expiration Owner k QX1 12 a IV. Type of POWTS System/Component/Device: Check all that a 1 1 / ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil XL Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) f V. Dis ersal/Treat ent Area Information: a Design Flow (gpd) Design Soil Applicatio ate(gpdsf) Dispersal Area Requi d (sf) Dispersal Area Proposed (sf) System Elevation t-(SO 0. X10 p , ~J I y~ l6~ VI. Tank Info Capacity in Total # of Mapufa cr `CJ _ Gallons Gallons Units U y - J Y New Tanks Existing Tanks d o Y 2 b- t 0vG 6,00 L~ a U V) Z Ell) w 0 0, Septic or Holding Tank 1 O O /ti D O ( c f S~' C' Q h f~`~ Dosing Chamber 1 6 0 G O' o (,V e SPJ-C o l, C J2 Ae X VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number 4i ~ ~ M r°~25 (u73 ~~S' 3v7-1 ~~d Da t red! 4 ell Plumber's Address (Street, City, State, Zip Code) AI-71r %A/jfh 5r- /R, 'ver !--q VIII. Coun epartment Use Only Permit Fee Date Issued Issuing t Signature Approved rsap$ Reason for Denial 4.75 - do -119111,3 IX. Condi QW easons for Disapproval 3, Co y ~.e^,S eJ A11L 1. septic tank, e~t filler and J c, ~a :.dispersal ce8•must all be, hM eery I maintained t t, ~ r as per management plan provided by plumber. 31A# as*k requi VMft nnttst be maintain6rl is * WOci& p6d• rordklafim. Ali ~ a 6- Q' Low Out 44e. Attach to complete plans for the system and submit to the Cou ty only on paper not less than 8 1B z 11 inches in size SBD-6398 (R 11/11) Plot Plan, Page s of 8 Property Owner/ LaN~ 1"=4©ft. Legal Description 5w,X4 or' TRL u wV,i, s 1{wept where note4 Tag~S,, r-z,>vJ, -Tomu of um opal, sT, c.i .otx. cc ,,►-n~. M = Backhoe pit tMAID i~ltsEpN sink ~ ~,?z Gtc~ North 'Lv-eV-' ~oa~c ~YLA-LN0~~ v~~n~ d ~U ear , $~RooM ~ur5~"1~ ~-5 A2ce55a Z 3'*go►r~ G~ou~ ~rsrlN~ r' ~r ~ N a rsT/A1G yv 5~5 AA4N~ _ a D a orzy W'aLL~ PEA C i ? ?e2 c-w- g 1 ~ a New w~~s~t , '1 COMBO ~ c s Fly 49. ! SPfKF 10 TOSS ldt°.~1Sadb ~,e4u~lD ;L,rx tA MeM toll, 4D ~ X o~ aRpW~ t~lTcrt qvo ' PG 20, ~r'ENC~ u:NE Site Location: ` 1171% h ~ .4vt.~" T y 4wI>~,~T DIVISION OF INDUSTRY SERVICES o~5tit' \ 0 9 * 10541 N RANCH ROAD HAYWARD WI 54843 Q Contact Through Relay SP C•Cf www.dsps.wi.gov/sb/ S www.wisconsin.gov Scott Walker, Governor ~~~~'SSfn A''w` Dave Ross, Secretary June 18, 2013 CUST ID No. 224832 ATTN. POWTS Inspector MARY JO 1 UPPERT ZONING OFFICE HOLLISTERS SOIL TESTING & DESIGN ST CROIX COUNTY SPIA W9875 690TH AVE 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 06/18/2015 Identification Numbers Transaction ID No. 2260783 SITE: Site ID No. 791395 Jeffrey J Delong Please refer to both identification numbers, 1165 200TH Street above, in all correspondence with the agency, Town of Hammond St Croix County SW1/4, NW1/4, S1, T29N, R17W FOR: Object Type: POWTS Component Manual Regulated Object ID No.: 1434498 Maintenance required; Replacement system; 450 GPD Flow rate; System(s): Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01/01, R. 10/12); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. 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, P O W'T stats. Condltty The following conditions shall be met during construction or installation and prior to occupancy or use: PRO Install pursuant to plan modifications indicated in red ink. EP TMENT OF C A copy of the approved plans, specifications and this letter shall be on-site during construction and open to IVIS OF SAFETY 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 SEE CORRE P construction/installation/operation. In granting this approval the Division of Industry Services 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 and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. MARY JO HUPPERT * Page 2 6/18/2013 ~cerely, Fee Required $ 250.00 (1~~ This Amount Will Be Invoiced. r When You Receive That Invoice, Edwin A Taylor / Please Include a Copy With Your Waterwater Specialist, Integted Services Payment Submittal. (715)634-3484, Monday - Friday 8:00 am To 4:30 pm WiSMART code: 7633 Edwin.taylor.wisconsin.gov Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Industry Services (formerly Safety & Buildings) will be modified. Code references with prefixes starting with "Comm" have been replaced with "SPS" to recognize the relocation of the Division of Industry Services from the former Department of Commerce to the Department of Safety & Professional Services. Additionally, all IS (formerly S&B) codes have been renumbered and addressed in a "300" series. For future reference, the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. MARY JO HUPPERT Page 2 6/18/2013 4;ncerely, Fee Required $ 250.00 F This Amount Will Be Invoiced. r - When You Receive That Invoice, Edwin A Taylor Please Include a Copy With Your Waterwater Specialist, Inte ed Services Payment Submittal. (715)634-3484, Monday - Friday 8:00 am To 4:30 pm WiSMART code: 7633 Edwin.taylor.wisconsin.gov Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Industry Services (formerly Safety & Buildings) will be modified. Code references with prefixes starting with "Comm" have been replaced with "SPS" to recognize the relocation of the Division of Industry Services from the former Department of Commerce to the Department of Safety & Professional Services. Additionally, all IS (formerly S&B) codes have been renumbered and addressed in a "300" series. For future reference, the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. 4 F MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: JEFFREY J. DELONG Owner's Name: (same) Owner's Address: 530 C.T.H. M River Falls, WI 54022 Legal Description: SW1/4 of the NW 1/4, S 1, T29N, R17W Township: Hammond County: St. Croix Subdivision Name: NA Lot Number: 1 Block Number. NA Parcel I.D. Number: 018 -1001 - 40 - 000 I Plan Transaction No.: } Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank S. , O Page 5 System maintenance specifications !ally 1~."~Fi=.1• Page 6 Management and contingency plan ®1~ = Page 7 Pump curve and specifications VED'.R .A Page 8 Plot plan )MMERCE -Fl US rD BUi 3 DEN Designer Mary Jo Huppert License Number. 1859 - 007 Date: 06/11/13 Phone Number. 715 -426 -1775 Signature: p- Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01) Version 7.0 (R. 03/2012) Page 1 of 8 . r 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 383-44-3 in-situ soil treatment for 1.50 Peaking Factor (e.g. 1.5 = 150%) fecal coliform of 36 inches. 450.00 Design Flow (gpd) 4.00 Site Slope _ 94. ^ C ntour Line Elevation (ft) ter CAS ~0 ~e9d pth to Limiting Factor (in)s - _ In-situ Soil Application Rate (gpd/ft) Distribution Cell Information i 75.00 Dispersal Cell Length Along Contour (ft) = 6.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) i 1; Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Pressure Disribution Information network? Enter Y or N (C or E) _ 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. 0.156 Orifice Diameter (in) 3.191 Estimated Orifice Spacing (ft) = 9.38 ft2/orifice 2.00 Forcemain Diameter (in) f 68_00 Forcemain Length (ft) Does the forcemain drain back? 93.00 Pump Tank Elevation (ft) Enter Y or N 4.55 System Head (ft) x 1.3 11.09 Forcemain Drainback (gal) 3. Vertical Lift (ft) 46.90 5x Void Volume (gal) 1.00 Friction Loss (ft) 57.99 Minimum Dose Volume (gal) 0.00 In-line Filter Loss (ft) 25.85 System Demand (gpm) 6 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. o tions choice in. dia. options choice 0.75 1.25 x x 1.00 x 1.50 x 1.25 x x_.___. 2.00 1.50 x ! 3.00 2.00 x 3.00 x Gallons/inch Calculator (optional) Treatent Tank Information ; Total Tank Capacity (gal) 1_'_1_0__00__.0_0"'1 Septic Tank Capacity (gal) i _ Total Working Liquid Depth (in) Wieser (Manufacturer gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 600.00 Dose Tank Capacity (gal) Po!yLok ; Filter Manufacturer 16.76 Dose Tank Volume (gal/in) 525 Filter Model Number Weiser I Manufacturer Project: JEFFREY J. DELONG Page 2 of 8 Mound Plan and Cross Section Views T . 1/10 B ; . J Observation Pipe rK. • :.:t r: J l.J ' 1. .r:J.J.J:J:: l.J r t r t r r r l f'J : • r f r : 1 LPL L • L.L L.'. L~L••. L.S.L.• 1 L L.L•L•L•L•L L L~ L L L 1:1•L L L L' L~L•L•L. 1'.~':r.JY J., 1. t. .:J•J•J J•J.J.J.:.J'. :.•.1'.l.j~:7.,f. J..~:1.,%'•f.• J.t•` A L%L.•..L v 'L.L L:L.L: L.•.:L:L.L••.• S.L.•. L.•..L.L:L: L.L.L.L.L•L:S.1.L.L.•..1 L:L.L.L: ' Lrtir.r.r• J.:•r•r.r.: •:.:•r•:•r 5 r•r•r•J.r•: •r.r.; .r•r•r•r•r•r•:•:.r• r.r.r.; ' L••.•L• '•.•L.L.L•L.L••..L•L•L•L. L•1•L L.'.•L:'.•L.•..'.•L.L.L.•..L.L.L.•.. •..L S:'.•L•L••.• }•r•: •r•: .:.r.r.r.t•r•r•r•:.t•r.: •r.:.: r.r r.:.J•:•r•: •r•r•r•t.r.t': •r•:.:•; •r • •..L.L.L•L••..L.L.L.L•L•'.•L.L.L.L.L.L.L•L.L•L.L.L•y::..•..•..L•L•L•L.L.L•L•L•L•'.•L•L•S•S•`.•L•1• W ...1 .............................................1.... - B . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . T .'.W i L Mound Component Dimensions ~3a.gs A 6.00 ft E in H 1.00 ft K ft B 75.00 ft F 9.25 in z ,D ft L t ft /0/. S 3d.OD D in G 0.50 ft J d•a . ft W 3a ft 450.00 (ft2) Dispersal Cell Area 1432.88 (ft2) 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 q$.ya Finished Grade 9&' (ft) ,!!!//fff,.... H G Flo. 6 3 F 96sW (ft) Lateral (ft) Dispersal Cell - Invert Dispersal Cell] . Elevation D 4 4 94.13 (ft) Contour Elevation 4.0 % Site Slope Geotextile Fabric Cover Shading Key Dispersal Cell See lateral details on 1~ S Topsoil Cap c 1.5 ft tir~r•;if.r.:.r J.:;r.r•r•J•r•r Page 4 for number, size, L. L•L•L•L•L L".•1•L•L• Subsoil Cap m o ry;,t•r.:;;ti••:.r:r•rti;tit r1; and spacing of laterals. L.Lr4: tir:; L:ti•L Jti;ti f ASTM C33 Sand r.J.t.: r•r•J.r.. r..''rr Laterals are equally L L L•°. ~ti•L.S. L•L.L•L•L•L.L•Le1. tfL~ r r.rhlrtrs .rrrr:::rrlr: r, 1.. J F spaced from the Typical Lateral r~r ® Tilled Layer H0.5 ft W :.L.L• • •'.•L•`..•. 1.1.'.•L•lf1• distribution cells d•; •:•r•l..•.r•r~ r•J•: L•L•L•L L•L•L•L.L L•'••L•L•L r•r•r•r •Q r•J•r•r•:•:.r•r.a i•r•: •:•J• Q S. L.L.L. Aggregate d' o S.. L.•..L.L.L.L.•..L'..L.•..L••.•L centerline in the •r•r•r•r•r•r.:.; .r.J•J•: •J•r•:•r.r - A distribution cell (AxB). Project; JEFFREY J. DELONG Page 3 of 8 Center Connection Lateral Layout Diagram Force main connection via tea or cross to maWOld at ang point. ILateraft are identical I P S Ak- =Turn-upwtbsltvalveac mt2 wt231 LaRerBls&forcemehtSctt40RVG aleanoutplug per SPS Table 384.30.6 Holes drftd on the bmcm of the iateral. Number of Laterals 4 Orifice Diameter 0.156 in Lateral Diameter 1.25 in Orifice Spacing (X) Jiff ft Lateral Length (P) 36,0aW ft Orifices per Lateral 12 Lateral Spacing (S) 3.00 ft Orifice Density 9.38 felorifice Lateral Flow Rate 6.46 gpm Manifold Length 3.00 ft System Flow Rate 25.85 gpm Manifold Diameter 1.25 in Total Dynamic Head 8.61 ft Forcemain Velocity 2.64 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and SPS 316.300 WAC 4 in. min. Disconnect Tank component is properly vented Alternate outlet location Forcemain diameter Weiser Manufacturer 2 in. Ca aacit 600.00 Gallons Volume 16.76 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 19.44 325.81 B 2.00 33.52 C Pump off elevation (ft C 3.46 57.99 93.91 D 10.90 182.68 D Total 35.80 600.00 Dose tank elevation ft Bedding un Ter tank. 93.00 Alarm Manuafacturer SJE Rhombus Note: Switches Alarm Model Number Tank Alert A6 g „ containing mercury may not be used in Pump Manufacturer :Zoeller`_ this system. Pump Model Number 98 Pump Must Deliver 25.85 gpm at $.~k ft TDH Project: JEFFREY J. DELONG Page 4 of 8 s s e i' OA- s 8.1d r 6 -4 s K K' 4n{d OAd Mound System Maintenance and Operation Specifications Service Provider's Name Johnson Sanitation J Phone (715) 273-5811 POWTS Regulator's Name i St Croix County Zoning Office Phone 71-5) 4680] System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 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 Frequency Septic and Pump Tank Inspect and/or service once eve 3 ears Effluent Filter Should inspect and clean at least once eve 3 ears Pump and Controls Test once eve 3 ears Alarm Should test month) Pressure System Laterals should be flushed and pressure tested eve 1.5 ears Mound Inspect for ponding and seepage once every 3~rears Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, 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 vl 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: JEFFREY J. DELONG Page 5 of 8 Mound System Mapagement Plan Pursuant to SPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals (SBD-10691-P (N.01101), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01)] 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 SPS 383.33, 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, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the fitter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced d 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 113 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. Pump 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 System No trees or shrubs should be planted on the mound. Plantings may be 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 BOD5, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOOS, 30 mg/L TSS, 10 mg/L FOG, and 104 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. Continency 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 with a component of the same or equal performance. 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 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. Project: T Pk/ ~ bEt A)C- Page 6 of 8 a i/o o r/4 W HEAD CAPACITY CURVE MODEL '98` 30 4 5/8 25 I g 3 5/8 ' s 20 V 15 O + + 4 , 4 h `o U1 10 4 3/16 .l.p 5 c 1 1/2-11 1/2 h1PT U.S. GALLONS 10 20 40 56 a, 70 >o LITERS 0 so 1; 240 FL)W PER MINUTE MODEL 98 60 CYCLE Feet Goaom Meters Liters 5 72 1.5 Z73 10 61 it 23t 15 4s 4.6 170 12 ZO 25 61 % tAA YaluC 2Y 006971 43/16 SKIM CONSULT FACTORY FOR SPECIAL. APPLICATIONS • Electrical alternators, for duplex systems. are available and - variable level float switches are available for aortkoftV supplied with an alarm. and three phase systems. • Med*ncal alerriators. for duplex.. systems, are available - Doug pkjgybadc variable level float switches are available with or without alarm switches- for variable level long Cycle controls. SELECTION GUIDE Standard all models - Weight 3S tbs. H.P. 1. Integral float operated 2 pole nlectlanicai sw i ch, no external oantrd required. 2 Skoe pig t variable knrel ftel switch or double piggyback variable level. 98 ser les . Control Selection tkat swiedt. Rerer to 1910477. mom volle-ph klhodo Anw 811011101" Duplex & Med>enirxl aemalm 1U-01)72 or 10.0075. hm 115 1 Argo 9.4 1 or18 T - 4. Sea FM071Z forte model of Electrical AltaneW. MOB 115 1 Non 9-4 2 or 2&6 3 or4 & 5 5. Control swildt 104)225 used as a control acilvalur, specify duplex (3) or (4) fkxdwjsWm CM 230 1 Aldo 4.7 10<18 7 - 6. Four (4) hole 3-Pak. junction box for wale ftht connection awkeddn E98 230 1 Nat 4.7 2 or2 & 6 3 or4 -&5 ordUpiett cps 10-0002 7. Two (2) hole J-Pak for wahwdgM corutectim or splice. CAU110N For inbowilion on adMorel Zoeffwpmdwbtafm-lo,a at an plggl6edrVaftb Lod9trN All installation of controls, protection devices and :firing should be done by a qualified 1W477.Be66fwtAlhel>ow. AAOMBC , &mwSwA3pii ,gADW, licensed electrician All electrical and safety codes should be fulkwed including the most SsglePitase901filerPteapCordmIL FMUlItAb=81 . MM recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). RESERVE POWERED DESIGN, For unusual conditions a reserve safety fator is engineered into the design of every Zoeller pump. AeA1LIF& P OL OOK 111W ,rctc rp SNP70t 36411GOeel?aaRowl 1Yfdwkc arsd.. - KY 4W11-1111111 h wraxoa&ereon7 AY/MP ! (5M773-2Z3T-II ZWP01r-- X(SM774~ M D~~ON~ FA ~l • 6 Plot Plan Page 8 of 8 Property Owner 1»=40ft Legal Description sw'~ +et N w Yg, s i , (except where noted) -roww of A"M0t4b sT c"x Ce =Backhoepif iaJts~oN s= - North FvLtr ev~'.~ ~oa~c u ~n o~ ~SniJ~ 3 lg~AROOM 1 u.s al ~ -:~-5 ' L~P ) s+z s►a~i~ SE'S 94 C,(1 0 ~F W. k,c, Z 3'*goYE G3R01~1N~ ~1~T/AIlo ~ ~ .SE~!~ 'r~N a r.sT7uG ~ g~ ~y3M~~DCW~ 2 ASAA) £ 7~12y W-EIL p~ G9 t~~ ~ o Nsw w~ l COMBO ~pie,~p P~ 5 FbRjC&MA-W , ~w1 CO¢otlA40 ~ 7~a A ¢ aRftWAGE t]~TcN JWA - w s~R~.,N -r%u~ ~~NCE uNE Site Location: h ~ ~4vc ✓ i DIVISION OF INDUSTRY SERVICES ' 10541N RANCH ROAD ARTAI HAYWARD WI 54843 PF ~ ~TC\ Contact Through Relay 7y www.dsps.wi.gov/sb/ d~ www.wisconsin.gov P S Scott Walker, Governor f ~0 Dave Ross, Secretary ~,SStON ~ June 18, 2013 CUST ID No. 224832 ATTN: POWTS Building Inspector MARY JO HUPPERT ZONING OFFICE HOLLISTERS SOIL TESTING & DESIGN ST CROIX COUNTY SPIA W9875 690TH AVE 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 (Please forward a copy of this letter to the fire department conducting inspections of this project.) CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 06/18/2015 Identification Numbers Transaction ID No. 2254615 SITE: Site ID No. 791395 Jeffrey J Delong Please refer to both identification numbers, 1165 200TH Street above, in all correspondence with the agency, Town of Hammond St Croix County SWIA, NW1/4, S1, T29N, R17W FOR: Object Type: Soil Saturation Determination Regulated Object ID No.: 1431133 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. Only those object P. 0. types listed above have been approved; other submittals such as plumbing and those listed below under Also Submit, Cond may also be required. Key Item(s) APPF D RTMEN • 1. Approval is hereby granted pursuant to s. SPS 385.60(2), Wis. Adm. Code, to estimate the depth to seasonal F,5EE F 99AFF so il saturation based on an interpretive determination process. Approval of the interpretive determination negates the requirement in s. SPS 385.30(2)(b), Wis. Adm. Code to designate the ground surface as the higest level of soil saturation when redoximorphic features are less than 4 inches below the bottom of the A horizon. RR • 2. The estimated highest level of prolonged soil saturation approved under this determination is 7 inches below grade. At least 30 inches of sand lift on top of 6 inches of unsaturated, in-situ soil is required for adequate treatment and dispersal. • 3. The basal soil application rate for the mound shall be 0.6 gpd/sf, and the linear loading rate 6.0 gpd/ft. • 4. Chisel plowing to a depth of 8 inches immediately prior to sand placement is required to improve vertical water movement into the soil solum. • 5. Landscaping up-slope of the mound shall be incorporated into the POWTS design to prevent surface water from concentrating along the up slope edge of the mound and to divert surface water drainage away from the system. • 6. This approval shall remain valid unless the site is altered in such a way that the depth to soil saturation would change or if saturated conditions are observed for seven consecutive days at depths less than 3 feet below the infiltrative surface of the POWTS distribution component. • 7. This approval in no way relinquishes the use of color patterns to estimate the depth to high groundwater on any other parcels or portions of parcels. MARY JO HUPPERT . Page 2 6/18/2013 • 8. A copy of this approval letter and attachments must accompany the mound system design for this site for purposes of plan approval and sanitary permit issuance. 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. You are responsible for complying with state and federal laws concerning construction near or on wetlands, lakes, and streams. r Rdwin , Fee Required $ 240.00 This Amount Will Be Invoiced. When You Receive That Invoice, Taylor P lease Include a Copy With Your Waterwater Specialist, Integrated Services Payment Submittal. (715)634-3484, Monday - Friday 8:00 am To 4:30 pm WiSMART code: 7633 Edwin.taylor.wisconsin.gov MAY 2 8 2013 VE DETERMINATION REPORT YSERVICES iNTERORETI- f I Property Owner: JEFFREY J. DELONG E 530 C.T.H. MM River Falls, WI 54022 Site Location: ~ 1165 200P Street SW'/ of the NWY4, Sec. 1, T29N, R17W Town of Hammond St. Croix County I Structure To Be Served: 3 bedroom dwelling Prepared by: ~ ~W. t . & lonally L4, ~L rpm V% f OF COApM CE Y NO DING, ' I ~ Hollister's Soil Testing F1 Design SPOV EN E W9875 690th Avenue River Falls, WI 54022 Phone and Fax#: (715)426-1775 I i I L _ l , i r ; Page 2 - Delong site based on the slope of the land, vegetation and observations. Some surface water is diverted fro the site due to the location of the dwelling. 2. The tested area is at the slope away from the dwelling and site with a 3 percent linear direction. r 3. Subsurface Water: some rainfall leaves the site and some is absorbed into the A horizon. Some evapotranspiration will take place. The silt loam texture within the A horizon has good structure with root and worm action taking place. The subsoil has a higher clay content and a weaker structure which tends , to hold more water due to the evidence of redoximorphic features which varies from 8 to 30 inches. i 4. Soil Saturation: soil appears to become saturated under the A horizon due to evidence of the redoximorphid, features. The site is mapped as a Skyberg series which is described as somewhat poorly drained on foot slopes and in drainageways of ground moraines. Mapped near the site is the Auburndale series which is subject to poi ding. 5. Surface Water Elevations - this area is within the Lower Chippewa River Basin. There is surface waters approximately 3/4 mile of the proposed site. See the attached map from the St. Croix County website showing the location of Pine Lake to the east of the site and flows at a southeasterly direction. A small drainageway drains the plowed field to the east a flows westernly to the road right-of-way ditch. is drainageway will minimize surface and subsurface drainage to the site. See the attached plot plan for the soil evaluation report. In a fattow field to the south some hydrophytic vegetation was observed. C. Geomorphology 1. Parent Material - The parent material is clay loam tilt. 2. Landform Type - The proposed system is in a deep lager of loess over glacial deposits of ground moraines. 3. Landscape Position and Local Topography - The pr 4 osed system is bated on the southwestemly end of a gr nd- i i I ' r Page 3 - DeLong i moraine created by the glacial period in Wisconsin. The slope poston is on the backslope. The shape of the slope is linear and convex to a minimum degree. The ground surface elevation is at 1180 feet mean sea level with fairly tower elevation to the south west of the site for the proposed POWTS. E. Soil Series and Mapping Units -The Soil Survey of St. Croix County has the area mapped as a Skyberg Series. This soil tester 1 encountered the conditions similar. The very dark grayish brown A horizon was observed. The typical profile per the Soil Survey is (in a cultivated area): 0-8", very dark grayish brown, friable, moderate, medium granular structured silt loam 8-10", grayish brown, friable,weak thin and medium platy structured silt loam with common fine and medium prominent yellowish brown mottles 10-18", grayish brown, friable, moderate medium platy stilt loam with many medium prominent yellowish brown mottles 18-25",grayish brown, moderate coarse and medium subangutar blocky structured heavy loam with many coarse prominent yellowish brown mottles 25-32", grayish brown, moderate coarse subangutar blocky structured heavy loam with many coarse prominent yellowish brown mottles 32-60", grayish brown, massive, firm heavy loam with many coarse prominent yellowish brown mottles The series is described as somewhat poorly drained soils on gently stoping areas on foot slopes and drainageways of ground moraines. The A horizon is of a dark grayish brown Munsett color 10YR3/2 which indicates a good organic matter content. This indicates that relatively good drainage is occurring with aerobic conditions in the top eight inches. F. Field Observations - the proposed site is in lawn and has been for many years. The soils identified were similar to the Skyberg Series The entire landscape was dry except in the horse pasture to the west. One soil pits had water observed at 23 inches and observed the draiin tite from the dwelling was directed to the pit. The two other pits were observed after one-half hour and no water entered the pits. Ther has been. no cutting or filling in the area. Drain file was observed in t j Page 4 DeLong drainageway to the road right-of-way ditch. The construction of t . dwelling does limit water flowing to the site. i i G. Comparative Analysis - All soil borings had tow and high redoximorphic conditions under the A horizon that were common, medium and distinctive. Two pits did have a one inch under the A horizon with no redoximorphic features. There is no prolonged saturation for more than 7 consecutive days within the top 8". H. Government Reports and Comments - This soil tester had an approved interpretive determination report on property located 4 mies east of this site in 2005 on property owned by Kenneth Graf. There are new and replacement mound systems within the area. There was a new mound system installed in 1997 directly across the road at a lower elevation. See attached soil evaluation. i IV. Conclusion and Recommendations - the site is suitable for a POWTS as evidenced by the redoximorphic conditions described abovie. There appears to be no evidence of hydric soils or hydrophytic vegetation. Most of the surface water leaves the site due to the position in the i landscape. There is a slope to the site of 3% and no surface pondini anywhere near the POWTS location. No prolonged saturation occurs within the top 8" as evidenced by lack of the redoximorphic features. The saturation occurs in the subsoil. There are no gleyed or soils haviing peat or muck. i 1. The sand fill shall be 2.50' of ASTM C-33 code required. 2. The system shall be as tong and narrow as possible. 3. Plow depth should be the maximum required depth of 12 inches during dry soil conditions so there is no chance of soil smearing. 4. The system loading rate to be a maximum of 0.4 GPD/ft2. 5. Construct the toe area of the mound system at a 1:4 ratio instead of the required 1:3 to increase absorption area. i 6. System contour should be located at the highest possible elevation within the tested area. Recommended system elevation to be at 99.66 feet. The State of Wisconsin, Department of Safety and Professional Services will review the site and report to make a final decision. I i Page 5 - DeLong l i Submitted by, i i May Jo uppert Certified Soit Tester #224832 Designer #1859-007 May 22, 2013 i i i REFERENCES: 1.) Martin, L. (1965). The Physical Geolop of Wisconsin. University of Wisconsin Press. Madison, Wisconsin. Z.) Soils. Downloaded from University of Wisconsin Education Courses website. 3.) Soil Survey of St. Croix County. (1978) United States Department of Agriculture, Soil Conservation Service, with the Research Division of the College of Agriculture and Life Sciences, University of Wisconsin. 4.) State of Wisconsin. Department of Commerce Code, Chapters 83 and 85. 5. United States Geological Survey. Topographical and aerial maps downloaded from : http://terraserver.microsoft.com 6. St. Croix County. St. Croix County Development Management Plan. Physical Features Analysis. Downloaded from http://co.st.croix.wi.us.com , Wisconsin Department of Commerce SOIL EVALUATION REPORT `rage ~ of-!- Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County ST. CROIX Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 018-1001 YO - 000 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. " Date Please print all information. Reviewed by . Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location 1:1 El JEFFREY J. DELONG Govt. Lot SW 1/4 NW 1/4 S 1 T 29 N R 17 E (of) W Property Owner's Mailing Address ;rn:S!!Name or CSfuq~ 530 C.T.H. M V4, P996 City Nearest Road State Zip CodPhone Number r Vllage ■ Town 200th Street River Falls, WI 54022 ( ) 14- 3 450 Gpp New Construction Use[q Residential I Number of bedrooms Code derived design flow rate E] Replacement Public or commercial - Describe: ft. Parent material clay loam till Flood Plain elevation if applicable *TA General comments An Interpretive Determination Report approved by the State of Wisconsin Department of Safety and Professional and recommendations: Services (DSPS) is required before a POWTS is allowed on this site. A mound system with a 28" sand lift would be required with a 0.4 loading rate. PROPERTY ADDRESS: 1165 200th Street E Boring# Q Boring • Soil lication Rate ❑ Pit Ground surface elev. 100.00 ft. Depth to lurking factor l 1 in P Ho Texture Structure Consistence Boundary Roots Dominant Color Redox Description rizon Depth Gr. Sz. Sh. *Eff#1 "Eff#2 in. Munsell Qu. Sz. Cont. Color 1 3vf-co 0.6 0.8 0-10 10YR3/2 sil 2fgr mvfr as fr. as 2vf-co 0.4 0.6 2 10-11 - sicl 2fgr mfr 3 11-16 10YR5/3 cld 10YR4/6 sicl 2f-mgr mfr cs 2vf-co 0.4 0.6 0.3 m2p7.5YR4/6&10YR6/2 cl if--m mfi lvf-m 0.2 4 16-23 10YR5/3 Water ob- served at 23" (drain tile from base- ment was 20 ft. from pit) Boring 98.90 10 a Boring # pit Ground surface elev. ft. Depth to limiting factor in. Soil ication Rate GPDIff Ak# Horizon Depth Dominant Color Redox Description Texture G Sz. Structure Consistence Boundary Roots - *Eff#1 *Eff#2 in. Munseil Qu. Sz. Cont. Color 1 0-9 10YR3/2 - sil 2fgr mvfr as 3vf-ccs 0.6 0.8 mfr as 2vf-co 0.4 0.6 2 9-10 10YR5l3 sicl 2f~' mfi 1vf-co 0.4 0.6 3 10-16 10YR5/3 c1d7.5YR4/6&10YR6/2 sicl 2fgr One stone; some gr/cobs. * Effluent #2 = BOD ~ 30 rngft_ and TSS 30 mg/L * Effluent #1 = BOD > 30 220 mg/t- and TSS >30:S 150 mglL CST Nom, CST Name (Please Print) re Number 224832 Mary Jo Hu ert ollister's Soil Testin & Desi pale Evel n Conducted Telephone Number Address W9875 690th Avenue, River Falls, WI 54022 05-14-13 (715) n 42426 - 1775 Property Owner DELONG, Jeffrey J. Parcel ID # 018 - 1001 - 40 - 000 Page 2 of 3 Boring ❑ Boring # El Pit Ground surface elev. 98.80 ft. Depth to Sm bM facttor 8 in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-8 10YR3/2' sil 2fgr mvfr as 3vf-co 0.6 0.8 2 8-14 10YR5/3 c1d 7.5YR4/6&10YR6/2 sicl 2f r mfr cs 2vf-co 0.4 0.6 3 14-19 10YR5/3 m2d7.5YR4/6&10YR6/ cl 2fabk mfr as 2vf-m 0.4 0.6 4 19-26 10YR3/6 m2p7.5YR4/6&10YR6/ sl Om mfr cs lvf-m 0.2 0.6 5 26-30 10YR3/5' m3p7.5YR4/6&10YR6/ scl Om mefi cs - 0.0 0.0 6 30- c/till Some -5%); few cobs. for 1 /2 hr. and no water w ob- served n gr (1 pit left open as ❑ Boring # n Boring d Pit Ground surface elev. ft. Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Cow Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F-1 Boring # Bo Pit rng Ground surface elev. R Depth to turtling factor in. Soil Application Rate Horizon Depth Dominant Coke Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BODS > 30:5 220 mg/L and TSS >30 < 150 mglL * Effluent #2 = BCq < 30 mg1L 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. S&}8330'rest (8.07/00) Plot Plan for Site and Soil Evaluation Page 3 of 3 Property owner -rz`l ,_T I"=40f. Legal Description may'/ o F THg M w s i , (except where noted) TzgxS. i~17~. _Ta~AJ OF nnoNa sr. cKoIx CO" =Backhoepit wts~oN stet , w q,77- ar ~North pLv" f Ewa~~( f ~~,5-rinl~ 3 6 vE" MM=41 1 SPitS£ ~rJ 7 R SoA ouuD / I A_5. V M / 00 00 f nRPW_s~c.~ ~~TGN -w '4-- W ~Cn1 MILE vpatA K Site Location: 0 j ~FYF~ L-HI E V_ old" n Y r+P , a Yp , 1 ~ f~Jr ♦ i~ a r 4 Y r,s xhA-SKIN„ 2 y 3ws ~~.s q s~l` p °i YT, Fj~ ;~y ,€~.~d X.f45Y~ .p,'~,.i'Y,~' i ,~yYhq: kr: -_3 c 4 ~ d . Z r o ~ r - w f ~a6 m r W ~ W (Do T ~ J"•r + r~ CA f _ f r"" C AL r. ~ ~ j 1 ~`t, .r r ~ ..erg. T~ - - • ~ ~ . 2 F ll , i0 1 t - T t c 5k r I ~1 ST. CROIX COL 54 N ~_oA1~)~1FFfy ~A,JN d F M aN~O VOW sheet 46) R: 17 W. ~ R. 16 W. _d V - J v ~ -y Fn8 i ' ~ 5 S8. ' i~`t fl~ co Fo X1'1$ a O 107~! `g FnB e , W SrA x x " rt N 2 .OS_ ljljlj G P7 ra a°;_ ~ i ' Sh6 Mat ,,~'s .?s - a V&B SrA, ao 1 30t, FEET (Joins sheet 62) I e o o I b 0 4 Q m I 02 ~md~ I I LL C O ItO .E o I i up I t( t C ONO I i Z a c m I to I ~ . r.. Z~7 8E G C 0 °•s t t ? ~ N c I we ; 0 N O a' aI pooCL $ '~J Z m N H ~ j 1 •N 1200 I I 0 z a A Fiy boo a~ C a~ _ r 80l r ` it 0. v ae i IL I rrw E o C '1 A off. an O R pin Yarrin ton From. David Steel <djsteel@frontiernet.net> Sent:. Tuesday, October 30,2012 10:36 PM TW. Ryan Yarrington Subject: Untitled.PDF Attachments: Untitled.PDF HI Ryan, B8 is the one that would be good for an A+0 mound 8 inches of 10yr3/3 silt loam and then 10yr 4/4 sift loam withc2d 7.5yr5/6 redox features see what you think the worst soil I saw was B2, 93, B4 and 136is really bad 87 and 88 There is a lot have mold in the bop horizon id did some more holes finer to the south but the where Grodty did the mown oacross the~ro d The person that Canary grass and some sedge growing all over the property. Henry lives at the house now is Jerry Guerldnk, he doesnt think there is any thing wrong with the system although the waterfewrac running out of the vent pipe down next to the drainage ditch. the corn field to the east is not part of the property. T is electric and the horse is fine so tell Pam not to worry.) go in the north pasture through the gate next to the garage and the south pasture through the gate in the south east corner of the yard if you have any questions please call me thanks and happy hunting Thanks David Steel Steers Soil Service 715-760-0347 . ~ t33 o P . N w 13 It ~ 1 . R7 Q t f L m J A 4 k o c ~n➢ a A f~~ c °r O m m~W a a _ ~ a m~ N ~g p v. o w I ~r CD 250 _f } 35C• 00 N fV D CAD W u OD to 2 H 1259 05 B00 > 0 N Y 10 I c ~ r --4 0 w W T I t~ Wisconsin Department of Commer VALUATION REPORT Page I of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County ST. CROIX Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel 1 01 - 1001 - 40 - 000 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Revi ed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04(l) (m)). ,711 -3 Property Owner Property Location JEFFREY J. DELONG Govt. Lot SW 1/4 W js T 29 N R 17 E (or)❑W Property Owner's Mailing Address Lot # Block # Subd. N or CSM# 530 C.T.H. M 1 V4, P996 City State Zip Code Phone Number ity Village own Nearest Road River Falls, WI 54022 ( ) Hammond 200th Street New Construction Use>] Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD E] Replacement n Public or commercial - Describe: Parent material clay loam till Flood Plain elevation if applicable N A- ft. General comments An Interpretive Determination Report approved by the State of Wisconsin Department of Safety and Professional and recommendations: Services (DSPS) is required before a POWTS is allowed on this site. A mound system with a 28" sand lift would be required with a 0.4 loading rate. PROPERTY ADDRESS: 1165200th Street a Boring # 11 Boring Q Pit Ground surface elev. 100.00 ft. Depth to limiting factor I I in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlft? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-10 10YR3/2 sil 2fgr mvfr as 3vf-co 0.6 0.8 2 10-11 10YR5/3 - sicl 2fgr mfr as 2vf-co 0.4 0.6 3 11-16 10YR5/3 c I d 10YR4/6 sicl 2f-mabk mfr cs 2vf-co 0.4 0.6 4 16-23 10YR5/3 m2p7.5YR4/6&10YR6/2 cl If--mabk mfi lvf-m 0.2 0.3 Water ob- served at 23" (drain tile from base- ment was 20 ft, from pit) F 2 Boring # Boring 98.90 10 El Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-9 10YR3/2 sil 2fgr mvfr as 3vf-co 0.6 0.8 2 9-10 10YR5/3 - sicl 2fgr mfr as 2vf-co 0.4 0.6 3 10-16 10YR5/3 cId7.5YR4/6&10YR6/2 sicl 2fabk mfi Ivf-co 0.4 0.6 One stone; some gr/cobs. * Effluent #1= BOD > 30:5 220 mg/L and TSS >30:5 150 mg/L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Si CST Number Mary Jo Hu ert Hollister's Soil Testing & Desi 224832 Address Date Evaluation o ucted Telephone Number W9875 690th Avenue, River Falls, WI 54022 05 - 14 - 13; revised 06-11-13 (715) 426 - 1775 t. DELONG, Jeffrey J. 018 - 1001 - 40 - 000 Property Owner Parcel ID # Page of 3 3 Boring # Boring 98.80 8 E] Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-8 10YR3/2 sil 2fgr mvfr as 3vf-co 0.6 0.8 2 8-14 10YR5/3 cld 7.5YR4/6&10YR6/2 sicl 2fabk mfr cs 2vf-co 0.4 0.6 3 14-19 10YR5/3 m2d7.5YR4/6&10YR6/ cl 2fabk mfr as 2vf-m 0.4 0.6 4 19-26 10YR3/6 m2p7.5YR4/6&10YR6/ sl Om mfr cs lvf--m 0.2 0.6 5 26-30 10YR3/5 m3p7.5YR4/6&10YR6/ scl Om mefi cs 0.0 0.0 6 30- chill Some gr (1-5%); few cobs. Pit left open for 1/2 hr. and no water was ob- served. F41 Boring # R Boring 9Q,45 9 Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-9 10YR3/2 sil 2fgr mvfr as 2vf-co 0.6 0/8 2 9-11 1 /4 sicl 2fabk mfr lvf--m 0.4 0.6 F Boring # S Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 5 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. SB"330Teg (R.07/00) Plot Plan for Site and'Soil Evaluation Page 3 of 3 Property Owner fVFrOJ-a Laves I"=40ft Legal Description -sw'Al of -rwe m w / . s T (except where noted) ,Z,14 -P RI-M, •-rnwAi of A"MOAM sr. Coll. caAQP# hoepit North ~ ~tsTinl~ 3 ~~RooM Liz , $nTtaM OF 51LA r 2,3`~govE. ~ r~o f Z I J a / -goo, oo . { qS.$0 ieOD JIM AM WiW t Rg, 99. od ~ BAA= 1 SPIKE irl R ZG i A50ri~ 00. .00 1 7~a~,, ~ DRPW~G~ U)9CM ~ac ~EK rC $A~IK ' I E c..tr4F,7 Site Location: lto tk EVE V) a~ v~• ' 't .l I Division of Industry Services 'V vXT ,F, 10541 N Ranch Road I 53843-642 INSPECTION REPORT Hayward, W715-643-4870 3 ~Kl RECEIVED S JUN 21 2013 S10N Pv Si Lh Scott Walker, Governor ~ CUUNiY Dave Ross, Secretary Date of Inspection: June 11, 2013 Persons Present: Mary Jo Huppert, Project Name: Jeff DeLong Darrell Hubbell, Charlie Bratz, Project Address: 1165 200th Street Ryan & Pam (St. Croix Co. Zoning) Use: 3 bedroom residential home Certified Soil Tester Name and Address: Design Flow (gpd): 450 Mary Jo Huppert, CST 224832 Hollister's Soil Testing & Design Legal Description: SW1/4 of NW1/4, Sec 01, W9875 690th Avenue T29N4R17W River Falls, WI 54022 Township: Town of Hammond Owner Name and Address: County: St. Croix County Jeff DeLong 530 CTH °M" Transaction ID Number: 2254615 River Falls, WI 54022 A field review was conducted at the above-referenced site to verify soil conditions documented by CST Mary Jo Huppert on May 14, 2013 for a proposed mound dispersal area. The proposed area is positioned on a linear footslope with a 2 to 4 percent gradient. A shallow, constructed drainageway is located 25 to 50 feet downslope of the tested area. Dominant site vegetation is lawn sod (Poa pratensis). Three verification soil profiles were examined to a depth of 18 inches near CST sample borings 61, B3, and B4. Soil properties observed in the verification profiles conform to those reported by Ms. Huppert in her report. A silt loam epipedon (10YR 3/3-2 matrix) overlies a silt loam to silty clay loam argillic horizon (10YR 5-4/4-3 matrix); structure is moderate to the depth of observation. Common Fe-oxide depletions (10YR 5-6/2) and accumulations (10YR 5/6-8) are present in the argillic horizon immediately beneath the plow layer. The shallowest depth to observed mottling was 7 inches in the verification profile near B3. No evidence of prolonged saturation (i.e., oxidized root channels or gleyed ped faces) was observed in the plow layer of any verification profile. These soils are moderately permeable in the upper 18 inches. Recommended Design Parameters Limiting factor depth: 6 inches Design basal area loading rate: 0.6 gpd/ftz Design linear loading rate: 6.0 gpd/ft Additional Considerations Roof runoff from the nearby house located upslope of the tested area should be diverted away from the proposed mound area. Direct any questions regarding this matter to my attention at 715-634-3484 or to Edwin.Taylor@wisconsin.gov. Ed Taylor, Wastewater Specialist ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CE ainCATION FORM Owner er eUS Mailing Address _ l t LS 2C>61-"- S-~ 3 e.e.►~ Lij S ~~O(1 Z S 40c) Propetty Address l1 S ZOO t..) Jw ~ ii (Verification required from Planning Department for new construction) City/State ~c C A J] Parcel Identification Number Q (O ^ 1 O D l LIO-0c0 LEGAL DESCRIPTION Properly Location SlJ_ %1, A) ✓ Sec. TZ N RJ2 W, Town of o .~»ra Subdivision Lot # Cff1M r Survey Map # 3,2J7 7 Yy . Volume q -,.Page # f Warranty Deed # '7 7 S'303 volume . Page # Spec house ❑ yes ff no Lot lines identifiable ~i yes ❑ no SYSTEM MAINTENANCE Imm use and maimtenanceof your septic system could resuttim its premature f dureto handlewastes. Propermatimmaace 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 fututicm of the septic tank as a treatment stage in the waste disposal system. The properly owner agrees to subunit to St. Croix Zoning Departinent a certification form, signed by dic owner and by a maaterphrmber, joum"mmphm*a, nskw dphnmber ara lic ensedpuropervexibing that(I) the on-rite wastmiterdu peel system is is proper operating condition and/or (2) after inspection and pumping (if necessary), septic tank is lei than, 1t3 full of sludge. I Mwe, the undersigned have read the above requirements and agree to tnamtaia tlaa private sewage disposal system with due standards CrerttficetiOn set forth, herein, as set by the Department of Commerce and the Department of Mahal Resources, Stain of Wisconsin. stating that your septic system has been mamtaimed must be completed and returned to the St. Croix County Zoning office within 30 days of the time year date. oxpastion ,1 / 'd-/zl OF APPLI DATE I fJWNER CE~TiFICATION I (we) certify that all statements on this form we true to the best of my (our) knowledge. I (we) am (ate) the owner(s) of ;=0 by virtue of a warranty deed recorded in Register of Deeds Office. 0 //-3 APDATE s«~*t Any informaon mk4 ented may result in the sanitary permh being revoked by the Zoning Departinalt. Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey reap if reference is made in die warranty deed FORM NO. 983-A c.2'73 ~•3 '1 FILED S 0 CT 1 1980 JXMM o• c0#44113. Jk.'WW of so*" 11~ gA C'WX Comfy. V Whom $ CERTIFIED SURVEY MAP CERTIFIED SURVEY ' I, Arthur L. Wegerer, registered land surveyor, hereby certify: That in full compliance with the provisions of Chapter 236.34 of the Wisconsin Statutes and the provisions of the St.Croix County Subdi- vision Ordinance and under the direction of Dale Kramer, owner of said land, I have surveyed, divided, and mapped said parcel of land, that such plat correctly represents all exterior boundaries and the subdi- vision of the land surveyed; and that this land is the SW4 of the NWT, Section 1, T29N, R17W, Town of Hammond, St.Croix County, Wisconsin, to-wit: Beginning at the W~ corner of Section 1; thence NO°02133"W along the West line of the SW-4 of the NWk 1325-051; thence N89°52'35"E along the North line of said forty 1322.901; thence SO°01116"E along the East line of said forty 1324.771; thence S$9°51151"W along the South line of said forty 1322.411 to the point of beginning. Contains 40.23 Acres subject to Town Road right- saf,;,jyay over the westerly 331 thereof. ,,•,,••~\SC O NS/~~,','' I Dated this /9`-day of_Lc_Gc,6,1980 % rT) ARTHUR L % O Arthur L. Wegerer, R.L.S. 963 Dit{~ foffW G>oineertL 00 EILSWORTH NORTH LINE SW- N IN 9 N890 52'35"E' 1322.90' WIS. 66.0 90. 04'52 31 -336.28 303.28' ~~~''•N~eSUR~11~g~$ 133 00 , e9 3 33~~~ I 3 N ti to M f%I W M x cc _J ~i - O N I a; i 3N1 LOT I W W LOT 2 M 9.72 ACRES 30.51 ACRES 'ZLLJ M M to M 3 ON EXISTING HOUSE 2-' ON THIS PARCEL. "J t o 3 O + 00 0 z ° APPROVED ~ F W Q) 133 33~ SEP 18 1980 W ST. CRODC Coop-Irv 3 I . 2p C0A4Pe HE EAA" ft*ft *W o0 moo. r r/4 .11( 303.28' 986. 13' o~9a 7RNE 336.28 S89°51'51W 1322.41 IE JI SOUTH LINE SW- NW pa SET I"BY24"IRON PIPE WEIGHING SCALE 1"=200' 1.13 LBS. PER. LINEAL FOOT. O' 100' 200 - 400' Vol. 4 Page 996 80- 54 THIS INSTRUMENT DRAFTED BY 8 1 5 3 8 6 7 State Bar of Wisconsin Form 1-2003 Tx: 4125417 WARRANTY DEED 978303 BETH PABST Document Number Document Name REGISTER OF DEEDS ST. CROIX CO., WI 05/09/2013 4:15 PM THIS DEED, made between EXEMPT#• NA Jerome A. Geurkink, a single person and Amy J. Geurkink, a single person REC FEE' 30.00 1'11,(!_ ArvLvt 71 •!-I"Sgn ("Grantor," whether one or more), TRANS FEE• 270.00 and ' Jeffrey J. Delong PAGES: 2 ("Grantee," whether one or more). Grantor, for a valuable consideration, conveys to Grantee the following described real Recordin- Area estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ("Property") (if more space is Name and Return Address needed, please attach addendum): Premium Title Group PO Box 188 Part of SW v. of NW % of Section 1-29-17 described as follows: Spring Valley, WI 54767 Lot 1 of Certified Survey Map filed October 1, 1980 in Vol. "4", page 996. # 312348 Town of Hammond, St. Croix County, Wisconsin 018-1001-40-000 Parcel Identification Number (PIN) This IS homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: Roadways, Easements, Restrictions, and Rights of Way of Record. Dated Aril 26, 2013 (SEAL) (SEAL) Jerome A. Geurkink * Am / J Gedkial/ n ,~G (SEAL) (SEAL) * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF I/J )J ~~~71~ ) authenticated on NYA K. Rmi t 2t/ ss. ) COUNTY NOTARY PUBLIC * STATE OF WISCOMIN Personally came before me this 04/26/2013 , the above-named Jerome A. Geurkink (If not, to me n the person s) who executed the foregoing authorized by Wis. Stat. § 706.06) instr ment and ack edged t s e. THIS INSTRUMENT DRAFTED BY: Tanya K Seeger, Closing Agent * Tanya K See r Premium Title Group Notary Public, St e ofA4inftesm t,,J ~5 ~t~r15'n My Commission (is ermanent) (expires: 01/22/2017 } (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED © 2003 STATE BAR OF WISCONSIN FORM NO. 1-2003 • 11ypf&me below signatures. ALL-PURPOSE ACKNOWLEDGMENT State of I J~J ~ S c,,-n,5 I ' i County of Ci201 p i On 0 (O 16% 13 before me, e DATE NAME OF NOTARY PUBLIC personally appeared r k:j nk nL'J' 1 Scm NAME(S) OF SIGNER(S) ❑ personally known to me OR proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized CjACKIEHEN y P bOc KUdINt instrument cst the perrsonb(s) I or the entity upon signature(s) of Notary state of Wisconsin which the person(s) acted, executed the instrument. 0.4 tr~ WITNESS my hand and official seal. Place Notary Seal or Stamp Here m' SIGN T OF NOTA k; I e, rye-~-s~ ~tC.~n rn ATTENTION NOTARY: Although the information requested below is OPTIONAL, it may prove valuable to persons relying on this Acknowledgment and could prevent fraudulent reattachment of this certificate to another document. DESCRIPTION OF ATTACHED DOCUMENT k~o"rra4J(-l b" THIS CERTIFICATE TITLE OR T PE OF DOCUMENT MUST BE ATTACHED TO THE DOCUMENT DESCRIBED AT RIGHT NUMBER OF PAGES oQ 19-0 'ao 13 DATE OF DOCUMENT SIGNER(S) OTHER THAN NAMED ABOVE 2 of 2 Q o 3: ° m p u, N a op a o cy °O o N s, O n N v r- 0 ~ O c O w o N C L. O U) CL N N p m z Li c o L O O' W CC) ' Q r .S v~ I I 0 z E z = °o a m z U ~ I o z a c m z c N N 7 N N d O N z z z N a) E a C- o f o o a` a 30 c cu E z j m (A ~i °(D' O O O ~aaa a C) C) 0 N o ^i o ~n !A J U N 0) O) z Ln Z-- a O O - O O O O c a ° m Q z Z co C) 3. ~ a m m I n o p o c ° . N C O O U O O d O p o m 5 5 n a o j\ y~ 0 0 u~ a)( m a) v p o o d c 0 N E E .mod a c L o 00 o 0 2 Y o z N Z z~ V ` ~xt a uIL CL 75 2 a rr`w~i w E _1 A 0 0- 2 0 vi 0 ~✓LP ti ST. CROIX COUNTY WISCONSIN - ZONING OFFICE 1 r N M M ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 SEPTIC INSPECTION / WATER TEST REQUEST FORM Please specify desired test(s) & remit appropriate fee with application. Outside water lines are often turned off during winter months, making access to the home necessary. Please make arrangements with this office to insure that entry can be gained. 0 Water (VOC's) $185.00 ['Septic $50.00 0 Water (Nitrate & Bacteria) 45.00 0 Nitrate & Bacteria I] Water (Lead Concentration) 21.00 retest $15.00 Owner: 4-b4 &L! 44 Requested by: Address:)/ 5 -z-00M s f- Address: Z__ ZIP [3 Q,w~ W ZIP ~ Telephone NQ: (116)10g4.3& f~L_ H Telephone N4: ( ) 715 10-At- 3aob W Property address ( F ' re W & Street) : 11&5 aaa mS BA4" 0--T509ag, Location: SZ6) Sec._4_, T.,,:?~N, R17 W, Town of Hdm Realty firm: Lock Box Combo: Closing Date: O Jo ~U~T O BE COMPLETED BY~P OP RTY OWNER *PROVIDE A SKETCH OF HOUSE & SEPTIC SYSTEM ON REVERSE OF THIS FORM* Water sample tap location: Is the dwelling currently occupied? Yes ❑ No If vacant, date last occupied: Age of septic system: ,-fa 44_, Septic tank last pumped by: ~ate:Z?q(,o Previous Owner's Name(s) : Have any of the following been observed? ❑Y Slow drainage from house. OY Sewage Back-up into dwelling. OY AN Sewage discharge to ground surface or road ditch. OY1 Foul odors. t Other comments relative to system operation: I certify that the above information is complete and true to the best of my knowledge. OWNERS SIGNATURE: &~OZ14 DATE : lD 9 7- r 1/94 OWNERS DRAWING OF HOUSE & SEPTIC SYSTEM LOCATION IN ,17 r; r e w ~ ~ C~ C TO BE COMPLETED BY INSPECTION AGENCY System design &/or permit on file? []Yes ❑No Soil series per SCS Soil Survey: sheet # Type of soil absorption system: []Below grd ❑At-Grd OMound Approx. size 'X []Gravity []Dose OPressurized Ft.2 []Bed []Trench []Dry Well []Holding Tank 00utfall pipe OBSERVED DEFICIENCIES 00ther []Unknown Septic tank Setbacks: []House OWell []Prop. line []Other Dose tank Setbacks: []House []Well []Prop. line []Other []Locking cover OWarninglabel []Pump/Floats []Alarm []Elec. wiring Soil Absorption System Setbacks: []House []Well []Prop. line 00ther OPonding: []Discharge: General comments: INSPECTORS SKETCH OF SYSTEM LOCATION N Inspector Title ST. CROIX COUNTY WISCONSIN ti ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road - Hudson, WI 54016-7710 . I= (715) 386-4680 July 21, 1997 Dale and Wendy Kramer 1165 200th Street Baldwin, WI 54002 RE: Reimbursement for Septic Inspection Dear Mr. and Mrs. Kramer: Enclosed you will find a check in the amount of $50.00 for a reimbursement for a septic inspection fee. This was cancelled on 7/21/97 per a phone conversation with Mrs. Kramer. If you have any other questions regarding this, please call our office at (715) 386-4680. Sincerely, Q2 407-~ David A. Dacquisto Zoning Director Enclosures sm Parcel 018-1001-40-000 06/22/2009 08:17 AM PAGE 1 OF 1 Alt. Parcel 01.29.17.7A 018 - TOWN OF HAMMOND Current I-XI ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - GEURKINK, JEROME A & AMY J JEROME A & AMY J GEURKINK 1165 200TH ST BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1165 200TH ST SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 9.720 Plat: N/A-NOT AVAILABLE SEC 01 T29N R17W SW NW LOT 1 C.S.M. VOL Block/Condo Bldg: IV P996 Tract(s): (Sec-Twn-Rng 401/4 1601/4) WQauCb~-G~ i 01-29N-17W Notes: Parcel History: Date - . oc # Vol/Page Type 01/05/1998 570753 1286/197 WD 2009 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 11/04/2008 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 33,000 145,200 178,200 NO UNDEVELOPED G5 7.720 13,700 0 13,700 NO Totals for 2009: General Property 9.720 46,700 145,200 191,900 Woodland 0.000 0 0 Totals for 2008: General Property 9.720 46,700 145,200 191,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 206 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 G NKt~I" K; DES p• p 7~7 ,4 3 ~~gbtat ~+GWaHr V 6% CM TI FI ED SURVEY MAP r CER CERTIFIED SURVEY hereby certify' urveyor I, Arthur L. Wegerer, registered land sof Chap'er 236.34 of the That in full compliance with the provisions of Chap said Wisconsin Statutes and the provisions of the St.Croix Counwneruo~l saideparcelrof land, that vision Ordinance and under the direction land, I have surveyed, divided, ofetsubdi- such plat correctly represents all exterior boundaries and-th visi sion of the land surveyed; and that t s land is the SW4 St.Croix County, Wisconsin, Section 1, T29N, R17W, Town of Hammond, to-wit: thence NO°02'33"W along Beginning at the Wr corner of Section l~ thence N$9°52'35"E along the the NWestorth line line of of stheaid SW~ foforty the NW4 ~32thence SO°01'16"E along the 90 * °5lt51,rW along the South line of said forty 1322.41' 77t; thence S$9 East line of said forty 1324to7the point of beginning. Acres subject to Town Road right~~ggt;~j„ay ove r the Contains 40.23 westerly 33" thereof. I Dated this )a`~ day °f 1980 n ARTHUR L • • .5 9 3 Dz fG neer (T). °f . o Arthur L. W R egerer, T. - ELLSWORTH ; NORTH LINE SW - NW W is. . • • N 89-52'35"E 1322.90 \ Ih I Na S U R'X '52" ~tttttttu~t~tt~~t~~ 90004 66.0 I 336.28' 1 j ~7 ~9 3 303.28 3 OO. 3 z 3 331' r I ~3 O NW U) fri Z M ~J CO I- C N U) U-) LO LOT 2 w 3 N~ LOT w rn I 9.72 ACRES 30.5 ES ro o 3 N EXISTING HOUSE N o 0 O OW Z O I ON THIS PARCEL. , o APPROVED to O 3 O I Z I cn W ZI S EP 18 1980