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018-2007-19-000
. Croix Wisconsin Department of CommerUr PRIVATE SEWAGE SYSTEM County: St Safety and Building Division INSPECTION REPORT Sanitary Permit No: 563852 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: Hammond, Town of 018-2007-19-000 Delta Construction, Inc. CST BM Elev: Insp. BM Elev: BM Des ription: Section/Town/Range/Map No: /90 k U ! ov` d~ U L 05.29.17.958 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER S CAPACITY STATION BS /~Hy FS ELEV. Septic v~ t4- /dQa BenclX M 13 < t) Dosing Alt. BM 17.7 AGtc31[4P Bldg. Sewer ~K * -5 ~ca Z -Z Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/LWELL BLDG. ventt irIntake ROAD DtInlet Septic Dt Bottom ZZ-' 7(o, Dosing Header/Man. 4.41 Q M iA-* #6 Aeration Dist. Pipe pI 7, l Holding Bot. System 7 r Final Grade Z PUMP/SIPHON INFORMATION J Manufacturer GPM nd St Cover 7 Model Number 11C 2/03- _ f c7 TDH LiZZ fi, Friction-Sss,~ System H a TD H 17 J I Forcemain Length Dia- Dist. to well` SOIL ABSORPTION SYSTEM M BEDITRENCH Width Length No. Of nche PIT DIMENSIONS No. Of Pits Inside Dia.' Liquid Depth DIMENSIONS SETBACK SYSTEM TO L57 ' P/L BLDG WELL LAKE/STREAM CHLEACHING AMBER OR Manufacturer: INFORMATION UNIT Model Number: Type Of S tem: Zy _ L a V ~j~ DISTRIBUTION SYSTEM -it Header/Manifold/ v Distribution /I x Hole Size x Hole Spacing ~ Ve Air In ke Pi es ~1 Z v Length Dia Length Dia Ti Spacing 7 SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil 0 Noes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / q / 1 Inspection #2: Location: 1657 115th Ave a mond WI 54015 (SW 1/4 NE 1/4 5 T29N R17W) Farm View Ridge Parcel No: 05.29.17.958 1.) Alt BM Description L 2.) Bldg sewer length = 5 LIB sj , ~ b-4- 9 1 ~k~ - amount of cover = o w vuf-, (jp~Nlch~ -f C ~r OCsm B~"I Plan revision Required? Fe-1 Yes WNo Use other side for additional information. 1 J - - Date Insepctor ignature Cert. No. SBD-6710 (R.3/97) PLOT PLAN PROJECT Bob Rohret ADDRESS 2572 Oakridoe Ct. Maplewood MN 55119 SW '1/4 NE 1/4S 5 /T 29 N/R 17 W TOWN Hammond COUNTY ST. CROIX SYSTEM ELEVATION 95.0' BEDROOM 3 CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND )00( SEPTIC TANK SIZE 1000 gallons DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 456 # of chambers none BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 1001 ❑ BOREHOLE O WELL * H. R. P. same as benchmark Scale = 1/4" = 10' 509' Property Line 2 acre parcel Town Road Tank is to be properly bedded and provided with lockdown corers with approved warning labels Area 15' below yste m ij 1b is to remain undisturbed null F1 B-3 r4 92' ❑ 10% Slope o use 93' l 4' well is to I I B- WDNR setbacks 9 5' Grading is to be done to divert t run-off away from system 309' Property Line B.M.* PUMP PERFORMANCE CURVE w PUMP PERFORMANCE CURVE PUMP PERFORMANCE CURVE SUMP I EFFLUENT MODELS LL EFFLUENT MODELS 318",112" & 314" SOLIDS PASSING CAPACITY 318', Irt 8 314" SOLID PASSING CAPACITY 140 53/55 1 ° MODEL 48 57159 72 76 98 1371139 14014140 151 152 153 135- 1e1 Feet Meters Gal. Liters Gal. Leers Gal. Liters Gal. Liters Gal. Liters Gal. Liters Gal. Liters Lifers Gal. Liters Gal. Liters - Gal. i 5 1.5 29 110 43 163 38 144 50 189 72 273 93 352 86 326 50 169 69 261 77 291 10 3.1 22 83 34 129 30 114 40 151 61 231 79 299 80 303 45 170 61 231 70 285 125- 15 4.6 10 38 19 72 14 53 30 114 45 170 64 242 73 276 38 144 53 2(11 61 231 20 6.1 17 64 25 95 36 136 66 250 29 110 44 167 52 197 120, 25 7.6 - - - - - - - 8 30 9 223 16 61 34 129 42 19 36- Mae 30 9.1 - - - - - - - - - - 49 185 - - 23 87 33 125 tt 40 12.2 28 106 11 42 17 50 152 - - - - - - - - - - - - - - - - - - - - 60 18.3 - - - - - 32 1 70 21.3 - - - - - - - - - - - - - - - - - - - 80 24.4 - - - - - - - - 30- t 90 27.4 - - - - - - - - - - - - - - - - - - - - 100 30.5 - - - - - - - - - - - - - - e 110 33.5 - - - - - - - - - - - - - - - - - - - - 28- 120 36.6 130 39.6 - - - - - - - - - - - - - - - - - - - Shut-off Head: 18 R 5.5m 19.251E 5.9m 18 fL 5.5m 25 R .6m 231E .0m 26 R .9m 9 ft 15.2m 30 fL9.1 m 38 R 11.6m 44 R 13.4m 26- 85- 2 4165 75- z 7 185/4185 18614186 18814188 18914189 191 16114161 16314163 16514165 a Gal. L9ms Gel. Liars Gel. L9Qs 0 4163 Gal. Liters Gal. Liters Gal. Uters Gel. Um Gel. L4ers 65 100 379 61 231 61 231 - - 58 220 145 519 145 549 45 170 93 352 61 231 61 231 58 220 140 530 140 530 45 170 227 61 231 - - 56 220 134 507 135 517 45 170 1 so 181 1e9 M2Z7) 4161 4199 223 60 227 se 126 464 131 496 45 170 170 216 % 58 122 462 125 473 45 1 140 5 2% 58 220 85 322 N 220 116 439 120 454 45 170 1 50- 172 55 206 70 285 58 220 104 394 109 413 45 170 1 4188 3 125 50 189 51 193 56 220 eD 341 97 367 45 770 57 39 148 32 121 58 220 71 269 95 322 46 170 23 87 9 34 52 197 51 193 69 281 45 170 1 - 10 38 - - 126 106 1 193 45 170 153 - 31 117 2 8 34 129 45 170 - 1fi BO 17 & 40 151 - '411L _ 4 15 _ _ 30 114 1 30 _ _ _ p 76 4165 10 6 M1(20.1m) 89 M1(26.4m) 73 fL(223m) 114 f.(34.7m 91 R(27.7m) 110 R(33.5mI 137M141.am1 98 i 009922 1 A CAUTION Model 185/4185 should not be subjected to 2 less than 30 feet TDH. 557,, 76 1_ NOTE: For Pump Performance on Model 112, Industrial column ° 10 ZO 30 b 50 W 70 80 90 109 its 120 130 140 150 explosion proof pump, see FM021 9. GALLONS UTERS 0 e0 160 24 320 400 4a9 No FLOW PER MINUTE W MODEL 211 264 266 267 268 270M27o 28214282 26G4284 2929292 2939293 29/14294 2954785 SEWAGE AND w a. e. m m e m w__ DEWATERING ;o R 80 m w a x v' ~a 'mn n r. we m He m 24 2 ra s 722 70 20- 65 I xl] uuumi a 1LS Qua. Q n p 18 60 009904 a 16" 7 = 55 - 50 z 0 14 q5 a 293 12 40 PUMP PERFORMANCE CURVE Ns 44, NN 10 35 SEWAGE MODELS 30 25 2" SOLIDS PASSING CAPACITY 266, 282 270 6 20 267, 15 4 10 2 5 211 264 292 284 294 295 A CAUTION Model 29314293 should not be p subjected to less than 15 feet Ti 10 20 30 40 50 60 70 80 90 160 110 120 130 140 t50 160 170 180 190 260 210 220 23 GALLON51 LITERS 6 g0 16,0 240 320 400 480 560 640 720 860 FLOW PER MINUTE C Copyright 2003 Zoeller Co. All rights reserved. 6 County - X Industr Services Division y Sanitary Permit Number (W be titled to by Co.) 1400 E Washington Ave P.O. Box 7162 2 <3 T7 T, dison• WI 53707-71.62- D 5~_ J 6 RECEIV State Transtictlon Nummber Sanitary Pu ni pPlication 3 Z In accordance with SPS ::83.21(2), Wis. Adm. Code, submission ofthis form to the appropriate gj>:l~ .ZiaAA FFu?{{~~ ZP is required prior to obtair ing a sanitary permit Note: Application forms for state-owned POWTS are submitted to Proleet Address (I different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be use(Vp (3pWiliA p N Y ur oses in accordance with the Privacy Law, s. 15.04(1 )(m)Stats.~. 1&5 7 /f 1. A Aication Information - Please Print All Information Property Own erne - Parcel # Property Owner's Mailing Address Property Location / G City, State a Z' Code Govt Lot Phon Number _''/a,/f/ Section 4.0 q cIe II. Ty e of Building (check a that apply) f N; R~ of W r2 Family Dwelling-- Number of Bedrooms 1-2 Subdivision Name - Dk G,D [J..~, 1Q►ti Block ❑ Public/Commercial - Describe Use . -t- ~j- ❑ City of__.-_ _ ❑ State Owned Describe User__ - CSM Number ❑ Village of olll ownof_YL/L~2/2TJLJ-- I ll. Type of Permit: (C (heck only one box on line A. Complete line B if applicable) ew System ❑ Replacement System ❑ Tre-annent/Holdirig Tank Replacement Only ❑ Other Modification to Existing System (explain) B• ❑ Pertnit Renewal ❑ Permit Revision ❑ Change of'Pluniber ❑ Permit Transfer o New List Previous Permit Number and Date Issued Be ore Expiration - Owner IV. Type of POWTS S ;item/Component/Device; (Check all that a I ❑ Non-Pressurized In-Grou-id ❑ Pressurized In-Ground ❑ At-Grade nd > 2d in, 01 suit:blc soil Mound < 2 Ill. uitable soil El Holding Tank ❑ Othe -Dis rsal Component (explain)_- ❑ Pretr milnent Device (explain) V. Dis ersal/ Treat nt Area Information: ----`E-=~r~ Design Flow (gpd) Desi=;n Soil Application Rate sf Dispersal Area Required Dts rWaP (sf) ✓System Elevatifor`~- 3 VI. Tank Into . Capacity in Total ak of Manufacturer - Gallons Gallons Units 61 O V New Tarrks Existing Tanks u U tti y U N 'lJ VI % 4V w U v n i C7 a Septic or Hording Tunk ~ - - Dosing Chmnber _ / - - ~ VII. Responsibility Statement- 1, the undersigned, assume r risibility for installation of the PO W'I'S shown on the attached plans. Plumber's Name (Print) Plumber's S" ure MP/MFRS Number Business Phone Nu: her Plumber's Address (Street, City, Slate, Ztp ode) J VIII, unt /De artment.Use Only pproved ❑ D' •ap , Permit Fee Date fss•~ee~Q Issui ~g A it Signature - ✓en Reason for Den: I $ t 25 ~J IX. Condit ~AAlIf3W~i~casans a Disapproval / n t f 1, Septic tank, effluent lifter and 3 Ca ncY i . onS fti t0/o l~ a CLtL r~ dispersal cell must all be services / maintained I e (J ~I as per management plan provided by plumber, 2..AM'"#idick req Is must be m~irttatix~d A tack to complete plans to, the system and submit to the County only on p er tot I'ss an 8 112 x I I inches in size P~.S ewLCt~. SBD-6398 (80313) AARxr,~r DIVISION OF INDUSTRY SERVICES 141 NW BARSTOW ST FL 4TH WAUKESHA WI 53188-3789 K Contact Through Relay ^ www.dsps.wi.gov/sb/ www.wisconsin.gov °~ss10IN s Scott Walker, Governor Dave Ross, Secretary July 18, 2013 CUST ID No. 226900 ATTN.• PO WTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING INC ST CROIX COUNTY SPIA 1432 120TH ST 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 0711812015 Identification Numbers Transaction ID No. 2271352 SITE: Site ID No. 792831 Bob Rohret Please refer to both identification numbers, Lot 19 Farmview Ridge above. in all correspondence with the Town of Hammond agency. St Croix County SWl/4, NE1/4, S5, T29N, R17W Lot: 19, Subdivision: Farmview Ridge FOR: Description: Mound, 3 bedroom Object Type: POWTS Component Manual Regulated Object ID No.: 1437521 Maintenance required; 450 GPD Flow rate; 28 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01/01, R. 10/12), Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-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 De ent per s. 145.06, stats.` The following conditions shall be met during construction or installation and prior to occupancy oiFe This system is to be constructed and located in accordance with the enclosed approv taRC "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD-1069 d the ,Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Syste N 2.0" SBD-10706-P (N.01/01). CIO The building sewer and distribution network piping shall be of material listed b 4.30-3 and 384.30-5, Wis. Adm. Code. F 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 the mound component manual. A copy of this information must be given to the owner upon completion of the project. All holding/treatment tanks are to comply with SPS 384.25(7)(a). SHAUN R BIRD Page 2 7/18/2013 Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per SPS 384 product approval conditions. A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. Owner Responsibilities: • SPS 383.52 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. SPS 383.54(1). • SPS 383.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. SPS 383.54(4) shall be considered a human health hazard. • SPS 383.55 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. 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/operatiom 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. Sin y, Fee Required $ 250.00 This Amount Will Be Invoiced. When You Receive That Invoice, Julia Lewis-Osborne Please Include a Copy With Your POWTS Reviewer 2, Integrated Services Payment Submittal. (262) 397-6005, Fax: (608) 283-7481 WiSMART code: 7633 julia.lewisUdwisconsin. 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 Contrliewe 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. Cover Page JUN 2&2013 INDUSTRY SERVICE S Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 6/ 25/13 Owner: Bob Rohret Location:SW1/4 NE1/4 S5 T29 N,R17 W Lot 19 Farmview Ridge Hammond System type: Mound System Manuals Used: Mound Component Manual Version 2.0 (01/31) Pressure Distribution Manual Version 2.0 (01/31) Page# 1. Cover Page 2. Mound Plot Plan 3. Mound Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7-8. Maintance and ntigency plan 9-11. Soil test 12. Filter Specification d cross section 9'oA~j'O Shaun Bird OG < Y S Signature Sr~Qy'QLq~O License number 2269 0 'R `SF~S FSAo ~'/G, 'L~F~L FS cF PLOT PLAN ]PROJECT Bob Rohret ADDRESS 2572 Oakridoe Ct. Maplewood MN 55119 SW 1/4 NE 1/4S 5 /T 29 N/R 17 W TOWN Hammond COUNTY ST. CROIX SYSTEM ELEVATION 95.0' 3 BEDROOM CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1000 gallons DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 456 # of chambers none BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' ❑ BOREHOLE O WELL *H.R.P. same as benchmark Scale = 1/4" = 10' 509' Property/ Line 2 acre parcel Town Road Tank is to be properly{ bedded and provided with Iockdown covers with approved warning labels A ree 15' be I ow syste m is to remain undisturbed Huffcutt Combo Tank Pro 3 B-3 Bedroom 92, House 93' ❑ 109 Slope )4' weI I is to I I B- ONR setbacks 951- B-1 Grading is to be done to divert run-off away/ from system 309' Property Line B.M.* Mound System Cross Section Ctnd Plan View - - - _ i Dimension Feet f J ~ A 1 Jr B k L YL•'; D YL• • • 1• Y4•L•• I l l J.l.J• yL S YL•4K•4.4•L 4 .V J•JM•JY•rY•1+1.1•l•r•l•r• '••Y4K•LKK• ~ •t}r}}} ••ai:?7r}i:iyyJL•i r.F'Fi:ii:'•L•}•}•Ll•G:{+{!4YK'r{:{+,'!{:{:{l•{:y i':{{i:{};i1.rRiiiyi}i •r.J.l.r• A I ~L•4•LKfL• •4•L•LK•{••••L•4•L•4•L•L LiY r~f•r•i•i•i •I•J•1•r•l•%.f•rM •••}1.•LK•~{K1. ; '•1J•~•1•/• l•J•J• • J•J•J•J•hJ•1•}• L'}f}J~fLJJLJ•'~t{r}f~•Y•1•y \ \ YY11 L.YL.Y4. x[4.4 1~\: I F •S. L 4 4 4 K.LK{Y~•L•1K.LK.LK.L~4.4•LK• r f J. r.1.1.f.r.f. J.l•r J•1 f••r.J.J.1. J•J • f•1 l•rYT~f~f.J• •J •1•J.J.J.J.J• 1 •N1.4• N.1K LK.Y1.L•1•L.L• •~.L. / V JY J l•NJH•hF}JYY• } • . 4.4.4.4.4.4• 4.4.1.5.4.4.4.4.4.4{ • l f 1 J J J•l•J•J• •J•J• } • • • L♦ •LK• K•Yti•L• • J r 1 J J•%• - Y4•Y4 r•J•JV•l•J K•4K•4K• J1.1 • 44444•L• I Y rYY r. • 4K• . . . . JJ}J• • } . LR 1L J•J• 4 L J J 4.4• 1 { J M• L• JY•J Y•rY J•JY• JY•1 W .ti~a•~~~~•ka•~•~•r~•~`.J.J{J. F F l I 1 G 11 Z. _ 1 I H t~ 1 - i I I . to 1 I I J L w K - - Z f) 41 L _ Slope % ~ =Topsoil =ASTM C-33 Clean a +4J4.114 ggrega'te O = 4 in. sch. 40 pvc L:- A Cap Material sand fill =Y2 to 2 /z in. dia. •4J4J4J• ` ` observation pipe Geotextile~ Fabric G I I J Jy.J AJ•rV• f.J.l•:.~ Z R ;K•YL•LJ}; F 4•Y4• •L. •J .J.ltJ4f.f~JN• ..yy V i `D E Ft Contour Plowed Surface Slope Direction GENERAL INSTALLATION: The mound area is staked out along the design contour. Existing vegetation is mowed and raked off the site. The mound basal area (L x W) is plowed with a moldboard or chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to form a '/a inch soil wire when a sample is rolled between the palms of the hands. ASTM C33 quality sand is placed immediately after plowing. Sand is placed with a tracked machine keeping 12 or more inches of sand under the tracks or is placed overhead by a backhoe. Special care must be used when placing sand of less than one foot thickness to minimize compaction of the plowed surface. After the topsoil cap is placed, the entire mound is seeded and mulched to promote vegetative growth, limit eros on and protect from freezing. The observation pipes are slotted in the lower 6 inches and secured in place with rebar or a closet flange. 10/071gj Page of Pressure Lateral Layout Two Laterals - End Manifold 4 Threaded j Cleanout Lateral "Turn-up - Plug Manifold P M X t - - { , - Long Force Main Sweep i/ 90 //1I Bend Distribution Network S ecifications Pressure System Construction Lateral Diameter z. In. Manifold Diameter Z In. Laterals are i,onstructed of Schedule 40 PVC Orifice Diameter. 3 In. pipe. Orifi(.es are drilled perpendicular to X Orifice S acin, a In. the pipe witr. a sharp drill bit and face down. L Lateral Length;) _Ft. Lateral turn-,ups terminate with a threaded M (Manifold Lend) Ft. cleanout plus; and are enclosed in a 6-8 inch Force Main Diameter _ In. diameter laxAn sprinkler valve box accessible 6 Ft_ om :tinisheci grade. FoYCe Main Length li • • • • • Grade • • • ;C 6-8 Inch Lawn Sprinkler Valve BOX Page - , _ of 03/05 lgj i Septic-Dose Wank Cross. Section And Pump Performance, Specifications Tank Manufacturer Pump Manufacturer Tank Model Number p Pump Model Number Aft Total Tank Capacity 3 C Alarm Manufacturer Max. Bury Depth j Alarm Model Number Switch Type C" Filter Manufacturer Total Dynamic Head (TDH) - Feet Filter Model Number Elevation Head_ L~ Distal Pressure 3ill 67. Network Loss Minimum Pump f erformanre Relluired Force Main Loss GPM1 1-@ 5-, Ft TDH Total outlet Manhole 1Vkin. 4" Above Grade With Locking 1Je~ice. Inlet Matiht~lle Manhole. Min. 4" Above Grade < 6" Below Gri d.e Sealed Watertight Securely Mounted Wnh Locking Device weather Junction Box - •Y. .Y. u.Y hipished Grade - r i Irnl Vent Min. 12" Disconnect Above Grade Means with Vent cap Outlet Filter - - - - --q P__ t7l Inlet _ Inlet Baffle - ' - - - Switch Settngs and Reserve Capacity Weep 5 GPI Hol e B Dimensihes Voi:ume Gal. (reserve) ; • ; Tank. 4ko~/,,-? off Elevation C M) B: 2 L7 S > ~Ft (dose) C Bottom (dead) D p bElevation Total y,2, Y ! Y ! 1,l,,; {•t►1•w'.►i i ~ ~ .►i ~ t 1 i t ~It>~ ~ .•i1i II i•~ "ly1:Mt•.+~ .•11.•i i i ~ 1 •1; ! 1`,`. 1 1 > , s . ~ ~ `I ~ ~ 1;f .1>•> ~ > , septic/dose tank is bedded and back filled in accordance with the GENERAL INSTALLATION: The manufacturer's product, approval specifi,38tions. Maximum depth of bury as, specified. by the manufacturer may not be exceeded without prior approval- Manhole covers exposed to grade have an effective looking device (padlock) instalied_ Piping at the inlet and outlet is of approved material, connected to the tank with 'watertigh't fittings, and laid on stable soil to provent sealing or sagging. The force main is sleeved with 4" Sch. 40 ?VC to bridge the tank excavation and the .sleeve is sealed watertight. Electrical.sen►ice complies with NBC.300 and Comm 16.2:4. Page of 02/Q5 U t WaSt.ew gg ry SEN-40 Series 4/10 hp Submersible Effluent Pump, 3/4" Solids Construction Flow - Liters/Minute 0 50 100 150 200 250 300 Cover Epoxy=ccgted Gast iron 11 35 Mayor Ale *po teg st i _ 30 10 9 Impeller Material Thermoplastic'Elastomor 25 8 x T k: 7 129 20 8 m Volute Epoxy-coated cast iron 15 d Mechanical Shaft Nitrile with carbon and 10 3 Seal ceramic faces 5 2 r~ e 6 14 r,jr(iL, 1 t13R A l I8.9 t Y~. F 0 0 Shaft Steel 0 20 40 BD 80 it ` ' ki Flow - Gallons/Minute Bring 'r pier IsYed, v~~. -F fl15' 8.15` ~ I1 -----48T-SEN-40-AF SEN-40 Specifications . ` 750 SEN-40 509211 d/10 115 1 1/2" FNF'7 9!920 80 70 60 45 25 32 14 ?7526.._6 t 6Qd 2~DISCHARGE SIZE AMPSiVVA17S SEN-40-AF 508213 4/10 115 1 1/2" FNPT 9/920 80 70 60 45 25 32 14 21750 4, 2 4 P92Q70 ai ' if 2~ 'e 17 Q } Franiclin Eloctric 400 East spring Street, Bluffton, IN 46714 Tel: 260.824.2900 • Fax: 260.824.2909 vuww.franklin-elecric.com Form; 996199 7.11 POWTS OWNER'S MANUAL & MANAGEMENT PLAN page of • 1LE INFt}RAgATiON Owner ~j~~ SYSTEM SPECIFICATIONS Permit # T_7X"-A_, F_~t'c ank Capacity al El NA ank Manufacturer ❑ NA DESIGN PARAMETERS Filter Manufacturer Number of Bedrooms - NA O NA E ffluent Filter Model El NA Number of Public Facility Units &A Pump Tank Capacity G~ DNA j Estimated flow (average) Pump T al al/day p ark Manufacturer NA I Design flow (peak), (Estimated x 1.5) - - J'Z~ gal/da Pump Manufacturer Soil Application Rate ❑ NA ~ gal/day/ftZ Pump Model p NA Standard Influent/Effluent (duality Monthly average" Pretr;atrr16'nt Unit L ~q Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter O Peat Filter ✓ Biochemical Oxygen Demand (BOD5) 5220 mg/L © NA O Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg/L J Dislefeclion ~l~retreated Effluent QuaN ~ - _ --D Other: ty Monthly average Dispersal Cell(s) Biochemical Oxygen Demand (EiODs) 530 m /L A g 0 in-Ground {gravity} d In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L R NA L1 At-Grade i and Fecal Coliform (goometric-mean) s1 0Q cfu/100m1 d Dri Line p- 0 Other: iMaximum Effluent Particle ulze X in di- aE]ONNAA 1c?ther: M NA Other: - r• 0 NA "Values typical for domestic we.stewater and septic tank effluent, Other: - - - 0 NA IAINTENANCE SCHEDULE Service Evilmt i Service Frequency inspect condition of tank(s) At least once every; O mont s) ~ear(s) (Max[mum 3 years) DNA out contents of tank(s; When combined sludge and scum equals one-third (X) of tank volume 11 NA llnspect dispersal c ell(s) At least once every: month s) ears (Maximum 3 years) DNA :lean effluent fitter At least once every: ~ ❑ month(s) --M_~ - !e ` year(s) ❑ NA Inspect pump, pump controls & alarm At least once every; month)s) L3 NA (:.-lush laterals and pressure Lost At least once every: menu(s) V 11 NA ether: At least once every: 0 month(s) ❑ A ether. _ - ❑ Year(s) NA ❑ NA MAINTENANCE INSTRUCTIONS (inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master (Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must linciude a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of wmbined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the focal regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (t) or more of the tank volume, the entire contents of I'he tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, lznd any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. page of START UP AND OPERATION , For new construction, prior to use of the P0W1'S check treatment tank(s) for the presence of painting products or other chemicals thrlt may Impede the treatment process and/or darn age the dispersal cell(s). If high concentrations are detected have the contents of thi, tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill alcove normal highwater levels. When power Is restored the excess wastewater will big discharged to the dispersal cell(s) In one large close, overloading the cell(s) and may result in the backup or surface discharge of effiuenlt. To avold this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to thle effluent pump or contact a Plumber or POWT33 MaIntainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade sell absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWT:13: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation dralln (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting produeils; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or Is permanently taken out of service the following steps shall be taken to Insure that the system is propcoy and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:. All piping to tanks and pits shall be dis nonnected and the abandoned pipe openings sealed, • The contents of all tanks and pits shall by removed and properly dlsposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with null, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS falls and cannot be repaired the following measures have been, or must be taken:, to provide a code complirpnt replacement system: L7 A suitable replacement area has been evaluated and may be utilized for the location of a replaN ement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by requitled setbacks from existing and proposed :structure, lot lines and wells. Failure to protect the replacement area will result in the neled for a now soil and site evaluation to aMablish a suitable replacement area. Replacement systems must comply with the ruled In effect at that time, ❑ A suitable replacement area Is not available due to setback and/or soil limitations. Barring advances In POWTS technology a holding tank may be Installed as a last resort to replace the failed POWTS. The site has not been evaluated to Identify a suitable replacement area. Upon failure of the PC:WTS a soil and site evalual~on t be performed to locate a sultablo replacement area. If no replacement area is available a holding tank may be installed) as a last resort to replace the failed PORTS. Mound and at-grade soil absorption .systems may be reconstructed in place following removal of the biomat at the infiltrative su ace, Reconstructions of such systems must comply with the rules in effect at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREA'T'MENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE O~ A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Phone Li /-A SEPTAGE SERVICING OPERATO PUMPER' LOCAL REGULATORY AUTHORITY --Narne ZA_~f Name Phone ? J lC~ Phone This document was dratted In compliance with chapter SPS 383.22(2)(b)(1)(d)&(t) and 383.54(1), (2) & (3), Wisconsin Administrative Code. C"T210GE INSTRUCT10jvS ~rll~ai~lnrr ~+'r•~'W x trry Nt tl►r Yrgwr 9.artlur , 4vblalr+rd er►dw1•filar mtrraitrtw a "YItYi llal YIIitY +d'tVYra 11!lklltk 1i turd( UYYtY h IranrrlYlU. ~'hb~r~ kllblY trltirer inC f,NyYr~vY111YAfYi+rio tfwl p(pe1~ ►W lira A+ukl►At +er errlru9,t wuMlf ) uddlilYlu~If 11 1 wa t"It9r din unrr►a iiV t.ty tin Cieaw is NcllJ Ilr I}P +IfIwt1YCI1 ON v,ku. 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IAlthtp li.ty 9:00019, rurek +r+n,ptultAttly+ rrNNkit)~ l;pY,a tr1 rkitr1k91Jr► the r~udgrt _ IEky►,Y k►YY Yllu bakhtrv. o9 om uwlk used viot J14sit 1 fie evilin 4111I1 rlffllYmt9l. Jl. 11I41cx 9<am a lYlvrht lrtirrat laapa► t, t"" tre4ilwrwd bWNW thC1 il11+IY1'i' eer C9,rr t►llsia, >COrt►el ' autlet Aw"k r• iurerid"o final liar eamou get, two tiYt01r ba►,uNAS,w ri41I109100 the S. Slldrr tile kavirldooll tab aavl 01911; 01, the Co"wm fill' KlpiNtlN~ Ili. 91' a blk5 swltrll tulflr►ar:lrrr! tx. blr► Nhrk7rl it; IiIYYJiB,`#Z', tlrcr suorlEr;la w• ahimld lYu ►rt►o9evAed 16y 9,rrrnalry r;la,lif w'duckwirlar+ tlo , , With wm%r (rrliy A9Yli liarlkl,kd N. Wf1iNs hWdh)g the r duWwi) over 9(901 Bt41~aM:e; `~Vly Ydll 1f. S tgt11d ():1111b Mti I; cPa_t,o r f ►eNer1 p"oh Irfll unlq, mwkkis rsu'u jig fmpltuivr, ~Voterval IN ri Its 1d Wi 9Y hi t! , a4 ' U. If Vlks NuUlFlch Isi ut%fnast9 ~I~ tIkY1~l'. N117 tli~, larrrls.. ~_',f)I t,il~/11111y rfarkwless WOP1141w OV 11*11i$lhlh infif lfltvjr ;alYli ' t?{rb., y MI,slerx tl►+n "itMr aaeitidgld 1109k; 10441 the tllt:ar laclcas i4a tl.u 11011."011 fit 1140 1lttl~t;Gy~ daYArrr ul►tir yy rx7lAiw, 1t -Replace and dnsbru the ilGtygiW "Ouhllip wl Ulm Milk. ~a . 1. ~VcdJpa+rl Ini, "t l1,i 6 GWl' ~ ~N'ilfY'yilf..~i1~~Ih1Ia»1Gwx~Ir. ~'~'"~•".M111~1[,~i~,,~MEGM~ii [M~i~~►"'~.tii~~,~ ST. CROIX COUNT"( SEPTIC TANK MAINTENANCE.,'~GREEMENT AND OWNERSHIP CER.Tr ICATIGN FORM: Owner/Buyer O lp _ 2{ - - Mailing Address J S 70~ f IL Address __~(Q5 IL (Verification required firorn Planning & Zoning Department for new construction.)---- ~ City/State _ _ Parcel Identification Nut -iber 019 LEGAL DESCRIPTION Property Locatiorf- ~ 1/4 Sec. , T Z~'_N R--- Town of Subdivision 1 k•~- V`) __1S_L_ , , -Lot J Certified Survey Map # _ , Volume - ' Page # Warranty Deed Vohime Page # Spec hou'ke "yds " no Tot line:, identifiable yes o T V~A SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, 0 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 was le disposal system Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zo.n kg Department a certification form, signet] by the owner and by a master plumber, journeyman plumber, restricted plumber or a licersed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. r/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Departrr+.ent of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form e true to the best of my/om knowledge. 1/we andare the owner(s) of the property described above, by virtue of a warranty d ed recorded in Register of Deeils Office. Number of bedroo~ OF PL ANT(S) 2 /ll-/3 DATE n y ormatio at Y is misrepresented may result in the sanitary permit being rolvoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified serve map if reference is y P made in the warranty deed. (REV. os/05) lINIII Illllf 111111 If 111!111 111 State Bar of Wisconsin Form 1-2003 8 1 5 6 7 8 3 WARRANTY DEED Tx:4128000 979100 Document Number Document Name BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI 05/22/2013 3:32 PM THIS DEED, made between Travis Rohl EXEMPT#: N /A ("Grantor," whether one or more), / REC FEE: 30.00 and Delta Construction. Inc. V/ ("Grantee," whether one or more). TRANS FEE: 44.70 PAGES: 1 Grantor, for a valuable consideration, conveys to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Recording Area Croix County, State of Wisconsin ("Property") (if more space is needed, please attach add "P '~S{3STRACT & TITLE L0 19 Plat of Farm View Ridge in the Town of Hammond, St. Croix County, 1200 HOSFORD STREET, SUITE 201 Wi nsin. HUDSON. WI 54016 (p 7 018-2007-19-000 Parcel Identirication Number (PIN) This is not 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: easements, restrictions and reservations, if any, of record. Dated (SEAT,) ~ (SEAL) • *T avis Rohl (SEAL) (SEAL) * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) n authenticated on STATE OF V " ) ) ss. *KrlstIna Ogland P COUNTY TITT.E: MEMBER STATE BAR OF WISCONSIN Personally came before me on (If not, the above-named Travis Rohl authorized by Wis. Stat. § 706.06) to me known to be the person(s) executed the foregoing ent d ac ow dged the e. THIS INSTRUMENT DRAFTED BY: Kristina Ogland.Estreen & Ogland *Re ecca Lehrman oe 304 Locust Street. Hudson. WI 54016 Notary Public, State of V\AA vk ~':7 75) My Commission (is permanent) (expires: 1 " ( ) (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 Type name below signs INFO-PRO"' Legal Forms 800-855.2021 www.lnfoprofomrs.com lA01~bJa REBECCA LEHRMAN ROEN di NOTARY PUBLIC F.1INNESQTA ' MY Conran. Expires jan. 31. 2015 1 of 1 Q O N _ _ _ , ^ N 89'51'32" E 1316.00' UNPLATj SANDS V) 134 _ - - ; 330.63' a L,fi 308.46' HWE =1062.2' 653.99' / - - - - } _ -7 r. r L,z - B.M. TOP Of 3/4" / LBO =1054.2 IRON vIN E1.EVA71ON ~ N H111H =1055.0' u6 , L20 / 1053.85' N HWE =1 15.00' 20 055.0' LBO 1057.0• ORAINA(A 160607 S.F. 1.80 =1057.0' 1 DRA{NAGE t EASEASEtv}LN7 3.69 Ac. rn( \ tl q EASE-MEN 6N 1 15.00' 1 L _N 8734'27" W 506.31' \ \ 30 ~z / 7 of \`~N 29 121880 S.F. o tS 134722 S.F. LA 7°W ( 21 ry 2.60 Ac. p 81160 S.F. ~Cl 2! p, 3.09 Ac. `o I a 1.86 Ac. kN 1 Oti nr " 2a m _ 80_'09`01" yy l r \rn ~ TEMPORARY II w zl 122374 S.F. cA p IN ~Sg• 1Lp EASEMENT. To od i 21 S. 46 Ja 2.61 Ac w UP REMOVED a 226.12' ` h N EXSE~t15~1ON OF ' f ( RDADNAr ( < 1 ? m 15.00' f . O' iN 66302 S.F. q ! I - S4~/ \ \ l N 86f F4 Liz 1.52 Ac. v \ 1 TO CE v Q-~f 1 0 L' O V/ C 3 S EAS CL w I 1 I X86 S6. 91 Zo Q w TEMPORMY ' 2 \ \ G 1 '1.: /I 3o 4S. Z ICUL-DE -SAC ,Il I / Z7S.F. `~w EASEMENT, i0 11902 F . JOE REMOVED 23 N 1.6.5 Ac. EsSTTERLY '?I 113623 S.F. ! 4/ 63bT \ \ v G y ~~A 19 - - - _ f EXTENSION OF ! 2.61 Ac. S2" `L i HWE 1 76 ` a 7Ar. 2r N E .4, 0 26 69891 S.F. 31 in C ^ \ N 6 1.60 Ac. 82454 S.F. I"'7 / 7.89 Ac. co cil 04 RAGE \1 n X73 N 84'40'47" yy + i AENT \uw NO / a/ ~w 47 425.82' J r 25 Ep f 66574 S-F. O I / 32 B.M. TOP OF 3/4• V N 1.53 Ac IRON PIN ELEVATI \ ON j `W 1 I \ 6 ~h / 47 \ r S7 • 1 q1 , 1 79961 S.F. toe5.s6' `t i 1.84 Ac. Iv co 41 / 221'33".._W 459.01' 9 Lni 4_9 \\c' 24 U) 69641 S.F. 72161 S.F. 1 i NIA ! Tb/ z`~ 1.60 Ac. 'T'/ 33 1.66 Ac ~I ( /2 / N 1• 88149 S.F. 1 C] 2.02 Ac. 1N ~ I~~/off 2>S.~ ?1e •3;1 `~9 i O 18 F m ✓ i i N ' h1 72244 S.F. J7; ~ ` 1.66 Ac. 4 66477 S F S 89'26'33" W 230.23' 1.53 Ac. • v 2~ 1 EAST-WEST 1/4 SECTION LIN( yp/ 17 9 s. F. 33.,'/c, / N 5 5•S'q 4`+ N ` a 6890 i _w t tal 08 S+ ~ C 1.58 ac. ''3'16 39' a z N) SAL TOP OF 3/4" in nl PIN ,OY4.3 EIEVAfiQ 35 QI V g% D I / 66591 S.F. J 75381 S.F. \ 3 l . 1.73 Ac 10\°,1 1.53 Ac. fN o °rf 91 17" w / 1FO N 8!x'35'54" E 492,26- - - -j~ c al 41 `D - o z to a ' 36 ,n 15 o N I 02 65390 S.F. 111321 S.F. .r N ~ , I 1. 50 Ac. } ~ i 2.5b Ac. 'tv 1 ti yy 4 97'2813" W 636.09' _.I 184.70' 14 / - 37 - - 253.43' 38 " r a SOIL EVALUATION REPORT PageI- of " Wisconsin Department of Commerce Division of Safety and Buildings County in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. L i percent slope, scale or dimensions, north arrow, and location and distance nearest road. Revie Date Please print all information. t t) (m))' Pomona[ information you provide may be used for sawnd ~ . , - Prooe Location Property Owner (orW Gott. Lot /4 14 S N R E T DLot iF ocK # Subd. me or CSM# , Property Mailing Address State i Zip Code Phone Number ity ❑ Village Town Nearest Ro NewConstruction Us . Code derived design flow rate -y GPD Residential I Number of bedrooms _ 0 Replacement ❑ Public or commercial - Describe: 2 Flood Plain elevation if applicable Parent material General comments and recommendations: SL" 5 4e~ ,e 0 ED Boring # BOring Ground surface elev. ft. Depth to limiting factor in. pit i ication Rate Texture Structure Consistence Boundary Roots GPD/tE Horizon Depth Dominant color Redox Description •Eff#1 'Eff#2 in. Munson Qu. Sz. Cont. Color Gr. Sz. Sh. A , _I L X311. 5 s C'~ s --rn- / ,of Boring # Boring g ft, Pit Ground surface elev. Depth to limiting factor in• Soil Application Rate Texture Structure Consistence Boundary Roots GPD/fP Horizon Depth Dominant Color Redox Description •Eff#1 •Eff#2 in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. ~f 7, r ~7, , S' i EIE Effluent #2 = BOD 1 30 mg/L and TSS < 30 mg/L • Effluent #1 = BOD > 30 220 mglL and TSS >30:S 150 CST Number CST Name (Please Print) r 22 Numb Bird Plumbing, Inc. Shaun Bird 22 hone Number Date Evaluation Conducted Telep Address 51 ~l 715-246-4516 1008 192nd Ave, New Richmond, WI 54017 / w Owner Parcel ID # Page of Property ® Boring # ❑ Boring APit Ground surface elev. b ' ft. Depth to limiting factor in• Soil Application Rate . "Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 D'I~ 312 S .b -Z _ c Fr W I F , 16 iF- .7 ,ij n1 o- .6 a Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor Soil ication 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 ❑ a Bonng # Boring Ground surface elev. ft. Depth to limiting factor in. ❑ Pit 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 = BODD > 30 < 220 mg1L and TSS >30 < 150 m9A- ' Effluent #2 = BODS 30 mg/L and TSS 30 mglL 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. SBW330 (8.6100) 3 Soil Test Plot 91n Project Name P.C. Collova Bldrs. Inc. B' Address P.O. Box 489 Somerset Wi 54025 STM #226900 Lot 19 Subdivision Farm View Ridge p 5/8/04 SW 1/4 NE 1/4S 5 T 29 N/R17 W Township Hammond ❑ Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Surrey Iron System Elevation 95.0' *HRpSameasBenchmark Alternate Benchmark Top of 1/2" Pipe @ 100.2' 509' Property Line Scale is 1" = 40' unless otherwise noted 45' B-3 ❑ 10% Slope 30' 51 90' 93' B-2 10' B-1 120' 95' 309' Property Line Alt. ' B.M.