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HomeMy WebLinkAbout261-7000-16-001 16-1 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 563844 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: X City Village Township Parcel Tax No: City of New Richmond, airport properties City of New Richmond 261-7000-16-001 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: tnC7~j S 25.31.18. TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing C~ Alt. BM lg.ce Aeration Bldg. Sewer -7 76,2_ Holding St/Ht Inlet 9, 3 Z TANK SETBACK INFORMATION St/Ht Outlet • 615 -7,q, TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet ~r- Septic Dt Bottom Dosing Header/Man. Aeration Dist. Pipe r g Z5 gL~ Holding l~ 7 System x-,Z oA, )7- ,poll ~l 93 Final Grade ~e 7 PUMP/SIPHON INFORMATION Manufacturer Demand St Cover GPM l A~e~-- z • ~P / a0 •3 Model Number TDH Lift Friction Loss Syste - Ft Forcemain Length Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches ( PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 I ICwG`~ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: / INFORMATION Type Of System: 10 1 CHA LINER OR 7 7A Or G Vj- /6o Y L _ Model Number: GG0.J6 aK• ~ 1 ~J: DISTRIBUTION SYSTEM g Header/Manifold Distribution x Hole Size x Hole Spacing Vent o Air Intake L ~1 Pipe(s) ~G'i, S•~ - G Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/S dded xx Mulched Bed/Trench Center s, b 2 Bed/Trench Edges ` Topsoil ~ Yes FE-1 No Yes 0 No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: Row 16 Hanger 1 New Richmond, WI 54017 (NW 1/4 SE 1/4 25 T31N R1 8W) rr s Lot 16-1 Parcel No: 25.31.18. 1.) Alt BM Description = .L1~~G~- GoJ C~ ~,ti S d- ~G G'Z d r 2.) Bldg sewer length - amount of cover 142- Plan v~- Plan revision Required? ❑ Yes No -7 ~ 2 I 5~ E4 V"_~;kj Use other side for additional information. " C/3 SBD-6710 (R.3/97) Date Insepctor's nature Cert. No. g_ d CLr) A ~ Off. ~ ~ ~ ~ o .mss cj ~ s i itj 10 ~ 2 1 lk M 11.17~i \ 4 ~I County Industry Services Division ( 1400 E Washington Ave Sanitary Permit Number (to be filled in by Co.) ICI P.O. Box 7162 / Madison, WI 53707-744-, 5 I J7 g ~ z toss (O to Transaction Number it Application L/U( yy & 8 b z Nsion of this form to the appropriate goverfig9ni 0 tW in accordance with SPS 383V.240 is required prior to obtaining pplication forms for state-owned PCyFS are subttfittd~t Prgiect Address (if different than mailing address) the Department of Safety and Profess% ~Peisonal information you provide may be tfsejfprCsecondary nn purposes in accordance with the Priv w, s. 15.04(1)(m), Stats. + K~ `~4 n G r -11IV7)- 1. A lication Information - Please Print All Inform tion P cel # Property Owner's Name . i I!~P~ 01#10 0 1•~ o~ e~ ~ 2(o( - _7600 - Property Owner's Mailing Address . ~P6f~Property Location 0,3q 0/,.. P(~ St!,~~ r +fr~P Govt. of /a, Section !/V City, State Ziip/p Code 7 Phone Number /a.55 / , 11 1/" e/ Y` 40 7 ~Z (%r Z low I q T _ N; Rt ~J(circlE or e® II. Type of Building (check all that apply) Lot # / Subdivision Name ❑ 1 or 2 Family Dwelling -Number of Bedrooms ` Block # Public/Commercial -Describe Use City of N, CSM Number ❑ Village of ❑ State Owned -(Describe Use Q /I ( ❑ Town of Q, dC ~ O 4~ l,..J D C..In~w.rtOG~ 111. Type of Permit: (Check only one ox online A, Complete line B if applicable) A. whew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) List Previous Permit Number and Date Issued B. ❑ Permit Renewal El Permit Revision `❑Change of Plumber ❑ Permit Transfer to New tBefore Expiration Owner IV. T e of POWTS S stem/Com onent/Device: Check all that a I) $N on-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound 24 in. of suitable soil Mound < 24 in. of Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) 7Des~ign sal/Treat ent Area Information: Dis er al Area Proposed (sf) System E~vati w (g pd) Design Soil Application Rate(g so Dispersal Area Required (sf) P 0 S (,43 0. C G.JIr ° Info Capacity in Total # of Manufacturer U N Gallons Gallons Units 4 New Tanks Existing Tanks r 2i U U G. Septic or4&&W *Xank Dosing Chamber VII. Responsibility Statement- 1, the undersigned, assu respon ' for installation of the POWTS shown on the attached plans. MP RS Number Business Phone Number Plumber' a (Print) Plumb ign to e16 Z, ('5; y 7 Plumber's Address (Street, City, State, ig Ce) Y bo 7-7 ViI oun /De artment Ilse 0nIv Permit Fee Date Issued Issuing A Signature Approved tsapprove tr-ovi Reason for ial / J IX. ConditUSTEAWWtNMeasons for Disapproval' 1 L sd(R w 1. Septic tank, effluent fifter and `3 ~ 'r~ q✓~'S Qa ;;dispersal cell must all be services I maintained r`ti ~ as per management plan provided by plumber. / 21 tgp ' 0 re e1Iertts MU8t be t> wntained is peR pods ordinalrtces Attach ch to compt lete plans for the system and submit to the County only on paper not less than g tai x 11 inches in size SBD-6398 (R0313) ~phRTMg DIVISION OF INDUSTRY SERVICES 10541 N RANCH ROAD HAYWARD WI 54843 3 0 S Contact Through Relay j P S www.dsps.wi.gov/sb/ w www.wisconsin.gov °~'~'ss•._`~I°_,Scott Walker, Governor Dave Ross, Secretary July 02, 2013 CUST ID No. 139462 ATTN. POWTS Inspector TODD L SINZ ZONING OFFICE TL SINZ PLUMBING INC ST CROIX COUNTY SPIA E5609 708TH AVE 1101 CARMICHAEL RD MENOMONIE WI 54751-5520 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/02/2015 Identification Numbers Transaction ID No. 2268962 SITE: Site ID No. 159966 New Richmond Municipal Airport Please refer to both identification numbers, W Hanger Rd above, in all correspondence with the agency. City of New Richmond, 54017 ,r~ P O.W.T . St Croix County; Fire Dept ID: 5502 Condition NW 1/4, SE 1/4, 525, T3 IN, RI 8W FOR: X50 I Facility: 733227 NEW RICHMOND MUNICIPAL AIRPORT PETER WARBALOW HANGAR W HANGER RD DEPARTMENT OF CO ! N $,~FETY A NEW RICHMOND 54017 F Object Type: POWTS Component Manual Regulated Object ID No.: 1436265 ~E CORRESPO Maintenance required; 57 GPD Flow rate; System(s): In-ground POWTS Component - Ver. 2.0, SBD-10705-P (N.01/01, R. 10/12); Commercial System, 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, stats. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. 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. TODD L SINZ a Page 2 7/2/2013 Sincerely, ' Fee Required $ 250.00 1 Fee Received $ 250.00 Balance Due $ 0.00 Edwm A Taylor Wastewater Specialist , Integrated Services WiSMART code: 7633 (715)634-3484, Monday - Friday 8:00 am To 4:30 pm 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. d TODD L SINZ Page 2 7/2/2013 Sincerely, Fee Required $ 250.00 l Fee Received $ 250.00 Balance Due $ 0.00 Edwm A Taylor Wastewater Specialist, Integrated Services WiSMART code: 7633 (715)634-3484, Monday - Friday 8:00 am To 4:30 pm 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. i 9 t Construction Materials & Techniques All materials must comply with Comm 84 and be installed in accordance with manufacturer's specifications. Construction methods must comply with the following Component Manual: In-ground Absorption (v. 2.0) - SBD -10705- P Location: SW 1 /4-SW 1/4-S24-T31-R18W City of New Richmond County: St Croix Date: 6-18-2013 MY Owner: Peter Warbalow 'ED MERCE 4EN Address: 1134 Creek side Circle Stillwater Mn 55082 Plumber: Todd Si Signature: License # MP 139462 Attachments: 6748 Plan Approval Application SBD-8330 Page 1: Cover 2: Design criteria and sizing 3: Plot plan 4: Plan view/system cross section 5: Maintenance t Page I.of 5 Design Criteria Yes Wastewater Contaminant Load: 30 mg/L < BOD5 220 mg/L Anticipated septic tank effluent 30 mg/L < TSS < 150 mg/L Fecal Coliform > 10,000 cfu/100 mL Fats, oils, grease :5 30 mg/L 1FTE x13 x1.5 =19.5gallons/day 1 Floor Drain for water heater x 25 x1.5 = 37.5gallons/day Min.Design Flow = 57 gallons/day New Drainfield Design Flow = 57 Gallons/day Design Calculations In situ designed loading rate 57 gallons/sq. ft. per day Depth to estimate high ground water >90 in. Depth to bedrock >90 in. Cross slope at system Level % New Septic tank 280 gallons New Effluent filter Orenco FT0822-14BA Septic Tank Sizing Minimum septic tank size required for 3 years service frequency is 119 gallons by spreadsheet Calculation; Using Huffcutt 600 gallon septic tank. Trench Sizing 57 gpd/.7 per sq ft = 81.43 sq. ft minimum effective area for medium sands Install 8 infiltrator, Quick 4-W shells which @ 20 sq. ft each EISA plus 5.8 sq ft for a pair of end caps gives 165.80sq ft EISA. System loading rate is 57 gpd /81.43 sq ft =3 gpd per sq. ft. * * * * * *Drainfield oversized /Installing 4 extra chambers******* S~ d , ».r e to - S co r).0 co ~s ° Lo J I ! ~ Y'om' V 1 of ~ ~ ~ v Q ~ s ~J) a rra 27 J t o y 9 1 ~ I a ~ J J s C~l o 6/4 ~ J T J r POWTS OWNER'S MANUAL A MANAGEMENT PLAN Page of r~. ;+F~ICE;INFORMATION. SYSTEM SPECIFICATIONS +nbr Tank Manufacturer ~j~ ! ❑ NA. Permit # $6 ptic ❑ Dose ❑ Holding Vol b QQ gal. Tank Manufacturer owk METERS ,,~*.B^F! Q Septic ❑ Dose ❑ Holding vol, gal tN~inq,~gof gedroQms, , Effluent Filter Manufacturer ~ e,0 El NA NOmB~r o PUbIIC PacilltyUhi s I 8t8d ev Effluent Filter Model f-O.-Q1~f,& A, r), flow gal/day E.el1 (...eage Pur~rp'fdan,.`acturer Design (peak) flow = (Estimated x 1.5) hr; In Sftu SQII AppllCatlon. z Pump Model Rate al/day/ft 'llty Monthly average' Pretreatment Unit 5tantlard Iiiff UBnUEffltnf " Peat Fitter Fats, Oil & Grease (FOG) 530 mg/L , ❑ Sand/Gravel Filter ❑ NA Mechanical Aeration El Wetland Biochemical Oxygen Demand (13005) s220 mglL pis nfec;ion Oth e r. Total Suspended Sohds'(TSS)' s150 mgit ' O Q Pretreated Effluent Quality Monthly average Manufacturer ❑ NA Biochemical Oxygen Demand (BOD5) s30 mg'L Dispersal Ceil(s) In=Ground (pressurized) Total Sus ' 7iil b'5tilid5 (TSS) 53Q mglL' NA found r y - ❑ • . Pecal Coliform (g'edrrtetrie mean) ,5104 cru/i OOMI ❑ At-Grade ❑ Mound ' rn dia..: 0 NA ❑ Drip-Line ❑ Other. Maxlmum Effluent Particle Size ~ , Other. ❑ NA NA 0 her; ❑ Other: ❑ NA 'Values lypleel for domestic wastewater and septic-tank effluent MAINTENANCE SCHEDU4E,' 3erViEeEvent - Servlca Frequency Mon At aasone t s (Maximum 3 yearo) [I NA:. o evE fY s condition of tank(s) ~ Inspect r w„ ❑ When combinedsludge and scum equals one-th rd of tank volume NA'. Pump out contents of tank(s)'" ❑ when the high water alarm is activated ❑ month(s) (Maximum 3 years)` C:) NA Inspect dispersal cell(s) At least once every" ear(s) ❑ month(s) ❑ NA Clean effluent filter At least once every ear(s) month(s) NA Inspect pump, pump controls alamn At least once every: year(s) LJ month(s) NA : Flush laterals and pressure test At least once every: p ear(s) ❑ month(s) El NA er At least once every ear(s) Other: NA MAINTENANCE INSTRUCTIONS d dispersal P POWYS Maintainer- one of the e ing Operator (pumper). Master fnspeCtions of tanks and ResirlctedllSewerl,POW>S Ibns~en Individual ear to one o Sp ta fog w Servicing lice es orator Tank cto r Plumber; Master Plumber p y 9 ken hardware Identify any crack dr leaks; ) to denti an missin or ro r Inspections must include a.casual ins ection'of the tan,rs meesure.the,..volume.of combined.slucige and scum and a check for any back up or ponding of effluent on the ground su face The dispersal eel [(a) shall be visually inspected to check lie effluent levels in the observation pipes and to check for any ponding of effluent g g to a falling condition and requires o.o ftegin.. rouftd surface, The pondm of eHUenton the round surface may indica the i mrnedlate notification of the local re Mato authont entire ' e e . of the tank volumeth When the dornbined accurhulato'n of Sludge and s^um in an reatment tank equals one-third or more with o chapter NR ,the en n, 113, Contents,„of. the,►ank shall beremoved h} y a SeP.tag e Servicrn rator and disposed of in accordance Administrative Code. 9 Operator ' Alh.other.aervices,.includtng.buf nof,limiled,.,to the'servicng of effluentfdters,.mechanical or p essurized compdnents pretreatment units,' that require servicing at intervals of 12 months or less require documentation recorded on the deed regarding maintenance requlremetits y ervice event ' A service e report shall be provided to the local regulatory authority within 30 days of completion of an s CM,~ tt2io2) Page of ~ START UP AND OPERATION For new eonstruction,. prior, to use1 of, the POWTS check treatment tank(s) for the presence of painting products solvents or other chemicals that may impede the treatment process'.and/or damage the soil dispersal cell(s): If high tbnCentrations are detected have then` System start up shall'rtbt occur:whelh soil conditions are frozen at the infiltrative surface i. 'During extended power outages pump tanks may fill above normal high water levels. When power is restored the excess;wastawa,tef will s be discharged to the dispersal cell(s),.in one large dose and:may overload them:resuiting in the•'backup`dr surface dscharge of effluent:. tank` removed by a Septage derv ciilg Operator prior to restoring! pourer to the to avoid this, situation `ha_ve.th'ld Contehts of the pump' effluent pump or contact a Plumber,.or POWYS Maintainer to assist in manually operating thie pump controls to restore normal levels witDohiin not the drive or park tank. ompact the area with{ . vehicles over tanks and dispersal cells Do not drive or park over, or otherwise disturb or c n 1.5 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may-improve- the performance and'prolong the life of the POWTS,: 9 degreasers; dental floss diapers disinfectant~s fat' foundation;. drain' (sump pump) di by schaegecfivtteand vegetable peeli gs; gasolabe; grease- herbicides meat scraps medications;, oil; painting products; pesticides; sanitary napkin ;tampons; and water softener brine.; ABANDONMENt. When the POVV`YS fails„arid/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned incompliance with chapter Com6i 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The:contents,ofall tanks and pits shall,,be removed and properly disposed 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 soil, gravel or another;inert solid material. CONTINGENCY he POWTS fails and cannot be. repaired the following measures, have.. been or... must: be taken,... to provide a, code compliant reply ment system ` j A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption >t. ..system,.,The,replacement. area should be protected from disturbance and compaction an,d,should not be Irifririged„upon In Required setbacks from exlsting'and proposed structure, lot lines and wells Failure to protect the~replacernent:area will result iri'the i5eed'forS"riew soil,and site evaluation'to establish` a suitable replacement area: Replacement systems must complywitli'1W U i in effect at that time . . ❑ A suitable'r60Ig6 h* t- iirea'is.fnot available due:#o'setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a fast`fesort to 'replace the failed POWTS. C3 The site has..not;li evaluated'to dentify a suitable replacement area :;Upon, failure of the POWYS a soil and site evaluation must be performed to locate a suitable replacement.area,,.lf no replacement area-is.available a holding.tank.may ; be installed as a last resort to,replace the failed POWYS. g p Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. 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, TREATMENT TANK UNDER ANY-,CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF'A TANK MAYBE'*DIFFICULT 'OR IMPOSSIBLE i... ADDITIONAL COMMENTS . POWTS INSTALLER POWTSWAINTAINER Name Name Phone. Phone' 8EPTA(3E>SERVICING OPERATOR. P...UMQER LOCAL,REGULATORY. AUTHORITY Name'.;. Name . /3-+ fU Phone Phone ` S (3) This document was drafted by the Chippewa County Zoning Department in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1)..'.(2.) Wisconsin Administrative Code. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer ~lFl~i9L 0 w os'r~tc.t~ m~ S.refrL Mailing Address Ot. 7 Property Address /yC w !21 C 0,C0 AJ7 (04.~ ~(Verification required from Planning Zoning Department for new construction.) City/State /~F~ J'~-I c /)L+,~l 14r~ Parcel Identification Number a LEGAL DESCRIPTION AFw W1 d~ Property Location 1/4 , 1/4 , Sec. , T N R/ W, Town/of_- Subdivision Lot , Certified Survey Map # , Volume , Page # Warranty Deed , Volume , Page # Spec house yes no Lot lines identifiable yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. CuLtificatiun staiiug thai youi septic system has been maintained must b;~ C.ompictcd awl rctUrlcd to th" .Sit. Croix County Pla=-Lng Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty deed re orded in Register of Deeds Office. Number of b ooms~ SIGNATURE OF APPLICANT(S) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) Wisconsin Department of Commerce SOIL J&ALUATION REPORT Page of 2 Division of Safety and Buildings in accordance wit o • Wis. Adm. Code County C~'pl`~ Attach complete site plan on paper not less than 8 1 / 1 es ze. Plan must include, but not limited to: vertical and horizontal r e poi M), direction and Parcel . . ~rrV percent slope, scale or dimensions, north arrow, ati and distance to nearest road. Please print all information, fly ,z Date Personal Information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)) . /j;~-Zj Property Own Property Location Rp W \-Q,r- W Govt. Lot Jbd 1/4 ~C?4~V T N R , E (ore --i( Property Own'er's Mailing Address k 1 Lott Block # Subd. Name or CSM# City State Zip Code Phone Number City ❑ Village Nearest Road New Construction Use: ❑ Residential / Number of bedrooms Code derived design flow rate GPD ❑ Replacement \ Public or commercial - Describe: Atr~t4r ~LC► _ Parent material W cc,5~ Flood Plain(felevation if applicable /J _ ft-Z-- - - - - f p General comments recof-e-t Co/L& QAv~MA-0- baIp"J'✓ ~f `o 0-4~C¢S5 and recommendations: lp, 95,X\ SAC ; -a Boring Q p © 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 -7 T~ 11," 6- ? Bo # Boring ~j surface elev.. =/-91'5-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. 'Ef1#1 `Eff#2 6023 t s 3Y s~ Y-Y ~-sv 9 is 115Y)2 471 C> 41'q t-5 > 30 < 220 mg/L and TSS >30 < 150 mg/L `Effluent #2 BOD < 30 m9/L and TSS < _ 30 mg/L Effluent #1 - - BOD _ II * CST Name (Please Prim S' n tar 2,W,; CST Number H ; o~ 7Z r Mond ate Evaluation Conducted Telephone Number Address 350,,1 ~C° '~emtc ck Rci ~D/~ 44 11 f,- 9 :7 CZ p PropertyOwnerf)e- V~y l(30-1`La-- Ms Parcel ID# Page -f of F-3-1 Boring # Boring q ❑ Pit Ground surface elev. I ~'Z ft . Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft Z in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ff#1 ff#2 6 -/Z V5 re -31) ~ 1~a ~Y~3/z s l 3 s = 'fk t a 3 ~1-5"Y2 N s s 3S{r - z y s ❑ Boring Boring # ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ff#1 ff#2 I i ❑ Boring I ❑ Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit =Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ff#1 ' ff#2 I Effluent #1 = BOD 5 > 30 < 220 mg/L and TSS >30 < 150 mg/L " Effluent #2 = BOD 5 < 30 mg/L and TSS < 30 mg/- The Dept. of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate Format, contact the department at 608-266-3151 or TTY through Relay. SBD-8330 (RO5/13) Property Ownerp B or Parcel ID # Page ~j Borin # ing ~Cw Pit Ground surface elev. 10'Z ft. Depth to limiting factor in. Soil Application Rate z Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ff#1 " ff#2 6 -/Z 12-5Ye311 o r s~ ~ a 3 ~Y1Z s G' %s~sy~7 s _ ❑ Boring ❑ Boring # ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft ' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ff#1 ' ff#2 F-- ❑ Boring ❑ Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPDIft z in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ff#1 ff#2 Effluent #1 = BOD 5 > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD S < 30 mg/- and TSS < 30 mg/L The Dept. of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format. contact the department at 608-266-3151 or TTY through Relay. SBD•8330 (R05113) II O ~ A) cr cc1 x rr Qo > CV-) v CO Z a -p C-) o 4S L 3 d M J ~ Ryan Yarrington From: Mike Demulling <mike@nrairport.com> Sent: Friday, July 19, 2013 1:58 PM To: Ryan Yarrington Subject: Re: Row 16 Hanger 1 septic location Hi Ryan That site looks perfect. II Thank you! Mike Demulling On 7/19/2013 12:55 PM, Ryan Yarrington wrote: > Hi Mike, > Just let me know if this is ok. > Thanks > Ryan Yarrington > St. Croix County Land Use Technician > 715-386-4680 1