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HomeMy WebLinkAbout018-1059-10-105■ County: St, Croix Wisconsin Department ofi Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT Sanitary Permit No: 567280 0 (ATTACH TO PERMIT) State Plan ID No: GENERAL INFORMATION Personal information you provide may be used for secondary purposes[Privacy Law,s.15.04(1)(m)]. I City Village X Township Parcel Tax No: Permit Holder's Name: 018-1059-10-105 Peterson, Larry K. & Lisa Miller Hammond, Town of CST BM Elev: IInsp.BM Elev: IBM Description: Section/Town/Range/Map No: 8 m I 66"c 26.29.17.403A5 TANK INFORMATION 1 (/I(y/� ELEVATION DATA TYPE MANUFACTURER I) 3 CAPACITY STATION 3 BS 5/ 63I/ ■ FS EL Septic 'Z'A.- 4 Benchst, Z. /6Z-1 7 00 . Dosing ‘p � � /__ Pa 4� 46$ -9/ Alt. BM^�.0..011 C - 2. Si /MO .2._ ✓�1� ✓ Bldg.S�eJwer ' 4�1.�s 9 7� 3 5 F'r� Pa (� '. � � St/Ht Inlet Holding v 7.6V 9 . 2? St/Ht Outlet \ TANK SETBACK INFORMATION TANK TO Fa WELL BLDG. a Air Intake ROAD Dt Inlet •••. ` Septic c,7 " ) G.5 1 Dt Bottom Z 4/ �� 3 q Dosing J / / D I Header/Man. L 5-3.7 17, t,�13 / 11 ,5 5 , 71r Aeration ` $ Wn�A)d_ Dist.Pipe ' S .'64 Gl7 ,S Holding Bot.System k I,.S _ 9/_ c. .54 Final Grade Iv PUMP/SIPHON INFORMATION li.60 9 i .4-5 et Manufacturer A 61(1. Demand St Cover n 6. 2.� /Qo. Z� • Model Number � , / I �V TDH 1Lift7 Vcl Friction�oss System Heydk TDH 6 I Ft C. Forcemain Length Dia. •/ Dist.to Well / ,, 7S d SOIL ABSORPTION SYSTEM BED/TRENCH Width / Length / No.Of Trenches PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Dept` DIMENSIONS 3 1 'Tau.G� �- SETBACK SYSTEM TO P/L / BLDG / WELL LAKE/STREAM CHAMBEIR OR Manufacturer: �Z �/6� INFORMATION Type Of System d- D I /� 4— UNIT Model Number: 6� /�j Ca�� 14/v �1 DISTRIBUTION SYSTEM eaA.k x Hole ize x Hole Spacing g VeZlo Air I e Heade(Manifold Distribution r�/ Pipe(s) �� �� Length Dia ` Length Dia Spacing / SOIL COVER '. qZ � x Pressure Systems Only xx Mound Or At-Grade Systems Only /,V Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched p /�g.,,,,. Topsoil Yes E No Bed/Trench Center Bed/Trench Edges p ` Yes No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: / / Inspection#2: / / Location: 791 190th Streekpaldwin,WI Co 4002(NW 1/4 NW 1/4 26 T29N R17W) NA Lot 4 Parcel No: 26.29.17.403A5 1.)Alt BM Description= " ,a I C i j CLett.,■%—. 1.— /.." ar--_5 2.)Bldg sewer length= 13 4s - IA,, 7 -amount of cover= // rJn 6v.- yz a,,__ et)g12) ____I Ian revision Required? El Yes � 3 7� e other side for additional information. Date J Insepctor's gnature Cert.No. 9710(R.3/97) mmerce.wi.gov Safety and Buildings Division County , it.. 201 W.Washington Ave.,P.O.Box 7162 ST. CROIX ' co,C O fl S'fl Madison,WI 53707-7162 Sanitary Permit Number(to be filled in by Co.) Department of Commerce 57,72' V S . . - Permit Application State Transaction Number In accordance with s.Comm.8 I(. �`ts.*.dm.Code,submission of this form to the appropriate governmental 2.3 / 42 5 unit is required prior . ', .0' ...: itary permit. Note: Application forms for state-owned POWTS are Project Address(if different than mailing address) submitted to the rt . . Comm . Personal information you provide rtfay,,ke used for secondary 791 190TH STREET purposes in accord ith the P. y Law,s. 15.04(ixm),Stats. e BALDWIN, WI 54002 I. A s r lication I m to —Please Print All Information Property Owner's Name pi ''// 0 Parcel# LARRY PETERSON '- U 0; 018-1059-10-105 Property Owner's Mailing Address ''O/�,C Property Locations /4-5 791 190TH STREET , DUNTY Govt.Lot 4 r City,State Zip Code Phone Number NW y,, NW 1/4, Section 26 BALDWIN, WI 54002 N/A (circle one) T 29 N; R 17 Eor\O II.Type of Building(check all that apply) Lot 4___D ❑ 1 or 2 Family Dwelling—Number of Bedrooms Subdivision Name Block# 10/2714 4 Public/Commercial—Describe Use MACHINE SHOP ❑ City of ❑State Owned—Describe Use CSM Number ❑ Village of I 1 f e4A-GQ.. O q /L /�o 10/2714 7 Town of HAMMOND • III.Type of Permit: (Check only one box on line A. Complete line B if applicable) . A. C.XNew System ❑Replacement ment S y stem ❑Treatment/Holdin g Tank Re p lacement Only El Other Modification to Existing System(explain) B. ❑ Permit Renewal ❑Permit Revision ❑Change of Plumber List Previous Permit Number and Date Issued ❑Permit Transfer to New Before Expiration Owner .L C.JGLAJ IV. . ,e of POWTS S stem/Com'onent/Device: Check all that a l ,I _ _. Non-Pressurized In-Ground 7ressurized In-Ground ❑At-Grade ❑Mound>24 in.of suitable soil ❑ Mound<24 in.of suitable soil ❑ Holding Tank ❑Other Dispersal Component(explain) ❑Pretreatment Device(explain) V.Dis,ersal/Treatment Area Information: '. Design Flow(gpd) Application Rate( f) Dispersal Required -„---! "-rea Proposed(s Syste levation ��r,Soil A lication Ra �+s Dis rsal Area Re wired(sf) � P ( � ��'� ' �'91'�/S1S rte` .6 /92•S ,. '2ao VI.Tank Info 1� Capacity in Total #of Manufacturer Gallons Gallons Units if s - r O j U New Tanks Existing Tanks � gAiok ��� u o «? V � S *a` U v, g rn wc7 w Septic or Holding Tank 1.00 0 1,500 1 W ISERI X Dosing Chamber 500 0 500 1 .WE.I. .. 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 ' to MP/MPRS Number Business Phone Number PAUL KOEHLER / 225410 246-2660 Plumber's Address(Street,City,State,Zip Code) 7J4' 9'Z.3 /2 Zg 321 WISCONSIN DRIVE, NEW RICHMOND, WI 54017 i VIII. unty/Department Use Only pproved ❑Disappro ed Permit Fee Date Date Is ue/d 2 Issuing ent Signature r Glv n for Denial $ �`� t� // ZG �3 ah _111W,t . IX.Condrt1:,'S AIA tank,efluent ons an or Disapproval 3) 4 ;4t�.5 in- 6-r /�„I(,Q,, AAR-. �. peptic tank,etttu+ent fixer and ff�''v7� /v1}l 1 dispersal cell must all be stn4ces_(tmtaintainecl ,p. g, — t t 1/1t...% 9e'Cd••`-:- • as per management plan provided by pluttr. �� All setback requirements must be mainta llteCI .d\ t t G as per app ble code/ordinanoss; J l 1 t')'S J" 1tia.• - i'1'►,✓� t ,,,n.a..... a Z Attach to complete plans for the system and submit to the County only on paper not less than 8 112 x 11 inches in size SBD-6398(R.02/09)Valid thru 02/11 10/17/2013 THU 17: 59 FAX 2001/001 . 'it,e- Z or: 13 0 . -\ ;, :y� 10/03/13 LARRY PETERSON 791 190TH STREET • BALDWIN, WI 54002 NW 1/4 NW 1/4 S 26 T 29 N R 17 W \. .\' -\ . . . s • ST. CROIX COUNTY • TOWN OF HAMMOND PARCEL ID� -1059-10-105 idEISER 1'5@0 SEPTIC TANK iTW/POLYLOK 525 FILTER- SYSTEM ELEVATION 97.15 • Tb7: BENCHMARK #1- BOTtOM OF STEEL:SIDI i r-- BENCHMARK 2. SP!K W/ORANGE RIBBC � c IN 12' ' . PINE 'FREE . • -I: SCALE 1"-40' See Pate l 3 A FoR o PROD ECt' DE5cRr low . Y . 7 (4 . . c7.1% ;7' r /,,e // ,■---.--.. . N O e e . I • . . 1'4ai . •• 1 'C 14 tq 3e't" A. . v oe eat - w vgYARTNr DIVISION OF INDUSTRY SERVICES yti 94, 3824 N CREEKSIDE LA o6% ��� HOLMEN WI 54636 3 ; j` ,, k Contact Through Relay ',,,,It www.dsps.wi.gov/sb/ c, . www.wisconsin.gov ssfoNz+ Scott Walker,Governor Dave Ross,Secretary October 17,2013 CUST ID No. 225410 ATTN:POWTS Inspector PAUL R KOEHLER ZONING OFFICE COUNTRYSIDE PLUMBING&HEATING INC ST CROIX COUNTY SPIA 321 WISCONSIN DR 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/17/2015 SITE: Identification Numbers Larry Peterson Transaction ID No.2314255 791 190TH Street Site ID No. 795972 Town of Hammond Please refer to both identification numbers, St Croix County above,in all correspondence with the agency. NW1/4,NW1/4, S26,T2 FOR: Description: Commercial Non-pressured In-ground POWTS/—.5%slope/Pump delivery Object Type:POWTS Component Manual Regulated Object ID No.: 1451116 Maintenance required; 116 GPD Flow rate; 58 in Soil minimum depth to limiting factor from original grade System(s): In-ground POWTS Component-Ver.2.0,SBD-10705-P(N.01/O1,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 CONDI requirements. AP• No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, DEPT OF stats. PROFESSIO The following conditions shall be met during construction or installation and prior to occupancy or use: DIVISION OF IN Reminders: • A sanitary permit must be obtained from the county where this project is located in accordance with the digit` requirements of Sec. 145.135 and 145.19,Wis.Stats. SEE CO'R • Inspection of the private sewage system installation is required.Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d),Wis.Stats. • A state approved effluent filter is required.Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required.Access to the filter for cleaning must be provided per SPS 384 product approval conditions. • All POWTS component piping material shall be SPS 384,Wis.Adm.Code compliant. • 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. Note: Changes made to this plan were acknowledged and approved by the system designer. PAUL R KOEHLER Page 2 10/17/2013 Owner Responsibilities: • The current owner,and each subsequent owner,shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • 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). • 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. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise makin g 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 q g P Y P 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. Sincerely, Fee Required$ 250.00/c1 —"'� This Amount Will Be Invoiced. •ar M Swim When You Receive That Invoice, POWTS Plan Reviewer,Integrated Services Please Include a Copy With Your (608)789-7892,Mon-Fri, 7:15 am-4:00 pm Payment Submittal. jerry.swim @wisconsin.gov WiSMART code:7633 • Edwin A Taylor,Wastewater Specialist,(715)634-3484,Monday-Friday 8:00 am To 4:30 pm 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. PAUL R KOEHLER Page 2 10/17/2013 Owner Responsibilities: • The current owner,and each subsequent owner,shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • 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). • 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. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of 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. Sincerely, Fee Required$ 250.00 ��!/ �� � This Amount Will Be Invoiced. M Swim When You Receive That Invoice, POWTS Plan Reviewer,Integrated Services Please Include a Copy With Your (608)789-7892,Mon-Fri, 7:15 am-4:00 pm Payment Submittal. jerry.swim @wisconsin.gov WiSMART code:7633 cc: Edwin A Taylor,Wastewater Specialist,(715)634-3484,Monday-Friday 8:00 am To 4:30 pm 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 :s w, • ,.„ ley PS Chapters 360-366. . CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: LARRY PETERSON Owners Name: LARRY PETERSON Owner's Address: 79.1.. 190TH STREET, BAT. _wTN, WT j 54002 • Legal Description: NW 1/4 NW 1/4 S 26 T 29 NR 17 W Township: HAMMOND County: ST. CROIX - • Subdivision Name: 10/2714 rIONALLY Lot Number. 4 ROVED SAFETY AND Parcel ID Number: 018-1059-10-105 NAL SERVICES Page 1 Index and title )USTRY SERVICES . Page 2 Plot Plan Page 3 System Sizing&Cross-Section Page 4 Filter Specs .. Page 5 Maintenance Information _ PONDENCE Page 6 Management Plan Page 7 St.Croix Cty Septic Tank Maintenance Form Page 8 Warranty Deed Page 9 CSM or Plat • Attachments:Soil Test&House Plans Designer/Plumber: • PAUL KOEHLER License Number.. 225410 Date: 9/16/13 Phone Number 715-246-2660 Signature Designed pursuant to the In-Ground Soil Absorption Component Manual for POWTS Version 20 SBD-1'0705-P(N.01/01). Page 1 P4 be iv A Purr TA. Ni4 CRASS-s crtaz f FLOAT serrtN g. PAbe. (2.. t Cs SP. T'Au K �.yr s PA iv? (3 1955eRvAr!o/u P t pE D ETA I I- P.Ab' 13A . I?tzot)> 1 f T•r()NI • 10/17/2013 THU 17: 59 FAX 1001/001 17137e- i of 13 • c) , 10/03/13 LARRY PETERSON 791 190TH STREET + BALDWIN, WI 54002 NW 1/4 NW 1/4 S 26 T 29 N R 17 W A • ST. CROIX COUNTY TOWN OF HAMMOND PARCEL ID# 018-1059-10-105 W.EISER 1,500 SEPTIC TANK . • J/POLYLOK 525 FILTER SYSTEM ELEVATION 97.15 • _{---_r.-)------: BENCHMARK #1- BOTTOM OF STEEL .SIDIr e a l~' BENCHMARK #2. SPEK _W/ORANGE RIBBOT • _ �!- IN 12" . PINE TREE • --t SCALE 1"-40' _ See pq,6e '3A FoR PROJ l ECG r)E5c j fZ ri�Dto it • 0 o o� A `° /34V. //// / t N 0 • e e . t • • 1 . -t(at1 . 1 v K ftc 13067," v 3 d'1" . 0 n4(-4"1..,11'7 , . . a• P . h S . t'Tn. • ,,,..k , - _ --, (),..., ..„ c„,.. ... ..., ,,, (i . , k. L .t ,,,. , 1-4 it ( . . ,... —I: j.. *s.? -- Ci",...) Ql. , . . - .. M . , I•a Cr •q r ;;.- • tki . r9 1s b wL 0 0. 1.4- a. . N cri B ? . a � .'1 . . . . i Z -d (1 c...4 - o 442,io t"'1 . 4 — 3 Oft all .Cb .1- r ® . x 'o'0 3 • l ,, • tR .9 w a t? LLl ~� �' s s6 S 5- . '4 g �' ��- .-?N a• t= O u O O - P M s - cv to o ; 9 %. . f 3 1 N u,. Lk. '''' . • - i Ce.- 4, t ..t- 1-- . 1 • u► ._� 117 s If ¢ vi o 1 / POI. „` OJ INSTALLATION INSTRUCTIPOANSti Int x" "Fracas:,Drainage A � o� PL-525/PL-625 FILTER PL-525/PL-625 FEATURES & BENEFITS • Features & Benefits: •Rated for 10,000 GPD •PL-525 = 525 Linear Feet of 1/18" Filtration • PL-625 = 625 Linear Feet of 1/32" Filtration PL-525. PL-625 •Accepts 4"and 6" SCHD. 40 pipe The PL-525!625 Effluent Filter should operate efficiently •Built in Gas Deflector for several years under normal conditions before •Automatic Shut-Off Ball when Filter is Removed requiring cleaning. It is recommended that the filter be cleaned every time the tank is pumped or at least every •Alarm Accessibility three years. If the installed filter contains an optional alarm,the owner will be notified by an alarm when the •Accepts PVC Extension Handle filter needs servicing. Servicing should be done by a certified septic tank pumper or installer. . RECOMMENDED PRODUCTS Polylok PVC Filter Extension Handle ,. 111111111- • ,i. ; t a I1�Et a � 4T ' , . Risers&Riser Covers Extend& LokTm Riser Safety Screens Filter Alarm Panel and Polylok risers bring your Polylok Extend&Lak'"" Polylok safety screens SfnartFllter Control septic tank cover to grade. . is a simple, easy to use prevent tragic accidents Switch This allows locating and solution that can extend from happening by children Polylok filter alarm panels servicing your filter easier the inlet or outlet pipe and and pets falling into open and switchs provid a visual and time saving by elimi- make filter and/or baffle septic tank entrances. and audible notification of nating digging to find tank installation a snap. impending filter and tank entrance. Fits 3"and 4".pipe, servicing. • For a full list of Polylok products ptease visit our web site at www.polylok.com Ab h.... So,1.. 0,0,0,1 0,.,,.1.11.. ...a.• __ AN ., __._ __..... ._ _ ...ow, ■ 0 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Passe ' of -2..# FILE INFORMATION • SYSTEM SPECIFICATIONS Owner LARRY PETERSON Septic Tank Capacity 1,500 ❑ NE Permit# gal - Septic Tank Manufacturer WEISER CI NF- DESIGN PARAMETERS Effluent Filter Manufacturer pOLYLOK 0 N A Number of Bedrooms I Q NA Effluent Filter Model 525 ❑NA Number of Public Faoility Units 0 NA 'Pump Tank Capacity gal 0 N4 Estimated flow(average) 77 gal/day Pump Tank Manufacturer ❑N.4 Design flow (peak), (Estimated x 1..5) 115.5 gal/day Pump Manufacturer ❑N.4 Soil Application Rate gallday/ftt Pump Model ❑N,4 Standard Influent/Effluent Quality Monthly average' Pretreatment Unit 0 N.a Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter 0 Peat Filter Biochemical Oxygen Demand MOOS) 5220 mg/1- 0 NA 0 Mechanical Aeration 17 Wetland Total Suspended Solids (TSB/ 5150 mg/L 0 Disinfection ❑ Other: _ Pretreated Effluent Quality. Monthly average Dispersal Cell(s) - Ci N;4 Biochemical Oxygen Demand (B0D5) 530 mg/L . Cl In-Ground (gravity) . W In-Ground (pressurized) 1 Total Suspended Solids (TSS) 530 mg/L El NA 0 At-Grade 0 Mound Fecal Coliform (geometric mean) 510"ofu/100ml 0 Drip-Line ❑Other; _ Maximum Effluent Particle Size Ye.in dia. ❑ NA • Other. El N,k Other: ❑ NA Other: •• D N.> • *values typical for domestic wastewater and septic tank effluent. Other: CI NJD MAINTENANCE_SCHEDULE Service Event V Service Frequency Inspect condition of tank(s) At least once every: 3 D.yawls,a) (Maximum 3 years) -0 NA D.ysar(s) Pump out contents of tank(s) _ When combined sludge and scum equals one-third (Y,)_of tank volume DNA Inspect dispersal cells) At least once every 3 O 0 month(s) wads.) (Maximum 3 years) ❑NA • Clean effluent filter : At least once every: C7 month(s) D N 0 year(s). _ Inspect pump, pump controls&alarm ' At least once every: D month(s) D.NA N A O serfs) 1 Flush laterals and pressure tit At least once every; N/A 0 most {s)yawls) • NA, other. At least once every: 0 s) 0 NA D year(s) . .other: OA • • ..r.r.. •MAINTENANCE INSTRUCTIONS V 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; POINTS Inspector; POWTS Maintainer: Septage Servicing Operator. Tank • inspections must include a visual inspection of the tank(s)to identify any missing or broken hardware,identify any cracks or leaks, Measure the volume of combined sludge and scum and to cheek for any back up or pending of effluent on the ground surfaos. • The dispersal cells) 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 the ground surface may Indicate a failing condition and requires the•immediate notification of the.local regulatory. authority. . �_.._.__ When the combined accumulation of sludge and scum in any tank equals,one-third. (Y3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR;`11:3, Wisconsin Administrative Code. All other services,including but net limited to the servicing of effluent filters, mechanical or pressurized components,.pretreatment .units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS.Maintainer. . A service report shall be provided to the looal regulatory authority within 1Odays.of completion of any service event. . 174&e._ b 3 ig, N1 V1V1 VV L,V!1i4'1V • • START UP AND OPERATION Page Z'of 2 For new construction, prior to use of the POWTS cheek treatment tankls) for the presence of painting products or other ohemic that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contet of the 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 above normal highwater levels. When power is restored the excess wastewater will discharged to the dispersal cells) in one large dose, overloading the cell(s) and may result in the backup or surface discharge effluent. To avoid this situation have the contents t nts of the pump tank removed by a Septa s Servicing Operator prior to restart p ow er to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls . 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 an within 75 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 tt POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; f11 foundation drain (sump pump) water; fruit,and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; col .painting products; pesticides;sanitary napkins;tampons;and water softener brine. . ADANDONMENT When the POWYS fails and/or is permanently taken out of service the following steps shall be taken to Insure that the system I properly and safely abandoned in compliance with chapter Comm 83.33, Wisoonsin Administrative.Code: • • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. 4 • The contents of all 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 witf soil, gravel or another inert solid material. • • CONTINGENCY PLAN • • If the POWTS fails and cannot be repaired the following measures have been, or,must be taken, to provide a code compliant replacement system: • Et A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil. absorption . system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by . • required setbacks from existing and proposed structure, lot lines and:wells. Failure to protect'the replacement area. t IiI . - result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must . comply with the rules in effect at that time. EI A suitable replacement area is not available•due to setback and/or soli limitations._ Barring advances in POWYS • technology's.holding tank may be installed as•a lest resort to replace the failed POWTS. • e .• - er. g tk•ors T�DfJI Tl; OR-Al NS4trRd • O- Mound and at-grade soil absorption systems may be reconstructed in place following removal of the blomat at the infiltrative surface. Reconstructions of suoh-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 NC T . . -ENS#A SEPTIC, PUMP'OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH.MAY RESULT. .RESCUE OF A 'PERSON FROM-THE-INTERIOR OP A TANK MAY BE DIFFICULT OR IMPOSSIBLE. • ADDITIONAL.COMMENTS - • .PCiti(fiS INSTALLER • POWTS MAINTAINER • Name COUNTRYSIDE PLUMBING &.HEATING, '' _ INC]�.,: Name : PAUL KOEHLER _:y: . • • one. . 715-246-2660 _._... - .. Phone 715-246-2660 SEP'FAGE SERVICING OPERATOR(PUMPER) LOCAL REGULATORY AUTHOittTY • _ Name . POWERS LIQUID•-WASTE MANAGEMENT Name _ -r. fo tau ! zorJE Phone 7.15-246-5738 Phone : -7/5- 3 ... ye(Q4'). . • .:This document was dratted in compliance with chapter Comm 83.22(21(bI(llkd)&lfl and 83.54(11.(21&(3), Wisconsin Mm inistrative Code. .�.. • —�. �•• �� ....+.. av vv a.ua .t,, VVV RVVV 01 GVLYLL'4 PA.6c? 1 3 u 111 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWN ERSUIP CERTIFICATION FORM Owner/Buyer LARRY PETERSON r _w Mailing Address 791 190TH STREET, BALDWIN, WI 54002 Property Address SAID (Verification required from Planning&Zoning Department for new construction.) City/State BALDWIN WI Parcel Identification Number 018-1059-10-105 LEGAL DESCRIPTION Property Location NW ''4 , NW '/a, Sec. 26 ,T 29 N R 17 W,Town of HAMMOND Subdivision 10/2714 w M , Lot# 4 Certified Survey Map# SO 7261 ,Volume JO ,Page# -� . Warranty Deed # g1 LJ go ,Volume 2� ,Page# / 3 Spec house O yes ffno Lot Iines identifiable I'i yes 0 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 arc 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 vorifying that(1)the on-site wastewater disposal systems 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. I/we,the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth,herein,as act by the Department of Commerce and the Department 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 are true to the best of my/our knowledge. I/we am/are the owner(a)of the property described above,by virtue of a warranty deed recorded in Register of Deeds Office.. Num f bedrooms 0 I3VS t'\ne rf 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.dad. (REV.08/05) . --- 8118QJ iRti, -----'--- � KA1'E[LEEI[ H. MALSH 2 9 5 p P 4';; 13 1 �ICROIX COa,� D R RECEIVED FOR RECD BAR OF CLAIM six FORM s—2000 12!28/2005 1 RECORD 1 STATE QUIT CLAIM DEED . QUIT CLAIK DEED EXEC BM Document Number • 11.00 Karen D.Peterson,Grantor,and mpg E: between COPY FEE: This Deed is made described real estate in St. PAS 1 Larry K.Peterson, ' tee the following Grantor quit claims to Gran Croix County,State of Wisconsin. Quarter I, Part of the Northwest Quarter of the Northwest Q ship srs(2�1 'West,more ' (NW Vt of NW V4)of rt ,Range T e Seventeen Twenty-nine(29)North,Rang (4)of Certified Survey particularly described as Lot Four�14�as Document NO0'One(1) Maps recorded November v mb r 10, ,19 3 being a part of Lot er 30,199 , Page 2271. Nordin: of Certified filed Survey recorded in Vol.8,Pag Address of Certlf•.ed Survey� x,�and Return• Together with all appurtenant right, title and interests. Phillip and R t s of Fact,Conclusion of Law and Todryit Law Office,S.C. entered to a Finding t Court for St.Croix Cotes, P.O,Box w This deed is given P� ed and filed in the Circuit Larry K Peterson and 540t6 Judgment Wisconsin, Divorce enter the Marriag deed, erS° . Hudson,WI Case No.By said Judgment in re g said Judgment of Divorce and this Kaz� n relinquishes is. Y t tide and interest in the above described property. Peterson relinquishes all right, 01S-1059-10-105 Parcel Identification (PIN) This is not 2005. Dated this I A day of • e °'---- KAREN D.PETERSON ACKNOWLEDGMENT AUTHENTICATION ) • day of ,2005. STATE OF WISCONSIN )ss. 1 Signature(s)authenticated thus ) Croix County 005, St.Cr Kof�1 day of��'�+2 BAR by WISCONSIN Personally came before me this who executed the ER STATE !mown to be the person I lviENiB 706.06,Wis.Slats') the above named to acknowledged the E. db § a T�TL authorize Y (If not, foregoing instrument and WAS DRAFTED BY ' \ foreg ,. THIS INSTRUMENT , � 1, / �i i a �} Attorney D e'�O� vTodO NO ypublic,StateofWin�ntstn �r No.10 sin My Commission expires: w Office,S.C. -onsin Debra A.Shower 'Unheated or acknowledged.Both are not necessary•) Notary Public -Tscity must be typed or printed beiow their signature. STATE BAR OF WISCONSIN FORM Na 3—2000 PA( e- 90 13 F 509729 CERTIFIED SURVEY MAP Located in part of the NWT of the NW' of Section 26, T29N, R17W • Town of Hammond, St. Croix County, Wisconsin; being Lot 1 o: I- ob • Certified Survey Map recorded in Volume 8, Page 2271 at t-,-�.o . St. Croix County Register of Deeds office. 4 at CD OC . N0V301993. i ,� • I I Laos NW Corner of • % &QobC0.NY 1 Section 26 A— LANDS _ J Centy Section Monument 4 r i Aluminum Cap Found North line of the NW} of Section 26 • U. �. HI N89 0'4_ /R12., 30143"E N89 30'43"E 388.54' ~' -V 0 195.99' '04• 142.55' 2264.35' a : 6qE 11' • - - '"1 t 011;4.- • N89°56149"E 261.72' `„\ „,..: '%I. IN-'�ti3` - Ni Corner of 1%I. "' Section 26 ;--I 6 Railroad Spike Found N � ° WW' 1 z�.� LOT 3 . y4 � �i I ,.e I �' 2.65 Acres Inc. R/N on . c : _ _� I a I� 115,336 Sq. Ft. Inc. R/W cc: _ N .., _ N • ., Z OI I cn N IN • 2.33 Acres Exc. R/W °' • c.• = a --I 4. "' 101.383 Sq. Ft. Exc. R/W I "' Y O +' I L....1-,.. _ Im - W • Ad . d N .-', i r LC,`T 2 m .� t -r c o 0.11-= w `m a 4- --25. 89 . O H � VE • m C N M g: = 364.33' • >_ >. °C.:0 LOT 4 24 o o -°o ST.CROOCCOUNIT C'.10 ° °0 1.79 Acres Inc. R/W o Cry CVO ° c IST�"' '._' N I N N ..+ -' ` 78,126 Sq. Ft. Inc. R/W I,,,ZMliv'r'a[ 1.67 Acres Exc. R W CI / '. S3' 33' _�'I ( I 72,960 Sq. Ft. Exc. R/W , ___�� .%1 l I 1 25.84 e`' , _ 365.31 • .ei: n�/tl/!d ; I 38900810911W 391.15' m.�► data ..:' T _ Scale in Feet -,.+••Ai alsaiM �-.; _ • � _ •'' •. 0 50 100 200 ,� 3' P y r -• °.� LEGEND ` s m . 3 = Section Co rner Found t •,-. .- i •+• MI I" Iron Pipe Found - D.O.T. Monument �1,'. Pr5: 0 1" x 24" Iron Pipe a Set,of Section 26 1.68 lbs. per linear foot. OWNER 2" Iron Pipe e Found 1" Iron Pipe a Found Ken Peterson 100' Roadway Setback Line 1958 C.T.H. "J'r Baldwin, NI 54002 VOLUME 10 PAGE 2714 • This instrument drafted by Michael Erickson Proj. No. 93-61 17A6e (per ( 3. 0 erred p • A II T 6cc.t. C14,011ele.s . fa doVL Crra W i r GeT . p,Saoll rt 0 - - . LOOK a-s& ct- ;■0, P - \ I' ►i) • Y1 , h ...._\10.x/1 o n co pis 1 S S[sa t q V,_ i o t,15 ' , . I .• I ' 1 1 to pear, 0(114 .• n , ' fie.,-.,,•. TiournKati � A 01ti - I :,• y ..c.-....i.; 7r , /L t.,,:es , - i, • _cA ,�G,-) ;60 6 • ' j . 1 • .0 - . e . 't p,o t (..14 • -,,t5 • • X . I- . /.,./a ///ifir) eL 9,o y ea/A.17 CO ) . . : • �' 36,5 3 54.I� ��4t. , A ' Z.5 �' zq, 6 csAL6- ;4i1+'i'rt�n I724„_Dfvsw. S 1E • 'Aar; ha' ,I ea. .Z!, f 68, ye bAL:,.4 • ila'+, / /6S >? o! ,,I.IJ 1._. ' •`.PJ p /nand&cte49- [Ieuiis '.- , •c • Pup •• . ...TD .,N‘ . -. - ' l a. - . • • • • •: --..... • -..._...•� . -.....- - -: ------ _. ... -- --- - .. . . - .... . • x-). . • 4245-, An/` E./..,,,,,t4,,,.... - ' Zs. - .-, .— . 4 . 1-):i . . .,. • __ ,...\ . . i ; . 1 .. .. r...... • • • .. • ...- . . . : . • . . .: . . . . .:..... . . . . . .. 1nrx_ 1 -r I • . ' M GOULDS PUMPS Submersible f Effluent Pump 1 _.._. _.. MODEL PE • ,__o.LDSFUf-1p- • : JUMP ' a SPECIFICATIONS MOTOR FEATURES Pump—General: General: •Corrosion resistant , • Discharge: 1W NPT • Single phase construction. • • Temperature: 104°F(40°C) • 60 Hertz •Cast iron body. • maximum,continuous when • 115 volts •Thermoplastic impeller and fully submerged. • Built-in thermal overload pm- cover. . • Solids handling:W tection with automatic reset •Upper sleeve and lower maximum sphere. • Class B insulation. heavy duty ball bearing • • Automatic models include a • Oil-filled design. construction. APPLICATIONS'' float switch. • High strength carbon steel •Motor is permanently • Specially designed for the • Manual models available. shaft lubricated for extended . following uses: . • Pumping range:see PE31 Motor. service life. • • Mound Systems performance chart or curve. • .33 HP,3000 RPM ■Powered for continuous • Effluent/Dosing Systems PE31 Pump: • 12.0 Maxiniiith amps operation. • Low Pressure Pipe Systems . • Maximum capacity:50 GPM • Shaded pole design •All ratings are within the • Draining • Maximum head:25'TDH PE41 Motor: working limits of the,motor. •Quick disconnect power • Heavy Duty Sump/ PE41 Pump: • .40 HP,3400 RPM cord,20'standard.length, Dewatering • Maximum capacity:60 GPM • 7.5 Maximum amps heavy duty 16/3 SJTW with • • Maximum head:29'TDH •• PSC design NEMA 5-15P,three prong, •. PE51 Pump: PE51 Motor: 115 volt grounding plug. • • Maximum capacity:70 GPM • .50 HP,3400 RPM •Complete unit is heavy duty, . • , • Maximum head:37'TDH • 9.5 Maximum amps portable and compact. • METERS FEET •• PSC design it Mechanical seal is carbon, 40 r ,° ceramic,BUNA and stainless 2E51 . __ MODELS:PE31,PE41,PE51 steel. • • • 35 �` — HP:33,.40,so ■Stainless steel fasteners. • • 10- 30 � . 2 GPM. .AGENCY LISTINGS - '. . .. i� 1• ---- �..1Ei111 - - • s 25 .���r� r_��r-.an o� • u v��iliea i1 CPCHS 20 !�Ir���111111���go Tested to-UL 778 and z. R<•..�■��-�. X0.......`1 oKIIIIIIIM.IIIIIIIitiglik66. CSA 22.2 t08 Standards • By Canadian StandardsAssodation• 1 15 ����•• �• e..ttttt•` Rle#LR30549 • �1i 111111 - - .• 1∎:1®111 Gourds P+nnps is 1509001 Registered:. - 1111/1/11 - • - 5 _ 00 10 • 20 30 40 50 60 10 GPM 80 • ••0 ' . 10 • ` 15 • . M3m . • •Goulds Pumps • • . • caPAcrry - • . . •• O 2002 Goulds Pumps • - • ••Effective November 2002 • '. n.J BPE31/41 • 'ITT.Ir dus#r1 ?Al '- « ef 13 D Z x y m _ 69 " _ _ AS 93" D READ c 57" y z - n m N .'O n M u !Ill —I FIER 4" CAS • \z 3" 61i" -- 5" 8 0 D ��W 11 y - \\,......i.....W 4" CAS 11 I RI m 0 13 221 y 54" �� -zi a O m o z z Z z Z o D r —I cn ? D c r m D v � z o2myO��0 Z y A'"E ;E O y z ° n p$D . ∎ PDpm D° y o v� �=�oFzoxo s2P °mo d m I��= y uO f* 1 O 0 N n■ O 60 N '� Z O d C F tz -1 l d '' y O v D v D OOo 1 n D rn f*1 y ei, ,,,PI M I m rEn . . \N_ A a v m O ' NZ O if) V C 0 4" D- W ,O IP' w n O 0 74 a << z °w _ �O Z -0 O I Z� z 00 mm j Vly y Po 0 M m z o W 0 CTS < � y �r D yo O P A > I °y w m m Z nm 0 Rl O D ��_°rte rO� n _ K -1 -< v m a H y Z , z z Dalh o m D -u O m m zC c� rn OD O (� m W�*1 0 y `'n D n D v O A r . O C H z o I xi 73 A Z z \D__% y W1000/500-MR DRAWN BY: SME SCALE: 1/4"=1'-0" PRE-POUR: -r. _. SEPTIC MANUAL WIEWER C0RCIETE DATE JANUARY 2010 DATE:. POST-POUR: \Z W3716 US HWY 10 MAIDEN ROCK. WI 54750 o REVISED JAN. 2010 800-325-8456 FILE wl000/oa-+n Dtbe 13 ®F t 3 Water tight cap 4" min. dia. Piping material can be ASTM D2665,D1785 or D3034 Slot 6" min. min. Inflltrative.surface\-- , Water Closet Collar Bar " min. dia.) Observation pipes must: - . • be located such that there are a minimum of two installed in each dispersal cell at opposite ends from one another . • be located near the dispersal cell ends • be at least 6 inches from the end wall and sidewall • be installed at an elevation to view the horizontal or level infiltrative surface within the dispersal cell Observation pipes may be located less than 6 inches from end walls or side walls if specified in state—approved manufacturers'installation instructions. • (,e-- 1344 o lj • ntrYS , e Olzto MBING &HEATING. INC. • 321 WISCONSIN DRIVE NEW RICHMOND, WISCONSIN 54017 715-246-2660 • TOLL FREE 1-800-542-4243 f October 14,2013 • To Whom it May Concern, Pro Fab is a facility with four(4)employees that makes specialized transmissions.The only waste for this facility is bathroom and break room sink waste.There are no trench drains,and no catch basins. Respectfully Submitted, Paul Koehler Plumbing Estimator • • • ' I • PLUMBING • HEATING • AIR CONDITIONING • SHEET METAL • • WISCONSIN REGISTERED DESIGNER (MP CREDENTIAL#664713) . N . kb v\\ 441- er-- I NilIi c.. kj), % I 1 .%•••• •••■• 1 .411... 4 (:),...., ,. P .. Vo �r 11. . N 4 k o m ‘,..; _ r _ 1 ______...._ 1 1 ......_.. ...... 11 g T ` 11 r ` c y( B. r x 1T 1 4 o0 o` A. G L t!1 J. , I ,_ r q'- , 3 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page / of 3 Division of Safety and Bus in accordance with Comm 85,Wis. Adm. Code u Attach I non aper not less than 81/2 x 11 inches in size.Plan.must n /'Sr. ` o/y inc iced rtical and horizontal reference point(BM),direction and D. pe pe,s or dimensions,north arrow,and location and distance to nearest road, 0/ Q -/p- to 5 so, Please print all information. ex) R.eevie 4. , Date Personal information you provide may be used for secondary purposes(Privacy Law,x.15.04(1) i�}i , "c5 4 .vu(/ ,i //zs//3 Property Owner r Property Local &J� Lat- Pe_4--eirSor� Govt.Lot AA()C J(,J1/4 S.2 e:, T..y N R 17 E(o Property Owner's#filailing Address Lot,# Block# S .Name or CSM# /04.1 7/y ?9/ l avtL - -1-.- R0. 60)(c 31, City State Zip Code Phone Number ❑City ❑Village .Town Nearest Road Qald?UDI,\ ,ujr, yoo , eT,$ ) 7q4- 5-.?3o f-lam,M oKd , 90 itx S Eal New Construction Use:❑ Reel.-.r- . •..- . ... . ..5 A /r Code derived design flow rate . GPD ❑Replacement ►! Public or commercial-Describe: Al ,. , I n t ..5•h O • - , 1/ 1 or Parent material ©. "7110 . Flood Plain elevation if applicable AM- ft. General comments and recommendations: ..7-1z 5f // 5c/5 ---anti .a aj 5eJo eoST- .A1 1 Y;0.G1-4---- (1'!-/ usE mottorn ' RRd< _ v 3ci 1/ I 1' e Svi �l erS °0-- /� I-vV� „►-i , ' . ff 7;,/ ,Affuni a - ' 11 / Boring# �-,/ 0 Boring / i St I�-/A llik °/ /- 'iiit. / dr✓ ( i Pit Ground surface elev. if O ft. Depth to limiting factor 611 in. Soil APP lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/rf in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 `Eff#2 / �4 g j � 10-\112 — 5i) .3rnsb� AI c.v.) . LO , /o`/t2 .— 5(1 3 i.-.,k Sbl< n� L L A) 'i� fa/ . $ t 3 .. S-.s1( 1 o `11t --- (M15 s v.t 1 C__(..0 1 C I of . 7 1. (o I 58-84 1©Y le. -S -1 7. 5'R -i fi g. n s) vt4 1 . "T r, 6 1:2-X\ 0 Boring# L_7�Boring /� >8�i Pit Ground surface elev. 7 7 t.) ft. Depth to limiting factor In. 'Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPO/ft' in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 'Eff#2 i 0-11) 1 o VR 3 S() ,a wl s b ie J k c w ai)‘-- • o . 8 1p- fo 'yl�yrj 5i/ :2. WI. Sbk , k cw i ✓f . 8 3 - 104X — Celt) 5 O sl . v)-L) < (-4) Iof . 7 03 5 5-6-84 jo 4k COQ5 n ' w, 1 1 . o *Effluent#1 =BOD1>30<220 mg/L and TSS>30<150 mg/L *Effluent#2=BOD <30 mg/L and TSS<30 mg/L CST Name(Please E:' t Si gnat CST Number v,Al I 71145 eSa`, g i .�L .� - a.p o. Ya Address (�r Date E uatavff on Conducted Telephone Number A) 7c 9 y �w,/ ) Spri.ig va lk,e� . 9-it /3 (7/s- 77-) `.3-71 • Property Owner Llii-Ir4 Ve -et-SBv" Parcel ID# O fe-/0 -/O /0 Page . 4'of 3 Boring ❑ Boring p i'Pit Ground surface elev. 99 07 ft. Depth to limiting factor 3-g in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIf in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 •Eff#2 c- o-/4i IOvk 3. Ay ikl;� 51/ 3 m5 bk c 1� ( ) ' - b e /43Yid�R9C4_._41511 . sbk . K 3 39-% (c N k_ -b 1�1 e-01." 0 4G, !{ C' 53 of o-6- Cu) 1 U . 5— /, 0 94-S (0-a " '"" 06 S 0 s v>1 ( C V✓ — • 7 1 r to 5 51-EeS io'y -I f 7. VI (c) 5 6 S , 5— It v Boring# ❑ Boring Pit Ground surface elev. 9g, 7 ft. Depth to limiting factor >8' in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/IP in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 •Eff#2 10.‘i g. ---- r l 3 vx s 6k d k - , g a �U- in•12 _ S 3 ►� ,512k ��,�_I� c- ? ' F _ _ g' 3 _34-3T 1 o IR �� .r y 54-to In ) -- (r)s o s r . S' i, �i7• � n ,I 4* 0 Boring 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 l GPD/f 2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 •EfW2 •Effluent#1 =BOD6>30<220 mg/L and TSS>30<150 mg/L •Effluent#2=-BOD6<30 mg/L and TSS<30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format,please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330(R.mroo) i Property Owner 1,G I-i t, tefft-S8h Parcel ID# O" —1°6-7-1° "'/C� -- Page--1 s'of 3 Boring# ❑ Boring iPit Ground surface elev. fg. ? ft. Depth to limiting factor g In. b 1i Soil Application Rate Horizon Depth ,Dominant Color Redox Description Texture Structure . Consistence Boundary Roots GPDrft in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Efl#2 6„19 rov.k g 4-- s 1 3 ek s bi 1. cu.) ' F . c . e y s 3 3v-y� nom, ��--� 1 f oN fZ n�c.s i 5 �a u.) O f tnt � r �� . S-- I Li </4-,51 (01R 54 �- b� �i'6 5 O 59 Y-t t e.t✓ — . 7 1� ro S Se-Ee r cy2 -r_ f 7. SYR -, . 5' o Boring# ❑ Boring AT Pit Ground surface elev. 9gt 7 ft. Depth to limiting factor >g0 in. Soil Application Rate Horizon Depth Dominant minant Cobr Redox Description Texture a Structure Consistence Boundary Roots GPD/ft= in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Ef#1 'Eff#2 f , r--IV— • r I. -- 5(1 trn 5 6k of lt e ` g 3 141- 3y in‘if?._ 1 3 �► so, . '. C_ 't f. - 6 , 34-54 /DM (::, — 7:14.r . r) s- irk_ l o c r. • • 7 i ys4-S{l in q 5t1 — C-F')-5 v s, rdl i i 0 • n Boring# ❑ 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/ft2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Etf#1 *Eff#2 'Effluent#1=BOD6>30<220 mg/L and TSS>30<150 mg/L Effluent#2=BOD6<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. S BD-8330(R.07/00) 1 €Q, fiT —1 s (% T (\ . 1\ � n 1 4 1 S 1 O \ 1 v 0 v 7o f S T In ■ 0 Q t p ' G --•, .--v N o O a LI, !E S,-1, G ) t 0 It ri F'p\ '4� �'�� 1 I I 313 e F,7 r 7 50 �_ rt . w 4 > — 7