Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
018-1086-07-000
o c m o ft v o c -: v m A ^ to O Cn Cl) = N O 'Z 0 A N w O O m w O w a) CD 7 3 CD Pi = 3 N I� C1 tCa N 3 to p � Cn C °� N C 7 7 j V (b O N CD 0 � 7 Cn N O O CM O n CD w O V p 3 O • 7 UI O_ 7 O 1��1 y w L' v D fl CD A v 07 3 o o oi corm L 0 N co CD o N CD (-D4 0- (p O C ° O O O c rf A N � V :E CA 3 3 - 3 O O a 0 O m N 4 r I o N D D o °1 O O 7 O N CD c 3 (D O 3 m CD -1 N cn y C [p Z CD A 7 O O 0 P A 3 z D a CA) v I � o s3 rn0 D 3 CD CD O Cn C N Q C CD N w 7 0 w 3 CD G (D a V T 7' O "' 0 T N 1.0 O w C a CD N CL N w 0 7 Z d C p 7 N 3 O O CD to CD (D 7 C m N 3 m O C 7 W •- n O 0 CD c iS 7 O N O N a w (D ' CD C CD A, = O o � 7 0 =y �N a $_ �2 a n o _ - cn o' CDCD > > a 0 kli ° CD a 0. Clo CD Dq n N O 3 m n �1 c m f 3 ° �1 m 0 m _ ... (D \ 1 3 � � T T z N O W== N O• M O m O O N I e� 3 c 9 rn� p m cn rn C o c m 5 V o p ° a o N ',I £ oo '* N N 3 o C d O C ! O� CD z D a t D Co a < 07 < CD CD C o rn { CD °o c) 3 n o c N N N j PL °� • I O O O cQ r f/1 U1 O N CD 3 CD 0 (D a CD m CD m a) rr y N 4 D D c 4 CL !rr • N) N ° C 3 m o CD CD -1 N c A 2 A CD A O i z N O 3 ? ° o z N z CD A W o v 3� Ow o °w o v o To maQLn..a Cp a CD <ccaQ3NNc�0c 0 3 °D�•° a 0 7 a N 3 CD • O m Q 1 < •° D) Q W O X --I c N a n O . ': O a 3 N CD Cn - M < - m = n ° f 0 ai 3 c n� E w d° 3 o m tn 3.� ° m° d 0. �o.m� °c —_� v 3 0F° c° 3 w m cn N a< a �.m 3 m a° ° ac CL s � m o m m m 3- 3 c° O ID N (�D O. N o ' cc p fl- N 3= RD -.4 o < C�p� ° f � >> m o m 0 m a m sy CD �D3 =` oy mo ` a _ < 3 < CD m< v c a o N n a 3 D° 0 CD O. 3 Dl O_ < C N CD CD O _ n m aDo ° am c •O -p 3 to .� C W mo� ° C x�vf d��DV° n� a .�+ C j c N N z CD CD N C= fD O7 pJ 7 N a a (D O O O m m 3 c a° Q a ° Co v e aID <m a 0 A O CD < DQ ER O N a O Cl N Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 506213 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: Stensland, Carroll & Marilyn I Hammond, Town of 018 - 1086 -07 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 20.29.17.627 TANK INFORMATION a., ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic �,.- Y '. Benchmark ( r � J 6{• 7 Dosing Alt. BM 'G ation" Bldg. Sk wer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION P TANK TO P/L , WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Y Dt Bottom Dosing , t Header /Man. 3.33 /G • .5 Aeration Dist. Pipe fa7. Holding Bot. System Final Grade PUMP /SIPHON INFORMATION Manufacturer r'4 Demand St Cover • GPM .� Model Number - a J TDH Lift Friction Los System Head TDH Ft 1� 0 i j Z� Forcemain ft f Dia. j Dist. to Well , r SOIL ABSORPTION SYSTEM BED /TRENCH Width Length No. Of TrenVvs PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS' - SETBACK SYSTEM TO P/L BLDG IWELL LAKE /STREAM LEACHING Manufacturer: \ INFORMATION CHAMBER OR Type Of ystem: _ 1 UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold IDi s ribution x Hole Size x Hole Spacing Vent Air Int Pie ♦ Air Length Dia 1A t Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over r Depth Over xx Depth of 1 XX Seeded/Sodded T xx Mulched Bed/Trench Center z '; Bed/Trench Edges Topsoil i " Yes No Yes No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 1622 89th Avenue Hammond, WI 54015 (NW 1/4 NW 1/4 20 T29N R17W) Hammond Oaks Lot 7 Parcel No: 20.29.17.627 1.) Alt BM Description = 2.) Bldg sewer length ^- - amount of cover = + Plan revision Required? ❑ Yes No , 1 _ Use other side for additional information. SBD -6710 (R.3/97) Date (t Insepctor s Signature f Cert. No. elomearetirM.wi.isv SaKV end 8M"W Din Wm 20 1 W. Wa>iriapw AMC., P.O.9M , lit i Nsdaoa. vY) S?7i07 -7162 saaa) . �� / tr:cs *ytRi Blakely F*rwit Apokatim , salu Trsrx a t+wbtx i is r.aoadr�cr with r~ Cow 33,i IL Wdk #r. CWt L WW9J rM of d* tMw uIM MX*pti rs tlarerrnat+al '- . ! era ti rNaited prW x ob aa" a oaakw} pasiL MOW A70kakoa IMtrta Atr POWT$ we "NJU W mas4 'dM awdwr tw: *Wwk r,%i nlwiMC! >n rlte aT'"m of r,rnaaaoa, rsa=w. M(om eka !w prWW ri" ba aua tw F M LM&IS. I lax sub 1622 89 th Ave �ira.l r - p O%ftf s t+tuac ` : s E Carrol[Stensland i 018 - 10 -0 7 -000 ' 9 19 PARIS ave . N. 7�p Dart. La I NW NW So Still Mn. 1 5 - rcitcic.r ^-� --- T N-. R_1_torw 1t. YrIK of {cMae6 d IMt appt? j Lore . ar2 Fir :y DasMq{- �:n+i►xof i>11,Pra�n► " b 4jw *• Ha mmond Oaks I Adt�cX'ana�N'tutt - ?srxtte UYe �'� Ci GStr of Ir 20.29. 1 7.627 am cc Hammond ` RE Tips of A. C04 14 Was 5 Ka "Wakk) -- � j U `:sv y'�►' ��a ' 4 • "lnaasttrlNlAL fiali 1 'C! _ Modilleiaamtal;xi.A�S�a t. N'rfi Rune W i feint Iwvr iao i of IMwait r Tranelrr N Nwe et hm'itws and V* bead i tiarteE.prararri eN+wer s /2,00 F 1 , �Ohi 399667 � l te- tavara D rwaaarat/ ta[kaa6 ©moo* M+erd 2 3+ 9a. creak" sett 9 utwme t U it eteaMM m: F; 7'aUt �] iMAer Digtaretl taaNtaisx !a. �iait) fnlreraaear nnri.: te�grsia �•. •rra .� Are DM4 1 RAWWOO , tkciNa sea Ica tWEi) o Atet t Area Acp *W (*) $plea Ehweiiaa 450 A 1 450 450 106.27 T'L Ta lc lob ra Told S � MnnaMcYaei r ( Qa+itas Galbu I llrit► ---- -- L T G Oc u I .�► my , Eatnayr ranks , P � - 1 dr eTaea Apri klie r �.' X 160 Wieser X V)L )• tYr sale F.u�tlrtr'ellenretPRrRt R' a 707Phaae Keith Knudtson 648443 1 651-470-1737 rMkf'i. A*.** (ftM M S coda) 927 150th St.Roberts W 54023 t NL z4pmed ` �' ► i e itir.ra n a .d tkga I i wpr„r ei - !~ Ow�r r Gvas NoR tar DrmA s f� w "/ ✓ r Qq j 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained as per management plan provided by plumber. _ 0 w as per applicab 'fie o finances. - ~Q'C*""i' fe" "0qMWw�lw.G.a=s�� i2Glirsr.P b'LV `� fJ 'Ta G� �"�''�ts7 Qsrep 0 2 t> 6 rc7 e it �$ z•' t��c t i.SL. Oro Cad ; �� a (y � .� p+ 4 • Y sti .a Y O {{t aC. w . AAA.. •s f • �. r ,. g x Lw...� o4.t) zI V l.Y n •QA ' ,fit - Y-+►'� b� t-t a3C Sw w a `,�[ 2�/ �• i Q.� F.Y E1 M. �r tr N 1 Y V N C L 6� T 60.; f ri v.+- :L fi 2 I{ - 1- `^' f� Lk N4 LR 1Z . SZS l t vw•.s o z o 4.0 , CA 1 `` tt;v. `O V•t�l V / k oa Jr w i w oti _ ZS two - 1.x•0 ` (.o�.Y ww �� S 1 L: w lu 'sa.vr Yom\ I ec �� 'AP•l Q.`W d�+ l /L, �vt'Iv.�1tTO.A� y � z "9•i �K c.�h o» AIL" grow (`l$.��� ct Ct � Y Jt�� �0•.wR���1.v Safety and Buildings 4003 N KINNEY COULEE RD commercemi.gov LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 i sco n s i n www.commerce.wi.gov /sb/ www.wisconsin.gov Department of Commerce Jim Doyle, Governor Mary P. Burke, Secretary May 22, 2007 CUST ID No. 648443 ATTIC• POWTSInspector ZONING OFFICE KEITH E KNUDTSON ST CROIX COUNTY SPIA 927 150TH ST 1101 CARMICHAEL RD ROBERTS WI 54023 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/22/2009 Identification Numbers Transaction ID No. 1395540 SITE: Site ID No. 725397 Carroll Stensland Please refer to both identification numbers, U.S. Hwy 12 & State Hwy 160 above, in all corres ondence with the agency. Town of Hammond St Croix County NWl /4, NWl /4, S20, T29N, R17W Lot: 7, Subdivision: Hammond Oaks FOR: Description: Mound (Reconstruction) / Three Bedroom / Sloping Site Object Type: POWTS Component Manual Regulated Object ID No.: 1131331 Maintenance required; Replacement system; 450 GPD Flow rate; 32 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01101), Pressure Distribution Component Manual - Version 2.0, SBD - 10706 -P (N.01 101); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Reminders • This system is to be constructed and located in accordance with the enclosed approved plans and with the component manuals listed above. Co1 14 • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Apl? Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. ) O WN ON • 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. SE E CC • Inspection of the POWTS 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. Stat KEITH E KNUDTSON Page 2 5/22/2007 • Comm 83.22(7) 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. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation /operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Charles L Bratz POWTS Reviewer U , Integrated Services WiSMART``cod"e: >7633' (608)789 -7893 , 7:45 am - 4:30 pm Monday -Friday charles.bratz@wisconsin.gov cc: Leroy G 7ansky, POWTS Wastewater Specialist, (715) 726-2544, Friday, 7:00 A.M. To 3:30 P.M. RECEIVE PAY 0 9 2007 Carroll Stens land Mound SAFE7-y 131JILDINGS I'Vansactio" 4, Ct)nstructioij Materials and Techniques - Jals 111ust i.ollipl v-, th Corn.an 4and be installed iq accctr at (, w o ('t,)nstructk)n nietho(ls tnuSt (:oinply with the tbllowinp, Coinpo rolartua!,, Mound, SBD-10691-1 I) 1 /0 1 Disti-lbution, SKD-10 (01/01 I co 7 NW' 1/4, NW 1/4. '�ec, 20, T 29 N, R 17 st, 05/07/07 Carrol Stensland 919 Paris Ave North Stillwater Mn. 55082 Keith Knudtson 648443 MPRS 6A Approval Page 1:Cover 2:Plan to repair mound 3:design criteria & calcuations 4:Plot plan inally 5:System cross section 6:Plan view, lateral detail OVED 7:Pump tank exit detail OF COMMERCE 8:Pump curve NWWS 9:System management ,;::SPONDEN j page 1 of 9 Plan to remove and reinstall mound We plan to do the following because of damage to mound piping and rock by what appears to be a backhoe: Remove top soil, then carefully removing rock and pipe down into clean mound sand. Replace sand back to 106.62 ft. over 105.8 ft. contour. The 100 ft. bench mark is the surveyors %" iron pipe in the northeast corner of lot, and is still there. After inspection replace the one foot of top soil and seed and mulch the entire mound. Install Goulds 3871 -EP05 pump. Install Polylock 525 filter on outlet of septic tank. Former owner Todd Hans Former plumber Mike Rogers Transaction ID No 691770 Site ID No. 639245 I P Design Criteria Residential Wastewater Contaminant Load: 30 mg/L < BOD < 220 Anticipated septic tank effluent 30 mg/L < TSS < 150mg/L Fecal Coliform > 1 0,000 efu/ 1 00 n1j, Fats, oils, grease < 30 mg/L Bedrooms x 100 gaVbedroorn /day x 1.5 gallons/day hydraulic load Design Calculations In situ designed loading rate -Z_ gallons/sq. per day Depth to estiniated high ground wa � I - in, Depth to bedrock 6U in. Cross slope at system 5 8 % Force main length '& ft. of Z in. Mani fold/header lengthy ft. of in. Drain-back gallons t,ateraJ length 0(. i - a_ ft. of in. L.ateral elevation Z ft. @ bottom of lateral I-ateral hole size 7— n. TsZ- In. ct ft.) Spacing holes/lateral _ - - -- -- holes total X - al volurne L Wer, I g allons I otal lateral discharge rate Network pressurd-compensation los.;es gallons/minute @ ft. head ft. 1- elevation difference fl. Friction loss V' -1 ft @ Z gallons/minute dotal d-vnamic head h?. _9 ft L / s* hon Ld A- InIP --7,%7--- gpm ft- of head Manufacturer Model # e-AO45 Dose volurne gallons 1.ift/s1r*on tank gallons Septic tank gallons Effluent filter Z NICaSUrernent pump on and off HeThl alarm from tank bottom in. Reserve capacity gallons spt;c> sales re Page of C? / b �.� �. �..� � t" �- '� � sn��,..�t ��, � �-�•f Do \.: � I f � L} x �fi S� r cs� w•c . a � L..1 t o..1 AX Y mow s %04- VI ��s g i �W f " " �V ut M• 4°6n' �KS .� �', � 1a+ti a'V' \ \'T J E (� F e r j '� 14� OTC A.i•�� L�viw .r►a� � to s vt� t � T Z . �' ,,1,,,,,.,,,,._,_ �i < '2•. ` � , �..,., � • � e � 1 Z e � — �---- �5-- .mot ' `l Lo t f i 1 r ( r I � t IL �{ ---- .___ --- _.�_�._ ��k•j jr 46r IL C, Y o k cX `"^r y r v 9- �. c r a ©t • �'S 'L. Y'. o� s.-r� o ,... i t ,,."� ¢..,. � c_¢.,.. � �.a.. 4a +� 1 S o •... � . v.. ! � � a.r� ( � -3` 1 "� LOCKIWG COVER u cx ray Q4aCK D44c. 4&4tGT --- r, 4" IL 7'lT 4 4 10 raQt�TuRl� P4 ` SoIL_ 24" Z.U. d0 Mlwu i V i_ h f� r L 4 c. Phi, r ts Al 3` cWT �+>< � �`...._'° pa1 yr zat��f" !� T C 1' � � 1 # I RurtP � SEPTrC E _SPEC.jFfr - ATIc l J DOSE - �il-v\bER OF OOSCs: P1 K Wh T ^ to K SIZE, I \ `y+° - y, `"� .�..v...CrAL4.pkJ5 DOSE UOLUM£ ALARP1 K/WI1fAGT1 R<f►6i: S 1 '� a yr IMCLUDIA.1(s SACKFLOW: , 1 ^ COL L W Ll 1-4 � r !PEEK. CAPACITIES: A= IUCHCS OR 6f C,A,_ :.. SW ITCH L,..:.tU ire M 0 D E kJUMI'liti.R« r U L rt t 5 OR � Z, �......._ Ns- HEa OR A �Wl%H TVPrz, �--- --- � C.' PUMP A £! D ALARM ARC To e r P°t11tiIlMUI"1 DISCMARC.t RAr INSTALLED Ow sC PnRATC VCRTICA,L WFFERCWC.0 CCTW[CW PUMP CFF AUQ 013TRIQUTIOW PIP£,. `Ii ✓ FCCT FELT + , .klQj hum ►JET'WORK SUPPLY PKE SSLIKE . . . , �.� ICE OF it?ACC -AIN X l ct F/ . (,(a, toOICFItICT10ii FACTOR ----- FEET -- — G TOTAL OyUAMIC. HEAD FEET c Ala 2 oe� ,M GOULDS PUMPS submersible Effluent Pump MODEL 3871 EPO4 & EP05 Seri APPLICATIONS • Fully submerged in high ■ EP05 Impeller: Thermoplas- ■ Bearings: Upper and lower Specifically designed for the grade turbine oil for tic enclosed design for heavy duty ball bearing lubrication and efficient improved performance. construction. following uses: heat transfer. ■ Casing and Base: Rugged • Effluent systems • Homes Available for automatic and thermoplastic design provides AGENCY LISTING • Farms manual operation. Auto - superior strength and corrosion Canadian standards Association • File # LR38549 s�" Heavy duty sump matic models include resistance. � • Water transfer Mechanical Float Switch ■ Motor Housing: Cast iron Goulds Pumps is ISO 9001 Registered. • Dewatering assembled and preset at the for efficient heat transfer, factory. strength, and durability. SPECIFICATIONS ■ Motor Cover: Thermoplastic FEATURES cover with integral handle and • Solids handling capability: float switch attachment points. 3 /4" maximum. ■ EPO4 Impeller: Thermoplas- N Power Cable: Severe duty • Capacities: up to 60 GPM. tic semi -open design with rated oil and water resistant. • Total heads: up to 31 feet. pump out vanes for mechanical • Discharge size: 1' /z" NPT. seal protection. • Mechanical seal: carbon - rotary/ceramic - stationary, BUNA -N elastomers. • Temperature: _ 104°F (40°C) continuous o METERS FEET 140 60°C intermittent. 10 _ • Fasteners: 300 series - - -�� - stainless steel. 9 so 5GPM .__. • Capable of running f- ._._ dry without damage to $ zs Fr components. P z5; .... - -- t — 777 Motor: i r x • EPO4 Single phase: 0.4 HP, 6 20, - 115 or 230 V, 60 Hz, 1550 RPM, built in overload with > 5 automatic reset. a 4 -� • EP05 Single phase: 0.5 HP, o EPOS 115 V or 230V, 60 Hz, 1550 3 lot_ r RPM, built in overload with j EPO4 automatic reset, z t - — • Power cord: 10 foot s =_ - -- . -_.._ , . ;_ _.__ ,_ ___ ��._ ._ _.._ . �. 4,_ _; standard length, 16/3 1 S1TW with three prong grounding plug. Optional 20 0- 00 . _ ___... zo_ so 40 50 GPM foot length, 16/3 S1TW with three prong grounding plug (standard on EP05). 0 2 4 6 8 10 12 m3 /h CAPACITY Goulds Pumps Mound System Management Plan Purtsuant to Comm 83.54, Wis. Adm. Code l This system shall be operated in accordance with Comm 82 Wis. Adm Code, and shall maintained in accordance with its' component manuals ISBD- 10691 -P (N.01/01) and SSWMP Publication 8.6 (01181)) and local or state rules pertaining to system maintenance and maintenance reporting- death No one should ever enter a septic or pump tank since dangerous 9� may be Pfesent that could cause Septic and pump tank abandonment shall be ill accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers. access rulers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall to sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches In diameter shall be secured by an effective locking device to prevent accidental or u nauthofted entry into a tank or component. Tank The septic tank shall be maintained by an Ind Ividual cartified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shah be disposed of in soc:ordanoe with NR `i 13. Wis, Adm. Code. The operating condition of the septic tank and outlet fitter shall be assessed at least once every 3 years by inspectk m. The outlet filter shah be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tarn that may slorlrgh off the filter when removed from Its enclosure. If the filter Is equipped with an alarm, the filter shad be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have ks contents rammed when the volume of skudge and scum in the tank exceeds 1/3 the liquid volume of the tank. if the contents of the tank are not removed at the twine of a triennial assessment, maintenance personnel shah advise the owner of when the next service needs to be performed to maintain less than maximum scrum and sludge accumulation in the tank. The addition of biological or chemical additiv os to enhance septic tank performance is generally not required. However, if such products are used they shah be approved for septic tank use by the Department of Comrnerce. Pump Tank The pump (dosing) tank shah be inspected at least once every 3 years. AN swtdnes, alarms, and pumps shall be tested to verity proper operation. If an effluent filter is installed within th a tank it shall be inspected and serviced as necessary. Mound and Preasurs Distribution Svatare No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erreion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soh compaction may hinder aeration of the kftrntive surface within the mound and snow compaction in the wing will pvxnote frost penetration. Coke weather installations (October - February) dictate that the mound be heavily mulched as protection from freezing. Influent quality Into the mound system may ncrt exceed 220 mg/L BODE, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BW,, 30 mg/L TSS, 10 mg/L FOG, and 1 cfu/100 ml for highly treated effluent. Influent firer may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided urith a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at Most once every 18 months. When a pressure best is performed it should be compared to the initial test when the system was installed to determine if orifice dogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal call shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above S inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Confinasntw Plan If the septic tank or any of its components beawme defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. H the dosing tank, pump, pump controls, slamn or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. if the mound component fails to accapt wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing barual area if toe leakage occurs or by removing biologically dogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. 91 Division of Safety and Buildings in accordance wiit " Q9,.Wis. y Attach complete site plan on paper not less than 8 1/2 x 11 Inches in r "must include, but not limited to: vertical and horizontal reference point (8ion ar, , d. ` -0 percent slope, scale or dimensions, north arrow, and location and dis near�#st " Par B 1. . # "' DEC i f J ap APPLICANT INFORMATION - Please print all inform , �i tC?i;c e w Date Personal information you provide may be used for seconder purposes (Privacy 5.04 (1) (60ONTY y Z CP Property Owner fjV M 5 I L:Q 1,,AM p G b Property Locations` � ,! 1,J [�N BA (j � �, Govt. Lot 4u i/ 1/4,S 2.0 4f ,N,R l E (o& Property Owner's Mailing Address Lo Subd. Name or CSM# 11 ' 532- M i uotS ©TA 577. EAS j yo q -7 ,+M.MO,VD City State Zip Code Phone Number c Nearest Road ST* UL �. �s�Q' �s/ ) ' C Vil l age Town b mew Construction Use: [R esidential / Number of bedrooms _. _ __ Addition to existing building Q Replacement Q Public or commercial - Describe: Code derived daily flow �© gpd Recommended design loading rate ?�_ bed, gpd /ft ' 3 trench, gpd /ft Absorption area required-31-5- _._bed, ft2 3 S trench, it 2 Maximum design loading rate L bed, gpd1ft =trench, gpd /ft Recommended Infiltration surface elevatlon(s) s 3 _ _ ft (as referred to site plan benchmark) Additional design /site considerations Parent material �d 'fis ® N. � �[ v Flood plain elevation, if applicable '- = I — It 1 !U : Suitable for system Conventional ?Ou In- Ground �PressuuT AT -Grade system Holding Tank Unsuitable for system 0 S [ U L U EJ S LSO [l S [is �iYt7 ® S SOIL DESCRIPTION REPORT Boris # Horizon Depth Dominant Color Mottles Structure GPD /ft Boring Texture Consistence Boundary Roots hR� in. Munseii Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trenc 4 d -te ipy� 3! /Jes.6,� Ground 3 L l . l /O elev. Depth to limiting 41a factor r 3 2,,jn. Remarks: Boring # 2- �-- J1 --.� / C - Z ; • 3 2. IV, 16 WIL � 5 '/ 17'fW Ground L .� .. r-- _ �. / •� el ev. .01 62 c2 Ma 4/4 X03 eft. foy2 4r/- Depth to limiting factor 3 2,, 1n. Remarks: CST Name (Please Print) R ®��R1 -• u4�(]�G�'T^ Signature Telephone No. �` 1 ��s• 38G • �� � s r'+dd ►ess / Date � �4S�T N�m� r _ o d IA to � lb 0 - 7 A 6 4 `�7 I � o t � ORIGINAL 1445 Us . consin Department of Commerce SOIL EVALUATION REP �iVED I of 2 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code I Cwt led Soil Testing iqpoty 1%1V Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must StP 1 — include, but not limited to: vertical and horizontal reference point (13M), direction and ---- -- percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 0 Please print all information. By Date � \ Personal information y ou provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Z! Property Owner Property Location Hans, Todd Govt. Lot NW 1/4 NW 1/4 S 20 29 N R 17 W - or - o , p - e - r - t -- y - Owner's - Mailing — Add - re — ss Lot# Block # Subd. Name or CSM 4827 Third St., NE 7 t Hammond Oaks — State - Zip Code Phone Number _j_ ___ ' - j City' - a V"'illage Town -- n — Nea - r - e — st __Road _ ,____ City T '" MN 55421 i 763-786-7846 Hammond USHW 12 1A New Construction Residential / Number of bedrooms 3 Code derived design flow rate GPD Replacement Public or commercial Describe: Parent material loess over till ________'__________ Flood plain elevation, if applicable NA General comments and recommendations: install 4'x 112.5' rock unit mound on 105.8 contour as downslope edge of rock w/ 0.5' sand fill - This report a supplement to Ulbricht report, 11/1/99 F9 Boring # Boring Pit Ground Surface elev. 105.8 ft. Depth to limiting factor 32 --in Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary GPD/ftl in. Munsell Qu, Sz. Cont. Color Gr. Sz. Sh. 1 0-10 7,5YR 3/2 sl 2 10-18 1 7_ Z3� scl 3 1 , 1822 7 5YR 4/4 sl 4 22-2 Is 5 24-27 i 7.3YR 4/4 s 6 27-32 1 6/6 s 7 32 36 1 CYr 6/6 f2d 7.5Yr 4/6 s Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L na 'ur "g e CST Name (Please Print) igna ure UST Number Henry F, Grote 222774 Add ress ed Soil Testing Date Evaluation C6nTLFctid eiiphone Number E. 4366 353rd Ave., Menomonie, W1 5 11/21/01 715-233-0398 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page J___ of FILE INFORMATION SYSTEM SP Owner L Septic Tank Capacity al ❑ NA Permit # ( V p� ( Septic Tank Manufacturer ems ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer d� ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units WA Pump Tank Capacity L gal ❑ NA Estimated flow (average) al /day Pump Tank Manufacturer ❑ NA r Design flow (peak), (Estimated x 1.5) at /day Pump Manufacturer ❑ NA Soil Application Rate al /day /ftz Pump Model S� ❑ NA Standard Influent/Effluent Quality Monthly average* Pretreatment Unit -ryq Fats, Oil & Grease (FOG) <30 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD 530 mg /L ❑ In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L X.NA ❑ At -Grade mound Fecal Coliform (geometric mean) 5510" cfu /100ml ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: ❑ NA Other: 11 NA Other: ❑ NA i * Values typical for domestic wastewater and septic tank effluent. Other. ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) 13 least once ever ? monthls) y v gtle-ar(s) (Maximum 3 years) ❑ NA Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume 03 NA Inspect dispersal cell(s) At least once every: ❑ month(s) (Maximum 3 ears) ❑ NA �l�ar(s) 3 y ears) effluent filte I At least once every: wear! ,(s) ❑ NA Inspect pump, pump controls & alarm At least once every: ❑ month(s) ❑ NA ❑ year(s) Flush laterals and pressure test At least once every: ❑ month(s) ❑ NA ❑ year(s) Other. At feast once every: ❑ month(s) ❑ year(s) ❑ NA Other. ❑ 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 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 check for any back up or ponding of effluent on the ground surface. 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 on 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 (Y 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 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of S12 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 POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents 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 be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the 4ontents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS 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 soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit: and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanerr. taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code; • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • 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 with 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: ❑ 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 will 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. ❑ 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 POWTS a soil and site evaluation muit 12e perfor med to Ic a e rep acement area. n ble a holding tank may be installed as a last reso to - 0face the failed POWTS. Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat a the infiltrative surface. Re^ t 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 MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Q Name deg 'd Phone ,. Q _ Phone C- - SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name / ' 9 Name S " r p ! Zo it K 92 kb?�e Phone _ . 41 This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83,54(1), (2) & (3), Wisconsin Administrative Code. ST. CROIX COUNTY Z03XING OFFICE CERTIFICATION STATENAENT FOR 141LIZATION OF AN EXISTING SEPTIC TANK `This is to ccrtify that I have Inspected the septic Uik presently serving the residence located at: Section . 4 5 loig�, _0 _ _ Town" _,N, Range/ �? W, Town of St. Ctom CoLmty Wisconsin. Upon inspection,. I certify that I have found tae tank(s), to the best of my knowtedge, will conform to the requirements of Corran. 84-25, and it (they) appear(s) to be functioning pToperly. Most recent date of Did flow back occur froze, absorption systcin? Yes (if no, skip next line.) Approximate volume or length of time: gallons minutes Capacity: 14ve Construction: Pr Concrete Steel Other Manufacturer (if known): Ag-e of Tank (if known): Signature) *(Liccn&ed P umber Signatize) (Print Name) (Title) ( Number) UTMPRS - o/�_,7 - Foyn to he completed by licensed plumber (s. 14- Wisconsin Statutes) or licensed disposer (NR 113 Wiscorsin Administrative Code) shr t tl; 1 AN& MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer r A rro l 9tPnG1 And Mailing Address 919 Paris Ave N. Stillwater Mn. 55082 Property Address 1622 g g t h Ave Hammond W i 54015 ✓ (Verification required from Planning & Zoning Department for new construction.) City /State Hammond W i Parcel Identification Number 018-1086-07-000 LEGAL DESCRIPTION Property Location NW 1 /4 , NW 1 /a , Sec. 20 ' T 29 N R 17 W, Town of Hammond Subdivision Hammond Oaks , Lot # Certified Survey Map # , Volume , Page # Warranty Deed # 3 , Volume AJA , Page # Spec house yes no Lot lines identifiable 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 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. 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 set 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(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms s /21� 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) r� 8 3 5 1 7 7 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX Co., WI RECEIVED FOR RECORD 09/22/2006 03:00PH WARRANTY DEED EXEMPT # REC FEE: 15.90 TRANS FEE: 330.00 COPY FEE: RET!!RM TO: CC FEE: r ;� cr ^I W re rp... PAGES: 3 33' SPECIAL WARRANTY DEED KNOW ALL PERSONS BY THESE PRESENTS, OHIO SAVINGS BANK, (the "Grantor"), 200 OHIO SAVINGS PLAZA, 1801 EAST NINTH ST, CLEVELAND, OH 44114, for and in consideration of TEN DOLLARS 00/100 ($10.00) and other good and valuable consideration received from CARROLL STENSLAND & MARILYN A. STENSLANe(the "Grantee "), whose tax mailing address will be, 1622 89 AVE, HAMMOND WI 54015, does GIVE, GRANT, BARGAIN, SELL and CONVEY unto said Grantee, the Grantee's heirs, legal representatives, successors and assigns the real property located in ST. CROIX County WISCONSIN, and more particularly described as follows: *husband and wife with Marital Property with Survivorship Rights SEE ATTACHED LEGAL DESCRIPTION Metro Legal Se —ices EDIR_ET 511253 A Parcel ID 018- 1086 -07 -000 619514 XN'D 427614 Property Address: 1622 89 AVE, HAMMOND WI 54015 1hi5 1 not hotw5kadl .P' To have and to hold the" above granted and bargained premises, with the appurtenances thereof, unto the said Grantee, the Grantee's heirs, legal representatives, successors and assigns forever. And the Grantor covenants with the Grantee that Grantor is well seized of the above described premises, as a good and indefeasible estate in FEE SIMPLE, and has good right to bargain and sell the same in manner and form as above written, and represents and warrants that the same are free from all liens, claims and encumbrances created by or through Grantor, except for real estate taxes and assessments, general and special, which are a lien but not yet due and payable, and any and all other liens, claims and encumbrances created by or through Grantee, and that Grantor will warrant and defend said premises, with the appurtenances thereunto belonging, to the said Grantee, their heirs, legal representatives, successors and assigns, against all lawful claims and demands made by any person claiming by or through Grantor, except as aforesaid. IN WITNESS WHEREOF, Grantor has signed and acknowledged this Special Warranty Deed as of Se tember/ P Cp /2006 Signed and Acknowledged OHIO A G BANK in the Presence of / : a fe ra s i s bank ✓ "v e, M rk kman, Vice President Ohio Savings Bank o �s I I of 3 State of Ohio ) SS: County of Cuyahoga ) Before me, a Notary Public in and for County and State, on this 6 day of September, 2006 personally appeared the above named Mark Larkman, Vice President of Ohio Savings Bank, who acknowledged to me that, with due authorization and as such officer, he did sign the foregoing instrument of said federal savings bank, and that the same was his free act and deed, individually and as such officer, and the fre ct and deed of said federal savings bank. Notary Public�B��C (SEAL) My Commission expires on 7��c5 2of3 EXHIBIT A PARCEL 1: Lot 7, Hammond Oaks Subdivision, Town of Hammond, St. Croix County, Wisconsin. AND PARCEL 2: Together with a shared driveway easement for ingress and egress as shown on the recorded plat. File No.: 511252 3of3 ro I oD .... I rt c a GC4 en Ni — c, I X 13 ' ZL L'�S —1 �' co — of : 9t, ion I D s e �'�I3 o # n ;a 84'`Z, 13 'OS 80�'8t� iol � ^'01 .9t'gsZ M I w \ Sam ps•L I I I I I .cc I,�4 c \ 13'OS 0£S'S9 S380V i I `\ 4ti 101 IN 13 'OS 9'C t� �� w I ,N I � N ;i A �\ I z iq� I o , •� ' � \ Mg� dS. �VZeZ I I V ► I I I I \ 'tZ'9SZ A l \ m m 1 .,0 .6t . S � I , I ' 86ZO` \ I Ln v I \ I I I I 10 ;o \ Cn U v I saJOy 0' l 2 \ \'�• SaJDD 6 �' N iD �� 'bS — I 1 r Z \ 1�'OS o°�I I� I l l O 1 I� m i3wnssd� N a \ ; ASS 6 I o I I• o \ lol I I I ' dOt 'A313 \\ 3 06'��Ol �\ �� S2 ,cc I .SO' ( I I= I = II J0 d01 \ = NOIIVA313 \\ ° 9SZ M .9 ,�s.tos I �_ m VNHON38 •o! \ 831VM HOIH \ I I I I ID p 1N I � I I I \ 31N3Sb'3 \ \ I I S3�IOt1 (I I I� `A Amin \ 1 I W 13 'OS d9S�1� I I *0. *91 "'e\ 3`0VNI` dCl \ I (rn - '1 _� O o00 I `s\ b Fs.�sZ\ ,�, � 1 I � 1Q3 I w Itv � cn 6 'eG t \ << I I C I - I m s I I 1 0 I + n I �' st.o� N ssZG �9 ( f 1.01 l I Z 00 I \ a. p t9'SSZ 3 1 r,St. ON D I Z 00 "_ or ' saioo pZ•Z �o �� N w1N o v r� I c Io w 13'OS LZ096 Im ' ti © © w I I I °� "' � M Zb 101 V /� S�2i0b' l0' l I = I = ' I rn co I 1 3 'O zZOtit, 2 o D I I A ��.' /� �' a n � �0 5 101 I m N �� / / F D N v AI W I ' m �• _ 1 ��1111 • Mft rm IM i + �i c c , � � �1 ����e•v�i�� ,� I r • F i tl • i : •7 7 - . - - 1111 \1. al. ,!•!e ►!!!.!!� � •, .�. 'I • �. �, . �jQl j!! �1!° w • ����• a���s� .r+r�aa� ' � i � i � 1 , ��� .! ` ♦ �e a���������������������������������������� - ..-..� _rte. 11 � . d •� �� •�w�� �� ������ ������_����_� +_� \_��•►: \tea \��.V�\ I WN 50, 1A NA Ro �� '► , %ter iill V � , � �,+ i5 .w n s n s \ �i •.� , �r • ' ►i ►. *o ►i► •c +rs�is� \\ 1►i�ie•ect<►e� ♦ q •� _� + � l o�fl,>� ► � o � l �� 1 ���,��� s , Zip; PI INNER lu�•e!•1� � -w c oo �. � �► ..l...... � . , r,�... ►,i�3 � ' � � �� ��•,� �)- ��'•�� �!!lslO� \l 1�!`� ° !'e w e's ° o ! ►��' +', •�� �� � ������ �� ; F ,. � , r�'.��helili�f ►�l�� � � ►�� el WNW IN BENCHMARK TOTAL AREA 76.52 ACRES w W win' CMP WANDS NO STRUCTURE OR 1► 1 � �,' � , ► �� `�� rvv.►C��'I � ! 14..! ►ems. •, .r.�i •o. G 1 �•e�c� s.' iGTC�r r 1 . � o.e .0 v:� ., ,. � ileidrlio�t+�►�!' �' r 0 /` ' ►^�r ►li������ I X1 ►ilili►ili�ili�' ` 1 • ,. O F I RON P . S ZE IMPROVEMENT OF ANY ELEV. 1071.06 MINIMUM LOT 1 ACRE "r • • CORNER NO VEGETATION Al ri • OWN VATHIN THE VISION CORNER MAY E 4:/ ♦ • • •. HL INCHES IN "EIGHT' AREA IS NW CORNER ST. PAUL, MN . • 551 14 ♦ , , .. 02 -02-00 • Ft REVISED AS PER ZONING OFFICE •- — ]ms� ADDED BERM AS PER LWCD V ERTI C AL I= ®0 •• ® . ' BUILD Z • • .. CO UNTY .. . CO MMENTS REVISI A GRAPHIC RELEASED FOR REVIEW 0 50 ®mm DESCRIPTIO ST. CROIX COUNTY WISCONSIN '" - rrNON ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016 -7710 r (715) 386 -4680 • Fax (715) 386 -4686 July 18, 2005 Mrs. Judy Steiner Edina Realty 400 Second St. S. - Ste 130 Hudson, WI 54016 Subject Site: Parcel #018 - 1086 -07- 000,1622 89 Ave., Hammond, WI Hammond Oaks, Lot 7 RE: POWTS Inspection — System Damage Dear Mrs. Steiner: On July 14, 2005, Kevin Grabau and I conducted an onsite inspection of the POWTS (Private Onsite Wastewater Treatment System) for the above - mentioned property. According to Realtors for the property, septic tank covers were not visible and could not be located. Original installation of this POWTS occurred on 09/06/2002. Based on our July 14 inspection, the septic tank has been removed and the mound system has been severely damaged. Broken pieces of the mound system lateral pipes are visible in several locations. A piece of 4 -inch pipe coupled to a 2 -inch pipe was all that remained in the former tank location indicating that the force main from the tank to the mound cell was broken. No evidence could be found that the septic tank is still onsite. The future homeowner will have to contact a plumber for a replacement system with a state plan approval and a County sanitary permit. Plans would include details for removing the old mound system and installing a replacement in its place. The other option is for a Certified Soil Tester to complete a new soil test in another location and then apply for a replacement system as mentioned above. If you have any questions, please do no hesitate to contact Kevin Grabau or I at the Planning and Zoning office. Sincerely, Ryan Yarri gton Planning & Zoning Technician — POWTS Inspector /ml cc: Leroy Jansky, Dept of Commerce Permit file Parcel #: 018 - 1086 -07 -000 03/28/2005 02:58 PM PAGE 1 OF 1 Alt. Parcel #: 20.29.17.627 018 -TOWN OF HAMMOND Current �_X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner * OHIO SAVINGS BANK OHIO SAVINGS BANK 1801 E 9TH ST STE 200 CLEVELAND OH 44114 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1622 89TH AVE SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 1.450 Plat: 2039 - HAMMOND OAKS LOTS 1/59 '00 SEC 20 T29N R17W PT NW NW HAMMOND OAKS Block/Condo Bldg: LOT 007 LOT 7 1.450AC Tract(s): (Sec- Twn -Rng 401/4 1601/4) 20- 29N -17W NW NW Notes: Parcel History: Date Doc # Vol /Page Type 12/13/2004 782333 2713/468 SD 09/17/2001 656759 1719/632 WD 08/1012000 627995 8/3 PLAT 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 56739 158,100 Valuations Last Changed: 06/30/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.450 20,400 112,000 132,400 NO Totals for 2004: General Property 1.450 20,400 112,000 132,400 Woodland 0.000 0 0 Totals for 2003: General Property 1.450 20,400 112,000 132,400 Woodland 0.000 0 0 Lottery Credit Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount 010 - GARBAGE SPECIAL ASSESSMENT 60.00 Special Assessments Special Charges Delinquent Charges Total 60.00 0.00 0.00 0 to p 3 v n d .. o o c m ., cs 3 0 0 y rn N N ao C) N 7 a n Q O 0 N V �1 Cn I 3 m N N 00 0 co 1 m o v u') z D O. 3 e m (E D En a D �! co N 3 0 0 CD 0 3 = o CCD CD ° ° 3 n c N N N Q r! Q L T - 0 (M z tNy w CD v v 3 .O. O CL Z CD °f �^ O m _ m CD CL z - N z O 0 D D o v N o O � Ef o' E _� ° N • O CD O 3 c 3 W 0 O S fD Q m 0 Z W O 3 n N s _0 C n' o CD Q A z O m Cl) m O u p o < li� 2 Poo 0 W m c z a 3 A v 3 z v CD z CD -' v � a I r- v > ID a N 0 m O S T c m °—' c �. o a CD a m F D o C 3�� sy c v N 0' d 7 0 5 3 c n =r N y (D Q O N CL Op O N N t o O p tA M O M CD v4 in O ti 0 CD O � b O CL ti MEMO DATE: December 5, 2002 TO: Mike Rogers, Rogers Plumbing, Inc. FROM: Pam Quinn, St. Croix Zoning Contractor RE: Mound sites in Hammond Oaks Subdivision, Hammond Twp. There are five (5) other systems in Hammond Oaks that still require your attention. The mound locations below were included in a drive -by inspection of Hammond Oaks Subdivision by myself and Rod Eslinger on 12/2/02. These mounds require access boxes or other protective enclosures for lateral turn ups and additional soil and/or mulch cover to meet requirements in the mound and pressure distribution component manuals (see Table 3, "Turn ups" in version 2.0 of Pressure Distribution manual). Lot 30 looks especially in need of some final soil cover, which may be the responsibility of the owner, or frost protection (see 8 Permit # Lot # Address '// 6� r� lbdivisionffown 405181 4 1614 89th Ave. — final inspection Hammond Oaks, Hammond 399667 7 1622 89th Ave. —final inspection Hammond Oaks, Hammond 420360 35 866 162nd Street — final inspection Hammond Oaks, Hammond 420363 37 872 162nd Street — final inspection Hammond Oaks, Hammond 420359 31 1614 86th Ave. — final inspection Hammond Oaks, Hammond You and I had previously discussed the need for installing access covers during 10/31/02 inspections for lots 24 and 25. It was my understanding that you intended to get covers installed as part of other plumbing jobs in the subdivision. Please provide the Zoning Dept. with a date that these five mounds can be inspected and verified that state code requirements have been met. Safety and Buildings 4003 N KINNEY COULEE RD LACROSSE WI 54601 -1831 TD #: (608) 264 -8777 erc isconsin www w ww.commerce.state.wi.us/sb ons .wisonsin.gov Department of Commerce Scott McCallum, Governor Philip Edw. Albe etary November 28, 2001 RECEIVE0 CUST ID No.225094 ATTN.• POWTS Inspector DEC p 5 2001 ZONING OFFICE CFO+X COUNTY MICHAEL P ROGERS ST CROIX COUNTY SPIA ZONING Ott \ N4563 320TH ST 1101 CARMICHAEL RD MENOMONIE WI 54751 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 11/28/2003 Identification Numbers Transaction ID No. 691770 SITE: Site ID No. 639245 Todd Hans Please refer to both identification numbers, Hammond Oaks above, in all correspondence with the agency. Town of Hammond St Croix County NW1 /4, NW1 /4, S20, T29N, R17W Lot: 7, FOR: Description: Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 822202 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01 /O1) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD- 10706 -P (N.01 /01). • 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 insure that the operation, maintenance and monitoring duties as described in section VIII of the Mound manual, and section VI of the pressure distribution component manual are complied with. A copy of this letter including instructions and information relating to proper use and maintenance of the system must be given to the owner and each subsequent owner upon completion of the project. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. • Limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • Comm 83.52(3) The activities relating to evaluation and monitoring mechanical POWTS components after the initial installation of the POWTS in accordance with an approved management plan shall be conducted by a person who holds a registration issued by the department as a registered POWTS maintainer. MICHAEL P ROGERS Page 2 11/28/01 • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). In addition, 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. • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • 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. Stat A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Charles L Bratz POWTS Reviewer II , Integrated Services WiSMART code: 7633 (608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday cbratz@commerce.state.wi.us 1622 89th Avenue, HAMMOND, Wisconsin 54015 List#: 3001686 List Price: $177,000 Status: Active Sold Price: $0 Market Time: County: ST. CROIX Date Closed: Taxes: $2,320 Prop Type: Single Family Residential ,c.► _ Ownership Type: Main Area: 805 - WESTERN WISCONSIN `" `� `"�► . i Style: One Story Year Built: 2002 Construction Status: Under Construc/Spec Homes Development: Hammond Oaks Bedrooms: 3 Baths: 2 ten• Bath Full: 2 % Bath: 0 '/s Bath: 0 % Bath: 0 MapPoint• Bath Characteristics: Foundation Size: 1152 Above Ground SgFtg: 1152 Finished SgFtg: 1152 Below Ground SgFtg: 0 Room Name Dimensions Level Description Dim. Level Bedroom 1 12x13 Main Bedroom 2 9x9 Main Bedroom 3 10x9 Main Bedroom 4 Dining Room 114 Main Dining Room: Informal Dining Room Family Room Family Room Char: Kitchen 8x10 Main Fireplace:0 Living Room 16x10 Main Fireplace Char: 02005 MiorosoR Coip 02004 Na4TEQ , and forGDT, Inc. I Amenities: None Directions: Special Search: 3 BR on One Level, All Living Facilities on One Level 194 E HAMMOND EXIT NORTH ON Shared Rooms: HWY 12 SOUTH ON 160TH ST. EAST Basement: Full ON 89TH AVE. Appliances: Range Air: None Accessible: None Heating: Forced Air Fuel: Natural Gas Water: Well Sewer: Private Garage Stalls: 2 Other Parking Spaces: Parking Char: Other Map Page/ Coordinates: 999/A1 PID Number: 0018108607000 Common Wall: Restrictions /Covenants: Waterfront Name: Lake/Waterfront: Judy Steiner, GRI, Lot Dimensions: IRREGULAR Acreage: 1.5 Exterior: Metal/Vinyl Pool: ABR Roof: Asphalt Shingles SALES School District Info: 9003 - SAINT CROIX CENTRAL 715 - 796 -2256 CONSULTANT, Association Fee: $0 Fee Frequency: SINCE 1985 Fee Includes: WI & MN LICENSED Homestead Tax Year: 2004 EXCEPTIONAL Tax w/ Assessment: $0 Assessment Balance: $0 PROPERTIES Assessment Pending: No Remarks: House is not completed. Shared driveway. Buyer to verify measurements. MEMBER Direct Office: 715- 386 -0221 iudysteiner @edinarea Ity.com 1 Edin Rea lty Wisconsin Department of Commerce • PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: • 399667 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)]. "I p 1 - 7 - 10 Permit Holder's Name: City Village X Township Parcel Tax No: Hans, Todd I Hammond Township 018 - 1086 -07 -000 CST BM Elev: Insp. BM Elev: BM Descri tion: 16 OT 41 *1-7 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. S WIZ Z Of. 101 '7 Septic Benc mark elm 0. 1 7- 3 0 - oa Dosing bna Alt. BM Aeration / p� Bldg, Sewer � -0 Holding O St/Ht Inlet 15.3 96 . o SVHt Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet 4e_A5 brad y fo 9• Z Septic i Dt Bottom IL ,� ab 4 /0 D i Dosing Header /Man. la-71 JL1 Aeration Dist. Pipe �• Z• 3 Holding Bot. System �� �3• 3. 6V al �- PUMP/SIPHON INFORMATION Final Grade QSa• /4Y• .3 Manufacturer Demand St Cover GPM Y Model Number � ZD' TDH Lift , �� Friction L s System Hp TDH Ft _ ILI i a--C Forcemain Length Dia. 2 h Dist. to Well , SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of Trenches PIT DIMENSI No. Of Pits Inside Dia. Liquid Depth DIMENSIONS /� 2 / SETBACK SYSTEM / TO P/L BLDG WELL LAKE /STREAM LEAC Manufacturer: INFORMATION ChV R OR Type Of System: O T Model Number: /t� J / � C DISTRIBUTION SYSTEM A l s 4 Header /Man ifold �kj Distribution /aq,r x Hole Size x Hole Spacing Vent o Air Intake /� Pipe(s) 6� I S / Length�A Length 1 V Dia 2 Spacing 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 Yes i No i Yes No `�P� COMMENTS: (Include code discrepencies persons present, etc.) Inspection / / Z Inspection #2: /_67/ Location: 1622 89th Avenue Hammond, WI 54015 (NW 1/4 NW 1/4 20 T29N R17W) Ham q on d Oaks L D V* %arcel No: 20.29.17.627 op or 1.) Alt BM Description � � ~� C /�i d"�M yo�/?1 pla-h sG � 416 ems/ 2.) Bldg sewer length= / Q amount of cover 9 f R ` b ! � 4� �(�� d,( fp AAN � rn g1S'1d -- 3.) Contour= �/ /05 n revision R � Yes No f q ither side for additional information. -- - Date Insepdoe -- ignature Cart. No. '0 (R.3/97) Safety and Buildings Division County o 1 a 201 W. Washington Ave., P.O. Box 7162 �'�J�s'l>� Madison, WI 53707 - 7162 Site Address �Q Department of Commerce a0 gS �- ���J (m� Sanitary Permit Applicatieq " �. Sanitary Permit Number In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ' , 31r may be used for second purposes Privacy Law, s15,04 (1)(m ❑Check if Revision I. Application Information - Please Print All Information State Plan I. r b 1 940 Prop Narne Parcel Number ap . a /7 Property Owner's Mailing Address + S Property Location , E %, S 20 T N, R 1'7 6J City, State Zip Code Phone Number, - , Lot um e Block Number i Subdivision Name CSM Number aw rr,, 65qI 7 - urn Intid 6M5 H. Type of B ' ing (check all that apply) aS �•/ ❑City 111 or 2 Family Dwelling - Number of Bedrooms 8& Lnum 4 ^"' ❑Village ❑ Public /Co rcial - Describe Use J °S• Township m ❑ Sta7e lcffi*4� te O " u It Q s�M- Nea e Road X 112•S' Jo 0.83 l III. Typ f Permit: (Check only one box on line A (numbering scheme for internal use). Complete Me B if applicable) A. 1 X New 2 ❑ Replacement System 3 ❑ Replacement of 6 ❑ Addition to For County use System Tank Only Existing System B. ❑ Check if Sanitary Permit Previously Issued Permi t Number Date Issued IV. Type of Permit: (Check all that appI )(numbering scheme is for internal use) 44 ❑ Non - Pressurized In- Ground 21 Mound 47 ❑ Sand Filter 50 ❑ Constructed Wetland 22 ❑ Pressurized In- Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other V. Dispersal/Treat ent Area Information: /p Design Flow (gpd) Dispersal r a Dispersal a Soil Application Percolation Rate S ystem Elevation Final Grade Required Proposed Rate(G s. /Da S (Min. /Inch) Elevation D a�60 , a VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanks Tanks AAA Septic or Holding Tank Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsib0 installation o f the POWTS shown on the attached plans. Plumber's Name rint) Plumber' �tu n MPRS Number Business Phone Number P Plumber's Address (Sftd, City, State, Zip Code) VIII County ! Department - Use Onl Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) Surcharge Fee) ❑ Owner Given Initial Adverse . Determination 52-57. 1 s IX. Conditions of Ap ro al/Reasons for Disannroyal n //�� /� `t tkzs � �-- 's , ){ , - K 9 A , 3 � �o a A�✓o Cwv M S � �R -�t�. F►�"`y t�fnQ a42 .w. w0. s cu-Q. S c� S � - Kb. _ t o.,,Z' � }vs r,nt �$ t Qsit 1 wit t Zv i �� � m° Pv� /(1 , c omplete plans o thkCounty only) for a yg stem on�p of tb#n 8u2 x F tv inches 1n size / . S DB 6 98 . 05J0 ot.r�e J ►, ) „� , ', ��,�,,��a ono ree. � Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TD #: (608) 264 -8777 erc Visconsin www w ww.commerce.state.wi.us/sb ons .wisonsin.gov Department of Commerce Scott McCallum, Governor Philip Edw. Albert, Acting Secretary November 28, 2001 CUST ID No.225094 AM. POWTS Inspector ZONING OFFICE MICHAEL P ROGERS ST CROIX COUNTY SPIA N4563 320TH ST 1101 CARMICHAEL RD MENOMONIE WI 54751 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 11/28/2003 Identification Numbers Transaction ID No. 691770 SITE: Site ID No. 639245 Todd Hans Please refer to both identification numbers, Hammond Oaks L above, in all correspondence with the agency, Town of Hammond St Croix County NW1 /4, NW1 /4, S20, T29N, R17W Lot: 7, FOR: Description: Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 822202 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01 101) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD - 10706 -P (N.01 /01). • 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 insure that the operation, maintenance and monitoring duties as described in section VIII of the Mound manual, and section VI of the pressure distribution component manual are complied with. A copy of this letter including instructions and information relating to proper use and maintenance of the system must be given to the owner and each subsequent owner upon completion of the project. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. • Limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • Comm 83.52(3) The activities relating to evaluation and monitoring mechanical POWTS components after the initial installation of the POWTS in accordance with an approved management plan shall be conducted by a person who holds a registration issued by the department as a registered POWTS maintainer. MICHAEL P ROGERS Page 2 11/28/01 • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). In addition, 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. • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • 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. Stat A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 vGC� Balance Due $ 0.00 Charles L Bratz POWTS Reviewer II , Integrated Services WiSMART code: 7633 (608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday cbratz @commerce.state.wi.us Todd Hans - Mound Transaction # Construction Materials and 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 Manuals: Mound, SBD- 10691 -P (01 /O1) Pressure Distribution, SBD- 10706 -P (01 /O1) Location: Lot 7, hammond Oaks NW 1/4, NW 1/4, Sec. 20, T 29 N, R 17 W Town: Hammond County: St. Croix Date: November 27, 2001 Owner: Todd Hans V, Address: 4827 Third St., NE Fridley, MN 55421 CM G' Plumber: Mike Rogers t�0 Signature: `' A4 r License # MP 225094 Attachments: 6748 -Plan Approval Application SBD -8330 page 1: cover 2: design criteria & calculations 3: plot plan Cont*tlonaffy 4: system cross section APPROVED 5: plan view, lateral detail 6: pump tank exit detail ►RTMENTOFCOMaCE 7: pump curve 8: system management SEE CORRESPONDENC page 1 of 8 Design Criteria Residential Wastewater Contaminant Load: 30 mg/L < BOD < 220 mg /L Anticipated septic tank effluent 30 mg/L < TSS < 150mg/L Fecal Coliform > 10,000 cfu/100 mL Fats, oils, grease < 30 mg/L Bedrooms x 100 gal/bedroom/day x 1.5 gallons /day hydraulic load Design Calculations In situ designed loading rate o z- gallons /sq. ft. per day Depth to estimated high ground water in. Depth to bedrock in. Cross slope at system % Force main length 1 ° ft. of Z in. Manifold/header length ft. of in. Drain - back gallons Lateral length @ ft. of Z in. Lateral elevation x'°12 ft. @ bottom of lateral Lateral hole size SZ- in. @ 3s'rZ in. ( �% • q b ft.) Spacing 119 holes /lateral 3 holes total Lateral volume gallons Total lateral discharge rate ZO '' Z gallons /minute @ 3 14 ft. head Network pressure compensation losses �' `'s� ft. Elevation difference 9 t ?1 3 ':� ft. Friction loss (9 - 6 ° 1 ft. @ Z gallons /minute Total & namic head �' ft. Pump /shon gpm @ �-° ft. of head Manufacturer °�^-�- � Model # G Dose volume gallons 40 Lift /siphon tank 0 - 1 0 • L%c c-0 6 '''O gallons Septic tank gallons Effluent filter Measurement pump on and off g Si in. Height alarm from tank bottom b in. Reserve capacity 4 gallons specs.caicsses Page Z_ Of i f f \ OK� 1 �6.�►i`d � 1d3 ���AM `e� �� 1�lww�OvAt7A,�l - 1 v w..s CCC Y'� J g,- 2, Ap ; �pve.Q wKy s \p� L}'11 rotak i �wIA. WY �1 ode ` ({ a \ U ( C y .P• � O N � � y( d ^� i}y �.w. 1� kl r � Q�� ( \ � L , iV 'V V►<J'{�.{7, r S s ss ' /t•W o wt Z u / cl \ 1 rr �w O►V &.4%- I N c�t�, es.� \..a \ o ,r _ c7. S7 V rr I i I 'I i . �_. Ir 5, 1 b \.x x SJ, O TC L.O •!'ovc!- �� h u r r / • l Z L 1� 01 ''C o v 1 ..t w..X co,.�. � �- �O o� o ".► l : "► t � 2. �1 b � � a N-�1 ( � •s i ��� s o� g • C 4� � c) LOCICIWG .,GOVfiR 7UNCTior+ 8ccc u,W,yN sue. Z X BEX . mot G1WCK DI�GDU�tCT� --1 4 4a I {{ OF 4° P►P` 3' P vc no No►STu9eED 24 YE tv u I.D, �I d" 4 o Sol L. M4�1►IOLE i ' r 1^4 • o A" P� AppaovLo $"T JbM'.J W FL .L AL 3' ObfT0 T ON — (JG,puwO Q 3 . 44 Ow Pu+lP COA�.RET'c . L�" b�oCK 5EPTIC t _ SPEGIFCCATIQMS DOSE l�9 e.Ao- TAWS MA►JUFACTUKCK: (DUMBER OF DOSES. PEK TAWK SIZE: k 6 GALLONS ..DOSE VOLUME ALARM N1AA4UFACTUii,CR; S zk �c �v INCLUDING ISACKFLOW: \ O ` G���0 S i P=CL WLIM -EK: \ ° ► �'} ``� CAPACITIES: A= X41 IIJCHCS OK OALLOL. 5 SwITCH TYPE: l� Z VS , t B � IucNES oa c...L Lo.;s GuMP MAIJUFACTURCR: i_ C •�_iuGHCS OR \o\'c, GAL� GuS MODEL WUMDER� �o•4t D■ INCHES OR GA, LL3�;. SWITCH TbIPE: \A.% Q.4�# " Q07E: PUMP AWD ALARM ARE TO DC MINIMUM DISCHARGE RAT lo. t GrM INSTALLED ON SEPARATE CIKCL 7o VERTICAL DIFFEKEWC1 BETWEE►J PUMP OFF AIJO OISTRIDUTIOW PIPE,. FEET + MIUIMUM ►JETWORK SUPPLY PRESS .. .. , .. , , . , . S, FEET + �g FEET OF FORCC M /p AIW X ` �.- �... FACTOR.. '— TOTAL D HEAP FEET IIJTERIJAL DIMLWfilows OF TAWK: LEAIGTH p � q ;WIDTH ... .;LIQUID DEPTH IL --1 SHEF S • DETAILS Pump Characteristics Performance Data P UW1 40 Me�>� �nFt4oM1 sMtF4GMa Arao�oriC Mrlelr S?IEF40A1 SWUM 30 Honepsir 4111 Pd lead hop 12 es SHff40 Ma1w type 66 d Pde 14 Pedal �� ILPJOL hm l0 10 Vokw 11S !7D Hats 64 ralp.f tlt+r I W F Melrs. FhW Tale, 0 10 20 30 40 50 60 10 M A GPM Imola,i,• ass A DIXw r St:e I i/ wT sgw wea 8/4• Dimensional Data W*M 10 bL POWN CAN 1818. UM 8'V td. t9eA f30' e4fti•ftll Materials of Construction fi11 ,_, 4 Uww" I�inAi ,. 54ieHss Sled Oi Dbk*k 01 ywcM M*w K UO Im Fb co ISO Seri Slrk Ilerintaol Sai frw:; wNw /Famrlc I p Skeh Sul SW I*, AmdaW Slat Spre„� St+et•Iraee Saeel .� � i6,Yt� MOM on" (� LqbwW iic - lnene Storrs ( a71 P• lso.el � lo"= Flair NNWW 001114 SiMI An Qmensiaw to InOw. MeuIC tgr IrnarVaL" uee- Corttponent akyWVJQ s MY WI : 118 VAIL Fnsi�..rs Sl * - ' n SW Dtrninatarw dam rot v consl aeon purm unless cenft. Dwwoio s wV at eppraorrnte. Ormff I" iQhamm. We rrarre tro IcK t0 mike revOoms to pat MKI VW tae* 5PMWGO q UP &OWWW Tbwo*$* whhout mica. - Y-r *44wowd legal t* ipow - IUr HYDROMAT116 Pentair Pump Group USA CANADA 94 ga„tq Rood AAlond, Okla 44805 ISO 9001 CeO;F;iep 269 Tritium Drive K;rchww, Ontario, CwA& N20 4W5 el: 419.289.3042 Fats: 419.281.4067 wvm.hrdrornolic.wm Tea; 519- 896.2163 Fax: 519 - 896633'! Item +t W -024 901= IOM ` System Management 'Management of this system is critical. As a condition of approval of these plans this system management section must be reviewed with the owner, and the owner must be provided with a complete set of plans including this management section. If problems develop with the adsorption system or any other system components, the installing plumber, Rogers Plumbing, 715- 235 -1132, or the St. Croix County Zoning Office, 715- 386 -4680, should be contacted for assistance. General Proper functioning of an on -site disposal system, "septic system," is significantly dependent on the volume of water which flows into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the better and longer the system will function. Typical system components include a septic tank or compartment to settle out solids and contain as water, a um tank or ntain greases and oils a filter on the outlet of the septic tank to retain small articles of the same pump o g P P density compartment to allow a dose to be accumulated, a pump and controls, and finally some type of soil adsorption cell to recycle the water in a manner to protect ground water quality and public health. I . If the septic tank is installed prior to sheet -rock and/or painting, pump the septic tank before normal use begins to ensure adherence to contaminant load design criteria. 2 Install water- saving appliances whenever and wherever possible. 3. Repair even small water leaks as soon as possible. 4. Never pour grease or oil down any drain or stool. 5. Garbage disposals are not recommended; if you must have one, use it sparingly. 6. No paper products other than tissue should go into the system. 7. No chemicals should go into the system. 8. Avoid surge flows of water; try to spread laundry throughout the week. Maintenance 1. The septic tank must be inspected every three years by a properly licensed person. 2. If necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids volume equals one third of the tank volume. 3. When the septic tank is pumped, any solids in the bottom of the pump tank must be pumped, and the filter must be back - washed into the septic tank to remove accumulated material. 4. Periodic observation pipe inspections should be made by the homeowner to examine the state of the in -situ soil adsorption cell. I i the n Quarterly inspections are recommended; a licensed lumber should be notified if effluent is consistent onded n adsorption Q Y P p Y P rP cell. 5. If this system contains specific treatment components other than those mentioned here, maintenance requirements will accompany their specifications. 6. The pumping components for this system include an alarm which must be installed and remain on a separate circuit from the pump. If the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allows reserve capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or two days should pass before any necessary repairs can be made. 7. Avoid compaction such as vehicle traffic within 15' down -slope of the adsorption system. 8. Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system. 9. Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth. 10. Surface drainage must be diverted around the system; avoid landscape changes which might send surface run -off into the system area. 11. Warning: Do not enter septic, pump or other treatment tanks; death may result because they may contain lethal gases or insufficient oxygen. Contingency Plan Wastewater monitoring of volume and quality is not a normal requirement for low effluent strength systems; such monitoring may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83.54 (2). Pumping and hauling of wastewater may be necessary while analysis and repairs are implemented. Additional testing, designing, and /or installation of additional treatment components or conversion to a holding tank may be necessary. Page 8 of 8 E- 7fr1 FfX R_• PLlhSEXr {, Fi'c h.O ; 1` , ,::t5 iW7 Pcc. a' 2001 11:F341 P3 rd .r 6, I �1' �,::I'T,� 'f.41`E;, trf. ^.I', i ?...!'!:1']C.'ii AG�'F!'1',•t]. ? *•:'1. -� °. t ,f 1,*�;er:F.:aii.7n t .. �. I r P t.._. l (: 'dMi � �S:- Ir,•:Cnl . C:i7yi2 Atc .. �arc4! `iIcr]IFj Kumbcr LEG -J. TWS CC" RI;PT _ i' "3i7•. "ry hncanon "'<, ti . I' A _J�JV', xow ref' SJtd1Vlaiurl ..._ .. - - -- -. l.dt $ CKriiried Survey Map � ._.......,.._........, r.� r ... ._.... ._. , `, � Hirt]? _ .._.._._._�_� Pa ;e # NN'urraixt}' Deed �j3Z Spec 'house L ycW 0 il,., l..ul 'lines iir.millab'.c ED .,c3 i.:l no SYST Tmprnper WSe and au.J1i,:tC114ut'COi sepfic A }rn,e , , ,; ,;.I result' in its prCnl3+u a tai]taro t a 1, iayla �lasta9• pti>p!lmail lilA�t.�t ' corsits cf ruzpi_p out Ltie :t(. '.ati: aver; throe yaors 1O, •rtcf, if needmd by a ],rcristJ pnrrjr'er.. A hat you put into *0.W- APO' mo otFr';r the t+rncur.n of tht ,rpti.: rsr,;: 4 a trCG mlan{ .'9 , in 71.# ware diT,3d%! by ten, 1'i'•a Property P+a', r.ytW 1 to enhmtr ro Su C'rd]'. .', ^g 1 0erurrtslent 3 cCL(ific"iiun {6etry si,%"d by the oamre apd L; � "!j';• auster�l:, nber �Ull; I1 CYt1, iu(. I� ,t,iL'cfic3k' >titC�f]iIt111r�:�f lu `er,edpumpc.rvcri;yir'e'#:s Use' 4pi31LW7 ►fit4WatOrdtfpG�il�ira!f!• ^ 1" is 4a yiaprr o,3oremg c,1tidid c'ti "rid!ar t;2) after in4petti C•r. km y 1 ?•+riniag (if, n4eez6ary -, tE, Aep ric sink ie !cv; thorn III full of'' l Iu&- . a& LL¢SCtSir have rePLI Lhe 6havt requirvmentg't^•I :�i�rc :" u maimuill the pri%Ve Sew'Aaad:rrp 8361 % VAth giv •4'i}itiM' ^ s:: kGrlii, hareiN as scr ly^ the )gN1mj) - .nt of Comirner[r x w:1 i trP�nmeur t,r?faru;at.su,i,cc� 3rptt G Y► "sscat�iu• Cart#fMWL;' •' 1.;Attr.g than yoUr SCJ.ri,7 SySTrTt ll« tnta rnail>rained n i:� C -• mpl•lecd ;nd rt'I m#4 NN t}:e Tt Vroix k toklutyy Z011=3Ofree4 , :'• ii3Y'3 Oftl»t- tiirr.R Ytmc c-:pirsaon dar,:, tj?' srartrxI.M.: Or : NFF *.Ir4'r I,aT13 '7 1 i (wo P(t f`' 11 A a! 1 11a CC me n orl tL is f ort';1 JI4: .•' :I) tr)r hr gr of my (f:ur) k7iulv'] at in to r e) ILi G1y'� ,'• the propariy acs :abe.l +to1'e' t'. unit of i A-.rrai ry r t rwC! tied in Register of Dee is Ofti.-e, ;t NA '. ,L OF APT LIC'A 'F DATR q its }rmmian t_hal i m s•reprIcne ed rma rest k i,, '1'r, canitaw• pcamit b0i4g. %cvaL•e4 by thr Zoniop Deps,rtrnet : r •" !nelude tvitta rlSi� M�1f7tICGtI rR r 4t:trnped war'rsnry Jtmd CiQm th RtlaWtlr sf 113aad1 uilice ii copy of ihe,rs.�1r cfi gtr vey iraf. if reference is mado in thr warn►sty deed �Y. I { 1 0'd 28Z39S..ZIS SNOISSIWSNIdNI 03Wklb Wd 0£:b0 Z VO —Nt$r I ' P 0 N'rATE 111t1k Of' W 1bCOtiGIK ruRNf : • 1994 f - r•5rf�s�l5 I WARRANTY 0EE1) a. ., W1 This aerd, made between f[olntrirti [,and Cori,nraionra ..... �d_'ENEII r ilR RECORD MManesota COrpUrtltba i ll-ev0; :0.10 s' -- cratt�or,:trd r _ iSAtiSr'� FEE; 1i, 7^ _�._._�.... 1 Ea � Crtutlor, for r Valtiable cons(deration, Cor,vc y i and wartallis LV a • S (irdr thq following dsteribed f al estate In 5t. Croix . _.._ __. •• coljoly, Stale of Wisconsin 91 _ k JL'i'm6 If • N' xrn• Aral R61UM r16l :•c �— T 4 Lot ,7. 4rrutwn 4 OaksSub4visioO , TownOfHatIL 1110 d , St C C0 ottstn l "u •= taentifi.•alivn Yw,ddr tC3: �.... . –_ r fv� is not .. homl!sNad gl;�perty', (is) is Tint) i i 1 hE� ry t$ , I ri { - i:!ecapti0n; to V+3rrsnlie8 SubJr•l tU rotna, C' �SejnCUis ,rc>:(+tCtipns,cGtetu,lttw alrtl rl±;(us Of "M of TcVGtti, H Itrn , ; iTRilading but tall lintited to those for dra;r�,Tgo,tvulot relmltian,pandiog,and or lit illucs as may be shnwn un the pl:d of }ltbtu Qrtks SOpdivislon recorded u1 Vol S of Plsts, pap I, 51. [;roir County. Wis vt 5in. (1re warranties of Jus died, eid>Lr expressad or in>vlicd art iimikdby the granlut to the n!' S OU SgMee, or anyone in lbe clytin of 10c, w Utc eunsidara(iut) cxptcTUd trrei n, I IL ;LL being Lhe sum . day of August } r 11jim bii d 1 :utd Cut po rutx)n ' 't _ - • prealdcnt Milli" I. U;0 AC'KNDWLEDGrUN'l A • AUTHENT[CA'i MN S';n11 ur• ui \c:Ur•tiiTw g{gnawcial – -- ttamiF — CUUnty.l pgr�raillY crane before rte Ihtc 17th tLy of t � r _.._.... , .... . –... _ ........_ – August 2r)p1 the drovettamed a{ithamse0 e _ -- Austin J. Balliott t d this (!uY of _._ 1TLL �{F!o113t ?R s fnl E IInA Of' W[S j (t) SiV t) , rte p, „y,ct) to l,e the rcrson(sl Who 4satiled the Imcgains — t �.. —+ ins,�u:u,t au1 �tknowled the srttlte :,�” if not ..— wah by i 706.06,14iy Stara y u] A. 1lsilktn ^' PJWt ♦.BIUI+Sri3 , Pa 1 d3 •� o .�t.tAlertrrraawr I ills I N K?AU 7w/ r..il WAS D Is A1 R. U t SY w CC•wYwOtt srw +at : .... . –... My Cou,nti • _.. —.. -- _ dWnuatY 31C, titutersnjlKOCr 5 moY b` authcnuratul of +�. .. ... � + °�t tx parntxncnl. (If uctl• craw rspuxuan drtG Nl A gp+llvu, Attorney it ■n au krowle f3uth YI'c not t 1Jo ttlll i'u 1 •Nuttw or pertan sianlns+ , T any "•paciry should be typed tX printed Wow FA IL( aignuul5r { rTAT[ YAa OF NY t3CVY111f WARRANTT a ritO ratW na. i • t99� S y NI• PI(�: FI ".BIUFAl,f �,t1NPANY Nyt ISV tM', •ti; a(y,w)�•luQl A y G. tr6'd $8Z$98LZT9 SNOISSI1WISN081 OOWtIO Wd ZZ:t•0 Z6- 190 –Nor - ?9 ORIGINAL j 1445 Wisconsin Department of Commerce SOIL EVALUATION REPO �/ RE CEIVED 1 of 2 Division of Safet and Buildin s �' C?d�t led Soil Testing Y 9 in accordance with Comm 85, Wis. Adm. Code r nunty FV L,r J �fA Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must Stir 4#$X t— include, but not limited to: vertical and horizontal reference point (BM), direction and rchl I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 00Lt7Y Please print all information. Re iwpe�l By ,{�Cl> Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property O wner Property Locat . Hans, Todd Govt. Lot NW 1/4 NW 1/4 S 20 29 N R 17 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM 4827 Third St., NE 7 Hammond Oaks City r ".k` State Zip Code Phone Number City III Village W Town Nearest Road Mneageks- i MN 55421 1 763 - 786 -7846 Hammond USHW 12 New Construction Use: Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement Public or commercial - Describe Parent material loess over till Flood plain elevation, if applicable NA General comments and recommendations: install 4'x 112.5' rock unit mound on 105.8 contour as downslope edge of rock w/ 0.5' sand fill - This report a supplement to Ulbricht report, 11/1/99 7 Boring # Boring Pit Ground Surface elev. 105.8 ft. Depth to limiting factor 32 i n. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0 -10 7.5YR 3/2 - sl 2 10 -18 7.5YR 4/3 - scl 3 18 -22 7.5YR 4/4 - sl 4 22 -24 7.5YR 4/4 - Is 5 24 -27 7.5YR 4/4 - s 6 ! 27 -32 1-0YR 6/6 - s 7 32 -36 10Yr 6/6 f2d 7.5Yr 4/6 s ' Effluent #1 = BODS> 30 < 220 mg /L and TSS >30 < 150 mg /L ` Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L CST N ame ease not tgna ure Number Henry F. Grote 222774 Address Certified Soil Testing Date Evaluation Conducted Telephone Number E. 4366 353rd Ave., Menomonie, WI 54 5 11/21/01 715 - 233 -0398 NL.. . 1Vw- t er , 29- 1� w iL p ... v� � 1•J U�v+O•+d( G� 31 ' S �nI.Z� qo r A na 14�•�Lo I4 -, �-Lls 4oq -o rN lk 0 ca � S t om• � !.i•� O.�. }�v�. fi`r'st aX9+v w � e �Q i n i- Ne J U U NOOK A mc r 9 8 k n o 0" — 77 ./ 0 -e" 0 HOC I...... ...- :tom:" _RRS_ • 13' -s0" x +e' -a' � -' f9�A!'Ol�ly+ry �• R&S � f I' 1 ^ X11 To 8BZ898LZ19 SNC'ISSIwsNtNI 03WIZIt! Wd 6T:t+® zo — •tr9 — 'ior Wisconsin Department of Industry SOIL AND SITE EVALUATION / Z Labor and Human Relations Page of Division of Safety and Buildings in accordance wi :fQ9, Wis. Attach complete site plan on paper not less than 8 1/2 x 11 inches in si Plt#ti musty r Co include, but not limited to: vertical and horizontal reference point (BM) ireption a rig_ n P ?` �I " , , percent slope, scale or dimensions, north arrow, and location and dis n � to nearest - e6 d6 ` Pardel't, APPLICANT INFORMATION - Please print all inform Hon. ,, cti� Rev we Date Personal information you provide may be used for secondary purposes (Privacy L w; s. 15.04 (1) N -Y Z Property Owner R U IN R l ep 1,,AA3 p d ,Property Location > `\ L) �d Il� p7� i 1� 7 Govt. Lot - �' 4 NA/ 1 /4,S 7.0 T)•� ,N,R I E .�oLJ Property Owner's Mailing Address Lo M/--_L Subd. Name or CSM# 33 2- h i uNtSoTA 577. EAST I qo q 7 4A"O.V City State Zip Code Phone Number r Nearest Road w Z 'JT• UL- HN. 5S'1O 1 (�G5/ )222.'5557-5 ❑City ❑Village Town 44 1 mew Construction Use: G iesidential / Number of bedrooms 3 Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow yfy gpd C Recommended design loading rate * bed, gpd /fi trench, gpd/ft Absorption area required _ bed, ft 57 j trench, ft Maximum design loading rate Z" bed, gpd /fi '_3 trench, gpd/ft Recommended infiltration surface elevation(s) SJa • 3 ft (as referred to site plan benchmark) Additional design /site considerations 14 1 AAAkpow t Parentmaterial /meys 6Gae Veys - T f /X� Flood plain elevation, if applicable e +�_ ft Suitable for system Conventi MoM d In- Ground Pressur AT -Grade System in Fill Holding Tank Unsuitable for system ❑ S L7 U L'J 5 ❑ U ❑ S ❑ S El [�.t� [0 S SOIL DESCRIPTION REPORT Boring Horizon Depth Dominant Color Mottles Structure GPD /ft 9 Texture Consistence Boundary Roots �, in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench A a -& ioy�e 31 3 — L ifshk 3& Ground elev. Depth to limiting factor 3 - in. Remarks: Boring # / /f 4,e di w 1( . S he 4 cS z. ' 3 Ground L — •� " elev. ciA -.4 CL / l o ft. — �- • 3 Depth to limiting I I I factor 3 2, — in. Remarks: t� CST Name (Please Print) RoBr-RT Zt�aR�et�T Signature • 3 8 & n8; ` I Address Date CST Number � - Mo./* Wyss �Z�3�s Private Sewage Consultants 655 O'Neil Rd. PROPERTY OWNER N um Q I eo L �� SOIL DESCRIPTION REPORT pa e . Z of 3 9 PARCELLDI L H ,4 M A y 0 AJD 4A S 01 8D Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell 9u. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 3 / !o c / s .30 A0 es Ground ! 0 I e Nk� "{ ' —• .'� elev. Ll Depth to d limiting ! f 40 VA actor LL,ft in 7•S V v Remarks: Boring # Ground elev. Depth to limiting factor in. -- Remarks: Horizon Depth Dominant Color Mottles Structure GPD /ft Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trenct .Boring # Ground ' elev. ft. Depth to limiting factor in. Remarks: �4 Boring.# Ground elev. ft. Depth to limiting factor I ` in. Remarks: W SBDW -8330 (R. 08/95) 1 ` os 0 �h ca r ` O - a w , 4 ' VI �f ; th zi z ; o \ C � pi OAS - r n1 O ( I I