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018-2005-10-000
Wisconsin Department of Commerce Safety and Building Division PRIVATE SEWAGE SYSTEM INSPECTION REPORT C~NE~'L INFORMATION (ATTACH TO PERMIT) Personal` '!nation uou provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m) Permit Holtlers Name: City Village X Township Miller Homes of Hudson, LLC Hammond, Town of CST BM Elev: Insp. BM Elev: BM Description: ~~ (~~nr~ r ~~ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic Dosing ~ C~~~ ~ ( Aeration ~- Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ~ Z~ / / ~'f ~ . X001 _.~-~ /b ' Dosing 7z~~ ~ J~ ~ V' Aeration ~'._ ' Holding PUMP/SIPHON INFORMATION % 1Y Manufacturer errand ~Ll-~Z. GPM Model Number ~~ ~~ ~~ ~~ TDH Lift q~ Friction Loss System Head / TDF~, Ft , ~ ~ / ~ Forcemain Length / Dia. ~// Dist. to well ~ /,^ , SOIL ABSORPTION SYSTEM ELEVATION DATA County: St. Croix Sanitary Permit No: 463317 0 State Plan ID No: Parcel Tax No: 018-2005-10-000 Section/Town/Range/Map No: 31.29.17.936 STATION BS HI FS ELEV. Benchmark A . 0 ~ oq.Z~- ~ O(p . 2 Alt. BM ~~ w t ' Bldg. Sewer ~~ St/Ht Inlet /,~ 1 13.00 r 9'~0.2~- St/Ht Outlet Dt Inlet Dt 13etter~ ~ (c .3 Q Zt Header/Man. 5 ` Z~ ~ . Dist. Pipe ~• J~Z~ q ~. 1 Bot. System ~~~ ~~C"/ Final Grade ~ ,'~ / ~~ St ver •(.~ 8, 20 lob. o~ C~„~-~-.r" 10.E 1~ 6• ~~ 1 •~ i ps+ ~ i' ~. ~~-n tae-~.~" S'~ I e!8 0 / /0 . fro / l0 . ~ /~O . ~ BEDITRENCH Width ~ Length / No. O Trenc s PIT DIMENSIONS No. Of Pits Inside Di Liquid Depth DIMENSIONS ~ ~7. ~(,j ~~, ~- ~ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: n / ~ ~ ~~ UNIT Model Number: ~ du ~ [~ DISTRIBUTION SYSTEM Header/Manifold ~ ~ ~Di `l'Z Distributiogn , ~ t t y L h ll~ • ~(~ i ~ ~2' S i ~" ~~ x Hole Sizg / f ~1 ~ x Hole Spacing / f Z • ~ L Vent to Air Intake ~~~ " ~ a Length engt pac ng D a SOIL COVER x Pressure Systems Onlv xx Mound Or At-Grade Systems Only ~ G Depth Over / Bed/Trench Center Depth Over Bed/Trench Edges ~ xx Depth of Topsoil xx Seeded/Sodded N xx Mulched , N Y I es o es ,~ o CO NT In ode di cre s, er ns res nt, etc. In ion #1:S1~ ©~ /~S_ In ection #2: / / ~~~ ~g~( ~tf~~x _ >' FYett~~p ~soZ P ~` N~l,~ ~ P Loca ion• 660 153rd Street Hammond, WI 5401 (SW 1/4 NW 1/4 31 T29N R17W) ighland Ranch Lot arcel No: 31.29.17.936 1.) Alt BM Description = 5 ~ t - ~o"`~'`~ ~~<tr~s~-~('t~ ) ~~~ N`~`~ ~` ~."c~u'--~5 d v'~_ r 2.) Bldg sewer length = ~ ~ ~ O - amount of cover = ) ~ /r.~ ~ C.bu.,pr , Plan revision Required? ^ Yes No Z_ Use other side for additional information. "' ~~ SBD-6710 (R.3/97) Date Insepctor ~~3~ 7 Cert. No. Wisconsin Department of~Commercg Safety and Building Division ~` GENERAL INFORMATION Personal~nformatiorcyou provide may be ' ~ ~ PRIVATE SEWAGE SYSTEM ~' ^,~, ,i,~ INSPECTION REPORT 1\ ~° ~ ~o~` (ATTACH TO PERMIT) ~dTerseconda urposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Miller Homes of Hudson, LLC Hammond, Town of CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~ ~ C`-'fZ- i ~ / ~, I ~~- L ~~~ Dosing ~ t~ Aeration ~ Holding _ .. _ .. TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. V to Air c~ t i iviwny .;~ - PUM SIPHON INFORMATION Manufacturer ~ C.LL~ Dema GPM Model Number N ~~ TDH Lift Friction Loss System Head TD Ff Forcemain Length Dia. Dist. to well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length DIMENSIONS SETBACK SYSTEM TO INFORMATION Type Of System: DISTRIBUTION SYSTEM P/L ELEVATION DATA 1 STATION BS ~ I FS ELEV. O(o , 2Z Benchmark ~ c:> Alt. BM Bldg. Sewer St/Ht Inlet ' 3, v' J SUHt Outlet Dt Inlet Dtf ~ /~ • 35 Head n. .Pipe Bot. System Final Grade St r ~Zp )~ . DIMENSIONS No. 1 Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing Sn~l CnVER v Dr~enrn Sve4cme f]nly YY Mnnnd (1r Qt-Grade SVSfen1S Ortly Depth Over De Over xx Depth of xx Seeded/Sodded xx Mulc ed Bed/Trench Center B rench Edges Topsoil Yes No - Yes No C~IIp~N~ ~ S: (InC~de coli~ is pencies, persons present, etc.) Inspection #1: / / Inspection #2:__!_i___/___ Locat on~ 60 153r Street Ham d WI 54015 (SW 1/4 NW 1/4 31 T29N R17W) Highland Ranch Lot 10 Parcel No: 31.29.17.936 1.) Alt BM Description = 2.) Bldg sewer length = ~,(~ -amount of cover = ~ ~ u~ ~ _ `t~~~.2(~ Plan revision Required? I Yes i .:I No _ ._ Use other side for additional information. !.__ _._i- ______-~ - -- - --- --- - - - -- - Date Insepctor's Signature SBD-6710 (R.3/97) County: St. Croix Sanitary Permit No: 463317 0 State Plan ID No: Parcel Tax No 018-2005-10-000 Section/Town!. ge/Map No 31.29.17.936 I ~__. Cert. No. l J ' ~ Safety and Buildings Division 201 W. Washington Ave., P.O. Box 7162 County S ~ ~ r ~ t ~C. ~~~®~Sr~n Madison, WI 53707 - 7162. Sanitary Permit Number (to be filled in by Co.) De artment of Commerce ~~ (608) 266-3151 ~ ~ / "~ ~ ~ r Sanitary Permit Application State Plan I.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ~ ~ ~~ o ~ ~~ b ~~ may e used for secondary purposes Privac Project Address (if different than mailing address) I. Application Information -Please Print All Informati •' ~~ ~ ~~ n d ~ / i Property Owner's Name y-- :_~~ %: `!;,! Parcel # Lot # Block # ~-~- (J Property Owner's Mailing Address "" ~ F " si L ~~~~ i t i _i~~i~.; ~ 5 ~ o~ operty Location - ~ ~ ~ ~~ ~ ~ City State Section ~ '-'! ~~' ' , Zip Code Phone Number > > ~`+ U ~ S '~ 1V ~.v ~ S~~ ~ ~p 7'5~~~~~7~~1 Z (ciicl e) ~ 7 ~ II. Type of Building (check all that a 1 PP Y) N; R E r W T ^ 1 or 2 Family Dwelling - Number of Bedrooms ~ S'tQ,n-d,gJ{e~ ~O~,td a.. P'p M ^ ~ CSM Number Subdivision Namen (~ ~ Public/Commercial -Describe Use (/ C O v~~ o uM' ~(, = G~ ? r 7 ~ - ~ i~ '1 ~ q Kq( CC~N G ll ^ State Owned -Describe Use V vl ~o ~ 4~ ? fix, O ~ ^City ^Village~Township of aMl N(O ar III. Type of Permit: (Check only one box on line A. Complete line B if applicable) p - _ A. New S stem y ^ Replacement System ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System B• ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. T e of POWTS S stem: Check all that a I ^ Non -Pressurized In-Ground ound > 24 in. of suitable soil ^ Mound < 24 in, of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^ Recirculatin S thetic Media Filter I g Yn ^ Leaching Chamber ' ~_aDrip Line ^ Gravel-less Pipe ^ Other (explain) V. Dis ersal/Treatment Area Information: C~ ~ r ~. ~ S Design Flow (gpd) Design Soil Application Rate(gpdsfJ Dispersal Area aired (sf) Dispersal Ar Proposed (sf) System Elevation nn ~.o ,F: ~~ o.y isy~ ~~oa ~syg~ 6o q~.~s VI. Tank Info Capacity in Gall Total l Number Manufacturer Prefab Site Steel Fiber Plastic I ons Ga lons of is Concrete Constructed Glass I New Faasting ' ~ ~ ~s Tanks Tanks I Septic or Holding Tank / L So 7 ~O D ~S ~~ Aerobic Treatrnent Unit L ~Bt ~¢. /av F: Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. i Plumber's Name (Print) PI ~er's Si star MP/MPRS Number Business Phone Number ' Plumber s~Address (Street, City, State, Zip Code) VI oun /De artment Use Onl Approved ^ Disapproved Sanitary Permit Fee includes Groundwater Date Issued Is ng Agent igna a (No S s Surcharge Fee) ~ ~ 1 S-~ p-= ~ /~~ 5 ^ Owner Given Reason for Denial ~~"77 O[ IX. Conditions of Approve eason~ €onr Disapproval ~ ' 1~ ~~ ~lx YST ER: ~~~:c~c.(~ y~~~ /.LG 7~uP~ 1 1 Septic tank, effluent filter and f ~ /° - dispersal cell must all be serviced / mamtalned ~ - ~ ~ ~7 ° `~" as per management plan provided by plumber ~~ E~ L~0~2G~~%L~:A~I~' G~-1S ~ / ~ 2, All setback requirements must be maintained ~~ ~^ ~ ~?j~G~ T""`,~ ~~'~'r~'~u~"1 as per applicable code/ordinances. ~ - •-- ~...-..y v..y~ .v. we e~sacw vu paper uU{ {Ca9 Wa0 Ol/L Y 1r InebC1 In SIY! .~ Z~ SBD-6398 (R. 01/03) ~I ;s ~. Imo. Q ~~~~.~ ~~`~ ~~ ~, T proposed c,J; es+.r wLP ~,SO/8~ co~+-b,~a~%on s.r./~! c. ~/ eFf/li 4+t F,-~ a.t•~.T. out/.c~. 0 P os' ~Oi~ e(/Q~u.aCi~l~Yl P~~f ~ ~X i~S t.~n 8 i'a o~ t e leva.-E~bn tl Sc-al e ~ /'_ ~o' ,~Q~~~BSS ~tio P/a ~E o~ Qmmo~ S~ , Croik eo.~ cJi. Pt,op~osed ~,v~/ /oc~~i~„ s ~ ad- off.; O Q- vs p °~ ~ .4 ~ ~' ~ ~ Proposed 1 ~ d ~Cr~V2.~J0./ ~ 8z vo ~: 1 of dra~.,a9t,-~ ~ ~i,i~ 1~ aie4 bo~cndru ~ '+ ~ ,~ ~ / ~ ~ IO~~oG~1~ '~ V`11 S~S~~to.~~ i .1 -~ i 1 ~1 1, o SI ~~~ 1,~ ~~ ~ :: 1 j' ~1 . ~1 - ^ ~ t 1 1 1 1 ~ ProlWS~mo~,,~da~ 1 ~ ;s~oc~sct,/Ce~/. Two (~ 1 11 /a ~erc/S a.~ /yz.~~' 88. yV 1 ~ i~ i ~~ i`i ~ 1~ ~~ ~ ~ 1. . ~ iS.~ ''d S~~e c~ 1 ~~ i L 41 ~~ 3.3.8 g ~ i 1 of ~/s~ ,. .C. . ~! . p Assu.r~l e leu = /Gl'I.G~.' /l~i8kb~r~n~ {~ok~z bast. E/ev.~ ~ io~.z2 ~~ j~, go{' 9 ~,. commerce.wi.gov i ^ isconsin Department of Commerce Safety and Buildings 4003 N KtNNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www. comme rce.wi. gov/sb/ www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary February 09, 2005 CUST ID No.225036 MICHAEL P MC DONELL A.C.E. SOIL & SITE EVALUATIONS LLC 1070 HUNTER RIDGE RD HUDSON WI 54016 ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 02/09/2007 SITE: Miller Homes 660 153nd Ave Town of Hammond St Croix County SW1/4, NW1/4, S31, T29N, R17W Identification Numbers Transaction ID No. 1106955 Site ID No. 694641 Please refer to both identification numbers, above, in all comes ondence with the a enc . FOR: Description: Four Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 1003562 Maintenance required; 600 GPD Flow rate; 34 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual -Version 2.0, SBD-10691-P (N.O1/01); 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, COD stats. The following conditions shall be met during construction or installation and prior to occupancy or use: pEp RTIi Approval Requirements: N OF • This system is to be constructed and located in accordance with the enclosed approved plans and with the SEE COI "Mound Component Manual foc Private Onsite Wastewater Systems VERSION 2.0" SBD-10691-P (N.01/O1) and the SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST_SAS (01/81) • Per manual cited above, 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. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR S11 & 812e • 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 MICHAEL P MC DONELL Page 2 2/9/2005 • 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 shalt 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, Charles L Bratz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday cbratz@commerce. state.wi.us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 .. ~ ~ ~~~ MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN~~'~ ~~~ ~G,c~ Residential Application ~ ? `® INDEX AND TITLE PAGE ~G~ ~~Os ~~ Project Name: Sam Miller 4 bedroom residential mound system ~S Owner's Name: Sam Miller f% ~1.~'r'1Q(/ ~Tyy~2,S cr,~U.~SQ~. Lam, Owner's Address: P.O. Box 151 Trout Brook Road Hudson, WI 54016 Pcl. Add.: 660 153rd Street Legal Description: SW1/4NW1/4, Sec. 31, T.29N., R.17W. Township: Hammond County: St. Croix Subdivision Name: Highland Ranch Lot Number: 10 Block Number: na Parcel I.D. Number: 018-2005-10-000 Plan Transaction No.: Page 1 Index and title Page 2 3 Data entry i M d d ~I~~p~rZ~IY Page raw ngs oun Page 4 Lateral and dose tank ~ ~~~~ ~ Page 5 System maintenance specifications j,. ~D~MER Page 6 Management and contingency plan f~ C~ t) I Page 7 Pump curve and specifications NGS Page 8 Site Plan =SPONDENC Page 9 Soil Evaluation Report Designer: Mike Mc Donell Date: 01 /31 /05 License Number: 225036 Phone Number: 715-386-8692 Signature: ~~ ~,~, Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) Version 3.0 (03/01/01) Page 1 of 9 Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) I R Residential or Commercial Design F _ 400.00 Estimated Wastewater Flow (gpd) ~~ 1.50 Peaking Factor (e.g. 1.5 = 150%) 600.00 Design Flow (gpd) _ __ 10.00 Site Slope (%) __ 97.75 Contour Line Elevation (ft) ~ 34.00 Depth to Limiting Factor (in) 0.40 !n-situ Soil Application Rate (gpd/ft2) ~__ _._..___.v._ Note: Sand fill (D) calculations assume a Table 83-44-3 in-situ soil treatment for fecal coliform of <= 36 inches. Distribution Cell Information 90.00 Dispersal Cell Length Along Contour (ft) = 6.67 Cell Width (ft) ~__ __1.00 Dispersal Cell Design Loading Rate (gpd/ft2) ~_ _ _ 1~ Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution ' Y _J Pressure Disribution Information network? Enter Y or N (c ore) ! e Center or End Manifold 3.33 Lateral Spacing (ft) If N above, enter the elevation (ft) j _______ 2 Number of Laterals of the highest point. ~_ ~._ __; __ 0.125 Orifice Diameter (in) (e.g. 0.25) ~_~ __2.00 Estimated Orifice Spacing (ft) = 6.67 ft2/orifice 2.00 Forcemain Diameter (in) _40.00 Forcemain Length (ft) Does the forcemain drain back? (,~Y ____, ____ 910_0) Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 6.92 Vertical Lift (ft) 1.15 Friction Loss (ft) 14.56 Total Dynamic Head (ft) 6.52 Forcemain Drainback (ga!) 81.15 5x Void Volume (gal) 87.67 Minimum Dose Volume (gal) 37.07 System Demand (gpm) Lateral Diameter S election in. dia. _ o tions choice 0.75 ~ ~ - 1.00 ---~__ -- ; ~ ~ 1.25 1.50 x ---_- z --- 2.00 x ~ __-- ----.. -- I 3.00 x ,"----~.__; Manifold Diameter Selection in. dia. o tions choice - 1.25 1.50 x I~_ -- x i x 2.00 3.00 ~-___. Gallons/Inch Calculator (optional) Treatment Tank Information I 800.64 Total Tank Capacity (gal) _.-- 1250.00 Septic T__ank Capacity (gal) ~_ _ 36.00 Total Working Liquid Depth (in) ,Wieser Concrete i Manufacturer 22.24 gal/in (enter result in cell 649) Dose Tank Information Effluent Filter Information 800.64 _ Dose Tank Capacity (gal) Zabel Filter Manufacturer _ 22.24 Dose Ta k Volume (gal/in) n -_ _ ~ A100 Filter Model Number _ _ _ ~WieserConcrete ;Manufacturer __ Project: Sam Miller 4 bedroom residential mound system Page 2 of 9 Mound Plan View 1 H 1.00 ft K 7.88 ft z 10.54 ft L 105.75 ft J 4.13ft W 21.34ft 1548.21 (ft2) Basal Area Available 9.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 100.04 (ft) - . ,a~ r.,.. G * H ~ ~..,. I F . • : ~ : ~ ~ ~~ ~ ~ 98.75 (ft) Lateral Dispersal Cell 98.25 (ft)~ Invert Dispersal Cell ~ ~ ~ ~' ~ ~ ~ Elevation E • ' D ~ ; ~; • 'i•]• i']']']•i•i•S~]~i'~] ] ] ]~i~ Shading Key 1Q ®Topsoil Cap Q ~~~~~ Subsoil Cap ASTM C33 Sand ~~~~~"`]`-]: Tilled Layer 05 Aggregate 1/10 B •. •observation Pipe '0' • • . ~~~' K ,.5 .~.~ .. .:I.:;. •B T Mound Component Dimensions -~ -+ _1 _l A 6.67 ft E 14.00 in B 90.00 ft F 9.50 in D 6.00 in G 0.50 ft 600.00 (ft2) Dispersal Cell Area 6.67 (gpd/ft) Linear Loading Rate 9' 10.0 % Site Slope ~ _~ . ~ Dispersal Cell a c c ~ 1.5 ft ,,,,,,,, ,, ,,,,,,,,,,,, ,,,, ,,, ~ ~ ~ . .~ e ~ d _~ v 0.5 ft ~ ti., '.'.Typical Lateral I ' ~ L F c . . . A 75 (ft) Contour Elevation Geotextile Fabric Cover See lateral details on Page 4 for number, size, and spacing of laterals. Laterals are equally spaced from the distribution cell's centerline in the distribution cell (AxB). Project: Sam Miller 4 bedroom residential mound system Page 3 of 9 i ` End Connection Lateral Layout Diagram Laterals centeredocvrtheA&Bdimension ~=Turn-up+m'ballvalve orcleanoutplug `I P All laterals are iOentical If- X-~ I Holes drilled on the bottom of the lateral I equally spaced S Force main connection via tee or cross to manifold at any point. Laterals & force main of PVC Sch 40 (per COMM Table 84.30.5) Number of Laterals 2 Lateral Diameter 1.50 in Lateral Length (P) 88.44 ft Lateral Spacing (S) 3.33 ft Lateral Flow Rate 18.54 gpm System Flow Rate 37.07 gpm Total Dynamic Head 14.56 ft Orifice Diameter Orifice Spacing (~ Orifices per Lateral Orifice Density Manifold Length Manifold Diameter Forcemain Velocity 0.125 in 2.01 ft 45 6.67 ft2/orifice 3.33 ft 1.50 in 3.79 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and -~-~- ~- Comm 16.28 WAC ~ 4 in. min. Disconnect Tank component is properly vented Wieser Concrete Ca acit 800.64 Volume 22.24 Manufacturer Gallons gal/inch Dimension Inches Gallons A 18.55 412.46 B 2.00 44.48 C D Total 5.45 10.00' 36.00 121.30 222.40 800.64 Alarm Manuafacturer ' LevelArm Alarm Model Number DLV __ A B C D ing under tank. Pump Manufacturer !Zoeller Pump Model Number!98 Pump Must Deliver 37.07 gpm at 14.56 ft TDH F- Alternate outlet location Forcemain diameter ~ 2 in. Weep hole or anti- siphon device P~ ump off elevation (ft) 91.83 Dose tank elevation (ft) ~- 91.00 Project: Sam Miller 4 bedroom residential mound system Page 4 of 9 Mound Svstem Maintenance and Operation Specifications 9 ~ y f POWTS Revudlator's Name i St Croix Counpts Zon ng Dep't _ i Phone'7715?386?46 0 { System Flow and Load Parameters Design Flow- Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow -Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1250 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Ta Effluent Fil Pump and Contrc Alai Pressure Syste Moui i(fl ~k Ins ect and/or service once eve 3 ears er Should ins ect and clean at least once eve 3 ears 'Is Test once eve 3 ears m Should test month) m Laterals should be flushed and ressure tested eve 1.5 ears td "' Inspect for ponding and seepage once every 3 years Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravify and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished .,.~~......... ............... Grade \ , 6-8" Diameter Lawn . . Threaded Cleanout Sprinkler Valve Box ~ ~ ~ ~ ~ Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Sam Miller 4 bedroom residential mound system Page 5 of 9 ~. ._ ~i~A~/CAF~A~IT~lr' ~U~V~ ._ __ y ~ ,__. HEAD CAPACITY CURVE ~i EFFLUENT MODELS - - --! 1-- - _- - ' ~ ! TOTAL DYNAMIC hIEAU/CAPgCIIY PER MIkL 7E I I "'-- '---1---~. -- ;-- - ~ EFFLilEN7 AND DEWATERINO - ~"--I-- ---~ - - -_-. -- _ -- - ---- - -- - - --- - I ~~~ _I ~ r i-. - -- _.'_ _ _.1_- _. --i--` h;EF ES --57,59^ 97 9tlm 1'.7179 1'i i 10.1 ~ 85 ._~(- 66 d5 ~ lud cs _,,_ - _ 1i _ _ _ _y_.~ ~T M. ' Gw lus ITd las Gd Crs La~. Gd. Lln r d..ln 1 ~7 Lr lvs ~. lr al „ Cr. _ I_ r ~> 1.52, 1] 15, 6 !12 Jx .77 IGI JB1 106 .401 .~BIT7 -61 y)I_ __ _--. .~f i~_ ~_, ' ~ ~ l-0 7.OG 7-1 I~6 17{ c1-271 7i 70.100 376 ~ 61 231 61 ?31 ~ 5,: ZIJ ,dAJ 151 5:: - _ _ _. _ ~.~ -I_ _ _ _ _ ___ 'S-4.57 IY T- _ IJJ r., 170 5. 21.1 91 744 t SJ <"27 _~.-.~_. _ __ - _~ Z'v 'a2 a, 14 aw ~'\. __..~___ _ -r -I__ _ ___ __ 6 15~T.$d Jv 1J< 82 510 5J 227 _80 ~. R7 ~ '- Sb xiV _ 75' S1C Iw: 5~. _ x _ 1r \~ -_ i ICI ~.5 7!F'._ _ _ _ 71 2n0 57 216 59 2'i! ~ :.t Z1 ~ J ae. IU 5:.7 -- 1 ~_ mac.. _ _r 1- 1- - -- ! a alb _^ _ _ l c6 z,a 1 S6 x-6, _SB 1~V r.O 7~C _.6 xdr .bl Iz--w1 -t _ -, - - - -r- -~- - - ' i °_ 1219 -- - - 46 a 71 so v ' sb a 1 ~zu_ :~ za; 1 a,- 39 . - ~ i 18L ~ ~ ,A -15.21 ~'~ - __._ - - __._._ __ti._._ - _ _ I F'--~-. _--._ __ ____ - I 21 ~ I,0 ~ U 1,;5 51 I9 E 'xli :f 2L~ 1 r ~. . I ~_._ _- _ 160 1&x9 ~ _ ___ - __^_7 ___ 6M1u> _u IB T ~_ ~__ 1 ~_ - \1 __ -f r --- --j-- i Jo xt^a~ - - - ~. _ w I11 c ,,e - 1r ,! ,~ 7c ,a; 6?'~ 5J 24.56 - '-- _ l 11 ~'1__. _ _ t]c i_ _.~ ~I ___ _ .. r -~- 47 27:aJ 1f ------- J: IY;~ ---ir)7 ;~) -- __ - I _ _. I~ ,9G 7Q 1b. - - - --I -~" ---- - --- - t- I: - I \ OS^ _- - - '- ...3200 _ -. -- _-_ }I}I -__ _ ._.__ _ - __._ _ 9 <5 :7.75' ~' ~~' _ 5t C6' 6) 7 ' I , - I _ _ ~ - ~ , _~ _ -~'_-- _ -_ -- EFFLUEiVT & dEWATERING _ _ _ _ _ Ids ~__ ~_ Warning: tv1odal 185 should no. ~e sub~ectea tl~ !e -- - - - 1 5 --- - than 30 feet TDH. _ __ 18~ "~~ r- ~-- - - -- - - - - - -- - - - Note: For Head Capacity on ,Model 1 12, industrial /ySG~~ ~~' __ - -- -- - - coiurnn-ex losion proof -- -T-t- - ~ -- -- P ( purrlE> ;ee Ft:1 21 ;. T L~. ~ ... 7 - - - I i - --Ilat; - - - - -- --, ,- - - --;-- ~-- -- --II-- - - -- _ :,:: a-. ~ ! ~~~151>fi' ~ I SEWRGE & DEWA~" i EF~ING - ~ ----r-- T--~--i-- ~aL~_on. _ ,- _ sc Eo~~o_so~~~ oo I ,o__~?,~ ~~0 1.0 ~~o .bo W/aRNING: MOdel 29~.? Stlu..lld nUl be ;Ubj+;Cl~d _:TE~,S a ,~ 210 ;z I,o Idl ,- SGJ »0 _ ~37,079.P.r+1, ~+,nfrn'a.h s~yoply ra~c-"~,Qcl. to less tnai,I 1~ ~~~ : TL~i. 0 2a ~- Ei ~~.----~-~_ - i_.--- i--- --~ - --- --- T07AL DYNAMIC h'EAD/CAPAC;ITY PER MINUTE ~ -~~~_ - _ ---, _ ~_ SENAGE ANO DEK'ATERIVG I ' - I SENIES x6x 268 207 x58 292 2d1 PP I 257 x,. ~ lJ ' __ __- _ ____ -___ _. - __ I~ --I _ >> >-- -~~- - _ FL _M Gal. LI s Gal Llrs Gal Urs -I. Llrs. Ga Urs C'a' Llrs, Gal Urs : Gal __Irs G I cr, r, I - __ ~ -_ __._ _ ___ __ _ _ d3 .,i - T_ _- ~ -- _ - 5 1 52 90 3a1 126 ada 128 48i_ _ 1 B a8< 13J +9._ 180 6dl Ii0 536 _ __- Ix s~ ~ - ~~_' ` -it r-- - - _ _ ._ __ Ic 3 0_ f 60 x27 tl9 707 B9 7J7 ~ t9 371 9- JG( _IStl 59b 127 aoS _ lel ~ ( - I 1- 1 5 I "2.5 d5 ,C t89 5J Itl9 J Ids 6 23E 135 511 J6 aJ1 I]0 +92 l05 0 F~ CG ~ i b .- i i ~~~ ~_ _- ~ _ __ -_ ~ 2C fi IC 16 3B U 3~ _ _.3 1b ~. 31 12_- IOo 101 dd J 3 I 5 $ 15C S ~ _ 6d c 1~ ~\ 2 7 ~ ~ -' - _- - - ~ - )fi 23d d T] II,t '0 - 13c 5 > 7 __ `~I x 9i _. -__ __. _.__- _~ __ - :: _ ___.- _--.r _ i -~ ~ ~ ~ __ __.._ .__. _. ` -_ _. aJ 1~ 17 I.B ril, X40 121 i~~. aJ 's. '~ E i _ -- _ r .__ iC 12 S I I _.._ _ _ _ '. ___ __ I s ~~)~ s .as s ). , _- --- - - _ sc Is z: 1- ~ --- - ---r- ___. _ _ - - 6L IB 25 5 1' c 3' - r~- - - ~ _- _ -_ If I _ _ _ I •- _ _. r--r 1---_ __ ._ - __ _. _- 21 i-. ~ . I i _ _-. 6-_ J ___~ _ _ .. _ _ 5J __l. , - L i I I -- I ~ I 2 ~~\I - ---~- -- - -i --- ---'-'-~----- ---~~ -I ---1 ~ -,- --- - - ---T -~-- - - ' j ~.. _ _ - - - -1-- ! _ _ I d - ~ -- - - ( ~ 799 -~~ ~~ 1 - - -- -- ; ~ -- T ---' -- ~__ - --- ----- -- -,--- -1 -f --- - -- I ~i 1 __ - -~~--17ez-~--- - - --I- - --r-,- ----, -~-- --- --,--- --- i ~ I ,c - t-_- __ -. --~ 7s2 - ~~-- 7 -, -~---- I I ---- - -- -- -- - ~ ~---- I ~~- __I-.- -zea 7 2es I I ~ ~ ! 782 766, 267, 76H -~- -- 784 1--- - - - G:.L' Chl IG .C 7) 40 SO oC hJ BO ~-r-~ 50 lOC' T1U 12) t30 130 1S0 167 170 t8u 19J 200 tJl TEryS ) -- _--_~,~ _~_-`--160 2t0_~ _- U~p ----40U 48U 58u 630 '2U E:) Y~BU ~~ , ~ o~ ~ Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code e eral This system shelf be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stets. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet fitter shall be cleaned as necessary to ensure proper operation. The fitter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the fitter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1 /3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank, The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pumo Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter Is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution Svstem No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L GODS, 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided wfth a flushing point at the end of each lateral, and tt is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is pertormed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Continaencv Ptan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced wfth a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Sam Miller 4 bedroom residential mound system Page 6 of 9 ~i.Q~ ~~ I proposal t,~7i escr' wLP ~4~8~D Co*-b~~ta~bn S.T./P. G ~/ e{~/l,~~i.L` F-~-- .J ats.T. owE-l.c.~. v- - i4/~ProK. ~o ca-fi'v~ ~ OT' C~,"ain49G"'~'~' 1 ~ 4req boccnclrU 1 / IO~,~~~G 1; 5y S~ tiT 0 S- ~, r1 ~ D~ ~1 l ?' d d~,_ n O ~ va p a 4.. ~ ` - 1 3~3. $g 1 ~ - E 0~~4 .e. • ~ -P It<iBkL+dr~n~ ho u~ 52 a Proposed 0o d. r; ve~.v0.y 1 ~ ~ - - 1 ~ Prgcnstd mo~.nd a-~ ~ - - ;s~~'Sa./Ce/% Two i - -- /e f er~c/S a~ /yam ~~.r 88. S!S~ 1 ~ ~ ~ a.t Z.S3.' ~v- '~ -~i 1 - - -~1 1 11 ` s: ~ - - (~ ~,~~1 4 ~ ~I-- • EX~S~^ 8i'ade e I¢vo-bfb~ ~ t Sca/ ¢ : / _ gyp, QQ~•~~8ss ~tio P/4~ off' ~q~/and ~4ec/~ ~.o~' Qmnan~ Sb.Crpit! C'oycJ/. ~i Plbpo3¢rol {,t)~!~ /OClaL~%GY! t i /J'~.3 ~d SEre e,>` Ib. /,S A1, : Teo o f e lec. (~'ra.+sF~r~n~, bo.u. E/ew ~ ro~.zz' Py. 80~' 9 U , ,. Wisconsin Department of Commerce Division of Safely and Buildings SOIL EVALUATION REPORT in ~Mnrrtnnec with r:nmm AS Wic Grim CMa 1855 Page 1 of 3 A.C.E. Soil & Site Evaluations ' Attach complete site plan on paper not less than 8'/ x 11 inches i i ~ n must County St. Croix include, but not limited to: vertical and horizontal reference point ( io d t Parcel I D a rest road. percent slope, scale or dimemsions, north arrow, and location and dis . . 0 8-2005-10-000 O Please p nn ~ Revi Date Personal information you provide may t~}l4acy L used s. 1 . )). ~ ~ ~S 15 S Property Owner Prope ovation Sam Miller ~~~ U 4 2~~4 Govt. Lot SW1/4 NW 1/4 S 31 T 29 NR 17 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# P.O. Box 151 ST. CROIX COUNTY 10 Plat Of Highland Ranch City Stat ~ City J Village ~ Town Nearest Road Hudson ~ WI 54016 (715) 386-2769 Hammond 153Rd St. & 66Th Ave. iV New Construction Use: ~ Residential !Number of bedrooms 3 Code derived design flow rate Replacement ~ Public or commercial -Describe: Parent material Glacial drift Flood plain elevation, if applicable General comments S'~ ¢.~ C~ ~ and recommendations: Install mound system at elev. 100.50' at 6" above 100.00' contour. 4n 1~S 450 GPD na ~ ' l Boring # ~ Baring 1/ Pit Ground Surface elev. 100.25 ft . Depth to limfting factor 38~~ in• Soil Appligtion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 `Eff#2 1 0-9 10yr3/3 none sil 2fsbk mvfr as 2f,1m 0.6 0.8 2 9-19 10yr5/4 none sil 2fsbk mvfr cs 2f,1m 0.6 0.8 3 19-28 7.5yr4/6 none Is Osg ml cw 1f 0.7 1.6 4 28-38 10yr6/8 none s Osg dl cw 1 f 0.7 1.6 5 38-80 10yr4/4 f2f 7.5yr5/8 Ifs Osg dl - - 0.5 1.0 Boring # :~:~ Boring If Pit Ground Surface elev. 99.70 ft. Depth to limiting factor 34" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP Dlft~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 "Eff#2 1 0-8 10yr3/2 none sil 2fsbk mfr as 2f,1m 0.6 1.0 2 8-14 10yr4/4 none rls & co 2fsbk mvfr cs 1fm 0.4 0.6 3 14-26 10yr5/6 none gr s Osg dl gs 1f 0.7 1.6 4 26-34 10yr4/4 none Is/scl Osg/2msbk dUdsh gi 1f 0.4 0.6 5 34-47 10yr8/2 f2d 7.5yr5/8 L.S. B. R. na na - 1f na na Horizon #4 consists of an irregular, disco uous mixture f soils indicated. Horizon #5 contains >50% limestone fragements. Fragements are 7' - 4" X 1/2" t 'ck with Is/scl mix between fragements. "Effluent #1 = BOD ~ 30 <_ 220 mg/L d TSS >30 < 150 /L (fluent #2 = BOD < 30 mg/L and TSS <30 mg/L CST Name (Please Print) Signature CST Number James K. Thompson ~~ 3602 Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number sen Par dsnn I aka I anw nsrxnia i .rd09n 10/12/2004 715-248-7767 Property Owner 5arr- Miller Parcel ID # 018-2005-10-000 Page 2 of 3 n Boring # Boring 1 ~ I Y^f Pit Ground Surface elev. 96.75 ft. Depth to limiting factor >52" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots / in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-9 10yr3/3 none sil 2fsbk mvfr as 2f,1 m 0.6 0.8 2 9-16 7.5yr4/6 none sicl 2fsbk mvfr cs 1fm 0.4 0.6 3 16-30 7.5yr4/6 none grls/sl Osg/1msbk mUmfr cw 1f 0.4 0.7 4 30-40 10yr4/4 none gr Is Osg dl gw - 0.7 1.6 5 40-52 10yr5/6 none s Osg dl - - 0.7 1.6 Horizon #3 consists of an irregular, discontinuous mixture of soils indicated. ^ Boring # _.~ Boring _J Pit Ground Surtace elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ^ Boring # ~ Boring J Pit Ground Surtace elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Descripiion Texture Structure Consistence Boundary Roots P /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 ~ 150 mg/L * Effluent #2 = BODS<30 mg/L and TSS <30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please wntact the department at 608-266-3151 or TTY 608-264-8777. os' 0 s ~. `~ o ®o A ~ 1 1 $~ 1 ~ ~ 1 1 ~ ' 9~9 y6• ~ ~ ~ 1 .4/~P~oX, /o co.~•'~ 4 OF dra~.,a9c.,-~ ~ ~' 1 ~ ~ are4 bo~.cndrU ~ ~ / ~ 10~,51op~~ ~ i1 X99.99' two ~3 ~ 5y s fy,Ka~ i i ~~ ~ ~ ~ ~ ~ ~ ~ ~ o ~ ~~,oo' ` ~ 4i o ~ 3~3. $~~ ~~~N .e. • v -P Assu~nr~lelev. _ /QO.cn.~ /1 ~ i~k6or~ n~ ho k ~e. ~,C/Sti~rsy 8i^adc e 1 e/a6~6n ,QQ~Mess.c~t~o ~/Qf of f~i / /and ,Pun uL/ 7n , o ~' /s.~ '~Ld Sire CL, O Ib.iS.M.~ TPofelee, ~~a..iSFN"~nc~ bust. ~/ev.` ~ io~.zz_' P9.30{'.3 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHII' CERTIFICATION FORM `?Z ~lsm ~ /~~~os~~ ~~ Owner/Buyer Mailing Address a ~ /r ~ S ~ ~~ ~So '~ !.~ ~ S ~° ~'~ Property Address ~o ~ 0 ~ S3 ~ a ~-C.~ (Verification required from Planning Department for new City/State f~4,~, wlo h~ W ! Parcel Identification Number LEGAL DESCRIPTION ~/',, •y36 Property Location sW `/., ~ `/., Sec. 3 ~ . T2 ~ N-R~_~~ ,~,~V~~'Town of ~'~4 ti14 wt D K~. Subdivision ~ ~ S ~- < <+- N. ~. ~ ~ ~ ~ ~ .Lot # ~ D Certified Survey Map # 7 3 7 d 7~ ,Volume Page # S Z W n D # 7 ~ ~ ~ 9 Volume Z S $ Page # ~ Z- U~ ~ D~~r~ ~~o~ S3~ Spec house yes ^ no D Lot lines identifiable ~ yes ^ no SYSTEM MAINTENANCE 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. The property owner agrees to submit to St. Croix Zoning Department a certif cation form, signed by the owner and by a masterplumber, journeyman plumber, restrictedplumber or a licensedpumper vcrifyingthat (1) the on-site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. ~ ~ ~ / ~~ O .~ t;NAT1JRE LICANT DATE OWNER CERTIFICATION 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 roperty descn'bed above, by virtue of a warranty deed recorded in Register of Deeds Office. AT(JRE F LICANT DATE s««•** Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. *****"` *• Include vrlth this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed .u: 27oyP say ` STATE BAR OF WISCONSM FORM 3 - 2000 Document Number QUIT CLAIM DEED This Deed, made between Sam E. Miller, a single person Grantor,. and Miller Homes of Hudson, LLC, a Wisconsin Limited Liability Company Grantee. Grantor quit claims to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Lot 10, Highland Ranch, Town of Hammond, St. Croix County, Wisconsin Area 7'61 156 REGISTER OF DEEDS ST. CROIX CO. , NI RECEIVED FOR RECORD 11/29!20@4 03:45PI[ QUIT CLAII( DEED EXElB1T # 15S REC FEE; 11.00 TRANS FEE: COPY FEE: CC FEE: PAGES: 1 Heywood, Cari & Anderson, S.C. 816 Dominion Drive, Suite 100 P.O. Box 12S Hudson, WI 54016 018-2005-10-000 Parcel Identification Ntanber (PIN) This homestead property. (is) (is not) Together with all appurtenant rights, title and interests. Dated this ~ ~~ day of November e AUTHENTICATION Signature(s) Sam E. Miller authenticated this day of November , 2004 r 2004 / _ `p ~ a~~ "` Sam E. Miller s ACIQKOWLEDGMENT STATE OF WISCONSIN ) ss. ST. CROIX County ) Personally came before me this ~~~ day of November , 2004 the above named Sam E. Miller TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person(s) w authorized by § 706.06, Wis. Stats.) instrument and acjcno dged the ; ~~ . THIS INSTRUMENT WAS DRAFTED BY - X1/1 ~ (~it~ ~L. L , Heywood, Cari & Anderson, S.C., 816 Dominion Drive, Suite 100 Notary Public, State of WI,SCON P.O. Box 125, Hudson, WI 54016 My Commission is permanent. (~' (Signatures may be authenticated or acknowledged. Both are not necessary.) ~ ~~ ~ - *Names of persons signing in any capacity must be typed or printed below their signature. STATE BAR OF WISCONSW QUIT CLAIM DEED FORM No. 3 - 2000 INFO-PRO . ~ ' the foregoing 4~p1~IM/,,,,, ~r w !y . ~ ~ •• ~s .- ,,.1 ; ~y-s c~'ra~on te~• r O , ' `1_2587 ~' 62~ 7tS~.699 KATHLEEN H. MALSH STATE BAR OF WIS(:ONSIN FORM 2 - 2000 REGISTER OF DEEDS Dot;ument Number WARRANTY-DEED ST. CROIX CO. , WI RECEIYED FOR RECORD This Deed, made between Bruce J. Moll and Thomas S. Aaby - 06/03/2004 10:30AK MARRAKTY DEED - EXE1'PT # Grantor, and Sam E. Miller, a single person _ REC FEE: 11.08 TRANS FEE: 792.00 ' COPY FEE: --- - CC FEE -~ _ PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin 'f more space is needed, please attach addendum:) Lots 4, 5, 6, 7, 8, 9, 'an 10, P t of Highland Ranch in the Town of Hammond, St. Croix oun ,Wisconsin. i. ~' F Exceptions to warranties: Easements and restrictions of record. Area Name and Return Address F~=c 6 018-I069-00-400 Parcel Identification Number (PIN) This is not homestead property. 6i~ (is not) Dated this ~ day of , 2004 AUTHENTICATION Signature(s) authenticated this_ day of , TITLE: MEMBER STATE BAR OF WISCBT (If not, ~` -~ authorized by § 706.06, Wis. Stats.? Q, .r THIS INSTRUMENT WAS Dlc"~E Thomas A. McCormack ~,~ l~ Baldwin, WI 54002 ~~i , (Signatures may be authenticated or acknowledged. Bot q etc .~ tf1 X O U - * Bruce J. A ---- ._ * Thomas S. Aaby ~- ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. St. Croix County ) [Y rsonally came before me this ~~ day of 2004 the above named Br J. Moll and Thomas S. Aaby __._. tom no be the person(s) in ru t acknowledQed~ Notary Public, State of My Commission is pen ,nt. ([f not, state expiration date: ~- ,,~•) \~ ' Names of persons signing in any capacity must be typed or printed below their signature. ' WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 2 - 2000 1NF0-PRO (800)655.2021 www.infoproforms.com Parcel #: 018-2005-10-000 Category 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 * MILLER HOMES OF HUDSON LLC MILLER HOMES OF HUDSON LLC 868 KELLY RD HUDSON WI 54016 Districts: SC =School SP =Special Property Address(es): * =Primary Type Dist # Description " 660 153RD ST r/ SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 1.970 Plat: 2089-HIGHLAND RANCH LTS 1/13 018/03 SEC 31 T29N R17W PT SW NW HIGHLAND RANCH Block/Condo Bldg: LOT 10 LOT 10 1 970 . ( AC) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 31-29N-17W SW NW Notes: Parcel History: Date Doc # Vol/Page Type 11 /29/2004 781156 2704/534 QC 06/03/2004 764699 2587/624 WD 08/22/2003 737073 9/82 PLAT 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 57050 30,800 Valuations: Last Changed: 07/15/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.970 25,800 0 25,800 NO Totals for 2004: General Property 1.970 25,800 0 25,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code 02115/2005 03:59 PM PAGE 1 OF 1 Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 r ~,S'h~~4iy+~ ~~~/~~aPOWTS OWNER'S MANUAL & MANAGEMENT PLAN Page ~ n,~ v ,~E INFORMATION /~/f cif -- - Permit p ~Y' ~ ~ /~ DESIGN PARAMETERS Number of Bedrooms ^ NA :Number of Public Facility Units NA Estimated flow (average) ~0 al/da Design flow (peakl, (Estimated x 1.51 ~, O O al/da Soil Application Rate ~ !'1~ al/da /tt~ Standard Influent/Effluent Quality Monthly average' Fats, Oil & Grease (FOG) 530 mg/L B~cchemical Oxygen Demand (BODE) 5220 mg/L ^ NA Total Suspended Solids (TSS) x150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BODE) S30 mg/L Total Suspended Solids (TSSI s30 mg/L ^ NA Fecal Coliform (geometric mean) 5104 cfu/100m1 Max mum Effluent Particle Size Y8 in die. ^ NA Other ^ NA ''values typical for domestic wastewater and septic tank effluent. SYSTEM SPECIFICATIONS Septic Tank Capacity ~ Z,SO ~pd al G '~:- Septic Tank Manufacturer wC.l S ~- ^ N:. ~ Effluent Filter Manufacturer 2rQ g E ^ N:. Effluent Filter Model ~} - ~ 00 C N:; Pump Tank Capacity pd al ~ NA Pump Tank Manufacturer ~~~ s M/ ~ NA Pump Manufacturer ZO ~~~ r 9g ~ NA Pump Model /$ /~ ~j ~ ~ NA Pretreatment Unit I~NA ^ Sand/Gravel Filter ^ Peat Filter ^ Mechanical Aeration ^ Wetland ~ ^ Disinfection ^ Other: Dispersal Cell(s) G ~~%^ In-Ground (gravity) ^ In-Ground (pressurized; L At•Grade Mound ~' I ^ Drip-Line ^ Other: I a Other. r, NA ~ Other C, NA a Other. ^ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tanklsl At least once every: ^ monthlsl (Maximum 3 year(l ear(s) C N~ Pump out contents of tanklsl When combined sludge and scum equals one-third (Y~1 of tank volume G f~A inspect dispersal cell(sl At least once every: ^ month(s) IMax3mum 3 years) 3 ^ year(s) ~ NA Clean effluent fiher At least once every: ^ monthlsl / - '~- jg ear(sl ~, N,: ~ Inspect pump, pump controls & alarm At least once every: ^monthlsl. ,. ^ yearlsl G ~, Flusr; laterals and pressure test At least once every: ~ ^monthlsl ^ year(s) - r~:, other At least once every: ^ month(s) ^ year(s1 C, N;, O;her 1 i/ h MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certificarcns Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator, Tanti inspections must include a visual inspection of the tanklsl 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 celllsl shall be visually inspected to check the effluent levels in the observation pipes and to check for any pond~n 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,I or more of the tank volume, the entire ccntents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR t 13 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. ~'1 ';'~' UP AND OPERA`rION Page ?' of Z - - F'or 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 celllsl, 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 celllsl and may result in the backup or surface discharge of effluent, To avoid this situation have the contents 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 1 5 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain lump 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 permanently 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 POWT fails and cannot be repaired the following measures have been, or.must be taken, to provide a code compliant replaceme system: ~~~,, ,,, 1 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. / f~ T rJ/r al a a o mg ank . fZO+-(1817Eb ~'or2 N cl~ o~ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < < WARNING > > SEPTIC, PUMP AND OTHER TREATM ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE 0 oA PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER Name /~ ~ 1~ ~ ~ LCD Phone ` ~ ,~ SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Phone This document was draft d POWTS MAINTAINER Name Phone Name s C ~ d ZD~(~ Phone ~/S_ 3S/~_ ~ e ~n compliance with Chapter Comm 83.22(21(bllti(dl&(f) and 83.54(11, {2) & (3), Wisconsin Administrative Code. ~ .. i /~" . ~ ~ .i ~. . ~ ~ _. ~ to , .Z... ~.__-___ ..... ~. ATION -• .995' .. ~ •T ~... , . . y'.. ~ ~~ . ACRD'-..=:~~-~, ...... ... •~`:.... ~ .' , ....... :%....... .../. ~~ T`j~' ~`. `~.•fi • ...~.~~ .......r. '.... \~'• ~~ R gs _ ... 1= ~.3 F2'~, .' .. ~ ....' \ .`.'~ • 3.90 ACRES. • ...... ..... • .. , MW ...... , . ~ ..... . • 169',840'SD •, FT ' . • ~ ,i ' '~ ~2°55'23•E 213.3T J Ngq°50'01•E 18` •OT `~re ~ ' . • • • HyVE'= 992.00' . ~. - - ~! S6,, ~ .. a.5q'4l•.E~ '•~ ~` BENCHMARK ~ ~ 5-- Z ~ S ~c\ • :. ' . ~ . . ' N~ •. ~' ' •',' .. ~ o ELEV. =999.19 j EVATION = 9~ j ~ N ~ ~j~/Q,. ~ . ° rn ) °~' ~\c'~ . ~ Ep,SEMf~ .. ;4~ N 89°48'25' W ~1_~ - - - -- 26.5.00' ~. `~`~ C6 . .~ ._+. .24'-- • - 1 ' 7 ~ - ~~ BENCHMARK ~ ~ _ ''~ '~ ~ ~ , EgFV CH 100017 ., ' c ,s:V. i 001.35 ~4 .- _ %, ~ ,r ~~ _ - _~ 89°48'25= 292.05_ - -~I-~ ~ - -1 r~ \~ DRAII~L - .. '' - ~ • . • ~~ . .. ... ~~ LOT 1 O ~ ~ ~ , `, ~ ` 4z ,~ ~.,. ..•,..,, •• ~ Z ----- -- . CQ~ ~ .. . _ " ~ . S (~ ~ ' •',' •' . • . • ... ~ 1.97 ACRES I ~ ~ I L .' • 1 ~ ~ ~~ ' ~ . , .. ~ ~ 85,843 SO. Ff . `, ~~ 1 C'- •~ `C . ~ ... • ... ~ F-INVE = 997.00' ~ s ~ 681 11 ~ ~ , ~~ .. `' ' ...... ~ ATION = 1000 ~ \ , . , , .. ~ • .. LBO•ELE1/ C3 ~ HWE ~ 1.75 ACRES ~ • • ~ p '. 1 ~~ \ C6 ~LE30 I ~ N 76298 SD. FT. s .. ~ , BENCHMARK 0 .\ \ ~ ' . ~...... • • ~ ~ 100'106 N HWE = 996.00' I .... p • • ~ . • , ' , ' • . . ~ ELEV. _ ~ ~ LBO ELEVATION =999 , ~ ~ ~ ' ' ' .. .. .' . •E~ 343• ®~ i ~, ~ \ ' BENCHMARK ~ . ~ ~ ELEV. = 1012.85 I . ' ~ . . . . ~ S 89°48'25" E 311.62' ~ ~ 3 r,~ ~fr~, ~ $ ~ ... ,LOT. ,9~.' ; \ ~' ~ I S ~ ~ ~ ' :'r.' .......... ~ LOT ~ ~ I I . a6. 2.80 ACRES ' ~ BENCHMARK ~~.. I '`' '. 100852 O / --- _S 89°48'25' E68.00 I • W 121,777 3G1,'F'T: ~ ELEV. _ , / I' I ' r. -.100 ~ .1.55 ACRES -• I -- • •~ . ~ ° . "' , ~ ATION. ~ 1005 .~ 67,711 S0. FT• I ' . ' LE~O.ELE~! • . ~ N r "•Z ........... ~ ... ~ HWE = 1000.00' I . • .. ' ~n I I .. •~U LBO ELEVATION - 1003 I " .: ' . • ... ; • ~ • . ~ • • . ' . ' • ~ ~ / S ., r ~, ... ., .. .. I ^d I S 89°48'25' E 311.02' I ~ ~. ' • .' ~ . ' .' ~ ' .'~ ~~ ~. ,~. 1 . r . ~ • rf LOT 2.92 ACRES ~ ' • ' ' 2 1.62 ACRES 70,436 S0. Ff. 126,999 SCI. FT. ........ , . 1004.00' HWE = 1001.00' \°~~ ~~~\ HWE _ LBO ELEVATION = 1 ~ ' ~ ' ~ ' ' • ~ LBO ELEVATION = 1007 • ~ ~. - 3 wiswnsn Department of Commerce SOIL EVALUATION REPORT Page ~ ~ Division of Safety and Buildings in a~ordance wim ~ ` : ,"" °°"' .~ . C'rU Attach complete si6e plan on t not less man 81/2 x ~ ~ • ~ 3r~.l~lan must include. but not Ikrdbed to. vertical and horizontal reference (BM), directlon and ~aroe! ID. pert~rit sbpe, scale or dimensions, twRh arrow. and location nil dtsteric~ to.nea~re~t~f. s Date Please print aif infiprmation ,' "~,~~f p. ~ evtewed by Personal information You pmvida may ba uae0 for saeondarY t~ (PrivacY•Law~a.,l;.~'!t) im),)7 Property Owner Z~ , , / Govt Lot ~ 114 ,(1(.~J114 S ~ ( T Z ~ N R ~ ~- E (or~ ~r~c-e cs l ~ property Owners Mailing Address Lot # 81odc # Subd. Name ar CSM# D v ~ rlU I^ a ~a /tC ~1 C;ty state Zip code phone Number ^ city [) Viga9Q f~ Tawr- Nearest Road 57 ~ I ~x m yv~oilt~ w l S~~ 5 ( ~ ) 74 ,._5 ~q( 1 U`~`1~h ~¢ New Construction Use: ~ Residential ! Number of bedrooms 3 -~.- ~e derived design flow ram _ L~~Q C~ GPD ^ Replacement Public or cornmercisl - Describe: ~~~ ~ Parent material ~ ~ J~~ 5 ~ __ Food Plain elevation d applicable Gy / General comments . S S{,,gym 2 Ie U ~ -~o ~ ~r P /~ch q' S, OO Low ~~Qy• So ~~-~.~ ~ / ~` / and recommendations. ~ ~~~%F `~ / ~~r- ~j~ ~p O, cf 1 I I ~~9 # ~ ~g n~.....a .,.:.~.,..s a1~ Y ~. 2~ R_ Death to limitlti3 ~r ~D ~ e..a e~Knn RaMr i ~ Horan Z .T Depfh in. -zl l-~ . rn ----- Dominant Color Mansell v -- - - Redox Destxiption (1u. Sz. Conl Cobr -- Texture rcl Strutxure Gr. Sz. 5h. ~ o Cons~tence ~ r 1 Boundary ~ ~-- Roots l~l' _ GP 'Eff#1 '`~ DIIt= 'Eff#2 `~ ~Z ' EAklertt fit= BOU > 3U C zzp mgR aria t ~ you ~ f ~, rrryn. ............._ _ _ __~ _ _ _ CST Name (Please ) --~ rCST Nurtdrer J d ~~ Date Evabration Conducted Telephone Number x-113 ~~~5=~!-~~~,~s ~ -/3 -off 7~s-~~d-~z ~~ U Boring ~ Boring # ® Pit Ground surface elev. ~ ~~ ~ _ Horizon Depth. Dominant Color Redox Description in. Mansell Du. Sz. Conl Cobr I 6-/~ ~1 Z ~ Z ~ L~ ~- in. R. Depm b fimittng factor ~Qi Texture Structure Consistent Boundary Gr. Sz. Sh. Si ` _ r CS S~~I /~ C S QS ~ ~ Roots - .. g~ lion Rate GPD/ttiz 'Efl#1 'Eff#2 ~ S ' L `~ lam- lz ..n e..A TCQ ~ '~Il enr,fl P. ' ,. C) ~ ~ Parcel ID # _ / CJ-f- ~~~ _~-- Page _~~ ~ ~_ property Owner _ ~ goring Z ~. Bas+9 # [~ Groretd surface elev. ~ 0 ft. Depth to ~t9 >~ ~ - Soi Rat Pit ~~ Depth ~~ Cobr Redox Texdue Structure Consistence Boundary Roots GPDIIEr Gr. Sz. Sh. 'Eff#1 ~~ in. MatseN flu. Sz. Cant Cobr _~ 31Z _ ~~l -7~s c~ 1~~' ~~ ~ _` ` a Boring # ^ Boring -- ^Pit Ground surfarx3 elev. ft. Depth to fxnitir-g factior in. Sod Rate Horan Depth Dominant Color Redox Description Texture Srudure Consistence Boundary Roots GPD/fP `Etf#1 'Eff#2 ~. Messed 4u. Sz. Copt Cobr Gr. Sz Sh. ^ firing # [~ Boring Ground surface elev. R Depth to Im~iting factor in. ^ Pit ~~ ~~ Rate Horizon Depth Dominant Color Redox Deauiption Texture Structure Consistence Boundary Roots GPDIIt? Gr_ Sz. Sh. 'Eff#t 'Eft#2 ~. Mme{ t1u. Sz. Cart Cobr ' Effluent #1 = BODS> 30 < 220 mglL and TSS >30 < 150 mglL 'Effluent #2 =GODS <_ 30 mglL and TSS <_ 30 mgfL The Department of Commerce is an equal opportunity setvtce provider and employer. If you need assistance to access services or need material in as alternate format, Please contact the department at 608-266-3151 or TTY 608-264-8777_ SBD-Y33O1R.07/IXII PAGE~OF~ ~Tt~A;F ~ ~ ~' LOT# /~ LEGAL DFSCRTPTION ScA~ ~.U~ ~ S 3 ~ T Z~ .N.R. 1 ~E(or~ ~i 3 rR SIGNA gmZ DATE ~ " /.-~= c•3