HomeMy WebLinkAbout020-1483-05-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County. St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
572897 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: Village X Township Parcel Tax No:
City
Waldschmidt Travis Hudson, Town of 020-1483-05-000
CST BM Elev: Insp.BM Elev: BM Description: Section/rown/Range/Map No:
657- 16.29.19.3074
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER �, � CAPACITY STATION BS HI FS ELEV.
i
Septic 7.• l Benchmark
Alt.BM
Aeration Bldg.Sewer 7. 1 1#
Holding St/Ht Inlet
�•$ 3
TANK SETBACK INFORMATION St/Ht Outlet
TANK TO P/L WELL BLDG. ent Air 19take ROAD Dt Inlet
ljoJ�. ,jdt
Septic �n _ z4 $I � Dt Bottom
Dosing �T Header/Man. g 3
93 •Z
Aeratio Dist.Pipe g• 3 '73
' 2
S. 5 9
Holding Bot.System 9• 3 4Z•Z
9. 5 4
PUMPISIPHON INFORMATION Final Grade q, d 7 7
Manufacturer GP Demand St Cover /,I J� Z • Coq
Model Number F° r
TDH Li Friction Loss System He TDH Ft
Forcemain Lengt ia. Dist.to well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No.Of Trenches PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth
DIMENSIONS 3 �'
SETBACK SYSTEM TO `+P/L JBLDG WELL LAKE/STREAM LEACHING Manuf ct re
INFORMATION CHAMBER OR T-X
Type Of System: nn 90 ,� /n UNIT Model umbe: �/
Co��e +a ,S S /VAT � 0 � !t5
DISTRIBUTION SYSTEM L k61--o r✓- orb jA , 4 4--1(o = 3 Z--
HeaderMlaanifolld J Distribution x Hole Size x Hole Spacing Ivent t Air Int ke
�_ Pipe(s) (,�e b�- S
Length Dia Length Dia Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over xx Depth of xx Seeded/ dded xx M ed
Bed/Trench Center Bed/Trench Edges Topsoil "I-, Yes Ej No
COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: / ! Inspection#2:
Location: 982 McDonald Lane Hudson,WI 54016(NE 1/4 NW 1/4 16 T29N R1 9W) South Willow Acres Lot 5 Parcel No: 16.29.19.3074
1.)Alt BM Description= �r G6J�`r G��.'M L
2.)Bldg sewer length= 2� 5 6 ;,� Sa••-� S
-amount of cover= /
Plan revision Required? ® Yes No 4
Use other side for additional information. ?'q —
Date Insepctor's hatur Cert.No.
SBO-6710(R.3/97)
PLOT PLAN 'i
PROJECT Travis Waldschmidt ADDRESS 476 Ctv RD A Hudson Wi 54016
NE 1/4 NW 1/4S 16 /T 29 N/R 19 W TOWN Hudson CO TY ST.CROIX
SYSTEM ELEVATION 91.9/91.8' 6' below qrade 3/31/15 BEDROOM 3
DATE _
CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK
1000 gallons LIFT TANK SIZE DOSE TANK SIZE
MOUND SEPTIC TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32
k BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter BEAR Filter
BOREHOLE (D WELL *H.R.P. Same as Benchmark
All piping shall be SDR 30/34,within 10'
of tank,piping shall be Schedule 40. B-1 Scale = 1 /4" = 10'
to be>5' below grade
30' 30'
70' 40' 40' Property Line
10' 0' B.M.*
B-3
B-4 So'
' 1%Slope
2-3' X 66' cells with>3' spacing
B-2 Vents
10'
McDonald Lane
25' Scale is 1" = 40'
unless otherwise
noted
Pro 3
Bedroom Propety Line
House
Vent
>6„ Quick4 Standard
of Caver Leaching Chamber
with 20.0 ft2 of Area
5.6ft^2/pair of end caps
12"
4' Long Grade at System Elevation
3411
��m at'�r _ (49 . .. County I
r 1 `l•,®� c, Safety and Buildings Division CS+•( fe0 OC
Q A ��4.. 201 W.Washington Ave.,P.O.Box 7162 Sanitary Permit Number(to be filled in by Co.)
T ' , r ��Qe� Madison,Wi 53707-716
`4\a\
\ Q �0,e,, ., = 572 8 I
• State Transacti umber
.tt,cQ nitary Permit Application
In accordance with 3piS„ 1(2),Wis.Adm.Code,submission of this form to the appropriate governmental unit
is required prior to oillitkling a sanitary permit. Note:Application forms for state-owned POWTS are submitted to Project Address(if different than mailing address)
the Department of and Professional Servies. Personal information you provide may be used for secondary
purposes in accordance with the Privacy Law,s,15.04(1)(m),Stats. l
I. Application Information-Please Print All Information F2.- 1LLC n a
Property Owner's Name I Parcel
I` 1 S tuo.,_,(c , SCkM.i r 16ZD - l 433- c S —z
Property Owner's Mailing Address Property Location
(1. 36-74
'/-7 6 C f Govt.Lot /
City,State / Zip Code I Phone Number NE ;,, /, Section 6
..
/4,1)4_,--, (-�l1 , , e Z 9 / (circle•• e
II.Type of Building(check all that apply) , Lot# T N;/12 :or W
Subdivision N
" -nr.2FamilyDwelling-Number ofBedrroLoo n
/ Ok C d 21ock it —5- L42/1/9-(4././L�
❑Public/Commercial-Describe Use
El City of
. ❑State Owned--Describe Use CSM Number l ❑Village of
'il4wn of
2- b,'Isi- Ce.a6-77,-) it9+460 (litawl,e-Cs------eC4C.t,
III.Type of Permit: (Check only onk box on line A. Complete line B if applicable) ZQ^IL-- X
A. eve System ❑Replacement System El Treatment/Holding Tank Replacement Only 1 Li Other Modification to Existing System(explain)
r ' I
B. ❑Permit Renewal ❑Permit Revision I ❑Change of Plumber CI Permit Transfer to New List Previous Permit Number and Date Issued
4 Before Expiration . Owner
IV.Type of POWTS System/Component/Device: (Check all that apply) i - - !OA); �
Non-Pressurized In-Ground ❑Pressurized In-Ground CI At-Grade ❑ Mound>24 in.of suitable soil ❑Mound<24 in.of suitable soil
❑Hol• g Tank ❑Other Dispersal Component(explain) ❑Pretreatment Device(ex, ain _
V.Dispersal/Trea ent Area Information: G . '- . i j
Design Flow(gpd) Design Soil Application te(gpdsf) Dispersal Area Required(sf)/ I Dispersal Area Propo• d ' System El bation
9
J , 44- B-Z.
VI.Tank Info Capacity in Total 4 of Manufacturer u
Gallons Gallons Units
o v
1 m o J
v
I New Tanks xisting Tanks a
&2A J n v n v
Septic or Holding Tank j V / i�Y —sr tw
Dosing Chamber '
VII.Responsibility Statement-1,the undersigned,, ��a responsibility for installation of the POWTS shown on the attached plans.
P is Name(Print) PI s Signature MP/MPRS Number I Business Phone her
Plumber's Address(Street,CI ;State,Zip Cod 1
3 Z 7--o i S/. Q.c_,<./ VI , ) 3 , / i
-,unty/Department Use Only ,
Approved I - ••rsappr. Permit Fee Date las ed Issuing Ag/nature • / i
II en Reason for Denial `I �• .� `�_
IX.Condi''.,. . 1Y••lr'rl1 •"easons.for Disapproval 3 J�t J, �' • " ••• rovi.(, AQ '�`'I. 'Septic ank,effluent filter and 6o�w (� ( i
dispersal cell must all tag servFc9s I maintained W I 1 y (AAA, 44. ,it,g r^^.4) •k CP L,
. as per management plan provided by plumber. d-tMD
2. AO-setSak yequirements must ber:rpaintained ,t it.:‘,.... ,/
as per appllcabie`codei/ordinance;. 7, ��a 15 W t. S ! `a 2a.n∎1'J
Attach to complete plans for the system and submit to the C ty only/ ,ffJ-paper not less than 8 io z 11 inches in size j
SBD-6398(R. 11/11) 5 j;641.46? ti I t,J l tes4)4"--
`5 t
' er/
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 3/31/15
Tr Travis W I hmi
Owner: a a dsc t d
Location: NE1/4 NW1/4 S16 T29N,R19 982 McDonald Lane Hudson
Manuals Used: In-ground absorbtion system (version 2.0)
Page#
1. Cover Page
2. Plot Plan
3. Chamber Cross Section
4-6. Maintanance and Contingency Plan
7. Filter Specifications ��'eet
/ 1
/t
Signature / r ib,
License n - • -r#226900
PLOT PLAN
PROJECT Travis Waldschmidt ADDRESS 476 Ctv RD A Hudson Wi 54016
NE 1/4 NW 1/4S 16 /T 29 N/R 19 W TOWN Hudson COUNTY ST.CROIX
SYSTEM ELEVATION 91.9/91.8' 6' below grade 3/31/15 3
BEDROOM
DATE
CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32
hi BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter BEAR Filter
❑ BOREHOLE O WELL *H.R.P. Same as Benchmark
All piping shall be SDR 30/34,within 10'
of tank,piping shall be Schedule 40.
B-1 Scale = 1 44" = 1
to be>5' below grade
30' 30'
B.M.*
70' 40' 40' Pro pert Line
10' Vents 0' A
B-4 III 50' • B3
2-3' X 66' cells with>3' spacing
1% Slope
B-2 Scale is 1" = 40'
unless otherwise
201 noted
Propety Line ST
15'
McDonald Lane
Pro 3
Bedroom
House
ao Vent
>6" Quick4 Standard
of Cover Leaching Chamber
with 20.0 ft2 of Area
V 5.6ft^2/pair of end caps
4' Long
3 4" Grade at System Elevation
Cross Section of Infiltrator Quick 4 Leaching Chamber
Typical cross section for 2 of 2 cells
Quick 4 Standard Leaching Chamber
with 20.0 ft2 of Area per Chamber
5.6ft^2 pair of end plates To be >1' above grade
Finish grade elevation
Typical Installation 97.9'
Vent I Grade 414. OVent
3'1 4" 3'
• X30/34 Septic Tank
Long 1„ 5' 5 Long 1„
5' Lon Grade at System Elevation
3 6" Grade at System Elevation
Spacing 5'
2-3' X 66' ' Cells
Same on other end Observation tubeNent
At end of cell
A
16 chambers per cell
System elevations:
A_91.9'
B 91.8'
ST, CROIX COUNTY
SEPTIC TANK IVIAINTENANCE .i .GREEIVIENT
AND
OWNERSHIP CERTIFICATIGN FORM
------, ,
,
_ ___... _.. ...._......... _
Mailing Address V7,4
---------_
Property Address mc 0 v „„a
... ............._. ..
(Verification required from Planning& Zoning Depaitinent for new construction.)
11 Oal-a".--.'70...Or)
City/State Parcel Identification Nut.Ther ..WX:' .1
........_.
LEGAL DESCRIPTION PitAA'Ir
Property Location NE ¼ , AAd ¼ , See./6 T Z? N 1-{ W, Town of
/i
Subdivision (49-exiCL,JI_Llokt.i 4 eA,A0 . _ , .1,01
Certified Survey Map # , , -\/01 um e ....--- „ Page //
-- -.
Warranty Deed # q 50) oto Vo I ume , Pag
e...---.11
_... ._.._..
- -- - -_-_—_ -,
Spec house qi
1111)
lot line, identifiable no
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
improper use and maintenance of your septic system could result in its pr.miature failure to handle wastes. Proper
maintenance consists of pumping out the septic tank every three years or sooner, it needed,by a licensed pumper. What you put into
the system can affect the unction of the septic tank as a treatment stage in the was i e disposal system. Owner maintenance
responsibilities are specified in§Conun. 83.fi2(1) and in Chapter 12 -St. Croix County Sanitary Ordinance.
I
The property owner agrees to submit to St. Croix County Planning &Zan Ing Department a certification form, signed by the
owner and by a master plumber,.journeyman plumber,restricted plumber or a licensed pumper verifying that(I)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 eommerce and the Department of Natural Resources, State of Wisconsin.
Certification stating that your septic system has been maintained must be complete,l and returned to the St.Croix County Planning &
.4oniug Department within 30 days of the three year expiration date.
I/we certify that all statements on dos fo m are flue to the best of my/our k itowledge. I/we am/ale the owner(s) of the
property described above, by virtue of a warran t deed recorded in Register of Deeds Office.
Number of bedro ms .41
---------
I 1-----
-
SIGNATURE OF APPLICANT(S) DATE
***Any information that is misrepresented may result in the sanitary permit being(evoked by the Planning &Zoning Department. ***
Include with this application a recorded warranty deed from the Register of Deeds Ejffice and a copy of the certified survey map if
reference is made in the warranty deed.
(REV.08/05)
pOWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of
SYSTEM SPECIFICATIONS ❑ NA
FILE INFORMATION �/n Tank Manufacturer: a to
Owner �P P/',/'� t
IA Septic ❑ Dose ❑ Holding Volume: iy (gal)
Tank Manufacturer:
fg.NA
DESIGN PARAMETERS
• Number of Bedrooms: ❑ NA ❑ Septic ❑ Dose ❑ Holding Volume: (gal
Number of Public Facility Units:
NA Vertical Distance Tank Bottom(s)to Service Pad:, /4- (ft)
(gal/day)
Horizontal Distance Tank(s)to Service Pad: (ft)
Estimated(average)Flow: , provided if vertical is>15 feet or
Specific servicing mechanics must be p
Design(peak)Flow=(estimated x 1.5): Cf�" ) (gal/day) if horizontal is>150 feet. Specs is instructions to be provided on back.
In Situ Soil Application Rate: ,--) (g
al/day/ft2) Effluent Filter Manufacturer. ,5b.--/95a-
, ❑ NA
Effluent Filter Model:
Standard(Domestic)Influent/Effluent Monthly average Effluent
Fats,Oil&Grease (FOG) 530 mg/L Pump Manufacturer:
Biochemical Oxygen Demand (BODs) 5220 mg/L ❑ NA - Pump Model:
Total Suspended Solids(TSS) 6150 mg/L
High Strength Influent/Effluent Monthly average Pretreatment Unit Manufacturer.
(FOG) >30 mg/L
(B005) >220 mg/L NA ❑Mechanical Aeration ❑Peat Filter
(TSS) >150 mg/L �� \\ ❑Disinfection ❑Wetland
Pretreated Effluent Monthly average ❑Sand/Gravel Fitter ❑Other:
(BOD5) 530 mg/L Soil Absorption System
(TSS) s30 mg/L p` Ground(gravity) ❑In-Ground(pressure) 0 NA
Fecal Coliform(geometric mean) 5104 El At-Grade ❑Mound
0 Other:
Maximum Effluent Particle Size '/e in dia. ❑ NA ❑Drip-Line ❑ NA
Other:
ANA Other:
MAINTENANCE SCHEDULE Service Frequency
Service Event , .W
•
�— hen combined sludge and scum equals one-third('h)of tank volume
Pump out contents of tank(s) ❑When the high water alarm is activated
,r_17> (Maximum 3 years) ❑ NA
Inspect condition of tank(s) At least once every: .year(s)
2 amonth(s) (Maximum 3 years) ❑ NA
Inspect dispersal cell(s) At least once every: ar(s)
/ [,month(s) ❑ NA
Clean effluent filter At least once every: . �year(s)
'l ❑month(s) NA
Inspect pump,pump controls&alarm At least once every: ❑year(s)
_ ❑month(s) NA
Flush laterals and pressure test At least once every: ❑year(s)
❑month(s) NA
Other: At least once every: ❑year(s)
❑ NA
Other:
MAINTENANCE INSTRUCTIONS one of the following licenses or certifications:
Inspections of tanks and soil absorption systems shall be made by an individual carrying c t er
P )•
Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector,ei PO missing Maintainer or hardware, identify any Operator ( u leaks,
Tank inspections must include a visual inspection of the tank(s) identify Y
absorption the volume shall be visualllly inspected to check the effluent levels back he observation pipes and to check for any ponding of effluent
onsoretion
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 of the tank shall be sludge and scum
Septage treatment
tank disposed)ofrin more of the accordance volume,the entire NR 113,
contents of the tank shall by
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<_12 months,shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority within 30 days of completion of any service event.
GMW-005(02/05)
•
• 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, solvents or other
chemicals or sediment that may impede the treatment process and/or damage the soil absorption system. If high concentrations are
•detected have the contents of the tank(s)removed by a Septage Servicing Operator(pumper)prior
, Pump tanks may fill above normal highwater levels prior to startup or due to pump failures. Start up or restoration of power under these
conditions is not recommended, as the excess wastewater will be,discharged to the soil absorption system in one large dose causing an
overload that may result in the backup or surface discharge of effluent and damage o(pumper) system.
restoring P
or POWTS Maintainer to assist in manually operating the pump controls until normal effluent levels are restored within the pump tank.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
Do not drive or park vehicles over tanks or the soil absorption system. 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 treat
floss
tanks and soil absorption system: acids, antibiotics, baby wipes, •cigarette butts, condoms, cotton swabs, degreasers,
diapers, disinfectants, fats, foundation drain (sump pump) discharge, fruit and vegetable peelings, gasoline, greases, herbicides, meat
scraps,medications,oils, painting products, pesticides,sanity napkins,solvents,tampons, and water softener brine discharge.
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 s. Comm 83.33,Wisconsin Administrative Code:
• All piping to tanks,pits and other soil absorption systems 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(pumper).
• 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
repl ement 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 eva proposed structure, lot lines a Failure t protect replacement
n
for a new soil and si te evaluatii on to es establish a suitableeplaceme tarea. Replacement systms must comply with the rules in
effect at the time of their permit issuance.
❑ A suitable replacement area is not available due to setback and/or soil limitations. If the soil absorption system cannot be
rehabilitated and barring advances in POWTS technology,a holding tank may be installed as a last resort.
❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation
must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a
last resort to replace the failed POWTS. .
❑
surface.a and at-grade soil absorption
s och systemsmus comply reconstructed rules in in place effect a following meremoval of the biomat at the infiltrative
WARNING TREATMENT TANKS, PUMP TANKS, AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES OR LACK
i� SUFFICIENT OXYGEN TO SUSTAIN LIFE. NEVER ENTER ANY TANK UNDER ANY CIRCUMSTANCE. DEATH MAY
RESULT. ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK MAY NOT BE POSSIBLE.
ADDITIONAL INSTRUCTIONS:
POWTS INSTALLER POWTS MAINTAINER.1 1 Name _A a.4- ).7) , G'f
Phonec„u ,.r / / [l J ���' ,17 f-
� � °O`r��. / L7 Phone 7 �/
SEPTAGE SERVICING OPERATOR(PU PER) LOCAL REGULATORY AUTHORITY
s �' A
�+� �J Name /- -r.t�
Name /l,'-'"_ /'i%/�9Y�-� ��L,.- _ 7
Phone % l,1 -- C7-�t7 .C�ei I Phone / J
This document was drafted by the staffs of the Green Lake, Marquette and Waushara County POWTS regulatory agencies in compliance with sections
Comm 83.22(2)(b)(1)(d)&(f)and 83.54(1),(2)&(3),Wisconsin Administrative Code.
'°` . . ``'' CARTRIDGE E INSTRUCTIONS
FILTER
2 009, . nw
0 s :r5 w s
Installation ' ., ,�C
STEP 2 Dry fit the filter case onto the end of the outlet pipe to ensure it is
^K
centered under the access opening. If not then either insert more pipe into the
an through the outlet or solvent weld (clue) additional pipe onto the outlet 41{;
y Li 4Ill
pipe. '1.;< d _.'
STEP 2 While the case is still dry fitted on the outlet pipe,
measure the length 4:;:',:, °=� '�`
of 3/4-inch pipe needed to brace the filter to the tank end wall if utilizing the ,.'
optional supplemental side support. If side support method is not utilized,
proceed to step four.
STEP 3 For installations utilizing the optional supplemental side support: 0 �,
solvent weld the 3/4-inch pipe onto the filter case. If side support method is not -"4r
ir
utilized, proceed to step four. ,
STEP 4 Solvent weld the filter case onto the outlet pipe. Insert the filter
cartridge into the case, pressing down until the filter locks into the bottom of ''' :
a t ;-
the case. ,. A'�t
STEP 5 If a VRS switch is utilized: insert into the filter and lock by turning
:' . ;..
clockwise 90°.
Maintenance
1. The effluent filter should be cleaned every time the septic tank IS .� I.' " ,,Si'k
serviced. `"` lt `,z N
?. Open the outlet access opening to inspect the tank and filter. ,`fin f„ Illl tm-4''
3. Pump the septic tank completely, making sure to remove the sludge •..
layer on the bottom of the tank and not just the scum and effluent. `_7
. Once the effluent level has been lowered below the invert of the ., ....,... 4,. . , 01- .
outlet pipe, firmly pull up on the filter handle to dislodge the ,.c
cartridge from the case. ,.
5. Slide the cartridge up and out of the case for cleaning.
6. If a VRS switch connected to an alarm is present, the switch
ors
should be removed by turning counterclockwise 90° and cleaned -
with water only a4
7. While holding the cartridge on its side !large flat surface facing :�x
W"!
down) over the access opening, rinse off the cartridge with water ` � ^
only, making sure all septage material is rinsed back into the tank. ,! _ ',: 4.111111111
t inserting into filter and a ,
8. If VRS switch is utilized, replace by 9 x�
turning clockwise 90°. .*Alm '3 y "4•
9. insert the filter cartridge back into the case, pressing down until t
the filter locks into the bottom of the case. "'' 1.' ' `2"< ''"
I0.Replace and secure the access opening on the tank.
BEAR ONS?TE"FILTER CARTRIDGE-FIVE-YEAR LIMITED wARRANTY
BEAR ONSITE"Filter Case-Lifetime Lmvte•war a^ v
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♦ Wiso nsin Department of CoSEnPrcU 6 7017 SOIL EVALUATION REPOR ,%i Page j_of 3
Division of Safety and Buildings
. aricPf4lance with Comm 85,Wis. Adm. Code r
County/� (
Mach complete site plan on paper not less than 8 1/2 x 11 inches in size.Plan must v�' ���1
include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. 4/
percent slope,scale or dimensions north arrow,and location and distance to nearest road. p/ !t C „t
Please print all information. garApp Date
Personal information you provide may ale used for secondary purposes(Privacy Law,s.15.04(1)(m)). U.1.--"2"1-4A., !J 13
Property Owner Property Location ,
J ��a()jai/ffr Govt.Lot A,/12-: 1/4 14 4 TZ? N R/9E(o6
-Property Owner's Mailing Address Lot# Subd. Name CSM#IBl # 1 So Ur-/ Wit-col-kJ Ac,e-Es
City State Zip Code Phone Number ❑City ❑ Rage ®Town Nearest Road
— , I '/D/ (C s/)''36—g72% /74-46Z-17,----, 1)1 1 C DO USS A A51-1
ow Construction Use: Residential/Number of bedrooms_��� _ Code derived design flow rate_!0z?/6 00 GPD
❑Replacement ❑ Put,licc commercial-Describe: _
Parent -- -
Parent material ejC-C/c"-/Yt...--/ Flood Plain elevation if applicable )19 s1 —^ft.
General comments 5O,n-Q-Clce-y i L'-Ae 4v t/ u� &/f1 K7 7 rad /
and recommendations: 0' i
System Type 0,t//l Y.✓'-' System Elevation / ■!/
/ Q Boring
r Boring# /
2,pit Ground surface elev7 L r 9 ft !. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Colol Redox Description Texture Structure Consistence Boundary Roots GPD/ftZ
in. Munsell , Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 •Eff#2
` I 0 -11-- /0 /31i_ _ _? /I�i AI • #. w 0
a iL- 1 /t ',.5// �—' >, d
3 8'1' 7// S ,06-0,/ in / y✓l� ,sill r /? b .
, 19. 1 t'w 1--,6 .. .
"ii/ . _
IBonng# ii Boring /
Pit Grot.nd surface elev.?7. (i_ft. Depth to limiting factor ! o in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munselt Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 *Eff#2
5/ at r mFr c.� 2 -6 1,a
7_ /3-CG /4if/y C/ earlf , I • -
.7 G®/y10ye 1// MIMI rn l a rL a
iici
10"/PA _ . ,
1
Effluent#1=BOD >3+)<220 mg/L and T S> • < },�/-e 1ent#2_BOD30mg/LandTSS30mg/L
CST Name(Please Print) /,- - / CST Number
Bird Plumbing, Inc. Shaun Bird / i4. 226900
Address ate Evaluation Conducted Telephone Number
1008 192nd Ave, New Richmond, 54017 /- 'a., 715-246-451 ,
c
r.
Property Owner Parcel ID# _ Page _ _of
1 13 Boring#
17:1 Boring -�
Pit Grow Id surface elev. /g?. / /'_ft. Depth to limiting factor / C in.
Soil Application Rate_
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots ' GPD/ff
in. Munseli Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2
I 0-11., /09,-/-2- S / ,'rod' ,, 1 (S ,2-7--}, o (o 1 . 0
Z �)z-. i y r / - '-I tip,,. ,,-.‘„. .c 9 i e ,Y .�
'eV goy, �G -- S 7)S 9 i .01-,1, , /9../.r._.1,/4, .1 i.CO
I L/
Boring# ❑ Boring q 77
I I pit Ground surface elevlCC��.j_ ___ft. Depth to limiting factor )j b in. .
Soil Application Rate
Horizon Depth Dominant Color' Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 'Eff#2
1 0-1L Or.3/,2_ Si 07,1,9 - mf„T Ci 01- / 6 /
z 12-7,2. '°r s/y -- e I as-.61( m('r- yk.2 I-c ' V i
_3 7g-I36 /py i 1/L, S 05 m I ivi,¢ /0,4- • -7 1 i (o
Boring ❑ Boring
# Ground surface elev. ft. Depth to limiting factor in.
❑ Pit ,
Soil Application Rate
Horizon lepth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 `Eff#2
Effluent#1=BOD,>30<220 mg/L and TSS>30<150 mg/L *Effluent#2=BOD,<30 mg/L and TSS<30 mg/t.
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an a4emate format, please contact the department at 608-266-3I51 or TTY 608-264-8777.
SBD-8330 ta.eroor
•
Soil Test Plot Pla
Project Name Travis Waldschmidt S A Bird
Address
476 Cty Road A �L
Hudson Wi 54016 •STM #226900
Lot 5 Subdivision Da e 8/31/12
NE 1/4 NW 1/4S 16 T 29 N/R19 W Township Hudson
DI Boring Q Well PL Property Line County ST. CROIX
BM or VRP Assume Elevation 100 ft. Top of survey iron
System Elevation TBD *HRPSame as Benchmark
B-1
30' 30'
\B.M.
70' , 40' ÷ 40' Property Line j(�s'
10' 0'
B-3
B-4
50' 1% Slope
Scale is 1" = 40'
�.,, B-2 unless otherwise
noted
C. B-2
Propety Line
McDonald Lane
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