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HomeMy WebLinkAbout040-1303-00-041 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 578918 0 GENERAL INFORMATION State Plan ID No: Q Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 25 ! S Permit Holder's Name: City Village X Township Parcel Tax No: Oeverin Homes LLC, aka Oeverin Pro ertie Troy, Town of 040-1303-00-041 CST BM Elev: Insp. BM Elev: BM Description: ~}2 Section/Town/Range/Map No: qq GSA r+ r # J 22.28.19.1776 TANK INFORMATION EL ATION DA A A J11 A r% TYPE MANUFACTURE P~ STATION BS HI FS ELEV. Septic 1 MCI C Benchmark JA s, 9 q • 32. Dosing V Alt. BM rL ,~~M Bldg. Sewer 1. l~ U o Holding S Ht Inlet I TANK SETBACK INFORMATION NK TO P/L WELL BLDG. Vent to A' Inta ROAD n e NO-M tic Dt Bottom -7 I • L, ~ i 0M J ea d enwlv Ak A 101 ~ (O-Z FOS, Aeration Dist. Pipe 5 0 Z.2 Li 3. 35 Z I 0 .Z Holding Bot. System y• I p I ,#S i. 7 Final Grade PUMP/SIPHON INFORMATION Manufacturer `x Demand St Cover ( t I 1 GPM Model Number 61 t i,5 r He &XI [arQ. p0 TDH Lift' , Fricti T Los System Head /~~0y TDR ` Ft ~ ilk ~f %AA I's Forcemain Length Dia..2 11 Dist. to Well,J(~ I`J SOIL ABSORPTION SYSTEM V BED/TRENCH DIMENSIONS Width Length ( No. r ct~eI~ PIT DIMENS No. Of Pit Inside Di Liquid Depth DIMENSIONS IONS 1 /l/l.. SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Type O CHAMBER OR ter0: _ 2~ 2:11I , 1 ` UNIT Model Numbe DIST N SYSTEM 01R ~USI' Soy dr~rty~ Heade anifo Distribution x Hole Size 2 x Hole Spacing Ft to Air Intake Pipe(s) It 21 _j Z 12 1 is Spacing Length Dia Length SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only h Over I Depth Over xx Depth of I 1 xx Seeded/Sodded ulched Bed ench Center Bed/Trench Edges / Topsoil Yes Fgw] No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:ff_/ / #2: Pl6W -a, par7i ~xe~inspection Location: 224 Walnut Hill Way River Falls, WI 54022 E 1/4 SE 1/4 22 T28N R19W) Walnut HIIl p Farm aka he Tribute Parcel No: 22.28.19.1776 1.) Alt BM Description= Rikw ~bvu - wk\ Abb 4n @ i6w*(\ 2.) Bldg sewer length = 1 Q 1 S IN`t l ( - amount of cover - ~ v I I' Plan revision Required? ❑a Yes No 9 Q - 1~ ~ l 6 Use other side for additional informa, /n. O Date Insepctor's Signature Ce SBD-6710 (R.3/97) rt. No. PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 SE 1/4 SE 1/4s 22 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROIX SYSTEM ELEVATION 101.0' 1.0 sand lift! DATE 5/28/15 BEDROOM 4 CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA # of chambers Ilk BENCHMARK V.R.P. Top of 1/2" steel pipe ASSUME ELEVATION 100° Filter BEAR Filter ❑ BOREHOLE O WELL * H. R. P. Same as Benchmark All piping, shall be SDR 30134, within 10 B.M.* Property Line of pip4 shall be Schedule 40. B-3 3% Slope 99.5' ❑ B-4 Wei nut Hi I I Ways 100.0 ❑ B-1 Grading is to be done to B-2 100.5' divert run-off away from system Huffcutt Combo Tank Area 15' below _y system is to remain Tank is to be properly b dded undisturbed and provided with lockd wn covers with approved warning labels Pro 4 0o m House Wei I is to meet all WDNR setbacks Property Line Property Line Scale = 1/4" = 10' 1 Acre Lot i'.OP ~ County 4. Safety and Buildings Division 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) P Madis~pP~.WL53ZD762 o T --r----- State Transaction Number Permit Application -7 9- In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form 20 the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for stale-owned POWTS are submitted to Project Address (if different than mailing address) T,(J1 / U t the Department of Safety and Professional Servies. Personal information you provide may be used for secondary Zz L / u oses in accordance with the Privac Law, s. 15.04 I m)I Stats. W 1. A lication Information - Please Print All tnformatii n r Parcel t Property Owner's Name (%e,;, r) ~ 1 016.- 03 _ Property Owners Mail b Ad ss Property Location ll L , i Gout. Lot ~f City, State t Zip Code 1 Phone Number Section !d le o T'ZO _ N- R tot E o 4yr Type of Building (check a at apply I Lot 1 G Subdivision N e 1 or 2 Family Dwelling-Number of Bedro _ ck N -1 l ❑Public/Commercial-Describetlse dl` aa~, V11e ❑ G. City of r~ CSM Number ❑ Village of ❑ State Owned Describe Use f of <K I/ X 7 0 "j- 111. Type f Permit: (Check only one box on line A. Complete line B if applicable) A. ew System El Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) I I / List Previous Permit Number and Date Issued B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber iI ❑ Permit Transfer to New Before Expiration Owner W. Type of POAITS Svstem/Com onent/Device: Check all that apply) tn. 0 1 )A 1 ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound ? 24 in. of suitable soil ound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain)- ❑ Pretreatmen Device (explain) V. Dis ersaVrreat ent Area Informati n: t Desi Flow (gpd) D Soil Appli on Rate(gpdsf) Dispersal Area Require f) Dispersal Area Propl ~ iZ System Elevation est / 7D O Z~' 'OCR f \71. Tank Info I Capacity in Total # of Manufacntrer ° v v Gallons Gallons Units °j i New Tama E>:ishng Tanks I ~ / ~ 1' ~ c v ~ ~ m .i° 1 (yv rn v~ Septic or Holding Tank ~ ~ j a,1 ~ Dosing Chamber j 70 VII. Responsibility Statement- the undersigned, assu ponsibility for installation of the POWTS shown on the attached plans. Plumber'. Name (Print) Plumber' attire MP/MPRS,~Number Business Phone Nttmbe 1 122 5L-, Plumber's Address (Street, City; S , Zip Code ` z VI ouatv/De artment Use Only Permit Fee Date sued Issuing eni pproved Signature ❑ rsapprove [ Z5 OCR Z6 ' 15 El en Keason ffor D2nial 1.A M. Conditffla WAtV N 'asons for Disapproval 3' 1 I p mac,,, i tno .~~a.ck "rv t.' •5eptic'tank, effluent filter and .dispersal cell must all be ser`vtces / mairitatned L j , F k, ✓ A as per management plan provided by plumber. 3. t t*' gt*9mwts must be malks i ~d t as ca s cods l o►dinanc~s. ° a~ rbJa, ~-e- I `at'e' Attacb to complete plans for the system and submit to the County only on pa r not less than R 1P. a I1 inches in s t l~ SBD-6398 (R. 11/11) PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 SE 1/4 SE 1/4s 22 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROIX SYSTEM ELEVATION 101.0' 1.0 sand lift! DATE 5/28/15 BEDROOM 4 CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE 1 .0 ABSORPTION AREA # of chambers BENCHMARK V.R.P. Top of 1/2" steel pipe ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL * H. R. P. Same as Benchmark All. piping shall be SDR 30134. arithin 10' B.M.* Property Line of tank, piping shall be Schedule 40. 99.5' B-3 3% Slope ❑ B-4 Walnut Hi I I Way 100.0 ~ B-1 Grading is to be done to B-2 100.5' divert run-off away from syste m H uffc utt Combo Tank Area 15' below system is to remain Tank is to be properly bedded undisturbed and provided with lockdown covers with approved warning labels Pro 4 Bedroom House Wel l is to meet all WDNR setbacks Property Line Property Line Scale = 1/4" = 101 1 Acre Lot i',,. 0 P 1, SHAUN R BIRD Page 2 4/9/2015 is of a type conforming to the standards or specifications of chs. SPS 382 and 383 and this chapter and ch. 145, Stats. • Maintain well and waterline set backs per SPS 383.43(8)(i). Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. 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/instal lation/operation. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 This Amount Will Be Invoiced. When You Receive That Invoice, Patricia L Shandorf Please Include a Copy With Your POWTS Plan Reviewer, Division of Industry Services Payment Submittal. (715) 634-7810, Fax: (715) 634-5150, M - F 8:00 a.m. - 4:45 p.m. WiSMART code: 7633 pat.shandorf@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484 , Monday - Friday 8:00 am To 4:30 pm ptiyART,'Lfg~r DIVISION OF INDUSTRY SERVICES JP 10541 N RANCH ROAD HAYWARD WI 54843 3l D S Contact Through Relay P S http://dsps.wi.gov/programs/industry-services www.wisconsin.gov ~O'ss10 rA1S~ Scott Walker, Governor Dave Ross, Secretary April 09, 2015 CUST ID No. 226900 ATTN POWTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING INC ST CROIX COUNTY SPIA 1432 120TH ST 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04/09/2017 Identification Numbers Transaction ID No. 2529795 SITE: Site ID No. 811544' Oevering Homes Please refer to both identification numbers, 224 Walnut Hill Way above, in all correspondence with the agency. Town of Troy St Croix County SE1/4, SE1/4, S22, T28N, R19W FOR: COND Description: Mound, 4 bedroom residence APP Object Type: POWTS Component Manual Regulated Object ID No.: 1531139 p,r OF Maintenance required; 600 GPD Flow rate; 16 in Soil minimum depth to limiting factor from original grade; Systerp Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01/01, R. 10/12), Pressure Distribution Component M~ir ROFESSI Ver. 2.0, SBD-10706-P (N.01/01, R. 10/12); Effluent Filter DIVISION OF IN The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be construct and located in accordance with the enclosed approved plans and with any component manual(s) referenced ab The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all c e S COR 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: Key Item(s) • 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 component manual are complied with. A copy of this information must be given to the owner upon completion of the project. Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per SPS 383.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of SPS 384.10. No fixture, appliance, appurtenance, material, device or product may be sold for use in a plumbing system or may be installed in a plumbing system, unless it SHAUN R BIRD Page 2 4/9/2015 is of a type conforming to the standards or specifications of chs. SPS 382 and 383 and this chapter and ch. 145, Stats. • Maintain well and waterline set backs per SPS 383.43(8)(1). Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 This Amount Will Be Invoiced. When You Receive That Invoice, Patricia L Shandorf Please Include a Copy With Your POWTS Plan Reviewer, Division of Industry Services Payment Submittal. (715) 634-7810, Fax: (715) 634-5150, M - F 8:00 a.m. - 4:45 p.m. WiSMART code: 7633 pat.shandorf@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 3/ 31/15 Owner:Oevering Homes Location: SE1/4 SE1/4 S22 T28 N,R19W 224 Walnut Hill Way Troy Manuals Used: Mound Component Manual Version 2.0 (01/31) Pressure Distribution Manual Version 2.0 (01/31) Page# 1. Cover Page rIONALLY 2. Mound Plot Plan ROVED SAFETY AND 3. Mound Cross Section NAL SERVICES 4. Pipe Cross Section/Pipe Layout DUSTRY SERVICES 5. Pump Chamber Cross Section 1 6. Pump Curve ~ pp DENCE 7-8. Maintance and Contigency plan 9-11. Soil test r 12. Filter Specification and cr s section y ' 3 Shaun Bird Signature , License numb 226900 PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 SE 1/4 SE 1/4S 22 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROIX SYSTEM ELEVATION 101.0' 1.0 sand lift! DATE 5/28/15 BEDROOM 4 CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA # of chambers BENCHMARK V.R.P. Top of 1/2" steel pipe ASSUME ELEVATION 100° Filter BEAR Filter ❑ BOREHOLE O WELL * H. R. P. Same as Benchmark All piping shall be S DR 30134, within 10 B. M. Property Line of tank piping shall be Schedule 40. _Ak B-3 3% Slope 99.5' B- 4 Walnut Hill Way 100.0 0 B-1 Grading is to be done to B-2 100.5' divert run-off away from system Huffcutt Combo Tank Area 15' below system is to remain Tank is to be properly bedded undisturbed and provided with Iockdown covers with approved warning labels Pro 4 Bedroom House Well is to meet all WDNR setbacks Property Line Property Line Scale = 1/4" = 10' 1 Acre Lot Mound System Cross Section and Plan View Dimension Feet A J I 7 B 1 •L L L L Lr L L r f r fLrLr r Lf r f r r r r iiiIi4:4{{r: r`r r r Lr f L/ >"L: A I rLr L r Lr r r r r r r r r r r f r r r r r .{r:,:1`.ir{~+.',• ~:T(}}~~~:/~,+.''• Lr •rL rLr I C.. 1~.',y rLr r rL JLILJLrLIL •r•Jil•L••J1J,•LrLr•L•+hJ4J ~:`;ti+LJL.L.L.L~LfLj.L.\rL ~.r1rLf4fL ~tij~•.•~rti:•'L •.r.J.. r r f 1 F t \f .j r f :L LJLj\r L 1jLJL LJLrlrtj4 LJL Lr rLf•r r rLrLf,•r rLr f rLr •r•r t r r ••f l r l~ J LJ l 1 I G f a- W I Z 4 ~ 1 : I I 1 II,~ - 1 , I 1 I J L1,7 L 1 - 1 = Topsoil = ASTM C-33 = Clean aggregate = 4 in. sch. 40 pvc Cap Material sand to 2 in. dia. observation pipe - fill Geotextile G H Fabric r...r.r •.:1 Lr~r r•r'r•r•J:r•:'•i• D E { Plowed Surface Ft Contour Slope Direction GENERAL INSTALLATION: The mound area is staked out along the design contour. ExistinU vegetation is mowed and raked off the site. The mound basal area (L x W) is plowed with a moldboard or chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to form a `A inch soil wire when a sample is rolled between the palms of the hands. ASTM C-33 quality sand is placed immediately after plowing. Sand is placed with a tracked machine keeping 12 or more inches of sand under the tracks or is placed overhead by a backhoe. Special care must be used when placing sand of less than one foot thickness to minimize compaction of the plowed surface. After the topsoil cap is placed, the entire mound is seeded and mulched to promote vegetative growth, limit erosion and protect from freezing. The observation pipes are slotted in the lower 6 inches and secured in place with rebar or a closet flange. 10/071gj Page of Pressure Lateral Layout Two Laterals - End Manifold 4---- Threaded . Cleanout Lateral Turn-up Plug Manifold Am- M 40 X 1 Long Force Main Sweep gU Bend kDi Network Specifications Pressure System Construction r - In. eter Inn. Laterals are constructed of Schedule 40 PVC 5/32- ln. I pipe. Orifices are drilled perpendicular to er in Q In. the pipe with a sharp drill bit and face down. (Lateral Length) Ft. Lateral turn-ups terminate with a threaded L M (Manifold cteanout plug and are enclosed in a 6-8 inch Length} L f Ft. Force Main Diameter c~' -In. diameter lawn sprinkler valve box accessible Force Main Len =th from finished grade. Grade 6-8 Inch Lawn Sprinkler Valve Box ~ III 1 age - OI 03/05 l9) Cross Section And Pump Performance Specifications Septic-Dose Tank Manufacturer Tank Manufacturer Model Number" Tank"Model Number / 2.s-? MufTa tal Tank Capacity Model Number Max. Bury Depth Type Fitch , F Total Dynamic Head (TDH) - Filter Manufacturer Elevation Head Filter Model Number Distal Pressure 3 Network Loss Minimum pump Performance Required Force Main Loss TDH Total GPM f outlet Manhole Min. 4" Above Grade With Manhole Min. 4" Above Grade Securely Mounted With Locking Device Lacking Device. Inlet Manhole < b" Below Grade Sealed Watertight Weather-proof Junction Box ar Finished Grade Vent Min. 12" Disconnect Above Grade Means With Vent cap outlet Filter Inlet Baffle Inlet a--"""` A 1/41 Weep Switch Setgn and Reserve Capacit3' Hole Tank Volume = '7 GPi B al. 1,4: Inches Volume G Dimension (reserve) A Off Elevation C (alarm) B 2 y, - Ft-,- Bottom {dose) c D Elevation D' r Ft (dead) , . -9 Total i:: a.a a:.•.•; 'r:::•::>: :l i=a < a la) i•1 .a: ` ,,a <f;i ati .Y .•.•';•.>j ~•.•a a >,1' in accordance with the back ed N: The Septic/dose tarik is bedded and specified by the manufacturer may not GENERAL IN5TALLATYO Maximum depth of bury as device (padlock) TA approval specifications, gradduct a have an effective locking manufacturer's pro royal. Manhole covers exposed to the tank watertight fittings, and with be exceeded without prior et roved material, connected 40 PVC to bridge the tank installed- Piping at the inlet and outlet is of approved The force main is sleeved with 4" Sch• 30Q and Comm 1b.2:i. laid on stable soil to p~ient settling or m ice complies with NEC excavation and the sleeve. is sealed watertight. Electrical Page Of 02105 U A _'Y T P~ u.WAT~'~ N~ v J 1 yrAu CAP nrODtL 52 ~3 -00 7- 2 5 29, 71 4 6 1 152 i 9- 4, r I - t - 2 - c.J 4- t i I D-I 50 8i) ^v7 20 0 CALCNS r?TRS gr 160 44, - - - -s J// ✓ CONSULT FACTORY FOR SPECIAL APPLICATIONS b - Timed dosing panels available. ✓ Electrical alternators, for duplex systems, are available and supplied avlth an alarm. I switches are availab;e for controlling single phase Variable level contro systems. 7 j • Double piggyback variable level float switches are available for variab,e ~ - level long and short cycle controls. , • Sealed Qwik-Box available for outdoor ns:aliatlnns• See"1"4'~' Over 130°F. (54°C.) special quotation required. 1521153 Series - Control Se- - 1521153 MODELS ---1 MoGe?- pm35 ! Srmp:ex ` Duplex_ C 1.5 s zosa Model Yo1ts.Ph 65 t 2nr3 1L y - -Non 85 nciu'eu 2 or BN1521 115 1 -Aut-°-t rt- 2 cr 3 2-` -40 1 Non 4 3 n lu ed 2 or 3 BEt52 i122 30 _ r A 0 1~ 5 ; 2or -3 SELECTiOk GUIDE -Tii Non I vback variable Level float N153 - 7 10 5 Inc!- ed 2 8Nt53r 175 Auto 1 5 3 1--- 2 or 3 Single ciogybaCk varaDle level floa:5wltch or oub e p gG; E15 23~3D 1 Non 5xacti Rer t0 F°•10,17 . 53 included 230 fur eorrec mode! of Elzctncai P.temator E-Pak ex `y (151 Ruto 1_- 3 2 See h;D'~ n CAUTION 3 'Jariacie level control switch 10-0225 used as a control actwa;or, specify dup' . All installation of controls, protection devices and wirin g should be done by a qualified cluding the licensed electrician. A11 electrical ode (NEC) and the occupational Safety and Health Act OSHA). s or i4! float system recent National Electric Code RESERVE POWERED DESIGN 7peiler GImo For unusual conditions a reserve safety factor is engineered into the design of every - MAIL TO: P 0 30X 16347 yfa~! ,acrurersot - 47 G SHIP TO 3649 o p oad %NC: ~9~~„ 4,D yp, QI/A417-YPUM.FS ~l i,v he. 800) 9 8-PU.MP _ C , ® 1502!7718-2T31 '74-3024 ~~1llY/~ _ `•ax{532! http://Www•zoeller.com © Copyright 2000 Zoeller Co. All rights reserved- I - POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page or SYSTEM SPECIFICATIONS FILE INFORMATION Septic Tank ter Capacity Manufacturer /.Z al ❑ NA Owner A. Septic Tank Manufacturer [3 NA Permit ❑ NA Effluent Fil DESIGN PARAMETERS ❑ NA ❑ NA Effluent Filter Model Number of Bedrooms pump Tank Capacity al ❑ NA Number of Commercial Units Pump Tank Manufacturer NA Estimated flow (average) al/da Pump Manufacturer ❑ NA Design flow (peak), (Estimated x 1.5) al/d ❑ NA Soil Application Rate al/da W Pump Model A Monthly average' Pretreatment Unit C1 Peat Filter Influent/Effluent Quality ❑ Sand/Gravel Filter Fats, , Oil & Grease (FOG) 530 mg/L ❑ Mechanical Aeration ❑ Wetland Biochemical Oxygen Demand (GODS) 420 mg/L ❑ Disinfection ❑ Other. Total Suspended Solids (TSS) 5150 m /L Manufacturer Pretreated Effluent Quality ❑ NA Monthly average" Dispersal Cell(s) 13 "round (pressurized) en Demand (BODS) 530 mg/L ❑ In-ground (gravity) o Biochemical oxygen ❑ At-grade und Total Suspended Solids (TSS) 530 mg/L -m- ther. Fecal Coliform (geometric mean) 510` cfu/100ml ❑ Dri ine Maximum Effluent Particle Size Y, inch diameter values typical for domestic (non-cammerclaQ wastewater and septic tank effluent. « Values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Frequency Service Event At least once every ❑ mont ear(s) (Maximum 3 yrs.) inspect condition of tank(s) Pump out contents of tank(s) When combined sludge and scum equals one-third (Y,) of tank volume At least once every ❑ mon fear(s) (Maximum 3 yrs.) Inspect dispersal cell(s) ~d ❑ months ar(s) Clean effluent filter At least once every At least once every t ❑ months, ear(s) ❑ NA Inspect pump, pump controls alarm At least once every ❑ months ear(s) ❑ NA Flush laterals and pressure test ❑ months ❑ year(s) ❑ NA Other At least once every ❑ months 0 year(s) ❑ NA ocher At least once every MAINTENANCE INSTRUCTIONS following licenses or Inspections of tanks and dispersal cells shall be made by an individual carrying one POWTS Maintainer, Septage certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector of f the oken Servicing Operator. Tank inspections must include volume of combined s wedge and scum andto check for anyrback up hardware, Identify any cracks or leaks, measure inspect ed to check the effluent levels shall or ponding of effluent on the ground surface. The dns of efflcelnt on the ground slurface he ponding of effluent on the in the observation pipes and to check for any po 9 authority. ground surface may indicate a failing condition and requires the immediate notification of the local regulatory 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 ch. NR 113, Wisconsin Administrative Code. pretreatgment components, and any The servicing of effluent filters, mechanical or pressurized POWTS components, by a certified POWTS Maintainer. other maintenance or monitoring at it*ervals of 12 months or less shall be performed completion of any service event. shall be provided to the local regulatory authority within 10 days of comp Y A serncp report START UP AND OPERATION For new construction, prior to use of the POWTS check rdamage the d spe a cell(s) of high conrcenPrat ohs a~e other chemicals that may impede the treatment process and/or the tank(s) removed by a septage servicing op detected have the contents of operator poor to use. Page of for the presence of painting products or other chemicals thr if RAT{ON nt tank(s) START UP ANb OPE damage the dispersal cell(s). if high concentrations are detected have the contents o t h;" f the O S rheck treatme For new construction, prior to use o andlor may impede the treatment proces operator prior to use. tank(s) removed by a Septage servicing op the exc shall not occur when soil conditions are frozen at the infiltrative su ace. wastewater will ess pump tanks may ,ill above the cell(s) and may result in the backup operator prior to restoring power a to the System startup r• normal hlghwater levels. When power is restored or During power outages surface discharge ofefflerrt. discharged to the dispersal cell( s) in one large dose, pV t nk removed by a Septage elating th Servicing e pump controls to restore normal levels To avoid this situation have the c ly op ontents of the pump effluent pump or contact a Plumber or POWTS Maintainer to assist in manual act the area within within the pump tank vehicles over tanks and dispersal cells. not drive or park over, or otherwise disturb or comp of the POW1 '3~. Do not drive or park the life 15 feet down slope of any mound or at-grade soil absorption area. performance and prolong from the wastewater stream may improve the medications; oil; painting products; swabs; Reduction or elimination of the following rease; herbicides; meat scraps; ; condoms; cotton antibio(sumptics; pump) baby water; wipes; fruit and cigarette butts-, peelings; gasoline; gdegreasers; dental floss; diapers; disinfectants; fat; foundation drain pesticides; sanitary napkins; tampons; and water softener brine. is properly Wisconsin Administat v elCodel be to insure that the system ABANDONMENT 'andlor is permanently taken out of service When the POWTS fails and safely abandoned in compliance with chapter Comm 83.33, openings seated. • All piping to tanks and pits shall be disconnected and the abandoned pipe of by a Septage Servicing Operator. • The contents of all tanks and pits shat{ be removed and properly disposed • Altar 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 l in, CONTINGENCY PLAN measures have been, or must be taken, to provide a code comp J1, If the POWTS fails and cannot be repaired the following replacement system: ement soil n by requn.,e, e replacement area has been evaluated and may disturbance and utilized compaction and shoo ldenotcbe infri ged upon t' y re nee` reel wilit res in the 13 A : setbacks The e rep from lacement existing area and should propb sedostructuurer lot liii ets and wells. Failure to prottectt l systems tacement must area comply with the ruler, 1 for a new soli and site evaluation to establish a suitable replacement area. Repl effect at that time. p A suitable replacement area is not available due to setback a led/POsWTSmitations. Barring advances in POWTS techno oyN holding tank may be installed as a last resort to replace on failure of the POWTS a soil and be site i4 installed= ~'~.~he site has not been evaluated to identify a suitable replacement area. Up ✓ must be performed to locate a suitable replacement area. if no replacement area is available a holding tank may s rnova{ of the biomat at the tnail installed a last resort to replace the failed POWTS. ound and at-grade soil absorption systems may be reconstructed ce rules in effeplace ct atlthat t e. surface, Reconstructions of such systems must comply «WARMNG» SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIRNANLETHAL GASSES AND/OR Y C RCUMSTANCES J DEATH INSUFFICIENT MAY RESUL~ RESCUE r~l'i ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UND PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS MAINTAINER POWTS INSTALLER Name / Name , . Phone ~c- Phone LOCAL REGULATORY AUTHORITY SEPTAGE SERVICING OPERATOR PU PER. Name Name Phone Phone r J+ 383.54(1),(2) & (3). Wisconsin Administrative Code. This document was drafted in compliance with chapter SPS 383.22(2)(b)(1){d)&(f) and Wfsaat inowwknerttofcarmace SOIL EVALUATION REPORT Pepe / of_ Diviebn of Safety end s in aoooromm wish cotnnt a5. Wis. Adm. Code b cmr 5T. G,e o! 1L S, Parcel i.D. ° b EROSION CONTROL PLAN must be ~ perewxswo'sm completed before sanitary permit issuance Renewed uyCX/U Pw m YAx.oti a yee pro~rid~ wry be wW tm Noondwy pu pom (Pdnq Lw. IL 15.04 (1) (m)r PMp"oWner % H4 cwi. i of R!! ~vq IM s T 2$ N R / 9 & (ot) W To D j33 ERS Tf: f~ T_ Pmpariy Oesrer's Mailing Address Law BOM U 556d Name or CSW &015 CA wiu Av-P- CKY S"W-R Sbka Code Phom Nunber ❑ citr ❑ ► tle Q Tam Nearest Road 6•iPO0E- HTS MAJ 5S07€p G512y8• Ivf 7-Roy so. Mo~ER reAa { R New CWWkUC W Uw [1 ResidwW / Ntrt W of bedrocM Coda derived design lbw oa cPD 0 t 0 Pudic or am11c1- Dosabe: IL Parent rrtatatid /D - -1 D - I I Food Pkdn elevation N appGcade - CiwwW cormrnts and reaa,Mrrndararrs: , AOt;+ 7T,--s~ 5v/T?0ZP- /FA /4- / 0V-,0v SysT"• us2-0 F 0 ~ /00. N ® Pft prated Wxfaoeelev. R Do* b tirdtirtg factor h Sol Awkalon Rake fiatmn Depth Dotrrinnt Odw Redox eaaa*k n To*wa skudm c4n* erne Noredery Roofs Opp* b ilt MW" QLL SL CW& CdW Gr. SL Sh. 'EM 'E 31 L ~-FshK s ctv 3 t y G a. y ~o rc' y/ Z o R SiC a tiK S c / 5 G o SiG zM, bk ae Gt cS S 0 2 ~o S Z 3 2- 3 S 2 c z morj 5c& />GS d 0A • oYA (.1z 0 Bo*v 00 51S,71 pit Gmundwr+faoeelev. R DepthbWnftklgfecW Sol Awk-Mm Rate h D ® tiarteon Depth Domkwt Cdai Red_grc Desatokm Texture Str,dee Cww"w ca eocrndary Roofs GPDW in. Mwed Qu. Sz Cont Cow or. SZ Sh. 1 t I o• S io L z-fshK ~5'f-f Cw N 2- o s4- :)f c .s N Q _ - / Cr Z ~cS .5 160 - 5! /-F G Z G' D G2-T G L / 7~S G~U . /Oj i2 lr Z • Eflkm* 91 w NOD 1,30 1220 .9t end TSS 1,30 11 SO Q& • 01m0#2 = 13001130 myt std TSS 130 VL C9TdW cf3T Name tPaaee R Zi `B R i e i T- she I ~2 '7 5; ,flab{ Dab Evakmdan Cadtsbd ToWphone Nurnwr Uibricht & Assgciates s~T- y' o20d ?t f. 77a, • ,3 yy i.., 2812 10th Ave. Spring Valley, WI 54767 1 71 P/Ms F 4PpRo x . 2- yo 4 &ej; oyp•/o8S•s o yp . io s?( ~o aa~ oyo /o'G 20 • oav oyo /0z- Gp•Mo o yo ' io g6 - 70 • 6i'J1J oyo• Ioe(9- 0'6 --W i lvq~~v v r' TODD l3?E ~S ~EOT- Gtr Z 3 t J t Baring lr ❑ &-V Gronaw au elev. ! / 3L s 9LN fl Deptln to Wn*V taetor ~ S ser Rye liatFmn Depth Dongrwt Color Redmu DesabCen Texdee Structure comistaioe Boundary Roots GPGRF In. MLWM* Qu Sy- Cara. Color Gar. Sz. Sh. Ew -"a o G /o R L 245h old 4) J -f . S P #6- Al L s c r 7C o ~i L /7cs cs Z 3 1-9 Q c "Fors SoG ti LI L 3 ❑ # ❑ Pit Ground surface elev. R Depen t0 tf FOV UCIOr in- Sot ApPlimmilm Rate Haiun Depth Oararwo Color RadioxDw=*Som Texture Snatrae Corlsiderm Boundary Raab GPDIR im Munsed CAL Sz Cont color OF. 94 SIL 'Ett62 ❑ ❑ pit Ground anrfaceelev. ft. Depth to factor In. Sot Rate Acoftwilon Horizon Depth Dordnam cow Radmc oesa"M. Textue Once Bonandary Roofs in. munsa1 Qu. SZ Cont Color . Sz Sh. -owl mm F-I Borhrg ❑ft ❑ PN Ground suface etev. fl Depth to vrniYrng Fannon in. Sot Avollogm Rata tioamn Depth Dm *wt Colm Rsdmr OMOWM- Texkm sbuchrre Geromwnw Isomrdary tioota OPM III murmd C Cont Color Gr. Sz. S+. 'l WI 'EtFii2 i E1lkrant 81= BDDr> 301220 mglt and TSS >30 S 150 nV& ' EAkient t12 s OW._ 30 mgrl. and TSS 30 WAWL 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, pie= WWW the department at 608-266-3151 or TTY 608-264-8777, seoaunta,rAOr PLOT PLAN WALNUT HILLS FARM. LOT # / Pg. 3 of 3 Q = Contour elevation lines. • = Backhoe Soil pits. 0 = Benchmarks set, maRKED WITH FLAGGED lathes. 1/2" steel conduit pipes. 0f ~r SCALE: 1" FI Lod-y~/ 0, 0 c l o . 99.30' 301~ r yy HL /3 /02 d • V LoT-' ~ ~ )3M i w ~ S~55ESr~v zf~i~ozti► .tio~,~o ~ p,✓fn v 2 G i:v.r /~O. S O sT ~yUV.vv S ysT- Itch ' 5~55~ „ S~4 lo a . J 7 ~ L . s~. GoT G d T' yo ~ FILTER Fs 2A4$ . -`TM t tt Installation STEP 1 pry fit the filter case onto the end of the outlet pipe to ensure it is rte` centered under the access opening. If not, then either insert more pipe into the . . tank through the outlet or solvent weld (glue) additional pipe onto the outlet1 Pipe. VIII , STEP 2 While the case is still dry fitted on the outlet pipe, measure the length of 3{4-inch pipe needed to brace the filter to the tank end ll if ut'uitilingetthe optional supplemental side support. If side support proceed to step four. STEP 3 For installations utilizing the optional supplemental side support: t,. solvent weld the 3/4-inch pipe onto the filter case. If side support method is not w: 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 r the case. ~r STEP S If a VRS switch is utilized: insert into the filter and lock by turning z► clockwise 90°. Maintenance 1. The effluent filter should be cleaned every time the septic tank is r , serviced. 2. Open the outlet access opening to inspect the tank and filter. remove the layer IV septic tank 3 yerpon the bottom of the completely, and notjust rtheoscunnand effluent. 4. Once the effluent level has been lowered below the invert of the outlet pipe, firmly pull up on the filter handle to dislodge the 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 should be removed by turning counterclockwise 90° and cleaned with water only. 7. While holding the cartridge on its side (large flat surface facing ~y down) over the access opening, rinse off the cartridge with water only, making sure all septage material is rinsed back into the tank. m 8. If VRS switch is utilized, replace by inserting into filter and ` turning clockwise 90°. 9. Insert the filter cartridge back into the case, pressing down until 9 the filter locks into the bottom of the case. 10. Replace and secure the access opening on the tank, BEAR c3NSZTE"' FILTER CARTRIDGE - FIVEYEAR LIMITED WARRANTY BEAF ONSITE" Filter Case -bfetime l mite., Wa anty 7-i 2* t, r it, VZi a x0m wv~wl_bmrovsit~! 877-ML FILTERS (653-45831. - I ST. CROIX COUNTY SEPTIC 'T'ANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address nL ~~19t~G 1 Property Addres Z 2 Y b'4 hl _ (Verification required from Pla~ nning & Zoning Department to w construction.} City/State Parcel. Identification Number C .----L3 63 LEGAL DESCRIPTION Property Location S - Y . , J % , Sec. Z Z, T Z-9N R W, Town of / f T - Subdivision _ - Lot Certified Survey Map # - Volume _ Page # Warranty Deed # Qc6 Volume - IPage # Spec house yes no Lot }fines ider<tifiablo S no SY TEM M AINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper iaintenance 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 e wate poa y s t em. O wn er maintena cc responsibilities are specified in §Counn. 83.52(1) and in Chapter 12 th s dis s l s n - 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 Rsources, of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. CroixtCo ty Plannin & Zoning Department within 30 days of the duee year expiration date. g I/we certify that all statements on this form are true to the best of my/our knowledge. I/we arn/are the owner(s) of the property described above, by virtue anty deed recorded in Register of Deeds Office. Number of bedrooms 1 4 TGNAT OF APP C1L T(S) - - DATE. ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning cot Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified stirvey map if reference is made in the warranty deed. 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I I r l I I I I I I I I I I I I I ~I ~I I I I so ~ I I I I I .ze+asssnai eaovr 0 I I I I ~ ~ I I I I I .Tree I I I I I I I I L I I I I I I I ~ I I I I 1 I I I 1 I I I J I I 4o m m Property Owner _ Parcel ID # Page of Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Sal lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 a Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 Boring # ❑ Boring F-1 ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon ')epth 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 = BOD5 130 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD8330 (RbPoO) RECEIVED, MAY 2 0 ? 01 ~ Wisconsin Departmg717.0 "ISOUNTY SOIL EVALUATION REPORT Page of Division of Safe ,tbM ft "DEVELOPMENT In accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must 1-0 11 include, but not limited to: vertical and horizontal reference point (BM), direction and Paroel I. 0q0 q _ 0 X -L0 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. J Please print all information. Revie by Date Q Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). IO V Property Owner Property Location v Govt. Lot 5 1/4 ~1/4 S 2- T 2 N R E (or w Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# f ~j e t k a u.4 1! CK v.,/ city State Zip Code Phone Number City ❑ Village Town Nearest Road q- X01-7( ) r ~ W. &4/04 New Construction Use: 413esidendal / Number of bedrooms Code derived design flow rate GPD ❑ Replacement , C1 Public or commercial - Describe: Parent material /L X 0(20 Flood Plain elevation if applicable 4/404 ft. General comments and recornmendations: System Type rn~ System Elevation Boring # 131 0 Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor 2- 10 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. •Efl#1 •Eff#2 6-/0 "U r r r~ ra io s; IN i224- Aj),4 3 d4-10 s s Al 3 F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication 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 Effluent #1 = BOD. > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Si re CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address ate Evaluation Conducted Telephone Number 715-246-4516 1432 120th St, New Richmond, WI 54017 l h PLOT PLAN PROJECT Oeverino Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 SE 1/4 SE 1/4S 22 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROIX SYSTEM ELEVATION 101.0' 1.0 sand lift! DATE 5/28/15 BEDROOM 4 CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA # of chambers BENCHMARK V.R.P. Top of 1/2" steel pipe ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL * H. R. P. Same as Benchmark All piping shall be SDR 30134, wdt in 10' B•M.* Property Line of t piping shall be Schedule 40. B-3 3% Slope 99.5' B-4 Walnut Hi I I 'day 100.0 ~ B-1 Grading is to be done to B-2 100.5' divert run-off away from system H uffc utt Combo Tank Area 15' below system is to remain Tank is to be properly bedded undisturbed and provided with lockdown covers with approved warning labels Pro 4 Bedroom House Wel I is to meet all WDNR setbacks Property Line Property Line Scale = 1/4" = 10' 1 Acre Lot 1 OIL ?DDS? /3J'E e STEDT- rtyOwner Paroef ID o 3 -V page F3-1 0 B° ~y.3Z zs ss . I Ground surface elev. ft. Depth to ti d" factor ka Depth- Soil Rate Don* =t Redox Descriptlat Texture structwe Consistence Boundary Roots G in. Munseff Ouu. Sz. Cont. Color Gr. Sz. Sh. `ENI 'EW 1 a •G /a R L aol~ w 2~• /D L S G / f . Cp • !G /a Sew 2 -F6 e - . S • z o S11- /7CS 100" CS • Z . 3 o c hors SCC -ftS/i ~1,,, z •3 ; F-11 # F---- Pit Ground surface elev. ft. Depth to biting factor in. Application Rate . D~lh Dominant Redox Description Texhrre Stare Consistence Sol Boundary Roots plication R[[rs GPDff fdil;iSeII Q1L SZ. Cont t'.OtOr tr. &Z. Sh. 'Eff#9 °EM2 Pit Ground surface elev. ft. Depth to factor in Hortzon Depth Dominant Cola Re c SLIM Rate in. iolor Texture Consistence Boundary Roots GP[}M in. Memseti tQu. S17- CorN cont color Sz. Sh. •Ew1 'Eff#2 F-I soft # ~ &Mng mt Ground surface elev. 0. Depth to Positing factor In. Sc Rate ticxtzon Depth Doc *wA Colm Redox Texhre Struelure conststenee Boundary t3oa[s GPDW in. Munsell Chu Cont. Color Gr. Sz. Sh. "Eff#t 'Eft#2 e ° EfthteM #1 = BogD > 30 < 220 ffxj . and TSS >30 < 150 mgtL ' Effluent #2 = BCOD ` 30 nxft and TSS < 30 mgiL The Department of Commerce is an equal opportunity service provider and employer. Ifyou creed assistance to access services or need material in an alternate format, please contact the depattment at 608-266-3151 or TTY 608-264-8777. seoaiso puma? r Wisconsin Department of commerce SOIL EVALUATION REPORT Page / of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code • V county G ST JL- c ~ . complete lim EROSION CONTROL PLAN must be I.D. Parcel percent slope. completed before sanitary permit issuance Reviewed byOU -1-3 03-00 Dat r Pomona! kdonmeon you provide may be used for secondary Purposes (Privacy L-. s- 15-04 (1) M11- 1 Property Owner repo Property Location ro i~p 133 ERS T•a7U T- % fll/ NX coca. Lo( All e*4 5' 1/4 S T ZB N R /f E (or) w Property owner's Mailing Address Lot # Block # Subd. Name or CSM# !ont5 CA Wia eve . ~ WALWOr wi1 City SNWQ State Zip Code Phone. Number . ❑ City ❑ Village ( Town Nearest Road -poor HT% MN 5So71, &Sl) 19,f Io9~ -ROY sD. lflouER 0 P- New Construction Use: C9 Residential / Number of bedrooms Code derived design flow rate GPD ❑ Replacement ❑ Public or commercial - Describe: tA Parent material /o ~-sS D U.er 7f !/lS Flood Plain elevation if applicable ft. General comrnents and recommendations: t,.~4- T~''s -SVy7"~9r3/~ I~d/2 ~4' /JoU'UD "1 S f /51'• 7.t Sl"A-?G-- LD " S A,c~v i L/ t~ a Boring # swim N ® Pit Ground surface elev. !oo ft. Depth W Writing factor in. Rafe Horimn Depth Dominant Color Redox Description Texture Struc tLire consistence Boundary Roots GPDff In. Munsell Qu. Sz. Cond. Color Gr. Sz Sh. •Eff#1 TOM ~ / 61 y /b ~Q L. a'FS`Jk cS G lt> 3 y N 2- o R I SIL 2 (5 hK cS 4 C5 /f ' 5 • 9- %A • ~ D SIG z,~, bit ~ GI cs I ~ . S ~ D /2 S ! o s Gr C . Z . S Z •q 75 C2 hors SGL k L0 y2 r/z J Boring # 0 Boring oo . 5 Z S.s. s' ® Pit Ground surface elev. ft. Depth to limiting factor L in. Sol riCBtJOri Rate t~ Horb= Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDNt= In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. -Eff#1 •01#2 IN 2- S• o SL:f C I~ •s N •►S D ~Si~ ZfSLr C . s . ~I /cCS G Z /D -a 81', /Ol i2 li Z. Effluent #1 =130D > 30 < 220 nglL and TSS >30 1150 rrg/L • Effluent #2 = BOD 130 ng/L and TSS < 30 mgfL Signature CSTumb az N$ er csr Name (Please P" •R , -Zt L6 R i c t.1' Address Uibricht & Assgciates Date Evaluation cord Telephone Number Private aoD3 7U- 77P,• 39V 2- 2812 1 Oth Ave. Spring Valley, WI 54767 I o RO 2 ~y~ • /ors • so • o~ oyo . 16 k(P • io • o~ oyp • 1056 ' zd • o~ oyo • /081 • oyo•/o*6-70- o yo . Ito • o~ IY PLOT PLAN WALNUT HILLS FARM. LOT # / Pg. 3 of 3 Contour elevation lines. = Backhoe Soil pits. Q = Benchmarks set, maRKED WITH FLAGGED lathes. 1/2" steel conduit pipes. o SCALE : 1" = 30 F1 JE 13M o- ~ a`f y2 o~ s yip 9R. 30_ Vq NL !3~ /off ,s ~oo,so- o v L 13M~► w .1~ SvyS~sr~ ~,vi'~ox~i ~-tovND v12 G~:v~ /p0• S d ` GD,1`70i2 a _ s sT - ~y .v 17 5-. Go T" L God yd &*/t/ 1v h111 lc iro-I T©D!~ r31E l~ STEDT- G proper(yownet 3 ' Page z Parcel ID # of F31 I Groundsurface elev. yy.3z 2,5 R- Depth to limftfng factor in. _ Sol! ieation Rate tlcxizon Depth Dominant Color Redox Description Texture Structute Consistence Boundary Roots GPM IM Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 °Etfft2 1 aG /oRi L z~L4 d, w 13 •S o c mot S ScC -acs Z 3 ersring # ❑ tior;ny - ❑ pit Ground surface elev. ft. Depth to limiting factor . 5~. Soil ication Rate 1 lorizon Depth or Dorrrinartt t;of Rec4ax Description Texture Structure Consistence Boundary Boots GPDff trr. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. •frif# 1 40192 Swing pit Ground surface elev. ft. Depth to I" g factor in. ~ Rate Horizon Depth t7ornirrant Color Redox Description- Texture a Consistence Boun dary Roots GpDM In. Munsell Qu. Sz. Gant. Color f. SL Sh. 'Eff7#i 'Eff#2 F] aDdng F# Q Boring pit Ground surface elev. ft. Depth to limiting factor In. SW tion Rate Horizon Depth Dominant Col Redox criptiun. Texhxe Shucture Consistence Boundary Roars OMM In. Munsell Qu. Cont. Color Gr. Sz. Sh. °Eff#t 'Efff#2 Effluent #1 = BDDg > 30 < 220 mgrl.. and TSS >30 fi 150 rng/f. ° Effluent #2 = BOD5 < 30 ntgt€, and TSS ¢ 30 rnWL The Department of Commerce is an equal opportunity service provider and employer. if you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. sna-assa i~snwr