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HomeMy WebLinkAbout032-2000-50-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 579027 ~6- 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)j. Permit Holder's Name: City Village X Township Parcel Tax No: L'Allier Family Trust c/o James J. & Eu ene J. Somerset Town of 032-2000-50-000 CST BM Elev: Insp. BM Elev: BM Description: d Section/Town/Range/Map No, 0' US~ 5 jfiV V~/ V STG7_ 36.31.19.468C1 TANK INFORMATION 1 \ EL ATION DAT TYPE MANUFACTURERYP_ PACITY STATION BS HI FS ELEV. z IN- 1. 1DJ. p0, Septic EFI)Wr .-Go / Benchmark ,0 1bl • 00 .D M. .~Id . S w I 5 3 9~. (o Aeration Bldg. Sewer HD ct (0. 01 olding ~ • StfM? Inlet 7.2 9y. ~ TANK SETBACK INFORMATION StA*-Outlet 7.5 ILIJ TANK TO P/ WELL BLDG. Vent to Air Intake ROAD Septic L4 I Dosing e d an. 8.ds V•~' Aeration Dist. Pipe 8.3 1 S. Holding Bot. System ~y t - 1 • Cl Z PUMP/SIPHON INFORMATION Final Grade Z.5 Manufacturer and t Cover GPM Model Number TDH Lift Fri oss System Head TDH Ft Ida, L~ ~ L1 / 31 q~• Forcemai Length Dia. Dist. to Well G 11 I I At le v- MID vdaj Y, A b# t4 SOIL ABSORPTION SYSTEM / LO BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Dept DIMENSIONS / LEACHING SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM CH AMBER OR Manufacturer: INFORMATION r /Gjj7U Typ Of Systerrt O~ 2) _ f UNIT Model Number 1Re ►VI J1~! G- vl L IBUTION SYSTEM T ) MI) Ne! h bor Head anifold Distribution x Ho Size/ Ix Hole Spacing Vent t Air Intake ! 1 Pipe(s) Length_ Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Dept v G Depth Over xx Depth of xx Seeded/Sodded xx Mulched Be renc Center Bedrrrench Edges/ Topsoil 'Yes H] No _~es E] No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 730 180TH AVE SOMERSET, WI 54025 (SE 1/4 SW 1/4 36 T31N R1 9W) metes & bounds Lot Parcel No: 36.31.19.468C1 1.) Alt BM Description = (L T~~ CDv /I , ~Gf M .r'bxijrnv& , -rhivj A be = i /Tfr 2.) Bldg sewer length t' -amount of cover _ Ll 31 _41 > Plan revision Required?#~& Yes No 4 13 Use other side for additional information. SBD-6710 (R.3/97) Date Actors Signature Cert. No. rrna~ RECEIVED County t Safety and Buildings Division f 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) P S on, W! 53707-7162 Ati JUL 1 2015 "ll LC A 2--7 4~ 6 - OMM . "J";"'a' 9 Apphca 1 Store ranSantlon ylnber L as In accordancc with SPS 38321(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address) j the Department of Safety and Professional Setvies. Personal information you provide may be used for secondary Purposes in accordance with the PFiV4CY Law, s. 15. 1 m , Stats. 11 3 0 Av~ L Application Information - Please Print All Informs ' T Property Owner's Name e, V a Parcel # ! L 032- Property Owner's ing Address {Property Location n 1 Go lot `f t G City, state Zip Code Phone Number /4, lion trd ~Z~ / 87 ' [ J L Z A) II. Type of Building (check all that apply) Lot # T / N; R or w or 2 Family Dwelling-Number of Becirwais Subdivision Name Block # A ❑ Public/Commercial - Describe Use 44 " ❑ City of ❑ State Owned - Describe Use CSM Ntmtber ❑ Village of n I ~ / t ~ / ~ ~ r Town of l~ III. Type of Permit: (Check only ne boz on line A. Complete line B if applicable) A 20 ❑ New System actvmCut System El Treatment/Holding Tank Replacement Only ❑ other ModificationtoExisting.System (lain) B. List Previous Permit Number and Date Issued ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber 11 Permit Transfer to New Before Expiration Owner Ljm r LI Type of POWTS System/component/Device : Check all that apply) CR,T Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) - ❑ Pretreatment Device (explain) V. Dis rsal/Trea eat Area Information: Design Flow (gpd) Design Soil Application F.ate(gpdsf) Dispersal Area Required (s Dispersal Area Pro d (sf) Systctn Elev ~ ~ VL Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units ° c .0 2 T5 Now Tanks Existing Tanks ) J, t u p ~ y a Z !N f/I TML tJ n v x C Septic or Holding Talc Dosing Chamber VII. Responsibility Statement- 1, the undersigned, a responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Pl s Signature MP/MPRS ?Humber Business Phone Number <U[ Plumber's Address (Street i , State, Zip ) VIII. untv/DS artment Use Only Z I Approved C Disappro Permit Fee Date sued Lcsuing . t Signature y Reason for Denial 7 ' j Oil DL Conditi--~ W-19101asoas;for Disapproval Sept tarty ettitlent fillter and" . 3 6 by a n dispersal celf must all be r0ce / Maintained as per management plan provided by plumber. t~1+2 2. 41'8t l'bijuirOmenis mustge maintairi6d N per code I ordinance.. 4 4-6 /y~ee,l K- a ~~t'- GoftiP l_ Attach to comptett plans for the system and submit to be County only oa paperLnot Tess than s trt 1 11 iuchees 3n sin / SBD-6398 (R. 11/11) PLOT PLAN PROJECT Euaene L'Allier ADDRESS 701 Parent St. Somerset Wi 54025 SE 1/4 SW 1/4S 36 /T 31 N/R 19 W TOWN Somerset COUNTY ST. CROIX SYSTEM ELEVATION 93.5/93.4 5.5' below grade DATE 7/12/15 BEDROOM 3 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 Ilk BENCHMARK V.R.P. Bottom of siding ASSUME ELEVATION 1009 Filter Lifetime Filter ❑ BOREHOLE O WELL * H.R.P. same as benchmark 180th Ave Scale is F = 40' Scale 1 /4'1 10' unless otherwise noted All piping shall be ASTM SDR 30/34, within 10' of tank, piping shall be ASTM F891 L4 11 (share Driveway 7' 0% Slope B-2 2-3' X 66' cells with >3' spacing X~ 100' ,v 5 t 15 70' B_3 25' Existing 3 75 Quick4 Standard Bedroom Leaching Chamber House of Cover with 20.0 ft2 of Area 10' B.M.* 5.6ft^2/pair of end caps 35' 4' Long 12" T 15' 3 4 Grade at System Elevation 19 15' B-1 t.~ .t D W old system is to 5 be pumped and 7' ' ~ S buried 5 Property Line GNo- r 1SV Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 7/12/15 Owner: Eugene L'Allier Location: SE /4 SW1/4 S36 T31 N,R19 730 180th Ave Somerset Manuals Used: In-ground absorbtion system (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross Section 4-6. Maintanance and Contin y Plan 7. Filter Cross Section Signature License number #2269 PLOT PLAN PROJECT Euaene L'Allier ADDRESS 701 Parent St. Somerset Wi 54025 SE 1/4 SW 1/4S 36 /T 31 N/R 19 W TOWN Somerset COUNTY ST. CROIX SYSTEM ELEVATION 93.5/93.4 5.5' below grade DATE 7/12/15 BEDROOM 3 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 BENCHMARK V.R.P. Bottom of siding ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark 180th Ave Scale is 1" = 40' Scale = 1/4" 10' unless otherwise noted All piping shall be ASTM SDR 30/34, within 10' of tank, piping shall be ASTM F891 Well (shared) Driveway 7' 0% Slope B-2 2-3' X 66' cells with >3' spacing 100' 70' Existing 3 B-3 25' Bedroom Quick4 Standard House Leaching Chamber 15' A-O t ' B. M. * with 20.0 ft2 of Area 10 35' 5.6ft^2/pair of end caps ST 15 3 4Grade at System Elevation 15' O 15 B-1 15 DW Old system is to 7 , S be pumped and 5 , buried Property Line 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 99.01 A' e' Grade Vent Avent 4" .~~30/34 =ank 3' S' Long 191 3699 Grade at System Elevation 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 B System elevations: A_93.5' B 93.4' ST, CI2OIX COl1R`aT'e SEP'1,1C TA1\,'~K'VI A]N't'EN ANCE , t(.ik )-?Elt,4 t, , ANI) OWNFR.S.IIIP 0:RTI-F WA'I1t-,N FORM Owner/Buyer ' Mailing Address Verd;ication required from Pianntng b. Zoning Ik;pmtnent for new cotisirucuon.) City/State LEGAL DESCRIPTION I/ 1~ Properly Location-54 t.c../'/a , cc- 6 1 ~ 1:/ W, Town c~c~~ SubdIVIS1011 Lot ~r Certified Survey Map # V(itttrtf, Pagc Warranty Feed # - _-.C~ Pare It spec house yes o l,ot het{-~ identifiable o no SYSTEM MAINTENANCE AND OWNER CERTIFICATION improver use and maintenance of your septic system) could result in its pr,-mature failure, to handle wastes. Proper maintenance consists of pumping out the septic tank every three yeat:s or sootier, 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. Olvner maintenance responsibilities are specified in §Connn. 83.52(1) and iii Chapter 12 - St. Croix. County Sanitary Ordinance. The property owner agr(c:s to submit to St. Croix tbunty PlanIutie & /on T2t; Department. a certification form, signed by the owner and by a master phunber, Journeyman plumber, restricted plumhci or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspct-Ion and putrtping (if necessary), the septic tank is less titan 1/3 fitll of sludge. 1/we, the undersigned have read the above requirc:mcnts and agree to maintain the private; sewage disposal systeol with the. standards set forth, herein., as set by the epartznent oi't_ ommiercc and the Dcpa tnnent of tiatural Rc sotut,rss, State of Wisconsin. Certification stating that your septic: systern has been maintained must be complete, l and returned to the St. Croix County Plarrtrinlr, & Toning Department within 30 dates of the three y ,ar expiration date;. 1/we certify that all statements on th form arr. trot: to flw best of" my/ocn k aowledge. l/we am/m e, the owner(s) of the property described above, by virtue of a war anti decd recorded ill ltcg;ister: of Deeds Office, i'VtrYnber of bedroo SR gl'UItI; OF APPLICANT(S) DATF `_**Any information that is misrepresented may result ire the stutitaty permit being o:voked by the Planning & Zoning Departmum. Include with this application a recorded warranty deed Liomthc, Register of'Deeds lice and a copy ofthe certified survey snap if reference is made in the warranty deed, (R14 V. 08/05) POWTS OWNER'S MANUAL $ MANAGEMENT PLAN Page of SYSTEM SPECIFICATIONS FILE INFORMATION Owner ; e -d Tank Manufacturer. El NA Permit # Septic ❑ Dose ❑ Holding Volume: (gal) DESIGN PARAMETERS Tank Manufacturer: J-NA Number of Bedrooms: ❑ NA ❑ Septic ❑ Dose ❑ Holding Volume: (gal) Number of Public Facility Units: `j~_NA Vertical Distance Tank Bottom(s) to Service Pad:,{ Q_ (ft) Estimated (average) Flow : (gal/day) Horizontal Distance Tank(s) to Service Pad: J / 1r/ (ft) Specific servicing mechanics must be provided if vertical is >15 feet or Design (peak) Flow = (estimated x 1.5): (gallday) if horizontal is >150 feet. Specific Instructions to be provided on back. In Situ Soil Application Rater , (gal/daye) Effluent Filter Manufacturer: ZjK6_1,j'Q~ ❑ NA Standard (Domestic) influent/Effluent Monthly average Effluent Filter Model: a r~ Fats, Oil & Grease (FOG) 5_30 mg/L Pump Manufacturer: Biochemical Oxygen Demand (BODs) s220 mg/L ❑ NA A Total Suspended Solids (TSS) "5150 mg/L Pump Model: High Strength Influent/Effluent Monthly average Pretreatment Unit (FOG) >30 mg/L Manufacturer. (BOD , s) ❑ Mechanical Aeration ❑ Peat Filter / (TSS) > > 15250 0 m9n mg/L A ❑ Disinfection ❑ Wetland Pretreated Effluent Monthly average ❑ Sand/Gravel Filter ❑ Other. (BODs) 530 mg/L Soil Absorption System (TSS) 530 mg/L XMA Fecal Coliform (geometric mean) 5_10, Ground (gravity) ❑ In-Ground (pressure) ❑ NA ade ❑ Mound Maximum Effluent Particle Size t~ in dia. ❑ NA ❑ Drip-Line ❑ Other: Other: NA Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Pump out contents of tank(s) hen combined sludge and scum equals one-third (3~) of tank volume ❑ Wfi-eirrthe high water alarm is activated Inspect condition of tank(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA ear(s) Inspect dispersal cell(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA tear(s) Clean effluent fitter At least once every: month(s) NA ,Kyear(s) Inspect pump, pump controls & alarm At least once every: ❑ month(s) NA ❑ year(s) Flush laterals and pressure test At least once every:. ❑ month(s) NA ❑ Year(s) Other: At least once every: ❑ month(s) NA El year(s) Other: NA MAINTENANCE INSTRUCTIONS Inspections of tanks and soil absorption systems shall be made by an individual carrying one of the following licenses or certi lions: Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector, POWTS Maintainer or Septage Servicing Operator ( umper). Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks r leaks, measure the volume of combined sludge and scum and a check for any back up or ponding of effluent on the ground surface. The soil absorption system shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any treatment tank equals one-third or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator (pumper) and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code: All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units. and any servicing at intervals of 5512 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) START UP AND OPERATION Page of 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 to use. 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 to the system. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator (pumper) prior to restoring power to the pump or contact a Plumber 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 of the treatment tanks and soil absorption system: acids, antibiotics, baby wipes, cigarette butts, condoms, cotton swabs, degreasers, dental floss, diapers, disinfectants, fats, foundation drain (sump pump) discharge, fruit and vegetable peelings, gasoline, greases, herbicides, meat scraps, medications, oils, painting products, pesticides, sani4r 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 replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at the time of their permit issuance. 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. ❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. WARNING TREATMENT TANKS, PUMP TANKS, AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES OR LACK 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 Name Name a.~. Phone Phone dZ SEPTAGE SERVICING OPERATO PUMPER LOCAL REGULATORY AUTHORITY Name Name t Phone Phone 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. i G m ~ a o a r O o. ~ N {D O Is/ { m ( o _ o..... _ co O y O .p A P i I 3 t ,r r V. 324, R 2 Y1515, P. 33T V . 316, P. 338 SF D ATEB WISCONSIN i D I RECEIVED & PLED t = I~ DOUGLAS FOLLME 3 SECRETARY srAT[ WEST 2ss'. =con 130 , _ _ _ _ IS 9' ROOT u~ CEL1.14R EN Ry H FENCE ' ENCROACHES ~ I 20! 130 WEST r•; > cc S 0 to t EUGENE J. 1.'Al..tER 0 0 EUGENE J. 1.'A LL 1ER 1 o V.42a p t16 - V.54 1 , P. 539 n / In 41 it in GARAGE 1203 e~ ! Et1iCF20AC?•fE'S l~fi. ray ti .-10 EAS Elf a NT 130 143 , ' . -G RA en W £ S T = 'mss ENC A R CH till i 31 134' 24 'EASEMENT € ST t 2.4 1 ; 75 ' -L21;e i nr EUGENE J. CAt_ L1ER ' i V .4 j - 60, P. 42 d GEORGE FAC F ; 1 HARRY H. - ; _V.324 , P. 4q gyp' v# i$ HENTON clu V.485, P. 53 2 0 in 134' s i 299 m 143 a1 ' , I 75 ' l F i,. 4 I Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings 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 include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Q _ - Please print all information. Re ' ed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ~IWI Property Owner / Property Location T N R E (or) W Alf / P Govt. Lour 1/4 1/4 115 Property Owner's M61fi% Address Lot # Block # Subd. Name or CSM# City State Zip Code Phone Number ❑ City ❑ Village Town Nearest Ro d s a~z--( .5 0 l~e~- 37 ❑ New Construction Use'919esidential / Number of bedrooms Code derived design flow rate 15627 GPD eplacement ❑ Public or merclal - Describe: Parent material plc! cG/ Flood Plain elevation if applicable General comments s s ' / [ tjt v y j' and recornmendations: System Type w it/kJ~ System Elevation F ~ # Boring F 1 pit Ground surface elev. ~ !J ft. Depth to limiting factor M -Din. 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 Z - s 3 S LIiA id , '7 Zo G 6 t 5tl Bori ng # O Boring / RL Pit Ground surface elev. ft. m' factor 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 -L Q- 52 " 2 C' 2 A0 l Ge l • Effluent #1 = BOD. > 30 < 220 "A and T >30 < 150 ' Effluent #2 = B D, < mg/L and TSS < 30 mg/L CST Name (Please Print) CST Number Bird Plumbing, Inc. Shaun Bird ure 226900 Address Date Evaluation Conducted Telephone Number 1432 120th St, New Richmond, WI 54017 715-246-4516 Property Owner _ Parcel ID # Page of Boring # Boring ® fLl Pit Ground surface elev. ~14 ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 ©r~~ - CL-'o eyl 0 Z I-b - 4'1 ;L) A J " It V~j It /A4 F] Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Cola Redox Description Texture Structure Consistence Boundary Roots GPD/fP 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 ')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 = BODS > 30 < 220 mg/L and TSS >30 < 150 mgA- ' Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SB"330 (8.6/00) Property Owner Parcel ID # Page of 3 Boring # ❑ Boring Pit Ground surface elev ft. Depth to limiting factor in. Sal lication Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 alp LTV- s IA4 I► IS'-FV 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 Boring # ❑ Boring F-1 ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Sal Application Rate Horizon ')epth Dominant Color Redox Description. Texture Stricture Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/l- ' Effluent #2 = BOD, < 30 mgA- 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. SBD4330(R.rvoo) Project Name Eugene L 'Allier ird Address 701 Parent St. Soil Test Plo/6/15/15 Somerset Wi 54025 226900 Lot Subdivision D SE 1/4 S W 1/4S 36 T 31 N/R19 W Township Somerset [-I Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Bottom of siding System Elevation 93.5/93.4 *HRPSame as Benchmark 180th Ave Scale is 1" = 40' unless otherwise noted Well (shared) J Driveway 7' 0% Slope B-2 100' 70' 15' B-3 25 Existing 3 Bedroom House 10' B.M.* 35' ' 15' B-1 15 DW 7' S 5' Property Line