Loading...
HomeMy WebLinkAbout040-1304-10-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 578980 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Nelson Jeff M. & Karen B. Troy, Town of 040-1304-10-000 CST BM Elev: Insp. BM Elev: BM Descriptiopp~ Section/Town/Range/Map No: '6T,3. 041 lJ )M , GS 08.28.19.1816 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. 'A J$ Septic I.0 Benchmark Alt. BM F; S /1/ 5 Aeration Bldg. Sewer , 7 Holding St/Ht Inlet C~ -3 9V -6 -7 TANK SETBACK INFORMATION St/Ht Outlet 5.a TANK TO P/L WELL BLDG. ent Air Intake ROAD Dt Inlet \ \ Septic 33 ate/ / Dt Bottom / . $ Dosing Header/Man. $Ct Aeration Dist. Pipe ft. ~Q Holding Bot. System • I Soto, $ Ix, a Final W7. to PUMP/SIPHON INFORMATION % ~r1 y, to 14 Manufacturer GePM nd St Comer /45 Model Number TDH Lift ion Loss System Head H Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM Liquid Depth BED/TRENCH Width Length No. Of Trenche_ f PIT DIM N~ SIONS No. Of Pits Inside Dia. DIM 3 ENSIONS $L. 3 ) r vt SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufa re . 4-1 INFORMATION /0^iVAY-7 ~ I ?p CHAMBER OR ~j l -L Type y -5 J / UNIT Model NUtnb L4 A4 <5 jr_ va DISTRIBUTION SYSTEM 7.a 3 - Cop S _ ~S Header/Manifold J( Distribution x Hole Size x Hole Spacing Vent to r Intake I P ipe(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 Seeded/ LYes xx Mulched Bedfrrench Center 3 , .5 j Bed/Trench Edges Topsoil T E No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: - /Y/ I ~ Inspection #2: Location: 435 Sunset Dri~ dson, WI 54016 (NE 1/4 SW 1/4 8 T28N R1 9W) Sunnss~t Valley Lot 10 Parcel No: 08.28.19.1816 1.) Alt BM Description 6b La c, 2.) Bldg sewer length = 53 - amount of cover = q ~1 n f a l ► ~b f j~~ ~'e U jCL Plan revision Required? ❑ Yes❑ No Use other side for additional information. Date Insepctor's Signature Cert. No. SBD-6710 (R.3/97) v7 L Lo P ME rq SWI4 s 1 Z6 0lp, ,q w L ©T44 10 SUPSe-r V AL.L!C--- I Tt~ W t? ot` -T-F,'04 s r L' R61 V G Ti y 223272 f smu 1 c~ e / 10 1~. V t t C, 4 T~Fpparxryr County AdusIff Ses Division D ngton Ave 5T 641v: H 7 ~ $ P ~ P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) Is 0] w 707-7162 /T) ~~cS(023PL~ ( State Transach ber Wpy nit Application In accordance W SPS4.21(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 the Department of Safety and Professional Services. Personal information you provide may be used for secondary Project Address (if different than mailing address) purposes in accordance with the Privacy Law, s. 15.04(1)(m), Stats. ~ 7 / 35 S (~nSC~J 1 y` 1. Application Information - Please Print All Information Property Owner's Name Parcel # -_J -C, F F 160-50" 0 0q0 i3oy- COE) Property Owner's Mailing Address y~,.~ Property Location L13 SV Q5CT IJIz fU C- Govt. Lot Z7 ISJ City, Statue Zip Code y Phone Number N E S11A'/<, Section one) 7'f VOSC3 /0 wJ (1 ~ L T N R 1CJ (circle # f II. Type of Building (check all that apply) of ~or 2 Family Dwelling - Number of Bedrooms ` Subdivision Name G ~8 , / ❑ Public/Commercial - Describe Use S t Block # 0P `r 1KL"-f✓ V pJSI ❑ City of ❑ State Owned - Describe Use ~ % CSM Number ❑ Village of j D 1S1V-160T7bN (.aLS W Z.v 2Z 2-0 c ~-l 136~?S ! RTown of My III. Type • Check only one box on line A. Complete line B if applicable) b A. New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner I Com onent/Device: (Check all that apply) ~fw Non-Pressurized Irt-Ground ❑ P ssurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ o Oth ' ersal Component (explain) ❑ Pretreatment Device (explain) V. Dis ersal/Treat nt Area Information: )2 / Design Flow (gpd) Design Soil Applicatio Dispersal Area Re ed (sf) Dispersal Area Proposed (so Sy in E evation G.~ ~djyJ /_000 1 Rate(gpdsfl S /ZD(7 10~~~ 2-V ( VI. Tank Info Capacity in Gallons c o Total # of Gallons Units Manufacturer w New Tanks Existing Tanks IN / j , / is U Cn V1 w C7 a Septic or Holding Tank , V~ 1/ s~"~~{ ❑ ❑ ❑ ❑ Dosing Chamber ❑ ❑ ❑ ❑ ❑ VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print s afore MP aig R ber Business Phone Number Plumber's Address (Street, City, State, Zip Code) 86 Y_ 5 J. 0 ~yc~9 VIII. Coun /De artment Use Only ) [s3j~ 'b pproved seppreve Permit FFete.( Dat Iss d Issuin gent Sign re GC~ caner Given Reason for enial $ / J • ~p e-A IX. Condi e s or lsapproval nu+enerandD .dispersal cell must all be services / maintained es per, management plan provided by plumber.. *requil'ements must,l,maiMafnd -as psr appkabis lade ! orditarlc~e. Attach to complete plans for the system and submit to the County only on paper not less than 81/2 x 11 inches in size SBD-6398 (R03/14) CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: ZC_ Owner's Name: owner's address: y s sv I~o!~r R i 1itC3IJ w 1 Legal Description: f V E SW'ly T Z6 Ill k/ t Township: I ~0%) County: 5T C,RQAV Subdivision Name: rJ_( : Lot Number: /b Parcel ID Number. o 'to Page 1 Index and title Page 2 Plot Plan Page 3 System Sizing & Cross-Section Page 4 Filter Specs Page 5 Maintenance Information Page 6 Management Plan Page 7 St. Croix Cty Septic Tank Maintenance Form Page 8 Warranty Deed Page 9 CSM or Plat Attachments: Soil Test & House Plans Designer/Plumber. _E'F'F 1F_1)Y' License Number /V}~ f ZZ.~2 yZ Date: IS Phone Number -716 - w h 3 y~ Signature DesNned pursuant to the to-Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P (N.01/01). Page 1 'q Sw4i s $ T28 olp, )q w LOT-4 10 &UPSGT VAI.LG I ter- CRMV CTY Tb kJJ o F T'i?A ~ 2Z,32yZ SDIL, a6viNl-6 4 '/0 \ ~av 125b &,AL vJICI~OL2 -AtjiC to ~Z b i2 8 2 . 1 (o D~ i i i ~t R~tiCtl mAk'~';3,W e rz ~~h i 1~~ SOS 5 (Li LOW 75, gyp ~_ft s tries i 4' Lilo. tuww Tne 2 vworobufvwmp" Tho ~u~eo~uarAnd A~e1~ ~ 11Vl~lGT ~Ro~ EISA Rs*g sq ft pordwrA Sd lgp i Raft gpdtqft ,,~apa o..> lbws,=, Is fto a Rub 4. ~ E38A 60 cis 3mmof - 1 P14P a'.._.._. 6 , v Installation and Maintenance Instructions installation Step l Dry fit the filter case onto the outlet pipe going to the drain field. Ensure it Is centered directly under the access opening. (if outlet pipe is already in a fixed position, additional pipe may need to be added) Step 2 If utilizing the additional single side support and the two bottom supports: While the case is still dry fit to the outlet pipe, measure and cut 1"schedule 40 pvc pipe to the length needed to extend from the hubs that are pre-molded into the case to the side wall and the inside floor of tank. solvent weld pipe into the hubs that are pre-molded onto the case. Step 3 Solvent weld the case to the outlet pipe. Insert the fitter cartridge into the case pressing down on the cartridge until it locks into place at the bottom of case. Step 4 if utilizing a vertical read switch: Insert switch into the hole pre-molded into the top of the filter. Press straight down until it locks into place Maintenance 1) Remove the access lid of the tank. Note: To ensure undesirable solids do not exit the tank and into the drain field, the tank should be pumped out until the level of effluent is below the-outlet level of the tank. 2) To remove the filter cartridge from the filter case, pull up firmly on the handle of the cartridge dislodging it from the case. (if utilizing a vertical read switch, removal of switch is optional) 3) Using an ordinary garden hose, rinse the filter cartridge ensuring all visible septage material is removed. 4) Place the filter cartridge back into the Alter case pressing down on the cartridge until it locks into place. 5) Place the access lid back onto the tank ensuring it is secure. Lifetime filter has a lifetime limited warranty: Lifetime filter LLC warrants the filter will be free of manufacturing and workmanship defects during normal use for the period of time the original purchaser owns the product. Lifetime filter will provide a replacement filter in the event that the original fitter was not damaged during the installation or maintenance process. Damage to this product caused by accident, misuse or abuse will not be covered under this warranty. Improper care or malfunctions resulting from product not being installed, operated or maintained property-will void this warranty. Lifetime filter assumes no responsibility for labor charges, removal charges, installation or other incidental or consequential costs. Contact: mik~fil~~~com Phone: 502-7242231 POWTS OWNER'S MANUAL AND MANAGEMENT PLAN w FILE INFORMATION SYSTEM SPECIFICATIONS owner Septic Tanis Capacity [Z-60- gal ❑ NA Permit # Septic Tank Manufacturer MLSgM ❑ NA DESIGN PA~F►AMETFRS Bfftuent Filter Mew L Q6 ❑ NA Number of Bedrooms 1 ❑ NA Effluent Filter Model NA Number of Commercial Units NA Pump Tank Capacity NA -,1_60 RLdqj Pump Estimated flow (average); Tank Manufacturer NA NA Design flow (peak), estimated x 1.5* d RaVday Model NA Soil Application Rate pn~ Unit NA InfluentlEillaeat Quality (NA❑) Monthly Average' 0 Sand/Gravel Filter ❑ feat Filter Fats. Oil & Grease (FOG) S 30 mgtL ❑ Mechanical Aeration C3 Wetland Biochemical Oxygen Demand (BODs) < 220 mgtL M Disinfection ❑ Other. Total Suspended Solids (TSS) Manufacturer: Modek 250 .t* Dispersal Celt(s) Pretreated Effluent Quad Monthly Average KIn-ground (gravity) ❑ Inrground (pressurized) Biochemical Oxygen Ds) S 30 mg/L ❑ At grade ❑ Mound Total Suspended Solids (TSS) 5 30 mg/L ❑ Drip-line Other Fecal Coliform (geometric mean) <}0 cfu/100011 ❑ Leaching Chamber Main6cttrrer Maximum Effluent Particle Size 1/8 inch diameter ModelQjt&- 4 , Laying *Wastewater Flow Verification and Calculations: Soil Application Rate (id/fl Area Req. 0)(Other than bedroom based) Infiltrative StnrfacelC~tsmber-FSIA f Minimum Number of .s FFlow/Loading Rates aria p Aggregate pesi Values typical for domestic (non-commercial wastewater Materials: all materials must comply with WI Adm. Code and septic tank effluent. COMM84 and be installed per manufacturers specifications, ***Values typical for pretreated, wastewater. and apprimA letters. DESIGN CRITERIA ❑ "Wisconsin At grade Soil Absorption System, Siting, Design & Construction Mamiat" (Converse et.a1.1990) ❑ "Wisconsin Mound Soil Absorption System: Siting, Design & Construction Mannar Converse, J.C. and EJ. Tyler. Publication 15.22 ❑ "Design of Pressure Distribution Networks for Septic Tank-Soil Absorption 5ystemi- Publications 9.6 ❑ "Design of Conventional Soil Absorption Trenches and Beds". RJ. Otis - ASAE Publications 5-77 and "Design Mound - Onsite Wastewater Treatment and Disposal Systems7. EPA 62511-80-012 October 1980 ❑ SBD -10570-P (86/99) "At-Grade Component Manual Using Pressure Distnbution" )SBD -10567-P (R.6/99) "In Ground Absorption Component Mannar 0 SBD -10705-P (N.01101) "In Ground Soil Absorption Component Manual" Version 2.0 ❑ SBD -10628-P (N.6199) "Recirculating Sand Filter System Component Manual" ❑ SBD -10656-P (N.6/99) "Split Bed Recirculating Sand Filter System Component Manual" ❑ SBD -10572-P (R.6199) 'Mound Component Manual, ❑ SBD -10691=P (N.01101) "Mound Component Manual" Version 2.0 ❑ SBD -10595-P (8.6/99) "Single Pass Sand Filter Component Manual" ❑ SBD -10657P (R.6199) "Drip-lime Effluent Disposal Component Mannar, ❑ SBD -10573 P (R 6199) "Pressure Distribution Component Mannar, ❑ SBD - I0706-P (N,0101) "Presswe Distnbution Component Manual" Version 2.0 ❑ Drip-line Eff luent Dispersal Component Manual for Multi flo Onsite Wastewater Treatment Units MAINTENANCE AND MANAGEMENT MAINTENANCE MONITORING SCHEDULE Service Evert Service Inspect condition of tank(s) At least once every ❑ months s 3 Pump out contents of s When combined sludge and scum uals one-third 113 of tffiIk vohmne s At least once every mouft adsL Maxima 3 ym) s Clean effluent filtex At least once ever ❑ months OLyea Inspect controls &c alarm At least once every ❑ months ❑ year(s) ❑ NA Flush laterals and test At least once ovary ❑ months ❑ s ❑ NA At tract nnrr .wrav n months ❑ veer(s) ❑ NA - -_v _ System start up shall not occur when soil conditions are frozen at the infiffrative surface. OPURA.TIO?N The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity and quality of the wastewater stream will affect the performance and longevity of your POWTS. The installation of water-saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water softeners, iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground surface whenever possible. Note: this does not include laundry wash, showers, dishwater, etc. Thus system a designed to handle domestic strength wastewater, h v%,n r the disposal of food based greases and oils, vegetabk/hnrit peeps and seeds, bones, and food solids such as those produced by a garbage disposal should be minimized. Toilet tissue is the only paper throe should be discharged into the system. Other non-biodegradable items such as baby wipes, tampons, sanitary napkins condoms, cigarette baths, dental floss, and cotton swabs should not enter the systems, Chemicals such as petroleum products, paint, disinfectants, pesticides, antibiotics, solvents, etc., should not be flushed into the system as they can seriously damage your POWTS and contaminate your drinking water supply. Maintain a regular steady flow by spreading laundry washing throughout the week. Avoid vehicle traffic over all system components. Compaction of snow over the dispersal unit may cause it to freeze up. D valves valves shall be operated in the following mannor. 0 Alarms Alarms should be tested on a regular basis by the home owner. If an alarm sounds, contact an individual licensed to service POWTS, There is normally a h day reserve under regular operating conditions, however water should be conserved until my problems with the system are corrected to prevent back-up of sewage into the dwelling or surfacing. INFECTION Inspection shall be made by an individual carrying one of the following licenses or certifications: Master Phunber, Master Phoulm Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per dr attached Maintenance Schedule). D Septic Tanis Ca nponent Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of coznbMed sludge and scum and to check for any backup or ponding of etlfueat to the ground surface. Access op= W used for service or assessment shalt be sealed and/or locked upon completion of service. Any defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective locking device to prevent accidental or unauthormed entry into the tank When the combination of sludge and scum in any tank exceeds one-third (1/3) or more of the tank voh wr, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with Chapter NR113, Wisconsin Administrative Code_ Thu outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. Provisions are to be made to retain solids in else tank Filter cleaning may be necessary at more fiequent intervals than stated in the maintenance schedule to keep the system operating. D Pump Chamber/Treatment Tanks Component The inspection mast include a test of all electrical equipment such as pumps, alarms ad figs. A visual check must be made for leaks, backups, surfacing, nussinng or broken security devices and other hardware and the cxmdidort of any filters. Any service needs or repairs shall be promptly taken care of M ItWhound Gravity Component Dispersal Cells The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection far any evidence of surface seepage or discharge. Any discharge to the ground surface must be prosy roported to dw rognlatory authority. Ponding at depths greater than 75%.of the height of the component may indicate overloading or impending hydraulic f iffure necessitating more frequent monitoring. Page ~ • .4 p Mound, At-Crane, In-Ground Pressure The inspection shall inchmde recording the levels of ponding, if any in the observation tubes and a visual iron for any evidence of surface seepage or discharge. Any discharge to the VWW surface must be promptly reported to the y authority. Pondiug greater than 75% of the height of the component may indicate overloading or impending hydraulic fsihtre necessitating more frequent mR►n- ing. The pressure distribution system is provided with an opening at the end of each lateral to be used for Bushing. Ilia laterals should be flushed at least once every three (3) years. Pressure checks of systems with multiple laterals should be done to ensure that equal distribution of effluent is occurring to promote the longevity of the syst m. for intenance= inspection, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin AdministrAtive Code. ABANDONMENT When the POWTS fags and/or is permanently taken out of service the following steps shall be taken to ensure that the system is properly and safely abandoned in compliance with Ch. COMM 83.33, Wisconsin Administrative Code. - All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. - The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. - After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or other 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: Q A suitable replacement area has been evaluated and may be utilized for the location of a replacement sorb absorption system. The replacement area should be protected from dime 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 from existing and proposed structure, lot lines and wells. Failure to protest the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Reps system awn comply with the rules m effect at that time. p A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS tochnalogy a holding tank may be installed as a last resort to replace the failed POWTS. p 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. E3 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. <<WARMG» SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTIAN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAWER Name p Name Phone Phone SEPTAGE SERVICING OPERATOR LOCAL REGULATORY AUTHORITY Name A 1 its( A> Phone Phone /5 - (o - m-/ (o O i ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Jeff Nelson MaiingAddrems 715E Blue Jay Lane Property Address 435 Sunset Drive 6 CVerification required from Planning & Zoning Department for new construction.) City/State Hudson, Wl Parcel Identification Number 040-1304-10-000 LEGAL DESCRIPTION -10 Property Location N r/ SW V4 , Sec. $ , T 2$ N R W, Town of Tray u n set Valley Lot # Subdivision Plat: S 10 Certified Survey Map # Volume , Page # Warranty heed # (before 2007)Volunie , Page # Spec house 0yes0no Lot lines Identifiable [ayes❑no SYSTEM MAINTENANCE AND OWNER CERTLFICATIC3N Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §SPS. 9$3.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St, Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 113 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Safety And Professional Services and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form: are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, ue a warranty deed recorded in Register of Deeds Office. Number of bedroo 4 \,I M IGNARM OF APPLICANT(S) f DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 04/12) " rn i x I o ti -/-VN I x D i I ~ r*m x ti WFST L /NE~0F TH NE t/4 xsk~oo 056' W 2637.26' p :t \ \ \ x oo o (n 6 8.39 x I m z t> ' ~~co ` avol COOK o m m 4 Npol X/i Y `4. _ ~ r I y . b' try % rn 3 ODD --q -rn411 O 1 O~po~ o \ l p \ w Z -I oo "'1 1 1 M> 0 M •-I / O- v x, o °DZ Cn O ~ -I 9' 8 0 % OD Aso ' ~O S~ 9? rn C I 1 o • V, ~p C) Clam's Drawing Room, LLC 201 5 3gx€ 3m zRx=gg3Ke~ `MM. $3a~~~4 ra I I _ I!I 21 = rn I ! I - ! I! goo i. i' III O rn yI _ - I A_1_ II I I I II ! !Tf"~ I! I Ilu!lil F 0 0 I~ C2, I'1 .I 1 7~ "1 III I (D I I ~v7 I 70 C) o Z ° lain's Drawing Room.- u $ ~ ~ 436,/'U/VfET DRIVE, FiUD,/'ON, WI54016 • P N p ©laeDrawing Room, LLC 2015 119- o 4o.K>3g` 3~~°sa9R a va ~~ae3A a >9 Inl A i i i i p b ~6 i u 4 ~ WgA~: sew N hg$~f~ ~ e O rn a~pm f n ~~I a o. O ~ 6 i of ~ r a 4 I oR ° .3-ntrz qsa d z q ib®6 o n z ua U 2a , n ° ~ ~ ~A b an 8 a m A i n .u.o; I _ on m 4g~aa - IIIII _ - q P >'R yr I II Ms,o~ ~ I z 1 I 1 QT I~ I4 Q1 $ { E s Og$m O p n Z Q n u O C m n --1 O N e i§ wnorncc roQ z s JEFF & KfaRE/V /VELfO/V lain's Drawing Room.- g `s e& a 436fU/fET DRIVE, HUq/'O/9, WI 54016 • T Y v ©laln's $Drawing Room, LLC 2015 FIl° A~2 ~ge~ n, n 'z 3za °p~ $K ~2ua m .m.,~...F ° ^x I I Y, ~ r _ I I ~ ~ I k „ o- ~ I 35 C 4 $ 8~ b4lO F I^ a ~ ~ ~a ° o 4 A 11, s N ~ urG 4. P~I~ Cl _ > _ ~IOI iTS.B. Q r n oN Z p e y .v.z ere. ~.aeeM .-..1 X r ■ n-.wzixz ' roroo-o e - - - - - - - - - - - - - - - - - - -P e'-o ea_vn aaw ooores + - - i I G- i t ~ O INI I I I 3° - I ~t~i I=1 wlo I €z__ I n - I I a u~eS, I~I 81- I tl-~p I ° 3 ~ pp I I ~~46I~I I I II ~ S$ °p I$I Eta j c = 'sin N. i p m 9a~, I I bo I ~ rtc J~~1rI I reb dni~x ° 8 i"x 4~ " - a I I A bill b~~~ it I 4 I I beam , y a s ~ I x° 30 F b I ~ I N4 5 r H ~ u .250. fl BFI~I ° $7 ° Qo ®I N ~ ~a ~l+ I I4: I I& 70 a@a: 0 7u ~ C 0 00 czn O S 5 O. x z CN ~ ~ F ~ t✓•JrtJGlCtron: JEFF & KAREN AEL/'O/9 lain's Drawing Room.- HAR e a 436./'U/i -T DRNE, HUDlON, WI 54016 Y • > - G ~ uwirrT.~.,., Q laln's Drawmg Room, LLC 2015 a3a~a E 333 age ~~'T5s3 s" s=, 35R's°s t Q~n~°4 aV 39-X r-- -----\---------N--------- x I I 1 ~n I I _ 1 o I I ~ I 1 _ I I I I I I c I I I I I I I 1 -1 I I I I I I ' I I I I I s J^ I N I I I I ~a I I i - JN ~ IN 1 I I 9 a - - - - - - I 1 ~ I ~y _ I I 13 A {Iz O m IN iz I T iu ma _Ju Z u I_ n Ju j II I m L I I ~ ' 1 = I ~ ~ x 1 I 1 O B I i _ I I I 1 I i 4- I I r- I I ~ I I j I I ' 1 1 1 I _ I ' r I I ~ I ~ I I I I I I I ~u J I I Jry I I I 1 I 1 - ~ I I I 1 ~m I I 3 I ~ I -1 - L I I ~ I I I I ~ Rm - W I I o` ac Z)r ~ I \1I I 0 I I I I O 1 d _jz I I a Z OI i I ~ 1 -1 70 0 03 O 1 N~ Ut O _ -I Z n A F R ErnaF m Z q JEFF & KAREA Af O/i ~ loin's Drawing Room.u. b e a g&' 436fU/~/ET DRIVE, KUDfOP, WI 54016 • P V A r WisconsinDepartrnentof ommerce EC`'VE 'OIL EVALUATION REPORT Page I of 3 Division of Safety and Bui ings in accordance Comm 85, Wis. Adm. Code Attach complete site on paper not lesUP 4/2 x 1 inches in size. Plan must County ST. CROIX include, but not limited : veffl ontal pant (BM), direction and Parcel I.D. I~ percent slope, scale imens' loco fad4istanAe to a road. Q v- R Dat e Please p OFFI~ n aLLIPM. Personal information you provide may be used for dary rposel; Q Property Owner Properly Location 171 ■ ARTHUR & MARIYLN FEYEREISEN Gad. Lot - NE 1/4 SW 1/4 S 8 T 28 N R 19 Property Owners Mailing Address Lot # Block # Subd. Name or CSM# 420 Townsvalley Road 10 - Sunset Valley City State Zip Code Phone Number Epty DvNage own Nearest Road Hudson, WI 54016 ( 715) 386 - 2122 Townsvalley Road 0 New Coon t1.seEj Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD ® Replacement Public or commercial - Describe: Parent material outwash/sandstone Flood Plain elevation if applicable _ ETA R and conwrlents g9 3 ~o y ? Conventional In-ground trenches - to be designed by installer =VlmlsC~- f Ika 0.4 r 0,5 loading rate din locatigyt ofrenc 912-7 1111PO d 11 PB- Boring , Boring Q Ground surface elev. 891.81 ft. Depth to limiting factor ~ in. Sal Application Rate Horizon Depth Dominant Col Redox Description Texture Structure ConsWenee Boundary Roots GPDW in. Munsell Qu. Sz. ConL Color Gr. Sz. Sh. *Eff#1 *0102 1 0-4 10YR2/2 - 1 2f-lsbk mvfr cb 3vf-m 0.6 0.8 2 4-17 10YR2/2 - I 2f-msbk mfr ab 2vf-m 0.6 0.8 3 17-36 10YR3/6 - I 2f-msbk mfr aw 2vf-m 0.6 0.8 4 36-41 10YR4/4 - sl 1 f-msbk mvf as 3vf-m 0.4 0.7 5 41-56 10YR4/4 - s & gr Osg dl cs - 0.7 1.6 6 56-93 10YR4/4 - fs Osg dl 1.0 (Horizon 4 has 20.25% gr.) 10/1 B ] Boring # ❑ Boring L83--0)310LS OK, >96 El pit Ground surface elev. ft. Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. MunSell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *0#2 1 0-5 10YR2/2 - sl 2fabk ds cb 3vf-m 0.6 1.0 2 5-17 10YR2/1 - l 2mabk ds ai 2vf-m 0.6 0.8 3 17-27 10YR3/3 - I 2fabk mvfr ab 2vf-m 0.6 0.8 4 27-52 10YR3/4 - 1 2fabk mfr cw lvf-m 0.6 0.8 5 52-96 10YR5/4 - s Osg ml 0.7 1.6 * Effluent #1 = BOD > 30:5 220 mg/L. and TSS >30 < 150 ffg/L * EMu(! t 02 =E3013,:5 30 mg& and TSS < 30 mg/L CST Name (Please Print) /Ch A/ / CST Number Mary Jo Hollister N Qi ]~,,y 224832 Address Date Evaluation Conducted Telephone Number W9875 690th Avenue, River Falls, WI 54022 01 - 13 & 07 - 08 - 04 (715) 426 - 1775 Property Owner FEYEREISEN, Arthur (Lot 10) Parcel ID # (Pending) Page 2 of 3 Boring Boring C # Pit Ground surface elev. 887.33 'ft 11~1 Depth to limiting factor >104 inSod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consrstenoe Boundary Roots GPD/tf in. Munsell Qu. Sz. Cont. Color Gr. Sz Sh. *Eff#1 *Eff#2 1 0-7 10YR2/2 - sl 2fsbk ds cb 3vf-m 0.6 1.0 2 7-13 10YR2/2 - sl 2&bk dsh ab 2vf-m 0.6 1.0 3 13-37 10YR2/1 1 2f-msbk dsh cb 2vf-m 0.6 0.8 4 37-45 IOYR3/3 - sil 2f-mabk mfr as Ivf-m 0.6 0.8 5 45-63 /4 - sil 2fabk mfr cs Ivf-m 0.6 0.8 6 63-104 10YR3/4 - s 0s9 ml - - 0.7 1.6 1 167, Boring # ~ Boring Jl~ Pit Ground surface elev. ft. Depth to knifing factor in. Sod Application Rate Horizon Depth Dominard Color Redox Description Texture Structure Cortsistence Boundary Roots GPDIfF in. Munsed Qu. Sz Cont. Color Gr. Sz. Sh. " Eff#1 *Eif#2 F-1 Boring # Boring Pit Ground surface elev. ft. Depth to Crrritirg factor in. Sod ication Rate Horizon Depth Dorninant Color Redox Description Texture Structure Consistence Boundary Roots GPQM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Ef1#2 ' Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 rng/L * Effluent #2 = BODS < 30 mg/- 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[34Meg (R07M) _ P Of P~A V pAG~ Y N 1Pe5 SLR. - CF THE MAA V14, q TROY St; CROIX 1 S DI-50L PaMla W/ PAMOE NO COM M 83 5MACK PMWLM 1. bq4 Arm f r C 06.8 QT aw .882. /110 B-TC 333'10' 1.8 669. ~c yea . . FftL g v,~ueY / p y '/~n2 VID. QI) L CK) CN C14 I M .N o x o E .y ♦ 1.50 Ile, g3 ~ 2 ♦ 22 ; / x ♦ 'c 00 ♦ I Q ~ ` lip,8 Z ~ 0 u)~ 00 W 100 <ui 00 f- Z a c L ro h.~ \ -JO Q v C Q tY c1l ` x - ♦ (n /Z I } ..o. 03 o g 1S f 01 0T W 296.7 •.O c' ui -N xmoo l^ (D "t OZW x I 00 Q0 IN 6£'8 9 can a= rn rn x \ .9Z*L29Z M '99, ` %x f•/l 3N Hl -40°33N/ 7 1S-W I z N x w I I Q W r I ^i x N Q I O N rn X 1 % ~ / w