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004-1056-30-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division Sanitary Permit No: INSPECTION REPORT 579055 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: Rode, William A. & Janet Cady, Town of 004-1056-30-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 24.28.15.383 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI !FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer ✓6 f Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent t Air Intake ROAD Dt Inlet Septic Dt Bottom t Dosing Header/Man. Aeration Dist. Pipe Holding Bot. System -5 Final Grade rid 3 L: d • PUMP/SIPHON INFORMATION Manufacturer Demand St Cover v i GPM Model Number TDH Lift. Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM w " Header/Manifold ; Distribution Ix Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing ' SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over q Over Over xx Depth of Txxeeded/Sodded s xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes No 0 Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 246 330th Stre Knapp, WI 15474,9 (NE 1/4 SE 1/4 24 T28N R1 5W) 40 acres Lot; rcel o• 24.28.15.383 lam A` 1.) Alt BM Description = r 91 C r✓J . , P /a ~_j - " = r ~ " I P 2. Bldg sewer length -amount of cover Plan revision Required? ❑ Yes No Use other side for additional information. ` Date Insepctor's Signature Cert. No. SBD-6710 (R.3/97) QI}Imerce.Wi.gOV Safety a Di ion count), n I Y t) 201 W. Washington Ave., 2 X ~YD C S Madis , -7162 4 7 anitary Permit Number (to be filled in by Co.) rt?ff nerce -OMMU1,41 I I K__ Sanitary Permit Application State Transaction Number U / In accordance with s. Comm. 83 21(2), Wis. Adm. Code, submission of this form to the appropriate governmental L l ` unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are reject Address (if different than mailing address) submitted to the Department of Commerce. Personal information you provide may be used for secondary purposes in accordance with the Privac Law, s. 15.04 1)(m), Slats. 14 1. Application Information - Please P ' t All Information L-)- ci Property Owner's Name Parcel # l ` 16 DD ---,o u<no Property Owner's Mailing Address Propem Location 6! - Govt Lot City, State Zi ~Code Phone Number ~6 d~'~j ~jf3f~~ (~ff-~/ circle on 1G~ T17/9 N; R NPLW II. Type of Building (check all that apply) Lot # I or 2 Family Dwelling - Number of Bedrooms Subdil'vision Name 1-3 c-#-- Block# yl1L;'S ❑ Public/Commercial - Describe Use ❑ City of ❑ State Owned - Descrit Use CSM Number ❑ Village of I J Town of X /D Aa-1- III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A New System ❑ Replacement System ❑ TreatmenUHolding Tank Replacement Only ❑ Other Modification to Existing System Icyplainl I .!-7 1 B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber sfer to New List Previous Permit Number and Date Issued ❑ Permit Tran Before Expiration Owner IV. Type of POWTS System/Component/Device: Check all that apply) j> A" T-0 L1 ❑ 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. Dispersal/Treat ent Area Information: Design Flow (gpd) Design Soil Application Rate(gp f) Dispersal Area Required f Dispersal Area Proposed (sf) System Elevation "1. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units New Tanks Existing Tanks v eo Septic or Holding Tank Dosing Chamber VII. Responsibility Statement- 1, the undersigned, assume responsibility for installation of t e POWTS shown on the attached plans. Plumb Name (Print) Plumb 's Signature MP/MPRS Number Business Phone Number Plumber's Address (Street, City, State, Zip Code) VIII unto/De artment Use Onlv Approved El D Permit Fee Date I sued Issuing lit Signature ~Z $ ~Z5 • ~ g !q f l5 er Reason for Denial IX. ConditSYSTEMIQW NERteasons for Disapproval I., Septic tank, eftluentf9ter and D .dispersal ce8.must all be services / maintsllnod ` i n. t.✓l M. J i asper management plan provided by plumber. 2. - AQ*pM"ftlr►uxt;,be MWnttln'6d. as per applicable / ordimnca. Attach to complete plans for the system and submit to the County only on paper not less than 8 1l2 x 11 inches in size SBD-6398 (R 02/09) - - - - ;yr,~ J o% r b ~ - ~ ~s- i J Y~~~~~~=-G l ~1 _ - Y - .rte----- _ Cbm by tZ~~u~ 1 0 R7~i DIVISION OF INDUSTRY SERVICES 3824 N CREEKSIDE LA HOLMEN WI 54636 t Q a1 Contact Through Relay http://dsps.wi.gov/programs/industry-services yT~ S G 1 www.wisconsin.gov ~~OssroN~ sw~~ Scott Walker, Governor Dave Ross, Secretary August 14, 2015 CUST ID No. 226524 ATTN: POWTS Inspector ROGER L TIMM ZONING OFFICE TIMM EXCAVATING ST CROIX COUNTY SPIA 3128 20TH AVE 1101 CARMICHAEL RD WILSON WI 54027 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/14/2017 SITE: Identification Numbers William Rode Transaction 1D No. 2584141 246 330TH St Site ID No. 815789 Town of Cady Please refer to both identification numbers, St Croix County above, in all correspondence with the agency. NEIA, SETA, S24, T28N, R15W FOR: Description: Three Bedroom Mound System / 9% slope Object Type: POWTS Component Manual Regulated Object ID No.: 1550017 Maintenance required; 450 GPD Flow rate; 20 in Soil minimum depth to limiting factor from original grade System(s): Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01/01, R. 10/12), Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01/01, R. 10/12); Effluent Filter 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 constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code CON requirements. AP No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s. 145.06, DEPT O stats. PROFESSi The following conditions shall be met during construction or installation and prior to occupancy or use: DIVISION OF I Reminders • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.19, Wis. Stats. .:ct< CGRr • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made w the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per SPS 384 product approval conditions. • All POWTS component piping material shall be SPS 384, Wis. Adm. Code compliant. • The area within 15' downslope of the dispersal cell shall remain undisturbed. Vehicular traffic, excavation or soil compaction is prohibited in this area. • _ 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. ROGER L TIMM Page 2 8/14/2015 Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. SPS 383.54(1). • 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. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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 S 250.00 Fee Received $ 250.00 Balance Due $ 0.00 Gerard M Swim POWTS Plan Reviewer, Division of Industry Services (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633 jen-y.swim@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm ROGER L TIMM Pale 2 8/14/2015 Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. SPS 383.54(1). • 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. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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 S 250.00 a Fee Received S 250.00 Balance Due S 0.00 Gerard M Swim " POWTS Plan Reviewer, Division of Industry Services (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633 j erry. swim@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484 , Monday - Friday 8:00 am To 4:30 pm MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: 201D Owner's Name: William Rode Owner's Address: 662 Gilbert Rd. Hudson WI 54016 Legal Description: NE/SE s 24 t 28 r 15 w Township: Cady County: St. Croix a 'vNALL Subdivision Name: 40 ac. Parcel ROVED SAFE I AND, Lot Number: NA Block Number: AL SERVICE;, .4.R Y SE2' a Parcel I.D. Number: 004-1056-30-000 Plan Transaction No.: Page 1 Index and title - - - Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications pi al- ?LAO'S 5;,,1 s C V41-u C, icr v w k? i r S~sL Designer: Roger Timm License Number: 226524 Date: 07/29/15 Phone Number: 715-772-3214 Signature: This System esigned Pursuant to DSPS 381-385, Wis. Adm. Code and the Following Component Manuals: Mound Component Manual for POWTS Version 2.0 SBD-10691-P (N. 01/01, R. 10/12), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01, R. 10/12) Version 7.0 (R. 11/12) Page 1 of 7 t7 t5/lei/ LC11 Z) 10-. L,~ f 13 ! ! U4Z'JL r 1K5 1 ritiIVIS ~FiLUWlIV rri~7G Mound and Pressure Distribution Component Design Design Worksheet Site Information (R or C) R Residential or Commercial Design Note: Sand flll (D) calculations assume a 300.00 Estimated Wastewater Flow (gpd) Table 383-44-3 in-situ soil treatment for 1.50 Peaking Factor (e.g. 1.5 = 150%) fecal collform of {m 36 Inches. 450.00 Design Flow (gpd) 9.00 Site Slope 100.00 Contour Line Elevation (ft) j 20.00 Depth to Limiting Factor (in) - 0.40 In-situ Soil Application Rate (gpd/ft) Distribution Cell Information 1 90.00 Dispersal Cell Length Along Contour (ft) = 5.00 Cell Width (ft) 1.0_0 Dispersal Cell Design Loading Rate (gpd/ft) t 1 Influent Wastewater Quality 1 or 2 Are the laterals the highest point in the distribution _ Y Y Pressure Disribution Information network? Enter Y or N (C or E) C Center or End Manifold 2.50 Lateral Spacing (ft) If N above, enter the elevation (ft) _ 4 Number of Laterals of the highest point. 0.156 Orifice Diameter (in) 4.00 Estimated Orifice Spacing (ft) = 10.23 ft2/orifice 2.00 Forcemain Diameter (in) 75.00 Forcemain Length (ft) Does the forcemain drain back? Y 93.50 Pump Tank Elevation (ft) Enter Y or N if 4.55 System Head (ft) x 1.3 12.23 Forcemain Drainback (gal) 7.67 Vertical Lift (ft) 81.12 5x Void Volume (gal) 0.94 Friction Loss (ft) 93.35 Minimum Dose Volume (gal) )1 `-r I 0.00 In-line Filter Loss (ft) 23.69 System Demand (gpm) 13 16 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection choice in. dia. options choice in. dia. options 0,75 1.25 x 1.00 x 1.50 x i x 1.25 x 2.00 1.50 x x 3.00 2.00 x 3.00 x Gallons/inch Calculator (optional) Treatment Tank Information I Total Tank Capacity (gal) 1000.001 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Wieser Concrete Prod Manufacturer gal/in (enter result in cell B49) Dose Tank Information Effluent Filter_ Information 60336 Dose Tank Capacity (gal) Pol Lok Filter Manufacturer 1676 Dose Tank Volume (gal/in) IPL525 _ jFilter Model Number Wieser Concrete_ Prod Manufacturer Pcpject; Page 2 of 7 Mound Plan and Cross Section Views T 1/10 6 . JJ Observation Pipe K O A W - B - z . L Mound Component Dimensions A 5.00 ft E 21.40 in H 1.00 ft K 10.05 ft B 90.00 ft F 9.50 in z 12.64 ft L 110.10 ft D 16.00 in G 0.50 ft J 6.20 ft W 23.84 ft 450.00 (ftz) Dispersal Cell Area 1587.33 (ft) Basal Area Available 5.00 (gpd/ft) Linear Loading Rate 9.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 103.13 (ft) v ♦ H G T F Dispersal Cell 101.83 (ft) Lateral 101.33 (ft) ~,;Y Invert $ Dispersal Cell t E D Elevation . ; 100.00 (ft) Contour Elevation 9.0 % Site Slope Geotextile Fabric Cover Shading Key c T Dispersal Cell See lateral details on 10 Topsoil Cap c 1.5 ft Page 4 for number, size, Q Subsoil Cap 0- Q and spacing of laterals. ASTM C33 Sand 1° Laterals are equally `0 2 F spaced from the Tilled La er d 0.5 ft Typical Lateral y W distribution cell's © Aggregate © o centerline in the A distribution cell (AxB). Project: Page 3 of 7 UO/ 14/ LrJ 1'J 1CJ. LJ 11'J f ! 04L7L r 1lCJ I DHINN DHLLWll i Center Connection Lateral Layout Diagram Force main connection via tee of cross to manifold at mg point. Latet als are Identlc Ad P S 0=Turn-upwfbaIIvaIva or I402 Laterels&forcemainSch40PVC oloanoutplug per SPS Table 384.30.5 Holes drilled on the bottom of the lateralNumber of Laterals 4 Orifice Diameter 0.156 in Lateral Diameter 1.50 in Orifice Spacing (X) 4.21 ft Lateral Length (P) 44.21 ft Orifices per Lateral 11 Lateral Spacing (S) 2.50 ft Orifice Density 10.23 ft2/orifice Lateral Flow Rate 5,92 gpm Manifold Length 2.50 ft System Flow Rate 23.69 gpm Manifold Diameter 1.50 in Total Dynamic Head 13.16 ft Forcemain Velocity 2.42 fusee Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and $ SPS 316.300 WAC 1 4 in. min. FnectDlacon ----ii-- Tank component is properly vented F- Alternate outlet location Forcemain diameter Wieser Concrete Prod Manufacturer 2 in. Ca acl 603,36 Gallons Volume 16.76 gal/inch A Weep hole or antl- Dimension Inches Gallons B siphon device A 20.43 342.41 B 2.00 33,52 C Pump off elevation (ft) C 5.57 93.35 -t 94.17 D i 8.00 134.08 D Total 36.00 603.36 Dose tank elevation ft) 3" Bedding un er tank. 93.50 Alarm Manuafacturer fSJE Rhombus Note: Switches Alarm Model Number Tank Alert1_ ( containing mercury may not be used in Pump Manufacturer Gould this system. Pump Model Number EP04 ~„_.T Pump Must Deliver 23.69 g p m at 13.16 ft TDH Project: Page 4 of 7 40-al l y ~ 1 Mound System Maintenance and Operation Specifications Service Provider's Name Roger Timm Phone 715-772-3214 POWTS Regulator's Name St. Croix Co. Phone 715-386-4680 System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 ftz Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once eve 3 ears Effluent Filter Should inspect and clean at least once eve 3 ears Pump and Controls Test once eve 3 ears Alarm Should test month) Pressure System Laterals should be flushed and pressure tested eve 3 ears Mound inspect for ponding and seepage once every 3 years Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SIPS 384.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished Grade 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Page 5 of 7 Mound System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01, R. 10/12), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD- 10706-P (N. 01/01, R. 10/12)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with SPS 383.33, Ws. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281 48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1 /3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5, 30 mg/L TSS, 10 mg/L FOG, and 101 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. "--RGOULDS PUMPS Submersible Effluent Pump MODEL 3871 A,d4l EP04 & EP05 JAM;* Series APPLICATIONS • Fully submerged in high ■ EP05 Impeller: Thermoplas- ■ Bearings: Upper and lower grade turbine oil for tic enclosed design for heavy duty ball bearing Specifically designed for the lubrication and efficient improved performance. construction. following uses: • Effluent systems heat transfer. ■ Casing and Base: Rugged • Homes Available for automatic and thermoplastic design provides AGENCY LISTING • Farms superior strength and corrosion manual operation. Auto- AM' Canadian Standards Association • Heavy duty sump matic models include resistance. ~ File # LR38549 • Water transfer Mechanical Float Switch ■ Motor Housing: Cast iron Goulds Pumps is I50 9001 Registered. • Dewatering assembled and preset at the for efficient heat transfer, factory. strength, and durability. SPECIFICATIONS ■ Motor Cover: Thermoplastic • Solids handling FEATURES cover with integral handle and 3 g capability: float switch attachment points. /4" maximum. ■ EP04 Impeller: Thermoplas- 0 Power Cable: Severe duty • Capacities: up to 60 GPM. tic semi-open design with rated oil and water resistant. • Total heads: up to 31 feet. pump out vanes for mechanical • Discharge size: 1'/2" NPT. seal protection. • Mechanical seal: carbon- rotary/ceramic-stationary, BUNA-N efastomers. • Temperature: 104°F (40°C) continuous 140°F(60°C)intermittent. METERS FEET • Fasteners: steel. series 1 ° stainless - - 9 30 -~~.-5 GPM • Capable of running dry without damage to 8 + - - - - - - - - - 2s Pr components. 25 o - - - a Motor: _ i - - - - - - • EP04 Single phase: 0.4 HP, 6 20 115 or 230 V, 60 Hz, 1550 Z ( I I_ 5 - - - - - -t - - - j RPM, built in overload with o 15I_ _ automatic reset. 4-~ hase: 0.5 HP, o 3 10l + _ - - EP05 • EP05 Single p 115 V or 230V, 60 Hz, 1550 RPM, built in overload with EPo automatic reset. 2 E - automatic Power cord: 10 foot 5 standard length, 16/3 1 t__ - - - - - S1TW with three prong grounding plug. Optional 20 ° °0 10 20 30 40 50 GPM foot length, 16/3 S1TW with three prong grounding plug (standard on EP05). 0 2 4 6 8 10 12 m3/h CAPACITY Goulds Pumps © 2003 Goulds Pumps Effective July, 2003 ITT Industries RJR?? I) e;p, Rb )e La,&e.s ai r' ~a ya t. r Cow brae o ao yo' Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 x I I inches in size. Plan must St. Croix Include but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 004-1056-30-000 Percent slope, scale or dimensions, north arrow, and BM referenced to nearest road. Please print all information Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)) Property Owner Property Location William Rode Govt. Lot NE v. SE v, s 24 T 28 N R 15 w Property Owner's Mailing Address Lt # IBlock# ISubd.NarneorCSM# 662 Gilbert Rd. City State Zip Code Phone 0 City 0 Village 0 Town Nearest Road Hudson WI 54016 Cad 246 330`h Street Q New Construction Use: @ Residential / Number of Bedrooms-_ Code derived design flow rate 450 GPD 0 Replacement 0 Public or Commercial - Describe: Parent Material Loess over Till Flood Plain elevation if applicable N/A ft. General comments and recommendations: Boring 1 Boring # ® Pit Ground Surface Elevation 99.6 ft. Depth to Limiting factor 20 in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz, ont. Color Gr. Sz. Sh. 'Eff#1 -Eff#2 1 0-7 10YR2/2 - SIL 3-f-gr mfr cs 3 f-co 0.6 0.8 2 7-13 10YR5/4 - SIL 1-co-bk mfr gs 1-m 0.4 0.6 3 13-20 10YR4/4 - SIL 2-m-bk mfr gs - 0.6 0.8 4 20-24+ 10YR4/4 7.5YR4/4&1OYR5/2 f-3-p SICL 1-co-bk mfi - - 0.2 0.3 Boring a Boring # >48 in. aPit Ground Surface Elevation 100.1 ft. Depth to Limiting factor Soil A li ti n Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-7 10YR2/2 - SIL 3-m-gr mfr cw 3 f-co 0.6 0.8 2 7-18 10YR4/4 - SIL 2-m-bk mfr gw 2 f-co 0.6 0.8 3 18-28 10YR4/4 - GRSIL 2-m-bk mfr gw 2 f-m 0.6 0.8 4 28-48+ 10YR4/4 - VGRS 0-sg ml - 1 m 0.7 1.6 ' Effluent #1 = BOD5> 30:S 220 mg(L and TSS > 30:5 150 mg/L " Effluent #2 = BOD5 30 mg/L and TSS 30 mg/L CST Name (Please Print) Signature CST Number Mark Iverson 46672 Address Date Evaluation Conducted Telephone Number P.O. Box 155 Hammond, WI 54015 July 10, 2015 715-796-5664 Property Owner William Rode Parcel ID# 004-1056-30-000 Page 2 of 3 F Boring # ❑ Boring Pit Ground Surface Elevation 97.1 ft. Depth to Limiting factor 39 in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-9 10YR3/2 - SIL 2-m-gr mfr gw 3 f-co 0.6 0.8 2 9-14 10YR4/4 - SIL 2-m-bk mfr gs 2 f-m 0.6 0.8 3 14-19 10YR4/4 - SICL 2-m-bk mfr gs 1 f 0.4 0.6 4 19-28 10YR4/4 10YR312 manganese wncentrabons GRSL 2-co-bk mfi gs 1 f 0.6 1.0 5 28-39 10YR4/4 - S 1-co-bk mfr gs 1 f 0.7 1.6 6 39+ 7.5YR4/4 5YR4/4 f-2-d VGRLS 0-sg ml - 1 f 0.7 1.6 ❑ Boring 4 Boring # Bpit Ground Surface Elevation ft. Depth to Limiting factor in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ❑ Boring S Boring # aPit Ground Surface Elevation ft. Depth to Limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ t2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 I - i i i * Effluent #1 = BOD5> 30:S 220 mg/L and TSS > 30 < 150 mg/L * Effluent 42 = BOD5 S 30 mg/L and TSS S 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. Page 3 of 3 0 ft. 24 ft. 40 ft. 80 ft. N ~ ov ^p p (oP °f 31Q Pv 0 B-2 pp BM#2 - Top of 3/4"PVC Pipe 100.1 106.8' p4~ / p^ 0 ~O .C~ B-1 99.6 B-3 Proposed 97.1 Ho se 103.1' All property lines are greater than 100' from the proposed system area • = Ground Surface Elevation BM# & Description . Bench Mark B 1 - Boring Location & Elevation Elevation 100' - Owner: William Rode Site Information: Completed By: Mark Iverson, PSS #197 662 Gilbert Rd. NE1/4, SE1/4, S24, T28N, R15 680 Larcom Street Hudson, WI 54016 Town of Cady Hammond, WI 54015 St. Croix County 715-796-5664 Phone: CST# 46672 CI tS/ 14/ LrJl~ 1rJ: L.3 !10! l04L71 r 1K51 ni-Nr\ nFAL-DWiN rHl7G ~'-I CL :2 _o o U e _ z ( u S a Q LD V/ U.~ Lr) wZ a Z lO J ~ Ir Iy W - O 4L Q V- N a I U d F X~ W? o C~ u 0a-- aN Q a o o= cn a Q o fl) V) U Q U ~m Q ZZ o~d o QQ o w O Q W I ¢ L p (O ID J < Vl 00 t\ y Q C) In O n 10 n p z Ww L'j p O F- J f~ F- F-N V1 t- [V t~ d V V J c 04. w ~ r n, to n- ww WsL) LLI co J ~ ~ f- ANN C7 LLJ Q W z (n DOCd~~ ~p~ OOY 00w Q QaoadwWQ~a °zma zoo Z 1 u CD mU 2 J yM QQ'S~ 2 _p W W W < J J (1 O V D z J AA ✓ 4G 1 y W „Zv J I 1 , i ; Lij z „S I „s W Lli O J u 6i U V) U In Lh I I I .I ~ I I 1 I I I I I 4 I I I ~ I I I 1 I 1 I I I I I l,..l „9S & K,~~ INSTALLATION INSTRUCTIONS pI)L~.g & Wastewater P"rodducfcts ADiv¢ion ® A of Poylok Inc. P-ast Dwm PL-525/PL-625 FILTER PL-525/PL-625 FEATURES & BENEFITS V Features & Benefits: • Rated for 10,000 GPD -7 • PL-525 = 525 Linear Feet of 1/18" Filtration W`? PL-625 = 625 Linear Feet of 1/32" Filtration PL-525 PL-625 .Accepts 4" and 6" SCHD. 40 pipe The PL-525/625 Effluent Filter should operate efficiently • Built in Gas Deflector for several years under normal conditions before ,Automatic Shut-Off Ball when Filter is Removed requiring cleaning. It is recommended that the filter be cleaned every time the tank is pumped or at least every .Alarm Accessibility three years. If the installed filter contains an optional alarm, the owner will be notified by an alarm when the .Accepts PVC Extension Handle filter needs servicing. Servicing should be done by a certified septic tank pumper or installer. RECOMMENDED PRODUCTS Polylok PVC Filter rYr Extension Handle 4i c _ 3 tT~_ Y v. I L s afi~ Risers & Riser Covers Extend & Lok- Riser Safety Screens Filter Alarm Panel and Polylok risers bring your Polylok Extend & LokTM Polylok safety screens SmartFilterTm Control septic tank cover to grade. is a simple, easy to use prevent tragic accidents Switch This allows locating and solution that can extend from happening by children Polylok filter alarm panels servicing your filter easier the inlet or outlet pipe and and pets falling into open and switchs provid a visual and time saving by elimi- make filter and/or baffle septic tank entrances. and audible notification of nating digging to find tank installation a snap. impending filter and tank entrance. Fits 3" and 4" pipe. servicing. For a full list of Polylok products please visit our web site at: www.polylok.com Y w U O U d Of cn Z J w y o ~ W p c!J ~ v n- cr ~ ~ 4 T LLJ (Z) c) co = ch C-) . as SS Q C Q a' 6 ~ 'V pv Z- OOoO ~'y,~,-~ @ w(n OBE F of Q W ~O Q O0 Q LL- Cf) C) a_ O Q ~Y U NO U 7 _ J j Cl) 0 00 CC LL1 O CJ c J co U N 0 M U CO Cl) I00 O ~ Lo C'5 ~ 00 Lq ~ J ~ 1 II I I N U ti 'II~ II I ' O N ~I u I N cn F-- oZ w~ Q O S Z Q U UJ U) Z<`o j CD~ X w = U ~ v7 0 ~ W =D Y w Z p w U Ctf W U S Q O ~ U) v J O Ur W Z co W N a- j - - O U) = N 0 n a.w0 J W N U ® zF- a0 J o 0 2 n z w u_ LL. M W Cj _ I Q j 2 i 1 J of OW of co r) Q co ~mU- ~ZEZ W Q N F- W U~ J CD Lo ZD F ~QQO::D LO X0- 2=0co INSTALLATION INSTRUCTIONS EY NO K Inc. Irmo rat-fr P Prodrecastucts Drainage 0 % Division of PolylkInc. PL-525/PL-625 FILTER INSTALLATION INSTRUCTIONS Center filter with opening ' Z - a 2 s to J_ J 7 FL 0 e e Additional pipe or Polylok Extend & Lok- Glue for centering. Step 1: Step 2: Step 3: (A) Locate the outlet of the septic tank. (A) Before installation, place the (A) Glue the filter housing on the (B) Remove tank cover and pump tank filter housing on to the outlet pipe. outlet pipe. if necessary. (B) Make sure that the housing (B) Insert the filter cartridge in the is positioned so the filter can be housing, making sure the filter removed from the tank for cartridge is properly aligned and maintenance and service. completely inserted in the housing. MAINTENANCE INSTRUCTIONS ~s I i E" j u u I \ Step 1: Step 2: Step 3: Locate the outlet of the septic tank. (A) Remove tank cover and pump (A) Insert the filter cartridge back if necessary. into the the housing making sure FILTER DO NOT USE WHEN PLUMBING REMOVED (B) Pull the filter out of the housing. the filter is properly alighed and completely inserted. (C) Hose off the filter over the septic tank. (B) Replace septic tank cover USE :RUBBER G=FFILTERR Make sure all solids fall back into the WHEN CLEANING septic tank. TANK ALERTO I Alarm System Easy-to-install liquid level alarm system for indoor use. This alarm system monitors liquid levels in lift pump chambers, sump pump basins, holding tanks, 241-1 sewage, agricultural, and other water applications. The Tank Alert' I alarm system can serve as a high or low level alarm depending on the float switch 4 model used. I The alarm horn sounds when a potentially threatening liquid level condition occurs. The horn can be silenced, but the warning light remains on until the condition is remedied. A green "power on" light indicates power to the alarm panel. ~r 1 SPECIFICATIONS NEMA 1 enclosure, designed for ease of installation, rated for indoor VOLTAGE FOR 120 VAC MODEL: use. Primary: 120 VAC, 50/60 Hz, 5 watts max. Red "alarm" light, green "power on" light, alarm "test" switch, and (alarm condition) horn "silence" switch. Secondary 12 VAC Alarm horn sounds at 86 decibels at 10 feet (3 meters). VOLTAGE FOR 230 VAC MODEL: Can be used with any UL Listed / Recognized switching mechanism (not UL Listed or CSA Certified) rated to include 1 amp, 12 VAC load. Primary: 230 VAC, 50/60 Hz, 5 wafts max. Alarm system (when installed on separate circuit) operates even if (alarm condition) the pump circuit fails. Secondary; 12 VAC Complete package includes standard SJE SignalMaster® control ALARM ENCLOSURE: 6 x 4 x 2.5 inch switch with 15 feet (4.57 meters) of cable (other lengths available) (15.24 x 10.16 x 6.35 cm), NEMA 1 metal and mounting clamp. Switching mechanism operates on low voltage and is isolated from ALARM HORN: 86 decibels at 10 feet the power line to reduce the possibility of shock. (3 meters) UL Listed. srcuauwc POWER CORD: 6 foot (1.8 meter) G nul CSA Certified. LR54245 LISTED FLOAT SWITCH CONNECTION TERMINAL: Three-year limited warranty. zeax draulic For float switch connection only. Do not apply power. (Voltage across terminals is 12 VAC. Maximum line impedance for 1 ' 1 initiating device: 5 ohms). When ordered with the alarm, this system is available with: FLOAT SWITCH: SJE SignalMasterl control switch with mounting clamp alternate float switch models for high or low level warning. Cable: 15 feet (4.57 meters), flexible 18 gauge, 2 conductor (UL) SJOW, water- / 120 VAC primary voltage or 230 VAC primary voltage (230 VAC resistant (CPE) model is not UL Listed or CSA Certified). Float: 2.74 inch diameter x 4.83 inch long (7 cm x 12.3 cm), high impact, corrosion resistant polypropylene housing for use in sewage and non-potable water up to 140°F (60°C) Rh5u_` usW PO Box 1708, Detroit Lakes, MN 56502 1-888-DIAL-SJE • 1-218-847-1317 1-218-847-4617 Fax SEE BACKSIDE FOR ORDERING INFORMATION. email: sje@sjerhombus.com www.sjerhombus.com 77 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND f OWNERSHIP CERTIFICATION FORM Owner/Buyer '.J I j 4;u m Mailing Address d <ilti &,--V 4 Property Address 14, u.~ 5 4 (Verification required from Planning & Zoning Depa t for new construction.) City/State 5~~. Parcel Identification Number d0- / 7 (v -~o~ LEGAL DESCRIPTION Property Location Afi' I/4 , S L~ '/4 , Sec. qlY_, T 28 N Roe~ W, Town of / Subdivision Lot # Certified Survey Map # Volume , Page # Warranty Deed # , Volume Page # Spec house Nes no Lot lines identifiable es no SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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 §Comm. 83.52(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 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned'to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this f , are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warr ty deed recorded in Register of Deeds Office. Number,of bedrooms 3 SIGNATURE OF APPLICANT(S) 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. 08/05) SOIL EVALUATION REPORT Page I of 3 ~pen~t of Commerce 'Division of Safety and B ildings In accordance with Comm 85, dm ode : ~ 201 ~ county JULAeh com 1 ite plan on paper not less than 8 % x 1 I inches in size. Plan must g S St. Croix OR ~4 NW. vertical and horizontal reference point (BM), directio Parcel I.D. 004 M~ -l 056-30-000 Sj. 2 mensions, north arrow, and BM referenced to nearest road. Reviewe ~y ate 10M Please print all information 9 s Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)) Property Owner Property Location R I S w William Rode Govt. Lot NE v4 SE i, s JT 21 Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 662 Gilbert Rd. City State Zip Code Phone ❑ City ❑ Village Q Town Nearest Road Hudson WI 54016 Cad 246 330th Street 0 New Construction Use: @ Residential/ Number of Bedrooms 3 Code derived design flow rate 450 GPD ❑ Replacement ❑ Public or Commercial - Describe: Parent Material Loess over Till Flood Plain elevation if applicable N/A ft, General comments and recommendations: 1 Boring # Boring ® Pit Ground Surface Elevation 99.6 ft. Depth to Limiting factor 20 in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 `Eff#2 1 0-7 1OYR2/2 - SIL 3-f-gr mfr cs 3 f-co 0.6 0.8 2 7-13 10YR5/4 - SIL 1-co-bk mfr gs 1-m 0.4 0.6 3 13-20 10YR4/4 - SIL 2-m-bk mfr gs - 0.6 0.8 4 20-24+ 1OYR4/4 7.5YR4/4&10YR5/2 f-3-p SICL 1-co-bk mfi - - 0.2 0.3 Boring 2❑ Boring # ❑ spit Ground Surface Elevation 100.1 ft. Depth to Limiting factor >48 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fl in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 'Eff#2 1 0-7 10YR2/2 - SIL 3-m-gr mfr cw 3 f-co 0.6 0.8 2 7-18 1OYR4/4 - SIL 2-m-bk mfr gw 2 f-co 0.6 0.8 3 18-28 10YR4/4 - GRSIL 2-m-bk mfr gw 2 f-m 0.6 0.8 4 28-48+ 10YR4/4 - VGRS O-sg ml - 1 m 0.7 1.6 I * Effluent # 1 = BOD5> 30 220 mg/L and TSS > 30 < 150 mg/L * Effluent #2 = BOD5 30 mg/L and TSS 5 30 mg/L CST Name (Please Print) Signature CST Number Mark Iverson 46672 Address Date Evaluation Conducted Telephone Number P.O. Box 155 Hammond, WI 54015 Jul 10, 2015 715-796-5664 Property Owner William Rode Parcel ID# 004-1056-30-000 Page 2 of 3 3 Boring # 0 Boring ❑ OPit Ground Surface Elevation 97.1 ft. Depth to Limiting factor 39 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-9 10YR3/2 - SIL 2-m-gr mfr gw 3 f-co 0.6 0.8 2 9-14 10YR4/4 - SIL 2-m-bk mfr gs 2 f-m 0.6 0.8 3 14-19 10YR4/4 - SICL 2-m-bk mfr gs 1 f 0.4 0.6 4 19-28 10YR4/4 10YR3/2 manganese concentrations GRSL 2-co-bk mfi gs 1 f 0.6 1.0 5 28-39 10YR4/4 - S 1-co-bk mfr gs 1 f 0.7 1.6 6 39+ 7.5YR4/4 5YR4/4 f-2-d VGRLS 0-sg ml - 1 f 0.7 1.6 F1 Boring # Boring aPit Ground Surface Elevation ft. Depth to Limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Boring Boring # 21pit Ground Surface Elevation ft. Depth to Limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD,> 30!C 220 mg/L and TSS > 30:5 150 mg/L * Effluent #2 = BOD5 30 mg/L and TSS S 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. Page 3 of 3 Oft. 24 ft. 40 ft. 80 ft. N GpiP `I ^p p (oP oj'314? O B-2 pp BM#2 - Top of 3/4"PVC Pipe 100.1 106.8' pQ~ p^ 60 0 ~O B-1 99.6 B-3 Proposed 97.1 Ho se 103.1' All property lines are greater than 100' from the proposed system area • = Ground Surface Elevation BM# & Description = Bench Mark B-1 - Elevation 100, - Boring Location & Elevation Owner: William Rode Site Information: Completed By: Mark Iverson, PSS #197 662 Gilbert Rd. NE1/4, SE1/4, S24, T28N, R15 680 Larcom Street Hudson, WI 54016 Town of Cady Hammond, WI 54015 St. Croix County 715-796-5664 Phone: CST# 46672