HomeMy WebLinkAbout040-1304-15-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: 582039
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
Permit Holder's Name: City Village Township Parcel Tax No:
Precision Builders JPZ LLC TOWN OF TROY 040-1304-15-000
CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No:
J O1. 3$~ o d G 1-,!`0 08.28.19.1821
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER N~3, CAPACITY STATION BS HI FS ELEV.
Septic I ' I -S'- 3" Benchmark
W I t-.561- F•~1.... 3 a 6o 767. (P 7- 76/.33
Dosing i Qe C~ /b Alt. BM ,~~•14- . $5 9a 2.77
Aeration Bldg. Sewer
7.z 90I).
Holding St/Ht Inlet T7T' 119
TANK SETBACK INFORMATION St/Ht Outlet 7
5.a5 X69 8.
TANK TO E PAI WELL BLDG. an to Air Intake ROAD Dt Inlet
Septic 7-7 Dt Bottom
Dosing Header/Man.
Aeratio Dist. Pipe /j, `y 4 ~'tv .-7
6 9 L Z
Holding Bot. System '7C)
S •'7
/Z.0 8gS• Z 4k,.
PUMP/SIPHON INFORMATION Final Grade
/tf~ J~ . -Z
Manufacturer Demand St Cover /
GPM lfi Odtl, GTaZ .-7
Model Number
TDH Lift riction Loss System He TDH Ft
Forcemain Length Dia. Dist. to well
SOIL ABSORPTION SYSTEM
BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pit Inside Dia Liquid Depth
DIMENSIONS 3 9D 2 f Qu("-A 111~
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer. P, II
INFORMATION CHAMBER OR 1'~ , 17 ~a--"-
Type Of Sy /DA jsz 9a x / /L UNIT Model Number:( J (/II
DISTRIBUTION SYSTEM 2•}- ZZ : JS
Header/Manif ld Al Distribution Ix Hole Size x Hole Spacing Vent to Air Intake
Length Dia q- Pipe(s) w e--':4-S
Length Dia Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
De
pth of xx Seeded/Sodded xx Mulched
Depth Over Depth Over TT
BedlTrench Center Z Bed/Trench Edges psoil Yes No Yes 0 No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2:
Location: 443 HORIZON C=mil ~~J~~• L2- C et/4,(-,,b tj1 7, Cw S
1.) Alt BM Description - / 111
2.) Bldg sewer length = SZ
- amount of cover = ~ - , ~ ~
Plan revision Required? Yes No O
Use other side for additional information.
SBD-6710 (R.3/97) Date Insepctor's Sig ature Cert. No.
County 94 rzd 6v,
Safety and Bu' 47 201 W. Washington B 71 Sanitary Permit Number (to be filled in by Co.)
. Madison, 53
cl. ~a'i~N'rY 'S Z O 3
r~ RliTY Otz-v LOPMi=NT
Sanitary Permit Application State Transaction Number
In accordance with SPS 38321(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit A44-
is required prior to obtaining a unitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address)
the Department of Safety and Professional Servies. Personal information you provide may be used for secondary
purposes in accordance with the Privacy Law, s. 15. 1 m .Stets. 2
L Application Information - Please Print All Information T ( ✓ ~l O~ ~fl~R-~
Property Owner's Name Parcel #
oA) ~l~a>G2 Z LL c b 36 / 00
Property Owner's Mailing Address Property Location,01r eZT
N a E gr~/
o
Govt. Lot "
City, State / Zip Code Phone Number
/y le-~ % Section
7 L~ 5 01 -e- 90.5- 70-m (circle on
Lot # T N; R E WW
II. Type of Building (check all that apply)
rb' / Subdivision Name
or 2 Family Dwelling -Number of Bedrooms
Block A) ~ -I- 1'C
L L ~ ~
❑ Public/Commercial - Describe Use Ok e+4 _
❑ City of
4~
❑ State Owned - Describe Use CSM Number ❑ Village of
A 1 b~ ( ZZ G own of
III. Type of Permit: (Check only on box on line A. Complete line B if applicable)
A. New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain)
B. ❑ Pemiit.Renewal ❑ Pemtit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued
Before Expiration - Owner -V4 A-1k&
°
W. T e of POWTS S stem/Com onent/Device: Check all that apply)
)(Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound 2:24 in. of suitable soil ❑ Mound < 24 in. of suitable soil Q~~ C
❑ Holding Tank ❑ er Dispersal Component (explain) ❑ Pretreatment Device (explain)
V. Dis ersaVrreat ent Area Information:
Design Flow (gpd) Design Soil Application Rate(gpds Dispersal Ar (so Disperrssal Area Pr opo ed (sf) System Elevation
0 rr
/ O . P.
VI. Tank Info Capacity in Total # of Manufacturer
Gallons Gallons Units d °O o
New Turks Existing Tanks v
~p y
41
vz v~
vii W Ex, C7 f3.
Septic or Holding Tank
Dosing Chamber
VII. Responsibility Statement- 11, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
Plumber's a (Print) Plumber's Signature MP/li9Ie Number Business Phone Number
7125 -27 7-3 4-'YW
Plumber's Addreg (Street, City, State, Zip Code)
t U)0 ¢ t t,f 6/
oun epartment Use Only
Approved ❑ve Permit Fee Datq Issu Lssu' ent Signature
$ V5 nn G
Po Reason for Denial
IX Condi~ U(`6au~ teasons for Disapproval \ Q n
f."`~epfkitank, effluent fdtwand 3)
Ln., OW06r al cell must all bee servtces !'maintained
per management plan provided by plumber, A4A e .60 3
2..M- k fequirertaenls must be malrltaitiisd
as per appkable code / Ordinances. ~
Attach to complete plans for the system snd sub it to themy ody on paper not less than 8 to x 11 in es in size
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CONVENTIONAL COMPONENT DESIGN
Residential Application
INDEX AND TITLE PAGE
Project Name:
Owner's Name: 6cl 51D11,~ ~((J S u PZ 41-,f Owner's Address: "d Z I
Legal Description: J` I -J
$ Z $ ~~?y
Township:
County: ~T Cffo /
Subdivision Name: (66;- V
Lot Number:
Parcel ID Number:
Page 1 Index and title
Page 2 Plot Plan 0We- K ~ C
Page 3 System Sizing & Cross-Section Sflc ,~i4,u(.~
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: License Number: Z ~q
Date:
Phone Number 7ls Z73,l~~c~f!
Signature
Designed pursuant to the in-Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P (N.01/01).
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- or 2- Family Dwelling In-ground Soil Absorption System 2-cell Convention k,
Daily Wastewater Flow (DWF) _ # of bedrooms x 150 gal/day/bedroom = gal/day
Design Loading Rate (DLR) or Soil Application Rate = / •gpd/ft2 (per SPS Table 383.44-1, 2, or 3)
Required Distribution cell area = DWF gal/day _ DLR gpd/ft2 = ft2
# Chambers =Required Distribution cell area gs ft2 _ ? ft2/unit EISA Chambers
Chamber Manufacturer and Model: LL) O-l 4- LL-eI It &'It ! it (z. _7;
Actual Distribution cell area = Required cell area v ft2 360
ft2/ unit EISA End Cap Pair ft2
Cross-Section In-ground Soil Absorption System (2-cell):
4" Schedule 40 PVC
vent pipe with vent cap
12 inches minimum 12 inches minimum
g oD
!inches Soil Cover
Trench 1 Sys-
tem Elevation /
c Z inch Chamber Height
I, ft Trench 2 System
ft I
I ---J Elevation
-ft It
Trench Separation Leaching Chamber Width
ft to limiting factor
Plan View In-ground Soil Absorption System (2-cell):
Trench 1
3 ft
ERM Modify
header/
ft design as
Leaching Chambers needed.
Trench 2
El 1 4 inch Header
Sch. 30 3~
• ft with end camps
Draw O for a Vent and for Observation Pipe above. They will be located ft from the end of the cell.
Vent pipes shall be Schedule 40 PVC and extend at least 12 inches above finished grade.
Observation pipes that extend above finished grade must also be 4 inch Schedule 40 PVC.
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POWTS OWNER'S MANUAL MANAGEMENT PLAN
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner G Z (ZC Septic Tank Capacity I Zn o al ❑ NA
Permit # Septic Tank Manufacturer w I S CR ❑ NA
DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA
Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA
Number of Public Facility Units J~l NA Pump Tank Capacity aI A
Estimated flow (average)gal/day Pump Tank Manufacturer ► 2 A
Design flow (peak), (Estimated x 1.5) (e, 00 gal/day Pump Manufacturer XfIA
Soil Application Rate al/da /fts Pump Model A
Standard Influent/Effluent Quality Monthly average* Pretreatment Unit A
Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter
Biochemical Oxygen Demand (BODE) 5220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland
Total Suspended Solids (TSS) 5150 mg/L ❑ Disinfection ❑ Other:
Pretreated Effluent Quality Monthly average Dr1n-Ground ersal Cell(s) ❑ NA
Biochemical Oxygen Demand (BOD.) 530 mg/L ! (gravity) ❑ In-Ground (pressurized)
Total Suspended Solids (TSS) 530 mg/L ❑ NA ❑ At-Grade ❑ Mound
Fecal Coliform (geometric mean) 5104 cfu/100m1 ❑ Drip-Line ❑ Other:
Maximum Effluent Particle Size Ys in dia. ❑ NA Other: ❑ NA
Other: ❑ NA Other: p NA,
*Values typical for domestic, wastewater and septic tank effluent. Other: i ❑ NA
MAINTENANCE SCHEDULE
Service Event Service Frequency 13 mo Inspect condition of tank(s) At least once every : p ear( )(s) (Maximum 3 years) i7 NA
Pump out contents of tank(s) When combined sludge and scum equals one-third (Y3) of tank volume ❑ NA
Inspect dispersal cell(s) At least once every: ® year( )(s) (Maximum 3 years) ❑ NA
❑
Clean effluent filter At least once every: month(s) ❑ NA
® earls)
Inspect pump, pump controls & alarm At least once every: R U month(s) ❑ NA
3 H ear(s)
Flush laterals and pressure test At least once every: 3 month(s) 0 NA
Other: At least once every: ❑ month(s) ❑ NA
13 ear(s)
Other:
❑ NA
MAINTENANCE INSTRUCTIONS `
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications:
Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank
inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks,
measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface.
The dispersal cell(s) 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 tank equals one-third (Y3) or more of the tank volume, the entire
contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with 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 512 months, shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority within 10 days of completion of any service event.
GMW (4101)
START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or othe L cal:
that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents
of the tank(s) removed by a septage servicing operator prior to use.
System.start up shall not occur when soil conditions are frozen at the infiltrative surface.
During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be
discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of
effluent; To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring
power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to
restore normal levels within the pump tank.
Do not drive or park vehicles over tanks and dispersal cells. 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
POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat;
foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil;
painting products;. pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS fails and/or is permanently taken out of service the following steps shall lie taken to insure that the system is
properly and safely abandoned In compliance with chapter 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 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 that time.
❑ A suitable replacement area Is not available due to setback and/or soil limitations. Barring advances in POWTS
technology a holding tank may be installed as a last resort to replace the failed POWTS.
❑ 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. 11 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> >
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN 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 tROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINER
L Name " n' p r, MC-L5 Name
Phone -71 - Z 7 3 7` T elV Phone
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name 3-0 HNSo^J $-.4,vlf,4 +rv Name Sr C~d1X Zd~l
Phone 7/5 Z 7 3 5 Phone 7,"--f- 11-Y690
This document was drafted In compliance with chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.64(1), (2) & (3), Wisconsin Administrative Code.
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
OWNERSHIP CERTIFICATION FORM
Owner/Buyer _ ~~C ~~/4l LLD ~1^'~ Z C L c
Mailing Address 7 -t Go
Property Address AY 3 (moo~1 Gp
(Verification required from Planning & Zoning Department f n w construction.)
City/State Parcel Identification Number /0 C'
- Do
LEGAL DESCRIPTION
Property Location A) CL %a '/4 Sec. T -aN R W, Town of -~jQ p J
Subdivision Su,t1 f j,0 A C, Lot
Certified Survey Map # Volume . Page #
Warranty Deed # 7 Volume Page #
Spec house yes 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.
I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the
standards set forth, herein, as set by the Department of Commerce and the Department of Natural 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.
I/we certify that all statements on form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the
property described above, by virtue of a w anty deed`recorded in Register of Deeds Office.
Number of bedrooms
SI ATU12E OF APPLICANT(S) LJ- L 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)
~<a
Quick4 Plus Standard Chamber Side and End Views
1
48"
(EFFECTIVE LENGTH)
5
F 34"
i .Quick4 Plus All-in-One 12 Encap Front, Side and End Views
t
11.2"
13"
8" INV~ RT 8" IN4 ERT 17M ~J\ 5.3 INVERT
33"--~
I Quick4 Plus Ali-in-One Periscope
OUICK4 PLUS
d ALL-IN-0NE PERISCOP
~60'SWNEL )
6"
12.7" INVERT ~ oulcK4 PLUS
ALL•I14-0NE 12 9" I .
ENDCAP r-II
F Quick4 Plus Standard Chamber Specifications
ii
' Size (NV x L x H) 34" x 53" x 12" (86 cm x T35-cm x.31 cm)
Invert Height 0:6", 5.3',8,0', 12.7..
r Effective Length 48" (122 cm) (1 ,5 cm, 8 4 cm, 18.5 cm; 22.6 cm)
INFILTRATOR SYSTEMS, INC. STANDARD LIMITED WARRANTY
(a) The structural Integrity of each chamber, end plate, wedge and other accessory manufactured by Infiltrajpr ( "Units"), when Installed and
b operated in a leachfield of an onsite septic system, in accordance with Infltrator's Instructions,' is warranted to the original purchaser ("Holder")
against defective materials and workmanship for one year from the date that the septic permit Is Issued for the septic system containing the Units;
provided, however, that if a septic permit is not required by applicable law, the warranty period will begin upon the date that installation of the
septic system commences. To exercise its warranty rights, Holder must notify Infiltrator In writing at Its Corporate Headquarters In Old Saybrook, F
Connecticut within fifteen (15) days of the alleged defect. Infiltrator will supply replacement Units for Units determined by Infiltrator to be covered
by this Limited Warranty. Infltrator's liability specifically excludes the cost of removal and/or Installation of the Units.
(b)THE LIMITED WARRANTY AND REMEDIES IN SUBPARAGRAPH (a) ARE EXCLUSIVE. THERE ARE NO OTHER WARRANTIES WITH RESPECT
TO THE UNITS; IN LUDING NO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE
(c) This Limited Warranty shall be void if any part of the chamber system is manufactured by anyone other than Infiltrator. The Limited Warranty INFILTRATOR
does not extend to incidental, consequential, special or Indirect damages. InfiltPStpr shall not be liable for penalties or liquidated damages,
including loss of production and profits, labor and materials, overhead costs, or other losses or expenses incurred by the Holder or any third party. systems inc.
? Specifically excluded from Limited Warranty coverage are damage to the Units due to ordinary wear and tear, alteration, accident, misuse, abuse
or neglect of the Units: the Units being subjected to vehicle traffic or other conditions which are not permitted by the Installation instructions; failure
to maintain the minimum ground covers set forth in the Installation Instructions; the placement of improper materials Into the system containing 6 Business Park Road • P.O.
Box 768
the Units; failure of the Units or the septic system due to improper siting or improper sizing, excessive water usage, Improper grease disposal,
or improper operation; or any other event not caused by Infiltrator. This Limited Warranty shall be void if the Holder falls to comply with all of the Old Saybrook, CT 06475
terms set forth in this Limited Warranty. Further, in no event shall Infiltrator be responsible for any loss or damage to the Holder, the Units, or any
1 third party resulting from instailation or shipment, or from any product liability claims of Holder or any third party. For this Limited Warranty to 860,577,7000 • FAX 860.577.7001
apply, the Units must be installed in accordance with all site conditions required by state and local codes; all other applicable laws; and Infiltrator's
installation instructions. 800.221.4436
(d) No representalive of Infiltrator has the authority to change or extend this Limited Warranty. No warranty applies to any party other than the www.infiltratorsystems.com
original Holder.
The above represents the Standard Limited Warranty offered by Infiltrator.' A limited number of states and counties have different warranty
requirements. Any purchaser of Units should contact Infiltrates Corporate Headquarters in Old Saybrook, Connecticut, prior to such purchase,
to obtain a copy of the applicable warranty, and should carefully read that warranty prior to the purchase of Units.
f}A~ " • P • i ~ rW 0 ® ~ ~ ~
U.S. Patents: 4,759,661; 5,017,041; 5,156,488; 5,336,017; 5,401,116; 5,401,459; 5,511,903; 5,716,165; 5,588,778; 5,839,844
Canadian Patents: 1,329,959; 2,004,564 Other patents pending.
Infiltrator, Equalizer, Quick4 and Quick4 Plus are registered trademarks of Infiltrator Systems Inc. Infiltrator Is a registered trademark In France. Infiltrator Systems Inc.
is a registered trademark In Mexico. Contour Swivel Connection Is a trademark of Infiltrator Systems Inc. 0 2009 Infiltrator Systems Inc. Printed in U.S.A. PLUS0510101SI-2
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Nov 4 5 09.16p Hollister's Soil Testing 715-426-1775 p.4
Fram: ASOPeteraon Mike.Petersan arandt.co;m B
Subject: tot 15
Date: OaDber 26, 2015 at 7:46 AM!
To: EWI,%iiiia_mipeterscciC6cor*,easiniat
Please note'setback....
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LOT 15,
1.557 ACRES
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Wisconsin Depa anti SOIL EVALUATION REPORT 1 3
Division of Safety uddings Page
n ST. CROIX COUNTY in acooxW" w+th Comm 85, Wis. Adm. Code
Att~~ Fii'PePtical ~ than 61/2 x 11 inches in size. Plan must County ST. CROIX
indude, Nut Wort to: ver and hor6zontal re Wence Point (BM), direction and
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Par o91 I D 040 - 1304 - 15 -000
Please print a# hdbnnaffon. Date
P trrforr Mh- YOU WVVWe may be used for secondary purposes (POVOCY Law, s. 15.04 (1) (m)).
Property Owner Property locatton i Q
PRECISION BUILDERS JP2 LLC '
Property Owners Mailing Address Cont. Lot NE 1/4 SW 1/4 8 T 28 N R 19 yy
Lot # Bbdc # Subd. Name or CSM#
City N5740 1242 nd Street 15 - Sunset Valley -AM zip Code Phaw Number Villoge own Newt Road
Prescott, WI 54021 1( lrwr ) Horizon Court
a New Construction Use / Number of bedrooms 4 Code derived design flow rate 600 CPD
® Ruptawnent 0 Public or cormrreraai - Describe:
Parent material outwash/sandstone Flood Plain elevation if applicable
General comments ~1
and recommendations: Conventional In-ground trenches - to be designed by installer
0.5 or 0.7 loading rate depending on location of trenches
Property Address: 443 Horizon Court
PB_ Boring # 0 Boring
Pit Ground surface elev. 906.66 ft. DOM to knitiing factor 108 in.
Sod Application Rate
Hoxt m Depth Dominant Redox Description Texture Structure C,onslstenoe Boundary Roots Gppff
in. MunsaN Qu. Sz. Court. Color Gr. Sz. Sh. 'Eff#1 *01182
1 0-8 10YR2/2 - l 2f-msbk mvfr cb 3vf-m 0.6 0.8
2 8-14 1OYR2/2 - 1
2f-mabk mfr ai 2vf-m 0.6 0.8
3 1425 10YR3/4 - 1 2f-mabk mfr aw 2vf-m 0.6 0.8
4 25-38 i0YR3/6 -
s Os mi as 3vf-m 0.7 1.6
5 38-72 10YR3/6 - cs & gr Osg ml as 0.7 1.6
6 72-108 10YR4/4 - fs Osg ml as 0.5 1.0
7 108- 10YR4/4 c2f loYR4/6 fs Osg MI - 0,5 1.0
1E# soft Pit Ground surface elev. 906.23 ft. Depth to ti nbV factor 113 in.
Horizon Deepth Dominant Color Redtac Rate
Texture Structure Corgi Boundary Roots qEM
in. Murl8ell Qu. Sz. Cont. Color Gr. Sz. Sh. " Ef i '01#2
1 0-4 10YR2/I - I 3fabk ds cb 3vf-m 0.6 0.8
2 4-17 10YR2/1 - I 2f-ma&sbk ds ai
2vf-m 0.6 0.8
3 17-30 10YR3/4 - sii 2f-mabk mfr cs 2vf-m 0.6 0.8
4 30-42 10YR3/6 - s Osg cs 2vf-m 0.7 1.6
5 42-113 10YR5/4 - s Osg 0.7 1.6
ral (Horizons 4 & 5 have some gr.)
' Effluent #1 = BOD > 30 < 220 mg& and TSS >30:S 150 nV& ' Effluent #2 = t30D < 30 r..-A and TSS 30 mg&
CST Name (please Print) _ Z:Z CST Number
Marv Jo Hollister
jm6k It 224832
DConducted Telephone Number
W9875 690th Avenue, River Falls, WI 54022 01 - 13 & 07 - 08 - 04 (715) 426 - 1775
1
Property Owner FEYEREISEN, Arthur (Lot 15)
Parcel ib # (Pending) Page 2 3
Boring E)
Pit Ground surface elev. 904.22 # > 120
Depth to limiting factor in.
Horizon Depth Dominant Color Redox Sal R
Description Texture Stnxxure Consistence Boundary Roots GPD/tf
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 '01#2
1 04 10YR2/1 1 3fabk ds cb 3vf-m
0.6 0.8
2 4-10 1OYR2/1 1 2fabk ds as 2vf-m 0.6 0.8
3 10-20 10YR3/4 sl 2f-mabk mfr cb
2vf-m 0.6 1.0
4 20-120 10YR3/6
s Osg d1 - 0.7 1.6
ew cobbles; Horizon 4 has some pockets of IOYR5/4
D Boring # Boring 898.90
Pit Ground surface elev. ft. Depth to limiting facts >94
in.
Horizon Depth Dominant Color Redox Soil Application Rate
Description Texture
Stricture Consistence Boundary Roots GPD/(f
in. Munsen Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *002
l 0-14 10YR2/1 1 2fsbk mfr 0.6 0.8
2 14-23 1 2fabk mfr 0.6 0.8
3 23-32 I0YR4/4 sil 2fsbk mfr 0.6 0.8
4 32-36 7.5YR4/3 sl 2fsbk mvfr
0.6 1.0
5 36-48 7.5YR4/3 s Os m1
0.7 1.6
6 48-94 7.5YR3/4 s Osg ml 0.7 1.6
some gr 9
❑ Boring # S Boring Ground surface elev000 . 901.00 ft.
Pit Depth to Wiling factor >94 in.
Horizon De
Application am
in. pth Dominant Redox Description Texture Structure Consistence Boundary Roots M*EfWl*Efr#2
Qu. Sz. Cant. Color Gr. Sz. Sh. 1 0-18 10YR2/1 1 2fsbk mvfr
0.6 0.8--
2 18-24 2fsbk mfr
0.6 0.8
3 24-32 10YR4/4 I 2fsbk mfr 0.6 0.8
4 32-36 7.5YR4/3 sl 2fabk mvfr
0.6 0.8
5 36-50 7.5YR4/3 s Os ml
0.7 1.6
6 50-94 7.5YR3/4
s Osg m1 0.7 1.6
some gr
EMuent #1 = SODS > 30 < 220 mg& and TSS ?gyp 1511 mgiLl~ 'Effluent #F2 = <
, _ 30 mWL and TSS < 30 mg1L
a
The Department of Commerce is an equal opportunity rvice 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.
SBD-8330Test (807/00)
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Wisconsin Department of coerce S IL EVALUATION REPORT Page I of 3
Division of Safety and Buildi s OCT • 4 with m 85, vv,. Adm. Code
Attach complete site pla p x 11 a Ian u ~Y ST. CROIX
include, but not limited to vertica d' ;n Parcel I.D. R~
percent slope, scale ord" ~N I a di nee o n W6
Please print all information. Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).
Property Owner Property Location
ARTHUR & MARIYLN FEYEREISEN Cor< Lot 1/4 SW 1/4 S 8 T 28 N R 19
Property Owner's Mailing Address Lot # Block # Subd. Name or CSW
420 Townsvalley Road 15 - Sunset Valley
city State Zip Cade Phone Nmber ®Vllage Nearest Road
Hudson, WI 54016 ( 71) 386 - 2122 Townsvalley Road
New Construction UseE) 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 appicable WA- ft.
General comirrients
and recommendations: Conventional In-ground trenches - to be designed by installer
~qq 0.5 or 0.7 loading rate depending on location of trenches
/~e✓ go% 3Y/ 30 - 7a
PB- Boring # ❑ Boring
Q Pit Ground surface elev. 906.66 ft. Depth to limiting factor 108 in.
Sal ApWication Rate
Horizon Depth Dominant Cola Redox Description Texture Structure Consistence Boundary Roots GPD/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
1 0-8 10YR2/2 - 1 2f-msbk mvfr cb 3vf-m 0.6 0.8
2 8-14 IOYR2/2
2f--mabk mfr ai 2vf-m 0.6 0.8
3 14-25 10YR3/4 - 1 2f-mabk mfr aw 2vf-m 0.6 0.8
4 25-38 I0YR3/6 s Os
as 3vf-m 0.7 1.6
5 38-72 10YR3/6 cs & gr Osg m1 as 0.7 1.6
6 72-108 10YR4/4 fs If Ng ml as - 0.5 1.0
7 - I OYR4/4 c2f t0YR4/6 fs Osg ml - - 0.5 1.0
B Boring # Boring
F - M 906.23 >1 13
Pit Ground surface elev. ft. Depth to limiting facto in
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
in. Munsefl Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 '011112
1 0-4 10YR2/1 - I 3fabk ds cb 3vf-m 0.6 0.8
2 4-17 10YR211 -
1 2f-ma&sbk ds si 2vf m 0.6 0.8
3 17-30 1 /4 - sil 2f-mabk mfr cs 2vf-m 0.6 0.8
4 30-42 IOYR3/6 - s Osg dl cs 2vf-m 0.7 1.6
5 42-113 10YR5/4 - s Osg ml - - 0.7 1.6
onzons 4 & 5 have some gr.)
' Ef ient #1 = BOD > 30 < 220 mg/L and TSS >3o:5 150 mg/L * Effluent #2 = BOD < 30 mg& and TSS < 30 mg/L
CST Name (Please Print) ature ~ CST Number
Mary Jo Hollister 224832
Address Dale Evahiation Catducted Telephone Number
W9875 690th Avenue, River Falls, WI 54022 01 - 13 & 07 - 08 - 04 (715) 426 - 1775
Property owner FEYEREISEN, Arthur (Lot 15) Parcel ID # (Pending) Page 2 of 3
I-] C Boring # Boring
Pit Ground surface elev. 904.22 ft. Depth to limiting factor >120 in.
Sod Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM
in. Munsel Qu. Sz. Cont. Color Gr. Sz. Sh. -Eff#1 -Eff#2
1 01l 10YR2/1 - 1 3fabk ds cb 3vf-m 0.6 0.8
2 4-10 10YR2/1 _ 1 2fabk ds as 2vf-m 0.6 0.8
3 10 /4 - si 2f-mabk mfr cb 2vf-m 0.6 1.0
4 20-120 10YR3/6 - s Osg dl - - 0.7 1.6
ew cobbles; Horizon 4 has some pockets of 10YR5/4 cs.)
F-I Boring # Boring
Pit Ground surface elev. ft Depth to kniWv factor in.
Sod ication Rate
Horizon Depth Dominant Color Redox DesrsigitiOrr Textre Structure Consistence Boundary Roots GPDW
in. Mtnselt Qu Sz. Cord. Color Gr- Sz. Sh. 'Effii`1 'Eff#2
❑ Boring # SBonrg
Pit Ground surface elev. R Depth to limiting factor in.
Sou Application Rate
Horizon Depth Dominant Color Redox Description Texture Strucb" Consistence Boundary Roots GPDffF
in. M resell Qu_ Sz. Cord. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
Effluent #i = BOD, > 30 < 220 mgtL and TSS >30 < 150 mg& ~ Ef l cent #2 = BoD, < 30 mg/1- and TSS < 30 mg/L
The Department of Commerc is an izqual pv:- s=- pr ,.v ,.rn ti _
creed material in an akernate forma, please contae-t the department at 608-:.266-:3 151 or 'E -t Y 6OS-2644777 Sliv-433ihestik.;i;,iiw
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