HomeMy WebLinkAbout040-1026-60-000
Annk~v County
RECEIVED Safety and Buildings Division St. Croix
j 201 W. Washington Ave O. Box 7162 Sanitary Permit Number (to be filled in by Co.)
P Madison, WI 53 -71
Noll 47
FsstoKti
:.OMMUf Y V§Mjt Application State Transaction Number
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In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental u it Z (QZ ~?jT~
is required prior to obtaining a sanitary permit. Note: Application forms for state owned POWTS are submitted to of t Address (if different than mailing address)
the Department of Safety and Professional Services. Personal information you provide may be used for second
purposes in accordance with the Privacy Law, s. 15.04(1) m), Stats. 345 Riverview Dr., Hudson, WI 54016
I. Application Information - Please Print All Information
Property Owner's Name I Parcel # 0
YMCA Of Greater St. Paul - & Q 74 - /b Llo
Property Owner's Mailing Address Property Location 46- co:>
2125 E. Hennepin Ave., #150 Govt. Lot
City, State Zip Code Phone Number NE _NW '/4, Section 06 (circle one) 414t)
Minneapolis, MN 55413 54016 612 209-9299 T 28 N; R 19 E or W
II. Type of Building (check all that apply) Lot #
❑ I or 2 Family Dwelling -Number of Bedrooms O ~MM t rC.v Na Subdivision Name
Na
Block #
❑ Public/Commercial - Describe Use Welcome Center Na
❑ City of
11 Village
El State Owned-Describe Use CSMNumber of
Na ❑ Town of Troy
III. Type of Permit: (Check only one box on line A. Complete line B if applicable) Zo,
A. lNew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain)
B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued
Before Expiration Owner
IV. Type of POWTS System/Component/Device: (Check all that apply) ie,Ik 004 ❑ 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 x lain) ❑ Pretreatment ain)
V. Dis ersal/Treat Ant Area Informati : 1040I or "Q-4 Plus" Standard chambers & 8 end c Pol Lok PL-625 ftluent filter in 2nd Wieser septic tank
Design Flow (gpd) Design Soil Application Dispersal Area Required (sf) Dispers System Elevation
1,447.50 Gpd 0.750 Gpd/Sq. Ft. 2,067.86 sq. ft. 2,10%0 Sq. Ft. pp~ 838.00'
VI. Tank Info Capacity in Total # Of Manufacturer
Gallons Gallons Units o o
U y
New Tanks Existing Tanks y cU~. Y y a
PO I4, ~s U in
Septic or Holding Tank 1,565 3,130 2 Weiser Concrete X
Dosing Chamber Weiser Concrete X
VII. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number
Gary Za a MPRS 222373 (715) 386-2850
Plumber's Address (Street, City, State, Zip Code)
715 6"' St. N, Hudson, WI 54016
VIII. oun /De artment Use Only
Approved ❑ Disa roved Permit Fee Date Issued Issuin gent Signature
$ /Z liS
riven Reason for 'al, 5 • ~ /
IX. CondilSiltBTdI AftVDltAReasons for Disapproval em.
1. Septic tank, effluent fitter and 3, Ls4;,y^ 4 f
a+ ~ ik C7V'L ~t. e
dispersal cell must all be services / maintained ^nc
as per management plan provided by plumber. 1 n PX.
2. =All.setbalick requirements must 0e=irmiintittried
as per applicable code / ordinances.
Attach to complete plans for the system and submit to the County only on paper not less than 8 1/2 x 11 inches in size
SBD-6398 (R. 11/11)
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~Qtir~xT~TF~~ DIVISION OF INDUSTRY SERVICES
10541 N RANCH RD
HAYWARD WI 54843-6462
31~ Contact Through Relay
P S http://dsps.wi.gov/programs/industry-services
www.wisconsin.gov
ror+
Scott Walker, Governor
Dave Ross, Secretary
November 09, 2015
OUST ID No. 222373 ATTN: POWTS Inspector
GARY T ZAPPA ZONING OFFICE
ZAPPA BROTHERS INC ST CROIX COUNTY SPIA
715 SIXTH ST N 1101 CARMIC14AEL RD
HUDSON WI 54016 HUDSON WI 54016-7708
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 11/09/2017 Identification Numbers
Transaction ID No. 2628245
SITE: Site ID No. 816874
Ymca Camp St Croix Welcome Center Please refer to both identification numbers,
345 Riverview Dr above, in all correspondence with the agency.
Town of Troy, 54022
St Croix County
FOR:
Object Type: POWTS Component Manual Regulated Object ID No.: 1574177
Maintenance required; 1,448 GPD Flow rate; 145 in Soil minimum depth to limiting factor from original grade;
System(s): In-ground POWTS Component - Ver. 2.0, SBD-10705-P (N.01/01, R. 10/12); Commercial System, 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
requirements.
No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06,
stats.
The following conditions shall be met during construction or installation and prior to occupancy or use:
Care should be used in placing the distribution box so that unequal settling does not occur.
You may wish to use aggregate in combination with adjustable flow apparatus.
Reminders
• Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of
the POWTS explaining that periodic cleaning of the septic tank outlet filter is required. The access opening
used to service the filter shall terminate at or above finished grade with a watertight cover.
A copy of the approved plans, specifications and this letter shall be on-site during construction and open to
inspection by authorized representatives of the Department, which may include local inspectors. All permits
required by the state or the local municipality shall be obtained prior to commencement of
construction/installation/operation.
In granting this approval the Division of Industry Services reserves the right to require changes or additions should
conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review
shall relieve the designer of the responsibility for designing a safe building, structure, or component.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
0
GARY T ZAPPA Page 2 11/9/2015
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 $ 325.00
Fee Received $ 325.00
Balance Due $ 0.00
AA~~Cx--"
Carl J Lippert
Wastewater Specialist, Division of Industry Services WiSMART code: 7633
(715)634-5035, M-f 7AM - 12PM
carl.lippert@wisconsin.gov
cc: James K Thompson, Ace Soil & Site Evaluations
Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm
Zappa Brothers Inc
Conventional POWTS Index & Tilte Sheet
Project Name: YMCA Camp St. Croix Welcome Center
Owners Name: YMCA of Greater St. Paul
Owner's adress: 2125 E. Hennepin Ave. #150, Minneapolis, MN 55413
Site address: 345 Riverview Dr., Hudson, WI 54016
Project Location:
Subdivision: Na
Legal Description: NEi/4NWv4, Sec. 06, T.28N., R. 19W., Tn of Troy, St. Croix Co., WI.
Parcel ID 040-1025-80-000
Page I Index and Title Sheet
Page 2 Site Plan
Page 3 Dispersal Cell & Septic Tank Sizing Calcualtions
Page 4 System Cross Section
Page 5 Infiltrator "Q4" Plus chamber specificatons CONDIT14 '-LY
Page 6 Septic Tank Cross Section APPRC:
Page 7 Filter Specifications Qs-pT,
Page 8 System Management Plan _ F
Page 9 Grading Plan PROFESSIONAL K-0 r'
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Attachments: Soil Evaluation Report
Mater Plumber Restricted Service: Gary Zappa, Dep't. of SPS Credential #222373
Signature: Date:
Page 1 Of 9
Design pursuant to In-Ground Soil Absorption Component Manual for POWTS, version 2.0 SBD-10705-P (N.01/01)
♦f~~,oo.seel~~ole e/ed.
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YMCA - Camp St. Croix Welcome Center
DISPERSAL CELL & SEPTIC TANK SIZING CALCULATIONS
JOB DESCRIPTION:
Property is owned and operated by YMCA of Greater St. Paul. Septic system will serve proposed Welcome Center.
Proposal includes installation of two Wieser Concrete septic tanks in series and four (4) subsurface dispersal trenches.
Sizing based on projection of 80 daily visitors, 5 full time employees all shifts, 4 floor drains, no food preparation or
service. Design assumes domestic rength waste`
DESIGN FLOW CALCULATIONS - Visitor Center
Design Wastewater Flow: (965.00 Gpd daily flow)(1.5 conversion factor) = 1,447.50 Gpd
(5 employees) (13gal. per employee) = 65.00 Gpd
(4floor drain)(25 gal./drain) = 100.00 Gpd
(80 visitors/day)(10 gals per) = 800.00 Gpd
Daily wastewater flow = 965.00 Gpd
DISPERSAL CELL SIZING CALCULATIONS:
1. Design flow = 1,447.50 Gpd design flow
2. Infiltrative surface elevation to be: 838.00'
3. Infiltrative capacity of native soil within 3' of infiltrative surface: 0.7 gpd/sq. ft.
4. Absorption area required: 2,067.86 sq_ft.
5. Absorption area as proposed: 2,103.20 sq. ft. (104 chambers total)
Infiltrator "Quick 4 Plus" = 20.00 sq.ft. EISA per chamber, "Quick 4 Plus" end cap/pair = 5.20 sq.ft. EISA
2,067.86 sq. ft. - (4 pair end caps)(5.20) = 2,047.06 sq. ft./20.00 = 102.36 chambers required
Number of trenches: 4 @ 26 chambers per trench
Trench width: 2.83'
Trench length: 107.00'
Trench spacing: 6.00'
Total system area: 30.0'x 107.00'
SEPTIC TANK CAPACITY CALCULATIONS:
1. Proposed Septic Tank Capacity & Manufacturer: 3,130 gallons - Two (2) 1,565 gallon Wieser Concrete treatment
tanks in series
2. Design wastewater flow = 1,447.5000 gpd
3. Minimum required capacity: 3,027.60 Gallons
(1,447.5) + (11.61 x 3* x 19.30) + (46.77 x19.30) = 3,022.38 *(Requires a maximum 3 year maintenance cycle)
1, 447..50gpd / 75 gpd = 19.30 gpd person equivalency
4. PolyLok PL-625 effluent filter to be installed at proposed septic tank outlet.
(1,447.5x2.088 "magic number")= 3,022.38 gallon capacity required on 3 year maintenance cycle.
Pg. 3 of 10
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POINTS LOCATIONS
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Quick4 Plus All-in-One Periscope INFILTRATOR WATER TECHNOLOGIES STANDARD LIMITED WARRANTY
(a) The structural integrity of each chamber, endcap and other accessory manufactured by
Infiltrator ("Units', when installed and operated in a leachfield of an onste septic system in
QUICK4 PLUS accordance with Infiltrator's instructions, is warranted to the original purchaser ("Holder") against
ALL-IN-ONE PERISCOPE defective materials and workmanship for one year from the date that the septic permit is issued for
(360° SWIVEL) 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 notrfy Infiltrator in writing at its Corporate
Headquarters in Old Saybrook, Connecticut within fifteen (15) days of the alleged defect. Infiltrator
will supply replacement Units for units determined by Mfif6ator to be covered by this Limited
Warranty. Infiltrator's liability specifically excludes the cost of removal and/or installation
of the Units.
12'7• INVERT (b) THE LIMITED WARRANTY AND REMEDIES IN SUBPARAGRAPH (a) ARE EXCLUSIVE.
THERE ARE NO OTHER WARRANTIES WITH RESPECT TO THE UNITS, INCLUDING NO
IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE
(c) This Limiter) Warranty shall be void If any part of the chamber system is manufactured by
anyone other than Infiltrator. The limited Warranty does not extend to incidental, consequential,
special or indirect damages. Infiltrator 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. Specifically excluded from Limited Warranty
1 coverage are damage to the Units due to ordinary wear and tear, alteration, accident, misuse,
T abuse or neglect of the Units; the Units being subjected to vehicle traffic or other conditions which
6 are not permitted by the installation instructions; failure to maintain the minimum ground covers
W forth in the installation instructions; the placement of improper materials into the system
containing the Units; failure of the Units or the septic system due to improper siting or improper
9•' sizing, excessive water usage, improper grease disposal, or improper operation; or any other
event riot caused by Infiltrator. This Limited Warranty shall be void if the Holder fails to comply
with all of the terns 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 third party resulting from
installation or shipment, or from any product liability claims of Holder or any third party. For this
Limited Warranty to 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.
(d) No representative of Infiltrator has the authority to change or extend this Limited Warranty.
No warranty applies to any party other than the original Holder.
The above represents the Standard Limited Warranty offered by Infiltrator. A limited number of
4 Business Park Road states and counties have different warranty requirements. Any purchaser of Units should contact
P.O. Box 768 Infiltrator'S
Old Saybrook, CT 06475 Corporate Headquarters in Old Saybrook, Connecticut, prior to such purchase, to
860-577-7000 • Fax 860-577-7001 obtain a copy of the applicable warranty, and should carefully read that warranty prior to the
INFILTRATOR 1.800-221-4436 purchase of Units.
www.inflltratorwater.com
U.S. Patents: 4,759,661; 5,017,041; 5,156,488; 5,336,017; 5,401,116; 5,401,459; 5,511,903; 5,716,163; 5,566,778; 5,839,844 Canadian Patents: 1,329,9; 2,004,564 Other patents pending.
Infiltrator, Equalizer, Quick4, and Sidewinder are registered trademarks of Infiltrator Water Technologies. Infiltrator is a registered trademark in France. Infiltrator Water Technologies
is a registered trademark in Mexico.
Contour, MicroLeaching, PolyTuff, ChamberSpacer, MurdPort, Posilodk, QuidkCut, OuickPlay, SnapL ock and StraightLodk are trademarks of knfitrator Water Technologies.
Polyt-ok is a trademark of PolyLok, Inc. TUF-TITS is a registered trademark of TUF-TITE, INC. Ultra-Rib is a trademark of IPEX Inc.
O 2013 Infiltrator Water Technologies, LLC. AN rights reserved. Printed in USA PLUS05 0713
Contact Infiltrator Water Technologies' Technical Services Dep. for assistance at 1-800 -221-4436
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Conventional Septic System Management Plan
Pursuant to SPS 383.54, Wis. Adm. Code
General
The conventional septic system shall be operated in accordance with SPS 382-384 Wis. Adm. Code, and shall be maintained
in accordance with component manual SBD-10705-P (N.01/01). All local and/or state rules pertaining to system
maintenance and maintenance reporting shall be complied with. Questions on the operation or maintenance of the system
should be directed to the installing plumber, Zappa Bros. Excavating at (715) 386-2850 or the St Croix County Zoning
Department at (715) 3864680.
Septic Tank
Septic tank servicing mechanics comply with SPS 383.54(1)(e). Septic tank to be located within 150' of service pad, with
bottom of tank to be 15' below service pad elevation. The operating condition of the septic tank and outlet filter shall be
assessed at least once every two years by inspection. The septic tank contents shall be removed when the sludge and scum in
the tank exceed 1/3 the liquid volume of the tank. The contents of the septic tank shall be disposed of in accordance with NR
113, Wis. Adm. Code, by an individual certified to service septic tanks under s. 281.48, Stats. If the contents of the tank are
not removed at the time of a biannual assessment, maintenance personnel shall advise the owner of when service will be
needed to maintain less than 1/3 scum and sludge accumulation in the tank. 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. Septic tank manholes 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 the tank.
No individual should ever enter the septic tank as dangerous gases may be present that could cause death. Septic tank
abandonment shall be in accordance with Comm83.33, Wis. Adm. Code when the tank is no longer used as a POWTS
component. The addition of biological or chemical additives to enhance septic tank performance is generally not required. If
such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings
Division.
Soil Absorption Cell
Trees or shrubs should not be planted directly on the soil absorption system. The area above and around the system should
be seeded and mulched as necessary to prevent erosion and provide some degree of frost protection. Traffic (other than for
vegetative maintenance) over the system is to be avoided. Soil compaction may hinder aeration of the infiltrative surface
within and above the system and will promote frost penetration during cold weather months. Cold weather installations
(October-March) dictate that the system be heavily mulched for frost protection.
Influent quality into the system may not exceed 220mg/L BOD5, 150 MG/L TSS, and 30 mg/L FOG. Influent flow may not
exceed maximum design flow specified in the permit for the installation.
Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the
owner. Levels above 4 inches indicate an impending hydraulic failure requiring additional, more frequent monitoring.
Contineencv 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. Excessive ponding within the dispersal cell will be eliminated by installing a new soil
absorption cell to bring the system into proper operating condition.
Pg. 8 of 9
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ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer YMCA of Greater St. Paul
Mailing Address 2125 E. Hennepin Ave., #150, Minneapolis, MN 55413
Property Address 345 Riverview Dr., Hudson, WI 54016
(Verification required from Planning & Zoning Department for new construction.)
City/State Hudson, W1 Parcel Identification Number 40-1025-80-000
LEGAL DESCRIPTION
Property Location NE '/4 , NW , Sec. 06 , T 28 N R 19 W, Town of Troy
Subdivision Plat: Na 'Lot # Na
Certified Survey Map # Na , Volume Na , Page # Na
Warranty Deed # (before 2007)Volume , Page #
Spec house 13yes0no Lot lines identifiable El yes[]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 §SPS. 383.52(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 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.
I/we 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, by virtue of a warranty deed recorded in Register of Deeds Office.
Number of bedr s Na
CCU 10/26/15
(!I )NATURE 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. 04/12)
RECEIVED
A T~ ~ { 2419
-7 d-2 T Wisconsin Departrlo4SOIL EVALUATION REPORT- ge , 1 of 3
6eawftefce SPS ?P~ - - ST LF'oky
(~.(~.;~/I0Ut4pTy ~~.J']~(~~',cordance with 8enrrr8&,, Wis. Adm. Code A.C.E. Soil & Site Evaluations
SI[e County
Ata plan on paper not less than 8'/ x 11 inches in size. Pla St. Croix
include, but not limited to: vertical and horizontal reference point (BM), directio parcel I O 110 ua- -cam
percent slope, scale or dimemsions, north arrow, and location and distance t( t
a* 4Q:208
Please print all information. Rev' ed By Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 12 /
Property Ownei FLoi YMCA Camp St. Croix - Welcome Center NE 1 N 1/4 6 T 28 N R 19 W
Property Owner's Mailing Address # Subd. N e or CSM#
2125 E Hennepin Ave. #150 City State Zip Code Phone Number Village a Town Nearest Road
Minneapolis MN 55413 (612) 465-0567 Troy 345 Riverview Dr. & Co. Rd. F
New Constructior Use: I Residential / Number of bedrooms Code derived design flow rate 1450 GPD
.ej Replacement ✓j Public or commercial - Describe: Welcome Center
Parent material Glacial Outwash Flood plain elevation, if applicable na
General comment:
and recommendations: Soils suitable for conventional dispersal cell at 0.7 gpd. Recommended linfiltrative surface elevation to be
838.00'. i
Boring # I Boring
wf Pit Ground Surface elev 846.10 ft. Depth to limiting factor >180 in. Soil Application Rat
Horizon Depth Dominant Redox Description Texture Structure Consistence Boundar Roots GPD/ft2
in. Color Qu. Sz. Cont. Colo Gr. Sz. Sh 'Eff#1 'Eff#2
1 0-16 1Oyr2/1 none I 2fgr mvfr aw 2vf,fm 0.6 0.8
2 16-29 1Oyr4/4 none sil 2fsbk mvfr cw 2vf,fm 0.6 0.8
3 29-38 1Oyr4/6 none sil 2msbk mfr cw 1vfm 0.6 0.8
4 38-56 1Oyr4/6 none sil lcsbk mfr gw - 0.4 0.6
5 56-180 1Oyr5/4 none s Osg dl - - 0.7 1.6
F 2 ] Boring # Boring
6I Pit Ground Surface elev 844.00 ft. Depth to limiting factor >152" in. Soil Application Rat
Horizon Depth Dominant Redox Description Texture Structure Consistence Boundar Roots GPD/ft2
in. Color Qu. Sz. Cont. Colo Gr. Sz. Sh -Eff#1 'Eff#2
1 0-7 1Oyr2/2 none sil 2fgr mvfr aw 2vf,fm 0.6 0.8
2 7-15 1Oyr4/4 none sil 2fsbk mvfr cw 2vf,fm 0.6 0.8
3 15-19 1 Oyr4/4 none sl 1 msbk mvfr cw 1vfm 0.4 0.7
4 19-24 1 Oyr4/4 none gr Is Osg ml cw - 0.7 1.6
5 24-152 1Oyr5/4 none s Osg dl - - 0.7 1.6
If
11 I
Effluent #1 = BOD 30 <220 mg/L an TSS >30 < 1 mg Effluent #2 = BOD5< 30 mg/L and TSS < 30 mg,
CST Name (Please Print) Signat CST Number
James K. Thompson a.----62yc(/
Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number
340 Paulson Lake Lane, Osceoa, WI 54020 10116/2015 715-248-7767
Property Owner YMCA Camp St. Croix - Welcome Parcel ID # 040-1025-80-000 Page 2 of 3
3] Boring # Boring
f Pit Ground Surface elev 843.15 ft. Depth to limiting factor >145" in. Soil Application Rat
F
Horizon Depth Dominant Redox Description Texture Structure Consistence Boundar Roots GPD/ft2
in. Color Qu. Sz. Cont. Colo Gr. Sz. Sh *Eff#1 *Eff#2
1 0-12 1Oyr3/3 none sil 2fgr mvfr aw 2vf,fm 0.6 0.8
2 12-36 1Oyr3/6 none sil 2fsbk mvfr Cw 1fm 0.6 0.8
3 36-43 1Oyr3/6 none Is Osg ml cw lfm 0.7 1.6
4 43-145 1Oyr4/4 none S Osg ml Cw - 0.7 1.6
C 15
VI
❑ Boring # Boring
Pit Ground Surface elev ft. Depth to limiting factor in. Soil Application Rat
Horizon Depth Dominant Redox Description Texture Structure Consistence Boundar Roots GPD/ft2
in. Color Qu. Sz. Cont. Colo Gr. Sz. Sh *Eff#1 *Eff#2
I
~I
I
❑ Boring # J Boring
Pit Ground Surface elev ft. Depth to limiting factor in. Soil Application Rat
Horizon Depth Dominant Redox Description Texture Structure Consistence Boundar Roots GPD/ft2
in. Color Qu. Sz. Cont. Colo Gr. Sz. Sh *Eff#1 *Eff#2
* Effluent #1 = BOD ? 30 <220 mg/L and TSS >30 < 150 mg * Effluent #2 = BOD 5< 30 mglL and TSS < 30 mg,
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.
SBD-8330 (R.07/00) A.C.E. Soil & Site Evaluations
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