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AR,"`t.~T ® Industry Services Division County O j RECEIVE / r f , \T C 1400 E Washington Ave t r DE 3 1 Madison, WI x 716 ,i2 Sanitary Permit Number (to be filled in by Co: ) COMMUNrrS it Application p teTransaefrmtNnmber In accordance with SPS 38321(2), Wis_ Adm. Code, submission of this form to the appropriate Bove Y 3 is required prior to obtaining a sanitary permit. Note. Application forms for state-owned POWTS are. submit tt Project Address (ifditfmxd than reading address) the Department of Safety and Professional Services. Personal information you provide may be used for secondary purposes in accordance with the Privacy jaw, s. 15. l m Stats. ~5 Q 25P L Application Information - Please Print AAlpformation ` Property Owner's Name parcel # Property Owner's Mailing Address S ~ ~J Property Location 73,2.0./4. s ~w 7 e, City, State Zip Code phone Number Govt Lot Ala ~ Section ~ GO CDC7C LO 0 ~ 7 ' (circle one T N; R E o> Lot 11. Type of Building (check all that apply) F4014 An 1 or 2 Family Dwelling-Number of BedroomSubdivisionN~~a//me Block# 7d Y` c,"5 ❑ Public/Commercial - Describe Use,- ❑ City of ❑ State Owned- Describe Use I CSM Number ❑ Village of / 2 VT", of r X O J l► I1L Type of Permit: (Check only one boa on line A. Complete line B if applicable) A. ❑ New Sy R lacement System ❑ TreatmentJFlalding 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 Befbre Expiration Owner / IV. T of POWTS stem/Com nent/Device: Check all that apply) ❑ 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) ❑ Prefteahnent Device (explain) V. Dis nnVrrea ut Area Information: A l Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (st) System Elevation 3 Oct) 3 o 0 3 s 75-- 5- V1. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units New Tanks Existing Tans L u c S~ r fin/ r0 'O 7 Z c in v~ 0 a. Septic or Holding Tank 1.100 Dosing('hamber Roo DOLI t' tr VII. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the PQWTS shown on the attached plans Plumber's Name (Print) Plum s Signaturg MP/MPRS Number Business Phone Number Plumber's Address (Ste City, State, Zip Code) :1176 y l S ~~n Ua c S 767 VUL oun fDe rtment Use Only Approved ❑\L Permit Fee Date •~ued Issuing Signature ❑ CG n Reason for $ 6Z5' ~Z•V Ix Condi easons f= Disapproval S e f 'Septic` k, effluent fills. twwS l tlisperxal cee.must all be services / maintained e ~ W t W+°`t'.~"• as"per, management plan provided by plumber. 2:. sk itdrem~nts reellet- maintaittd n n pai't~icaele code / ordinances. 6U -b b~•~.. ~b 6e a6e 06 P" 4 Attack to complete plans fir the system and submit to the County ouiy on paper not leas than 8 t/i z 11 inches In six SBD-6398 (R. 08/14) rp y~ Rf..; 41 r Irz ACRES E J p,A,,pc-A -,J Tv o Ec,,,- G-- I ''q 73eq W i esec-s r<~C l rye ~•"'L Cop ~k-[Pcc. /t~~o E+C7 / , r r~ r p t4 ~f 1 EYceVt Shy rp /00. CC F 1~c7. ~ ~~bv l`otip~itT'r DIVISION OF INDUSTRY SERVICES GA oJ~ 9 3824 CREEKSIDE LN s^~ HOLMEN WI 54636-9466 Contact Through Relay http://dsps.wi.gov/programs/industry-services www.wisconsin.gov ~o 1014 P, wr Scott Walker, Governor Dave Ross, Secretary December 09, 2015 CUST ID No. 220292 A= POWTSInspector BENNIE W HELGESON ZONING OFFICE HELGESON ENTERPRISES ST CROIX COUNTY SPIA N7649 STATE ROAD 128 1101 CARMICHAEL RD SPRING VALLEY WI 54767-8709 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 12/09/2017 SITE. Identification Numbers Paul & Chia Yang Transaction ID No. 2644447 2549 25TH Ave Site ID No. 803884 Town of Eau Galle Please refer to both identification numbers, St Croix County above, in all correspondence with the agency. NEI/4, SWIA, S23, T28N, R16W FOR: Description: Four Bedroom Mound System / -6% slope Object Type: POWTS Component Manual Regulated Object ID No.: 1578823 Maintenance required; Replacement system; 600 GPD Flow rate; 7 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01101, 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 requirements. G~TVL~OT No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, dEF AFFR stats. T OF The following conditions shall be met during construction or installation and prior to occupancy or use: DIVI CAN OFS'®N INDU Reminders e 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. Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with COP, "-SP ® the designated county official in accordance with the provisions of See. 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 gust 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. o 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 BENNIE W HELGESON Page 2 12/9/2015 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 $ 250.00 E Fee Received $ 250.00 erar Balance Due $ 0.00 d M Swim POWTS Plan Reviewer, Division of Industry Services (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633 jerry.swim@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484 , Monday - Friday 8:00 am To 4:30 pm BENNIE W HELGESON Page 2 12/9/2015 Owner Res po nsibiEtries 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 383.50(1). ® In the event this soil absorption system or any of its component parts malfunctions so as to create a heath 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 POW TS. 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 shah 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 $ 250.00 i Fee Received $ 250.00 Balance Due $ 0.00 erard M Swim POWTS Plan Reviewer, Division of Industry Services (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633 j eery. swim@wiscousin. gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm i INDEX SHEET DEC 2015 jN0LJ116 1 h SE VICES PROPERTY OWNER: Ar C k i;0. YCt.11 -IS-141 d A-, . WOOAui1l-e, LUY. 5'4/0.7$' PROJECT NAME: ~cth M PROJECT LOCATION: 1 J MUNICIPALITY: Cw u C~ l COUNTY: St. C A of DESIGN: PRESSURE DI=STRIBUTION MANUAL, VERSION 2.0" SBD-106706-(N.01/01) MOUND COMPONENT MANUAL VERSION 2.0" SBD- 10691-P (N.01101) CONTENTS: /VA1 LY Page 1: Plot Plan UEFb Page 2: Cross Section and Plan View of Mound - TY ANO vlC,~Fs Page 3: Distribution Pipe Layout TRY 5t:RVlCE's Page 4: Septic Tank and Pump Chamber Cross Sectio d Specification a,e Page 5: ~,(l j. P ( d C7~~DC1R_ Tank Specifications Page 6: Pump Specifications Page 7: Observation Pipe Detail Page 8: POWTS Owner's Manual & Management Plan- Pg 1 Page 9: POWTS Owner's Manual & Management Plan- Pg 2 Name: Bennie Helgeson Signe • 4 Address: N7649 Hwy 128 Spring Valley, WI 54767 Credential Number: 220292 S-A Ao, e ,VO ACRES PLwIlet-1. Re i, vi =c ! .T To 13,,- T IV I(a cv y -8eq ° •i w, c c ebr S l 13 / i Telp e5f'' p Pi "e /"y 7D v •e BSI ` / Arte- p Q3 Exce-vt A, Sh©4s s 1 /00.00 Page Of Synthetic Covering Distribution Pipe ASTM C3-3 Sand ~ t.sA /6?44S Topsoil H_ G 3 E % Shope CELL Of 2r- 2 :2 Force Main. Plowed /©/0- Ce. ,3 a 4 ,F' .6r°? 2 Aggregate Plowed I 4/2 in~~tj7~~~en~~ Sctr~' Layer ''r c h>Sei ~joprr►c~ c~ D Ft. Y►'► ~ n i w, urrm c~e fot✓ o Cross Section Of A Mound f 7 7 Ft. F YO Ft. G Ft. Signed: A 'Y.S- Ft. H / Ft, B License Number: ..K 13,31 Ft. Date: L/ O.i.?Ft. J 7 Ft. Position of I jY Ft. Force Main W.3:~- D Ft. L J Observation Pipe B K IF--_-------- A ! o---- o y 6 W L - =------------~I Distribution 7~ELL Of ~p Pipe 2 2 2 I Aggregate Observation Pipe TuRN-UP&sc./ 4rek 3063, 7~ ~ e GcS r/ j ~J Ce C t n~~ /e Ct t= .(s-7Db j IC/ Plan View of Mound Perloroled Pipe Oeloll End View ' Perloroled ~ . Jo`\obo~`' PVC Pipe I-- s Holes Located on Bottom are Equally Spaced PVC Force -Main * .from Pump r: a~ /e PVC ' Monllold Pipe ~$QV~Ora?5 "-a pitiribullon..• ` Pipe Distribution Pipe Layout P R X 304 Y} r, Signed: Hole Diameter 9_ Inch License Number: Lateral " Intl (es) Date: Manifold " Inches Force Main " a Inches TAME" Mleo. 103,o Pe tes Rer- ' e rct 6 re) l ~a l~s z ~c~5/ Page_!Y_Of SEPTIC TANK & PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS 4" MVENT PIPE 12" MIN. ABOVE GRADE 6 WEATHERPROOF 25' FROM DOOR, WINDOW OR JUNCTION BOX APPROVED FRESH AIR INTAKE TWITH CONDUIT MANHOLE COVER W1 PADLOCK E WARNING LABEL rle-,,, /00,_00fL IL 4" MIN. 18" IN. r.D. u INLET , WATER TIGHT SEALS GAS• ~ PPROVED LT E P, A SEAL F 1 TIGHT t TF ~of° AOINTS WITH. APPROVED PPROVED PIP; PIPE 3'e Q' ONTO ONTO SOLID C OLID SOIL SOIL PUMP OFF ELEV . T . D 3" APPROVED BEDDING UNDER TANK . CONCRETE PAD SPECIFICATIONS ._,atg. t r cj s _ r~ L_~t~ ALL SEPTIC / DOSE r ~ TANK MANUFACTURER : W i ~.Se 1 A. Carl, X 's 3r (7c3' . TANK SIZES: SEPTIC /~_000 GAL. DOSE VOLUME INCLUDING DOSE gp,/)_ GAL. /~>56 F~.. ,FLOWBACK: Off, 76 GAL. ALARM MANUFACTURER: 5_7 E eA h,,,~,S CAPACITIES: A = ~g INCHES = 4/,~29-3.V GAL. MODEL NUMBER: _ 164 SWITCH TYPE: f' c a„ / r1o B = 2 INCHES y . YYGAL. PUMP MANUFACTURER : 4:5Loald-5 C = 5~147 INCHES = LLLGAL. MODEL NUMBER: f'o SWITCH TYPE: f~*/o D = .-,2 INCHES = 2j9.l9GAL. REQUIRED DISCHARGE RATE ,&4( GPM PUMP & ALARM WIRING AS PER ILHR 16.23 WAC VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE FEET + MINIMUM NETWORK SUPPLY PRESSURE . . . . + FEET FORCEMAIN X AFT/100 FT. FRICTION FACTOR.. FEET TOTAL DYNAMIC HEAD = _FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH WIDTH DIAMETER LIQUID D-MYTTF SIGNED: LICENSE NUMBER: DATE: 1/88 of 53" 96.. 41" LA 2 w 4- : m 3" I I I I i 6" o DD- m o ?1 Der mpg Vf (n IT N IrT'I r C7 D N I O m "--I m A i m O m -v }S(\ f m II ~ u ~ s 44" < z lyl ~Tl~ bi I I I P II D z o I c r D 39" m X m m D z c n m c D n ~ O D Xp N -i r r O D D O O z m ZZ A p c m m m D m m mi mmcn O V) D O n m Z PZ mDr-OZf=_*1DOOD`-) On C m m z 0 D 00 >O -0~i90 = ~Z m '(A m n N c z D ~rooA'm('! 'wr''O; -0 o rn N~ o ao Nw N-+m-iirlO~~A m O D o o N o D D ~0~a' ~Op_ 0 0 pp m O W O Z m C m -n r co o Z Z "D m O vp a 0 n n 0 > Z o 0 0° 00 N C z z O W m I v D m O to o m ~m r m m C Z CO f7 O A r cI~ /I m m z m z m m cn m \ ? WLP1200/800-MR MIESER CODCBET SCALE: 114"-l' REV NO. DATE: mi DRAWN BY:SWT 0 ~ zz SEPTIC MANUAL W3716 US HWY10. MAIDEN ROCK, N 54750 DATE: JANUARY 2001 \ REV. JAN. 2004 800-325-8456 FILE! WLP12O0 800-MR • 0'9/17/2015 THU 15:20 FAX 715 831 4621 First Supply 4- 7 I&Q03/004 FIRST SUPPLY LLC 596 Cameron St, Eau Claire, Wl 54103 ITT GOULDS PUMPS M a Cie_ 3 9 7/ E'©s' Wastewater PERPORMANiCE RATINGS COMPONENTS Total Need Gallons Per gem (ft. of watery Mute No. I Description EP04 E005 I impeller 5 53 - 2 Base tD 6 10 46 62 3 Pump Casing 15 36 55 e a Mechanftal Seal 20 21 46 5 Ball Bearings 25 0 33 S 6 0•Rin 9 30 - 11 7 r Cord 5 B Oil Filled Motor 4 k Motor Housing! 3 9 StstorAssembl 10 Motor Cover METERS FEET 10 9 30 - - - - -•-5 GPM 2.5 Ff 25 s _v 6 0 15 r-EP1011 ~ 3 10 J._..... . E 4 5 0 00 10 20 30 40 50 GPM L 0 2 4 6 S 10 12 m3/h CAPACITY 3 Water tight cap 4"' min. dia. Piping material can be ASTM D2665, D1785 or D3034 8.~ 6" min. 41 Slot min.' Infiltrative surface Water Closet Cellar Bar (3/8" min. dia.) VbserV, 66r pipes must. 0 be located such that there are a minimum of two Installed in each dispersal cell at opposite ends from one another be located near the dispersal cell ends • be at least 6 Inches from the end wall and sidewall • be installed at an elevation to view the horizontal or level inflltratlve surface within the dispersal cell observation pipes may be located less than 6 Inches from end walls or side walls If specified state-approved manufacturers` installation Instructi in ons. POWTS OWNER'S MANUAL & MANAGEMENT PLAN Pa e FILE INFORMATION 9 ~ of Owner ~ SYSTEM 'SPECIFICATIONS Permit # Tank Manufacturer: W le,Se►r ❑ Rteptic ❑ Dose ❑ Holding Volume: OD (gal) E06 NA DESIGN PARAMETERS Tank Manufacturer: W' e S e, Number of Bedrooms: ❑ NA NA ❑ Septic fr3'6ose ❑ Holding Volume: Number of Public Facility Units: g c© (gal) ar1gA Vertical Distance Tank Bottom(s) to Service Pad: f.7 (ft) Estimated (average) Flow : A (00 (gal/day) Horizontal Distance Tank(s) to Service Pad: /'0 Design n (ft) g (peak) Flow = (estimated x 1.5): 6 pO (gal/day) Specific servicing mechanics must be provided if vertical is >15 feetor if horizontal is >150 feet. Specific instructions to be provided on back. In Situ Soil Application Rate: (gal/day/ft2) Effluent Filter Manufacturer: o Standard (Domestic) Influent/Effluent ManthlY average Effluent Filter Model: S',~ S7 ❑ NA Fats, Oil $ Grease (FOG) s30 mg/L Biochemical Oxygen Demand (BODs) s220 mg/L ❑ NA Pump Manufacturer: jct/ ,S Total Suspended Solids (TSS 6150 mg/L Pump Model 3 Y71 _ ❑ NA High Strength Influent/Effluent Monthly average a F Y 9 Pretreatment Unit (FOG) >30 mg/L` Manufacturer: (BODs) >220 mg/L (TSS) >150 mg/L A ❑ Mechanical Aeration ~3-NA Pretreated Effluent ❑ Peat Filter Monthly average ❑ Disinfection ❑ Wetland (BODs) s30 mg/L ❑ Sand/Gravel Filter ❑ Other: (TSS) !;30 mg/LjA Soil Absorption System Fecal Coliform (geometric mean) 5101 ❑ In-Ground (gravity) ❑ I~yr.GGround (pressure) ❑ NA Maximum Effluent Particle Size % in dia. [01 NA ❑ At-Grade iJ'ivtound Other: 13 Drip-Line ❑ Other: ❑ NA Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Pump out contents of tank(s) ❑ When combined sludge and scum equals one-third ❑ When the high water alarm is activated O of tank volume Inspect condition of tank(s) -At least once every: a g month(s) G[1 year(s) (Maximum 3 years) ❑ NA Inspect dispersal cell(s) At least once every: ❑ month(s) "year(s) (Maximum 3 years) ❑ NA Clean effluent filter At least once every: month(s) ❑ year(s) ❑ NA Inspect pump, pump controls & alarm At least once every: month(s) ❑ 'year(s) El NA Flush laterals and pressure test 'At least once every:' 3 C3 month(s) Other. year(s) ` ❑ NA At least once every: ❑ month(s) Other: El year(s) ❑ NA ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and soil absorption systems shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector, POWTS Maintainer or Septage Servicing Operator (pumper). 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 a check for any back up or ponding of effluent on the ground surface. The soil absorption system shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on. the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any treatment tank equals one-third or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator (pumper) and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code: All other services, including but not limited. to the servicing of effluent filters, mechanical or pressurized components,,pretreatment units, and any servicing at intervals of <_12 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 30 days of completion of any service event. GMW-005 (02/05) Page__q__ Ofq START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other chemicals or sediment that may impede the treatment process *and/or damage, the soil absorption system. If high concentrations are detected have the contents of the tank(s) removed by a Septage Servicing Operator (pumper) prior to use. Pump tanks may fill above normal highwater levels prior to startup or due to pump failures. Start up or restoration of power under these conditions is not recommended, as the excess wastewater will be discharged to the soil absorption system in one large dose causing an overload that may result in the backup or surface discharge of effluent and damage to the system. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator (pumper) prior to restoring power to-the pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls until normal effluent levels are restored within the pump tank. System start up shall not occur when soil conditions are frozen at the infiltrative surface. Do not drive or park vehicles over tanks or the soil absorption system. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the treatment tanks and soil absorption system: acidst antibiotics, baby wipes, cigarette butts, condoms, cotton swabs, degreasers, dental floss, diapers, disinfectants, fats, foundation drain (sump pump) discharge, fruit and vegetable peelings, gasoline, greases, herbicides, meat scraps, medications, oils, painting products, pesticides, sanitary napkins, solvents, tampons, -and water softener brine discharge. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with s. Comm 83.33, Wisconsin Administrative.Code: , • All piping to tanks, pits and other soil absorption systems shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator (pumper). • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance- and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. 'Replacement systems must comply with the rules in effect at the time of their permit issuance. ❑ A suitable replacement area is not available due to setback and/or soil limitations. If the soil absorption system cannot be rehabilitated and barring advances in POWTS technology, a holding tank may be installed as a last resort. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. WARNING TREATMENT TANKS, PUMP TANKS, AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES OR LACK SUFFICIENT OXYGEN TO SUSTAIN LIFE. NEVER ENTER ANY TANK UNDER ANY_ CIRCUMSTANCE. DEATH MAY RESULT. -ESCAPE OR RESCUE ;FROM ' f`lE4NTERiOR OF`i _-TA14KMA - OT RE POSS0t--f: ADDITIONAL INSTRUCTIONS: POWTS INSTALLER POWTS MAINTAINER. Name h M t S. CL e5-0lP% Name k v~So~ . ti t n h , lie Phone 1 Phone SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORITY Name J rn S o~. QU t°~~ t h Name 'r COI ! COUstJ~ ZOtn t vi Phone f~ V3gl I Phone 010- 3 ~p L/ (ri O This document was drafted by the staffs of the Green Lake, Marquette and Waushara County POWTS regulatory agencies in compliance with sections Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. START UP AND OPERATION Page '7 of _ - For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other chemicals or sediment that may impede the treatment- process'and/or damage-the soil absorption. system. If high concentrations are detected have the contents of the tank(s) removed by a Septage Servicing Operator (pumper) prior to use. Pump tanks may fill above normal highwater levels prior to startup.or due to pump failures. Start up or restoration of power under these conditions is not recommended, as the excess wastewater will be=discharged to the soil absorption system in.one large dose causing an overload that may result in the backup or surface discharge of effluent. and damage *to the system. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator (pumper) prior to-restoring power to•the pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls until normal effluent levels are restored within the pump tank. System start up shall not occur when soil conditions are frozen at the infiltrative surface. Do not drive or park vehicles over tanks or the soil absorption system. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the treatment tanks and soil absorption system: acids, antibiotics, baby wipes; cigarette butts, condoms, cotton swabs, degreasers, dental floss, diapers, disinfectants, fats, foundation cirt~in (sump pump) discharge, fruit and vegetable peelings, gasoline, greases., herbicides, meat scraps, medications, oils, painting products, pesticides, sanitary napkins, solvents, tampons;'and water softener brine discharge. . ABANDONMENT. When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with s. Comm 83.33, Wisconsin Administrati4e.Code: • All piping to tanks, pits and other soil absorption systems shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator (pumper). • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken,. to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance- and compaction and should not be infringed upon.by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. 'Replacement systems must comply with the rules in effect at the time of their permit issuance. .171 A suitable replacement area is not available due to setback and/or soil limitations. If the soil absorption system cannot be rehabilitated and barring advances in POWTS technology, a holding tank may be installed as a last resort. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank maybe installed as a last resort to replace the failed POWTS. Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. WARNING TREATMENT TANKS, PUMP TANKS, AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES OR LACK SUFFICIENT OXYGEN TO SUSTAIN LIFE. NEVER ENTER ANY TANK UNDER ANY. CIRCUMSTANCE. DEATH MAY -RESULT -ESCAPE .ORRESCUE PROM Tf--'Hi`:MTEPJOR OF::A- AWK MOT B'E S1gt ADDITIONAL INSTRUCTIONS: POWTS INSTALLER POWTS MAINTAINER Name l Phone D % S"' Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY F JCi~►v.S.~.lfl4 r4cL+ icyvN Name ~~Gt I C~ C3Q.t." 7~at (.I. . f~ P 73 Phone 33(o 116 This document was drafted by the staffs of the Green Lake, Marquette and Waushara County POWTS regulatory agencies in compliance with sections Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. U 2 5 9 0 P 134 -7 6s10 C.I KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO.. WI STATE BAR OF WISCONSIN FORM 2- 2000 RECEIVED FOR RECORD Document Number WARRANTY DEED 06/07/2004 10:00AN THIS DEED made between Wayne A. Albri tson and Josephine F. WARRANTY DEED g EXEMI)T # Albrigtson, husband and wife, Grantor, and Paul T. Yang and Chia T./ Yang, husband and wife, as Survivorship Marital Property, Grantee. REC FEE: 13.00 Grantor, for a valuable consideration, conveys and warrants to Grantee TRANS FEE: 885.00 COPY FEEi the following described real estate in St. Croix County, State of Wisconsin: CC FEE: PAGES: 2 SEE ATTACHED EXHIBIT A Recording Area Name and Rearm Address: Edina Realty tle, Inc. 400 S. 2"d St. - Suite 115 Exceptions to warranties: Hudson, WI 5 016 Easements, restrictions and rights-of-way of record, if any. 417859 O C Parcel Identification Number (PIN) This is not 1• -)mestead property. Dated this 20th day of January, 2004. I-T"tQ- A * Wayne . Albri son * Joe hine It Albri von AUTHENTICATION ACI*.NOWLEDGMENT Signature(s) STATE OF WISCONS N ) ST. CROIX COUNTY, ) ss. authenticated this 20th day of January, 2004 Personally came before me this January 20, 2004 the * above named Wayn-, A. Albrigtson and Josephine F. Albrigtson, husband and wife to me known to be the person(s) TITLE: MEMBER STATE BAR OF WISCONSIN who executed the foregoing instrument and acknowledged the (If not, authorized by § 706.06, Wis. Stats.) THIS (NSTRUMENT WAS DRAFTED BY *Judy Larrie Edina Realty Title -Doug Berg Notary Pub]' State of lVisconsin 400 South Second Street # 115, Hudson, WI 54016 My Comm' W9rAm0fA-* expiration date: ) (Signatures may be authenticated or acknowledged. Both are not necessary.) 11/4/200 - *Names of persons signing in any capacity must be typed or printed below their signature Notary Public State of Wisconsin WARRANTY DEED STATE BAR OF WISCONSIN FORM No.2-2000 U 2590P 135 Exhibit A tion 23, St. Croix County, State of Wisconsin. E'/z of SW /4 of Sec jp Z~ ONWIP Property Address: 2549 25th Ave. Woodville, WI 54029 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer C K C Mailing Address y o~g Property Address -e ~ ~o v (Verification required from Planning & Zog Department for new. construction.) City/State Y( Parcel Identification Numbers 16.6) -7 QUO®~ LEGAL DESCRIPTION J J Property Location )U) Lj % , Sec. T a-~-N R-.._W, Town of Subdivision Certified Survey Map # Lot # Volume Page.# Warranty Deed Volume Page # Spec house 0 yes 81nO Lot lines identifiable e-ye's ❑ no SYSTEM MAINTENANC AND OWNER CERTIFICATION Improper use and maintenance maintenance consists of your septic system could result in its premature failure to handle wastes. er 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. . nanc The property owner agrees to submit to St. Croix County planning & Zoning D owner and by a master plumber, journeyman plumber, restri cted plumber or a licensed Pumper verifying that (1) rte tffoe on signed by the wastewater disposal system is in proper operating condition and/or (2) after less than 1/3 full of sludge. inspection and pumping (if necessary), the septic tank is I/we, the undersigned have read the above requirements and agree to standards set foxes hervin, .as set by the D maintain the.private sewage disposal system with the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned t Zoning Department. within 30 days of the three ye expiration date, o the St. Croix County Planning & I/we certify that all statements on this rm 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 bedrooms SIGNA O PLICANT(S) . DATE ***Any information that is misrepresented may result in the sanitary permit being revoked g by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a co reference is made in the warranty deed. copy of the certified survey map if (REV. 08/05) Wisconsin Department SOIL V*CAMPORT Page 1 of 3 Division of Safety and B Idings Q1(~ In accordance with dm. Code 3Q County Attach complete si ALn pa >'h x 11 inches in size. Plan must St. Croix Include but not limite~ti reference point (BM), direction and Parcel I.D. Percent slope, sc:$e6 orth arrow, and BM referenced to nearest road. 008106720000 ;Oj`l'~~~ Please print all information Re iewe b pate Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)) -7/31 IN Property Owner Property Location Paul & Chia Yang Govt. Lot NE SW s 23 T 28 N R 16 w Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 2549 25t' Ave CState Zip Code Phone ❑ City ❑ Village 0 Town Nearest Road WI 54028 612-916-6512 Eau Galle 25th Ave. ❑ New Constru ' Use: 0 Residential / Number of Bedrooms 4 Code derived design flow rates / 600 GPD 0 Replacement ❑ Public or Commercial - Describe: ~L~+^°~ Parent Material Loess over Till Flood Plain elevation if applicable N/A ft. General comments and recommendations: 1 Boring # Bormg 0 Pit Ground Surface Elevation 100.0 ft. Depth to Limiting factor 7 in. Horizon Depth Dominant color Redox Description Texture Structure Consistence Soil A li tion Rate Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-7 10YR3/2 - SIL 2-m-gr mfr CS Y 0.6 0.8 2 7-10 10YR3/2 7.5YR4/4 f-1-f SIL 2-m-gr mfr as 2f 0.6 0.8 3 10-16 10YR5/4 7.5YR4/6 c-1 A CL 2-m-bk mfr gs 2f 0.4 0.6 4 16-21 10YR4/4 10YR5/2&7.5YR4/6 m-2-p CL 2-co-bk mfi gs 1f 0.4 0.6 5 21-34+ 10YR4/6 10YR5/1&IOYR5/8 m-2-p C 0-m mfi - - 0.0 0.0 a Boring # 13 Boring OPit Ground Surface Elevation 101.0 ft. Depth to Limiting factor 9 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 0-9 10YR3/2 - SIL 2-m-gr mfr CS Y 0.6 0.8 2 9-12 10YR3/2 7.5YR2.5/2 f-1-f SIL 2-m-pl mfr as 1f G-t a,&0, J- 3 12-20 10YR5/4 7.5YR5/8 f-1-d SICL 2-m-bk mfr gs 1f 0.4 0.6 4 20-24 10YR4/3 7.5YR5/8 m-2-p CL 2-co-bk mfi gs if 0.4 0.6 5 2448+ 10YR5/4 7.5YR5/8&10YR5/1 m-2-p C 0-m MVfi - - 0.0 0.0 • Effluent #I = BOD5> 30:5 220 mg/L and TSS > 30:s 150 mg/L ' Effluent #2 = BOD5 5 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 May 30, 2014 715-796-5664 Property Owner Paul & Chia Yang Parcel ID# 008106720000 Page 2 of 3 Boring Boring # OPit Ground Surface Elevation 100.0 8. Depth to Limiting factor 7 in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P' /W in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Efl##l "Eff#2 1 0-7 10YR3/2 - SIL 2-m-gr mfr Cs 3f 0.6 0.8 2 7-10 10YR3/2 7.5YR4/4 f-1-d SIL 2-m-bk mfr as 2f 0.6 0.8 3 10-16 10YR5/4 10YR5/8 f-1 -f SIL 2-m-bk mfr gs if 0.6 0.8 4 16-28 10YR5/4 10YR5/8 c-1-f CL 2-co-bk mfr gs 1f 0.4 0.6 5 28-40+ 7.5YR4/3 7.5YR3/4 c-2-f CL 0-m mfi - - 0.0 0.0 a Boring # ❑ Boring HPit Ground Surface Elevation 98.5 Depth to Limiting factor 9 M. Soil Application 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 0-9 10YR3/2 - SIL 2-m-gr mfr cs 3f 0.6 0.8 2 9-13 10YR3/2 7.5YR4/4 f-1 -d SIL 2-f-bk mfr as 2f 0.6 0.8 3 13-18 10YR5/4 10YR5/6 f-1 -f SICL 2-m-bk mfr gs if 0.4 0.6 4 18-23 10YR5/3 10YR5/6 c-2-d CL 2-m-bk mfr gs if 0.4 0.6 5 23-31 10YR4/2 7.5YR4/6 m-3-p CL 2-co-bk mfr gs if 0.4 0.6 6 31-48+ 10YR5/1 10YR5/6 m-2-p C 0-m mfi - - 0.0 0.0 Boring # oPlt Ground Surface Elevation 94.9 ft. Depth to Limiting factor 0 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fe in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 1 0-8 10YR3/2 10YR4/6 f-1-d SIL 2-m-bk mfr as 2f 0.6 0.8 2 8-15 10YR5/4 10YR5/8&5/2 c-2-p SIL 2-m-bk mfr gs if 0.6 0.8 3 15-21 10YR5/6 10YR5/1&7.5YR4/6 o-2-p SICL 2-m-bk mfr gs if 0.4 0.6 4 21-28+ 10YR4/6 7.5YR5/8&10YR5/1 m-3-p CL 0-m mfi - if 0.0 0.0 * Effluent #I = BOD5> 30 220 mg/L and TSS > 30:5 150 mg/L • Effluent #2 = BOD5 30 mg/L and TSS 30 mgf 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. Property Owner Paul & Chia Yang Parcel ID# 008106720000 page 2 of 3 Boring # 13 Boring spit Ground Surface Elevation 100.0 ft. Depth to Limiting factor 7 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 1 0-7 10YR3/2 - SIL 2-m-gr mfr cs 3f 0.6 0.8 2 7-10 10YR3/2 7.5YR4/4 f-1-d SIL 2-m-bk mfr as 2f 0.6 0.8 3 10-16 10YR5/4 10YR5/8 f-1 -f SIL 2-m-bk mfr gs 1f 0.6 0.8 4 16-28 10YR5/4 10YR5/8 c-1-f CL 2-co-bk mfr gs 1f 0.4 0.6 5 28-40+ 7.5YR4/3 7.5YR3/4 c-2-f CL 0-m mfi - - 0.0 0.0 ❑ Boring F4 Boring # Hpit Ground Surface Elevation 98.5 ft. Depth to Limiting factor 9 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 1 0-9 10YR3/2 - SIL 2-m-gr mfr cs 3f 0.6 0.8 2 9-13 10YR3/2 7.5YR4/4 f-1-d SIL 2-f-bk mfr as 2f 0.6 0.8 3 13-18 10YR5/4 10YR5/6 f-1-f SICL 2-m-bk mfr gs 1f 0.4 Q6 4 18-23 10YR5/3 10YR5/6 c-2-d CL 2-m-bk mfr gs 1f 0.4 0.6 5 23-31 10YR4/2 7.5YR4/6 m-3-p CL 2-co-bk mfr gs if 0.4 0.6 6 31-48+ 10YR5/1 10YR5/6 m-2-p C 0-m mfi - - 0.0 0.0 ❑ Boring Boring # Opit Ground Surface Elevation 94.9 ft. Depth to Limiting factor 0 in. Soil Application Rate Horizon Depth Dominant Color Redo, Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-8 10YR3/2 10YR4/6 f-1 -d SIL 2-m-bk mfr as 2f 0.6 0.8 2 8-15 10YR5/4 10YR5/8&5/2 c-2-p SIL 2-m-bk mfr gs if 0.6 0.8 3 15-21 10YR5/6 10YR5/1&7.5YR4/6c-2-p SICL 2-m-bk mfr gs 1f 0.4 0.6 4 21-28+ 10YR4/6 7.5YR5/8&10YR5/1 m-3-p CL 0-m mfi - if 0.0 0.0 * Effluent # 1= BOD5> 30:5 220 mg/L and TSS > 30:S 150 mg/L * Effluent #2 = BOD5 s 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. if you need assistance to access services or Need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. Page 3 of 3 0 ft. 24 ft. 40 ft. 80 ft. N Sewer Pip Ho e BM#3- Bottom of sidin BM#1- Top of 3/4"PVC Pipe 116.7' 100.0' kOrOJ ° c 0 B-1 26 E 100.0 B of 39" C Pipe to 102 B-5 94.9' M B-4 98.5' B-2 101.0') B-3 100.0' 1 ~ ~O• O~ 99' Property Line > 50' from the proposed location • = Ground Surface Elevation BM# & Description Elevation =Bench Mark 00, =Boring Location & Elevation Owner: Paul & Chia Yang Site Information: Completed By: Mark Iverson, PSS #197 2549 25th Ave NE1/4, SW1/4, S23, T28N, R16W 680 Larcom Street Woodville, WI 54028 Town of Eau Galle Hammond, WI 54015 St. Croix County 715-796-5664 Phone: 715-781-1850 CST# 46672 lz c) y O ~i bo o I 4 0 C ~ o a~ ~ ! C C 3 N 0 - cc N 01 t U 0 (p M N Q ~ >cmrn I ID p> ~ > (L 3 ~m oo3.a~ I Q_ 4006 N - E D) ! N Q. 7 tr- 'O O m C Z 00 C C N LL O N 2 Q a .w c CL v Orin °o I Q mv~m a I O v ~ I z a E o z m El C,4 H z d CO cca as ~ E C9 V 'o o z It c 0 d v o m 0 z E ~ ~ U y -o ~ U c N = C O N co 0 r_ ~N O O N O C 0 a Q O n 0 N Q Q z (A z N Go w C%i (D v C3 0 LO N ~2f H c m D D a D o E 0 0 Y •ti ~aaa 10 a~ o 0) I L °r- r Q N J U LO rn 0) 0 N v o o N a N 0 0 .3 .II 7 N m CL d °1 ¢ z v,~0), a3 m C T U) C ~Y O U) N O Q O LO 0 (O tl C C 0 0 0 0 1 N ~ N tl 4. O O V it M y C N N W O~ ~ c N N M (D ~ N I M~ O N 0 0 N '00 'D C (p Op 7 Q O N WI, 2' O z y z z' (n ..r r i ik Q ` d FE r~ 0 0 S r A 0 IL 0 0) ci DIVISION OF INDUSTRY SERVICES o~vARTM ~ °N 10541 N RANCH ROAD HAYWARD WI 54843 d Contact Through Relay 3 $ P w www.dsps.wi.gov/sb/ $ c` www.wisconsin.gov A~O~ssio~stiS~~ Scott Walker, Governor Dave Ross, Secretary July 14, 2014 CUST ID No. 46672 ATTIC- POWTS Building Inspector MARK W IVERSON ZONING OFFICE EVERGREEN IRRIGATION INC ST CROIX COUNTY SPIA PO 155 1101 CARMICHAEL RD HAMMOND WI 54015 HUDSON WI 54016 (Please forward a copy of this letter to the fire department conducting inspections of this project.) CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/14/2016 Identification Numbers Transaction ID No. 2424319 SITE: Site ID No. 803884 Paul & Chia Yang Please refer to both identification numbers, 2549 25TH Ave above, in all correspondence with the agency. Town of Eau Galle St Croix County NE1/4, SW1/4, S23, T28N, R16W FOR: Object Type: Soil Saturation Determination Regulated Object ID No.: 1492882 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. Only those object types listed above have been approved; other submittals such as plumbing and those listed below under Also Submit, may also be required. I The following conditions shall be met during construction or installation and prior to occupancy or use: • Approval is hereby granted to use a depth to zone of saturation of 7 inches, as determined by the certified Soil Tester in the May 30, 2014 Interpretive Report by Mark Iverson, CST, for designing soil absorption P.~ components. The CST's report was submitted in accordance with section SPS 385.60(2), Wis. Adm. Code. All conditi0i, soil absorption components shall be in accordance with chapter SPS 383, Wis. Adm. Code. AJ?PRC • Hydrologic conditions at this site require a linear loading rate not to exceed 4.5 gal./lin.ft./day and a basal loading rate not to exceed 0.6 gal./sq.ft./day. ppRTMEW of DIE OF f Y • Soil permeability could be impaired by compaction in the tested area; therefore, the proposed system area must be protected from compaction prior to system installation. • This approval is limited to the tested area described by Mark Iverson, CST, as part of this referenced SEE GORRE~ Interpretive Report. This report may not be applied to any other portion of the subject parcel or to other parcels. Reminders • The decision on the Interpretive Determination Report does not have an expiration date. 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. In granting this approval, the Division of Industry 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 code compliant component. The Division does not take responsibility for the design or construction of the reviewed items. MARK W WERSON Page 2 7/14/2014 Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. We look forward to working with you to make this code-compliant construction. A full size 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. If plan index sheets were submitted in lieu of additional full plan sets, a copy of this approval letter and index sheet shall be attached to plans that correspond with the copy on file with the Department. If these plans were submitted in an electronic form, the designer is responsible to download, print, and bind the full size set of plans along with our approval letter. A department electronic stamp and signature shall be on the plans which are used at the job site for construction. Sincerely, Fee Required $ 240.00 This Amount Will Be Invoiced. When You Receive That Invoice, E win A Taylor Please Include a Copy With Your Wastewater Specialist, Integr Serv es Payment Submittal. (715)634-3484, Monday - Friday 8:00 am To 4:30 pm WiSMART code: 7633 edwin.taylor@wisconsin.gov r w t INTERPRETIVE DETERMINATION REPORT Property Owner: Paul & Chia Yang 2549 25" Ave Woodville, WI 54028 Site Location: NE'/4 of the SW 1/4, Sec. 23, Town 28N, Range 16W Town of Eau Galle _N St. Croix County Prepared by: oo Iverson, PSS #197, CST #46672 June 27, 2014 •S. Date naW Evergreen Irrigation Inc. "VED Mark Iverson, Professional Soil Scientist 4011) CE P.O. Box 155 Ha mmond, WI 54015 Phone: 715-796-5664~ Fax: 715-796-5246 e-mail: everareenetckbaldwin-telecom net TABLE OF CONTENTS 1. Introduction 1 II. Project Information 1 III. Method 1 IV. Discussion of Results 2 A. Local Hydrology 2 B. Geomorphology 2 C. Soil Disturbance and Hydraulic Modifications 2 D. Landscape Position and Local Topography 3 E. Soil Series and Mapping Units 3 F. Wetland Inventory Map 5 G. Field Observations 5 H. Comparative Analysis 6 1. Government Reports and Comments 6 V. Conclusions and Recommendations 6 VI. References 7 Ygf' TABLES Table I - Soil Series Characr~n'Wcs Table 2 - Hydric Soil Classific~tbri FIGURES Figure 1 - USGS Topographic Map Figure 2 - Soil Map Figure 3 - Wetland Inventory Map APPENDICES Appendix A - Soil Evaluation Report I. INTRODUCTION On May 30, 2014 Mark Iverson, Professional Soil Scientist #197 and Certified Soil Tester #46672, completed an interpretive onsite soils evaluation. An interpretive evaluation is required because the site does not meet the requirements to install a new/replacement private on-site waste treatment system (POWTS) through completion of a conventional onsite soils evaluation (<A+4 inches of acceptable soil must be present). The onsite evaluation was completed through the observation of the soil profiles at five test pit locations. This report has been prepared to present the results of an interpretive onsite soils evaluation. The evaluation was completed at the request of the client, Paul Yang. The property is located on 25th Ave., 1/2 mile west of Co. Hwy. B in the Township of Eau Galle, St. Croix County, Wisconsin. II. PROJECT INFORMATION The following is site-specific background information: Property Owner: Paul & Chia Yang 2549 25" Ave Woodville, WI 54028 Site Location: NE %4 of the SW '/4, Sec. 23, Town 28N, Range 16W Parcel ID # 008-1067-20-000 Town of Eau Galle St. Croix County Historic Land Use: Fallow Field (Not tilled for more than 10 years) Current Land Use: Fallow Field Vegetation: The vegetation within the tested area consists of miscellaneous grasses. There are no signs of stress within the tested area due to excess. Hydric vegetation was not observed within the project area. III. METHOD This interpretive evaluation and report was completed following the guidelines set forth in Comm 85.60(2) of the Wisconsin Administrative Code and in the summary provided by Leroy Jansky titled, "Preparing the Interpretive Determination Report" (March 13, 2002). 1 • t IV. DISCUSSION OF RESULTS A. Local Hydrology 1. Surface Water Drainage Patterns - Minimal surface water drainage is received over the majority of the tested area. This is because the proposed location of the POWTS is near the nose of the slope. There is a possibility to receive some surface water from upslope however most of the surface water runs off via the sideslopes. The proposed system location is on the backslope within the hillslope profile position. The slope within the proposed system area is approximately 3 to 6%. 2. Subsurface Water Drainage - The silt loam texture and lack of compaction within the surface horizon of the fallow field offers good infiltration and lateral movement of precipitation received on site. Compaction was not observed in most of the soil profiles, with the exception of boring #2 which had slight compaction in the lower three inches of the surface horizon. 3. Artificial Drainage Devices - No artificial drainage devices were observed during the completion of the evaluation. 4. Contributing Drainage Area - The proposed system area is located on the backslope of the hill slope profile. The summit of the profile is located greater than 100 feet east of the proposed installation contour. There is contributing drainage area up slope of the tested area. A surface water diversion ditch is recommended to be constructed to limit the effects of potential surface water received from upslope. 5. Soil Saturation - Saturated soil was not observed in any of the test pits completed the day of the soil evaluation. Soil test pits that were completed the week earlier were filled with water to within 18 inches of the surface. 6. Surface Water Elevations - Surface water within the immediate vicinity of the site, if present, has been identified on Figure 1. B. Geomorphology 1. Parent Material - The parent material is loess over glacial outwash/till. 2. Landform Type - Ground moraines. C. Soil Disturbance and Hydraulic Modifications The proposed system location is in a fallow field. No hydraulic modifications, such as drain tile or ditches, were observed at the time of the assessment. No additional surface water is received from impervious surfaces. 2 D. Landscape Position and Local Topography The regional topography is shown on figure 1. The ground surface elevation is approximately 1140 feet mean sea level (msl). The topography within the proposed system area is shown on the site map included in Appendix A. The proposed system elevation is 100.0 (site specific elevation). The shape of the slope within the proposed system area is linear (perpendicular to the contour) and convex (parallel to the contour). FIGURE 1- USGS TOPOGRAPHIC MAP t~ F r .0 13 . III r m 7 J 3 0G M E. Soil Series and Mapping Units The Natural Resources Conservation Service Web Soil Survey maps the soils on the property and within a reasonable distance of the house as Freeon Silt loam (FoB), Magnor silt loam (MaB), and Skyberg silt loam (SrA). The location of 3 L each soil type is identified on Figure 2. The primary soil characteristics as described in the series descriptions are identified on the Table 1. TABLE 1- SOIL SERIES CHARACTERISTICS Texture Parent Material Permeability Drama e Series Horizon Horizon Surface Subsurf. Surface Subsurf. Clas s Fo SIL L/SL Silty Sea. Till M MS MW Ma SIL SIL Loess Till M MS to S SP Sr SIL SIL/SICL Loess Till MS or S MS or S SP Abbreviations Permeability IM = Impermeable MS = Moderately Slow RA = Rapid VS = Very Slow M = Moderate VR = Very Rapid S = Slow MR = Moderately Rapid Drainage Class VP = Very Poorly W = Well P = Poorly SE = Somewhat Excessively SP = Somewhat Poorly E = Excessively MW = Moderately Well Table 2 - H dric Soil Classifications NRCS - USDA Soil Series Component Inclusions USACOE Fo No None No Ma No Adolph No Sr No Auburndale No USACOE = US Army Corps of Engineers FIGURE 2 - SOIL MAP 4 F. Wetland Inventory Map The Wisconsin Department of Natural Resources surface water viewer was reviewed to identify wetlands mapped on the property. The wetland inventory map is included as figure 3. Wetlands are mapped on the west side of the property however none were identified near the test location. FIGURE 3 - WETLAND INVENTROY MAP x R.- c ~r G. Field Observations The soil present within the proposed system area is dissimilar to the description of the mapped soil units, Magnor and Freeon, identified on the Natural Resources Conservation Service Web Soil Survey. The A horizon extends 10 to 13 inches below surface within the proposed system area (Borings 1, 2, 3, and 4). Medium, moderate granular structure is dominant in the top of the surface horizon extending to a maximum depth of 7 to 9 inches. Redoximorphic features were observed in the second horizon. The second horizon had primarily moderate granular and blocky structure with the exception of boring #2 which had moderate platy structure. The clay content increased below the topsoil. Moderate soil structure is present to a maximum depth of 21 to 28 inches below surface where massive clay and clay loam soil are encountered. 5 The soil on site does not meet the hydric soil criteria. The lack of hydric soils indicates that the soil is likely not saturated for greater than 5% of the growing season (approximately 7 consecutive days). A dominance of hydrophytic vegetation was not observed within the proposed system area. The lack of these features does not preclude the possibility that the soil is saturated for a prolonged period of time prior to or on occasion during the growing season. H. Comparative Analysis Soil borings 03-1, B-2, B-3 and B4) were completed within the proposed system area. An additional boring was completed down slope (B-5) of the proposed system area. The texture and structural features of boring 5 were similar to that of the tested area. The redoximorphic features in boring 5 were present at the surface indicating that the area downslope is saturated to the surface for a longer period of time. 1. Government Reports and Comments No other government reports have been observed for this property. V. Conclusions and Recommendations Seasonal saturation appears to be limited to greater than 7 inches below surface within the proposed system area, the majority of the time. The lack of soil dominated by low chroma colors within the proposed system area indicates that the redoximorphic features observed are not due to a high water table or perching conditions. The cause of the redox features observed in the test pits is most likely attributed to short-term seasonal saturation due to slow permeability of the dense glacial subsoils. The site is suitable for installation of a POWTS (mound system) for the following reasons: 1.) Redoximorphic features were not observed in the upper 7 inches of soil within the proposed system area. 2.) Neither hydric soils nor a dominance of hydrophytic vegetation are present within the proposed system area. 3.) The slope at the proposed system location is approximately 3 to 6%. The slope is uniform with no dips or valleys at the proposed system location. 4.) The lack of soil dominated by low chroma colors indicates that the redoximorphic features observed at depth are due to temporary seasonal saturation and not from a permanently high water table or perching condition. 6 The following recommendations should be considered during installation of the proposed system: 1. The system should be installed on the 100.0' contour to stay within the tested area. 2. Sand fill shall consist of 2.5' of material meeting ASTM C-33 specifications. 3. To break up the surface and the platy structure observed in boring 2 tillage must be completed with a chisel plow to a minimum depth of 12 inches below native ground surface during dry conditions after placing 3 to 4 inches ASTM C-33 soil over the infiltration surface. 4. The basal loading rate shall not exceed 0.2 GPD/ft2. 5. The system shall be designed to have a linear loading rate of 4.5 GPD/ft or less. 6. The system should be designed for a four bedroom house. 7. The system will follow the contour and be slightly concave. The final approval of this site must be made by the Wisconsin Department of Commerce and the St. Croix County Zoning Department. This report represents the observations and professional opinion of Mark Iverson, Professional Soil Scientist (#197) and Certified Soil Tester (#46672). VI. REFERENCES 1.) Soil Survey Staff, Natural Resources Conservation Service, United States Department of Agriculture. Web Soil Survey. Available online at http://websoilsurvey.nres.usda.gov/ (accessed 6/19/2014). 2.) State of Wisconsin. Department of Commerce Code, Chapters 83 and 85. 3.) US Department of Agriculture, Natural Resources Conservation Service. 1996. Field Indicators of Hydric Soils in the United States. G.W Hurt, Whited, P.M., and Pringle, R.F. (eds,). USDA, NRCS, Fort Worth, TX. 4.) Schoeneberger, P.J., Wysocki, D.A., Benham, E.C., and Broderson, W.D. (editors), 2002. Field book for describing and sampling soils, Version 2.0. Natural Resources Conservation Service, National Soil Survey Center, Lincoln, NE. 5.) United States. Us Geological Survey. Topographical downloaded from http://terraserver.microsoft.com/ 6.) St. Croix County. St. Croix County Land Information System. htip://72.21.230.178/website-/-`pasystem/gisportal.htm 7.) United States. United States Department of Agriculture - Natural Resources Conservation Service. Hydric Soil List for St. Croix County, Wisconsin. ftp://ftp-fc.sc.egov.usda.gov/WI/Soillyd/hydIO9.htm 7 8.) United States. Us Army Corps of Engineers. 1987. Corp of Engineers Wetland Delineation Manual, Technical Report Y-87-1. USAEWES Environmental Laboratory, Vicksburg, MS. 9.) Wisconsin Department of Natural Resources. Wisconsin Department of Natural Resources - Surface Water Viewer. Wetland Maps. http://dnrmaps wsconsin gov/imf/imf jsp?site=SurfaceWaterViewer 8 APPENDIX A SOIL EVALUATION REPORT 9