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HomeMy WebLinkAbout008-1067-10-000 RECEIVED County Safety and Buildings Division St. Croix 0 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) Madison, WI 53707-7162 ST, CROIX COUNTY 5<9 0(og COMM ftWaW fY LP4 A Hp11CalOn State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit 2656472 is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to the Department of Safety and Professional Services. Personal information you provide may be used for secondary Project Address (if different than mailing address) purposes in accordance with the Privacy Law, s. 15.04(l m), Stats. Same Z,511.3 1. Application Information - Please Print All Information Property Owner's Name / Parcel # Garlend & Sharon Fregine 008-1067-10-000 Property Owner's Mailing Address Property Location 2548 25d' Ave. Govt. Lot City, State Zip Code Phone Number SE _ NW Section 23 (circle one) Woodville, WI 54028 (715) 698 - 2804 T 28 N; R 16 E or W IL Ty37"F of Building (check all that apply) Lot # U~ I or amily Dwelling - Number of Bedrooms 2 Na Subdivision Name I ❑ Public/Commercial - Describe Use Block # Na Na ❑ City of ❑ State Owned - Describe Use CSM Number ❑ Village of 3 Na Co of Eau Galle aas III. Type of Permit: (Check only one box on line A. Complete line B if applicable) 2* ya, x A. ❑ New System Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B• 11 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 S stem/Com onent/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) ❑ Pretreatment Device (explain) V. Dispersal/Treat ent Area Information: Pol Lok P1-525 effluent filter to be installed at ST outlet Design Flow (gpd) / Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation J 1.0 Gpd/sq. ft. ASTM-C33 sand d 104.50' at 30" ae 300 Gpd 0.6 Gpd/sq. ft. native soil 300.00s 30V q. ft. 50 300.00 Sq. Ft. p 102.00' contour VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units H o v New Tanks Existin Tanks R U m }0r o w p ro g w dl /ofz t- 5 W U w Septic or Holding Tank Na 1000 1000 1 Wies Concrete X Dosing Chamber N 600 600 1 Combination ST/PC X VII. Responsibility Statement- , the undersi d, assume respons' for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's igna MP/MPRS Number Business Phone Number James K. Thompson MPRS 30021 (715) 248-7767 Plumber's Address (Street, City, State ode) 340 Paulson Lake Lane, Osceola, WI 54020 VIIL Count !De artment Use Only ,Approved ❑ Permit Fee Dat Issu d Issuin ent XftntrY12'~ eve n Reason for Denial Z IX.Condi~easonsforDisapproval 1. Septc tank, ettre 1 f §nd disi*mai cell must all Eac as pernanagement pled 04 461- -i 111N4 ~f, n 5 6 r / 2. SRN seRx~ck regl~!1'~rt M911,0@ M@0004 y.1 6dt ~eM- 1-b ss per applicable tilde / OId duns toe 4~ J Attach to complete plans for the system and submit to the County o ly on paper not less than 8 1/2 x 11 inches in size SBD-6398 (R. 11/11) Po~oosLd /lfeccn dC e /27 j' ~i~el/t~uQyOl~Pi w/ 3 ,ymv'd's~Weo/% TwoC~ ~.r:s ..q ~.w(t e%L.! /a Z -r ,Q /S u,- s~o is/%e °ori etJ U Sloace da i sz: d I Corn 1.~4/~1 ~ c%.S~cc/Un ~r 9./lG Scvys!/1~i~ Sc~,13~ 8 \ ~GcuGa/(~y S~.C(c7rX ~c.IA o rJCI.tio0B" /D0-6100 i ~ d It h~/O C.tJCr g Al- r~ 1 t 1 ~ /.2"w,d-6k dwt;hq~ o~ 1 \ b v C = bo ~M O ~ ~ ~ ~ ~ ~ r Pv le. r7~/ ~ ~ ~~,"S6hQ~j s.r.Sro~t~td.f ff di slO~lSa/~ Y N• in ~ 9p ~ Jb - To 5c a bo<n died ~ G of of t~icti'= ~ ~ '°o Q 4S ~O~rCoO'G. p ~ °o- fOPOS~-o~u7iC3t/~'oncrGEC. 3 ~ wLP/cee~Gco-~ck Comb%n~'ar, ~ ~ S.f ou~l~• ~ s 84 -zS 8 t,J - _ - faw ed o/ ~ct°/ o~rT~rati DIVISION OF INDUSTRY SERVICES ~o~~ ` 10541 N RANCH RD HAYWARD WI 54843-6462 3 D$ Contact Through Relay e P S http://dsps.wi.gov/programs/industry-services v www.wisconsin.gov A ~O 'ss[ON~ti Sw Scott Walker, Governor Dave Ross, Secretary January 11, 2016 CUST ID No. 30021 ATTN: POWTS Inspector JAMES K THOMPSON ZONING OFFICE ACE SOIL & SITE EVALUATIONS ST CROIX COUNTY SPIA 340 PAULSEN LAKE LN 1101 CARMICHAEL RD OSCEOLA WI 54020-5413 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 01/11/2018 Identification Numbers Transaction ID No. 2656472 SITE: Site ID No. 820453 Garlend & Sharon Fregine Please refer to both identification numbers, 254825TH Ave above, in all correspondence with the agency. Town of Eau Galle St Croix County SE1/4, NW1/4, 523, T28N, ROAV FOR: Object Type: POWTS Component Manual Regulated Object ID No.: 1582343 Maintenance required; Replacement system; 300 GPD Flow rate; System(s): EZflow Mound Component Manual, (R. 7/12); 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. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, P.O.W. stats. Cnnditt The following conditions shall be met during construction or installation and prior to occupancy or user AP P R • A copy of this approval letter and index sheet shall be attached to plans that correspond with the copy on file DEPARTMENT OF with the Department. Changes to the approved plan must be submitted for review and approval. Failure to DI SAFETY properly attach the approval and index page to plans that match the copy on file with the Department may result in enforcement action under s. 145. 10, Stats. • This system is to be constructed and located in accordance with the approved plans, and the "Mound 'E GORRES Component Manual for Private Onsite Wastewater Systems Version 2.0" SBD-10691-P (N.01/01, R. 10/12). • This system is to be constructed and located in accordance with the approved plans and with the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems Version 2.0" SBD-10706-P (N.01/01). • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil. Proper soil moisture content can be determined by rolling a soil sample between the hands. If it rolls into a 1/4- inch wire, the site is too wet to prepare. If it crumbles, site preparation can proceed. If the site is too wet to prepare, do not proceed until it dries. • Abandon the existing system components per SPS 383.33 x JAMES K THOMPSON • Page 2 1/11/2016 • The system was designed to meet the influent quality defined in SPS 383.44(2)(a) The quality of influent discharged into a POWTS treatment or dispersal component consisting in part of in situ soil shall be equal to or less than all of the following: 1. A monthly average of 30 mg/L fats, oil and grease. 2. A monthly average of 220 mg/L BOD5. 3. A monthly average of 150 mg/L TSS. • SPS 383.54(3)(b) (b) The servicing frequency of an anaerobic treatment tank for a POWTS shall occur at least when the combined sludge and scum volume equals 1/3 of the tank volume. • The inspection, maintenance and servicing reports shall be submitted to the governmental unit within 30 calendar days from the date of inspection, maintenance and servicing. • The owner is responsible for the operation and maintenance of the private onsite wastewater treatment system (POWTS) in accordance with SPS 383 and the approved management plan • The owner of a POWTS shall be responsible for ensuring that access opening covers remain locked or secured except for inspection, evaluation, maintenance or servicing purposes. • Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • Provide a copy of the approved POWTS plans and this letter to the owner. • Prohibit vehicle traffic and soil disturbance within 15 feet of the downslope edge of the mound pursuant to "Mound Component Manual Version 2.0" SBD-10691-P (N.01/01, R. 10/12). 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. 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 Fee Received $ 250.00 Balance Due $ 0.00 f Edwin A Taylor Wastewater Specialist, Division of In try Services WiSMART code: 7633 (715)634-3484, Monday - Friday 8:00 am To 4:30 pm edwin.taylor@wisconsin.gov ~ s f EZflowo MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Garlend & Sharon Fregine 2 bedroom replacement mound Owner's Name: Garlend & Sharon Fregine Owner's Address: 2548 25th Ave., Woodville, WI 54028 Property Address: Same Legal Description: SE1/4 NW1/4, Sec. 23, T.28N., R.16W. Township: Eau Galle County: St. Croix Subdivision Name: Na Lot Number: Na Block Number: Na Parcel I.D. Number: 008-1067-10-000 Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 EZflow mound drawings Page 4 Lateral and dose tank Page 5 Distribution media nally Page 6 System maintenance specifications N t" PO Page 7 Management and contingency plan Page 8 Pump curve and specifications MMME Page 9 Site Plan BUI o NG - - - - NDEN E Designer om son License Number: 30021 Date: 12129/ 5 Phone Number: J715) 248-7767 Signature: S.~ Designed Pursuant to the EZflow Mound Component Manual Ver. August 20, 2007, SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01, R. 10/12) EZflow Mound Version 3.0 (R. 3/1/12) Pagel of 9 Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) r Residential or Commercial Design 200.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 = 150%) 300.00 Design Flow (gpd) 7.00 Site Slope 102.00 Installation Contour Line Elevation (ft) 130.00 Contour Length Available (ft) 6.00 Depth to Limiting Factor (in) 0.60 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 3.00 Cell Width (ft) 3, 4, 5, 6 7 8 9 or 10 Only 100.00 = Dispersal Cell Length (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (c or e) c Center or End Manifold 0 Lateral Spacing (ft) If N above, enter the elevation (ft) 2 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) 1.50 Estimated Orifice Spacing (ft) = 4.55 ft2/orifice 2.00 Forcemain Diameter (in) 85.00 Forcemain Length (ft) Does the forcemain drain back? Y 91.00 Inside Pump Tank Elevation (ft) Enter Y or N 0.00 Forcemain Filter Loss (ft) 6.50 System Head (ft) x 1.3 13.86 Forcemain Drainback (gal) 13.00 Vertical Lift (ft) 31.48 5x Void Volume (gal) 1.37 Friction Loss (ft) 45.34 Minimum Dose Volume (gal) 20.87 Total Dynamic Head (ft) 27.19 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 1.00 1.50 1.25 x x 2.00 1.50 x 3.00 2.00 x 3.00 x Gallons/Inch Calculator (optional) Treatment Tank Information 603.36 Total Tank Capacity (gal) 1000.00 Septic Tank Capacity (gal) 36.00 Total Working Liquid Depth (in) Weiser Concrete Manufacturer 16.76 gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 603.36 Dose Tank Capacity (gal) PolLok Filter Manufacturer 16.76 Dose Tank Volume (gal/in) PL525 Filter Model Number Weiser Concrete Manufacturer II Project: Garlend & Sharon Fregine 2 bedroom replacement mound Page 2 of 9 t Mound Plan View 3 1/10 B J Observation Pipe.:. l K: :T••••T. - I W .1.... . ..-T. B :::n I 40 L Mound Component Dimensions ft A 3.00 ft E 32.52 in H lift ft K [Aft B 100.00 ft F 12.00 in I ft L ft D 30.00 in G F77---0-5- ft J W 300.00 (ft2) Dispersal Cell Area 1898.73 (ft2) Basal Area Available 3.00 (gpd/ft) Linear Loading Rate 10.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View EZflow Dispersal Area Finished Grade 106.50 (ft) • H . z G •I F Dispersal Cell 105.00 (ft) Lateral 104.50 (ft)--► - 6" Invert Elevation Dispersal Cell t Elevation D 3 102.00 (ft) Contour Elevation 7.0 % Site Slope Typical Dispersal Cell Shading Key See Page 5 Topsoil Cap > d c. Approved Geotextil1 Fabric Cover P3 Subsoil Cap a y c 2.0 ft ~ ASTM C33 Sand ° RIM Tilled Layer 5 o Media F c"n 0 0.5 ft See details on page 4 for number, size, and spacing of laterals. Laterals are located in the 4" gravity distribution pipes as shown on page 5. Project: Garlend & Sharon Fregine 2 bedroom replacement mound Page 3 of 9 Center Connection Lateral Layout Diagram Place Appropriate Lateral Diagrarn From Right Below F' P I a X-~~~::~2~`~ L itc., ils & foie-, main c4 P'VCScit 40 fiL=e point up excerd e've'y ! per SPS Table 384 30-5 4 °tt} Ella' f)QIL; c. l;sy; rf fort af:ifi.if.i^ . I = Tumajp n' mall iI E or rl2invir p1Uq Number of Laterals 2 Orifice Diameter 0.125 in Lateral Diameter 1.25 in Orifice Spacing (X) 1.52 ft Lateral Length (P) 49.40 ft Orifices per Lateral 33 Lateral End (Z) NA ft Orifice Density 4.55 ft2/orifice Lateral Spacing (S) 0.00 ft Manifold Length 0.00 ft Lateral Flow Rate 13.59 gpm Manifold Diameter NA in System Flow Rate 27.19 gpm Forcemain Velocity 2.78 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and SPS 316.300 WAC 4 in. min. Disconnect ---tt Tank component is properly vented E-- Alternate outlet location Forcemain diameter Weiser Concrete Manufacturer 2 in. Capacity 603.36 Gallons -T Volume 16.76 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 19.29 323.38 B 2.00 33.52 C Pump off elevation (ft) C 2.71 45.34 T 92.00 D 12.00 201.12 D Total 36.00 603.36 Dose tank elevation (ft) Bedding And Backfill As Per Manufacturer 91.00 Alarm Manufacturer SJ Rhombus Alarm Model Number SJE 1011421 Pump Manufacturer Zoeller Pump Model Number BN152 Pump Must Deliver 27.19 g p m at 20.87 ft TDH Note. Switches containing mercury may not be used in this system Project: Garlend & Sharon Fregine 2 bedroom replacement mound Page 4 of 9 EZf/owe Distribution Cell Media Layout 3.00 Cell Width (ft) 1.50 Sidewall to Lateral (ft) Distribution Cell Cross-section Arrangements 3 ft Wide Component Legend ® SR1-7A Bundle - 5 ft or 10 ft lengths SR1-12A or EZ 1201A in 5 ft or 10 ft lengths SR3-12H or EZ 1201 P or GxM SR3-12H in 5 ft or 10 ft lengths O 4" Perforated Distribution Pipe With Pressure Lateral Inside • Turnup Enclosure - - - - - Pressure Lateral Bundles are covered with approved geotextile fabric as per the their product approval. Distribution Cell Plan View Layout - Typical 3.00 Cell Width - A (ft) 100.00 Cell Length - B (ft) Center Connection Lateral Layout Diagram Force Main 3 ft Wide Center Connection Project: Garlend & Sharon Fregine 2 bedroom replacement mound Page 5 of 9 Mound System Maintenance and Operation Specifications Service Provider's Name James K. Thompson Phone R(715) 248-7767 POWTS Regulator's Name ISt. Croix County Zoning Dep't Phone 386-4680 System Flow and Load Parameters Design Flow- Peak 300 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 200 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 300 f:2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once eve 3 ears Effluent Filter Inspect and clean as necessary at least once eve 3 ears Pump and Controls Test once eve 3 ears Alarm Should test periodically Pressure System Laterals should be flushed and pressure tested eve 3 ears Mound Inspect for ondin and seepage once eve 3 ears Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap and are secured in as shown in the EZflow Mound Component Manual Ver. August 20, 2007. 2. Dispersal cell media conforms to EZflow products approved for use with the EZflow Mound Component Manual Ver. August 20, 2007. Media is covered with an approved geotextile fabric. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished Grade 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Lateral Ends at Last Orifice Where Variable Length Cleanout Begins Long Sweep 90 or Two 45 Degree Bends Same EZflow Synthetic Media Diameter as Lateral 1.10 Feet ~ Distribution Lateral --*1 4 Lateral Cleanout Project: Garlend & Sharon Fregine 2 bedroom replacement mound Page 6 of 9 Mound System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [EZflowMound Component Manual 8/20/07, Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. Septic and pump tank abandonment shall be in accordance with SPS 383.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner as to when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Wisconsin Department of Commerce. Pump Tank The dosing (pump) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. If the force main has a weep hole, it should be noted if it is functional during pump operation, and if not, it should be cleaned. No one should ever enter a septic or dose tank since dangerous gases may be present that could cause death.- Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOOS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODS, 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 3 years. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Garlend & Sharon Fregine 2 bedroom replacement mound Page 7 of 9 f PUMP PERFORMANCE CURVE • TOTAL DYNAMIC HEADIFLOW so MODEL 151/152/153 PER MINUTE iss EFFLUENT AND DEWATERING t2 MODEL 151 152 153 152 Feel Maters Gal. Ulers Gal. Ut" Gal. Ulm 10 30 5 1.6 50 189 89 261 77 291 10 3.0 45 170 61 231 70 266 a- 26- 161 15 44 38 1" 53 201 81 231 2-047' 20 6.1 29 110 44 167 52 197 A,If~ s 25 7.6 18 81 34 129 42 159 tb 30 9.1 23 87 33 125 4 36 10.7 22 85 10 40 12.2 _ 11 42 ShuWff Head: 30& 9.1m 381L (11.&18 44 t. (13.4m) 2 5 0146WB 0 10 20 30 40 80 1 90 1 C•M1.ONs UTEAS 40 80 1 40 260 1 2L 3 FLOW MRUWUTE 014505A Model 151 Models 1521153 CONS6LT FACTORY FOR o SPECIAL APPLICATIONS i7~ a,4 . 3718 45M 327rd2 456 • Tined dosing panels available. • Electrical altemetors, for duplex systems, are available and wupplled with an alarm. 374 3 27732 • Variable level control switches are available for controlling single phase systems. 3 718 3 2792 • Double piggyback variable level float switches are available for variable level long and short cycle controls. • Sealed QAA-Box available for outdoor. installations. See FM1420. • Over 130•F. (54'C.) special quotation required. 15111521153 Series 111 Via ' 12118 15111621163 NODE Li Control Salecdon r Yodel Volts-Ph Node Am Sim ax Duplex 3 ua N151 115 1 Non 5.0 1 2 or 3 4 u BN151 115 1 Auto 6.0 Included 2 or 3 9151 230 1 Non 3.2 . 1 2 or 3 BE/ 51 230 1 Auto 3.2 Iroiuded 2 or 3 SK24" SK2064 N152 115 1 Nan 8.5 1 2 or 3 9152 115 1 Auto 8.5 Included 2 or 3 Ell 52 230 1 Non 4.3 1 2 or 3 BE152 230 1 to 4.3 Irduded 2 or 3 N153 115 1 Non 10.5 1 2 a 3 BN153 115 1 Auto 10.5 Irduded 2 a 3 E153 230 1 Non 5.3 1 2 a 3 SELECTION GUIDE BEt 53 30 1 Auto 5.3 Included 2 or 3 1. Single piggyback variable level float switch or double piggyback variable level float 4 CAUTION svAQh. Refer to FMO477. All installation of controls, protection dsvioss and wiring should be done by a qualined 2. See FM0712 for correct model of Electrical Alternator E-Pak, licensed aleotrician. All dwtrical and safety coda should be followed Including the most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA), 3. Variable level control Switch 10-0225 used as a control activator, specify duplex (3) or (4) float system. RESERVE POWERED DESIGN For unusual conditions a reserve safely factor is engineered into the design of every Zoeller pump. AWL TO P.O. BOX 16347 Manufacturer; Loulavl& Ky 4 02 55-034 7 SHIP To. 3849 Cane Run Road Manufacturer; ol.. y Loukvlbe, 31 Ky 40211.1951 PiLIAPS SNCE htgpJAwww.zo911w om P!/MP (502) 778-27 "S FAX (502) 77~35~8 PUUP r /999 0 Copyright 2004 Zoeller Co. All rights reserved. P , 4g~9 , ' •h r r+o/ooSLd /Y/sun al x6 O-OV,;-127. G,3' SOi~Q1~k/uaCro~ ~Pi ~ w/ 3'YleV',Y,-S Sloaceda~/.5.2, d ~ y Sc~'d A~~ S cc,13, tau Ga►//,e SE.C, oix ,"15 &oil r~G Uo CiM o. o ~ ~Xi.SEr.•I q \ ~ ~ ~ ~ ~ ~ ` ~o~ sb Pv !e ~ r7 ' ~ 6~i S~OC/so /Ll `>Ge~ . yp /KEG. 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CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Garlend & Sharon Fregine Mailing Address 2548 25th Ave. Property Address Same (Verification required from Planning & Zoning Department for new construction.) City/State Woodville, WI Parcel Identification Number 008-1037-10-000 LEGAL DESCRIPTION Property Location SE '/4 , NW '/a, Sec. 23 , T 28 N R 16 W, Town of Eau Galle Subdivision Plat: a , Lot # a Certified Survey Map # Na Volume Na Page # Na Warranty Deed # (before 2007)Volume Page # Spec house ElyesOno Lot lines identifiable 0yesOno 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 113 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 thi 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 wa anty deed recorded in Register of Deeds Office. Number of bedrooms 2 AQ qllu~ / / /,5~ 7 1- SIG`f'~ATVRE 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) 0.6 SST- 2o1 to- 005 2420 Wisconsin Department of SPS SOIL EVALUATION REPORT 01 "J'S8f page 1 of CAE in accordance with "*M A.C.E. Soil & Site Evaluations ® County Attach complete site plan on paper not less than 81/2x 11 inches in size. Pla St. Croix include, but not limited to: vertical and horizontal reference point din c io percent slope, scale or dimensions, north arrow, and location an~~nod Parcel I.D. 20 ~ ~ 008-1 7-10 00 Please print all information. ST. CRO LON ME Review y Date// f Personal information you provide may be used for secondarW~y a-t) Property Owner Property Location Garlend & Sharon Fregine Govt. Loi SE 1/4 NW 1/4 23 T 28 N R 16 W Property Owner's Mailing Address Lot # Block # Subd. Name or SM# 2548 25th Ave. na na Na City State Zip Code Phone Numbei City __j Village yj Town Nearest Road Woodville WI 54028 (715) 698-2804 Eau Galle 250Th St. New Construction Use: Residential / Number of bedrooms 2 Code derived design flow rate 300 GPD jell Replacement wji Public or commercial - Describe: Parent material Glacial Till Flood plain elevation, if applicable na General comment: and recommendations: Site requires "A+0" interprative determination approval through Wisc. Dep't of Safety & Professional Services. Efl Boring # Boring ✓ Pit Ground Surface elev 101.19 ft. Depth to limiting factor 10" 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 0-10 10yr3/3 none sil 2fgr mvfr as 2fm1c 0.6 0.8 2 10-15 10yr5/3 c2d 7.5yr5/8 sil 2fsbk mvfr cw 1vf,fm 0.6 0.8 3 15-21 10yr4/4 m2f2d 10y 62& sicl 2fsbk mfr gw 1vf 0.4 0.6 ❑ Boring # `J Boring ✓f Pit Ground Surface elev 102.11 ft. Depth to limiting factor 12" in. Soil Application Rat Horizon Depth Dominant Redox Description Texture Structure Consistence Boundar Roots GPD/ft' in. Color Qu. Sz. Cont. Colo Gr. Sz. Sh *Eff#1 *Eff#2 1 0-9 1Oyr3/2 none sil 2fgr mvfr as 2fm1c 0.6 0.8 2 9-12 10yr4/4 none sil 2fsbk mvfr cw 1vf,fm 0.6 0.8 3 12-19 10yr4/4 f2f7.5yr4/6 sicl 2fsbk mfr gw 1vf 0.4 0.6 * Effluent #1 = BOD 30 <220 mg/L a TSS >30 < 1 mg * Effluent #2 = BOD5< 30 mg/L and TSS < 30 mg, CST Name (Please Print) Signatu CST Number James K. Thompson i_ 36e2 3002V Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, WI 54020 10/16/2015 715-248-7767 ` Property Owner Garlend & Sharon Fregine Parcel ID # 008-1067-10-000 Page 2 of 3 7 Boring # -.-j Boring ✓_j pit Ground Surface elev 98.99 ft. Depth to limiting factor 10" in. Soil Application Rat Horizon Depth Dominant Redox Description Texture Structure Consistence Boundar Roots GPD/ft, in. Color Qu. Sz. Cont. Colo Gr. Sz. Sh *Eff#1 *Eff#2 1 0-13 10yr3/3 none sil 2fgr mvfr as 2f,1 m 0.6 0.8 2 10-13 10yr3/3 f2f 10yr6/6 sil 2fsbk mvfr Cw 1vf,f 0.6 0.8 m2d 7.5yr5/8 & 3 13-20 10yr5/3 f2d 10yr6/2 sicl 2fsbk mfr - 0.4 0.6 F-1 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/ft; in. Color Qu. Sz. Cont. Colo Gr. Sz. Sh *Eff#1 *Eff#2 ❑ Boring # Boring j Pit Ground Surface elev ft. Depth to limiting factor in. Soil Application Rat Horizon Depth Dominant Redox Description Texture Structure Consistence Boundar Roots GPD/ft° in. Color Qu. Sz. Cont. Colo Gr. Sz. Sh *Eff#1 *Eff#2 * Effluent #1 = BOD 5 30 <220 mg/L and TSS >30 < 150 mg * Effluent #2 = BOD 5< 30 mg/L 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 toes, Glcl~sn v/~ S/~a/vn r/ ~9i/1G D G[~CUOi (/r ~/1, Ga~ 1, , 55/O~ 0 3, tau 6o/le, S~.C(Z?iX LIA /Ocj.,rE o09- /0&7- /6 -Cco t y ' ► t I r~ , t r ` of t \ \Pi v G o tCS oda'k~e~d h 12 ` ` q•~~/ Qes,da~K~e o ~ 3 S d ' c- eda o~ rood d P 3 o.('3 DIVISION OF INDUSTRY SERVICES 1s, jxRT"r~TO 10541 N RANCH RD c~5 s HAYWARD WI 54843-6462 Contact Through Relay '3 t S P ^I http://dsps.wi.gov/programs/industry-services y~ S w www.wisconsin.gov ior~tisti¢ Scott Walker, Governor Dave Ross, Secretary January 11, 2016 CUST ID No. 30021 ATTN: POWTS Building Inspector JAMES K THOMPSON ZONING OFFICE ACE SOIL & SITE EVALUATIONS ST CROIX COUNTY SPIA 340 PAULSEN LAKE LN 1101 CARMICHAEL RD OSCEOLA WI 54020-5413 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 01/11/2018 Identification Numbers Transaction ID No. 2656464 SITE: Site ID No. 820453 Garlend & Sharon Fregine Please refer to both identification numbers, 2548 25TH Ave above, in all correspondence with the agency. Town of Eau Galle St Croix County SE1/4, NW1/4, S23, T28N, R^ FOR: Object Type: Soil Saturation Determination Regulated Object ID No.: 1582342 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. The following conditions shall be met: • Approval is hereby granted to use a limiting depth to zone of saturation of 10 inches, as determined in the P.O.W Interpretive Determination Report by James Thompson, CST, dated 10-16-2015. The CST's report was Coll ift submitted in accordance with section SPS 385.60(2), Wis. Adm. Code. All soil absorption components shall be in accordance with chapter SPS 383, Wis. Adm. Code. p,~. ? T, RK • Soil conditions at this site require a linear loading rate not to exceed 6.0 gal./lin.ft./daY and a basal loading rate ()EPA AII:~OT SAES not to exceed 0.6 gal./sq.ft./day. p • 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; it is very important that site preparation and plowing ~EE CQRR be performed when the soil is sufficiently dry. • This approval is limited to the tested area described by James Thompson, CST, as part of this referenced 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. JAMES K THOMPSON Page 2 1/11/2016 Sincerely, , Fee Required $ 240.00 Fee Received $ 240.00 Balance Due $ 0.00 win A Taylor Wastewater Specialist, Divisio of Industry Services WiSMART code: 7633 (715)634-3484, Monday - Friday 8:00 am To 4:30 pm edwin.taylor@wisconsin.gov i i A+0" Interpretive Determination Report Garlend & Sharon Fregine Property Introduction A Soil & Site Evaluation of this site was completed by James K. Thompson, Dep't. of Safety & Professional Services Credential #30021 on October 16"', 2015 . The purpose to determine the suitability of the site to accommodate a replacement Onsite Wastewater Treatment System (POWTS) to serve an existing residence located on the property. The existing parcel contains approximately 40 acres, primarily consisting of productive and fallow agricultural land. The results of the evaluation indicated that soil suitability is uniform throughout the site, with suitable depths of soil ranging from 10" - 12" (A+0" to A+Y). An onsite soils verification was completed by Ed Taylor, Dep't, of Safety & Professional Services Wastewater Specialist, on November 16d', 2015. Proiect information: The proposed mound site is located in the northwest corner of the SE'/4NW'/4, Sec. 23. T.28N. R. 16W., Tn. of Eau Galle, St. Croix County, WI., lying approximately 175' north of the center line of 25 h Ave. and 60' west of the east property line. The site has been manicured lawn for several years. Methods Soil color, texture, consistence, and Redoximorphic features have been evaluated and recorded on the attached Soil & Site Evaluation Report in accordance with Chapter SPS 385.60(2), Wisc. Administrative Code. The initial field investigation of the site included evaluation of 6 hand dug pits, two of which were verified by Mr. Taylor. One-foot contour intervals were determined within and surrounding the proposed system location by collecting rod and transit elevations at all soil pits and at 10' grid intervals throughout the proposed system area. Additional elevations and horizontal measurements were taken as needed to identify landscape position and deternme separation distances from dominant landscape forms. Local Geology St. Croix County is underlain by Prairie du Chien limestone and St. Peter sandstone, which is overlain with glacial till, forming the principal soil parent material. A search of Department of Natural Resources Well Drilling Reports filed for wells constructed within the geographic region indicated soil depths of 6Me '~139' overlying sand stone and Dolomitic limestone. Static water levels are found at 75'- 190' below gr, vy Geomornholo2y Parent Material: The parent material of this site is consistent with the mapping units - Magnor si1gttAt as shown in the U.S.G.S. Soil Survey Manual, consisting of sandy loam glacial till overlain by a g 6titLl) glaciation Aeolian loess cap. These soils are somewhat poorly drained with moderately slow pe ea i Landscape position: The tested area is positioned on the back slope of a glacial ground moraine a O' nominal Mean Sea Level (MSL) elevation of 1165'. The moraine extends gradually upslope to the east - northeast to a nominal elevation of 1200' MSL The proposed system contour lies approximately 35' in elevation below a uniform, convex summit slope located 1,400' north east of the site. The moraine extends downslope from the tested area in a west - southwesterly direction approximately 300' to an unnamed intermittent drainage way at the toe slope having a nominal elevation of 1140' MSL, continuing southerly to an eventual elevation of 1110' MSL. Slope and Aspect: The contour within and adjacent to the proposed system area is convex linear, with a slope shape that is linear along the vertical contour and convex along the horizontal contour. The ground slope is consistent at 3% - 7% with a southwest aspect of 260°. Local Hydrolotzy: Surface Water Drainage: Surface water drainage is uniform throughout the proposed system footprint and 1 the surrounding area within 100'. The linear convex slope throughout the tested area disperses surface water flow away from the proposed system area. The road ditch, located 80' south of the proposed system area conveys surface water runoff away from the site in an westerly direction where it enters an intermittent waterway. There are two areas of concentrated flow. The first being the intermittent water way discussed above, which is located approximately 300' west and southwest of the tested area and drains in a southerly direction where it discharges to a second intermittent waterway. The two waterways converge 1,900' southwest of the tested area with the water flow continuing on in a southeasterly direction. Subsurface Water Drainage: The A and B horizons consist of moderately structured silt loam providing good infiltration potential. When combined with the uniform 3% - 7% slope across the proposed system area, this site should provide good lateral subsurface water flow. Soil Saturation: Soil pits were evaluated throughout this property during the months of October & November, 2015. Soil pits were evaluated to depths ranging from 18" - 32". Saturated soil conditions were not encountered. Field Observations: Soil Morphology: The soils within the proposed system area were found to be consistent with the Magnor mapping unit as shown in the U.S.G. S. Soil Survey of St. Croix County, Wisconsin. Moderately structured silt loams were observed ranging to a depth of 12" - 15" with moderately structured silty clay loams below ranging from 12" - 20". Redoximorphic Features: Redoximorphic features were not observed within the A horizon of any of the soil profiles, with all profiles displaying redoximorphic features at A+0". No evidence of prolonged saturation was observed within the upper 6" of the A horizon. Redoximorphic concentrations were observed as Fe concentrations within the upper portion of the B horizon and throughout the C horizon. Redoximorphic depletions were observed within the lower portion of the B horizon and throughout the C horizon. Hydric Soils: The soils at this site do not meet the necessary criteria to be categorized as hydric soils. Government Reports: Ed Taylor, Wisconsin Department of Safety & Professional Services Wastewater Specialist, assessed soil conditions at the site by means of an onsite soil verification conducted on November 16'', 2015. The Taylor report confirms the suitability of the site to accommodate an A + 0" mound. Conclusions and Recommendations: Conclusion: No redoximorphic features were observed within the A horizon of any of the evaluated soil profiles, and indicate that the highest level of saturation is found at 6" below surface elevation. The lack of hydric soils indicate that the site is likely saturated for less than 5% of the growing season. This, coupled with the lack of redoximorphic depletions in the upper horizons and the strong matrix colors displayed throughout the soil profiles, indicate limited saturation within these soils. The redoximorphic features observed are likely a result of short-term seasonal saturation. The moderately structured silt loam soils in the A horizon and upper part of the B horizon will accommodate the infiltration and dispersal of applied wastewater from the POWTS and will allow treated effluent to be assimilated into the subsurface soils. The linear convex slope will accommodate uniform dispersal of both naturally occurring surface water and applied wastewater away from the site. Seasonally saturated conditions do not occur within the upper 10" of the soil profile as evidenced by the lack of redoximorphic features. The site has a minimum of 6" of unsaturated in situ soil for treatment and dispersal of treated wastewater effluent and is therefore suitable for a mound POWTS as allowed by SPS 383.44(3)(b)l. 2 Recommendations: 1.) The mound dispersal cell should be constructed on the 102.00' contour in a convex linear shape as indicated on the Soil & Site Evaluation Report. The dispersal cell should be designed and installed using as much of the available contour length as possible - approximately 100.0'. 2.) Thirty inches (30") of ASTM-C33 sand fill shall be placed beneath the upper edge of the dispersal cell. 3.) The linear loading rate for application of septic tank effluent should be 4.5 gpd/linear ft. or less and the basal area application rate should not exceed 0.20 gpd/sq. ft. 4.) The mound shall be constructed to divert surface water around and away from the mound. A surface water diversion trench should be constructed at approximately 10' wide extending between 10' - 20' upslope of the mound site. Additional fill should also be added directly upslope of the upper toe of the mound and tapered into the diversion trench and graded to direct surface water around and away from the mound area. 5.) The mound shall be constructed in accordance with Dep't. of Commerce regulations and recommendations including the removal of all vegetation from the site prior to site preparation. 6.) The site should be chisel plowed to a minimum depth of 12". Final authority for approval of a POWTS mound on this site lies with the appropriate regulatory authorities. the Wisconsin Dep't of Safety & Professional Services and the St. Croix County Zoning Dep't. This report and its observations, recommendations and conclusions are the professional opinion of James K. Thompson, Dep't of Safety & Professional Services Credential #30021. References: Soil Survey of St. Croix County. Wisconsin. July 1978. United States Department of Agricultural Soil Conservation Service in cooperation with Research Division of the College of Agriculture and Life Sciences University of Wisconsin. Department of Safety & Professional Services Chapters SPS 383 and 385, Wisconsin Administrative Code.. Field Indicators of Hvdric Soils in the United States. 1996. G.W. Hurt, Whited, P.M., and Pringle, R.F. United States Department of Agricultural, Natural Resources Conservation Service, Fort Worth Texas. Hydric Soil List for St. Croix County, Wisconsin. United States Department of Agricultural, Natural Resources Conservation Service. ftp://ftp,se.se.egov,usda.gov/wi/soil/liyd/liydlO9htm Field Book for Describing and Sampling Soils. Version 2.0. 2002. Schoeneberger, P.J., Wysocki, D., Benham, E.C., and Broderson, W.D. (editors) 2002. Natural Resources Conservation Service, National Soil Survey Center, Lincoln, NE. U.S. Geological Survey. Topographic Map download, htlp://www.terraserver.microsoft.com Wisconsin Department of Natural Resources. Well Construction Reports. http://prodmtexOO.dnr.state.wi.us Ground Water Resources and Geology of St. Croix County, Wisconsin. 1976. Barman, R.G. & Trotta, L. C. 3 r-iMS. ylv.' ~ ~ -rte r A`i .•'~r ~p~-y.; ail Adpcw ALI t 'Al ,b ~.ti< x ~ Yom, a'~ w M1 > ` > t g t • > i { ♦ a r1." 3 " t, s J~ t a k r'- CD i I ~ ff ~ II r r NN. r l m ai ~1 co m E u `I Q Yt • ! 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SEWER SYSTEMS River Falls, WI 54022 TOPSOIL • FILL • GRAVEL FREE ESTIMATES 10 Phone: (715) 425-9448 CRAIG BAKKE 7l5~17 715-684-3583 Cell: 715-760-2082 1943 4TH AVE. WEST, BALDWIN, WI 54002 23 2420 Wisconsin Department of SPS SOIL EVALUATION REPORT Page I of ~E PsPS 3gr _ in accordance with Gsamm8ra, Wis. Adm. Code A.C.E. Soil & Site Evaluations County Attach complete site plan on paper not less than 8/z x 11 inches in size. Pla St. Croix include, but not limited to: vertical and horizontal reference point (BM), directio percent slope, scale or dimemsions, north arrow, and location and distance tc Parcel I.D. 008-1067-10-000 Please print all information. Reviewed By Date Personal information you provide may be used for secondary purposes (Privacy Law, s. Property Ownei Property Location Garlend & Sharon Fregine Govt. Lof SE 1/4 NW 1/4 S 23 T 28 N R 16 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 2548 25th Ave. na na Na City State Zip Code Phone Number j City J Village ✓j Town Nearest Road Woodville WI 54028 (715) 698-2804 Eau Galle 250Th St. _j New Constructior Use: Residential / Number of bedrooms 2 Code derived design flow rate 300 GPD 1P1 Replacement _f Public or commercial - Describe: Parent material Glacial Till Flood plain elevation, if applicable na General comments and recommendations: Site requires "A+0" interprative determination approval through Wisc. Dep't of Safety & Professional Services. Boring # I Boring e pit Ground Surface elev 101.19 ft. Depth to limiting factor 10" in. Soil Application Rate Horizon Depth Dominant Redox Description Texture Structure Consistence Boundar Roots GPD/fti in. Color Qu. Sz. Cont. Colo Gr. Sz. Sh *Eff#1 *Eff#2 1 0-10 10yr3/3 none sil 2fgr mvfr as 2fm 1 c 0.6 0.8 2 10-15 10yr5/3 c2d 7.5yr5/8 sil 2fsbk mvfr cw 1 vf,fm 0.6 0.8 3 15-21 10yr4/4 r m tz2d 1 yr0yr6/2 & sicl 2fsbk mfr 9w 1 of 04 0.6 I 2] Boring # , I Boring ✓f Pit Ground Surface elev 102.11 ft. Depth to limiting factor 12" in. Soil Application Rat Horizon Depth Dominant Redox Description Texture Structure Consistence Boundar Roots GPD/ffi in. Color Qu. Sz. Cont. Colo Gr. Sz. Sh *Eff#1 Eff#2 1 0-9 10yr3/2 none sil 2fgr mvfr as 2fm1c 0.6 0.8 2 9-12 10yr4/4 none sil 2fsbk mvfr cw 1 vf,fm 0.6 0.8 3 12-19 10yr4/4 f2f7.5yr4/6 sicl 2fsbk mfr gw 1vf 0.4 0.6 Effluent #1 = BOD 30 < 220 mg/L a TSS >30 < 1 mg * Effluent #2 = BODS< 30 mg/L and TSS < 30 mg, CST Name (Please Print) Signatu CST Number James K. Thompson 36e2 300V Address A.C.E. Soil, Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, WI 54020 10/16/2015 715-248-7767 r Property Owner Garlend & Sharon Fregine Parcel ID 008-1067-10-000 Page 2 of 3 7 Boring # I Boring ej pit Ground Surface elev 98.99 ft. Depth to limiting factor 10'' in. Soil Application Rat Horizon Depth Dominant Redox Description Texture Structure Consistence Boundar Roots GPD/W in. Color Qu. Sz. Cont. Colo Gr. Sz. Sh *Eff#1 *Eff#2 I 1 0-13 10yr3/3 none sil 2fgr mvfr as 2f,1 m 0.6 0.8 2 10-13 10yr3/3 f2f 10yr6/6 sil 2fsbk mvfr cw 1vf,f 0.6 0.8 m2d 7.5yr5/8 & 3 13-20 10yr5/3 f2d 10yr6/2 sicl 2fsbk mfr - 0.4 0.6 ❑ 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/ft: in. Color Qu. Sz. Cont. Colo Gr. Sz. Sh *Eff#1 *Eff#2 F-1 Boring # J Boring _f Pit Ground Surface elev ft. Depth to limiting factor in. Soil Application Rat Horizon Depth Dominant Redox Description Texture Structure Consistence Boundar Roots GPD/ft' in. Color Qu. Sz. Cont. Colo Gr. Sz. Sh *Eff#1 *Eff#2 I Effluent #1 = BOD 5 30 <220 mg/L and TSS >30 < 150 mg * Effluent #2 = BOD 5< 30 mg/L 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 .dCelc✓ &4041`66- - - Ex > <e A, ~r;b ~ 2Sy~ ~•'~✓e• D 6JcCb~l/~~/C, ct7/,, 5~1oJ~ c~ Z 3, Sc.'4l/1i0y*.5 S!<ed T iix.,'e. / ~ ~v, T , o f S~.Cvlt ~ ~ v v ,tit 1 i ~ a 82- EXiSEii!5 (~t~C!! ,di SSUrriG U e Ic= loo.; O✓tI~CRJ~J a 3 ~ a - 13 3 d ' c- _ edge o~ ~'aad e,