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Home My WebLink About030-2025-40-000 ~c do.)5-Ye -(,co Lei 3u a L-137 0 APR 2 3 2019 /L ! r,z ~.nt2 I av` laa i ij - - -:;'npnen[ FIELD INSPECTION & SERVICE REPORT _ INSTA.LLATION_AUTHORI'LED SERVICE; I'RO~''IDER Instaliauon Address. }'(i /re e- ~rMe_ Narne: ~.Q..¢- : xQ.C. E So,%t5.'Ee Elt✓c.¢ 'o (~G U ner \'amc ~v Street: %1ail .-address: itt7'~rG 4av I Mail Address: 3 La- - o 1 c 91.• Ss/092- gyp (Q~ u7/. S`S~OZO _-State Zio Ci S:alc Zia Phone (1105 9-57??Fax Phono (9/S~Sfl9.7761 Tax _e-mail a-mail p«seiv ions'i efn~6. Ref_ INSTALLATION INFORMATION - Mond ~o. Brower Bread and $c:ia: Yu. ,etc of [nstailation Date of last wrnp-out Size I I_.. EQUIPM -T- DETAILEDCOMMENTS OFSITE CONDITION - OPERATION YES NO .'MAINTENANCE PERFORMED OR REQUIRED J.1ectrical Panelts --i Visual Alarm 0 eratin - n Audio Alarm Operating L 'ifprescn1_^ ✓ Blower(s): I . Air Inlet Filter Clean - ^._Blower 10Od Vents Clear _-_J~ - Excessive Noise I Excessive Vibration ✓ ~ - - ~_Treatment Unit sl: - - - - UcusualOdor - Z.¢ a-y1,CT 'stem Vent _ 17 Pumpout Required: - ?nmary' Scttliag_7_onc ~ - - - - Acrobic Treatment Zone I - --i EFFLUENT: LIMIT SULT Estimated Dafly F"low - - - H i5tandard Unite) 6-9 S-U. j - - Color [clear {r Iernperar-- t Dissolved Oxygen (efttuenl) 2 m 'L Udor T Slightly C / - Musty odor _ not se tic) OWNERSIGNATURE TECI-INICIAN_SIGN.AIURE ' SERVICE DATE - --7 ~I APR 2 3 2019 I FIELD INSPECTION & SERVICE REPORT INSTALLATION _ AUTHORIZED SERVICE PROVIDER ~~larne6 / o.nps.-, Instailaoon Address. Q e_ C Name: ad. A : .C. E ,SaWtS,'& Et✓r Owner Name Street: _ Mad Address. /<f1/ il?L ~t~ Mail Address: 3y('! r,CsenV ~ State Sf~ - FOGf~ "0/. City o S t~OSO Zip Ci _-QSC State Zip Phone (7/S-)5W-57?jFax ( Phone (915).20-7747 Fax e-mail l e-mail R ua/_Jv_ 0 ,6 .Net _ _ INSTALLATION INFORMATION - - V!odel Ne. i Blower Brand and Serial No. Date of Installation Date of last pumpou: Size W4 le (.<-w- V0 F / 0 20/G i BQUIPM T DETAILED COMMENTS OFSITECONDITIO:~S- OPERATION yES NO MAINTENANCE PERFORMED OR REQUIRED Electrical Panel s Visual Alarmeratin _Audio Alarm Operating - - L_ (if resent - I Blower s Ai(lnletFiherCleen i Blower Hood Vents Clear ,Excessive Noise Excessive Vibration T~rta_tment Unit(s): evc-~- Unusual Odor i- L S_Jvstem Vent / - - ti-- - Pum out Re uirtd: ' Prim §ettling Zone ,i _ - - Aerobic Treatment Zone EFFLUENT: LIMIT RESULT (-td - Estimated Dall Flow - \ cC., U CU J _pH (Slnndard knits 6-9 S.U. Color Clear - z _ Temperature« '7 Oxygen eMuent 2m Odor c cr'- Slightly Musty odor f (no( septic) OWNER SIGNATURE TECHNICIAN SIGNATURE SERVICE DATE J' pppp, i Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: 5897 O Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). 2718241 Permit Holder's Name: City Village Township Parcel Tax No: Mike & Sue Favilla TOWN OF SAI T JOSEPH 030-2025-40-000 CST BM Elev: Ins BM Elev: BM Description: ,ySection/Town/Range/Map No: du , of lJ 22.30.20.437D C 19 TANK INFORMATION . 1 LEV I DATA TYPE MAN T RER I~ STATION BS HI FS ELEV. Septic Benchmark W 1 a 5,5 3 LUZ ~p/~ Alt. BM ✓et 1!~ 6i , L-fa A Z~ S Ht inlet 01 . 8 O ~ A1tjjdk,5 V S Ht Outlet TANK SETBACK NFORMATION b~ TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet _N rin Septic k Dt Bottom L Dosing Header/Man. 71116n Dist. Pipe olding Bot. System Final Grade PUM,P1SiPHO INFORMATION ` Manufacturer Demand St Cover IN, GPM Model Number ~ cohr TDH Lift Friction Loss I System Hea TDH Ft J Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM 'CAKE/STREAM LEACHING Manufacturer: - INFORMATION Type Of S em: CHAMBER OR Model Number: UNIT DISTRIBUTION SYSTE Header/Manifold Distribution - - x Hole Size x Hole Spacing- Vent to Air Intake _ - Pipe(s). Length is Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of ded/Sodded xx Mulched Bed/Trench Center ch Edges Topsoil xx See Yes No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 1481 PINE TREA C hags 4 L°Ck b 1.) Alt BM Description 2.) Bldg sewer length X ANS-Xv PS) - amount of cover Plan revision Required? ❑ Yes 11_~ o Use other side for additional information. SBD-6710 (R.3/97) Date Vlnsepctorr's Signature ert. No. County Safety and Buildings Division St. Croix Cl W. Washington Ave., P.O. Box 7162 Salutary Permit Number (to be filled in by Co.) v Madison, WI 53707-7162 / RECEIVED O ~ State Transaction Number Sanitary Permit Application In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the ap ra ~Q` ltal unit 2718241 is required prior to obtaining a sanitary permit. Note: Application forms for state-own491A ' Mn,itted to Project Address Pifferent than mailing add ess) the Department of Safety and Professional Services. Personal information you prt f Mo l - t6UW.dary ~ ('0~ purposes in accordance with the Privacy Law, s. 15.04(1)(m), Stats. v vv~~~~ ~t TT Same L Application Inform tion - Please Print All Information - lj U. ac,, 31 Property Owner's Name Parcel # 3) Mike & Sue Favilla 030-2025-40-000 Property Owner's Mailing Address Property Location 1481 Pine Tree Ln. Govt. Lot I City, State Zip Code Phone Number Section 22 (circle one) Houlton, W1 54082 (715) 549-5799 T 30 N; R-20 E or W 11. Ty a of Building (check all that apply) Lot 4 3 Na Subdivision Name +1'1 or 2 Family Dwelling - Number of Bedrooms Na ,/A ~ / ~r Cx Block ii 1 ❑ Public/Commercial -Describe Us ❑ City of CSM Number ❑ Village of ❑ State Owned - Describe Use _ ~ ~ ~ ' l ~ ~ ~ Na rown of St Joseph III. Type of Permit: (Check only one box online A. JComplete line B if applicable) ~V ❑ New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only her Modification to Existing System (explain) Installation of ATU & filter/settling chamber List Previous Permit Number and Date Issued R. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New Before Expiration Owner #7362 issued 8/23/78 IV. Type of POWTS System/Component/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) retreatment Device (explain) White Knight WK-40 ATU V. Dispersal/Treat nt Area Information: PolyLok PL-525 effluent filter to be installed in filter Wieser concrete canister Design Flow (gpd) Design Soil Application Rate(gpdst) I rspersa f ea Required (sf) Dispersal Area Propose s ystem ovation 450 Gpd 1.6 Gpd/Sq. Ft. 281.25 sq. ft. 624.00 Sq. Ft. Existing 94.25' VI. Tank Info Capacity in Total # of Manufacturer a Gallons Gallons Units p ° New Tanks Existing Tanks p v a' U in s w C7 P, Septic or Holding Tank 320 1,000 11320 2 Wieser & Weeks Concrete X Dosing Chamber F-T VII. Responsibility Statement- It,, the mt ersigned, ass me responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber s Signature MP/MPRS Number Business Phone Number James K. Thompson _ MPRS 30021 (715) 248-7767 Plumber's Address (Street, City, State, Zip Code 340 Paulson Lake Lane, Osceola, WI 54020 VII ount '/De artment Use Onlv Permit Fee Data Issued Issum ent Signat e Approved Disapproved $ A16() ~Q rven Reason for ial IX. Condi ~Wq'~{Reasons for Disapproval >j: _pfvs'tank,etflvtnt filter ~,n~fi disper-: ,i cell must all §.e spt`Ic,?s h8 n_Cre4 as,per management plan pro tided by plumber. 2. Alks+elbock requirements must,w* maintr it ed as per Wpficrbla code / crdinemes. Attach to complete plans for the system and submit to the County only on paper not less than s 112 x II inches in size ti131)-0398 (R 11/11) y ~ Say%edt~l~ca~onfz'E ~ ♦ E,r~s~, i~j ~-sa ~e L 1 e~ ~ 1,n c, U V / y8i /~Ac 7-~`< La.~e god sec. zz, 77304 3~.CrQ)X~ cJ! /Qndscq~oce/clr~ ~eLn. e(eC~7iLSefJiCe~ 62;"n9 64 Ex;"sin cLJce~s C'ir,cr~® 4S 3 ~ I ToPo- „Wecam=99.63 Bew~n? d~o d~o~ ~ / l e. 3 b ~~M , U .4ssca4 ec/e/z-t =lee. try' Qesde„c ~I I I 4Jel( N E o i I i 3°a ~ Index & Tilte Sheet - Conventional POWTS Rejuvination Project Name: Favilla Conventional dispersal cell rejuvination W/ White Knight WK-40 ATU Owners Name: Mike & Sue Favilla Owner's adress: 1481 Pine Tree Ln., Houlton, Wl 54087 Site address: Same Project Location: Subdivision: Na Legal Description: Gov't lot 1, Sec. 22, T.30N., R. 20W., Town of St. Joseph, St. Croix Co., W1. Page 2 State Approved Plans Page 3 Septic Tank Maintenance Agreement Page 4 Certification of Existing Septic Tank Page 5 Parcel Map Page 6 Warranty Deed Mater Plu er tricted Service: James K. Thompson, DSPS Credential #30021 Signature: - Date: Page 1 of 6 Design pursuant to In-Ground Soil Absorption Component Manual for POWTS, version 2.0 SBD-10705-P (N.01f01) tip4RrsrE, DIVISION OF INDUSTRY SERVICES v ~~fo 2331 SAN LUIS PL STE 150 GREEN BAY WI 54304-5211 r;/ } Q $ \1aI Contact Through Relay ~''11 P $ http://dsps.wi.gov/programs/industry-services www.wisconsin.gov 2 OssroN tisti Scott Walker, Governor Dave Ross, Secretary AP June 09, 2016 ~T OF Sti <-,OFESS'ONA CUST ID No. 30021 ATTN: POWTSInspector 3 i 0 N OF INED 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 SEE CORRESP CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 06/09/2018 Identification Numbers Transaction ID No. 2718241 SITE. Site ID No. 824904 Mike & Sue Favilla Please refer to both identification numbers, 1481 Pine Tree Ln above, in all correspondence with the agency. Town of Saint Joseph St Croix County Government Lot(S) 1, S22, T30N, R20W FOR: Description: White Knight WK-40 Rejuvinati; 11 Object Type: POWTS Component Manual Reguiatcd rrj-c( tl o0, Maintenance required; Replacement system; 450 GPD Flow rate; 92 in Soil m iaimuni :1t I7Ijh o hirir.n < ii'o[?i original grade; Aerobic Treatment Unit, Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • Yearly Maintenance per ATLI POWTS Dispersal Cell Maintenance & Contingency Plan. (P.7) • The department may require metering or monitoring of the effluent from this product to evaluate the operation and compliance to SPS 383.44 effluent quality parameters. 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. JAMES K THOMPSON Page 2 6/9/2016 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 $ 80.00 Fee Received $ 80.00 Balance Due $ 0.00 Tim Vander Leest Private Sewage Plan Reviewer, Division of Industry Services WISMART code: 7633 (920)492-2214, Monday - Friday 6 am To 3:30 pm tvanderleest@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm JAMES K THOMPSON Paee 2 6/9/2016 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 $ 80.00 Fee Received $ 80.00 Balance Due $ 0.00 Tim Vander L,eest Private Sewage Plan Reviewer, Division of Industry Services WiSMART code: 7633 (920)492-2214, Monday - Friday 6 am To 3:30 pm tvanderleest@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm i 1 Index & Tilte Sheet - Conventional POWTS Rejuvination Project Name: Favilla Conventional dispersal cell rejuvination W/ White Knight WK-40 ATU Owners Name: Mike & Sue Favilla .~Li~id 11~'~ Owner's adress: 1481 Pine Tree Ln., Houlton, WI 54087 Site address: Same i,w DE E; 3C Project Location: Subdivision: Na Legal Description: Gov't lot 1, Sec. 22, T.30N., R. 20W., Town of St. Joseph, St. Croix Co., Wl. Parcel ID 030-2025-40-000 Page 1 Index and Title Sheet Page 2 Site Plan Page 3 Treatment Tank / ATU installation cross section Page 4 Dispersal Cell Sizing Calcualtions Page 5 ATU POWTS Agreement Page 6 ATU POWTS Service Contract Page 7 ATU POWTS Maintenance & Contingency Plan Page 8 Filter Tank Specifications Page 9 Filter Specifications Page 10 Existing Treatment Tank Certification Page 1 l Septic tank Maintenance Agreement Page 12 White Knight ATU Certification Letter Atachments: Soil Evaluation Report 4L z, i V t-L N 0 9 20 Mater Plu icted Service: James K. Thompson, DSPS Credential #30021 Signature: Date: Lc- l/ Page 1 Of 12 Design pursuant to In-Ground Soil Absorption Component Manual for POWTS, version 2.0 SBD-10705-P (N.01 /01) 1► Index & Tilte Sheet - Conventional POWTS Rejuvination Project Name: Favilla Conventional dispersal cell rejuvination W/ White Knight WK40 ATU Owners Name: Mike & Sue Favilla Owner's adress: 1481 Pine Tree Ln., Houlton, WI 54087 Site address: Same T9y ~0~6 ~Fs Project Location: Subdivision: Na Legal Description: Gov't lot 1, Sec. 22, T.30N., R. 20W., Town of St. Joseph, St. Croix Co., WI. Parcel ID 030-2025-40-000 Page i Index and Title Sheet Page 2 Site Plan Page 3 Treatment Tank / ATU installation cross section Page 4 Dispersal Cell Sizing Calcualtions Page 5 ATU POWTS Agreement Page 6 ATU POWTS Service Contract Page 7 ATU POWTS Maintenance & Contingency Plan Page 8 Filter Tank Specifications Page 9 Filter Specifications Page 10 Existing Treatment Tank Certification Page I 1 Septic tank Maintenance Agreement Page 12 White Knight ATU Certification Letter Atachments: Soil Evaluation Report Mater Plumber Restricted Service: James K. Thompson, DSPS Credential #30021 Signature: Date: Page 1 Of 12 Design pursuant to In-Ground Soil Absorption Component Manual for POWTS, version 2.0 SBD-10705-P (N.01/O1) ` c Renee%n%ot/one. ~ D ~od.la~/ 5eC-,z2,T3od. •/4PP~~ /ocli~~ 1O(.a~.~ T. CC'S{ _~O~pk, '~P~~C,y, ~oco~an off, KJw'~ <d~U~i✓Q~e , X u~ andStr.~dtL✓ ~(t/1. ZIeL~ri C S¢(JiC2^~` .~E COI X030-Zo~S-4~D~Q9p :o I ° i,l V76e; LAJ/f4f)l .4- Jam- i h 1 1<1,4.4 -o ao~.lcE ~ 3 0 2 ndt, a Fuw~ Lul= 9(t (rs' Z.~S~,d , g~Qdeatc~~.ct=99.0' ; r ToP n' ~ !~e% carte= 9963• I ~ v QeS c%nC( t r(ssu.nedelet =IOD.~.~ ~ ~ 'k• A f (~,,,~pressc ~ ~o•-~~~~sso~{~ous;.~s Co✓ A', ,Ale ms.,~fyh Cad ~n, S 11~..d EXi shin ~.s s?xc E%on G ~c~ d e ~4 do . P;pe ~ " •u t f ~a(~o s ed r,J,'CStr-- - CIO nc rtbG X209 ° f2 Sc/i. ~0 R'Csc.:! /,7t lea/y L.o~P,C-S1S wK ~O ~ tali-~:o•~ -s- ~'ea~irlanfGcn.~ Ex~s~~ fz~F/t. ~i SZ~GI, ~X~S~ oU0 9rP p5. 3 a~'/Z DISPERSAL CELL SIZING CALCULATIONS 1. Design Wastewater Flow: (3 bedrooms)(100 gpd estimated flow)(150% design factor) = 450 gpd Design Flow 2. Infiltrative capacity of native soil: 0.7 gpd/sq. ft. eff. quality #1 / 1.6 gpd/sq. ft. eff. quality#2 3. Absorption area required: 281.25 sq. ft. 450 gpd / 1.6 gpd/sq.ft., effluent quality #2 4. Existing absorption area: 624.00 sq. ft. (12' x 52' x 18") Pg. 4 of 12 Document NO. ATU POWTS AGREEMENT Owner name and address: Michael C. & Sue Favilla 1481 Pine Tree Ln. Houlton. WI 54087 n ~ This indenture, made by ONNner and their successors in interest, own a POWTS (Private Onsite Wastewater Treatment System) requiring regular monitoring and maintenance in accordance xvith the manufacturers recommended Return to: procedures. These procedures must be performed by a manufacturer authorized service provider licensed by the State of Wisconsin to perform these services. James R. Thompson Results of these procedures shall be reported to the appropriate Governmental 340 Paulson Lake Lane Unit as required by code. Osceola, WI 54020 Location of POWTS: Parcel ID#: 030-2025-40-000 1481 Pine Tree Ln.: Lot: Na. Block: Na. SubdivisionJCSM: Na, Being part of: _Gov't lot 1. Sec. 22. T.30 N.. R. 20 W., Tn. Of SL Joseph. St. Croix Count,,, Wisconsin. Parcel Number: 030-2025-40-000 POWTS DESCRIPTION: One (1) White Knight WK-40 containing one (t) aeration treatment unit with treated effluent discharged to existing conventional dispersal component. OWNERSHIP RIGHTS AND RESPONSIBILTY FOR POWTS: Property Owner as described holds sole ownership rights and is responsible for insuring inspection, op on and maintenance of POWTS. f, ; r c1 c. G s~~t Favilla (131Y) Acknowledgement: These named, Michael C. Favilla & Sue A. Favilla. known to me to be the person executing the foregoiii instrument. Subscribed and sworn to before me this day of 14q 5___--- OTARY PUBLIC, State f Wisconsin My Commission Expires: August 31, 2019 Instrument Drafted By: James K. Thompson Po 01- 12 ATU POWTS SERVICE CONTRACT The proper operation and maintenance of the components listed below will significantly influence the performance and life expectancy of the POWTS (Private Onsite Wastewater Treatment System). This agreement authorizes A.C.E. Soil & Site Evaluations, L.L.C. personnel (Service Provider) or their representative access to the POWTS components during regular business hours to perform regular inspections and routine maintenance of those components. It is herby agreed by and between Owner and Service Provider that in consideration of the payments provided for herein, Service Provider will provide a manufacturer trained and State licensed inspector to perform periodic inspections of the POWTS components as set forth below. Service Provider will prepare a written inspection report after each inspection containing any recommendations for the operation. maintenance, and or repair of the POWTS deemed appropriate by the Service Provider. A copy of the report will be provided to Owner and the appropriate Governmental Unit. Service Provider will supple additional services, parts, or labor only after autltor-Wition by purchaser. This agreement does not assume any responsibilities or obligations that are normally the responsibilities and obligations of the Owner and does not cover any costs associated with operation. maintenance and or repair of the POWTS. In no event shall Service Provider be responsible for any special or consequential damages, including but not limited to, loss of time, injurN to person or property. or incidental economic loss due to equipment failure for any reason whatsoever. This agreement shall remain in effect for a period of two (2) years from the date of PO WTS installation. and will be automatically renewed each year thereafter unless amended or cancelled by either party with 30 days written notice. Thls agreement may be cancelled by Owner only if replaced by a service contract NN it Ii another service provider authorized to inspect arid maintain the specific POWTS components in question. Purchaser agrees to pay Service Provider the smn Of $ 150.00 per inspection. Four (4) inspections will be provided over the first two-year period at six-month intervals. Payment for the first four inspections will be included in the cost of the POWTS design. One (1) inspection per year will be conducted thereafter with inspection fees billed at the time of inspection. Additional fees associated with effluent testing. when required, will be billed at time and material cost. POWTS DESCRIPTION: One (1) White Knight WK-40 containing one (1) aeration pre-treatment unit, pre-treated cfflu, nt discharged to existing Conventional dispersal component constructed in accordance 6th State Code. POWTS Location: 1481 Pine Tree Ln., Houlton WI., located in: Gov't lot 1 of Sec. 22, T. 30 N.. R. 20 W., Tn. of St. Joseph, St. Croix Co., WI, Parcel #(30-2025-40-000 Otivner name and address Michael C. & Sue A. Favilla 1481 Pine Tree Ln. Houlto , C 0 j lit . ~ L ~ ) I (Sue -1.. Favilla) Q ~itel Service Provider: A. oil & Site Evaluabons. L.L.C. X40 Paul on Lake Road Osceola, I 5' 20 gas I . Thompson) - - Instrument Dratted Bv: James K. Thompson Pao 0 of I ATU POWTS Dispersal Cell Maintenance & Contingency Plan Pursuant to Wisconsin Dep't. of Safety & Professional Services 383.54. Wis. Adm. Code General The POWTS shall be operated in accordance with Dep't. of Safety & Professional Services 382-384 Wis. Adm. Code. and shall be maintained in accordance with component manual SBD-10706-P (N.01/01). All local and/or state rules pertaining to system maintenance and reporting shall be complied with. Questions on the operation or maintenance of the system should be directed to the installing plumber. Jim Thompson at (715) 248-7767 or the County POWTS Inspector at (715) 386-4680. Effluent Qualitv The sewage effluent concentration levels generated at this site will be residential strength effluent as defined bN the Wisconsin Dep't. of Safety & Professional Services. Influent quality entering the dispersal component of the POWTS may not exceed 30mg/L BODs. 30 MG(L TSS. and 30 rng/L FOG. Contim,encv Plan if the septic svstem or any of its components become defective, the component shall be repaired or replaced to keep the system in proper operating condition. Aeration Treatment Units shall be immediately repaired or replaced with approved components of the same or equal performance. Persistent ponding within the dispersal cell will be addressed by installation of a replacement mound dispersal cell. Septic Tank The operating condition of the septic tanks shall be assessed at least once annually by inspection. The septic tank contents shall be removed when the sludge and scum in the tank exceed 1/3 the liquid volume of the tank. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code, by an individual certified to service septic tanks under s. 281.48, Stats. If the contents of the tank are not removed at the time of the annual assessment, maintenance personnel shall advise the owner of when service will be needed to maintain less than 1/3 scum and sludge accumulation in the tank. Any treatment tank opening deemed unsound, defective. or subject to failure shall be replaced. Exposed access openings shall be secured by an effective locking device to prevent accidental or unauthorized entry into tanks or other components. No individual should ever enter a septic tank or pump tank as dangerous gases may he onlc,1,rr !1)10 ~ nijld >>,sc dca111 Start-Up Procedur 1. Inspect aerator 2. Test effluent samples as needed to determine BOD. TSS. & Ph lcvels of efilucnt. Biannual Monitorini & Inspection Procedures: I . Visually inspect all system components. 2. Monitor existing dispersal cell to determine condition of bio-mat and remediation of hydraulic 3. Evaluate sludge levels in septic tanks and pump contents as required by inspection. 4. Inspect treatment tank outlet filter & clean as needed. 5. Determine dissolved oxygen levels. Collect and submit BOD, TSS & Ph samples as needed. 6. ATU Inspections shall include the following: Blower Unit: Inspect blower unit and air intake, clean or replace filter as needed. Check for excessive heat, noise or vibration. Alarm &/or Control Panel: Test electrical connections, current draw, alarm, pressure switch and lvgh water alarm. Adjust or repair as needed. Treatment Unit: Inspect manhole rings, covers, locks, vents, etc. determine operating condition of the unit by visual observation & measuring sludge volume in treatment tanks. Measure dissolved oxygen. temperature and pH of effluent. Collect effluent samples for B.O.D.. Ph & T.S.S analysis as needed. Replace Bacterial lnoculators annually or as needed. 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No. z ~r Z W3716 US HWY 10 MAIDEN ROCK, WI 54750 DATE: JANUARY 2012 DATE . 3/6 12 POST-POUR: REVISED JAN. 2012 800-325-8456 FILE: W320-MR c d Technica1:,S' cifications Mon. PL-525 ~EFFL UEN7" FILTER ( OMME *1. ) 6112" BkL G4ECK EXCEPTS 6' SHO 1C / ~ FOR IN.ET EX1EN 71CN 14 35 I I _ DL%ET BUSHING EXCEPTS I ~l -i Try i 1068 .-.J `,VIII, I~ 51 I I II . 3 I ~ i i ]102 ~ .ryd III r I ~ ~I'' I I I q I PL-525 FILTER HOUSING - 1981 opt / PART NO -30142-525 T' 11ATERIPL HOUSING - POLYPROPYLENE I OUTLET BUSHING •PVC III ~ I 6.58ALL •HDPE L SOCKET EXCEPTS F~OATSWTCH ~ J- 1 \ - Laid" ~--1 10,13 EXC)EPTS1'SCH1G FOR H W)LEE)CIEN➢ON 10,81 , ~n J a 624 533 OF,ns'SLOTS F 45 ! - 9.56 7 SOCXETEXCEPTS 6.W L ' t3} BALL PUSH ROD OPENING .I O 777 77 ~ I 7 09 I I ~ CpEl;NG i 20.T I ~i ~ I' I i OI O .L4"4' 1 19 02 1 721.1 1I I' i,. v,v 3.: I I ~ Y II II ~I ail. POIYLOK PL-525 FILTER CARTRIDCE gy ~I PARTNO, - 30141.525 +A. - l MATERIAL -POLYPROPYLENE `~L ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF EXISTING SEPTIC TANK(S) This is to certify that I have inspected the existing septic and/or dose tank presently serving the following residence: (Street address) 1481 Pine Tree Ln., Houlton, WI 5408 located at: Gov't iot' 14, 14, Section 22 , Town 30 N, Range 20 W, Town of St. Joseph , St. Croix County Wisconsin. Upon inspection, I certify that I have found the tank(s), to the best of my knowledge, will conform to the requirements of SPS. 384.25, and it (they) appear(s) to be functioning properly. Most recent date of inspection or service May 12, 2016 Did flow back occur from absorption system? Yes No x (if no, skip next line.) Approximate volume or len,01i uftime: Naallor~; N-i ~ni~~utcs Tank Capacity: 1,000 gallon Construction: Prefab Concrete x Stcel Otllcl Manufacturer (if known): Weeks Concrete ge Tank (if known): 38 years, installed 8/23/1978 Pen7n number (rf State permit #7360, County permit #258 -s James K. Thompson Licensed Plumber rgnature) (Print Name) MPRS MPRS #30021 (Title) (License Number) MP/MPRS May 27, 2016 (Date) Form to be completed by licensed plumber (Dept of Safety and Professional Services Chapter 305 and s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) Rev. 2/2012 P ~o~'~~Z ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mike & Sue Favilla Mailing Address 1481 Pine Tree Ln., Houlton, WI 54082 Property Address Same (Verification required from Planning & Zoning Department for new construction.) City/State Houlton, WI Parcel Identification Number 030-2025-40-000 LEGAL DESCRIPTION Property Location Gov't 1v4 Lot 1 V4, Sec. 22 , T 30 N R20 W, Town of St. Joseph Subdivision Plat: Na , Lot # Na Certified Survey Map # N a ,Volume N a J age # N a Warranty Deed # (before 2007)Volume Page # Spec house ❑yes[Zlno Lot lines identifiable El yes []no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §SPS. 383.52(1) and in Chapter 12 - St. Croix County Sanitary OrdinnAcc The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Safety And Professional Services and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my/our knowledge. Ihve am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number o rooms 3 05/25/16 A F 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 ii' reference is made in the warranty deed. (REV. 04/12) _ l~o~lL SAFETY AND BUILDINGS DIVISION Plumbing Product Review commerce.wi.gov P.O. Box 2658 Madison, Wisconsin 53701-2658 ■ TTY: Contact Through Relay sconsin tiepartment of Commerce Jim Doyle, Governor Richard J. Leinenkugel, Secretary October 2, 2008 KNIGHT TREATMENT SYSTEMS MARK C NOGA, VP 281 COUNTY ROUTE 51A OSW EGO NY 13126 Re: Description: CHEMICAL OR PHYSICAL RESTORATION FOR POWTS Manufacturer: KNIGHT TREATMENT SYSTEMS Product Name: WHITE KNIGHT MICROBIAL INOCULATOR/GENERATOR Model Number(s): WK-40 AND WK-78 Product File No: 20080513 The specifications and/or plans for this plumbing product have been reviewed and determined to be in compliance with chapters Comm 82 through 84, Wisconsin Administrative Code, and Chapters 145 and 160, Wisconsin Statutes. The Department hereby issues an approval based on the Wisconsin Statutes and the Wisconsin Administrative Code. This approval is valid until the end of DECEMBER 2013. This approval is contingent upon compliance with the following stipulation(s): • This product must be utilized in accordance with the manufacturer's printed installation instructions and this product approval. If there is a conflict between the manufacturer's installation instructions and the product approval, the product approval requirements will take precedence. • The elevation of the system's infiltrative surface must be above the estimated highest groundwater elevation or bedrock by the distance prescribed in column entitled "Fecal Coliform >10000 cfu/100 ml" in Table Comm 83.44- 3, Wis. Adm. Code. • A copy of this approval letter and the manufacturer's printed installation instructions must be supplied to the buyer of this product. • The outlet baffle of the septic tank, which has this product installed, must have installed an effluent filter capable of filtering particles of 1/8 inch in size or larger. • This product must be installed by a properly licensed plumber. • A state Sanitary Permit must be obtained when this product is installed. • The IOS-500 inoculant must be exchanged at least on an annual basis. SBD-10564-E (N.10/97) File Ref: 08051301.DOC KNIGHT TREATMENT SYSTEMS Page 2 October 2, 2008 PRODUCT FILE NO. 20080513 • This product is approved to be installed in existing and new treatment tanks to rejuvenate failing soil dispersal areas. The product may be installed in single or two compartment tanks. . The product may be installed in the second compartment of a septic tank; preference is to have the product placed in the main compartment or inlet side of a two compartment tank. . To promote having an area of quiescence and that of settling in a single compartment tank, locating the product off center--towards the inlet side of the tank-- is the preferred procedure. • For installations where the access opening is not directly above the desired product location within the tank, a standard installation practice involves the use of a flexible air line between the air supply's riser entry point and product; in some installations to existing tanks, access modification may be needed. This approval supersedes the approval issued on 12/23/2003 under product file number 20030401. This approval letter shall be incorporated with your previously approved plans and/or specifications approved under product file number 20030401. The department is in no way endorsing this product or any advertising, and is not responsible for any situation which may result from its use. During the period that this product approval is in effect, it is the responsibly of the submitting party to inform Commerce of any changes to the contact information or an address change. Renewals will be sent to the address of record. Sincerely, Jean M. MacCubbin, CST Engineering Consultant--Plumbing Product Reviewer Commerce; Safety & Buildings Div. PO Box 2658 201 W Washington Ave. Madison WI 53703-2658 Phone: 608-266-0955; Fax: 608-283-7456 E-mail: Jean.MacCubbin@wisconsin.gov Enc. 2251 Wisconsin Department of SOIL EVALUATION REPORT Page t of 3 Commerce A.C.E. Soil & Site Evaluations in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 81/2 x 11 inches in size. Pla County 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. 030-2025-40-000 Please print all information. Reviewed By Date Personal information you provide may be used for secondary purposes (Privacy Law, s Property Ownei Property Location Michael C. & Sue A. Favilla Govt. Lot 1 114 1/4 S 22 T 30 N R 20 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1481 Pine Tree Lane Na Na Na City State Zip Code Phone Number City J Village ✓j Town Nearest Road Saint Joseph WI 54082 712-549-5799 St.Joseph Pine Tree Lane I New Constructior Use: 1/ Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement - Public or commercial - Describe: Parent material Glacial drift Flood plain elevation, if applicable Na General comment: and recommendations: Soil suitable for ATU rejuvination of hydraulically failed dispersal cell. Replacement mound requires 2 trench system & ATU to reduce loading rate and overall system length. FTI Boring # Boring ✓j Pit Ground Surface elev 100.03 ft. Depth to limiting factor 28" in. Soil Application Rate Horizon Depth Dominant Redox Description Texture Structure Consistence Boundar Roots GPD/ft; in. Color Qu. Sz. Cont. Colo Gr. Sz. Sh 'Eff#1 I `Eff#2 1 0-5 1Oyr3/3 none sil 2fgr mvfr cs 2fmc 0.6 0.8 2 5-16 1 Oyr4/4 none Ifs Osg dl gs 2fm,1 c 0.5 1.0 3 16-28 1 Ory4/6 none Is Osg dl aw 2fm,1 c 0.7 1.6 4 28-36 1Oyr5/6 f1d 7.5yr5/8 Ifs Osg dl cw 1f 0.5 1.0 5 36-42 7.5yr4/4 c2f 7.5yr5/8 vfs Osg dl gw 1f 0.4 0.6 6 42-58 1Oyr5/4 fld7.5yr5/8 SBR/vf Osg dl - 1f 0.4 0.6 Horizons #4 & 5 consist of sand stone residuim. Horizon #6 consists of sandstone bedrock as determined by resistance to knife penetration. 7 Boring # -'-J' Boring V, Pit Ground Surface elev 95.80 ft. Depth to limiting factor 46" 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 0-5 1Oyr3/3 none I 2fgr mvfr cs 2fmc 0.6 0.8 2 5-21 1Oyr414 none Is Osg ml gs 2fmc 0.7 1.6 3 21-42 1 Ory4/6 none Is Osg ml cw 2fm,1 c 0.7 1.6 4 42-46 1Oyr5/4 none Ifs Osg ml cw 1vf,f 0.5 1.0 5 46-52 1 Oyr4/4 fl d7.5yr5/8 Ifs Osg dl ci 1 vf,f, 0.5 1.0 6 52-58 1Oyr7/2 c2d 7.5yr5/8 SBR/vf Osg dl 1vf 0.4 0.6 Horizon #6 consists of sandstone bedrock as determined by resistance to knife penetration. Effluent #1 = BOD ? 30 <220 mg and TSS >3 < 150 mg ' Effluent #2 = BOD5< 30 mg/L and TSS < 30 mg. CST Name (Please Print) Sig ture: CST Number James K. Thompson 3602 Address A.C.E. Soil & Site Evaluation Date Evaluation Conducted Telephone Numbei 340 Paulson Lake Lane, Osceola, WI 54020 7/5/2011 715-248-7767 Property Owner Michael C. & Sue A. Favllla Parcel ID # 030-2025-40-000 Page 2 of 3 ` 3] Boring # Boring ✓J Pit Ground Surface elev 99.37 ft. Depth to limiting factor >75'' 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 0-5 1Oyr3/3 none sil 2fgr mvfr Cs 2fmc 0.6 0.8 2 5-17 1 Oyr4/3 none sil 2fsbk mvfr cw 2fm,1 c 0.6 0.8 3 17-27 7.5yr4/4 none sl/Is mix 2msbk/Osg mfr/ml gw 1fm 0.6 0.8 4 27-52 1Oyr4/4 none s Osg ml cw 1vf 0.5 1.0 5 52-75 1Oyr4/4 none Icos&gr Osg ml 0.6 1.0 H#5 has very high clay content. Clay skins evident on individual sand grains. Loading rate reduced to reflect reduced permeability of horizon associated w clay content. 47 Boring # -i Boring ✓j Pit Ground Surface elev 98.85 ft. Depth to limiting factor >92" in. F 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 0-6 1Oyr3/2 none sil 2fgr mvfr aw 2vf,fm 0.6 0.8 2 6-21 1Oyr4/4 none sil 2fsbk mvfr Cw 2vf,fm 0.6 0.8 3 21-28 7.5yr4/6 none Is Osg ml Cw 0.7 1.6 4 28-56 1Oyr5/6 none s Osg ml cw 0.7 1.6 5 56-92 1Oyr5/4 none s Osg dl 0.7 1.6 Boring # _,;1 Boring J Pit Ground Surface elev 99.32 ft. Depth to limiting factor >98" 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 1 0-8 1Oyr3/2 none sil 2fgr mvfr aw #2vf, 0.6 0.8 2 8-22 1Oyr4/4 none sil 2fsbk mvfr cw 0.6 0.8 3 22-27 7.5yr4/6 none Is Osg ml Cw 0.7 1.6 4 T27-60 1Oyr5/6 none s Osg ml cw - 0.7 1.6 5 60-98 1Oyr5/4 none s Osg dl - 0.7 1.6 Effluent #1 = BOD ? 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 serN ices of need material in an alternate format, please contact the department at 608-266-3151 or'fTY 608-264-8777. SBD-8330 (R.07/00) A.C.E. Soil & Site Evaluations CJ ~ MX 44 e✓ e. Sccc Q mod,'/lQ U / y8/ rtc 7l-,et Lae- --Sec. zz, r-i04. ~PP~at /oc~6'~ o{ /7. zoc~7., Tq• oF'S~_So~lc, i4PP~aX. /aco~'pn o..~' ~pu.r'; cd~~i✓Q~e 3~.Cof) ~i /andsc~,occ✓cl~y/etn. electrif 5ef~;cE~i X030-1 o2$-~fO-6ZVO az ~~ncc 62 ; n .Z, G(J 4 Gf2.S ~ , ~ ~ n S ~ gi ctr~~4LP_ ScpK'c. ~ ~~edea~~~rt=99.0' ~ s Top c7~ Y?~ l e% cam= 99.G.~ 8e.,c ~i a.~.o d~o~ .3 % l e. 3 bey ~u~•h .4ssu.+ied e (e✓ = /OD.t~• ~es/o%nCc l i I i I ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF EXISTING SEPTIC TANK(S) This is to certify that I have inspected the existing septic and/or dose tank presently serving the following residence: (Street address) 1481 Pine Tree Ln., Houlton, WI 5408 located at: Gov't lot 1 '/4 '/4, Section 22 , Town 30 N. Range 20 W, Town of St. Joseph , St. Croix County Wisconsin. Upon inspection, I certify that 1 have found the tank(s), to the best of my knowledge, will conform to the requirements of SPS. 384.25, and it (they) appear(s) to be functioning properly. Most recent date of inspection or service May 12, 2016 Did flow back occur from absorption system? Yes No x (if no, skip next line.) Approximate volume or length of time: Na gallons Na minutes Tank Capacity: 1,000 gallon Construction: Prefab Concrete X Steel Other Manufacturer (if known): Weeks Concrete Tank (if known): 38 years, installed 8/23/1978 Permlt umber if kn State permit 97360, County permit #258 James K. Thompson icensed Plumber Si nature) (Print Name) MPRS MPRS #30021 (Title) (License Number) MP/MPRS May 27, 2016 (Date) Form to be completed by licensed plumber (Dept of Safety and Professional Services Chapter 305 and s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) Rev. 2/2012 s~ r LLI t N i -4-4`dl JNid H G J Z W z rr w LO N ea ~ s oa~ w N p-9 N U C O c p T7 O Ep m 17 y H o p W +M~ O c p 00 1v3wd013n30ulNnwwo, AiNnoo xloao is 3 ~ ~ 2qO 2251 Wisconsin Department of Nnr SOIL EVALUATION REPORT 1 of 3 Commerce in accordance with Comm 85, Wis. Adm. Code A.C.E. Soil & Site Evaluations Attach complete site pl _ p IPrA/2 x 11 inches in size. Pla County St . Croix include, but not limited to: vertical and horizontal reference point (BM), directio percent slope, scale or dimensions, north arrow, and location and distance t( Parcel I.D 030-2025-40- 00 Please print all information. Review y Date Personal information you provide may be used for secondary purposes (Privacy Law, s Q Property Ownei Property Location Michael C. & Sue A. Favilla Govt. Lot 1 1/4 114 22 T 30 N R 20 W Property Owner's Mailing Address Lot # Block # Subd. Name or QKSM# 1481 Pine Tree Lane Na Na Na City State Zip Code Phone Numbei City Village ✓i Town Nearest Road Saint Joseph WI 54082 712-549-5799 St.Joseph Pine Tree Lane New Constructior Use: ✓ Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD ✓I Replacement Public or commercial - Describe: Parent material Glacial drift Flood plain elevation, if applicable Na General comments and recommendations: Soil suitable for ATU rejuvination of hydraulically failed dispersal cell. Replacement mound requires 2 trench system & ATU to reduce loading rate and overall system length. FTI Boring # Boring Pit Ground Surface elev 100.03 ft, Depth to limiting factor 28 in. Soil Application Rat Horizon Depth Dominant Redox Description Texture Structure Consistence Boundar Roots GPDff in. Color Qu. Sz. Cont. Colo Gr. Sz. Sh 'Eff#1 'Eff#2 1 0-5 1Oyr3/3 none sil 2fgr mvfr cs 2fmc 0.6 0.8 2 5-16 1 Oyr4/4 none ifs Osg dl gs 2fm,1 c 0.5 1.0 3 16-28 1 Ory4/6 none Is Osg dl aw 2fm,1 c 0.7 1.6 4 28-36 1Oyr5/6 f 1 d 7.5yr5/8 Ifs Osg dl cw 1f 0.5 1.0 5 36-42 7.5yr4/4 c2f 7.5yr5/8 vfs Osg dl gw if 0.4 0.6 6 42-58 1Oyr514 f 1 d 7.5yr5/8 SBR/vfs Osg dl - 1f 0.4 0.6 Horizons #4 & 5 consist of sand stone residuim. Horizon #6 consists of sandstone bedrock as determined by resistance to knife penetration. 2 ] Boring # Borirnt h F V Pit -oun,: 6'0, - - Uet,tfi t- ;rr .mu actor Moil ,ypNlrca;.o, Kai 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 1 0-5 10yr3/3 none I 2fgr mvfr cs 2fmc 0.6 0.8 2 5-21 1Oyr414 none Is Osg ml gs 2fmc 0.7 1.6 3 21-42 1 Ory4/6 none Is Osg ml cw 2fm,1 c 0.7 1.6 4 42-46 1Oyr5/4 none Ifs Osg ml cw 1vf,f 0.5 1.0 5 46-52 1Oyr4/4 f1d7.5yr5/8 Ifs Osg dl ci 1vf,f 0.5 1.0 6 52-58 1Oyr7/2 c2d 7.5yr518 SBR/vfs Osg dl - 1vf 0.4 0.6 Horizon #6 consists of sandstone bedrock as determined by resistance to knife penetration. Effluent #1 = BOD 5 30 < 220 mg and TSS >30 < 150 mg ` Effluent #2 = BODS< 30 mg/L and TSS < 30 mg. CST Name (Please Print) Is- Signature: CST Number James K. Thompson. 3602 Address A.C.E. Soil & Site Evaluation Date Evaluation Conducted Telephone Numbei 340 Paulson Lake Lane, Osceola, WI 54020 7/5/2011 715-248-7767 I need material in an alternate lormat, please contact the department at 608-266-3151 or 1 TY 609-26 4-9777. stst)-s;zo rk 0- 00) N.C.E. 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