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HomeMy WebLinkAbout038-1119-70-120 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: Safety and Building Division St. Croix INSPECTION REPORT Sanitary Permit No: GENERAL INFORMATION (ATTACH TO PERMIT) 592164 Personal information you provide may be used for secondary No purposes [Privacy Law, s.15.04 (1)(m)] NA Permit Holder's Name: City Village Township Parcel Tax No Oevering Homes, LLC TOWN OF STAR PRAIRIE 038-1119-70-120 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 29.31.18.494C-10 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic f f ~ Benchmark Alt. BM Bldg. Sewer 10 109.16 H Ht Inlet , f ~ L~ ~efi Z 2 TANK SETBACK INFORMATION S Ht outlet &05 101-7 TANK TO / WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic } N Dt Bottom Dosing Head /Man. Aeration Dist. Pipe Holding Bot. System - Vr ! ,v ~v W / W PUMP/SIPHON INFORMATION Final Grade Manufacturer - Dema St Cover GP Mo Number TD Lift Friction Loss System Head T Ft 4,.. \ Forcemain ~ Length ©ia,ist. to well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depp DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Type O~U ern t CHAMBER OR `V' 4 UNIT Model mbar: D IBUTION SYSTEM ead aAamifold, Distribution cin Ven to Air Intake Pipe(s) f:g n th Dia r Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over n Depth Over xx Depth of xx Mulched Bed/Trench Center' Bed/Trench Edges y Topsoil G Y - I 7 Yes No C Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 933192ND AVEIN~ I1 n~~- ,rs~►1~d @ i'(tSpe c'fl'(?(~-s 1.) Alt BM Description Emil l~6v~ 2.) Bldg sewer length = ~ 1 Gl~ - amount of cover =?j ~1B `I IDS C Plan revision Required? ❑ Yes 'Z No Use other side for additional information. Li I Z , -I L SBD-6710 (R.3/97) Date In epctor's Signature Ce . No. 0) 0 county ~ L 2r Safety and Buildings Division 8 ti b 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be fiIIed in by Co.) Madison, WI 53707 7I VELOPMENiTT ' 59z/(~ LOP AEK15GRR7F3CA TrssactionN.ber Sanitary Permit Applicati~. In accordance with SPS 38321(2), Wis. Adm Code, submission of this form to the appropriate govemmentaI unit is required prior to obtaining a sanitary permit Note: Application forms for state-owned POWTS are submitted to P 'cot Address (if different than mailing antes 1/► the Department of Safety and Professional Servies. Person) information you provide may be used for secondary /1, ,y, oses in accordance with the Prier Law, s. 15. 1 m , Stats. ~j 17 Z `IC) L L Application Information - Please Print All Information Properry Owner's Name J t T ° r Z ~ azcel # Property Owner's Mailing Address r` , G U S r n} t. r Property Locavon (1 q~ j I. f' I I i C I ,7 Govt Lot City, state ) Zip Code I Phone Number e~ 't R J tj ~a L Se tou f lc o~ IL Type of Building (check a I t at apply) Lot 4 T -J L N; R E ~r W ) 2 Family Dwelling - Number of Bedrooms Subdivision Name 10 ❑ Public/Commercial -Describe Use ok BJoel # D City of ❑ State Owned - Describe Use CSM Number (pb ❑ ± aage of mown of r - Z- &%5k- CtLU w 116 44 U Vd l Z7 ter Z 4.s III. Type of Permit: (Check only on ox on line A. Complete line B if applicable Pew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Oilrer Modification 14 F.>dsting System (explain) B- D Permit Renewal D Permit Revision D Change of Plumber D Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner I 4_V_ IV. T ofPOWTS System/Co m onent/Device: Check all that a 1 L~l Non-Pressumied In-Ground D Pressurized In-Ground ❑ At-Grade D Mound > 24 in- of suitable soil D Mound < 24 in. of suitable so' ❑ Holding Tank D other Dispersal Component (explain) D Pretreatment Device (explain) V. Dis rsal/freatmentArea Information: S ign Flow (gpd) Design Soil Application Rate(gp f) Dispersal Area Required (s Dispersal Area Pro sed (sr) System ovation ~~?J / s . J VL Tank Info Capacity in Total # of Manufacturer ' Gallons Gallons Units s n u o New Tanks F+imng Tanks .m U ~ o U y S. U 2 m A m P w L Septic a Holding Tank Dosing Chamber I VII. Respousibility Statement- I, the undersigned, in esponsibility for installation of the PORTS shown on the attached plans Plum 's Name (Print) Plum s ignature MP/MPRS N ber Business Phone Nlmrb e A~f Plumber's Address (Street, City: , Zip oull a artment Use Only proved sapprove Permit Fee~j -Date Is ed / Issuing. Signature eason for Denial i Is 41 00I p Z I DL Conditi ns 4Y~~iftFqffPProval disper:s,i cell must all be ser,ices ! m. nta±ec' 3) C,~~d(~Q~ a,(?~a A~~,✓V is per.Maragement plan proAdedby plumber. I_ / 2. ` 4~1 alri~j~lc rccluirerwnts must be maintained as per codw / ordinawe3. Attach to complete plans for the systrm and submit to the County only" paper not Mss than 8 L7 z 11 inches in size SBD-6398 (R. 11/11) System PLOT PLAN PROJECTh ADDRESS 1254 Norwav Pine Circle New Richmond Wi 54017 SE 1/4 SW 1/4s 29 /T 31 N/R 18 W TOWN Star Prairie COUNTY ST. CROIX SYSTEM ELEVATION 99.5/98.0 4.5' below grade 10/3/16 3 DATE BEDROOM CONVENTIONAL XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32 BENCHMARK V.R.P. top of 3/4" pipe ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE 0 WELL *H.R.P. same as benchmark 192nd Ave Scale = 1/4" = 10' ST A IL 10' 10' 25' 270' Pro 3 20, 0' B.M.* Bedroom House 60' i~ 20 ti 50' B-3 15% Slope 10' Vents B-2 All piping shall be ASTM SDR 30/34, within 104' 102'100' 10' of tank, piping shall be ASTM F891 Vent >6" Quick4 Standard of Cover Leaching Chamber with 20.0 ft2 of Area c j 0 5.6ft^2/pair of end caps 4' Long 12 34" Grade at System Elevation Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 10/3/16 Owner:KBvia-D.ischt Location: SE1/4 SW1/4 S29 T31 N,R18W lot 1 192nd Ave Star Prairie Manuals Used: In-ground absorbtion system (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross Section 4-6. Maintanance Contingency Plan 7.Filter Cross SO ion Signature f License n b r#226900 System PLOT PLAN PROJECT Z~h y ADDRESS 1254 Norwav Pine Circle New Richmond Wi 54017 SE 1/4 SW 1/4S 29 /T 31 N/R 18 W TOWN Star Prairie COUNTY ST. CROIX SYSTEM ELEVATION 99.5/98.0 4.5' below grade 10/3/16 3 DATE BEDROOM CONVENTIONAL )00( CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32 BENCHMARK V.R.P. top of 3/4" pipe ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark 192nd Ave Scale = 1/4" = 10' ST 10' 10' 25' 270' Pro 3 B-1 20, 0' B.M.* Bedroom 60' House 20 50' B-3 15% Slope 10' Vents B-2 All piping shall be ASTM SDR 30/34, within 104' 102'100' 10' of tank, piping shall be ASTM F891 Vent >6" Quick4 Standard of Cover Leaching Chamber with 20.0 ft2 of Area 12 5.6ft^2/pair of end caps 4' Long 34" Grade at System Elevation Cross Section of Infiltrator Quick 4 Leaching Chamber Typical cross section for 2 of 2 cells Quick 4 Standard Leaching Chamber with 20.0 ft2 of Area per Chamber 5.6ft^2 pair of end plates To be >1' above grade Finish grade elevation Typical Installation ~ 104.0' ent ,jV Grade Vent 4" 3' ~~30/34 Septic Tank 11 11 5' 5' Long 1 36 Grade at System Elevation Grade at System Elevation Spacing- 5' 2-3' X 66' Cells Same on other end Observation tube/Vent At end of cell A 16 chambers per cell B System elevations: A-99.5' B-98.0' i r tn: I' 1 P 11I{ ~ It J I~ 1 i ~ I I ~ J: I j ~ ! I o P - . cc P O P O , O ' i .Y !I h ~ i fEf ~o i C tm co a; c: I, POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of ILE INFORMATION SYSTEM SPECIFICATIONS Owner Permit # t Septic Tank Capacity al ❑ NA Septic Tank Manufacturer C/ ❑ NA ESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA i Number of Public Facility UnitsA Pump Tank Capacity Estimated flow (average) , al ! al/da Pump Tank Manufacturer NA I Design flow (peak), (Estimated x 1.5) ~0 aUda Pump Manufacturer NA Soil Application Rate , aUda ~z Pump Model i Standard Influent/Effluent Quali NA tY Monthly average Pretreatment Unit ~ Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BODs) 6220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 m 9/L ❑ Disinfection ❑ Other. Pretreated Effluent Quality Monthly average Dispersal Cell(s) Biochemical Oxygen Demand (BODs) 530 mg/L in-Ground (gravity) E3 In-Ground (pressurized) Total Suspended Solids (TSS) c30 mg/L 7 ❑ At-Grade ❑ Mound Fecal Colifbrm (geometric mean) 5104 cfu/100m1 7 ❑ Drip-Line ❑ Other: iMaximum Effluent Particle Size X in dia, ❑ NA Other. (Other. ❑ NA NA Other: 11 NA *Values typical for domestic wastewater and septic tank effluent Other. ❑ NA NIAINTENANCE SCHEDULE Service Event Service Frequency linspect condition of tank(s) At least once every: 13 earts(s) (Maximum 3 years) 13 NA Pump out contents of tank(s) When combined sludge and scum equals one-third (X) of tank volume ❑ NA Inspect dispersal cell(s) At least once every: ❑ month(s) (Maximum 3 year(s) Years) El NA Clean effluent filter At least once every: earth(s) El NA i Inspect pump, pump controls & alarm At least once every: 0 month(s) )s❑ NA 1 lush laterals and pressure test At least once every: O year( js) qN r. At least once every: 13 month(s) ether: ❑ year(s) MAINTENANCE INSTRUCTIONS (Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master (Plumber: Master Plumber Restricted Sewer: POWTS inspector, POWTS Maintainer, Septage Servicing Operator. Tank inspections must Include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of icerrmbined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local lmgulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Y) or more of the tank volume, the entire contents of j:he tank shag be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent fitters, mechanical or pressurized components, pretreatment units, land any servicing at intervals of s12 months, shall be performed by a certified POWTS Maintainer. 1k service report shall be provided to the local regulatory authority within 10 days of completion of any service event. Page of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals ti*t may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of thO tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are from at the infittrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will ble discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to thle effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWT$: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water, fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting produc#s; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS faits and/or is permanently taken out of service the following steps shall be taken to insure that the system is propetly and safety abandoned in compliance with chapter Comm 133.33, Wisconsin Administrsfw Code:. • All piping to tanks and pits shall be disconnected and the abandoned pipe openings seated. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS falls and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ~A~suftable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption systeim. e replacement area should be protected from disturbance and compaction and should not be infringed upon by requhled setbacks from existing and proposed structure, lot lines and welts. Failure to protect the replacement area will result in the nW for a new soil and site evaluation to establish a suitable replacement area. Replaeemorit systems must comply with the rule;t in effect at that time. 0 A suitable replacwwd area is not available due to setback and/or soil limitations. Barring advances in POWTS technologN a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a sail and site evaluation must be performed to locate a suitable replacement area. if no replacement area is available a holding tank may be installed) as a last resort to replace the failed POWTS. ❑ Mound and at-grade soil absorption systems may be reconstructed in piece following removal of the biomat at the infittrafive surface. Reconstructions of such systems must comply with the rules in effect at that time. «INARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES ANWOR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TAN UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE O~ A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Name S rte, Phone i Phone ~ SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORITY Name Name ~c r s Phone Phone J > E This document was drafted in compliance with chapter SPS 383.22(2)(b)(1)(d)&(l) and 383,54(1), (2) & (3), Wisconsin Administrative Code. ST. CROIX COUNI'y SEPTIC TANK MAINTENANCE .AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer - - l > r Mailing Address 0 FU c Property Address -A C% cathou required from Planning & Zoning Department for new construction.) City/State Parcel Identification Number LEGAL DESCRIPTION Property Location 5E Y4 ,1 %a , Sec. , T 5 N R~ ~W, Town of t 1 )0Cax~ d • Subdivision _ Lot Certified Survey Map # ' Vc glum , Page # Warranty Deed # , Volume , Page # Spec house yes no Lot line., identifiable yes no SYSTEM N AIIVTENANNCE 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 was to disposal system. Owner maintenance responsibilities are specified in §Comm 83.52(1) and in Chapter 12 - St Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signet} 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. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this 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 deed recorded in Register of Deeds Office. Number of bedrooms 9 A/V I - / OF APPLICANT(S) ~ DATE ' ^ ,f 1 rr ?A .Q✓ / ***Any information that is misrepresanted may result is the sanitary permit being revoted by the'Planning & Zoning Department, Include with this application a recorded warranty deed from the Register of Deeds GfEce and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) S'r. CROIX COUNTY SEPTIC 'T'ANK "NTENANCE, AGREEMENT - AND OWNERSHIP CERTIFICA I'.ION FORM T Mailing Address 7T- ProPert y Address 4 G3 ` 3 i ` n - (Verification re regWred from planni~ng& City/State zoning Department for new construction.) - Parcel Identifyeatian Number LEGAL DESCRIPTION lot i'` Property Location; Subdivision -__w, Town oi' Cer"led Surve _ _ ' YMap # , Warranty Deed # Volume Page # Volume Spec house yes page # no SYSTEAf Afl.ot lines identifiabl yes - AINTENANCE AN no D pWNER GERT C. TIOIV Improper use and maintenance of r~nteenance consists ofpump~ g out Yo'~ septic the s System could result in its premature failure to ystem can affect the function o 'Ie septic tattle every three years or handle wastes. t'eSPonsibilities are s the septic tank as a treatment sooner, if needed, b a Proper specified in §Cartmt. 83-52(f) stage in the waste dis y Hcensnd Punper_ Whgt o and in Chapter 12 - St sosal system. Owner Y u put into The property owner agrees owner and b to submit to St Croix Coon . t:roix tY Ordinance maintenance . tivastewater by ester plumber, County Pi ctis disposal system is in1 Heyman Number, restricted planning Long DePartineut a certification less than I /3 full of sludge, proper opera ' Plumb,, or a licensed form, signed by dTr ting condition end/or (2) after inspection an e pumping that l ( )the on-site l Uwe, the (it. necessary), the septic tank is standards set fb undersigned have read Herein, as set he ab°ve requirements and agree to Certifcation statirt by the bepartment of Co am, the private sewage intain g that your septic system has been nurterce and the De disposalsystem Lotting DePaihrient within 30 maintained pa''T1em of Natural Resource State with the days of the must be completed and re x of Wisconsin. three year expiration date. turned to the St. Croix certify that all statements oft this form are true to the hest of mY/uut deed property described above, by virtue of a w knowledge. 1/we atrr/are the recorded in ReKister of Deeds O~dg owner(s) of the Nultnber of bedrooms AT OF APPLICANT(S) ***Any information that is Tr"SrePresented may result iii the sanitary permit be DATF. in Include with this application a recorded g revoked by the Planning & zoning De referent warren g Pamnent. e is made in the warranty deed. deed from the K.egister of Deeds office and a copy of the certified survey imp if (REV. 08/QS) W ~ F JJ ~ ~ I QW 30 ~ cif ow sc UZ a mQ' I I I I I I I I I ' I I I a~; I I I I IW I a I z I s - 0 0 sa r--- -N - - ae a - . I ua~vrvn ~ II I e3 n~vx a3mw 1 I i VI iFS j ~m ¢~I - III $ 51 - - - - - - - - - - - - - - - - - - - - - old Ol 111 Qa I wnis~aaztmn I 7`` /✓r% III 8 8 ~b a a <<° i e I':I I I1 1 I - - - - - - - - - - - - - - I ❑ li 1 y i It ii I I 11^~ i i 1 I I I p El cW{ ~ 0011 I~ ~ I I ~Y' 1 ~ ~P\3~ e I I II A e I II 11 ?B ~~RII , 1 I I SP ~ J I 3 1 I 3 I M1 b 11 1 I T T T-] I T -T 1 ¢et - _ I L J L I I I I=, 1; r---- - I `}i~qF ooz.~samwuawa~ i ~ I I II ~ ~ j 1' 8 G I i I~ j 1 Qc~ ' ~ F I I I e 4--- 8 8 ob J 3 7 ~`r SSJAGSJNT5KXY wscorlsinDepaft~entofC SOIL EVALUATION'REPORT Division of Safe ty ~r~ Page of ~ ~~PMEi~C~ in accordance with Comm 85, Wis. Adm. Code ~yt`U~ County Attache site plan on paper not less than 8 112 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. A PeA~li t" Please print all information. RZ by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). &141~s ~C/ Z 7 Property Owner r Property Location j IN,/ 1 Govt. Lot c'- ~ 114S 1/4 S 7 T i N R 3 E (or Property Owner's Mailing Address Lot # Block # Subd. Na "C Z7 City fate Zi a Phone Number ❑ City ❑ village o Nearest Roa New Construction Use: 5K Residential / Number of bedrooms Code derived design flow rate l 5-7 GPD ❑ Replacement ❑ Public or mmeraal -Describe: Parent material it ~~C~!r✓ Flood Plain elevation if applicable ft. General comments; 4~ ; ~h, l amt and recommendations: ` System Type f 0 -Z t2 p CM{ / System Elevation f S FT Boring Boring # ® pit Ground surface elev. ~ ft. Depth to limiting factor L~ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 ILI J t~ V t .4, n I L) t~ r 2 Boring # ❑ Boring J R Pit Ground surface elevl X ()lft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/f? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 2- P;Al j Z-) d I y Effluent #1 = BOD. > 30 < 220 mg/L and TSS >30 < 150 ` Effluent #2 = BOD. < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) e CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1432 120th St, New Richmond, WI 54017 `7 - 715-246-4516 Property Owner _ Parcel ID # Page of ❑ Boring Boring # L~ I Pit Ground surface elev. ft. Depth to limiting factorz_ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPDtff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. - ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ❑ Boring Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil lication Rate Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPDtff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BODS > 30 < 220 mg1L and TSS >30 < 150 mgA_ ' Effluent #2 = BOD5 < 30 mgA- and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an altemate format, please contact the department at 608-266-3151 or TTY 608-264-8777. sBD-9330 (8.6/00) Property Owner _ Parcel ID # Page of Boring # ❑ Boring J K Pit Ground surface elev. ft. Depth to limiting fador/ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Z. ❑ 12- Boring # Boring F-1 ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2 F-1 Boring # 1:1 Boring El Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD5 > 30 < 220 mg/L and TSS >30 < 150 mgA- ' Effluent #2 = BODS < 30 mg& and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SOD4330 (RAM) w H Soil Test Plot Pla Project Name Kevin Disch S Bird Address 1254 Norway Pine Circle New Richmond Wi 54017 TM #226900 Lot 1 Subdivision Da a 7131116 SE 1/4 S W 1/4S 29 T 31 N/R18 W Township Star Prairie Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of 3/4" pipe System Elevation 995/98.0 *HRpSame as Benchmark 192nd Ave Scale is F = 40' unless otherwise noted B-1 25' 270' Pro 3 20 B.M.* Bedroom 40' 60' House 20 50' B-3 15% Slope 10' B-2 104' 102'100'