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HomeMy WebLinkAbout040-1326-06-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 592257 GENERAL INFORMATION State Plan ID No: NO Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)] O Permit Holder's Name: City Village Township Parcel Tax No Brandon & Savanna Raciborski TOWN OF TROY 040-1326-06-000 CST BM Elev: Insp. BM Elev. BM Description: , w Section/Town/Range/Map No: r rlXG~ 17.28.19.2198 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER C( PACITY STATION BS HI FS ELEV. Septic enchmark 1 VV 634?, Dosing Alt. BM Oil Aer~t4ierl- IF Bldg. Sewer 3 83.3 -Ir Of, F~eidtTR,~ SUHt Inlet 5:07 v,&7 TANK SETBACK INFORMATION St/Ht outlet - 5 3Z Sy Y/ TANK TO P/L WELL BLDG. n e t Inlet Septic 37 /2-1 . /pr Dt Bottom Dosing Header/Man. $970 X1.0 811 31 Aeratio Dist. Pipe S'•77 83-77 Holding Bot. System / 7 ~.y3 S 3.33 PUMP/SIPHON INFORMATION Final Grade 'SS Z Manufacturer Demand St Cover / e dp p !F- v L7 . S Mo Number T H Lift Friction Loss em Head Ft F emain Dia. Dist. to Well SOIL ABSORPTION SYSTEM ,5- + 75`-t7,S__ BED/TRENCH Width --ngtth- - , No. Of Trenches n 7 PIT l DIMENSIONS No. Of Pits Inside Dia. ____lLiquid Depth 5-1 DIMENSIONS /f , l SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: 1t./L _ INFORMATION T e Of S stem: CHAMBER OR /nT7 6( ' /I ~ & / UNIT Model Nu er: DISTRIBUTION SYSTEM Wesy- Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing ids SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth gmer Depth Over xx Depth of xx Seeded/Sodded xx Mulched Be Center Bed/Trench Edges / if Topsoil e Yes ❑ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: / I of ~ C n s Lads do . t Location: 401 MEADOW VALLEY BAY -Z ~r 1&0 1.) Alt BM Description= 7*- Pvo iio,+ 1mfA 0 2.) Bldg sewer length = "j - amount of cover = kill N? q 2,, 01 Cover o n.4 , Plan revision Required? ❑ Yes S60 j / 7 Use other side for additional informat n. SBD-6710 (R.3/97) Date Insepctol gnature Cert. No. 51fir~, _ 0 0 0 S/ rf County 6 Safety and Buildings Division 0 ~k r 201 W. Washington Ave., P.O. BOX 7162 Sanitary Permit Number (to be filled in by Co.) ` : S 1 APR 0 Madison, WI 53707-7162 ST. CROIX COUNTY 7 1 6`/ ZZ5 7 11 A x Sanitary Permit " --I* State Transactiomber In accordance with SPS 383.21(2), Wis. Adm. Code, submiss lt is required prior to obtaining a sanitary permit. Note: Applica ) Project Address (if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. 15.04(Ixm) tats. 01 Meadow Valley Bay L Application Information - Please Print All Inf ma ' n Property Owner's Name / Parcel # Brandon & Savanna Raciborski 040-1326-06-000 Property Owner's Mailing Address Property Location S , f - 401 Meadow Valley Bay Govt. Lot #6 City, State Zip Code Phone Number NW_ NW_ Section -17 Hudson 54016 28 19 (circle one) T N; R x14r W II. Type of Building (check all that apply) Lot 1 or 2 Family Dwelling - Number of Bedrooms 5 # 6 Subdivision Name Lik Meadow Valley of Troy ❑ Public/Commercial - Describe Use ~a~-- ❑ City of t ❑ State Owned - Describe Use ACSM Number ❑ Village of b~ a~ i~ Town of Troy III. Type of Permit: (Check only fine box on line A. Complete line B if applicable) 0^A- ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) ew System List Previous Permit Number and Date Issued B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New Before Expiration Owner IV. Type of POWTS System/Component/Device: Check all that apply) Ion-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank er Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis ersaLlTreat ent Area Information: I fl Design Flow (gpd) Design Soil Applicatiof e(gpdsf) Dispersal Area Required (s Dispersal Area Propos (sf) System Elevation -6~9- ) .7 Q • 0 B~,9q VI. Tank Info Capacity in Total # of anufacturer Gallons Gallons Units a L o ° New Tanks Existing Tanks cU~ y m a. U inn ~ rn w C7 Gi. Septic or Holding Tank ( Wieser w/ Polylock 25 x Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number Tim DeYoung L 2 664713 715-246-2660 Plumber's Address (Street, City, State, Zip Code) i VII bunt epartment Use Only Approved rsappro Permits Fee Date ssu Issuing nt Signature ven Reason for enial $ T ,5 , 7 IX. Condi, easops for Disapproval is a is 1' t+! . 3) ~l cc o., 2I 4*04ftw 1:4, M. tat A 62b*"" Dart pr&nftd dv lam. Na a C. S (oe.~ ' ^ COL; 10 PW OPPIWM9 c4d* / cftt;urnpi. Attach to complete plans for the system and submit to the County only on paper not less than 8 1/2 x 11 inches in size SBD-6398 (R. 11/11) CULDESAC \ I I I I I LOT 6 I I 1 I I I ~O I ~ I O~ I PROPSED I C WELL j 50 ft I I\\ % Pro'oose S beoro \ m ho \ Ue \ dr ~OI \ 1 l,J Wieser 1000/ 0 combo tank 1F/ \ OBSERVATION d• olylock 525 filter Distribution box AREA 1 B1 f, ~ O 50 ft S ° \ AREA 2 3 trenches 75x3 \ System elevation 85.99 / 3 8189.59 B2 91.39 B3 89.04 BENCH MARK 1 EL 100.00 TOP o~°:' e. OF STEEL PIPE \ BENCH MARK 2 EL 93.3 TOP OF \ 2" PVC PIPE v SLOPE 8% SCALE 1" = 40 FT. MEADOW VALLEY OF TROY LOT 6 NW1/4NW1/4S17T28R19W \ TROYTOWNSHIP CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Raciborski's new Home Owner's Name: Brandon & Savanna Raciborski Owner's Address: 401 Meadow Valley Bay Hudson WI 54016 Legal Description: NW1/4,NWI/4, S17, T28N, R19W Township: Troy County: St Croix Subdivision Name: Meadow Valley of Troy Lot Number: 96 Parcel ID Number: 040-1326-06-000 Page 1 Index and title Page 2 Plot Plan Page 3 System Sizing & Cross-Section Page 4 Filter Specs Page 5 Maintenance Information Page 6 Management Plan Page 7 St. Croix Cty Septic Tank Maintenance Form Page 8 Warranty Deed Page 9 CSM or Plat Attachments: Soil Test & House Plans Designer/Plumber: Tim DeYoung License Number: 664713 Date: 03/31/2017 Phone Number (715) 246-2660 Signature Designed pursuant to the In-Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P (N.01101). Page 1 CULDESAC \ I I I 1 I LOT 6 I I I I I I I O I PROPSED I O I WELL 50 ft j I I Proposed S bedrooms ~ house WL Wieser 1000/ NO combo tank '0~ OBSERVATION PIPES `Ods~ d~~ olylock 525 filter col cO ~ j. Distribution box AREA 1 / . B1 0 0 50 ft \ . ~ 3 trenches 75x3 ~d► AREA 2 SLOPE / System elevation 85.99 B3 / 8189.59 B2 91.39 / B3 89.04 V. SLO o / BENCH MARK 1 EL 100.00 TOP OF STEEL PIPE BENCH MARK 2 EL 93.3 TOP OF 2" PVC PIPE SLOPE 8% SCALE 1" = 40 FT. MEADOW VALLEY OF TROY LOT 6 NW1/4NW1/4S17T28R19W TROYTOWNSHIP II I AL SOIL ABSORPTION SYSTEM DETAIL/ GRAVELLESS LEACHING UNIT Page of Project Name: ~etj•i'c ,Q~ r , 6t No. of Cells Per Cell ft Cell Width Total No of 3 t~ / iz 7 S fl Cell Length S sq fl EISA Per Cell _ ft Cell Spacing sq ft Total EISA 12S''~' ~ >fial Manufacturer Model Laying Length EISA Rating Infiltrator EZ1203H-5ft 5.0' 25.0 LEZ12031-1-10ft 10.0' 50.0 Gravelless Leaching Unit Manufacturer: Gravelless Leaching Unit Model: 2_p 203-j~ .-fD,~, Z JZa3 .•',!a , Finished Grade 8/. c~q Typical Cross Section Observation Pipe with approved cap or vent Soil Backfill 36 Geotextile Fabric S• 9ft Infiltrative Surface 12 in Q ( ~y3 8 0 ft Limiting Factor `g arm in Slotted and Anchored Vent/ Observation Pipe with Cap ■rr■rerc■■■■■ere■■■■re■■■ea ■rr■rr■■■e■ uerrrr■■■■■r■■e■■r■■■rr■r■rre■■e■r Plumber/Designer Signature: License li''I/~2 Date: I 4 0 g Q MA aI Q m AA pq o \ OO a a M U O U c vi O ?W M co M O U N U W M c0 Ln M JO co ~ C O N J LO U O r- r c0 N L,j Y w \ W U 0 U F J cn J / W Z W m N i ~N i _ QcV=n00G LL- LLJ cc) CL v Y w Up a U = cn Oa 0to p ZJOf ww ZCfl 2QCy dN =oti 00 E W p co j Q-, wo N W cn m Z M M m 0 Q~ Q~0 0 wV p' Z~ ZOr.Z ~cn uj OWE p~ a- 0Q 0Q 0 U) U O va Win.. 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J ONw OZa U !n w U W pW (n O z(DOxOOO 0U(n p(U~ Q ° Z a X0 a- M F- V) W 0 nU O000< LLi°WC3W Q~C~ <3: U O Q V) O Na z z 3 m U 2 J ~i m J ?i H p z U O LL Q W W W p < Y Y N Z Z < U~ U J Q W I Q I H a ~ U w ° a rr z „tiS a > O w d a w Of ~0 wa 04 / - \ I N ; w rm = w 5; V) I N I ~ I I ~ ~s I o p Q O W I V) X c~i~ a Q 19 w a w in o I' g a l I I I W / J-) :2 O 0 W i ~ N a W J U Z_ L5 D z ab3b < „£6 sv J69 wa Q U) Y Z Q H POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page I of '2- FILE INFORMATION SYSTEM SPECIFICATIONS 12 Owner o`, Septic Tank Capacity 1 0D gal ❑ NA Permit # Septic Tank Manufacturer W J" ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer P u. ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model S ZS ❑ NA Number of Public Facility Units ❑ NA Pump Tank Capacity gal XNA Estimated flow (average) , gal/day Pump Tank Manufacturer •MNA Design flow (peak), (Estimated x 1.5) gal/day Pump Manufacturer B(NA Sail Application Rate / gal/day/ft2 Pump Model S:NA Standard Influent/Effluent Quality Monthly average*lv Pretreatment Unit $NA Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD5) 5220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg/L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BODS) 530 mg/L jQ In-Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L ❑ NA ❑ At-Grade ❑ Mound Fecal Coliform (geometric mean) <10' cfu/100ml ❑ Drip-Line ❑ Other: Maximum Effluent Particle Size Ye in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA *Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: 3 ❑ month(s) (Maximum 3 years) ❑ NA K year(s) Pump out contents of tank(s) When combined sludge and scum equals one-third ()3) of tank volume ❑ NA Inspect dispersal cell(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA id year(s) Clean effluent filter At least once every: ❑ month(s) L'3 ❑ NA year(s) _ Inspect pump, pump controls & alarm At least once every: ❑ month(s) NA ❑ year(s) Flush laterals and pressure test At least once every: 'D month(s) $ NA ❑ year(s) Other: ❑ month(s) At least once every: NA ❑ year(s) Other: NA 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; POVVTS 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 combined sludge and scum and to check for any back up or ponding of effluent an 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 regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Y3) or more of the tank volume, the entire contents of the tank shall 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 filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. Page Z 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 that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be 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 the 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 POWTS: 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 products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with, chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or:must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. T ' RTUTS. 11 110 1UPTaCu"Jun a o ding jank afuati be ' e ai e FRD44181TZ~, 9::bR- A/>;1"J G~f`!STWVcl- l0fli ❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Name Phone 2~~~ Phone '71 1 - 2 y~ - 2 &Z> SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name ~c~ Jr E Name S-`- ~IW ( Lou 2(jll~j/J Phone Phone This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer q e /'U 0/_ r1l Mailing Addres f'd / ~'3c w Ac Lr' /Y -If- ,i ~ __--1',y q-4\6 Property Address°~~ ~l ~u~fa4 SYU/6 (Verification required from Planning & Zoning Department for new construction.) City/State 44", A/-I- Parcel Identification Number Gov - /3~G - p~- o LEGAL DESCRIPTION Property Location*V % , %4 , Sec. T N R IV W, Town of Subdivision Plat: Lek. ~y dy Lot # Certified Survey Map # Volume , Page # Warranty Deed # (before 2007)Volume , Page # Spec house oyesxno Lot lines identifiablatlyesOno SYSTEM DI&LLTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment. stage in the waste disposal system. Owner maintenance responsibilities are specified in §SPS. 383.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Safety And Professional Services and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on th7wdevd 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 recorded in Register of Deeds Office. Number of bedroom Pi A SIGNATURE O 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) UE'V Departm6nPbf° L EVALUATION REPORT #1745 3 P Safety and i accordance with Gomm 85, Wis. Adm. Code Page 1 of 3 Professional SeA 112 0 ? Schmitt Soil Testing, Inc. Attach complete site plan o pe;r rrta w61 i# '11 inches in size. Plan must County St. Croix include, but not limited to? 6AWAdThlo@.bwiWLr ~t~~oint (BM), direction and percent slope, scale or dimensions, north arrow, nd location and distance to nearest road. Parcel I.D. D A~ P600 lease print all information. J r eview - D t Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location DCCI Land Planners__ Govt. Lot NW1/4, NW1/4, S17, T28N, R19W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1505 Hwy 65 P.O. Box 445 6 Meadow Valley Of Troy City State Zip Code Phone Number City Village ! Town Nearest Road ~l New Richmond WI 54017 Troy East Cove Rd << New Construction Use Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement Public or commercial - Describe: Parent material Outwash Sand - Flood plain elevation, if applicable NA ft. General comments Area is suitable for a conventional system with a 0.7 gpd/sgft rate. Possible system elevation for Area 1 is 853. Slope is 8%. and recommendations: EXTW _ (1G .NCB &4 49,Ze 77411 Ld-r Gee Nrl,l2 rn s i rc. ~ s F-11 ! Boring Boring # <j Pit Ground surface elev. 89.59 ft. Depth to limiting factor 110+ in. ISoil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consisten Boundary Roots __GPD/ft2 _ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ~Eff#1 'Eff#z 1 0-13 10yr3/2 none I 2mgr mvfr as 1vf 0.6 0.8 2 13-23 7.5yr4/4 none sil 2msbk mfr gw ivf 0.6 0.8 3 23-30 7.5yr4/6 none grsl 2fsbk mvfr gw 1vf 0.6 1.0 4 30-48 10yr5/4 none grcos Osg ml cs 0.7 1.6 5 48-110 10yr6/4 none s Osg ml 0.7 1.6 1 Boring l ❑ Boring # j Pit Ground surface elev. 91.39 --ft . Depth to limiting factor 112+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consisten Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 1 0-10 10yr3/2 none I 2msbk mvfr as 2vf 0.6 0.8 2 10-21 10yr4/4 none scl 2fsbk mfr gw 1vf 0.4 0.6 3 21-40 10yr4/6 none grsl 2msbk mvfr gw ivf 0.6 1.0 4 40-69 10yr5/6 none Is lcsbk mvfr cs 0.7 1.6 5 69-112 10yr6/4 none s Osg ml 0.7 1.6 166 Effluent #1 = BOD? 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature: CST Number Thomas J. Schmitt 227429 Address Schmitt Soil Testing, Inc. Date Evaluation Conducted Telephone Number 1595 72nd Street New Richmond, WI 54017 5/5/2014 715-760-1978 SBD-8330 (R 07/00) Property Owner DCCI Land Planners _ Parcel ID # Page 2 of 3 ]Boring F3 Boring # Pit Ground surface elev. 89.04 ft. Depth to limiting factor 110+ in. - Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 •Eff#2 1 0-14 10yr3/2 none I 2mgr mvfr as 1vf 0.6 0.8 2 14-24 10yr4/6 none sicl 2fsbk mfr gw lvf 0.4 0.6 3 24-32 7.5yr5/6 none grsl Osg ml gw 0.6 1 4 32-110 10yr6/4 none Is Osg ml 0.7 1.6 r) L-001 _ i Boring F-1 Boring # I Pit Ground surface e _ _ ft. Depth to limiting factor _ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 j in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#t *Eff#2 Boring F-1 Boring # j 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/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD5> 30 < 220 mg/L and TSS >30 <150 mg/L ' Effluent #2 = BOD5 < 30 mg/L and TSS <30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (R.07/00) Schmitt Soil Testing, Inc. ` Page 3 of 3 Conducted bv: Conducted i+o-- Schmitt Soil Testing. Inc. Name: DCCI Land Planners Thomas J. Schmitt, CST 227429 Address: 1505 Hwv 6 1595 72nd St. City, State, Zip: New Richmond, WI 54017 New Richmond, WI 54017 C(k/ ©~r Phone: 715--7660-1978 Subdivision: Meadow Valley Of Troy 5l~L Signature ~/~f b s Lot No.: 6 Date Legal Description: NWI/4 NWI/4 S17 T28N R19W Backhoe Pit Township, County: Troy Township, St. Croix County Bench Mark 1 El. 100.00' Top of 1" Steel Pipe. Control Pt 3 (889.78'). Bench Mark 2 El. 93jo'Top of 2' PVC pipe. 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