HomeMy WebLinkAbout032-2172-13-000
lepartment of Commerce PRIVATE SEWAGE SYSTEM County: c
_uilding Division St. Croix
INSPECTION REPORT Sanitary Permit No
GENERAL INFORMATION (ATTACH TO PERMIT) 592129
State Plan ID No:
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. ~ \"/~,f-1}-
Permit Holder's Name: City Village Township Parcel Tax No:
Brad & Charity Palmer TOWN OF SOMERSET 032-2172-13-000
CST BM Elev: Insp-.~BIy1 EleY~v- BM Description: Section/Town/Range/Map No:
l 00 V UxAfi C 10ox fSPc 18.30.19.1453
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS H FS EV._
t0 D 1v.0
Septic 2
Y Y 1 /6(~ / Benchmark -1. I
Alt. M AT ~r±~ PvL`v •05 V ,if 11.0-1 87.3(o
Aeration
Bldg. Sewer 2Z Q Q
Ht Inlet
N. 3 y, o
TANK SETBACK INFORMATION e pt Outlet / `7 r' O 83-77
TANK TO P/Lr WELL BLDG. Vent to Air Intake ROAD Dt Inlet
60
Septic 5d , f
V } Dt Bottom
Dosing Header/Man. Q 0
Aeratio' Dist. Pipe 7&-IL
Holding Bot. System
Final Grade
PUMP/SIPHON INFORMATION Zo• 21•~ 7 • Z,
facturer D and St Cover
GPMI q. 'n
Model Number
FF'&efqikn H Lift Friction Loss stem Head TDH Ft
an
rLengtt>v' Dia. Dist. to well
40-0 al I H6
cig
SOIL ABSORPTION SYSTEM t
BED/TRENCH Width / Length No. Of Trenches PIT DIM
DIMENSIONS No. Of Pits Inside Di a. Liquid Depth
DIMENSIONS
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: fU e
INFORMATION
pe Of System: CHAMBER OR
V(t b(~~ L /5' (to -7 / UNIT Model N ber
ON
(f f S
P~S
TRIBUTION SYSTEM , v CAST
eader/ nifold Distribution x Hole Size x Hole Spacing Vent o Air Intake
If /r Pipe(s)
Length Dia Length Dia Spacing
SOIL COVER j 1 x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over xx Depth of xx Seeded/Sodded
Bed/Trench nt r ed/Tren Edges , ` Topsoil xx Mulched
c~
Yes D No Yes No _I E] COMM TS: (Include code discrepencies, persons present, etc.) Inspection #1: 5/ I -7 Inspection #2:
Location: 345 153RD AVE 1r►rcPit, ML4 ~S 01)
VV ~~,;n S Lo~~.s l
1.) Alt BM Description = hi Lno- CovoL S Pei/, P' U n,1b
2.) Bldg sewer length = VANW: 13O Of CLIO 4V en it II I
_ - amount of cover = 1
wo%,112' wl tqo) itr on All
Plan revision Required? [j Yes ;X No L J--]4
Use other side for additional information.
- - L- A fl A7~
SBD-6710 (R.3/97) Date InsePct-r` nature Cert. No.
oEraarsr~tr.. County
I I `7-CErtl/\/'D Industry Services Division
r s 1400 E Washington Ave
P kP 2 6 2016 P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.)
Madison, WI 53707-7
COUNTY
iii XXF2
%(PVW -nit Application G80 "Transaction N ber
In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental uu,1 ~TR
is required prior to obtaining a sanitary permit. Note: Application forms for state-owmed POWTS are submitted to
the Department of Safety and Professional Services. Personal information you provide may be used for secondary Project Address (if different than mailing address)
urposes in accordance with the Privacy Law, s. 13.04(1)(m), Slats.
K<
1. Application Information -Please Print AI rmation
Property Owner's Name (~i 4~V I Parcel #
i
Property Owner's Mailing Address Property Location 133 0. 1 q , q5J
Govt. Lot
City, State Zip. Code Phone Number %4, '/4, Section l
(circle o
T,3'D N R Eor(3L
II. Type of Building (check all that apply) Lot # ,
J0 I or 2 Family Dwelling - Number of Bedrooms ubdivision Name
❑ Public/Commercial -Describe Use 6)r- Ab _G
Block # Gp > C~ -
❑ State Owned - Describe Use ❑ City of a ode AA n CSM Number❑,I Village ofl
~.J bk- C tokh t0i Iq (l -~A J ~I Z7 ~I sdi lm Town of
III. Ty,~-pe{ of Permit: (Check only on box on line A. Complete line B if applicable)
A. Jl New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) _ - Jr,4
B. ❑ Permit Renewal F-1 Permit Revision El Change of FR~~ rmit Transfer to New List Previous Permit Number and Date Issued
Before Expiration Plumber r `
d &
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 < 2 in. of suitable soil
Holdmg ank er ispersal Component (explain) ❑ Pretreatment Device (explain)
V. Dispersal/Treatment Area Information:
Design Flow (gpd) Design Soil Application Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation
Rate(gpdso
VI. Tank Info Capacity in
Gallons y c
Total # of ~ o 'D B
v U '
Manufacturer Gallons Units c ° a
New Tanks Existing Tanks
. P_ U cn m v)
[r U 0..
Septic or Holding Tank AE) ❑ ❑ ❑ ❑
Dosing Chamber ❑ ❑ ❑ ❑ ❑
VII. Reapo ibility Statement- I, the undersigned, assume resp nsibility installation of the POWTS shown on the attached plans.
Plumbe s ame (Pri /I Plumber's Sign MP/MPRS Number Business Phone Number
Plumber's Address (Street, City, State Zip Code)
VIII. unt /De artment Use Only
Approved Permit Fee Da Issue Issui gent Signatur
tven Reason enial $ 7413 5
IX. Condtt% wReasons for Disapproval art ,
1. tank, efAturif filter bnii 1 V
'disomsl cell must all be spr Ices 1 mr ntgj:!r+ec +
per management plan u cte number. 6
2. A11 11 setback regtairer:lents must be mai maintz u;ed J d Ik. r4i ~1,.~
as per apF.licabIR code / :rdiriancr,3.
Attach to complete plans for the system and submit to the ounty only o per not less than 8 1/2 x 11 inches in
SBD-6398 (1103/14) J .
QAINDW3E3YAVE
r
MME oRo 4, / f Jj - -
_
- - - - - - - - - - M lv - / aN
r
1
i I '
i _
CONVENTIONAL COMPONENT DESIGN
Residential application
INDEX AND TITLE PAGE
F ge 1 Index and Title Project
ge 2 Plot Plan Name:-_
ge 3 System Sizing & Cross-Section Owner's
Page 4 Filter Specs
Name:
Page 5 Maintenance Information
Owner's
Page 6 Management Plan Address:
Page 7 Septic Tank Maintenance Form
Page 8 CSM or Plat
Attachment: Soil Test
Legal Description: 2-734 11-;(2 94
Subdivision:
Lot #
Town:
County- X
Parcel ID# 7
Designer/Plumber: License # ,
-,2
Signature:
_ Date:
Comments
Designed pursuant to the In-Ground Soil Absorption Component Manual for POWTS Version 2.0
Index+TitleConv 2/3/2012
~.erJif/ `/~~~'E~' ~ TP u:T Io~k•C ~ fQ.~. Ll; ~ti',
f
i
r
_ r
e
I
it
~'~(ycp ` 9
J
Soil Absorption System Cross Section
9-3112' ft
_ L tt
4° Schedule 40 Final Grade
PVC Vent Pipe
With Vent Cap ft
Leaching -D,
Chamber -{f
System Elevation
3 r fr ft
Soil Absorption System Plan View
y ft
ft Leaching Trench 1
Chambers
111110111111111111111111 1111 111111111111111 ia.
4"D
Trench 2 Header
Vent Or Observation Pipe
u~ F_ ,ids
Trench ,73
Leaching Chha/m)b/er S/pecifications /
Manufacturer And Model. 27 :f
EISA Ratina sq ft per chamber Soil Application Rate gpd/sq ft
gpd Design Flow : 7_ Soil Application Rate ? EISA = Chambers
3 rows of chambers each.
Page _ of
gp~STALLMIOKII INS I u6 l W J
Law& LL-6FILTER
N_'_ys ~ mo=t y~ , y..., _ •Y~ i
_ is ~ .c E,~ '°r'` ~ .:•-r.:.+=•.-u' p> ~,:w rc
NAM-
06
A( t' c d J".. n 1EtOt73~ 2~-G_.. t <^4. - ,y
"
-
Step 1:
the auftt OFD tank- (A) 8siur pbr-a to,
(A) Lamfv ierhouft OD tDftOOSEP pe. pa~
p) Ronmwe Ct3Vet' a~td ~}uls (B) ~~c- gatrw t~q ts)
ff Fl y is i ned so thetl r mn be
pm*wy snood 'l
Garhtdg
i2fi[FfVEC from me t £[ICFClF
' in tile hous -
MMM
:';if'3IM
i
f { a~, . w r alt, ~
MEW
V'-
CMM
zn:
IN gM
r~ j':•.- - i ,fie f
'Tt
t ^i- ly `t !C!L 1~ -~s.. u•'"-"--.:.~•ti =J-^T"Et:i
Swp F_ 5 p €racIc
Laca€a fhe ouffet ci~e SeOr, IanlL (A) Remove -n!€ GUvO and PUMP tA~ ~ ming mIlIhIp
tB) Puff fhe ' olgof to housing
f ,~2 tR}S s'r~3t7:~.'~t te-.-test
.rm~:7t,y~r~fz
and
Z~K
(B) p
cover
s6(7
j=j
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page J of
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner Septic Tank Capacity gal ❑ NA
Permit # Septic Tank Manufacturer ❑ NA
DESIGN PARAMETERS Effluent Filter Manufacturer
o ❑ NA
24111 1
Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA
Number of Public Facility Units [Zf NA Pump Tank Capacity gal ANA
Estimated flow (average) gal/day Pump Tank Manufacturer 21-NA
Design flow (peak), (Estimated x 1.5) -G) gal/day Pump Manufacturer ,t NA
Soil Application Rate gal/day/ftz Pump Model NA
Standard Influent/Effluent Quality Monthly average* Pretreatment Unit NA
Fats, Oil & Grease (FOG) _<30 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter
Biochemical Oxygen Demand (BODO _<220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland
Total Suspended Solids (TSS) <_150 mg/L ❑ Disinfection ❑ Other:
Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA
Biochemical Oxygen Demand (BODO 530 mg/L Pd in-Ground (gravity) ❑ In-Ground (pressurized)
Total Suspended Solids (TSS) 530 mg/L Of NA ❑ At-Grade ❑ Mound
Fecal Coliform (geometric mean) <_10' cfu/100ml ❑ Drip-Line ❑ Other:
Maximum Effluent Particle Size %9 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: ❑ month(s) (Maximum 3 years) ❑ NA
[9 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
year(s)
Clean effluent filter At least once every: ❑ month(s) ❑ NA
(-year(s)
Inspect pump, pump controls & alarm At least once every: ❑ month(s) ;O NA
❑ year(s)
Flush laterals and pressure test At least once every: ❑ month(s) J<NA
❑ year(s)
Other: At least once every: ❑ month(s) ❑ 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; 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 combined 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 regulatory authority.
When the combined accumulation of sludge and scum in any tank equals one-third (%3) 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 <12 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.
GMW (4/01)
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
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.
❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site
evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank
may be installed as a last resort to replace the failed POWTS.
❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the
infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time.
< <WARNING> >
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 INSTALLE POWTS MAINTAINER
i Name
Name
Phone _ C' Phone
S
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name 1
Name
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.
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
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.
❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site
evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank
may be installed as a last resort to replace the failed POWTS.
❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the
infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time.
< <WARNING> >
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 INSTALLE I POWTS MAINTAINER
Name ) Name
Phone S _ Phone
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name Name
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. CROLX COUNTY
SEPTIC TANK -1\LA NTTENANCE AGREEMENT
AND
O'Wt\7ERSHIP CERTIFICATION FORM
Owner.Bu-Ter ?AU g1--
Mailing Address ~5 3~ fit' ~~J
Propern,* Address 5 55" Y6 02,5
(Verification required aom Planning & Zoning Department for new constructs .
City State ~orY1 G i (/,~i Parcel Identification Number 0f-5'7---Z-1-1Z,-
LEGAL DESCRIPTION
Property Location , t/4 ; Sec. __L_ 9? T N R~W, Town of ryt ~
Subdivision Plat: ST C-40 V A.IAT161JAL- '%-rHK4 J Lot #
Certified Survey leap n
Warranty Deed rr
Spec house L' yes Nno Lot lines identifiable yes 0 no
SYSTEM MAIllrI E-N a.NCE A_ND 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(l) and in Chapter 12 - St Croix County Sanitary Ordinance.
The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the
owner and by a master plumber; journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site
wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is
less than 113 full of sludge.
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 Safety And Professional Services and the Department of Natural Resources,
State of Ddisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix
County Planning & Zoning Department urithin 30 days of the three year expiration date.
Uwe cerdfn that all statements on thi form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the
property described above, by virtue of a w ty deed recorded in Register of Deeds Office.
Number of bedroo s
S GNATL`RE OF APPLICAN-T(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 Once and a copy of the certified survey map if
reference is made in the warranty deed.
(REV. W12)
SAINT CROIX NATIONAL SOUTHERNe aE6STATES z
Northwest r of the Q 18,
outhwest Located in the NortheasttWQ~Per 30 of ththSRange 19 West, Town ofeSomerset. Stt..uCroix County,SIsconsin m
~I
Q'
UNPLATTED LANDS J
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O 11~. .rd Eaw*e+l ? 2 f -N I a i
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202.082 sq.
Qom. A 2 9 152.386 ,q.0. 757'~L°
Ge 3.498 acres ;C? T R75•
Bj6,Seto 4.639 ones
130.677 sa.fL u
. 314 arcs
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a Hatched seas represent skpes of 2119111 130,113 sq.a. 130.722 sq.n.
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30'BCO soft
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Wis. Dept. of Safety and Professional cis 6 SOIL EVALUATION REPORT XXF2GBOSWIWTR of
Division of Safety and Buildings ] ~Ct' ~ L q
in accordance with SPS 385, Wis. Adm. Code ,
ST. CROIX COUNTY County
Attach complete site plan;DQ(M hq>I1~ ches in size. Plan must
include, but not limited to: vertical and horizontal reTeftint (BM), direction and Parcel I.D.
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
La -
-
127.
Please print all information. Review by Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04(l) (m)).
Property Owner Property Location
Govt. Lot j 114 114 S N R E (or6N i
Property Owner's Mailing Address Lot # Block # Subd. IName or CS
City \ State Zip Code Phone Number
❑ City ❑ Village Town Nearest Road
® New Construction Use:. Residential / Number of bedrooms Code derived design flow rate 41K GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material fr?,; {3,~ Flood Plain elevation if applicable ft.
General comments
and recommendations:. 77 j
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 nsistence Boundary Roots GPD/ft z
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. * ff#1 *#2
-
r~
Boring # Boring
® Pit Ground surface elev. 3, 5; , ft. Depth to limiting factor ~ in. Soil A lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. * ff#1 ff#2
-9
- -
AJ
I
* Efftue #1 = BOD > 30 < 220 mg/L and T >30 150 mg/L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/-
CST Nam (P se P' t) Signatur CST Number
Address Date Evaluation Conducted Telephone Number
71
SBD-8330 (RI 1/11)
r ~ J
Property Owner L, Parcel ID # Page y of
Boring # ❑ Boring
® pit Ground surface elev. J A. Depth to limiting factor ? in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ff#1 ff#2
sb
w 4'
Boring # l Boring
[a pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. * ff#1 ff#2
.f 11f)
_ JG / a
F1 Boring a Boring # ~ Pit Ground surface elev. ft. Depth to limiting factor
Horizon Depth Dominant Color Redox Description Texture Structure nsistence oundary Roots GPD/ft z
in. Munsell Qu. Sz. Cont. Collor Gr. Sz. Sh. ff#1 02
* Effluent #1 = BOD 5 > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD $ < 30 mg/L and TSS < 30 mg/L
The Dept. of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to
access services or need material in an alternate format, contact the department at 608-266-3151 or TTY through Relay.
SBD-8330 (RI 1/1 1)
Property Owner 4' Parcel ID# Page I-V of
51 Boring # rl Boring
® pit Ground surface elev. 7 ft. Depth to fimiting factor% in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure onsistence boundary Roots GPD/ft 2
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. ff#1 ff#2
/J
s _ 4
42
Boring # t~ Boring
I~ Pit Ground surface elev. ft. Depth to limiting factor ;~5,- in.
• Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. * ff#1 V#2
l as 6~
_ Ze
Boring
Boring # Ground surface elev. ;1 ft. Depth to limiting factor in.
Pit
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure onsistence Foundary Roots GPD/ft z
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ff41 * ff#2
T
tl
* Effluent #1 = BOD e > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD 5 < 30 mg/L and TSS < 30 mg/L
The Dept. of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to
access services or need material in an alternate format, contact the department at 608-266-3151 or TTY through Relay.
SBD-8330(RI1/II)
I
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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I of 3
Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Steel's Soil Service Inc.
Attach complete site plan on paper not less than 8'/ x 11 inches in size. Plan must County St. Croix
include, but not limited to: vertical and horizontal reference point (BM), direction and 1
percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parcel I.D. 03-( -)L/ Please print all information. Re ewed By
Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ` o "T
Property Owner Property Location /
Residential Development, Inc. Govt. Lot na NW 1/4 SE 1A S 18 T 30 N R 19 W
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
8929 Aztec Dr. 13 na St. Croix National Southern Estates
City State Zip Code Phone Number City Village ✓ Town Nearest oad
Eden Prairie MN 55347 952-934-6238 Somerset 3(f 5- Cty Q d
✓ New Construction Use: ✓ Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD
Replacement Public or commercial - Describe:
Parent material Knolls of pitted outwash Flood plain elevation, if applicable na
General comments
and recommendations: Conventional system, system elevation 102.86ft. Trenches spaced and depth to code 5.84ft below grade.
❑ Boring # Boring
✓ Pit Ground Surface elev. 102.30 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 0-16 10yr3/1 none I 2msbk mfr cs 1f .6 .8
2 16-24 10yr4/4 none sl 2msbk mfr cs na .6 1.0
3 24-31 5yr4/4 none scl 2msbk mfr gw na .4 .6
4 31-62 7.5yr4/4 none sl 2msbk mfr cs na .6 1.0
5 62-110 7.5yr4/6 none cos osg ml na na 7 1.6
❑ Boring # Boring
✓ Pit Ground Surface elev. 102.30 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 0-8 10yr3/1 none I 2msbk mfr cs 1f .6 .8
2 8-25 10yr4/4 none scl 2msbk mfr gw na .4 .6
3 25-40 7.5yr4/4 none sl/Is 2msbk mfr gw na .6 1.0
4 40-110 7.5yr4/6 none cos/ms osg ml cs na .7 1.6
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
David J. Steel 248956
Address Steel's Soil Service Inc. Date Evaluation Conducted Telephone Number
l'~~ 5/- <?-116 H, .5 7/14/2004 715
Property Owner Residential Development, Inc. Parcel ID # Pending Page 2 of 3
❑ Boring # Boring
Pit Ground Surface elev. 108.7 ft. Depth to limiting factor 110 in. F 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 0-8 10yr3/1 none sil 2msbk 4mfr
gna.7 2 8-60 Oyr4/4 none ms osg 3 60-110 7.5yr4/6 none cos osg ❑ Boring # Boring
Pit G
round 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
i
❑ Boring # Boring
Pit Ground Surface elev. ft. Depth to limiting factor in. F 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 "CfY 608-264-8777.
Page 3 of 3
STEEL'S SOIL SERVICE INC.
David J. Steel 994 200th St.
CST-POWTSM Residential Development, Inc. Baldwin, WI 54002
Lic. #248956 NW1/4,SE1/4,S18,T30N,RlgW Bus.(715) 684-5680
Town of Somerset, St. Croix Co. Fax.(715) 684-3449
St. Croix National Southern Estates, Lot 13
This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your
use. The location of this test may or may not be as shown, as permanent lot lines were not established at
the time the soil test was conducted. Legend
1" = 40'
♦ =Benchmark Ele. I OO.OOFt
Top of 3/4" pvc pipe
• = Alt Benchmark Ele. 99.30Ft
Top of 3/4" pvc pipe
11 = Borings
Boring Elevations
B 1=10230Ft
7a, B2 = 102.3017t
B3 = 108.70Ft
B4 = 00.0017t
70
4.1
3°~r
u
~I