HomeMy WebLinkAbout236-1756-02-010
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No
(ATTACH TO PERMIT) 597311
GENERAL INFORMATION State Plan ID No
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
Permit Holder's Name: City Village Township Parcel Tax No:
MELVIN ASHFORD CITY OF HUDSON 236-1756-02-010
CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No:
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark
J ~ F;e /oar ~
Dosing Alt. BM
AerrrtVr Bldg. Sewer
Holding rt St/Ht inlet 57,
7
TANK SETBACK INFORMATION St/Ht Outlet
5• 9
TANK TO P/L WELL L G. Vent Air Intake ROAD Dt Inlet
Septic Dt Bottom
Dosing Header/Man.
s
Aeration Dist. Pipe
G•b L-S
Holding Bot. System 716 x 411.5
PUMP/SIPHON INFORMATION Final Grade 3.5
Manufacturer DPMand St Cover Z-3 1646 Z
f^~ J
Model Nu
T H Lift Friction Loss System TDH Ft Y
Forcemain Dia. Dist. to Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside QLL__ Liquid Depth
DIMENSIONS
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufactyrgr:
INFORMATION CHAMBER OR d~
Type Of System: ^
O b q w NA- 7-14 UNIT Model Nu
Jr- 4
DISTRIBUTION SYSTEM
la.
asA- 7, T -1,>r Z, $
4
Header/Manifold. Distribution x Hole Size 'r Spacing Spacing Vent to Air Inta
Pipe(s) ~to
Length Dia_ Length Dia Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched
Bed/Trench Center Bed/Trench Edges Topsoil - IJI No es ~ No
COMMENTS: (Include code discrepencies, persons present, etc.) Insp tion #1: In ection
Location: 1826 RIVER RIDG R CA, W4X
1.) Alt BM Description = 1 +-,5 4,o Gdk_JS a
2.) Bldg sewer length = 1 A
- amount of cover = Z~
-7 1
Plan revision Required? ❑ Yes ~n No 1L6j ''7
Use other side for additional information. - I
SBD-6710 (R.3/97) Date Insepctor's SlUgnature Cert. No.
r
TEA -T Lark 0 11 ~ (I
9FStttr County
Safety and Buildings Division
l K qr - 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.)
MAY X1.;3 20 I
p Madison, Wl 53707-7162
T CRO X COUNTY 5 / 73 I
ber
Sanitary ermit Application StateTran;W_um
In
accordance with SPS 383 .21(2), Wis, Adm. Code, submission of this form to the appropriate governmental unit
is required prior to obtaining a sanitary permit Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address)
the Department of Safety and Professional Servies_ Personal mformatio provide may be used for secondary
purposes in accordance with the Privacy Law, s. 15.04(l m), Stats.
L Application Information - Please Print All Information / ✓ lr~
Property Owner's Name Parcel # i
) A-- I ~S _ -ct i o
Property Owners Mailing Address / Property Location
L/ Govt Lot
City,
Zip Code Phone Number , ,
Section ~4c 7
J t (c" le on/9j
11. Type of Building (check all that apply) ; Lo
2 bdivision Name
1 or Family Dwelling -Number of Bedrooms Su
6K a~
❑ Public/Commercial - Describe Use
00 C. I f
CSM Number ❑ Village of
❑ State Owned -Describe Use
2 ❑ Town of
w 2b-Z7 K
11I- Type of Permit- (Check only one box on line A. Complete line B if applicable)
A. QM „y, .
ew System lacemem System ❑ Treannent/Holding Tank Replacement Only ❑ Other Modificanon to Existing System (explain)
B- ❑ Permit Renewal ❑ Permit Revision ED] Change of Plumber =iN-ewL"" evious Permit Number and Date Issued
❑ Permit TraBefore Expirat ion I Owner
IV.
Type ofPOWTS System/Corn onent/I3evice. (Check all that a I
Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soi1,~~S _ _
❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain)
V. Dis rsaUTreat ent Area Informatio .
Design Flow (gpd) Design Soil Applicati Rate(ppdsf) Dispersal Area Required (`sf) Dispersal Proposed (sf) System Elevation
VL Tank Info Capacity in Total # of Manufacturer
Gallons Gallons Units o y
New Tanks Existing Tanks c m I
o a m e
U n C, i
Septic or Holding Tank
Dosing Chamber L<f • lr' - I
VII. Responsibility Statement- I, the undersi4am responsibilit y for installation of the POUTS shown on the attached plans.
Plumber's Name (Print) nature. MP/MPRSl ss Phone N ber
-7 Plumber's Address (Street State, Zip bode)
G f ~4 d l i
NTR,Countv/Department Use Onlv
Approved ❑ Di Permit Fee Date', ued Issuing. Signature
❑ rven Reason for Denial
IX- Conditi 1 Q,1s for D 4Pproval
~ r.ia<~ r llo- 3~ rS 5 6~e C.. mil,
'di" m*i cell must 411 l4- -n L101U rx
'!s per ;paralgernent plan pt a tided Uy pluilnbPi, e QD_,Q_ !
a. =ia t+ t a/ ,rdtn ►ralMrifs ems. ,f~-fea
as p!rbia Godw / S,Mi11uIM37GE, ►M
Attach to complete plans for the system and submit t1le County ply on paper aot les n 8 rrz z I1 inches in size
tie-N'X
SBD-6348 (R- 11/11)
System PLOT PLAN
PROJECT Melvin Ashford ADDRESS 10731 Hawthorne Trail Hudson Wi 54016
1/4 1/4S 36 /T 29 N/R 20 w city Hudson COUNTY ST. CROIX
SYSTEM ELEVATION 96.0/95.9 3' below grade 5/2/17 BEDROOM 5
DATE
CONVENTIONAL XXX CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000/630 LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 1 091 # of chambers 54
BENCHMARK V.R.P. Top of well ASSUME ELEVATION 100' Filter Lifetime Filter
❑ BOREHOLE O WELL *H.R.P. same as benchmark
Scale is F = 40'
unless otherwise
noted
New 5 All piping shall be ASTM
Exisiting house to be torn down Bedroom SDR 30/34, within 10' of tank,
House piping shall be ASTM F891
B.M.*
250'
we
50' 10'
Huffcutt combo ST tank
-1 10,
60'
B-3
St. Croix River 25'
0% Slope
60' 2-3' X 110' cells with
Vent >3'spacing
>6" Quick4 Standard B-2
of Cover Leaching Chamber
with 20.0 ft2 of Area
5.6ft^2/pair of end caps 60'
Long 12 100' to south lot line
3 4" Grade at System Elevation
B-4
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 5/2/17
Owner:Melvin Ashford
Location: Govt lot 3 S36 T29 N,R20 W 1826 River Ridge Rd. Hudson
Manuals Used: In-ground absorbtion system (version 2.0)
Page#
1. Cover Page
2. Plot Plan
3. Chamber Cross Sectio
4-6. Maintanance and C~6 itigency Plan
7.Filter Cross Sectio
i"
Signature
License num6e' # 26900
System PLOT PLAN
PROJECT Melvin Ashford ADDRESS 10731 Hawthorne Trail Hudson Wi 54016
1/4 1/4S 36 /T 29 N/R 20 W City Hudson COUNTY ST. CROIX
SYSTEM ELEVATION 96.0/95.9 3' below grade 5/2/17 BEDROOM 5
DATE
CONVENTIONAL XXX CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000/630 LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 1091 # of chambers 54
BENCHMARK V.R.P. Top of well ASSUME ELEVATION 100' Filter Lifetime Filter
❑ BOREHOLE O WELL *H.R.P. same as benchmark
Scale is 1" = 40'
unless otherwise
noted
New 5 All piping shall be ASTM
Exisiting house to be torn down Bedroom SDR 30/34, within 10' of tank,
House piping shall be ASTM F891
B.M.*
250'
We
50' 10'
Huffcutt combo ST tank
B-1 10
60'
B-3
St. Croix River 25'
0% Slope
60' 2-3' X 110' cells with
Vent >3'spacing
>6" Quick4 Standard B-2
of Cover Leaching Chamber
with 20.0 ft2 of Area
12 5.6ft^2/pair of end caps 60'
Long 100' to south lot line
Grade at System Elevation
34"
B-4 IF /
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 99.0'
Vent Grade 3' 4„ :2L,
x/30/34 Septic Tank
5' Long 5' rade at System
Elevation
3 6" Grade at System Elevation
r Spacing 5'
2-3' X 110' Cells
Same on other end Observation tube/Vent
At end of cell
A
B
27 chambers per cell
System elevations:
A-96.0'
B-95.9'
POWTS OWNER'S MANUAL $ MANAGEMENT PLAN Page of
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner n
' Septic Tank Capacity i ❑ NA
Permit # Septic Tank Manufacturer ❑ NA
3ESIGN PARAMETERS Effluent Filter Manufacturer ` 0 NA
Number of Bedrooms NA Effluent Filter Model ❑ NA
i Number of Public Facility Units - A Pump Tank Capacity al NA
Estimated flow (average) al/day Pump Tank Manufacturer NA
i Design flow (peak), (Estimated x 1.5) C. al/day Pump Manufacturer NA
Soil Application Rate J aUda Nt2 Pump Model NA
i Standard Influent/Effluent Quality Monthly average" Pretreatment Unit NA
Fats, Oil & Grease (FOG) S30 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter
Biochemical Oxygen Demand (BOD5) x220 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 (BODs) 530 mg/L "-round (gravity) ❑ In-Ground (pressurized)
Total Suspended Solids (TSS) 530 mg/L ❑ At-Grade ❑ Mound
Fecal Coliform (geometric mean) x104 efu/100ml ❑ Drip-Line ❑ Other:
Maximum Effluent Particle Size Ya in dia, ❑ NA Other. ❑ NA
10ther.
' A Other:
❑ NA
"Values typical for domestic wastewater and septic tank effluent Other: ❑ NA
IAINTENANCE SCHEDULE
Service Event
Service Frequency
(inspect condition of tank(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA
ear s
(Pump out contents of tank(s) When combined sludge and scum equals one-third (36) of tank volume ❑ NA
(Inspect dispersal cell(s) At least once eve ❑ month(s)
ry' ear(s) (Maximum 3 years) ❑ NA
(:.lean effluent filter At least once every: ! l 0 m ar(sjs) El NA
nspect pump, pump controls & alarm At least once every: ❑ month(s) ❑ NA
❑ year(s)
1=lush laterals and pressure test At least once every: ❑ month(s) ❑ NA
❑ year(s)
ether. At least once every: ❑ month(s) ❑ NA
I~ther: ❑ year(s)
❑ 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
iinclude a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of
immbined 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
I-egulatory authority.
When the combined accumulation of sludge and scum in any tank equals one-third or more of the tank volume, the entire contents of
{:he tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin
Administrative Code.
INI other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units,
land any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer.
la service report shall be provided to the local regulatory authority within 10 days of completion of any service event.
pap of
START UP AND OPERATION painting ~Products or other chemicals th*t
check treat spersal nt~i s} if for the high presence concentrations are detected have the contents of thO
For new construction, prior to use of the POWTS i
may impede the treatment process and/or damage the dspers
tank(s) removed by a septsge 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 or the surface excess discharge wastewater will ble
will bia
discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup restoring power to tnL
To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to
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. the area within
Do not drive or park Vehicles over tanks and dispersal eels. Do not drive or park over, or otherwise disturb or compact,
15 feet down slope of any mound or at-grade soil absorption area. the life of the pOWf:
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong foundation drain
anfibiotios; baby wipes; cigarette butts; condoms; cotion swabs; degreasers; dental fioss; diapers; disinfectants; fat;
(sump pump) water, fruit and vegetable peelings; gasoline, grease; herbicides; meat scraps; medications; oil; painting producils;
pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT shall be taken to insure that the system is PrapetiY
When the POWTS fails and/or is permanently taken out of service the following steps
and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrafive 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 property 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 filed with soil,
gravel or another inert solid material.
CONTINGENCY PLAN code cornptint
If the POWTS falls and cannot be repaired the following measures have been, or must be taken, to provide a
replacement system:
;FCble replacement area has been evaluated and may be utilized for the location of a replacement soil absorption systep•
The replacement area should be protected from disturbance and compaction and should not be infringed upon by requiged
setbacks from existing and Proposed structure, lot lines and wells. Failure to prated the replacement area will result in the nged
for a new soil and site evaluation to establish a suitable replacement area. Repiaoemexrt systems must comply with the nAe:l in
effect at that time.
❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technologK a
holding tank may be installed as a last resort to replace the failed POv4TS.
❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evalualMon
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 reconstri'ded 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 MOT
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 COMMEN'T'S
POWTS INSTALLER POWTS MAINTAINER
r
Yf l J
Name,
~r, ,r Phone
SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORITY
Name 2~ f r Name
Phone Phone
This doc unw t was drafted in compliance with chapter SPS 383.22(2)(b)(1)(d)&(f) and 383..54(1), (2) & (3), WWconsin Administrative Code.
h !t=
't
\ Ii
~i
V P
V
L7 ~ ~
co
j
~ i
~ I
y
i
l a
S c y" ~y~
O 'D v>
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE .'AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer
Mailing Address
Property Address
Gr t." C C c F: 1.
(Verification required from Plarmi Zoning Department for construction.)
City/State Parcel Identification Number
LEGAL DESCRIPTION
Property Location i/4 , r/4 , Sac. , T N RL W, Town of ' r
Subdivision , Lot #
/
Certified Survey Map # , V'alume Page #
Warranty Deed # t} , Volume Page #
Spec house yes (no) Lot line-- identifiable y no
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use and maintenance of your septic system could result in its premature fail= to handle wastes. Proper
maintenance consists of pumping out the septic tank every three years or sooner, ii= 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 wads 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, signed by the
owner and by a master plumber, joumeyman 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 retuned to the St. Croix County Planning &
Zoning Department within 30 days of the three year expiration date.
Uwe certify that all statements on form are true to the best of my/our k:aowledgc. I/we am/are the owner(s) of the
property described above, by virtue of a deed recorded in Register of Deeds Office.
Nu r of bedrooms A
s
SIGNA AP LICANT(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. 08/05)
I ,
a
0
x
' ~ `~I III~III
ILI
i
I A ir~
I, o
i
r
I ~ I '~4R•0+~•([ lalatl€IAI~ sI
_i
I
21
0
0
x ~
ul
3
O ~
(III' 0 ~ 3
a
I I I
11Qb
i
~ i j
E
~ FT
i
I¢I I I I I ~ I~ ~ISI~ ~ al
e
m
x;
i
~ m
P
I ~
i
a
yY SL3i
~ ~ Tt3Nf1
d
F I
N ♦ I
9
:0) c
Jac
~I
L
n3 \
0
P
-I ..V/
6
F
~r
E
4
d N _
o r ~
~k
r p
011,
a
Jar
I ',I
d r
LJ P
A
0
N
„0,8
iz
KECEIVEC
C~
l,. MAY 0 3 201"1
Wisconsin Department of Commerce SOIL MCIV t Page of
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code
County e'
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must ) 70t
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. 2,31,r-117
tO - 6Z-- `b
Please print all information. Revi by Date
61 _ Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 5
Property Owner Property Location
j~. l , Govt. Lot 1/4 1/4 13> T N R E (or W
Property Owner's Mailing Address Lot # Block # Subd. Na CSM#
n
City State Zip Code Phone Number ACity Village ❑ Town Nearest Road
jiti,
yyllkA
41/ J
❑ New Construction Use: residential / Number of bedrooms. Code derived design flow rate _Z~ GPD
Replacement ❑ Public or commercial - Describe:
Parent material &ee--l Flood Plain elevation if applicable ft.
General cortxnents
and recommendations:
System Type C/11- n-~ i.) = [ Gt System Elevation
F T1 [D Boring # E] Boring
pit Ground surface elev. y-7 ft. Depth to limiting factor _ in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in.. Munsll Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2
i
® Boring # f~ Boring
h~l pit Ground surface elev. l 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
(-il 101
If An
Effluent #1 = BOD. > 30 < 220 mg& and TSS >30 < 150 • Effluent #2 = BOD. < 30 mg/L and TSS < 30 nxVL
CST Name (Please Print) ture CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address Date Evaluation Conducted Telephone Number
1432 120th St, New Richmond, WI 54017, 715-246-4516
Property Owner _ Parcel ID # Page of
Boring # ❑ Boring
' g.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
j '41
7 V-
it
~r
Boring # ❑ Boring
❑ pit Ground surface elev. *=-r - Depth to limiting factor rl n 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
J-1
❑ Boring
F-1 Boring # Ground surface elev. ft. Depth to limiting factor in.
❑ Pit
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 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODS < 30 rng/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.6/00)
Property Owner _ Parcel ID # Page of
Boring# E] Boring _ -
Dpit Ground surface elev. t ov ft. Depth to limiting factor L~ in.
Soil Application Rate
Horizon Depth Dominant Color Redoz Description Texture Structure Consistence Boundary Roots GPDIff
in. Munsell Qu. Sz.. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2
1
tr
i
Boring # U Boring
U Pit Ground surface elev. 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
r
i
❑ Boring
Boring # Ground surface elev. ft. Depth to limiting factor in.
F-1 ❑ Pit 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 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODS < 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-9330 (R.6100)
Soil Test Plot Pl
Project Name Melvin Ashford -
n $ird
Address 10731 Hawthorne Trail'
Woodbury Mn 55129 / STM #226900
Lot 1 and 2 Subdivision Date 5/2/17
Govt Lot 3 S 36 T 29 N/R20 W
City Hudson
Boring Q Well PL Property Line County ST. CROIX
BM or VRP Assume Elevation 100 ft. Top of well
System Elevation 96.0/95.9' *HRpSame as Benchmark
Scale is F = 40'
unless otherwise
noted
New 5
Exisiting house to be torn down Bedroom
House
B.M.*
250'
We
50'
B-1
60'
B-3
25'
0% Slope
60'
St. Croix River
B-2
60' 100' to south lot line
B-4