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HomeMy WebLinkAbout026-1306-00-002 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Safety and Building Division St. Croix INSPECTION REPORT Sanitary Permit No GENERAL INFORMATION (ATTACH TO PERMIT) 597328 State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)] PermiTEIev Name: City Village Township Parcel Tax No VAVIEW WEST INVffBM TOWN OF RICHMOND 026-1306-00-002 CST BInsp. BM Elion: Section/T own/Range/Map No: A50 414- AS P% 18.30.18.1609 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Q`~ 1 S Septic / ' w `,t e.111 rl Z X60 Benchmark 3 • Z /e3.5 ioa, a t- HZ'S Alt. BM ,.r. Aeration Z-1 r~ [tHt ldg. Sewer Holding 5. `tY S UHt Inlet TANK SETBACK INFORMATION Outlet 3 97. 18 TANK TO P/L WELL BLDG. ent to it Injake ROAD Dt Inlet Septic 33 Dt Bottom ` Dosing Header/Man. ~t Aeration 7 . Dist. Pipe q t Holding Bot. System PUMP/SIPHON INFORMATION Final Grade Demand St Cover q, er g_ ~~gt.Well GPM Zh Z • ( ~aO• Co 4Forcemaitn rer 5'a S Friction Loss SyTDH Ft Length Dia. SOIL ABSOR PTION SYSTEM BED/TRENNWdthS Length ~ ( No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIO/v Z `~Q ® SETBACM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATSystem. A CHAMBER OR T•,~ ~~'l ~i.~ ~4.."* Z6 ,33 Model Number: DIS TRIBYSTEM ♦ k ' V Header/Manio) Distribution x Hole Size x Hole S acin Inta Vr rJ Pipe(s) \ 19 Ven 14-(( LDia T Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx De th of Bed/Trench Center 3• Q xx Mulched Bed/Trench Edges To soil Seeded/Sodded / p Yes No Yes ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 992 154TH AVE So; ~b a, ('G &-U41 t Z A to A0~' ~ f / 1.) Alt BM Description = C6j"L'%- lJ~ 2.) Bldg sewer length = 2,44 / ` L-Wure - amount of cover ~J ~ Plan revision Required? Yes No '~7 ~ 2 / Use other side for additional information. / J SBD-6710 (R.3/97) Date InseCert. No. 'rta County Safety and Buildings Division s6 g P r!I NSA{ 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) ark $f , Madison, WI 53707-7162 ' Y z ~A 5 -7 3 z Sanitary Permit Application State Transaction Number 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 ect Address (if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary ur oses in accordance with the Privac Law, s. 15.04(1 (m , Slats. D I: As licatiop Information - Please Print All Information Y Property Own is ` ame r ' Parcel # Property wrier' ailing Address C _/2 ~j - J City, State UN o`L WPME Y4, Y4, Section Zip Code Phone Number (circle one IL Type of Building (check all that apply) Lot # T, N; R_ 1 r E w2V 1 or 2 Family Dwelling - Number of Bedrooms Subdivision Name ted Block # El Public/Commercial -Describe Use ? ~J a ❑ City of ❑ State Owned -Describe Use CSM Number El Village of Z ter G ~5 l~ f- ff Town of_ i✓fj~~''~/r) - III. Type of Permit: (Check onl one box on line A. Complete line B if applicable) New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B• ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber El Permit T List Previous Permit Number and Date Issued Before Expiration Transfer to New Owner h,~ / IV. T e of POWTS S stem/Corn onenUDevice: Check all that a liply) ~ F./" 1A ` P\Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound 24 in. of suitable soil ❑ Mound <24 in. ofsuitable soil ❑ Holding Tank Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis ersal/Tre ment Area Information: Design Flow (gpd) Design Soil Application Rate(gpds Dispersal Area Required (sf) Dispersal Area Proposed ( System Elevati n VI. Tank Info Capacity in Total # of Gallons Manufacturer Gallons Units y o New Tanks Existing Tanks ) C r U r_ m Septic or Holding Tank 6 L a' U Dosing Chamber VII. Respon ibility Statement- I, the undersigned, assume responsi lity for installatiop of the POWTS shown on the attached plans. Plumber' me (Prin , Plumber's gnature- - _ J MP/MPRS Number Business Phone Number Plumber's Ad ress (Street, Ctty State, Zip de) > 5 1117 VIII. Coun /Department Use Only i Approved Permit Fee Date slued Issuing t Signature ❑ O tven Reason for ial /7 IX. Condi a P q~_U, iiss~aypprovyal~y~ .NpI{I...91isi..ElilLLli► ` r 4 !~Cil pr< ttvrt*irxd p (e5~ I*oR»90IF11111 00*1 041411101M. 1 Attach to complete plans for the system and submit to the County only on paper not Icss than 81/2 x 11 inches in size SBD-6398 (R. 11/11) ~ r \i G~~} b i I CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Owner's Name: i y- K CL "l 1f Owner's Address: r Legal Description:/` Township: 3, ~,Un County:, Subdivision Name: Lot Number: Parcel ID Number: 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 ttachments: Soil Test & House Plans Designer/Plumber: License Number: Date: 1117 Phone Number -2217 Signature Designed pursuant to the In-Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P (N.01/01). Page 1 ~ ~ ~ ~ ;tea i~~ ~ l i I j i i i i i I l _ - _ _ _ I lDc~ T I I/ ~ N ~ _ ~ Q ~d~~ ~ ` , , ` ~ , w , ~ , . ~~~r _ / ~ _ _ \ icost~~k i _ ~l. ~i - ~ _ _ glmftm crass 85WOR 4'&40 PVC Vent Pipe Wo VerA top Leaching Chamber System Elevation Sell }SEF i011${iS Ett PhO 1011W . I 1 Leasing Trench 5 Vent Or Obsetvaiion Pipe Chambers s I°U& ILL Tcenc, 2 Header bar Spaeffleatons Manufacturer And Model EISA Racing,=--~ s4 -t per chamber 96i3 RPPfica €ion Raw 7 gpcw..iv4 it gpd Design Row i Safi Applicnfion Rate EISA = _.~~Chamhers Z MWS of CharnberS each- Page QT 2 _y L---6,2 FI T~.~~^.R ''~j~'$yP.•`..~1'~•~'.vY..ytU~~t:- .--r.rY V_ >.vi - ~ ° C-TIOS t INS =O I - f aaliai~ As J la"w',"mol 00 82 L~:.+~_; I' zx-~ ~ .•/-^•>r~ = • tGo ag -giep 2: €ior on steps: flF~ E teuuff " e- au€i. (04) Lomfe ttO auHeF -housing on ' ire and PUMP imk ~COUS 1'3 nacassa(Y- is Wined s~ the r mm W auk and tilaI ~ ilisil~irr,3a~ce~d ~~rtro AINTr ~ € v lAlm-wj 10-1,10 w•}: f---~--~~=~•:- - i,~'-, ~ tea _ -.ls~ 14 Eli 1 i _ ~~w- F - ..S f~_j,~~.~-~ -1 t=duo-.- _ _ _ stap 2: o of Ire ° + c e u cover and pump t ~ s t7 Oudet ff- fib Of #m -gar W+~LI++~"•"i~i Wm amVie'sk ut end Rsqlw-lsePff 0 tR* co're'' mals up POWTS OWNER'S MANUAL & MANAGEMENT PLAN Pagef FILE INFORM TI N SYSTEM SPECIFICATIONS Owner _ Tank Manufacturer: 1 Lid ❑ NA Permit # Septic ❑ Dose ❑ Holding Volume: (gal) DESIGN PARAMETERS Tank Manufacturer: .1 NA Number of Bedrooms: j ❑ NA ❑ Septic ❑ Dose ❑ Holding Volume: (gal) Number of Public Facility Units: 0 NA Vertical Distance Tank Bottom(s) to Service Pad: (ft) Estimated (average) Flow : (gal/day) Horizontal Distance Tank(s) to Service Pad: (ft) Specific servicing mechanics must be provided if vertical is >15 feet or Design (peak) Flow = (estimated x 1.5): `S (gal/day) if horizontal is >150 feet. Specific instrpctions o be provided on back. In Situ Soil Application Rate: (gal/day/ftz) Effluent Filter Manufacturer: f c°y ~ Standard (Domestic) Influent/Effluent Monthly average Effluent Filter Model: ❑ NA Fats, Oil & Grease (FOG) 530 mg/L Pump Manufacturer: Biochemical Oxygen Demand (BOD5) <220 mg/L ❑ NA .f NA Total Suspended Solids (TSS) x150 mg/L Pump Model: High Strength Influent/Effluent Monthly average Pretreatment Unit (FOG) >30 mg/L Manufacturer: (BOD5) >220 mg/L J4 NA El Mechanical Aeration El Peat Filter ANA (TSS) >150 mg/L ❑ Disinfection ❑ Wetland Pretreated Effluent Monthly average ❑ Sand/Gravel Filter ❑ Other: (BOD5) <_30 mg/L Soil Absorption System (TSS) <_30 mg/L ~RJ NA Fecal Coliform (geometric mean) 510" A In-Ground (gravity) ❑ In-Ground (pressure) ❑ NA El At-Grade El Mound Maximum Effluent Particle Size '/8 in dia. ❑ NA ❑ Drip-Line ❑ Other: Other: ❑ NA Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Pump out contents of tank(s) ~4 When combined sludge and scum equals one-third (%3) of tank volume ❑ When the high water alarm is activated Inspect condition of tank(s) At least once every: ❑ month(s) year(s) (Maximum 3 years) El 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 j year(s) Inspect pump, pump controls & alarm At least once every: ❑ month(s) -13 NA ❑ year(s) Flush laterals and pressure test At least once every: ❑ month(s) 19JNA ❑ year(s) Other: At least once every: ❑ month(s) ❑ NA ❑ year(s) Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and soil absorption systems shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector, POWTS Maintainer or Septage Servicing Operator (pumper). 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 a check for any back up or ponding of effluent on the ground surface. The soil absorption system 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 treatment 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 (pumper) 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 30 days of completion of any service event. GMW-005 (02/05) 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, solvents or other chemicals or sediment that may impede the treatment process and/or damage the soil absorption system. If high concentrations are detected have the contents of the tank(s) removed by a Septage Servicing Operator (pumper) prior to use. Pump tanks may fill above normal highwater levels prior to startup or due to pump failures. Start up or restoration of power under these conditions is not recommended, as the excess wastewater will be discharged to the soil absorption system in one large dose causing an overload that may result in the backup or surface discharge of effluent and damage to the system. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator (pumper) prior to restoring power to the pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls until normal effluent levels are restored within the pump tank. System start up shall not occur when soil conditions are frozen at the infiltrative surface. Do not drive or park vehicles over tanks or the soil absorption system. 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 treatment tanks and soil absorption system: acids, antibiotics, baby wipes, cigarette butts, condoms, cotton swabs, degreasers, dental floss, diapers, disinfectants, fats, foundation drain (sump pump) discharge, fruit and vegetable peelings, gasoline, greases, herbicides, meat scraps, medications, oils, painting products, pesticides, sanitary napkins, solvents, tampons, and water softener brine discharge. 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 s. Comm 83.33, Wisconsin Administrative Code: • All piping to tanks, pits and other soil absorption systems 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 (pumper). • 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 the time of their permit issuance. ❑ A suitable replacement area is not available due to setback and/or soil limitations. If the soil absorption system cannot be rehabilitated and barring advances in POWTS technology, a holding tank may be installed as a last resort. ❑ 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 TREATMENT TANKS, PUMP TANKS, AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES OR LACK SUFFICIENT OXYGEN TO SUSTAIN LIFE. NEVER ENTER ANY TANK UNDER ANY CIRCUMSTANCE. DEATH MAY RESULT. ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK MAY NOT BE POSSIBLE. ADDITIONAL INSTRUCTIONS: POWTS INST ER POWTS MAINTAINER Name _ Name Phone 5 _ _ e Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name LNa ePhone e This document was drafted by the staffs of the Green Lake, Marquette and Waushara County POWTS regulatory agencies in compliance with sections Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. ~ of START UP AND OPERATION Page For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other chemicals or sediment that may impede the treatment process and/or damage the soil absorption system. If high concentrations are detected have the contents of the tank(s) removed by a Septage Servicing Operator (pumper) prior to use. Pump tanks may fill above normal highwater levels prior to startup or due to pump failures. Start up or restoration of power under these conditions is not recommended, as the excess wastewater will be discharged to the soil absorption system in one large dose causing an overload that may result in the backup or surface discharge of effluent and damage to the system. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator (pumper) prior to restoring power to the pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls until normal effluent levels are restored within the pump tank. System start up shall not occur when soil conditions are frozen at the infiltrative surface. Do not drive or park vehicles over tanks or the soil absorption system. 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 treatment tanks and soil absorption system: acids, antibiotics, baby wipes, cigarette butts, condoms, cotton swabs, degreasers, dental floss, diapers, disinfectants, fats, foundation drain (sump pump) discharge, fruit and vegetable peelings, gasoline, greases, herbicides, meat scraps, medications, oils, painting products, pesticides, sanitary napkins, solvents, tampons, and water softener brine discharge. 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 s. Comm 83.33, Wisconsin Administrative Code: • All piping to tanks, pits and other soil absorption systems 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 (pumper). • 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 the time of their permit issuance. ❑ A suitable replacement area is not available due to setback and/or soil limitations. If the soil absorption system cannot be rehabilitated and barring advances in POWTS technology, a holding tank may be installed as a last resort. ❑ 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 TREATMENT TANKS, PUMP TANKS, AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES OR LACK SUFFICIENT OXYGEN TO SUSTAIN LIFE. NEVER ENTER ANY TANK UNDER ANY CIRCUMSTANCE. DEATH MAY tv<" RESULT. ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK MAY NOT BE POSSIBLE. ADDITIONAL INSTRUCTIONS: POWTS INST ER POWTS MAINTAINER Name Name Phone _ Phone 5 SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name a Phone Phone This document was drafted by the staffs of the Green Lake, Marquette and Waushara County POWTS regulatory agencies in compliance with sections Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. ST. CROIX COUINrn SE.DTIC TA N~&P*'-N -A- CF, .A.GRED&N ' N 0'VVNTRSP2F CERTIFICATION FO C Amar. Buyer \ ' &A CAT Address ki~ , S c I7 (V eriftcation"required from. Planning & ZMing DepartmM. for new construction.) Parcel Identification Number l 1 (j - Ue~ - CU~ LEGAL DESCR.IPTTOI ~ileC. "I' _INr R~ W, Town of ~j~•~A/0 opeiy Locauo /.,Sec. Subdizision Plat: a2s ®(fib), lot # Certified Survey Map 7jjr , Volume , Page Warranty Deed T (be-fore 2007)Volume , Page t Spec hauie i yes o no Lot Ines i able , yes 0 no SYSTEM IYIAMTMNANCE AND OVYWER CRRTIPICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumper out the septic tank every three years or sooner, if needed, by a licensed pumper- ghat you put into "tee system can arsect tbe fun dL of the septic ramie as a treatment stage in the waste disposal system. Owner maintenance r esponsibilities are soect.~.ied` in §SPS- = 83-52(1) and in Ghapwr 12 - SL Croix. County Sanitary Ordb auce. t'be propem, owner agrees to submit to St Cron County Plannm7 g & Zonmg DeparLt=t a certrficarion form, sued by the owner and by a master plumber, journeyman pitnnber. 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 Cif necessary), the septic tank is less than 15 fall of sludge. I/we, the undersi-med have read the above requirements and agree to main a the private sewage disposal system with the stanaads set fbirth, herem. as set by the Department of Safety And Prof canal Services and the Department ofNaurtal Resmtroes, :Stare of Wr3scoasm_ Cart 5tadon sta=Q that your semc system has been wed must be completed and reawned to the S't. Croix County Planni Zonmg Depaummr within 30 dais ofthe three yew expk-Ab h date;. Uwe certify that all statements on 16 form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of 77: deed recorded in Register of Deeds Once. 'Number of bedrooms 7~ 51/ol / 7 A.ny infbrmauon that is misrepresented may resuh iat the sanitary permit being revoked by the Planning & Zoning Department include w6 this application a recorded warranty deed.:&om the Reggster of Deeds Once and a copy of the wed survey map if reference is mad in ttte warranty deed. REV. 04IJ-7) I J p K, E, FENCE IN POOR 17' E 2641m79' I-COROFTM i LOT 2 'T. L` 1.634 . 71.11 lal M " 16 Vs i' i L F ~F . ior- Y sir ■ ~r - ° 50074'20"E 196.20' ,L 500'24'20"E 438.42' 1119._.._ H217. ;moo ~ 353.27' 1' , 65 ( n La I • w-, I m co 1io @ va vl..o (Ii ® coo z t~ F. E i Q Ju~cw H40 S06 -A,9,2.9 E _50.43 ~,C . e-e in LLI 1 0 C-4 f" J(D l w ci H42 *E <(n S07 63 + in 318.68 + coo ~ w In , ~n uw, ! t; I, rte6ci~ r^! r" y1 1 1 (5 to E 0 ~ N AA.K.*Q t05 Q Oll W + Z 0 (n L',! + 0 co t! 5 a ' co S .a♦ U') W HO a m r :548`33'45" E 2 (wn aO ~ ! ,Fg w e ~ ~ ~ Z ~ {E a T ~$in~ l Q r omr, It C-) I a a C/3 a v MM 9*.07-z05 : A ) r~,U U E-i A -.4 " I r _ . #1487 `visconsin SOIL EVALUATION REP al. Department of Commerce in accordance with Comm 85, Wis. Adm. Code Page 1 of 3 Division of Safety and Buildings Schmitt Soil Testing, 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 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. 02 1~ > V660 Please print all information. Review; y c~ !o Date Personal information you provide may be used for 04 (1) (m)). ~Q -7 1 Property Owner "Proper ~y Location Sienna Corporation Govt. Lot NE114, E1/4, S18, T30N, R18W Property Owners Mailing Address S F P ~ 20 Q Lot # Block # Subd. Name or CSM# 4940 Viking Drive Suite 608 2 The Glens Of Willow River City State Zip Coe l?M.reFN4mbWUN Y 'L ity Village Town Nearest Road Minneapolis MN 5543 Richmond 100Th St. New Construction Use. Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement Public or commercial - Describe: Parent material Outwash Flood plain elevation, if applicable na ft. General comments and recommendations: Area is suitable for a conventional system with a 0.7 gpd/sgft rating. Possible system elevation for Area L is 94.70'. ❑ Boring # !4 Boring Pit Ground surface elev. 98.29 ft. Depth to limiting factor 135+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistent Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-9 10yr3/2 none sil 2fsbk mfr gw 2f .6 .8 2 9-33 10yr3/1 none sit 2fsbk mfr gw lvf .6 .8 3 33-40 10yr4/4 none sil 2msbk mfr gw .6 .8 4 40-61 10yr4/6 none sil 2msbk mfi Cs .6 .8 5 61-79 10yr5/4 none grcos Osg ml Cs .7 1.6 6 79-135 10yr5/6 none s Osg ml .7 1.6 b Boring 2 Boring # Pit Ground surface elev. 98.88 ft. Depth to limiting factor 115+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistenc Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-12 10yr3/2 none sil 2fsbk mfr Cs 2vf .6 .8 2 12-29 10yr4/4 none Sid 2msbk mfr gw lvf .4 .6 3 29-36 10yr4/4 none sl 2msbk mfr Cs 1vf .6 1.0 4 36-115 10yr5/6 none s Osg ml .7 1.6 ~ n u Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODS < 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 9/15/2006 715-247-2941 SBD-8330 (M7/00) Property Owner Sienna Corporation Parcel ID # 2 Page 2-of 3 Boring # Boring Pit Ground surface elev. 99.40 ft. Depth to limiting factor 117+ 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 *Etf#2 1 0-11 10yr3/2 none sil 2fsbk mfr as 2f lvf .6 .8 2 11-26 10yr4/4 none sicl 2msbk mfr CS 1vf .4 .6 3 26-35 10yr5/4 none grcos Osg ml as lvf .7 1.6 4 35-51 10yr5/6 none grcos Osg ml as .7 1.6 5 51-117 10yr6/4 none s Osg ml .7 1.6 Boring # Boring Fi-I 1! pit Ground surface elev. 99.38 ft. Depth to limiting factor 115+ -in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-13 10yr3/2 none sil 2fsbk mfr as 2f,ivf .6 .8 2 13-23 10yr4/4 none Sid 2msbk mfr cs 1vf .4 .6 3 23-33 10yr4/6 none sl 2msbk mfr cs 1vf .6 1.0 4 33-45 10yr5/6 none s Osg ml as .7 1.6 5 45-115 10yr6/4 none cos Osg ml .7 1.6 u 51~.1b o~Z.►ta ❑ Boring # 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/ft' 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 Sal Testing, Inc. Page 2 of ~3 Conducted by: Conducted For: ,Schmitt Soil Testing Inc. Name: Sienna Corporation Thomas J. Schmitt, CST 227429 Address: 4940 Viking Drive Suite 608 1595 72nd St. City, State, Zip: Minneapolis, MN 55435 New Richmond, WI. 54017 Phone: 715-247-2941 ` Subd.Name: The Glens of Willow River Signature: Lot No.: _ Date: lS, i 6 Legal Description: AIZ 114 SEI/4 S18 T30N R18W Backhoe pit Township, County: Richmond, St. Croix Bench Mark El. 100.00' Top of 2" pvc pipe _ Alternate Bench M-rk El. A)00 / Top of l Slope= j9c 5, Contour Line El. &A Contour Line Length IVI-' _ /V rll Scale 1" = 40' 41- r ay ~ 33; Me4~p 57~ Ae A-- This oil and Site Evaluation was completed to titltili a zoning requirement. It mayor may not be in a location suitable for you use.