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010-1054-80-000
V Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: x~~ w Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 ' Permit Holder's Nam C City /Village Townsh' Parce a o: I • ~V~/~ /1Aa r'S 7 rll •:6G her GN~GT 6!~ • 't1~ $O ~ ~dO CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: . A4 • 3~7 TANK INFORMATION ELEVATION DATA .22q 107,Z-f 0 TYPE MANUFACTURER CAPACITY 5~ forms- HlI FS ELEV. t a Septic Benchmark ^ Dosing Alt. BM i. , f+; 10. Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TC P/L WELL BLDG. Vent to it Intake ROAD Dt Inlet Septic Dt Bottom Dosing y * ; r Header/Man. _ t. I - Aeration Dist. Pipe 0 Holding Bot. System r ? ` Final Grade PUMP/SIPHON INFORMATION Pvlanufacturer ZVI (4a Demand St Cover GPM ) Model Number ' 'r TDH Li j Friction Loss, System Head TDH Ft j 5i Forcemain r~Ih Dia. r 1 Dist. to Well , SOIL ABSORPTION SYSTEM BED/TRENCH Width j Length ]No. Of Trenches PIT DIMENSdONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO BLDG WELL LAKE/STREAM LEACHING Manufacturer: 1 ~ , J , INFORMATION CHAMBER OR Type Of System: j_ UNIT Model Number: :jt DISTRIBllTiQN SYSTEM l ; Header/Mxn-1fold Distribution n ix Hole Size ' Ix Hole Spacing Vent to Air Intanke/ Pipe(s) ; ^ Length Dia Ya + Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over E r Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center ° ► .',l Bed Trench Edges Topsoil Yes ❑ No L] Yes ❑ No r ` COMMENTS: (Include cod crepencies, persons present, etc.) Inspection #1: R40 PInspection #2: 40 Location: 1.) Alt BM Description 2.) Bldg sewer length = t Ila amount of cover = J G~ ~0 Plan revision Required? ❑ Yes No Use other side for additional information. L& ONO Date *se Signature Cert. No. S8D-6710 (R.3/97) i}►v~2c 1- 614 .0 Bar s+:; ~.=x county -2 Sanitarr'Permit Number (to be filled in by Co.) V t» madlson, WI 53707-7162 _ y UKry 36 I PM C)FVELO ~0 anitary Permit Application State Transaction Number -7 _56, A In accordance with SPS 383.21(2), Wits. 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 Sen ies. Personal information you provide may be used for secondary ur oses in accordance with the Privacy Law, s. 15.04(1 )(m), Stats. ZS 7 al, 1. Application Information - Please Print All Infor ation J / Property Owner's Name Parcel # .Sze J ( Property Ow s Mailing Address Property Location 3 ib, .3q 2 0/ Wei Govt. Lot City, State Zip Code Phone Number y G ~C' y,, Section //•-~l C - (circle one) A' f T~N; REcVV II. Type of Building (check all t t apply) y Lot # Subdivision Name ,,Rl or 2 Family Dwelling - Number of Bedroom. Block # i C.~ ~'~G~( ❑ Public Commercial - Describe Usc ~aCJ ❑ City of ❑ State Owned - Describe Use CSM Number ❑ Village of Town of 111. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ❑ New System Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (c fr) B• ❑ Pennit Renewal ❑ Permit Recision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner 1 IV. Type of POWTS System/Component/Device: (Check all that apply) 1 ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. Of suitable soil A~rMOLind < 24 in. of suitable soil ❑ Holding Tank ❑ Other Disp°ersal Component (explain) ) El Pretreatment Device (explain) V. Dis ersal/Tre tment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Propo ~d f)~ System Elevation C 15 VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units s U J _ 1 New Tanks Existing Tanks c d a :C Septic or Iloldino Tank ao~ 1Gs Dosing Chamber ; y (jC VI1. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shohn on the attached plans. Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number Plumber's Address (Street. City, State, Zip Code) y~ VIII. County/De artment Use Only Permit Fee Date Issue Issuing gent Signatu c Approved ❑ Disapproved S ❑ Owner Given Reason for Denial `7{1 d ✓ JI/ 1X. Condit A easons for Disapproval C k; 4~ ~W (a ~lvCa i. lw in tack eAwar Aer rh•i °S disper at cell rust aU be sf j _k #s t rm rimed t Gr' Com' t.•J~ Y'~•~ eJ~- as per ~:agement plan pIUtided by olumbe:. 2. A~1 >wEl4pt~t rectrirertarns must Gt rr~ rrt, ir:e i w per # FkWs to& /,rdit1a7rw. 6 11 f t C Attach to complete plans for the system and sub it to the County only n pa er not ITS than 8 t/2 x 11 inches in size SBD-6398 (R. I I/1 1) I SCALE 1" = 40 FT NJ BMA BOREING FEED LOT AREA 65 D IVE WAY SYTEM ELEVTION 100.00 CONTOUR LINE 2578 140TH AVE TOWN OF SPRINGFIELD ST CROIX COUNTY SE1/4SE1/4S23T30R16W FEEn LnT Qi iNi OFF UIFI A BM 1 TOP OF WEL 06.9 A WIESER 1200/800 COMBO ANK POLY L C 525 FILT B1 HOME 0 0 0 BM 0 OF EAST TANK CO ER 3 LOCK DOWN CO- 104.2 VERS ABOVE GRADE B5 101. 126. X29.65 MOUND SYSTEM ° Oak tree SYTEM NEEDS TO BE CHISEL PLOWE MIN OF 13" WITH 3 TO 4 INCHES 0 ASTM C-33 SOIL MIXED IN 101 B 0 2 s 6servation pipes 100 OAF Q 99 O'lOa B4 98 INSTAL SYTEM ON CONTOUR 100. HOLD AS CLOSE TO B3 AS POSSIBLE AS PER LINE 8 ON PAGE 7 IN THE INTERPETIVE DETERMINATION REPORT. I~ IT WOULD BE WISE TO READ PAGE 5,6 AND 7 OF REPORT BEFORE INSTAL. i' 4~T+1F.-~. DIVISION OF INDUSTRY SERVICES 3824 CREEKSIDE LN r HOLMEN WI 54636-9466 f K Contact Through Relay http://dsps.wi.gov/programs/industry-services www.wisconsin.gov r ~0 ~ss101,;N Scott Walker, Governor Laura Guti6rrez, Secretary May 23, 2017 CUST ID No. 225410 ATTN: POWTS Inspector ZONING OFFICE PAUL R KOEHLER ST CROIX COUNTY SPIA E5678 704TH AVE 1101 CARMICHAEL RD MENOMONIE WI 54751-5522 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/23/2019 SITE: Identification Numbers Amarylis Schreiber Transaction ID No. 2943783 2578 140TH Ave Site ID No. 837729 Town of Springfield Please refer to both identification numbers, St Croix County above, in all correspondence with the agency. SE1/4, SETA, S23, T30N, R16W FOR: Description: Four Bedroom EZFlow Mound System \ Sloping site Object Type: POWTS Component Manual Regulated Object ID No.: 1704433 Maintenance required; Replacement system; 600 GPD Flow rate; 9 in Soil minimum depth to limiting factor from original grade; System(s): EZflow Mound Component Manual, (R. 7/12), Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01/01, R. 10/12); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. , No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, tr- APp, stats. T QF ~y The following conditions shall be met during construction or installation and prior to occupancy or use: f /V C)'z 5A10 Reminders • A sanitary permit must be obtained from the county where this project is located in accordance with th requirements of Sec. 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with _ i the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. • The existing POWTS shall be properly abandoned per SPS 383.33, Wis. Adm. Code. • All POWTS component piping material shall be SPS 384, Wis. Adm. Code compliant. • The area within 15' downslope of the dispersal cell shall remain undisturbed. Vehicular traffic, excavation or soil compaction is prohibited in this area. • A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department which may include local inspectors. PAUL R KOEHLER Page 2 5/23/2017 r Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. ;era cerely, Fee Required $ 250.00 This Amount Will Be Invoiced. rd MSwim When You Receive That Invoice, POWTS Plan Reviewer, Division of Industry Services Please Include a Copy With Your (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm Payment Submittal. jerry.swim@wisconsin.gov WISMART code: 7633 cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm PAUL R KOEHLER Page 2 5/23/2017 Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the properly owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2); nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. ;cere'y, Fee Required $ 250.00 -"tW This Amount Will Be Invoiced. rard M Swim When You Receive That Invoice, POWTS Plan Reviewer, Division of Industry Services Please Include a Copy With Your (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm Payment Submittal. jerry.swim@wisconsin.gov WiSMART code: 7633 cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm i ' EZflow® MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: AMARYLIS SCHREIBER 1 Owner's Name: AMARYLIS SCHREIBER i I Owner's Address: 2578 140TH STREET GLENWOOD CITY WI Legal Description: SE1/4SE1/4S23T30R16W Township: EMERALD County: ST CROIX Subdivision Name: Lot Number: Block Number:, Parcel I.D. Number: 10105480000 4z Tyq Plan Transaction No.: .S RS/ - Page 1 Index and title SE Page 2 Data entry Page 3 EZflow mound drawings Page 4 Lateral and dose tank Page 5 Distribution media Page 6 System maintenance specifications Page 7 Management and contingency plan Page 8 Pump curve and specifications Page 9 PLOT PLAN Page 10 PLOTPLAN OF LOT Page 11 SOIL TEST 4 PAGES Page 12 INTERPRETIVE REPORT Designer: PAUL KOEHLER License Number: MP 225410 Date: 05/18/17 Phone Number: 7152462660 Signature:,...- Designed Pursuant to the EZflow Mound Component Manual Ver. August 20, 2007, SSWMP publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01, R. 10/12) i EZflow Mound Version 3.0 (R. 3/1/12) Page 1 of i f Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) r Residential or Commercial Design 400.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 = 150%) 600.00 Design Flow (gpd) 4.00 Site Slope 100.00 Installation Contour Line Elevation (ft) 150.00 Contour Length Available (ft) 9.00 Depth to Limiting Factor (in) 0.40 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 6.00 Cell Width (ft) 3, 4, 5, 6, 7. 8 9 or 10 Only 100.00 = Dispersal Cell Length (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution F_ Y Pressure Disribution Information network? Enter Y or N (c or e) c Center or End Manifold 3 Lateral Spacing (ft) If N above, enter the elevation (ft) 4 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) 1.50 Estimated Orifice Spacing (ft) = 4.55 ft2/orifice 3.00 Forcemain Diameter (in) 100.00 Forcemain Length (ft) Does the forcemain drain back? Y 93.00 Inside Pump Tank Elevation (ft) Enter Y or N 0.00 Forcemain Filter Loss (ft) 6.50 System Head (ft) x 1.3 36.70 Forcemain Drainback (gal) 9.13 Vertical Lift (ft) 62.95 5x Void Volume (gal) 0.81 Friction Loss (ft) 99.65 Minimum Dose Volume (gal) 16.43 Total Dynamic Head (ft) 54.37 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x 1.00 1.50 x 1.25 x X 2.00 x x 1.50 x 3.00 2.00 x 3.00 x Gallons/Inch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1200.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Weiser Concrete Manufacturer gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 800.00 Dose Tank Capacity (gal) POLY LOCK Filter Manufacturer 22.24 Dose Tank Volume (gal/in) 525 Filter Model Number Weiser Concrete Manufacturer Project: - AMARYLIS SCHREIBER Page 2 of 12 i Mound Plan View T j 1/10 B ::L J Observation Pie i .y: S. y"1L~ ~y.. :S: y:S> '''r.~5.:a~'4::r'::::{,: 5.:5'K':'S':1'}1:'~: ~5.^S~ :'S: S: S.:•ti A yi.:''4. yi4~ti y:y:'4.5:•5,:'t,: ys+{;. ~y;.'t;. r'w:~y'. I .................:.:.:.....:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:I:.... . B I Q . L Mound Component Dimensions ft A 6.00 ft E 29.88 in H 1.00 ft K Aft B 100.00 ft F 12.00 in z 13.60 ft L ft D 27.00 in G 0.50 ft J 10.04 ft W 600.00 (ft2) Dispersal Cell Area 1960.23 (ft2) Basal Area Available 6.00 (gpd/ft) Linear Loading Rate 10.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View EZflow Dispersal Area Finished Grade 104.25 (ft) 09 ,1/11/1; ♦ H ,,//11/111/, 21/1/11111 G 1 1 F Dispersal Cell 102.75 (ft) Lateral 102.25 (ft) - 6" Invert Elevation Dispersal Cell Elevation E D 3 A A-. 100.00 (ft) Contour Elevation 4.0 % Site Slope Typical Dispersal Cell Shading Key See Page 5 1❑ Topsoil cap > a) Q. 2 Subsoil Cap ~ 2 2.0 ft Approved Geotextile Fabric Cover 83 ASTM C33 Sand ° . Tilled Layer F5 EZflow Media IF 1:ysys:;yr U) O 0.5 ft U i - A See details on page 4 for number, size, and spacing of laterals. Laterals are located in the 4" gravity distribution pipes as shown on page 5. Project: AMARYLIS SCHREIBER Page 3 of 11 t t i i E r Center Connection Lateral Layout Diagram Place Appropriate Lateral Diagram From Right Below Force mai n connection .ia tee of cross to manifold at ang point. Laterals are identical Ar- S P S Turn-up vfball valve or Latarats & force main of PVC Sch 40 cleanoutplug per SPS Table 384.30.6 Orifices paint up, ew_ept every 5th one points doNvn for drainage, Number of Laterals 4 Orifice Diameter 0.125 in Lateral Diameter 1.25 in Orifice Spacing (X) 1.52 ft Lateral Length (P) 49.40 ft Orifices per Lateral 33 Lateral End (Z) NA ft Orifice Density 4.55 ft2/orifice Lateral Spacing (S) 3.00 ft Manifold Length 3.00 ft Lateral Flow Rate 13.59 gpm Manifold Diameter 2.00 in System Flow Rate 54.37 gpm Forcemain Velocity 2.47 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 slid b, SPS 316.300 WAC 4 in. min. Disconnect _ Tank component is properly vented E Alternate outlet location Forcemain diameter Weiser Concrete Manufacturer 3 in. Capacity 800.00 Gallons -T Volume 22.24 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 21.99 489.07 B 2.00 44.48 C Pump offelevation (ft) C 4.48 99.65 93.63 D 7.50 166.80 Total 35.97 800.00 D Dose tank elevation (ft) Bedding And ackfill As Per Manufacturer ♦ 93.00 Alarm Manufacturer SJ RHOMBUS Alarm Model Number PS PATROL Pump Manufacturer zoller _ v Pump Model Number 161 Pump Must Deliver 54.37 gpm at 19.18 ft TDH Note: Switches containing mercury may not be used in this system. Project: AMARYLIS SCHREIBER Page 4 of 12 i Uflowe Distribution Cell Media Layout 6.00 Cell Width (ft) 1.50 Sidewall to Lateral (ft) Distribution Cell Cross-section Arrangements 6 ft Wide GM860" Component Legend ® SRI JA Bundle - 5 ft or 10 ft lengths SR1-12A or EZ 1201A in 5 ft or 10 ft lengths SR3-12H or EZ 1201 P or @OM SR3-12H in 5 ft or 10 ft lengths 0 4" Perforated Distribution Pipe With Pressure Lateral Inside • Turnup Enclosure - - - - - Pressure Lateral Bundles are covered with approved geotextile fabric as per the their product approval. Distribution Cell Plan View Layout - Typical 6.00 Cell Width - A (ft) 100.00 Cell Length - B (ft) Center Connection Lateral Layout Diagram Force Main 6ftWide - - Center Manifold Project: BORGERING Page 5 of 11 Mound System Maintenance and Operation Specifications Service Provider's Name DARRELS SEPTIC Phone 7154251025 POWTS Regulator's Name (PAUL KOEHLER Phone 7152462660 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1200 gal Maximum TSS 150 mg/L Soil Absorption Component Size 630 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Mr or service once every 3 years Effluent Filter clean as necessa at least once eve 3 ears ry ry i] Pump and Controls e 3 ears Alarm eriodically Pressure System uld be flushed and pressure tested every 3 ears Mound onding and seepage once every 3 years Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap and are secured in as shown in the EZflow Mound Component Manual Ver. August 20, 2007. 2. Dispersal cell media conforms to EZflow products approved for use with the EZflow Mound Component Manual Ver. August 20, 2007. Media is covered with an approved geotextile fabric. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished Grade 6-8" Diameter Lawn/ Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Lateral Ends at Last Orifice Where Variable Length Cleanout Begins Lon Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral EZflow Synthetic Media 1.18 Feet Distribution Lateral -►I~--- Lateral Clean out - Project: Amaryllis Schreiber Page 6 of 12 Mound System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [EZflowMound Component Manual 8/20/07, Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. Septic and pump tank abandonment shall be in accordance with SPS 383.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner as to when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Wisconsin Department of Commerce. Pump Tank The dosing (pump) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. If the force main has a weep hole, it should be noted if it is functional during pump operation, and if not, it should be cleaned. *****No one should ever enter a septic or dose tank since dangerous gases may be present that could cause death.**** _Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD5, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5, 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 3 years. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Amaryllis Schreiber Page 7 of 12 PUMP PERFORMANCE CURVE " EFFLUENT MODELS PUMP PERFORMANCE CURVE PUMP PERFORMANCE CURVE SUMP / EFFLUENT MODELS 140 3/8', 1/2° & 3/4~ SOLID PASSING CAPACITY 3/8", 1/2" & 3/4" SOLIDS PASSING CAPACITY 42 13 MODEL 48 53/55 4 191 et M 57/59 72 76 98 1371139 140/4140 13 Fs' Srs 2991. ;i'o 43. Liters Gal. Liters GaL Liters Gal. Liters Gal. Liters Gal. Liters Ga1.151 Liters Ga 152 Liters Ga153 Liters 10 3.1 22 83 34 129 38 144 50 189 72 273 93 352 86 326 3 12 189 fig 261 77 291 30 114 40 151 61 50 15 4.6 10 38 19 72 231 79 299 80 303 45 170 61 231 10 265 12 20 6,1 _ 14 53 30 114 45 170 64 242 73 276 38 144 53 201 61 231 36- 16 25 7.6 - _ _ - 17 64 25 95 11 4886 30 01 _ _ _ _ 36 136 66 250 29 110 44 167 52 197 ' - - _ - - 8 30 59 223 16 61 34 129 42 159 3 119 40 12.2 - _ _ _ _ - - - - - - 49 185 - 23 87 33 125 32 105 100 80 24.4 _ _ _ - - - - - - - - _ - - - - 3 95 100 30.5 2 110 33.5 90 120 36.6 2 130 39.6 _ - - - - - - _ _ - - - o es Shut-off Head: 18 ft. 5.Sm - - - - - - - - w 19.25 ft. 5.9m 18 ft. 5.5m 25 ft. 7.6m - - - - 2 e0 23 ft. 7.Om 26 ft. 7.9m 50 ft. 15.2m 30 R. 9.1 m 38 ft. 11.6m 44 ft. 13.4m 416 a1s5 `z 7s 22 70 ° 1633 161/4161 163/4163 16514165 185/4185 186/4186 2 66 188/4188 189/4189 191 V Gal. Liters Gal. Liters Gal. Liters Gal. Liters Gal. Liters Gal. Liters Gal. Lifers Gal. Liters 1 60., 100 379 61 231 61 231 _ _ 549 145 549 45 170 4861 169 93 352 61 58 220 145 55 4189 85 322 fi0 227 fii 231 _ _ 58 ~0 140 530 140 530 45 170 1 140 79 299 59 223 60 227 _ 58 ~0 134 507 135 511 45 170 50 4140 70 2fi5 57 216 59 223 _ 58 220 128 484 131 496 45 170 62 235 55 206 58 220 85 58 220 122 4fi2 125 473 45 170 1 188 45 170 46 322 58 220 71fi 439 120 454 45 45 4188 20 76 33 172 55 206 70 285 58 220 104 170 ~ - - 15 125 50 189 57 193 58 220 394 109 413 45 170 12 4 752 - 39 748 32 121 90 341 97 367 45 170 23 56 220 71 269 85 322 45 170 153 97 9 34 52 197 1 35 - - - 10 39 - 45 170 51 193 69 261 45 170 26 106 51 193 45 170 30 157 _ _ _ _ - - - 31 117 2 8 34 129 45 170 185 - _ _ _ - 16 80 - - 17 64 40 151 25 4185 - - _ _ - 4 15 - - - 30 114 _ 20 76 20 98 56 fl.(17.im) fib R. (20.1 m) 89 ft.(26.4m) I'll 22.3m) 114 R(34.7m) 91 tt{27.7m) 110 R.t-rr) 137 1 (41.5m) 1 4 1 009922 2 j 48 72 53,55 761 5 I A CAUTION Model 185/4185 should not be subjected to 0 57.59 139 less than 30 feet TDH. 10 20 30 ao so NOTE: For Pump Performance on Model 112, Industrial column GALLONS 60 70 80 90 100 110 120 130 140 150 LITERS o explosion proof pump, see FM0219- 80 760 240 320 400 480 560 FLOW PER MINUTE SEWAGE AND 211 264 266 Mill MODEL l~ 267 268 270/4270 282/4262 28414284 292/4292 293/4293 29414294 295/4295 24-{ 80- DEW4TERING i i 75 zz 70 1 0 ~ isz - s lay zol - 5 -i - I 65 - - sn~~oa a a n - l nie w nsR rm 60 sm~ I ~ as 1 8 0 I I x 009901 55 a 50 0 14~ 45 2 2931 0 12 1 40 G35 PUMP PERFORMANCE CURVE 11 30- URVE 8J 25 SEWAGE MODELS 282 j 1270 6- 20 266'1 1 2ff SOLIDS PASSING CAPACITY 11 4-I 15 I 70 ~ i I 2-1 1 1 5 1 0 1 211 264 1292 284 294 295 A CAUTION 10 20 30 40 50 60 70 80 90 100 110 120 130 140 150 160 170 180 190 200 210 22C 23 Model 293/4293 should not be GALLONS subjected to less than 1fi fe TDH et LITERS 0 80 160 240 320 400 480 560 640 720 800 FLOW PER MINUTE © Copyright 2003 Zoeller Co. All rights reserved. 6 SCALE 1" = 40 FT NJ BM Q BOREING BS FEED LOT AREA D IVE WAY SYTEM ELEVTION 100.00 CONTOUR LINE 2578 140TH AVE WN OF SPRINGFIELD CROIX COUNTY LSEl/4SEl/4S23T30Rl6W WEL FEED LOT RUN OFF BM 1 TOP OF WELL 106.9 I 0 WIESER 1200/800 COMBO ANK POLY L C 525 FILT B1 HOME 0 0 0 BM O OF EAST TANK COVER 3 LOCK DOWN CO 104.2 VERS ABOVE GRADE 65 126. X29.65 MOUND SYSTEM 101. 0 Oak tree SYTEM NEEDS TO BE CHISEL PLOWE MIN OF 13" WITH 3 TO 4 INCHES 0 101 ASTM C-33 SOIL MIXED IN B o .2 `r 100 Observation pipes Q 99 O'jOo 64 98 INSTAL SYTEM ON CONTOUR 100. HOLD AS CLOSE TO B3 AS POSSIBLE AS PER LINE 8 ON PAGE 7 IN THE INTERPETIVE DETERMINATION REPORT. IT WOULD BE WISE TO READ PAGE 5,6 AND 7 OF REPORT BEFORE INSTAL. POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page I of 2 FILE INFORMATION SYSTEM SPECIFICATIONS Owner W Septic Tank Capacity 1.1 do 11 NA Permit # gal Septic Tank Manufacturer ❑ NA S~ b DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms `Lf' ❑ NA Effluent Filter Model Sts` ❑ NA Number of Public Facility Units 19, NA Pump Tank Capacity gal 13 NA Estimated flow (average) gal/day Pump Tank Manufacturer 4/ry l ❑ NA i' Design flow (peak), (Estimated x 1.5) ~~lJ gal/day Pump Manufacturer ~ A', ❑ NA Soil Application Rate gal/day/ftz Pump Model ❑ NA Standard Influent/Effluent Quality Monthly average* Pretreatment Unit o~ NA Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BODE) _<220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 51 50 mg/L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BODS) 530 mg/L ❑ In-Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L ❑ NA ❑ At-Grade kMound Fecal Coliform (geometric mean) 5104 cfu/100m1 ❑ 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: .fc7 E3 year mon(s)th(s) (Maximum 3 years) 13 NA Pump out contents of tank(s) When combined sludge and scum equals one-third (EY3 Ekv me ❑ NA Inspect dispersal cell(s) At least once every: ❑ month(s) ea rs) R~N A ❑ year (s) Clean effluent filter At least once every: month(s) ❑ NA 1'ty s• 15 year(s) Inspect pump, pump controls & alarSJAAt Sleast once every: ❑ month(s) ❑ NA .ct year(s) Flush laterals and pressure test once every: 13 month(s) A year(s) ❑ NA Other: At least once every: L.] month(s) ~ NA Other: ❑ 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 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 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 y 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. area. UPG)P p}> T a o dingtank aluati FR N418 rF~~ 1: D f - 1~1 ~w ~AhJS~RU«l D be i e tailed ❑ 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 ANDIOR INSUFFICIENT OXYGEN. DO NO 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 t e'•l Name Phone ~~r~ 1 Phone ~!Z SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name LT"Z 2oej t/j r 1 sue' ~~Q ( (~(f N Phone Phone I T/'r 1~1 This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d)&(fl and 83.54(1), (2) & (3), Wisconsin Administrative Code. RECEIVED JUN 0 7 2n1 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT ST. CROIX COUMTY AND ,OMMUMITY DEVELOPMENT OWNERSHIP CERTIFICATION FORM Owner/Buyer Amarylis Schreiber Mailing Address 2578 140th ave Property Address 2578 140th ave V (Verification required from Planning & Zoning Department -for or- constructioon.) City/State Glenwood City Wl Parcel Identification Number 1 0 1 05480000 LEGAL DESCRIPTION Property Location SE SE ,4 sec. 23 T 30 N R 16 w Town of EMERALD Subdivision Plat: Lot # Certified Survey Map # , Volume Page # Warranty Deed # (before 2007)Volume , Page # Spec house ElyesE]no Lot lines identifiable ❑yesE] no SYSTEM MAINTENANCE 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 this form 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 warranty deed recorded in Register of Deeds Office. Number of bedrooms 4 :~~f~ 5/ 31 17 /SIATURE OF 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) DIVISION OF INDUSTRY SERVICES - 10541 N RANCH RD tiaar-+rr - ~l F, HAYWARD WI 54843-6462 Contact Through Relay $ z http://dsps.wi.gov/programs/industry-services~,.~ i~ wwwmisconsin.gov \ro: Scott Walker, Governor Laura Gutierrez, Secretary RECEIVED April 14, 2017 CUST ID No. 46672 APR 2 0 2011 ATTN.• POWTS Building Inspector ST. CROM COUNTY MARK W IVERSON -,OMMUNITY DEVELOPMENT ZONING OFFICE EVERGREEN IRRIGATION INC ST CROIX COUNTY SPIA 617 CTY RD J 1101 CARMICHAEL RD ROBERTS WI 54023 HUDSON WI 54016-7708 CONDITIONAL APPROVAL SITE: Identification Numbers Amaryllis Schreiber Transaction ID No. 2926703 Site ID No. 836731 2578 Town 144 Springfield ingfi Ave eld Please refer to both identification numbers, St Croix County above, in all correspondence with the agency. SE1/4, SEI/4, S23, T30N, R16W FOR: Object Type: Soil Saturation Determination Regulated Object ID No.: 1699090 The following conditions shall be met: • Approval is hereby granted to use a limiting depth to zone of saturation of 9 inches, as determined in the Interpretive Determination Report by Mark Iverson, CST, dated 03-31-2017. The CST's report was submitted in accordance with section SPS 385.60(2), Wis. Adm. Code. All soil absorption components shall be in accordance with chapter SPS 383, Wis. Adm. Code. • Soil conditions at this site require a linear loading rate not to exceed 6.0 gal./lin.ft./day and a basal loading rate not to exceed 0.4 gal./sq.ft./day. • Soil permeability could be impaired by compaction in the tested area; therefore, the proposed system area must be protected from compaction prior to system installation; it is very important that site preparation and plowing be performed when the soil is sufficiently dry. Plowing of the proposed mound area shall be in accordance with instructions provided in the report by M. COAA Iverson. DEPT OF Sce APP • This approval is limited to the tested area described by Mark Iverson, CST, as part of this referenced Interpretive Reporb~' IF~ANO report may not be applied to any other portion of the subject parcel or to other parcels. SjON OF ZA Reminders The decision on the Interpretive Determination Report does not have an expiration date. • The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Code Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 14E:'E Wisconsin Statutes, is responsible for compliance with all code requirements. CORRQ • In granting this approval, the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, Fee Required $ 240.00 Fee Received $ 240.00 Balance Due $ 0.00 Edwin A Taylor Wastewater Specialist , Division of Industry Services (715)634-3484 , Monday - Friday 8:00 am To 4:30 pm edwin.taylor@wisconsin.gov r INTERPRETIVE DETERMINATION REPORT Property Owner: Amaryllis Schreiber 2578 140 Ave. Glenwood City, WI 54013 Site Location: SE '/4 of the SE '/4, Sec. 23, Town 30N, Range 16W Town of Springfield St. Croix County Prepar(-' ' CST #46672 Varklverson, `Tr0A-4LLY ROVED March 31, 2017 PROFESSIONAL ate DDUSTRy SER~CES Evergreen Irrigation Inc. Mark Iverson, Professional Soil Scientist 617 Cty Rd J Roberts, WI 54023 Phone: 715-684-9125 'P N e-mail: evergreenirrinc@gmail.com TABLE OF CONTENTS 1. Introduction 1 IT. Project Information 1 III. Method 1 IV. Discussion of Results 2 A. Local Hydrology 2 B. Geomorphology 2 C. Soil Disturbance and Hydraulic Modifications 2 D. Landscape Position and Local Topography 3 E. Soil Series and Mapping Units 3 F. Wetland Inventory Map 4 G. Field Observations 5 H. Comparative Analysis 5 1. Government Reports and Comments 6 V. Conclusions and Recommendations 6 VI. References ...............................................................................................................7 TABLES Table 1 - Soil Series Characteristics Table 2 - Hydric Soil Classification FIGURES Figure I - USGS Topographic Map Figure 2 - Soil Map Figure 3 - Wetland Inventory Map APPENDICES Appendix A - Soil Evaluation Report L INTRODUCTION On March 28, 2017 Mark Iverson Certified Soil Tester #46672, completed an interpretive onsite soils evaluation. An interpretive evaluation is required because the site does not meet the requirements to install a new private on-site waste treatment system (POWTS) through completion of a conventional onsite soils evaluation (<A+4 inches of acceptable soil must be present). The onsite evaluation was completed through the observation of the soil profiles at five test pit locations. This report has been prepared to present the results of an interpretive onsite soils evaluation. The evaluation was completed at the request of the client, Amaryllis Schreiber. The property is located at 2578 140th Ave. in the Township of Emerald, St. Croix County, Wisconsin. II. PROJECT INFORMATION The following is site-specific background information: Property Owner: Amaryllis Schreiber 2578 140th Ave. Glenwood City, WI 54013 Site Location: SE t/4 of the SE 1/4, Sec. 23, l owji 30\v , Range 16'Vk Parcel ID # 010-1054-80-000 Town of Emerald St. Croix County Historic Land Use: Lawn Current Land Use: Lawn Vegetation: The vegetation within the tested area consists of miscellaneous grasses. There are no signs of stress within the tested area due to excess or insufficient moisture. Hydric vegetation was not observed within the project area. III. METHOD This interpretive evaluation and report was completed following the guidelines set forth in Comm 85.60(2) of the Wisconsin Administrative Code and in the summary provided by Leroy Jansky titled, "Preparing the Interpretive Determination Report" (March 13, 2002). 1 IV. DISCUSSION OF RESULTS A. Local Hydrology 1. Surface Water Drainage Patterns - There are no surface water drainage patterns within the tested area. Surface water drainage is received from up slope and flows over the proposed site via sheet flow. The feed lot to the north does have pooled manure. The overflow from the feed lot flows east of the proposed system area. The proposed system location is on the backslope. The slope within the proposed system area is approximately 4 to 10%. 2. Subsurface Water Drainage - The silt loam texture and lack of compacti within the surface horizon of the lawn offers good infiltration and latera' movement of precipitation received on site. Moderate compaction (plat structure) was observed in the first or second horizon of borings 3, 4, an 5. The platy structure limits the infiltration of surface water within the profile. During and immediately following frozen conditions and following heavy precipitation events, runoff will be much greater. 3. Artificial Drainage Devices - No artificial drainage devices were observed during the completion of the evaluation. 4. Contributing Drainage Area - The proposed system area is located on the backslope of the hill slope profile. The summit of the profile is located approximately 500 northwest of the proposed installation contour. There is contributing drainage area up slope of the tested area however the majority of the potential drainage from upslope is diverted by building and the driveway. The concave shape of the constructed mound upslope will need to be filled in order to divert water away from the infiltration area and around the system. 5. Soil Saturation - Saturated soil was observed at 30 inches below surface in boring #I but not in any other borings. 6. Surface Water Elevations - Surface water within the immediate vicinity of the site, if present, has been identified on Figure 1. B. Geomorphology 1. Parent Material - The parent material is loess over glacial outwash/till. 2. Landform Type - Ground moraines. C. Soil Disturbance and Hydraulic Modifications The proposed system location is in an existing lawn. No hydraulic modifications, such as drain tile or ditches, were observed at the time of the assessment. No additional surface water is received from impervious surfaces. I 2 D. Landscape Position and Local Topography The regional topography is shown on figure 1. The ground surface elevation is approximately 1180 feet mean sea level (msl). The topography within the proposed system area is shown on the site map included in Appendix A. The proposed system elevation is 100.00 feet (site specific elevation). The shape of the slope within the proposed system area is convex (perpendicular to the contour) and convex (parallel to the contour). FIGURE I - USGS TOPOGRAPHIC MAP 23 ~r / •r 124 -1170 Q t C J 4.J osCd 5ysi6m, 1 ~t on - Decor - E. Soil Series and Mapping Units The Natural Resources Conservation Service Web Soil Survey maps the soils on the property as Freeon silt loam (FnB), Magnor silt loam (MaB), and Rib silt loam (RhA). The location of each soil type is identified on Figure 2. The primary soil characteristics as described in the series descriptions are identified on the Table 1. 3 TABLE I - SOIL SERIES CHARACTERISTICS Texture Parent Material Permeabili Soil A E or B Drainage Series Horizon Horizon Surface Subsurf. Surface Subsurf. Class Fn 'IT SIL Loess Till M MS to S MW Ma SIL SIL Loess Till M MS to S SP Rh SIL SIL/L Loess or All outvvash M MR P uvium Abbreviations Permeability IM = Impermeable MS = Moderately Slow RA = Rapid VS = Very Slow M = Moderate VR = Very Rapid S = Slow MR = Moderately Rapid Drainage Class VP = Very Poorly W = Well P = Poorly SE = Somewhat Excessively SP = Somewhat Poorly E = Excessively MW = Moderately Well TABLE 2 - HYDRIC SOIL CLASSIFICATION NRCS - USDA Soil Series Component Inclusions USACOE Fn No None No Ma No Adolph No Rh Yes Hydric Yes USACOE = US Army Corps of Engineers FIGURE 2 SOIL MAP ~n -RQ ~y ....,......_......r""°, "Il 4 4 F. Wetland Inventory Map The Wisconsin Department of Natural Resources surface water viewer was reviewed to identify wetlands mapped on the property. The wetland inventory map is included as figure 3. Wetlands were mapped on the east and north side of the property in yellow and wetland indicator soils are marked on the south, east, and north sides of the property in pink. No were wetlands or indicator soils are identified near the test location FIGURE 3 - WETLAND INVENTROY MAP V7- fit = . 144, 11 fa. U r m a all G. Field Observations The soil at both ends of the tested area observed in B-1 and B-3 had redox conditions at a much shallower elevation than the boring (B-2) in the center of the tested area. The redox was likely at a lower elevation near B-2 due to the presence of coarser sandy loam soil and lack of compaction that was observed in the second horizon of B-3. The detailed soil profile observations can be seen in soil evaluation report included as Appendix A. All of the test pits surrounding the proposed system area (B-l, B-2, and B-3) have moderate, medium, granular silt loam present at the surface. The soil has a soil application rate of 0.6 GPD/sq. ft. for Eff#l. The subsoil directly beneath the top 5 horizon varies significantly in the different test pits and includes sandy loam, silt loam, and sandy clay loam textured soils with structures from moderate blocky to moderate platy and loading rates from 0.0 to 0.6 GPD/sq.ft. Plowing of the moderate platy structured soil will reorient and break up the soil peds to a more granular structural orientation and therefore improve the acceptable loading rate of subsoil. The soil on site does not meet the hydric soil criteria. The lack of hydric soils indicates that the soil is likely not saturated for greater than 5% of the growing season (approximately 7 consecutive days). A dominance of hydrophytic vegetation was not observed within the proposed system area. The lack of these features does not preclude the possibility that the soil is saturated for a prolonged period of time prior to or on occasion during the growin. season. H. Comparative Analysis Soil borings (B-1, B-2, and B-3) were completed within the proposed system area. Two additional borings were completed, one upslope (B-5) and one down slope (B-4) of the proposed system area. The texture, structure, and depth to redox features of borings 4 and 5 were similar to that of the tested area. 1. Government Reports and Comments No other government reports have been observed for this property. V. Conclusions and Recommendations Seasonal saturation appears to be limited to greater than 9 inches below surface within the proposed system area, the majority of the time. The lack of soil dominated by low chroma colors within the proposed system area indicates that the redoximorphic features observed are not due to a high water table or perching conditions. The cause of the redox features observed in the test pits is most likely attributed to short-term seasonal saturation due to slow permeability of the dense glacial subsoils. Reorientation of the platy structure observed in B3 by chisel plowing after placing 3 to 4 inches of ASTM-33 sand on the system area will aid the dispersion of effluent through the subsoil. The site is suitable for installation of a POWTS (mound system) for the following reasons: 1.) Redoximorphic features were not observed in the upper 9 inches of soil within the proposed system area. 2.) Neither hydric soils nor a dominance of hydrophytic vegetation are present within the proposed system area. 3.) There are no topographic features that concentrate flow toward the proposed system area. 6 4.) The slope at the proposed system location is 4 to 10%. The slope is uniform with no dips or valleys at the proposed system location. 5.) The lack of soil dominated by low chroma colors indicates that the redoximorphic features observed at depth are due to temporary seasonal saturation and not from a permanently high water table or perching condition. The following recommendations should be considered during installation of the proposed system: 1. The system should be installed on the 100.0' contour to stay within the tested area. 2. Sand fill shall consist of 2.25' of material meeting ASTM C-33 specifications. 3. To break up the platy structure tillage must be completed with a chisel plow to a minimum depth of 13 inches below native ground surface during dry conditions after placing 3 to 4 inches ASTM C-33 soil over the infiltration surface. 4. The basal loading rate shall not exceed 0.4 GPD/ft2. 5. The system shall be designed to have a linear loading rate of 6.0 GPD/ft or less. 6. The system will follow the contour (100.0') and be nearly linear. 7. The area upslope of the mound must be altered to limit the influence of surface water received from upslope. The surface water must be diverted around the ends of the mound. 8. Install the system as far to the south, near B-3, as possible. The final approval of this site must be made by the Wisconsin Department of Commerce and the St. Croix County Zoning Department. This report represents the observations and professional opinion of Mark Iverson, Professional Soil Scientist (#197) and Certified Soil Tester (#46672). VI. REFERENCES 1.) Soil Survey Staff, Natural Resources Conservation Service, United States Department of Agriculture. Web Soil Survey. Available online at http://websoilsurvey.nres.usda.gov/ accessed [12/18/07]. 2.) State of Wisconsin. Department of Commerce Code, Chapters 83 and 85. 3.) US Department of Agriculture, Natural Resources Conservation Service. 1996. Field Indicators of Hydric Soils in the United States. G.W Hurt, Whited, P.M., and Pringle, R.F. (eds,). USDA, NRCS, Fort Worth, TX. 4.) Schoeneberger, P.J., Wysocki, D.A., Benham, E.C., and Broderson, W.D. (editors), 2002. Field book for describing and sampling soils, Version 2.0. 7 Natural Resources Conservation Service, National Soil Survey Center, Lincoln, NE. 5.) United States. Us Geological Survey. Topographical downloaded from t~Z 'lc(~'cl~f:l't1.0Ylll,r~»Cf~l C,y}11i` 6.) St. Croix County. St. Croix County Land Information System. 7.) United States. United States Department of Agriculture - Natural Resources Conservation Service. Hydric Soil List for St. Croix County, Wisconsin. , 8.) United States. Us Army Corps of Engineers. 1987. Corp of Engineers Wetland Delineation Manual, Technical Report Y-87-1. USAEWES Environmental Laboratory, Vicksburg, MS. 9.) Wisconsin Department of Natural Resources. Wisconsin Department of Natural Resources - Surface Water Viewer. Wetland Maps. APPENDIX A SOIL EVALUATION REPORT s Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Dordtww gs In accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 '/2 x 11 inches in ' Pla ust St. Croix }r~olimited to: vertical and horizontal reference point (B dire an Parcel I.D. O1 O-1 S4, O-OOO e e t s ope, scale or dimensions, north arrow, and BM ref•^- Date ST. CROIX COUNTY Please print all inform R/ W7Snw1Qd RC1ffmay be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)) 7 fYo erty Owner Property Location ~Amaryllis Schreiber Govt. Lot SE v4 SE v, s 2 T N R 16 w Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 2578 140th Ave. City State Zip Code Phone ❑ City ❑ Village 0 Town Nearest Road Glenwood City WI 54013 Emerald 140th Ave. ❑ New Construction Use: 0 Residential / Number of Bedrooms 4 Code derived design flow rate 600 GPD 2 Replacement ❑ Public or Commercial - Describe: Parent Material Loess over Till Flood Plain elevation if applicable N/A ft. General comments and recommendations: 1 Boring # Boring 0 Pit Ground Surface Elevation 100.0 ft. Depth to Limiting factor 12 in. 1 Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. S_z. Sh. *Eff#1 *Eff#2 1 0-12 10YR2/2 - SIL 2-m-gr mvfr cs 2 f-m 0.6 0.8 2 12-20 7.5YR4/4 5YR5/4 f-1-d SCL 2-m-bk mfr gs 1m 0.4 0.6 3 20-30 7.5YR4/4 5YR5/4 f-1-d SL 2-m-bk mfr gs 1m 0.6 1.0 - - - - - - - - 4 30-42+ 7.5YR4/4 wet & soupy SL soupy wet - - - - I Boring ❑ Boring j # opit Ground Surface Elevation 99.2 ft. Depth to Limiting factor 25 in. _ Soil A lication 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 0-10 10YR2/2 - SIL 2-m-gr mfr cs 2f 0.6 0.8 2 10-19 10YR4/4 - SL 2-m-bk mfr gs 1 m 0.6 1.0 3 19-25 7.5YR4/4 - SL 2-m-bk mfr gs - 0.6 1.0 4 25-32+ 5YR4/4 5YR3/2 f-1-d SCL 2-m-bk mfi - - 0.4 0.6 I J • Effluent # 1 = BOD5> 30:5 220 mg/L and TSS > 30 < 150 mg/L ' Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Sign CST Number Mark Iverson 46672 Address Date Evaluation Conducted Telephone Number P.O. Box 155 Hammond, WI 54015 March 28, 2017 715-796-5664 S ` I Property Owner Amaryllis Schreiber Parcel IM 010-1054-80-000 Page 2 of 3 Boring # 0 Boring Wit Ground Surface Elevation 100.0 ft. Depth to Limiting factor 9 in. Soil Application Rate _i Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2_ in. Munsell Qu. Sz. Cont. ColorGr. Sz. Sh. *Eff#1 *Eff#2 1 0-9 10YR2/2 - SIL 2-m-gr mfr cs 1m 0.6 0.8 2 9-13 10YR5/3 7.5YR6/6 f-1-d SIL 2-f-pl mfr gs 1f 0.0 0.2 3 13-23 10YR4/4 7.5YR4/6 c-2-d SIL 2-m-bk mfr gs - 0.6 0.8 4 23-32+ 7.5YR4/4 5YR5/8 c-2-p SCL 2-m-bk mfr - - 0.4 0.6 Boring # ❑ Boring OPit Ground Surface Elevation 96.2 ft. Depth to Limiting factor 27 in. - Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP_D/ftZ in. _Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-11 10YR3/2 - SIL 1-co-pl mfr as 1m 0.4 0.6 2 11-27 10YR4/4 - CL 2-m-bk mfr gs 1 f 0.4 0.6 3 27-35+ 7.5YR4/4 5YR4/6 c-2-p SL 1-co-bk mfr - - 0.4 0.7 Boring # O Boring Wit Ground Surface Elevation 101.3 ft. Depth to Limiting factor 13 in. _ Soil Application Rate j 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 0-11 10YR2/2 - SIL 3-m-gr mfr as 3f 0.6 0.8 2 11-13 10YR5/4 _ SIL 2-m-pl mfr gs 1f 0.0 0.2 3 13-19 10YR5/4 10YR5/8 c-1A SICL 2-m-bk mfr gs 1f 0.4 0.6 4 19-28 7.5YR5/3 5YR4/6 c-2-d SL 1-m-bk mfi gs - 0.4 0.7 5 28-40+ 5YR5/3 5YR46 c-2-d SL 1-co-bk mfi - - 0.4 0.7 I * Effluent # 1 = BOD5 >30 < 220 mg/1, and TSS > 30 < 150 mg/L * Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg/1, 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. { M Page 3 of 3 0 ft. 24 ft. 40 ft. 80 ft. BM#1 - Top of well 106.9' Feed Lot covered patio 'e B-1 BM#2 - Top of [ast tank c 100.0 10 ' A House B-5 101.3 A= 0 oak 0 ~p o B-2- 0 991 cf'/0 O~ 13- 100.0 ~p0 9g 9a D962 • = Ground Surface Elevation BM# & Description Elevation = Bench Mark B-1 Boring Location & Elevation 100' Owner: Amaryllis Schreiber Site Information: Completed By: Mark Iverson, PSS #197 2578 140th Ave SE1/4, SE1/4, S23, T30N, R16W 617 Cty. Rd. J Glenwood City, WI 54013 Town of Emerald Roberts, WI 54023 St. Croix County 715-684-9125 Phone: 715-265-4774 CST# 46672