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HomeMy WebLinkAbout002-1087-40-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division Sanitary Permit No INSPECTION REPORT 597379 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)] 2952970 Permit Holder's Name: Co Village Township Parcel Tax No: DUSTIN CESAFSKY TOWN OF BALDWIN 002-1087-40-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 1N1 1 GST 34.29.16.504B TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER i CAPACITY STATION BS HI FS ELEV. 41 Septic Benchmark 3 q / 66 Dosing r 7 ~V~ All- BM CoJ-jo~ 6 44 Bldg. Sewer 47 / do ~a I IL - Holding St/Ht Inlet 9a CO TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L, WELL BLDG. ent to it Intake ROAD Dt Inlet Septic Dt Bottom 73 75' 1Z / ~O• Z g Dosing Header/Man. 3 7 14 7 s Z'7 Aeration Dist. Pipe Z 1 / r Holdin Bot. System g 3.5 /Lb, 3 v , 9 /aZ PUMP/SIPHON INFORMATION 4:il, 14 Final Grade Manufacturer Demand St Cover -'1 ) cq Y GPM J C J1~r / Model Number S~ $ f /JCZ Z't 0 TDH Liti Friction~o Z_ System H arc TDH-1-1 Forcemain Length ' Di~ I if I Dist. to well SOIL ABSORPTION SYSTEM BED/TRENCH Widthj / Length No. rench s PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ' I) L, SETBACK SYSTEM TO 1\ I P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer INFORMATION CHAMBER OR Type f stem: UNIT Model Number: of 11,3,1 S -7 k DISTRIBUTION SYSTEM Header/Manifold Distribution z ' Ix Hole Size Ix Hole Spacing'/ V o Air Int Pipe(s) V,J~ A Jl 3 s 3z 3 Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only w r.r Depth Over Depth Over xx Depth of xx Seeded Sodded 1xx Mulched Bed/Trench Center J~ Bed Trench Edges Topsoil yl ] No Yes, No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Z 1-°7 inspection #2: Location: No Address Available G~ee~ v N/~ (~e 1. Alt BM Description = ~'t ~O`>tf~. '~3+-~n' LI 2.) Bldg sewer length = Z 3 P - amount of cover = jZ, Plan revision Required? Yes No C7 Use other side for additional Information.. Date 9 Insepctor's Signat Cert. No. SBD-6710 (R.3/97) P d 7 - g County Safety and Building sion _ 201 W. Washington e- Box '7162' St. Croix Permit Nu'm''b)er (to be filled in by Co.) ~ ~ Madison. WI - Sanitary Ma t / Department of CommerC State Plan I.D. Number j App 2952970 In accAt~,t~ Comm 83.21, Wis. Adm. Code - you provide may be used for secondary purpo. -04(1)(m) ProJect Address (if different than mailing address) L Application Information - Please Print All Infot _..ation 4/ GS /2J Parcel # Lot # Block # Property Owner's Name Dustin Cesafsky Property Location ,'•~``i ~i L" Property Owner's Mailing Address 2418 County Road BB SW y,, NW Section 34 City. State Zip Code Phone Number 54028 715-456-0524 29 16 (circle one) Woodville, WI F N; R r ✓ 11. Type of Building (check all that apply) Ok- ew OJ K~ Subdivision Name CSM Number I or 2 Family Dwelling - Number of Bedrooms 4 ❑ Public/Commercial - Describe Use ❑City ❑vdiage Qfownship of Baldwin ❑ State Owned - Describe Use III. Typ of Permit: (Check only one box on line A. Complete line B if applicable) 0.44-10 ew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System List Previous Permit Number and Date Issued B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New Before Expiration Plumber Owner IV. Tv e of POWTS System: Check all that a I d ❑ ❑ Non -Pressurized In-Ground ❑ Mound > 24 in. of suitable soil Mound <24 in. of suitable soil ❑ At-Grade ❑ Single Pass Sand Filter Constructed Wetland r ~ec eY1 Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculati Sa d Fi to ❑ e Recirculating Synthetic Media Filter ❑ Leaching Chamber 13 Drip Line ❑ Gravel-less Pipe ❑ Other (explain) ► V. Dis ersal/Treatment Area Information: S Elevation Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (st Dispersal Area roposed (sf) y stem /W ~5 Capacity in~ Total Number Manufacturer Pre ab Site Steel Fiber Plastic VI. Tank Info Gallons Gallons of Units Concrete Constructed Glass New Existing z Tanks Tanks Septic or Holding Tank x 1200 1 WI ser x Aerobic Treatment Unit Dosing Chamber x 00 1 Wieser X V11. Responsibility Statement- 1, the rsign a me re nsibility for installation of the POWTS shown on the attached plans. Plumber , Si tur MP/MPRS Number Business Phone Number Plumber's Name (Print) 715-231-7375 Lewis Bjork 253976 Plumber's Address (Street, City, State, i e) f E7818 County E, Menomonie, WI, 54751 V111. ntv/De artment Use Oni Sanitary Permit Fee (includes Groundwater Date ssue Issuing A Signature( o St, s) Approved Disapproved Surcharge Fee) ❑ ven Reason for Den al l0 IX. Conditions of Approval/Reasons for Disapproval 3 / n t~ SYST04 OWNEItr i ~J7WJ ~ I ~ I . 1. '.aeplk t rk, etf mn; iiw ofid r tiiWer:sii cell nust all tie sto. C?s ! ti+.filnta:p f as,per maragemen! plan prohaed bV plthnber. 2. EAU' *'reaWretaent+s mtrst.hte t tarst : e64 as per wrk r+bls C46! ! ::Mi u►nca~. Attach complete plans (to the County only) for the system on paper not less than 81/2 z 1 I inches in size SBD-6398 (R. 01/03) CHECK BOX AS APPLICABLE. CHECK BOX AS APPLICABLE. PAGE 2 O F!_G' 0✓ SOIL EVALUATION o Scale: 130 30 45 60 7 ]SYSTEM SITE MAP PLOT PLAN PROJECT NAME: 2 DESIGN FLOW: 600 GPD 7.5 Dustin Cesafsky I~ Attach design flow calculations for commercial plans. PROJECT ADDRESS: 2418 Cty Rd BB Pipe Material / ASTM Standard (Tables 384.30-3 & 384.30-5) N Sanitary Sewer: 4 3034 / BM Symbol:r BM Elevation: 100 FT Force Main: 2 / SCh 40 BM Description: Top lot corner iron Indicate north by IMPORTANT: Slope Gradient 2 Well Symbol (if applicable): 0 drawing an arrow Show ground elevation contours at suitable intervals, of Tested Area: on the aporoprlte line. 0 r Vol Flory, L 9gI , \o4- ev V L 4$6 411k it Q ~~=gym ~ ~~s 1712 31 DIVISION OF INDUSTRY SERVICES 10541 N RANCH RD I{y\ HAYWARD WI 54843 6462 Contact Through Relay ` P httP//dsPs.wi.9ov/Pro9rams/industrYservices / www.wisconsin.gov ssic 0~ Scott Walker, Governor Laura Gutidrrez, Secretary June 09, 2017 CUST ID No. 253976 ATTN: POWTS Inspector LEWIS C WORK ZONING OFFICE LEWIS BJORK LLC ST CROIX COUNTY SP1A E7818 COUNTY ROAD E l 101 CARMICHAEL RD MENOMONIE W1 54751-6637 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 06/09/2019 Identification Numbers Transaction ID No. 2952970 SITE: Site ID No. 838698 Dustin Cesafsky- New Mound Please refer to both identification numbers, 2417 Cty Rd Bb above, in all correspondence with the agency. Town of Baldwin St Croix County SW 1/4, NW1/4, S34, T29N, RI 6W FOR: Object Type: POWTS Component Manual Regulated Object ID No.: 1709444 Maintenance required; 800 GPD Flow rate; System(s): Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01/01, R. 10/12), Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01/O1, 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, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • A copy of this approval letter and index sheet shall be attached to plans that correspond with the copy on file CQ" with the Department. Changes to the approved plan must be submitted for review and approval. Failure to A PPR properly attach the approval and index page to plans that match the copy on file with the Departmebt mav result 1A~~~ p in enforcement action under s. 145. 10, Stats. L7t1'T OF DIVISION OF zND • This system is to be constructed and located in accordance with the approved plans, and the "Mound Component Manual for Private Onsite Wastewater Systems Version 2.0" SBD-10691-P (N.01/01, k. 10/12). • This system is to be constructed and located in accordance with the approved plans and with the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems Version 2.0" SBD-10706-P (N.01 /01). • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. SEE CORRE Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil. Proper soil moisture content can be determined by rolling a soil sample between the hands. If it rolls into a 1/4- inch wire, the site is too wet to prepare. If it crumbles, site preparation can proceed. If the site is too wet to prepare, do not proceed until it dries. t LEWIS C WORK Page 2 6%9/2017 • The system was designed to meet the influent quality defined in SPS 383.44(2)(a) The quality of influent discharged into a POWTS treatment or dispersal component consisting in part of in situ soil shall be equal to or less than all of the following: 1. A monthly average of 30 mg/L fats, oil and grease. 2. A monthly average of 220 mg/L BOD5. 3. A monthly average of 150 mg/L TSS. • SPS 383.54(3)(b) (b) The servicing frequency of an anaerobic treatment tank for a POWTS shall occur at least when the combined sludge and scum volume equals 1/3 of the tank volume. • The inspection, maintenance and servicing reports shall be submitted to the governmental unit within 30 calendar days from the date of inspection, maintenance and servicing. • The owner is responsible for the operation and maintenance of the private onsite wastewater treatment system (POWTS) in accordance with SPS 383 and the approved management plan • The owner of a POWTS shall be responsible for ensuring that access opening covers remain locked or secured except for inspection, evaluation, maintenance or servicing purposes. • Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • Provide a copy of the approved POWTS plans and this letter to the owner. • Prohibit vehicle traffic and soil disturbance within 15 feet of the downslope edge of the mound pursuant to "Mound Component Manual Version 2.0" SBD-10691-P (N.01/01, R. 10/12). 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. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. 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 addres- 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. Sincerely, Fee Required S 250.00 This Amount Will Be Invoiced. ,L When You Receive That Invoice, Edwin A Taylor Please Include a Copy With Your Wastewater Specialist , Division of I dustry Services Payment Submittal. (715)634-3484 , Monday - Friday 8:00 am To 4:30 pm WiSMART code: 7633 edwin.taylor@wisconsin.gov LEWIS C BJORK Page 2 6/9/2017 • The system was designed to meet the influent quality defined in SPS 383.44(2)(a) The quality of influent discharged into a POWTS treatment or dispersal component consisting in part of in situ soil shall be equal to or less than all of the following: 1. A monthly average of 30 mg/L fats, oil and grease. 2. A monthly average of 220 mg/L BOD5. 3. A monthly average of 150 mg/L TSS. • SPS 383.54(3)(b) (b) The servicing frequency of an anaerobic treatment tank for a POWTS shall occur at least when the combined sludge and scum volume equals 1/3 of the tank volume. • The inspection, maintenance and servicing reports shall be submitted to the governmental unit within 30 calendar days from the date of inspection, maintenance and servicing. • The owner is responsible for the operation and maintenance of the private onsite wastewater treatment system (POWTS) in accordance with SPS 383 and the approved management plan The own er of it _ Tr V-«VV)T1 J C. s 11A L _11 11bL be •l_ 1,. fo.. ensuring that ~ access 1....1 Iesporls Ible thopet uig Cvvcrs rculanI iwncu yr secured except for inspection, evaluation, maintenance or servicing purposes. • Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • Provide a copy of the approved POWTS plans and this letter to the owner. • Prohibit vehicle traffic and soil disturbance within 15 feet of the downslope edge of the mound pursuant to "Mound Component Manual Version 2.0" SBD-10691-P (N.01/01, R. 10/12). 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. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. 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. Sincerely, Fee Required $ 250.00 This Amount Will Be Invoiced. When You Receive That Invoice, Edwin A Taylor Please Include a Copy With Your Was ewater Specialist, Division of dustry Services Payment Submittal. (715)634-3484, Monday - Friday 8:00 am To 4:30 pm WiSMART code: 7633 edwin.taylor@wisconsin.gov PAGE 1 OF 6 Mound Plan Index & Cover Sheet Component Manual Design References: Version 2.0, SBD-10691-P (N.01/01, R. 10/12) & Version 2.0, SBD-10706-P (N.01/01, R. 10/12) Pg 1 of 6 Index & Cover Page Pg 2 of 6 Plot Plan Pg 3 of 6 Mound Cross-Section & Plan View Pg 4 of 6 Distribution Network Specifications, Pg 5 of 6 Pump Tank Specifications Pg 6 of 6 Management Plan Attachments: Enclosures: Pump Curve POWTS Application for Review Plastic Manholes / safety nets/ covers Soil Evaluation Report & Site Map Septic / dose tanks / Alarm / effluent filter Project Name / Description Dustin Cesafsky -New Mound Design Owner Name(s): Dustin Cesafsky Phone: 715 _456 _0524 Owner Address: 2418 County Road BB Zip: 547022 Project Address: same Govt. Lot: SW 1/4 of NW 1/4, Section 34 T 29 N-R 16 E ❑ or W❑✓ Township: Baldwinn County: St. Croix Project Parcel ID Designer Information 01VA LY Designer Name: Lewis Bjork Phone: 715 _WE 7375 7 Designer Address: E7818 County E , Menomonie WI _ Zip: 54,7 w E-mail: lewisbjork@yahoo.comE:..... License Number: 253976 Remarks: ~.;UNDEN Date: 5-23-2017 Signature: _ Original signature required on each submitted copy. CHECK BOX AS APPLICABLE, CHECK BOX AS APPLICABLE. 0 SOIL EVALUATION Scale: 1" = 30' 0 SYSTEM PAGE 2 OF~ SITE MAP ° 30 45 60 PLOT PLAN PROJECT NAME: ^ Dustin Cesafsky 7,52 DESIGN FLOW: 600 GPD / \ Attach design flow calculations for commercial plans. PROJECT ADDRESS: 2418 Cty Rd BB Pipe Material / ASTM Standard (Tables 384.30-3 & 384.30-5) BM Symbol: BM Elevation: 100 N Sanitary Sewer: 4" 3034 FT BM Description: Top lot corner iron Force Main: 2" sch 40 Slope Gradient(%) WeliSymbol(ifapplicable): Indicate north by IMPORTANT: of Tested Area: 2 Q drawing an arrow Show ground elevation contours at suitable intervals. on the approprite line. O t L-XAM;' / Prc ~y) ~k t 0~ - I `tiE t Floe. L GA„~.k~ ti Lr IV ~ ~ i7 i 11 -4 011, f~ ( R Witt; 'N g ~ 5lo~E 8~ 157, clxwor J/ k otf TrAnn~! ~S ~ t lr Z Goo ~ r~+ 50 t~ PP'~.5 P L 4o 1717 /cb 0 7C I J ✓ V v PAGE 3 OF 6 w 00 > o O w ° °o - M F- - m U M r ^ U Cl) 11 LLJ o LLI ° o w = _ Un Z \ > v o ° 4t r-- u U) U) Y U) z Q Q O I I I I J Z w w Lr)~ I ~ ~ I c U) cn 0- W \ I io~i a. ~ J I ~ n zyl I Q \ I , a I I I°al I w W (n o U ry o II I~ Lli cn J~ I I I Z p I- w y1 N I° C/) I a~ J Z o II II :E- :D a \ it I > 0 O0 I = o €a Iw£ 0 o I0 (D ~ I ~ I m -2 z I o ~ ~ I I ~Lo~ ~ w I I I I ~ t I to Q ~G o I I I w i I I~ o I Lo L_J cz I I I I I o w o I I = s o I I I o iB U CID If o°" o w I~- U= a~ Ewa I p a o 0 o co N - I I II a cnw - j l I I p p m w° I I I c Z ~•ao C: L) a=~ ~ ~ II I o LU J \ I -a 1: J Q) m c < LL a E I II L s ° I 0° ' > Z cn ° ° Q N~ Cl) CL ri 3 l i 1 = c? ° v L--J - cw~ U \ a O > o ° 30 Q 0 M - \ I ~ N I oo PAGE 40F6 LL Y LC) co z N Lf) N V Q Li J L ~y r N z O Z O zE 'a II II II II II z O O o a'm LLJ U c z F- o W o Q U N > ~ Wv m m ~ -°fl W a o a~ M d Q O Cc CM 0) = (1) of J W m _L ^ U Q L ° ° Of O N m ~ a zU C/) IL CD -0 x w z a~ o w E C) U 0.0 D 2 Cl) O d a :6 2 w z cc V O V J U O O J Q N F- m z - U X.d " = x aS U U U p O Q v O n U °a m y a T `o c i U- N c~ O co E U X o W N-0 o ~Q U) co a) 0) .Q - = L) 00 O m u m aa) -0 N Q1 w C, U x a ~ c ~P v= I I Q ry C. Lam( ~P J/a? a a U) a C/) a~ 0 co 0 J I I c N O N z Cl) p m U 1 ~ 2 J - O O U W ~n O C N z N U N •n _ L N V 1 O z N Ql 0 _ Cl) CL) > O U 0 o 06 O ~ o aJ J x a ~I ~r aE v Q m ° / J H U) LU io m W \ L _ + Q a~ LL Q U U _ / p II z U) z O z J a ~ f- Q ~ U- U > > a N 6 W ° S Cl) > / W ' n L) N ~ / m m ~ m 3 m ~ a~ N cn > a, F- o in a U U -0 3 0 a 'C- N E c U s p O o o W y O v a > N' X m rn - a Q a) c0 O a~ o o L C/) O O o m` C- a O n w c z Q p Nom p T-0 a O J -c L - U U Y ° m 42 ~ m v U L ❑ ❑ Q Q O U L_ m a 3 PAGE 5 OF 6 SEPTIC / PUMP TANK SPECIFICATIONS 4"0 Vent Pipe (No Scale) >10 ft from Building Electrical must comply with 12" Min, or 2.0 ft above SPS 316 and NEC 300 Established Flood Elevation Weathe Extend manhole riser as necessary. (typical) Weatherproof Approved Junction Box IMPORTANT: Vent Cap Approved Locking Manhole I with Warning Label Attached Anchor tank(s) as necessary / (typical) pursuant to SPS 383.43(8)(g) Conduit 4" Min, or 2.0 ft above Established Flood Elevation (typical) Finished Grade /--Airtight Seal Quick Disconnect } CAPACITIES @ al/in a 16" Min. g (typical) c. Depth (in) Volume (gal) 9-3 Weep Approved Joints with Hole Approved Pipe 3 ft onto B 2.0 44.48 A ~rl Solid Ground [C] ®F (typical) 7 155.68 B Alarm ~'-on } [C] PUMP-OFF *Pump Tank Liquid Level = Pump ELEVATION = 86.58 ft 3~ 5 in ~ - ~_off a Force Main Diameter = 2 In D Concrete INSIDE BOTTOM - Block ELEVATION = 86 a ft Force Main Length = 20 ft 3" Approved Bedding Material Beneatr Force Main Void Volume = 163 -gal J 7n d = 14.27 ft [C] Total Dose Volume TDV = 8~~o 43 D + M= -eft gal/dse (5X total lateral Void volume < TDV < 0.2X design flow) + =~-ft + (force main drainback volume) ftMIN. PUMP DISCHARGE RATE 28 .3) - gpm TOTAL D={ PUMP TANK: SEPTIC TANK(S): Volume = 800 gal Total Volume = 1200 gal Manufacturer: Wieser Manufacturer(s): Weser Pump Manufacturer: Zoehler Pump Model: 152 Install approved effluent filter at the septic tank outlet (See attached pump curve.) Immediately upstream of the pump tank inlet Controls/Alarm Manufacturer: SPI Filter Manufacturer: Orenco Bio Tube Controls/Alarm Model: Observer 500 Float switches containing mercu are prohibited. Filter Model: FT -0822-14B PAGE 6OF6 Mound Management Plan IMPORTANT: The owner of this mound system shall be responsible for its perpetual operation and maintenance pursuant to requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisc. Admin. Code, this system shall be considered a human health hazard if not maintained in accordance with this approved management plan. Furthermore, all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in accordance with SPS 383.52 (3), Wisc. Admin. Code. Maximum Dispersal Area Operating Limits: Design Flow = 600 gpd; BOD5 220 mgL-'; TSS 150 mgL-'; FOGS 30 mgU1 Inspection Checklist INSPECT EVERY 3 YEARS o type of use o age of system o nuisance factors (i.e. odors, user complaints, etc.) o mechanical malfunction (i.e., pumps, valves, switches, floats, etc.) o material fatigue (i.e., leaks, breaks, corrosion, etc.) o solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution / drop boxes) o neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.) o extent of ponding in distribution cell prior to dosing o dosing irregularities (i.e., pump re-cycling, float switch settings, etc.) o electrical components (i.e., wiring, connections, switches, controls, timers, alarms, etc.) o distribution lateral or lateral orifice plugging (measure lateral distal pressure - compare to design specification) o surface discharge of effluent or sewage back-up into structure served Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary) o Septic and dose tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis. Stats. when the volume of solids in the tank(s) exceeds one-third (1/3) the liquid volume of the tank(s) or as required by local ordinance. Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code. o Effluent filter(s) shall be inspected every 3 years and shall be cleaned when necessary to remove any accumulated solids according to manufacturer's specifications. A servicing period will always be greater than 12 months. o Distribution laterals shall be flushed once every 3 years or when necessary. System maintenance reports shall be submitted to the proper local government unit in accordance with SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to: Name of individual or company: Lewis Bjork LLC Phone: 715-231-7375 Local government unit: St. Croix County Phone: 715-386-4650 Local government unit address: Carmichael Street Hudson zip: 54016 Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wisc. Admin. Code. Repair or replacement of failed or malfunctioning components shall comply with SIPS 383, Wisc. Admin. Code. No product for chemical or physical restoration of the POWTS may be used unless approved by the department in accordance with SPS 384, Wisc. Admin. Code. Contingency Plan In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to a plan submitted to the appropriate agency for review and approval. A failed mound dispersal component may be re-constructed within the originally approved area after removal of all failed components. System Abandonment If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code. .)39213-(33.(TIF PPTG IMAGE, 750 x 865 PIXELS) - SCALED (9IH1"I'PS://17)\'.(1L1?APAllLAD.CObI/RrP/rooLS/9:3928-(i3.tiI1 C+~J uj PUMP PERFORMANCE CURVE MODEL 151/152/153 50 14 153 I 45 3 I 40 12 35 10 15 U 30 Q Z 8- 25 151 I4- , O i- 6- 2 15 4- 10 E 2- 5 I 0 ITI 10 20 30 40 50 60 70 80 90 100 GALLONS LITERS 40 80 120 150 200 240 280 320 360 FLOW PER MINUTE 014508 lOF l /17/9Alfl' 161-97 AIM f CONSTRUCTION PRODUCTS 3f Tuf-rite Riser SYstem Safety Lid in 6" Tall Riser 4 screws included with each Safety Lid Access hole allows pump-out 4 without removal i Concrete Lid with handle. Use the Safety Pan to cast con- Safety Lid Top and Bottom View your own n con- crete lid. f` For safety the lid can be filled with " concrete. Our'Concrete Keepers' lock `I i the concrete into the lid. 24"-RISL-FLAT-SL is made with 2 sets of screw holes (close-up view) for proper alignment in 6" tall and 12" tall risers 24x12 Available in 4 diameters. Size Part No. Qty / Carton 24x6 12" 12-RISL-FLAT-SL 38 16" 16-RISL-FLAT-SL 30 20" 20-RISL-FLAT-SL 20 Safety Lids sit on Riser Ledges with matching screw holes 24" 24-RISL-FLAT-SL 17 I12-RISL-FLAT-SL in 16-RISL-FLAT-SL in 20-RISL-FLAT-SL in 24-RISL-FLAT-SL in 12-RIS-GREEN 16-RIS-GREEN 20-RIS-GREEN 24x12-RIS-GREEN i 1200 Flex Court, Lake Zurich, IL 60047 *ANN, T U F sT I T E Tuf-Tit0', Inc. I 6M-M9/OOUdW :311-d 99te-SZ~-008 p \ :anod-1SOd HA3~J' 56753737-73-7 V0 OSLtiS IM 'NOOa N301VW OL kMH sn 9LL~w z 3138~1l0~ Ibf1NbW OIld3S W :70d-3ad :3dOM :J.B NMVaO 8Vq-008/OOZ1dIM N W ~ w LLJ J V_' W C) H Q z > w D ° mO w cY w Z) OC U - i w W In a- < (n (n r Z OCE t= a w d m C) ~H J uj V) WD Q ° Of Q ~ ~ m o z H (n L~ ~ H ^d w cr_ o Of m U Z 0 O z ~ H O o o Z _O Q m vi m 0:kQ zz n a- W W 00 m ~O Q Q J U J J Q V m J Z 3: LL O Q H O a~ c Q 0 Op mN w-W Coo z a_ O J Q U Q a o U O- nj r- I 0 LJiwW wz v~ N a a o JQ IiON mod' - Np v y Q _ a 0 cD oo Q Q <t N 0i 2 00 Z D M :2 LL, I M W ww r4) N Q ~OSOO.. F-W ~(j N _V) MN 00 0FN ~ tn~ N9 't ~J~> WQQW Q Wd~, Z Y O W M: M (0 t w W 0 o U _Z ~ (n W U z Z~ O 0) Z LLI O H F- O U) ~ U S~ F W (n F- O N (ii p ~Or- OQw Opw Q w Uw Oo O? O Z-1 jZC9UH0~~ DU(n0 !n U2 d mF(~ x w0 F- Q a- ~ x N j)f Y QOOQWwOWC1 Z: Qz O U U Z J 7 Z~m U~SJ ~m-21 Q~(.~ Q~iv 0 z C) 0O LLJ F- F- s LQ J J J 2 Q Y > Z N o a z z o z O< N U I Q I H Q J LLJ U F z „62 a > o a a l i I I z I" W II II I I w l ► I L° JI II I 11 II I I 1I I~ > III > U) lI I~ 1 1 I w Q I1 Of f I o 0 0 - „92 N w JI w wQ ll, i 11 cn Jm p w 11 I 11 119 «tiv h 2 or~ w w C r N l 1 o w U Q W H ~ w z J Q Q03a l~ w _ w 96 Q SV 2S N Y z Q F- ALA. SYSTEM, fR 7 Septic Products Inc. "Observer 500" Series Indoor/Outdoor Alarm Features & Benefits • NEMA 4x Thermoplastic Enclosure • Large Alarm Condition Indicating Light Q • Audible Horn rated 85db @ 10' . Alarm Test-Normal-Silence switch • Automatic Alarm Reset ==KVE1t 500 Supplied w/Cord Grip for Float Switch hk%od0w%ftW AMM Vieftm Installation r}}, • Includes 15' Mechanical Alarm Float °a° & mounting tie strap + • 6' Power Cord with 115 volt plug agsstME Teas • Suitable for Indoor or Outdoor Use • Two Year Limited Warranty • Available in both High Water & Low Level Alarm versions Dimensions ' 3 a.38RVM aW ~ tnr 71 641 Ll (FRONT) V POWER (SIDE) 12M PLUG *Note: Consult the factory for other available options. Septic Products, Inc. 1378 Twp Rd Ashland, Ohio 44805 Ph: (419)282-5933 Fax: (419)282-5943 Orenco stems' 4" Biotube° Effluent Filter °a InccrporatetlSy 1-800-348-g843 Installation and Maintenance Instructions Biotube Effluent Filters* extend drainfield life by prevent- ing solids from leaving the septic tank. Our 4" filter comes in its own housing, in both 36" and 28" lengths. Our 18" Jr. insert filter comes with or without its own housing. Biotube Effluent Filters install in minutes, inside new or existing tanks. y 4" Biotube 4" Biotube Jr. Effluent Filter Effluent filter v Step 1: Test-Fitthe Effluent Filter Access Top seal Test-fit the effluent filter on the septic tank's outlet pipe riser plate without gluing. Make sure it fits plumb. Install assembly Handle y Tank wall Clearance as snug as possible to the tank wall, but ensure. sufficient clearance for removing filter cartridge. I y Filter cartridge Biotube Effluent -Outlet sF Filter pipe ; 4T The Biotube Effluent Filter, with its housing, is suspended in the septic tank, supported by the 4" outlet pipe. *Protected by U.S. Patent #'s 5,492,635 and 4,439,323 NIN-Fr-Fr-1 Rev. 22.7/04 Page 1 of 4 Installation Instructions (continued) Step 2: Attaching Filter to Tank Two attachment methods can be used: 1) Glue the filter onto the tank outlet pipe using appropriate primer and glue. 2) A stainless steel set screw can be used to - secure the filter instead of glue. This illustration shows the gluing technique for installing a filter into a new septic tank. Installing a filter into an existing tank is a custom, site-specific job. Step 3: Extending Cartridge Handle For easier access when servicing, the cartridge Tee handle handle may be extended using a longer length of 3/4" "C1kar schedule 40 PVC pipe. Setscrew u 3/4" schedule 40 pipe Set screw e~ u., Cartridge handles can be extended for easier access. NIN-FT-FT-1 Rev. 2.2, 7/04 Page 2 of 4 Maintenance Instructions Orem* Systems' 1.800-348-9843 4" Biotube° Effluent Filter How to Clean Your Effluent Filter To ensure your effluent filter is functioning properly, it should be inspected every year. Under normal conditions, your effluent filter will function for several years before cleaning is necessary. The filter should be cleaned when it becomes clogged enough to restrict normal flows out of the septic tank. At a minimum, the filter should be cleaned whenever the tank is pumped. Most people prefer to have a septic tank service provider take care of filter maintenance and cleaning. You can find a septic tank service provider in the Yellow Pages, under "Septic Tanks & Systems." Or you can contact your county health department for a list. If you wish to inspect and/or clean your effluent filter yourself, be sure to dress properly. Wear full-length pants and shirt, shoes, gloves, and goggles or glasses. Then follow these instructions: 1. Remove the access lid to your septic tank by unscrew- ing the stainless steel lid bolts with hex head wrench provided. If your lid is above ground, it will be easy to find. If it is buried below ground, find the marker that a te . indicates its location. x` 2. Remove the filter cartridge by grasping the tee handle and lifting it out of its housing (see photo 1). 3. Spray the cartridge tubes with a hose to remove any material sticking to them (see photo 2). Ensure the three orifices in the optional flow modulation plate inside the filter are clear of any debris. Make sure the rinse water Photo 1. Remove the filter cartridge by lifting it out of its runs back into the tank, but do not allow solids material housing. to fall into the open filter housing. 4. Firmly place the cartridge back into the housing. 5. Some effluent filters come with an alarm that activates when the filter needs cleaning. If you have an alarm, check to make sure it is working by lifting the float with a stick. An audible horn should sound. The alarm panel is normally mounted on the side of the house or in the garage. Note: If your effluent filter doesn't have an alarm system j~~ and you would like one, call your local septic system installer. 6. Record the date that you inspected and/or cleaned Photo 2. Spray the cartridge tubes with a hose. your filter on the form that follows. If you checked the alarm or made any other observations about the tank or system, include that information under "Notes." 7. Attach access lid by placing it on the riser, matching the openings in the lid with the bolt catches. Insert lid bolts into catches and tighten with hex head wrench NIN-FT-Fr-1 provided. Rev. 2.2, 7/04 Page 3 of 4 Inspection/Maintenance Forin Date installed: Model tank: Size: Model of filter: Single/double compartment: Date Cleaned? inspected yes no Notes: Important Names and Numbers System service provider: Phone: System installer: Phone: Septic tank pumper: Phone: Electrician: Phone: Designer: Phone: NIN-FT-FT-1 Rev. 2.2, 7/04 Page 4 of 4 5. aaAV~ rao 3ovae ~~vm • L~.»d, ram w aa..~.».., . ~ B6EB-9EB-51L~ W O••• •~•W!1 t>W.( s.( h' lII l ~ lJ1.Y 91ON s,aa~Vaa LIOU$L/$ I/M/9Z/$ LOOIG 'Silo aNiv-17 nva AAV NPJ91Sal0 OOLI „O;/ LIOZ/L!/l -aNOr+d ZZY-9/ ~NV~d 2!31Nao .~nddns saaonine lVNOiSSadOad ant 910Z/LCICI 91OZ1$11Z! 30N34/S3al (XS~t>30 a°~"° 3w°H -lNVdwOO Naowm Nvw,Ln 9/OZ/60/Ll 9/-0E-1/ '31Y0 Y~/N -woJ oVLIINO.o N Nl7,~O17= (~cA O Z O~ W~ O m O~ } u- 0 0 r ~ ~ „o-,os J y y 4,SL 46L Q w qE-,9 EL-,5 „91L-,L „916-,9 „trL „4,01 ,O,L „9EI',f „9EI',f nr. arses sdv on[ ~ d Q k~9 p w U 4 Q a Q U Ln 4 W S - £I Q Q N f °o Q P W 3 (X W N~rc .eo~, ;R N s m .w N ~ LL~o v s W Q.,~ U d es pis ~E° I .,o-,ol P R, m a Oo , r o Q N3hi~ll>I ° U ~ 4 W ~ ~ Z ,a.a ~I ='st ~o O o O} s I:.., U • ~s U o ~ D 3~~„3 W ~~a g ~ ~p34` ~s LLJ &oa - - os p e - O r - v o o w 0 t P a~ aoB; RL ~ ~ _ m p l7 I ~ Q O „o,a nm a . s w „o-,61 U Q `P o~c ~ 3 WW(Q o o flYL q4 L-1 ~Jll ql„«~ oa .,,f-LI o.~£-£ .~ol, " o-E.SfOI,f LU U- „'t9-.61 6-,l „510,9 „41Y,Y „AI-,LI -1 U- Q ~ ~ ~ o-,os Q } ND ul U- Ca Q l1J o Ino~.a~~ ~oo~~ Ise s. aa.Lin no A_v . nvm aLOn s,aa~vao LlOL/4L/5 LIOZ/£Z/5 LOLhS 'GIM 3bIVlO nV3 '3/.V Na319-M OOLI ~,P,/ • p9/1 410414111 '3NOHd LLY-9/ ~NV7d '1 %ll a31N3O A~ddnS SJ3O-lIn9 WN0I943dONJ 3H1 910e//'Z/ 91OZ/511Z1 3~N30/S3a (XSjly3~ -aGNW awon ,kNVdwO'D a39wm NVw.~n 9/04/60/L! 91-0E-11 91hO VIN "JO.IVVWNOV „P 85 G P 4 Q . 0 n ...............r a......................, ,R4....... g 4 Q • z 7 4 4 4 4 ~o~o „L~sl ssnai aoo~a „oL - }v ~o~o .L'6I ssnaL aoo~d „oL p ° ~O W Q 4 UJ : 7 Q 0 Q ~ II 0 m ....RK.V` „0,8 ,.ty8-,II „ty8-,61 .6-,L ,~Y4,LL „o-es ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Dustin Cesafsky Mailing Addres 2418 Cty Rd BB 2418 Ct Rd BB Property Address y (Verification required from Planning & ning Department for new construction.) City/State Woodville,wl Parcel iden ' ►cation Number 002108795000 LEGAL DESCRIPTION Property /4 Location sw ,4 nw , Sec. 34 , T29 NR16 W,TownofBaldwin , Subdivision Plat: n/a Lot # n/a Certified Survey Map # n/a , Volume n/a Page # n/a Warranty Deed # n/a (before 2007)Volume n/a Page # n/a Spec house ❑yes[Dno Lot Iines identifiable Elyes❑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. 1/we certify that all statement 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 o a warranty deed recorded in Register of Deeds Office. Number of bedrooms 4 Dw~) 5ft" 6 /1 X17 SIGNATURE 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) Ryan Yarrington From: Lewis Bjork <lewisbjork@yahoo.com> Sent: Thursday, June 15, 2017 2:38 PM To: Ryan Yarrington Subject: Fwd: Proposed house Sent from my Whone; please excuse any typos... Begin forwarded message: From: Dustin Cesafsky ot, > Date: June 15, 2017 at 2:36:36 PM CDT To: Lewis Bjork< F",,rr,. > s_fmi> Subject: Fwd: Proposed house Sent from my Verizon 4G LTE smartphone Original message From: Alex Blackburn < . iackhoi ii f, _ > Date: 5/30/17 11:32 AM (GMT-06:00) To: Dustin Cesafsky < < - I 4i)live-.c(-w > Cc: Tamara Wittmer <1 :nr~_Era.WiItirncr'~i Subject: Proposed house Dustin, After conducting our onsite inspection on May 26, 2017 the staked location for your house, driveway and septic system at 2418 County Road B complies with the 50 foot wetland setback requirements. Shoreland grading permits will not be needed since your excavation is approximately 400 feet from a navigable waterway and it does not drain directly to the waterway. Let me know if you need any more information for the building inspector or builder. ~t aa;.i~c~rr St. Croix County ecialist 1 Ryan Yarrington From: Lewis Bjork <lewisbjork@yahoo.com> Sent: Thursday, June 15, 2017 2:39 PM To: Ryan Yarrington Subject: Fwd: 2418 Cty Rd BB Woodville planning Sent from my iPhone; please excuse any typos... Begin forwarded message: From: Dustin Cesafsky <CluStin c I iu liv_~cxt- 1> Date: June 15, 2017 at 2:35:56 PM CDT To: Lewis Bjork <Ic_wi5hjot_h a vahooxom> Subject: Fwd: 2418 Cty Rd BB Woodville planning Sent from my Verizon 4G LTE smartphone Original message From: Alex Blackburn <i1lex.I .-ickhunn a)co.saint-croLv I.us> Date: 6/7/17 9:29 AM (GMT-06:00) To: Dustin Cesafsky <dustins c l ,~Hiv c.corn> Cc: oCtice~a'allcroixxoni - Subject: RE: 2418 Cty Rd BB Woodville planning Dustin and All Croix, The five parcels owned by Dustin Cesafsky were bought on the same deed and are considered one large 50 acre parcel. The "lines" are from the original land survey that divided land into 40 acre parcels and are the current tax parcels. Dustin's property straddles four different tax parcels. Alex Blackburn St. Croix County ILancl Use and Cosiservation Speciiali From: Dustin Cesafsky [mailto:dustin cl@live.co ] Sent: Tuesday, June 6, 2017 1:36 PM To: Alex Blackburn <Alex.Blackburn co.saint-cr . > Subject: Re: 2418 Cty Rd BB Woodville planning Hi Alex, i Can you verify that we are able to build on our property line, I was speaking with St. Croix inspection and they wanted an email stating what you mentioned on the phone, that the parcel lines are just for tax purposes and setbacks do not apply to them. Thank You, Dustin From: Alex Blackburn <Alex.BlackburE&co saint-croix.wi.us> Sent: Thursday, March 16, 2017 12:45 PM To: Dustin Cesafsky Cc: Kevin Grabau Subject: RE: 2418 Cty Rd BB Woodville planning Dustin, What is your phone number again? Aex Blackburn t. Croix Count, : se and rvat on Sp►eciatf From: Dustin Cesafsky [rnailto:dustin c1~comj Sent: Thursday, March 16, 2017 1:46 PM To: Alex Blackburn <Alex.Blackburn co.saint-croix.wi.us> Cc: Kevin Grabau <Kevin.G_rabau a co.saint-croix.wi.us> Subject: Re: 2418 Cty Rd BB Woodville planning They were purchased together, there are 5 parcels total. I am getting the wetland delineation completed first, like mentioned in the previous email, they will be onsite once the growing season begins. This is a preliminary layout and 1 of 2 options if wetlands are encountered. I have researched this and the DNR has a wetland delineation program (this is the one I am using) I have called several times as this would be much easier to explain over the phone but no one has answered or returned a call. The purpose of contacting you prior to the final house location is to know whether or not this location can be an option when I meet onsite with the DNR as I would like to have several options to avoid impacts or at least reduce impacts. If I have a few options the DNR will see I am doing my diligence to protect the areas . At this point I would like to know whether or not I can place the house as shown on a parcel line or if the parcel would have to be joined? Thanks Dustin 2 From: Alex Blackburn <Alex.Blackburn c)co.saint -croix.wi.us> Sent: Thursday, March 16, 2017 11:24 AM To: Dustin Cesafsky Subject: RE: 2418 Cty Rd BB Woodville planning Dustin. Did you buy these all together on one deed, or were they separate purchases? You should get the wetland delineation done first before planning the house location. The setbacks will depend on the quality of the wetland. You stated the DNR was doing a wetland delineation. You may want to research this further, typically the DNR requires you to hire the wetland delineator. The setback for the driveway is 10 feet from the edge of the surface gnat to the lot line. Alex Blackburn - St. Croix County Land Use and Conservation Speciali t From: Dustin Cesafsky [mailto:dustin c~liye.com] Sent: Wednesday, March 15, 2017 9:36 AM ' To: Alex Blackburn <Alex.Blackburn (@co.saint-croix.wi.us> Subject: Re: 2418 Cty Rd BB Woodville planning Alex, Yes I am referring to the setback for the parcel line, we do own both parcels but wasn't sure how it is handled. For the driveway, I believe the setback is 10' from the neighboring parcel corner? Thanks Dustin From: Alex Blackburn <AI(.x.blackbwii,, t . ,wit ri~)i ~vI ti<,> Sent: Wednesday, March 15, 2017 7:21 AM To: Dustin Cesafsky Subject: RE: 2418 Cty Rd BB Woodville planning Dustin, When you talk about setbacks not being met, is that because the house is on one of the parcel lines? Alex Blackburn°°i St. Croix County Land Use and Conservation Specialist From: Dustin Cesafsky [mailto:dustin c1 jiy-e,cowl Sent: Monday, March 13, 2017 5:17 PM To: Alex Blackburn <Alex.Black burn _Pco.saint_croi > 3 Cc: #Jamie < , ;,'-k t[l'> Subject: 2418 Cty Rd BB Woodville planning Alex, My wife and I are planning to build this summer in Woodville, I put together a map for the proposed building location. I am in the process of getting estimates to build but wanted to see if the attached drawing is acceptable. It looks like the lot was cleared on node B in the past but as you can see the area is in a wetland bank per the county GIS site. I have already contacted the DNR and they will be doing a delineation as soon as the growing season begins. I would like to put the house between parcels C and D but it does not meet setback requirements, the further we go back into the woods the more expensive the drive and power will be so I would like to keep it as close to the road as possible unfortunately with the expected wetland limits this is it. Also, do you happen to know the wetland setback for the county? I looked online but was unable to find anything. Thank You, Dustin 4 RECEIVED ~'s T-r`. ► - /a Wisconsin Depart r> ofrCohulg SOIL EVALUATION REPORT Page I of 3 Division of Safety ~n uildings $.r Capp( COUNTY ccordance with Comm W s dm de ~VELOPM _ W 1 0 a County St.Croix Attach,&OMM b IA n paper not less than 8 1/2 x 11 i ze. Pl - include~but not limited to: vertical and horizontal reference point (BM` Parcel I.D. percent slope, scale or dimensions, north arrow, and locatir» Brest road. QQ - 6i 7.. _ Please print all in " Revi by Date Personal information you provide may be used for secor urposes (Privacy Law, s. 15.04 (1) (m)). (0 A? ' Property Owner Property Location Dustin Cesafsky Govt. Lot SW 114 W 1/4 S 4 T 29 N R 16 E (or) Property Owner's Mailing Address Lot # Block # Subd. Name o CSM# 2418 County BB B - Part of 40 aces City State Zip Code Phone Number ity village ■ Town Nearest Road Baldwin WI 547022 ( 7)15-456-0524 County BB New Construction UseE] Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement Public or commercial - Describe: NA Parent material Loess over scl / till Flood Plain elevation if applicable 4;-4 ft. General comments Install new moundsystem on the 98.6' contour , use 1.75' sand lift , 7' x 85' rock cell and recommendations: P 1 Boring # 11 Boring R Pit Ground surface elev. 98.75 ft. Depth to limiting factor 15 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 q 1 0-4 10yr3/3 A 2fgr mvfr cs 2f .6 .8 x \ 2 4-6 10 r3/2 sil 2fsbk mvfr gs if .6 .g 3 6-15 7.5yr4/5 sil 2msbk mvfr gs if .6 •8 4 15-20 7.5yr4/6 C2P5yr 5/8, 1 0yr6/2 SCI 0 _ _ F P2 Boring # ® Boring 98.1 15 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 1 0-4 10yr3/3 A 2fgr mvfr cs 2f .6 .8 2 4-6 10 r3/2 sil 2fsbk mvfr gs 2f/Im .6 .8 ~J 3 6-15 10yr4/4 sil 2msbc mvfr gs if .6 •8 15-20 10yr4/6 C2P5yr5/8, 1 oyr6/2 scl 0 _ - _ Effluent #1 = BODS > 30 < 220 mg/L and TSS >30:< 150 m ffl nt # BO 1, < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Sign CST Number Lewis Bork 253976 Address Date Evaluation Conducted Telephone Number E7818 County E Menomonie WI 54751 5-17-2017 715-231-7375 Property Owner Cesafsky Parcel ID # Page 2 of 3 p3 Boring Pit Boring Ground surface elev. 98.75 ft. Depth to limiting factor 15 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-3 1Oyr3/3 - A 2fgr mvfr cs 2f .6 .8 2 3-6 10 r3/2 - sil 2fsbk mvfr gs 2f .6 .8 rX 3 6-15 10yr4/4 - sil 2msbk mvfr gs 1 f .6 .8 15-22 1 Oyr6/4 C2P5yr 5/8, I Oyr6/2 scl 0 - _ F-1 Boring # Boring 1.7 x Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 'Eff#2 Boring ❑ Boring # 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 " 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-83301 est (R.07/00) CHECK BOX AS APPLICABLE. CHECK BOX AS APPLICABLE. SOIL EVALUATION Scale: V = 30' F✓ SYSTEM PAGE 2 OF 3 SITE MAP 30 45 60 PLOT PLAN NAME: 5z DESIGN FLOW: 600 GPD Dustin Cesafsky Attach design flow calculations for commercial plans. PROJECT ADDRESS: 2418 Cty Rd BB Pipe Material / ASTM Standard (Tables 384.303 & 384.30-5) r 100 FT N Sanitary Sewer: 4" / 3034 BM Symbol: BM Elevation: BM Description: Top lot corner iron Force Main: 2 / SCh 40 Slope Gradient Indicate north by IMPORTANT: of Tested Area: 2 Well Symbol (if applicable): O drawing an arrow Show ground elevation contours at suitable intervals. on the approprite line. 7!5 = `1ST-6S2f o ,C~5~5 SfrQirsv~~ (H) BK 986 ®Az a ~6 a S`a/o F 9~~s ® (~<SyN C5=w I~ ,r ► ~i So j P,4,5 Q 4o 1712 0