HomeMy WebLinkAbout032-1065-30-030
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
(ATTACH TO PERMIT) 597431
GENERAL INFORMATION State Plan ID No
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
Permit Holder's Name: City Village Township Parcel Tax No:
Ryan & Rachel Witthoft TOWN OF SOMERSET 032-1065-30-030
CST BM Elev: Insp. BM ev: r M Description: Section/Town/Range/Map No:
24.31.19.324A-30
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER Fs AT CAPACITY STATION BS HI FS ELEV.
Septic J►.~ Benchmark
F'; f, ~a I S?s Alt. BM (1, 1 09 te .
Aeration Bldg. Sewer ~
Holding St/Ht Inlet 3 .9 Ad 5
TANK SETBACK INFORMATION SUHtOutlet •3 mz-CV
TANK TO . q/L WELL BLDG. (Sent it Intake ROAD Dt Inlet \
Dt Bottom
Septic 75 7-44
Dosing Header/Man. V
9
Aeration Dist. Pipe • 3 ~r Zi.Z.
g• °17 • `TS
Holding Bot. System ~C(N~
PUMP/SIPHON INFORMATION Final Grade Mau
Manufacturer Demand St Cover
GPM J40
Model Number $,7 98,
TDH Lift Friction Loss System H TDH Ft
TZ 9 •a 9172.73
Forcemain ngth Dist. to Well
17. r
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Trenches PIT DIM SEA IONS No. Of Pit Inside Dia. Liquid epth
DIMENSIONS S6 3 erAe
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: ~Z FIO~..~
INFORMATION CHAMBER OR
Type Of System: N
0 /
C-0 /40/ UNIT Model Number: ar S
DISTRIBUTI N SYSTEM COA- -F +e3 % Z 4:,;f Q,
rHeifoagth er/ Mand Distributx Hole Size x Hole cing Ve/ toaAir take
Pipe(s) /K
nDia Length Dia Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only ro
Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched
Bed/Trench Center Bed/Trench Edges Topsoil
a (0 ZI Yes No Yes No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2:
Location: 707 210TH AVE G ✓l 5 5 t5 v~
1.) Alt BM Description =
2.) Bldg sewer length = 24 ^
- amount of cover = > .3
Plan revision Required? ;Yes )<"'N0 Use other side for additional information.
SBD-6710 (R.3/97) Date Insepctor's g ature Cert. No.
PLOT PLAN N
Project Name: Witthoft 4 Bedroom Conventional Septic System
I
Legal Description: NW114, NW114, S24, T31N, R19W P.I.D: Part of 032-1065-30-000
Subdivision Name: NA Lot 3
Township: Somerset Parcel Size: 3.34 Acres SCALE: 1"=60'
County: St. Croix
System Elevation: T1= 98.22 Proposed 80.00' EZ Flow Trench
Slope: 7% T2= 97,72 Proposed 80.00' EZ Flow Trench
A BM1 Elevation: 100.00' Top of 1" PVC Pipe T3= 96.22 Proposed 80.00' EZ Flow Trench
0 BM2 Elevation: 99.90' Top of 1" PVC Pipe
■ Backhoe Pits:
Tank Wieser Concrete WLP1250-MR
See CSM for complete view of parcel Effluent Filter Polylok 525
4 Inch Sch 40 -ASTM D2665
4 inch 3034 - ASTM D3034
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Page 2
v*vr, iijre County
T St. Croix v
•J D$ RECEIVED Industry Services Division
1400 E Washington Ave Sanitary Permit Number (to be filled in by Co.)
p~ P_O. 716
' S w Madison, W 70 16
AUG 201
Q2ZGq 19
pPl MZQJAY ,date "Fransaction Number
In accordance with SPS'3 Is. Aof 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
the Department of Safety and Professional Services. Personal information you provide may be used for seconda Project Address (if different than mailing address)
purposes in accordance with the Privacy Law, s. 15.04(1)(m), Slats. 707 210"' Avenue
1. Application Information - Please Print All Information
Property Owner's Name Parcel #
Witthoft, Ryan & Rachel r~
Property Owner's Mailing Address Property Location a y. 31• r a7~- 3
303 Lilac Lane
Govt. Lot
City, State Zip Code Phone Number NW %4, NW '/4, Section 24
Shoreview, MN 55126 circle one)
T31 N R 19EorI$
11. Type of Building (check all that apply) Lot #
® 1 or 2 Family Dwelling - Number of Bedroom / . 3 Subdivision Name
`v NA
Bloc
❑ Public/Commercial - Describe Use 1. r Est Oltn C ~ YO
P`_/ ' 1 El city of r
❑ State Owned - Describe Use ❑ Village of
CSM Number
y ITS ®Town of Somerset
i Tr iVUIJ6'V ~ivv r "d ~iJW LW I
III. Type of Pei•rUtt heck 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 (explain)
B F-1 Permit Renewal ❑ Permit Revision ❑ Change of El Permit Transfer to New List Previous Permit Number and Date Issued
Before Expiration Plumber Owner
IV. Type of POWTS S stertiXom onent/Device: (Check all that apply)
Non-Pressurized In-Ground ® Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil
❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) f
V. Dispersal/Treatment Area Information: ~/1f
oposed (st) System Elevatio
600 Rate(gpdst) 1200 98.22', 97.72', 96.22'
Design Fl (gpd) Design Soil Application Dispersal Area Required (st) 7Ma.nufacturer
0.5
nfo Capacity in
VI. Tank I
Gallons Total # of U
Gallons Units 2 o 2
New Tanks Existing Tanks a U 75 n T3,
Septic or Holding Tank 1250 1250 1 Wieser Concrete J/ ® ❑ ❑ ❑ ❑
Dosing Chamber ❑ ❑ ❑ ❑ ❑
VII. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
1Business Phone Number
Plumber's Name (Print) Plu V Si ture / MP/MP77~
John Schmitt 223760 715-760-0486
Plumber's Address (Street, City, State, Zip Code)
616 1501n Ave. Somerset, WI 54025
VIII. County/Department Use Only
Approved ❑ Disapproved Permit Fee Date Issued Issuing Agent Signature
❑ Owner Given Reason for Denial $ oell
IX. Conditions of A pproval/Reasons for Disapproval ~ S ✓e
SYSTEMN ER:
1. Septic tank, effluent filter and MaoC~ d(/1
dispersal cell roust be serviced../ maintained
as per management plan provided by plumber.
2. All s m~',,fi~e~ce Ianhc fT
as per appli~41&0 GVUE 7VTII7f~c7TTC2~.the system and suhmit to the County only on paper not less than 8 1/2 x I I inches in size
SBD-6398 (R03/14)
I
CONVENTIONAL COMPONENT DESIGN
INDEX AND TITLE PAGE
Project Name: Witthoft 4 Bedroom Conventional Septic System
Owners Name: Ryan & Rachel Witthoft
Owner's Address 303 Lilac Lane
Shoreview, MN 55126
Legal Description: NW1/4, NW1/4, S24, T31N, R19W
Township Somerset
County: St. Croix
Subdivision Name: NA
Lot Number: 3 Block Number
Parcel I.D. Number Part of 032-1065-30-000
Plan Transaction No.
Page 1 Index and title
Page 2 Plot Plan
Page 3 Septic Tank Specifications
Page 4 Effluent Filter Information
Page 5 System Sizing & Cross Section
Page 6 EZ Flow Information
Page 7 & 8 Management and contingency plan
Page 9 Septic Tank Maintenance Agreement
Page 10 & 11 Warranty Deed
Page 12 CSM
Attachment 1 Soil Evaluation Report
Attachment 2
Designer: John Schmitt Licnese Number: MPRS 223760
Date: 8/3/2017 Phone Number: 715-760-0486
Signature:
In-Ground Soil Absorption Component Manual Version 2.0 SBD-10705-P (N. 01/01)
Page 1
PLOT PLAN N
Project Name: Witthoft 4 Bedroom Conventional Septic System
Legal Description: NW1/4, NW1/4, S24, T31 N, RI 9W P.I.D: Part of 032-1065-30-000
Subdivision Name: NA _ Lot 3
Township: Somerset Parcel Size: 3.34 Acres SCALE: 1^=60'
County: St. Croix
System Elevation: T1= 98.22 Proposed 80.00' EZ Flow Trench
Slope: 7% T2= 97.,72 Proposed 80.00' EZ Flow Trench
A BM1 Elevation: 100.00' Top of 1" PVC Pipe 13= 96.22 Proposed 80.00' EZ Flow Trench
0 BM2 Elevation: 99.90' Top of 1" PVC Pipe
■ Backhoe Pits:
Tank Wieser Concrete WLP1250-MR
See CSM for complete view of parcel Effluent Filter Pol lok 525
4 inch Sch 40 -ASTM D2665
4 inch 3034 - ASTM D3034
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The PLX25 Filter is rated for 10,000 GPD (gallons per day) making it one of the largest filters in its class. It has
525 lidiear feet of 1/16" filtration slots. Like the Polylok PL-122, the Polylok PL-525 has an automatic shut-off ball
installed with every filter. When the filter is removed for cleaning, the ball will float up and temporarily shut off
the system so the effluent won't leave the tank. `
Alarm
for 10,000 GPD (gallons per day). Switch
p 10,000 GPD ? (Optional)
525 linear feet of 1/16" filtration.
v Accepts 1" PVC
Accepts 4" and 6" SCHD 40 pipe. Extension Handle.
Built in gas deflector.
Automatic shut-off ball when filter is removed.
< Rated for
Alarm accessibility. 10,000 GPD
~ t r
Accepts PVC extension handle.
Ideal for residential and commercial waste flows up to f'yf 525 Linear Ft.
of 1/16"
10,000 gallons per day (GPD).- Filtration Slots
1. Locate the outlet of the septic tank.
2. Remove the tank cover and pump tank if necessary.
Accepts 4" & 6" ~y
3. Glue the filter housing to the 4" or 6" outlet pipe. If SCHD 40 pipe
the filter is not centered under the access opening use a
Polylok Extend & Lok or piece of pipe to center filter.
4. Insert the PL-525 filter into its housing.
Certified to
5. Replace and secure the septic tank cover. NSF/ANS1 standard 46
The PL-525 Effluent Filters will operate efficiently for
several years under normal conditions before requiring
cleaning. It is recommended that the filter be cleaned
every time the tank is pumped, or at least every three
years. If the installed filter contains an optional alarm,
the owner will be notified by an alarm when the filter
Gas Deflector
needs servicing. Servicing should be done by a certified
septic tank pumper or installer. Automatic
Shut-Off Ball
1. Locate the outlet of the septic tank.
2. Remove tank cover and pump tank if necessary.
3. Do not use plumbing when filter is removed.'
4. Pull PL-525 cartridge out of the housing. _
5. Hose off filter over the septic tank. Make sure all
solids fall back into septic tank.
6. Insert the filter cartridge back into the housing making
sure the filter is properly aligned and completely inserted. Polylok, Zabel & Best filters accept Easily installs
7. Replace and secure septic tank cover. the SmartFitterOo sw=itch and alarm. into existing tanks.
Polylok, Inc. 3 Fairfield Blvd. Wallingford, CT 06492 Toll Free: 877.765.9565 Fax: 203.284.8514 www.polylok.com
Page 4
SOIL ABSORPTION SYSTEM DETAIL / GRAVELLESS LEACHING UNIT
Project Name: Witthoft 4 Bedroom Conventional Septic System
Gravelless Leaching Unit Specifications
Manufacturer Model Laying Length EISA Rating
Infiltrator EZ1203H-5ft 5.0' 25.0
EZ1203H-10ft 10.0' 50.0
System Sizing
EISA Rating per Foot of EZ Flow fe Soil Application Rate 0.5 gpd/fe
600.0 gpd Design Flow _ 0.5 Soil Application Rate _ F-5 I EISA = 240.0 Feet of EZ Flow
trenches 80 feet long each
3 No. of Cells 8 Per Cell
3 ft Cell Width 24 Total No of 1203H
80 ft Cell Length 400 sq ft EISA Per Cell
3 ft Cell Spacing 1200 sq ft Total EISA
Typical Cross Section
Finished Grade 100 ft Observation Pipe with
approved cap or vent
Soil Backfill
36 inch Geotextile Fabric
>3 ft
12 Inch > aft. Slotted and Anchored Vent/Observation Pi
II t with Cap
O
98.22 ft. /
>36 inch 97.22 ft. \
96.22 ft. Infiltrative Surface
Plumber/Designer Signature:
License MPRS 223760 Date: August 3, 2017
Page 5
Installation Instructions for 46E Ow TM
EZflow Systems in Wisconsin FILTRATOR
Wisconsin Department of Commerce, Safety and Buildings 5. The Absorption area (SF) necessary for a given site shall
Division, has reviewed the specifications and/or plans for this ; be sized based on maximum daily sewage flow (GPD) and
product and determined it to be in compliance with chapters ; the Permeability for the site. If certain criteria is met, the
Comm 82 through 84, Wisconsin Admin. Code, and Chapters ; EISA sizing can be used in Wisconsin, resulting in a 40%
145 and 160, Wisconsin Statutes. All sites must meet the Site smaller drainfield.
& Soil Conditions & Locations & Isolation distances as noted in ;
local regulations. 6. Place EZflow bundle(s) in the EZflow configuration ap-
proved by system design permit specified for the particu-
The approved products are 1203H (3-12" bundles with pipe in lar site. The top or center-most bundles containing pipe
center bundle in 5' or 10' lengths) and 1203HP (3-12" bundles are joined end to end with an internal pipe coupler. Any
with pipe in each bundle in 5' or 10' lengths. additional aggregate only bundles that may be required,
should be butted against the other aggregate-only bun-
A single pipe bundle contains a four inch perforated pipe sur- dies and do not require any type of connection.
rounded by EPS aggregate and is held together with poly-
ehtylene netting. A single aggregate bundle contains aggregate 7. The top of each GEO cylinder contains a filter fabric pre-
only and is held together with polyethylene netting. manufactured in between the netting and aggregate. The
fabric is inserted to prevent soil intrusion. The installer
Materials and Equipment Needed shall make sure the the GEO is positiioned upward and is
• EZflow Bundles ; in contact with the fabric contained in the adjacent cylin-
• EZflow Geotextile Fabric der before backfilling.
• EZflow Internal Pipe Couplers
• Pipe for Header and Inlet 8. The EZflow Drainfield Systems should be installed in a
• Backhoe/Excavator level trench in all directions (both across and along the
trench bottom) and should follow the contour of the ground
Installation Instructions surface elevation (uniform depth), with all continuous
The instructions for installation of EZflow products are given adjoining 10-foot cylindrical bundles placed end to end,
below. This product must be installed in accordance with state with central bundle distribution pipe interconnected,
rules defined in chapters Comm 82 through 84, Wisconsin Ad- without any dams, stepdowns or other water stops.
ministrative Code, and Chapters 145 and 160, Wisconsin Stat-
utes, as well as the local health department's current design 9. The trench top shall be graded such that water will not
manual. pond. Backfill should be seeded or sodded immediately
after completion to reduce erosion.
1. After the local health department has determined sizing,
configuration, and layout for the EZflow systems, stake 10. EZflow EPS bundles are flexible and can fit in curved
or mark with paint the location of trenches and lines. Be trenches as may be necessary to avoid trees, boulders, or
careful to set correct tank, invert pipe, header line or dis- other obstacles.
tribution box and trench bottom elevations before instal-
lation of pipe bundles. 11. EPS aggregate is lighter than water, therefore, it might
be expected that natural buoyancy forces would tend to
2. Remove plastic EZflow shipping bags prior to placing : cause EZflow assemblies to float out of ground when
bundles in the trench(es). Remove any plastic bags in the ponding occurs. Field experience has shown, however,
trench before system is covered. that this is not a problem when systems have a minimum
• of 6" of soil cover as recommended by manufacturer.
3. This product must have geotextile fabric that meets re-
quirements of s. Comm 84.30 (6) (g), Wis. Adm. Code,
installed directly on top of the product and extending 1203H-GEO
down along the sides of the product to a point at least six
inches from the bottom of product. Geotextile
• aj Barrier Material
VJIIJ
4. When installed in a trench, the trench should be dug to
• Dili i-
a width of 36 inches. This not only saves labor in excava- 2 = r'
tl)~ IL I - Ik3
tion, but also provides better load-bearing capacity after
backfilling is complete.
36" - 0
Page6
POWTS OWNER'S MANUAL & MANAGEMENT PLAN
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner: Ryan & Rachel Witthoft Tank Manufacturer: Wieser Concrete ❑ NA
Permit# E] Septic ❑Dose ❑-folding Volume: 1250LP
DESIGN PARAMETERS Tank Manufacturer: Wieser Concrete NA
Number of Bedrooms: 4 0 NA ❑ Septic ❑Dose ❑-Iolding Volume: gal
Number of Public Facility Units: E NA Vertical Distance Tank Bottom(s) to Service Pad: ft
Estimated (average) Flow: 400 gal/day Horizontal Distance Tank(s) to Serivice Pad: ft
Design Flow = estimated x 1.5: 600 gal/day Specific servicing mechanics must be provide if vertical is>15 feet or if
In Situ Soil Application Rate: 0.50 gal/day/ft2 horizontal is > 150 feet. Specific instructions to be provided on back.
Standard Domestic Influent/Effluent Monthly average Effluent Filter Manufacturer: POLYLOK ❑ NA
Fats, Oils & Grease (FOG) 530 mg/L Effluent Filter Model:
Biochemical Oxygen Demand (BOD5) :5220mg/L El NA Pump Manufacturer:
Total Suspended Solids (TSS) 5150mg/L Pump Model:
High Strength Influent/Effluent Monthly average Petreatment Unit NA
Fats, Oils & Grease (FOG) 5530 mg/L Manufacturer:
Biochemical Oxygen Demand (BOD5) s220mg/L Q NA ❑ Mechanical Aeration ❑ Peat Filter
Total Suspended Solids (TSS) 5150mg/L ❑ Disinfection ❑ wetland
Petreated Effluent Monthly average ❑ Sand/Gravel Filter ❑ Other:
Biochemical Oxygen Demand (BOD5) 530mg/L of sore tion ystem
Total Suspended Solids (TSS) 530mg/L NA L''J In-Ground (gravity) ❑ In-Ground (pressure)
Fecal Coliform (geometric mean) 5104cfu/100m1 ❑ At-Grade ❑ Mound
Maximum Effluent Particle Size: /e in dia. A ❑ Drip-Line ❑ Other:
Other: ❑ N Other: ❑ NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
When combined with sludge and scum equals one-third ('/3) of tank volume
Pump out contents of tank(s) When the high water alarm is activated
month(s) El
NA
Inspect condition of tank(s) At least once every' 3 ~ ears (Maximun 3 Years) At least once every: 1.5 month(s) (Maximun 3 Years) ❑ NA
Inspect dispersal cell(s) year(s)
At least once every: 1.5 month(s) ❑ NA
Clean effluent filter year(s)
At least once every: month(s) ❑ NA
Inspect pump, pump controls & alarm year(s)
month(s) ❑ NA
year(s)
month(s) ❑ NA
year(s)
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 Insepector; POWTS Maintainer; Septage Servicing Operator (pumper). Tank
inspections must include a visual inspeciton of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks,
measure the volume of combined sludge and scum and a check for any back up or ponding of effluent on 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 indicated a failing condition and requires the immediate
notification of the local regulatory authority.
When the combined accumualtion of sludge and scum in any treatment tank equals one-third 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
Admininistrative Code.
All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, petreatment units,
and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority within 30 days of completion of any service event.
(Rev.2/05)
Page 7
START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products,
solvents or other
chemicals or sediment that may impede the treatment process and/or damage the soil 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 extended 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 and may overload them resulting 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) discharge; 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, pits and other soil absorption systems shall be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator.
• 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 the opportunity to obtain a sanitary permit for
a code compliant replacement system:
® A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system.
The replacement area should be protected from disturbance and compaction and should not be infringed upon by required
setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil
and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at the time of their
permit issuance.
❑ A suitable replacement area is not available due to setback and/or soil limitations. If the soil absorption system cannot be
rehabilitated and barring advances in POWTS technology, a holding tank may be installed as a last resort.
❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation
must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to
replace the failed POWTS.
❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative
surface. Reconstructions of such systems must comply with the rules in effect at that time.
WARNING: TREATMENT TANKS AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES AND LACK SUFFICIENT
OXYGEN TO SUPPORT LIFE. NEVER ENTER A TREATMENT TANK OR HOLDING TANK UNDER ANY
t" CIRCUMSTANCE. DEATH MAY RESULT. ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK IS VERY DIFFICULT.
ADDITIONAL INFORMATION:
POWTS INSTALLER POWTS MAINTAINER
Name: John Schmitt Name: John Schmitt
Phone: 715-760-0486 Phone: 715-760-0486
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name: Owners Choice Name: St. Croix County Zoning
Phone: Phone: 715-386-4680
This document is intended to meet minimum requirements of Ch. Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code.
Use of this document does not guarantee the performance of the POWTS. Page 8 0 ^ nL
ST- CROIX COUNT Y
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OWNERSHIP is
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C,SI-300-0140
RECEIVED
` Department of , OIL EVALUATION E R ' #1872
S P $ Safety andRR O in accordance with Co 5, Ad Page 1 of 5
Professional Services
ST. CROD( COUNTY Schmitt Soil Testing, Inc.
Attach complete site plan of s r~~Prinches in St. Croix
include, but not limited to: vertical and horizontal reference point (Bf „ --limn and - -
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D.
Part _of_:_0_32_-1065-30_L)6&- _
Please print all information. Revie lie"I yDate
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).
Property Owner Property Location
Dufresne, Craig & Rebecca Govt. Lot NW1/4, NW1/4, S24, T31N, R19W
Property Owners Mailing Address
Lot # Block # I ubd. Name or CSM#
128 Arch Street 3 CSM PENDING
City State Zip Code Phone Number City Village Town N est Road
Amery WI 54001 715-268-9015 Somerset za~ 210Th Ave.
New Construction Use: ( Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD
Replacement Public or commercial - Describe:
Parent material -Outwash Sand (Plainfield Series) Flood plain elevation, if applicable _ NA ft.
General comments Area suitable for a conventional system with a 0.5 gpd/sgft rate. Possible system elevation for Area 1 is 95.90' (High trench), 96.30'
and recommendations: (Low trench). Slope of area is 7%.
F-1 Boring
1 Boring #
Pit Ground surface elev. 102.22 ft. Depth to limiting factor 100+ in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots G_PD/ft2 _
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. I *Eff#1 *Eff#2
1 0-6 10yr3/4 FILL sl 2fsbk mvfr cs 2m,2f 0.6 1.0
2 6-24 10yr4/4 FILL sl 2msbk mvfr as 2m,2f 0.6 1.0
3 24-36 10yr3/3 none sl lmsbk mfr cs 1vf 0.4 0.7
4 36-52 10yr4/4 none sl 2msbk mvfr gW 1vP 0.6 1.0
5 52-61 7.5yr5/6 e s Osg ml - gW 0.7 1.6
6 61-100 10yr6/4 ),'~",n s Osg ml 0.7 1.6
AM
Boring
F2 Boring #
Pit ~ndi surface elev. 98.92---ft. Depth to limiting factor 102+ in. Soil Application Rate
Horizon Depth Dominant Color ( Redox Description Texture Structure Consisten Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-7 10yr3/4 none sl 2fsbk mvfr cs 2f,lvf 0.6 1.0
2 7-27 10yr4/4 none sl imsbk mfr gw 1vf 0.4 0.7
3 27-40 10yr4/4 none scl 2msbk mfr gW lvf 0.4 0.6
4 40-52 10yr5/6 none Ifs Osg ml cs 0.5 1.0
5 52-102 10yr6/4 none s Osg ml 0.7 1.6
-
I
Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 < 30 mg/L and TSS S.30 mg/L
CST Name (Please Print) Signature: CST Number
Thomas J. Schmitt 227429
Address Schmitt Soil Testing, Inc. Date Evaluation Conducted Telephone Number
1595 72nd St. New Richmond, WI 54017 3/27/2017 715-760-1978
SBD-8330 (R.07/00)
Property Owner Dufresne, Cry & Rebecca _ Parcel ID # Part of: 032-1065-30-_000 Page 2 of 5
Boring
3] Boring # pit Ground surface elev. 98.92 ft. Depth to limiting factor 105+ in.
F
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 _
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#t *Eff#2
1 0-9 10yr3/4 none sl 2fsbk mvfr as 2m,2f 0.6 1.0
2 9-16 10yr4/4 none sl 2msbk mvfr gw im,2f 0.6 1.0
--3 16-42 - 7.5yr5/6- - none gris Osg- - ml gw 2vf 0.7 1.6
r-- i
4 42-64 10yr6/4 none fs Osg ml as 0.5 1.0 II
5 64-105 10yr6/4 none s Osg ml 0.7 1.6
--f-F 7-- -
11 Boring
4
F 1 Boring #
Pit Ground surface elev. - 102.22 ft. Depth to limiting factor 100+ 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 0-6 10yr4/3 FILL sl j 2fsbk mvfr cs 2f,lvf 0.6 1.0
2 6-22 10yr4/4 _FILL sl 2fsbk mvfr as 2f,1vf 0.6 1.0
3 22-26 10yr3/3 none sl 2fsbk mfr cs lvf 0.6 1.0
4 26-38 10yr4/4 none sl 2msbk mfr gw 0.6 1.0
5 38-45 10yr5/6 none Is Osg ml gw 0.7 1.6
6 45-100 10yr6/4 none s Osg ml 0.7 1.6
Boring
F 5 Boring # Pit Ground surface elev. 102.22___ ft. Depth to limiting factor 0 in.
- Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots G_P_D/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-6 10yr3/4 FILL sl 2fsbk mfr as 2m,2f 0.6 1.0
2 6-24 10yr5/6 FILL sl 2msbk mfr as 2m,2f 0.6 1.0
3 24-32 10yr3/3 none sl lmsbk mfr cs 1vf 0.4 0.7
'i 4 32-50 10yr4/4 c2d 7.5yr6/8 sl imsbk mfr gw 0.4 0.7
1~ 7 5yr~2
5 50-72 10yr5/4 none s{~" lmsbk mfr cs 0.4 0.7
6 72-95 7.5yr5/6 none Is/- Osg ml 0.7 1.6
is does not meet the qualifications for the 2 foot rule
* 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-8330 (8.07/00) Schmitt Soil Testing, Inc.
Property Owner Dufresne-- C-rai & Rebecca------- Parcel ID # Part of: 032-1065-30-000 Page --3 of 5-
Boring
- 'F6 ]Boring # Pit Ground surface elev. _--_1-04.12___ ft. Depth to limiting factor O in.
- - - Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots G_P_ D/ft2 _
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 `Eff#2
1 0-12 10yr4/3 FILL sl 2fsbk mfr cs 2m 2f 0.6 1.0
2 12-38 10yr4/4 FILL sl imsbk mfr gw 1f,lvf 0.4 0.7
3 38-47 10yr3/3 none sl lmsbk mfr gw 0.4 0.7
c2d 7.5yr6/8
'a\ 4_- 47-58 10yr5/3 sl lmsbk mfr cs 0.4 0.7
7.5yr6/2
5 58-72 7.5yr5/6 none I Osg ml gw 0.7 1.6
6 72-100 10yr6/4 none s
Osg ml 0.7 1.6
This does riot meet the qualifications for the 2 foot rule.
i
F-1 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/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I *Eff#2
I
I
F-1 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 I _GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
i
Effluent #1 = BOD,,> 30 < 220 mg/L and TSS >30 -150 n?g/L Effluent #2 BOD,. < 30 mg/L and TSS < 30 mg/L
I he Dcpmrimenl ol, Commerce is an cquai opporturrily Sel ice prov idcr and cmployer. 11) ou need assistance to access ,cn ices or
need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
SBD-8330 (R.07/00) Schmitt Soil Testing, Inc.
Page 4 of 5
Conducted by: Conducted For:
Schmitt & Sons Excavating, Inc., _ Name: Craig S Rebecr►urresne- 1
Thomas J. Schmitt, CST 227429 Address: 128 Arch Street j
586 Valley View Trail City, State, Zip: Amery, W1 54001
Somerset,W1 54025 ' - - -
Phone: 715-7 1978 PI D: 032-1065-30-000
Signature Lot No. _3 CSM Pending
Date .3- Legal Description: NWl/4 NWl/4 S24 TYN R19W
~
■ Backhoe Pit Township, County: Somerset, St. Croix County
A Bench Mark 1 El. 100.00' Top of 1" PVC Pipe
0 Bench Mark 2 El. 99.9s' Top of 1" PVC Pipe ! - -
Slope= 7%
Scale 1"= 60'
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