HomeMy WebLinkAbout026-1306-00-020
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No
ATTACH TO PERMIT 597445
GENERAL INFORMATION State Plan ID No: ;j
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)] f V # 1
Permit Holder's Name: City Village Township Parcel Tax No
OEVERING HOMES TOWN OF RICHMOND 026-1306-00-020
CST BM Elev: Insp. BM Elev: BM Description Section/Town/Range/Map No:
a 18.30.18.1627
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER { CAPACITY STATION BS HI FS ELEV.
Septic
aoof t Benchmark
D.ltsjng `a .
Alt. BM
Aocativrr ' Bldg. Sewer f l
I
Flok+rfg / St7Ht Inlet j
TANK SETBACK INFORMATION Z
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic
Dt Bottom
Dosing Header/Man. r-
Aeration .
Dist. Pipe l ' 6, Cl
Holding Bot. System
Final Grade
PUMP/SIPHON INFORMATION
Manufacturer Demand St Cover r' ^
GPM f 1 ' ck _ •Q~ .
Model Number
TDH Lift Friction Loss System Head TDH Ft
Forcemain Length Dia. Dist. to Well
SOIL ABSORPTION SYSTEM BED/TRENCH Width Leng}w►~ INo. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS e,' y
i
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufactur
INFORMATION
pe Of Pyr~tem CHAMBER OR
1 +i #W 4 }'1tA UNIT Model Nber.
1
DISTRIBUTION SYSTEM
Header/ N[3ni d Distributio_p.~_-.. x Hole Size x HoleSpacing Vent to Air Intake
1 i Pipe(s)-
SOIL Dia Length Dia Spacing C
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only % Depth Over t` l IDepth Over xx Depth of xx Seeded/Sodded xx Mulched
Bed/Trench Center ~n P Bed/Trench Edges Topsoil
^•t i[ Yes No Yes G' No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2:
Location: 1524 96TH ST i ` t
1.) Alt BM Description=
I [ i~s►;®
2.) Bldg sewer length = °1l
- amount of cover= d
to ~
Plan reision f equired? Yes No
Use other side for additional ~t
'.J 7" .,1•
Date In tor's Signature Cert No.
SBD-6710 (R.3/97)
C--
~~oa"aT nT4~ County r-" `
Safety and Buildings Division
=9 :t K AUG Q j ICJ 1 201 W, Washington Ave., P.C. Box 7162 Sanitary Permit Number (to be filled in by Co.)
P NladisoV1 X5O7-7"62
ST. CROIX COUN`fiY
il -2 57
5 4 7 4r-r
NITY DEVELOPME SEc~
KHGEZHN07P StaleTransactionlN bet
Sanitary Permr. _ _i _ ,
In accordance with SPS 383.21(2), Wis. Adm_ Code, submission of this form to the appropnau b~•.. . its
is required prior to obtaining a sanitary permit Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address)
the Department of Safety and Professional Servies. Personal information you provide may be used for secondary
purposes in accordance with the Privacy Law, s. 15. 1 m ,Star.
L Application Information - Please Print All Informatit .3 L
Property Owner's Name Parcel ii
00 C`,r , OCR6-1306-00 00 ~
Property Owner's Mailing Address 4 e Property Location m Q . 1Y. /60V/
e ~ T
- c vt_ Lot
City, State Zip Code Phone Number r ,
b, Section
circle on
T N; RE W 1
H. ype of Building (check all that apply) n Lot
r 2 Family Dwelling -Number of Bedroo Subdivision Name
1~
❑Public/Commercial-Describe Use 6~ Block r "t ( j r~ , v
❑ City of f~-/1-
❑ State Owned - Describe Use CSM Number ❑ Village of 1
1 cetkt, w 23+-V) G f - Town of
fS 11z
M. Type of Permit: (Cbeck only one ox on line A. Complete line B if applicable)
A. odwk- System Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) t
)
B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued
Before Expiration Owner
.3ype T of POWTS S stem/Com onent/Device: Check all that apply)
rlon-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound ? 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil /t1
❑ Holding Tank Other l`ersal Component (explain) ❑ Pretreatment Device (explain)
V. Dis rsaVTreat nt Area Information:
Design Flow (gpd) Design Soil Application Rate(gpdsfi Dispersal Area Required (sfl Dispersal AWa Pro d System Elevation
-24
VI. Tank Info Capacity in Total # of Manufktu=
Gallons Gallons ' Units ' o u
New Tanks Existing Tanta Y_'~ ~r+1- .m v U ,
U rn
Septic or Holding Tank
Dosing Chamber
VII. Responsibility State t- I, the undersigned, responsibility for installation of the POWTS shown on the attached plans.
Plum 's Name (Print) Plum_ ` s pature MP/MPRS Number BusLj7
hone N, ber
~ / x (
Plumber's Address (Street, City. State, Zip )
VIII. antv/De artment Use Only
Approved Permit Fee Date Issued Issuing t Sign e
L&e
r W
Own S
en Reason for Dental $ f
IX Coaditf
00 'asons for Disapproval
1. ; it, tank, a fic&n, tilte, Pfi,i
.2 3, a J 11ke.,'40 isper cell dust all be s, rc:as ! r r m 5
per ;-,jar agement plan p: o tided by plwmbe:. Jr
2. ' setback recuwQr^tenlns MUStxbet-lalttt, tt'id -Y\
as per applicable cod / . ina,maa.
Attach to complete plans for the s}scam and submit to the County only on paper not less than 812 z l I inches in size
SBD-6398 (R. 11/11)
System PLOT PLAN
PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017
SW 1/4 SE 1/4S 18 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX
SYSTEM ELEVATION 95.5/95.4' 3.5' below grade 8/8/17 BEDROOM 3
DATE
CONVENTIONAL XX)< CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 933 # of chambers 46
BENCHMARK V.R.P. Top of 2" pvc pipe ASSUME ELEVATION 100' Filter Lifetime Filter
❑ BOREHOLE O WELL *H.R.P. same as benchmark B.M.*
56 B-131' 141' Property ine
102' B-2 49
55'
2-3' X 94' cells with >3' spacing
Vents
d
B-3 30,
Scale = 1/4" = 10'
_S if y
25
{ Pro 3
Bedroom
House
01
r
177' Property Line
387' Property Line
Vent
>6" Quick4 Standard
All piping shall be ASTM SDR 30/34, within Leaching Chamber
10' of tank, piping shall be ASTM F891 of Cover with 20.0 ft2 of Area
5.6ft^2/pair of end caps
12"
4' Long
Grade at System Elevation
34'
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 8/8/17
Owner:Oevering Homes
Location: SW1/4 SE1/4 S18 T30 N,R18W 1524 96th St. Richmond
Manuals Used: In-ground absorbtion system (version 2.0)
Page#
1. Cover Page
r 2. Plot Plan
3. Leaching Chamber Cross Section
4-6. Maintanance and Contingency Plan
7. Filter Cross Section
Signature
License number M,,6'900
Cross Section of Infiltrator Quick 4 Leaching Chamber
Typical cross section for 2 of 2 cells
Quick 4 Standard Leaching Chamber
with 20.0 ft2 of Area per Chamber To be >1' above grade
5.6ftA 2 pair of end plates
Finish grade elevation
Typical Installation 99.0'
Vent PC/ G rade Vent
3' 4„ 3'
x/30/34 Septic Tank
5' Long 1 5' 5' Long
Grade at System Elevation
36" Grade at System Elevation
Spacing- 5'
2-3' X 94' Cells
Same on other end Observation tube/Vent
At end of cell
A
B
23 chambers per cell
System elevations:
A-95.5'
B-95.4'
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner 0 r _ j~ y Septic Tank Capacity al ❑ NA
Permit # 7- f=i Septic Tank Manufacturer 0 NA
C
3ESIGN PARAMETERS Effluent Filter Manufacturer 0 NA
Number of Bedrooms 0 NA Effluent Filter Model 0 NA
i Number of Public Facility Units A Pump Tank Capacity gal NA
Estimated flow (average) -gal/day a~d~ Pump Tank Manufacturer NA
i Design flow (peak), (Estimated x 1.5) l - Pump Manufacturer NA
i
i Soil Application Rate ailda ife Pump Model 111 NA
i Standard Influent/Effluent Quality Monthly average'' Pretreatment Unit NA
Fats, Oil & Grease (FOG) s30 mg/L ❑ Sand/Gravel Filter 0 Peat Filter
Biochemical Oxygen Demand (BOD5) 5220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Watland
Total Suspended Solids (TSS) <150 mg/L ❑ Disinfection 0 Other.
Pretreated Effluent Quality Monthly average Dispersal Cell(s) 0 NA
Biochemical Oxygen Demand (BODs) 530 mg/L round (gravity) ❑ In-Ground (pressurized)
Total Suspended Solids (TSS) 530 mglL -NA 0 At-Grade ❑ Mound
Fecal Coliform (geometric mean) 5104 cFul100m1 ❑ Drip-Line ❑ Other:
iMaximum Effluent Particle Size lfi in dia. ❑ NA Other. 0 NA
Other. NA Other: ❑ NA
"Values typical for domestic wastewater and septic tank effluent Other ❑ NA
AINTENANCE SCHEDULE
Service Event Service Frequency
linspect condition of tank(s) At least once every: ❑ month(s) (Maximum 3 years) 0 NA
-D ear s
(.Pump out contents of tank(s) When combined sludge and scum equals one-third (X) of tank volume ❑ NA
❑ month(s)
Ilnspect dispersal cell(s) At least once every: }year(s) (Maximum 3 years) ❑ NA
Clean effluent filter At least once every: month(s) 0 NA
.year(s)
Inspect pump, pump controls & alarm At least once every: 0 month(s) NA
0 year(s)
[:lush laterals and pressure test At least once every: 0 month(s) NA
❑ year(s)
ether. At least once every: ❑ month(s) NA
❑ year(s)
lather: 4A
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
linclude a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of
wmbined 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 or more of the tank volume, the entire contents of
j:he 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,
land any servicing at intervals of:02 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 of
START UP AND OPERATION Ce of painting products or other chemicals t1*t the For new Construction, Prior to use of the POWYS check treatment i(,s} If for high concentrations
are detected have the contents of thO
may impede the treatment process and/or damage the -d~P
tank(s) removed by a septage servicing operator prior to use.
System start up shall not occur when =1 conditions are frozen at the infiltrative surface. over is restored the excess wastewater will bo
During power' outages pump tanks may fill above normal highwater levels. When P or surface discharge of effluent.
discharged to the dispersal cep(s) in one large dose, overloading the cell(s) and may result in the backup r to restoring power to ft
To avoid this situation have the contents of the pump tank removed by a Septage Servicing operator Pilo normal levels
effluent pump or contact a Plumber or POWTS Maintainer' to assist in manually operating the pump controls to restore
within the pump tank. disturb or compact, the area within
Do not drive or Park Yehkdas over tanks and dispersal cells. Do not drive or park over, or Otherwise Z feet down slope of any mound or at-grade soil absorption area. romance
and prolong the life of the POWr$:
Reduction or elimination of the following from the wastewater stream may improve the dismfec ants, fat; foundation drain
antibiotics, baby wipes; d~rete butts; condoms, cotton swabs; degreasers; dental foss; ss; diapers;
s; gasoline; grease; herbicides; meat scraps; medii~ions; out; ling producos;
(sump pump) water; fruit and vegetable P~m9
pesticides; sanitary napkins; tampons, and water softener brine.
ABANDONMENT taken out of service the following steps shall be taken to insure that the system is pnopeoy
When the POWTS fails and/or is Perim may
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 Senftn9 OPeretor.
• 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 to provide a code comPr4rd
if the POWTS falls and cannot be repaired the following measures have been, or must be taken,
pment system:
rep
ble replacement area has been evaluated and may be utilized for the location of a replacement soil awn systelm.
The replacement area should be protected from disturbance and compaction and should not be Infringed upon by requirled
lines and wells. Failure to protect the replacement area will result in the neled
setbacks from existing and proposed structure, tot Re systems must comply with the rules in
for a new soil and site evaluation to establish a suitable replacer
effect at that time. advances in POWfS technologK a
❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring
holding tank may be installed as a last resort to replace the failed POWTS.
site evaluOon
C3 The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a sal and Installed as
must be performed to locate a suitable replacement area. if no replacement area is available a holding tank may
a last resort to replace the failed POWTS.
❑ Mound and at-grade soil absorption systems may be rued in place following removal of the biomat at the 'mfiltretive
surface. Reconstructions of such systems must Comply with the rules in effect at that time.
«WWARNING>>
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT
RCUM ANC S. DEATH MAY RESULT. RESCUE O~ A
ENTER A SEPTIC, PUMP OR OTHER TREATMENT Y 01 CULT O IMPOSSIBLE.
R CI
PERSON FROM THE INTERIOR OF A TAN
ADDITIONAL COMMENTS
POWTS INSTALL ER POWTS MAINTAINER
- ; Name
Name E, / f
Phone Phone I~'-o' ( tf
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name '7~ a?' / Name
Phone Phone
Administrative Code.
This documentwas drafted in compliance with chapter SPS 383.22(2)(b)(1)(d)&(f) and 383..54(1), (2) & (3), Wiscormsin
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ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer 6~e L.) e i o ~
Mailing Address
Property Address 5
(Verification required from Planning & Zoning ep nt for new construction)
City/State _ Parcel Identification Number
6 ~ - 136 (0 66 - a za
LEGAL DESCRIPTION
Property LocatioC-0 Vj. S %a , Sec.
TN LLW, Town of, c-t vtiy~ r
Subdivision
f
Lot # L 0
certified Survey Map #
Volume Page #
Warranty Deed # -----~,Volume Page #
Spec house res no
Lot lines ideatifiabk yes no
SYSTEM MAINTENANCE AND OWNER CERTMCATION
Improper use and maintenance of your septic system could result in its premature failure to
maintenance consists of pumping out the septic tank every affect three years or sooner, if needed, by a licensed pumper. te
res e syste it are specified in Co tank as a treatment stage in the waste disposal system. Owner mainteenantceou put into
§ mm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary OrdinanCe
The property owner agrees to submit to St. Croix County Planning owner and The
a master plumber, journeyman ty lanning & Zoning Department a certification form,
.wastewater disposal plumber, restricted plumber or a licensed pumper verifying Shed by the
less than 1/3 of sludge. is in proper operating condition and/or (2) after inspection and that the on-site
full
Pumping (if f accessary), the septic tank is
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 Commerce 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 thr4-- ear expiration date.
I/we certify that all statements on rm are true to the best of my/our knowledge. I/we am/are the owners of the
property described above, by virtue of a w deed recorded in Register of Deeds Office. )
Number of bedrooms
IGNA OF APPLICANTS
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 nap if
reference is made in the warranty deed.
(REV. 08/05)
s
379.24 . , 34.26-1A \
t4BA640, 5 E i
LOT 20 - 1 1 1
1.789 ACRES +
J
~ 77,936 SQ. FT.
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.._..-387.08!---.._....~.._..~..1 1
N89'21'33"E 741.31'-- +
120' TRAIL ANb UTILITY ~t 1
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~WiSCOns%h SOIL EVALUATION REPORT #1473
Department of Commerce in accordance with Comm 85, Wis. Adm. Code Page 1 of
Division of Safety and Buildings Schmitt Soil Testing, Inc.
Attach complete site plan on paper not less than 8%2 x 11 inches in size. Plan must County St. Croix
include, but not limited to: vertical and horizontal reference point (BM), direction and
percent slope, scale or dimensions, north arrow, and location istance to nearest road. Parcel I.D.
_ 2
Please print all i Revie d By Date
Personal information you provide ma use d ry purposes (Pdv Law, s. 15.04 (1) (m)).
Property Owner 6 1Q0 Property Location ~P
Sienna Corporation Govt. Lot SW1/ SE1/4, S18, T30N, R18W
Property Owner's Mailing Address Coo-," Lot # Block # Subd. Na a or CSM#
4940 Viking Drive Suite 608 T. GRO~X 20 The Glens Of Willow River
City State ip Code umber City Village ,1 Town Nearest Road
Minneapolis MN 4351, Richmond 95Th St.
7,I New Construction Use: Residential / Number of bedrooms 3 Code derived design flow rate GPD
Replacement Public or commercial - Describe:
Parent material Outwash Flood plain elevation, if applicable na ft.
General comments
and recommendations: Area is suitable for a conventional system with a O.Q_Wd/ sgft rating, recommended rate. Possible
system elevation for Area 1 is 95.50'. Slope is 0%.
Boring # !Boring
F1_1 - Pit Ground surface elev. 99.28 ft. Depth to limiting factor 93 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft'
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-10 10yr3/2 none sl 2mgr mvfr as 2m,2f .6 1.0
2 10-24 10yr4/4 none scl 2msbk mfr gw 1vf .4 .6
3 24-37 10yr4/6 none sl 2msbk mfr gw 2vf .6 1.0
4 37-61 10yr5/6 none cos Osg ml cs .7 1.6
5 61-93 10yr6/4 none s Osg ml as .7 1.6
6 93-105 2.5y6/6 c2d 10yr6/6 vfs Osg ml .4 .6
10 r7 1 i
Boring 15.3
Boring # ,
Pit Ground surface elev. 99.01 ft. Depth to limiting factor 79 fin. 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 0-10 10yr3/2 none sil 2mgr mfr as 2m,2f .6 .8
2 10-24 10yr4/4 none sicl 3msbk mfr gw 1vf .4 .6
3 24-78 10yr2/6 none s Osg ml as .7 1.6
4 79-100 2.5y6/6 c2d 10yr6/8 vfs 0 ml .4
10yr7/1 6
„ x,12
41.1
* Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODs < 30 mg/L and TSS < 30 mg/L
CST Name (Please Print) Signature: CST Number
Thomas J. Schmitt 227429
Address Schmitt Soil Testing, Inc. Date Evaluation Conducted Telephone Number
1595 72nd Street New Richmond, WI 54017 9/13/2006 715-247-2941
SBD•8330 (R.07100)
Property Owner Sienna Corporation Parcel ID # 20 Page 2 of
Boring # -Y-j Boring
Ground surface elev. 98.84 ft. Depth to limiting factor 81 ✓ 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
F 3 1 0-11 10yr3/2 none I 2mgr mfr as 2m,2f .6 .8
2 11-20 10yr4/4 none sl 2msbk mfr gw 1vf .6 1.0
20-33 10yr4/6 none sl 2msbk mfr CS 1Vf .6 1.0
4 33-81 10yr5/4 none cbs Osg ml as .7 1.6
5 81-96 2.5y6/6 c2d 10yr6/8 10 r6/1 vfs Osg ml 4 6
L Boring
Boring # Pit Ground surface elev. s_ 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
E 7 i s t. G'' T; V-
4
r,
d
Boring
F-1 Boring # 1 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
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 (8.07100) Schmitt Soil Tes ing, Inc.
Page = of ?
Conducted by: Conducted For:
Schmitt Soil Testing Inc. Name: Sienna Corporation
Thomas J. Schmitt, CST 227429 Address: l%f5'v f'/' k' by e lc~
~,„~~~~/r, S`SY'S-
1595 72nd St. City, State, Zip:
New Richmond, WI. 54017
Phone: 715-247-2941 Subd.Name: The Glens of Willow River
Signature: Lcrz_/ Lot No.:
Date: i 1-3 i G Legal Description: X1/4 SE1/4 S18 T30N R18W
® Backhoe pit Township, County: Richmond, St. Croix
A Bench Mark El. 100.00' Top of 2" pvc pipe
A Alternate Bench Mark El. IC v 9/2 Top of
Slope= Contour Line El. Al t~ Contour Line Length / z
l
i
Scale V = 40'
ll l `
This Soil and Site Evaluation was completed to fulfill a zoning requirement. It may or may not be in a location suitable for you use.