HomeMy WebLinkAbout026-1306-00-063
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
(ATTACH TO PERMIT) 597455
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
DAVID & NANCY HAINES TOWN OF RICHMOND 026-1306-00-063
CST BM Elev: Insp. BM Elev: BM Description: `
~ Section Town/Range/Map No:
~ T 1 777 18.30.18.1670
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURE • . \ CAPACITY STATION BS HI FS ELEV.
Septic Benchmark ,
Dosing Alt. BM f • ti
r-N
7, 11,
Aeration , Bldg. Sewer
Holing St/Ht Inlet
TANK SETBACK INFORMATION St/Ht outlet`
TANK TO PJL WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic TF
y t t Dt Bottom
Dosing Header/Man.
Aeration Dist. Pipe j s
Holding Bot. System
-
PUMP/SIPHON INFORMATION Final Grade 77-
Manufacturer Demand StCov
GPM
Model Number
TDH Lift Friction L~§s System Head TDH Ft
Forcemam ength Dia:"- - Dist. to Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Trens PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS
X" 5
SETBACK SYSTEM TO P/L y BLDG WELL LA /STREAM LEACHING Manufacturer
INFORMATION CHAMBER OR
Type-Qf System:
t f
UNIT Model Number:
DISTRIBUTION SYSTEM
Header/Manifold Distribution x Hole Size x Hole Spacing Ventlo Air Intake
' I. Pipe(s) l` " r (y
Length Dia . Length Dia Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over , Depth Over xx Depth of xx Seeded/Sodded xx Mulched
Bed/Trench Center f Bed/ rrench Edges Topsoil
Yes No yes No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2:
Location: 985 152ND AVE
1.) Alt BM Description
2.) Bldg sewer length
- amount of cover =
4
Plan revision Required? ❑ Yes No a r l
fit, f'~ ~ r
Use other side for additional information. C ~7 .
Date Insepctor's igp Ture»-_... Cert. No.
SBD No.
-6710 (R.3/97)
,S4- ~2 - 02? 3
County ~ Aev, Safety and Buildings Division
s, D 2 2p1~ 201 W. Washington Ave., P.O. Box 7162 Sanitary i(to be filled in by Co.)
° P V' r9 ~U~ Madison, WI 53707-7162
00(OaVNC 755
S~SC State Trarrsactian berm
anitary Permit Appl8 Ali,
In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to tht- rnit
is required prior to obtaining a sanitary permit. Note: Application fors for state-ownea Proj t Address (if different than mailing address)
the Department of Safety and Professional Servies. Personal information you provide may be
W ^ ^ I
purposes in accord ~i
ance with the Privac Law, s. 15.04(1 m , Slats. SV~ 1. Application Information Please Print All fo ation
Property Owner's Namey a~ r Parcel #
Property Owner's Mailing Address Property Location `L'eo
Govt. Lot
City, 5 to Zip Code Phone Number y, = y. Section ZIS_
circle one
id T_ j N, R S E o
7 2-
I Type of Building (check all that apply) Lot #
a
Nam
1 or 2 Family Dwelling - Number of Bedrooms Subdivision N
#
❑ Public/Commercial -Describe Use Block ❑ City of
CSM Number ❑ Village of
El State Owned -Describe Use
C J Town of r, -
a
III. Type of Permit: (Check only one ox online A. Complete line B if applicable)
A. V~ New System ❑ Replacement'System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain)
B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued
Before Expiration Owner t -27 4-,m IV. Type of POWTS System/Component/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 S
❑ olding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain)
nformation:
V. Dis ersaVrnr
pds Dispersal Area Required (sf) Dispersal Area Proposed (st) System Elevation
Design Flow (gApplication Rate(g
Ok
VI. Tank InfCapacity in Total # of Manufacturer
Gallons Gallons Units n 2 o o
15
d U
New Tanks Existing Tanks U H
a a
~o l o~C. ~SZS U
Septic or Holding Tank -
Dosing Chamber
VII. Responsibility Statement- I, the undersigned, assume responsib' ' for installation of the POWTS shown on the attached plans.
Plumbe s ame (Pr" t) Plumber's gnature MP/MPRS Number Business Phone Number
i? 2 n . /
Plumber's Address (S et City, State, Zip C.Qcje)
VIII. un /De artltlent Use Only
Approved isappr Permit Fee Date slued Issuin yentSgnaturc
cgReason for Denial
IX. Condit isapproval -,;ui C441 Mu _1 p60
Pia Lk-o W
Attach to complete plans for the system and submi the Cou only on paper not less than 8 t2 x I I inches in size
SBD-6398 (R. 11/11)
copy
43
,F:
CONVENTIONAL COMPONENT DESIGN
Residential Application
INDEX AND TITLE PAGE
Project Name:
Owner's Name:
a
Owner's Address: I J✓ iC
✓n i ti L S S f 7
Legal Description:
Township:
County: ( X/
i
Subdivision Name:
Lot Number: _ Z
Parcel ID Number:
a~
Page 1 Index and title
Page 2 Plot Plan
Page 3 System Sizing & Cross-Section
Page 4 Filter Specs
Page 5 Maintenance Information
Page 6 Management Plan
Page 7 St. Croix Cty Septic Tank Maintenance Form
Page 8 Warranty Deed
Page 9 CSM or Plat
Attachments: Soil Test & House Plans
L~
Designer/Plumber. License Number.
. lr
Date: , Phone Number 97
Signature
Designed pursuant to the In-Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P (N.01101).
Page 1
1
~u
T Q Q'
B 9 -
Ri ~n
.4LSuL-4
PVCvent pipe
-vm Vent Cap
Leaching fig
Chamber Sysiefn Eteuatian
t J /
Soll Ahso tiOti met VIS-W
Ml !Rul
LeacWuW 3' rte I
_._L- ft Vent or Observafm Rpe Chambers
Dia.
'i'rextt i 2 Neuter
ManufacWrer And Model r~-
EiSA Rafting " si ft per chamber 860 APPHcation Fame . ~7 9
- SA=_ ._f,;harrriiers
gpd Design Flout 5a dApplicationRate. Ei
2 raves of dwmbers each.
page OF
of N 4~+ ! ~ j R^s58 .R Yikyy'Y
t Sa d+
FL; 525 EFFLUENT FILTER
Polylok, Inc is pleased to add its -
new commercial filter to its existing
line of quality effluent filters. The
l-=
PL-525 is rated for over 10,000 GPD Alarm
Accepts PVC
(gallons per day) making it one of accessibility extension handle I'
the largest commercial filters in its
class. It has 525 linear feet of 1/16°
filtration slots. Like the Polylok
P1=122, the new Polylok PL-525 has j`
an automatic shut off ball installed 525 finParfeet
with every filter. When the filter is of 1/16' ~g
'
filtration slots Rated for over
removed for cleaning, the ball will
10,000 GPD
float up and temporarily shut off
the system so the effl uent won't t -
leave the tank. No other filter on -
the market can make that cfaimr ~ Accepts 4° & 6"
SCHD. 44 Pipe
t
PL-525 Maintenance: The PL-525 Effluent Filter should
operate efficiently for several years
under normal conditions before
requiring cleaning. It is recom-
mended 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 needs Gas deflector ,x
servicing. Servicing should be A!
IF „Automatic shut-off
done by a certified septic tank
pumper or installer, ball when filter x
i' is removed
1. Locate the outlet of the U.S- Patent Noe 6,U15,483
septic tank. 5,371,640
2. Remove tank cover and pump
tank if necessary. PL 525 Installation: 1. Locate the outlet of the
3. Do not use plumbing when septic tank.
filter is removed. Ideal for residential and com- 2. Remove the tank cover and
4. Pull PL-525 out of the housing. mercial waste flows up to pump tank if necessary.
5. Hose off filter over the septic 10,000 Gallons Per Day (GPD). 3. Glue the filter housing to the
4° or 6° outlet pipe. If the
tank. Make sure all solids fall filter is not centered under the
back into septictank access opening use a Polylok
6. Insert the filter cartridge back Extend & Lok or piece of pipe
into the housing making sure to center filter,
the filter is properly aligned and 4. Insert the PL-525 filter into
completely inserted, its housing.
7. Replace septic tank cover. 5. Replace the septic tank cover.
T
7
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page .S of
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner
, - - Tank Manufacturer: lL ; ; y J_ /__-Z ❑ NA
Permit # /P~ Septic ❑ Dose ❑ Holding Volume: (gal)
DESIGN PARAMETERS Tank Manufacturer: NA
Number of Bedrooms: ❑ NA ❑ Septic ❑ Dose ❑ Holding Volume: (gal)
Number of Public Facility Units: JA NA Vertical Distance Tank Bottom(s) to Service Pad: (ft)
Estimated (average) Flow : (gal/day) Horizontal Distance Tank(s) to Service Pad: (ft)
Design (peak) Flow = (estimated x 1.5): - (gal/day) Specific servicing mechanics must be provided if vertical is >15 feet or
y) if horizontal is >150 feet. Specific instructio s o be provided on back.
In Situ Soil Application Rate: 7 (gal/day/ftz) Effluent Filter Manufacturer:
❑ NA
Standard (Domestic) Influent/Effluent Monthly average Effluent Filter Model: S
Fats, Oil & Grease (FOG) 530 mg/L Pump Manufacturer:
Biochemical Oxygen Demand (BOD5) <220 mg/L ❑ NA NA
Total Suspended Solids (TSS) x150 mg/L Pump Model:
High Strength Influent/Effluent Monthly average Pretreatment Unit
(FOG) >30 mg/L Manufacturer:
(BOD5) >220 mg/L NA
(TSS) >1 50 mg/L El Mechanical Aeration El Peat Filter NA
❑ Disinfection ❑ Wetland
Pretreated Effluent Monthly average ❑ Sand/Gravel Filter ❑ Other:
(BOD5) <30 mg/L Soil Absorption System
(TSS) <_30 mg/L NA
Fecal Coliform (geometric mean) <104 9 In-Ground (gravity) ❑ In-Ground (pressure) ❑ NA
❑ At-Grade ❑ Mound
Maximum Effluent Particle Size Y8 in dia. ❑ NA ❑ Drip-Line ❑ Other:
Other: ❑ NA Other: ❑ NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
Pump out contents of tank(s) 2r When combined sludge and scum equals one-third (Y3) of tank volume
❑ When the high water alarm is activated
Inspect condition of tank(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA
j9year(s)
Inspect dispersal cell(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA
year(s)
Clean effluent filter At least once every: ❑ month(s) ❑ NA
rA year(s)
Inspect pump, pump controls & alarm At least once every: El month(s) El 0 NA
year(s) -
Flush laterals and pressure test At least once every: ❑ month(s) 0 NA
❑ year(s)
Other: At least once every: ❑ month(s) ❑ NA
❑ year(s)
Other:
❑ NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and soil absorption systems shall be made by an individual carrying one of the following licenses or certifications:
Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector, POWTS Maintainer or Septage Servicing Operator (pumper).
Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks,
measure the volume of combined sludge and scum and a check for any back up or ponding of effluent on the ground surface. The soil
absorption system shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent
on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate
notification of the local regulatory authority.
When the combined accumulation of sludge and scum in any treatment tank equals one-third (Y3) or more of the tank volume, the entire
contents of the tank shall be removed by a Septage Servicing Operator (pumper) and disposed of in accordance with chapter NR 113,
Wisconsin Administrative Code.
All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units,
and any servicing at intervals of _<12 months, shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority within 30 days of completion of any service event.
GMW-005 (02/05)
Page of
START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other
chemicals or sediment that may impede the treatment process and/or damage the soil absorption system. If high concentrations are
detected have the contents of the tank(s) removed by a Septage Servicing Operator (pumper) prior to use.
Pump tanks may fill above normal highwater levels prior to startup or due to pump failures. Start up or restoration of power under these
conditions is not recommended, as the excess wastewater will be discharged to the soil absorption system in one large dose causing an
overload that may result in the backup or surface discharge of effluent and damage to the system. To avoid this situation have the
contents of the pump tank removed by a Septage Servicing Operator (pumper) prior to restoring power to the pump or contact a Plumber
or POWTS Maintainer to assist in manually operating the pump controls until normal effluent levels are restored within the pump tank.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
Do not drive or park vehicles over tanks or the soil absorption system. Do not drive or park over, or otherwise disturb or compact, the
area within 15 feet down slope of any mound or at-grade soil absorption area.
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the treatment
tanks and soil absorption system: acids, antibiotics, baby wipes, cigarette butts, condoms, cotton swabs, degreasers, dental floss,
diapers, disinfectants, fats, foundation drain (sump pump) discharge, fruit and vegetable peelings, gasoline, greases, herbicides, meat
scraps, medications, oils, painting products, pesticides, sanitary napkins, solvents, tampons, and water softener brine discharge.
ABANDONMENT
When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly
and safely abandoned in compliance with s. Comm 83.33, Wisconsin Administrative Code:
• All piping to tanks, pits and other soil absorption systems shall be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator (pumper).
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil,
gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant
replacement system:
J~f A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system.
The replacement area should be protected from disturbance and compaction and should not be infringed upon by required
setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need
for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in
effect at the time of their permit issuance.
❑ A suitable replacement area is not available due to setback and/or soil limitations. If the soil absorption system cannot be
rehabilitated and barring advances in POWTS technology, a holding tank may be installed as a last resort.
❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation
must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a
last resort to replace the failed POWTS.
❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative
surface. Reconstructions of such systems must comply with the rules in effect at that time.
WARNING TREATMENT TANKS, PUMP TANKS, AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES OR LACK
Imo„ SUFFICIENT OXYGEN TO SUSTAIN LIFE. NEVER ENTER ANY TANK UNDER ANY CIRCUMSTANCE. DEATH MAY
RESULT. ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK MAY NOT BE POSSIBLE.
ADDITIONAL INSTRUCTIONS:
POWTS INSTALLER POWTS MAINTAINER
Name Name
r7
Phone ca Phone
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGU TORY AUTHORITY
Name Name
Phone Phone
This document was drafted by the staffs of the Green Lake, Marquette and Waushara County POWTS regulatory agencies in compliance with sections
Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code.
START UP AND OPERATION Page Z of
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other
chemicals or sediment that may impede the treatment process and/or damage the soil absorption system. If high concentrations are
detected have the contents of the tank(s) removed by a Septage Servicing Operator (pumper) prior to use.
Pump tanks may fill above normal highwater levels prior to startup or due to pump failures. Start up or restoration of power under these
conditions is not recommended, as the excess wastewater will be discharged to the soil absorption system in one large dose causing an
overload that may result in the backup or surface discharge of effluent and damage to the system. To avoid this situation have the
contents of the pump tank removed by a Septage Servicing Operator (pumper) prior to restoring power to the pump or contact a Plumber
or POWTS Maintainer to assist in manually operating the pump controls until normal effluent levels are restored within the pump tank.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
Do not drive or park vehicles over tanks or the soil absorption system. Do not drive or park over, or otherwise disturb or compact, the
area within 15 feet down slope of any mound or at-grade soil absorption area.
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the treatment
tanks and soil absorption system: acids, antibiotics, baby wipes, cigarette butts, condoms, cotton swabs, degreasers, dental floss,
diapers, disinfectants, fats, foundation drain (sump pump) discharge, fruit and vegetable peelings, gasoline, greases, herbicides, meat
scraps, medications, oils, painting products, pesticides, sanitary napkins, solvents, tampons, and water softener brine discharge.
ABANDONMENT
When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly
and safely abandoned in compliance with s. Comm 83.33, Wisconsin Administrative Code:
• All piping to tanks, pits and other soil absorption systems shall be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator (pumper).
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil,
gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant
replacement system:
F A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system.
The replacement area should be protected from disturbance and compaction and should not be infringed upon by required
setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need
for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in
effect at the time of their permit issuance.
❑ A suitable replacement area is not available due to setback and/or soil limitations. If the soil absorption system cannot be
rehabilitated and barring advances in POWTS technology, a holding tank may be installed as a last resort.
❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation
must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a
last resort to replace the failed POWTS.
❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative
surface. Reconstructions of such systems must comply with the rules in effect at that time.
WARNING TREATMENT TANKS, PUMP TANKS, AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES OR LACK
SUFFICIENT OXYGEN TO SUSTAIN LIFE. NEVER ENTER ANY TANK UNDER ANY CIRCUMSTANCE. DEATH MAY
RESULT. ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK MAY NOT BE POSSIBLE.
ADDITIONAL INSTRUCTIONS:
POWTS INSTA ER POWTS MAINTAINER
Name Name
Phone Phone
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGUL TORY AUTHORITY
Name Name I
Phone Phone I(-
S _ r _
This document was drafted by the staffs of the Green Lake, Marquette and Waushara County POWTS regulatory agencies in compliance with sections
Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1): (2) & (3), Wisconsin Administrative Code.
ST. CROIX COUNTY
SEPTIC TANS I-1AR~.t TCE AC>RF.B&MNT
AND
OWNERSHP CERTIFTCATTON FORM
Ow=fBuyer
l?4 Ac&ess
C\7M- Bczdon regard frown Pig & Zing D Ot fcr 7nvw txmstruct
d=J,
Cit5=IState = l~ I.- Panel Idaxt ficadm lmZber -~2 /Z
LEGAL RM( RR'I`I0N
Prope ty Location 1/.: > V4, Sec. T _ 3C N, R W, Town of
Subdivision Plat: 7 r ~i ./y I t! 1^k1j Lot #
Certified Survey Map # Volume , Rage #
arnmay Dtad AS
(ire 7)Volume . Page #
Spec douse .0 yesJ~'no Lot -Ihm MMt&bk j$/ "s~ ifl
SYSTEM MAINT NANCE ANrD OWNRR CERTIR`IC
improper use and maintenance of your septic system could result in its prematizm faittue to .handle wastes. Proper
ma,sfrezia„ce consists of pumping out the septic tank every three years or sooner, if weeded, by a licensed pungw- What you put into
ibe sysem can affem the fl=on of ifie septic tank as a treatment stage in the. waste disposal systm tamer Mamtenanm
responsftalides are s fred in MS. 38332(l) and in Chagcer 12 - St Crain County Sanztary Ordigan=
t be property owner agrees to s far 1- to St: Cry County Plambg & Zaobg Der a catt5cadw form, signed by the
owner and by a mastw pttmnber, journeyman plumber, reseed phmaber ar a licensed pumper vm*ing that (1) The on-site
,Avjtewater disposal system is m proper operating ooudition =&or (2) aft inspection and pumping (lfneremary), flee septic tank is
less than 18 fall of sludge.
1(we, the un .°d have read the above dents and agree to m aintam the private sewage disposal system with tbe
standards set ft-& barain. as set by !he Dqxr4ang of Sam And Se vx= and ft Depwtmva ofd Res,
State of Wes. won yaw sic sys hisbeen must be completed and rem to the St. Croix
County Plauning & Zft DeparuDent wilbin 30 days of the ftw year caq)kafim dom.
Uwe certify dw all its on this : are true to the best o€my/ow knowledge Uwe am/are the owAes(s) of the
property described above, by ti'ir~ue of a deed reams in Rq;ister of Deeds Office,
loUM f bedromms
SICYNTA.TT`RE OF APP!`,. TCA_N-T(S), DATE
4sty information that is mis pre~seated may refit at she saaitary pest being revoked by the Pbn=g 8c Z= mg DepaMnem
:include wisjt this application a Tended warranty deed from the Register of Deeds Office and a copy of the cartMed survey map if
refmmce is made in the waazzy deed.
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® scons%h SOIL EVALUATION REPORT #1503
Department of Commerce in accordance with Comm 85, Wis. Adm. Code Page 1 of 3
Division of Safety and Buildings Schmitt Soil Testing, Inc.
Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County St. Croix
include, but not limited to: vertical and horizontal reference point (BM), direction and
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D
63 / /
Please print rmation. Revie d By Date
Personal information you provide may be us for s~ Law, s. 15.04 (1) (m)).
d / b
Property Owner roperty Location
Sienna Corporation S ovt. Lot NE1/4, E1/4, S18, T30N, R18W
*W U #
Property Owner's Mailing Address
/ U0 6 Lot Block # Subd. Name or CSM#
4940 Viking Drive Suite 608 ST. 63 The Glens Of Willow River
City Stat -X4 ~ ode Phon ri~ier City I Village Town Nearest Road
Minneapolis MN 55435 Richmond 100Th St.
New Construction Use: Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD
Replacement Public or commercial - Describe:
Parent material Outwash Flood plain elevation, if applicable na ft.
General comments
and recommendations: Area is suitable or a conventional system with a 0.7 gpd/ sgft rating. Possible system elevation for Area
1 is high trench 101.4', low trench 100.2'. 8-5
m rA-a. I !'.t,:
Boring
Boring #
F-11 Pit Ground surface elev. 102.05 ft. Depth to limiting factor 110+ in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistenc Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. -Eff#1 'Eff#2
1 0-6 10yr3/3 none sl 2fsbk mfr as 2f .6 1.0
2 6-17 10yr4/4 none grsl 2msbk mfr gw 1vf .6 1.0
3 17-30 10yr5/4 none grcos Osg ml cs .7 1.6
4 30-59 10yr5/6 none s Osg ml cs .7 1.6
5 59-110 10yr5/4 none cos Osg ml .7 1.6
Boring # Boring
Pit Ground surface elev. 102.05 ft. Depth to limiting factor 110+ in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistenc Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. REff#1 'Eff#2
1 0-14 10yr3/2 none sl 2fsbk mfr cs 2f,1vf .6 1.0
2 14-26 10yr4/3 none sl 2fsbk mfr gs 1vf .6 1.0
3 26-35 10yr4/4 none scl 2msbk mfr gs lvf .4 .6
4 35-45 10yr4/6 none Is lcsbk mvfr gs 1vf .7 1.6
5 45-62 10yr5/4 none grcos Osg ml cs 1vf .7 1.6
6 62-110 10yr5/6 none cos Osg ml .7 1.6
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 9/16/2006 715-247-2941
SBD-8330 (R.07/00)
Property Owner Sienna Corporation _ Parcel ID # 63 Page 2 of _ 3
n3Boring 'Boring # Pit Ground surface elev. 99.30 ft. Depth to limiting factor 64 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 0-21 10yr3/3 none sl 2fsbk mfr gs 2m,2f .6 1.0
2 21-30 10yr4/4 none scl 2fsbk mfr gs 1vf .4 .6
3 30-48 10yr4/6 none sl 2msbk mfr gs lvf .6 1.0
4 48-64 7.5yr5/6 none grcos Osg ml as .7 1.6
p m2d 7.5yr6/8
l\ 5 64-71 5yr4/4 7.5 r6/1 sl Om mfi as - .2 .6
6 71-108 10yr6/3 none fs Osg ml .2 .6
❑ Boring # Boring
Pit Ground surface elev. 100.93 ft. Depth to limiting factor 110+ 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
1 0-17 10yr3/2 none sl 2fsbk mfr gs 2m,lf .6 1.0
2 17-25 10yr5/3 none sl 2msbk mfr gw lvf .6 1.0
3 25-37 10yr4/4 none scl 2msbk mfr Cs lvf .4 .6
4 37-62 10yr5/6 none grs Osg M1 Cs .7 1.6
5 62-110 10yr5/4 none cos Osg ml .7 1.6
❑ Boring # Boring
pit Ground surface elev. 105.47 ft. Depth to limiting factor 105+ 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 0-14 10yr3/2 none grsl 2fsbk mfr Cs 2vf .6 1.0
2 14-53 10yr5/6 none s Osg ml gw .7 1.6
3 53-105 10yr5/4 none cos Osg ml .7 1.6
OVA
i
Effluent #1 = BOD5> 30 < 220 mg/L and TSS >30 <150 mg/L * Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg/L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
SBD-5330 (R.07/00) Schmitt Soil Testing, Inc.
Page - of .3
Conducted by: Conducted For:
Schmitt Soil Testing Inc. Name: Sienna Corporation
Thomas J. Schmitt, CST 227429 Address: 4940 Viking Drive Suite 608
1595 72nd St. City, State, Zip: Minneapolis, MN 55435
New Richmond, Wl. 54017
Phone: 71✓✓5jj-247-2941 Subd.Name: The Glens of Willow River
Signature: Lot No.: ((i
Date: Legal Description: /V, 114 SEl/4 S18 T30N R18W
Backhoe pit Township, County: Richmond, St. Croix
A Bench Mark El. 100.00' Top of 2" pvc pipe
Q Alternate Bench Mark El. 0 Y. S Top of ~2" /~c16
Slope= _ Contour Line El. 1'A- Contour Line Length At;
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X1a
,r
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Scale 1/t✓ <
1 /
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47-36
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This Soil and Site Evaluation was completed to fulfill a zoning require It may or m of be in a location suitable for you use.