HomeMy WebLinkAbout040-1170-10-005 (2)
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
(ATTACH TO PERMIT) 582076
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: FCity Village Township Parcel Tax No:
Jonathan & Mary Wood TOWN OF TROY 040-1170-10-005
CST BM Elev: Insp. BM Elev: BM Description: . I PA-A- ion/Town/Range/Map No:
/ , 7 4 Nay ( ; ~ 36.28.20.646F-05
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic ~ Benchmark
to :I s D~U /3,91 725,1 Iii. Z:7
Dosing ~v s/ Ap B ~7 •7167- 7T -41 a i t
RtTOh a~ Bldg. Sewer
, /q.7 7e5~Y
Holding St/Ht Inlet
TANK SETBACK INFORMATION St/Ht Outlet
TANK TO L WELL BLDG. ent Air Intake ROAD Dt Inlet a
Septic ~ /m 25 $1 Dt Bottom 4 07
~g
Dosing Zv Header/Man. r t -716.
7 4%) Aeration v Dist. Pipe
ls, -709.
Holding Bot. System /b• 701. ?
PUMP/SIPHON INFORMATION Final Grade I2. LS -7/2-13
Manufacturer Demand St Cover ~/6 r7
403 ~1.
Model Number
Z46 7/t
Loss System Hea TDH
TDH Lift, 9Z Friction
2- *0 AJIt
Forcemain 7 Length Dial 0 Dist. to Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Trenches PIT IMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS 7 /L
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: c
INFORMATION CHAMBER OR TJ~~,`~
Type Of64' a ~ /GZ UNIT Model N tuber:
C t /`~+~1LJ C.L
DISTRIBUTION SYSTEM ~2-0-/f 6✓S
Header/Manifoltl / Distribution Ix Hole Size x Hole Spacing Ve o Air I e
C, Pipe(s) •~o~ ✓
Length % Dia_ Length Dia Spacing V% at,
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Iched
Bed/Trench Center 3,57 Bed/Trench Edges Topsoil
Yes No Yes No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspect' n #2:
Location: 206 N ILWACO
W C)
1.) Alt BM Description = M GO `r + v-t_ d
49L
2.) Bldg sewer length
- amount of cover = /A~f`" i
2~ a~- Jdf 40 I
Plan revision Required? ❑ Yes >No ~~f? o
Use other side for additional information.
Date Insepctor's Si ture Cert. No.
SBD-6710 (R.3/97)
~Q~nraiF\ a 4 Coun
Safety and Buildings Division St. Croix
201 W. Washin tgqn A4:71P;0. Bdx 71'62 Sanitary Permit Number (to be filled in by Co.)
1 IP 1 APR 13 ~0 i Madison,, Wl 5~7,V--7162
L' (J
Fcs~uta~~~ ~
j Sanitary Permit Application State Transaction Number
In accordance with SPS 383.21(2), Wis, Adm. Code, submission of this form to the appropriate governmental unit Na
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 Services. Personal information you provide may be used for secondarypurposes in accordance with the Privacy Law, s. 15.04(1 m , Stats.
206 North Ilwaco Rd., Hudson, WI 54016
1. Application Informatio lease Print All Information
Property ey's Name Parcel # O /76 /O - 60S
rd
Jonathan Woo 0 12
Property Owner's Mailing Address Property Location ~y( I (Z- a \
♦ e Jl
3099 North View Lane Govt. Lot 1
City, State Zip Code Phone Number y %4, Section 36
Woodbury, MN 55125 54016 (612 209-9299 (circle one)
T 28 N; R 20 E or W
11. TTY a of Building (check all that apply) Lot #
Ild'I or 2 Family Dwelling - Number of Bedrooms 2 Subdivision Name
Na
Block #
El Public/Commercial - Describe Use Na ❑ City of
I Ad
Vv i-1111 e of
❑ State Owned - Describe Use CSM Number L
7 L►~J'Town of Trod
111. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A.
❑ New System t!T Replacement System 11 Treatment/HoldingTank Replacement Only El Other Modification to Existing System (explain)
B. El Permit Renewal Permit Revision 11 Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued
❑
Before Expiration Owner
IV. Type of POWTS System/Component/Device: (Check all that apply) ~~j 1 , 1 /
on-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable s I ❑ Mound < 24 in, of suitable ssoil . C.
❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatm.,rrt Device ex lain
V. Dis ersal/Trea ent Area Information: 30Infiltrator "Q4 Plus" Standard chambers & d c P<,i Lok PL-525 effluent fill in new Wieser s tic tank
Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal ystem Elevation
709.00
300 Gpd 0.50 Gpd/Sq. Ft. 600.00 sq. ft. SN~Sq. FtXU)
d
VI. Tank Info Capacity in Total # of Manufacturer
Gallons Gallons Units J:1 o ~ v_
New Tanks Existing Tanks 0 v
a U Con m rn w C7 Z
Septic or Holding Tank 1,000 1,000 1 Weiser Concrete X
Dosing Chamber 650 650 1 Weiser Concrete X
VII. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number
Gary Za a MPRS 222373 (715 386-2850
Plumber's Address (Street, City, State, Zip Code)
715 60' St. N, Hudson, Wl 54016
VIII. Coun epartment Use Only 17
Approved Permit Fee Date slued Issuing ent Signature
475 • 7-Z3 J~
r iven Reason for nial
IX. Condi Td&AP firhlE*Reasons for Disapproval r~t 6,^.
1. Septir. tank, erflt ent filter and ;3 (moo 07`'~► I
disper.:ni cell must all bg~,aivic?s ! r ,ir z rgc
as per management plan pronded`by plumber. rt-ECG' `r`aw I/•^
2. All set0eck requirements must t o malnt i4d
as per apFNcable tom! / ordinancl as, 0 Id1~l e0 23 U
Attach to complete plans for the system and submit to the County only on paper not less than 81/2 a 11 i es in size ,
SBD-6398 (R. 11/11)
a So,~ Ada/uau~o,.,lD,
nm~,ryu~~od
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Dose-Conventional POWTS Index & Tilte Sheet
Project Name: Wood 3 Bedroom Replacement Dose-Conventional POWTS
Owners Name: John & Mmary Wood
Owner's adress: 309 North View Lane, Woodbury MN 55125
Site address: 206 North Ilwaco road, Hudson, WI 54016
Project Location:
Subdivision: Na
Legal Description: Gov't lot 1 (NWt/4NWv4), Sec. 36, T.28N., R. 20W., Tn of Troy, St. Croix Co., WI.
Parcel ID 040-1170-10-000
Page 1 Index and Title Sheet
Page 2 Site Plan
Page 3 Dispersal Cell & Dose Chamber Sizing Calcualtions
Page 4 System Cross Section
Page 5 Pump Tank Cross Section
Page 6 Pump Curve
Page 7 Filter Specifications
Page 8 Distribution Box Cross Section
Page 9 System Management Plan
Page 10 Septic Tank Maintenance Agreement
Page 1 I Parcel map
Page 12 Waranty Deed
Attachments: Soil Evaluation Report
Mater Plumber Restricted Service: Gary Zappa, Dep't. of SPS Credential #222373
Signature: Date:
Page 1 Of 12
Design pursuant to fn-Ground Soil Absorption Component Manual for POWTS, version 2.0 SBD-10705-P (N.01/01)
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--rwv (2j cnCddS&'i6 d!5 4,-r;4 l.E1a., 6vy.
~c~: ~rC a1u! , 709.0' r r
/
~ i PJ 1 i r
l•,. 45.Nl. 7-5-yo cl'lGtf- s `-'ec. E/¢v = 7oS~r{3.~ „
WOOD DISPERSAL CELL & DOSE CHAMBER SIZING CALCULATIONS
Dispersal Cell Sizing Calculations
1. (2bedrooms)(100 gallons estimated flow)(1.5 design factor) = 300.00 Gpd design flow
2. Infiltrative capacity of native soil = 0.5 gpd/sq. ft.
3. Absorption area required: _ 600.00 N. ft.
4. Absorption area as proposed: 611.60 sq. ft. (30chambers total)
Infiltrator "Quick 4 Plus" = 20.00 sq.ft. EISA per chamber, "Quick 4 Plus" end cap/pair = 5.80 sq.ft. EISA
600 sq. ft. - (2 pair end caps)(5.80) = 588.40 sq. ft.
588.40 sq. ft./20.00 = 29.42 chambers required
Number of trenches: 2 @a@~ 15 = 30 chambers total
Trench width: 2.83'
Trench length: 63.00'
Trench spacing: 7.00' on center
Total system area w/ 4' center spacing: 10.00'x 63.00'
5. Infiltrative surface elevation: 709.00 `
Dose Chamber Sizing Calculations
1. Force Main:
Diameter 2"
Length 150'
Flow rate 35.00 gal./min.t
Friction loss 3.87' (150')(2.58 ft./ 100') = 3.870 ft.
2. Total dynamic head:
Min. supply pressure 0.00' (forcemain to discharge to distribution box & gravity feed to trenches)
Vertical lift 6.00' (P.C. bottom = 703.0.0",Off float = 704.0', Invert of Dist. box inlet = 710.0')
friction loss 3.87'
Total dynamic head = 9.87' -3 -p ~j-
3. Pump selection:
Manufacturer & Model number: Zoeller BN 53
Pump will discharge approx. 35.0 gpm @ 9.87' TDH (Flow Velocity 3.57 ft./second)
4. Dose chamber: Wieser WLP1000/650-MR - 38" liquid depth @ 17.00 gal./inch (646.00 gal. actual)
A) One day holding capacity: 20.00" = 340.00 gal.
B) Alarm setting: 2.00" = 34.00 gal.
C) Dose volume: 4.00" = 68.00 gal. (300ga1.)(20%) + (.164X150') = 84.60 gal. max. dose
D) Reserve storage: 12.00" = 204.00 gal.
Pg. 3 of 12
I
Soil Absorption System Cross Section
7/4( 0 ft
4" Schedule 40 Final Grade
PVC Vent Pipe
With Vent Cap 7/6 ft
Leaching i
Chamber 7010 ft
System Elevation
1 _83 ft d/0 ft
t
Soil Absorption System Plan View
&3 ft
2,83 ft
ft Leaching Trench 1
Vent Or Observation Pipe Chambers Eaj
4" Dia.
Trench 2 Header
Leaching Chamber Specifications
Manufacturer And Model 'Q-/
EISA Rating ?-0.D sq ft per chamber Soil Application Rate o. 5- gpd/sq ft
3Ga gpd Design Flow = 0.5-Soil Application Rate 20.0 EISA = 30 Chambers
2 rows of /5'- chambers each.
Page of
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TOTAL DYNAMIC HEAD/FLOW
W PUMP PERFORMANCE CURVE PER MINUTE
MODELS 53155/57/59 EFFLUENTAND DEWATERING
Q 6 20 MODEL 53/55/57/59
w
= Feet Meters Gal. Liters
4 15 5 1.5 43 163
0 10 3.0 34 129
15 4.6 19 72
TrJ ° 2 00"1 Shut-off Head: 19.25 ft.(5.9m)
5
3718 631,16
4 E18 - 1 52,i; 5:2 NAT
0
10 20 30 40 50 3 718
GALLONS js- rr1. or j,s7F~/SCCOAcI.
LITERS 0 80 160 +
FLOW PER MINUTE 4
CONSULT FACTORY !
! I
FOR SPECIAL APPLICATIONS ! i
i
Variable level float switches available.
i l
' Variable level long cycle systems available.
• Available with special cord lengths of 15', 25', 35' and 50'.
Alarm systems available. l
10 1118 I I
• Duplex systems available. !
j I
' 33712
i aKaki
m eSeW~ _ Control Selection - -Ustin ci _.l k 14U(. v (J
~_YOdal Voira PhewTMods Am T Sim ea Du ex CSA UL i. Integral tl~t operated mechanical switch, no external control required.
A153 55 8 M57F9 1t5 1 Auto 9.7 1 Y Y 2. Single piggyback variable level float switch or double piggyback variable level
i N53r55 8 N57159 115 1 Non 9.7 2 3 a 4& 5 Y Y float switch. Refer to FM0477.
' BNr- 53 115 1 Auto 9.7 Y Y 3. Mechanical agemator'M-Pak' 10-0072 or 10-0075.
SN57 115 1 Auto 9.7 - N Y
' BE53157 230 1 Auto Y y 4. See FM0712 for correct model of ElectricalAtlernata.
053155 & D57159 230 1 Auto 4.8 1 y y 5. variable level control switch 10-0225 used as a control activator, vAh Electrical
E53/55 & E57159 230 1 Non 4.8 2 3 or 4 & 5 Y Y Alternator (3) or (4) float system.
' $KI~e piggy switch included.
For inkirrmahononaddknalZoe4erprodictsrefer tocatalogonP49ybadVariablef.eveiFloatSwitches, FM0477; AI! insta:iaLon of controls, protec5on devices and should be done by a quaMied
Electrical aterrtaOw,FMO486; Mechanical NBernetor.FM0495;&X*SewageBasins, FAf0487;ancl Single Phase licensed electrician. All electrical and safety codes should be followed including
the
Swnpies PurM ConlroVAlarm Systems, FM0732 most recent National Electric Code (NEC) and the Occupational Safety and Health Alt
;OSHA).
RESERVE POWERED DESIGN
For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump.
MAIL TO, PO. BOX 16341
~Oe / Lousvltk, tCy 4 02 56-034 7 Marwfacttaarsoi.
1 ~~,1!i /wC~WI(TaJ HIP To 3848 Cane Run RoaO
Louti-213 1(Y 4 02 11-1 86 1 n'•, ~rPuuve SrcE /99.9
iugolAvww.zoaUorcom PV/G!P !D_ 1(5SO2) 7782131.1(800) 928PUMP
FAX (502) 774 3624
a Copyright 2004 Zoeller Co. All rights reserved.
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Filters
s
PL-525 EFFL UENT FILTER
Polylok, Inc is pleased to add its
new commercial filter to its existing y
line of quality effluent filters. The 4
PL-525 is rated for over 10,000 GPD Alarm
gallons per da IBC
y) making it one of accessibility Accepts PVC
the largest commercial filters in its extension handle
class. It has 525 linear feet of 1/16"
filtration slots. Like the Polylok
PL-122, the new Polylok PL-525 has ~ ' -
an automatic shut off ball installed 525 linear feet i
with every filter. When the filter is of 1/16° x
removed for cleaning, the ball will filtration slots Rated for over
float up and temporarily shut off 10,000 GPD
the system so the effluent won't
leave the tank. No other filter on
the market can make that claim! Accepts 4° & 6°
SCHD. 40 Pipe
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
servicin . Servicing should 3 Gas deflector
9 be V ,
done by a certified septic tank Automatic shut-off
pumper or installer. pk1 ry'-`r~ ball when filter
1. Locate the outlet of the U.S. Patent No# 6,015,488 is removed
septic tank. 5,871,640
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
tank. Make sure all solids fall 4" or 6" outlet pipe. If the
back into septic tank. filter is not centered under the
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.
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Dose Conventional Septic System Management Plan
Pursuant to SPS 383.54, Wis. Adm. Code
General
The conventional septic system shall be operated in accordance with SPS 382-384 Wis. Adm. Code, and shall be maintained
in accordance with component manual SBD-10705-P (N.01/01). All local and/or state rules pertaining to system
maintenance and maintenance reporting shall be complied with. Questions on the operation or maintenance of the system
should be directed to the installing plumber, Gary Zappa at (715) 386-2850 or the St. Croix County Zoning Department at (715)
386-4680.
Septic Tank
Septic tank servicing mechanics comply with SPS 383.54(1)(e). Septic tank to be located within 150' of service pad, with
bottom of tank to be 15' below service pad elevation. The operating condition of the septic tank and outlet filter shall be
assessed at least once every two years by inspection. The septic tank contents shall be removed when the sludge and scum in
the tank exceed 1 /3 the liquid volume of the tank. The contents of the septic tank shall be disposed of in accordance with NR
113, Wis. Adm. Code, by an individual certified to service septic tanks under s. 281.48, Stats. If the contents of the tank are
not removed at the time of a biannual assessment, maintenance personnel shall advise the owner of when service will be
needed to maintain less than 1/3 scum and sludge accumulation in the tank. The outlet filter shall be cleaned as necessary to
ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank
that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be
serviced if the alarm is activated. Septic tank manholes risers, access risers, and covers should be inspected for water
tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of
service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater
than 8 inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank.
No individual should ever enter the septic tank as dangerous gases may be present that could cause death. Septic tank
abandonment shall be in accordance with Comm83.33, Wis. Adm. Code when the tank is no longer used as a POWTS
component. The addition of biological or chemical additives to enhance septic tank performance is generally not required. If
such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings
Division.
Pump Tank
The pump (dosing) tank shall be inspected at least once every two years. All switches, alarms, and pumps shall be
tested to verify proper operation. If an effluent filter is installed at the pump discharge, it shall be inspected and
serviced as necessary.
Soil Absorption Cell
Trees or shrubs should not be planted directly on the soil absorption system. The area above and around the system should
be seeded and mulched as necessary to prevent erosion and provide some degree of frost protection. Traffic (other than for
vegetative maintenance) over the system is to be avoided. Soil compaction may hinder aeration of the infiltrative surface
within and above the system and will promote frost penetration during cold weather months. Cold weather installations
(October-March) dictate that the system be heavily mulched for frost protection.
Influent quality into the system may not exceed 220mg/L BOD5, 150 MG/L TSS, and 30 mg/L FOG. Influent flow may not
exceed maximum design flow specified in the permit for the installation.
Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels above 4 inches indicate an
impending hydraulic failure requiring additional, more frequent monitoring.
Continzency Plan
If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the
system in proper operating condition. Excessive ponding within the dispersal cell will be eliminated by installing a new soil
absorption cell to bring the system into proper operating condition.
Pg. 9 of 12
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer J-ohn..& Mary Wood
Mailing Address 3099 North View Lane, Woodbury, MN 55125
Property Address 206 North Ilwaco Road, Hudson, WI 54016
(Verification required from Planning & Zoning Department for new construction.)
City/State Parcel Identification Number 40-1170-10-000
LEGAL DESCRIPTION
Property Location Gov't Lot 1 ,/4 , Sec. 36 , T 28 N R 20 W, Town of Troy
Subdivision Plat: N a , Lot # N a
Certified Survey Map # N a , Volume N a , page # N a
Warranty Deed # 877174 (before 2007)Volume , Page #
Spec house Oyes Ono Lot lines identifiable 0yesE]no
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper
maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into
the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance
responsibilities are specified in §SPS. 383.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance.
The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the
owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site
wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is
less than 1/3 full of sludge.
I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the
standards set forth, herein, as set by the Department of Safety And Professional Services and the Department of Natural Resources,
State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix
County Planning & Zoning Department within 30 days of the three year expiration date.
I/we certify that all statements on th' form are true to the best of my/our knowledge. I/we am/are the owner(s) of the
property described above, by virtue of a w ty deed recorded in Register of Deeds Office.
Number of bedrooms 2
SIGNATURE OF APPLICANT(S) DATE
***Any,info~mation 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)
J DECK/
RECONSTRUCTION '
100 arc O
',;,FXLESSTHAN 12%~ \~lp
Vi~ 'SLOPES AREA
PROPOSED °I BUILDING
PAVER / / I RECONSTRUCTION/
/ WALKWAY EXPANSION
PROPOSED DECK--`
s
WALKWAY
!A: xMx;
/PROP
OSED
/ /'DRIVE ''"ti
STRUCTURALi
/j/ + l J '`~(vP i / / EROSION CONTROL /
SANS
/ l I l l i i i / i , O
CDQ~
PROPOSED
PROPOSED/ -
WELL / ' STONE STEPS
pt / s / / / / / / / /
/ / ~ , /,/,gyp/ /i,/ / / i ♦[L/ / / ~ ~0
L4j
50
'i0
LESS N12%
//,!/SL DPES AREA/
12 THAN
SLOPES LESS
2 p'
AREA/ 3//
®
• RECEIVED
2241
Wisconsin Department f ComrrrQe 11 2 11 SOIL EVALUATION REPORT Page I of 4
Division of Safety and uildings` ` L in accordan with Comm 85, Wis. Adm. Code A.C.E. Soil & Site Evaluations
_r.Utn ~oiut,iTY County
Attach complete elPL4gNWpg0&V06 0Mt>EE1 i ches in size. Plan must St. Croix
include, but not li point (BM), direction and
percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parcel I.D.
0-1170-10-000
Please print all information. eviewed Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). i ~
y.
Property Owner Property Location /
Jonathan D. Wood Govt. Lot 1 1/4 1/4 S 36 T_ 28 N R 20 W
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
3099 North View Ln. Na Na Na
City State Zip Code Phone Number City Village ✓ Town Nearest Road
Saint Paul MN 55125 Troy North Ilwaco
New Construction Use: ✓ Residential / Number of bedrooms 2 Code deri~ ed design flow rate 300 GPD
✓ Replacement Public or commercial - Describe: 1114 q e2
Parent material Glacial Outwash - Flood plain elevation ?,f applicable Na
General comments
and recommendations: Soil suitable for in-ground POWTS. Site must be approved by various governing agencies prior to
system installation. Proposed system elevation = 709.00'. D ^ S_ CXd
❑ Boring # Boring
✓ Pit Ground Surface elev. 714.02 ft. Depth to limiting factor 102" 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 0-17 1Oyr3/2 & 4/4 none sl fill 2fgr mvfr ci 2fmc Na Na
2 17-40 7.5yr4/6 none Ifs Osg ml gw 2fm,1c 0.5 1.0
3 40-96 1Oyr4/6 none s Osg ml cw - 0.7 1.6
4 96-102 7.5yr4/6 none Ifs Osg ml ai - 0.5 1.0
5 102-108 7.5yr4/6 none LSBR na na - - na na
1
❑ Boring # Boring k13"
kv. ✓ Pit Ground Surface e 71 .44 ft. Depth to limiting factor 89" 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 0-17 1 Oyr3/2 & 4/4 none sl fill 2fgr mvfr ci 2fmc Na Na
2 17-89 7.5yr4/6 none Ifs Osg ml cw 2fm,1c 0.5 1.0
3 9-96 ~10yi-4/6 none LSBR na na - - na na
V
Horizon #3 consists of limestone fragments comp ing >50% of horixzon. Voids and crevises between fragements are filled with 7.5yr4/6 Ivfs.
* Effluent #1 = BOD5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 <.30 mg/L and TSS < 30 mg/L
CST Name (Please Print) Signature: - CST Number
James K. Thompson / z- - 3602
Address A.C.E. Soil & Site EvalugOefiis Date Evaluation Conducted Telephone Number
340 Paulson Lake Lane, Osceola, WI 54020 4/11/2011 715-248-7767
Property Owner Jonathan D. Wood Parcel ID # _040-1170-10-000 Page 2 of 4
3 ] Boring # Boring -
✓ Pit Ground Surface elev. 712.31 ft. Depth to limiting factor 84" in. Soil Application Rate
F
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 0-25 10yr3/2 & 4/4 none sl fill 2fgr mvfr ci 2fnnc Na Na
2 25-40 7.5yr4/6 none ifs Osg ml gw 2fnn,1c 0.5 1.0
n _ -
3 40-55 10yr4/6 2 none s Osg ml cw - 0.7 1.6
4 55-84 7.5yr4/15 ~Z none ifs Osg ml ai - 0.5 1.0
5 84-89 7.5yr4/6 none LSBR na na - - na na
-70
Horizon #5 consists of limestone fragments compri Ing >5 %0 of hor on. Voids and crevises between fragements are filled with 7.5yr4/6 Ivfs.
11
it 4L
❑ 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 *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/ft2
in. Mansell 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 (R 07/00) A.C.E. Soil & Site Evaluations
PROPERTY OWNER: Jonathan D. Wood SOIL AND SITE EVALUATION 2241 Page 3 of 4
PARCEL I.D.# 040-1170-10-000 A.C.E. Soil & Site Evaluations
REPORT MEMO
Soil conditions within thetested area are suitable for a shallow in-ground POWTS consisting of two trenches at 3'x
62' each. Dosing will be necessary to reach the sytem elevation of 709.00' from the building site - existing grade =
709:09'. Pressurized distribution is recommended to prevent possible effluent seepage through sidewalls of trench
and breaking out on slope face.
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