HomeMy WebLinkAbout020-1081-70-000 (2)
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
(ATTACH TO PERMIT) 600221
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:
GARY VINDAL TOWN OF HUDSON 020-1081-70-000
CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No
a0-o", ap 29.29.19.331 G
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic C:,.~ 81'►h I - W 1 r~~' d Benchmark 9 /65,7
Alt. BM ay
F1 1 I~ vW'i^LaJU ~(L"
Aeration Bldg. Sewer
Holding St/Ht Inlet
TANK SETBACK INFORMATION St/Ht Outlet 7
TANK TO P/L WELL BLDG. ent Air Intake ROAD Dt Inlet
oJAA, \ e
e tic Dt Bottom
ftu 33 ~I L'f
Header/Man. 9 `I,~ Z
Aeration Dist. Pipe 41,-7 94, Z
9.1s Iq. If
Holding Bot. System /6,7 3.2
16,19 C/3 . 1 *1
PUMP/SIPHON INFORMATION Final Grade gg g9 • I
Manufacturer Demand St Cover /
GPM 6 T
Model Number
TDH L Friction Loss System He TDH Ft
7
Forcemain Dia. Dist. to Well SOIL ABSORPTION SYSTEM /
BED/TRENCH Width_ Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS ;
SETBACK SYSTEM TO P/L BLDG, WELL LAKE/STREAM LEACHING Manufactt er`
INFORMATION T / { /)yA} CHAMBER OR (~a 1
y O I~ Sys lO.ti~ 7 / 0 ✓ / / J UNIT Mode r v4.
DISTRIBUTION SYSTEM I IkI, 4-- 3 Z
Header/Manifold/ Distribution x Hole Size x Hole Spacing Vent to Air ntake
Pipe(s) /C!
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 ~w Bed/Trench Edges Topsoil No 'Yes No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2:
Location: 790 CARMICHAEL RD c r%~a
1.) Alt BM Description =
2.) Bldg sewer length = / C.. ~Cr~ r+ ~h
-amount of cover= Plan revision Required? ❑ Yes o 4 (-7
Use other side for additional informati✓✓on.~' O L~~ ~
Date Insepctor's gnature Cert. No.
SBD-6710 (R.3/97)
V
I 5A►v-;),n ` 3.3e
a~
ECl IVE Count}
Safety and Buildings Division ~
C K 201 W. Washington Ave., P.O. Box 7162
y~ Ng~ Madison, W! 53707-7162 Sanitary Permit Number to be filled in by Co.)
r OCT 004 2011i
: OMMUNI I11.it Anni1r~+„ - "'ate Tnmsa`ci
In accordance with SPS 383.21(2), Wis. Adm. Code, submit 56063G4ME
is required prior to obtaining a sanitary permit Note: Applic 66T R _ .,,urea to Project Address (if different than mailiAadd
the Department of Safety and Professional Servies. Personai may be used for secondary
oses in accordance with the Priv Law, s. 15.4{1) m),
L A lication Information - Please Print All Information V
Property Owner's Name i Parcel #
n vy l/ a Si ~ (,y
A, -L
Property Owners Mailing ess
2n, -
t~ Property Locatronr~ y ; 19-33)
City State I Govt Lot
+ Zip Code Phone Number
t/4 / y4, Section
~ aclc o
11 Type of Building (check all that a c7 Lot # T? N; R E W
2 Family Dwelling - Number of Bcdr
Subdivision Name
#
~ Public/Commercial -Describe Use Block
City of
State Owved - Describe Use CSM Number ❑ Village of
' own of
J11. Type of Permit: (Cbeck only one boz om ne A. Complete line B i7f applicable}
A.
Q 1~1ew System Replacement System ❑ Treatment/Holding Tank R Iacement OW
A
eP y ❑ Other Modification to Existing System (explain)
B ❑ Permit Renewal ❑ Permit Revision El Date- Issued
Change of Plumber 11 Permit Transfer to New List Previous Permit Number and Before Expiration Ovmer
TV. T ofPOWTS System/Component/Device: Check all that apply)
on-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 LL of suitable soil ❑ Mound < 2 in. of su' le soil
❑ Holding Tank Offer persal Component (explain) 5
El Pretrcatrnent Device (explain)
V. Dis rsalfTreat ent Area Informatio .
Design Flow (~.pd) Design Soil Applicati i1, _
te(
gpdsf) Dispersal Area Required (s • Dispersal Area proposed st) System Ele anon
7 q
VLTank Wo tip riyin r ~S
C ac' Total # of Manufacnuer ~ '
Gallons Gallons Units
New Tanks Existing Tanks 0 J ° v.
Septic or Holding Tank °i " L
Dosing Chamber
VII. Responsibility Statement- the undersigned, ume responsibility for installation of the PORTS shown on the attached plans.
PI 's Name (Print) Pi s.Signature
l _ MP/MPRS Number Business Phone Number +
P 's Address Str eet City, State, CID
2- T '
VI ounty/De artment Use Only
proved isapproved Permit Fee Date Iss ed Issuing Ag iananre
❑ (honer (a f: Reason for Denial V /
IX Conditi ons for Disapproval
1. tank; edkl:ni li to n
di!ipe:aAi cell must dil be ^s' , , nt ^eF
as-psr,"r3gement plan,) L iut ri by Number. i
2. A:aelhlN`.k rect;ir f:,e s mu tut t.:a;rt.:ir:t i
as per rppUct a cod,: / :.rdinancv.
Attacb :o a,mplete plats for ,he system and submit to the County only on paper not less than 8 >n z 11 inches in sir
SBD-6398 (R. 11/11)
System PLOT PLAN
PROJECT Garv Vindal ADDRESS 2425 Colleae Drive Lake Havasu Citv AZ 86403
NW 1/4 NW 1/4S 29 /T 29 N/R 19 W TOWN Hudson COUNTY ST. CROIX
SYSTEM ELEVATION 93.8/93.6/93.4' 6' below grade DATE 10/4/17 BEDROOM 3
CONVENTIONAL XXX CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 676 # of chambers 33
BENCHMARK V.R.P. Bottom of siding ASSUME ELEVATION 100' Filter Lifetime Filter
❑ BOREHOLE O WELL *H.R.P. same as benchmark
Well Carmichael Road -
Sr,ul° - 1 /Tn - 10'
40' Scale is 1" = 40'
Existing 3 unless otherwise
Bedroom
House noted
25'
sT
200'
3 4
30'
50 C~
110-
18' X 36'
Garage
1 Vent 15' M.* All piping shall be ASTM SDR 30/34, within
10' of tank, piping shall be ASTM F891
15' 20 10'
B-2
Vent
B-1 >6„ Quick4 Standard
of Cover Leaching Chamber
5' 3% Slope with 20.0 ft2 of Area
5.6ft^2/pair of end caps
4' Long 12
Grade at System Elevation
34"
3-3' X 46' cells with >3' spacing
Ven
Lico~
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 10/417
Owner:Gary Vindal
Location: NW1/4 NW1/4 S29 T29N,R19W 790 Carmichael Road Hudson
Manuals Used: In-ground absorbtion system (version 2.0)
Page#
1. Cover Page
2. Plot Plan
3. Leaching Chamber Cross Section
4-6. Maintanantn gency Plan
7. Filter Cross 8. Existing S Signatur , r!
, .r
License ber #226900
System PLOT PLAN
PROJECT Garv Vindal ADDRESS 2425 College Drive Lake Havasu Citv AZ 86403
NW 1/4 NW 1/4S 29 /T 29 N/R 19 W TOWN Hudson COUNTY ST. CROIX
SYSTEM ELEVATION 93.8/93.6/93.4' 6' below grade 10/4/17 BEDROOM 3
DATE
CONVENTIONAL XXX CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 676 # of chambers 33
BENCHMARK V.R.P. Bottom of siding ASSUME ELEVATION 100' Filter Lifetime Filter
❑ BOREHOLE O WELL *H.R.P. same as benchmark
Well Carmichael Road
Scale = 1/4" = 10'
40' Scale is F = 40'
Existing 3 unless otherwise
Bedroom
House noted
25'
ST
200' ~r
3 ' 4 1l~W
30'
50
18' X 36'
Garage
1c, Vent 15' M.* All piping shall be ASTM SDR 30/34, within
10' of tank, piping shall be ASTM F891
15' 10' - AL B-2
15 Vent
B-1 >6" Quick4 Standard
of Cover Leaching Chamber
5' 3% Slope with 20.0 ft2 of Area
5.ft
6^2/pair of end caps
12
4' Long
Grade at System Elevation
34„
3-3' X 46' cells with >3' spacing
Vents B-3
Cross Section of Quick 4 Standard Leaching Chamber
Typical cross section for 2 of 3 cells
Quick 4 Standard
Leaching Chamber with
20.0 ft2 of Area per
Chamber 5.6ft^2 pair of end plates To be A' above grade
Finish grade elevation
Typical Installation 99.6'
Vent Grade ~ Vent
AK 4'
4 Septic Tank
5 4' Long 1
Grade at System Elevation
34Grade at System Elevation 34"
Spacing 5'
3-3' X 46' Cells
Observation tube/Vent
Same on other end To be located on end of Cells
~%A
B
System elevations: C
A-93.8'
B-93.6'
C-93.4'
11 chambers per cell
ST. CROIX COUNYV
SEPTIC TANK MAINTENANCE .AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
r
Owner/Buyer (_J.{
Mailing Address /
Q Az
Property Addressk
2 ?2_2
(Verification required from Planning & Zoning Department for new c n truction.)
City/State Parcel Identification Number
LEGAL DESCRIPTION
" r ~er
Property Location/✓L lam' j/4 sec. T/ `
' L_ N i W, Town of
Subdivision
Lot #
Certified Survey Map # Volume , Page #
-
Warranty Deed # VoltunePage # ✓
Spec house yes no Lot liras identifiable yes
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, ii 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 §Comm. 83.52(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 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 three ear expiration date.
I/we certify that all statements on s form are true to the best of my/our knowledge. I/we andare the owner(s) of the
property described above, by virtue of a anty deed recorded in Register of Deeds Office.
Nil er of be roo
I
SIGNATURE OF APPLICANT(S)
/
DATE
***Any information that is misrepresented may result in the sanitary permit being r'':voked 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. 08/05)
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner
r Septic Tank Capacity ❑ NA
al
Permit #
Septic Tank Manufacturer ❑ NA
)ESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA
Number of Bedrooms r ❑ NA Effluent Filter Model 7 i/ ❑ NA
Number of Public Facility Units "lid N
A Pump Tank Capacity
P al NA
Estimated flow (average) Jt'~2 gal/day Pump Tank Manufacturer NA
1 Design flow (peak), (Estimated x 1.5) avda Pump Manufacturer NA
Soil Application Rate , aUda /ftZ Pump Model NA
i Standard Influent/Effluent Quality Monthly average" Pretreatment Unit NA
Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter
Biochemical Oxygen Demand (BOD$) Q20 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland
Total Suspended Solids (TSS) 5150 mg/L ❑ Disinfection ❑ Other.
Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA
Biochemical Oxygen Demand (BODs) 530 mg/L -Ground (gravity) ❑ In-Ground (pressurized)
Total Suspended Solids (TSS) 530 mg/L ❑ NA ❑ At-Grade ❑ Mound
Fecal Colifnrm (geometric mean) 5104 cfu/100m1 ❑ Drip-Line ❑ Other:
iMaximum Effluent Particle Size Ya in dia. ❑ NA Other. ❑ NA
Other.
❑ NA Other:
❑ NA
*Values typical for domestic wastewater and septic tank effluent Other: ❑ NA
AINTENANCE SCHEDULE
V- Service Event
Service Frequency
Ilnspect condition of tank(s) At least once eve 1:1 month(s)
n`' ears (Maximum 3 years) ❑ NA
(Pump out contents of tank(s) When combined sludge and scum equals one-third ('/a) of tank volume ❑ NA
linspect dispersal cell(s) At least once every' E ❑ month(s)
,year(s) (Maximum 3 years) ❑ NA
Clean effluent filter At least once every: a.year(s)s) ❑ NA
nspect pump, pump controls & alarm At least once every: ❑ month(s)
NA
❑ year(s)
{=lush laterals and pressure test At least once every: [I month(s) NA
❑ year(s)
Dther. At least once every: ❑ month(s) ❑ NA
~?ther: ❑ year(s)
NA
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
include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of
icembined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be
irisually 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.
I,Nhen the combined accumulation of sludge and scum in any tank equals one-third (X) 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.
INN other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment 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 10 days of completion of any service event.
Page of
START UP AND OPERATION or other Ctlemic~is that
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products have the contents of thlt
may impede the treatment process and/or damage .dispersal cell(s). If high concentrations
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. will bp
During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater effluent
discharged to the dispersal cell(s) in one large dose, overloading the oeli(s) and may result in the backup or surface discharge
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 cones to restore normal levels
within the pump tank. the area within
Do not drive or park Vehicles over tanks and dispersal cels. Do not drive or park over, or otherwise disturb or compact,
15 feet down slope of any mound or at-grade soil absorption area.
:
Reduction or elimination of the foibwing from the wastewater stream may improve the performance and prolong the fife of the POWT$ dis~edents; fat: foundation drain
antibiotics; baby wipes; cigarette butts; -condoms; cotton swabs; degreasers; dental floss; oil; painting per ;
(sump pump) water, fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps' ; di ' medicaWns; nfer, an
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 propetly
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 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 falls and cannot be repaired the following measures have been, or must be taken, to provide a code compiiOnt
replacement system:
0 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 reclutiled
setbacks from eAsting and proposed structure, lot lines and wells. Failure to prated the replacement area will result in the neled
for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rule$ in
effect at that time.
0 A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS teehnolugN a
holding tank may be installed as a last resort to replace the failed POWTS.
The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a sal 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.
13 Mound and at-grade sal absorption systems may be reconstructed in place following removal of the biomet at the infift tive
surface. Reconstructions of such systems must comply with the rules in effect at that time.
<<WARNING>>
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TAN UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE O~ A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE
ADDITIONAL COMMENTS
POWTS INSTALLE POWTS MAINTAINER
Name
Name f /
Phone Phone , J
SEPTAGE SERVICING OPERATOR (PIJMPER) LOCAL REGULATORY AL"ORlTX
Name Name
Phone Phone /)J"`
~Se
j
This document was drafted in compliance with chapter SPS 383.22(2)(b)(1)(d)&(f) and 38154(1), (2) & (3). Wisconsin Administrative Code.
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ST. CROIX COUNTY ZONING OFFICE
CERTIFICATION STATEMENT
FOR UTILIZATION OF AN EXISTING SEPTIC TANK
This is to certify that I hav i pected the septic tank presently
serving the residence located at:
Section T~~'N, R W, Town of
_ Upon inspection, I certify that I have found
the tank and baffles to be in good condition, and it appears to be
functioning properly.
Last time serviced:
Llid flow back occur from absorption system?
Yes /,...No (If no, skip next line)
Approximate volume or length of time: gallons minutes
capacity:
Construction: Prefab Concrete Steel Other
Manufacturer: (If known) :C'
Age of T k (If known) : C~~fi'cL/
( ngtu're) (Name) Please print
(Title) (License Number)
Date
form to be completed by licensed plumber (s.145.06, Wisconsin
Statutes) or Licensed Disposer (NR 113 Wisconsin Administrative
Code)
- - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Plumber (applying for sanitary permit) Certification:
In accepting the above statement regarding existing septic tank
condition, I certify that the tank to the best of my knowledge will
conform to the requirements of ITR 83, is. Adm. Code (except for
inspection opening over outlet baffle
NaCr~,,~ Signat MP~MPRSIL ~'1J
OCT 0 ` D 1 1)
Wisco egs bt6t r r (rce `I R c r'O RT Page of
Div's' WROP(1IMENT 6BTR560B3G4ME
in accorr
County , .
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must `
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. '7
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. / l `d T,~
'~7P
Please print all information. Revie by D~~at//e~~
Personal information you provide may be used for secondary purposes (Privacy Law, s. Property I '
' r -
Property Owner Property Location
Govt. Lot 1 /4 1,14,.,04 Z T 44 N R E (o w
Property Owners Ma' ' r/Je~~ss Lot # Block # Subd. Na or CSNW
City n , late Zip Code Phone Number ❑ City LMll ~,,ge Town Nearest Road
96 Z2~~ (6tZ -69
❑ New Construction Us esidenYial /Number of bedrooms Code derived design flow rate GPD
Replacement Public or com al -Describe:
P,,Z?h material a4_ Flood Plain elevation if applicable 4:~L f~ ft.
General comments
and recommendations:
2, C
System Type rL System Elevation
Boring # nn g r~ cR:i t Ground surface elev. -f- t ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2
r/^ J. ✓L/
Ell,
ID-D
Boring # Boring
Ground surface elev. ft. Depth to limiting factor L~ in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
J 6~1 " l
9-
1
i-f
1' .
IV 1'e
' Effluent #1 = BOD. > 30 < 220 n-dL and TSS >30 _ 150 ' Effluent #2 = BOD. < 30 mg/L and TSS < 30 mg/L
CST Name (Please Print) CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address D e Evaluatipn Conducted Telephone Number
1432 120th St, New Richmond, WI 54017°- ` 715-246-4516
Property Owner _ Parcel ID # Page of
Boring # ❑ oring C
Pit Ground surface elev. I ft. Depth to limiting factor ~n.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
d ,
All
1
1
Boring # ❑ Boring
F-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 GPDM
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
Boring
Boring # Ground surface elev. ft. Depth to limiting factor in.
F-1 ❑ Pit
Soil Application Rate
Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/fF
on. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mgA- ' 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 (8.6100)
Property Owner _ Parcel ID # Page of
Bonng # oring
12~ V Pit Ground surface elev. ► ft. Depth to limiting factor n.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
'Eff#1 'Eff#2
in. Munse►I Qu. Sz. Cont. Color Gr. Sz. Sh.
r(
.tL
F 'P%
F-1 E] Boring # Boring
pit Ground surface elev. ft. Depth to limiting factor )n Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
Boring
F-1 Boring # Ground surface elev. ft. Depth to limiting factor in.
Pit Soil lication Rate
Horizon ')epth Dominant Col Redox Description. Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
Effluent #1 = BOD5 > 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 (8.6100)
y
Soil Test Plot Plan ;
Project Name Gary Vindal Shaun' rd
Address 2425 college dr.
Lake Havasu City AZ 86403
CSTM #226900
Lot Subdivision Date `10/4/17
NW 1/4 NW 1/4S 29 T 29 N/R19 W Township Hudson
Boring Q Well PL Property Line County ST. CROIX
BM or VRP Assume Elevation 100 ft. Bottom of garage siding
System Elevation 93.8/93.6/93.4 *HRpSame as Benchmark
Well Carmichael Road
40' Scale is 1" = 40'
Existing 3 unless otherwise
Bedroom
House noted
25'
T
200' 30'
18' X 36'
Garage
10' Vent 15' .M.*
20' 10'
B-2
15'
B-1
5' 3% Slope
B-3