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HomeMy WebLinkAbout026-1133-05-000 (2) Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. CI'OIX Safety and Building Division INSPECTION REPORT Sanitary Permit No (ATTACH TO PERMIT) 600237 GENERAL INFORMATION State Plan ID No: Personal information you provide maybe used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village Township Parcel Tax No: Ted & Nancy Neuman TOWN OF RICHMOND 026-1133-05-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: / o dF F; Ce 06.30.18.918 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. ~c `OC r~ Septic Benchmark L C~ ~i ~d'7`.~ ;(.JCS 7 J Q"WM y~ Alt. BM 0 ~I Aeration Bldg. Sewer ~t Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO WELL BLDG. Vent it Intake ROAD l Ott t[~N/~, v t 7 q/ Septic i~ 5a 5~ U ~f ' AFiL QJ~ (O I ~I Dosing Header/Man. 01 Aeration Dist. Pipe CTA O v~ Holding Bot. System PUMP/SIPHON INFORMATION Final Grade Manufacturer GP Hand St Cover 1 L / Model Number - 00, TDH L Friction Loss System Head Ft 1e ( Q Q Forcemain Length la. Dist. to Well ~o /6-3 941.7 SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches ` s PIT DIMENSIONS No. Of its Inside Dia. Liquid Depth DIMENSIONS 3 /1 SETBACK SYSTEM TO P/L BLDG IWELL~ LL LAKE/STREAM LEACHING Manufactu INFORMATION Typ f System. CHAMBER OR O v I t 15 7 i UNIT Mode) u ber- DISTRIBUTION SYSTEM / ZS~ Zg 1' ✓S Header/Manifo f Distribution x Hole Size - role Spacing Vent to 7Intake ♦~Pipe(s) j _ i Length Die Spacing + - Length 'Dia SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Mulched Depth Over Depth Over xx Depth of xx Seeded/Sodded r Bed/Trench Center ` Bed/Trench Edges Topsoil No a No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 924 172ND AVE L a 1.) Alt BM Description 2.) Bldg sewer length = - amount of cover = ~0~ `aJ a Gam.. Ve Plan revision Required? ❑ Yes No )61215 1/',I Use other side for additional information. 7 - Insepctor's SCert. No. Date SBD-6710 (R.3/97) Ply,.. sa:~ o~~ ~+L. : Lk 54N t),j i1--:5, / ' V D COrnlty (l O ¢ q a, f Safety and Buildings Division 5-t ~ ;'2118 p ~ u i i 201 W. Wash'sngton Ave., 7 Box 7162 Sanitary Permit Number (to be filled in by Co.) K Madison. W~ 53707 7162 2 ~ S ST. CROIX COUN ~ C~tJ ~ ~(}IVIMUNfT1/ REV Lop ENT SJ S ran'action Number Sanitary Permit Application Tp7 P ~ I Y I/ In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this forffi to 1111 avin-pl MR T-O m"66md is required prior to obtaining a sanitary permit. Note: Application forms for statc-owned PGWTS are submitted to Ptoject Address (if different than trailing address) the Department of Safety and Professional Servies. Personal information you rovide may be used for secondary nf% i NJ purposes in accordance with the Privacy law, s. 15.04(1)Lm), Stats. L Application lot atir - Please Print All Information Parcel # Property Owner's Name, / j 7 r property s ding s Property Location fa , D ` 1 J Govt Lot l1 C State 41 Zip Code Phone Number/ Section (circle one N; R E II. pe of Banding (check all that apply) Subdi ion Name t~(+_2,Family Dwelling-Number of Bedrooms ~f ❑ Public/Commercial - Describe Use ❑ City of CSM Number ❑ 'Village of , ❑ State Owned - Describe Use b. Of I - L3 III. Type Qf Permit: (Ch on box o ine A. mplete line B if applicable) A [ SyyK or System ent/Holding Tank Replacement Only ❑ Giber Modification to Existing System (explain) List Previous Permit Number and Date Issued B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber 11 Permit Transfer to New Before Expiration ~°er onent/Device: Check all that a I essurized In-Ground ❑ Pr In-Ground ❑ At-Grade ❑ Mound > 24 it, of suitable soil © Mound < 2 sum e soil Iv~ Tank al Component (explain) ❑ Pretreatment Device (explain) ` o l ^ V. Dis rsaVTreatment Area Informati Design Flow (gpd) Desi oil plicati ate(gpdsf) Dispersal Area Requir fl Dispersal Area Propo System Elevation VL Tank Into Capac' in Total # of Manufactmer ~ Gallons Gallons Units New Tanks Existing Tanks n U ins I ern =C hkd 0 Septic or Holding Tank Dosing Chamber VII, Itesponsibifity Statement- 1, the undersigned, assume r o bilih for installation of the POWTS shown on the attached plans. Pi 's Name (Print) Plumber's a MPRvIPRS Number Business Phone Number P1 M Address (Street, City: S p Code) ~ --z G VIII. untv/De artment se Only Permit Fee Date Isfued Issuing Ag ignattue proved ❑ prove $ f~ / 1 on for Denial ILfi IX_ Conditi slr)pproval °~nsacs,; cxM muter an !~e'1f~1 r, `t1E:ln~e~ PN 7W'sptnen! Plan pro *W by plumber. l et:~ents mussit,d t:~mntr.irc~t i Wkfth CA& / &naxal. Attach to complete plans for the system and submit to the County only os paper not less than 812 x 11 inches in size SBD-6348 (R. 11/11) I System PLOT PLAN PROJECT Tedd Neumann ADDRESS 924 172nd Ave New Richmond Wi 54017 SE 1/4 SW 1/4s 6 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX SYSTEM ELEVATION 96.0/95N95.8 5' below grade 10/6/17 BEDROOM 4 DATE CONVENTIONAL XXXCONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1200 gallons LIFT TANK SIZE /37/ DOSE TANK SIZE , HOLDING TANK SIZE LOAD RATE ABSORPTION AREA `C'- # of chambers 75 66 BENCHMARK V.R.P. Top of ST cover ° ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE SWELL *H.R.P. same as benchmark i Scale is 1" = 40' 172nd Ave unless otherwise noted 3-3' X 102' Cells with >3' spacing, system is being oversize B-2 1 as per the suggestion of the county zoning department. 0` Existing system has failed 1% Slop Pro 4 Bedroom House B.M.* 20' 25' T 30' Valve - 18' 0' 80' Well B-1 40' Vent Vents >6" Quick4 Standard' of Cover Leaching Chamber with 20.0 ft2 of Area 5.6ft^2/pair of end caps 120' 4' Long 12" 34" Grade at System Elevation 11 piping shall be ASTM SDR 30/34, within 10' of tank, piping shall be ASTM F891 Property Line ' Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 10/6/17 Owner:Tedd Neumann Location: SE1/4 SW1/4 S6 T30N,R18W 924 172nd Ave Richmond Manuals Used: In-ground absorbtion system (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Leaching Chamber Cross Section 4-6. MaintanOce and Contingency Plan 7. Existing ptic Tank Form Signat~ Lice se nu4er #226900 System PLOT PLAN PROJECT Tedd Neumann ADDRESS 924 172nd Ave New Richmond Wi 54017 SE 1/4 SW 1/4s 6 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX SYSTEM ELEVATION 96.0/95H95.8 5' below qrade 10/6/17 4 DATE BEDROOM CONVENTIONAL XXX CONVENTIONAL LIFT HOLDING TANK 1200 gallons LIFT TANK SIZE DOSE TANK SIZE MOUND SEPTIC TANK SIZE HOLDING TANK SIZE LOAD RATE ABSORPTION AREA 1@h@- # of chambers 75 BENCHMARK V.R.P. Top of ST cover I ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL -11.R.P. same as benchmark Scale is 1" = 40' 172nd Ave unless otherwise noted 3-3' X 102' Cells with >3' spacing, system is being oversize B-2 1 as per the suggestion of the county zoning department. Existing system has failed 1% Slop Pro 4 Bedroom House B.M.* 20' 25' T 30' Valve B-1 18' 0 80, Well 40' Vent Vents >6" Quick4 Standard of Cover Leaching Chamber with 20.0 ft2 of Area 120' 12" 5.6f A2/pair of end caps Long 34" Grade at System Elevation All piping shall be ASTM SDR 30/34, within 10' of tank, piping shall be ASTM F891 Property Line 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 >1' above grade Finish grade elevation Typical Installation 101' Vent ACI Grade Vent 4' 4" 4' X30/34 Septic Tank 4' Long 1 5' Long 1 Grade at System Elevation 34" Grade at System Elevation 34" Spacing- 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-96.0' B-95.9' C_95.8' 2 XO chambers per cell I ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT : AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Ll"29i )7) Property Address (Verification required from Planning & Zoning Department for new construction.) City/State Parcel Identification Number LEGAL DESCRIPTION Properly Location 1/. ~V. , Sec. k , T N R!fL ~,~W, Town of~~ L_ Lot # ~ Subdivision Certified Survey Map # Volume ~ Page # Warranty Deed i , Volume , Page # ✓ J Spec louse yes n Lot hne:: identifiabl y SYSTEM MAIN'T'ENANCE AND OWNER CERTIFICATION Improper use and mamt enauce of your septic system could result m its premature f dlure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, ft needed, by a licensed pumper. What you put mto the system can affect the f inctiion of the septic tank as a treatment stage in the waste disposal system Owner maintenance reap xmbilides are specified in §Comn. 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 fffi of sludge. I/we, the undersq~ed 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 retied to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on dds form are true to the best of my/our knowledge. I/we am/ate the owner(s) of the property described above, by of deed recorded in Register of Deeds Office. Nu f b ms SIGNATURE OF APPLICANT(S) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. ImInde with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if refs rove is made in the warranty deed. M"- 08105) POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS ❑ NA Septic Tank Capacity Owner ff'c_ al Permit # Septic Tank Manufacturer v ❑ NA 3ESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units ANA Pump Tank Capacity al NA Estimated flow (average) c~aUda Pump Tank Manufacturer NA i Design flaw (peak), (Estimated x 1.5) aVda Pump Manufacturer NA i Soil Application Rate ' gal/day/ft 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 (BOD5) Q20 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 1150 mg/L ❑ Disinfection ❑ Other. Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BODs) 530 mg/L in-Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L ❑ At-Grade ❑ Mound Fecal Coliform (geometric mean) !104 cfu/100ml ❑ Drip-Line ❑ Other: iMaximum Effluent Particle Size Ya in dia. ❑ NA Other. ❑ NA 10ther. NA Other: 0 NA *Values typical for domestic wastewater and septic tank effluent Other ❑ NA AINTENANCE SCHEDULE y Service Event Service Frequency iinspect condition of tank(s) At least once every: month(s) (Maximum 3 years) ❑ NA year(s) (Pump out contents of tank(s) When combined sludge and scum equals one-third (X) of tank volume ❑ NA Inspect dispersal cell(s) At least once every: El .month(s) (Maximum 3 years) ❑ NA ar(s) ~ mo Olean effluent filter At least once every: nth(s) ( >g-Icear(s) ❑ NA nspect pump, pump controls & alarm At least once every: ❑ month(s) NA ❑ year(s) 1%sh laterals and pressure test At least once every: ❑ month(s) NA ❑ year(s) 7ther. At least once every: 0 month(s) El 111 NA year(s) j3ther. ' NA MAINTENANCE INSTRUCTIONS !Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: aster (Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspectioni 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 i~-ombined 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 Iegulatory 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 shah 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 treatment tank(s) for the presence of Pwnfing Prods or other chemicals that For new construction, Prior to use of the pO a a the, dispersal cell(s). If high ooncenUabons are detected have the contents of thO ,may impede the treatment process andtor damage 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. astewater will bleoutages pump tanks may fill above normal highwater levels. Why Power is restored the surface excess d'rs wasWm to ettlu b During power s in one large dose, overloading the cell(s) and may result in the backup or harge of discharged this the tsper$~ tank removed by a Septage Servicing Operator prior to restoring power to ft e avoid this situation have the contents of the pump in manually operating the pump controls to restore normal levels effluent pump or tact a Plumber or POWTS Maintainer to assist i within the pump tank. disturb or compact, the area within Do not drive or park Vehicles over flanks and dispersal cells. Do not drive or park over, or otherwise 15 feet down slope of any mound or at-grade soil absorption area. wastewater stream may improve the performance and prolong the life of the foundation POWTVT$: Reduction or on of e1►mi apes; ci the foggbbutts; Uutts; from condom s; the , cotton t cton swabs; degreasers; dental floss; diapers; disinfectants; fat; drain baby do . medicatons; oil; Painting products; (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; pesticides; senItM napkins; tampons; and water softener brine. and/or taken out of service the following steps shall be taken to insure that the system is propefily ABANDONMENT with permanently chapter Comm 83.33, Wisconsin Administrative Code:. and When the safely abanddS POanoned fails in compliance is permanently • 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 property 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 fitted with soil, . gravel or another inert solid material. CONTINGENCY PLAN code cornplint If the POWTS falls and cannot be repaired the following measures have been, or must be taken, to provide a replacement system: ystem. infringed soil ed upon by absorption r systeled ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement The replacement area should be protected from disturbance and compaction and mkt not m be eet area ed result in the ui4ed protect the will setbacks from existing and proposed structure, lot lines and~ment lam t to must comply with the rule4 in for a new soil and site evaluation to establish a suitable rept effect at that time. in POVYTS technologl! a ❑ A suitable replarx~nt area is not available due to setback and/or soil limitations. Barring advances .holding tank may be installed as a last resort to replace the failed POWTS. - site has not been evaluated to identifil a suitable n3ptacernent area. Upon failure of the POWTS a sail and bsite e evaiua#on as must be pew to locate a suitable replacement area. if no replacement area is available a holding tank may a last resort to replace the failed POWTS. removal of the biomat at the infiltra#ive ❑ Mound and at-grade soil absorption systems may be reconstructed in place following surface. Reconstructions of such systems must comply with the rules in effect at that time. <NVARNING» SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES ANDIOR INSUFFICIENT OXYGEN. DO NOT RCUM ANCES. DEATH MAY CULT. RESCUE O~ A ENTER A SEPTIC, PUMP OR OTHER TREATMENT T NI FUND O IMPOSSIBLE. R CI PERSON FROM THE INTERIOR OF A TANK MAY ADDITIONAL COMMENTS S INSTALLER POWTS MAINTAINER Name Name r~ < r . l Phone Phone SEPTAGE SERVICING OPERATOR MPER LOCAL REGULATORY AUTHORITY Name Name Phone Phone This document was drafted in compliance with chapter SPS 383.22(2)(b)(%d)&(f and 383..54(1), (2) & (3), Wlsc~ Administrative Code. ST. CROIX COUNTY ZONING OPPIct CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SE TANK 't'his is to certit Y?that I have inspected g the ;ervin f the septic tank Presejltjy Section reside e locate Er - N c~ T the tank an upon inspection, I R _-W, `1'owrj c;f and baffles to be certify that I have roLl' functioning properly. in good condition and it appears to he "Eli clt time serviced: 1 aid flow back occur - _ _ Y from absorption system? _ . Na (If no, skip next line). Approximate volume or length of tim , _ e, gallons construction: Prefab Concrete Steer M-Allufacturer: (If known) Other Age of T (If known) (S' .i9 'r ure t~ (Name) Please print---- Ik itle) Z `,~f c~'77 1 JUIcense Number - IT to 1"c3rm to be completed b Statutes) or License y licensed plumber Code} d Disposer NR (S.145.06, Wisconsi-n V - - _ - _ - i 113 Wisconsin Administrative ['lumber (aPPlying for sanitary permit) Certification: In accepting the above statement re condition, I certif gardi existing septic tank conform to the ry that the tank to the e t of my knowledge will s of ILHR 83r Adm. Code {except for l.nspec=fff utlet baffle Name - Signat e 'e zz / 1KP/ MFRS AILROAD r- 1314/001 100 UNPLATTED LAND NORTH LINE OF THE S 1/2 OF THE SW 1/4 S89.20'55" 2596.63' 135.60 187.68 1 4.42 s00• 297.90' 1 190.00 132.00 200.00 60~< 620.00 z -2563.63- I MENT 8 p G~S %Z•42W _-g 60YR V- 9861 ~I ~ W - 2N ~Ft SE~~4T' g~1 t`-__-__--_-_ - ~__~e{OOYR v i n h ; oy~L981 A O i o 96 j V1 - y h p C17 r N $~ph S 217.72. _ 0.00_ 16 8 S - 589'20.55'W 267.72• C15 r'ss.SJ. y 96,648 5 gFtt 4 'BUILDING _ 2.2 Acres# v SZ? \15J , \ \ 0Y) 88,184 SgFtt C18 `~?t?0 f 0 \ r 16 2.02 Acres# ? 710. p 00 0 3 Lo ,857 SFt ~1hENS x~s*\ ` 65 00' \ \C e~/!p/~ \ 'oo 2.02 Acres z C~0 \0{7• SF \ - - __--wry o o yhZF~'Fti~ 7/fs`/ \ \ SS\♦ ~bS?0F? \500~ co ly 50 7 C/T- \ \ c 12' UTILITY 16 e5~ 4 SgFt# 95,097 SgFtt z o 117, C23 154. 2.18 Acres# 28 N~ oll - - - 2 90_ 2.70 Acres# \ w - - - - - Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County. St. Croix ` Safety and Building Division INSPECTION REPORT Sanitary Permit No: 399638 0 GENERAL INFORMATION ~/od G -fo-Y) v (ATTACH TO PERMIT) State Plan ID No: s3/f<j~ Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: Village Township Parcel Tax No: Neumann, Ted L. 177 Richmond Townshi 026-4990-8@980 CST BM Eiev: Insp. BM Elev: BM Description: ` Ca n D r l TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark /00 Dosing / 0") 1 D Aeration Bldg. Sewer 3~ /G 57 Holding SUHt Inlet TI t /6. 6. G Z TANK SETBACK INFORMATION St/Ht Outlet -7 46 2 TANK TO ~l WELL J BLDG. Vent to Air Intake ROAD Dt Inlet Dt Bottom Septic Dosing Header/Man. Aeration Dist. Pipe Z Q. 3 f »f Holding Bot. Systbn) 076 I ' t II Final Grade .9 a 1 PUMP/SIPHON INFORMATION Manufacturer 5fqand St Cover y c ~ Z' l GP Model N ber TDH Lift Fr]ctio oss System Head TDH Ft Forcemain ngth ia. 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 Manufactu ~ 1 ~-n INFORMATION Tyqrpf System: / CHAMBER OR (mil, t7 v~J n' UNIT Model Number. 6~ t DISTRIBUT19 S / .2n cf Header/Manifo d i ribution x Hole Size x Hole Spacing Vent Air Intake r j( ti P, (s) r '1 r t!'/, p., / a Length Dia Length_S,(La Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Lt t n O rN Depth Over Depth Over xx Depth of xx Seeded/Sodded 2 T ulched Bed./Trench Center 1 Bed/Trench Edges Topsoil Fil Yes ~1 No Yes ® No COMMENTS((:(I~rjclude code discrepencies, persons present, etc.) Inspe lion #1: Inspection #2: Location: 924' pnd Avenue New Richmond, WI 54017 IS 1/2 SW 1146 T330~N Rei W) Pine Valley L_oO Parcel No: 06.30.16.• <n I 1.) Alt BM Description = rlv ('bW 4c d .Sl~wl w Co6~~a' j1611 2.) Bldg sewer length = 7,0 - amount of cover = t oo uPil (vi p~(y a, t Plan revision Required? ' Yes No i GGy""~ Use other side for additional information. I Date tnsepctors S nature Cent No. SBD-6710 (R.3/97) r Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must county _ + f ° include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 4 ^ percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Reviewed Date 7 Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)j. ;V Z3 Property Owner Property Location Govt. Lot h 1/4 jLj~l/ S(7 N R E r) W .11 1Z A, Property Owner's Mailing Address Lot # Block # Subd. Name or city ~ftte p Code Phone Number ❑ City ❑ V Age own earest Road r ( ) ❑ New Construction Use: Residential / Number of bedrooms Code derived design flow rate GPO Replacement ¢ ❑ P~ubl'l' or commercial - Describe: Parent material 0 Flood Plain elevation if appli ble ft. General comments and recornrnendatiens: (J~ ~7 It- <1 System Type Lee System Elevation Boring # F/-1 ❑ Boring / pit Ground surface elev/-Dj-lll?j ft. Depth to limiting factor ! f ~ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 in. -57 1"j 1 Eli, Boring # ❑ Boring pit Ground surface eley✓A~-/- ft. Depth to limiting factor. /~f? 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 Effluent #1 = BOD. > 30 < 220 mg/L and T >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 141 Address Date Evaluation Conducted Telephone Number 1432 120th St, New Richmond, WI 54017 715-246-4516 Property Owner _ Parcel ID # Page of F-1 ❑ Boring Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff 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 in. 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 = BOD3 < 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-9330 (8.6/00) Soil Test Plot Plan Project Name Tedd Neumann Sha Address 924 172nd Ave New Richmond Wi 54017 M #226900 Lot 5 Subdivision Pine Valley Date 0/6/17 SE 1 /4 S W 1 /4S 6 T30 N/R18 W Township Richmond Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of septic tank cover System Elevation 96.0/95.9/95.8 *HRpSame as Benchmark Scale is 1" = 40' 172nd Ave unless otherwise noted B-2 10' 80' Existing system has failed 1% Slope Pro 4 Bedroom B.M.* House 20' L25' T 30' 20' 18' 80' B-1 Well 120' Property Line I