Loading...
HomeMy WebLinkAbout020-1096-10-000 (2) Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 600263 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 & VICKIE PORTER TOWN OF HUDSON 020-1096-10-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: /c GST 33.29.19.388F3 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark i a l+C 1 ?Z Alt. BM r 3.33 9Y• 3 L.J. c Aeration ; I Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet 7• TANK TO O~P` k WELL BLDG. Vent to A Intake ROAD Dt Inlet Septic > DtBottomr`,. O 4A 9(.,P5 Dosing ~U 7 Header/Man. 7.77• 9'/, 3 Aeration Dist. Pipe 1 Holding Bot. System Final Grade 9~• PUMP/SIPHON INFORMATION C/ r' Manufacturer Demand St Cove GPM Model Number T 13• 3 TDH L Friction Loss System Head Ft O g 9 I . O Z s, Forcemain Length Dia. Dist to Well q, y • a SOIL ABSORPTION SYSTEM JQ , 2 `14 BED/TRENCH Width Length No. Qf Trenches "NSIO&S No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~T( : SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer INFORMATION CHAMBER OR ~Q Typ o0 SystemO 96 UNIT Model Number: Q0.)( [J,~ icw o~-/ DISTRIBUTION SYSTEM Header/Manifold / Distribution Ix Hole Size re Spacing Vent tgAerlntV /6 pipe(s) 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) ` s Bed/Trench Edges Topsoil No es No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / Inspection # Location: 659 BRADHURSTTDDR d~~ GaJe~. foa-- ! dc,1~, ,c 1.) Alt BM Description 2.) Bldg sewer length = G - amount of cover -1 I Plan revision Required? ❑ Yes <No 1 I 13!'`~ ) Use other side for additional Informat Z. Date Insepctor's Sir re Cert. No. SBD-6710 (R.3/97) oECEIVEC OCT U ! r Industry Services Division County ' ll c, 1400 E Washington Ave =51 . C~ C l ST CROIX COON P.O. Box 7162 Sanitary Permit Number (to be filled in by CAD.) . MMUNVTY DEVELOPME T Madison, WI 53707-7162 ` Sanitary Pem State Transaction Number In accordance with sPS 383.21(2y Wis. Adm. Cade, sut 5W RZQQT82DM4W nit is required prior to obtaining a sanitary permit. Nate: Ap _ _ _ a a Wff11=d'1D Project Address (ifdiffacm than mailing address) the Department of Safety and Professional Services. Personal information you provide may be used for secondary in accordance with the Priv Law, s. 15. 1 m Siats C I. APPlicatiOn Information Please Print A31 Information p T Property Owner's Name _ Parcel # Property Owner's Mailing Address Property Location 3 ~ H ~ b rj u t~ Govt Lot City. State Y/ L Zip Code Phone Number 6~tifl % /nJE Section 4 L(Q )L t; (v? Jul Ldp (circle II. TYi1e of Bunld, T 21.4 N, R I q E o W' ~,7 a~ (check A that apply) Lot it .40 1 012 Family Dwelling- Number of Bedrooms Subdivision Name Block ❑ Public/Commercial -Describe Use X ! ❑Cityof_ ber Vil f 11 State Owned- Deane Use CSM Num _ 38 ❑ ~ of IIL Type of Perms- ( boa on-lt} Ae Complete line B if applicable) A. ❑ New Systems ( Replacement System Treatrnen0lolding Tank Replacement Only ❑ Oilier ModiSc m- to Erdstin8 S YsGan (explain) B• ❑ Permit Runcorn! ❑ Permit Revision ❑ Charnge of Plumber 11 Permit Transfer to Now List Previous Permit Number and Date Issued Before Expiration Owner j~. -4 tY IV. T of I"VYT3 o Mgt/Device- Check all that apply) ,ON-ft---d in-Ground ❑ ft" -d In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in ofsuitablc sot ❑ Holding Tank ❑ OUur Dispersal Component (ePl--) ❑ Pre reatment Device (explain) /Ot.s, ' V. Din rsaLlTreatment Area Information- Design Flow (gpd) Design Soil Application Rif) Dispersal Area Requrirod (sB Dispersal Area s f3 System Elevation -5i 1 170, 7f,' Vt. Tank jnfo Capacity in Total # of Manufacturer V Gailots Gallons Units / ► am d1 ~7~ t 11 New Tanta Existing Taoics 7 ` Septic " HWding Take R it D A<- V11. Res 7rility Statement- I, the undmtsed, assume for isstallati"of the POWYS shown on the Stacked Pori Plumber's Name (Print) Pl i Ml'jMpRS nether Business Phone Number Plumber's Address (Street, City, Stott, Zip Codc) f~ VIII. Conn '/De rGment Use On roved Permit Fee Date t Sigtlatue canon for Denial s g5 . i'Jt5 3 / 7 IX. Coodi is pproval ;tiMt}ier.si sq dust ap 3l'~'s rite ii" 5a v S M r]6 d S'PW 1jW.*G lhW plant pro holed by piumbet 2 'A#4vft@q*'*Oft-~m i int. a neflit .ired 0,4j- cam! 1 W as Pr IipFowag cork I :rdinamm. d rld,~ Attach to aampifte phaa fir tb6 system sad wbimit to the C- ouly as popes ant thaw a W ~c t r inebes in 11.* t Q~ IA. ct~ 1. SBD-6398 (R- 08/14) ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGMa&W AND OWNERSHIP CERTIFICATION FORM Owner/Buyer 1-14 t: s /ir Mailing Address (SA,1AE) Property c r r(VeriScation &iom Pia>uiing Zottmg De~rartme+nt for naw consOrt~ciion_) City/State 41A, t~ S c! t,~ : - Pau eel identification Number LEGAL IDFSC1t~P7'ipN Proptxty Location 5kU Town of Subdivision Platy - - Lot LOt # Cert~ Survey MAp # , j j~j'' o L C~ Vottmte Page # Warranty Deed # (before 2007)V01ume page It Spec horse ©yesElo Lot lines identifiable Dyespmro MTEM MA,iN7>rrlvsVr1W AND © R f'ERTIFIt, TION Improper use and maintenance ofyour septic system could result in xnsiits premature failura La handle ntenaace consists of pumping out the Septic tank every three y or sooner, if nature, by a licensed pumper. the system can affect the ftmction of the septic tank as a ftwnew stage m the waste disposal "stem Ownu What you put into responsibilities are specified in $SPS. 383.52(1) and in Chapter 12 - St Croix County Sariitar}+ Ordinance. owner and mP"y owner agrees to srbmit to St Croix County Planning & Zonut by a master plumber, jormmtymm plumber. teatmicitd g ar a cg tb alti) be nL, si$9nee by the wr+s4evvatet disposal system is in Plmanber or a licensed pumper verifying that (1) on_Sif less than M full of sludge- Prof WwWW9 oonditioa and/or (2) after inspection and pumping (¢II ry) , lb, septic tank is Uwe, the undersigned have read the above requirements and agree to standaMIS Set S MM --tam lbe Private --wage disposajystgm valb 0. w,set f wksm ~ ~ the Department of Safety And Profim ~ and the t wish the the yon: Septic system has been maims mgt be WMPItd and ~'ac°n`nt of urMatural ned s lbe S rcer Co'~ Pig & Zoning Department within 30 days of the three year expiration date. d to the St Croix 11vM Mttfy that all statements on this form amt true to the best of my/our knovdadge_ Viwe aWa t the owttem(S) ofthe Property described above, by virtue of a wfaaGy dead reeor&d in Rcgister of Deeds Office. --a Number of bW--Mom TC7RE OF APPLICANT(S) strd: l7,/ > 7 *":Any boa that is mica may result in the wc. ax m, y permit beiug_rewolred-by thaPl~~ Vodude with this application, a recorded - t ~ ~ r: t sf"r ~x is n MWD in the warnwty deed warranty dead from the RAgmkw of Dees Qg and a' copy of the oa tr{eu survey map if (REV W12) i t 40 a~ tf E NE'/c! Sty; 39 Tz !+~tiaso sr. CRn1x rat; !trry it,,ettsennts~~, 3.Zraf~s ~ f3K~~iu~ST ~R~ t~~~ DZ© J1~7~ lL► ter) .~'Y v-%~ f'V ci G;f-\Z, S'rtel.i~- ~ ~ -tq tEe- , 33 - j PAGE 1 OF 4 In-Ground Gravity Plan Index & Cover Sheet Cornpo w# Manual Design Ref mncw. Version 2.0, SBD-1070 -P (N.01101, R. 10/12) Pg 1 of 4 Index & Cover Sheet Pg 2 of 4 Plot Plan Pg 3 of 4 Dispersal Area Cross-Section & Plan View Pg 4 of 4 Management Plan Attachments: Enclosures: ~ ~ ; r secs POWTS plication for Review V!,AU.~1 - Soil Evaluation Report & Site Map GZ Fu uJ 5(~~c~ ' ~ , bE~D '-E PT( ti ~ ' ~E lAI Project Name ! Description Owner Name(s): DAnD Nl.' V~cKIF. C~L'~:Tr-r2 Phone: ~i5 - -3-77 _ ©65-1 Owner Address: _ ~ gah'A11U t jK~5T I)p_ 1, A L . h . cry Zip: y ai/d Project Address: ) _ Govt. Lot: 5vJ 1 /4 of Aj 1 /4, Section 3 S , T z` I N-R q E Q or W,~ Township: LADto county: C)c:K/C Project Parcel lD 0 ~ G .--1 oqL -1C G cL; Designer Information Designer Name: ,/1/~AKV ~o -~-~uP~'-2T Phone: 7u` - 4J~ - 1 ~7 Designer Address: 2~Sy R ti K IAI& A THulZs of am Ru~rWZ zip: a`18.~C E-mail: 6l(i4f-(ClestQ11~ pu+lwK. CLO►►~ Thissp Y stain p• nL License Number: - -185q - p© -1 9fi f'~Ilek Remarks:. P~4ARY dp ' :a e WUPPC~ ®1$39 ' 90 Fa i' - ~r !r!►lt/~u~latiltl~ Signature: c > Date: 9 ~z Z01 side a, each submb!d cow. I~ P .PAM Vie 1AF74. amm i+kAsoN Sr. Crcax ~o1zrY t~u~seoNSius 3.2.Ta)%&2b5 13Kt4Qi{u~51' ~R~ DZ4~ 11~? .N I oo,tp -f7 CP -ID a ~ of V92\1 ev of- N, J ~ A `K ~ ' •LO ~ ~y1 y ~ Z~f Sme Iq 35 n 0- b 10r PFMIIWr IWI~ mesa. into" sOrm.rvaT~ipi~s. Inc me Eft +r~wsn e~.i"powaeu~asaetaoa~ ernw,~t,.~ Fe..rwr fr~~a.aa ~IioMrl~lsrr~awaaataii~/~il~ a c ~ i { + f 1 0~y 1 Z f 171- 4-3 it ~ ))6911.pl LA VI b a g PAGE 3 OFy J ~E mt O 02 : 17 n a t 01 Q C m to ~J ik Q j= c m CL ao CA W~ m ~g aEz xm pv W to ~ E I w a r f CV) Z{ a w cn wp7@ Em it ,taw m m w 0 U ~ ~ Qw o v O vU) z 3 Ls~ II i m -9 cu CL a s O w CL a a CL' N o= n Q M U a o I I "F~ ' m Q U E C s= I I CC W C- U) if x ~ G C V CL LD l N N o d. I t~ u~ U = I w w a) U I I a n WI N h C~ ~ II I z u ~ m o~ , ~s m D CL ` 0 w a w w~a I II i r J I I J C} > v I 11 i o Z ¢QZ IN o I II Z U a Z ! + c% I I PAGE 4 OF 4 In-ground Gravity Management Plan IMPORTANT: The owner of this in-ground gravity system shall be responsible for its perpetual operation and maintenance pursuant to requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisc. Admin. Code, this system shall be considered a human health hazard if not maintained in accordance with this approved management plan. Furthermore, all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in accordance with SPS 383.52 (3), Wisc. Admin. Code. Maximurn Dispersal Area Opel its: Design Flow gpd; BODs c 220 mg0; TSS 150 mg:'; FOGS 30 mgL4 Inspection Checklist INSPECT EVERY 3 YEARS o type of use o age of system o nuisance factors (i.e. odors, user complaints, etc.) o mechanical malfunction (i.e., pumps, valves, switches, floats, etc.) o material fatigue (i.e., leaks, breaks, corrosion, etc.) o solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution / drop boxes) o neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.) o extent of ponding in distribution cell prior to dosing o dosing irregularities - if applicable (i.e., pump re-cycling, float switch settings, etc.) o electrical components - if applicable (i.e., wiring, connections, switches, controls, timers, alarms, etc.) o distribution lateral or lateral orifice plugging (measure lateral distal pressure - compare to design specification) o surface discharge of effluent or sewage back-up into structure served Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary) o Septic and close tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis_ Slats. when the volume of solids in the tank(s) exceeds one-third (113) the liquid volume of the tank(s) or as required by local ordinance. Disposal of contents shall be pursuant to NR 113, Wisc. Amin. Code. o Effluent filts(s) shall be inspected every 3 years and shall be cleaned when necessary to remove any accumulated solids according to manufacture's s. A service will ~ servicing period always be greater than 12 months. System maintenance reports shall be submitted to the proper local government unit in accordance with SPS 383.55 Wisc. Admin. Code. Report any component failure or matfunction to: Name of individual or company: B6-Tl Leap P LX e t,-jATLAU G• Phone: 71, ZS-(o ZCO Local government unit: _ `3'I (,'-F, 01,E CLU.4~ tkA) IT Y _DL-k E LpPM Eft!) Phone: -7/ 5 - 9 $ L- t-) LS6 _ Local government unit address: 4 u 5 t 4 l ZIP: W/ Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wisc. Admin_ Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wisc. Admin. Code. No product for chemical or physical restoration of the POWfS may be used unless approved by the department in accordance with SPS 384, Wisc. Admin. Code. Continency Plan In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to a plan submitted to the appropriate agency for review and approval. A failed "round dispersal component may be abandoned and replaced by a code-complying dispersal component in a pre-determined area of suitable soils. System Abandonment If use of this POWfS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code. ])AVID O9 22 z F T! p!~ 4b, n (3 _ L c I ~1 4 co ~1 -O as Cam. ~ m o~ o < ° z z Z D to rr~ i o o ~ M41 CO CD ff7~ o~ M p -0 m 4. N Oe i O i m i i r --i Fg S O m o m I T 1 W ! N oo O }7eS6'A940 M f in O N j 07 ~z~i cVn I auarasa S 96 d2fif-OWS m ' s : I o `z{ ° f 0 ZZVId ON1300W S9v4stust '131 mmvmsara o NO-ulOd 13 SDN6f1d1 dlNa' Y 3U17S L ~ Sgy1'JlILLV~OI ar,oa 3rLL Lf10 wwa z ,3N,dIW,i 3NL D 3Ag1@lONa 1f1D LfYl ~ ~ ,aouvnsiSw m aanm u ttw+aaa -D O O O n i :x> 36 1- NtC-PA r m °o f z N aroaa rn 0 L -0 =w~cn SUIL --4 aRLNaWl31DA3HAIA { -;O O !fe`A ' do ~ F r, ~I cry- .i z D 1 ~ N G7 4 p m U ~J ~Pvl up C) O n 43j" D N ~ O O -U NDD mo m~~ 0x i C~rIZD DDS D A I Z r- V) Z CA M> O 2" -or, NOD 37 2" Z m 6" w z m -ur 4~ D x - r n 2 D V) Z 0 m 18" MIN. r m N C O ! r' r ~ 37" -1 " O z 4 o XN = O m z v cn m A D ~D Z N _ TI I Dj N U) W D ;J r 00 mX0 Z--i m Z _D p0•-107 M C m rri D D m Cwt r- --n U) O m D z r -I In C- ~ 0 z~ can ' FlLTER CANISTER DETAIL MIENERCINCIETE M DRAWN BY: Swr SCALE:3 -0 PRE-POUR REV. z SEPTIC MANUAL W3716 US WWY 10 MAIDEN ROCK, WI 54750 DATE: JANUARY 2010 DATE OST-POUR: ~0 REV. JAN. 2010 800-325-8456 FILE: SHEET 13 INDUSTRIAL GROUP--7 Number of EMow 1203H sections needed (.5 = Five foot section) Load to Two Bdrm. Three Bdrm. Four Bdrm. .7 9 13 17.5 .6 10 15 20 .5 12 18 24 .4 15 22.5 30 .3 20 30 40 .2 30 45 60 **As per Wisconsin Dept. of Commerce approval (Product file #20020187 dated July 23, 2002), the EISA sizing of 50 square feet for the 36" x 10' EZf1ow 120311 product may only be used if the following stipulations are met: • Product must receive wastewater having a BOD5 value between 30 and 220 mg/L and a TSS value between 30 and 150 mg/L. Product must be installed in individual excavations that create a dispersal cell that is horizontally separated from other dispersal cells in other excavations by at least 3 feet • Product must be installed in a dispersal system that has the top of the dispersal cell at or below original grade. • If the above three stipulations are not met then the EZflotis 120311 product will need to be sized at 30.0 square feet per each 36" x 10' section. * * * In all applications, whether sized using the EISA number or not, a state approved geotextile fabric most be used to cover the top of the EZftow product. While it is permissible to partially cover the sides of the two outside bundles, it is imperative to insure that the entire bottom of the trench and AT LEAST 6 inches of sidewall remain open (uncovered with fabric) so as to achieve maximum soil exposure. w EZ w q EZ i Oi 1) 1 Approved EZ flow Products EZ/!ow 1202V IV VV VV 4 :;~~V VVYV +749 'rV 94991 ~V 49V4 V9V49• V Q Woe Vs ~QV• V VM rv e ~ Yv' 9 19 VF 4s cP P , Vra P F ep ' V s~~ 4 a +roa V x •ack.-" v •t u, 91^'t •ra r~ r P4 EZfiow 1202V is approved on a foot for foot basis. After the system has been completely covered, only drive across the trenches when completely necessary. Never drive along the leach trench lines. To avoid additional soil compaction, prevent any heavy equipment from driving across or along the leach field area. Sod or seed the leach field area to control erosion, as may be required by Permit or local rules or policy. Maintenance The owner of the system shall at all times properly operate and maintain the onsite sewage disposal system. Only sanitary sewage shall be introduced into the system. EZpw Inspection All sewage disposal installations, including repairs, shall be inspected before being covered. Systems to accommodate new structures shall not be used until inspected and approved per Rules Sec., II.,C. Septic tank, header pipe, distribution box, leach trench bottom, grade, depth, and cover shall be in accordance with County rules and regulations or policy and shall be installed per EZflow Manufacturer's Installation Guide. ST. CROIX COITNTV SEPTIC TANK MADnTMNCE AGREEMEXT AND O RSffiP CERTIFICATION FORM OwnerABuyer Mailing Address ( S,,k:vt E) . Property ;.q t s u~. l (V~cation d frrNm Piam3ing Zonmg Department for new COQ-) City/State to Sf n t ~ Parcel Idtrttification Number LEGAL DES R-~pTION Property Location V4 T 2-6 NR W T..,,r ;I,,n. i - > - - 7- -~,Lyat2, 6 Subdivision Plat! p Lot; Certlf ed Survey Map # U o o Z Volume 0 Page# Warrant9Deed a (before 2007)Volume pag, # Spec house t: iy"E-h. Lot lines idantif able L]yesona SYSTEM M~TR_,NANCE ANiI p CERTIFICATION rawate-Mce linpn►per use aml maintenance ofyour septic SY'stera could consists of p3m ping out the septic tank every three years or sooner failtae to handle mss. p3oper in its preimatum the system can zd the frmci~3 of the septic task as a t needed, by a licensed pumper What you put into Wftm 3saibiiities are wed in $SPS 383.52(1) and in Chapter 12 stage m the waste rospo - St Croix Co~~ Owner maintenance ~Y Shy Ordinance. Tbe Fmpecty owner agrees t° submit to St: Croix Co ovmer and by a master plumber; J° plumber, mslnich~mg c'~oaiztg Dep»nt a certification fiorm, signed by a th wastewater ~s mw system is in Plumber or a ficeased p verifying that (I) the oa-site less 9M 1/3 full of sludge. 1 P~ offing oondmon and/or (2) after inspection and pumping (ifnecessary), the septic tank is VVffl- standards the ~nndtusigned haw e read the above req~ _aud agree to maintain the Pll~ sewage ~ of Wiset fix* se by *e g~~ Safily m has been °nat Services Dep~cnt~ of ~Natm-al g,aso~i~ce Plannrng & Zoning Department within 30 days of the flee year exp must be completed and to ffie St Croix FAY described ado an St8tBUMis on this form are true to the best of my/our krwwl v,,, by virtue of a decd rcwr&d in Rc*stcr of Deeds Offict. ardarc *e owner(s) ofihe NUmber et bedrooms SIGNA'£TJRE OF APPLICANT(S) Cad. l7J 17 I7►ATE "Any whoa dW's mod May result in the + salritmtY permit bcin&zmked-}yy ttla 3n ~ t . r 4eA. I-Jude with ftS 2q3jAw3b,, 2reco3+rjerl w-rar3 1, R:t `.wY z'' 3s mode m the deed, ty deed f.. pf'& OffiG and a Copy of the ccriirfied =rvey map if (R 'ITV. OV 2) ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF EXISTING SEPTIC TANK(S) This is to certify that I have inspected the existing septic and/or dose tank presently serving the following residence: (Street address)~651"1 located at: 1/4, ~nl/4, Section 3 5 , Town 2 7 N, Range~'17/ W, Town of '4(vc L ~ v J , St. Croix County Wisconsin. Upon inspection,1 certify that 1 have found the tank(s), to the best of my knowledge, will confonn to the requirements of SPS. 384.25, and it (they) appear(s) to be functioning properly. Most recent date of inspection or service l C'~ '7 ho 1 ,7 Did flow back occur from absorption system? Yes No (if no, skip next line.) Approximate volume or length of time: gallons minutes Tank Capacity: jG%06) Construction: Prefab Concrete_ Steel Other Manufacturer (if known): ~S Age of Tank (if known): Permit number (if mown) Ocensed Plumber Signature) (Print Name) 7 (Title) (License Number) MP/MPRS (Date) Form to be completed by licensed plumber (Dept of Safety and Professional Services Chapter 305 and s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) Rev. 2/2012 m swS719~ K~ Wiy„on~jp ~t~d Professional Services 57 L/ Divisio SOIL EV!?R PART Page I of 3 12 -A ID NQV Q 2 .01, in accordance with SPS 383, Wis. Adm. Code County ST. CROIX Attach e~t less than 8 1/2 x 11 inches in size. Plan must inG r1 i horizontal reference point (BM), direction and Parcel I.D 02 - 1096 - 10 - 000 slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Revie by Da Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)) /;/,y// Property Owner Property Location DAVID M. & VICKIE A. PORTER Govt. Lot SW 1/4 E 1/4 33 T 29 N R 19 E (or) W Property Owner's Mailing Address Lot # Block # Subd. ;Nam!r CSM# 659 Bradhurst Drive 3 V5, Pg 1220 City State Zip Code Phone Number ity []Village own Nearest Road Hudson WI 54016 ( ) Mad'san Bradhurst Drive © New Construction Use[D Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD n Replacement ® Public or commercial - Describe: Parent material sandy Flood Plain elevation if applicable CIA ft. General comments Conventional In-ground trenches 0.6 loading rate and recommendations: 1 43 a dr/ o Go AJ XI''SCVkc^ WEms.. EJ0 l a.+A 1e r ✓►~lc~- J lS n n 1 Boring # Boring Pit Ground surface elev. 96.30 ft. Depth to limiting factor >65 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 1 0-15 7.5YR2.5/1 1 2f-ma&sbk mvfr as Ivf-m 0.6 0.8 2 15-21 7.5YR2.5/2 1 2fabk mfr cs 2vf-co 0.6 0.8 3 21-29 7.5YR3/3 - sil 2fabk dsh cs 2vf-co 0.6 0.8 4 29-59 7.5YR4/4 A 2fa&sbk dsh es lvf-m 0.6 1.0 5 59-65 7.5YR4/4 s Osg dl Ivf-f 0.7 1.6 Horizon I is fill material. r Boring# ©Boring ~ 94.0 ~ W-14 F271 T- >60 Pit Ground surface elev. ft. Depth to limiting ctor 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 I 0-21 7.5YR2.5/1 I 2f-ma&sbk mvfr as Ivf-m 0.6 0.8 2 21-42 7.5YR2.5/2 sil 2fabk mfr cs 2vf-co 0.6 0.8 3 42-48 7.5YR3/3 A 2fabk mfr cs 1 of-m 0.6 0.8 4 48-60 7.5YR4/4 sil If-mabk dsh lvf-f 0.4c 0.6 Horizon I is fill material. ` Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L " Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Sign t CST Number MARY JO HUPPERT Hollister's Soil Testin &Desi n 21~224832 Address Date Evalu Conducted Telephone Number 28497 King Arthur's Court, Danbury, WI 54830 08 - 17, 2017 (revised: 10-30-17) 715-426-1775 SBU-8330 (Z07 13) Property Owner PORTER, David Parcel ID # 020 - 1096 - 10 - 000 Page 2 of 3 Boring ❑ Boring # Q Pit Ground surface elev. 94.20 ft. Depth to limiting factor >64 in. Sol Appkation Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsefl Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 `Eff#2 1 0-15 7.5YR2.5/1 1 2fabk mvfr as lvf-m 0.6 0.8 2 15-23 7.5YR2.5/1 1 3fabk mfr Cs 2vf-co 0.6 0.8 3 23-31 7.5YR3/3 sil 2fabk mfr cs Ivf-m 0.6 0.8 4 31-60 7.5YR4/4 sicl 2fabk mfr cs lvf--f 0.4 0.6 5 60-64 7.5YR4/4 s Osg dl lvf--f 0.7 1.6 WFJZWJ I ' All AL - ❑ Bomg # H Boring Pit Ground surface elev. ft. Depth to limiting factor in. Sol Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsefl Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eif#2 Boring # Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rath Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPQAf in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 •Eff#2 Effluent #1 = BOD, > 30 < 220 mgA- and TSS >30 < 150 mg/L ' Effluent #2 = BOD5 _ 30 mglL and TSS < 30 mg/L SBD-8330 (807113) p1m p w J Of Ow D-4vj he )\JE' ~c xt~ CA $~~oe pit s y ~3K u~ ~x { ~e/ CZ e ir~rv- l~ Ur>~ Non* ol~ ' s \ Aga / ! Y `0 i\ e r Me.Locafitm. x tz {c` ?q L-3