HomeMy WebLinkAbout020-1143-00-000
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7j SERCO Laboratories
1931 West County Road C2. St. Paul. Minnesota 55113 Phone (612) 636-7173 FAX (612) 636-7178
LABORATORY ANALYSIS REPORT NO: 22606 PAGE 1
08/11/92
St. Croix County Zoning DATE COLLECTED: 08/03/92
911 4th Street DATE RECEIVED: 08/04/92
Hudson, WI 54016 COLLECTED BY : CLIENT
DELIVERED BY : CLIENT
SAMPLE TYPE DRINKING WATER
Attn: Mary J. Jenkins
SERCO SAMPLE NO: 69032
SAMPLE DESCRIPTION: MATTILA y
ANALYSIS: C _
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Bromodichloromethane, ug/L <0.2 2
Bromoform, ug/L <0.5
Bromomethane, ug/L (Methyl bromide) <1.0 ✓
Carbon tetrachloride, ug/L <0.2
Chlorobenzene, ug/L <1.0
Chloroethane, ug/L (Ethyl chloride) <0.4
2-Chloroethylvinyl ether, ug/L <0.4
Chloroform, ug/L 0.9 A
Chloromethane, ug/L (Methyl chloride) <0.6
Dibromochloromethane, ug/L <0.4
(Chlorodibromomethane)
1,2-Dichlorobenzene, ug/L <1.0
.(o-Dichlorobenzene)
1,3-Dichlorobenzene, ug/L <1.0
(m-Dichlorobenzene)
1,4-Dichlorobenzene, ug/L <1.0
(p-Dichlorobenzene)
Dichlorodifluoromethane, ug/L (Freon 12) <0.5
1,1-Dichloroethane, ug/L <0.1
00
1,2-Dichloroethane, ug/L <0.2y
(Ethylene dichloride).
1,1-Dichloroethene, ug/L <0.2
trans-1,2-Dichloroethene, ug/L <0.1 ~f
1,2-Dichloropropane, ug/L <0.1 w z~ 2 y
cis-1,3-Dichloropropene, ug/L <1.5
trans-1,3-Dichloropropene, ug/L <0.9
< means "not detected at this level". 1 mg = 1000 ug.
Member
ArA~
70 SERCO Laboratories
1931 West County Road C2. St. Paul. Minnesota 55113 Phone (612) 636-7173 FAX (612) 636-7178
LABORATORY ANALYSIS REPORT NO: 22606 PAGE 2
08/11/92
SERCO SAMPLE NO: 69032
SAMPLE DESCRIPTION: MATTILA
ANALYSIS:
--1-------------------------------------- <5-0----
MAhylene chloride, ug/L
(Dichloromethane)
1,1,2,2-Tetrachloroethane, ug/L <0.2
Tetrachloroethene, ug/L <1.5
1,1,1-Trichloroethane, ug/L <5.0
1,1,2-Trichloroethane, ug/L <0.1
Trichlorofluoromethane, ug/L (Freon 11) <0.7
Vinyl chloride, ug/L <1.0
Benzene, ug/L <1.0
Ethylbenzene, ug/L <1.0
Toluene, ug/L <1.0
Trichloroethene, ug/L <0.4
tan 0A -
This sample's analytical result are / are--mot below the U.S. Epa's SD
WA Maximum Contaminant level of 1 30/91 for those requested compounds
which are also on the SDWA MCL list.
A: This parameter observed in lab blank at a concentration of 2.1 ug/L
< means "not detected at this level". 1 mg = 1000 ug.
0
Member
A r,~,
SERCO Laboratories
1931 West County Road C2. St. Paul. Minnesota 55113 Phone (612) 636-7173 FAX (612) 636-7178
LABORATORY ANALYSIS REPORT NO: 22606 PAGE 3
08/11/92
All analyses were performed using EPA or other accepted methodologies.
Samples that may be of an environmentally hazardous nature will be
returned to you. Other samples will be stored for 30 days from the
date of this report, then disposed of by SERCO Laboratories. Please
contact me if other arrangements are needed. This report may not be
reproduced, except in its entirety, without prior written approval
fr»m SERCO Laboratories.
Report submitted by,
Diane J. Anderson
Project Manager
< means "not detected at this level". 1 mg = 1000 ug.
0
Member
ST. CROIX COUNTY ZONING OFFICE
St. Croix County Courthouse
911 4th Street
Hudson, WI 54016
Telephone - (715)386-4680
The St. Croix County Zoning Office offers the service of septic
and water inspections to Lending Institutions, Realty Firms, and
private individuals.
Completion of this form is gaertti a1. , o t_1m t fire -,ran, -r-t , i7 ;1 ,
located.
Please provide the folloWil-Ig informa-ricn,
fee made payable to St. Croix County Zoning Office, and mail,
along with form to the above address. Testing will be done as
soon as possible after fee and form are received..
WATER TESTING----------------------------FEE: $ 35.00
(For nitrates and coliform bacteria)
WATER TESTING FEE: $185.00
(For VOC'S)
SEPTIC SYSTEM INSPECTION-----------------FEE: $25.00
(Determines if system is properly functioning at,time of
inspection)
PROPERTY OWNER'S NAME: AM~S AND P,4,"6L4 S 414
jrI Lq
PROP. ADDRESS: 44-V6 CITY
A Legal Description 1/4 of the 1/4 of Section TA
~l\ Town of QA) Lot Number Subdivision: p,14,2~ !/i = GsJr
f r FIRE NUMBER $ S LOCK BOX NUMBER C~ I G / 5 AD~/V,
~i`
Z? Color of house ealty sign by house? a If so, /ist firm:
PLEASE INCLUDE, IF AT AZ.L POSSIBLE, A HCAP,i.e,COPY OF PLAT BOOK,
WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET.
Testing of residential water requires a sample that is fresh. If
the home is vacant, and has been so for some time, the water line
must be purged by running the water for several hours before the
test can be conducted.
WINTER TESTING: Many times water lines are turned off, or sill
cocks are turned off, making access to the home necessary. If
this is the case, please make proper arrangements with this
office to ensure time when entry may be gained.
Firm or individual requesting services: jE. t PA~t~tA S. /'Ni4i7t,¢.
Telephone Number. 396 •35166
REPORT TO BE SENT TO: FiRsi r1504A4 4 SAdi4/6 &P i< k4c~ roSS,E -ifilfpa
0701 S ~u7F/ oZND S% t'0+3v -Q aD W S D/6
CLOSING DAIIJE:
signature
Parcel 020-1143-00-000 12/06/2005 08:45 AM
PAGE 1 OF 1
Alt. Parcel 17.29.19.739 020 - TOWN OF HUDSON
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
O - MATTILA, JAMES E & PAMELA
JAMES E & PAMELA MATTILA
985 SHERMAN LA
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description * 985 SHERMAN LA
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 1.380 Plat: 2276-PARK VIEW ESTATES 2ND ADD
SEC 17 T29N R19W PARK VIEW ESTATES 2ND Block/Condo Bldg: LOT 46
ADD LOT 46
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
17-29N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
2005 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 10/25/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.380 55,900 203,000 258,900 NO 05
Totals for 2005:
General Property 1.380 55,900 203,000 258,900
Woodland 0.000 0 0
Totals for 2004:
General Property 1.380 28,700 204,200 232,900
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 118
Specials:
User Special Code Category Amount
018-RECYCLING SPECIAL ASSESSMENT 27.00
Special Assessments Special Charges Delinquent Charges
Total 27.00 0.00 0.00
AS BUILT SA.*'ITARY SYSTEM REPORT
.rR J' , TOWNSHIP SEC. T N R Ti
ADDRESS ST. CROIX COUNTY, WISCONSIN. .
DIVISIONur `G 5c' ~t' LOT '14 LOT SIZE YY-'~~J
PLAN VIEW
Distances S dimensions to meet requirements of H62.20 JUL 1979
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM _
IT I
I !
_47
0 ~ ~ ~ ~ I 1 I
t - -
I I J j ! I ;Indicate Northi Arrow I
I ( ; C j 'SCALE r fe
1-
TIC TANK(S) MFGR.+L 3, e's• CONCRETE STEEL
NO. of rings on cover Depth DRY WELL
ACHES NO. of T width length area
no. of lines- width / length area
depth to top of pipe
' iEGATE /~y -
t: RATE c /C 1c5; I AREA REQUIRED S_,~_ " AREA AS BUILT
-claimer: The inspection of this system by St. Croix County does not imply complete
.;Dliance with State Administrative Codes. There are other areas that it is not possible
inspect at this point of construction. St. Croix County assumes no liability for
;:-"em operation. However, if failure is noted the County will make every effort to
w.>rmine cause of failure.
:'ASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.
-'INSPECTOR
DATED PLUMBER ON JOB 1(3z~i
LICENSE NUAiBER
z Y
• REPORT OF INSPECTION INDIVIDUAL SEWAGE SYSTEM
San.itany Penrn.it
State S e pt.i c- _
NAME Townsh.ip Croix County
Location
SEPTIC TANK
Size gattons. Number o j Compartments j
Diztanee Fnom: Wet 6t. 12% an greaten slope ~ 6t j
BuiZd.ing f j, - / 6.t. We.t.eands 6t.
Highwaten 6t.
DISPOSAL SYSTEM '
Distance Fnom: we.Z~ S~ f 6,t. 12% an greaten s.Zope fit.
Bu.i.?_d.ing it. W ettands Ft.
H.ighwaten - Sz.
FIELD DIMENSIONS:
Width oS .trench l 6t. Depth o6 rock be.Zow tiZe .in.
(l Length o6 each tine_ 6t. Depth a6 rock oven tite-~ .in.
i Number o6 tines Depth o4 tite below gnadelzl~/in.
.36
lotat .Zength o~ Zines j j 6t. S.Zope o~, .trench 0, in pen 100 fit.
Distance between Zines to 4t. Depth to bedrock _6t.
Tota.e abs onbt.ion atea~~t2 Depth to gnoundwaten-6t.
2
Required area 6t Type o4 Coven: Papers on Straw
PIT DIMENSIONS:
Number o6 pits GnaveZ around pits yes no
Outside d.iametT,7 Depth b etow intet 6t.
2
Tota.Z absonbti6t
Area equined It2
INSPECTED BY I AA I k ~)L) i TITLE '
APPROVED DATE_ 197
REJECTED , DATE 197.
rEH 115 Rev. 9/78
r REPORT ON SOIL BORINGS AND PERCOLATION TESTS
• WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES
P.O. BOX 309, MADISON, WISCONSIN 53701
~<<~s
LOCATION:'/4// Sectionlzl_IT4 ` N,RZLe (orti ownship or Municipality-/
Lot No. , Block No. 2)';Z
t ~S 1< AS County 01 Cr X
division Name
Owner's/Buyers Name: ~~14AjCS ~ Alli77~' Z
/
Mailing Address: (E / SC/3d 5
TYPE OF OCCUPANCY: Residence No. of Bedrooms COMMERCIAL
EFFLUENT DISPOSAL SYSTEM: NEW~REPLACEMENT -ALTERNATE SYSTEM OTHER
DATES OBSERVATIONS MADE: SOIL BORINGS E`- 7 PERCOLATION TESTS 27
SOIL MAP SHEET S-- NAME OF SOIL MAP UNIT U4 S 0-411
PERCOLATION TESTS
TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE
NUM- INCHES THICKNESS IN INCHES SINCE HOLE BOLE AFTE INTERVAL MIN/IN
BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3
/
P-
P-
P-
SOIL BORING TESTS
TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR,
NUMBER INCHES TEXTURE, MOTTLING AND DEPTH TO BEDROCK
OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES
B- ` /(c aco~_ S " S "S _-7 941~
B-
B- ri C LL /iI S /
PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas.
Indicate number of square feet of absorption area needed for building type and occupancy Indicate scale or distances.
Give horizontal and vertical reference points. Indicate slope.
~ /ysrHf~
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/4 / A4 e/YJ4 ere - ~/a 5 a 1- G.u. X"4-/ t A e r ~/1 Y. a.,q c r ,~L~✓ e a'
F I, the undersigend, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods
specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best of my
knowledge and belief.
Name (print) /~f~ic LtiCs`~ `c `J I,,,e4 S ey Certification No.
~ 1)4 1,1"✓so,v (.zits Sys'/~
aLC. zr-
Address
Name of installer if known
T
CST Signatu
Copy A -Local Authority re `
State and County State Permit #
PLB 6 f Count Permit
Permit Application Y
- for Private Domestic Sewage Systems County
*DENOTES STATE APPROVAL REQUIRED
Date Approval. Received from State if Required State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
B. LOCATION: AIC '/4 /VE Section _L7, T N, R / (or) Lot# Y& City
Subdivision Name, nearest road, lake or landmark Blk# Village
l Township 1- 016y-yl
C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance
Single family Duplex No. of Bedrooms 41 -No. of Persons
D. SEPTIC TANK CAPACITY / 3y Total gallons No. of tanks
HOLDING TANK CAPACITY Total gallons No. of tanks
Prefab concrete X' Poured-in-Place Steel Fiberglass Other (specify)
New Installation .X Replacement
Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-PlaceOther (Specify)
E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate- 0_5 Total Absorb Area sq. ft.y~0 '~rC'c~ ~siEa[
New X Replacement Alternate (Specify)
Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenc s
Seepage Bed: " Length- /7F7 ~ Width Depth 3-2 Tile depth (top) No. of Lines - !V47 Seepage Pit: Inside diameter Liquid Depth No. of Seepage
Pits
Percent slope of land_ Yom= /C1is~ Distance from critical slope
WATER SUPPLY: Private R Joint ❑ Community ❑ Municipal ❑
Owners name as listed on EH 115 if other than present owner:
I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20,
Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared
by the Certified Soil Tester,
NAME 1lF_~7A,3' C.S.T. #jd j - /55"S and other information
obtained from f (owner/builder).
.Plumber's Signatufe- e'-j- MP/MPRS1/V# C Phone # /
1 ~
Plumber's Address C4. ~-a-z-
PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20. Well loca-
tion shall be included on the sketch. Indicate or dimension location of all wells on the property or neighbors
property. If well has not been drilled please indicate.
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Do Not Write in Space I~el w FOR COUNTY AND ST TE DEPARTMENT USE ONLY C
Date of Application Fees Paid: State C C+ounty, ? L` D
Permit Issued/-~ date) / 7 Issuing Agent Name
Inspection Yes No State Valid# Date Recd
1. county (vv to copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701
2. state (pink copy) 4, plumber (canary copy) Revised Date 7/1/78
6.1