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Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT sanitary Permit No: 600399 GENERAL INFORMATION ATTACH TO PERMIT) 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: Pamela Rohde TOWN OF TROY 040-1294-00-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 16.28.19.1685 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header/Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP/SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length 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 Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size Ix Hole Spacing Vent to Air Intake 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 Bed/Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 504 E COVE RD 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? ❑ Yes ❑ No LLLI Use other side for additional information. Date Insepctor's Signature Cert. No. SBD-6710 (R.3/97) coun e~ Safe and Buildings Division r 201 W. Washington Ave.; P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) Madiso W 537,07-7 I 2 ~ 66 3 ? C' rmit Applieat' state Transactiumber In accordance'+w•ith SPS is. Adm. Code, submission of this form to the appropriate governmental unit is required prid~ to a sanitary permit Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address) the Department'' afety and Professional Servies. Personal information you provi may be used for secondary purposes in accordance with Wrivacy Law, s. 15. 1) m), Stats. r- rJ L Application Informatin Please int All Information r) 0 /C Parcel # Property Owner's Name M CA- Property Owner's Mailing Address 67 Property Location l /1 i rY k.' r I Govt Lot City, S Zip Code Phone Number Section 1 l ~L circle o z f. -/r la. ,Type of Building (check all that apply) Lot T N, Rr E W Su nston Name r 2 Family Dwelling -Number oBedroom,, f ~ - ❑ Public/Commercial - Describe Use ❑ City of _ ❑ State Owned - Describe Use CSM Number ❑ Village of G Town of III. Type Permit: (Check only one box o ire A. Complete line B if applicable) A- ❑ ' em Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Outer modification to Existing System (explain) ❑ Permit Renewal El Permit Revision El Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued B Before Expiration Owner IV Type of POW TS System/Couionent/Device: Check all that apply) v in. of suitable soil essurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound 124 ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis rsanre went Area Information- (gpd Desist So' Application dsf) Dispersal Area Required (ST) Dispersal Area Propos (sf) System Elevation. J/ Design Flow 65 VI- Tank Info Capacity in Total # of Manufacturer u Gallons Gallons Units r J New Tanks Existing Tanla o P A W Y~/ bJ ( AAA, t ` U v~ v~ Septic or Holding Tank r I Dosing Chamber VII. Responsibility S ement- 1, the undersigned me responsibility for installation of the PORTS shown on the attached plans. Plumber's Name (Print) P s Signature MP/MPRS Number Business Phone N b PI tier's Address (Stree[, City; State, Zip j _ l Z_; r4..) d VIII. ountyMe artment Use Only 17 If 17 isedl sir Issuing ent Signature Approved ppr Permit Fee Date ❑ Given Reason for Denial ons for Djapproval IX. Condy Axn- Mar em W, "Mex: u sl+et ii cell -ust all be sir fCi S rit n ZC vs per ;v►anaf ement plan p!,o loerl by plumber. C e6~ llj4b 2. All k reC,l Fft, wvn mlrst ue ma rJI.E W per Popk I cxk`t / rd"' snms-A. Attach to complete plans for the system and submit to the County only an paper not less than 812 z t I inches is SBD-6398 (R. 11/11) System PLOT PLAN PROJECT Doua Rohde ADDRESS 617 Diamond Drive Hudson Wi 54016 SW 1/4 NW 1/4S 16 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROIX SYSTEM ELEVATION 89.0/88.9/88.8 4' below grade DATE 5/9/18 BEDROOM 4 v CONVENTIONAL CONVENTIONAL LIFT X00( HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE765 DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .4 ABSORPTION AREA 1516 # of chambers 75 BENCHMARK V.R.P. Top of power box ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark Property Line Scale = 1 /4 11 = 10' B. M. Replace area to be original soil test for county plat Vents 30' Scale is 1" = 40' poor soils 20'B-1 45',jr unless otherwise noted 0% Slope 0 Please note: this sight has been disturbed and appears to be a old gravel 3-3' X 102' Cells with >3'spacing pit. The tested area was the only spot I -3 found undisturbed soils suitable for a conventional system. W B-2 10' Pro 4 Bedroom 40' House Poor soils at a 2' lower grade 20' Huffcutt Combo Tank Vent Property Line All piping shall be ASTM SDR 30/34, within >6" Quick4 Standard 10' of tank, piping shall be ASTM F891 of Cover Leaching Chamber with 20.0 ft2 of Area 5.6ft^2/pair of end caps 12" 4' Long Grade at System Elevation East Cove Road 4 3 Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 5/8/18 Owner: Doug Rohde Location: SW 1/4 NW 1/4 S 16 T28 N,R19W 504 East Cove Road Troy System type: In-ground absorbtion system (conventional) Manuals Used: In-ground absorbtion system (version 2.0) Pressure Distribution Manual (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross Section 4-6. Maintanance and Contingency Plan 7. Filter Specifications Sheet 8. Dose Tank Cross Section 9. Pump Curve , .1 Signature License nu e #226900 System PLOT PLAN PROJECT Doua Rohde ADDRESS 617 Diamond Drive Hudson Wi 54016 SW 1/4 NW 1/4S 16 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROIX SYSTEM ELEVATION 89.0/88.9/88.8 4' below grade 5/9/18 4 DATE BEDROOM CONVENTIONAL CONVENTIONAL LIFT XXX HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE765 DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .4 ABSORPTION AREA 1516 # of chambers 75 BENCHMARK V.R.P. Top of power box ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark Property Line Scale = 1/4" = 10' B . M. Replace area to be original soil test for county plat Vents 30' Scale is 1" = 40' poor soils 20'B-1 45' unless otherwise noted 0% Slope 0 Please note: this sight has been disturbed and appears to be a old gravel 3-3' X 102' Cells with >3'spacing pit. The tested area was the only spot I -3 found undisturbed soils suitable for a conventional system. 0' B-2 10' Pro 4 Bedroom 40' House Poor soils at a 2' lower grade 20' Huffcutt Combo Tank Property Line Vent All piping shall be ASTM SDR 30/34, within >6" Quick4 Standard 10' of tank, piping shall be ASTM F891 of Cover Leaching Chamber with 20.0 112 of Area 5.6ftA2/pair of end caps 12 4' Long 3 4" Grade at System Elevation East Cove Road 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 93.0' Avent All, Grade \a t 4„ A~30/34 =Tank 4' 3 4" Grade at System Elevation 3 4 Grade at System Elevation Spacing 5' 3-3' X 62' Cells Observation tube/Vent Same on other end To be located on end of Cells A B System elevations: C A_89.0' B_88.9' C__88.8 25 chambers per cell POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of BILE INFORMATION SYSTEM SPECIFICATIONS Owner t Permit # Septic Tank Capacity ❑ NA Septic Tank Manufacturer ❑ NA 3ESIGN PARAMETERS Effluent Filter Manufacturer Z ! ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA i Number of Public Facility Units NA Pump Tank Capacity r al NA j Estimated flow (average) f i U aUda Pump Tank Manufacturer NA i Design flow (peak), (Estimated x 1.5) aUda Pump Manufacturer O NA tii Soil Application Rate Pump Model ❑ NA I aUda to p del ? Standard Influent/Effluent Quality Monthly average" Pretreatment Unit A Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter 0 Peat Filter Biochemical Oxygen Demand (BOD5) <220 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 round (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) 530 m L NA 91 ❑ At-Grade ❑ Mound Fecal Coliform (geometric mean) 5104 cfu/100ml ❑ Drip-Line ❑ Other: (Maximum Effluent Particle Size Ya in dia. ❑ NA Other. ❑ NA Other: Other: NA ❑ NA *Values typical for domestic wastewater and septic tank effluent Other: ❑ NA [AINTENANCE SCHEDULE ? Service Event Service Frequency (inspect condition of tank(s) At least once every: ❑ month(s) ea s (Maximum 3 years) ❑ NA (Pump out contents of tank(s) When combined sludge and scum equals one-third (X) of tank volume ❑ NA (Inspect dispersal cells} At least once every: ❑ month(s) year(s) (Maximum 3 years) ❑ NA -er (Clean effluent filter At least once every: ✓ C1 nionth(s) j ar(s) ❑ NA nspect pump, pump controls & alarm At least once every: jiQ month(s) ❑ NA 19ush laterals and pressure test At least once every: ❑ month(s) ether. ❑ year(s) ❑ NA At least once every: ❑ year(s) s} ❑ NA Ixher: ❑ 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 iinclude a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of ioombined 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 (X) or more of the tank volume, the entire contents of I:he tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. Iql other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, land any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. Ik service report shall be provided to the local regulatory authority Mthin 10 days of completion of any service event. Page START UP AND OPERATION or ather chemicals tli<jt For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products impede the treatment process and/or damage the .dispersal cell(s). If high concentrations are detected have the contents of thO tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are from at the infiltrative surface. During power outages pump tanks may fill above nornral highwater levels. When power is restored the excess wastewater will ble discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effiuenfL 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 contrDis to restore normal levels within the pump tank. Do not drive or park yehides over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance: and prolong the life of the POWT$: antibiotics, baby wipes; cigarette butts; -condoms; cotton swabs; degreasers; dental floss; diapers: disinfectants; fat; foundation drain (sump pump) water, fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; ail; painting products; 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 safety 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 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 fined 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 compliant rep system: 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 requirjed setbacks from existing and proposed structure, lot lines and wells. Failure to protect 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 rules in effect at that time. E3 A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology 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 sail and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be instaliedl as a last resort to replace the failed POWTS. ❑ Mound aril at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infritrajive 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 TANII~ UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE 0 A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS _ POWTS INSTALLER POWTS MAINTAINER Name Name Phone SEPTAGE SERVICING OPERATOR (PhIMPERI LOCAL REGULATORY AUTHORITY Name r° 7,~ r,~, F Name Phone 'l'l✓ J~~. Phone This doasnent was drafted in oompflance with chapter sPS 383.22(2)(b)(1)(d)&(f) and 383.54(1), (2) s (3), Wisconsin AdminWnlive Code. i ~ II fl+ ~ I~ F k I yr a k I P O a I I 1-i I I 4J r I --I i I Vo c v I C 3 j 4 4Y ice„ a; LL, I i Septic-Dose Wank Cross Section And Pump Performance Specifications Tank Manufacturer Pump Manufacturer Tank Model Number j Pump Model Number Y~7 -0 Total Tank Capacity Alarm Manufacturer Max. B' Depth ' Alarm Model Number Z-11) Switch Typo Filter Manufacturer Total Dynamic Head (TDH) Feet Filter Model 'l~umber f Elevation Head /Z 2 Distal Pressure Network Loss - Mininium Pump performance Required Force Main Loss GPM t TDH Total? S ` Outlet Manhole Min. 4" Above Grade With Locking Deg ice. Inlet Manhole Manhole Min. 4" Above Grade < 6" Below Grade Sealed Watertight Securely Mounted With Locking Device Weather-proof ti Junction Box - - - Finished Grade - Vent Min. 12" Disconnect Above Grade Means With Vent Cap ;i Outlet Filter Wet Inlet Baffle A Switch Se*gs and Reserve Capacity %a" _Tank Volume = GPI Weep Dimension; Inches Volume Gal. :a B Hole reserve k ' --0 06 X (alarm) B Z Off Elevation C (dose) C , Ft Bottom (dead) D <>,a ~r Elev D at ion Total r . Ft ~a-- i> < 1 ~f i 1 1 < / < t<< ta< < { t < t t>i < t < < •i 1>[ t t a s i . < < < < < < < a[> a<l [ s>t`t><>< < `a't>t ><'la > >t'{ r t>{ < ' >'>i l i > ><:>ta[,.,,a <a<,a, <i<>[aa>< < , < [ [ < a a t , < < l < < [ < i < [ { l i { { <`{•t•t>< 1>1't {alp[>f t•Iaa>1•<><><•1>s GENERAL INSTALLATION: The septic/dose tank is bedded and back filled in accordance with the manufacturer's product approval specifications. Maximum depth of bury as specified by the manufacturer may not be exceeded without prior Approval. Manhole covers exposed to grade have an effective locking device (padlock) installed. Piping at the inlet and outlet is of approved material, connected to the tank with watertight fittings, and laid on stable soil to prevent settling or sagging. The force main is sleeved with 4" Sch. 40 PVC to bridge the tank excavation aid the sleeve is sealed watertight. Electrical service complies with NEC 300 and Comm 16.28. 02/05 U Page of 250=SERIES 113 hp Sump/Effluent Pumps for Professionals! ALL MODELS FEATURE: MOTOR SPECIFICATIONS: • Rugged 1/3 hp motor, oil filled with 1/3 hp 115V 5.2 amps 60Hz thermal overload protection. Thermally Protected & Permanently Lubricated • 1/2" solids handling. (PSG) Permanent Split Capacitor Maximum Fluid Temperature: 140°F • 1-1/2" discharge. • Hermetically sealed motor and switch cavities, DIMENSIONAL DATA: and permanently lubricated bearings. • Liberty's UNI-BODY casting - a solid, one- Height: 10.5" piece housing that eliminates the lower motor seal ring found on other pumps. Major Width: 9.6" (manual model 250) • Epoxy powder coat finish PERFORMANCE CURVE • Vortex style impeller for superior PERFORMANCE CURVE solids-handling. Made of high temperature 2S engineering polymer. • Fasteners - all non-corrosive stainless steel. 20 s • 416 stainless steel rotor shaft. v L 15 w 5 = 250-series Cord Lengths ti Model 101 251(-2) 351(-3) 50-(-5) R 10 s 250 Standard Optional Optional Optional 5 2 y 251 Standard Optional Optional Optional 253 Standard Optional Optional N/A o 0 257 Standard Optional N/A N/A 0 1T233'0 40 5o 10' cord length standard on all models. For optional lengths, U.S. Gallons Per Minute add "-2, -3 or -5" suffix to model number. Example: for model 250 with 35' cord, order 250-3 Literr 3s s 1 n 156 192 s Per Minute EFFLUENTMODELS Model 250 Model 251 Model 253 Model 257 VMF Manual, no switch. Quick-disconnect Wide-angle float with VMF switch, magnetically wide-angle float, series (piggy-back) operated vertical float - mercury-free. plug, allows manual operates in a 10" operation of pump. diametersump. Certified Dual safety certification for C US the United States and Canada. Specifications are subject to change without notice. Liberty Pumps • 7000 Apple Tree Avenue • Bergen, New York 14416 • Phone 800-543-2550 Fax (585) 494-1839 www.libeHypumps.com Copyright © Liberty Pumps, Inc. 2017 All rights reserved. LLIT2500-R5/17 CORNER- ` FOUND L.QT 2.8. SAP MONAEN T o . 4 . W W c; C TO NE COR. LOT 13) ( N88° 57' 52"E) `n N88°57' 43"E 1302m44 - X - 138. 09'---- X X- 15 0. 02' X 267. 16 FNS. 2" IRON PIPE 417. 18' I N50' 03' 52' E 0. 34' ' r , . FROM SET IRON Q LOT 1. 73 ACRE 751 456 SQ. F SLOT g:w r, r• L OT 10.: 88 5 1. 19 ACRES I N f''~ . 27 ACRES: : Vr 52. 034 SO. FT. y 55, 289 SO. FT' R' ; • z C : cr 60 3 t sus, _ .01 OJ3 : J3'~ 'vN?4 99- 8 'At ~yTS.39. cjo• 236 X8.31 ~?6 is S83 04 55 00 7 A b 92' 136.97' 3 7. 60' 44' (1 unread) - sbird@frontiernet.net - Frontier-Yahoo Mail 5/3/18, 4:02 PM Q sbird@frontiernet.net search your mailbo-_~~ I 4 4, Free Shipping inbox (1) Fw: Septic Agreement People Easy Return u~a' ~~~Llyf! 1 r R , fit. Ktz1 't A l TAN r tk N'tRStIIf 4 f.t?f3F74 kttt ~Fj*t r~ Y i o er, ~I z 01~ ~"-a 4#tP~.. v I. "Irv aa~ d<a ~s. s~auarv'+:'t;erw~$~,,:,;x,~~.~s"x+ro e=n ffcri-z2^~ee.w,"~,z i+s n~ .,z;.fa~.ax-° a f~., k` a2 , a a~ f dp `8a 3 =k~&.1a$b.YSt s 'x p M /i , r$Y'ao t4Y -Tai: `a h§6lFN+ i1}($ a ~ 000,44 sittiv) rv. 3 .r " MW 4 W"-w4 +ws ,a c 4 w mrww ~r m as pa ~'ah~ t sv ;t, ws+°m uwa t^+r;"~ r„a wryer ,x rvva as d: a ..xma et xre ,a 3.aa:; zs~c°~~;*.Nz 34 eau -,~,-a",: ik 41 S a.. 5 a~ 9S $ Y`IDY ghak . 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SA bp... r , swag. aF~ 3a w# +Ps a~~ d£bv4 ug 1, s g" a.. `.,Za r ~ reSrw~a as ea.& n~ 6 ve*_a w r„r ,w, « wee .'t a,,,n, r.l sta b ire atrz° . i iF ~.xsre.:arax~ e~g~~re ~ v.ay asa;ey~~„ad ram. ~wres;~~4~'~«a¢~anc9rrrcak <.p~+~asww,:+.,«Cau'x.„:~m~ ~h»sr~pp~wh°aavsof~t~wt:3ax °'r s 6»~k« aas9ti~ m a~.t~ a.~¢.~..c~' m?.: fi ~a wta rr g *are-fig . gse>suia9 ~arrogy Ts aa;~ ?f~ f'gxyyre~ ~ #avar,~ $kuwsnrtas' a„ u+=aei ^aa ~5c,& raw k.,.ar Fad tke49Y*rs+sR rrzor'e 4'4aagag mf €k% s#rN P#a$ Mrh q+y t .F~. ea o"m mss.-¢:,ra mk°rsE Douglas Rohde President & CEO LHR Hospitality 432 Wabasha Street South St. Paul, MN. 55107 Empire Building, Suite 700 651-340-1880 Main 651-340-1624 Fax https://maii.yahoo.com/#mail Page 1 of 1 asl iI ~ w I i m f 0 N I) III r z.o j _ I~ z.o, - ~u - -o o , EH- ~g o s 5 N N I „r¢ _ I 1 i dr+a1 Z2 L') E Nail -L -Lb L, )j 0 LL II X 8005 \ 3~`rdQ15 _ I , I i ~I z - - Q,qF ,o , i ~Sy~a l BER_ ~ J8l; - I £ CZlf- -Z 6tL£Nmvl L6Nrnv7 RS I 5 r 0 9 <f.Vi9 N ~ - I ~~b24n4 - o SL r _ v5mc1 1 S~ tS ~ ELI ?s _ J yq 3 F .5. ~ ~ "i ~ I /CyG n `l o-b -2_cI 11 / ~ o I y ~ ~ _ m I 3s \ r „o F - i- ~,i Imo' ~ a 9 N6 "A N 3 ~ K~ - It i n+ O z O N ~ i z 3 _ Z-E2 Lf Ni''~vl E252N1'~V~ \ I \ ~i ,8 - ~I uQ~ \ Y AY tiv b~' =g x 6'IIZ 7 H I -111F \ 9x y H~ \ N -aal Z I O R IFS I Z It sl 74 IN I L ~ a~ it 0 ' _ ~ LI I ❑l I - `m Eq1I .3.y~ I ~7 - 0 2o~a ~ Wisconsin partment of Comm n,ty SOIL EVALUATION REPORT Page of Division of Afety and,,@ uildjnggl v pi~rnent }ty Vie. accordance with Comm 85, Wis. Adm. Code Co m County C Attach comol ee site on paper not less than 8 1/2 x 11 inches in size. Plan must 1Y-_ include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel D. , / percent slope, scale or dimensions, north arrow, and location and distance to nearest road. ( (-t J ' - VZr- Please print all information. Re ed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location _ Z 2 Govt. Lot y 1 /4 A l4 / T,/- N R/ E( W Property Owner's Mailing Addr Lot # Block # Subd. Na or CSNW t J State Zip Code Phone Number ❑ City ❑ Village o Nearest Road .Z /10 1 , ew Construction Use` esidential / Number of bedrooms 14 Code derived design ow rate 11 6 (r GPD ❑ Replacement P__ubli- or commercial -Describe: Parent material Flood Plain elevation if applicable ft. General comments l~C) `~e, _s _1' X13' L~i~(3~ ✓ i ~i' and recommendations: System Type-6 ~Jlitit System Elevation lr 0 / D / F7/ Boring # En] Boring q 4a pit Ground surface elev. 6 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 4 Boring # Boring c Pit Ground surface elev. O 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 ,t 1 VVV • Effluent #1 = BOD. > 30 < 220 moll- and TSS >30 < 150 ' Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) tu_re CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1432 120th St, New Richmond, WI 54017 l 715-246-4516 Property Owner _ Parcel ID # Page of Boring # ❑ Boring LS pit Ground surface elev. ft. Depth to limiting factor/ ~C in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDiff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 vn - ' ~ ~ L' 4✓ i -7 Q1, - L~ -71 .L ~ K ❑ 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 = BOD5 > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BODs < 30 mg/- 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. SOD-8110 (8.6/00) Property Owner _ Parcel ID # Page of ❑ Boring Boring # Pit Ground surface elev. C D ft. Depth to limiting factor /a 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 f ❑ Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redo, Description Texture Structure Consistence Boundary Roots GPD/fF 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 lication 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 = BOD, > 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 (8.6/00) Project Name Doug Rhode Soil Test Plot Plan Shau rd Address 617 Diamond Drive Hudson Wi 54016 Cb?M #226900 Lot 10 Subdivision Piney Woods Date 5/9/18 S W 1/4 N W 1/4S 16 T 28 N/R19 W Township Troy Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of power box System Elevation 89.0/88.9/88.8 *HRPSame as Benchmark Property Line B.M.* N~ L 30' Scale is 1" = 40' Poor soils 20' B-1 45' unless otherwise noted o' Please note: this sight has been disturbed 0% Slope and appears to be a old gravel pit. The tested area was the only spot I B-3 found undisturbed soils suitable for a conventional system. Replace area to be original soil test for county plat 50' B-2 0, 10' Poor soils at a 2' lower grade Property Line East Cove Road 1 Wisconsin Department of Commerce SOIL EVALUA -ION REPORT Page I of J r-ivision of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code _ County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must S C lx i include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. % ~ (f Please print all information. Revi -WPri Kv Date Personal information you provide may be used for se dary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location 1;:~)Otl_RJ'D _S p ~ ' ZOD 6e4-Lot S 1Q 1/4 NW 1/ S 1 1 T ~i N R 1 E W Property Owner's Mailing Address Lot # Block # Subd. Name r C # L i~1 WO O U j S ~ Cam! ti11N lJ`~7.) l City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road Iz1v ~ FfOun ~v1 5~1vzZ (~lS) ~1ZS- 6~~Z 1~-~~ E;~-.,.yyU~ \z~ New Construction Use: Residential / Number of bedrooms 3 Code derived design flow rate y Sly GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material t~ ~UTIn! f"~ 1a Flood Plain elevation if applica41e General comments ; d recommendations: 1 A ZU KA1 kJ l Q r~ S l Sr}1Z L f3U 0j1J C. L it ST CROY, S~~ Fi mac.- . F Boring # ❑ Boring i Pit Ground surface elev. 'I g- -7 ft. Depth to limiting factor ` b Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 J 0--7 t2_31 3 - Is 1~sbk mvf~, Z -16 > o I Jz yl 6 _ ``FS 1 cS b k m v'f t~ a s _ _ , S 3 1b-18 1~s lcshk i,- a-s - q - y ~-~f8 log Vz z~ - SL I 1 ~s bk y~-F~ Ct,v - Z - 3 S ~8-S~ low rz 3~~ _ si 1 0~..-, 1~►1~Ff- • o - z a 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/ftz in. Munse,l / 0 9 IC~, `12 3/~ - ~S X0'2 )vlVT' kj i L z Effluent #1 = BODS > 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) Signature CST Number Arthur L. Wegerer O 1'3 ~`6 `)0 220254 Address W e g e r e r Soil Testing & Design Service Date Evaluation Conducted Telephone Number 421 N. iiain St. River Falls, NI 54022 715-425-0165 Property Owner L Parcel ID It l )y 6 Page of Boring It ❑ Boring Pit Ground surface elev. 7 ft. Depth to limiting factor 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 o-~ to~>z t3 1 V ('-'sbk W) UT-c- ew 2 8-fig Lo~~ ~~(o - 0 g9 Yvt 1 C-Iw 3 \g-3S 1~~4ZZt - sL1 MuFl t~Ij •S , (to L4 3S-fig 1C) lz.2_( st lcsbt~ vn` - -,1 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/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 -Eff#2 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. it. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 -Eff#2 i i I I ~i Effluent #1 = BOD5 > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BODS < 30 rng/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.6/00) Property Owner L. Parcel ID it 1Nb 1 }`1 G Page Z of F~] Boring # ❑ Boring ® Pit Ground surface elev. 9 b -7 1t, Depth to limiting factor 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 Z 8-l$ Lo-1 R C) S9 lrvl Lt.U Z 3 \B -3S 1 t) Li z L - Sid Z ~s b k wl U ~i- caw , S . ~ y 3S-fig 10yt2 Z( - st.( lcsb~C m~~ - ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Horizon Depth Dominant Color Soil Application Rate Redox Description Texture Structure Consistence Boundary Roots GPD/f t2 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. Horizon Depth Dominant Color Soil Application Rate Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 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 (R.6/00) Wisconsin Department of Commerce SOIL EVALUATION REPORT Page ` of J Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must S C LX include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Reviewed by s Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). U0 Property Owner Property Location D A N R~~D 3 o P ODf L GGA 10t S1Q 1/4 NW 1/4 S T N R E (o Q Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# p LME~j Inl00D g S°,-7 Cy~1 NNy bz- Lfvij l 0 - - d City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road FtliS iw1 SgoZZ [s) L4 ZS- L4Z -T7Z/1) 1 iE{"ZT c~UE ~zc~' New Construction Use: [ Residential / Number of bedrooms 3 Code derived design flow rate SO GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material _ 0 V T)'j Pct ~a Flood Plain elevation if applicable - ft General comments and recommendations: 1~tJUYV~ 1j /q,'ycSp' 1nS`T-~LL8vnW CELL, "I "i Lm u" Z.o, 01= Sn~ ~t c-c . F Boring # Boring Ground surface elev. R -7 fL Depth to limiting factor ` in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color F Gr. Sz. Sh. 'Eff#1 'Eff#2 l 0--7 10`1 CZ-3 L 3 _ Is 1 '~-S bVc m v fi, CS - . -1 1. Z Z -7 -16 l~~t 2 V18 _ I`~s 1csb12 ( m vim- a.,S 3 tb-t~ ~o~t vzyI~ ot?1--jsL-jv , ~`F5 1c~hk~ w,v h as - •q ~ -~{S 10`2 V2- Z( - SL I 1 c~ b y,~-Fi^ ~j - Z _ 3- S ~1g-S'l 10'22-3~~ _ Si I o~ _ _ •O ..Z F-T F11 Boring # ❑ Boring /1 pit Ground surface elev. ft Depth to limiting actcr 4-t b in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munse!I 1-(7:-11. Z l a `I R- V l~ - s- 't G h S9 vet Z 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 Arthur L. Wegerer O1'31 220254 Address "T e g e r e r Soil Testing & Design Service Date Evaluation Conducted Telephone Number 4 2 1 i1. !lain St. River Falls, NI 54022 ZZ_L°I-p~ 715-425-0165 PLOT PLAN Page 3 of 3 Scale 1'=Z0' i i I_ i N i 13r1 h\ Z ^ I fl~i f I C3Q b u IvpT C-c~r~l ~ f~-T UY2 I N C Q o`r} I S t p ~s wt~ n _j v I I , ~ I ~.z j Dolt . 10 U .0' orv l'~ aei►v p I PEE- Lor eu,r-jvET~z__ >7f+ 103`j ib1-" 0f 'z Z, Tftt, w00b R-~~ 1i I ~-z~ ; vurX~ ti 715-425-0165 220254 -10 3l$ CST Signature Date Telephone 11-To. CST No. Job PTO.