HomeMy WebLinkAbout018-2021-21-000
;,as.ccusnr 0epartmerlolComme'r : PRIVATE SEWAGE SYSTEM Oo1i St. Croix
;a'ety a"rl 8uim7ine Dins¢n
INSPECTION REPORT Sanitary ner^ 1 No
GENERAL INFORMATION (ATTACH 10 PCRNIff) 605020
SOTe Peep IO N.
PerSU'ra. for^a'm" you Pouo;: Wray he .:xec IOr sucr.~nary purposes ~Pn aa,.:,' Lsw, s L`. ~ "irn
Per-it HWcer s Nace City Village IC",-ish.p Parrel Tax NO'.
Oevering Homes Invest5,lW3,I C TOWN OF HAMMOND 018-2021-21-000
CST VY Flev 1 I- s-,, IBM F Je~,'ipap0 SectioNTraUltan ,eT,lap No'
08.29.17.1302
TANK INFORMATION ELEVATION DATA 9L?, O
TYPE MANUFACTIiRFF., ! CAPACIIY SLATION S HI FS ELEV
Scclic U !
l~E~~; ~ I I i ~•~8 Herchmark
At BIA L F
r
Aeration 1, l 3.50 9i. tia
Bldg. Sewer
Holding _
- StHt Inlet
.I r(o
TANK SETBACK INFORMATION S.-Ht Wtte! 9p o
TANK TO PtI JLII BLDG +c-t :e rir wtak0 ROAD DI Inlet
~ ( 1, - _ - - - -
Septic of T l r DI BOCOr
Dosing
HeaderMar 9.3 0 FS &0
Aeration - - - - Dist. Pipe. p
L.3~ ~c~CoC'j
Holding System
PUMP/SIPHON INFORMATION Final Grade JD 9~O
Marulacture' Demand over
Model Nu er
Ic~.y ~Scv~
IIIH Li`, 2Loss- _ SystetnHii TDH Ft / c
1 1Q'5C~ O
Fo'cema.r Larglh Dim Dist. s l";ell
_
SOIL ABSORPTION SYSTEM
BEIEV"rii DIMEN IONS VA it', Length Nu. O! Tre ^he5 _
DIMENSIONS PIT DIMENSIONS N1. 01 lit, Inside D a Lrgaru Dcpm
SETBACK SYSTEM TO 1 Pi BLDG WELL LAKF+STREAM LEACHING NlanufaUdrers
INFORMATION
CHAMBER OR N
h
te 1ra1
UNIT 1.locel N:.r^he'
Itti
DISTRIBUTION SYST M (y F (,6 4-16
f/
Heatle 11 talc Distrih.:hn` x He _ Sue x Hale Sran nc 'gent tp Air Make
r~nes~ - - - - G) E~-
L4rrgtt, IT 1: 5 -I ; l e' I:h Do
:Oao-i,
SOIL COVER s:-'f Ii Qc: x Pressure Systems Only xx Mound Or At-Grade Systems Only
?CGC O,cr Depth aver a Death of xx SeedEjra`rllnen jXX "al" 1,, N,
Br;tl7.e v.h i;an'e' 1' I ~cerTreN-' I rl.~es~- - Topsoil
~i N,. Ve N•9
COMMENTS: ilrclude code :nscrepencies persons present etc 1 Irspedion at Inspection *2
Location: !0`t3 'wiTH ST
1 i Alt BN1 Desorption = ~.S' C)-*
2; Bltlg sewer ength = ?j~ r (-i~`Q1`f'-°
-amount or cover =-7(41' Plan revs: Rr ad dp Yes No 17 I r/ /M1 - _ L -j O lD
Use other side for atltlitional m(orrnation. l 7~l Q
- Dale Inr;C nahrr
z: r,u enn r:. 9r9'i $g- cc•r.. No.
n it' - - 51~~V .~loik- )17
Safety and 3ui:aings Dksoc .S y_(-_ Is] 1
r 0 S SI MAY 2 J 2018 201 W Vsashington Ave P. p. Box 7162 f Sanna?• Permit Numbc (to be flleG in by Co
;
P Mad:qon, ''Po 53707-7152
7132
r ie ,q
tarL Applicatio n Sa Trmty . Numl><r
a.. -„t L c a,tr 11'+ x; 21:-"' W. Adm. Cadc, . ;hrti >i.>r. of f' i •t¢ u,ti:
Fr N
is te9oir 1 pn c :.ham r inn a .u,i=re pqu:, Nn¢ ,•y,pu ban -kxms ur K ix : u,o J ~d i S u<>u in ed :n Tr'jeq id;hras /ifdldgm( than mailing addressl
d,e Dcpro[n <t wcn ai Pr>fcssinnvlxn•ta. P11111-11 tnfC:ramn o: pcv:oc'X. eo,td.-w ndaM1•
pu_-pa=m a..a uc ,.n Ci<: ova 1'w . A it -
1 t" capon lnform,titn Please Print All l lnlo rmatiou
pa ~ ~
PtWer[y Ua,u• c tr m{oy : dcr -
opcny:aaionCB. L ~7. IJv~
I.!_,Q-~ tGpm2 tat
City Sume n hp Code-- 1bone Nlmtbtt
ll- Type of Building /check all rbat ap v - - TaL~_N. R'-t - /L• d'
ru21 a% ther:;;u: Number of Bed: "nr_~ _ Ju t ssR n Name 7 -
C vt-t
~ ❑i'ubadil.;tmmgcisl-Ikv::he :'c: ~
City of
l State rhsn<A . Desm:oe Use _ ~ QI\• I 1 ~~.M \n,nb-: - ~ waxyt or
w 3orsb c~•,tef
JI. Tvp, f Permit: (C.heek on I., oe box on line A. Complete line H ifapphcablel
a_
3ys,ua ~nttcpl-...cmcn[S.:re=li~'rutmcn-3-~d-nq'f sil; Nc•rlvr::rnt Oory lt~L':u Modifi=ioa to ,sting S),go, 4nlami .
6 I J F=.1it i cnrwzI ! Pertai[ Revit.oc [I r'hz^.ge of l tomb,, l 1 Prr.:ir iraasfq to vcW.. L~'zi R~19us P<rmn Vumar and f}dte issued /(-J~
Before
Fxl r .:r I ! Ow:a _ aat(~-~`r.T C,y(J+U`-'
IV.- y of PO WAN SvstemlCbmVOnentJ),vice (Check aBthst apply)
+eeo-Proem, d Ir.-(-n~u:d J i4r~urvcd m<nn,23 _JP.:Trade I_ ci ;:f smable soil Mooed S 23 ,f suitable ,d S
llloldl Tv:k ];nncrl ts-+<ssa+ c:p m-tt'-y l,ml ❑Rcemornatr De.-ceixe1=1
Dspersai freA[ cnt Area Info, malwu
~P.r Flo+ I pn; Lkst°ct S .i App a m P.tt dui li5xes 1 Rica Rr4un.l i> 7ic at . --a I4 ro tn) t S)AC.i
7 1
ti.
suo
_
I L
I- 7aok Into - - apacm• in TnW I a of Manufa:xurcr = E .o j
ini(<ms :Oleos l;nin
h mks Ekiaay Tm$ w L) k i
Jcp[,c ur 11-M=auk : ~J--,~•.. - - -
Cxcsg
VII. RespoosibtGty Statement- L the nodersiior_d xv,. a m,cibihty for installation of the POW TS shown on the ayaabral plans.
I Urn' z Namr l'Prwt Thnn - - urr - -f NIPRS !cuabu 3ccine5s Poene V be
'lar,bu'S 69.as tSVeC, City. Stag.. LtP wilt; - - - . -
^VW1 utv/Department Use Only
ApPToyed L„ Pttmn:er Daic ~Issain ent S_2u r¢ -
' R Re:c \ir Gatiat l 14, J • co (pP )
Uti. Condit 53E4 anon for Pis~PProval 1 ,,I 1!//I~
1. tack, e. tcm , e* rn
oiyVat:~m cNl punt nil ~ "ycas - ~~!;;_gi J a~C/Y SOC.. /,t/ p5
es per.macagemen'. plan yo:loe 1 b'. n0e / Y
2 AY K ft" regLk r mm m.uitua ra;rt, lr t
: f/✓r l / O~f~, ~ ~p ' tG4, /4,,L)
1ls per epFicnbh C:rris i cr . rt)-
.4ns<L ,e rnmpine pram for,ke sr>,em ann subme u, Ibe '.1, . pepper o*f kso has 51111•x 7IL
SRD-6398 'it..' 1:
Svstem PLM PLAN
PROJECT Oeverine Horner ADDRESS'. 433 Cernonous Av(! Suite A News Richmonc 1N' :):01'
NW 1 ; 4 SE 1 : 4 S 8 ,-1- 29 N!R " tA' 'rot~'N Hammon COUNTY ST. CROIX
sN's'1'ENI ELEN ATION 88.0!87.0 5' below Grace 5!23" 8 BEDROOM 4
DATE
CONVENTIONAL. X``iX CONVENTIONAL LIE1' HOLDING 'I ANK
NIOI ND SEPTIC 1255 gallons LIFT TANK SIZE. DOSE 'L'ANK SIZE.
: TANK SIZE I11.1)1NG TANK SIZE LOAD RATE .5 AISSURI"PION ARLA 1212 # of chambers 60
BI-ACIIMARK V.R.1'. Too of so'vey iror ASSUME FTf V ATIO\ ]OW Filter Ule;.ime Hicr
❑ BOR11110LE O WELL "II.R.p. Same as nenchmarK
a;
B. N-1.
-17' Propurt% Line
Scale = 1/4" = 10'
Pro 4
Dculooni
House
ti- y,.
Ven;,
j0'
ST 90'
30' ,0'
B 1
20,
B- l " i.
i,
1 _ Pro,)cr. t.I nc
? X 133' ce~s with >3' SpaCITlp
VCw
>6.. (,)uicl:4 Standard
of Cover Leaching Chambir
with 30.0 ft-' of Area
5.6ft-'12'pair Of Cnd caps
I' Lon; 1
4 G?adc at SVSICIII Glevation 166th St.
Id- ,
r
A11 pipins Shall be AS I'M SDR 30.54, within /
10' o'. lard:, p pmg shall be ASTM 1-891
Copt
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi54017
715-246-4516
Date: 5/23/18
Owner:Oevering Homes
Location: NW1/4 SE1/4 S 8 T29N,R17W 1028 166th St. Hammond
Manuals Used: In-ground absorbtion system (version 2.0)
Page#
1. Cover Page
2. Plot Plan
3. Chamber Cross ction
4-6. Maintanance Contingency Plan
7.Septic Tank M tance A~ra~ment
Signature/
License u #226900
System PLOT PLAN
PROJECT Oeverino Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017
NW 1/4 SE 1/45 8 /T 29 N/1( 17 NV TOWN Hammond COUNTY ST. CROIX
SYSTEM ELEVATION 88.0!87.0 5' below grade 5/23118 BEDROOM 4
DATE CONVENTIONAL >00< CONVENTIONAL LIFT HOLDING TANK
11IOCNU SEPTIC T 1255 gallons LIFT TANK SIZE I)OSE TANK SIZTANK SIZE I101,DING 'T'ANK SIZE LOAD RA1'1; .5 ABSORPTION AREA 1212 N of chamhers
60
BENCHMARK V.R.P. Top of survey iron ASSEVIF ELEVATION 100' Filter Lifetime Filter
❑ BOREHOLE O WE'LL it. It. P, same as benchmark
*B.M.
217' Property Line 339' Property Line
Scale = 1/411 = 10'
Pro 4
Bedroom
House
;tl 93'
Vents
ST 13 90' 50'
30' 30'
20'
B-1
B ~0' 11% Slope
472' Property Line 5'
2-3' x 1 _2' cells, xvith >3' spacing
Vent
>6" Quick4 Standard
of Cover Leaching Chamber
with 20.0 ft2 of Area
5.6fIA2/pair of end caps
"
4' Loner 12
Grade at Svsfem Elevation 166th St.
34
All piping shall be ASTM SIR 30/34, Within
10' of tank, piping shall be ASTM F891
Cross Section of Infiltrator Quick 4 Leaching Chamber
Typical cross section for 2 of 2 cells
Quick 4 Standard Leaching Chamber
with 20.0 f12 of Area per Chamber
5.6ft^2 pair of end plates To be >1' above grade
Finish grade elevation
/ Typical Installation 93.0'
10t Grade Vent
3 X30/34 Septic Tank 3
5' Long t 5' S' Lon, t
Grade at System Elevation
36" Grade at System Elevation
Spacing 5'
2-3 X 122' Cells
Same on other end Observation tube/Vent
At end of cell
A
B
30 chambers per cell
System elevations:
A89.01
B-88.0'
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page _of_
FILE INFORMATION SYSTEM SPECIFICATIONS
[=Eet,
Septic Tark Ca act ❑ NA
- lam- - - P y
Septic Tank Manufacturer /fn -NA
7ESIGN PARAMETERS Effluent Filter Manufacturer IX I ~ ❑ ryq
Number of Bedrooms / ❑ NA Effluert Fitter Model ❑ NA
Number of Public Fadlity Units I JdNA Pump Tank Capacity ❑ NA
Estimated flow (average) - -
aUda Pump Tank Manufacturer ❑ NA
Design flow (peak), (Estimated x 1.5) G_- a Pump Manufacturer NA
- -gaUd_.y
Soil Application Rate ` ual/da /f~ Pump Model
NA
Standard Influent/Effluent Quality Monthly average' Pretreatment Unit NA
Fats, Oil & Grease (FOG) i 530 mg/L. ❑ Sand/Gravel Fitter O Peat Filter
Biochemical Oxygen Demand (BODs) 5220 mg/L U NA 7 Mechanical Aeration ❑ Wetland
_ Total Suspended Solids ('SS) I{ <150 mgn- Z Disinfection ❑ Other.
Preheated Effluent Quality I Monthly average Dispersal Cell(s) ❑ NA
Biochemical Oxygen Demand (BODs) 530 mg/L ° -Ground (gravity) ❑ In-Ground (pressurized)
Total Suspended Solids (TSS) s30 mg/L A U At-Grade ❑ Mound
Feral Cohform (geometric mean) i <_10" cuiloom1 ❑ Drip-Line ❑ Other.
Maximum Effluent Particle Size in dia. M Other: ❑ NA
over NA Other. - NA
1
-
"Values typical for domestic wastewater and septic tack effluent der ❑ NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
inspect condition of tank(s) At least once eve • ` U month(s)
y' _ ears (maximum 3 years) n NA
Pump out contents of tank(s) When combined sludge and scum equals one-third of tank volume ❑ NA
inspect dispersal cell(s) - At feast once every: nth
rlj ar(s)s) (Maximum 3 years) ❑ NA
lean effluent filter EI, month(s)
ry-~ .Year(s) ----❑NA
4EAtlet ast once eve
rasped pump, pump controls 8 alarm asonce ovary: El month(s) 13 4
- - year(s) _
Flush laterals and pressure test At least once every' ❑ month(s)
❑ year(s) NA
)tfrer - -
At least once every: 0 month(s)
C year(s) NA
❑ A
MAINTENANCE INSTRUCTIONS
inspections of tanks and dispersal cuts snall be made by an individual carrying one of the following licenses or certifications: Master
Plumber. Master Plumber Restricted Sewer; POWTS Inspector, PONrTS Maintainer, Septage Servicing Operator. Tank inspections' mast
linciude a visual inspection of the tank(s) to identify any messing or broker hardware, identify any cracks or leaks, measure the volume of
cembined sludge and scum and to check for any pack up or pending of effluent on the ground surface. The dispersal kxll(s) shah be
visually inspected to check the effluent levels in the observation pipes and to check for any pending of effluent on the ground surface.
the pending of effluent on the ground surface may inoicate a failing condition, and requires the immediate notification of the local
•egulatory authority.
When the combined aceumu!ation of sludge and scum in any tank equals one-third (Ya) or more of the tank volume, the enfire contents of
the tank shah be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin
(Administrative Code.
I5JI other services, inducing but not limited to the servicing of effluent filters. mechanical or pressurized components, pretreatment units,
and any servicing at intervals of <_12 months, shalt be performed o; a certified POWrS 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 other cfiernicels "t
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products Of
may impede the treabment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the
tank(s) removed by a septage servicing operator prior to use.
System start up shall not occur when sod conditions are frozen at the infiltrative surface.
During power outages pump tanks may flit above normal hlghwater levels. When power is restored the excess wastewater will be
discharged to the dispersal cells) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent.
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 controls to restore normal levels
within the pump tank.
Do not drive or park vehicles 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 POWr$'
antibiotics; baby wipes; cigarette buts; condoms; cotton swabs; degreasers; dental floes; diapers; disinfectants; fat; foundation drain
(sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting produce ;
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 propetty
and safely abandoned in compliance with chapter Comm 83.33, Wlsconsin 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 filled with soil,
gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS falls and cannot be repaired the following measures have been, or must be taken, to provide a code Compliant
replacement system.
A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption systeim.
e replacement area should be protected from disturbance and compaction and should not be infringed upon by requlred
setbacks from existing and proposed structure, lot lines and welts. Failure to protect the replacement area vA result in the need
for a new soli and site evaluation to establish a suitable replacement area. Replacement systems must comply with the effect at that time. rules in
❑ A suitable replacement area is not available due to setback and/or soil limitations. Bening advances in POINTS 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 sal and site evaluation
worst be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be instanedl as
a last resort to replace the failed POWTS.
❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biorrat at the milittative
surface. Reconstructions of such systems must comply with the rules in effect at &W time.
<<WARNING>>
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES ANWOR INSUFFICIENT OXYGEN, DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT, RESCUE O~ A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE
ADDITIONAL COMMENTS -
POWTS INSTALLER POWTS MAINTAINER
Name Name u~ / ~y
Phone J 7/ J L~ Phone
SEPTAGE SERVICING OPERATO PUMPER LOCAL REGULATORY AUTHORITY
_ Name Name ; f n
Phone / J ~.r L! Phone ,-7 h ' { J C , ~7
This doomnent was drafted in compliance with chapter SPS 3e3.22(2)(b)(1)(d)&(f) and 393.54(1), (2) 8 (3), Wisconsin Administrative Code.
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ST. CROIX COUNTY
SF,PTIC'CANK MAMfENANCFAGRFF-M-FNT'
AND
<1WNERSFUP CER'f1MCATION FORM
(hvntr/Ruyer_
Mailing Addre, -
6LZ
ProPerty Addrt .
(Verification required Crum Planning & u D _
epat finent fur
City/State new construction.)
c
Palcel Identification Ntunber ,a 1-
LEGAL DESCRIPTION
Property Location I / ,,)V
, t
/.r , Sec. ?I ; T l 1 N R I /
Subdivision F r+ - - - ' _ - 1 _)W, Town of
Zt r^ 1 .`fy _c'
Certified Survey Map # - - - _ _ , Lot # ~ I
/ - Volume Page #
Warrauty Deed # - - L c~ c ! - - - - - - - - - - - -
- _ _ Volume Page #
spec house vcs Ito - - _ -
l.ot lines identifiab! ye. no
SYSTEM MAINTENANCE AND U WNER L
ERTiFICA1'IUN
litrproper flae and maintenance ofyool s
maintenance: consists of nr ep5a system could result in its Prernatnre, fadurc to harrrfle
the sys'teut can affect the }unction of th wastes.
p trpiug out the septic tan}; every throe years or sonnet, if needed, b a you put into
m Proper
reSpousibilitics are specified in the
¢Cortnrr. septic tank as a treatment stage in the waxlc dis Y Gc:wuxatPumper .
R~.•i7 M What
- (1 and is Cbaptcr 12 - St. t:roix posal system owner mainactlauce
The ow County Sanitary Ordinance.
property ner agrees to smart, t to St. f`rotx t;otntly PlaalWig , 7.untit I)e:ent a
raster and by a master phrmilcr, Journeyman piurnbel, cted phcnl;rt or a licensed P mpt'a' verifying
wastewater disposal system is in proper operating ronditinn restri And/or (L) abet iaspec that (1) the. on site
less than 113 full ufshidpe.
standard tlun an certification ill", signed by the
-
Humping (if necessary), the septic tank is
"We, d c, the uud ffl. aed have toed the a bove r
the equircrncnts and apr
s set tbrlh, herein, as srr by Dcparrrttcut of l,urnrits and g De
Cettification ec It) maintain the private sews
stating that you Ptu'rowlit ofNatuntl Resourtie disposal system with the
TonicB Departntent wilYhui 3o days septic S
of ys thtem has been maintained fulls, he completed and returned to the St ces, Croix State of W expira CountyisPlanning consin.
e three year ar
Planning 8
I/wr. certify that all statcntcnts tion dale. oft this form a e truc to the best of
property described above, by virtue of a warranty deed record I in Register of Deeds e.
my/otu knuwl"dwlydRo- I/we anJatt: the ownt:r(s) oi'tha
IVulnber of bedrooms- `
1GNATII OF APPUCANT(S) SSG
***Auy information that is misrepresented r DATE
nay result in
Include with this application a the sanitary panrdt being revoked by the plan ninga2,otung Department_
recorded warranty deed from the Regisler of l)ceds (ifficc and a reference is made jn the warranty deed,
j copy ol'tiu certified survey map if
(REV. 001OS)
1
S 89.20",0" W 217.62'
J u9X r11 9`36 682
_ e~ti CD
LOT 18 h N~3
LOT 21 3
,f.
LOT U
LOT 2
LOT 19
X
66
4
I -OT 23
5. ~ 1
1
IT I
C
05
I
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Wisconsin Department ofComrnerce SOIL EVALUATION REPORT Pago _-r_of~
Division of Safety and Buildings
in accordance with Comm 85. Wis. Adm. Cooe
f County C I /'rr~~
~J
Attach complete site plan on paper not less Man 8 112 x 11 inches in size. Plan must l
inciude, but not limited lo: vertical and horizontal reference point (BM), direction and parcel LD _ /
percent slope, scale or dimensions, north arrow. and location and distance to nearest road. l GI d O 2
Please print all information. FVe-e)Zjk by Date
Pareenal Infonnatwi you provioe may oe azed nor zamnoary Oa~zez_(&wacglaw. . 15.04 (1) (m))_ l 1 z e, 7
Property Owner - operty Location
D2 v{ y n v: Lot ki' 114 J 174 Q 7 27 N R( E; 'N
P fly Owner's lure Addross Lo # Bicdc # SLod. Narne or CS&W
City rate D Code Phone Nu(frl~afl;; - - ❑ ❑ YllageTarn Nearest Road
UG
New construction Use Residential i Number of bedrooms "_3-__-- Code derived design flows rate "v GPD
❑Replacemenl ❑ Puutyicorcommelo:, +cribe.
Parent material _
._y~/ Flood Plain elevation. it applicable ft
i
General commarms
and .
rearmlerdations: ,
Sysiem Type Svstem Elevation
Boiling # Boring
a pit Ground surface elev. Depth to limiting factor in Soil indtion Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM
in. Munses Ou. Sz- Cont. Color Gr. Sz Sh. -Eff#1 •E1102
c/7 7 717 6
!
O
# ❑rfsonrg
,Lt )7 -
Pit Ground surface elev x' ~ 3 it. Depth to limning factor ')in.
S.^,il ligtipn Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD11
in. Munsefl Ou. Sz. Conn Color Gr. Sz. Sh. •Eff#1 -Eff#2
.16
V
Effluent #1 = BOD > 30 < 220 mg,'L and TSS >30 < 150• Effluent tr2 = BOO < 30 _ myt and TSS < 30 rtxy4
FCB;ro e (Please Pmt) /8• t~ura~ CST Numcer
umbing, Inc. Shaun Bird r ?_26900
Nt,moer
92nd Ave, New Richmond; VVI 54017 715-246-4516
"ol ^ n
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Property Oemer . Parcel ID Page _ _ of
Boring # ❑ Boring
fK Pit Ground surface e1av. ft. Depth to tinutlrg facto in. Soil Application Rate
a
Horizon Depth Domnnan[ Color Redox Description Texture Structure Consistence Boundary Roots GPDM
in. Munseli Ou- Sz Cont. Color Gr. Sz. Sh. 'Ett#1 •E1f#2
°E' fLbr 11 ~I/V ~~.V rlYl I it Gi ~I-
J
❑ Boring
❑ Boring ❑ Pit Ground surface elev. . -ft, Depth to hurling factor in. Soil Application Rate
Horizon Depth Dominant Redox Description Trvrture Structure Consistence Boundary Roots GPDHF
in. Munsell Ou. Sz. Cont. Cola Gr. Sz- Sh. 'Eff#1 'EfMX2
❑ Boring # ❑ Boring
❑ Pit Ground surface elov... 1t. Dopth to laniting factor in. Sae ication Rate
Horizon -)epth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM
in. Munsell Ou. Sz- Cont. Cola Gr. Sz- Sh. 'EfMit 'EB#2
u I
Efft uent #1 = SOD, > 30 < 220 mgt and TSS >30 < 150 mgt ' Effluent #2 = BODE 130 mgt and TSS _ 30 mgt
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SBP63J0(RaVO)
Soil Test Plot Plan;'j'
Project Name Oevering Homes LLC Shau Bird
Address P.O. Box 179
New Richmond Wi 54017 ,
CSTM #226900
Lot 21 Subdivision Hammond Hills Estates Date 6/2/07
N W 1/4 SE 1/4S8 T29 N/R17 W
Township Hammond
❑ Boring G) Well PL Propet•ty Line County ST. CROIX
BM or VRP Assume Elevation 10o ft. Top of Survey Iron
System Elevation 88.0/87.0 *HRpSameasBenchmark
217' Property Line 338' Property Line Scale is F = 40'
unless otherwise
noted
93'
Please note: survey was not
complete at the time of testing, 13 3 90' 50'
installer must check all setbacks 30' 60' 30'
prior to installation.
R-I
40'
B_ 11% Slope
472' Property Line
166th St.