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HomeMy WebLinkAbout030-1093-90-000 OVisrc .sir Doi of C:mmise'ce PRIVATE SEWAGE SYSTEM Cwn4y St. Croix SalcfV 2riC Lu n'r'1 UeNSePlI INSPECTION REPORT saniary vennc Nn 605065 i AT 1 AC H TO PERMIT) GENERAL INFORMATION state Prey ID NC Pelsnnai m'ilTi In 'tor. rmv: de may be use? for sett ~rrCary pis FoseS 11 % vacy 1aw s 15 U4 ',1 Permit HO. d!fs Nann: CFy V.Ilage. TuwnSnp Parcel tar Nc Michael & Jody Schulte TOWN OF SAINT JOSEPH 030-1093-90-000 CS" 369 Fl er h15p BM Lev H1d ion Seel., Tc,::', Rm a, Mill No 32.30.19.3420 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER r S CAPACITY STATION BS III FS FI EV 'M Septic J•o ~e00 Bencnmark ldfrr3 11(pq it all A. r AI! BP. c3 $ Aeration Bldg. Sewer 9 He aii - SLHt inlet 5 T 66 TANK SETBACK INFORMATION SUHt Outlet -5 . /d0 (o IANKTO RL WELL Ht f)(; Venruo .§i- n:,o ROAD DI Inlet 111 Senlic y, l , J 39 3Z y Dl Bottom ,v Dosing Header.-Man 7. IS "ill 5 Aeration 1) 11 Pipe 7.8 e4lq T • ! 4 8 2- Henri Bot system •7 - II PUMPlSIPHON INFORMATION Final Grade 4.3 /dZ Ma9utecturer IDernancl St Covey ` GPM r'IM~, CO Z'S Model Number - - - 1011 L. Fricti or Loss Systc'r Head TDH II Ee'U2ma r Lergth `a. Dier to WJI - SOIL ABSORPTION SYSTEM BEOtTRENCH olurt•_enaC, Nr.:)r ' - -yes I I PIT DIIdENSIONS Ke O! r'1s InSOe Ilia _ J lien i DIMFNSIONS /y 70Ao~.sa SETBACK SYSTEM TO P+L 81 1)(" WILL I AKt-,STR9 LEACHING Llan.,larhIIer INFORMATION CHAMBER OR t Type Of syslerrr, UNIT N1 'r o.1~c 6 1 G 7 T`v-V 'F q r DISTRIBUTION SYSTEM I4.-1(a =5Z S flcudairldaniS~Itl Ca bctnn Hole Size x1ce Suacr rl Vent lO Alfi a+e t„F ~ ~ Ems- 6 L,,r, 37 De Le xi, I)a SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only lr.p•I1 J f• )'(n' U r x r?pl' Pf X f ec'C.SJ4 J'J ,x 1aI llne;l D!',' ! `h Leandr S Flzd' h r .Ir . IGee. 1 f"'1 Nn Ves Nn COMMENTS: {lnclade code dix::ropcnces, persons present, etc Inspectio p #1 ~ ~a Inspect on b2 Location: •265 ROLLING HILLS TRL 1 1 All BIM Description = r//• I.L, 2. i Bldg sever length = z / - amount o' cover = ~I y!/ 7 2 P,an revisior Required? Yes t 0 Q q r♦ f/ I gs y Use ether side feI additional.rformation. :1alE Y In SeP!1C'1S $ra tll'P. f.P.rl No I e, Safely aria Buildings Divislor. L ✓ ` /M)' x ~8 ~r R 2018 ! 201'.N. i:tasnington Ave .?,C. Box' -C:2 ca:u>a~•Pcmit NUmba to, be fillW in by Co.) I' , , t Madison. WI 53707-7102 Si :Y i :D ; ~D5 GCS - Stet. 7rant'.:d twba anltary Pcrin 1 hcauon !t au~:ndau.,. wYh Si::;R 1~ 1 :Vi> Ada CWk, - t:h.s tote :c a ap :pnarc. gov~nm-aal twit I 'is teq:iirai pr..: W oh'.aminS a s;mrmty penis' Notc' :\Pr anent ``r. ms .cc sKS;eow•md P'JN f S yc submiueJ ro ~ Pn!iect gdd~s ;it di9crem t6ro mui:iur audttss) ' we D Partmcoi of Safe:) and ^r..fcsstonx: Sr ,m Pr-s.mal :ntorm=m von p:ovtdc mar, be used fot sa:tm t!G_ _ LiuTn. s m a xdaace wtb fbc PnvaCl, Law_s: i, c411 / L_ADDGcation Information e Print All Informs' o / Ytr'?~ { Ouna's N'amc t narul a / hupary fmncr s 4fmlmg Addms _ Propcrcy ;,oowon ~ a . 0,1 ,3 ya C may $Dru. ~C,- i.IT C k 11cm. ^Lunhv cl, U. Type of o11 cl~icctk'Latbffi pl b S~'oL !:ame / D!C ad - 't -7 ubticlattm'uCial -Occt bs Use ~-;r- V CSM NtanNr __....--_I ❑ Vluayc of Scae Oun d - xacnbe l se 16634'73 of J_r2~ _ cevLx txk on one box on line t f omplete line H if applicable) i ew ~ysecvt LRepla must syx= Fl lec:uuv t'H Replecaaem oo:) dta Mo'dCtf.:cazwn w Exir gS)st=Imp:aiu} \ Lice Previous Pecan Nww. and Date 1uucd - B. L. Pcrsat Reaewal ~ : r:mtl Hh'tswn Cbargc 7't::mba ) F'c..tri: T:aasfa to Ncw _ Be ore Expiraten yjx of PO«T - m oueo[Devire beck all that apply) .,-Yrncwizcd In-Cr •tnd Frinst vu {n-:irouad At{•rae Mund> 24 m. of wttab c s i \f uad =1 vt afsu:Wb)e soil ~ifolJ7lg'i alf'~ xr t Pns 1 t n tits t xF a>.i~ ❑ c ,st t v.:nii:.c (ncF :aia) L UispersalTrra ent Area loformanon - - I>~yt F7oa l i I)c..y. toil :\P;:l:vau~m Rs[c' difl upasd Arca dal vW l+ft Cta A r:rJ i51)Sslta~ne_s np~ t~ nk Litt „ ~ q 6- 3 I f nulaatov T~ VL Tank Ldo ~ r„nuvm lti Mol \:aIsh i t.a7ons - ~ 6al:oa: CmtS ''m c ! 1 f _ U 3 n I - 1iJY( .X_annS?2:L. ' • KL/ V Y I V L _ _ VIT. Responsibility Statemeo I the uadersiyoed. r rrafanubd_iti for f nzallation of for POR"rS sbowo ou the attached plans. 1^. t r s moc rf''t t~~ ?Im S ::.arms t•fP•'1wWR$ Vtmba Bus.uess Pbcne ~ianbv ; Au:6csi lSacx, Crt'- Statc, P Co9r: f ~ ~ ~ I l- '~At /~i~ - - - i ~ . Coue[v: Uepartmeot Usc Only te•mtt Fee ~ Ttate Lisaia rni JigJ-iat• I Appr rC I I r ~j CC IX. Coodi cpypt(prp{iit.approval Qre6er'je . cam' III oe x•~:.is_ (2, !f p•t :n1M.Xrernec). plan n^~'!ce•t UV p'umbe'. 2 Ai tuA~dt y lee must w r.,a.nt: d r 10 per adram". A[urb to rnmpMa Pa~+(o:nn~o-m md..uLmn mtM1e r.~~tv amr nu ryPe-noi lex. rCao 5:::1i w, Fe min SBD-6996 {X 11 11 V Svstern PLOT PL,1N i,im,l[c'I Mike Schulte ADDRESS 12518 Ma•o.less Wav N Lake Eno Mn 55044 SV1 1 +4 NE I?4s 32 T 33 \nk 19 t+' TCMN St. Joseph COUNTY S-. CROIX sYSTENI ELENA'YION 97.2`9ii3 c.5' he~ow arade 6;28!18 BEDROOM 3 DATE COAVENTION'AL XXY CON%EN'TIONAL LIFT HOLDIM;'I'AAK MOUND SEPTIC '1':1\K SIZE 10001 gallons 1,111 TANK SIZE DOSI, 'IANK SIZE H OLDIM; 'fA\I: SIZE 1,C1AD RATE. ABSORPTION AREA 651, # of rhambrrs 32 BENCHMARK Y.R.P. Too of 14" plpe ASSI NIF 1:1 F\ ATION 100' Filter Lifetime Filter ❑ BOREHOLE (DWELL "n.R.P, same as benchmark Properly I.ine 1 IA 11 .401 103' 1 Pro Bedroom 1(11' 274t1• House 2-1' X 60' cells with spacinc B-1 20* ST 99' 9`:z Slope Vents =Sf1' B-' Rolhn,' Hills T-au COPY Vent %11 piping shrill he AST\4 SDR 10;14, within >6" Quick4 Standard 0' of tank, piping shall he ACT\4 11'891 of cover Lcachin • C'hamher with 20.0 IC of area Proneriv Line 5.6ft"_ipair of end Baps d' l Lone (}rade at S. stc¢. Elevation Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 6/28/18 Owner:Mike Schulte Location: SW 1/4 NE1/4 S 32 T30N,R19W 1259 Rolling Hills Trail St. Joseph Manuals Used: In-ground absorbtion system (version 2.0) Paget! 1. Cover Page 2. Plot Plan 3. Chamber Cross Section 4. 6. Maintance and Contigency Plan 7. Filter Cross Section - Signature License number #226900 System PLOT PLAN PROJECT Mike Schulte ADDRESS 12518 Marquess Wav N Lake Elmo Mn 55044 SW I/4 NE I/4s 32 /r 30 ISM 19 w fotvN St. Joseph COUNTY ST. CROIX SYSTEM ELEVATION 97.2/96.3 5.5' below grade 6128/18 3 DATE BEDROOM CONVENTIONAL XXX CONVENrioNAL LIFT HOLDING TANK 1000 gallons LIFT TANK SIZE. DOSE TANK SIZE. )90UNU SEPTIC TANK Si'/.F, HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 H of chambers 32 k BENCHMARK V.R.P. Top of 3/4" pipe ASSUME. ELEVATION too' Filter Lifetime l;iltcr ❑ BOREIRH.E O WELL "II.R.P. same as benchmark Property Line Scale = 1/4" = 10' 103' Pro 3 101' Bedroom )5• House 2-3'X66' cells with >3' spacing B-1 20' ST 99' 9% Slope 150' B-3 0' 3 Vents 250' . 0' B-2 Rolling I fills Trail Vent all piping shall be ASTJi Sf)K 30134, within >6„ Quick4 Standard 0' of tank, piping, shall be ASTM F891 of Cover I •cachina Chamber Property Line with 20.0 ft2 of Area S.6ft^2/pair of end caps 4' Long l Grade at System Elevation 34" Cross Section of Infiltrator Quick 4 Leaching Chamber Typical cross section for 2 of 2 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 102.7' vent All' Grade Vent 3 I~30/34 Septic Tank 3 S' Lam• t 5' S' Lon ! low Grade at System Elevation 36" Grade al SVSIem 1'.Ievation Spacing__ 5' 2-3' X 66' Cells Same on other end Observation tube/Vent At end of cell A B 16 chambers per cell System elevations: A 97.2' B 96.3' POWTS OWNER'S MANUAL & MANAGEMENT PLAN Pages of~ BILE INFORMATION SYSTEM SPECIFICATIONS Owner h ( Septic Tank Capacity J J q8I 0 NA Per it # Septic 'Tank Manufacturer _ u NA )ESIGN PARAMETERS Effluent Fitter Manufacturer ❑ NA Numcer of Bedrooms ❑ NA Effluent Filter Model 0 NA Number of Public Facility Units ~,4 NA Pump Tank Capacity al NA Estimated flow (average) ' Pump Tank Manufacturer NA :5470 gal/day- flow (peak), (Estimated x 1.5) _ gal/day Pump Manufacturer NA Soil Application Rate 7 gal/day/ft' Pump Model NA Standard Influent[Effluent Quality Monthly average" Pretreatment Unit NA Fats, 01 & Grease (FOG) 1 <_30 mg/L C Sand/Gravel Filter 0 Peat Filter Biochemical Oxygen Demand (BOOB) 20 mglL U NA 0 Mechanical Aemfion 0 Wetland Total Suspended Solids (TSS) 5150 mg/L O Disinfection D Other Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BODs) <30 mg/l, Ground (gravity) El In-Ground (pressurized) Total Suspended Solids (TSS) s30 mg/L NA L At-Grade 0 Mouna Fecal Colifonn (geometric mean) 510° cfu/l00ml _ 0 Drip-Line D Other: Other. - - a .VA Maximum Effluent Particle Size ik in dia t7 NA Other. ❑ NA `Values typical for domestic wastewater and septic tank effluent. Other ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency 'inspect condition of tark(s) At least once every: month L) (Maximum 3 years) ❑ NA Pump out contents of tank(s) When combined sludge and scum equals one-third (Y) of tank volume 0 NA 'inspect dispersal oell(s) I At least once every: _ - 0`y onth(s) (Maximum 3 years) 0 NA ear(s) month(s) ❑ NA ;Clean effluent filer At least once every: ~ l R year(s) pump controls 8 alarm ei ast once every: 11 month(s) NA rspect pump - l - D year(s) =lush laterals and pressure test: At least once every: G month( s) D year(s) I - i)ther - - At least once every. D month(s) NA 0 year(s) Dther. 0 A. MAINTENANCE INSTRUCTIONS inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Mast-•r 'Plumber, Master Plumber Restricted Sewer; POWTS Inspector; POW'. S Maintainer; Septage Servicing Operator. Tank inspect' ins must include a visual inspection of the ank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of :ombined sludge and scum and to check for any back up or ponaing of effluent on the ground surface. The dispersal cell(s) shall he visually inspected to check the effluent revels in the observauun 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 cond tior, and requires the immediate notification of the local regulatory authority. When the combined aoaunulation of sludge and scum in any tank equals ono-third (Yo) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing operator and disposed of in accordance with chapter NR 113, Wisconsin 4dministrative Code. lyl other services, including but not limited to the servicing of effluent filters. mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority vdthin 10 days of completion of any service event. pop of rut tank(s) for the Presence of ;)among prodtx is or other chemicals fhrtt START UP AND OPERATION the pOWi S check treatment For new construction, prior to use of of the may impede the treatment Process and/or damage the dispersal cell(s). If high concentrations are detected have 114 contents tank(s) removed by a septage servicing operator prior to use. System start up shall not Occur when sod oonditians are frozen at the infiltrative surface. power is restored the excess wastewater will be During power outages pump tanks may lift above normal highwater levels. When Pc discharge of efttuenlL surface To avoid this dose, overloading the cell(s) and may result in the backup or to restoring pourer to the one discharged this sit the ua tion have don hatve car(the s) in COncontents laofrge the pump tank removed by a Septage servicing operator to restore prior normal levels effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the Pump controls within the pump tank. disturb or compact, the area within Do not drive or park Vehicles over tanks and dispersal cells. Do not drive or Park over, or otherwise 15 feet down slope of any mound or at-grade soil absorption area. rrna~ and prolong the fife of the POW S: Reduction or elimination of the following from the wastewater stream may improve the perfo dhsinfectarhts; fat; foundation drain antibiotics: baby wipes; cigarette butts: condoms: cotton swabs: degreasers; denial floss: ,Rapers pump) water, fruit and vegetable peelings; gamine: grew; herbicides; meat scraps: cation: oil: ping products; Pesticides; sanitary napkins; tampons: and water softener brine. ABANDONMENT is permanently taken out of service the following steps shall betaken to Insure that the system is proPeiry When the POWTS fails and/or ante with chapter Comm 83.33, Wisconsin Administrative Cade: and safely abandoned in ccmpR • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. Servicing Operator. • The contents of all tanks and pill shall be removed and property disposed of by a Septege • 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 code compliant if the POWTS falls and cannot be repaired the following measures have been, or must be taken, to provide a replacement system: sod absorption system. suitable replacement area has been evaluated and may be utilized for the location etas replacement r reyu(ped sult in the raged he replaownent area should be protected from disturbance and compaction and replacement area ed will reupon by setbacks from existing and proposed structure, lot lines and wells. Failure to Prole, the mart comply with the ruled in for a new soil and site evaluation to establish a suitable replacement area. Replant system affect at that time. advances in POWTS technology a ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to Identity a suitable replacement area. Upon failure of the POWTS a sal and site in vaiua as must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be a last resort to replace the failed POWrS. removal of the biomat at the infiltraVive ❑ Mound and at-gade soil absorption systems may be traced in place following surface. Reconstructions of such systems must comply with the rules in effect at that lime. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO HOT BE DITANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A ENTER SEPTIC, PUMP ROR OTHER OF A TREATMENT PERSON FROM THE INTO ADDITIONAL OM1ikENTS POWTS INSTALLER POWTS MAINTAINER Name Name (c.-- L 1 Phone Phone i' I MSEPTAGE SERV ICING OPERATOR SPE LOCAL REGULATORY~~Y A ^ Name ~11s_~j Phone 1 uhf .r This document was duelled in compliance win dxsPter sps 3e3.22(2)(b)(1)(d)&(f) and 393.54(j),(2) & (3), Wisconsin Admiristraflve Cate. r n I' P p n. 11 VVq °o n Q. ~ 7v , r `l r~ ST. C ROIX COUNT e SLI''1'1C 'TANK 'v1Al,\pi'LiNANCE. ; kGR FEMEN'T AND OW-N ERSIIIP CFRTIFICATI(_ N FORM Owmr,'13u)er Mail g Address it lj 1 Z(r. 5 Property Address r J~ L72 ~ (VeiilicatiouregnvedErom1}lum~~ung&_s?tr)m~ug~U<Ftp1attrentfi>rnewco[>Slructioln)` C'itwStatc_ - - - - PIxcel hicntiflcation Nut ibei _30 -1n f 2 LEGAL, DESCRIPTION Property I oeatiorifi N R W, 't'own ol::;;X J 0,(,- Subdivision l:ot fi - Certified Survey Map # / OC7 ~ pZ Vc lumc ~ , Page 41 Warranty Deed Volume Page h - Spec house yes m ten line, :denti[iable ye.~ no SYSTEM MAINTENANCE AND OWNER CERTIFICATION lmproper use and inamterance of your septic system could result in its pt.:mamre failure to handle wastes. Proper maintenauee consists of punipurg out the septic tack every [hiree years or, sooner, it needed, by a licensed pumper. What you pui mto the system can affect the hmctiou of the septic tank as a twannen' stage in the wasre disposal system Owner maintenance iasponsibilities are specified in §Comrn. 83.52(1) and ui Chapter !2 - St. Croix Co inty satritary Ordinance. The property owner agccs to subum to St. Croix County Plaruung & 'Lon mg Department it certification forni, signed by the Dwyer and by a ruaster pluniocr, joanteynrm plwnlxr. resu treed pbunbcr or a licensed pumper verifying that (1) the or,-site wasrcwater disposal system is in proper oeciating <oimvioii aril:; or (2) alter insp,, ::ion and pumpurg (if necessary), the septic tank is icss than 1/3 (till of siudgc. Vwe, the undeisigucd leo u rca~f tiic ab(, i- rryuiramorl` and apmr u+ imdntaur the private scwage disposal systetu with the alauaa ds set forth, herein, as scr b-, the Depar,r.tcat of Coy:unetcc avid fac Deparrinont o Natural Rcsourecs, State of R'isco"sirl. C'citification stating that yOty scptie system hB5 here iraimanicd must be completed and returned to the St. Croix County Planning & /,oning Depattuicnt within 30 clays of tLe three year expiration date. Vwe certify that all statements on t s form are true. to the best of lny:lute 1,uow•ledfllc. I.`we ariare the cwucr(s) of fire property described above, by vir(tic of a w• ranty aced recorded m: t tvyjstct nl Elect Is Office. Numbgr of dr Dins _ SIGNAfiUltti OF APPLICANT(S) DATE '".Anv infonratiun that is misrepresented ray result u; the sd:etary pcinmt baring r.'vuiCnl by the piarrnuig & lFniin}; Dcparnucn;. lnclude with this apphcation a recorded warranty rived trot" (he Register of Deeds Gffiee and it copy of the certified survey map it reference is made iu the warrant)' deed, (REV. W05) aouap!saa .1 m so9 p~ Fnn~ alh4aS-sm;)jpuy ar Sl HgmofSOSVIN s- f! I I a r F~ ~ ~ II l,t~' L -I z i ° I ( E i p F F E ' .r g r--- I' I I i ~ .1 I I I II 1 J~ _ Ire l 1;: ~ r L 12 L, _ o Z 6 o Q~ I a II I I JIB Y III WIC f ~ ~I. III I Z I } IIII µm~ FIM I y n Q ~ i ® LL F I III i I i I Li. j I S I 4 ~ I~ E I\\• tea:=.: LryEJ IO+j ~~y E .F 1 Q F J ' , W 1 ~ © J i ' i F ewuapisab I „6mm7 "AWR zq p-6. aQ„ a1h4o5-sn+eipuy J-]ISJVgOH2ITMOf\OSVAT u w 1Y- 4 1 Oflili ~I y;ii o y P ~ A I _ Z', I~. rr 2 & ZL 4, E O. 11 41 I + t-t 4 'i-.~ ~z i R + . LIJ i~ i I li aauap!saa ,6' 7 z;Wg3 xoyw,6ma, aa!nLpS - sMaipud -11 SAWOII WANlOf NOSV[1 s f pq` C a l;p~ i ' I ` cl t r i ~ ' . .rL ♦ aR r FA, I . i v o - - I , I is t, z e ,r r g u 85 s ZI f. DrJuapisa-d zm;3 zq 1y"66.'°'o 1 aliny:)S - smaipuV _ I J'1'I S1LV011 AINfOf XOSVIN f24 i o 4. 1 1 r El .r I ~ I I Y F, 13 i 2 i aD'' gale C[YS rr 1 a h~3 ~ ~i 1 m l~ y y l ~ w p - at W 1.. ar ' j~ S DLL ~D:A II S R v> sii Y3i7 r3FY r 1F31 ~ f' 11 1 r,~ Y 10 2018 CjT-poi, Dom{ Wscons+nD panin ' ol, priers SOIL EVALUATION REPORT Page of Division of in accordance w:th Comm 85. Wis. Adm. Code Attach complete site plan on paper not less tthan 8 112 x 11 inches in size Plan must Crxlnry nhdude• but not limited to vertical and horizontal reference point (BM), deeaicn and Parcel LD. > percent slope, scale or dimensions, north arrow, and location and distance to nearest road. ~ -,)L) - - 1 - J 04 Please print all information. Reese by Date Peno•u; i.lormaeon you powde may oe used for se nd.r purpoees (Puvaq• Lew, s 15.04 11) (m)) ~e Property Owner f / Property Lacation Govt. Lot114 ~1t4 S 12- T N R E r) W 17 Property Owners Mailing Address Lot # Block # Subd. Name M# l S' Cf (I - - ' tiJ - a'cr 3 e-city State 'p Code - Phone Number Q City 0 Village Town Nearest Ro#d T New Construction vse;9-Residential r Number of bedrooms Code derived design flow rate L' &f GPD ❑ Replacement ❑ Publi~cq or commercial - Describe Parent material Flood Plain elevationit applicable fl. General rornments Zt rw and retoo mlendabons: System Typo e 4) ✓f/~ G'> / System Ple•:ai nn__ ~ _ _ Bw g # J0 Bonrg Q / I pit Ground surface elev. I 0 t. Depth to limiting faaa /(J-in. Soil iCatiOrh Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDrf in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. 'Efl#1 'Eff#2 t5i -7 z ® ing # V Pit Ground surface elev. _ Depth _ L- fl to limiting factor in Sal IitdUon Rate Horzon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD.Kf in. `Munsell Qu Sz. Cent color Gr Sz. Sh. 'Eff#11 •Ett#2 .6 - 5L v S t I~~ v 3 0-7 2 11 rA Effluent 01 = BOD. > 30 < 220 ma and T >30 < 150 mgt ' rMuent #2 = BOD, < 30 mgt and TSS < 30 mat CST Name (Please Print) Si re CST Number Bird Plumbing, Inc. Shaun Bird 226900 AddrnS, Datc' C'oaV.ration GntludOd 1elephc+io Plmnbor 1432 120th St. Netro' Richmond, WI 54017 Z ` 715-246-4516 r- Property Owner _ Parcel ID # _ Page Of - Boring # ❑I-3Boring a C_pit Ground surfaceelev. Depth to Imuting factor inSoil itetierl Rate Horimn Depth Dominant Cobh Redox Description Texture Structure Consistence Boundary Roots GPDMF In Munsell Ou Sz. Cont. Color Gr Sz Sh 'EfM//1 'ERa2 3 f5 < - i , , t,/ '11 Boning At ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Sc; Iicalion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cent, Color Gr. Sz. Sh. 'Ef&1 T11#2 Boring q Bering D ❑ Pit Ground surface elev. _ ft- Depth to limiting factor in. Soil Application Rate Horizon 'lepth Dominant Cola Redox Description. Texture Structure Consistence Boundary Roots GPDAF in. Munsell Ou. Sz Cont. Cckx Gr. Sz. Sh. 'Effp1 •Ef #2 ' Effluent p1 = BODr > 30 1220 m91- and TSS >30 < 150 mgR ' Effluent 92 = BOOS < 30 ng& and TSS < 30 m91. The Department of Commerec 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. WrU{lIG f0. Ai1:R Property Owner _ Parce. ID Page _ of J Boring ❑~t Bonng lapit Ground so~tace elev. ft. Depth to limiting factor -Lin . SW'. IiGnticn Rare Honor. Depth I Dominant GWOr Redox Desorption Texture Structure Consistence j Boundary Roots i GPDlff in Munsef. Ou. Sz. Con, CWor Gr. Sz. Sh. •Eff#1 •E.R92 -3 1 K4, 2 - ;i'ci nf~ ~1~ h 7 i I ~ ~ f I Boring # I-= Boring u ❑ pit Ground swfaoe elev. tt. Depth to limiting `actor _ in Soil Aotil"tion Ratc Fianzon DepUr Dominant CWOr Rodox DesMpfinxr. 1 Ta ure SWWUre Consistence Beundaryj Roots GPDlff _ I in. Munsell Ou. Sz Conl Color GT. Sz. Sh 'En#1 ; 'EfW2 i ❑ Bow Boring Ground surface elev ft . . Depth to Smiting factor in . ❑ Pit Soil Application Rate Horizon lepth Dominant CWor Redox DescnpUon Texture Structure Consistence Boundary Runts GPDJff in Munsell Ou. Sz. Cont. CWor Gr. Sz. Sh. 'Eff#1 'Ef`#2 I I j I i I Effluent #1 = BOD, > 30 < 220 mglL and TSS >30 < 150 mgfL ' Effluent #2 = SOD, 30 mg/ and TSS < 30 ngrl 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. seouio rtaw:~ Soil Test Plot Pla Project Name Mike Schulte Sha n Bird Address 12518 Marquess Way N Lake Elmo Mn 55042 '1*4 #226900 Lot 3 Subdivision Dat 5/9/18 S W 1/4 NE 1/4S 32 T 30 N/R19 W Township St. Joseph ❑ Boring Q Well PL Property Line County ST. CROIX BN1 or VRP Assume Elevation 100 ft. Top of 3/4" pipe System Elevation TBD -HRpSame as Benchmark Property Line A .4 _ Scale is 1" = 40' unless otherwise noted 103' 101' 13-1 99' 9`s0 Slope G0' 150' 133 B.M.* u' 3 250' 50' 13-2 Rolling Hills Trail Property Line