HomeMy WebLinkAbout018-1040-00-200
Svstent PI.O"f P1,AN
Pit0.ILC7 Jtiar, Kent Ai)i>ltESs 965 Alexande, Road Hudson b1+i 54016
S l' 4 NE I r 4S 18 r 7' 29 N! R 1 W 'i ow\ Hammon'^ Cot N-1.1' ST. CROIX
1;YSTEA4 ELENA HON 102.2' 6+1811 8 4
DATE BEDROOM
CON%LNTIONAL A'I'-GRADE . CON1'ENTIONAI. LIFT HOLDING TANK
MOUND SL:1"fIC TANK SI/.L: 1255 Gallons 1,1E'1 TANK SIZE DOSE TANK SILL: 765
HOLDING TANK SIZE LOAD RATE .6 ABSORPTION AREA '.000 0 of chambers none.
BENCH.M.%RK Y.R.P. Base of poove• pole ASCL NU. LLI:A A'r1ON Hro' Filler Lifetime Filter
~BORLIIOLL. ON76I.1. sarneasbenchma,k
'roperty Line 200'
Se8:e !4" = 10 ' Gradln s to ho done to diver, run-off away %rorr system 1 50th st
5 acre lot
B-3 B-2
3% Slope El
102.5'
r^ rc 4
Bedroorr
:-louse
~ - 1
Hulicu:: Combc Tank B 100 5'
We, 20C'
Existin; system is to be
pumped and buries, current Area 15 below system is to remain undisturbed
location unknown
DIVISION OF INDUSTRY SERVICES
2331 SAN LUIS PL STE 150
' \ D GREEN BAY WI 54304-5211
Contact Through Re ay
PS http:Fdsps. wi.govipmgramstindustry sevices
y vrvv w'sconsin gov
AEI/ -
Scott Walker, Governor
Laura Gutierrez, Secretary
Ruh '018
(J I ID No. 226900 41 APOIt'IShaf"'i-lor
7ON1\G OFFICF
SIIAt,N R BIRD ST CROIX COUNT Y SPIA
14 120TII S I 1101 C.ARMICIIAFI. RD
NEW RICIIMOND WI 5.101?-6409 IR DSON W1 54016-7708
CONDITIONAL APPROVAL
PI-AN .APPROVAL. VXPIRLS: U7+231'2020 Identification Numbers
Transaction ID No. 3131263
SITE; Site ID No. 851439
bent Please refer to both identification numbers,
9?2 I()(1.1*11 St above, in all correspondence with the a~encv`~
Townol'llannnond - -
St Croix County
SFI 4. NF14, S18, 1'9N. K17W
FOR:
Description: Kesidential At-rade-Ness Construction
Object type: PMN IS Component Manual Regulated Object If) \a: 1786498
Maintenance required; 600 GPD I low rate; 41 in Soil ntininnun depth to limiting factor from original grade; S}'stem(s):
\t-trade Component Manual. Version 10. SBD-10854-P (N.0' 07. R. I: 12), Pressure Dislrihulion Component Manual -
Ver.?o,SBD-10'06-11(NMI '111. R. 10: L'i: Effluent Fillcr
l'he subminal described above has bccn rcvicwrd tin' confornumce with applicable Wisconsin Administrative Codes
and Wiscomin Statutes. The submittal has been CONDITIONAI I Y APPROVFD. This scstcm is ut be constructed
and located in accordance wilh the enclosed approved plans and with anv component manual(s) referenced above.
I lie owner, as defined in chapter 101.01(10), Wisconsin Suttules, is responsible fur compliance with all code
requirements.
No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.1 ~15.06.
slats.
fhe following conditions shall be met during construction or installation and prior to occupancy or use:
Key Items- PONYI'S Design Approval
• This system is to he constructed and located in accordance wilt the approved plans, and the 'At-trade I Isin;i
Pressure Distribution Component Manual Im Private Ousitc Wastewater SN,lcns Version 2.0" SItD-108>4-p-
P(N 0.3!0?l.
• Fence off dispersal area prior and during construction to protect and avoid disturbance, compaction and
use of the site.
• N ilh new construction, it is recommended not to aelivate the pump in the dose lank until the tanks are a
pumped prior to homeowner occupancy.
• ik4astewater generated from contractors cleaning of equipment and tools andior left over construction
(products shall not be discharged into the drains discharging to the private ensile wastewalcr treatment
system (PONN I ti), \4asle generated shall he properly disposed of on-site or off site.
• Any tall grasses, leaves and shrubs hill[ be cW short and removed prior to tillin_ the wrlitcc iia installation to
prevent malunb nuclei- the dispersal area. - r
\I.al \:X 81IiU ':rC; .__1118
• Prior to construction of the dispersal area, check the moisture content ofthe soil to a depth o1'3 inchc,.
Smearing and compactin_ of coot soil will result in reducing the inlillration capacity ofthc <oil. Proper soil
moisture content can be determined by rolling a soil sample hcmecn the hands. If it rolls into a 1/4- inch "ire.
the site is too wet to prepare. If it mumbles. site preparation can proceed. Ifthe site is too wet to prepare, do not
proceed until it dries.
• Provide surface water diversion around the trcatrnent tanks and at-grade dispersal component.
• The owner is responsible for the operation and maintenance of the private onsile wastewater treatment sy'stenh
WMV"IS) in accordance width SPS iii and the approved Management plan
• The owner of a POWTS shall be responsible for ensuring that access opening covers remain locked or
secured except tot inspection. c\aluauoc. maintenance or .cr\icin~: purposes
• Owners shall receive a copy of the appropriate operation and maintenance manual and or owner's manual for
the POW FS described in this approval.
• Provide a copy of the approved POWTS plans and this letter to the owner.
A copy of the approved plans, specifications and this Iener shall be on-site during construction and open to
inspection by mn11067ed representatives of the Dcparoncnt, which may include local inspectors. All permits
required by the state or the local municipality shall he obtained prior to commencement of
Construction installation operation.
In granting this approval the Division of Induso\ Services reserves the right to require changes or additions should
conditions arise making them necessar\ for code compliance. A, per state smts 101. 12(2). nothing in this review
shall relieve the designer of the responsibility Ibr designing it safe building, structure, or component.
Inquiries concerning this correspondence mac be made to me at the telephone number listed below. or at the address
_m Ihs letterliy
teaabou 10t 'ad essee shall provide a copy of This letter and the PO\\ I S management plan to the owner and any
u a~rs w ho AN res onsiblc liter the installation. operation or maintenance of the POW I S.
Sihr~~ l) I ce Required $ 350.00
This Amount \Vill Be Invoiced.
When You Rccervc Ihal Invoice.
Mar 5 1 nicer 11 Plzase Include a (opc \Vith Your
POW IIS Waslo atcr Spec a Division of Industry Scrv'ices Patvment Submittal.
(608)514-1 189 , Mon-fr , 7:(~ a.m. - 3:45 p.m. W ISMAR I code: 7633
mark.f ingerra'vwi.go\
cc: Edwin A Ta1lor, Wastewater Specialist. (715) 634-i l8 i, Mon-ft I. 8:00 ;\.M. - 4:30 P.M.
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date:6/18/18
Owner:Jean Kent
Location:SE 1/4 NE1/4 S18 T29 N,R17 W 972 160th St. Hammond
Manuals Used: At-Grade Component Manual version 2.0 SBD 10854 (N. 03/07)
Pressure Distribution Manual version 2.0 SBD 10706-P(N. 01/01 R. 10/12)
Page#
1. Cover Page
2. At-Grade Plot Plan
3. At-Grade Cross Section
4. Pipe Cross Section/Pipe Layout
5. Pump Chamber Cross Section A. L L Y
A.
*A~
6. Pump Curve 7-8. Maintance an C tigency plan g
9. Filter Specificatio s
A
ttachments: Soil st
Shaun Bird Signature
License num r 226900
0~F1 Page 1 of 9
I
SystenT PLOT PLAN
PRo.iFC'r Jean Kent ADDRESS 965 Alexander Road Hudson Wi 54016
SE 1/4 NE 1/4S 18 IT 29 N/R 17 w TOWN Hammond COLNT•1' ST. CROIX
SYSTEM ELFVATION 102.2' 6/18/18 BEDROOM 4
DATE
CONVENTIONAL AT-GRADE XXX CONVENTIONAL LIFT HOLDING TANK
1255 Gallons LIFT TANK SIZE DOSE TANK SIZE 765
MOUND SP:1''17C 'I':VNIh SI'!.G
HOLDING TANK SIZE LOAD RATE .6 ABSORPTION AREA 1000 # of chambers none
BENCHMARK V.R.P. Base of power pole ASSUME. ELEVATION too' Filter Lifetime Filter
El BOREHOLE
Property Line 200'
Scale = 1/4" = 10' Grading is to be done to divert run-off away from system 160th st.
5 acre lot
B-3 B-2
3<9 Slope 171 102.5'
Pro 4
Bedroom 1 O 1 .5'
House
Huffcutt Combo B-1 100.5'
dank
Well
B.M.*
044 200'
Existing system is to be
pumped and buried, current Area 15 below system is to remain undisturbed
location unknown
At-grade System Sloping Site Cross Section and Plan View
E llimensio-n--T{{{ P---'eet-{
' V•y.,•Yt•L:YYti;•..yti..•.1.YYY`.••-•'•.•--•'.L..•--:,`.-•..•...':•......• i I I {l
I ~f l~
~ ~ I !.J•f.t•t•J•t.t.f.f.f.t•t.J.:.: •f.f.t:: • :
ti.1.ti.4.M1. .ti.ti...ti..•...ti.1.L.ti..• I B JI
lr'6B
- -
W A I D z.o
I - -
F 0.5
G 1. 1.0
E --R-- - --~1- _ -T--
Slo c
- 1 =Plowed „}p7 -Clean aggregate Q - 4 in. sch. 40 pvc
I I 1.•.
_ basal area z to'_ 14 in. dia. observation pipe
Lateral with T opsoil Cap
aggregate over pipe
- Observation Pipe
Geotextile With Cap
Fabric
Topsoil Cap
711
C ---I
Slope Direction
(;I;l MU, INSTALLATION: 'The at-grade area is staked out along the design contour. Existing
vegetation is mowed and raked off the site. The basal area (L x W) is staked out and plowed with a
moldboard or chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to
form a 'A inch soil wire when a saunple is rolled between the palms of the hands. The A x B area is
Covered by clean aggregate deposited overhead by a backhoe. Special care must be used when
placing the aggregate to minimize compaction of the plowed surface. After the topsoil cap is placed,
the entire at-grade is seeded and mulched to promote vegetative growth, limit erosion and protect
from freezing. The observation pipes are perforated in the lower 6 inches and secured in place.
0105lgj Page of I _
Pressure Lateral Layout
One Lateral - End Manifold
- threaded
Cleanout
Lateral Turn-up Plug
Force Main
X - - -
/ L - Long
Sweep
/ 90
u Bend
Pressure System Construction
Distribution Network Specifications
Lateral Diameter - In.I Laterals are constructed of Schedule IU PVC
Orifice Diameter Z- In. pipe Orifices are drilled perpendicular to
X (Orifice S~acina) _ In. the pipe with a sharp drill bit and face down.
L (Lateral Length) _ Ft. Lateral turn-ups terminate with a threaded
cleanout plug and are enclosed in a 6-8 inch
FForce Main Diameter hi
Z--- diameter lawn sprinkler valve box accessible
Force Main I.en the Ft~
~ - liom finished grade.
• • • • • Grade
6-8 Inch Lawn
Sprinkler Valve - -
Box
Page of
f
03x05 Igj
Septic-Dose Wank Cross Section And Pump Performance Specifications
- - ump Manufacturer l rr
P
-ei
I enk Manufactur(2_~- -
at pump Model Number r 71/
1 tk Model Number
- tt- Alarm Manufacturer- 61~c
Total Tank Capacity -
Alarm Model Number ~k-Z
Max. Bury llepth 1
- - - ;1-L--...-_ Switch "Cype
Total Dynatntc Heed (TDH) - Feet
i Filter Manufacturer 1 - -
filter'vtodel Number E'levation Head _ 1(~ _ -
' - - - } I Distal Pressure
Network Loss _ 1
Minimum Pump Performance Required-- Force Main Loss
-
Outlet Manhole Min. 4" Above Grade With Manhole Min. 4" Above Grade
Locking Device. inlet Hellhole With Locking Device \
V" Below Grade Sealed Watertight Secntrel Mounted Weather-proof 1
Junction Box
- Finished Grade - -
f t*
Vent Min. 12" Disconnect
Above Grade Means
With Vent Cap
Outlet Filter
Inlet Inlet Baffle
Switch Settings and Reserve Capacity J~
Tank Volume - GPI Weep
_ B Hole
Dimension. Inches Volume Gal.
(reserve)
(alarm) B 2 Off Fevation
X. C
(dose) C. Ft Bottom
(dead) D > j - D F.levattion
Total
GENERAL INSTALLATION: Tito Septic/dose tank is bedded and back tilled 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 and the sleeve is sealed watertight. Elornric:aj servicehomplies with NEC 300 and Comm 16.23.
02/05 U Page .i of
280-SERIES
112 hp Submersible Effluent/Sump Pumps
The Liberty 280-Series provides a cost effective "mid- Performance Curve: 280-Series
range" pump for on-site waste water systems, liquid 40 12
waste transfer and commercial heavy-duty sump pump
applications that require higher head or more flow. 35 11
Designed around Liberty's unique"Uni-Body" casting, 30 9
the 280-Series will provide years of reliable performance. 25 8
All Models Feature: 20 6
• Vortex style impeller permitting passage of solids 1 5
up to 1L" 2 10 - 3
• 416 stainless steel rotor shaft
• Permanently lubricated upper and lower ball bearing 5 2
• Epoxy powder coat finish 0 0
• All fasteners - corrosion-resistant stainless steel 0 5 10 1 US. Gallons Per 45 W W W 65 M
Minute
• 1 %0 Discharge
• Stainless steel bottom screen -easiIY removable I - { _ W 2
0 38 78 11 14 156 192 2 228 270
• Maximum fluid temperature: 140'F. Uters Per Minute
280-Series cord Lengths Dimensional Data.
Model 10' 25'(-2)_ 35'(-3) 50'(-5) Weight 29 lbs.
280 Standard Optional Optional Optional F1ei9trC 13"
281 Standard Optional Optional Optional Major Width: 10" (model 287)
283 Standard i'onal Optional WA
287 Standard _ _Optional WA WA Minimum Sump Diameters:
10' cad length standard on all models. Foroptional lengths, Model 287. Model IVIF..
"
add "-2, -3 or-5" suffix to model number. 287 VMF.. 10
Example; for model 280 with 35' cod, order 2803 Factoryswitch Model 281, 283 Model 287
settings VMF
Motor Specifications Tum on level 13° 9.5°
Y2 hp 60 Nz 3450 RPM Turn off level 7" 4.0°
Oil filled, thermally protected
(PSC) Permanent Split Capacitor The Model 283 features a furry adjustable vide-angle float Differential
8.0 amps (115V) adjustments can be made easily by tethering the float to the dis-
charge pipe or other rnoun~ng point Vertical float model 287 is not
adjustable.
Y J_
Model 280 Model 281 L Model 283 Model 287
Manual, Wide angle Wde angle VMF Series
no switch flat switch float switch Vertical mag-
with quick- with series netie float for
disconnect (piggy-baclo smallerpits -
plug wBl operate in
a 10" diarneter
sump
ca-Us c Certified
Liberty Pumps • 7000 Apple Tree Avenue • Bergen, New York 14416 • Phone 800-543-2550 Fax (585) 494-1839
wwwJibertypumps.com Doprwp O Ube" Pumps, lnc 2017
Mn hm. LUT2oobnosW
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page - of
-ILE INFORMATION SYSTEM SPECIFICATIONS
Owner Septic Tank Capacity gal 0 NA
P - - - 1 a r l t'.:~- Permit 71
# Septic Tank Manufacturer ('L 0 NA
DESIGN PARAMETERS Effluent Filter Manufacturer r U NA
Number of Bedrooms 0 NA Effluent Filter Model 0 NA
I Number of Public Facility Units JJA Pump Tank capacity - al G NA
Estimated flow (average) aVda Pump Tank Manufacturer NA
l1y_fl_
i Design flow (peak), (Estimated x 1.5) al/da Pump Manufacturer 0 NA
Soil Application Rate adda le Pump Model - 0 NA
Standard Influent/Effluent Quality Monthly average' Pretreatment Unit
Fats, Oil & Grease (FOG) 530 mg/L 0 Sand/Gravel Finer 0 Peal Filler
Biochemical Oxygen Demand (BOD!) 420 ni U NA 0 Mechanical Aeration 0 Welland
Total Suspended Solids (TSS) 5150 mg/L 0 Disinfection O Other:
Pretreated Effluent Quality Monthly average Dispersal Cell(s) 0 NA
Biochemical Oxygen Demand (BODs) 1530 mgr. 0 In-Ground (gravity) U In-Ground (pressurized)
Total Suspended Solids (TSS) I _<.30 rrg/L -7KNA 74-Grade U Mound
Fecal Coliform (geometric mean) 5104 cfu/100m1 0 Drip-Line 0 Other:
Maximum Effluent Particle Slze in die U NA Other. O NA
Olhec NA Other. - 0 NA
'Values typical for domestic wastewater and septic tank effluent. Other. 0 NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
!Inspect conditon of tark(s) At least once every: 0 month(s) (Maximum 3 years) ❑ NA
jpyears
'Pump out contents of tank(s) When combined sludge and scum equals one-third (X) of tank volume 0 NA
onspect dispersal cell(s) At •eas: once every: El month(s) (Maximum 3 years) U NA
Oyear(s)
_ fi
- 7 G month(s)
'lean effluent filter Al least once every: ~-year(S) - U NA
- D month(s)
Inspect pump, pump controls & alarm At least once every: _ 6-year(s) _ -0 NA
"lush laterals and pressure test . At least once every: 0 month(s) ❑ NA
Ejyear(s) _
Other At least once every. fl month(s) -7 NA
year(s)
0 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
nclude a visual inspection of the tank(s) to identify any missing or broker hardware, identify any cracks or leaks, measure the volume of
combined sludge and scum and to check for any back up or pending 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 pending of effluent on the ground surface.
The pending of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local
regulatory authority.
When the combined accumulation of sludge and scum in any tank equals one-third (Y) or more of the tank volume, the entire contents of
he tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin
Administrative Code.
I5JI 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 within 10 days of completion of any service event.
1
. Page _ of
START UP AND OPERATION uct
For new construction, prior to use of the pOWTS ch tank for the presence of
the treatment process and/or damage the 6spersaltcell(s)) If high concentrations' are detected have thercontentsl oflthp
may impede
tank(s) removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
During power outages pump auks may fill above normal highwater levels. When power is restored the excess wastewater will be
discharged to the dispersal cell(s) in one large dose. overloading the cell(s) and may result in the backup or surface discharge of effluent.
ls
To avoid this situation have the he contents of the pump tank removed by a Sepage Servicing Operator prior restoring power to centrals to restore normal levethe
effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump
within the pump tank,
Do not drive or park vehicles over tanks and aispersal 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 POWTS: : disinfectants;
fat: antibiotics; baby wipes;
vegetable able peelingsAgasoliD grease herbicides; meat scrapsrsmedications; oil;; paintigalproducW
fruit cigarette
(sump pump) p)
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 prof
and safely 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 filled with soil.
gravel or another inert solid material
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code come Ian
replacement system:
compaction and should not be infringed absorption systeirn.
protected from disturbance and utlized for the
❑ (replacemearea replacement sharea has ould be been eva.uated and may be
The by equ ed nt area will
n the rule .in
result for a setbacks
and prosed
soil and site evaluation to establish a a lsu tlable replacemen Failure t Replacement sylstemsemust comply with (the
effect at that time.
❑ 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.
he site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evalualFon
must be performed to locale a suitable repiacement area. If no replacement area is available a holding tank may be installed) as
a last resort to replace the ailed POWTS.
Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infitra'iive
urface. 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 N
BE DNFFIICULT OR CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A
OF A T TREATMENT
ENTER A FROM SEPTIC, THE PUMP INTERIOR OTHER
PERSON
ADDITIONAL COMMENTS - - - - - -
POWTS INSTALLER POWTS MAINTAINER
<<_ - -
Name Name
/ Phone ~/J
Phone
/
SEP7AGE SERVICING OPERATOR LIMPER LOCAL REGULATO Y AUTHORITY
Name
Name
- ~j-,
Phone Phone
This document was drafted in comp;laoce with chapter SPS 383.22(2)(o)(1)(d)&(`l and 383 54(l), (2) & (3). Wisconsin Administrative Code.
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OWNIRSH11' CERI IFICAII(=.1; FORM
Owncr,'}3uver ~t'1~
F'ropcrtvAndretit
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nt fot new conshucnon) -
CiIvStatc Pate! Idcttti6canon Nunbes Q~~r J
LEGAL DESCRIl"TION
Property Locauo v a
- ~ ~ , 5:-;. 1 ~ ! V F` / ZW,
Subdi-s ision
-
- - - - - - - ~ /Lot r^J~-
Certified Survey Map Vt bmtc
Page
Warran"' Deed # V Valurne t;
- - - Page.
APec home ycn Louise. Idenntiable O
no
SYSTEM MAINTENANCE AND ONVNER CERTI ICATION
It:yxoocr use and ntamtcnaucc of luut'senlic sateen could result in its pr.•nlahtrc faila.c Io handle ev:tsfos. Proper
mamtctu:nces Consists of purtlping out the scpnc tank eo cry three gears or sooner, d needed, by a licensed pumper. '
the system can allect thctfunction of the septic rank as a treatrrtcntslage in the wa-s c disposal s l4 ,at You put into
vstent. Clwncr
responsbihtics are spccr.icd in womm. M3.52(i) nd maintenance
a
Nk ,at cl C:haptel 12 -St _ Croix Co mty Sa:iitarv Ordinance
The propcny owner agrees to suhrnit to St. Croix C:ouro,~ Plaunmg & Run ir-g Dcpar trm:nt a ccnificatiou Ibrn~ signed by [ho
owner and by a nlas[rr plwnbcr, jouncynwn plumber, restricted plum er o: a licensed punlpCr verifying that (I) the on-site
wastewater d*Posal system is in proper operating condition atulror (3)aflo utspcc:mn and pumprtty- (it necessary), the septic tvnk i:,.
Ic.v than Ira full of sludge.
IrwC. the uudcrsiprod iw\c read the:m,+vc rccunc.rn e19 and a red lu ncrm-am Or! private sew'ag, disposal s,;stcal with the
etaudards set fin th, heroin as .scr by the Depar t rcur of Commvicc and tha Depanr. :ati of (\ziural Resources, mate of wisconsnt.
cettilicarion atating that your septic, system Ilac been nlaintamcl must be complew.: and returned to she tit. Croix County Plamtmp dY
7,ortmg Deparnnent within 30 days o' -the threr, year capitation date.
1; we certify that all stalcmeuls o/2 e mta to the best of nry?our knowledge h'wc aneatc the ouverls) ofthc
propcrt described above, by vutf a h deed rccorfed m Register of Dce,Ls Oftic
L
N n er of bedroot
SKL1 11
C ! OF Al"PLiCANT(S) -
DATE
ny information that IS _nisrepiescutcd may resuit In tlx sae
dory permit being o_yoked by the 1'lanrcmg & Loruag Depanrncnt. "*x
Inc tilde ulth Iles appiicatioc at ecorded wan ar-ly deed iron Ihr Register of !Dubs Gflice and a copy of the cei 6lied swvcy Wrap it-
reference it made is the warranty deed.
(REV. 08415)
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Property (Tuner Parcel ID # / Page _ of _
❑ Borng
Boring #
Ground surface elev. //r~.' ft. Depth to limiting factor _y4 in
a pit -
Soil iralipri Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD#f
in. Munsell Ou. Sz. Conk. Color Gr. Sz. Sh. -Etf#1 -Eft#2
~ O'l3 0- 3 r, ~ ~ ~
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Boring # ❑ Boring
❑ pit Ground surface elev. h. Depth to limiting factor in
lication Ratc
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM
in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'EB#2
El Boring
r~ # E] Pit Ground surface elov. ft. Depth to limiting factor in.
SoA ,cation Rate
Horizon 'lopth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPDIff
gyn. Munsell Oki Sz. Cunt. Color Gr. Sz. Sh. 'Ef #l 'E##2
' Elfluent #1 = BODE > 30 < 220 mgt and TSS >30 < 150 ntglL ' Effluent 02 = BOO, < 30 mg& and TSS < 30 ntguL
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.
SHb XI\O IR 60!i
Property Owner_Parcel 10 N /Page -o1-_
[3 Boring J
F-1 Bon a RL pit Ground surface elev. Z Cnn ft Depth to limiting factor in.
Soil ticatirn Rate
Dommant Wor Redox Description Texture Structure Consistence Boundary Rods GPDM
Munsell ou. Sz Cent. Cote Gr. Sr. Sh. 'Etfat 'E3a2
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❑ Boring
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Soil ' liration Rate
Hcrizcn Depth Dominant Color Redox Description Texture Stnxdvo Consistence Boundary Roofs GPD."
in. Munsell oil Sz. Cant Cola Gc Sz. Sh 'EfNri 'Efte2
I
❑ Boring Bong
❑ pit Ground surface elov. ft. Depth to limiting factor in. See - AppLication Rate
Horizon '"th Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPDO
in. Munsell Gu. Sz. Cont color Gr. Sz Sh. 'Eft#l 'EBe2
Eftluont e1 x BOO, > 30 < 220 mg4 and TSS >30 < 150 mgrL ' Effluent 92 • 800,5 30 mgt and TSS < 30 mg•1
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an altemate formal, please contact We department at 608-266-7151 or TTY 608-263-8777.
seaanorxsaoi
Soil Test Plot Plan-' i
Project Name Jean Kent Shaun Bird
Address 965 Alexander Road
Hudson Wi 54016
QS I'M #226900
Lot 2 Subdivision Date 5/23/18
SE 1/4 NE 1/4S 18 T 29 N/R17 W Township Hammond
❑ Boring Q Well PL Property Line County ST. CROIX
Ml or VRP Assume Elevation 100 ft. Base of power pole
System Elevation 1022' *HRPSame as Benchmark
Property Line 200'
Scale = 1/4" = 10'
5 acre lot 160th st.
B-3 B-2
3% Slope 171 - 102.5'
Old Foundatio
to be removed
101.51
B-1
100.5'
Well
B.M.`
200'
Existing system is to be
pumped and buried, current
location unknown