HomeMy WebLinkAbout042-1053-30-100
DOU"ty
a
'.l it nep.- cnCom~om"''- PRIVATE SEWAGE SYSTEM St. Croix
SJIeIY aro Bu OrDl 'iloll''ll
INSPECTION REPORT Wifar; Pefni
GENERAL INFORMATION (AT TACH 10 PERM IT) State Pan:DNo 605135
Personal i -fx-at si yej pro•: de -ay oe used for seoondery p.rposes IPrivacy Law• s 15 c4 i l;nr l
re -a H:dcers Name Cry village IC"^5n I: Pa'Cel Tax No
Steven Huberty TOWN OF WARREN 042-1053-30-100
.:'d l bM L cv. I-sp Bfvl Elev. RM Di p0o° n SedCc .'Tavn+Rangctdap Nu
19.29.18.302A-10
TANK INFORMATION ELEVA ION DATA
TYPE MANUFACTURER 7 •x~ - CAPACITY STATION BS HI FS ELEV.
Septic ' Benckmark
Dosing An era
- 316 itI.o2-
Aeration Bldg. Sewer r 1 ~Vo(.
He Own - $0'HI Inlet 7 J to I. Cal
TANK SETBACK INFORMATION SVHt Ol.tlel 16~.3y
TANK TC RL WELL BLDG Vent to Ai•mate ROAD Dt Inlet -
Sep:C ~ _ Dt Bo:tcm
Dos ng HeacerAill
10c. 32
Aeration j, Dist. PRpe
c~(~la IoG-32
Hold rg , Bot System
/05. 18
PUMPISIPHON INFORMATION Final Grade
Manufacture Demand St Cover
GPM 3.P((Q tII-Os
11ode Numker
TDH LA \ Friction Loss System Head TDH Ft -
Po•Cenlant L n - B•e-__ _ _ D sf toyr , _ _ - _
SOIL ABSORPTION SYSTEM
BEDlTRENCH V:.d:h r Le-g:h No Of Trer--hes PIT DIME N7~~NS No C4 v¢'. Irs de'p a. _ 7l, d yizfft-
DIMENSIONS rr 3 - - / ! t
J 7J r- -
SETBACK SYSTEM TO PtL BLDG L,NELL LA TREAM LEACHING l.Iavjfa I -
INFORMATION CHAMBER OR W
TYG20~$'9ste^t I I UNIT MOdel f'yumter
fJ
C L 11Y~/ 7L
DISTRIBUTION SYSTEM
Heacv. Men told D sit Wen x Ilolt• Size x Fole Spacing Ven: to A' mtai.s
1 Pip=is1 - rr -
Lergrh/Ux Da_ Ly, length Da Spa, n9
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
')er.h. ver f Deph wen xXCeplF of 7"dCtlb;tlrted _ xx fvl~hM
See:' --i c•~ Ce-ter Re :,7ranrr Feges 'opsc j vez _ No j -1Yes INC
COMMENTS: Ono Lee Code disc'epences,cersonspresent etc; li or #1 Inspection #2
Location: gg1 83RD AVE /
l}a~ Cave C.lt1a< 4t L4 AS
1.) Alt BM Description - t T
2 ) Bloo sewer length = y,2
- amoum of raver = 7r4
~ I I I
Plan revision Reou red's Yes _-II No
Use other side for additional inrormalion _ / /a' 6 1'il!_T-1, TkV"nCIIK., J
S3D-E:IJ IR S+57; Oa:e IrseF=:o'S Si_aa.u_ CEC No
L
PI - ~ S ~IIJ 1
aMrn at\~ ~~l SI l r C
Industry Services Division ` -
I 1400 E Washington Ave Sar.l rn' I'curat \unlhu lb'. he IiIIcJ in by Co.)
ESL.<fI PO. Box 7162
Madison, = 53707-7162
1 fI g
- I -
L
Sanitary Pamlt Applicat1oi1- Stale Ilanslc'onNUmber
Ina; njance wth NI , 381 - lib Wlv _'ulm- C J Sohn s,wn of lhl 'onu tht unit
i1 avpuraJ poor 14 ohl.u an Y ;a rl us I cmlil. Now tpphcall n li In. .Lr 1 m, aaue.i I'I + ere ,uhnnllcd to YI 11d 1re» Iit':if III t than mailing adJlessl
the :kp InmalrtUf \ data m n t uJl Kcal YerxnnJ nduauation n u for Oe III he meJ for wconda '>;)I C, c, K;" Awoke
pnr r aas m e ux;lan as L. the S a r r I Jaa, s 1 Ill I am?. stab-- I. ii pplication Infor on me• se Print UI Information
' Ymul 9
I'lof ,talhaner'. Vsm - -
I lul m: sicacn -10>3-?.-1114
I otmy (laantt s Miming Vidwss
I'.il !foW Coal 101.
C in, stare Zlp Cain Phone Number NI Sf !6. Section 19
<d12 i I,yirdc Duct
Koh1n.. WI _ T'_9 N K S I' w~1'
~l 1. I ype of Building Icheck all that npplyl Lot a
Q I nr 3 I aaaK Daaa i. Nllmhct Of lia!roolns Suhdnluon \11
1, Public Commaual Dc.rihc t t, ~ d~ IPeck ^
1 ^f10~ ❑(nvd
❑ State (nailed De,cribc L c ❑ \''1 l,c ui
It skit s. ~kmwor 3 ~ ~d1C1L7V ~J/!75 11 Q Invn nl Nancn
Ill. r o ' ck only oAe box on line At. 11 Co a il'a h\able
\ NeDa ti\'slCill Ka1'Ia;tIDCa Sv91e➢. I ivitnr:m.I l +Idill, lank Rc;,Iac merll lh' I El ()tire, \lalrblalion to l'SUhllg S%scm le\plalnl
tJ
IS. CJ I'cnnn Keneaaal ❑ Yenoil Rca111011 ❑ C h inge of - J I en.il l?dn*ter to \cac List Prcviaus Pa lne Number and Dale Ismied
liclixe lspuan,w+ I hmlbcr U, "'1 r
m iponcnt DI ice: (Check all that a ply) - ~1dL
Von-I'rctsuri/aJ Indirool"I Prc"Miz d In-( round D m-(aadc fLJ, Mound 24 ul. oi'sllndbk sad L] filoun i - ?a in. or xdlahlc ant
it - I pa II r `nup earl lccpl:un, ❑ I'rcocatownt Dwice icai l im
hnn: - T '
V. Dls wcIVTrf-at it cnt Ana Inform
I>.~ ,n ! i+la ~.P' / Ua 1 n eau \pph..ln~m __T1)kpmal Area Kcyu•reJ I'I 171 p •1ul :'\ria I m cd ra! tia Lm P.laanlinn
!:r J Ruurp+lsli JJJ 11~: ~ 11.1 1492: I0422. 103 52
III L _ T-
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l'I. Tank Inf. c',gluta of
(,all on, linal n of Mall" aeuncr c u J
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saa L4IT 13is.ry:'I alias I~ J~a c ✓ i
a-❑Y ❑ ❑
❑
[()fill I _Wiosu'Cor refe _
c.•I , l lioldhigi Lint, 10110
t II Responsibility Statement- the under,agned, as umt nspnnublhla far in>lallation nn 101175 shoran nn the attar haJ pl Im_
I'Inm:f•.\an.I-:nu Plume/ee//J~~yy,///al ..r1l r'.:rc AllIs \unlher I41.vuu.. Phone Nunlher
Y/yKK:~ 'S-'N.LII:ISG
IOhll ClI Illllr -
I'Ilmrb r .:lJlrt+: isucct, ( in state /it
f I(i 1 - ~Aaac Somc.nal, AA1 54(1] 1
llt ountyt)cpmtmenl I eOnly
_ -T-. 1
\ppn•aaJ tse.rll T _ 1'crnl/n lseC Dal a//l~..ucdQ' I I:uim•. dent Signaler
Ilcniul 1 S
IVCondi a IF N,~lroa~l~l•IYfl Disapproval ,tJ
J r^~• 44e'
-II- n* till be IYL4~111 11
n per ,yaBrf! plu) peoll by Plume_
Z NI Ilefblfx (t Ipul{6 be n2:m. II '.f
tMlwapFkmMCO& /:ffrlMAMSI. _ li
\Ilach n, annplrla plnn. far IM1e srsn•m :md eubmll In the Collnl+ unl) in pnprr nor Icy than R r:: a 11 inches in •.r
SYSTEM PLOT PLAN
Design --low
-
Project Name: Steven Huberty 4N~
- . roa pins. calculations toi '
?fdJeCl Address' 991 E,3rC nien.r comm cDmmerGa'. plans: ' i
RMi Symbol. A BIVI Elevation- ICJ C,7 Pipe Matenals r AS7 V Standard
Scale: 1" = 50'
BM Desorption: Top of 2' PVC p lv arses 384.30-3 & 384.30-5 0 50 75 WC
RM2 SyrnW. Q BM Elevation- lo<^?' ~4'-;;(, 4d PVC AS-M C2,' 65
RM DCSedptlon TDp of Dhv-c• p'o9 rr $ 4' SCF '.A34 ~STM 0303E - - -
Slope Gradient o' Tested Area. ;10%: Sta ldord Standaz h'L.5''
Well Symbol Lit applicable)
Notes. Vr.~es
r96th Street
-de-sac Property Line
Propos d
BM2 `well i
1.~\.-4 \ Bedroom
\ \ - I-lous
Driveway
BM1 \3 \ X
Q)
c \
J
T
Wieser WLP1000-MR
o Septic Tank w/ Polylok 525
n
~ i
T1 3'x75' EZ Flow Trench El. = 104.92'
T2 3'x75' EZ Flow Trench El. = 104.22'
T3 3'x75' EZ Flow Trench El. 103.52'
(Trenches to have a minimurh of-1Z I
cover)-'
o
r
NV~
Property Line ~•QPY
CONVENTIONAL COMPONENT DESIGN
INDEX AND TITLE PAGE
Project Name: Huberty 3 Bedroom Septic System
Owners Name: Steven Huberty
Owner's Address P.O. Box 62
Roberts, WI 54023
Legal Description: NEJ/4, SE1/4, S19, T29N, R18W
Township Warren
County: St. Croix
Subdivision Name: NA
Lot Number: 5 Block Number
Parcel I.D. Number 042-1053-30-100
Plan Transaction No.
Page 1 Index and title
Page 2 Plot Plan
Page 3 Septic Tank Specifications
Page 4 Effluent Filter Information
Page 5 System Sizing & Cross Section
Page 6 EZ Flow Information
Page 7 Management and contingency plan
Pape 8 Septic Tank Maintenance Agreement
Page 9 Warranty Deed
page 10 CSM or Plat
Attachment 1 Soil Evaluation Report
Designer: John Schmitt Licnese Number: MPRS 223760
Date: 8/19/2018 Phone Number: 715-760-0486
Signature:/(
In--Ground Soil Absorption Component Manual Version 2.0 SBD-10705-P IN. 01/01)
Page 1
SYSTEM PLOT PLAN
Ic.v
Project Name: Steven Huberty Design 45013PC
- N
- - - - iIf[ae/I oe5ign flow ralculatrons for
Pro;erl Address. OS,' 83W Aecm.e commercial plans.
8M1 Symbol: A AM Flevalion. 1cc oC' Pipe Materials: ASTNI Stardaio
Scale: 1 " = 50'
BM Description-. Top of T' PVC Poe _ -abler 384.30-3 & 384.30 5
_ C 50 75 700
B102 Symbol'^ / .l BM Clevation' IC2 -1 M1' : :y40 PVC ASW 1)7eef, _
RM Descrption: -op c' ohono txxt k 5 4' SCi 1 3004 nSTM CY~34
Slope Gradient of Teslnd Area: sic',, Standarc - '2.5'
Well Symbol (if applicatae) _
Notes vr.195
96th Street
cul-de-sac Property Line
1\ 3 Propos d
BM2
well
4 Bedroo
\ House
\ 61 1 o Driveway
BM1 \ \ N \ rl 0
a)
J
T ti
a) Wieser WLP1000-MR
a)
o Septic Tank wit Polylok 525
T1 3'x75' EZ Flow Trench El. = 104.92'
T2 3'x75' EZ Flow Trench El. = 104.22'
T3 3'x75' EZ Flow Trench El. = 103.52'
(Trenches to have a minimum of 12" of
cover) t
a
0
a-
Property Line
i
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Page 3
Innov>fiv~ nil a i` ix~. ~ I
Hie PI. 525 Filler is rated for 10,000 GPD igallons Per day) making it one of the largos[ (hers in its class. It has
525 linear feel of On" filtration slots. Like the Polyluk PI. 122, the Polyluk PI. 525 has in automatic shut-off ball
installed with every filter. When the filter is removed for cleaning, the ball will Float up and temporarily shut aft
the system so the effluent won't leave the tank.
f c. ~ - tllenu tiwilrh
Rated for 10,000 GPD (gallons per day). Lr0nn GPD ^ Alarm-raq
,)19 linear feel of 111b" filtration. A(C,_rl, 1- I",C
Accepts 4" and 6" SCJ ID 40 pipe. r Extension Heidi,
Built in gas deflector.
Automatic shut-off ball when filter is removed. Raor
Alarm accessibility. I attal ecl t fer
Accepts PVC' extension handle,
Ideal for residential and commercial waste flows up to ,rf 1W
r'y'a
10,000 gallons Per day (GPD). FitrraWrr -1,a,
1. Locate the outlet of the septic tank.
2. Remove the tank cover and pump tank if nressarI Accepts, 4' 6,
3. Glue the filter housing to the 4" Or 6" outlet Pipe. If SCI ID 40 pipe
the filter is not centered under file access opening use a
Polylok Extend & Lok or piece of pipe to center filter.
4. Insert the PL-525 filter info its housing, r
G,ntilied to
a. Replace. and secure the septic tank cover. NSFIANSI Standard 46
the Pf.-525 Effluent Filters will operate efficiently for -
several years under normal conditions before requiring
cleaning. It is recommended that the filter be cleaned
.'v(-ry time the tank is pumped, or at least every three
wars. If the installed fitter contains an optional alarm,
the owner will be notified by an alarm when the filter Ga, D'-f e for
needs servicing. Servicing should be done by a certified
septic lank pumperoi installer. Automatic
tihut-eM( Rall
1 . Locate the outlet of the septic tank.
2. Remove tank cover and pump tank if necessary.
I)o not use plumbing when filler is removed.
4. Pull PL- 525 cartridge out of the housing.
5. Hose off Filter over thtr septic tank. Make sure all .
solids fall back into soplic tank.
n. Insert Lhe filter cartridge back into the housing making
sure the filter is properly aligned and co npletcly inserted. Polvtok. 7abcl ar liest filters ace pt Ea.av installs
Replace and secure septic lank coyer. the smartHftcr5'switch and alarm. into existing larks.
Polvlok, Inc. 3 Fairfield Blvd. Wallingford, C7 06492 Toll Free: 377.765.9569 Fax: 207.234.8514 wxvw.polglok amr
Page 4
PAGE 3 OF 4
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Page 5
Installation Instructions for '&EIZ Our'"
EZflow Systems in Wisconsin • . • flbyFILTRATOR
Wisconsin Department of Commerce. Safety and Buildings 5. The Absorpton area (SF) necessary 'of a given site shall
Ci.tisidn, has reviewed the specifications and/or plans for this be sized based on maximum daily sewage flow (GPD) and
Droduct and determined it to be in compliance with chapters the Permeabif ty for the site. If certain criteria is met. the
Comm 82 through 84, Wisconsin Admin. Code, and Chaplers EISA sizing can be used in Wisconsin, resulting in a 40%
146 and 160, Wisconsin Statutes. All sites must meet the Site smaller drainfield.
t~ Soil Conditions & Loc. ns Isolation distances as noted in
local regulations. 5. Place EZflow bundle(s) in the EZflow configuration ap-
proved by system des gn permit specified for the particu-
The approved products are 1203H (3-12" bundles with pipe in far site. The top or center-most bundles containing pipe
center bundle in 5' or 10' lengths) and 1203HP (3-12' bundles are joined end to end with an internal pipe coupler. Any
with pipe n each bundle in. 5' or 10' lengths. additional aggregate only bundles that may be required,
should be butted against the other aggregate-only bun-
A single pipe bundle centa rs a four inch perforated pipe sur- dies and do not require any type of connection.
rounded by EPS aggregate and is held together w.th ooly-
ehl;dene netting. A single aggregate bundle cor',gins aggregate 7. 'he top of each GEO cylinder contains a filter fabric pre-
only and s heid togotner with pnnelhylene rotting. manufactured in between the netting and aggregate. The
fabric is inserted to prevent scl intrusion. The installer
Materials and Equipment Needed shall make sure the the GEO is posfiioned upward and is
• FZft•)w Bundles in contact with the fabric contained in the adjacent cylin-
• EZflow Geotexble f abrie der before backfilling.
• EZflow Internal Pipe Couplers
• Pine for Header and Inlet 8. The EZflow Drainfield Systems should be installed in a
• Backhoe Excavator level trench 'n all direcbcns (both. across and along the
trench bottom) and should follow the contour of the ground
Installation Instructions surface elevation (uniform dept'n), with all continuous
The irshuctions for installation of EZflow products are given adjoining 10-foot cylindrical bundles placed end to end,
below. I irs p oduct must be installed in accordance with state with central bundle distribution pipe interconnected,
tiles defined in chapters Comm 82 through 84, Wisconsin Ad- without any dams, slepdowns or other water stops.
chinistrative Code, a-d Chapters 145 aoc 160, Wisconsin Stat-
ales, as well as the ioral health department's current design g. Tne trench top shall be graded such that water will not
manual. pond. Backfill should be seeded or sodded mmediately
after completion to reduce erosion.
I . Ater the local health department has determineo sizing
configuration, and layout for the EZflow systems, stake 10. EZflow EPS bundles are flexible and can fit in curved
or mark with pain[ the location of trenches ant lines. Be trenches as may be necessary to avoid trees, boulders, or
careful to set co^ect tank, invert pipe, header line or dis- other ubstadcs.
trbution box and trench bottom cleva:ions before instal-
la-,on of pipe bundles. 1 CPS aggregate is ligh:er than water, therefore. it might
be expected that natural buoyancy forces would tend to
2. Remove plastic EZflow shippng bags prior to placi-hg cause EZ11av+ assemblies to float out of ground when
bundles in the trench(es;. Remove any plastic bags in thc• : ponding occurs.: ield experience has shown, however,
trench before system is covereo. that this is not a problem when systems have a minimum
of 6' of soil cover as recommended by manufacture,.
3. this product must have geotextile fabric that meets re.
q,iirements of s. Comm 84.30 (6) (g). Wis. Adm. Code,
installed directly on top of the product and extending 1203H-GEO
down along the sides of the product to a point at least six
inches from the bottom of product. - Gr«ar xtiie
Gamier Dna'?r a.
r=t I
4. When installed in a trench, the trench should be dug to
a width of Winches. This not only saves labor in excava-
tion, but also provides better load-bearing capacity after
backfilling is complete.
Page6
PAGE 4OF4
In-ground Gravity Management Plan
IMPORTANT:
The owner of this in-ground gravity system shall be responsible for its perpetual operation and maintenance pursuant to
requirements of SPS 382-384, Wisc- Admin. Code, Pursuant to SPS 383,52 (2), Wisc Admin. Code. this system shall
be considered a human health hazard if not maintained in accordance with this approved management plan.
Furthermore. all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in
accordance with SPS 383.52 (3), Wisc. Admin. Code.
Maximum Dispersal Area Operating Limits:
Design Flow= 450 gpd; BODE 5 220 mgL"; TSS 150 mgL"; FOG 5 30 mgL"
Inspection Checklist INSPECT EVERY 3 YEARS
o type of use
o age of system
o nuisance factors (i.e. odors. user complaints, etc.)
o mechanical malfunction (i.e., pumps, valves, switches, floats. etc.)
material fatigue (i.e.. leaks, breaks, corrosion. etc.)
solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e.. distribution 1 drop boxes)
o neglect or improper use (i.e.. exceeding design capacities. prohibited activities, etc.)
extent of ponding in distribution cell prior to dosing
o dosing irregularities - if applicable (i.e., pump re-cycling, float switch settings, etc.)
electrical components - if applicable (i.e., wiring, connections, switches, controls, timers. alarms, etc.)
o distribution lateral or lateral orifice plugging (measure lateral distal pressure - compare to design specification)
o surface discharge of effluent or sewage back-up into structure served
Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary)
o Septic and dose tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis.
Stats. when the volume of solids in the tank(s) exceeds one-third (113) the liquid volume of the tank(s) or
as required by local ordinance. Disposal of contents shall be pursuant to NR 113, Wisc Admin. Code.
c Effluent filterlsl shall be inspected every 3 years and shall be cleaned when necessary to remove any
accumulated solids according to manufacturers specifications. A servicing period will always be greater than 12
months
System maintenance reports shall be submitted to the proper local government unit in accordance with
SIPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to:
Name of individual or company: John Schmitt Phone: 715-760-0486
Local government unit: St. Croix County Community Developement Phone: 715-386-4680
Loral government unit address: 1101 Carmichael Road, Hudson, WI ZIP. 54016
Any defective part of this system shalt be repaired. replaced, or removed pursuant to SPS 383.51 (1), Wisc. Admin.
Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wisc. Admin. Code.
No product for chemical or physical restoration of the POWTS may be used unless approved by the department in
accordance with SPS 384, Wisc. Admin. Code.
Contingency Plan
In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to
a plan submitted to the appropriate agency for review and approval. A failed in-ground dispersal component may be
abandoned and replaced by a code-complying dispersal component in a pre-determined area of suitable soils,
System Abandonment
If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code.
Page 7
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMEN'r
AND
OWNERSHIP CERTIFICATION FORM
Otvner(Ruyer Steven Huberty
P.O. Box~ZRoberts, WI 54023
Mailing Addres
Property Addres 991 83rd Avenue _
(Verification required fiom PLmning &louing, D riment for new cnnstruction)
City/State_RobertsiWI 042-1053-30-100
Parcel Identification Number
LEGAL DESCRIPTION
Property Location NE _''/4 , SE Sec. 19_, T 29 N R 1$ W Town of Warren
Subdivision Plat: Lot # 5
Certified Survey Map # _ - Volume . Pagc #
Warranty Deed # (before 2007)Volume Pagc
Spec houscOycs0to Lot lines identifiable EjycsE]no
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use and maintenance of your septic system could result in its premature failure n) handle wastes. Proper
maintenance consists of puntpinn out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into
the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance
responsibilities are specified in §SPS. 38~i52(I) and in Chapter 13 - St. Croix Count' Sanitary ordinance.
fhe property owner agrees to submit to tit. Croix County PlatumlG & Zoning Department a certification form, signed by the
owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site
wastewater disposal system is in proper operating condition and'or C) aficr inspection and pmnping (if necessary'), the septic tank is
less than 1/3 fill of sludge.
t'we, the undersigned have read the above requirements :nd agree to maintain the private sewage disposal system with the
standards set forth, herein, as set by the Department of Safely And Professional Services and the IX-partment of Natural Resources,
State ol'Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix
County planning & Zoning Department within 30 days of the three year expiration date.
1/we certify that all statements o his form are true to the best of my/om knowledgm: 11we atn/are. the owner(s) of the
rrat
try decd recorded in Register of Deeds Office.
property' described above, by virtue of a t
Number of 4 ms 3
S (G;NATf1RL OF APPLICA '(S) - - DATE
*'*Any infnnualion that is misrepresented nay result in the sanitary permit being revoked by the planning & Zoning Department. i0*
Include with this application a recorded warranty deed from the Register of I)ceds Office and a copy of the certified survey map if
reference is made in the warranty deed.
(REV. 04112)
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II J~e Dept #1303
S SALUATION REPORT
with Comm 85WisAdmCafe Page 1 or 3
P Professional Ser
a Schmitt Soil Testing, IncAttach complete site plan oh paper not less,lhart;815in sizePlan must County St. Croix
include, but not limited to vertical and honzonlaf,re (BM), direction and - - - - -
percent slope. scale or dimensions' dodha - , ocalion.kr~ drstNoe to nearest road. Parcel I.
042-1 53- -100
Please print all infor - - -
74W6Y4M2DE8NW Revie By Date
Persaial inrcrt^aMn you prov,do may be used for xerri
Property Owner Property Location
Albright, Robert & Sandra Govt Lot E114, j1/4,49, T29N, R18W
- - -
Property Ownlei s Marking Address ss Lot # Block # Sabot Name r CSM#
962 80th Ave. 5 CSM 19- 31
City Stale Zip Code Phone Number ;Jrty Village Town earest Road
Roberts WI 54023 715-749-3218 Warren 83Rd Ave
New Construction Use Residential: Number of bedrooms 3 Code derived design flow rate 450 GPD
Replacement Public or commercial - Describe.
Parent material out wash Plain _ Flood plain elevation. if applicable fl,
General comments An On-site evaluation of this area was conducted on 9-29.2017 by St. Croix County Community Development The area is suitable
and recommendations, for a conventional system with a Ngpd8sfl rave. Install system on the contour at a depth or 24'. Slope of area is 10%.
Boring # Boring -
Pit Ground surface elev 106.15 0 Depth to limiting factor 96+ in. Soil Application Rate
Horizon I Depth Dominant Color Redox Description Texture Structure ,Consistence Boundary Roots GPD:Yt2
in. Mansell Ou. Sz. Cont. Color Gr Sz. Sh. 'E##1 •1111#2
1 0-9 10yr3/3 none sit 2fsbk mfr as 2f 0.6 0.8
2 9-24 10yr4/6 none Sid 2msbk mfr gw if 0.4 0.6
3 24-72 7.5yr4/4 none sl lmsbk mfr qw 0.4 0.7
-t -
4 72-96 10yr4/6 none fsl j 2msbk mfr 0.4 - 0.8
l
/o
Fil Boring # Boring
Pit Ground surface elev. _ 105.65 ft Depth to limiting factor 100+ in Soil Application Rate.
Horizon Depth Dominant Color Redox Description Texture Structure Consislenc Boundary Roots GPDrf_f'
in Munsell Do Sz. Cont. Color 1 Gr. Sz. Sh. -E1141 'E"2
1 0-6 10yr3/3 none I 2fsbk mfr 6 2f 0.6 0.8
2 6-29 10 r4/4 none I 2msbk mfr gw if 0.6 0.8
3 29-60 10yr4/6 none st 2msbk mfr qw if 0.6 1.0
4 60-82 10yr5/4 none fsl 2msbk mvfr as 0.4 0.8
i
j
5 82-1001 1Oyr6/4 none ms 05g ml t 0.7 1.6
40 267 D15'7-6-
Effluent #1 = BOD,> 30 < 220 mgiL and TSS >30 < 150 mgti ' Effluent 02 = BODS < 30 mgrl, and TSS _ 0 m !L
CST Name (Please Print) Signature: CST Number
Thomas J. Schmit 227429
Address Print)
Schmitt Sod Testing. Inc. Date Evaluation Conducted Telephone Number
1595 72nd St. New Richmond, WI 54017 9/29/2017 715-760-1978
SRU-x~:n i N ;1`aCrr
Properly Owner Albright, Robert & Sandra PafcellD# 042-1053-30-100 Page 2 n!
I Boring
3 I Bonng #
L.~ Pit Ground surface elev. 102.99 h Depth to limiting !actor 97+ in. Sod pA.Sod iralical lion Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM3
in Munsell Qu Sz. Cont. Color Gr. Sz. Sh. •Erfp1 •Erfr2
1 0-10 10yr3/2 none I 2fsbk mfr as if 0.6 0.8
- - i-
2 10-21 10yr4/6 none i scl i 3msbk mfr gw if 0.4 0.6
- i
3 21-52 ! 10Yr4/4 none -el 2rsbk mfr qw 0.6 1.0
-
4 52771 10yr4/4 none fsl 2msbk mfr cs 0.4 0.8
- -
5 77-97 10yr5/6 none ms Osg ml 0.7 1.6
_ I
a Boring # Boring r
Pit Ground surface elev- 10.39 R Depth to limiting factor 78+ in
- Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure 'Consistence Boundary Roots GPD.rfl2
in. Munsell Qu Sz. Cont. Color Gr. Sz. Sin. •EH#t •ErHz
1 0-11 IOyr3/3 none I 2fsbk mfr as 2f 0.6 0.8
2 11-16 10yr3/4 none sl 2msbk mfr gw if 0.6 i 1.0
3 16-50 IOyr4/4 none $l lmsbk mfr gw Ivf 0.4 0.7
4 50-72 1Oyr4/4 none fsl Om Mill Cs 0.2 0.5
5 72-78 IOyr6/4 none ms 0sq ml - 0.7 1.6
- r
-
f 7 1 S- % 7 I .44
Boring 22•
❑ 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/fl'
in. Munsell Qu Sz. Conl. Color Gr. Sz. Sh •EffNI '042
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Effluent # 1 = BCD,> 30< 220 mg+L and TSS >30 150 mgiL ' Effluent #2 = BODS < 30 mgiL and TSS < 30 mgiL
the Department of Commerce is an equal opponunity sen icc prnv ider and employer. If Nou neat a.ssi~tamce to access serv ice, or
need material in an alternate lormol, plcaw contact the deportment at Bu8-266-31 i I or f-IY 608-261-R7??.
Co6ducted by: Conducted For: Page 3 of 3
Schmitt Soil and Site Evaluations Name: Robert and Sandra Albright
Thomas I Schmitt, CST 227429 Address: 962 80th Ave.
1595 72nd St. City, State, Zip: Roberts, WL 54023
New Richmond, WE 54017
Phone: 715-247-2941 Subd.Name: CSM
/O -9-~f Lot No.: 5
Legal I)escriptiore NE 1/4 SE 1/4 S19 729N RI 8W
Township of Warren, St. Croat Cty.
Bench Mark EL 100,00' top of 2" pvc pipe
Alternate Bench Mark El. 102.71' top of phone ped No. 5
Slope= 10%
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