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HomeMy WebLinkAbout261-1346-00-000 wsconsir Uuparme•v of Commeiee PRIVATE SEWAGE SYSTEM CUUrty. .5 CfDIX Safety and BU, dig Division INSPECTION REPORT Sar Tapir PemnC No GENERAL INFORMATION (ATTACH TO PERMIT) 605182 Stale Plan ID No. Personal informal 911 ye- Pro'cde -ay 9e Used for sedarda'y our eoles'nfrwacy Lar•'. s.15 C4 rl:nr l Permit Noldci's Name Fly village IC'Br'Shla ParceTax NC Greg Anderson CITY OF NEW RICHMOND 261-1346-00-000 CST BM Elev Ir;p BLa I ev. BM Descnpbon. SeC90nr l cmr!Rangc'Laaa No. fob Gfy\ '1 65T /op TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER , r9 CAPACITY STATION BS HI FS ELEV. Se-lic 1 ,zs~ Benchmark (h~ 1 ~ !1 111 ' i~ 1 T a ~D IC !j Art eNF1 Aeration Bldg. Sevrer 3 1 /d4, 25 Hold'rg _ S'-Ht Inlet TANK SETBACK INFORMATION sUH! Outlet 162.13 4 27 TANK TO P+L WELL LDG Vert ;c A Irtake ROAD Dt Inlet Sechc 7 /00f GT I 540y 1 I r D: Hot:om \ \ Dosing !U HeadedMan 934 161f118 Aeration Dist Pipe i1 1F`~ /od .9l Hold r _ g Bell. systerwz.33 H AI 1919,11, oil PUMPISIPHON INFORMATION Fina Grade eLj S: cad__ 9. (4 161,74 blanu(aclurer Demand St Cover / 5- l1 i6 , tdodel Nu cPM I (O 5 3.7 5'ga . l TDH Li't Friction Loss Syslem He I DI I F. _ F/0 S Fo'cema r Lerg:n Dla uu: IC veel SOIL ABSORPTION SYSTEM BED!TRENCH 'uY d:h Lcnge- Nr. C1 I, I,,, ps PIT DIk1ENSIONS Na •Pis :nsilli t. qi.d In DIMENSIONS 70 ~ - ~--3 -W(64 SET8ACK SYSTEM TO IIJJ P:L BLDG bVELL LAKE+STREAPA LEACHING Manu!a::!.•cr INFORMATION CHAMBER OR TA Type t Syslem UNIT DISTRIBUTION SYSTEM f? ! 1 7 I - s~ ✓5 Hea'e'~^.1an~i~; / Dish GdhLr r S 5 %'IOC $2e %h0 e. $(~3LIIIy JP.N!OIf lnfakC 5 Proelp p}lC -o;tn Ca ~ lengln Da Spa,- nt SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Deuth Over C=Gtr Ore' xx Degtr ar Seucecr S=JeJ xx M&IChed BP.d1Tfe nLr Cemel , Q~ BP.yfl'P,^Ln ECgeS ` !OPSC 11 \YCS NC T5 NO COMMENTS: ;Include code discrepenc'es, pe•scns present, etc.) Inspect or. M1 ~ Inspection #2. Location: 1745 115TH ST I / k?atl . Ad- r^, c_4- 1 All Bbl Desc'iotion= I Go J_t1_ 1 2.1 Bldg seater length = /C -a.'rountofcpver= J 7 qZ Plan revision Requiredo I Yes XNo 3C/,5: Use other side for additional rformation. l0 SBD rT10 iR 3:9;1 Dale Irs,;ovCf•, ignal.,re ;:en NO- r V4 e ~ tl Pp LC Bul di'r~ Iris cn ~ ~ p I J '.:i5hin IJ t>_ r' 0 Bux 7162 5,,Itj \m I r Ilo 611 i' 11 C.1 1 yam p1 11^^ - I LV 1 1 SJ 7- \ \ i ~ S, ~Y• J~ ~j ,y ST. CR IX C NTY ( 1 J ` D :AMMUNI REVEL MENT - el, T',rsaco.n (~n'Fdl dllltdlti' ZCITIII Application II I II ,i? • . ...t , 1 t II Or '1 loplla 'cnn' lal ~n • • rlu 1 11T -4 u I It j I 11, 1 \11 C li 11, 1 1 1 1 ITI, 1. ruI PMM {Ibnl t I{ I I t:rov 111411 nt i,r_. mlLrieTl I IT 11 I 1. 1 P I 9r I: 11 IF IF I vld. 11Y t f uud fI a Uy I 1 I I tth Ira I . I , at : m r - ti ej lQ+ /L S4o1 \rIh uunn lnGlrtnuinn - Pluvc Pnn[4111nfonnuchnl I Ct~oJO a A -ru• ,deco: a N. p ny l V, nr O.'. I _ tU ~ a Il, I i.. /.p C,.ic I h nc Nsm6e' - u t nn ~ 11 - Nt..,l I~kc.~vM~,.Yf S`t~l"~ ~ ISr 5~1.~1~0 - II Type of Buildup (check all that appl\I ~ pp ~qa. 3 5:` Im .nn Sam: . I IG._ \ t:-t ,I ltr,h ono 1 /c I n ~ I]lla I n rlel' 7~ III f\ ' . Y'heck ni. on ho\ on line \ complete line it if appheablel ~ t•f-~ Y LLn:,vnn I ,:m I ~ I an: -.l i ~ Lt.. T.inl. R ac.: tc:n lln7., _ Uth.: \.ludl': In: u I ,t..iu :~t:rl ~l. l R_ I'cm 1 R r [ is R bl w Pcc. n \u ,v, m I 1 v'.. 'a.unl Pe1n',l Itnt I'.u.. lice . Permit Tnn>iar 1 \e•n 1 I e1NT11e Uim Car nent Uc\IU ((heck all lhal apphl 5t <qw4mtoI L% ...n.! el II 6777, i. _..IF t:- (exld,l tI t.nalmcnt l le•.i I q,lak.; \ UI pc of Tre acme". \rea InfurntatiOn fl I cl.: U, :es\ed lpphaaar RalcI fl U nmal Area Reyl.ircd.:sl) Dep. dArs Rapn,ed.s sy> mCle'atiion` L 1( - l I;. III (q l::p II 111 100 FI! ul \I I ,t cuu:. I 1 l dl I G- It I:nla _ I 1 V'u+v I,I,A, l: / . I a 1 - i I t IF \ 11 H pll'1 `1blhl\ \I,ICepeul- I. the cold. raigned. a"uma ".,pomlh \ ear in,ull lum of the f U\\'rl,hnwn on 111 10a,hed plan: I - t n~ 'I P.un-b;a s Yen ¢urc~ \I \fl It\ \urtar Ouu.•, . PI. rm \cnd:a u hl I I"cr, < I ~.i: TiP; la,; ^ - 1 ✓ ~I \ Ill. Caunl\'!11e rrrtment Cse OWN _ cue:':: U..c' . I:. nr.• cal: Sim., 11Lr t.u _ I!pn; I (uaP I I 1\ s t hsnppru\ d $epft RQ.I. ~`Ilki +A.~ AL uispeevhl cell nm;t all tos''! ICLS ' • ' '1-`'-lr. /w 3) Po l V n-1 5 n per W*Mqtalon: pj,n pro ti by wwnbe /J Mblr'fWMrefrm ras marlt u r, aepk irx : a! ~p„bt+ bs1 r S 2 • i~► ~iP~~ tab! / xrG:uereu. ~ \:u. L m., mpl.o- iJ.m.:.n' .Le mm,:Ia wha:il o, :Lu <'nnna unlf an P+pel um ley II,:.n S I : \ I I inr hr. in ,i,, ~ ~ / /arc --Sir/✓ cr / /._?i,~/ ~',y"'c ' : q ✓~io'izw'p:,! : i ;~.O /mod - f - ~ f e I f t I f T ! _ I 1 ~ f I - tel. ~ f ~ i f - s ; c o p d / CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name Owners Name Owner's Address: i Legal Description: _ q' % ti x s' Township: - - > County _ Subdivision Name: Lot Number: Parcel ID Number. Page 1 Index and title Page 2 Plot Plan Page 3 ___System S_ izing & Cross-Section Page a Filter Specs Page 5 Maintenance Information Page 6 Manaq,emenl Plan Page 7 St. Croix Cty Septic Tank Maintenance Form Page 8 Warranty Deed Page 9 CSM or Plat Attachments: Soil 1 est & House Plans i Designer/Plumber: License Number: Date: Phone Number `J Signature Designed pursuant to the In-Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD-10105-P (N.01101). Page 1 C7X!-'C~ ~~'I~F-R~~Gif/ ~U•'~~~/--J~: ~`~'._~t_C= ~ ~~"~(.~~'JC~JGv R r E/ e"' x5m av" > 1cf //-<l 4114 ~ ~ r r 7w6/ a /0,2 J inn Soil Absorption System Cross Section 4 tt - ft 4° SchedWe 4o Final Grade PVC Vent Pipe With Vent Cap f- iL ft j Leaching Chamber System Elevation ft ft ft Soil Absorption System Plan View ft ft u11ur~1~ l l l 1~~I~l i r ft Leaching Trench 1 Chambers Mac& 4' Dia. Trench 2 Header Vent Or Observation Pipe Trench 3 ] Leaching Chamber Specifications Manufacturer And Model EISA Rating. ' sq ft per chamber Soil Application Rate gpd/sq ft gpd Design Flow ? Soil Application Rate EISA = i Chambers 3 rows ofl : chambers each. Page of Zco)k,inc FLUENT FILTER ( -1 eased to add its l filter to its existing line of quality effluent filters. The I Pf_525 is rated for over 10,000 GPD Alamt Accepts PVC gallons per day) making it one of accessibility extension handle the largest commercial filters in its class. It has 525 linear feet of 1/16" filtration slots. Like the Polylok ' PL-122, the new Polylok PL-525 has an automatic shut off ball installed 525 linear feet with every filter. When the filter is of 1116" filtration slots S 3 P Rated for over removed for cleaning, the ball will mono GPD float up and temporarily shut off H r the system so the effluent won't <;; leave the tank. Ato other filter on the market can make that claim! Accepts 4" & 6" SCHD. 40 Pipe\ The PL-525 Effluent Filter should operate efficiently for several years under normal conditions before requiring cleaning. It is recom- mended that the filter be cleaned every time the tank is pumped or at least every three years. If the installed "niter contains an optional J E alarm, the owner will be notified by an alarm when the filter needs Gas deflector servicing. Servicing should be done by a certified septic tank I~ Automatic shutoff pumper or installer. -::Vii ban when filter is removed 1. Locate the outlet of the a-. taceet Noe 6.015AW f septic tank. F, 3;1,w Agoo 2. Remove tank cover and pump - - - tank if necessary. 7( 1. Locate the outlet of the 3. Do not use plumbing when septic tank. filter is removed. Ideal for residential and com- 2. Remove the tank cover and 4. Pull PL-525 out of the housing. martial waste flows Up to pump tank if necessary. 5. Hose off fitter over the septic 10,000 Gallons Per Day (GPD). 3. Glue the filter housing to the 4" or 6" outlet pipe. If the tank. Make sure all solids fall filter is not centered under the back into septic tank. access opening use a Polylok 6. Insert the filter cartridge back Extend & Lok or piece of pipe into the housing making sure to center filter. the filter is properly aligned and 4. Insert the PL-525 filter into completely inserted. its housing. 7. Replace septic tank cover. 5. Replace the septic tank rover. POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page Of _ FILE INFORMATION SYSTEM SPECIFICATIONS O:vner ; - Tank 1VlanufacLrrer ❑ NA Porm:t Septic I I Dose I It lo'dirng Volume I"- ~ (gal) DESIGN PARAMETERS I ant Nlanutacturec NA K. i-inrr of Hcdroon)s. -i ❑ NA ❑ Septic ❑ Dose ❑ Hold rig Volume (gal) Number of Puhll_ Fl-cIlity Ull is. [4 NA Vc. deal Distance Tank tlottem(s) to Service. Pad: IT Estimated (ave,aoe) Flow :gahda.y) Horzcntal Distance lank(s) to Service f'ad- (l) - - - - - °occihc efvlcwg mechanic., nut he pro•:ided if wrtieal is 15 'eel or Dts'gn (peak' Flow _ (e t m'11CC x 15). (gel day) it he ILt n al Is>Irl NW, Spe( III( insyructiuns[,tu be provued on bark. In S k, Soil AppS:.at on 12atc (gal lavlft) Efflu_nl Fitter Pianufacturer.. q ` ❑ NA Standard (DOrnestln) Int .cnU[ffluen! l"lonlnly averace. Effluent filter 1Vlodel- rats. o f & tirczse (Fora) •:30 m51 Pump Nla%faUurel. 61c::hcmical oxygen oema)d (ROD,) _220 wgtL ❑ NA k7 NA --Total Suspended Solitl_ _s_(TSS) '150 nlgtl Purnp P.1oce.> High Slrength Influent.*'9unnt Monthly average; I'retreatment Urd (ion') 13U mgfl. FIarufaclurer- iBUU>) >220rr(VI LY-Ni+ ❑ NA ' er arl:n ❑ Peal Filter - _ i I sail >150 rigtL tvledla:ra I IDi: irfi CtiCn IIVVetland Pretrca:ed LH.ccn: Monthhy average L Said-'Gravel I-Iles ❑ Other. _ :Ron,) s30 mg4L SmIAbsorptonSystem (I SS) 30 mg.1 0 NA I-ecal Co'ifonn (geornei•ir. mean) S70' 2 rd'cound (gravity) ❑ l1 (,renlld (plessl.le) ❑ NA - I-I m Gfade I I Mound Maximum Efflvont Particle Size f in dia Li NA I-1 D•ip One I 1 Othe,: Other: - - ❑ Nip Or-r- - ❑ NIA MAINTENANCE SCHEDULE Service Event Service Frequency v Pu•np ~:V'•A••Ihen arnb-nzd sludr -..nrl scum ei:uals one-1h rd c'1') of :n-k volume cu' content:; o' tank(. al hcn the high •;:titer alarm is activated nspe<;t condihoil of tanks) At least once evey ❑ munm(s) (Maximum 3 years) ❑ NA Iyear(sl ❑ nlonlhisJ Inspect dispersal cell(s) At leas) once e•,re:y: (Maximum 3 years) ❑ NA Yeast°J Ciear effluent filter A east once every ~ monu•is) ❑ NA Inspect pump, pump conlrels & a arm At least once every. I-,ormi`" ,~NA _ L~ ti"3rlsi . ❑ mrn+m:x;' ~Q r hish laterals and pressure test At least onc^ c•Vcry ❑ NA )'eags) 0910r* - - - ❑ mcntWia A: least on:.,~, eves/ LI NA ❑ year(s,l I I NA MAINTENANCE INSTRUCTIONS I:°spec:.ors W tanks and soil absorption s;,•sterrs shall Le made by an individual carrying onc of file following f~censes o: cerlifica(iens. Piaster Plumber, N&Lstor Plumbs Rc:strict2d Sever, PO'V"VIS Inspector, 110'04 1S Piainta:aer Cl Seplage Servicire Operator (pumper) - Tank nspections must include a Visual Inspect on of the tank(s) to identify any missing or broken hardware, identify, ay cracks or leaks measure :he volume of comb red sludge and scum and a check fo• any back up or pending of effluent on the ground surface. The sell absorption system stall r,e visually Irspected to check the effluent lavers in the observation pipos and to cneck for any pending of effluent on the ground surface- -I tie pond. rig of effluent on the ground s-ralce may indicate a fall --j condition and requires the immediate notification of the local regulatory author :y. When the combined accumulation o` sludge and scum in any treatment tank equals one-third (k) or more of the tank volume. the entire contents of the tank shall be removed by a Septage Servicing Operator (pumpe•) and disposed of in accordance with chapter NR 113, Wi soonsin Admimstmflve Code. All ot•1ei services, Including but not limited to lilt sen•icing of o luent filters. mechanical or press-sized co:nponenls. pretreatment units. and any servic ng at intervals o` _12 months, shall he perfomled by a certified POVVTS Paa~rtaincr. A service report shall be provided to the local regulatory authority WIt'7;n 30 days of canplelion of any service e•Veat. GIiVJ 005 (02105) Page( of START UP AND OPERATION I,r cew: canstnlcbn, prior to use of the PO'WTS c,reck treatment tank(s) for the presence of painting products, solvents or other dFFemicals or se-1 wt-1 that may impede the hratment process andior damage the soil absorption system. If high concentrations are cetectcc have the contents of the tank(s) removed L•y a Septage Servicing Operator (pumper) prior to use. Pump tanks clay fit above normal higherater levels prior to s'artup or due to pump failure% Start no or restoration of power under these conditions is not recommcridcd, as the excess :vaste:vater wi.I he discharged to the soil absorption system in one large dose causing an overload that may res.ilt in the backup or surface cfscharge of efluent and daniage to 'It- sdste•n to avoid this situation have the contems of the pump tank ierlovod by a Septage Servicing Operator (p.mprr) prior to restoring rCNer x the pump or Conrad a Plumber or 110"N I S Maintainer to assist in wanually operating the pump ccntro s until normal eB:uent !eve s arc restored within the p,rmp tank. Systerl sta t up shall not oaArr when soil conditiors are fr07rn at tee infiltratve surface. Uo not dive or pa'k vehicles over tanks o, ,he soil absorption system. Do riot drive ci park over, or otherwse disturb or cornpad, the area writ^i•i 15 'act down slope of any mound or a:-grade soil absorption area. Redjctioc or elimination of the fdfowine (roll the wastewater stream clay improve the perfocnance and prolong the life of the treatment tanks anc soil aLsorption system. acids, antibiotics, baby wipes. agarel'e buts, condc•ns, cot= swabs, dogreasers. denial floss, diapers, dis nfeciarts facs, foundation drain (s.nnp rump) discharge,.. fruit arid vegetable peelings, gasoline,., greases herbicides, meal scraps mcdirations. oils. painting products pesticides sa ritafy napkins, so'vents• tampons, and water softener Lune cischarge. ABANDONMENT '::'hen the PO1:V TS to s andior is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned n compliance -.nth s. Cor1m 53.33 W soonsin Administrative Code' • All piping to tanks, pits and other soil absorption systems shall be discoir:ecled and :he abandoned pipe openings sealed. • The contents of all tanks and p is shall be removed and properly disposed of by a Septage Servicing Operator (pumper). • After pui all tanks and pi's shall Le excavated and removed or their covers removed and the void space filler! wTh soil, gavel or another inert solid material. CONTINGENCY PLAN If the PO'':115 fads and cannot he repaired the following meas(:res have been, or must be taker. to provide a code compliant rcrlacenienl system. A suitable -oplacemort area has Lee-) cvaluated and may oe L6iced for the location. of a replacement sod absorption system. The replacement a'ea should Le protected from distwwance and cumpaction and should net tre infringed upon by required seloacks from existing and pcopused strlc il'c- lot Inv:.; aid erells- Fai.we to protect the replacement area will resul' in the need for a nev; soil and s.te evaluation to ostablish a sit taGle 'eplacemcnt aroa. Rep'acement systems must comply with the rules in effect at the time of treir pormit issuance El A suitah~e replacement area is net available due to setback a•tdioi soil limitations. If the soil absorption system cannot be rehab litated and baring advances in POWTS lechnolc.gy, a holding tank may be installed as a last resort ❑ The site has not been evaluated to identify a suitable replacemert area. Upon failure of t,-.e POINTS a sow and s::e evaluation must be performed to locate a suitab'e repacerrenl area. If ro replacement area is available a holdirg tank may be installed as a last resort to replace the failed PO'rV I S. ❑ Mound and at -grade soil absorption systems gray Le reconsVOC'e6 in place following removal of the biomat a' the infiltrative surtn::e Reucnstiudicns of such systems mull comedy :vt~ the rues in e8e::t ai that 7m^ WARNING TREATMENT TANKS, PUMP TANKS, AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES OR LACK SUFFICIENT OXYGEN TO SUSTAIN LIFE. NEVER ENTER ANY TANK UNDER ANY CIRCUMSTANCE. DEATH MAY i~ RESULT. ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK MAY NOT BE POSSIBLE. ADDITIONAL INSTRUCTIONS: POWTS INSTALLER POWTS MAINTAINER ; SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Narie _ Name r/ ,.r• , - u: 71 lhis document was, dmfled by lLC staffs of the Creer. Lzkc blarqudt-, I -,d a.rsha ,a cor.rty POSNTS regulatory agencies in comp iance with sec'.i:rr; Comm R.3.22(2p;ti1(Ip;d)81f) and 83.~41y. (2) & iJi.'o14SCGn5in /ttlminisfr.;linNronc. I START UP AND OPERATION I Or l oo'1Strt.c3lon, p-~Or to Use of tne ?OVVTS c`ie:x treatment tarkisi for the presence of painting produ_s solvents or othe' cherr.ica's or sediment ma; may Impede the t-catrl process andror damage the soil absorption systern. If No!- conxmratlons are detected gave the coolants of the tanks; removec by a Septage Servici^.q Operator (ouri ono-te use. Pump barks may fll ahowe normal nlghr:ater ieve;s pnaa to staCup x cue to pump failures Start up o- restoraticn u` power under these ;;uneifions is 'lot recommended as ire excess wasle::ate• will oe dis:hargec: is the soil absorpi.on system in one targe. case causing an overioac that may res.rlt in trin baa:.rp c- sarfecx dlscha-ac ~ o' effluent and carnage to the systerr: Tc avolc this si.tuatior have tie contents o` the pump tank removec by a Septage Serv.c;ng Operate ipunroeri prior to restorinc power to the purrs o' co':tact a Plumper or PCYATS Maintainer to ass:s: in maa:ually uberalinq [ne pump cc-iVois unti normal efhuent leve,s are testcree within the puma :ank,. Svstem start up shall not as-.rr when soil conditions a-c- tmrcn n'th:- Inilbalive surface. Oc no- drive or park vel over tanks or tie soil absoralix- svsten'.. De not ddvi: o• nary. ever. o' othenvse cisturp 0, ";ompav., tile area wcttiri~ 15 feet do'rn slcue of any mound o' a: grace so: absarption area Reduotio- or ciim:natior of the foil swing om the v:asre:vak: stream m.ay hi:+, o've the perfom arr. e and nro cng the life of the treatment tanks anc sot. absorption svstwrt -nerds, anobrfl.'s harry wipes aga'ette bats, oondorns cotton swabs degreasers, cental ficss. d apers durn`ndants, fats fouhdatia drain !sump pomp: d:scnarce fruit a'ld vegetable peetincs gasoline. greases, herbicides, meat scraps 'ne icaiions, oils, naming prodil-M DEStlCldes sanitary napkins solvents tampons an: water softener brine discharge ABANDONMENT 4:412n the POLN`S fa is andro- is permanrn' y teKen a,s Of se-di❑e trre foliMlnc stews shall be taker tp m%xe that the system is properiy anc safely abandonec Ir compiian:r with s Cons' 6'.K3 Wscons n Administrative ode' • Al piping to tanks. pits ahc otne, soil absc,otio- systems shaft he disconnected arid the aba°docec pipe. caenings scaled • The contents o` at tanks and p is s'lall pe removed and pi-nn r,y disposed o` by a Septage Senvdag Operator (pumper; • After punp;nc, all ta-.ks and pits shal ae excavates anc removed o' their coves renoved and the void space fillec w& soil. gravel or ahuCte: inert solid materia:. CONTINGENCY PLAN I` the POINTS fails and ;:anno: be repaired the folinrnnc . measures have peem or must be taKen, to provide a cone compilant 'epia:F•mec system Al A. suitable teulacerr err a-ea nas beer eva'ua:ed and may be utihzcd for t:•te Io::ailor, cf a reo.acement soi absorption system. The repiacei-ie a'ea S')01.110 De protectec frcm distJrbancc and compaction and should not be infringed upon by required SB:baCKS. f•cn' existing and propOsec strtr-t.ce, lo: tines and wells . Faliure ls• protect trie replacement area will result r. the need for a new sot and sae evar.:atlor to estaoi:sh a suitable «:.placement a•ea Replaoement systems must cornp`y swim the rules r, e%ecl at t'ne time w Wei pe•rrr; issuance. ❑ k sitaole replacement area is riol available due is setbacf: anc'or sot Lmitaficos I` the soil absorption system cannot be rehabilitated anc oarnng advances in PO':VTS tec'Irdoyy. a holding tank. may nc Instaliee as a last reso- ❑ The site has nut been evai aced tc identify a suitab+e replacement area Upon fail rl of the PO1:117S a soil aid s- evaluation must be performed to to mr, a suitabie replx: nrlent area. If nc repiacwnent a'ea is avai,abic a hoid:ng tank may oe instated as a last resoC to -epiasr- the failed i'O'cNf ❑ Mound and a'--grade s~ I aosoiptior systems may be reconstn,ctnd it place following 'emava a` t-e biomat a' the infi.1rat've su•fac:e. Re o~1>: u~.ions cf s..d-i syste:l-s Must coelp°✓ stir. toe r.ilcs r ef`_ct a: tI-at tine. WARNING TREATMENT TANKS. PUMP TANKS. AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES OR LACK SUFFICIENT OXYGEN TO SUSTAIN LIFE. NEVER ENTER ANY TANK UNDER ANY CIRCUMSTANCE. DEATH MAY RESULT. ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK MAY NOT BE POSSIBLE. ADDITIONAL INSTRUCTIONS: PONTS INSTALLER PONTS MAINTAINER I N991; Narle SEPTAGE SERVICING OPERATOR fPl1M PERT LOCAL REGULATORY AUTHORITY I Nanrc t Ile - PI r fIJ c %y In_ cl Cc-en'. vrac nr.ftcd ty Inc. stair[. c ti-Crr-;:r Lang. :'.rc.leitp anc'::r.,.t a Jc~ 1!~ r 4 re~~ ton anencm Ir comp I_r.e aiu sed:cn- !'c yr F'_2'2 L1.1;:; d7 Gl;li aIJ' l54('Ij r1S Y 13.. ViscP'h.n hOmun-L the:ocE I ST. CROIX COUN'T'Y SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSIp CERTIFICATION FORM i ow-nerfBuyer Address Mailing ~ Property Address (Verification required from planning & Zoning Depatlment for new construction.) _ - Parcel Identification Number _L_11~ City/State " LEGAL DESCRIPTION :Sec. T N R I -,-W, Town of property Location Lot Subdivision Plat:__- # - . Volume Page Certified Survey gap # f ~35`{~Q (before2007)Volume Page# Warranty Deed # , Lot lines identifiable tl yes O no Spec house D yes no SYSTEM MAPi 1TEN ONCE AND OWNER CERTIFICATION maintenance of your septic system could result in its premature failure to handle wastes- w~ you put into Improper use and o out tic tank every three years or sooner, if nedd, by a licensd pumper. maintenance consists of -unction the septic tank as a _ the e disposal the system can affect ec~ d in §SPS. 8352(l) and in Chapter 12 - St. Croix County Sanitary sordinancee. maintenance responsibilities are tip si d b the The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form gn Y owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site sal system is in proper operating condition and/or (1) after inspection and pumping (if necessary), the septic tank is wastewater dispo less than 113 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the ices ofN the and esources standards set forth, herein, tier the Department t your septic system has been maintained must be co pletd and returrta ed Rthe S roix State of Wisconsin- Certification stating iration date. County planning & Zoning Department witlriri 30 days of the thn:e year exP Uwe certify that all statements on this form are true to the best of my/ D/our wfficee Ifwe amlare the owner(s) of the property ZOFLICANT(S) described above, d recorded in Register Number of bedroomSIGNI ATtIRATE $s:Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. xx' Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the waramy deed. rr. MW "..JM 4 Z ids lip, Jr, I' A- I ~C +C ,yR ~ K mod. ~ a+{1 rn `4 i ♦ a Y'~ sC ~ a -s'. i may!" ° C iw } w ` 4' V O 0 t It j' DF y' t s 4 ,lz v e 1+j,1 i S:~aj111401 fi'•R'.. / .y A iP as 1 _ 3" r 40. s „,l Parcel 026-1015-10-050 Val,d as of 10;12!201710:12 AM Alt. Parcel 04.30.18.51 D-05 TOWN OF RICHMOND ST. CROIX COUNTY. WISCONSIN Owner and Mailing Address: Co-Owner(s): GREGORY M ANDERSON PO BOX 179 Physical Property NEW RICHMOND WI 54011 Address(es): 1745 1 15TI I ST Districts: Distill Description Parcel History: 3962 SCH DIST NEW RICHMOND Date Doc, # VoUFaw Type 1700 WITC 09/09/2016 1;r~`q„+ ESMT 8020 0111'ER WILLOW REHAB DIST 09109/2016 1(iPS 1 ILII i WD 07/23/2014 ,W52 1 OC Legal Description: Acres: 27.500 06101/2007 ! AFF SEC 4 T30N R18W ALL THAT PT OF N 112 SE 114 mere LYING WILY OF CEN LN WILLOW RIVER EXC PT DESC TO CITY OF NEW RICHMOND IN 8505... Rwre Plat Tract (s-T•R 401/,1601/. GL) BlocWCondo Bldg NSA-NOT AVAILABLE 04-30N-18W 2017 Valuations: Values Last Changed on 08+31:2015 Class and Description Acres Land Improvement Total G5-UNDEVELOPED 27.500 61.900.00 0.00 61,900.00 Totals for 2017 General Property 27.500 61,900.00 0.00 61,900.00 Woodland 0.000 0.00 0.00 0.00 Totals for 2016 General Property 27.500 61.900.00 0.00 61,900.00 Woodland 0.000 0.00 0.00 0.00 2017 Taxes Taxes have not yet been calculated. Key Primary CERTIFIED S L R i' F. Y :'11AP located in the .Nurtltwre't 1/4 of the Sollth C'a St 1 %1 and to the Northeast 114 of the Southeast 114 o! Section 4, 7orrn.chip 30 .North, Range 18 West. (itT o1 New Rn-limonrt, St. Croix C'ounts'. Wisconsin -:-r r 4 ` lL Vii' _-i `c W s: ♦ r1 a: u ~ :,✓n'j ~ v n Imo- - rl C, c m U ~ .11,.4 1 i1 ~ c _ C_> r- r0 p 1. we -l r ` q r 1 ` v : '2l W p >~i :x.r unr+i Ic>_ 1 vlnp an ouarclc £y YZ TFELD ar L _GCr < f ' S n.ty St S7 a - ~•iO IX 'A 'A pg~ ,D(~ ~ J ~ i .~r whirr L+nd Strrvc) MOnumcn! n! a$ ,a - + an l yr -rbcd he cxroonq '.rco n SUR '^N..,wmw."'~^p _ Q 'om ~UtG... !<'=.rLO^ pnrp n: ':.r r</ Sc'[ f ~ L- ./ann:rs• rrni2✓ and drarna.ae 6d5c'mc`nt ~x S, r. F. /c><a; wrdc Rccc~• ; iaxmcn! [:r!E, - to Lot j of then Cr^:.rfrcxd _iusvey M.np, -'t-r "r GCOrdc.d m iJr: ,'✓mCnt Nc : (244•'.-1: V 4 ~ w t y a /'ih `7tr'c-'c-'t we-cf. 33" ,sk CY ~l unf>lattr'.d !.ants n.> +r irnC o. rc N,>-ci :vc5t i>%I 0,' Of rhe 750, AVe=r1UB u!.d t✓ and d. 7C Ca-cmcm: D < t - l C G' a♦' t ~ r It r Lot 3 I' CURVE DATA LurvC A.% =+..n_ C.Cn:.: ,::h~..,f L!., z•-.:i .,gcrrf NC. 'Cn.ytl. kn,. fi`n ,H.%~,n~rn.; iG°r!_arrpG' [i.-:>reo.?=. f-'- : fah .i4' i - B il,' <~S 14 SL. Croix CAum 1062834 I'aaC Ct!; C C"EKTIFIED SURVEY MAP located in the Northwest 1/4 of thr .Southeast 114 and in the Northeast 114 (,f the- S,,ijtlwast 1/4 of Section •1. Townxhip 30 North. flange 10 Hest, C7t_c' of N!•s H.iclun un d, ti(. Croix Count_$,. Wisconsin ~~gGO~~ti CARL W 4EmFLD S- IS" ST Ckax ~ ~9 ,H, oQ' p~,~a ~ arr. y~ SUR`I~~ 1 ~t n ra . ~Dc ~Q r~ti a~ 4luananum ~.al- Mc Women! .°JS: e Cnrvrr`: ' _i nph dramC: r^ !Z7 Qa q `L C~v f CJ ° o. U ".3-1... a urn !alxw aaharma ♦ Ill t~ ~ lanrra.v or i nra: na.an.a an or.t_. 1c ~ - o :e .a..amrrc r s-.ac \ -r. w d K U ~G.~=7~ _ - t c t~ r ' ~ ca re 1 A t j 4iunamom ~:,ap Mrnwar n.' >ou.:frs. r.: ~ lnun,i lramcfc Gd^rrf>pv: >L:+ci rrar: rrtaKCr IiNn.i ;i SEC770:ti SUMMARY SECTION 4. TOWNSHIP 30 NORTH, RANGA' 18 WEST i 7-237: :i!7FfT 3 7!- 5 5,1 ff f-"`= (r In G ' ~tl ~T S: Croix Gounry 106.'F z P:rpr + of - Q CERTIFIED SURVEY MAP located in the N'urthrrest 1/4 of the "Southeast 1/4 and in the- Northeasl. 114 of the- Southeast 114 of .Section 4. Township 30 North. Rank Id Rest. - C'itr of New /i'ir.-hill ond. .St.. t'rnix C'ourlt.t. K'i~c•onsin Surveyor's Certificate: 1 Carl W'. I lutlcxf Protes:ional L and Surveyor hereby rcrlrfy that I nave survpyp.t. o,wood and mapped narl of the Northwest ii of the Soullwast S4 and part of the Northeast !4 of the Southeast V,, of soc:bon 4. Township 30 North. Range 18 West. City Of New RK:11mood S!. Croix County. Wisconsin doscnbec! as follows • Cor.Irnencrr+9 a! too North n Corner of said `;Pchon 4, thence S00°50'00"E, along the west line of the Northeast % of said Section 4. 2725.58 feet to the northwest comer of said Northwest % of the Southetrs! r/. of said Spulrorl 4, being the point of beginning. • thence S89"b7'b4"F amrrq fhc worth Lou of said Northwest % of the. Southeast 464 49 feat • hwrmw S"uthvrly. 06 34 foet oluno the arc of a curve. said curvo Doing concave to thv northwest, having a radars of 628 30 hwl a cchial anglo of 08"47'08 flip long chord of which hears S27.21'04"W. 96.25 feet to the and of said Qurvp thence S58"521 47"L 618.0/fcut. • thence 589"01 01 'L. 887.02 tout to In, beginning of .a Irne rneundufmg the thread of flip WILL CA4 RIVER, lhuout, :3694,59-W along said meander fine. 1255 31 feet • thonr:a S0H'49'3/14' along said rnvandur line. 177.09 feet to the end of said meander Irne. • lhrn..r.• R89"37 :34-W 418 H9 feet to the wcs! Inc of suid Northwest of the Southuasl % • thence. N00"50'00-W along the west /wire o1 said Nodhwost b; of the S01ithnas7 ''V.., 1036.17 feel I, the point of beginning lnclurLny all /anus lying bufwewrr said meander lolc and the thread of the WILLOW I?IVFR. said lands being Doundod on the north by line hnanng S 89"(7101 "F 65 lee!, more or lest:, from the begoudno of said rncandor hnc• to the throad of the W1Li OW RIVFR and bounded on the south by a fine hearing N.89"37.34"E 90 feet, more or less. from the end of surd mriandor line to the thread of the WILLOW RIVER The above desenbed land is .cublpra to ngtlf of way for 1751°Avonue and/or 115'^ Street as shown on Sheet 1 of 5 Sheet end on Sheet 2 of.) ShaetS of this Certiliud Survey Map. That I have made this survey land division, and reap by the direction of Grpgory M. Anderson, owner of said land. i That said map is a correct mpmsentabon of the exler-eor bounduou-s of the lands surveyed and the subti'vrsron foadc. thereof Trial I have fully corrrph"d with the prov+Sror+s of Section 236 34 of the Wisconsin Slafutes. A E 7 of flip Wisconsin Administrative Corte and the Subdivision Reyulabons of the Gry of New RichmoTio w serve. ying and rnappv , the sera Cart W Imtfeld P.L No. 1544 \sGON3~,y December 18. 2017,1 CARL W Rpvlspd.larlaary 29. 2018 Y} HET."fLD Revised March 17. 2018 1544 ST CkLN7( FAt L WIS Q 9~~ SUR V ~~O _T _fz St Croix County I J,;'H:i4 : •nhE 4 or S V ' CERTIFIED SURVEY MAP located in the Nor-tllwcst 114 of the Southeast 1/•1 and in the Northeast 114 of the Southeast. 1/4 of Section 4, 7'o»-TIship 30 North, Range lU West. Cit r of Ncw- leich to rill d. St. Croix C'olrrlt 1-, H'Iscorlairr OWNFRS'S CFR rII-ICA I F OF 01-OICA ZION A., ownw, ! 1K ,vov :,wrhfv In"t !caused BIe 25 foof mde uldin, and wwn. c' easGnKmi tc he dedicated as mpmsentad on this Ce vied SoNpy Map. 1 "k.." colhh. that th's pio! 4a wounod pv S 236. 10 and 6.236 l: (o he suhnuftad M the f0lowvey lot apwovui w ebic cf on Otty of New Ibcnmond WrT NE SS the hand and soul of yard owhel lhis," day of 20 _ In pms2n L /f Gregory M Anderson ow,w Slate n; WiAxonx.) St CRUX 0wmty 1 N-~ F'ersnnally Came hefnre me thrS C2 ( day of 20 0w ubuvo " / vQAJ1y1 ; ~••Trr•/ natned Greyory M. Anderson. to rov known !c be the Santa poison who oxcuotmi the. torndomq q instmmnnr and .a<:krpwked.led the same 1``~ 2' - i ~nI = * >IC - i ' A C:ourrfY. Wrsxsuesm Nwary biw t/Rl. h j 2 OF'W15~ia``••~ ` CITY TREASURER'S CERTIFICATE STATE OF WISCONSIN) ST. CROIX COUNTY ) SS ! Severty Larpenbark, beery the duty elected qualified and acting Ireaswor of the Cal y of New Hwhmoocl i cfe hocohy aortdy that the, records ,)#)V utbrrr show no ergs ud t;axes or special assessments as of altcx.-hoo the land "NzincICKY to Iles ( Jedrherl Survey Map. 1wilf9 _ /L'EVW~r ~l LZ'ItL.CrtfJ~U~ - Dan, Beverly I nyenh. k, (-;,Iy Soler COUNTY TREASURER'S CERTIFICATF STATE OF WISCONSIN) ST. CRO1X COUNTY ) SS Denise Andennn, tx oq the duly appointed. qualihoe and acenq tmasumf fine county of Sl. cwo, ' do hweby rx;rlily that fha rvonnk: ur rrry o/r,", show no wwwwerlrpd tax v lps 'Ind no ~ unpaid laXoS 01 s(>BCIUI 215SUSynW n(S as of mrlfCh an 20 19,_ aflocfnxl (I,, lands Mcludod in this Corf red Survey Map w ~i \ h Cq,acl8 lcancQt ~OC"Gon ^ 1~ C1Date. w-o Clenise Anaom n. Sf. Crtx County Tmasumr 1 CITY COUNCIL RFSOI.UJION k Rasolvod that this C4:rhlk:af Swr vy Map, rn are City of New RIcl... ood Gm-gory M Andorson, owner. Is hemhy approved by the City Council V/ Da te Appm.od Fred -N7Onrw. Mayor / V (rate sirTnen' 1.7-21 SlgnrxY I qxf Fforov. Mayor (ARL W I hereby COlafy that the lumc o oci is a copy of a MNottZ ion adoplud by the City t7pullLi! of nc,- {,Y METFRD Cify of New Richmond y S-154-4 wts Gate f ar va B helm Cwty C Jerk ~Ce~ Sl1 F7v~•`"`v NV.9L1 N~• 1 C Croix County 10G2E34 >ayc 5 of (C~ S NEW RICHMOND UTILITY COMMISSION MINUTES ACGIJST 1, 2018 The regular meeling of the Ncw RIChInUnil I Itilily Cotttntission was held on :%ugust I, 2018 at 8:00 a.m. at the Civic Center. Pat Recker called the mccting to order at 8:00 a.m. Members Present: Bob NILIllen, Dan Casey. Gerry Warner. Mike Kastens, and Pat Recker. A motion vvas made by Bob Mullen to approve the agenda, seconded by Dan Casey, and carried. A motion was made by Gerry Warner to approve the minutes of the July 11, 2018 meeting. seconded by Dan Casey, and carried. A motion was made by (Mike Kastens to approve Jt IN 1-24,'_018 bills and disbursements, seconded by Gerry Warner. and carried. Public Comment: None 2018 Financial Report: Joel Fnders presented the 2"j quarter financial results. • Electric- Expenses were S371 K under budget due to wholesale electric prices, but revcnucs were $429K under budget due to seasonal trends and lower than expected commercial and industrial sales. • Water- YTD expenses S-59K under budget. but were more than offset by revenues that were $132K under budget. Revenues are expected to increase relative to budget in 03 as irrigation sales increase. • Sevrer- YTD revenues and expenses tracked close to budget, but second quarter only expenses were $29K over budget due to lift station roof replacements and sewer backup reimbursements. Capital Improvement Plan: Joel Gxlers presented Capital Improvements that are ranked important. Important projects arc defined as "A capital project that would be nice. but does not directly impact the satety or health of the community." • Meter Reading Equipment, project year 2018. estimated cost Water-$5,700, Sewer-S5,700 and Flect'ic-$7.600. This would be funded through Water~SewcrI'lectric Utility. • Replacement of Remaining Lead Fittings, project year 2019 - 2022, estimated cost S 100.000 per year. this would be funded through the Wafer I'tility. • Lab Sanitizing Washer, project year 2018• estimated cost $ 10,000. This would be funded Ihroueh the Scwcr Utility. • Purchase of Solar Shares, project year 2018. estimated cost $350,000. unfunded. • Knowles & klighview Subslalion ;\csthetie Improvements, project year 2020, estimated cost 560,000. Phis would be funded through the Electric Utility Water & Sewer RFP: Rae Ann Ailts gave an overview of the RFP. BIBS were received from three firms. Fhlers - $27.000, Trilogy Consuhing. LLC - S 11.715. and Raker Tilly - S39,000. Proposals were evaluated on multiple criteria including firm qualifications. experience, cost and timeline. Interviews were held with Trilogy and liltlers. Both firms have extensive experience in water and sewer rate cases within Wisconsin and experience in leading rate cases with the PSC. ']'be interview committee was I impressed with both turns experience. However. Trilogy's communication approach and visual presentation of information eras well received by the interview committee. The interview committee recommends awarding the water and sewer rate case to Trilogy Consulting. f.1.C. Motion was made by Bob Mullen to move torward with "Trilogy Consultinu, LTC with a bid of$3l?7'~, seconded by Mike Kastens, motion carried. Pole Attachment Agreement with Baldwin Telecom Inc.: [n mid-June. the City received an application from Baldwin Telecom to attach fiber optic cables to NRU ovrrhead lines along a portion of South Minnesota Avenue and the alleyway in between NIinnesota and Knowles front West 1 st to Wcst ?rd. Private telecom and elect ric utility attachments are commonplace throughout the LS, bill have been declining in favor of underground installations. New Richmond currently has four companies that attach lines an(] or equipment to municipal utility poles, including \cel Lnergy, Frontier Communications, Cellnet Technology, and Northwest Communications. In exchange for the use of municipal poles, cities usually charge a rental fee that is based on a standard space allocation percentage, and the revenue that must be generated annually to cover the cost of owning and maintaining the poles upon which attachments are made. Gerry Warner moved to approve the agreement as presented. seconded by Bob Mullen, motion carried. ood Pole Testing update: Three firms that perform wood pole testing vrere contacted to receive quotes and discuss scope of work and schedule availability. 'f'ile three firms were Osmose, Mi-Tech, and Karscz. Utility Services. All have perlormcd comparable work with investor-owned utilities, municipalities, and electric cooperatives. All of the liras also shared availability would be late summer or into the tall based on existing workload. Based on discussions with the firms, Karscz Utility Services. based in Pulaski. AUl was chosen to perform this work. Partial excavation with sound and bore is the method that will be most utilized to identify rejects, and Karscz oflcred the best pricing for this service. From a timing standpoint. we expect to complete roughly one-third of our system when their technicians are performing similar work lix St Croix Hectric. 'This is scheduled for late August. Additional testis;, miry be accomplished later this fall. or will continue in the spring ol'2019. Private Water and Sewer Request- 1745 115"' Street: Rae Ann milts reviewed the request Greg Anderson submitted to Community Development fin put in a private well and septic system at 1745 115"' Street. This property was recently annexed into the Cit. The request is being made due to the excessive cost for hook up to city water and sewer. Jeremiah Wendt stated they are looking at $90,000 for excavation costs alone. Dan Casey moved to instruct staff to proceed with the proper agreements fin well and septic as done in the past, seconded by Nlike Kastens, motion carried. Department Reports .Jeremiah Wendt reported for Bob Nlever, Water Superintendent: • Staff are busy with locates, and muter installations. • Water Scrvice replacement is taking place in the alley between W 1" Street & W 2"" Street. Steve Skinner, Lead Wastcavater Treatment Plant Operator: • VISA came to the W\VTP to rcvicra equipment to obtain intomtation to help put together the facility desicn. • Greg I lerrnansen tested for wastewater certification. • Staff is looking into the cost to replace a had Aqua guard fine screen brush assembly. Rae Ann Ailts reported for Weston Arndt, Flectric Superintendent: • Busy with new residential extensions • Busy with commercial extensions, Bakkcn Young & Federal Foam 0 94 new dwelling permits have been issues ys 100 for the year of2017 • 140'' Sweet lighting to be completed this year. 6 new light poles to be installed along County Rd K to Richmond Way Rae Ann Ailts, Finance Director: • 'I he 2019 budget is in I Lill swing. Sonic of the kcy notes are: o Safety and f,mils lirst o How do we become a destination employer o Keeping health care costs aftbrdable for employer and employee. as salaries and benefits account for 70'0 of the budget o Focus on staffing levels and technology needs • Two different software systems are currently being used by the Utility office. State are researching opportunities to become more efficient. • Budget meeting with department heads will take place today to review where needs are • Slalf is looking into additional ways to increase G-billing participation • AV'PPI is offering to have a professional photographer come in and photograph the community with no cost to the municipality. These photos can be used on the website. • Iunn software upgrade and training take place tomorrow Jeremiah Wendt. Director of Public Works: • 125'f' Street project is schcdulcd to start this week • Staff are working on water and se\yer replacements • Gast 4'h street project is expected to begin in late August Mike Darrow, Utility Manager: Not present 'there heing_ no further business. a motion was made by Gerry Warner to adjourn. seconded by van Cascy. and carried. The meeting adjourned at 9:00 a.m. Pal Becker. President (ferry Warner. Secretary RECEIVED A I -D L`S(~l} aP Wis. Dept.of Safety and Professional }+icq+r'. 1 r' SOIL. EVALUATION REPORT Page _.,._of_ Division of Safety and Buildings ST CRmiwith SPS 385, Wis. Adm. Cade OMMUN(TY D VE~q~ M~;" County Attach complete site plan ~r1 paper not less en x s in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent Slope, scale or dimensions, north arrow, and location and distance to nearest road. /,'y,;. - Date Please print all information. Re d b p Personal alrormabon you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Z/ p Property Owner Property Location Govt.l_ot 114} 114 TN R E(or- Property Owners Mailing Address Lot # Block # Subd. Name City State' Zip Code Phone Number ❑ City; ❑ Village OTown Nearest Road N p New Construction User Residential] Number of bedrooms, _ Code derived design flow rate 'r• GPD ❑ Replacement ❑ Public ar commercial - Describe: fl Parent material Food Plain elevation if applicable Gene* comments Zn-v- and recommendations: . h---• ftl, v Boring 1! t❑ boring c - k1 pit Ground surface elev.ft. Depth to limiting factor in. Soil ApPlication Rate Horizon Depth Dominant Color Redox Description Texture Structure nsislenee oundary Roots GPD/ft 2 in. Mansell Ou. Sz. Cont. Color Gr. Sz. Sh. ff#t ff#2 r - 7 i. tl ,Pj 0 Boring # ❑ Boring f7i pit Ground surface elev. ft. Depth to limiting factor 7i_ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure nsislence oundary RooLs GPD/ft ' Iff 02 in. Munsen Ou. Sz. Cont. Color Gr. Sz. Sh, tf#l V,!, ~.r - - - I r It Effluent #1 = l'30D > 30 22(1 rtgrL and TSS >30 _ mg/L ' Effluent #2 = Boo < 30 mg/L and TSS < 30 mgL CST Name (Pleas Print) / Signature .r - CST Number Address - - Date Evaluation Conducted Telephone Number - SHU-8130IRI V': i i Property Owner Parcel lD # A111-1 /i: - Z Page of - Boring 0 Boring # Ef Pit Ground surface elev. _ /Z/ . ; - fL Depth to fun" factor in. Soil Application Rata Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPDRI ' in. Munson Ou. Sz. ConL Color Gr. Sz. Sh. fi#1 f(#2 j / ,2 ' - / v . g I~ Boring# ❑ Boring I © pit Ground surface elev. //'j _ fl. Depth to limiting factor L- in. cal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure nsistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ff#1 02 ❑ Boling ] Borirg # m Pit Ground surface elev. i_l _ ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence undary Roots GPDIR ' in. Munseil Qu. Sz. Cont. Color Gr. Sz. Sh. fF#1 ff#2 Effluent #1 = BOD 30 <220 mg1L and TSS>30 < 150 mglL ' Effluent #2 = BOU < 30 m9ft-and TSS <30 mglL The Dcpt. of Safety and Professional Services is an equal opportunity service provider and employer. if you need assistance to access services or need material in an altcriale tomcat. contact the department at 608-266-3151 or TTY through Relay. mo-s~w tar rn