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HomeMy WebLinkAbout020-1023-70-000 'A4sccnsin Deparcm ,-I of omme'ce PRIVATE SEWAGE SYSTEM "cur L .St. Croix sa,ro•:~~a i+w :,i-;~ Civ,ion INSPECTION REPORT 'J"'l""No GENERAL INFORMATION (ATTACH TO FFRM.T) State P an D 605171 nu PC'Spr'LI r'lur"otiur' you D`o+i de may' ae used 'C' seCOrda'y DurpCseS'%nvab/ I_aw 5 C4 Pe--it Halcer s Na. Village. Towrsrip Pa-rl Taa No. Oevering Homes Investments LLC TOWN OF HUDSON 020-1023-70-000 :;,I Bill t e, Ili BSt I_lcv I BY Ucsuipl on SecacmrTowr RauyMdap No. 14029.19.105n TANK INFORMATION ELEVATION DATA I YPF MANUFACTURER CAPACITY STATION GS HI FS ELEV. Septic Benchmark Dosing Alt. BTA Al on Bldg. Server Holding SL'Ht Inlet SCHt Ol et TANK SETBACK INFORMATION TANK TO P1 VVELL BLDG. vent to All n:a.c ROAD D: Inle: septic Of Bottom Dosing HeaderrNten. Aerauon Dist. Pipe Honing Bot. Sys:en• Final Grade PUMPISIPHON INFORMATION GPM ATDHIF-otior Demanc St Cover Loss Sys1e'r flead IDIf Ft th Dia. Digl :o 'Nell ~I SOIL ABSORPTION SYSTEM BEDITRENCII Ninth t engi- Nc Cf Trenches PIT DIMENSIONS Nr. Cf is Ir, 9e Ile. Liq_id Dcol•r li DIMENSIONS SETBACK SYSTFTA TO Pil. BLDG 'lI LAKEiSTREAlt LEACHING 4lan.nactua-~ INFORMATION _ CHAMBER OR rac C, svs:c UNIT ~,U>oel Numtrer DISTRIBUTION SYSTEM Ilea:c r`.lar, lolC DrSInCAro^ x Hole Site a HC e Snacirg 71 lc i•.ir hake P oust I Cra Leng1F Dia Soul:.)g SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Dcp:hDVC - Ueol Oae' .xCepihof aSc: dcd+Sr 7tec. r,.. '.,ul.rer 6e:1'--e-ch r]e~h_r Bed~T,cnch c7grs s('I r Yes No Ver No COMMENTS: rlrcljde cede d screpi, persons present. etc.; Irscec:ion a7 Inspi 42: Location: No Address Available 1 ; Alt 810 Description = 2 ; Bil sewer lerg:h - amount of cover = Plan revis on Retail n Yes _ J No Use other side for additional rfo,malion. _ Dale Insepclors S 3nalure Cen. No. SBDi: 1C !R YJ7.1 - - s~N ao aso Fr- s , [ Safety an 3 iloin s Division l s 0 5~ Z31 W. Wasrimcito% Ave P.'> Rox -162 Santa, Permit Vumtl ;l04 tiled in by a) P 6 2018 ldaa u) , 53, 0 I if 2_ 6sanitary' Permit 05/7l \ application in axoukta.c wits: Spy 7F L' '.i'i.:.Q.T ~,:b:n i I L*., (am w We =rw:.9c gc. grvnw'.ui lmrt /V i y ;ir r I ;vui)a w vv pert- Ir f ,)t 4.pb torn llr s..l1e wneti P111 S a[c suh,""i re arn:ecr Ala. (d dtfterc, mm..:oailing addresti u. P,. = f ~etct, :a pr fc- venal S m t r mma: u u l Ilh>L You a+tdc ma_ I- us:J pm~xt v ao.., riamz w:Ia Wr uvacy l ew ...u4.I t'I r Q.~ L A licattou Info motion Plrase Print All lxtonuxtioo f'nn•.rv ('x-I s \,u') ar;:cl ly N --jv ernpert/Cnvn:r.. \tailxrb:aJdu~ _ Ynrpenv ia:auue LFL 14- Piro, S= ~ ,i,~ ~G ~ Phone VuIGa I Gov-, L~q G ~F ~ cS`rK on L T -5 (1L 1 l~ ~ t L - U /Type of Rmiding (check all that apply) Lnr= -L r S F.v uh iJt c .uq \I I ):u a[ f3cdn:oc / G . l S.IidM,nm 6ar.Ic n r $Gv:. T' uI i,.l _ ~,OIPy~ ~J Gly of t 1 slnte c,une.•i Ouer"M lac VIC i:4d N.lni, r V dl'Igc Of w ZtltZO~-ZA (~J~eCS _ _ ill. T eck unly one box on line A. Complete line R ifapplicableii ..c, S,,;= Replwmer. Sy>tnn I Trcavuerl::'idc:ng Taff: ,c'p--tutor rtth's Nloo&ficiciro~v 1 x ettmg Stsfae lrxpiav. R. F'c'tna iv;newi J mu Rr.e.i+:a _ in'a'vc of Pl is:r p:m)4 Trvsic: r,':rw Li<: "rrctio¢; Penlur Aumlw arlJ i}~ Issue2 R It a of Arm:(oniponc l)et iceJH I..k.1l that apPlt m I'ress~n.ed In (i: a:: f F~ s.>': 4< U rows I J .i:-i is z.k I `.h~d - In of ul.wlr roil ❑ hf and in. u'n,able s.;i c m Jn:er Uu , u t I.:r _ n pymt neut lkzuc ^Plu.o L Drspcnat l rea[ eut AfCV lnful matlnn - / ' w a ` pd i ks ;n \`I App:.:, m F I xre.) o.j ed .c, ~sSC c:I_..AU - J D S_ naI m Itc uird `tI C'r~ ' ~J u lank Info p *V='. a ,L ' ' f y .rs i roll Ins C!NL• I I ~ c acts kx.socg l~.N Ij l • III -V IL Rexpontlblhh Statemen the undersign,(, ass : -oj> t ilvt fur m-Sulhlmo of we POIAT aluwo on the amcbed I lam> _ l lunbec N.'Lfl. ILl : }Y 1" .inlJe lfF \r'1(\ !~arnbC 1 f LLa; C1S 1'b06G V W r~ Illlh_ J /WQrCAS iSnCCI• : Ry. S3L', GIt l-1dt V :ounrv:De ertment C>e Only lpprovcd I , . P rsl rc, Dan: Issue.^. ssu.na / in S•guturt _ rx. Couditiyns v~ ' w ,l If9rt }?f'prot'al ~ per, r.' e•. cell rust all be ::~.ICas ` rot InJ~ ~ IfJL~ r(~(~„ 1/• ~C'+•~ as par :rarayemen! plan p-~ tuen by ylwnl>e . 2. AB ee.!tW* r*Q M~171r1u1 Uo r.: r.4Jf e4 ~b rraL Cte.J.A~- ; u4- NK~vI w pr ppkrkh ca&.- / u4nanau. t Albei to <nmyl,lc Lmns fw li¢>,>len: and suhmn m rw nwurp oniV m toper .or Irv wa[ £ a :I iaihe m w - Svstem PLOT PLAN* PROJECT Oeverino Homes ADDRESS 1433 C;cmoro.js Ave Suite A Nivv R;chroonc Wi 540' I!4 NE I±4S 23 ,''T 29 \;R 19 Ni TmNN Hudson COUNTY S--CROIX SYSTEM ELEVATION 98.8198.1 4.5 below grade 8!2918 DATE BEDROOM p(~ COAYENTBIA:V. XX7. / U . C~ CONA ENTIOSAL LII7 HOLD6G TASK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE 7A\h SIZE BOLDING TANK SIZE LOAD RATE .5 ABSORI'TIOA AREA 1219 0 of chambers 6C k BENCIiAIARF \-.R.P. Top o' survey iron ASSUME ELI:v.ATIOA too' Filter Lifetim;: Piper ❑ BOREHOLE. 0 N'ItLL "ILR.P. same asbencimark lack Drive Scale = 1/4" = 10' Pro 4 T, -11 Hous ,5A S'l 3-3 X 80' cells with spacin, 25, B.\4.° R I B-2 90' 30* md vents Z;( 101' 1 Slop:: 1 .4 0 C/CI 0" Quick-1 Standard Coaching Chamber of er with 20.0 f12 of Ares 5.6ft^?%pair of end caps 4* Lops - Gradc at Svstem Elevation A 34" ;716 PropcrtN 0 All F=Pire ,h,,!11 he AS I :M SDR 30+34. within i(" of tank 1~ipi i vh 1. b "STM F691 Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 8/15/18 Owner:Oevering Homes unter Hills Estates Hudson Location: 1/4 NE1/4 S 23 T29N,R19W Lolmt~ersion2.0) Manuals Used: In-ground absorbtion syst Page4 1. Cover Page 2. Plot Plan 3. Chamber CroACoency 4. 6. Maintance aPlan 7. Filter Cross SeSignature License numbe tt 26900 System PLOT PLAN PROJECT OPvPnno Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 1/4 NE 114s 23 rr 29 NIR 19 1v 'rt»v% Hudson COUNTY ST. CROIX SYSTEM ELEVATION 98.8198.4/ 61 4.5' below grade D 8/29118 BEDROOM DATE. C+ CON'VEMIONAL XXX lu . CONVENTIONAL I.11"1' HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT' TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE. .5 ABSORPTION AREA 1219 If of chambers 60 RLNCUM1IARK V.It.P. Top of survey iron ASSUME ELEVATION 100' Filter Lifetime Filter ❑ RORE.IIOLE O N7iLI. ' 11. R. P. same as benchmark lack Dave Scale = 1/4" = 10' Pro 1 Bcdroorn House -1S ST 3-3' X 80' cells with >3' ,pacing 25' B.M.' B-1 90' B-2 ;o' 103 Vents 50 to], 4i Slope 45, B_3 99' Vent >6" Quick4 Standard of Cover Leaching Chamber with 30.0 f12 of Area ,).6ftA2/pair of end caps 4' Long t Grade at System Elevation 416' Propeny Line 34" All piping shall he ASI'M SDR 30/34, within 10' of tank. piping shall he ASTA4 F89t Cross Section of Infiltrator Quick 4 Leaching Chamber Typical cross section for 2 of-2 cells Quick 4 Standard Leaching Chamber with ^ 0.0 1(2 of'Area per Chamber To be >1' above grade 5.61*t _ pair of end plates / Finish grade elevation All Typical Installation Vent /l Grade V C11( :3' .A/30/34 Septic Tank 3 5' Iona t 55' Lone; I > Grade at System Elevation ;6" Grade at System Flevation Spacing X 3 X }2' Cells Same on other end Observation tube/Vent At end of cell A B chambers per cell System elevations: C7 A 9£-8 -1~ j" POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page - of 'FILE INFORMATION SYSTEM SPECIFICATIONS Septic 1 ank Capacity .S al n Na - Pemit # Septic Tank Manufacturer - NA Zrxu ,)ESIGN PARAMETERS Effluent Filter Manufacturer 0 NA Number of Bedrooms ! l NA Effluent =ilter Model 0 NA Number of Public Facility Units -'44A Pump Tank Capacity gal NA Estimated flow (average) yGG da Pump Tank Manufacturer NA Design flow (peak), (Estimated . 1.5) / au•"Y Pump Manufacturer NA - - - - L' - ~C - Soil Application Rate , aiida /f!' Pump Model NA Standard InfluenttEffluent Quality Monthly average' Pretreatment Unit NA Fats, Oil & Grease (FOG) i 530 mg/L Sand/Gravel Filter U Peat Filler Biochemical Oxyger. Demand (BODs) X20 mg/L Q NA 0 Mechanical Aeration 0 Wetland 1 otal Suspended Solids (TSS) --150 mg/, 0 Disinfection ❑ Other. Pretreated Effluent Quality Monthly average Dis ersal Cell(s) U NA Biochemical Oxygen Demand (BCDs) X30 mg/L. _ L - Ground (gravity) 0 In-Ground (pressurized) To-,& Suspended Solids (TSS) _30 mg/L ~NA AI-Grade ❑ Mound Fecal Colifomt (geometric mean) - 10° cfu/100ml \ 0 Drip-line 0 Other Maximum Efffuent Particle S!ze in dia. OA Other. L; NA Otter. Othe^ D NA Values typical for domestic wastewater aid septic tank effluent. chef U NA AINTENANCE SCHEDULE Service Event Service Frequency inspect condition of tark(s) At least orce every: 1 71 month(s) (Maximum 3 years) ❑ NA - - - - - - - _ - - ~j[i year( )Pump out contents of tank(s) I When combined sludge and scum equa,.s one-third (k) of tank volume G NA inspect - - - - • - - _ months} pecl dispersa, cell(s) Al least once every: (Maximum 3 Years) G NA ar(s) / month() Clean effluent filter At least once every. month) U NA_ - - - - L-I month(s) - - nsped pump, pump contmJS & alarm At least once every* NA year(s) 1-lush laterals and pressure test At least once every: U month(s) NA 0 year(s) Other At least once every: C1 month(s) NA 0 year(s) Xner - - - A. N 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, POW-S Maimamer, Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broker hardwaie, identify any cracks or leaks. measure the volume of combined sludge and scum and to check for any back up or poneing of efflue-ii on the ground surface. The dispersal cell(s) shall be wisaally inspected to check the effluent levels io the oluervaliun cipes and to check foi any pending of effluent on the ground surface. The pending of effluent on the ground surfaw. 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 (b) or more of the tank volume, the entire contents of he tank shalt be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. 411 other services. including but not limited to the servicing of effuent filters, mectan,cal or pressurized components, pretreatment units. and any servicing at intervals of -'12 months, shat be performed by a certified POWTS Maintainer. 4 service repot shall be provided to the local regulatory autMOnty .,Ntfrn 10 days of completion of any service event. Page _ of START UP AND OPERATION duds of other chemicals that are de roduc have the contents herrvic of the Copp coon trati of ons painti For new construction, prior to use of the POWTS check treatment to s) for may impede the treatment process and/or damage the dispersal cell(s). tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when sod conditions are frozen at the infiltrative surface. the excess wastewater w During power' outages pump tanks may fill above normal highwater levels. When Pcover is restored the wastew of eilI will be discharge b . discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup to restoring P~ to the To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator pna effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. otherwise disturb or compact, the area with n Do not drive or park vehidas over tanks and dispersal cells. Do not drive or park over, or 55 feet down slope of any mound or at-grade soil absorption, area. and prolong the life of the pOWTS Reduction or elimination of the following from the wastewater stream may improve the perforfnance fat foundation he O drain antibiotics: baby wipes; dliarette butts; condoms; cotton swabs; degreasers; dental floss diapers; ans prolong t medlofiecta ; , f n9 prod drain (sump pump) water, fruit and vegetable peelings; gasoline; grease; herbicides; meat saaps: pesticides; san'dary napkins; tampons; and water softener brine. ABANDONMENT shall be taken to insure that the system is propedY When the POWTS fails and/or is permanently taken out of service the following steps and safety 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 fined with soil, gravel or another inert solid material. CONTINGENCY PLAN code compliant If the POWTS falls and cannot be repaired the following measures have been, or must be taken, to Provide a replacement system: lacarrrent soil absorption systelrr'. -'suitable replacement area has been evaluated and may be utilized for the lo ~a ~W~ infringed upon io r ystemd The replacement area should be protected from disturbance and compaction setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area Wl result with the the need for a new soil and site evaluation to establish a suitable replacement area. Replacement sySterins must 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. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infitlralive surface. Reconstructions of such systems must comply with the rules in effect at dud time. «WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES ANDIOR INSUFFICIENT OXYGEN. DO NO ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS, - POWfS INSTALLER POWIS MAINTAINER Name Phone / j , Phone j J - SEPTAGE SERVICING OPERATO PUMPER LOCAL REGULATORY AUTHORITY r Name Name Phone Phone ; % f - ~ _ td and 363.54(11, (2) 8 (3). Wisconsar Administrative Code. This ktodme+rt was drafted in txxrtpliance with chapter SPS 383.22(2)(b)()()6(fl ti I \ t ~ it ~ 10 ' -N u ~ O - - `P I/ S'1'_ ('R(-))X CQL)N7'Y SUPI W l eVNK M AIN•f ENANCE --tGRFEAVNT AND 011' NE)ZSiffil C,F.RTIl<ICA1R- N FORM wneVBuyer k1whngAddress Property Address 77/ Av e, (Vcntication required from Planuugt :k, ZVIIIIi,L', Ucpalr;u1n, new constnu?tion.) Ct-- - - - - Parcc! kicutific'ation Nui ibei - LEGAL DESC'RIP I IUD Properly Loca.tlon ;1 Scc. l .f, ~~N It W, -1 owil of Subdivision , _4k Certified Survey Mal) it Warranty Used # SPEC {tOUSe \'E 1 poi H. idenufrab • vc¢ uo SYSTYM MAINTENANCE AND OWNFR CERTIFICATION Itapropet (INC and nutirrteaance of your sclaw 'vstem could result m Its prnraturc tairm. to h~ndly wastes. Proper tinanitcuoncc. consists of pnttrpinp out die scene arik evcry t1 lee vem& or somwr. !r needed, b\ a hccnsad puurpci What you part into the system call afflict the funrtiot ofthe septic tank is a nralme::tr slag, in dtc teas r disposal system. Owner mainteuaner_ iesponsibditics are specified in §Comm. h±211) acid ur Chaprct 17. - Se. crnix Chu uyy Sanitary nrdinaucr The property owaer agree:: to submit to St- i'fwx t mirav Plaumng & Zoning Depatuarnt cct:ifcation !orm. signed by Vic owner and Ilya master phunber, ;oitrncpnran plumber resumed plu:ubei or P. licensed peetipm verifying Brat (1) the oa site wastewater disposal sys:em is in proper oncr mw coniitimi ami ill (2) after h:spe,don arid pumping lit ncc..ssary), tlu- septic tank is less than V3 full of sludge. Pwc, du: uudertipned haws rca .tie abuse tcyuireme.n :ud ..I rw o rnawtanr the private 9ct%agr disposal 3ystcnl with thc: staud. ds set forth, hcrcut , as -.Cl by Pre Deparlrncut or Comer .:.r and ]Ile A-parrnnnt of Naural ltcaoutces, State of Wisconsui. (edification statuig that yma septic system has been nsiwained must be cnu plctvd and reunnrd to :hc St. Cmix County 1'laiuanp cL Zoning DepaPlimi t within 30 days of the duce year cxpnmtion date. ' Iiwc cernfy that all statcmculs oil thyyy'''`rrr~~/Ion r rir nun Io tire. bash of my'oui knov I c-'e_ I!'mr antiate tits rnv'uchsj ofilt: property described above, by viente a wayf my deed rcco dr d ut Rcj istcr of Dee b Office. Number of bedroom J/ SIGNAIT)RI.OF APPL1C NI(S) DATE **Any irtfm iuation that is vasiepicseuted trav result iu the satetary pcrnui Icing oavoked by the. Platumrg & Zoning Departnrcrit • luciude with this appleahon a reenidal warranty' deed from the Repista of Deeds I. Ali c and a copy of the . embed survey map if reference is nibs in the vvar inty Gerd. (RF.V. OW05) 1 flii -6 J I mot. I + J` I r Ij ~`1 ~I J I ` IC - \ - ~I L i F e. 41 ri 7 I ~ I ~ ~ Lr 1 'ill Cf Cam`. \ u; Il ` r : y c`i -I I t 3,' P F F y , • 11 @ ter. p 77 i - z: Oy II C3S Z r Y'I 4 f f13i I c Fty T~ @~ '•t a i; _ f (r i i. f tT, a t t r,~3 s + i i r lltLt 1 It ~ 4 i ` a III L ~4t 5 ' ~ ~'t ~ it a. e l~ ~ it 1 9 1 n F~ s 7't 'S T r`yi. y J - 4' vl ~ x d I 1l S : ~ ~ ~ { r s 7}td .n 1i. ill ~t( fS s 2 F i~ x ~ 5 ' I ' a x r r ~ Lr+ u 1 i r s , 's ~ a e- EE . E i 5 r E 7 3 ` . + Hk 7 rI =r j~! ,t 11;fl f7t e +p a " j I 1. f ! ~ lL ..~iw.s:. I~ ~~t•FTT j, J it 'i~i ft: w I it b f p~ '.;I is t~ •,x, - ' II !y tj!'il'i'6i:i I4~ I I !!I,' -ten lit 1 { 3~ IY .fA, 1 ~i a 1 l r i ;'t 1 a i l w K• It =j~ y r,l± Aso tA~ v•, { ~ tin c .fr r e p1,pi 4~°~ ` f i ~ F{Ni r ` ~ { n tNj :Lnl s ifOt" (~:5 a I [g, EE ai ii TL H1LL.-' LST_J. N-1 Ai~i :)F'! HF NE I- 1. -y I' rec. -~r ~E T1= S Lc~~e ~:1I\ ~ u~A .L 'Y!£1•.I1-~OJ'..Y JJ"V~t.43- WVY'cb~(\Y}il ^cAr1 ~L: Lln T=f Rtt JCPI F:'. LMWJ: ~V°cJl:l%.f1Y:IG]4'JP`: bfC,M'T tlY : ^a. law su4a ~F1G. ' uN1 ' yam... I c , LOT 6 - a LOT 3 LOT 4 I Iz.c-~ a--.. LOT 2 u c:va s.. ]E s•:;_ al LOI _ 1_CV4 ^ I I_: LLI _ t- 11. - D C)l - - - 15 ~sm.4'~ .,rte' ~ - LOT 20 Y: wvnr _ f y. \ \ \ 1 NNnr r LOT IF c ? - < 071 280 wismrainDo tot SOIL EVALUATION REPORT Oivision of Saf y and Bu N."ce Page _ of - j - I _ in accordance with Comm 85, Wis. Adm. Code Attach complete site plan, on paper yet less than 0 1!2 x 11 inches in size. Plan must Count' I include, but notAmiled4e-verbcaf and1honzontal-reference point (BM), direction and Parcel if) a,C;,- a Percent slope, scale or dimensions, north arrow, and location and distance to nearest road. O ZO + 7 _ m Please print all information. ReviO by Date P~l infomulan you provda may O used for seoa,4ary purywas (Privacy Law, s. 15 04 (1) lml) $ 9 o Property Owner Property Lccalior. V Q-..9 f Govt- Lot 1145 114 S T22 N R E( ) W Property Owners Mail ddr ss 1 Lot # Block # Su bd. Name or4CSW (Q/a aJ city a- Lp Code Phone Number ❑ city ❑ V ge Town Nearest Road ~y;~ i Jau) l~1 G ( ) 4 Z71, ConstnnWOn Usey3, i`esidenual! Number Of bedroom Code derived design flow 2te1/_.~ GPO ❑ Replacement ❑ Public ~C•It commercial • Describe' _ _ Parent material _ Ql Flood Plain elevation it applicable G 9 aid ene comments Lions System Type etj-, J _ _ System ElevationT'_~ # Boeing F Boring i pit Ground surface elev. ft. Depth to Irtu" factor in. Sort Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDMP it. Munsall Qu. Sz. Coal. Color Gr Sz Sh. 'Etl#1 'Eff#2 _t nil L k' o.l C JI'~ l LL/ 477 L Y6 it 1 Borg r❑7t Boring _ - - 1 FE- ©'Pll Ground surface elev. ft- Depth to limid factor'__ in. - Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure consistence Boundary Roots GPDlfF in. Munsell Ou. Sz, cont. Color Gr. Sz, Sh 'Eff#1 'Eff#2 i l~ o C. l ~e 1 e- I v Effluent 01 = BOD. > 30 < 220 nxA an TSS >30 < 150 ' EM t #'2 = SOD, < 30 mg4 and TSS < 30 mg`1- CST Name (Please Print) Sl~ CST Number P,ird Plumbing, Inc. Shaun Bird 226900 Address Data Evaluation Conducted Telephone Number 1432 120th St, New Richmond, WI 54017 6- ,30 715-246 4516 Property Owner___ _ Parce11D#_____ Page of 9 Boring / J Boring # c Pit Ground sufacee elev-1 [_l - if. Depth to lunitirg factor 4L n. ApV~bw Rate Horizon Depth Dominant Color Rrdox Description Texture Strutxe CansMence Boundary Rook GPDTf In. Munsell OU- Sz Conl Color Gr. Sz. Sh. 'E##1 'Eft#2 5 ` C_~ 1 ti a: l / wi r' Bonrg # ❑ Boring ❑ Pit Ground surfaceelev. ft. Depth to fimitirg factor in. Soil Application Ratel Horaeru Depth Danxnant Color Redox Description Texture Structure Consistence Boundary Roots GPON in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Boring 0 Boring F-I ❑ Pit Ground surface elev. Depth to IuNting tailor _ in. SW Rate Application Horizon 'lepth Donunant Color Redou Desrnphon Texture Structure Consistence Boundary Roots GPON in. Munsell Ou. Sz. Cool cola Gr. Sz. Sh. 'EB#1 'E##2 Ellkrent #1 = BOD, > 30 < 220 nxyL and TSS >30 < 150 mgr ' Effluent 92 = BOD, < 30 rng . and TSS < 30 mgr The Deparonent Of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate formal, please contact the department at 608-266-3151 or TTY 608.264-8777. SaPU3e (a sal I Soil Test Plot Plat( Project Name Oevering Homes SI un Bjrcf Address 1433 Cernohous Ave Suite Ai' New Richmond Wi 54017 G'STM #226900 Lot 20 Subdivision Hunter Hills Estates pot~ 6/15/18 1/4 SE 1/4S 14 T 29 N/R19 W Township Hudson ❑ Boring Q Well PL Property Line County ST. CROIX BNI or VRP Assume Elevation 100 ft. Top of survey iron System Elevation TBI) *HRpSameas Benchmark .lack Drive Scale is 1" = 40' unless otherwise noted 145' B.b1.* B-l 90' B-2 30' 103' 50' 101' 6rb Slope '1 B-3 99' 416' Properly Line