HomeMy WebLinkAbout020-1487-20-000
~0 `p1j St. Croix
vms:Onsin Cupar,w-rr. of !;Omrce¢D PRIVATE SEWAGE SYSTEM
::.Hey arm 6u to ".It C ~ ::c° :;a • Id-r Fr•.rm! Nc
INSPECTION REPORT 605171
GENERAL INFORMATION i,ATTACH10PERMIT) 3:a;CPr7 'Ur,0
Fe 1GI Tt ,rrat on y0o pnrn:ln tray De usco for 5eec":1..1r, puipnaes IPwac' Low 4 IS JA I' IIr-
Peinu:HCCer<•, a'rrC Cllj 'villd„c -cnr •:M1G ^BKCI'dx Flc.
Oevering Homes Investments LLC TOWN OF HUDSON 020-1487-20-000
C!al1M nsp ELI ntal:rstupdC- sectonr.,.,ll Gnq~'' 1, ".29.19.3111
TANK INFORMATION ELEVATION DATA
l VH`E A'1.7NJfAL-Vi.FR S'A.TIG'N BS HI FS F'. =v
Septic Tn 6enchrnarle
/Zod L.7 /'Ilo qua
t. eM.l la, Go
Aeraeorl Bldg Sevalr
Hobamg - _ _ SUHit Intel C)c
St.•Ht OWN-1
TANK SETBACK INFORMATION
-ANK 10 P,L V+1 I 6-CG .I :on r ntskC ROAD Jt Inlet
SepLC 01 Bcttorii
r-
2-7 12-0
Dosing Heade-;%Idn. T 3 "'M `L
irc•alion Disl. Pine q• 3 on
Holding - Dot. System q.3
r nal ,rake S .9 s
PUMP/SIPHON INFORMATION 160.
Vanu'aC•.Xf' cemand St Dove' /d Z • (o
Mode W
TCH . =ne!ian I oxs System Hr • TCH ft
FOP72'YtOi r' LC'
SOIL ABSORPTION SYSTEM
RED/TRENCH adt•. L,1111. NC. OfTra-.::ley PIT UIME NSIONS NC. Vf ~'I•: slda oi. I r4u i4~01t~i
4-1
DIMENSIONS 7 Z ~ G K~ SETBACK SYSILM TG!'PIL BI Lm VA71I LAKEiS I RIL"MI LEACHING ^ INFORMATION I CHAMBER OR UNIT hl.,Acl
Nk, DISTRIBUTION SYSTEM d Q✓S
!e?:1e 'rJ3`'09 DIStr GUIOO xHDe Situ •:Hee spa-l IttD.-irlr lake
9/ 6A
Lem;t-_7 ' S Ci3~ nene'h C a 3c8: "'l _
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
neF:n O'dcr /j Cep:n O:fir rx U2Gt' c' ~x uec0=d!oam:.d xx R', c^cd
YC5 'Jc
-!cJ:"roncn'J A.~ He>`re^.,p 4p,y n:: ` IDFSGiI es NO
COMMENTS: , ncnrlr cede d wepencles. persons present, etc.; Inspedion L Inspection 07
Location: 771 JACK AVE ( / c, dY\
I (id
t.': All Cbt Descr peon = /
2. i tit cy save' Ienyth = 27
an'c.nc o' cover = 11 ^ n
7 ~ g A
Pan revison Regd red? Yes Yc
llsc doer s de lc+ acurr era. uvomlat or.
- - CCH %c
- - Da•e I^sepctw's Sly tU'c
S~ ao ~ aso
Safety anc: p Li Iciirr s Civisiunr r~~_ -
T(< S- 231 •Jf.'J:dbhinUtd .v6 , PC 6a%'1eJ ^tiacuu.Y f~+rli: Nnnoc 1, be ;iliei n by (;o.+
P
S uutw- P,rtnit ApplicaLion 5: [ mxpa nr~ -
li rcco:W a. utAi SPS iRv ; •'s s 'WJ (3&-, f Ll, lazt to the aPpap vo<
is ir~u:red rr t Diu : a cv~m , ,atm Now {ppli a a ur , fnr.c'a¢-nDnc-, 1 o S ar- snhminc i to Nn.eet Adare+c (if ddirerit tha maiiirv- addrml.
he 1h>awcn (Set h :elA N fese',ta Scme ^I;on t .td rtatrm V -..j or, 6Ie clt b-
1 m d :or n-n S
UTO.s-s ins. of Lmr iA tlrPi >;'v Law 1iV4{rS -#7 IaCX I_ i
V ~ f1C.([r
L Application Information- Please Print •UI Information_
r lpem puucr> Nanic-
P _ Parcel4 -
9at;--INv wl, -vuo
Pr i m Nadine t u 0A rogrem rr::ulin. l1 i . JI
! .,J ~._--~~~.r1.T~(R~ /`N•'~•1 .i(-C.~/l.V_~_ ihw_lal
Cmc, .ita:c ~;:q C>. }'hJm t•urrbcr - r ~
~ ~ ~7 ~ Se uon L- _s_
T, N,
pype of Building Icbu6 all that npPI51
' _ h lf,sx ''u N.w' of L;~Cpup{s~tn. / L Si:bam ivn Same
UF+ fil . AV' ,I L r
h1bhU: a uvctal- l.czth : II - - -
L21 CIL) ,I
liatate Owx OcsW:M Li,c__- L_\V !:mnrlel ..T.-T.
ossr. <•f
~+~-t6c16~ w Ztlt?A+~ZA_
]11. T - ul. only ooe bos om fine Complete line R ifaPlAi c}
? -w Si5tet11 r plx'eraa : Sn<cn L ]n.wu...... . inp'tnai: ri T In.<ir :nl (ttKr i is .r,1:.- I f..rm.ri W... m F anipg Systcn iezp:aml
R ❑ P •nir 7?cocwel U ?cm.n Rrvw:n ~au.~c ,'.f I I I t. nr Perini Tralxfm m \zx LL, PxviQ us Pcrmn Ntoiia .,m LLm• ]saved
Ct lvpe of - 'stem loml ouen Device. IC hick all that apply)
I Prasi.. dh unl r tea l l <.+Lc utomd a.aic L ! oen:t' m. o!wnaal<- il Sl m m r`QwCablc ao.I q .
t Crtrr tTn _al n.m ~cxpla:ll - rl Prrram[rmn LkYlvx '..xVia.l.l ~ ~ l
A' Dispersal freaI cut Area luformanru: ~ Q1
+5 (v Few ,p I IIT aril, ycli<atrmH ~.•cll ilspr.-sa: r Requv i I1 a'spc sal yea iY~~p W 'iea cn ell,.Lwtu;
GG l ? /??-oJ 1L _
S1. lank Info . iapa.rt v.I vi
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i -::w~- viauR iaWu I JJ r ~ _ J ° _
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\1I ReSputurLI it) StatemenV't thr I mdersipoed..,e ponxibihry fur aw.1lation of the POW[ Shown on Iee attached plans
imr b< s\ame TJarPlum - naRCC _ bfP:bIPF.S Narrber krtucs., Phctx N., 5h,
•f.~mh•:sA.lArm ,Smm,t nY \ta¢.-r; ~od<; - -
Si _ :nua_rv Dr rartmmi Use OnLh-
pwvc -
KT ' omit l'K Daze lsS.M -!Loam:'. it ]t3t.a:we - -
Denal 7-D" 40 /7
I\. Cupditr itlp p 'P.r4AdNr 4}I}apprmal
onper.' i cell nu>t all be ti lc-_s ` r @ mtjF,m, 34 i ! ad. ne...J
ea pec mar.agemen! plot pro:ioeA lrv pfumtw.
2. AN fleRwr k rKuommmm mode uo r. &Mr H.td hO Yiaf. a WAI/~• i u~
as por ppbwbh code I mitumm. t t f
am: T m cumpleu pmro for iac»:ic¢ and mamii m rbr Comp evly m papa oo: Irc< man A t^ r 1I rachc, ¢ vu
System PLOT PLAN
PROJECT Oeverino Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017
1/4 NE 1i4s 23 IT 29 NIR 19 w'rOWN Hudson COLN'rY ST. CROIX
SYSTEM ELEVATION 98J$8.4 4.5' below grade 8/29/18 BEDROOM
DA rr:
CONVENTIONAL, XXX CONVENTIONAL LIFT IIOLDING TANK
1255 gallons LIVI' TANK SIZE DOSE 'DANK SIZE
NIOUND 5EP'rIti 11, K SIZE
HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 1211 p of chambers 60
BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION loo' Filter Lifetime Filter
❑B(1REHOLE OR'ELL *II.R.P. same as benchmark
Jack Drive
Scale = 1/4" = 10'5,
Pro 4
145' Bedroom
House
~ 5'
13.Iv1. 13-1 90' S'1' Z-?
30' 103'
10'
50' 2-3' X 122' cells with >3' spacing
101'
4"% Slope
45 80' -111-0
B-4
Vents
Vent
>6" Quick4 Standard
of Cover Leaching Chamber
with 20.0 ft2 of Area
5.6ft^Jpair of end caps
416' Property Line Long 12"
Gradc at System Elevation
34" All piping shall be AS'I'M SDR 30/34, within
10' of tank, piping shall be ASTM F891
System PLOT PLAN
PROJECT Oevenne Homes ADDRESS 1433 Cernohous Ave S.lite F New Rtchmoncl Wi 540'-
1: a NE 1!4s 23 !'r 29 Nnz 19 vv 'rovvN Hudson COUN11 ST. CROIX
sA'sTF.M F.I.E:N'ATION 98.8'98.4 4.Fbelow oracle, 8!29.'18 BEDROOM DATE
CONA'ENTIONAIXXX ~!i • ('USA"I:N'1'I0NAI. 1.11'1 HOLDING TANK
MOUND SI11'11C. 'T ANK SVL. 1255 oallons LIFT TANK SIZE DOSE TANK SIZE:
'
HOLDING TANK SIZE LOAD ICATE .5 ARsoRPrION AREA '.219 # of chambers 60
BENCHMARK A .R.P. Top of savvy iron ASSUME t:LevATION 100' Filter Lanni,- Filter
❑ BOREHOLF. O W111 -11. R. p. same as DencnmarK
,lac:k lkive
Scale = 1/411 = 10'
Pro 4
y,:uannti
~5. - Hour:
13 ST
3' X SO' Cells m ith >3' S1
H M13-1 13,
911'
10 T' I
Vents
.~0
l 101' \ -
1,; Slope
H_;
99'
I
>6" Quick-1 Standard
of Cover achin8 Chambcr
h 30.0 t:' of Ajea
1wr of end cams16' Prop:;rn Line ;4Grade at Svstem Elevation
L
O 1 All pipin shall be AST`4 SDR 30134, within
10" of tank. pipin,, shat be ASTM FF91
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 8/15/18
Owner:Oevering Homes
Location: 1/4 NE1/4 S 23 T29N,R19W Lot 1Hunter Hills Estates Hudson
Manuals Used: In-ground absorbtion syste/m (version 2.0)
Page#
1. Cover Page
2. Plot Plan
3. Chamber Cross Secti n
4. 6. Maintance and Co ency Plan
7. Filter Cross Secti
Signature-
License numbe # 26900
System PLOT PLAN
PROJECT Oeverino tlomes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017
114 NE 1/4s 23 /'I' 29 NIR 19 w'TOWN Hudson Cot1S'rY ST. CROIX
SYSTEM FI.FVATION 98.8;98.4 4.5'belowgrade 8./29.18 BEDBOOVI 3
1 DATE CONVTiN-1'IONA1. XXX CONVENTIONAL 1,11. 1 HOLDING TANK
I\IOUNp SEPTIC TANG SIZE 1255 gallons LIFT TANK SIZE HOSE 'T'ANK SI%P:
HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 1219 q of chambers 60
BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 11111' Filter l.ilctimc filler
❑BOREHOLE WELL sILR.P. same asbP.nehmark
Jack Drive
Scale = 1/4" = 10'
Pro 4
Bedroom
'5. House
145' ST
3-3' X 80' cells with >3' >acir ~ /25'
B.Nl.' B-1 B-90'
3Q' Vents
50
101'
Slope V'C
;1~B-3
tlrl,
of Cover aching Chamhcr
LGradc >6.. ick4 Standard
h 20.0 ft2 of Arca
4' Lon1tA2/pair of end caps
'i.1at System Elevation
416' Property Line
All pipin shall be ASTN7 SDR 30/34, within
10' of tank, pipin° shall be ASTN1 F891
Cross Section of Infiltrator Quick 4 Leaching Chamber
Typical cross section for 2 of_2cells
Quick 4 Standard Leaching Chamber
with 2 0.0 f12 of Area per Chamber To be >1' above grade
5.6lt _ pair of end plates
/ Finish grade elevation
Typical Installation 96'8" jD j
Vent Grade Vern
3 X30/34 Septic Tank 3
i' L.ono l,. 5' i' Lon, t..
36" Grade al Svstcm Elevation Grade at System Elevation
Spacing
sd--
3 X2' Cells
Same other end Observation tube/Vent
At end of cell
A
B
chambers per cell
System elevations:
A 924-
B-- -9 ~
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of _
BILE INFORMATION SYSTEM SPECIFICATIONS
Owner i"P ` Septic ;aria Capacity I ,
, ❑ NA
/~J?/~~
Permit # C" Septic Tank Manufacturer NA
)ESIGN PARAMETERS Effluent Fitter Manufacturer ❑ NA
Number of Bedrooms t O NA EMuent Filter Model ❑ NA
Number of Public Facility Units -,gf~A hump Tank Capacity al NA
Estimated flow (average) gaVday Purnp Tank Manufacturer NA
Design flow (peak), (Estimated = 1.5) gal/day Pump.Manufacturer NA
Soil Application Rate - I - ) gaiiday/fl"-_ Pump Model NA
Standard Influent/Effluent Quality Monthly average' Pretreatment Unit NA
Fats, Oil 8 Grease (FOG) 530 mgiL SandiGravel Filter L) Peal Filter
Biochemical Oxygen Demand (1300,-) <220 mg1L ❑ NA 71 Mechanical Aeration ❑ Welland
Total Suspended Solids (TSS) <150 mgw, D Disinfection Cl Other.
!Preheated Effluent Quality I Monthly average Dis e:sal Cell(s) C NA
Biochemical Oxygen Demand (BCD,) s3O mg/L _ L -Ground (gravity) Li in-Ground (pressurized)
lots Suspended Solids (TSS) I 30 mg1L ~6,f NA ❑ At-Grade D Mound
Fecal Cotifonr (geometric mean) _10` cfui100ml - ZI Drip-Line C Other:
Maximum Effluent Particle Size ~a in dia. ❑ NA Other. D NA
\A Other '.1 NA
"Values typical for domestic wastewater and septic tank effluent Other D NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
Ilnsped condition Gf tank(s) - At least once eve-y: month(s) (Maximum 3 years) f7 NA
year(s)
~ir3
Pump out contents of tank(s) I When combined sludge and scum equals one-third ()S) of tank volume Ll NA
C~
inspect dispersal cent(s) At least once every: month(s) ~*year(s) (Maximum 3 years) ❑ NA
(Clean effluent fit;er At least once every: month(s)
L1 NA
_ _ ear(s)
nsect O month(s)
P pump, pump conlrois 8 alarm At least onto every: O year(s) _ NA
Flush laterals and pressure test At least once every: ❑ month(s) NA
❑ year(s)
iDther At ;east once every CI month(s) ! NA
[)ther 0 year (s)
NA.
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal ceils snall be mace by an individual carrying one of the following licenses or cemftcaticns. Mast~lr
Plumber; Master Plumber Restricted Sewer; °OVJTS Inspector POVV'S Ma ntainer, Septage Servicing Operator. Tank inspections mast
linctude a visual inspection of the tank(s) to identify any missing or broken herdware, identify any cracks or leaks, measure the volume of
cembined sludge and scum and to check for any bacx up or ponding of efllue•u on the ground surface. The dispersal cell(s) shag be
visually inspected to check the effluent levels in the observaton oipas and to check for any ponding of effluent on the ground surface.
the ponding of effluent on the gmund 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 ('S) or more of the tank volume, the entire contents of
he tank shall be removed by a Septage Servicing Operator and disposed of in accxxdance with chapter NR 113, Wosoons:n
14dmiristrative Code.
Oil other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components. pretreatment unrs.
and any servicing at intervals of • 12 months, shall be performed h; a ceiafred POVVTS Maintainer.
A service report shall be provided to the local regulatory authority vAthin 10 Gays of completion of any service event.
page _ of -
START UP AND OPERATION cts or other chemicals th4t
For new construction, prior to use Of the POWTS check treatment to s(s) for he presence of is are qtr a
dad have the contains of the
may impede the treatment process andfor damage the dispersal If high 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 tanks may fill above normal highwater levels. When power is restored the excess wastewater will be
discharged to the dispersal cat(s) in one large dose, overloading the cell(s) and may result in the backup Or surface discharge of effluent.
To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to title
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. the area within
Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact
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 Ile of the POWT$:
antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants: fat: foundation drain
(sump Pump) water: fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products;
pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS faits and/or a permanently taken out of service the following steps shall be taken to insure that the system is properly
and safely abandoned in compliance with chapter Comm 133.33, 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 falls and cannot be repaired the following measures have been, or must be taken, to provide a code compliant
rep ant system:
ble replacement area has been evaluated and may be Utilized for the location of a replacement soil absorption systelm.
The replacement area should be protected from disturbance and compaction and should not be iri inged upon by recluhled
setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need
for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the ruletl in
effect at that time.
❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POW TS technology a
holding tank may be installed as a last resort to replace the failed POWTS.
❑ The she has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a sal and site evaluation
must be Pertomhed to locate a suitable replacement area. If no replacement area is available a holding tank may be installydl 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 infrltralive
surface. ReCOnstnrctions of such systems must comply with the rules in effect at that time.
<<WARNING>>
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES ANDIOR INSUFFICIENT OXYGEN. DO NOT
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
POWTS INSTALLER POWTS MAINTAINER
Phone Phone /J ^ s
SEPTAGE SERVICING OPERATO PUMPER LOCAL REGULATORY AUTHORITY
Name Fp me ' ,
-~z d Phone L ne r/ - y~!`-1 / ~
This document was drafted in compliance with chapter SPS 3a3.22(2)(b)(1)(d).(t) and 393.54(1). (2) 6 (3), Wisc«,sm Administrative Code.
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ST. C ROIX C0I1N'I `i
SEPTIC 1 ANK MAIN 'ITiNANCE r!iGRFFNIENT
AND
OWNERSLIIP CF:RT'lFICA'ITCN FORM
Owner.`Buvcr
JLZ~
R4,Uinv Address
Ptoperty Adds CsS 7 7l
- -1 &e.
(Verilicationrcy;urcdRun:?Itmaiug&Zonin4llrPa;tucm it:ewcnnstnit:uoa.j
Parcel Identification Nuftber - - -
LEGAL: DESCR1PT'1UN
Property Location " `,/F tea 'S % 4'3 I' L-pN R or
W, 'town of ~4
C Sun~/~~~~~'r
bi-Nltied l
ey.\lapiit-
Warranty Deed l
Vc)iume Page=,
Spcc house yc: ❑o ',or :III'- nlenntrib yes nu
SYSTEM MAINTENANCE% AND OWN ERCF.RTIFICATION'
Improper use. and iuauucnancr of your scl:nc ~YStcur ~xwld result m n is Pr,,nianuc tailurc to hmndlr wastes. Proper
uarnnenance cunsists 04 Punrpmt- out ti:e scimc, lank cvc;v thine wars or sooner, n necdsn. by a 1wen wo pumper- What You put into
the svstcrn can al?bet the 'unction of the septic tank as it nuahnea' stage m the w•as v disposal svstcni (honer ncantcnance
responsibilities ate spocn:ed in St'omm 8 i52(l l anti :n Chapter 13 - r r C uix Co into Sdnitarv OIdinimcc
The proper(}- owner agjee to submit to St. i ]oix Conurv Plantwrg Los ing Dcparhnent a ccr(if C.a(:on for ni, sihned by the
owner and by a master plumber, jean nevyrau plumber, ie;tuctcd plumber or a licensed pu:upcr vcutv ling that ( I ) d:c on-site
wastewater dispnsd sysicm rc at proper operanr% coohfton an:(;%or (2) after mspc,; iw t wid pumliml_ (il ncc: ssarv), the septic.. tank is;
less than U_I (bil of sludgc_
rase, the aodcm n .,i :ruvc read 4w atnvc meuuun a+r,P: and arse' lo nanCnil;in ilm pn nC u'wNage disposal sYSterrr wnh the
sraudards sot fia h, hcrrm, as sae by tire r)epar'ment of Coeurucrcc: and the llrparrawrit of Sahaal Rcsonr:es. Statr. of W'isi:orvsin.
C:enfificanon seatingHurt vow septic sy shoe has been mzintau cd na st be completed itod returned m the St. Croix Colony Platuwig &
Y,owng Department within 30 clays o+ tl:c three pear e:apnato-r (far,.
!;we certify that all slalcownis on rh lone :rc nae to ,hc best of nga'our t aowlcd),c L'•.vc amr'are the owner(s) ofthe
prupetty drectibed above, by-virnte 'a wa anly do ec rcctudci: it. Rmstet of Der. Is office
Number of bedroom,
6 SI NAT(IRE OF APPLIC.A_NT(S) D =
DA'Cf.
' '*Any irtforaratdon that is mnstcpresrnted Iran result is the salwary permit being o-voked by the Planning & Zoning Dcpaluncnt. '
molt/dC with tlus application a 'ec iudrd warianry deed from d.c keEisicn of )ccds fitcc,au1 it cope; of the ccrhtied purvey nap if
reference is uadc tie the wai r env deed.
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Wisconsin De rent ofSOIL EVALUATION REPORT Page o'
Division of Sa ty and Bdil Ingtl , s~ I
in 8004ancewith Comm 85. Wis. Adm Code county ,
j I
Attach complete site plan,pnpaper not lase ttfan 0 112 x 11 inches in size. Plan must '
include, but riot dnliiad-to-..emcatand h nzz-w-tal reference Point (BM), deedion and Parcel I D. d C;Ir- a
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 0 ZO - 76 - O
Please print all information. Rovie by Data pJy~
Pane l mloWkili n you Provide meY 1w vedd for aeW q Wu PO 1%rvacy Lsw. c. 15 04 (1) (m)) $ 9 /V
Property Owner Property location
O e-j A, n Govt. Lot 1;45 114 S T Z N R E (r) W
Property Owners Mai r Lot # Block # Subd. Name a
City tate , Zip Code Phone Number ❑ City ❑ V ge Town Nearest Road
pekj,L%^ V1 lsvo 111 ( 1 Ij;'~1, - i ce-.
Consinxdion Use-W: eesidential ! Number of bedrooms. Codo derived design flow rate 'r_.__ j!/l_ z c c. GPO
❑ ReplaoenleM ❑ Public commercal - Describe:
Parent material fi7Fr~ Flood Plain elevation if a+pp/livable ~~t{/J a1r r,Jrr__ _ _ /tt.
General oornments
and recmYMrWabons: 1- (_•y. ~~t ✓ ' y n / T~
System Type -",ttd~ System Elevation 77~f-F)_
1 Bon
Boring I
apit Ground surface elev. A?~~~ ft Depth to Writing factor_ in
#
Sal Appli Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPpHr
in. mensell Qu. Sz. Coro. Color Gr. Sz Sh. •Eff/#1 •Ef#l2
} ( r~ IrJ L J la, . i1 It .Ica G
t
-1 i JS fi~ J 1
it At Cl
If
) J
f❑f~ Boring
a - ,
Boring * -Pit Ground surface eiev. r - ft. Depth to limits tador ZL~_?.
Sal Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/iF
in. Munseli Qu. Sz. Cont, Color Gr. Sz. Sh 'EIf#1 'E.A#2
'ail
G- U, ~!L
h -
0 m
i I
l 1
Effluent #1 = BOD. > 30 < 220 mq1 anl!J TSS >30 < 15V ' Efllu nt #2 = BOP. < 30 r11g/L and TSS < 30 rruty'L
CST Name (Please Print) CST Number
Pird Plumbing, Inc. Shaun Bird 226900
Address Dato Lvaluation CondudOd Telnphune Number
?432 120th St, New Richmond, WI 54017 3f7 -f 715.246-4516
IL
Property Owner___ ParoellD# Page _._of_ _
Boring # Boring
v R Pit Ground surface elev. ft Depth to Gridtirg lector in.
Sal Mahon Rate
Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPDnff
in. Munsoa Qu Sz. Cont Color Gr. Sz. Sh- •Eff#1 •EM#2
77- 7
I(~ Bon # pit Ground surface elev.+ R- Depth to limiting factor in.
Soil Application Rate
Ftdrizon Depth Dominant Color Reciox Description Texture Stricture Consistence Boundary Roots GPD/ff
in. Murlsell Ou. Sz. Cont. Color Gr. Sz Sh. r 'Ef ftt 'Ef1#2
0- -e - n -r 16 K~X' s
I
z' I
i
J
❑ Boring # ° Boring
❑ pit Ground surface elev. ft. Depth to In" factor in.
Soo Application Rate
Horizon pth Dominant Color Redox Description. Texture Strucflve Consistence Boundary Roots GPDRF
n. Munaea On Sz Cont. Color Gr. Sz Sh. 'Ef#i1 -EM
Effluent #1 = BODE > 30 = 220 myl and TSS >30 < 150 mg4 ' Effluent #2 = BODr 130 rrxA and TSS < 30 mgt
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.
SBDUJOra.Geei
Soil Test Plot Pla#',
Project Name Oevering Homes St ut
Address 1433 Cernohous Ave Suite A i
New Richmond Wi 54017 '
"S"TM #226900
Lot 20 Subdivision Hunter Hills Estates pad 6/15/18
J
114 SE 1/4S 14 T 29 N/R19 W Township Hudson
❑ Boring Q Well PL Property Line County ST. CROIX
BN1 or VRP Assume Elevation 100 ft. Top of survey iron
System Elevation TBD =HRpSame as Benchmark
Jack Drive
Scale is F'= 40'
unless otherwise
noted
145'
BAT.* B-t R-2
90'
30' 10 103'
>0'
101'
Slope
45 ' B-3
99'
416' Property Line