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HomeMy WebLinkAbout020-1094-70-080 Va~sconsr Deparmenlof Commerce PRIVATE SEWAGE SYSTEM ccarly St. Croix Safety and BL Id nit Dia s on INSPECTION REPORT saruary PCnnrt No (A11 Ai TO PERMIT) 606998 GENERAL INFORMATION State Parr DNC ✓ersonal in'r.rmat on ym. acv de. may de used Im soJJneurJ p.aposes tPr~,a-, Lave s 15 D. 121802353-1 P=_nn t Had,•r`t, Name. C ty V Ilage Tawrii Pa•:el Tax No CPEC Exchange 41984 LLC TOWN OF HUDSON 020-1094-70-080 CS UN1 L uv Insp BM Elev E`d G^script on Se._tion Tcw"rRanglalMao Nu' 34 • `4~, 33.29.19.386A-08 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACIIY STATION BS HI FS ELEV Septic r 7 ' Benchmark 940 9 -3 •-4 Dosing 7. 11 ' ` At BM ,w J P C,,, ~/r 5 ~iJf,. 3 Aswiro'r Bldg Sewed, FI ArI_Q_ lZ,2 92Q•(o Ho Cinn Sul It In et - /3•f 927.78 \ TANK SETBACK INFORMATION SO It 0001 ROAD UI Inlet TANK TO C P 1J :NH I BLDG. :c•r e t~lle Septic 3bI 1L Ut Botlom 17,15 7rZ3. 7 Dosing y `J ra~ JS Heatler^atan /d.9 93o.L Aeralon Dist Pipe `Q. 90 936 - Holding - B^t. $ystern /r' 9o '3 vi 9 s Final Grace 4•,I 93T N. T, 1 PUMPlSIPHON INFORMATION Marufacture• 7 / Demand Sl Cover S3 4.3~ 34 !-,2, GPIv1 r Model Number 53 "7 0 TDH Li .6rFi c;lon Loss System Heay I ID I I r /lJ ~ Fcrcemain Len th I Dia If Dist. I>lael SOIL ABSORPTION YSTEM BEOiTRENCH F" "I'll Le - g:h No U' In"Iftl a PIT DIrENSIONS IN,: Cl =ns Ins JC D Liq:W DC"m DIMENSIONS SETBACK SVSTFD.110 P!L BLDG VJELL LAKE!STREAFA LEACHING R'prur•i rre r I T INFORMATION n CHAMBER OR rWw Z7 ZZ rC7-- UNIT !,!oC?I NUjQ ✓s DISTRIBUTION SYSTEM 6_44- C if " -C rleace- MA n role Urs1aF..,no- x Pc u site x 14]10 Spa: ng V J Ai• ' P ue Leralh 1:1,1 Lengtr Da_____- Spa:"ng SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only -Pir Ove• / Depth Cver xx De.:t~ e' xx Seedec Sucded .x M.Acheo Bc7+l rerch Cereer j r 3ev"I lrenCr Ftlyas ___1 ICp60il ` vgg No yes NO 1 I COMMENTS: ;Induce code dlsc-opencces. pe•scns present etc) Inspection p1 Irs-ect or A2. Location: 569 OUTPOST CP, d 1.f Alt BM Description = I 2.i Bldg sever length = 57Y - ari of cover = Plan revisior Requi•edn Yes XNo `l too Use other side for additional,rformatlon. Date nsepctor Sigr•atur Cen No. $RJ 5i'. f. (K ±r dl ,t.',` I f r ''Industry Services Division 1 1400 E Washington Ave l P.O Box 7162 S:util'arv Permit V umhcr iro he tilled in by Co p - ` S Mddison. 537,17-7462 p- Sanitary, Permit Application It! JLhT State Transact ion Number lu afford vKC with \PY l$l, 2l l?),_Wi~ Vol ^(011C , whntisshm oflhis Inrm in the xppn+pnale gavemmenlal unit Z P O & Z -35,5 - is required prior to nt+ttonain saamarv permit Note Application lomis thr aalc.,mned 110%A I'S are submitted to the kparlm(Tt rt Sa1tTV and I'rofc,,wital Sen t,ss. I'crsooal inhluoabon 1'uu provide may be used for sccondan, Ihniecl AAdrcns (if different than mailing address) posp scs in accordance with the r nv my law. UTi41lx,nL Slab, ry ~1 ~1 1. Application Information - Please Print 411 Information Pmpcrh (Iwnct \wuc I heel a ~roPE,Lf r~~ LLL1CP~G 626 - lo70 60 1D D~. K~~ )q q 2 p I'ngxrly 0"nn/ct's Mailing Addia> 1 I'rnpcrly LtValiuu S J , a f • I ✓ O4W- b-1 / V lL (rrvt. 1.01 Coq S Ic _ Zip C(Nie Phone \ulnhr 5, litiri.. Sceaon 3qp Icircl ~~D(/ ~l) 2-~ l I\-1 ~~i } [-J ~jr.s}- Z?6- 1l q~ f Zg I 1e i l rI~I. yTNpe of Building (check all that apply) I ail I~,it2 Family Dwclho,. Vomhct„f'Hednmms7~~ _ Sohdkision Nan: I !rr'UOile.'C~Ur11111e1Clid 1)csslilx ti,e 5TOc tc !(T r/i` Hln:k d Ot~~ ❑ city of ❑Stile(hsned-Dcxerlh IIse /66787"7 ❑ _ b'illayc of ♦1 .,.x Q I vSN1 Numhcr a III- 'I'yto o' p (Check m~one box on line :1.~'um Ito line B if ` az~pplicable~)~ ^1011111 of ~(.~psM lss~ [ New Sss0.m Rcplascniutl Systc(n I I IlcatmenVI luldine I ant, Rcplaccalan Only ❑ (aher Mollification to fouling System tevplain) B. ❑ Permit Renewal ---D Pe llm Rcv ision ❑ Change of ❑ Putnit Transfer to Ncw I isl Previous Permit Number and Date Issued - Pluudnr I Owner ! 3cfore ispimlion s`[' 4 I t Of POW I S S\StCH) COn1 OrCill, vi:e ICheck all that apply') C~ F :LA (a}~ un-Prcvutmcd lit(Imund ❑ Prc~wriicd InAnound 1-] AI-Grade ❑ Mound ` 24 lit of suilablc soil ❑ Mound 24 in ofstatable soil an ter klxrsal Component explain) ❑ Prevcalmcol Device (explain) V. Dis (crsalfl'realm tl Area Information: Design I low (1~'.p7AI Dc Ipll ,(,it npphlaoon Dfspu>al :\ica I(cgoiled I>(1 Di per/N/Ar(eaa Proposed (NJ Sx Al 111 I co l 5 / Kxu tPFAsf1 ~V~p 1- ~/r 4,1 L IVY (JD ,v?, VI. Tank Info ( upacfty in Gallons TO;,] P of z 8 c MwWlacluici _ Gallons I;nllt /~I} c v d e Va. Tank. bwsbng Tanks i u.. L it j Nepal: og is it(p.Ltad. 1 ❑ ❑ DoNing C'h:mbicr ❑ 4'll. Responsibility Statement- t lhr undersigned, assume re neibility for i allalion of lilt PO\4"I'S shown an the attached plans. - - Number's Name tprint l Plumber's Nnal" a MI! NIPRS Nil. -r Busiti m Phone Number l isld I. Sine -111'1+,96_` 15 235-2644 Plumher's Addw,, ISlmcl, OIN Slam, Zip ( 'uticl_ 15609 708" Ave Menomonie Wi 51751 Ount Department I se Only 4'111oved Punuil I'cc Dalc Ibsucd Issm Agcm Stgnatu xpp (h ~ (iww Rca,vn for lknitd 5 7_ O✓ ~ _.1 12 I~ _ IX. Co n d i11165Y(F}A~p 6EA~JReasons for Disapproval 1. Sept rk, E.11LCn t11c . 1`4 3) u'Spar cell "um all rv = . c - - n_t__ ? Ii as per .nar3yemen' pd.-„ ncs ~ 2 N e)'ftl;l,ipx:^(ms minzt w cert. e c. . - - Mgr~'(1g101arMi;:M;urcr. _ _ MmehInent.1.1 ,plan, for the cf•tem and submit to fort amny only nn lmyer not Its, than a 12 %H inches in .ire SBD-6398 (R0314) 0 m v 3 At eS o 1 I fl '1 f r? n o T ~~i • t`, ~ ~ rt4jJ DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PI _ D GREEN BAY WI 54304-5211 S Contact Through Relay '.I PS hill)/iclsps.wi.yovfpiogramsfindustry-sernres \ www.vnsconsin.gov Scott Walker, Governor Laura Gutierrez, Secretary December 1 I. 2018 CONDITIONAL APPROVAI. PLAN APPROVAI. EXPIRES: 2020-12-11 Plan Review: P\VTS-121802353_1 ;n TODD 1. SINZ x5609 708th Ave - Vlenommllie W 154751 sl'I E: - Onken Properties LLC 589 Outpost Circle Hudson %V1 54016 Saint Croix Coun1_v Town Of Hudson In-Ground Component Mallllal Descrinlion: 57 GPD /Dnrine In-Ground .St'stent) - (I floor Drain / Employee) %lailenance Required The submittal described above has been reviewed for conformance with applicable R'iscousin AJministrativc Codes and Wisconsin Statutes. The submittal has been CONDI1 [ON AI.I.I' AVIIROVP.D. This svstent is to be constructed and located in accordance with the enclosed approved plan, and with any component manual(s) referenced above. The owner, as defined in chapter 101.111(10). Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work al plumbing in the slate unless licensed to do so by the Department per s.145.(16, slats. I lie following condition. shall be met during construction or installation and prior to occupancy or use'. • Only waste that is categorised as domestic waste is ucrmitled to enter a POW'1 :S unless a letter of concurrence Ihrm the DNR that permits commingled waste accompanies the plan. • The system was designed to meet the influent quality defined in tiPti -rile quality ofintluenl discharged into a PO\\'TS treatment or dispersal component consisting in part of in situ soil shall be equal to or less than all of die following: 1. A nionlhly average of M nigI, flits. oil and grease. 2. A monthly average of 290 m- 1, HODS. 3. monthly average or 150 mgL *1SS • Preserve dispersal area prior and during construction to :avid dislurb;mcc, congrnrtion and use of the site. • With new construction; it is recommended not to activate the pump in the dose lank until the tanks are pumped prior to homeowner occupancy. • Wastewater generated from contractors cleaning of equipment and tools and or Iefl over construction products shall not be discharged into the drains discharging to the private onsite wastewater treatment system (PUN'-LS)- Waste generated shall be properly disposed of on-site or off site. • Prior to construction of the dispersal area, check the moisture content of the toil to a depth of 8 inches beha% file .y.rnl elevation. Smearing :tad rankling ufwel soil will result in reducing tile-infilllation capacity of the suit. Pruner soil moisturc content can be determined hy_rullinl a suit sample bet.vccn the hands. If it rolls intp_a L4- inch wire, the Site IS loo wet to prepare. If it crumbles. site preparation cau_pru_ceed. If -the site. is too wel to prepare. du not proceed until it dries. • Divert surface water from I1OXk I'S Area. • All piping Shall conform to SPS 'f able 38.1.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 Icrl per SPS 382.30 f I I )(c) • Tank Installation to folbne all manulaelure's recommendations. • Verify property line(s) prior to installation - Owner Responsibilities • 'I he current owner. and each subsequent owner, shalt receive a copy of this letter including instructions relatin" to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and or owner's manual for the POW I S described in this approval SPS 383.54(1). • In the event this soil absorplion sy stern or any of its component parts malfunctions so as to create a health haiard, the property owner onist follow the contingency plan as described in fine approved plans. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized represcmauves of the Department. which nun' include local inspc,tors. All permits required by the state or the local nwmcipabh shall be obtained prior to connmencennent of construction installation operation. In granting this approval the Division of Industry Services reserve; the right to require changes or additions should conditions arise making them necessary for code compliance. AS per state stair 101.1201, nothing in fill, reel," ,hall relieve the designer of the responsibility for designing a safe building, structure, or componcnl. Inquiries concerning this correspondence may be made it) me at the telephone number listed below. or at the address on this letterhead. Ilie above let'( addressee Shall provide a copy o1'this letter and the POWTS management plan to the owner and any Others who are responsible for file installation, operation or maintenance of the PAM'S. Sincerell~yy,,/ ~ T inn Vander Leest Private Sc,va:!e Plan Reviewer , Dn ision of Industry Srr% ces i9201492-'214 . Mon- I ri, 6:00 a in. - 3-30 p.m. SPS 384 Construction Materials (C. Techniques All materials must comply with Comm-84-and be installed in accordance with manufacturer's specifications. Construction methods must comply with the following Component Manual: In-ground Absorption (v. 2.0) SBD - 10705- P Location: NF.I/4 NE1/4 S33 T29N R19W Town of Hudson County St Croix vale: 12-4-2018 Owner: Onken Properties LLC. Address: 525 Commons Orrvc Woodbury MN 55125 Plumber. Todd Sinz Signature: License # MP 139462 Attachments: 6748 Plan Approval Application SPS 381 385 Page 1: Cover 6: pump ch unber cross section. Design criteria and sizing 7:pump curve 3: Plot plan 8: F.ffuenl Filter 4: drainGeld cross section 9 :Owners Manual 5: Septic Tank!Ptunp tank. 10 : Management Plan ~f ja Design Criteria Yes %k'astea'atcr (_-ontarninant Load: 30 mg/1. - BODS 220 mg/L Anticipated scptic tank cIl7ucnt 30 tng/l, <"1'SS < 150 mg.'L FcctdColiform---- 10,000 cfWt 00 mL Fats, oils, grease 30 mg-L i }'II: i x 13 x 1.5 19.5 gallons'day I floor Drains 25 x I x 1.5 37.5 gallons;day N in.Design Flow - 57 gallons'd'ay Drainfield Design Flow = 57 Gallons/day Design Calculations In situ designed loading rate 57 gallon, sq. fl, per day Depth to estimate high ground water >110 in. Depth to bedrock --1 10 ill. Cross slope at system Flat'%o Septic tank Wieser 840!500 gallons New Effluent filter lifetime LT U8 Septic Tank Sizing And Liftstation. Minimum scptic tank size required for 3 years service frequency is 119 gallons by spreadsheet Calcula6011; Using Wiescr 840/500 gallon septic, lilt tank. . 'T'rench Suing 57 gpd/.7 per sq ft = 81.43 sq. ft minimum effective area for mcdium sands I nstall 8 infiltrator, Quick 4-fir shells which 20 sq. M each EISA plus I x 5 8 sq 0 for a pair of end caps gives 165.80 sq tr EISA. ***t,1'c arc over sizi rig this system a~~o n=-. I I ~ s _ L V Imo` i ~ t,L I ~ ~O vJ N. ~ h\ -Its 1~l I/S Soil Absorption System Cross Section 4' Schedule 40 PVC Vent Pipe _WAh Vent Cap Leaching Chamber ~ft Soil Absorption System Plan View Vent Or Observation Pipe Trench Leachina Chamber Specificationyys~~ Manufacturer And Model t S~t (}pR~ CXULk `t EISA Rating 'ZD sq ft perchamber Soil Application s Rate gpd/sq ft C gpd Design Flow+ / ~`EJ Soil Application Rate + 1 ~St 6e EISA = Chambers rows of g chambers each. Page =F- of / 0 arae~omu.3,u 95~i8-47,i-O:rS z go ~arr~d-iso ~~YO no oc oo ~71Ya oscss W 'H.>oa warow C. ,.nv sn v:~rNl WnNVW OIld3S 'NIIOd-3b ,0-,!>,t, : '31Y3S dQ1l AE NNYbO 31311111 13331M W 21W-OOS/068M L w N w Q K J ZUZ 2: > w O coo s ° D w w w S s ~ V1 4. Zp° o F rn m I a U w~ ~ a 7 U C ~ ~ a n J wa k a J m w O ! O° `ice ¢ 0: F- Z W o z Q an d !a z L M F 3 O 0 4 0 -C- aO° ° °W ° Z F O a o O. fpm~ N mli ~ow vN n !"67 In a ON\ ♦YJ wI awls b . P N N= Y NN MWH m: i0 a Ud P z ^ a _ F n Q \"N ~"!w_y`'= ~aj' wiN } Z w uuNa// c\i cziz x'- It V) N3.-1- wf- V0W ~zs U V°-I W U W ww < Y oJG~z.7 :c ION oNj a n co a ti x° In 3 Z N#a°i cul3xw maacaj a~° ° i v N° m o Q yZj W 1- P s K.. °4 o a z S" z o z z ] °J < a N I < H Q U u I O 94 ~ i n z ~ w / w t I i - < ~n 1. ~ LS ~ Jx( < < W / ..5 i ° ~ m i I w J S O Fr N ~ U ,Nb < 4 0036 z £6 Stl ,;GS z < < SEPTIC TANK AND PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS Locking cover with wamirv.) IaheE. Ap;.:_ss Wcather Proaf Junofiae 3n'•. ',R IIt r..J > T above Grade n r I vnc r is a r... l.cc.rr t ,t,',:~ - above finished grave. / Access opening, no( lop of cover, must extend to Maximum cove(over Tank a point no greater than 6' below finished grade. E Disconnect 23' Min. Opening ..-ri ~ 18" min E- Alternate tv outlet J I location 23' Min. Force Main Diameter Opening Approved-v Building effluent filter r~ Main Length sewer to 118" A particle size Weep note or anti B siphon device. C D Pump (M E'v.! ' Goss TSnk Elev BM and backhll tank according to mar u/arluren specigutions Anchor tank as necessary to negate buoyant forces Note: All pipe and vent materials comply with Comm 84. Tank Manufacturer: Ulf. f% 2 111 Doses Per Day: / Tank Sizes: Septic.? Gallons GPD/ # of Doses: r rt gallons Pump v' G Z. Gallons Backtlow: IL I gallons Gallons Per Inch:/ Total Dose Volume: J t D allons yX~ Liquid Level: : Required GPM: Pump Manufacturer: Zd£LL[ y- Dimensions Inches Gallons Pump Model: Pj j - - A - '9 ~d7.79 B' L z. Alarm Manufacturer C D 7i /Y/• A Alarm Model: kie r Total Vertical Difference between pump off and distribution pipe Minimum Required Supply PressuPe, (0 for dosed conventional) _ f /P Feet of force main x 7y5 friction factor 1100 = a ~~n 2 ~ Total Dynamic Head = ~ r w ' PUMP PERF ANCE CURVE TOTAL DYNAMIC, HEAD ~ LL MODEL 55i57i59 FLOW PER MINUTE _ ~ 6 20 MODEL 53!55/57159 1J Feet Meters Gal. Uters ? a 5 1.5 43 163 a 10 10 3.0 34 129 15 4.6 '9 72 z 5- Shut-off Head: 19.25Ilt.(5.9rn) 0 1C :gi 4J 50 GALLON LITERS --T- 0 80 160 Fl OW PER MINUTE ooau> Model MODEL COMPARISON Seal Made Volts Pb Amps HP Ht Lbs Kg Slmplux Duplex M53r M55 Sin0lrt A.% 115 1 9.7 3n0 60 23 10 1 453i N55 Single Non 115 1 9.7 3110 61 23 10 2 3&4 A • RN53 Singlc Ain, 115 1 9J 3:10 W. 25 11 - • RE511RF57 Singly Aire 230 1 4.8 3110 24130 11113 D63 Smglc Aam 230 1 4.8 3110 60 23 10 1 E6XE55 singin then 230 1 4.8 grin FA 27 10 7 3144 a M57YM59 s"plo Auto 115 9.1 3n0 6C 29133 13: 1 N57tN59 Shgle Non 115 - 91 3r10 60 28 I29 12'3 2 3&4 • ON57 Single Auto 115 y,7 310 60 30 13 - DWiC59 9inDle Auto 7:90 4.x 3np ap 3Ui38 13rt5 1 ES7rF.69 Single Non 7?.0 -4.8 3`10 60 28!29 12113 2 3&4 E59 Single Nun 73(1 n.9 Y10 00 29 13 2 3&4 • 5.ngle plggyharx sw?ch Incluoeo. SPECIAL btODEL FEATURES Aecht pool cord length. era mailable in 16' :5 of%25' IR od and 35 : , 5, Or m; old lanp:hs oailable for 230V units o•Jy. BE and 8N models include a piggyback variable level pump swl:dl. Model 63: cast :ron switch case, moan and pump housing, a plastic impeller and hasp. Modal 57 all rest ow, ro,a,Imchon wish a cast Ton imoelle,. Model 55: brume switch "se. motor and Pump housing, a plastic mpoler and base. Model 59. bronco conalrucGun with a brume i•npelhi Optional Dump stand (.e1N )C-2421 t. SELECTION GUIDE 1. Integral flraPUpnrnted merhanical 9,vrtd1, no external control « quired. 2, Single piggyback variable lovul float switch or double piggyback variable level float switch. Refer to FM0477. J. See FM0712 for correct model of Llectrical Alternator. 4. Vaiable Level cwnor l t,Adtch W 0143 used as a con,ol activator w8h electrical aPernator J31 or (41 float system. OPTIONAL PUMP STAND P/N 10-2421 • Reducos pwimral clogging by dchris Iy s{ 'Easy assesr res • ns looks 0, bfcksunder our pump (P.y¢kdxa'ir Px • Mad o of d.aobhl¢. n off bull ve ARD Y 'd, nt:d,roa; • Rases fit p. 7" (5 m) c off a n of basin • Provides this ah Ifty to raise intake by adding nerviness of Ph' or 2" 2• , (DN40 or DNeh PVC piping I • Annchc zarurefy to pump • Aconmmpdalen mmp. dow ate ung and effluent amilicaUOns -7 NOIE. Make sun'toat is tree Icon vbrnrdion.t~9"`r"'_ _ - , ,.x / JD 0 CAUTION roar. at on : romros. y:atectior, devices tie ycnng should In, tlcre by a gualif ed I .,.,c Boor, r: a 11'. 1 take. u I a xt vices should be 1:twelid'. 9 oc 1.1!ta«4 National Enr vCnoy;`Ii::,aJ'.1x Darapalb,wl Safany and qaalm AI 10HA'.. P Copyright 2015 Zoelle-• Co. All rights reserved. '-302-778-2731 1 800-928-7867 1 3649 Cane Run Road l 1 auisville, KY 40211-1961 1 ww•w.zoefler.com The Best Just Got Better - 'OD The most efficient, the lowest maintenance, the most economical effluent filter! • Nearly Twice the Filtering Capacity • Estimated to go 3 Times • Longer Between Cleanings • • Cleaning Made Easy • • Does Not Retain Solids Between Plates • • Lowest Price • O M 90-10 d - Eliminates the collection of solids inside the cartridge. - Nearly twice the filtering capacity of any other filter. 0 SW no b - By eliminating solids between plates drastically reduces the need to clean. - Cleaning made simple and efficient. ~/8: 3500 GPD/Residential Strength Filtration 1/8" IT - 1/16: 3350 GPD/ Residential Strength o mom Filtration 1/16" - LT - 1/32: 3000 GPD/Recommended for Commercial use with Residential Strength - Filtration 1/3211 - LT - 1/64: 2500 GPD/Recommeotded for Commercial usage with Residential Strength - Filtration 1 f64" ~/o - 2700 Inches of Linear Filtration [~'vearly Twira thr~ ('ninnniifinnl ST. CROIX COUVIA' '71--2-C TANK N.AL'v'TENANC_ AGRR.EWENT AND O i NERSHIP CER=CATION FORM pu*n-Buyer 1... ~ MaLmj; Ada:ess ?:=iaL%g b Zomj _...:o.:.s...on=v...,_r.:. LEGAL DESCRIPTION m _~ca$on A j[- , Sec. .r N R f 9 W, " von of r~ Su:ocivisim Plat,----- 4 - ~rolsne 6 Ps e Certified $urt•ey Map (before 24J7)Voi me Pr : Warranty Deed 4 Saec aoue 7 ves~5(nn Lot lines idendfiab:c i yes no ,LkLNTEN~( f N1) O%N"'~-ERCERTMCATION :xp-nper l:Ce and :ri.is~azn e of yo-s septic systern cotild resuh in its p:=aae :emu a to handle wa;;ei. P: o zr mzint-:ante corsis's of ?m: p-mg o:n bn tart every tars: years or sooner, if needed, by a `_iceased pumper, Whai y:.L pta the svs-= can affect the fan:5on o: tae se?uc =-1 as a trea=ent stage in the waste dt.?asa. scr Owum i tec espor:stbllmes are specified in §,SPS. 3g?and in Chapter : - S! Croix CotmN Sacira-}~ Ckdinance. The ?mpe-ty owr,cr agrees ter s~~:r it t: CJCix C0 n,.y Planning & Zcnir e Deoarmenl z fn'rn.. s:_:ed'-l u. _ owner and 'cy a rnasta- ph=bur, il=T yman ;:Itrrnber, reseictec plumber or z licerscd p-.rapar .,o-~•.•:ug `aai :118:: on-sre. . wacmwater disposal system Ls :r. pr:,per one-atsg e.+ndidon and o. (<i e= =yection anc p,- p:ng ;r necesc^ sepnc zzmk 1:ssthn L3:c:lOfslndze. Uwe, tze =dersigred hxve ma,' tl,.. and zwee to oaint<m the ?rig a sewage :-~::sr: -1•s^rr.. s~tt::hc stsada s set forth, :herein. as set cy 8,e Drpa .a:°_r.: of Safety /.nd Professio^..al Sxius and tae D-'p =cnt l:s:rte _.rsotr~.;. State of Wisconsin. Cemmcauon >^-ng ta you septic *,stem aas beet maintained :n,.='oe cozy; lured and : tram-. ter t,e S*_ C-:> x Ccmmly ?tanning & Lo- n 1 naZ-_ w;[ain ;I da;rs of the titre: year e>?iration d- . l'we certify that a] ztir-m=as oc thu om are = to the best of my~ our km:w'.edge. I`we ami are the ewaerlsj of the pmpar'l over-ft, d albove, vir= o` x a a w deed//recorde l in Rrpst= of Deeds Ofm e. Number of bedrooms (~o +t e^° ~U ta; 6 / r~ SIGNAT7 7KF- OF AY,LiC.!,-\ '(S) DATE --AXv inf.tnaflon ha: is rdsrept went: m-4-.y ;:salt in the san:-try per^_tit'being revoked '^y he Planning & Depnrmtcnt Include vita this applicarion a recorded warnm~v deed Eom the Reg nc of D--!s 0`5ce and P. copy o1"the ere-~ e: s rvcy u ay reference is made jr. the wxr.:mri due (RED'. 04'L:) ••u .aµwrY"rvl I~I~v2.t( I,.•i 9•~,., i,a wosanu O - ti f 1L>Y 6H'L H 101 s~oa~l4aarVI--I Y:' IMIO.i.S-wnw(AIR-MOad I Q JG02103t•5 llq ~.vl 7f,>r•)ti.^.-.M -.50 ~ Oi -.G. tt.1011[J _ • ~ O I 4: 4• ~d `L L t: fa :E a i#t o o St I w I ' a •'i~ W + 6S u n j ~a } Ia i 1 t LL ~Y n n I ~a • ♦ w Ha 1' a ` 0 J . • ) o- Q= C 4 M u f _ i <as si y ~ E J1 'E 1' C ' ~ • )a Iu I. + a 1 n N 1 ~T.' d ` >s sw JL. + I Y) • Wi u S CSC-2ff1b-~o~ Wisconsin Department of Safety and Profedsional Services Page / of `Z_ Division of Industry Services SOIL EVALUATION REPORT I~ accordance with SPS 385, Whs. Adm. Code County Attach complete site plan on paper not iess than8112 x 11 inches in size. Plan must include. C r0 hut not limited ux vertical and horizo-4of reference point (BM), direction and percent slope, i Parcel I.D. - ' / 0 S'D scale or dimensions, north-arrow, and location and distance to nearest road /a ~7 - 4 _ Please print all information. j Rev' by / Date Personal information you provide may be used for secondary purposes Pnva„ Law, s. 15.04 1 m Property t(1 I f ~ Property Location p - ❑ 4W+ 4on rM rr1;. S"t), COC 1 YIL 6&11 Q - Govt. Lot L Y. AiE Y. S 33 T Z_ -N -R /-~-,--E (or Property Owner's Maili Acd n Lot # I Block # Subd. Name or CSM# ZS wr.Ms 'Qrh\1C_ _ _ City 'State / Zip Code P lone Number ❑ city ❑ Village ❑ Town Nea st Roa 11 iNelvConstruction Use: El Residential/ Numberofbedrooms -Code derived design flow rate `GPD' Zax~ ❑ Replacement Public or commercial - Describe: Parentrnaterial Uu~ 1,.5 C~(.~ Flood Plan elevation if applicabie~1~ ft. General comments andiecommendations: J r p (eco wrlvMa~ CUn J e ~~c ' cs (a"' 0.71 V Q r n 5T w 0t O1wJ or S s wvcc, ~thi SOrw c~W 1~v4~CDty~.cLO.YSt1a C~9n2/~~(241 l l Boring # ❑ Boring rJy /C i ®'Pll Ground surface elev. ~ft. Depth to limiting factor in. S I Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft' In. Mansell l -Qu, Az. Cont. Color Gr. Sz. Sh. I •Eff#1 •Eff#2 V - V 4 It/.M1-= i _ FT b~3S Z S~Y~i 5k2 Y/Y r 5't 64 0 G ® ,!7 01'5-11V 75,j 6/mil 5 - 07 6 10 C__ Boring San g , Pit Ground surface elev.9~ ft. q /I Depth to limiting factor/Oin. fr - - _f Soil Application Rate Horizon Depth Dominant Color Redox Oascription ' Texture Structure Consistence Boundary Roots GPD/FP In. Mansell Qu. Az. Cont. Color Gr. Sz. Sh. I _ •Eff#1 fEO2 - o Effluent 01 = SOD. > 30 5220 nlnd 7 30 mg/L - ' Effluent #2 - BOD, > 305 990 mg/I- and TSS > 30!9 150 m91L CST Name (Please Print) Signature ~-&2p CST Number ~ -7 D U e. ddress , Date valuat onducted Telephone Number SBD-8330(R04115) t j `I Boring # PRnng Ground surface elev/A/ ft. Depth to limiting factor I I in. I Soil Application Rate Horizon Depth DominantCobr Red ox Description I Texture Structure Consistence Boundary Roots GPD/FP In. Munsell Qu. Az. Cont, Color j Gr. Sz. Sh. , 'Etf#1 "E1t#2 IC ~ r O- 3 5Y 5D 5 ~i s S y ^lS 6-110 Y Z% 1-1 r1lu I ?r'~ -Q a i I Ll V., Boring # BodlCg © ip Pit Ground surface elev.1-IZ-1 .ft. Depth to limiting factor r Sail Application Rate Horizon Depth Dominant Color Redox Description i Texture Structure Consistence Boundary Roots GPD/Ft' In. Munsell Qu. Az. Cont Color Gr. Sz. Sh. 'Eff#1 'ER#2 0- y 3 "e4 r < o S7~ / 5 a - -6 H Or -7 i ?iW7 7-W; 7- Q3J - - Boring # ❑ Boring E III JJJ III ~ pit Ground surface elev/_ R. Depth to limiting factor _ yin. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture 'Structure Consistence Boundary Roots GPD/FP In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. M ,EM t D .Z t7 `3 3 Z or> 5 n 5a, z o_ 5 t g3 s ar.s `1 Dar. ~ rr ~ , ~ O oar rm2 .emu S oERiuent #1 BOD, > 30 S 220 mgfL and TSS > 30 5150 mglL Etnuent A=O~ , > 30 5 220 mg/L and TSS > 30!5 150 mg/L n 0 J , -r N w r ~3 Q- o M cp d l S 1~' 1 O O v k ✓J