HomeMy WebLinkAbout040-1044-30-000
v."sews-Decan"enlC.Con'•-race' PRIVATE SEWAGE SYSTEM -C_-tl St. Croix
S alci and e.l ding Jrvrslon
INSPECTION REPORT Sanl:ary PCrmil No
GENERAL INFORMATION :ATTACH TO PEHPaI',1; crate Plan 0 No 615321
I
-lom'at nn yo, vro:'ide may he '5e_ srand:ry l: o'posus (Pnvacy .a+. 5150 .1IIIII
Pen- I I:JdaY; Nnmo r:rly ape lonmship =meal-ax No
Nicholas and Hanna Kuehl TOWN OF TROY 040-1044-30-000
5l 'dV S IC: P-s- 5V Elev. titer 7aacnPacn SecnC^;TCwn:Iea r1laF N,
10.28.19.14513
TANK INFORMATION ELEVATION DATA
TYPE :!A\UEi+:`Ur+F•i r;pP,'v011v STAI ON BS li, FS CLCV.
septic Bwe;nmalk
Dosing At. GM
Herat a' l 3'.ag. Semc'
TANK SETBACK INFORMATION 1 Oll'1et
LANK TO '!L V:CLL R._ :rG, %~.t to Air Intake ROAD' Of Irel
77-
Se to ;y 7 /
Of Bgllon• - i
Dosing Heaae-lvan Voc> C) e)
Aera:ier Cisl. Pipe
Ylf:
700
lie ainq _ Fot Syslem II)
F.nal Orade
PUMP/SIPHON INFORMATION C~ 17 ~O
Mal.,loeturer Oemar'd St (:aver /
cnM d CA,.~d - /U fry c/
Mc,dcl N.nrmc^
fLAI -dl 'uca:;n L,•ss-. Svslem Head TD- F. / /1 Ab: ~./v
I ? -lM-
I-elcei lln L''IAjll'. Dia tJ.is TO YJCI
r _I~k I IlP a
SOIL ABSORPTION SYSTEM
BEWTRENCH ivId't J Lcngl- No. C^ Trenches PIT DIMENSIONS No. Of pits I-srre Url :.quid Dep:h
DIMENSIONS I - -
i
SETBACK !;Y, _-M F.; III BLCv^ 1:'CLL LAKCISPRG11a1 LEACHING 6lanutaclurer 1
INFORMATION CHAMBER OR Yl l 1
-r'ae C: "oy s:en - O• 11"" UNIT
IACCnI rl-r'TCr.
l )lh. Lv".•
DISTRIBUTION SYSTEM j+
-cd:cr'hran'oln Jrslr-SULm + rlcle Sve 1. Held Seaeing 'lent 1o A, tuake
r ptl _ J CvJT CI XJ
La-am Lc
J.a qt C a Soac ^ o
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Gcp.h Uvcr Ooah liver 1 Jecm C . leadeorS--ded xx Vulche::
na 7 r z i 7cd ^rcr c^ Edgc5 :o<.-d 1/
- - r_ r.o °ca rlu
COMMENTS: il:Idudecodediscrepencies, persoispresen: e:e.;, Inspec:IOr BI. Insl;r.than tt2.
Location: GGD (:)UI_FF TRi ` 11 U~ ` I
I i Al: B1,4 Description = \X21.1 (rt'v C' l~`~T*+,,r-3 I! 7,^_;f--
2 y C+ldg se•.ver el = 1r-
- amount of cover
1 r I'
Plan revision Required? 1. i Yes No
Use other side for adalhonal nVOUnaLOn. -
a:e rosepolor's Signa'urc Gel Nc
Si 3 571
e - U ~j L JT~
1 [i S:aety and 6oi>dinos Dms.or
201 'tA. Washington Ave.. P 0 Box 7151 rS ;n,~ Jam;. ;vucioer~'~tel6e at p;;o.;
riadsor,,LJ' 5370 -71E'L
58I1 l_rmlt t~ppllCatl Tran.a IM tinmba
n r cRC9~w~ SYS 3St 21:', %V, A -m Cod,,, h.bm s h t Leis lcT to the zpr[gtnae ;;>eznaW tmrt
q h ;1 pr r s rF auurC a amts pemta v e pcl n ,r fer, m, 1cc stye-. - -,aed w ISOIez Mdrm Vie' , ffacm than tuai.m= Ididressi
a in m f Sat tv aol ^r he>suvaau, s I h am.;J J C lotmafin4 you p:ot idc :ve ?x os.ds ^ rl ' , I' m
:'Ipl.,.~in 9r mlan<. wa't lhclms.L t }nw lilml SLCS` _ 11 fJ_~a{- _(Q((J(J tCe-
~
l ApplIrIf1Vn y a Na Information - Pleasc Print Ml Information
h ,er.> -~/TK) parcel'
keel
ert>~)we-rs Alailm; tAhe<>.-_-_..~~ Propene In:alnn Qi 19 II15 Q
I i.•rv, Sate Llp : Vc Photo i<urMr - }I [
1111 I I I /l) ~ .qU I sn:dcn
1~~~" i \ A/I ~ t~l YJ ~ L"CIS
11. Type of Building frherk all that apPl W
'T Or?Fwluty llwellinp, Na:ut+r_<;t R<;irt Dti/i Stdd>>wo Nanc
1❑lkw'nbC
'
N - 1
S:sl^fN-iN D_c_-,•Y :Ifr 1,.V:•r:xr r-' Vil;agc o`
Z Q °,Ll Z3k73 -Ce~g T,w,:,.t
Ill. r)w of Permit. (Check y one box on line A CAmpklc line If t(applicable) Z
- ~ ^ 3,ea: $\K[e.a hcauncn;:3o:in~ Ty.k keplacehuai: imi, ❑ :Nra MOdi'vcarioo to cxstitn, syA=!;xpla...l
1 6. P..rlah pc•ICw,d I: ai: Itnheon -n•:^c '.r }Ii nncr _i'rt,nl :ansietrFcw Lin Previous P.".1~ `v=wand DDatee i[.>urC
I k1• I i ti-r - I r?wv~r 1- I .7 I- 'ur
qty/1w eofi'F)A->1T`PC ySleur4l_ompnne ni Device- ,(,heck all that applyi
\_~s..ti n. f7rssv.~ L - Masu n :.t suiaAlc i I ❑ h4omrd <2-i in, of
~lI-hio:n_ u r:YAcr luFerzcl ('ul>Lv I1 expiaia _ - ❑ eccan r7' Je>iu exp=)- -ZZ
L' Dispersal-Trentmeot area Iv(ormaunv yJ
F')kh nflow / ,X>}PS U rlicann mod.! CLlst»I Ax. Re~u1r01--fl aI4ea 14., d (h $rskrr. I'Ieea40
93 -.kf
VI.'I'ank Info Papa m!n 'foal sot Mshuh'a;:mttr r T
G IL u r-n-Cou> Cmb
New Tad:.e =.uxl~a-ank L_
N
o- , ia;ri r r.u.
V1 1.
usiblhr> Statcmept~ l me uudml ned, a c respoomblhn' for iucta11ation_of the N)" Ts shown ou the attached
rh h r P ru: - S ^ Vc Plans
Iha Art s S -
fl.
~ ~ ''\'~HS !.umber BusmeuPhrnlcNhmiba-
~ ! (T
rte: >.4Jorcc,fSUe_L: err S.eh,,. .cl t -
ATII ~uol.'Dcnartment 1 <_c Ouly _ _ _
4Ff w'e'd h-apl~r P-miit:ec :as su "_szums •aa S:~ahm
_ n na,.a :nr„ia, S Sao . 6 /9
UC. CondiU ason),& Wpproval - - - -
(Aven sh toll Must aII Q~arh~ir ' r,v nib rgi ` / ~t Gl~fy~ l.,J fit'
n par TWfifMlBn! plar. p'4' dM by yllanbe',
2. N sle!Dmdl talfl.Yet^sne mhc:t w ~-:a,tk.t c
At'vr6 1<. eempkar y:am lur the vynrm nud>ubms to rbe Cnanq Doll oa N?Q nah Im 0au x h0 x n m-
m vn -
SAD-e13gK h,R I l I i
III
S~ slcni PLOI PLA\
PRoji ("I lk-!o KLV.11 :1UnIt ItSS 66:: COUlec Tsai I woSCr ii
NV'v' 1 i J NL I r 4S 1 0 i'I E N; R 1 9 V1 TOAVT Troy cOL NT1' ST, -IR01X ~
SYSTEM ELEVATION 92.891.`, E' nelnvr gradc. 5'29+19 BLDROOM d
U A'I'I _
C'ONAEN'I'IOS.AI. XXX CON EN'1'I0NAL 1.I1"r HOLDING TANh
1UUJ
M(H NU SEPTIC "G1Nh SIZE Gallors LIPI TANK SIZE DOSE TANK SIZI
-
HOLDING TANK SIZE LOAD RNTI .5 ABSORPTION' AREA 833 N of cbambersa-
BESCHNLIRK A'.R.P. -op of powor t»z ASSUNII: ELEVATION 1110' Filler I.: Iczime (":Iter
❑ B010:1101.1 (D Ac'E.LI. ' H.R.1-. surge as
~P.ft^h^terr.
I
c l l
Scale = 1/4" = 10'
L.\atiI-
Propcll\ Line. Red; you:
House
I,
/Flici Old drvwells are to be pumped and buticd
M.-- 13
4 5'
a'
9
Al
lfl Vent;
4(
B-1
IS" 1~
1 V:In
Qaic ri Standard
:aching Chamber
o Cover
'Cop with 20.0 Y?2 of .~~ca
5.6ft^2 pair o; end caps
Licl
100 Grade ;ml S\'SIe171 Elevation.
'4
11.11 pi:)in~:be A.STA9 S:?R ?'I:'4. \a;9-:n
10, of :anl;. p.p;ng s.`~a'1 fir AS IAI Fco_
C :puler Trail
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 5!28.•'19
Owner:Nick Kuehl
Location: NW-1/4 NE1,'4 S10 T28N,R19W 660 Coulee Trail Hudson
Manuals Used: In-ground absorbtion system (version 2.0)
Page#
1. Cover Page
2. Plot Plan
3. Chamber Cross Section
4-6. Maintance arjber )d Contigency Plan
7. Filter tion
Signatur
License 226900
I
System PLOT PLAN
FRO.IEC'•f Nick Kuehl y mmu.ss 66C Coulee Trail Hudson Wi 54017
NW 114 NE 1/4S 10 /'f 28 NIR 19 1Y fo%sN Troy C011N'I'Y ST. CROIX
SYSTEM ELEVATION 92.9:91.5 6' below grade 5129119 3
UA'f F BEDROOM
CONY ENTFONM1L XXX CONVENTIONAL LIFT 11OLUING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT"TANK SIZE DOSE TANK SIZE
HOLDING 'TANK SIZE Lone RATE .5 ABSORPHON AREA 933 # of chambers 46
It I:\C11 M,1 RK v. It. 1'. Top of power box ASSCM1IP: EI.I•:\•A'I'ION to()' Filler l.ildlnte Filler
❑ BOREHOLE WE1.I. a:11.It.I,. Same as benchmark
Well
11' Scale = 1/4 " = 10'
Existing
Property Line Bedroom
House Er-1
I
DW
90' Old drywcII are to he pumped and buried
100' )\\r
Hufftant Film Container
30' 100,
B.N1." B?
98'
if it,
~0 f ' V0111.5
96'
13 1
B-2 18~~2 Slope
Vent
>6" Quick4 Standard
of Cover Leachin,, Chamber
with 20.0 ft2 of Area
5.611^2/pai r of end caps
4' L.ona 1
MY 44 Grade at System Elevation
All piping shall be AS1'N1 SDR 0• .1, within
10' of tank, piping shall be ASTNI F891
Coulee Trail
Cross Section of Infiltrator Quick 4 Leaching Chamber
Typical cross section for 2 of 2 cells
Quick 4 Standard Leaching Chamber
with 20.0 1121 of' Area per Chamber
5.6ft^2 pair of'end plates To be >1' above grade
Finish grade elevation
Typical Installation 98.9'
Vent Grade Vennt
3 ../30;'34 Septic Tank 3'
i' Lon,, I 5 5' I.onn, t
Grade at System Elevation
iG' Gr;ide at Svslcnl Flevation
Spacing 5'
2-3' X 94' Cells
Same on other end Observation tube/Vent
At end of cell
A
B
23 chambers per cell
System elevations:
A-92.9'
B91.51
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page _ of
TILE INFORMATION SYSTEM SPECIFICATIONS
Ovn
Scpiic -anK Capacity dal C] NA
Permit Septic lank Manufacturer ❑ NA
DESIGN PARAMETERS Effluent Fitter Manufacturer a ❑ NA
n._~
Number of Bedrooms 3 n NA Effluent Filter Model / O NA
Number of Public Facility Units -ALVA Pump Tank Capacity gal NA
Estimated flow (average) I'> (S p ~a_lida Pump Tank Manufacturer NA
Design flow (peak), (Estimated . 1,5) ay
rump Manufacturer NA
aaud
Soil Application Rate / gaiiday/N' °ump Model NA
Standard Influent/Effluent Quality I Monthly average' Pretreatment Unit NA
-ats, Oil & Grease (FOG) 530 mg/t. C Sand/Gravel Filter O Peat Filter
Biochemical Oxygen Demand (BOD5) . <220 mgfL G NA O Mechanical Aeration ❑ Welland I
Total Suspended Solids (TSS) 5150 mg/l Q Disinfection D Other.
Preheated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA
Biochemical Oxygen Demand (BODs) <zo mg/L ❑ In-Ground (gravity) O In-Ground (pressurized)
Total Suspended Solids (TSS) _30 mg/L NA ❑ At-Grade O Mound
Fecal Coliform (geometric mean) -;10" cfu/100m1 ❑ Drip-Line ❑ Other
Maximum Effluent Panicle Size ;6 in die Other. '.Other: A Other- ❑ NA
"Values typica for domestic wastewater and septic tank effluent Other ❑ MA
MAINTENANCE SCHEDULE
Service Event Service Frequency
inspect condition of tank(s) At least once every: ~ ❑ month(s) year(s) (Maximum 3 years) IJ NA
Pump out contents of tank(s) When combmeo nudge and scum equals one-third ('fa) of tank volume LJ NA
r,rspect dispersal cell(s) At (east once every: month(s) (Maximum 3 years) D NP.
- - saris) -
"lean effluent filter At least once every: l~ I arts) NA
'rasped pump, pump controls & alarm At ;east onto every: O month(s) NA
❑ year(s) -
❑ month(s)
=lush laterals and pressure test At least once every: NA
❑ year s) Atie-r
- A: ;east once every. n month(s) A.
❑ year(s)
ether. - - - - -
-4A
MAINTENANCE INSTRUCTIONS
f!nspections of tanks and dispersal cells shall be mace by an individual carrying one of the following licenses or certifications. Maat*r
'Plumber; Master Plumber Restricted Sewer; PO`NfS inspector, POW-S Maintainer. Septage Servicing Operator. Tank inspections muai
include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of
::ombined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) strait be
visually inspected to check the effluent 'evels in the observation pipos and to diet Jk for any pending of effluent On the ground surface.
The ponding of effluent on the ground surface way inoicate a tailing condition and requires the immediate notification of the local
-egulatory authority.
When the combined accumuta:ion of sludge and scum in a•ly tank equals one-third (Y1) or more of the lark volume, the entire contents of
he tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin
(Administrative Code.
:Alt other services, madding but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units,
and any servicing at intervals of 512 months, shall be punormed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory autnouty ;rithin 10 days of cor:ipletion of any service event.
Page _ of -
START UP AND OPERATION trti products or other chemicels thr t
For new construction, prior to use of the POWTS check ~tcell( tank(s) If for the presence of high conceld aborts are detected have the contents of the
may impede the treatment process and/or damage the dispersal
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. r is restored the excess wastewater will be
During power outages pump tanks may fill above normal hlgttwater levels. When Pose of effluent.
discharged is the ion dk-persal cell(s) in one large dose, a re the cell(s) and may result in op backup erator or prior surfatoce restoring discharge power to the
coot have the coents r of the pump p tank removed by a sally Septage Servicing the controls to restore normal levels
effluent this situation
effuent pump or contact a Plumbeber or r POWTS Maintainer to assist in manually operating the pump
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 comps
15 feet down slope of any mound or at-grade soil absorption area. and prolong POWTS.
Reduction or elimination of the following from the wastewater stream may improve the perto~l~; and'd prolong the life of the
fat ~urthe ion drain
antibiotics; baby wipes: cigarette bul Condoms, cotton swabs; degreasers: dental floss; urain
(sump pump) water, fruit and vegetable peelings; gait llne; grease; herbicides: meat scraps; medice Ions; oil: painting Prod
pesticides; sanitary napkins tampons; and water softener brine.
ABANDONMENT shall be taken to insure that the system is props IY
When the POWTS tails and/or is permanently taken out of service the following steps
and safely abandoned in compliance with chapter Comm 83.33. Wisconsin Administrative Code:
• Ail 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 shell be excavated and removed or their covers removed and ft void space filled with soil.
gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS falls and cannot be repaired the foikrwing measures have been, or must be taken, to provide a code compliant
replacement system:
❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. t4m
requit led
The replacement area should be protected from disturbance and compaction and should not infringed[ areresrdtbn the need
setbacks from existing and Proposed structure, tot lines and wells. Failure to protect the replacement must comply with the rules in
for a new soil and site evaluation to establish a suitable replacement area. Replacement systems
at that time
suitable replace.ment area is not available due to setback and/or soil limitations. Baring 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 infittrarive
surface. Reconstructions 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 N
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
ER
POWTS INSTALLER M7~
Name r j J kc
Phone ' i 7e
OPERATOR MPER LOCAL REGULATORY AUTHORITY
SEPTAGE SERVICING
Name. f~ Name
< L Phone 7 S ~?~l - E::
Phone
d 383, l (2) & (3), Wisconsin Administrative Code.
This dousrrerrt was drafted in comlWiance with chapter SIPS 3a3.r1(zxb)(t)(a)a.(t? m ii
r ~
~r ( ~ ~'L•IIiJ~
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I ~St ~ ~ ~;f ~1Yf
ST. CROIX COUNTY 7,01TING OFF-LCF
CERTIFICATION STATEMENT
FOR UTILIZATION OF AN EXISTING SEPTIC TANS:
a is to certify that I have /inspected the septic
ing the L(~'1~l resides e is at .
1, T2- K _W, Ioo;c
E ecticn _
f JAL Upcn inspection, I certify that I gave
c tadt} and baffles to be in good condition, and it. at~pearr
:nct..ioning properly.
(yl,g~-~~
:st time serviced:
? Iow back occur f' om ab_;orption sys;.em-,
Y(+; _ No (If no, F;kip nex' line}
:.rcxi.mat_e vcl;ime or Lenct.h of time: q Ions mica:
rcacity: 119r-A~ /
-astruction: Prefab Concrete 7 Steel Othe_ _
r.ufac.urer: (If known):
t k (1f known): C(/Lfl/.'C✓~
- -
atu e) (Name) Please pr,nt.
j -z z 0,~
i~ (Licersc: Number) - -
t:. tc be co:r.pleted by licensed plumber (s.145.06, Wisconain
Statutes) or Licensed Disposer (NR 113 Wisconsin Administrative
,rie)
1"_:_cnber (applying for sanitary permit) Certification:
accepting the above statement regarding existing septic tank
nditi.en, I certify that the tank to the st cf my krowledae '.,il:
cor.for- to the requirements of. ILHR 83, 1's. Adm. Code (except tor'
spection opening o outlet baffle
Signatll - MPjM?RS~~~
ST. CROIX COUNT'i
SEPTIC TANK M INTENANCE iiGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
(
Owner/Buyer Nt'o~ Mailing Address .LL~e, j V O/
l~
Property Address _ ~_c AJ
(Verification required from Planning & Zoning Depamnent for new~cfonstntctiom) 7 ,.yam
City/state P=el Identification Nutaber
LEGAL DESCRIPTION
Property Loeatioryl/~j,) '/a , Sec. T L eN R/(~' _W, Town of
Subdivision > I of #
Certified Survey Map # Volume Page #
Warranty Deed # Volume Page #
Spec house yes no Uit lino- identifiable no
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use and n aituettance of your septic system could result in its premature failure: to handle wastes. Proper
ruainumance consists of pumping out the septic tank every three years or soorcr.:i needed, by a hcensed pumper. What you put into
the system can affect the function of the septic tank as a treatment stage in the waste disposal system Owner maintenance
responsibilities are specified in §Comm 83.52(1) and in Chapter 12 • St Croix Co:mty Sanitary Ordinance.
The property owner agrees to submit to St. Croix County Platming & Zoning Department a certification form, signed by the
owner and by a master plumber, jounicyrnsn plumber, restricted plumbcx. or a licensed pumper verifying that (1) the on-site
wastewater disposal system is in proper operating condition and/or (2) after inspection and punip ng (if necessary), the septic tank is
less than 1/3 frill of sludge.
I/wc, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the
standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin.
Certification slating that your septic system has been maintained must be completed and returned to the St. Croix County Planning &
Zoning Department within 30 days of the three year expiration slate.
I/we certify that all statements on for form are true to the best of my/our k nowledge. [/we amtare the owner(s) of the
property described above, by virtue of a Am unity deed recorded in Register of Deeds Office.
Number of bedrooms
~a s
SIGNA IRE OF APPLICANT(S) DAT '
***Any information that is misrepresented tray result in the sanitary permit being rwoked by the Planning & Zoning Department
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 Ln the warranty deed.
(REV. OWS)
1
WisconsinDopartmpnof Co~"ic~ SOIL EVAL ION REPORT Page of
Division of Safety and Buildings
in accordance ew4h Comm 85. Wis. Adm. Code C /JIB
Attach complete site plan, on nbllees than -T?Tx ll inches.n size. Plan must ~ nryJt' ~O✓~~
include, but not hmltb3-eniwl and horizontal reference point (BM). direction and Parcel I D /r~~ 2 -
percent slope. scale or dimensions, north arrow, and location and distance to nearest mad- G'
Please print all information. Rovi by Date q
Vsrson~lldorrn~LOn you gPle may print all infor tio (Prnsty LA+.s r50/(tlimg. V /
Property Owner Property Location
k k I Govt. Lot /t/ V4 ~ 11 S T Z F N R E for N'
Properly Ovrtrer's Mailing Address Lot b BIOUe # Srbd. or CSM4
(0 ^ -
Cdy State Tip Code Phone Number ❑ City ❑ Village own Nearest ad nn
f (7- 71,0 7- ❑ New Construction use evdenbal f Number of bedrooms Code derived design flow rate GPU
g~Feolaoemenl ❑ PuU,:; or mmoroal - Describe
Parent material Flood Plain elevation if appli !e
General comments SrJ n~.Q~ r.~[_ f e.Gi F.,~ ' -s
and recommendations:
C i3e l~ q e n
System T✓pe /A' 1L)~-! et e&r1,,j System f-:eva;i:v-
I _ d J ! 9~ J
F Bonrig # ❑ a Boring
pit Ground surface elev. ~ h. Depth to limiting factor , in.
Soil Aprilicabon Rate
Horizon Depth Dominant Cola Redox Description Texture Structure Consistence Boundary Roots GPDNP
in. Munsell Our Sz. Cont Color Gr. Sz. Sh, 'EB#t •Ef1#2
Z
3 '10- 6 -3s D s f i
senrg # ❑ Boring y/' /
pit Ground surface elev! M. Depth to ~irniting factor J ~ in.
Sal Appi,eaton Rate
Florizon Depth Dominant Color Redox Desorption Texture Structure Consistence Boundary Roots GPDtff
in. Mansell Ou. Sz. Cont Colo Gr. Sz. Sh. 'EM#1 'Eff#2
V~IT
1
,S
ll
Effluent #1 = BOO. > 30 < 220 _ and TSS >30 1 ' r luem #2 = BOD, < 30 mg.2 and TSS < 30 mW4
CST Name (Please Print) nature CST Number
Bird Plumbing. Inc. Shaun Bird 226900
.9ddwss Uab: E•ral_ua/ti/cn Cnnducb.d Telepnono Number
1432 120th St, New Richmond, WI 54017 -„2 7 r 715-246-4516
Propero; Owner Parcel ID # _ Page of _
Bowing # U Bonng
C~
pit Ground surface elov. v. ' ft. Depth to limiting factor ~L> M.
_ Soil iWtion Rato
Hnnzon Depth Dominant Color Redox Description Texture Structure Consslence Boundary Roots GPD#f
_ in. Mu_n_soll _O_u. Sz. Cont. Color Gr Sz Sh _ •Etf#1 •Eff#2
I D i v /10, 5 f 6 /10
Z D -S r s` S ~ `
6i~ `7
3 S Os~ ~l N
`gam
iI
Boring # ❑ Boring
❑ pit Ground surface cloy. ft. Depth to limiting factor in.
Sri! -Application Rate
4 foiuon Depth Dominant Colo( Rodox Description Texture Structure Consrsleroe Boundary Roots GPD#f
in. Munsell Ou. Sz. Cont. Color Gr Sz Sh. 'Eft#1 'EN#2
F Boring Boring
# Pit Ground surface elev. N. Depth to fimitrng factor in.
❑ -
Soil Application Rate
horizon 'kpth Dominant Color Rodox Description Texture Structure Consistence Boundary Roots GPD1ff'
in. Munsell Ou Sz. Cent. Color Gr. Sz. Sh 'Eff#1 'Ef#t2
Effluent #1 = SOD, > 30 < 220 m44 and TSS >30 < 150 mgt ' Effluent #2 = BOD, 130 mg.4 and TSS < 30 mgrl
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 formal, please contact the department at 608-266-3151 or TTY 608-264-8777.
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Property Owner °arcut ID # Page of
ES] Boring P :j BW ' L/'"~11
bl Pit Ground surface elev. v ! F,. Depth to limiting factor Sa. licabon Rate
Horizon Depth Domnant Color Redoz Desmplgn Texture Structure C.onsistencel Boundary Roots GPDIff
•Eff#1 •Eff#2
t. Sz Cont. Cdv G Sz. Sh
in. Munsell 071
2 O-S s iii" -J i
i
r
❑ Bonng # U Bonng _
G Pit Ground surface elev ft Depth to hm6n5 factor in Soli Application Rate
Horizon i Depin Dominant Color Red= Descripbon Texture I structure Consistence l Boundary Roots GPD/fF
i in. Munsell Qu. Sz. Cont. Color Gn. Sz. Sh I 'Eff#1 'Eft#2
I i
I
i
! I
i
i I
Boring # Boring
Pit Ground surface elev. _ tt. Depth to limiting tailor
Sad ipuort Rate
Horizon •lepth Dominant Color Redoz Description Texture Sttttcture Consistence Boundary Roots GPDIff
in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. 'E##1 'EP#2
i
I ~
Effluent #1 = BODE > 30 c 220 mgt and TSS >30 < 150 mglL ' Effluent #2 = BOD, 130 mggt and TSS f 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 TI-Y 608-264-8-77.
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Soil Test Plot Plan
Project Name Nick Kuehl slya I
Address 660 Coulee Trail
Hudson Wi 54016
~/5:`2 Ill # 226900
Lot Subdivision Da 9.19
N W 1/4 NE 1/4S 10 T 28 N/R19 W Township Troy
Boring Q Well 1'L Property Line County ST. CROIX
13M or VRP Assume Elevation 100 ft. Top of power box
System Elevation 92.9.+91.5 *HRPSameas Benchmark
\Vrl I
t1'
Fxiati„~ 3 Scale is 1' = 40'
Property Line Bcdroom unless otherwise
Hou" Er-1 Voted
DW
90'
DW
100'
13.1\1.' B-3
l0 '15'
45' 9S
' 10'
20
96
B-1
I3 ? IS'i Slope.
400'
COUILT ] !'nil