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HomeMy WebLinkAbout014-1041-30-000 (2) PRIVATE SEWAGE SYSTEM "!y St. Croix f N anc 3-I din ~ 7lvizhn ;r tay Parnlit Vc INSPECTION REPORT 615372 GENERAL INFORMATION ;ATTACH 10 PERh,II l j State Flan ID Na Po'se-ai inlmmat oe you provide w-, tat useco'er seo?nday puvoses [Pnvaey Lave s'v J4:1 iRni[ "'it HO"Ors Name t:,t, In,", , I'ace la.'!Jc Jason & Laurie Ellingson TOWN OF FOREST 014-1041-30-000 ;;;I BY Led. III Llav tiM ,,p c cn :;acLOn!I o,,^Ra-2cr.lap Nc 4 f~ W-11 - 19.31.15.299 TANK INFORMATION ELEVATIp DATA I"PL tdA.Nk,LACILRLRi,y 1 C;APACIIY STf, QN BS ..I FS FI. FV. Lv Septic -;r , BCrAn1'~ark w~•O„` //yy~~ 1-.~.. U. , ~cr R; th Y r1' I~ r~U✓ V W. Dosing 'I. Alt BM , ion ~•ts4-Gz-lb 8^3~ (g]a•to~ fi Iy Z_~ _ Sr Ht l-, FI . 5 l I At! HI ;)utter TANK SETBACK INFORMATION 7,15 . "ANKI: `;L VII--- RCAD ScufiC _ I _ I , I CI Rollem t a.(a G. Yo Dos ng Heade-tMan Aerati-n Dist. Pipe - {I ~ r -old nit 30, Systclr U. y r y j PUMP/SIPHON INFORMATION =final grade Q Gl talc I:darluus i 0e^nc+~d Sl ::ove• y •-y i f 17-~ GP V. ~ ~ I~ 10-delNr.wtw - It I,l 7,7 -25 TDH L.n I I c: cr L- Svstem a TD; R 77.36 !-V) 915.115 Ponccrlain _ength. Din. tol:ell SOIL ABSORPTION SYSTEM BEDy1RENCH ,ICth rt•.31h_ N. D. lmnwea~, RIrQw ONS tJc Ol Pit5 LiO.id CcpN DIMENSIONS 'v SETBACK SYSTEId1 TO P:'. B: DO :Nh LL U\ ' TREAIvI LEACHING `dc-u1:::-Lrcr (y INFORMATION 71 r CHAMBER OR T,;, t. ~t y '1• V I )rr UNIT 1.4a:al N_r^'~r -9j DISTRIBUTION SYSTEM ; • ~j I`Hadel, LlaOrold i! Csirtut.:n _ xH:>la :nze ,Il...panny 'Jcnt 1CA ,n:a.e f ~ Ppes, y' ~anye Da_I, V_ L. t , LI) SOIL COVER x pressure Systems Only xx Mound or At-Grade Systems Only Jecth C,c' Je:rlO Ceer :,Cp:h of v; `en::edr;;~dde7 - rx t.1_ ed 9ed" cnch : ^'M1Cr I I i!ed; -r ^ i-tlga. 'ocsc - Yes COMMENTS: {Ire:ovate cede dscepencles. persons pros nt, etc.; Ir<rectlo-t 01 Inspector 42. Location: 2", ,;,`Y63 1 I AV, HVn Dcsc'Ip1 er = h~ ~.a¢Y 1,•. (v.1a (~9s 7 i Rldg newel Iurg1t, = Iv Aji• ->rwunt -t -over - I ~J Fla-i revision Required' Yes I !No 74 r llx elhcl sIdc `or add~lional niormation. q/~ o C Cale Insap:::ror'e. anatur Cct No plc 4 y 1 .i-~-~ (~OLn Y 7 N t" afetV and Buildings Division r ~ Fv I t~ 207 ylUl 4`r<aS aShin000n Ave.. P.O. .O. Box 7162 Savutuy 1 <nuit Nu+nber (.0 6c tilled in by Co.) , i OSP ftI ,.1111- 643 bladlsn 53 2 /~~tJ 72 aq S / I - 01:0 L ~a[+2~+i _-IT7y ` ~'L~rq Slalr Trsnsndmn Y'n cr yllfTlf I')Lcati Q7~ 4Z~-~ c nrd:me w'r11+SJS 'b})I(2L \b w. Adur Ccde, soFausamnof,Fs tmuc tbcapprnytialt ROVemmcntal nail :3n::;ci:cA;u!o: :n ch:ai-:ir,r :aani:zry pcrm:L Nnic: Applicxhca txnslur stale-ux•nu11'UN"fS src suL•miL'cd to P:nicU Add.css (.f tiff ent drat moiling add:ss) r t p- tr col < St(ir +c.i Pmt Deal Jrn tes la'rsonal mt rm_u:+n yea providt nsy be aced f[=ecortdnry ~ - r --:un rd : -th deep t cv lav s 15,0 ~I1(m huts. I \pphrunr n Inlornrannn P am l r/m+t All lu_fnt ntRfh~ Pamcl il - PnP r'2~ ,:.ns d^_ rJl 1~~/ U~y -•lU y~-.j O.-DUG - '7 C, `,✓7~ 1'royWylR,cAlirm l.p a c r hU:rl Ald:csS City. Stale Lip Cade pbone, Number Sttaon J (feu it one) / C9✓ ~if~r_ - v~QS-7~r ✓ 7/-zzw -r-3 _v: R / -.LinrW--- I L T•ypc of Building (check All that n d • Subdivision N'amc I_ !cr7Yan:ily Usvclbng- Nombcrnt Bedro<mu I_ i•n[+li. `Gmm~trcisl-Describe C'sc_ _-1 _4✓~ IJ city of__ (ISbI :Jumbo Orl3 / 11~:atr,O•unal Dcmibcllu_- ,L Atl'Townof (oar1irte hoc B if rpphcnble) _ 7TAAD lL fI Type of Permit: (('hecko - n :•tmrnrH L!ii;!T.~n414 rpl.mmrnt(lnly - -(~O.hu hlo.iifau- tn4xi>fing Syslrm (explain) r 1 N. v Ryzt~m trg:l.+c<rn :t S, ~rer J ~ Lisl Previous Pcnnit Number and Q3~ls~d uni[Revisi+m ::w;^e of l'hmtba- emill'I'rv; fer in New r}~ 1~L _ 1 ercel Rear (hvuer W /J J Ac.orc Axpira:: 11% 'Ieof NON 1S Svstentlf43111 Ontnt Dcvice: (t; h it all that a ilv - _ _ ( /S7VC0 r- rmil< 24 is tfsuiablt ziil i Dc~ P:essvnud 1n r nand ❑ PR$Sn 1 r I. mni U Ond A nanl 24'n . ofsmHbl Soi) q_ P: vtroatnerd Dtvi (ex yl ain)_ ~I Yoldu'Ta'tl: nf)tF rDlmc.-Ica: p (tiller) - _ _.-t c t UrcpersaVl Yea ud Az ea Ldmm moo - - arcm likvAtimr J 7 '^n Tlaw (gpd)U<s:gn SCiI APP.r t: •e(gydsi) I ID-wcnd m:.N 9uur s Visycrsal Area Prof d S}. r1 la;d rE CIT Dtannfac:uru 1,V - ° ~'1. Tank Info P uty it, Galln;:g G;,!I:•rs 1)11 i y U ~ N'. Tank,, Iiiating Tanks :n u. l7 C-~ Sc cot ridding l'xk //O,o <T ,ho,vn, On line eosin ara-m7a L~ o y - (c p~ I - I I VII. It GVponslbthfy StalClnent-1_th undersrogned'usinn respmrsrbdity for hI1311alion ofthe PU\}•TAlPrb1l RSNu nb<Ncbed Buzmcst Phpnr. Nnmhr7r pkaol cr's Address (Street Oty, Stare, 7e11' Code) f- ✓yo S- -Ayj w1 SyUOz- - V1-11. 'ountytUL'tmrnt Use Only -4 Issuio ucn[Si a P-rmil P« Datelzsr it So -71 L auto for Disapproval ll(.Condtl - .t . 3' l~*b<•~TOA+~ t/~ s .AxaAWWA (*4w.ttn cen r:wm s1 bRAM iets-'AR 4WIL ` ~ WGw1 elAA•• ~ a as per TVraya Po 7 Pw' O v~ =eYVy 2. N nslbsr',k repittemm mrrsl w 1:!e:Pdiife M PK rXibbi fal ClItS? 1 M',91,n61. J\--_ r25J(yJX~ aaach to rnmptde plane for We vyx[<m ;uu1 submit tr. tM1e C'onnlr my av Paper r s tban %Inln 1~hez In riye G~ SBD-6398 (R11 t l) _1~ If i - - --1 ~c-5 - - - _ - `ipARI 4k DIVISION Or INDUSTRY SI-HVICCS - - 2331 SAN I UIS Pt GREEN RAY WI 54304-5211 0 p Contact Thrnuyh Relay H P $ hllp.lldsps m.gov/pr"tams/industry services wwwvVisconsin.Yov Tony Evers -Governor ~T. >In._ Dawn Crim - Secretary filly' I, 2019 CONDITIONAL- APPROVAL PLAN APPROVAL EXPIRES: 2021-07-01 flan Review: P%%TS-071900978-C DENNIS.I GlLLE 352 140th St Amery W1 54001 SITE: Jason Ellingson 2005 US I lw , 63 Saint Croix Forest FOR: Object 'I ypc. Mound ('omponcnl Manual \'er. -'.0. SBD-10691.1' (N.0I'O1. R 1012) Description: 450 CPD Mailenance Required I he submittal described above has been reviewed for conformance with applicable \k isconsin .Administiativc Codes and Wisconsin Statutes- 'I Ire submittal has been ('0ND1I IONALI.N' APPROVED. Phis svslern is to be constructed and located in accordance with the enclosed approved plans and wilh any component manual(s) referenced above. The ov.'ner, as defined in chapter 101.01(10). Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s. 1,15.06, stars. '(he following conditions shall be over during construction or installation and prior to occupancy or use: e 'phis system is to be constructed and located in accordance with the approved plans and with the "Pressure Distribution Component Manual for Private Onsite W asfewatcr Treatment Systems Version 2.0" SBD-10706-P (N.0 U0I • This system is to be constructed and located in accordance with the approved plans. and the "Mound Component Manual for Private ( lnsiie Wastewater Systems Version 2.0" SBD-10691-P(N.01?01). e fhe pressure network is to be constructed in accordance with publications SBD-10706-P(N01?01) "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems - Version 2.0" and.or the sizing methods of publication "SS W MP Publication 9.6 Design of Pressure Distribution Networks lot SI'-S.AS (01!81)" A copy of the approval plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the dale or the local municipally shall he obtained prior to cununenceincnl of constructions installation operation. to granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. Asper state slits 101 nothing in this review shall relieve the designer of the responsibildy for designing a sate building, stricture, or component. Inquiries concerning this correspondence may be made to are at the telephone number listed below, or at the address on this letterhead. 1 he above tell addressee shall provide a copy of this letter and the POW TS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Matthew Allen Janzen Wastewater Specialist, Division of Industry Services !715)340-0407 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Commercial Application INDEX AND TITLE PAGE Conditionally APPROVED Project Name: JASON ELLINGSON DEPT- OF SAFETY AND PROFESS!OW SERVICE Owner's Name: JASON ELLINGSON DIVISION OF INDUS ~~71 Owner's Address: 2005 US HWY 63 YY DEER PARK WI SEE CORRESPONDENCE Legal Description: SW SW S19 T 31 N R 15 W Township: FOREST County: ST. CROIX Subdivision Name: Lot Number: Block Number. Parcel I.D. Number: 014-1041-30-000 Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 P ~curve nd specifications ;6 7 /a o.4 TejT Designer: DENNIS GILLE License Number: 221471 Date: 05/29119 Phone Number: Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SBD-10691-P (N. 01/01, R 10/12), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01, R. 10/12) Version 70(R 11/12) Page 1 of 7 Mound and Pressure Distribution Component Design Design Worksheet Site Information (R or C) c Residential or Commercial Design Note: Sand fill (D) calculations assume a 300.00 Estimated Wastewater Flow (gpd) Table 383-44-3 in-situ soil treatment for 1.50 Peaking Factor (e.g. 1.5 = 150%) fecal col form of 36 inches. 450.00 Design Flow (gpd) 2.00 Site Slope 92.70 Contour Line Elevation (ft) 36.00 Depth to Limiting Factor (in) 0.60 In-situ Soil Application Rate (gpd/fe) Distribution Cell Information 75.00 Dispersal Cell Length Along Contour (ft) = 6.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution L ' J Pressure Disribution Information network? Enter Y or N (C or E) c Center or End Manifold 3.00 Lateral Spacing (ft) If N above, enter the elevation ft 4 Number of Laterals of the highest point. 0.188 Orifice Diameter (in) 2.00 Estimated Orifice Spacing (ft) = 6.25 W/orifice 2.00 Forcemain Diameter (in) ~ 100.00 Forcemain Length (ft) Does the forcemain drain back? I J 86.00 Pump Tank Elevation (ft) Enter Y or N E. 3.25 System Head (ft) x 1.3 16.31 Forcemain Drainback (gal) 7.20 Vertical Lift (ft) 67.44 5x Void Volume (gal) d7 4.48 Friction Loss (ft) 83.75 Minimum Dose Volume (gal) 0.00 In-line Filter Loss (ft) 47.19 System Demand (gpm) 14.93 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 1.00 1.50 x x 1.25 x 2.00 x 1.50 x x 3.00 2.00 x 3.00 x Gallons/Inch Calculator (optional) Treatment Tank Information 600.00 Total Tank Capacity (gal) 1000.00 Septic Tank Capacity (gal) 47.00 Total Working Liquid Depth (in) huffcutt Manufacturer 12.77 gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 600.00 Dose Tank Capacity (gal) pot Iok Filter Manufacturer 12.77 Dose Tank Volume (gaVin) 121525 Filter Model Number huffcutt Manufacturer Project: JASON ELLINGSON Page 2 of 7 Mound Plan and Cross Section Views 1~r10 * obsen: t )n Pip, K ~T - B - m L Mound Component Dimensions A 6.00 ft E 7441 1 in H 1.00 ft K 7.06 It e 75.00 ft F 9.50 in 6.10 ft L 89.11 ft D 6.00 in G 0.50 ft J 5.07 It W 17 17 ft 450.00 (1) Dispersal Cell Area 907.58 (ftz) Basal Area Available 6.00 (gpd/ft) Linear Loading Rate 7.50 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 94 99 (ft) G H 1 9120 (ft) F "DispersaiZen 93.70 (ft) Lateral Invert Dispersal Cell Elevation E D 92.70 (ft) Contour Elevation 2.0 % Site Slope Geotextile Fabric Cover Shading Key o i Dispersal Cell See lateral details on t❑ Topsoil Cap o Z Z. a 1 5 ft Page 4 for number, size, ❑ Subsoil Cap W o andspacing of laterals. - Laterals are ASTM C33 Sand 2 F equally Tilled Layer d 0.5 ft ?ywcal ~aterai " spaced from the Aggregate v e distribution cell's ~``''•'``'z centerline in the M-- A distribution cell (AxB). Project: JASON ELLINGSON Page 3 of 7 Center Connection Lateral Layout Diagram Force main connectionvia tee or cross to manifold at any point. Laterals are identical P 5 Turn-up nlball valve or IEXI r.12d1 Laterals &forCematn Seh 40 PVC cleanoutplug per SPS Table 384.3011 Holes drilled on tho bottom of the lateral. Number of Laterals 4 Orifice Diameter 0.188 in Lateral Diameter 1.50 in Orifice Spacing (X) 2.10 ft Lateral Length (P) 36.75 ft Orifices per Lateral 18 Lateral Spacing (S) 3.00 ft Orifice Density 6.25 ft2/orifice Lateral Flow Rate 11.80 gpm Manifold Length 3.00 ft System Flow Rate 47.19 gpm Manifold Diameter 1.50 in Total Dynamic Head 14.93 ft Forcemain Velocity 4.82 fUsec Dose Tank Information Locking cover with warring label and locking device acd sealed watertight Electrical as pe• NEC 300 and i SPS 316.300 WAC i 4 in. min. Disconnect Tank component is property :vented Alternate outlet bcabon Forcemain diameter huffcutt Manufacturer 2 in. Capacityl 600.00 Gallons _r Volume 12.77 galfinch A Weep hole or anti- Dimension Inches Gallons g siphon device A 32.43 414.09 B 2.00 25.54 C Pump off elevation ((t) C 6.56 83.75 86.50 D 6.00 76.62 i Total 46.99 600.00 D Dose tank elevation (ft) 3" Bedding un er tank. 86.00 Alarm Manuafacturer level alarm Note: Switches Alarm Model Number ~dvl containing mere l may not be uses Pump Manufacturer ZOELLER this sys:ec. Pump Model Number N140 Pump Must Deliver 47.19 gpm at 14.93 ft TDH Project- JASON ELLINGSON Page 4 of 7 Mound System Maintenance and Operation Specifications Service Providers Name GILLE TRKING Phone 715-268-6637, POWTS Regulator's Name POLK CTY ZONING Phone 715 485-92 System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Est mated Flow - Average 300 gpd Maximum BOD5 220 mg1L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 ttZ Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Ins ect and/or service once eve 3 ears Effluent Filter Should ins ect and clean at least once eve 3 ears Pump and Controls Test once eve 3 ears Alarm Should test month/ Pressure System Laterals should be flushed and pressure tested eve 3 ears Mound Inspect for ondin and seeps a once eve 3 ears ~:her Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration Lateral Turn-up Detail Grade v1 Finished M45 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution r g Swee 90 or Two egree Bends Same Diameter as Lateral Project: JASON ELLINGSON Page 5 of 7 Mound System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals (SBD-10691-P (N.01101, R- 10112), SSWMP Publication 9.6 (01181). and Pressure Distribution Component Manual Ver. 2.0 SBD- 10706-P (N. 01101. R. 10112)1 and local or stale rules pertaining to system maintenance and maintenance reporting. No one should ever enter aseptic or pump tank since dangerous gases maybe present that could cause death. Septic and pump tank abandonment shall be in accordance with SPS 383.33. Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic of pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking Device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic lank shall be maintained by an individual certified to service septic tanks under s. 28148, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet fitter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation, The fitter cartridge should not be removed unless provisions are made to retain solids in the lank that may slough off the fitter when removed from its enclosure. If the filter is equipped with an alarm, the fi.ter shall be serviced if the alarm is activated continuously. Intermittent fitter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 113 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify nroper . operation. If an effluent fitter is installed within the tank it shall be inspected and serviced as necessary Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter. and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg1L BODs, 150 mglL TSS, and 30 mgrL FOG for septic tank effluent or 30 mg)L BOD„ 30 mg1L TSS. 10 mg/L FOG, and 104 du/1D0 mL for highly treated effluent- Influent now may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed R should be compared to the initial test .vixen the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution vathin the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent pending, Pending levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in croper operating condition. If the dosing tank, pump. pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately . repaired or replaced with a component of the same or equal performance If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in Rs' present location by increasing basal area d toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating oondaion. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment dewces such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system Project JASON ELLINGSON Page 6 of 7 ri= PUMP PERFORMANCE CURVE MODEL 140/4'140/145/4145 2_ 0 66 _ 60 18 55 - - lti 50 j 4 45 0 W 12 ao r - 2 I 35- 0 10- 30- r 25 - 6 20- 4- 5 - - Hk lot' Ply v, --i T 1~- 5 L 145/ 1401 4145 40 10 20 30 40 50 60 70 80 90 GALLONS LITERS 0 &0 160 240 320 V-1 -)01 PFR PAIRII ITF 1 ,nno~i) Y 7 1 ~i.,E' }cr, l'v Y.` } m LC` „;'tN~K: Cdr rye y'RV .JC. T rb N ' K . i r~ J t. d rrg [I 7 {-1 C1 W Z ' ~ ~ ~ e~ 0'4. a ~r~p Z LLI o QQ rO s-. w o ` o j_ U c W ~ ~ rn 4x o q r M yam`, • : W~ ` 4 4 V ~ ~ F ~ r„ C: 0 F P ` m ° 5 cn -9 ca ~z; max„ - ` V Y ^ll ' V U w Q O v u U r E' E r(IJ j z ~i u ~y y5 ~ l7 ' ~ ~ c E e L 4 CJ y G 4 p Z a ^ ✓ V 4 V 4 gEes Z w ~a~~ s_= 4 q`c U t~x4 =~V 5 E g 4 a~ c ~ n ~ 4 E F e n 1~Y y ~ ^ y ~ v o (d r_R"3R` w _ 0 ga~s~x O V C L _ q 0 O V V V ~~OQ ~.f4 CV•LS r~ qr 1` 1 R, O O L V G ~ G 4 „~~g~goo F- gds"° 1 1 ~ `P~9~,. 1 cp 1 c e u. - ~ r. 1 € ~ 1 4-f 4g:o L Zy*~ Won u C y C N IE CO) rg~~Cos SSE i Y 1 1 1 ® C4 1 1 a ~ : W d3 1 •`d Ili z 1 1;4 ;j 11 4-4 _ - Z 2 ~ 571 - ap7z3T L y1~ I. ~e q - f 1 1 1 74 C-A I _ 1 T II t ---i - , - -ov $ ~I Get/ -a J-'- Y- , i ' I -1 CAL 1 1 I _ I I 1 _ ~ - I ice) I j- i .I ,-~-;~~L-'.-~--~- I 1 I T 1 I CS 7 ~l~- ir~3 Ws.Dept . of Safety and PiofesswnaI Services SOIL EVALUATION REPORT Page of Drrision of Safety and Buildings in accordance with SPS 385, Wis- Arlin Code _ County S7- Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan roust _ S _ ,ndude, but not limited to: vertical and horizontal reference point (BM), direction and parcel LU. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 0/"/.- /Oy/. -Yo- 6 "C' Please print all information. Reviewed by Date Personal information you Wuside may be used 1, sccondaiy purposes d2avacy Law, s. 1S C4 ti) (m))- Propertv Owner Property Locabon L- An Govt. Lot $Z(,i 1A SkA 14 S /9 T 3 r N R /~-E (or) W/ Prop OwnePs Mailing Addre _ / e Lot # Bbdc # Subd. Name w CSIJ# ~ov City j S / ~o S State A p Code Phase Number El city ❑Village 0-1 own Nearest Road L] New Construction Use: D? Residential I Number of bedrooms Code derived desgn flow rate __~✓S li GPD ~1Replaccmcnt [i P(pblricTUr commcrdel-D¢srnbe: _ Paren[material - ,pa/1 rlood Plain elevation if applicable R. General comments - and recommendations. Bonng I I ® pit Ground surface elev. ,1! -~7 ft. Depth to lirtubng factor in. H Soil 11 wb2n Rate Horizon Depth Dominant Color Redox Description -I'exturo 'Structure onsislence oundary Roots GPD/ft T in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ffgl - f412 L lG 7.SY 3%z - S1~ sG'~' 7~vf~ emu! 10-3 , Boring# ❑ Boring - _ ❑ Pit Ground surface elev. 9r,2 -7 It. Depth to limiting factor ._7 in. Horizon Depth Soil Application Rate Dominant Color Redox Description Texture Slnn]ure onsrstence oundary Roots GPDdt in. Mansell Qu. Sz, Cont. Color Gr. Sz. Sh. fHtf Y#2 Effluent #1 = BOD > 30 < 220 mgit and TSS >30 < 150 i g/L ' Effluent #2 = BUD < 30 n L a n nd TSS < 30 mgd. CST N me (Please Prin Signature ~I7y71.S 2_ Z11121umter CST N Dal e EvaMralion Conducted Telephone Number ~Z (ivI S c16 o.Z _ S'~5-/5 7i~ 7lf L6 S7 Propoity Owicr f'~ S•O/I Parcel ID Page _ or Coring # ❑ Boring Q -z t - - ❑ pit Ground sedate elev Depth to GrniOny (actor X(O in. Sod Applip,ion Rate Horizon Depth Dominant Color Redox Desenpti0n 'fexhue SlmCore ! )onsislcnce oundary Rppt~ GPD#t ' _ in. Mwsell Ou. -5z. Coot Color Gr Sz. St, '~=Fr•#t • :{tuz f a iz 7rnP3iZ h~sh';t Mr-l? - - z_ ~IXX~ inf-11F !vF y r Coring # ❑ Boring J pit Ground surface elev., ft. Depth to limiting factor in- Soil Ap n=otion Rate I umizon Depth FD~Omilantil Color F2rrlox Dcsaipti0n 7exlwe SW<YUr¢ .onsutenoe undary RooL^ GYDAt' In. Qu. Sz. C_ont Color Gr. Sn Sit. -R#1 { I Boring # U Boring - - -L _ _ ❑ Pit Ground surface Olev, ft. Depth to fimi6ng factor Ilu,iun Depth Dominant Cobr Redox Description Texture Structure .onsistence Boundary Root. G_PDfft ' in. Munsell Qu. Sz. Cent Color Gr. Si. Sh. tT#1 }#2 'Effluent #1-H90 >:7J< 220 mg)L and TSS 2J <)50.,gj. •E111uen1 f2 =GOi) r<30 mylt and TSS<WmgA. -f Lit Dcpt_ of Safety and Professional SecYices is au equal opportunity serve'(t provider and employer. If you need assistance to access service; or nccd marcria! in an ahem alc tnrncrt- conLtcl. the departmci t at 608-26&=3151 or TTY through Relay. pn~ nm uu in;l pt~ ;Fl ~ptST `7ir~ 2 2 / Si7 / ?-+--a f5c Olt ~riui•w.y 919,j - - -07 - - - - - - - - - - 1 SI'.P-i IC TA\Ik \IAI\'TENA''C'H M;k1 E\i \T AND OWNF.RS1I1P CF.RTIPi(-A.!!OX MPV: hanerRuvcr ~)~Su~ y1tISv1'~ - ai line Address 20~ S uS I I Inw' roperty Address 20v5~ l4S/(+lt1ti!/+_L (a I~F~~k~ tt/i Sy!J I\'criIica!it,n rcyuiIQai !wat 111anninC,\ Jonin Dcparltile tn lire I I ell cur.antc!ion. ) I". Stall' _ J c/jq( l 01/`// - 1I 1 OLiEL 7/~fK-!` / !/1!"CC; !C. ,t,.i~:~a';O(•. ~fil?i!`C!' f 1041 u cl 6)(;) LEGAL DESCRIPTION g See __L_ T h 11'• Ton O ;?ertv i_niattott n Strbdicision Plat: Lot ,rtiticd Son•cti Map 4 ' Volume Pauc't - - ts'arr:in,t Deed (bcforc 200?)\ olonte Pagr NLUNTEXANCE AND OWNER CERTIFICATION i.Iq„optr u"0 all nPrlwt-lm n•: v Ir' •.al - ...t .`:•:L• ll "'It: Ill n....l I I. r.., t.•~~, 11 t - I .'i, r li:J Iprce cu0111611 !•Wnl,ine out the septic tank Gkerv dlrcc rear, or ;Ooncr, it 1 lode,!. L•: a lieen,ed ptnnpcr. \\11 r.IO I .'I : ~ i:•In can a!'lirr the iiu:rUmt of the ,optic tmvl :n I;:;nment since in tiro •sas,c disi,o.nl rearm U:rncr maa:?cnar?cc I..;Ir~n.rhtitire. ate ,pen!i:d in ;SPS. iS?.tit ; I and m C'h:Inter I - ~t. C tulx Counic 5wutaty I )idutanee. °l: pnq,c t, I u 1 :::a.• : 10 irnli1 ill C toi`: ,IU I'icr,.l.t,_ S Aoat;t, DgmI a :.l cinl6..du,a :iau. ar..l i; . ~.r. IM and he a tnastet planrbel. )oklme\Itlan plumbel, %C'metcd 1,41111bel (lr it licensed ptunPcr wlifP ing that ( I I tits on-alto n,te"aier disposal sestet is in proper operating condition and. of lifter Inspection and plimpima ( ifneccssrlre), the septic Gad'.: than 1 i Intl ofsludge. ondcr>ia»ed harc read the aLo•: r nrgln r:»n::nts and ::r»cc !u rrr. r.!aie. t!r:• nr•..n.. ..xrorr :!r+po.al ra^QCl?t . v.luan6 .cl 1,»111, hclelm a. set he the Il, p:u uucm of tialcty And lliote„ioml! lctrices and the Department of Natural Resoulcr.. ,'Rl,cousin. Cell; ic:n ion la tin ! Brat c•aur ".-Ili c sr,lem has h;:ea :lminlal wed Inca he romp!eled and ret urr?ed to the It. C I e Mils. i'i;nurrly X zoning Dcp:nuueal l ± data ol'i!Ic ducc New cxpuiluon date. . ,.e ca ul, that .UUcmcnh on 11 Dorm .:r: tnt • to Ow Lo,l of IM „rr knornledrze I'a c am ale the ooner(s! nClLe dc,ct'lhcd ahol'c, by 1 Ntile or l o:u &-d :..,,:did I l iL: n:.lrl ,I) !kl:J, ( )!lice. Number of bedrooms b 1 Zoliq DA'! E (-i. 6V AME, 'A )111,ICAN I (S) ' Am iniixmwi.,a !11111 i, MISIt . :v.,i mn~'r.•sult n1 ih NA1Ir; rr Imiml Lam, rrr.li:rd he dtc pidmrino C /wlil:g llcpartl?tor!. ' nalnde I, it It 1111, appl w;k lion a Iceordrd ,c:o Ianl.\ deed Gonr the Rcpister of Decd, 0I'lice and a cope of the certified niece !nap if I, l'ercnec is made ill the rcnrramc decd Cztr r la-k LR I LAIT o L J~ Ifi` -.1 I rt k' C_S T 1ri-ia3 S. DePL of Sateq•and Professier.al.l"aervirzs E\ALUATIONREPORT Page a-* D- ision of Safety and Bindings ` it aecdrdartt~ vtth t+-'S 3~q ~ryis. A< in. "Ooe - ~ r a rr,• Cdum S / ttacr cempiete she plan on paper not le ar, 8.1'2 a 1 inche in size Plan rrus: `l.} Aide, out no: limited to. vertical and 1 uric ntni refure point (BP9' drteClign and Par:zt 1.0 _ erceni rigor. scale or dimensions nurtn afro", and location and dista.n.e to nearest -oatl C% C G O Please print all information. kem ven he Dale Personal intrnmati in You Pf"i,it rn:fy bs ~ec'O's°:;uucar, GurFcn as iP wo:u I:ra s. 15.04 :t Prdrgert~Owne~ - ' ProPe W rtY -ms6nc ♦ I G.rh ('~C/( /y,-✓u (WA Lo! Sk/ ? LIA S % 21 N n E{ori'~ Pro ^ Owners Pdaliing Aares _ _ - I n'. R ' Sic-9 C i Si)d . Nam ; C:iMN _ l"'' City Stale. .Ip Code 7 one Numx' C'-- ViCa^u ry/ cwr, Nearest Road Ij)eCr' l1Ini/<' IwJ SS/u67 77-,2216 Nev Cons vurtior Useaa'~ kv Idenllal : Numve- o- d~oru ors t- ode dertved destgr low rat- L✓~ U _ p Replo;.emen; or commCmiyl Describe: Parent mate ial__./~,C ci:valmn it appiiah. General mmenL ' u w f and recornmmendations. 4•~rr`+ri J~ Boring P".ulirry iF p ® Pit Gmund ridges eae'v -7.~ '.7_ ff. Depth to iirnHing face Soil Anohcawn Rate Hmrzo ^ o Depth ' Dominant Color kedox Des:;ndhon Texture Structure onsstence oundary Roo:s GPD/R ' IV. Muasah 1 Oa- S7 Cent. Colo, G r SL sh- fN.i7 f`#2 ` -/v -SY~ lkZf 57~ ;2r„SO'~ ✓NGf~1 I / C ,~o Boring # ❑ Boring -0 l ❑ rit Ground surface elev, ~,2• ft. Depth to fmitiag fa;.tor - la- _ Snit Arydli[ion kate io rizon ! Uuptn Dominant Coior Redox Onscriptiur. texture Simqure 'onsistenc-.e oandary Root 1 GPDM, - ' ir:. Munsell Qu. Sz_. Cont. Color r Sz. St.. ff# i 7• s[/bA ' - S• n~ s'v ins ~,F ,c: '0' L iGr : 7 /b i I t ) Effluent _ BOO 30 < 220 mg1L and TSS >30 < 150 mgF_ - Llll:rew ill = BOD < < 30 mgA and TSS c 3D mgA- CST Name (Please Prinf~ Signature CST Numner fvtdress ~ E7 ii errdmat-on Ccndnr ed '%lepnnne Num ~-Z /Sic S% ~~/n_-'b L_;' Sc/~c^9. r_lj_-lS 7iJ=JCf CGS Propurty Ovnioc /lrR' Par-el ICF ?age of f Boner, V iI Bonny _ Pit C' ou .d o.fam ctrv ~.•C _ arepll•. to 4mr mg far-o. ,S LG' _ in. JOC Npp IC-!rit= t brmn De,'tr. J~ i can• j i r C ccn[•hor srtu.t i SInlGare :o uistence ~ioundan• Roo r J!P - I ir. yunscll fu ` Con,. Color ~ G'. Sh - 1 r f- I Borin7: ~-s Gunig L Pit G*ounc mrace e - . _ It. C oUi IG nf,mry taaor -lurimn' Oeptt ~Domufanl Color) Rc^ i Cent Cticn T1exwre r nd t ut'- - - oil Coru•Y. I ~L 11(T _ i... MunFxdi ~ Qu. SZ Cent ula• - -r , I + i 1 _T_7:j f Boring x L. Scring A ❑ Pi; Ground surfa'~ elev. _ C [Wth to hmbng (anor_-in. _ - _ Soil Ann:i.-atino Rate I loraon - Depth Dominant Colo r Redox Desaip(ipn Texture Stru(7ure onsistunre ounday E2oclts _ G m.i Mun fn. sell Qu. S>. Cont. Color Gr. Sz Sh. ' Cfi:verrt Cl = 3,)D > 30 < 720 rngl[_ and TSS >3:) < 150 n g 1. • F_Mvenl Y2 = B•JD < 30 TG& and TSS < 30 mglt The Urpt. of Safeh' all(] Professional Sciwicrs is at; equal opportunity service provider and employer. Ifvou need assistance to ac.css services or cccd material in an altcrnatc format, cuntact the dcparlmcm at 607-2063151 pr ' throueh Rciw- .n:.-x!eofic:rl o Is", t W:7 - - - - - / S/e/ rte. ~ - - - - - - - - - - _