HomeMy WebLinkAbout022-1074-80-000 EPermi
Wisconsin Department of commerce PRIVATE SEWAGE SYSTEM Co St. Cf01X
Safety and Building Division INSPECTION REPORT Sa
538797 0
(ATTACH TO PERMIT) State Plan ID No:
GENERAL INFORMATION
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Parcel Tax No'.
Permit Holder's Name: City Village X Township 022- 1074 -80 -000
Kahler, Stuart & Amy Kinnickinnic, Town of
Section/Town/Range/Map No.
CST BM Elev: Insp. BM Elev: BM Description: �� I G I ` J 26.28.18.P414C
/6d
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY F7 � dS. FS EL
` /04 66
Septic � � W
Dosing i f Alt. BM ` * Z $ �1SZ.
Aeration Bldg. Sewer
Holding St/Ht Inlet
SUHt Outlet zJ J ! /DO (
TANK SETBACK INFORMATION
i Vent to Air Intake ROAD Otlalot 1_ _ 6 2� 4.
1,6 Z) / Header /Man. O
Dist. Pipe Bot. System 4� ( Z � 71
Final Grade �/� q 7 0
PUMP /SIPHON INFORMATION * 7 !
Manufacturer Demand S Cover
� ` /6Z.
Model Number
TDH ift Friction Loss System H TDH t
Forcemain Length Dia. Dist. to Well
SOIL ABSORPTION SYSTEM
BEDITRENCH Width Length No. Of Trenches ' PIT DIMENSIONS No. Of Pits Inside Di� Liquid Dep t�
DIMENSIONS /�L -` —�
i
SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM C LEACHI R OR Manufacturer., /1�. f
INFORMATION Type of System: 1�,/L UNIT Model Number: i+ rG k q C1
l3 11 JT
Co,n
DISTRIBUTION SYSTEM Gi v t tq sir It ke
x Hole Size x Hole Spacing W
Header /Manifold u Distribution
! T Pipe(s)
Length Dia r Length Dia Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only xx Mulched
Depth Over xx Depth of xx Seeded/ dded
Depth Over To soil Yes No
BedlTrench Center Bed /Trench Edges P ` Yes No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / /
Inspection #2: / /__
Parcel No: 26.28.18.P414C
Location: 127 Ponderosa Rd River Falls, WI __54022 (NW 1/4 SE 1/4 26 T28N R18W) NA ?
U-, � 6teA o D ^—
1.) Alt BM Description = /. (..+� �" Z Z \
2.) Bldg sewer length = � lE:dl 916 �Z �JS '
- amount of cover =
X1 3', - �,g34a�
Use other l s de for u additional i t Date Z �Inse pc t &' Sign re - Cert. No
SBD -6710 (R.3/97)
commerce i.9ov Sa4ty and Buildings Division County
201 W. ashington Ave. . ,ikox f St. Croix
'sco n ' „, UL 1 1 70 11 M ison, W 7 Sanitary Permit Number (to be filled in by Co.)
4 t DepartimM of m� I `J V
Saril cation State Transaction Number A)A
In accordance with s. Comm. 83.21( *,is.. Adm. Code, submission of this form to the appropriate governmental Project Address (if different than mailing address)
unit is required prior to obtaining a sanitary permit. Note: Application forms for state -owned POWTS are /
submitted to the Department of Commerce. Personal information you provide may be used for secondary Same # /� 7 O /14'G�
purp oses in accordance with the Privacy Law, s. 15.04 1 m , Slats. n n
I. Application Informs lease Print All Information
Property Owner's Name Parcel #
Stuart & Amy Kahler 022 - 1074 - 80 - 000 oe
Property Owner's Mailing Address Property Location /i G
127 Ponderosa Road
Govt. Lot
City, State Zip Code Phone Number NW '' /<, SE' /., Section 26
River Falls, WI. .949}6- 6 fpm 715 - 426 -9416 a one)
H. Type of Building (check all that apply) Lot # T 28 N; R 18 41 W
El or 2 Family Dwelling - Number of Bedrooms 4 2 Subdivision Name
Block # Na
❑Public /Commercial - Describe Use I LIA to Na ❑ City of
❑ State Owned - Describe Use CSM Number V 3 7 11 Village of
1 � ' r � � 4-Z!5 ^ �� ❑Town of K1rin1Ck1rn11C
III. Type of Permit: (Check only bne box on line A. Complete line B if applicable
A. ❑ New System .Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain)
B. El Permit Renewal El Permit Revision El Change of Plumber ❑Permit Transfer to New
List Previous Permit Number and Date Issued
Before Expiration Owner
IV. Type of POWTS System/Component/Device: Check all that apply) C 1 V
Non - Pressurized In- Ground ❑ Pressurized In- Ground ❑ At -Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil r
❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain)
V. Disp ersal/Treatment Area Information: 50 Infiltrator "Q-4" Standard Plus c ambers & 2 pr. endca s, of Lok PL -525 effluent filter
Design Flow (gpdy Design Soil Application Rate(gpdsf) Dispersal Area Required (s Dispersal Area Proposed s ystem eva n
600 gpd ✓ 0.60 gpd/sq. ft. 1,000.00 sq. ft. 1,020.40 sq. ft. `// 92.75'
VI. Tank Info Capacity in Total # of Manufacturer y
Gallons Gallons Units 2! c ° U
New Tanks Existing Tanks 9 2
E
09 1
Septic or Holding Tank 261 1261 1 Weeks Concrete C uJ X
Unknown X
Dosing Chamber Na Na Na Na
VII. Responsibility Statement- I, the and signed, assloue responsibility for inst o of the POWTS shown on the attached plans.
Plumber's Name (Print) ber' Signature MP/MPRS Number Business Phone Number
James K. Thompson
�-- MPRS 30021 (715) 248 -7767
Plumber's Address (Street, City, State, Zip Code)
340 Paulson Lake Lane, Osceola, WI 020
VIII. oun /De artment Use Onl
Approved ved Permit Fee Date I ued Issuing A t Signatur X�
rven Re r Denial
$ � j l �$, Gd 7 // //
IX. Conditions of Approval/Reasons for t approval n
SYSTEM OWNER 3) 6 1 A
I.
I ..Sepik tank, effluent filter and J
dispersal cell must all be services / maintained /
as per management plan provided by plumber. GOot Q. r
2. AN selbeok regtHrements must be maintained 1
as per t> e / wdillalncee. T Xj V ' w J
Attach to complete plans for the system and submit to the County only on paper not less than S 1/2 x 11 inches in size
SBD -6398 (R 02/09) Valid thru 02/11
O� V
H �
• 1�C4.�T /JroP. .SL�4�cC.
��k,1.6 s 4, x xle/
I27 I�ondei'o.�a �d •
�eMO�� SE.C/C)ilt�-
��de�asq
nc% "v 107sl- fad - cte
3 1 � cr�
1 la
x.53■ . `.
ell
v �
0
C
�' ybed�cw, t
/ �e5i1e.•rce
� 1
�arti l.. I
EXis�in /,cvv�a.F �P \ \\\ c i I J�� -ox. /oc4�a, �•
�a.,�f35�/`eCOn,�ec \\/�/ sI�fAJrrYJ3a3fL �ed el•ec L1Ke.
Corte= /42.35;'
Fri j secl wte%<" j orax, loea z<io.� o� All.d. MrlmenE
Conc rt,�e �l yyu.P. h d:s �3�/ � "n�
f�L - 52S � /eel � �/ • r o fj-� u 6ee., c?�o n c.al
o
Conventional POWTS Index & Tilte Sheet
Project Name: Kahler 4 bedroom Replacement Conventional POWTS
Owners Name: Stuart & Amy Kahler
Owner's adress: 127 Ponderosa Road, River Falls, WI 540
Site address: Same
Project Location:
Subdivision: Lot 2, CSM Vol. 3, Pg. 672
Legal Description: NWIA SE1 /4, Sec. 26, T.28N., R. 18W., Town of Kinnickinnic, St. Croix Co., WI.
Parcel ID #: 022- 1074 -80 -000
Page 1 Index and Title Sheet
Page 2 Site Plan
Page 3 Dispersal Cell Sizing Calcualtions
Page 4 System Cross Section
Page 5 System Management Plan
Page 6 Filter Specifications
Page 7 Treatment & /or Filter Tank Cross Section
Page 8 Parcel map
Page 9 Septic Tank Maintenance Agreement
Page 10 Certification for Utilization of existing septic tank
Page 11 Waranty Deed
Attachments: Soil Evaluaiton Report
Mater Plum er Restrict d Service: James K. Thompson, Dept. of Comm. Cpdentie4 #30021
Signature:
Date: ���
Page 1 Of 11
Design pursuant to In- Ground Soil Absorption Component Manual for POWTS, version 2.0 SBD- 10705 -P (N.01 /01)
�e z3
�ja:S� eled4�Or�
�o�Z� Csrrl do� / / ° � • �71,
be v c e
�-
.
frees
♦
4:E /7.vJ. Cp�r, of � �v � ` � .1
Ned ♦ ► v 1 y EXis�in
9 e fe /�•Gi7: � � M • + v 1 • I)2 %cjli Z °:!" y
uJel( 3
QrSile.ace s - t ( !
\ O ✓ !1
Awn)
EJlis /,coo a,F. �oub� \ \\ o i r l�� oar. /DC'4�.`c• �'
�+,�f35��`eCOnryECt+t -c�. \\� � �L';q�rn�3o3si 'cd else, L,rKe _
5.T /s la, l� /e Coin= /x.35. I O %C e{,� /usnE
�L-S2Ss lcc'i'� Q5 Cc de.
P� z or
KAHLER DISPERSAL CELL SIZING CALCULATIONS
1. (4 bedrooms)(100 gallons estimated flow)(1.5 design factor) = 600.00 Gpd design flow
2. Infiltrative capacity of native soil = 0.6 gpd/sq. ft.
3. Absorption area required: 1,000.00 sq. ft.
Infiltrator "Quick 4 "Plus = 20.00 sq.ft. EISA/chamber, Infiltrator "Quick 4" Plus end cap = 5.10 sq.ft. EISA
1,000.00 sq. ft. — (4 endcaps)(5.10) = 979.60 sq. ft.
979.60 sq. ft./20.00 = 48.98 chambers required
4. Absorption area as proposed: 1,020.40 sq_ ft. (50chambers total)
Number of trenches: 2@ 25 chambers per trench (50chambers total)
Trench width: 2.83'
Trench length: 103.00'
Trench spacing: 8.00' on center
Total system area w/ 5' trench spacing: 11.00'x 103.00'
Pg. 3 of 11
j
Soil AbsoMftn System Cross Section
q 750 ft
Final Grade
4° Schedule 40
PVC vent Pipe
With vent cap
Leaching _ 92.75
Chamber ft
♦— System Elevation
5� ft
Soil Absorctlon System Plan View
ft
2.83
ft
5.00
Leading Trench 1
ft
Vent Or Observation Pipe Chambers
4' Dia.
Trend 2 Header
Leaching Chamber SnecificationS
Manufacturer And Model Stan dard Infiltrator Quick 4 Plus
EISA Rating 2000 . sq ft per chamber Soil Application Rate 0.60 gpd/sq ft
600.00 gpd Design Flow + 0.60 Soil Application Rate + 20.0 EISA = 4 Chambers
2 rows of 25.00 chambers each.
j Page 4 of 11
Conventional Septic System Management Plan
Pursuant to Comm 83.54, Wis. Adm. Code
General
The conventional septic system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall be maintained
in accordance with component manual SBD- 10705 -P (N.01 /01). All local and/or state rules pertaining to system
maintenance and maintenance reporting shall be complied with.
Septic Tank
Septic tank servicing mechanics comply with Comm. 83.54(1)(e). Septic tank to be located within 150' of service pad, with
bottom of tank to be <_ 15' below service pad elevation. The operating condition of the septic tank and outlet filter shall be
assessed at least once every two years by inspection. The septic tank contents shall be removed when the sludge and scum in
the tank exceed 1/3 the liquid volume of the tank. The contents of the septic tank shall be disposed of in accordance with NR
113, Wis. Adm. Code, by an individual certified to service septic tanks under s. 281.48, Stats. If the contents of the tank are
not removed at the time of a biannual assessment, maintenance personnel shall advise the owner of when service will be
needed to maintain less than 1/3 scum and sludge accumulation in the tank. The outlet filter shall be cleaned as necessary to
ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank
that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be
serviced if the alarm is activated. Septic tank manholes 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 the tank.
No individual should ever enter the septic tank as dangerous gases may be present that could cause death. Septic tank
abandonment shall be in accordance with Comm83.33, Wis. Adm. Code when the tank is no longer used as a POWTS
component. The addition of biological or chemical additives to enhance septic tank performance is generally not required. If
such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings
Division.
Soil Absorption Cell
Trees or shrubs should not be planted directly on the soil absorption system. The area above and around the system should
be seeded and mulched as necessary to prevent erosion and provide some degree of frost protection. Traffic (other than for
vegetative maintenance) over the system is to be avoided. Soil compaction may hinder aeration of the infiltrative surface
within and above the system and will promote frost penetration during cold weather months. Cold weather installations
(October - March) dictate that the system be heavily mulched for frost protection.
Influent quality into the system may not exceed 220mg/L BOD5, 150 MG/L TSS, and 30 mg/L FOG. Influent flow may not
exceed maximum design flow specified in the permit for the installation.
Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the
owner. Levels above 4 inches indicate 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 proper operating condition. Excessive ponding within the dispersal cell will be eliminated by installing a new soil
absorption cell to bring the system into proper operating condition.
Questions on the operation or maintenance of the system should be directed to the installing plumber, Jim Thompson at (715)
248 -7767 or the St Croix County Zoning Department at (715) 3864680.
Pg. 5 of 11
- ^3•M q }
Y
• ® Filters
PL -525 EFFLUENT FILTER (COMMERCIAL)
Polylok, Inc is pleased to add its
new commercial filter to its existing
line of quality effluent filters. The
PL-525 is rated for over 10,000 GPD Alarm
(gallons per day) making it one of accessibility �--- -- Accepts PVC
the largest commercial filters in its extension handle
class. It has 525 linear feet of 1/16"
filtration slots. Like the Polylok
PL -122, the new Polylok PL -525 has
an automatic shut off ball installed 525 linear feet
with every filter. When the filter is of 1/16
removed for cleaning, the ball will filtration slots Rated for over
float up and temporarily shut off 10 ,000 GPD
the system so the effluent won't
leave the tank. No other filter on
the market can make that claim/ Accepts 4° & 6 "j
SCHD. 40 Pipe "
�j
PL -525 Maintenance:
The PL -525 Effluent Filter should
operate efficiently for several years
under normal conditions before
requiring cleaning. It is recom-
mended that the filter be cleaned
every time the tank is pumped or
at least every three years. If the
installed filter contains an optional
alarm, the owner will be notifiedK
by an alarm when the filter needs
servicing. Servicing should be Gas deflector
done by a certified septic tank
pumper or installer. Automatic shut-off
ball when filter
is removed
1. Locate the outlet of the U.S. Patent No# 6,015,488
septic tank. 5,871,640
2. Remove tank cover and pump
tank if necessary. PL -525 Installation: 1. Locate the outlet of the
3. Do not use plumbing when septic tank.
filter is removed. Ideal for residential and com- 2. Remove the tank cover and
4. Pull PL -525 out of the housing. mercial waste flows up to pump tank if necessary.
5. Hose off filter over the septic 10,000 Gallons Per Day (GPD). 3. Glue the filter housing to the
tank. Make sure all solids fall 4" or 6" outlet pipe. If the
filter is not centered under the
back into septic tank. access opening use a Polylok
6. Insert the filter cartridge back Extend & Lok or piece of pipe
into the housing making sure to center filter.
the filter is properly aligned and 4. Insert the PL-525 filter into
completely inserted. its housing.
7. Replace septic tank cover. 5. Replace the septic tank cover.
P wq
a 2�f a,9 1101V 4,, 0'/;t
7i 17
S4- f c blw k ex {y n i4
I ' �
� I i
I
I I
k Y
II �
a — 1
i c )
3� WEEKS MIN
3 "' RAY L WEEKS
----- ,y� �
N Richm
f
7Q��1
V
CERT 1 F1 ED 7U --- HVEY'M/\P
0- �.
4
� l
f �
l
APPROVAL OF THIS MtN AP PROVAL IS FOR
DOES No MEAN
i BUILDING S;T" OR SEPTIC SY TE1v1.
— 6�6 � REFER TO H62.i0.
Q�J
' EAST 1/4 CORNER
0: WEST 2609.66 SECTION 26,T28N, RI SW
QUARTER SECTION LINE APPROVED
ARFA �1lJG 23 1978
r` LOT I — 1.299 ACRES TO
ST. CZOiX C'JU 'tY
J r i i . 148 ACRES TO R , O.`iV Cp p,tEH£NSIY� PARKS FLA"
ANC ZONSNG GOMMtTi£E
O LOT 2 — 1,314 ACRES TO GL
°- 1.162 ACRES TO R.O.W.
cn
J
S88 ° 55'24'E 283.00'
9
250
O
O
I ry o LEGEND=
' W SOT I °
0 0 O 0= SET I "X 24" IRON
o PIPE WEIGHING 1.13
O
o LBS./ LINEAL FOOT.
Z
Z
33' S$8 ° 55'24 "E 283.00
25O' a O 50 100
O
CURVE DATA
LOT 2 L
CENTERLINE R O W. L
.
I" in,N IN R.
! ° 0 1 0 L O T p L ° 21' 36" d 5 °16'42"
z; N 0o 2141.03' R 2174.03'
NOTE= EXISTING HOUSE ON
G ', v THIS LOT 200.29' A 200,28
'A 0° 200.22 CH. 200.21' 33.1 259.21 00 ' N 3 HB N 3 °4257 ' W
N88 °5524 W 292.36'
II
1
! Vol 3 Page 672
RF 78 — 72 U
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner4o& "
�m r'� rrt .�✓
Mailing Address
Property Address 6a"';Ivp
(Verification required from Planning & Zoning Department for new construction.)
City /State ow��K j Parcel Identification Number (0 2-2 - /07,/-
LEGAL DESCRIPTION
Property Location 4 Y) '/4 , 5 6 ' /4 , Sec. Z4 , T ,28 N R & W, Town of
Subdivision Plat: 4 , Lot # .Z
Certified Survey Map # , Volume 3 , Page #
Warranty Deed # (before 2007)Volume , Page #
Spec house ❑ yes Lot lines identifiabl es ❑ no
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper
maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed 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 County Sanitary Ordinance.
The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the
owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site
wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is
less than 1/3 full of sludge.
I /we, 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 stating 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 date.
I /we certify that all statements on this form are true to the best of my /our knowledge. I /we am/are the owner(s) of the
property described above, by virtue of a warranty deed recorded in Register of Deeds Office.
N bedrooms
&— / I —/ �
S ATURE OF APPLICANT(S) DATE
** *Any information that is misrepresented may result in the sanitary permit being revoked 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 in the warranty deed.
(REV. 09/07)
ST. CROIX COUNTY ZONING OFFICE
CERTIFICATION STATEMENT
FOR UTILIZATION OF EXISTING SEPTIC TANK(S)
This is to certify that I have inspected the existing septic and /or dose tank
presently serving the following residence:
(Street address, f L X& ��� ��/ located
at: 4 4) ? 4 � '/4, Section � Town _� N, Range W,
Town of �� �'
� , St. Croix County Wisconsin.
Upon inspection, I certify that I have found the tank(s), to the best of my
knoN� ledge. will conform to the requirements of Comm. 84,25, and it (they)
appear(s) to be functioning properly.
N4ost recent date of inspection or service
Did flow back occur from absorption system? Yes No
(if no, skip next line.)
Approximate volume or length of time: — gallons minutes
Tank Capacity:
Construction: Prefab Concrete t om_ Steel _ Other _
Manufacturer (if known): _—
o nk (if known):
'ermit nu lber (if known'
icensed Plumber Signature) (Print Name)
(T (License Number)ZPRS
ate)
I orm to be completed by licensed plumber (Dept of Commerce Chapter 5
and s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin
Administrative Code)
Rev. 9!2008
1 2095 P 104 ��,46 a(
STATE BAR OF WISCONSIN FORM 7 - 1999 KATHLEEN H. WALSH
TRUSTEE'S DEED REGISTER OF DEEDS
Document Number ST. CROIX Co., WI
Debra L. Ovsak and Karen E. Johnson RECEIVED FOR RECORD
12/31/2002 08 :00AN
as Trustee of Harry L. Peskar Family Trust and Janice E. Peskar Family EXEMPT #
Trust REC FEE: 11.00
TRANS FEE: 495.00
for a valuable consideration conveys without warranty to COPY FEE:
Stuart A. Kahler and Amy R. Kahler, husband and wife, CERT COPY FEE
PAGES: 1
Grantee, the following described real estate in St. Croix
County, State of Wisconsin (if more space is needed, please attach addendum
Recording Area
Lot 2, Certified Survey Map recorded in Volume 3, Page 672, being part of the Name and Return Address
Northwest 1/4 of the Southeast 1/4 of Section 26, Township 28, Range 18, St. Croix 1 �-
County, Wisconsin. f� 6 — (1 2Z �,�
'33�,
P citd, m 3-7 -7 6 �
Metro Legal Services 022- 1074 -80 -000 `
EDIRET 377097 A Parcel Identification Number (PIN)
27815 TD 153882
Dated this ' day of December 2002
9�d
* Debra L. Ovsak * Karen E. Johnson
Trustee Trustee
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) Debra L. Ovsak, Trustee of Harry L. Peskar STATE OF WISCONSIN )
Family Trust, and Karen E. Johnson, Trustee of Janice E. Peska ) ss.
tL County )
authenticate this day of December 2002
3 ° Personally came before me this day of
the above named
* Kristina Ogland
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not, to me known to be the person(s) who executed the foregoing
authorized by § 706.06, Wis. Stats.) instrument and acknowledged the same.
THIS INSTRUMENT WAS DRAFTED BY
Attorney Kristina Ogland
Hudson, WI 54016
Notary Public, State of Wisconsin
(signatures may be authenticated or acknowledged. Both are not necessary.) My Commission is permanent. (If not, state expiration date: )
" Names of persons signing in any capacity must be typed or printed below their signature. Information Professionals company, Fond du Lac, wn
800 - 655 -2021
TRUSTEE'S DEED STATE BAR OF WISCONSIN
FORM No, 7 - 1999
U
2253
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page t of 3
Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code A.C.E. Soil & Site Evaluations
Attach complete site plan on paper not less than 8'% x 11 inches in size. Plan must County St. Croix
include, but not limited to: vertical and horizontal reference point (BM), direction and
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D.
02 1074- 0 -000
Please print all information. Rev' d By Date
Personal information you provide may be used for secondary purposes (Privacy taw, s. 15.04 (1) (m)). �, /zz
Property Owner Property Location
Stuart A. & Amy R. Kahler Govt. Lot NW 1/4 SE /4 S 26 T 28 N R 18 W
Property Owner's Mailing Address Lot # Block # Subd. N e or CSM#
127 Ponderosa Rd. 2 CSM Vo. 3, Pg. 672
City State Zip Code Phone Number J City J Village Y Town Nearest Road
River Falls I WI 1 54022 715 - 426 - 9416 Kinnickinnic I Ponderosa Road
New Construction Use: W1 Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD
Sol Replacement J Public or commercial - Describe:
Parent material Glacial Outwash Flood plain elevation, if applicable Na
General comments
and recommendations: Site suitabl tional POWTS dispersal cell with 0.6 gpd /sq.ft. /day loading rate. Proposed
system el t= 92.75'.
F Boring J # Boring
✓f Pit Ground Surface elev. 96.42 ft. Depth to limiting factor >1 10" in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/It'
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 - Eff#2
1 0 -15 10yr3/3 none I 2fgr mvfr gs 2f,1m 0.6 0.8
2 15 -26 10yr4/4 none I 2msbk mvfr gs 2f 0.6 0.8
3 26 -38 10yr4/6 none scl 2fsbk mfr cw 2vf,f 0.4 0.6
4 38-44 7.5yr4/6 none Is Osg ml cvv 1vf,f 0.7 1.6
5 44 -88 10yr4/6 none s/IS mix Osg mfr aw - 0.6 1.0
6 88 -110 j 10yr4 /6 none s Osg dl - - 0.7 1.6
Profile of H#6 from 93" - 110" observed by use of /hand auger through bottom of soil pit. Loading rate reflects reduced permeability of horizon
__ - -a ssociated with textural changes.
F2 ] Boring # -.1 Boring
Pit Ground Surf& elev. 97.68 ft. Depth to limiting factor >104" in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft'
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 `Eff#2
1 0-13 10yr3/4 none I fill Na Na aw 2fmc Na Na
2 13 -24 10yr3/2 none I 2fgr nvfr gw 2fm,1 c 0.6 0.8
3 24 -43 10yr4/4 none sl 2fsbk mfr gw 1 vf,f 0.6 1.0
4 43 -50 7.5yr4/6 none Is Osg ml cw 1vf,f 0.7 1.6
5 50 -104 10yr4/6 none /S Osg ml - - 0.6 1.0
�'9
Horizon 44 contains 1/8" - 2" horizontal ba of 10yr Is at " - 4" spacing. Loading rate reflects reduced permeability of horizon associated with
textural changes.
" Effluent #1 = BO D? 30 < mg /L a d TSS >30 < 1 0 mg/L uent #2 = BOD S30 mg /L and TSS < mg /L
CST Name (Please Print) Signatu CST Number
James K. Thompson 3602
Address A.C.E. Soil & Site Evaluations 2 �� — Date Evaluation Conducted Telephone Number
340 Paulson Lake Lane, Osceola, WI 54020 7/7/2011 715 -248 -7767
Property Owner Stuart A.& Amy R. Kahler Parcel ID # 022 - 1074 -80 -000 Page 2 of 3
3] Boring # Boring
V" Pit Ground Surface elev. 96.99 ft. Depth to limiting factor >96" in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P
in. Munsell Qu. Sz, Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 - 10yr3/3 none I fill Na Na aw 2vf,f Na Na
2 9-18 10yr3/2 none I 2fsbk ds gs 2vf,1f, 0.6 0.8
3 18 -29 10yr4/4 none sl 2msbk mfr gw 1vf 0.6 1.0
4 29 -39 7.5yr4/6 none scl 2fsbk mfr cw 1 of 0.4 0.6
5 39-45 7.5yr4/6 none t �I Osg ml cw - 0.7 1.6
6 45 -96 10yr4/6 none s Osg dl - - 0.6 1.0
Horizon #4 contains 1/8" -1" horizontal bands of 10yr 4/4 Is at 12" - 18" spacing. Loading rate reflects reduced permeability of horizon associated
with textural changes.
F-1 Boring # Boring
J
Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
❑ Boring # J Boring
J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
* Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg/L * Effluent #2 = BOD <30 mg /L and TSS <30 mg /L
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.
SBD -8330 (R.07 /00) A.C.E. 5011 & Site Evaluations
� n
z
`
• Loca,�r stake.
X27
�,
Al
be; /. 3 1 acrc5
Prucc-
� l
entl max o{'
A
2nb yalrar 3'/. t t , CPS��ttrc
EXiS�:n El�u = /oi<aD'
i
CA f
� y ' I
lawn/ \
4 A
an� tYJLj� I'`e.con ilk ak", �v "t e IC G (rKe.
�rp�j � L�CeK �"0"Dr^6x, �aCn,�io✓J o f I
CsncrGEe�( ��:5•fJry disl.u�$c/ - J I
S.T. w/ INol � //, �. b� u bcti�dohr.ol
�L -S2s'F /ate /
QS °� Code•
t��. or,_-