HomeMy WebLinkAbout020-1117-90-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division Sanitary Permit No:
INSPECTION REPORT 538883 0
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No:
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
Permit Holder's Name: City Village X Township Parcel Tax No:
Kelly, Patrick & Michelle Hudson, Town of 020-1117-90-000
CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No:
13 Ljeo- 19.29.19.496
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic t4j,~~ / Benchmark 2.72 9 7.-I qs• z -
Z-Alt. BM R,s. q19
664
Aeration Po Id 50,6 Bldg. Sewer 6v~ t-4
Holding St/Ht Inlet
6 9~ g
TANK SETBACK INFORMATION St/Ht Outlet
TANK TO CP/L''(( WELL BLDG. Vent to Air Intake ROAD Bt4ml6t• 7.1-7 96 . 7
SO~~1n ~~1 ati. Y•~
Septic Z-7 . ~iT
5Q_& M5 33 _ Header/Man. o ~A •
457 30
Aeration Dist. Pipe
Holding Bot. System
3' f s 9'~. 7G
PUMP/SIPHON INFORMATION Final Grade
c~~ 95
Manufacturer GPM and St Cover 66J4.
Model Nu r ( g g G~0
TDH Lift Friction Loss System Head TD Ft -76( 070 .13
Forcemain Length Dia. Dist. to well a DJ~ a ` 90• X13
SOIL ABSORPTION SYSTEM
BED/TRENCH Width / Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia` Liquid Depth
DIMENSIONS 3 `Q 7-
, rsru~
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
INFORMATION Type Of System: r CHAMBER OR Model Number: _
,tu,C, o, ,O•
rv 5~ ~cl Qom. Cj
DISTRIBUTION SYSTEM k
Header/Manifo~ / Distribution` \ x Hole Size x Hole Spacing Vent to Air Intake
(s) 1 Length T Di- Pipe
ngth Dia \ Spacing ` 6J S
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over xx Depth Q xx Seeded/S ded xx Mulched
Bed/Trench Center m Bed/Trench Edges Topsoil \ es No Yes No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2:
Location: 884 Willow Ridge I Hudson, WI 54016 (NE 1/4 NEE 1/4 19 T29N R1 9W) Willow Ridge Addition Lot 21 Parcel No: 19.29.19.496
1.) Alt BM Description = t I v( Z a v"
2.) Bldg sewer length = CN; S46'
C~ n Q
-amount of cover = J
Plan revision Required? Fd~ Yesi No
_
Use other side for additional information. JIG) il Pi l
Date Inseless r ~f ure Cert. No.
SBD-6710 (R.3/97)
2272
Wisconsin Department of Co merce S L EVALUATION REPORT Page 1 of 2
Division of Safety and Buildin tv~~ in acq with omm 85, Wis. Adm. Code A.C.E. Soil & Site Evaluations
y ~s47 i~ County
Attach complete site plan paper r5o( I ` size. Plan must St. Croix
include, but not limited to: v rti I rence point (BM), direction and
percent slope, scale or dim arrow, and location and distance to nearest road. Parcel I.D.
020-1117-90-000
Please print all infonnation. Reviewed By Date
► /
Personal information you provide may be used for secondary purposes (Privacy law, s.15.04 (1) (m)). O ZO- `1 ` V 96- 002
Property Owner Property Location
Patrick L. & Michelle L. Kelly Govt. Lot NE 1/4 NE 1/4 S 19 T 29 N R 19 W
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
884 Willow Ridge 1 21 Plat Of Willow Ridge
City State Zip Code Phone Number I City J Village J Town Nearest Road
Hudson WI 54016 715-381-2826 Hudson Willow Ridge I
J New Construction Use: Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD
f/ Replacement Public or commercial - Describe:
Parent material Glacial Outwash Flood plain elevation, if applicable Na
General comments
and recommendations: Soil evaluation comple erify suitability of soil conditions at 3' below existing drywells. Elevation at
bottom of drywel = 85.50'. O
F4 ] Boring # I Boring
Pit Ground Surface elev. 94.85 ft. Depth to limiting factor 152" in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/R'
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
1 0-26 10yr4/4 none sl fill na dh ci 3fmc na na
2 26-35 10yr3/2 none sil 2fsbk dh cw 2fmc 0.6 0.8
3 35-65 10yr4/4 none sl 2fsbk dh cw 1fm 0.6 1.0
4 65-70 7.5yr4/6 none Is osg dl cw 1f 0.7 1.6
5 70-152 10yr5/4 none s Osg dl - - 0.7 1.6
II~
H#5 contains approx.20% coarse fragment .
' Effluent #1 = BOD5> 30 < 220 mg/L and TSS >30 < 50 mg/L ' Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L
CST Name (Please Print) Signatur : CST Number
L-
Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number
11/16/2011
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commerce.wi.gov Safety and Buildings Division County
201 W. Washington Ave., P.O. Box 7162 St. Croix
tias Madis on, WI 53 707-7 1 62 Sanitary Permit Number (to be filled in by Co.)
nt of Commence
15 O 9
Sanitary Permit Application State Transaction Number
In accordance with s. Comm. 83.21(2), Wis. 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 ,J
submitted to the Department of Commerce. Personal information you provide may be used for secondary Same ~.17,:t7 1 Ot..~
purposes in accordance with the Privacy Law, s. 15.04 1 m , Slats. 00 /
1. Application Informatio lease Print All Informatioi RECEIVED
Property Owner's Name f p Parcel #
9 020-1117-90-000
Patrick & Michelle Kell " ,
Property Owner's Mailing Address Property Location
~j
S 1. C;RUiX GOUN'rY i y l
884 Willow Ridge I PLANNING & ZONING OFFICE Govt. Lot
City, State Zip Code one um er NE NE Section 19
(circle one)
Hudson, Wl. 54016 715-381- 26 T 29 N; R 19 E or W
II. TyBe of Building (check all that apply) Lot #
or 2 Family Dwelling -Number of Bedrooms 3 21 Subdivision Name
Block # Willow Ridge
❑ Public/Commercial - Describe Use Q' Na
❑ City of
❑ State Owned - Describe Use CSM Number ❑ Vill of
Na 1d'Town of Hudson
III. Type of Permit: (Chet only o e 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)
List Previous Permit Number and Date Issued
B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New
Before Expiration Owner
IV. Tjpy. of POWTS S stem/Com onent/Device: Check all that apply)
on-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil
❑ Holding Tank ❑ Other Dispersal Compone ain) ❑ Pretreatment Device (explain)
V. Dis ersaff r tment Area Inform i n:34 Infil for "Q-4 Plus" standard ch bers 8 do s, Wieser Concrete filter canister w/ Pol Lok PL-525 effluent filte
Design Flow (gp Design Soil Applic io dsf) Dispersal Area Req ed (sf) Dispersal Area Pro ed (st) System Elevation
450 gpd 0.70 gpd/sq. ft. 642.86 sq. ft. 720.80 sq. ft. 89.00'
J
VI. Tank Info Capacity in Total # of Manufacturer
Gallons Gallons Units a o b
New Tanks Existing Tanks w c°
a. U rA H 00 wC7 a
septic or Holding Tank Na 1,000 1,000 1 Unknown X
Dosing Chamber Na a Na Na
fo lation of the POWTS shown on the attached plans.
VII. Responsibility Statement- I, the u dersigned, ass me responsibility
Plumber's Name (Print) Plumbe s Sign 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 54020
VIII. Coun /De artment Use Only
Approved app7.en~Reasort Permit Fee Date I ued Issuing A Signature
$ Od
for Dental ! ' I
IX. Condi ' ~R easons for Disapproval
r 3 lot, o1.J
1. `Septic tank, effluent finer and 3 P
IM "w
dispersal cell must all be services I maintalne S•- ( tp
as per management plan provided by plumber. itf Uj CAL l 2. AD sefback requirements must be maintained
W per aPpIcable Cade 10 fdlrMV40. O Ja r
Attach to complete plans for the system and submit to the County only on pap r not less than 8 1/2 x 11 inches in size
SBD-6398 (R- 02/09) Valid thru 02/11
A e7x/Ls ; , grade k !ie .
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nes 3
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COPY
A. Lr~
Conventional POWTS Index & Tilte Sheet
Project Name: Kelly 3 bedroom Replacement Conventional POWTS
Owners Name: Patrick & Michelle Kelly
Owner's adress: 884 Willow Ridge I, Hudson, WI 54016
Site address: Same
Project Location:
Subdivision: Lot 21, Plat of Willow Ridge
Legal Description: NEI/4 NEI/4, Sec. 19, T.29N., R. 19W., Town of Hudson, St. Croix Co., WI.
Parcel ID 020-1117-90-000
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 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 PI ber Restric d Service: James K. Thompson, Dept. of Comm. Credential #30021
Signature: S Date: o?v ?-O//
Page 1 Of 11
Design pursuant to In-Ground Soil Absorption Component Manual for POWTS, version 2.0 SBD-10705-P (N.01/01)
• Soi/ e r/a/ua on
EX~ Sciii grade e lcv..`
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A T. z9of, oe 19e)- T.
.r~(Ievl<o{ 4jcis•aa' sego{"
8S..Sd ~ ,fxr~ /.off acres
L,6~m o~ g'/:f dry use
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DISPERSAL CELL SIZING CALCULATIONS
1. (3 bedrooms)(100 gallons estimated flow)(1.5 design factor) = 450.00 Gpd design flow
2. Infiltrative capacity of native soil = 0.7 gpd/sq. ft.
3. Absorption area required: 642.86 sq. ft.
4. Absorption area as proposed: 720.80 sq. ft. (34 chambers + 8 end caps total)
Infiltrator "Quick 4 Plus" = 20.00 sq.ft. EISA per chamber, Infiltrator "Quick 4 Plus" end cap = 5.10 sq.ft. EISA
642.86 sq. ft. - (8 endcaps)(5.10) = 602.06 sq. ft.
602.06 sq. 1/20.00 = 30.11 chambers required
Number of trenches: 4 @ 6, 8, 8 & 12 chambers per trench
Trench width: 2.83'
Trench length: 28.00', 34.00', 34.00' & 50.00'
Trench spacing: 9.00' on center
Total system area w/ 9' center spacing: 12.00'x 37.00' X 12.00'x 38.00'
Pg. 3 of 11
Soil Absorption Svstem Cross Section
9na ft
Grade
4" Schedule 40
PVC Vent Pipe
With Vent Cap W.y ft
Leaching
Chamber M. d ft
System Elevation
ft 4i.GO ft
Soil Absorption System Plan View
ft
ft
ft Vent Or Observation Pie Leaching Trench 1
Pipe Chambers
4" Dia.
Trench 2 Header
Leachina Chamber Specifications
Manufacturer And Model
~y/~7'¢,~-y~~ SL~.~c/ IO/4$
EISA Rating .74.0 sq ft per chamber Soil Application Rate 0.1 gpd/sq ft
Sao gpd Design Flow + D.7 Soil Application Rate + Aeon EISA = 3a.rKChambers
2 rows of /IAW chambers each.
Page of
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.
Effluent flow shall be alternated between dispersal cells on a two-year schedule by use of diversion valve. Effluent to
be diverted from new cell to old Drywells at 4 year anniversary of new system installation. Drywells to be utilized for a 1
year period. Effluent dispersal to be alternated between systems on a two year rotating basis thereafter.
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) 386-4680.
Pg. 5 of 11
• Filters
PL-525 EFFLUENT FILTER (I° ` .°F rrt l
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
10,000 GPD
float up and temporarily shut off
the system so the effluent won't
leave the tank. No other filter on
the market can make that claim! Accepts 4° & 6°
SCHD. 40 Pipe \
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 notified ,
by an alarm when the filter needs
servicing. Servicing should be Gas deflector
done by a certified septic tank Automatic shut-off
pumper or installer. 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. Puli 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
4' or 6 outlet pipe. If the
tank. Make sure all solids fall 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.
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ALTER CANISTER DETAIL SCALE:3/4" _ REV No.
DRAWN BY:SwT
WIESERCHURETE
\ Z SEPTIC MANUAL W3716 US MWYIO. MAIDEN ROCK, YA 54750 DATE: JANUARY 2008
° REV. JAN. 2008 800-325-8456 FILE: SHEET 13
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I
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/
Mailing Address
Property Address
(Verification required from Planning & Zoning Department for new construction.)
City/State s Parcel Identification Number D 7~D " 1117" W -eW
OYI. C.tal.
LEGAL DESCRIPTION
Property Location n'/4 , _gC'/4 , Sec. T _;g!tN R-/f _W, Town of 1/7e 69n
Subdivision Plat:_ (A.)~11&A) 4-ClC~.E,,, , Lot #
Certified Survey Map # , Volume , Page #
Warranty Deed # 0391 7 (before 2007)Volume Page # 73
Spec house 414= Plro'~_ Lot lines identifiable Ke_s
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.
1/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.
Uwe certify that all statements on this form are true to the best of my/our knowledge. I/we amiare the owner(s) of the
property described above, by virtue of a warranty deed recorded in Register of Deeds Office.
Number of bedrooms 3
SIGNA RE 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)
jv-pa
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:
(Streets address) 98 GJ ' IAr) g4e- ee~Svy~ t.D/, located
at: rl j5' '/q, de 1/4, Section o,A/n N, Range_ R W,
Town of //"A2(56-)-, , St. Croix County Wisconsin.
Upon inspection, I certify that I have found the tank(s), to the best of my
knoNvledge, will conform to the requirements of Comm. 84.25, and it (they)
appear(s) to be functioning properly.
Most 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 A-`--Steel _ Other _
4arnufacturer (If known):
A~r nk (if known): 'fib :Q4-d/f7-f _
ermit nu ber (if known)
5•---
- - 77~
cWT 'ceased Plumber Signature) (Print Name)
(Title) (License NumberIPRS
(Date)
Form 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. y 2005
to art
1548PAGE 73 a yon 1
y!'L
63Z06Z
WARRANTY DEED KATHLEEN H. WALSH
REGISTER OF DEEDS
ST. CROIX CO., WI
RECEIVED FOR RECORD
10-03-2000 2:30 PM
WARRANTY DEED
ERT C
EXEMPT #
DANIEL C. DIXON and SONJA M. DIXON, husband and C
CERT COPY FEE-
wife, hereby grant and convey, with warranty of title, to COPY FEE:
TRANSFER FEE: 647.70
PATRICK L. KELLY and MICHELLE L. KELLY, husband RECORDING FEE: 10.00
and wife, as survivorship marital property, the real estate PAGES: i
legally described as:
Return to:
ADO S ~ cQ
PIN 020-1117-90-000
Lot 21, Willow Ridge Addition to the Town of Hudson, St. Croix County, Wisconsin.
__~iln pit ~ •
C. DIXO SONJA M. IRON
STATE OF WISCONSIN) ACKNOWLEDGEMENT REBECCA J. PHANEUF
ST. CROIX COUNTY ) NOTARY PUBLIC
STATE OF WISCONSIN
Personally came before me on 2000 the above-named, to me
known to be the persons who executed the foregoing instrument, and acknowledged the same.
Notary
My commission Drafter C. W. Malick
I
2270
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 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 PI must County St. Croix
include, but not limited to: vertical and horizontal reference point ( d' and
percent slope, scale or dimensions, north arrow, and location and di tan o rleest road. Parcel I.D. 020-1 7-90- 00
_
Plea J1tfQI[gatLtl.. ~.Review By Date
Personal information you provi may (Priv y Law, 5.
Property Owner Pr rty Location
Patrick L. & Michelle L. Kell / s'a Govt. Lot 1/4 19 19 T 29 NR 19 W
Property Owner's Mailing Addr s Lot # Block # S bd. Name o CSM#
884 Willow Ridge I 3. t Rjj.:,; ouuil 1Y 21 na Willow Ridge Addition
city r _f City _J Village a Town Nearest Road
Hudson WI 54016 715-381-2826 Hudson Willow Ridge I
J New Construction Use: W1 Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD
i+ Replacement I Public or commercial - Describe:
Parent material Glacial Outwash Flood plain elevation, if applicable na
General comments
and recommendations: Site suitable for conventional POWTS dispersal cell with 0.7 gpd/sq.ft./day loading rate. Proposed
system elev.= 89.00'. Existing drywell infiltrative surface elev.= 85.50'.
Boring # .1 Boring
bm Pit Ground Surface elev. 95.05 ft. Depth to limiting factor >119" 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 0-18 10yr4/4 none sl fill na na ci 3fmc na na
2 18-33 10yr3/2 none sil 2fsbk dsh cw 2fmc 0.6 0.8
3 33-60 10yr4/4 none sil 2fsbk dsh ctnr 1fm 0.6 0.8
4 60-70 10yr5/6 none sil 1msbk mvfr cw 1f 0.4 0.6
5 70-74 7.5yr4/6 none Is Osg dl cw - 0.7 1.6
6 74-119 10yr5/4 none s Osg dl - - 0.7 1.6
H#6 contains approx.20% coarse fragments. 009 1
Boring # - I Boring /13 I
Pit Ground Surface elev. 96.07 ft. Depth to limiting factor >1 [2" 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 0-14 10yr3/2 none sil 2fgr ds cw 2fmc 0.6 0.8
2 14-27 10yr4/4 none sil 2fsbk ds gw 2fmc 0.6 0.8
3 27-62 10yr5/6 none sil 2msbk ds aw 1fm 0.6 0.8
4 62-68 7.5yr4/6 none Is Osg dl cw 1vf 0.7 1.6
5 68-132 10yr5/4 none s Osg dl I- - 0.7 1.6
r(
H#5 evaluated with hand auger from 107" - 132".
* Effluent #1 = BOD5> 30 < 220 g/L and TSS > < 150 mg/L * Effluent #2 = BOD5 <30 mg/L and TSS < 30 mg/L
CST Name (Please Print) Si ature: CST Number
James K. Thompson 3602
Address A.C.E. Soil & Site Evalu ns Date Evaluation Conducted Telephone Number
340 Paulson Lake Lane, Osceola, WI 54020 10/31/2011 715-248-7767
Property Owner Patrick L. & Michelle L. Kelly Parcel ID # 020-1117-90-000 Page 2 of 3
3] Boring # J Boring
Vf Pit Ground Surface elev. 96.27 ft. Depth to limiting factor >135" in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-12 10yr3/2 none sil 2fgr ds Cw 2fmc 0.6 0.8
2 12-23 10yr4/4 none sil 2fsbk ds gw 2fm,1c 0.6 0.8
3 23-49 10yr5/6 none sil 2msbk ds aw 2fm 0.6 0.8
4 49-52 7.5yr4/6 none Is Osg dl Cw 1vf,f 0.7 1.6
5 52-135 10yr5/4 none s Osg dl - - 0.7 1.6
tt H#5 evaluated with hand auger from 112" - 135".
❑ 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. *Efl#1 *Eff#2
F-1 Boring # - f I Boring
- Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots
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 = BODS < 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 (8.07/00) A.C.E. Soil & Site Evaluations
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