HomeMy WebLinkAbout231-1066-60-000 (2)
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
(ATTACH TO PERMIT) 597418
GENERAL INFORMATION 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 Township Parcel Tax No:
KEN & KAREN PETERSON CITY OF GLENWOOD CITY 231-1066-60-000 _T_ I CST BM Elev: Insp. BM Elev: BM De ription: Section/Town/Range/Map No:
1161.03 23.30.15.905
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic enc m
A-T L3, ark M•
Dosing Alt. BM
Aeratiorr- wer I
Holding St/Ht Inlet
_ 7
St/Ht Ou '
TANK SETBACK INFORMATION Z
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
I
Septic Dt Bottom
Dosing 1 ( Header/Man.
Aeration Dist. Pipe 0?.
Holding Bot. System T C$~3 Q1o
(J
Final Grade
PUMP/SIPHON INFORMATION
Man Demand St Cover ,
J
GPM iitif Tl
odel Number
TbH, Lift Friction Loss System Head TDH Ft (Za of
dJ Q ~ 7 • 7(.G
Forcemain Length Dia. Dist. to Well (a / / pE/f 7 -TP •
SOIL ABSORPTION SYSTEM I, 2Z
BED/TRENCH Width, Le th t No. Of Trenches PIT IMENSIONS No.`OfPits Insi Dia. Liquid Depth
DIMENSIONS p1L
SETBACK LEACHING INFORMAT ON SYSTEM TO P/L BLDG WELL LAKE/ TREA CHAMBER OR Manuf ~'~X'+ /
TOf System UNIT Model Number
DISTRIBUTION SYSTEM
Header/Manifold Distribution x Hole Si Ix Hole Spacing Vent tq Air Intake
t Pipe(s)x
Length 7 Dia Length Dia -Spacing - - 3
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over t Depth Over - xx Depth of ' xx Seeded/Sodded xx Mulched
Bedrrrench Center Bed/Trench Edges Topsoil Jam- Yes No es No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2:
Location: 460 WALNUT RIDGE DR
1.) Alt Description = -Avs Le ,
2.) Bldg g sewer length= L
i!
- amount of cover = V
Plan revision Required? ❑ Yes E No / f ! J
Use other side for additional information. (v "6 L
Date Insepctor's Signature Cert. No.
SBD-6710 (R.3197)
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 cuou w - (2 c)r- located
at: ~JW 1/4, 1/4, Section 7-3 , Town~_N, Range W,
Town of , St. Croix County Wisconsin.
Upon inspection, l certify that I ave found the tank(s), to the best of my
knowledge, will confonn to the requirements of SPS. 384.25, and it (they)
appear(s) to be functioning properly.
Most recent date of inspection or service -7
~ r
Did flow back occur from absorption system? Yes No )p
(if no, skip next line.)
Approximate volume or length of time: gallons minutes
Tank Capacity: 14,/od
Construction: Prefab Concrete Steel Other
Manufacturer (if known):, ,
Age of Tank (if known):
Permit number (if known)
(Licensed Plumber Signature) (Print Name)
pum~~, &\^&U~ I A5,5 I t9
(Title) -VI (License Number) MP/MFRS
(Date)
Form to be completed by licensed plumber (Dept of Safety and Professional
Services Chapter 305 and s. 145.06, Wisconsin Statutes) or licensed disposer
(NR 113 Wisconsin Administrative Code)
Rev. 2/2012
o nlrru Y~ ECE , j - - County y r
F-5 I
,~rl v-
Indus.ly Services Division ,
ki ~ Rl
\p P S 2011 1400 E Washington Ave Sanitary Permit Number (to be filled in by Co.)
P.O. Box 7162
lu COUNTY Madi WI 37 -71 • 7
Ft, ,o~w` 'ST. CROIX 7`!
Sanitary Permit A XKYFDK16B81Zq State TransactXQ~
In accordance with SPS 383.21(2), Wis. Adm. Code, submission ofthis form to the appropiim, alit
is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to
the Department of Safety and Professional Services. Personal information you provide may be used for secondary Project Address (if different than mailing addre )
purposes in accordance with the Privacy Law, s. 15.04(1)(m , Slats. ,.r}I(r~_
L Application Inform 'on - Please Print All I or ation
Property Owner's Name CVI*- Parcel #
Ile
Property 46~ Mailing Address Property Location ,3 Q N 0 - Govt~..~ Lot
City, State Zip Ell 5E 'I,, 6 W
i1
It. Type of Building (check all that apply) Lot#
KI or 2 Family Dwelling - Number of Bedroo s l Subdivision Name
❑ Public/Commercial - Describe Use Block #
[e~e tyof
El State Owned -Describe Use /
CSM Number E] Village of
cx-L C ~f 2 ❑ Town of
111. Type of Permit: (Check only one box on line A. Complete line B if applicable) a__
A. ❑ New System Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain)
B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and ate sued
Before Expiration Plumber Owner 2-`
IV. Type of POWTS System/Component/Device: (Check all that apply) J
Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil
❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain)
V. Dis ersal/TreatrDesign rea Information:
Design Flo (gpd) Soil Application Dispersal Area Required (sf) Dispersal Area Proposed (s System Elevation
4 (Z ate(gpdsf)
D
VL Tank Info Capacity in
c
Gallons Total # of ~ j
Ga Units Manuf turer L. klm o 2
New Tanks Existing Tanks 't U iii `nn w C7 0.<
❑ ❑ ❑ ❑
Septic or Holding Tank Gtl
lo -
Dosing Chamber ❑ ❑ ❑ ❑ ❑
VI
I. Responsibility Statement- 1, the undersigned, a mlation of the POWTS shown on the attached plans.
Plumber's Name (Print) Plumber's Si MP/MPRS Number Business Phone Number
Todd L Sinz _ MP139462 715-235-2644
Plumber's Address (Street, City, State, Zip Code)
E5609 708th Ave Menomonie Wi 54751
VIII. f;ounty/ De artment Use Only
Approved Permit Fee Date sued Issuing A Signature
;a;roved
en Re Denial $ • /7
IX. Condi10 all
~ Disapproval ~
CeT 1~ 46 W ; Z _ r L J~
f Kpetsgtt cell must all be seIcas its'-ems O1~' 7
ss,per rparmgement plan pro idea by Nlwnbe;.
2. ~U,s f* tiiret:wms must be maa,,Lir:E,1
as per rffftWals cote / ,:rdinance3.
Attach to complete plans for the system and submit to the County only paper not less than 8 1/2 x 11 inches in size -
SBD-6398 (R03/14)
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hth ~ E / t f ~ 7
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Private Onsite Wastewater Treatment System
Index and Title Page
Project Name: / L r sp'~'I ~/(2~'/iG(GGl y ~fL~
Owner's Name:
Owner's Address: 7-
2~- 8DZ
7K5--
/
Legal
Description: Z~~
Municipality: -Tn-Mrr, V44ftgC7,- City of ~r°!?ld~i~ (~G7y
County: 62Q /,y
Subdivision Naive:
Lot Number: A9 Block Number:
Parcel I.D. Number: 6p - /e')416 - ~Q QDO
Page I .~/✓J~,~j~
Page 2 p ~L~C7V
Page 3 ~vss ~lYl
Page 4 %
T~ L
Page 5 &t e!~tS
Page 6 ~1 ~/r'lvr.1 T fit/
Page 7 Tr
Page 8 l
Page 9 k
,q
Name of Designer: p G ^/L License Number:/ Signature: i
Date:
Designed Purs to i POWTS Component Manual and Comm 81-85:
In-Ground Soil Absoi Dti n Com n t Manual for POWTS Ver. 2.0 SBD-10705-P . 01/01
l
7
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133
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9
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hQ
lY~ i y~ ~1 I ~•..-.i F
f p
ice cc,
-:W' a 1~rc„ix Sc-[Q , ~ ~r`u~o5<~rlr _ s_
Nn is rooc> [-w1 cf "F y'' ~ck,e.,-
~ ~ ~ VL~rRr t
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` ° J 1 k
addf 8.14, jol
i,.,. 70i ~ 4 3`r-ors
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Soil Absorption System Cross Section
g8 ft
4' Schedule 40 Final Grade
PVC Vent Pipe -
Wdh-Vent Cap_ ry ft
N ft
System Elevation
~ft
Soil Absorption System Plan View
/ ft
D
2- ft
ft Leaching Trench 1
Chambers
4" Dia.
Trench 2 Header
Vent Or Observation _PJQe______ -
Leachino Chamber Specifications
~J 0
Manufacturer And Model ~~t/~/~~5 (yd l
EISA Rating sq ft per chamber Soil Application Rate ~gpd/sq ft
gpd Design Flow + r 'S~- Soil Application Rate + ~00 EISA = Chambers
rows of a-3 chambers each. A601 1) S
a x 7/- ~aa - 9P- 4a A~
Page of
E4AcXWAi~k VALV~S
ilea t. .ism: siiii,i"iiesi, strGngem, and rrrrmst cconorni€`.al dbencer valve ever invented iGr septic tank IGc'ch fielcl& k is riiadG
pastic u,in, `.v.: Mat: r bent ?ice: i or oQuouo iz; iightGr h! 1 t y~ o.i i 1-uQnnd, e nli
t3Tp,Jt.i siv , i,l
lib 'sivaiier vaiva teen flow rna be, controlled to individual or riluitip ie^ fields (up to three) in any cGanbinatiGrl. 'dvlth u
valk;c s-«en:, how !,i.„j be dba tamed to any w uiri!es. ,e alim flout, through all outlets, the va,ve stem miiay be
:,u,+i w 4plastic sewer and M n pipe to IIIAI rails; ouTLAt7 Gii the four b"ua diSiributiGi, box. funwantpci Gutiets iliaV be
se lad ;1v .n.:. Li,.liii ,l,d C, cz?.i>j- , he DP1 Gile, el.,c[a .•v1:7Gh i!!..:.,[vF=v> ut.., d=,r l.i ua,i may L3:; ..,!.ai iv iJa s,l ed , ;a L:
j '?!5P 0 Pv , DiV2r:F, Me MW 4 ass J5FV
b/5 4 A6b Jiverier i/a,ve L~i..ek 4 1.5Q .bAri
i F~ -
.r
PIN 0
i ..I ~,-_i ,.i lei ~'✓t .Y
The KIDS gravity flow 5aGkVVa1er Valve is deSi ined to protect low areas or baseriionts fr G,ii the Gackfiow Gf 'wasm fruiii
re ..i l' 1„ uva,=cL L,+e in L v e-F and sizes PVC. !i!ate'lc 1. it -s i. LI:; -i;i!ct,iive a,i+..a u Chem iiCaliv
al to i Pali ve to cast Von valves.
i he quid,,, aCTIGi i i appJer ailows unrestricted uii,°Girectional „GVv. Elasterner is gasket, in ,he flapper ensures a waier i„gi.
pia i- dc_ pp can. be 3asi; r ! emn;;. lved and : aG!_eGG
n
i-ii-~.czuci'u" cici;esS cap e is GaSiCr,t?u for hand aiu ?.iC~iiiGniru. Access cap neoprene ~ gasket p3iGViuuS ci ,r'iGSfilVi,, Srr.l. vciivi: iiuu
vut~~-.._ ~iL _ .~i L ,..,i!.,i._; e.1 ii1 !ilea ~v be e:ii~..Leiuc+J L.1 '-e or :il,. UV ~;i and ui ez+6i pipe YV I!I~ !~I...i'e uVN..d• to
_,s is _raie !cipher,:..
Lightweight, easy tG irisiLadi. Horizontal InsiailatiGn secluded. '.ti 1h aCrms an Gp; of Me valve hub ,'pointing in [he direction
coves cj E r=, a simple, econon,ic l M6&Cdvm i 171 ~ i ~ 1 9$E9 F~t'lG~~li i ~15~Y ~7l CA. i
a h
5 t~ he valve for it ~rkec1Li(,n and I
n.n I Stur~,y rl r he riser 'ay be s, to 7 5 R 3 75 10 756 V,, 10 5,
_i
I W i,s` % 5F'r, 3703 i i-.., i I 706 i WO O ; 16 s
s i
An a A F, P, i 61
'475P H, 475H 4.47 j 17.1E s• i,16 g
.lit
Wii i l
~a +#5 Qn ^,-an.r.W
ly.:
Nofe AN chnw!, o ui ~ nu uiut7l. ~t reyki me 6 > p -j p f - e> G,ny Avuiiul iii e , i-, My-
F i ,
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of
FILE INFORMATION SYSTEM SPECIFICATI S
Owner.
Tank Manufacturer: ~K p NA
Permit # eptic E] Dose El Holding Volume: gal
DESIGN PARAMETERS Tank Manufacturer:
Number of Bedrooms: 3 ❑ NA ❑ Septic ❑ Dose ❑ Holding Volume: gal
Number of Public Facility Units: -Q-NA- Vertical Distance Tank Bottom(s) to Service Pad: 131 11 ft
Estimated (average) Flow : o gal/day Horizontal Distance Tank(s) to Service Pad: ft
Specific servicing mechanics must be provide if vertical is >15 feet or if
Design (peak) Flow = estimated x 1.5: gal/day horizontal is >150 feet. Specific instructions to be provided on back.
In Situ Soil Application Rate: gal/day/ft Effluent Filter Manufacturer: ZOWJ5_~ ❑ NA
Standard Domestic Influent/Effluent Monthly average Effluent Filter Model: - op
Fats, Oil & Grease (FOG) <30 mg/L Pump Manufacturer:
Biochemical Oxygen Demand (BOD5) <_220 mg/L ❑ NA 12444_
Total Suspended Solids (TSS) <150 m /L Pump Model:
High Strength Influent/Effluent Monthly average Pretreatment Unit
Fats, Oil & Grease (FOG) >30 mg/L Manufacturer:
Biochemical Oxygen Demand (BODS) >220 mg/L ❑ NA -ETNA
Total Suspended Solids (TSS) >150 mg/L ❑ Mechanical Aeration ❑ Peat Filter
El Pretreated Effluent Monthly average e Disinfection El Wetland
Y 9 ❑ Sand/Gravel Filter ❑ Other:
Biochemical Oxygen Demand (BOD5) <_30 mg/L Soil Absorption System
Total Suspended Solids (TSS) <30 mg/L ❑ NA
Fecal Coliform (geometric mean) <104cfu/looml n-Ground (gravity) ❑ In-Ground (pressure) ❑ NA
Maximum Effluent Particle Size: in dia. El NA El At-Grade ❑ Mound
❑ Drip-Line ❑ Other:
Other: El NA Other: ❑ NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
Pump out contents of tank(s) en combined sludge and scum equals one-third (16) of tank volume
When the high water alarm is activated
Inspect condition of tank(s) At least once every:
❑ month(s) (Maximum 3 years) ❑ NA
PVP Odbar(s)
Inspect dispersal cell(s) At least once every: p month(s) (Maximum 3 years) El NA
l Qjcear(s) _ a
Clean effluent filter At least once every: , ❑ month(s) O~ ~ lvee~W ❑ NA
year(s)
Inspect pump, pump controls & alarm At least once every: ❑ month(s) ❑ NA
❑ year(s)
Flush laterals and pressure test At least once every: ❑ month(s) A
El year(s)
Other:
At least once every: El month(s)
El year(s) NA
Other:
❑ A
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master
Plumber, Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator (pumper). Tank
inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks,
measure the volume of combined sludge and scum and a check for any back up or ponding of effluent on the ground surface. The
dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent
on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate
notification of the local regulatory authority.
When the combined accumulation of sludge and scum in any treatment tank equals one-third (36) or more of the tank volume, the entire
contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin
Administrative Code.
All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units,
and any servicing at intervals of :A 2 months, shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority within 30 days of completion of any service event. Yq
(Rev. 8/14)
Page of
START UP AND OPERATION
For now construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals
that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents
of the 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.
During power outages pump tanks may fill above normal highwater levels, When power is restored the excess wastewater will be
discharged to. the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of
effluent., To avoid this situation; have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring
power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to
restore normal levels within the pump tank.
Do not drive Gr' pprk vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area
within 15 feet down slope of any'mound or at-grade soil absorption area.
Reduction or, 'elimination of the following from the wastewater stream may improve the performance and prolong the life of the
POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat;
foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil;
painting products; pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is
properly and safely abandoned in compliance with chapter Comm 83. 33, Wisconsin Administrative Code:
• All 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 properly disposed of by a Septage Servicing Operator.
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with
soil, gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS falls and cannot be repaired the following measures have been, or, must be taken, to provide a code compliant
replacement system:
O A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption
system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by
required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will
result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must
comply with the rules in effect at that time.
0 A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS
technology a holding tank may be installed as a last resort to replace the failed POWTS.
Cll-e 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.
O Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the
infiltrative 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 AND/OR INSUFFICIENT OXYGEN. DO NOT
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 -
POWTS INSTALLER POWTS MAINTAINER
Name /U~ Name
Phone Phone
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name le?tz-dr- //I/Z- Name
Phone
~9
ST CROIX COUNTV
SEPTIC ANK MAINTENANCE AGREEMENT
AND
OWt,ERSHIP CER11FICATION DORM
OWll /Buyer --EA: ~
"%Iailing Address /Nety k
Property Address nW-aod
(Verification required hou i Plattn(og Dora cnt for new construction)
City/state Lrzn~ /,c~Dpp C~yiy Parcel Identification Number ~3/ -~(00-d00
LEgA bESCRIPTION
Property I.OGdtI4tl U/ 14, V., 8(c. of 'r ik2o
Subdivision c-6]s~~•. 1_t►t #
Certified Survey Map # Volume Page #
Watt'rzly Deed #
Volume Page #
Spoc houso Q yes no Lot lines identifiable ,K yes ❑ no
SY I RNANCE
Impropause and maintenAmeof your sel pc aywrid could result in its premature failure to handle wastes. Propcr mAixttenance
consists of pumping out the -septic tank every tbrt a years or sooner, it needed by a licensed pumper. What you rut into the cyftom
can affect the function of the saptie tank as a trc,t kmeut stage in the waste disposst ayatern.
The property owner agrm to submit to 3% Croix Zoning Department a cortiftoa.tiuta form, signed by the awacr and by a
nrasterpturnber, jamneymanplumber, resttictedpl unbar or a licetucdpumpar verifying that (1) the on-site wastewaterdisposal system
is in proper operating condition andlor (2) after in:'pection "d pumptrtg (1f tteceasary), the septic tank is lass than 1/3 full of sludge.
Uwe, the, undersigned have read the above requires hents and s greo to maintain the private sewage disposal system with the standards
set forth, herein, as cet by the Deparnnent of Cote oerce oind the Deparunont of Natural Resources, Stito of Wisoousiti. CeOTO-Mien
stating that your soptic syntmt leas been rnaintxinel I must be cotnpleted and returned to the St. Cralx County Zouing Office Wid" 3tl
clays of the three, year expI Iron date.
1~ A 1IJkB of APPLICANT DATE
0
YT? ~ B-IJU, C ILO
I (tee) certify that All statemonts on this ; Irm pure "a to the best of my (our) )atowlcdga. I (wc) ant (are) the owner(s) of
the roperty dawribed bovc, t)yVirt~ue of 1 warm sty deed record,!) tin R.egettcr of Doe6 Office.
1 4A~`IJRE OF A.PPLICA41 ' - DATP
Arly information that is ruis-rrpresentcd rr ey result in the sanitary permit being revoked by the Zoning Dcpartme,it.
Include with this Application, a stamped warr arty deed ftorri tho Register of Deeds gf ice
a copy of the c, rtified survey rntp if reference is made in the wan'atity deed
i
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1319
Wisconsin Department of Commerce SOIL EVALUATION REPORT page 1of 3 - -
Division of Safety and Buildings in accordance with Comm 65, Wis. Adm. Code AC.E. Sal & Site Evaluations
Attach con fete site an on County
p pl paper not less than 8'/: xjtj es in size. Plan must St. Croix
include, but not limited to: vertical and horizon r~f~r, q p 'n , direction and -
a 4i scale or dimensions, north i8 aA4di 1tc~e to nearest road. Parcel I.D.
01~ - ; 231-1066-60-000, ID# 23.30.15.905
Please prim a),!,iip/armaW. ' By ode
Personal information you provide may usej or seco ~(>tlQtGlc~rivacy Lai s` 1 04 (1) (m)). - 2l
Property Uinrner Location
Kenneth J. & Karen Peterson ( r` + Lot NW 1/4 SE 1/4 S 23 T 30 N R 15 W
Property Owner s Mailing Address Block # ___~Subd. Name or CSM#
1545 Hillside Crt. ' courtT r 10 CSM Vol. 11, Pg 3225
City State `ifipttde )Grit City j village J Town Nearest Road
New Richmond WI 5 17 7 -~46 85~''~ Glenwood Ci Walnut Ri a Dr.
i
16 New Construction Use: 01 Residential / Nu of bedrooms 3_ Code derived design flow rate 450 GPD
Replacement ~j Public or commercial - Describe:
Parent material Glacial drift Flood plain elevation, if applicable na
General comments - - - -
and recommendations: Recommend installing trenches using infritrator high ca city cham at 88.50°.
Boring # _~j Boring
Pit Ground Surface elev. 93.41 ft. Depth to limiting factor >98°____-in. Soil p1ica6on Rate j
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots -_GPDlftz____
1 0-6 10yr3/3 none sil 2fsbk ds as 2f,1m 0.5 0.8
i 2 617 10yr5/4 none sil 2fsbk ds cs 2f,1m 0.5 0.8
3 17-29 10yr5/6 none gr sl 2msbk dh gw if 0.5 0.9
4 29-45 10yr4J4 Wane r. si 2msbk dh cw 1 I - 0.5 0.9
~-8`$°S'L~ - _ - - _9 - - I _ -
5 45-98 10yr5/6 none s & Is 0 sg dl - ) - - 0.5 0.9
Horizon #5 eosists of stratified layers of 10yr5/6 0sg s and 10yr5/4 Osg Ifs. Horizon loading rate adjusted to reflect reduced verticle penniab ility of
horizon associated with slight textural variations. H# 3 & 4 contain approx. 35% cobbles and stories.
Boring # _ Boring
jm Pit Ground Surface elev. -92..83--ft- Depth to limiting factor 104'° - in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPWft2_. _
1 0-13 10Yr3/3 - none- A 2fsbk ds as 2f,1m 0.5 0.8
2 13-50 10 r5/4 none sil 2fsbk ds cs 2f,1m 0.5 p.$
3 50-72 10yr5/6 none gr. si 2msbk dh cw if 0.5 0.9
4 72-104 10yr5/6 none s 0 sg dl - - 0.7 1.2
H# 3 - -approximately 100% cobbles and shoves.
" Effluent #1 = BOD ? 30 < 220 mg/L and TSS 30 < 150 mg,1 luen = BODS <30 mg/L and TSS <_.~0 mg/L
CST Name (Pk-ase Print) Sig ure: CST Number
James K. Thompson 3602
Address A.C.E. Soil & Site Evaluations ate Evaluation Conducted Telephone Number
Osceola, w1 54020 10/3/00 715-248-7767
r
Y Pity Owner Kenneth 1. & Karen Peterson Parcel ID # 231-1066-60-000 ID# Page 2of _ 3_-
;J Boring
3 B«;ng # -
Pit Ground Surfaceelev. 91.69 ft. Depth to limiting factor --->-101"- in_ Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots MAI!
C °Ef #1 'Eff#2
1 0-8 10yr3/3 none sil 2fsbk ds j as 2f,lrrt I 0.5 0.8
2 8-21 10yr5/4 none sit 2fsbk ds cs 2f,im 0.5 0.8
3 21-29i 10yr5/6 none gr. sl ! 2msbk dh gw if 0.5 0.9
4- 299-56 10yr4/4 none gr. st 2msbk dh Cw - 0.5 0.9
5 56-101 10yr5/6 none s & is 0 sg dl - - d 0.9
- - - -
Horizon #5 cosists of stratified layers of 10yrS/6 Osg s and 10yr5/4 Osg Ifs. Horizon loading rate adjusted to reflect reduced verticle permiability of
horizon associated with slight textural variations. H# 3 & 4 contain approx. 15% wobbles and sues.
Bonn9 # Boring _
Pit Ground Surface elev. 86.61- ft. Depth to limiting factor _ >100" in. Sal Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots _
*E ,CPDIfl
1 0-12 10yr3/3 none sit 2fsbk ds as 2f,lrn 0.5 0.8 I
j 2 12-34 10yr5/4 none rj 2fsbk ds Cs 2f,im 0.5 0.8
3 34-54 1Oyr5/6 none gr. sl 2msbk dh gw if I 0.5 l 0.9
4 54-80 10yr4/4 none gr. sl 2msbk dh Cw - 0.5 l 0.9 t
5 80-100 10yr5/6 none s & Is 0 sg dl - - 0.5 O9
Y
Horizon #5 cosists of stratified layers of 10yr5/6 Osg s and 10yr5/4 Osg Ifs. Horizon loading rate adjusted to ect Ljd verticle permi~Uility of
horizon associated with slight textural variations. H# 3 & 4 contain approx. 35% Cobbles and
4Z
J
H Boring # -j Boring 431
e Pit Ground Surface elev. 87.95-_-- ft. Depth to limiting factor >97" in. Soil Application Rate
Horton Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots ~sP1Z(ttr__ .
'Eff#1 `Eff#2
1 0-14 10yr3/3 none sil 2fsbk ds as 2 1m 0.5 11 0.8
2 14-29 10yr5/4 none sil 2fsbk ds Cs 2f,1m 0.5 0.8
3 29-42 10yr5/6 - none gr. sl j 2msbk dh Cw if 0.5 0.9
4 42-97 10yr5/6 none s 0 sg dl - 0.7 1.2
H# 3 ountains approximately 2011/o cobbles and stones.
Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD5 -S 30 mg/L and TSS < 30 mg/L
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