HomeMy WebLinkAbout022-1074-10-300
/'30
0V1&. cnsm ~ep::rtmertofCommerx PRIVATE SEWAGE SYSTEM Cou t' St. Croix
5a'cty..,j iim dir;p Diwsion
INSPECTION REPORT ""'itav "efn"t "o
SAT T ACH TO PERMIT) 600395
GENERAL INFORMATION ;i:ac Plan ID NO
Pel oL'la nfprria'.iGn VJn pre'vice ma'y t:e use!11ur seovtcary Purposes ]P•roooy Lav. 4 UA I Iljmj]
Pennn Fo dens NAme :ay VJla;le Trw-shin F arrel Tax Vo.
Todd & Carla Frey TOWN OF KINNICKINNIC 022-1074-10-300
CST 31.'. Flev Insp BM _ICV I!'d ❑es~nr.t an Secti,.n Tumi ;6nge9tap W
CST 26.28.18.4090
TANK INFORMATION ELEVATION DATA
IYPE NIANUFACTURFK i 5 CAPACITY STATION BS HI FS ELEV.
Sep: c b Berchmark
~ t° 200 ' S /0 /0!2~
Dosirg Alt. BM
Ge .v._, 7-:3 97• Z
n r Bldg. Se•.vet 1,q .7
F t t- '7
L !L SUHt Inlet
TANK SETBACK INFORMATION SUHI Outlet
~
TANK TO t P+1I , "JELL BLDG. na<e ROAD Dt Inlet ~
Sept n 5 I ~.3zi 3 Dt Bottom p
Doing J, I HeadedMan. C
I 07., 37
J
Aeration Dlsi. P,pe '57
Holding _ Hot System (,.7 p7• R.l
Grade 0 K~~
PUMPISIPHON INFORMATION Final G 111
Manufactorer Demand St G0:•9r
GOu~ 5 GPP.A ~I 7.3 77-4
Model Numbe• til~4 r 7b ~
IDH ILK: Friction oss System He(a II)) L F
3 to , 7
For-email Lo 11, 1 Daz D.st r, yell
2
SOIL ABSORPTION SYSTEM
BEDITRENCII %V IT Lcnytr Nn Of I wc-es VI I DIMENSIONS Nc 01 Pits Ins tle D a. 19,1e owh
DIMENSIONS 3 /OZ Z fGvl
SETBACK SYSIFN9 IO P1 BLDG WELL LAKFISIHLAM LEACIIING Manutarlurer
INFORMATION CHAMBER OR
(,y ON'~J[w~"O ~5 AtT 1-7 UNIT I,AnC^I a^be'. C
✓S
DISTRIBUTION SYSTEM aJ S it--Z.5 6b
Header'1,'a-du'd~ / :TSrtef, on Itch time xHOte S`pa_nry _ Atl".lake
LcnyR~ Di.; _ Length Uin~ S?acing I
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
or:rt' er I e:;t- c~ xx De9tn o` Seeued'SUdden .K rdtno-ea
Bedrli..n Ce-ter / ~ I •.:Ir lr.-.bi-d9es ~ Infs:iil es No Vc•s Nc
I
COMMENTS: ?Include cede dlsscrer)e rres• - ` eysons pies nit tc.? Inspection V C L lnssp'ection #2.
Location: trt PONDCROS 1 I ` r." e i' Coo JQ'~
I > Alt BIA Descrpt-on = S6dtL...I 5
2.i Bldg sewer length = 75 O JL/.7~ O r ~d I t.. S
- a•rount of cover - 7 'a 6 r
Plan revision Regwred? I Yes x No 00
3I I $ ~pqV 7 ' .I'
Use other side for adds: oral informaDOn _
')ale Insrpalc"S acute Cen No
'tiSU 5'IV iR a~s-1 4
- - -t-~~
(f tzc (Y'
t r Safety arid Buadi 1Bs Divsion
201 W. Washington Ave . °.0. Box 7162 Satritary Pcrmn?Nwnb:r (lo b- fbcd in by Co.
DS
P+ladisan,'t"vI 5S707-71C2 (Q(JllA613-1.5
s t Y p 2 2018 lJ61
L Y~_ - Sutc 7ransar:iu'. Number
'S P mit Appl.
In aoarduxq is +1n. Code, submission of dus f,,=. lc the a, proptia:e govc:wrcntnl unit
!,T different =an maiimg address)
is requced prior in oh.acw • a sa. na.- }a:r.it Note Appp-:ion forms for rat):-oH'ned R')Vi I S arc submitted tc• !'rojeU Address ,
i
the ;)cp: run:]:t of sri cty and l•: ufcss:ona. Scn•tcs. Personal :n4xntsuen you pr. vide may he used for secondary
u: oecs is acct: d:c:z ,vidt thc. Privacy Law, s. 15.04tj -SSw s ( Z L; ~n 05 ✓7
I Application Informatiun Please Print All Information _ -
I Fr~p r vJ-:most sN,nc
_ Propcny Locator. & fS • ticq G
Property V'•,ac: s A.aiiing:.J_i
_23 /?A •e'- A'I'V~ - om Lot
Cih•, Su;le Zip Code phone Numb-: (J C- _-5-(L)'i, Section
cuac "tic
f U Y-/Y'~L l L!/r !Jh _ _ T Z N; 1(
if. Type of Building (check all Clint appal)- l.e(N
Suldivisipn Nan¢
o, 2 Fatniy D,velhng -Suotbcr If SeJrwms
ak a~ aI> is a ('s 4.7
t i pubGc'Commeccial - DesaPne U>c ❑ City of
CS,y 5umhe; n Vil:ag- of
❑ S ale O,vr,::d - Desccibc Use
{tJ
a (~,a~ 2_ 5 z 5 fl
[II. Type o[ Permit (Check only o6e boz on line A. Complete lint I3 if applicable)
A \ew System U R pl e_ceneat System Tj 'frealmenbHoi in£ Tani: Replacement Only ❑ Odta hfod:6caticu to Existing System (explain i
I`-II~ pr.viotLl Permit Number and )ate Issued
Ft- 171 Pcrcui Renewal C Ycnnu R-vistun Change of Ylu:ab-: ❑ pct~it Tani7c: to Nc„
Before F.xpcauo.. (hancr
Il I_dPOW IS tiyslcm ComponentT)as¢e: heck all that apply)
,or.-pressu: i~.ea In imourd (.J I'ra;ur:=J 4. Ground U At-(iradc `•fut:nJ ^.4 u, or r_:mhle .it LJ Mound in of sua.ibie sod"
❑ I1o:din •I aru: U (Ahcr Uispersdl Compo,-,crtl resplain) U i,rarcahneal Device (explain) p ~t
V DispcnabTrc•tt cot Arcaln__furmatrnn: - - /
I i u v , ,',mod llc:en Sul pp.:caCC.: Rate(gprLs :).spr:seJ Area Re,luired sI) 7~ I tispctsal Area Pro wed (sf) Sysletn Ek • 'ion
~ 97,73
LT. Tank info (=apacit}• in Total N of ,llanu.3°tur-r
-F- Gallons Gallons 1:nils
w o U ~ V v °i v
' Nex:"aaks I l:xistiugTmks " ~ n~~,~ ~ I ~ Y ~ m `d
Sc s8rc Iieldu~ Pad: '1 [✓-i
Lis
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N'II Responsibility Statement 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
Plumuet s ante (Pmt) Y.unba s Sitmature 1 tvt?.?APAN \umbe: Business Phone Numbs: 1
~~rc(~, t C -Sr % 7z(vY97 7i5 z73 f~KEK
1% ..h ass (Street, Cry. Suit, Lip @d ; - -
vT _ ount."De artment Use OnFc
Pcrmn Fre Ualc sued) Q Issuin. gent Sift .trc
pprov-d -1~"'a''Pr°•' S LI'85 • 00
U Owttet ilivw Reac2n for Denial
IS. Condi Reasons for Disapproval M OcJ
L sepN: Lark, er lvisrc AID- cn,1
oiapet::,, Celt "LW A be s+,•.tc?s'r,•:.'ntt`. n ,vl~~ C fy~ keCL.6
n per ,nar.3yemen! plan ;r o nden by plu,noe:. ) .lf[LrJ .AX
2. All a~. * rec;ul" •an.s m,xd t ti ,r o.rt, it e i
0 pat tppdcrDh c,Y,: ; :r:1l:.:iv:n _ Attach to cu,aplrtn piatm for the system and submit tc the Coeaty only to paper not Ie+s than 5 1: [ I1 inches iu six
CONVENTIONAL COMPONENT DESIGN
Residential Application
INDEX AND TITLE PAGE
Pro;eca Nara
Owner's Name C/2r(Z(A )L- 2t`
Owner's Address ? /*PJ96- U/C- k)
~lUCn CaCCS Wit/ fee 21
Legal Description. flgJ > 2-4- 2 5'
To-,rship-
County S-f C ivzo r >e
Subdivision Name C- SIt 1
Lot Number
Parcel ID Number O -2 Z lo W16 122>,,r?
Page I Index and title
Page 2 Plot Plan /L ~/~R X02
Page 3 System Sizing & Cross-Section f I f Aluk,
Page 4 Filter Specs 2 Phu
Page 5 Maintenance Information
Page 6 Management Plan
Page 7 St. Croix Cb/ Septic Tank Maintenance Form
Page 8 Warranty Deed
Page 9 ) 9 9 CSv1 or Plat
Attachments. Soil Test & House Plans
Designer: Plumber. ilD~crT ~1C t-icense Number l~`' 29
Date: Phone Number
SlgnatL<e
Desi;rec Pursua•r: to the Ir-Gourd Sci: Absorplien Comccrert N181lual for PMNTS Version 2.0 SBD-10?O6-P ~N.ctrnt,,
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Quick4 Plus Standard Chamber Specifications 1
S;e L F i 3,1T x 63 o crn x 135 cm x 31 cm) E
Irve t Height' 0.6". 53", 8 0', 12.71
(1.5 cm, 8.4 cm, 18.5 cm, 22.6 cm) I
Effccti':e t enntf-i 48" (122 cm)
INF1LTHATOR SYSTEMS INC. STANDAND LIMITED WARRANTY
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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 chemical;
that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contontt
of the tank(s) removed by a soptage servicing operator prior to use.
Syatlsnt 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 toll(s) in one largo deals, overloading the cell(s) and may result In the backup or surface discharge of
affluent, To avoid this situation have the contents of the pump tank removed by a Soptage 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 tc
restore normal levels within the pump tank.
Do not drive or park vehicles over tanks and dispersal tolls. Do not drive or park over, or otherwise disturb or compact, the area
within 15 foot 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; tat;
foundation drain (sump pump) water; fruit and vegetable Feelings; gasoline; grease; herbicides; meat scraps; medications; oil;
painting products; pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS falls 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 to removed and properly disposed of by a Septago 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 fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant
replacement system:
❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption
system. 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 affect at that time.
O 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.
❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site
evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank
may be Installed as a last resort to replace the failed POWTS.
❑ Mound and at-grado soil absorption systems may be recbnstructod 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 0 fr 2 CL501V Name
Phone -715-- Z 7:3 - L,lff Phone
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name So1-t/✓SGN 5'1Ni4i1 +ro ✓ Nama /~R o.ev+~~dnhu• Sf CRDI%//Zv,1✓!
Phone 7/5 -z73--581 Phone /,j-Z 7 7is-386~T~bU
This document was drafted in compliance with chapter Comm 83.22(2)(bll1)(d)&(1) and 83.64(1), (2) & (31, Wisconsin Administrative Code.
POWTS OWNER'S MANUAL & MANAGEMENT PLAN
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner Septic Tank Capacity /Zoo gal ❑NA
Permit # Septic Tank Manufacturer W I rr f L°R ❑ NA
DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA
Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA
Number of Public Facility Unite .4 NA Pump Tank Capacity 1600 al ❑ NA
Estimated flow (average) yr6o al(da Pump Tank Manufacturer aj /ESE R ❑ NA
Design flow (peak), (Estimated x 1.5) Gov elide Pump Manufacturer O u L O O NA
Soil Application Rate al;day/f[z Pump Model PE {y/ ❑ NA
Standard Influent/Effluent Quality Monthly average' Pretreatment Unit ❑ NA
Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravol Filter ❑ Poet Filter
Biochemical Oxygen Demand (BODa) 5220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Welland
Total Suspended Solids (TSS) 5150 mg/L O Disinfection ❑ Other:
Protreated Effluent Quality Monthly average Dispersal Collis) NA
Biochemical Oxygen Demand (SOD,) 530 mg/L ❑ in-Ground (gravity) ❑ In-Ground (pressurized)
Total Suspended Solids (TSS) 530 mg/L ❑ NA ❑ At-Grade ❑ Mound
Fecal Coliforrn (geometric mean) 510` efu/100ml ❑ Drip-Line ❑ Other:
Maximum Effluent Particle Size Y$ in dia. ❑ NA Other: (J NA
Other: ❑ NA Other: D NA
'Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA
MAINTENANCE SCHEDULE
Service Event Servico Frequency
Inspect condition of tankls) At least once every: 3 p ear(s)(s) (Maximum 3 years) O NA
Pump out contents of tank(s) When combined sludge and scum equals one-third (Y) of tank volume ❑ NA
Inspect dispersal cells) At least once every: ® year(s) (s) (Maximum 3 years) ❑ NA
Clean effluent filter At least once every: ® year(s) 0 NA
Inspect pump, pump controls & alarm At least once every: H mooonth(s) ❑ NA
Flush lateral$ and ressure test At least once every: 3 IM oar(s)
Other: At least once every: ❑ month(s) ❑ NA
❑ ear(s)
Other: ❑ NA
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. Tank
inspections must include a visual inspection of the tank(s) to identify any missing or broken hard Ware, identify any cracks or leaks,
measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface.
The dispersal call(s) shall be visually inspected to check the effluent levels in the observation pipes and to chock 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 tank equals one-third (Y3) 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 Coda.
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 512 months, shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority within 10 days of completion of any service event.
GMW (41011
ST. CROIX COUNTY 1
SEPTIC TANK MAlNTr?NANCL .AGRFFMYNT
AND
OWNERSI11P CERTIFICATION liOPNI
Mailing Address 2k~>~,ANgVrf W_ SLg2Z
Property Address__ij t~ b {gip 5 J~ i J
(Vc,11wation renuumi from Planuin f .3. Zoning Department Rrr u w construction.)
CitvlSiatc RjVkR_ /)-115 l>?_t___ _ Parcel Identification Nurnber col b~_`J )D 30U
LEGAL DESCRIPTION
Property Location C , S W Sec. - , T 28 N R I e) W, Town of i~i tN; CV i N 01 C_
Subdivision Plat: Lot # /
Certified Survey N11)) ff 1%oiu! tc ,Page.i
Warrant' Deed ft - (before 2007)Volume Page
Spec house C yesyno Lot lines iden'ifiable L, yes J no
S N .S If M NI A I N;I'EN.AN('E AND OWNER CERTIF'ICAT'ION
Improper use and maintenance of your septic system could result in its premature rtilure to handle wastes. Proper
mainn:uance consists of pumping out the septic. (atilt every tlu;v years or sooner, if needed, by a licensed pumper. What you out into
the aysuem can affect lite function of the septic rack as a treatment stage in the waste disposal system. Owner maintenance
ra:ponsibilides are specified in §SPS. 38.3.52(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
rand by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (I) the on-site
rJ2,stewatcr disposal system is ut proper operating condition andlor (2) after inspection and pumping (if necessary), the septic tank is
ess than 1;3 full of sludge.
Uwe, the undersigned have read the above ruquiremcats and agree to manttain the private sewage disposal system with the
standards set forth, herein, as set by the Department of Safety And Professional Services and the Department of Natural Resources,
nc:: of 'Pi iscovsin. Certification Aali.i,, :hat your, septic system has been mau:tamed must be completed and returned to the St. Croix
enL ray !'I inning- & 7.oting Department within 30 days of the, three year expiration date.
,cc certity that all statements on thi form are true to the hest ofmy/our knowledge. I/we andare t'ne owner(s) of the
upcr :icscrtbed above, by virtue of a war my deed recorded in Register of Deals Office.
Number offjbrrlroorns p
S?( ~A FIIR O APPLICANT(S) DA"I'F
**.Any information that is misrepresented may result in the samuny permit being revoked by the Planning & Zoning Department.
Include with this application a rccoldn'd warranty dcod from the Rrgistcr of lleeds Office and a copy of the certified smwry map if
reference is made in the warranty deed.
( REV. 0412)
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HGOULDS PUMPS Submersible
Effluent Pump
PE
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SPECIFICATIONS MOTOR FEATURES
Pump - General; General: ■ Corrosion resistant
• Discharge: 1'k' NPT • Single phase construction.
• Temperature:104OF (401C) • 60 Hertz ■ Cast iron body.
maximum, continuous when • 115 and 230 volts ■ Thermoplastic impeller and
fully submerged. • Built-in thermal over" pro. cover,
• Solids handing: 1h" teWon veldt autOmatlCreset. ■ Upper sleeve and lower
maximum sphere. • Class B Insulation. heavy duty ball bearing
• Automatic models indude a • 011-filled design. construction.
APPLICATIONS Float switch. • High strength carbon steel N Motor Is permanently
S?edgily designed for the • Manual models available, shaft. lubricated for extended
fdowng uses: • Pumping range: see PE31 Motor. service Ve.
performance chart or curve. • .33 HP, 3000 RPM ■ Powered for continuous
• Mound Systems
• Efflaen0c5ing Systems PE31 Pump: • 115 volts operation.
• low Pressure Pipe Systems • Maximum capacity: 53 GPM • Shaded pole design ■ All ratings are within the
j • Basement Dralning • Maximum head: 25' TDH FE41 Motor working limits of the motor.
■ Quick disconnect power
t. • Heavy rDuty ing Surnp/ PE41 Pump: • .40 HP, 3400 RPM co-rd, 20'stvndard length,
Dewated • Maximum capacity: 61 GPM • 115 and 230 volts gth,
• Maximum head: 29' TDH • PSC design heavy or duty uty volt 16/3 dnv grounding
PE51 Pump: PE51 Motor p115 lug
• Maximum capacity 70 GPM • .50 HP, 3400 RPM ■ Complete unit is heavy duty,
• Maximum head: 37' TDH • 115 and 230 volts portable and compact ry
METERS FEET • PSC design ■ Mechanical seal is carbon,
40 1 .7 _ ceramic, BUNA and stainless
QE51r I I i MOD6Lt: PF31, ~e41, rest steel.
I I I I I.. .5 ■ Stainless steel fasteners.
35 HP.33.40.0
10 EI f I1 Z I f i I' I ! i I GPM
30 P AGENCY LISTINGS
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Wisconsin Department of Safety and Professional Services
Division o` Industry Services
SOIL EVALUATION REPORT Page I of I
in accordance with SPS 383, Nos, Adm. Code
Canty ST CROIX
Attach complete site plan on paper not less than 8 12 x 11 inches in size. Plan must
include, but not limited to vertical and horizontal reference point (BM), direction and Parcel I D. 022 - 1074 - 10 - 300
percent siope. scale or dimensions, north arrow, and location and distance to nearest road.
Please print aN information. Reviewe _ Date
Personal it/ormatlor yW orohde may be usrd fm Mcondary Wrpoxs (PtlvaC) Law, s. 15 04 (1) (n')l
Ropenr Owner Property Location
El
JOSGPII & MATHER HINZ Govt. Lot NE 1l4 SW t, S 26 T 'zx N R Ix E 1 tot) VV
Property Owner s Ma ling Address Lot # Btock # Sutxt. Naml! or CSI.MI
154310111 Avenuc I A,4011
city State Zip Code Phone Number ily Village To'wrn Nearest Road
Star Prdiric. WI 54026 ( ) ~~R 8 Ponders Drive
E NcwCunsbucUal LKe❑ Residential I Number of bedrooms , Nk Code derived design flow rate NK_ GPD
❑ Replacement ❑ Public or commercial - Describe.
Parent material sandy outwash Flood Rain elevation if applicable _ kr~- /~•'rei~~' ' 8
General comments On_sitc to venfy that the site is undisturbed as according to tic original test per request by St. Croix County
and recommendations'
Icvcrything appears to be in original condition.
(2.13 acres) V/
1❑ Boring # Boring
a Pit Gmund sunlaso clev it Depm to limiting lacto(nl.
Sal Ap kp canon Rate
I laizon Depth Dommant Colof Rcdux Dosaipoon 7extrxe Structure Consistence Boundary Roots GPD1ff
in. Mansell Qu. Sz Cont. Color Gr Sz. Sh. 'E"1 'E1f#2
~1I Strong # ❑ Bonng
I 0 Pit Groundsurface elev. R Depm to Ihnitng factor _M . Soil lication Rah:
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD1ff
in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Ef#11 'Eff#2
{
i
Effluen; # 1 - BOD > 30 < 220 mgr. and TSS >30 < 150 mgt. ' Effluent #2 = BOO, 130 mg11- and TSS < 30 mi
CST Name (Please Print) Signs re7 CST Number
224832
MA1tY JU_I IUI''EKI tl Iollister's Soil Tcsting&Disign) %
Address T.t Date Eva alt Conducted Telephone Number
W9x'S 01;0th Avenue. River Falls. W l 54022 12 on. _'01 715-426-1775
13!161
MAY 16 2018
VYlxensln Oeper4rtent of COmineroe. yl_' -"o" `-o"t1S8OIIt •ALl1ATION REPORT Pew
DNMw,or Sektyend0uHd1noj Community Developmen _d.
area o Wis. Adm. Code -
c0 1' ST, cRoIx
Atlach rm,rieM dlo phn on paper not bss Ihan 8 i!2 x 11 Nrhec N elre. PW+musl
edude• but not britod to: vedkal and hodxnnul reference point (11U, direction ono PI I.D.
P D1NC+
paloent slope. ecale or dimension, north arrow, end locellon and Qlstmwo to nearest road.
Plotless pHnf all Information. Reviewed DLnt
P«eaullNO.mN•u you poNe.m•ya•a..ers»w,a•y•vos»lerr+ecY+a+. r. ,e.[s (rt. VeB, % I W I~
Prop"Qwner uYYr.R: Pnowi Loatlon
& AI1?-YN i{wy uk lot n1E v< S' va S 76 2g _N n 16 _640 w
. _ Ld M 01otlc a t3ba. Hama a cssis
Pti'wly Osa+era MaWg Address
110 ' w1,j'Fx-OSI, DQ\V>r r^f~UOInXr LSA1 _
C%, Stela Zip Code Phone NLx"
OCity ❑vase erTaws+ Newest Row
R\U 12. At~yl 'I `~Y02~ (71~ 42S KiA3AJ1GklnlNtC ~NOCY~t7fiA 109-
9New Cones +tlm Uw.P4RedderAel Jlimhaol bedroana.-__M,_. Code derived design Now rate. 4Sa ciPC
❑Replecoman: G Pumocroorra»rclai /DesnNe:
_ n.
Parent material ou.'1 W A Hood min etevatxm a eppoa ~Al.
General nommentc Lo+t3~[tPtaYl'nvS- LJ.A 0,.& R shG 0.-7 and Worrmand"ofts: 3Y•sTEM Lv1=Uf^`C73 91.60' 9e
Boring a ❑ Bodnat
PII (imtad surface etev. n. Depth to Imphg lector 7132 hs SoY Appik:alla+ Rate
iodmn Depth oomlnard Color Hedm Cee *Icn T.t,, StruGurs Cgnslsleroa Bamoery Rook _ r1poff
In munsell Qu. SL Cont. Coon Gr. Si Sh. _ FJAI i 'Et`a2
0.~
0):m cl r, ' CS 0.5 L
I Qll 10 V AIL 51 c
-Z 14-;1 'k 4bx A CS 0=1 -I, z
X3ij 13 IMS C- D.-7 I.Z
y - 1 .~bK__ r CS ! 0,4 0.6
5_ 40 2 I 3 w o' to Eu tint lmsbk f{ 0.2- aj
S Z 1 S 6 j-
s
j BaNga Bark+g
pt Ground cuv4ro aMn•. 1, 19 R DaDOn F+IhtXt,lt,lmar 712_'1 h I Ion PA"
I Cpor R+dox Desaipllin Tied" AlNOheo Conswace Botmdary Rocla GPLIRI
Hcekon Depth Oar+dntnt J 'fadi -ERa2
N, Mw loll Qti Sz CdnL Gr- 3Z Sn.
..tea _ 5+i 3mbbt C4 -
1 t7-T 0.5 O.9
_ - L -
3 23`33 1 - 1461(-- s O.5 0.8
y to 3 - 5 to G y .y 0.1.
5 a fy _ s i m' tip G 5 0.4 _ 0.6
6 0Ye9utwx° S'l 1 _rt<{-t~ o s 0.2 0.3
7 L7-Iz? to as~ - 3 it 0 rnl O.7 1.2_-
EMuenl at - OW > 30 <220 aWL and TSS >30 a 150 mglL Etru t 02 = BOD < 30 nv& anS 0 59LL
CST Name (Phase print 10r+eWro _ CST M
W i e N-
~TE14 27
ate[vaAraoa+Caquctud TeleptonaNarber
Address
\AYN-) 6 RsJEMC FALLS WS ~lozz, 10-1\~0 _ C tl5)42b I~-tS
i
3
Proportyovmar HIAIZ IKVWAITCrM Pored 10V P DWG- pogo 2 of
F31 n scone
ph Grand etxfeos elev. _~.4~_ fl. DapC1 b 1hY1Ng faq[r ~f 30 In. Solt Rafe
Hodson Oapth DoMnard Color _ Redox Dwarpearl Texaxe Smwkrm Coraclalanee ea.ualely Roda OPOW
In. I.Ymeafl Du. St. Cord. Color .3r. Sz. Sh 'M 'Em
0-L p _ z My- Pa 05 0•
Z (*At. z I M!ShK CIS
to c f msbK O `er
3 A Z4
z4-33 le R s ! ms_ cs - p.
a -5$. p 3 - 5~ Im GS L~._ D.
L _ ~3-5-7 7.53114 - SI sb 1 _cS
l 3.)-b`f 7.5 IN - 5 Os r•11 cx"5 0,
64-1-300lo v499(. - S 059 m) O.1 I.71
y DoMO f [ u Pll OrowW svfpce obv. 9L. 17 fl, nWh b limlOYq IsMr 1I IrSoY Rae
I-&rx Depth oomhwd wo, Redox Den Tozbro ShVC&j ConsWence Bcwoery Roots _ OPDM
N. Mtrnael I C!a Sz Cnttlwfplk, Color Or. SL Sh. _ 'PAC1 'Etts2
f 0.1t )0 ' q OZ = f d CS 0. S n,
2 114 > 04agt s knh cS _ 0.4 0,(.
3 35- 0 '~2 s 1 m~byS} _ 5 cs 0.4 0.4)
Ly .+ZY6~ _ 1 sbK r 0.2 0,
S" JoZ•7L Oy2r 4 S .jt._ .-p~ r S 0.'7 1.2
~Z-133 A Y _ s r`tl O.'t t,L
at
VV,
Boring YrnJ7 Boring
tlY Pit umurd surleta ew, (17 0. "M b Ilmlkp factor ) 3 3 - N.
301 ~ Rata
}fodzal Depth 00minantColor Racbx Descdpoon Texture SWdure Consistence Bourgary Reols D((f_
in. _ Mvroe'l/ Qu. Sz Conl, Caior pr. St. Sh. 'EMO1 'E W2
1 0-S( In Vx, ~J2 SI ~ Sm b ..p~{7 CS _ `6
0 _/Z Cy 0.44 O.L
J O.4 O,f~
4 32-~ t4l l0 'a - ( "'d F^ -S
~ 54 -W IQ v r~ -1 e ~ t• re s f sb (r 0.2
s - s - o. 1.2
el . QQ
pMUenl N7 •600, >30 4 220 mlyL and TV >3~7i0 - EMUeM $2 = HOC),:! 20 m01L end 733 < 30 mg/L
The Deper'menl of Commerce is an equal oppodanity service provider and employer. If you need assistance 10 access set vices or
need material in an alternate romul, please contact the department at 608.266-3151 or TTY 608-264-8777.
wo-alr0.aat '
,w
PLOf PLAN
M Utz, FN ETH ~tINZ yd ' -
F t 6w
T74~s i-C uQU 74L°~ rK° v-p r
Ruj i _ Y.M~9IQK YL-
j-9U QiAW TQWOF KtLNJ
TCR 1 4-1EC
-soit DOla% wi aaax)e
W) COMM 85 %TDPCK PRo1 em5
/I xp(W
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f~ErD
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~ ~81 ~6?• w
bt-97.09' 9w?, p
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W scoriae Department of Safety and professional Sewk. c
Division of Industry Services
SOIL EVALUATION REPORT paq r,r
to acCorcanx mth SP5 335, Wls. Affair ;oCe
Cocnry ST. CRUX
Attach complete situ plan on paper not loss than n l12 x 11 in~tles in sire Plan most
include. but not lim led to vericAl and horizontal reference: pant (BM), d-reohnn Hart Parent 1.0 - 022 - 10'74 - i (1 tut)
percxmt scope, scale Air dimenvons, north anew, and lor:atiai and du,:lnCe to nonrest road.
Please print all inforrrlation. Reviewed by Date
Po zonal inrP-iotgn you pmv1~C na; tin .trend for scrnndery putpc6ps !P ivacY 1 0, : 15.04 (1; (rip.
Property owner Property LocaLOn
TODD W. & CARLA L_ FRFN Gaul Lot NE 1:4 SW v4 S -16 T 28 N R 18 E ( l WW
Property Of%ner's Mailing Address Lot a Block At Soon Name or CSMa
128 Ponderosa Drivc 1 V Id, p 401 I
Uy Stare Zip Codc Phorie Numtxa ❑cry []Village • Town Nearest Road
Itiver Falls. WI 1 5401' I { ) Ponderosa Driec
New Construction UseQ Resdential I Number of bedrooms _4 Cede denwd design flow rate 600 GPD
❑ Replaco:mnt Public of oonvnc:cial - Describe:
Paten! material sandy ouhrasll _ Flood Plain elevation it applLcalge It.
Crrnemt cnmmer.!s Convennonal In-ground trenches - 0 6loading rate pumping required.
and recommendations:
Addiltonal pit ctuidu ictl to emend system area out of huu.vc condnlction. Addition borings added.
SYSTFM F.1 FVA I6N 97.73 FT_ USINO NEW MI and,UK& HS.
6❑ Boring At ❑ Boring
P,t Gtourd sudacc::li:v 99911 IL Depti ii I nI lacor 66 If. Sod Application Rate
Horizon Depth Dominant Color RMax tksrrpkxl Texture Stn:mute Caos'stence Boundary Roots GPUdP
in. Munsell Uu. Sz. Cunt. Color Gr. Sz. Sh. _ 1EII41 'EIrk2
1 0-20 111Y'R7.+' sl 2f-insbk ds cs 3vd-co 0.6 1.0
2 20-411 IOY'R.1r'3 - Is Usg' dl gs 2vp-m 0.7 1.6
3 40-52 10TR3i6 s] Ifsbk & cs Nf=m 0.4 O.i
4 52-66 101'RSHi , Os All
s 1vI'f O.7 16
5 66-78 _ 10YR5i6 Ct?svurr; fs Osg ml 0.5 10 USA
r
7 Bonrgff ~ Hering
pit Ground surface elev. 1. DoptA to !im,tinq factor- m
- Soil licmon Rate
Horizon Depth Dominant Color Recox Description Texture Structure Cnnsistencc Boundary Roots GPDA"
in. Munsell Go Sz. Cmt Coles Gr. Sz. SC. 1EMAI 'Eft#2
1 0-22 MYR12 21-mcbk r11%h 0.6 LII
22-10 10YRV4 I II'nishk mfr - 0_4 l1.7
10-0 g dl _ 0.7 L6
I0Y11316 s IN
1
97 7,?
1 I
' G111ucn: 41 = ODD, > 30 220 tr AIL and 11155>:YJ < 159 mgL ' Effluent t/2 - BOD, < 30 rng^_ and TSS < 30 n'g,'L
r c T Name if"~-ase Print) smy."lun, CST Number
_
ILMARY JO HUPPERT Hollisters Soil Testing Desi n 45L 224812
1d~ress - 'e EzaLati ( ixfuctc Telephone Number
_n Vine \Rh1it`& 'pNR_ Vair~Iao%, \VI 54&311 66 - 06 & 09 - 21).201x 7I5-4?6-1775.
Pnloerty (3wner I RF) 1'u:41 .A Caii't Panel ID J• Ih? _ III +1 - Ill- ;(IO
Boring H Barmy
I-- -
❑ Pit Gramd surfaces elev. _ _ Il. DepCn to I;mting tacnr m. Soil , ,cation Rate
Han!nn Depth Dorwn nl Color Redox Dri rcnpim Texture Structure Consistence Boundary Roots GPD_tf_P _
to fvfunsell Du. Sz. Cont. C,-Aor Gr, Sz Sh. 'EfiHt 'E It #2
1 0 20 IOYR2,'2 sil 3f'shk mv0' - 0.6 0.8
2 20-28 IOYR 1.2 - 1 21=mxbk ds - - 0.6 0.8
3 'Q-SII 10YRV4 11=mshk dMi
v 50-61 1OYR3.'6 O,`, d 0.7 1.6
I
IA n Boring # ❑ Wong
Pit Grow! surface e-luv_ IL uupur to nrmuiq factor in _ 5ui1 Ii<:a[icn Rate
".17.0e Depth Dominant Color Rcdox Descnpl.on Texture Stvciure Consistence Boundary Roots GPD tr
in. Munscll Cie. Se. Qml. Color Gr. Sz. Sh 'Eff41 'Efftr2
Eloring
I,il Gnn:nn surface elev. ft. Depth to limiting factor m.
C-n~in4 lr _
_ Soil A .:cation Rate
l loncai Depth Douunant CoLx Redox Description Texture S:ructurc Consistence Boundary Roubs GPD'YT
In. MIAnsell Cu. Sz. Cool. Coto: Gr. St. Sh. 'Eff#l 'Eff#2
Lliluer:t?' =507., 90< nOr y,La-id t _ '1>aql- P'fn - 0 UD 'nqA. n,
+