HomeMy WebLinkAbout038-1072-95-000
PRIVATE SEWAGE SYSTEM St. Croix
:3 'uc
INSPECTION REPORT bat Formnr:n d~/b
GENERAL INFORMATION !AT n ` p PERM T e'Ian C lac . 1 A
"'n -
'•ermal for r::ao+ „F">':,ne n' t .rtr lu' •.eem Nav V. c-se ac} _nf 1. Pt IJA
IFe'°r'. HUJCfS Nnm• , * '1'i J,4e :iayne,~,r 'a'cs. ar Nu.
5ald n R.; f"e TOVe'N OF d - 16'7 - `.f- 600)
9B. E,ee: _ 81.! uov 2Ar De::cnvb~r;. a ,,on I wm:Ranovlan o
TANK INFORMATION ELEVATION DATA
7Yr'- MANl1F+c-T.lRE-:' ^ A^I'r' IJN H
? _ 1n L 1 w~-tt_ `'r~ Fce crnal. 1,79 l D /d6
a a
e.ratior, 3:c~ 5e:w:l ~ I I -7. 1
161.9 3
TANK SETBACK INFORMATION
'G1P~M.. -:':i ev-__ E,~r%e: e.' W- to KC R.1+'•.G JI .nIUI
5a - 57 7,9 c 3pttUl➢
I i
1
1=.ra 'iJlaoc
PUM?;SIPHON INFORMATION
'Iv,^.il N.1, 64
/ O• co
SOIL ABSORPTION SYSTEM
RF.XrRENUH Al".t' -17 DILIc NSIONS N. :i rce m~:oe fi,e _mwG Leow
DIMENSIONS it a , ~ ~
SETBA.^.N ' =l,'7- T L! HL%'.I. LAMIIFR 5 IAa-an:::we:
INFOi(MhTION ::HANKER OF
UNI' t.lwc No-nmr `
'v 4%=t • 7A6 -7 aVf4
DISTRIBUTION SYSTEM,
SOIL COVER r ^mssure Systems Only *1 w,r. O• t-G:ade Systems Only
ILan'n - :oe '-m r. wE~cc^v'fiaxec Ixo V: vmc
Ir,mi"~-n^.. i.e':t•~ HcC •Tron^t Eamr. _ _ i _
COMMENTS: nr.:wtle a.Ue J::crepR-in % parsons a'eser;. =iz Inspec9r, x' Irsp c•.i on e2
/l~t~ LeaJ~
Lowfior.:
41' SV C:gscri::3 a-: = W l 5t.'f C•~,
elac sewer len~tl = ~'Ni P J L I
a:rosin of : ove.' = Jl dI I- .,~-./I {I►/)
u!11-l- • SIOe T1 V - _ -
U c . i( .i]:rl,ai 1 CI1711I
?C G" 1S iPL_ _
• - •AN -calk- ai3
/ - Safety and Buildings Division St. Croix
Jy Y 1$ 201 W. Washington Ave.. P.O- Box 7162 Sannarc Pernnt Numhcr Ito be tined in by Co I
SpE'1 II.~L 27 20 MadisonWI 53707-7162
--Sani~an erfnitApplicat State,rnnsac,nnNon,her
In a, cor;t:mcc loth WS i\ I.' 1,,'1, U'u Adw C ode, submiss,on of Ihfz Ilnnl to the appmpnnle gar ernmenl it um1
i~ µYlun cJ n... to obtmning a ,ar,101 penm,. Note :\pphcmun blrm> Inr tole-owtted 11 )N'IS are shhmoted to Ptoiect Ad, rc.v 1.1 Adlhwnl than mailing address)
1h, IN ,I „(Sxtnly and pudi..ion:d Sr,tm's Parm:,l inh,t malion .ou p,oo iJe nu,y 1*• ,nod Ib. seeaudw,
pal,,,, vi e. o..: Jan:c a)th the 14ieus I,, s 1 tG/ I Nml. Stars
1. \ 1 licatinn Infnrmatinn - Plensc l' I In formation 2149 90th St
I'ngs', t. Ili. nc,->\:ono / I'ar<CIA
Richard and Marie Saltness 038-1072-95-000
1'mpan 1. honer', Mailing :Nddms, ptolva, lovaoon
2149 90th Street 6,,c1 1„t
ll N state 711.1 'nlc Phone Nu..iII NW Sb1L'.'.. Sect on -17
1 code one I
Somerset Wt. 54025 1 31 N, R 18 a nr Nv
11.'1 jpe of Building (check all that appl) ) i n J - -
❑ I or 2 1 miK U,ccllmg Number of 111 3 Suhdomon Name
+ nlock U
44IL
❑ publcCommIksn the lle
I) Stale Owncd Dcs ,dwl .c / O e - f'Sb1 Nu hr F1 Village nl
n V/6
(x linon of Star Prairie
111. Type of Permit: ((heck only one box on line It. ( loll, line it itw4liu-b c
n Nest tit stou ❑ Rcpkm.n,cnl Farm arm n' 111 11: 11 1 :n4. 1 •Lmancnl Ooh ❑ Ulher lbdtlleanae. it, Ilwslmg S\\ICm Iexplam)
it. I s1 he, on, Pout Number and Date !,,awd
El Permit R.... aI ❑ III Ke.,ston ❑ 1. hence of 17 .n;h.:r ❑ 1 ~mn1 )Pander to New
Ucf n I: xpiralion Owncr
IV. Type of PON" 1'S SyMemlComplmentlDes ice: (('.heck all that apply)
19 Nn:: Prc,,w,,cJ In-6rounJ n P,,-u:vi.! In-(t ..mna ❑ 1,-firma.: ❑ Mow,d 24 in of.wuable -°,i1 ❑ \gowtd 24 ,n. of unable snit
❑ IIo1Jmg I'w,k lnha D:fpy::nf l1 !ap.•.... I.xplmnl - ❑ P,.uemmem 1) ..cc (cxplaml
Dis rca Ufreatment Area Information:
I) .,gn l los' fgPd Iks,u, S, l :Np; lu.,.nm Ratcfjtl'I D,,I, a A,e. Rcywrcd I) Onpersal Area Propscd l.(1 St in I te, lu.n
450 E t _ 7
1. lank Info ap,env a, 1o1:d t f
Manu( clwa - - -
I{:dlom Gallon. Unit.
-N~•» fmd, ~ baswu•:a,ns Poly Lok ✓ ~ V ~ s ~ ~ '
-~~acn,IlelaNh•l`°m 1000 10000 1 Infiltrator 1060 X
:!oun¢ t hanh r
\ 1I. Itl'spnnYlb•lhy' Statement- I, the anderxMd me rdolu"r 14rinn of the F't\N"1'S shorn on the atlncheJ plun>
I lumher', Name 114mt) Stgn: e - - - Mi' MI'RS Number l suxss Pt w Nw)bcr
KPBh Knidtcpn 648443 T 651-470-1737
Plumbs,', Adbc,, SUCet,(i:..
927 150th Street Roberts VU. 54023
\'Ill. ('.unt%(De artnlcnt Ikc Onl\' -
:\p.rv 11 pamul Fa ILae. ssi f.., gcnl Siunat - - _
ZLM]
4c :r. 1111k,-'n
1\.(bndil ,r• . 6RIeR I~I rfllisapproval
uisperet,t cell must ell be s°o:k:rs I to+ 0-t_TOc
as per marafremen! Flsn pro rioe~ by plnmDef.
2. N new* rit Laiv'1em III ue ma.nt: it u4
tr per INkinillis rr)r. I :rAilerlsr.
\Ilo<h w.-ngdvla plan. liar the ..Inn anJ whmil it, the (uunh nJr n papar nut Ies, than N I1 0 11 inches in .or
Sill) 6±98 (It. I I i I I I
,e3 of 3
Anpruc 825ft to thesx
FM2149
90th Street Garage o ao ,o
I m` (real
beb - b R
Site Plan
A BM= Nail w/Pink Rbbon in Base of 14" UBB Elm Tree For Richard and Marie Saltness
HRP-Save Lot 3 Csm 4/1016 NWI/4 - SWI/4
AS9U-N e,D UKV.= lull.ae' Iq 17 :3 111-818`sY
Town of Star Prairie - SL Croix Couety
Baaflioe Pit
eLThmeBedrwm ~ox. 380ft to EastP/L
West Lot Line
from Home > 550_A t
\7
\`~I
13.96Ar eParcei
Eaating &aJSepfrr Tam.E~/
to be Replaced ,V , J Gj Y ,2 L j;-t•, A
f - /e-ben %arr0'
1 R r4 i
Note &&O-ngDraia F&ld dry
Nmw" Pares at hoM m ofwew pipe ma no
A., ojrpmding or mfow a,,yww
Wooded Slope 10%
1y
~ EdTURg DF. VeW
101.44• o
/ B rl
~BM
OA q Wooded sloe /
/tee is an Open Law
1oo.oa
F,kvatiom Data 9900'
B# 1 - 99.00' Wooded SZope
13#2 = 102.W 98-00 a KNUOTSON PLU91L:AiJ
B#3 - 97.80' 97.00, CONTRACTING,, LLB
B#4 - 9930' 927 t SOTH S7- 6-;9441,, PRs
S. E. 98.76' ,t03CR o-W 540 >BS26
cr s,~ 70-1
Manhole Cover = 102.98' Tested Area to P/L
Approx. 75R dpP l_r~ Line
jI
CONVENTIONAL COMPONENT DESIGN
Residential Application
INDEX AND MILE PAGE
Project Name Saltness tank -
Owners Name. Richard and Marie Saltness
Owner's Address: 2149 90th St
Somerset W i. 54025
Legal Description: NW1l4,SW04,SI7,T31NAI8W
Township Star Prairie
County. St. Croix
Subdivision Name:
Lot Number. 3
Parcel ID Number: 038-1072-95-000
Page 1 Index and title_
Page 2 Plot Plan
Page 3 System Sizing & Cross-Section
Page 4 A Filter Specs
Page 5 Maintenance Information
Page 6 Management Plan
Page 7 St. Croix Cty Septic Tank Maintenance Form
Page 8 Warranty Deed
Page 9 CSM or Plat
Attachments: Soil Test & House Plans
Designer/Plumber: Keith Knudtson License Number. 648443
Date.: 07/202018 Phone Number (651) 470-1737
Signatu J
_
Designed pursuant to the In-Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P (N,01/01).
Page 1
ge3of3
4
Approx 82sft to are St
PN#2149
90th SbIset Garage o m w
at.rs~, asr 0%.Q
1 rer - .o n
Site Plan
A RM= Nail w'/Pink Rbben is Bose of 14^ D811 Elm Tree Nor. Richard and Marie Sakmesa
* HRl-Same Lot3Csm4n016NW1/4-Swim
A&WM n gW. - taro w, Sec. 17 731N-RISW
Baomoe Pit Town of Star Prairie - St. Croix Connly
7YJrwBedroom Apprtac 380ft to Hart P/C
- - WE Home
WeuLor lure
from home > 550ft Wa1kQa
\7
13.96AcmPWmd EwliagS7orJSgWc ra #
A2 bex~raaa ~V 17/17 2n-fj Z-tv
® /OIcL) jcsdtY
IB .4
I Abre- Edwi gDrain FWd Ay
Norway Puree at bamom of wort pipe with no
Sits ofpm&w a►AOfmz Aschoge
woo" Slope
HahkrrgD.F. Vent
101.44• o J
/ B 41
1B az / ~BM
Wooded Slope
it an Opar Lane
.We
100.00'
Elevation Data 99 00'
B# I = 99.w Wooded
0#2 = 102-00' 98.001 1 3 Slope
KNUOTSON PLUI 10:, G
B#3=97.80' 97p01 CONTRACTING, LL--
11#4 -993V 927150TH ST. 646447MPFS
S.E. = 98.76' ROBERTS, WI 5-023-8-26
TeamdAreatoP/L c BLS 14ro-1;37
Manhole Cover - 102.98 _
Appmz 7S ft Appraz PropesryLUre JGy. S? -~ee
Infiltrator IM Series Septic Tank -1060 Gallon Capacity
A revolutionary improvement in plastic septic tank
design, the injection molded IM-1060 offers exceptional
long-term strength and is compatible with Infiltrator's
line of custom fit risers and heavy duty lids.
Septic Tank Effective Volume: 1094 gal
Total Storage Volume: 1287 gal
Size: 127"L x 62.2"W x 54.7"H
Two access ports: 24"
• Triple wall provides a thick composite wall structure that acts like a structural I-beam.
• Bulkheads offer superior structural stability under heavy loads
• Reinforced access ports do not distort upon backfilling or during pump-outs
• Can be pumped dry during pump-outs (no need to refill with water)
• Resistant to flotation in high water table conditions
• Can be installed with 6 to 48 inches of cover
• Available as single or dual compartment tanks
• Suitable for use as septic and pump tanks
• Flat bottom allow for easy storage and installation
• ~~0~ Filters
PL-525 EFFLUENT FILTER
525 Filter is rated for
4T. '1000 GPD (gallons per day) 1/16° Filtration Slots
^y it one of the largest filters
class. It has
a . 525 linear feet
" '6" filtration slots. Like the A.DWUFVC
_c . ok PL-122, the Polylok E, Hmde
=25 has an automatic shut
a _ail installed with every filter.
~e~ the filter is removed for
-=_ening, the ball will float up and
-porarily shut off the system so
effluent won't leave the tank.
S1S EY OIN6'
= other filter on the market can Fftu wormsei:
<a that claim. „ioooo r~ro
1
SI.HD. u . qx
e ate efficiently Filter should ®
_ _arate efficiently for several years -
--der normal conditions before
equiring cleaning. It is recom-
-ended that the filter be cleaned
eery time the tank is pumped or
!east every three years. If the
-stalled filter contains an optional
n_~arm, the owner will be notified
by an alarm when the filter needs
servicing. Servicing should be
done by a certified septic tank 0
camper or installer.
1. Locate the outlet of the U.S. Patent Nav 6,015,488 .--o eA"u°"'Ewn.,,~;"
septic tank s.871,E;40 RVWWa
.
2. Remove tank cover and pump
tank if necessary. 3. Glue the filter housing to
3. Do not use plumbing when the 4" or 6" outlet pipe. If
filter is removed. Ideal for residential and com- the filter is not centered
4. Pull PL-525 out of the housing. mercial waste flows up to under the access opening
10,000 Gallons Per Day (GPD). use a Polylok Extend &
5. Hose off filter over the septic Lok or piece of pipe to
tank. Make sure all solids fall 1. Locate the outlet of the center filter. See page
back into septic tank. septic tank. 19-21 for Extend & Lok
6. Insert the filter cartridge back 2. Remove the tank cover and information.
into the housing making sure pump tank if necessary. 4. Insert the PL-525 filter
the filter is properly aligned into its housing.
and completely inserted. 5. Replace and secure the
7. Replace septic tank cover. septic tank cover.
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of '2-
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner RichardSaltness Septic Tank Capacity 1060 gal U NA
Perma A Septic Tank Manufacturer Infiltrator 0 NA
DESIGN PARAMETERS Effluent Filter Manufacturer Poly Lok U NA
Number of Bedrooms 3 0 NA Effluent Filter Model 525 0 NA
Number of Public Facilry Units 0 NA Pump Tank Capacity gal 0 NA
Estimated flow (average) 300 al/day Pump rank Manufacturer U NA
Design flow Ipeak), (Estimated x 1.5) 450 gal/day Pump Manufacturer 0 NA
Soil Application Rate gailday/ft' Pump Model - 0 NA
Standard Influent/Effluent Quality Monthly average` Pretreatment Unit 0 NA
Fats, Oil & Grease (FOG) 530 mg!L 0 SandiGravel Filter 0 Peat Filter
Biochemical Oxygen Demand (BOOM 5220 mg/L n NA 0 Mechanical Aaration 0 Wetland
Total Suspended Solids (TSS) 5150 mg!L U Disinfection 0 Other:
Pretreated Effluent Ouality Monthly average Dispersal Cell(s) 0 NA
Biochemical Oxygen Demand (BOD,l 530 mg/L 0 In-Ground (gravity) 0 In-Ground (pressurized)
Total Suspended Solids (TSSI 530 mg/L 0 NA 0 At Grade 0 Mound
Fecal Coliform Igoomotric mean) 510` cfu/1 OOmI 0 Drip-Line 0 Other: _
Maximum Effluent Particle Size a in dia. 0 NA Other: _ 0 NA
Other: U NA Other: U NA
*Valum typical for dumrstic wastewater and septic tank effluent. Other' 0 NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
ls) (Maximum 3 years) 0 NA
Inspect condition of tank(s) At least once every: 0 mePearrls)
0
Pump out contents of tank(s) T When combined sludge and scum equals one-third (1) of tank volume 0 NA
0 month(s)
Inspect dispersal cell(s) At least once every: ❑ ycarisi (Maximum 3 years) L7 NA
Clean effluent fitter At least once every: U month(s) 0 NA
_U yarls)
Inspect pump, Dump controls & alarm At least once every: 0 month(s) 0 NA
0 year(s)
Flush laterals and pressure test At least once every: 0 month(s) 0 NA
0 yoarls)
Other: At least once every: 0 month(s) 0 NA
0 year(s)
Other' U 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 taekls) to identify any missing or broken hardware, identify any cracks or leaks,
measure the volume of combined sludge and scum and to check for any back up or pending of effluent on the ground surface.
The dispersal cellist shall be visually inspected to check the effluent levels in the observation pipes and to check for any pending
of effluent on the ground surface. The pending 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 (Y,) 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 <02 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.
Pane Z of v
START UP AND OPERATION
For new construction, prior to use of rite POWTS check treatment tanklsi for the presence of painting products or other chemicals
that may impede the treatment process and/or damage the dispersal celllsl. If high concentrations are detected have the contents
of the tank(s) removed by a soplage servicing operator prior to (Ise.
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 cellls) in one large dose, overloading the cellis) and may result in the backup or surface discharge of
oifeent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior 10 restoring
power to the effluent pump or contact a Plurnber or POWTS Maintainer to assist in manually operating the pump controls to
restore normal levels within the pump tank.
Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area
withir: 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
POV%TS: antibiotics; baby wipes; cigarette but-,s; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat;
foundation drain (surnp pump) water; fruit and vegetable peelings; gasoline; grease; herbicides: meat scraps; medications; oil;
painting products; pesticides; sanitary napkins; tampons; and water softoner 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
pi uperly and safely abandoned in compliance with chapter Comm, 63.33, Wisconsin Administrative Code:
• All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
• -he 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 fails and cannot be repaired rho 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. -hc 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 protact 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.
❑ A sunaole replacement area is nut available due to setback andior soil limitations. Barring advances in POWTS
technology a holding tank may be installed as a last resort to replace the tailed POWTS.
Upon talwFe of the e
f pJ1 Tt
N/r uluat iu a no rng (ank
beI a are t s. ~RDNIHIT~ ~a~ Corvs77zfle ato
U Mound and at-grade soil absorption systems may be reconstructed in place foiluwing removal of the biomat at the
infiltrative surface. Reconstructions of such systems roost 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
KNUDI Sub,!
POWTS INSTALLER CONTRACT POWTS MAINTAINER
Name 927150TH ST, r, Name
Phone CEL, i'. r'4- Phone
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY _
Name / Name 20/J lA
Phone Phone -7/ - 3F>'fo- ~~O C)
This document was drafted in compliance with chapter Comm 83.22(2)(6)1? )(dl&(f; and 83.5401. (21 & ;31. Wisconsin Administrative ::nda.
ST. CROIX COUNTN'
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OXVNERSI III' CER"I'IFICATION FORM
viler/litl,ct Richard and Marie Saltness
Vailint,, Address 2149 90th Street
Properly Addiess Same
(Verification required from Planning R Zoning Department for new construction.)
citx/State Somerset Wi. Pared Identification Number 038-1072-95-000
L,r(=AL DESCRIPTION
Property Location NW ' SW a . Sec. 17 31 N R 18- W, Town of Star Prairie
L3
Subdivision Plat: Lot»
Certified Surcev Map # Volume Pao u
Warranty Deed # (before 2007)Volumc Page #
Spec house❑yeslZbo I. of lines ident i fiahle p yes❑no
:iYSI ENI 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 (vn file septic tank every three years of- sooner, if needed, by a licensed Pamper, What you put fill,,
;),tent can affect the funcion of the septic tank as a treatment stage in the waste disposal system. Owner maintenance
rr;pon;ibilities are specified in $SPS. 31 .S_(I) and in Chapter 12 - St. Croix ('ounty Sanitary Ordinance.
'I ke property owner a_~rees to submit to Si. Croix County Planning & Toning Department a certification form, signed by the
o v,ncr and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifvi rig that (1) tale on-site
oastewater disposal system is in proper oper!aw. condition andlor t2) after inspection and pumping (if necessary), the septic tank is
i cs e iham P, full of sludge.
li we. the undersigned have read the above requirements and agree to maintain the private sewage disposal system with tile
standards set forth. herein, as set by the Department of'Sad'cty And Professional Services and the Department of Natural Resources.
State of Wisconsin. Certification slating that your scp:ic system has been maintained must be completed and returned to !hc Si. (huz
ounty Planting & Toning, Department within 30 days of the three vear expiration date.
Uwe certify that all statements this lbrrn are true to the best Of nt_.dour knowlcd_~c. I!we am are the ow•negs) of the
property described above, by virtue of a warranty deed recorded in Register of Deeds Office.
:umber of bedrooms 3
SIGNA I URF Ol APPIX- 1N'I'(S) DATE
'Any information that is misrepresented may result in the sanitary permit heing 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 it'
;eierence is made in the warranty deed.
(RE',. 04) 12)
-.I
wisoonsim )epar w4 of sa(My.gri{1N"al Services
Division'of171dustryServices t, ~vs #3342
SOIL EVALUATION REPORT Page 1 of 3
in accordance with SPS 385. Wis. Adm. Code Keith Stoner CST
1 County
Attach complete site Pilo on rWt less than 8%: x 11 inches in size. Plan must St- Croix
include. bul'nel fmifmdto_ d horizontal reference point (BM) dueclion and
percent idp~-`_sCaln~r-dimensions, north arrow. and location and distance to nearest road Parcel in
_ 038 1 72-9 000
Please print all information. Revie By Date
Personal mformawn you provde may, be used for secondary purposes (Pnvaey I aw, s 15 dA (1) ;m;p 1' /
Property Owner Property Location ~~u i. J
Richard & Marie Saltness Govt. Lot N V4, 114, S17. 131N, R181h7
Property Owners Mailing Address Lot # Block # Subd Name r CSM#
2149 90th Street 3 CSM 411016
City State Zip Code Phone Number City Village Town Nearest Road
Somerset 54025 Star Prairie Same
New Construction Use Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD
Replacement Pulak or commercial Describe
Parent material Sandy Outwash Flood plain elevation if applicable NA ft.
General comments Propose two 3 x 78' dispersal cells using a 6 SAR, Locate the upslope cell over the 99.00 cwnt x vrifli e SE - 98 XO Cercr
and recommendations: lower cell over the 98.00' eonlour with a SE - 95.00.
Boring
1 Boring #
Pit Ground surface elev. 99.00 M Depth to hmlhng factor >90 in Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlft-
in Munsell Ou. Sz. Cont. Color Gr Sz Sh 'Fftmt •F"
0-11 7.SYR3/2+3/4 Hllsystanld Is lfgr rnvfr cs 3f-co 0.7 1.6
2 11-14 7.5YR3/3 Buried A Is Ifgr rnvfr cs 2f-co 0.7 1.6
3 14-32 7.5YR4/4 Is Osg ml qs 2f-m 0.7 I 1.6
4 32-90 . 7.5YR5/4 - s Osg ml 2f-m 0.7 I 1.6
i '
~ I
Boring # Boring
Pit Ground surface elev 102.00 H Depth to limiting factor >120 in ;Soil Application Rate
Horzon Depth Dominant Color Redox Description Texture Structure Consistency' Boundary Roots _ GPD/ft'
in. Munsell Du S7. Cont Color Gr. Sz- Sh. 'I rcat Tfr«?
1 0-4 7.5YR3/2 - Is lfqr mvfr cs 3f-co 0.7 1.6
I
2 4-8 7.5YR4/3 - Is lfgr rnvfr cs 3f-co 0.7 1.6
i
3 8-34 7.5YR4/4 - Is Osg ml gs 21' cc 0.7 1.6
4 34-120 7.5YR4/4+5/4 - 5 Osg ml 2f-m 0.7 1.6
Effluent #1 = BODS> 30 < 22 mg7L and TSS >30 < 150 g7L • Effluent 02 = 8005 < 30 nV& and TSS < 30 mgA.
CST Name (Please Print) Signature: - CST Number
Keith Stoner 224059
4ddress Keith Stoner CST -)ate Evaluation Conducted Telephone Number
23220 Wood Creek Rd Siren,'ddi 54872 7113/2018 715-566 0900
cmI -c'Irib r,, ,
Property Owner Richard & Mane Sakness Parcel ID # 038-1072-95-000 Page 2 of 3
~~3 ] Boring# Boring
1 - I Pit Ground surface elev. 97.80 _ If Depth to limiting factor >84 in -
~Soil Application Rate.
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfft'
in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh 'E"I •Efl#2
1 0-5 7.5YR3/3 Is lfgr mvfr CS 3f co 0.7 1.6
2 . 5-9 75YR4/3 Is lfgr mvfr i CS 2f-co 0.7 1.6
3 9-28 7.5YR4/4 Is Osg ml gs if co ! 0.7 1.6
1
q 28-84 7.5YR4/4 - s Osg ml - If-M 0.7 1.6
_ I
Boring
4 Boring # Pit Ground surface elev. 99.30 ff. Depth to limiting factor >84 in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDrft'
in. Munsell Qu Sz. Cent Color Gr. Sz. Sh. T "I •Eff#2
1 0-7 75YR3/2 sit 2msbk mvfr a 3f-co 0.6 0.8
2 7-27 7.5YR4/3 sit 2msbk mvfr cs 3f-co 0.6 0.8
3 27-34 5YR4/4 d 2msbk mvfr gs i 2f-co i 0.4 0.6
4 3442 5YR4/44-514 Is Osy ml gs if-co 0.7 1.6
5 42-84 5YR4/4 I sr s Osg ml if-m 0.7 1.6
i ~ I I I
#5 2 3- tkinds of sl 5Y-3/4
Boring
Boring # PA Ground surface elev. If Depth to limiting factor 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 1EM12
i
L -
i
Effluent #1 = BOB" 30 < 220 mgiL and TSS >30 < 150 mgA- 'Effluent 7- BOD. < 30 mgrL and TSS <-30 mg,L
Val-,v 3 or 3
Approx. 825 ft to the St. \
FM 2149
90th Street Garage a ?C 41)
I ~ L.,c stele (F
w.~n - 40 ft
Soil Test Site Plan
A BM= NMI %%Tink I(bbon in Base of 14 1)1311 Elm lYee For: Richard and Maric Saltness
HRP =Came Lot 3 ('sin 4A016 NNNAM - SNN' 1/4
Sec. I? T31N-1418W
ASSL-MEDELEV. 100.00' town ol'Slar Prairie - St. Croix Connh
- Eackhoe Pit Approx. 380Jt. to East P/L
Three Bedroom
- `W L \ Home
West Lot Line
from Home > 550Jt. 'Walk-Chit
20.10
,v
13.96 Acre Parcel
Existing Steel Septic Tank
to be Replaced
r ~ :i III
Note: Existing Drain Field dry
Norwav Pines at hotttom of vent pipe with no
sign ofponding or surface discharge.
Wooded Slope 10%
c-
ExistingD.F. Vent
101.44' c
BM
Wooded Slope
Isite is an Open Lane
100.00
99.00'
F.Icvalion Data
98.00' Wooded Slope
13.)-> 11)2.UU' ii
97.00' -
R7 -1 99 luh 13th,2018
S.I vS -0~ i Keith E. Stoner CST# 224059
\1«hod (oscr HOOK Tested Area to P/1.
Approx. 75.1i. Approx. Propertv Line