HomeMy WebLinkAbout032-2177-07-000 I
I
Ntscon :r nl...... d ^.nn+•n PRIVATE SEWAGE SYSTEM VO00N .St. Croix
Sally and Bundmg Urvr r u
INSPECTION REPORT `,dn Llr> Fe(flli 607099
GENERAL INFORMATION AT-.A'1,.-1 10 PERMIT( SIdIe =.nl l:, re•
PHISCnE "U rratori V0L Dlovl'JB tray Ca u3ec tar S-cGnda "J (lu": ose511'n'vaC, La, s iS vA "':r
af`rTil 1'ndf`I'~ N:Ilnt' r:IIV "I'lldfJC Tf. /~n.h : PdfY.n .-IT
Daniel Bracht TOWN OF SOMERSET 032-2177-07-000
C61 6L! c r:'. 1'ss. did Elr'. IBN j"U'rit.0, ;eel::N Cm.nlRdn ,c0.1: n 1 N,
GST 1.31.19,1511
TANK INFORMATION ELEVATION DATA
IYI'L IAANULA~.'URER I-APAGI I1' F,ATI'')N BS H'. FI -V.
1
Septic, r I r -fir- s ~Q~ S^nchmarv. /63.5
L✓ /
RA!
1 . Ca Z. Ig 167.7
Acrallon Rlor Sev>~• p
1 r0 QZ•
11 i0l0l'Ig SVH: Inlet • t 161, -7
Sl; 'l)uLCt
TANK SETBACK INFORMATION Sf •S L SDI
~iANK IC: :NLL_ B-JG. c-t rpnniae RJA_' Ot ow \ \
I:>apec -)t Bottom
ICSIny ~eaderilJlan 1~1 `I M•
Aerallon :)Is[ Plpe
/a.K7 99' y
tl~ldi'tc7 - Rnt System 1/,q7
=final ;tale PUMP/SIPHON INFORMATION 44
~Q3
Manuta::lurw :iernanl: aUVN
::rla F ~w 2.1% 16-7.7.4
11,1nnel Number
i
'TDH Lift f-nrhor. Lus.S Svslcn' Hcad 'DH - _I
Fo'C$malC , ennlh 111a GAS: le Yvell
SOIL ABSORPTION SYSTEM
131,O11BENCH Jict, _enn!n I be Of Trrrc~ , I PIT DIMENSIONS Im oI .IL= Idc 71, aum Geptr.
DIMLNSIONS 3 2 ; r
SETBACK SYSTLIA T'• KD6 YELL _AKE:FTR_A1 IFAC14ING h1d'.'h:•'-f y~1
INFORMATION CH AMDER OR tiF-I• d
Tyne O ztcrr UNIT 1,1coc: N. m
I 10A-
44
33
C/o
DISTRIBUTION SYSTEM j9+4`1=
I-naCDl,lddnlfoli / r rnnbnn > 11°n- S., • Ho[ :.ndon. 4'en^' Ic. All Wake
4 Jrl.. _ rng I: '4pp::-•,n_. _
I,•_.iln' O
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
?ertn r Oe nth Ceps n1 c:11Sr - IJwcned
y~i .n r ar b~ ?,ell^ aNr Fdy,e:
V Nc Nc
COMMENTS: (Include curedlsaepenoes. ppumuns present. elc.l Inscection r' Inspecuor #2
Location: 614 222ND AVF E"r
1 All HM Ues::uphon = / l.. llnn
d.: Glda sevl'er length - 3
mm~un' of cove, _ 11 /tn
{'Ian revision RP.olnred" _ Yes <No (p _)Se other side tot additional Intenrlaiioo
r_w l%rxs&. azure Cert No.
Ill 1..• NSL Ce Vvicv, IOi%l\u:u - S6 fVlt lX,l 5 _
B
?n i.u •i Pwnil l.n Ir(lobe filled inby Co)
Ps o s 20 M11 1 n :I,, , I 71 162
19 7691
lttTNumber
i. Sali 0 pliat iol a
n:h. the 51 q I. III I+.111111 II ip:.I -i T .I:.; •1111 1 .`11111.1 ex ,,i I. II I S::rc sulmn:tcd:o Lj,.lAdd:cs iifdi'Yitnt than Ilia if:ngaddmssl
III f':a1no,.i ~I',_11 I.1_.cu:1, 1 .I_in:II icn 111,1-: I,INn 1" .o:l1:1 >'mni1.'
pilrill _-o .:..:r I • c.1:1. I I : 1.I S'Hi l h'o .Ito;, 7
1 Application Info) mahon I I_ra;_c I rinl 111 Information V : _,l aX lp
I nI t tJ:nn . Anu : P'l% cl
_ filer ('c.. i _-L;._7%'
V
II ptn, fiau I h (`u;• AJ e:: Prop, I: :.rfeJ-aI J('j I~•)
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T 5- V: R 19' !ri
- 11 Ispe of 1{addut;•(rbeJ all (ba(appiv) Iat:
I v'2 Fme I, V L I I it Ral......
y~>p~ -A j ` Sabdl 't/n/a ]2me
'Lill
u lash ~
❑Sl rt• Ii:onml lal-- ]cs.:-ilclse
Citv at*
CSM1:V::mi:r ~❑y\J ~.o r.__
` Q,s~ ViaCJ~/~1 ~ I Y 4w 19 is W Iu..vn :I: _=JC-,I hC`s~
111. 'I)'prof Permit: jCbeck only it., box on line A. Complete line It if applicable)
Jkli S,w System I n ~illl .:en1a1 v:1nu ~~1 I ry i I (Or h [1 t 1.1:1 M11 :ii:ia.. lion m Fri ain S}.¢m {explain)
IS Pen t 1 it P"'i"n, 1'cI nil Sua:In. 1 D_l, Iza:cd
r] I I,a Rea i,.ion U l,hcugc uC Pi.unher J nos 11'srs[cr to Aew
dc:crcl u 1 I U.vncr _ZNP1 . ~
IF. 'f}pe of PO\N'TS Svatcnu'C'omponentilleviee: (Check all drat apply) SSKK--
{ \ m t d In brcu.^..1 E Presc.v .1 6 Gron:ll _ r a' (h::aa rJ h.'o.-n p •n of stli::dde aril \I -Iw:a , y-n. 1 wg3,1C mil
U IL7 ny nk HMIN fl 1 .m In sdai'I. - _ _ _ ~]1'r. L. •nl Ueci< (oaflu:il_- _
\ Drymrsal Prcatment. Area Inlolmatinn _
t). 1rn I low icp..I D:.i;n Slll p.:ean.1 Rat gpdst5 Dispersal Ate Ite..wr.•:1 (sfl U np.tw! At ca PmpmeJ Isf Sv 1 m FI_aation
V f
1
VI. ank Into Crap,tT vi lala? Hot t11 lzclum
C II n- Gdka, Vr,ila 1~~~ G ~ -
a Tnr is - x` ~'Cank.. Qtl GVCrx G - = n n
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J,II - I. Iii n; I, F , ~ ✓ -
VII. Resp usiltility Statement- 1, thI. andani.nr. I. a.wau• r,:poasibilip for ino.dittion of Ill, PON% 1'S It o:vn ua Ih, allad" d pl:a. c.
i
P I I¢j K•=nI P IIN~Y' I 1 u hcl 4,r. Ivry - A71 I'd l' S Vuui'::' IR I'kt tte V,;mbrr
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Ill. kl1.n ~ .J.!1 a1S ..1 S Li. 7i~C,1 I
\ aunts 11 Lnt Intel)] Ua Only a _
Pcrm:I I cc Ual La1n :r m _ a tii; na1 re
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IX. Coudi1S1/al"AwNfiftr.nnnS Inr Ili.apprnval t
1. tsr:
Cell rai"t InD tvf1 r
Ir1+4xr:+:. . 'lrst an ba s+l•.103 LL't ^1'_ 95: d lp Y I
ss par aw ayerw! plan p widen W plum v.
2. AI tKR»r* t'swt;hitt~r:Jtxrn rtuxA w r.:cr.L-x e : a~
rper pg*fth tp}f 1 "rd'umel.
W,O, II. ......plate plan Iae nx>pRm sad falm.it In the Canny only on paper eat ks: Ilan a 11 11 inchs in siaa
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CONVENTIONAL COMPONENT DESIGN
Residential Application
INDEX AND TITLE PAGE
Project Name: ~n j'
Owners Name,
Owner's Address:
Legal Description: /`r'
Township
County:
Subdivision Name:
Lot Number:
Parcel ID Number:
Page 1 Index and title
Page 2 Plot Plan
Page 3 System Sizing & Cross-Section
Page 4 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 Tes & House Plans
r
Designer/Plumber % License Number:
°_1 s
Dale: A/I Phone Number
Signature
Designed pursuant to the in-Ground Soil Absorption Component Manual for POW TS Version 2.0 S6D.10705-P (N-01/01).
Page i
i Ir
1,3 N
1 jJ
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a 4
Soil Ahs012800 SVSbefe Cnnss Section
- ft
4' SdIeWle 40 FUIW Grade
PVC VratP%
VthVeit CW ft
Chamber - ►
- System Bevation
It / ft
Soil Absotfltion t%Ttwn plan View
tt
_ft
-=ft Vent Or Observation Pipe Trench 7
Cnambe~s
- CJ.J '4~bs : I(
®~I~IIDIIII1D~~fII~I[~II® 4' Dia
Trendy 2 Header
Leaching Gharer SDecfflcabons
anufacturer And Model
LEISARating
sq ft Pe
f chamber
Soil Application Rafe gpd/sq ft
sign Flow a ^ Sal
APpicafion Rate ; EISA = Chambers
2 rows of chambers each.
Page of
Fitters
PL.-WS E 9-1UENT RUERi ( L)
Polylofc, Inc is pleased to add ft
new conwriercial thor to if$ existing e
fine of quality effluent filMm The
PL-525 is rated for over 10.(100 GPD s
Alarm AmeliftPVC S
an
4allons'per day} makiN it one of av MiNIN
the largestcornmor tai fiifers in its - eadrrioakarae
loss It has 525 &war fee of ],'I6'
$
&ftradon slots. Like the Polylok c s ti- a
PL--12Z, the new Pblylok PI-665 has
an automatic shut off ben islalled sSiamrEeet
C
with every filter When the Miter 6 of 1h~ -j .
removed fortfeaning,thebanwill tonedtw
'i AN GIRD
float up and t emporardy start off
the syslem soft effluent wont
leave the tank. No aatrerfifter on
fluenmdvtCancrakethe Ckint O seRye'
PE-525 Ma Wmnance:
The PL525 Eiifuert Filter should
operate OWKWrtly for several years
under normal conditions before
requiring cleaning. It is recom-
mended that the fib be cleaned f t
every time the tank is purnped or
at feast every three years. If the r .
intoned fnfter cort 4m an optional ,
alarm, the owner will be notified r
by an alarm when the filter needs r-
sEnYrc&lg. Servicing should be _ ~v6x drBeclor t .1
done by a certified septic tank
pumper or install". ) :OEE- - r arwr®eea
1_ Locale the outlet of fhe l tis Pamtrrai 6M~s188 iarmaaared }
septic tank s sri eo
241ornoue tank cover and pump
tank if necessary. PE 525 Installation- 1. locale 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. Pry PLA1S out of the horsing. mercy l araste flaws up to pump tank if necessary.
5_ Bose off Sher over the septic 10,000 Gallons Par Day (GIRD). 3. Chine the filler housing to the
tank Matra sure all solids fan r or G outlet pipe- If the
filter is not centered under the
bark into septic tank
access opening use a f'dYlok
6. Insert the filler cartridge be& Extend & Lok or piece of pipe
alto the housirg-rnaking sure to carter finer.
the filter is property aligned and 4_ Insert the PL-626 filter into
complIel ly inseFla(L its housing.
7- Replace septictUA cover. r r 5. Replace the septic Tank cover
QY
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page =of_
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner Tank Manufacturer-ILI,
0 NA
Permit # -
¢J Septic 1-1 Dose ❑ Holding Volume: /,:•y zf, (gal)
DESIGN PARAMETERS Tank Manufacturer* NA
Number of Bedrooms: fI NA ❑ Septic U Dose ❑ Holding Volume: (gal)
Number of Public Facility Units- (,l NA Vertical Distance Tank Bottom(s) to Service Pad: (ft)
Estimated (average) Flow : - Tank(s) to Service Pad.
(gal/day) I Iorizon[al Distance
(ft)
Design (peak) Flow = (estimated x 1.5): (gaudy Specific servicing meciamrs must be provided if vertical is >15 feet or
Y) if horizontal is >150 feet. Specific instructionnp t be provided on back.
In Situ Soil Application Rate: (gaVdayfie) Fffuent Filler Manufacturer - r^/-
U NA
Standard (Domestic) Influent/Effluent Monthly average Effluent Filter Model:
Fats, Oil & Grease (FOG) •_30 mgt Pump Manufacturer*
Biochemical Oxygen Dornand (ROD;) 220 mg/L I NA F! NA
Total Suspended Solds (TSS) x150 mg/1 Pump Model*
High Strength InfluentEffluent Monthly average Pretreatment Unit
(FOG) >30 mg/1 Manufacturer
(BODs) >220 mgA. Ej NA [ El NA
_ (TSS) _ >150 mgA. Mechanical Aeration ❑ Peat Fifer
11 ad/Grr 111 Wetland
Pretreated Effluent Monthly average fl Saud/Gravel Finer _ _ ❑ Other. _
(Boos) <30 hng/L Soil Absorption System
(TSS) -30 mg/L 0 NA
Focal Coli (geometric mean) 'W d In-Ground (gravity) O Ir-Ground (pressure) ❑ NA
I_i Al-Grade ❑ Mound
Maximum Effluent Particle Size )fi in da. ❑ NA ❑ Diip-fine 1-1 Other:
Other ❑ NA Other:
❑ NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
Pump out contents of tank(s) When wnibined sludge and scurn equals one-third (Y) of tank volume
❑ When the high water alarm is activated
Inspect condition of tank(s) At least once every: U month(s) (Maximum 3 years) ❑ NA
_ Year(s)
Inspect dispersal cell(s) At least once every: - rl month(s) (Maximum 3 years) U NA
0 year(s)
Clean effluent filter At least once every: C month(s) - LI NA
year(s)
Inspect ptxnp, pump controls & alarm At least once every: L I month(s) P1 NA
_ fl year(s)
Flush laterals and pressure lest At least once every: 1 I month(s) 11 NA
❑ year(s)
At least once every: ❑ month(s) U NA
❑ Year(s)
Other:
U NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and soil absorption systems shall be made by an individual carrying one of the following licenses or certifications:
Master Plumber, Master Plumber ftestdced Sewer, POWTS Inspector, POWIS Maintainer or Seplage 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 soil
absorption system 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 or more of the tank volume, the entire
contents of the lank shall be removed by a Septage Servicing Operator (pumper) 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 512 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.
GMw-005 (02115)
Page of _
START UP AND OPERATION
For new txlnstnlction. prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other
chemicals or sediment that may impede the treatment process aridlor darnage lire soil absorption systern. If high concentrations are
detected have the contents of the tank(s) removed by a Seplage Servicing Operator (pumper) prior to use.
Pump tanks may fill above norms! highwater levels prior to startup or due to pump failures. Start up or restoration of power under these
conditions is not recommended, as the excess wastewater will be discharged to the soil absorption system in one large dose causing an
overload that may result in the backup or surface discharge of effluent and damage to the system To avoid this sltuahon have the
contents of the pump tank removed by a Septage Servicing Operator (pumper) prior to restoring power to the pump or contact a Plumber
or POWTS Maintainer to assist in manually operating the pump controls until normal effluent levels are restored within the pump tank.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
Do riot drive or park vehicles over tanks or the soil absorption system. 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 treatment
tanks and soil absorption system: acids, antibiotics, baby wipes, cigarette butts, condoms, cotton swabs, degreasers, dental floss,
diapers, disinfectants, fats, foundation drain (sump pump) discharge, fruit anc vegetable peelings, gasoline, greases, herbicides, meat
scraps, medications, oils, painting products, pesticides, sanitary napkins, solvents, tampons, and water softener brine discharge.
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 property
and safely abandoned in compliance with s. Comm 83 33, Wisconsin Administrative Code,
• All piping to tanks, pits and other soil absorption systems 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 (pumper) -
• After pumping, a!I 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 fass and cannot be repaired the following measures have been, or must be taken, to provide a code compliant
replacement system:
~J A suitable replacement area has been evaluated and may be utilized for the location of a replat:ermenl soil absorption system.
The replacement area should be protected from disturbance arid compadion arid should not be infringed upon by required
setbacks from existing and proposed structure, lot lines arts wells. Failure to protect the replacement area will result in the need
for a new soil arid site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in
effect at the time of their permit issuance.
❑ A suitable replacement area is not available due to setback ancvor soil limitations. If the soil absorption system cannot be
rehabilitated arid barring advances in POW I S technology, a holding tank may be installed as a last resort.
❑ 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 replacernent area. If no replacement area is available a holding tank may be installed as a
last resort to replace Pie failed POWTS.
❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the, infiltrative
surface. Re:;or structions of s,;ch systems must comply vith the riles in effoct at that time
WARNING TREATMENT TANKS, PUMP TANKS, AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES OR LACK
SUFFICIENT OXYGEN TO SUSTAIN LIFE. NEVER ENTER ANY TANK UNDER ANY CIRCUMSTANCE. DEATH MAY
RESULT. ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK MAY NOT BE POSSIBLE.
ADDITIONAL INSTRUCTIONS:
POWTS INSTALLER j - POWTS MAINTAINER
Name. p Name
Phone - - Phone
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name Name -
Phone Phone This document was drafted by the staffs of the Green Lake, Maryuero and vlaushaia County POWTS regulatory agenoes in compliance with sections
Comm 83.22(2)(b)(1)(d)&(f) and 83 54(1), (2) & (3). Wisconsin Admin sualim Cie.
ST. CROIX COiFN7Y
SEPTIC -AMC MALR'IEN'.ANCE AGRSEMEN '
AND
y4`^ c OWNERSHIP CERMCATION FORM
Owaec•Bt~er I r `~S S A Y 1
Mailing Addres}s~ So GLt L( rl r~ ~Yt- /v 5,56~(y
Pro Aacue 1 03
C\ieriiicanon roquitsd trom Planning & Zoning DapZrM=M for new aamsbuefion.)
City/State Parcel Identification Number I - • 7 7 - -"4
"r G AL DESCRIPTIO
T LN RLW, Tovm of_, t_
Prot Lxation 'Ili
i
Subdivision Plat i,:F /~;'7 Lot #
Certified Survey Map # Volume . Page #
Warranty Deed > (before 2007)Volume _ Page #
Spec house D yes 0 no Lot lines idrntineble a yes 0 no
SYSTEM MALNTWAfiNgK AND OWNER CERTIFICATION
Improper use and maintenance of your septic system could result in its premaaue failure to bandit wastes. Yrope
maintenance cMgM of pumping our the saptic tank every tutee years or S00138 r, if needed, by a licensed pumper. What you pm into
the system can affect the function of the s.-vtic teak as a treatmtot stage in the waste disposal system. Owner maintenance
tesponsibilities are specified in §SPS. 38352(1) and in C23apier 12 - St Croix County Sanitary Ordinance.
T'ne property owner ataees to submit to St Cron County Planning & Zoning Daim tment a ceatmcadon form, signed by Ste
owner and by a master plumba, journeyman plumber, res~icud plumber or a licensed pumper verifying that (I) the on-sits
wastewater disposal system ism proper operating eoudidem and/or (2) after inspection and pumping (if necessary), &a sWdc tRnk is
less than i.3 faU of sludge.
Uwe, the undo sgned have read the above requirements and agree to maintain the private sewage disposal system with the
standitrd= set facet, hamn, as ser by the Depa-mtmt of Safety And Profesmomal Services and the Depinumitut State of &sctmsim. CamficMan ~g that rammed Resources
guts septic svstrst has been. maiaiamr~ must be completed and rem to the SC Gtoie
Canary plannin Zoning Dap r wirba 30 daps oftbe throe year f epir~ dal-.
I/we certify that all statements on ' form are true to the best Ofmylora knowledge, I/we am/am the owner(s) of the
property described above, by virtue of a w - deed reoo¢ded in Register of Deeds Office.
Number of bedrooms
SIGNA T THE OF k?PLICA-N 7 (S). DAM
-'*.ry information that is misrepresenud may result in the sanitary petmii being revoked by the Plaonin & *r=
B DepartzntmL
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 wananty deed.
(REV. 0-11,U)
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Wisconsin Department of Commerce
SOIL EVALUATION REPORT Pago_ ~ of
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code
) r-
A;WCh complete site plan on paper not less than 8 112 x 11 inches in size. Plan must County
include, but not limited lo: vertical and horizontal reference point (BM), direction and Parcel I.D. -7
pe.icent slope. scale or dimensions. north arro•.v, and location and distance to nearest road.
Please print all information. Reviewed by Date
Personal informalmi you provide may he used for secondary purnse& i,P ac; 1.3n, s 13 P: (1) (ul)
Property Owner Property Location
L
L~ C Govt. Lot iW''' VAS F.' 7;4 S T / N R @ (orJtf'r'Property Owner's Mailing Address - Lot/ Block # Subd. Namg or CSM# -
City State Zip code Phone Number _ City Village &Town Nearest Road
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[ New Construction Use: 0 Residential 1 Number of bedrooms Code derived design flow rate es GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material<< S L! Flood Plain elevation if
applicable ff.
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General comments 7 fl
and recommendations: APR 1
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Bong # Boning P, 1 4, r+~+.d
Boring ❑ 1' 5 ,+-.+tY J.~~~ 1"` ~e.G
w i S ~o-«r F ; ~2!
F1, ® pit Ground surface elev. ~3 fl. Depth to limiting factor 7 V' in. Soil Application Rate
Horizon Deptn Dorinant Color Redox Description Texture Structure Ccnsrslence Boundary Roots GPDif 2 - d~1 t
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh- 'Efi#1 'Eff#2 J '~f
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Pit Ground surface elev. ~GL ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Desciplion Texture Structure Consistence Boundary Roots GPDA12
in. Munsell Qu Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'E"2 ' Effluent #1 = BOD, > 30 < 220 mg l- and 1 SS >30 < 1 i0 ray: L • Effluent #2 = BOD, < 30 mgll
and TSS < 30 mgfL
CST Name (Please Print) Signature CST Number
Address Date Evaluation Conducted Telephone Number
SDD-8310 (R07 001
f,c Property Owner Parcel ID # Page of -
Boring # ❑ Boring
Q Pit Ground surface elev. -f ! ft. Depth to limiting factor,': in.
Sell Application Rate
Horizon Depth Dominant Coior Redox Description Texture Structure Consistence Boundary Roos, CPD/It=
in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. / 'Eff#1 'Eff42
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F-I ❑ Boring
❑ pit Ground surface elev. ft. Depth to limiting !actor in,
8;.l Application Rate
Howon Depth Dominant Color Redox Descnphoo Texture Structure Consistence Boundary Roots GPDih2
in. Munsell Ou. Sz. Cort Color Gr. Sz. Sh. •Eff#1 -Eff#2
E] Bonng
F Bonng # El Pit Ground surface elev.. ft. Depth to limitinc facto:
Soil Application Rate
Homer Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDihr
in, Munsell Ou Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Elf# .
Effluent #1 = BODs> 30 < 220 mg:L and TSS>00 < 150 niy. L ' Effluent #2 _ BODt 30 m L and !8S < 30 mgrl
The Department of Contmerce is an equal opporhmity service provider and employer. if you need assistance to access services or
need material in an alternate formar, please contact the departn:em at 608-266-3151 or'1TY 603-264-8777.
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Soil Apalipllon Rate
Horizon Depth Dmninanl Cc'oi Redox Desrriptim TCxle1C Stru-turo Consistence tioundmy liwLI Gpont,
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_ Soil Appl,raL•cn Rate
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io Munsell all. Sz. Cent Color Gr. Sz. Sh 'EMP. 'Eff 2
• Fff6dent rrt R07„> 3C < 223 mg! and TSS >33 < 153 rnNL ' L10ueol trZ --J-00, < 30 mg4 and TSS < 30 mg+L
71te Deparunent of Cornnrerce is an equal opportunity service provider and ernployer. If you need assistance to access services or
need material iu it,. alternate t'orrnal, rleasc contact the department at 608-266-3151 or TTY 608-2648777.
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Parcel 032-2177-07-000 03128+20ce 04 36 Pn1
PAGE 1 OF 1
AIL Parcel 11.3'..19.15 032 - 1 O'; -iN OF 5;i'Af RSET
Current X ST. CROIX COUNTY. 1.1ISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
W,C1r2Gv< 00 0
Tax Address: Owner(s): O = Current Owncr, C - C.uren:
DAN[!-I BRnCHT O - BRACHT, DANIEL L-
.
9 S8 198 rH AVE
SOIAERSET 1^:I 1114025
Districts: SC: = School SP = Spec al Property Address(es): ' =Primary
Type Dist # Description '614 222ND AVE
SC 5432 SC AE:;RSE I
SP !a1 „riTC
Legal Description: Acres: 3 300 Plat: 10-013-I IIDDEN BILLS 032-04 4115
SEC 11 '3'N R191 PT S'A: S:'J H: UIIEN 191 LS Block/Condo Bldg: LOT 07
'04 LOT r7 13.3G I-'' - - -
Tract(s): (Sec-Tern-Rng 401.4 1601;4)
11 31N-191'.1 SW S4."
Notes: Parcel History:
Date Doc # Vol/Page Type
'2i13~ZX06 B.tCrwl 1011D
1'3!07x200- 17646e 26) 11ibG0 'dJD
:17x01'20C.' 767565 10x13 PLAT
12,3',2063 750,106 2483x200 EZ-1J
mere,..
2008 SUMMARY Bill Fair Market Value: Assessed with:
U
Valuations: Last Changed: 08110+2011',;
Description Class Acres Land Improve Total State Reason
RESIUEN' I IAl G' 5 911,1 55.500 C.
SS,50C NO
Totals for 2008:
General Property 3.3°1)f: 5j0 0 55.5.11
Woodland C.000 0 0
Totals for 2007:
General Property 3.300 55„100 0 55.500
Woodland 0.000 0 (i
Lottery Credit: Clair" Count: 0 Certification Date: Batch
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total O.OC O.f,O 0.00