HomeMy WebLinkAbout022-1064-50-050 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
4 488134 0
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No:
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
Permit Holder's Name: City Village X Township Parcel Tax No:
Rippie, Tim I Kinnickinnic, Town of 022 - 1064 -50 -050
CST BM Elev: BM Elev: BM Description: Section/Town /Range /Map No:
r
/ d , csr 22.28.18.2488
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
- r.-1eA-
Septic • ; F� ] 4,_ �i- C> Benchmark
12
Dosing ` �.� Alt. BM t ` s 35 / / • -5
vw o T d F �� oJ*1 A
Aeration /� Bl�dber
Holding t/ t n et 41 4 7! el
S t /Ht Outle
TANK SETBACK INFORMATION
TANK TO P/� WELL BLDG. V ent o Air In ROAD Dt I n l et �
ep is 9 � AhAr Zq 1 Z,41 — B ottom
g H eader/Man.
osm 9v Z�I1 7,14 q`7 �Z•�
A eration Dist. Pipe 5, tO /0/, 4 (o i
H olding Sot. system
i
ma ra e
PUMP /SIPHON INFORMATION 3 - la /a3
anu ac urer l�oJ1 S G D emand P over 60' — 7-
D ,
Jew I
TUH m odel um er f i 3 - �. . 15 1 166. Z
ric ion oss ys em ea
, 2,7_
orcem m e � i - e
g
DIMENSIONS - v r ., , s� mr
INFORMATION O c.�/� CHAMBER OR y�r� �k ��q,���
UNIT Model 11011100.
n
DISTRIBU MN SYSTEM 7 4-1 �
Length 5 Dia T Length \ Dia Spacing
x Pressure Systems Only xx Mound Or At - Grade Systems Only
Bed/Trench Center Y -7 Bed/Trench Edges \ Topsoil \ Yes J No es
`1
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection
Location: 1247 River Drive River Falls, WI 54022 (SE 114 SW 114 22 T28N R18W) NA Lot II1 Parcel No: 22.28.18.248B
1.) Alt BM Description = G � ti ak e 6
i [
2.) Bldg sewer length = 244 •� 1. wt� : j c
- amount of cover =
!a'
-- 7- 7
Plan revision Required? [j Yes
No
Use other side for additional information. 7
------ Insepct nature
SBD -6710 (R.3/97)
Safety and Buildings Division County /'
201 W. Washin Box 7162 , l� D N
Madiso L21\ iC tary Permit Number (to P e filled in by Co.)
De
Nvisco, me ( ! V C y$� 13q
S to Plan LD. Number
n' Permit ApplicPR 1 3 2006 Np
In accord ith C m 8 .21, Wis. Adm. Code, personal info u provide
may b or secondary purposes Privacy Law, s). CROIX COUNTY P Iect Address (if different than mailing address)
I. Application Information - Please Print All Information � /2'4 7
Property Owner's Name / ! Parcel # Lot # p 5 a Block #
;Ai 0 .
Property Owner's Mailing Addrjs Property Locatio/n� � t 7
/! ' l v l. � y., � 1 / %., Section v 7 0
City State / Zip Code Phoonne Number / f� Q �(
City
( i ! , <U T v < U N; R r� (c E org �i 3 4 v
II. Type of Building (check all that apply) a o e t^ SJb,n }�
Subdivision Name CSM umber
1 or 2 Family Dwelling - Number of Bedrooms c>J �01C
❑ Public/Commercial - Describe Us , M Ij / b�i,w clove ' -3
❑StateOwned - DescribeUse 3 1]14 CX-M w 1
l 7.1-1 -7fi ❑City_ ❑Village�Township of / '
III. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A ' :New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System
B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued
Before Expiration Plumber Owner
IV. Type of POWTS System: Check all that apply)
J t v
&Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑
Constructed Wetland ❑ Pressurized In- Ground 11 Holding Tank ❑ Peat Filter El Aerobic Treatment Unit ❑Recirculating Sand Filter ❑
Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain)
V. Dispersal/Treatment Area Information: . 1
6 00 Design Flow (gpd) Design Soil Applica�n Rate(gpdsf) Dispersa���Required (sf) Dispersal Area Prop sf) S tem Elevation
VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Units Concrete Constructed Glass
New Existing
Tanks Tanks
Septic or Holding Tank
Aerobic Treatment Unit /
Dosing Chamber t7
VII. Responsibility Statement- I, the undersi ed, assume responsibility for installation of the POWTS sho on t he attached plans.
P1 be.' 's a�
Name (Print) Plu a Signature MP/MPRS Number Business Phone Number
Pl tuber's Ad ress (Street, City, Stall ZiI K) �� / , ` !I�� S
VIII Use Onl
Sanitary Permit Fee (includes Groundwater Dad Issu Issuin gent Sign
Surcharge s"
Approved ❑, Isapp a Fee # L�N� L
❑ O ven Reason r Denial g ) K 4 0O r J� } r
IX. Conditions ofApprovaUReasons for Disapprovaf 1 �a 1 bets'' J ��� c es ,d
I sW III NM Z r all pnw
-jeqttmo AA pepooA veld Wauoftullw jtrd se
—/ Ile Muj Ilao lesiodslp b 1( e
pus Jeju l MW8 '>,uel 3!*S
:H3NMO W31SAS J 1 I
'7 (,t,✓,na.�, � �e�tJ i et,<„> Ci 51 YN-
Attach complete plans (to the County only) for the system on paper not less than 8112 z I1 inches in size n
SBD -6398 (R. 01/03) 5e
EROSION & SEDIMENT CONTROL PLAN Parcel # 22.28.18.348B
Site: 1247 River Drive Lot 1 Kinnickinnic Twp — Owner(s) Timothy Ripnie
Under St. Croix County Zoning Code 17.70(3)(b) 5: "The (Zoning) Administrator may attach reasonable erosion
prevention conditions to a permit approved for issuance." Wisconsin Admin. Code Comm. 21.125 requires the
building permit applicant and/or landowner to follow erosion control procedures and maintain them until the site
has been stabilized. Erosion control is a requirement of the conservation easement recorded for this lot.
The Owner is responsible for notifying all contractors performing construction on this site that an Erosion &
Sediment Control Plan is in effect and the following activities will be required in order to maintain compliance
with the plan:
1. The primary source for construction site runoff will be the house foundation excavation, driveway, and any
soil stockpiled until final grading and stabilization is complete. Septic system installation adds to temporary
disturbance, but establishing cover on exposed soils will prevent erosion. Apply seed and mulch as
recommended in #5 below. Maintain existing vegetation wherever possible to minimize erosion and
sediment movement. Surface drainage flows northeasterly toward Ted Creek. The proposed septic system
is >500 ft. from the 75' setback for the creek's Ordinary High Water Mark according to the USGS Roberts
Quad map.
2. Intercept and route contaminated runoff into stabilized vegetated buffer areas by creating temporary
diversions graded ALONG CONTOUR between construction areas and any potential receiving waters
(includes drainage ditches). Do not allow diverted runoff to be directed into surface water conveyances.
(See specification sheet for temporary diversions provided by Zoning Dept.)
3. If excavator grades the site to create temporary diversions (see #2) to contain sediment and leaves adequate
vegetative cover to protect areas of concern, installation of other products may not be necessary. However,
silt fence, straw wattles, or other approved sediment control products will be required if sediment
cannot be contained on owner's property with diversions and vegetative buffers. The POWTS or
Building inspector may evaluate ESC plan effectiveness and make recommendations to owner for any
action required to comply with applicable regulations.
4. Construction equipment and vehicles must utilize a stabilized driveway access off public road for heavy
equipment; this includes cement trucks, well drillers, and other contractor's vehicles that access the property
during construction. This helps avoid muddy, rutted conditions that may allow contaminated runoff to reach
waterways and/or drainage ditches. Property owner must repair damage to ditches resulting from multiple
access points and sediment tracked on public roadways must be removed at the end of each workday.
5. Stabilize new topsoil cover over septic system with seed and mulch immediately after installation - do.
not wait for final stabilization and/or landscaping of entire site to cover exposed soils on the system. If
weather will not permit seed germination, a heavy straw mulch cover will prevent erosion until vegetation
can get established. Erosion control matting can be applied any time of year and, if installed properly, will
provide protection even if seed germination is delayed.
The owner of record during site construction will be responsible for compliance with the ESC Plan. Please feel
free to contact me with questions regarding erosion & sediment control product installation.
Prepared by: Ryan Yarrington, Zoning Technician
Owner acknowledgement of ESC Plan requirements: —/—/2006
a
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SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
l � p
Owner/Buyer �1 i I� 1
Mailin g Address / �� L bc
Property Address
(Verification required from Planning & Zoning Department for new construction.)
City /State 66) eY &A &T, SY0 0 0 .1arcel Identification Number Lll
LEGAL DESCRIPTION
Property Location 3 E '/4 , �TZU 1 /4 , Sec. o�� , T 0 0 N R_&�W, Town of /1�J /C
Subdivision , Lot # J_ .
Certified Survey Map # �7 �/ 0 , Volume _ , Page # KO
Warranty Deed # �!5L' WJ , Volume c�` Page # a
Spec house yes no Lot lines identifiable yes no
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper
maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into
the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance
responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance.
The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the
owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site
wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is
less than 1/3 full of sludge.
I /we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the
standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin.
Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning &
Zoning Department within 30 days of the three year expiration date.
I/we certify that all statements on this form are true to the best of my /our knowledge. I/we am/are the owner(s) of the
property described above, by virtue of a warranty deed recorded in Register of Deeds Office.
Number of bedrooms Z (
5#1 r
- �_' // y/4�
SI NATURE OF P ICANT(S) DATE
** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * **
Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if
reference is made in the warranty deed.
(REV. 08/05)
U 2525P 222
7 5 6 4 4 3
DOC(MENT NUMBER
WARRANTY DEED KATHLEEN H. MALSH
REGISTER OF DEEDS
ST. CROIX CO., WI
RECEIVED FOR RECORD
David A. Thompson and Laura J. Thompson, husband and wife, Grantor, 03/12/2004 M45AN
conveys and warrants to Timothy G. Rippie and Stephanie J. Rippie,
husband and wife holding as survivorship marital property, Grantee, the WARRANTY DEED
following described real estate in St. Croix County, State of EXW #
Wisconsin:
REC FEE: 1i.00
TRANS FEE: 60.00
LOT ONE (1) OF CERTIFIED SURVEY MAP IN VOLUME SEVENTEEN (17) OF COPY FEE:
CERTIFIED SURVEY MAPS, PAGE 4502, AS DOCUMENT NUMBER 718706, FILED IN CC FEE:
ST. CROIX COUNTY REGISTER OF DEEDS OFFICE ON APRIL 24, 2003, BEING PAGES:
LOCATED IN THE SOUTHEAST QUARTER OF THE SOUTHWEST QUARTER (SE 1/4 OF SW
1/4) OF SECTION TWENTY TWO (22), TOWNSHIP TWENTY EIGHT (28) NORTH,
RANGE EIGHTEEN (18) WEST, TOWN OF KINNICKINNIC.
NAME AND RETURN ADDRESS
Together with easement over the Southeast Quarter of the Southwest
Quarter of Section 22, Township 28 North, Range 18 West as shown on Leo A. Beskar, Attorney
said Certified Survey Map and as described in volume 2196, pages 26 -28, RODLI, BESKAR, BOLES & KRUEGER, S.C.
as document number 716034. 219 North Main Street, P. 0. Box 138
St. Croix County, Wisconsin.
River Falls, W 54022
022 - 1064 -50 -000
Parcel identification Number
This is not homestead property.
Exception to warranties:
All easements, restrictions and rights -of -way of record, if any.
Dated this 10"' day of March, 2004.
(SEAL) A (SEAL)
David A. Thompson
(SEAL) (SEAL)
Laura J. Tholoon
AUTHENTICATION ACKNOWLEDGMENT
Signatures of David A. Thompson and STATE OF WISCONSIN )
nsa.
La ra J. Thomoson PIERCE COUNTY )
aut i to his loth d y of March, 2004 Personally came before me this day of
, 2 , the above named
to me known to be the person(s) who executed the
foregoing instrument and acknowledge the same.
Leo A. Beskar
TITLE: MEMBER STATE BAR OF WISCONSIN (Signature,
(If not,
authorized by 5706.06, Wis. Stats. ) • ( Name printed or zvoed)
THIS INSTRUMENT WAS DRAFTED BY: Notary Public County, Wis.
Lao A. Baskar, Attorney My commission is permanent. (If not, expiration date:)
RODLI, BESKAR, BOLES & KRUEGER, S.C.
219 North Main Street, P.O. Box 138
River Falls, WI 54022
T"11� . t'C.K.�'Jlv'• i'j;�;c_,l_. �-U\= V L �E 6 o r 6
Goulds
Submersible
Effluent Pum
3871 EPO4
EP05
APPUCAnONS • Fasteners: 300 series • FuUy s In high • itiator lam: Cast iron
ar
Sp tOr #m stairdess steel. grade turbine oil for for effir�eent heat transfer,
following uses. • Capable of running lubrication and efficient strength, and durability.
• Effluent systems dry Thermopias-
without damage to heat transfer. ■
components. tMotor Cover:
• Homes Available for automatic and tic tamer with Integral handle
• Farms Heavy Motor: mail - llatea and 00 switch attachment
• „ duty • EPO4 Sa>gle 0.4 HP, models huMe I points.
• Water transfer 115 or 230 , 61} Hz,1550 Flog Switch assembleil and ■ Power Cable: Severe duty
• Dewateft RPM, built in overload with t at the wory. rated oil and wad resistant.
automatic reset ■ BeadW Upper and lower
SI,ECIf�11�ATtONS •EP05 Single phase: OS HP,
115 V, 60 Hz, 1550 RPM, FEATURES heavy duty bag bearing
Pump: EPO4 built in overload with
■ EPO4 Nrpeller Thermo- construction. -
Solids handling capaW. automatic reset. P n e maximum. Power
AGENCY LISTING
a , • e cord: 10 foot
• Capacities: up to 55 GPM. standard length, 16/3 SJTO with pump out vanes for
� •Total heads: up to 24 feet. with three prong grounding mechanical seal protection. Co can" s nsso�at�on
• Thermo-
Discharge size. plastic enclosed d esign 1IY NPT. plug. Optional 20 foot pl Impeller. sign for (CSA listed model numbers
• Mechanical seal: carbon- length, 1613 S" with P
rotary/ceramic- s�onivy. three Prang grounding plug P�f end in "F" or "AC ".)
BUNA -N eiastomers. (standard on EP05). ■ Casing and Base: Rugged
• Temperature: thermoplastic design provides
104•F (40•C) continuous superior strength and
140•F (6(•C) intermittent corrosion resistance.
• Fasteners: 300 Series METERS FEET
Stainless Steel. 10
• Capable of running
dry without damage to s 30 '
—►
ac c 8 I
5 GPM
Pump: EP05 ! 25 Fr
• Solids handling capability: o 25
�/4 ma)(knum. w
• Capacities: up to 60 GPM.
i
• Total treads: up to 31 feet. g s
• Discharge size: 1W NPT. i 5
• Mechanical seal: carbon- }
rotary /ceramic -stationary, Q 4 15
I�F6J I
BUNA -N elastomers. c
• 104 (4M =ftuous ~ 3 10
140•F (60•C }intermittent. 2
5
V : 0 00 10 20 30 40 so G
0 2 4 6 8 10 12 m;fi
combination Septic- acid
PL(-MP CHAMBER CROSS SECTION AND SPECIFICA7101JS ' PAGE S OF
-VEIJT CAP WEATHER PIt00F
JUUCTION BOX .
'1'�C.I. VENT PIPC r� APPROVED LOCKIMC,
10 ' FROM DOOR. MAIJHOLE COVER AJIIH
AAIJDOW OR FRESH wA Rtu 1T J 6 t_ a6EL..
A� ►1ITAKE S
r
�• 1 �z. $ 16yM1L1. raR�
f
11�
y "IUS�t'ttlaa PIPC "PROVIDE I
IAJLE T
7 AIKTIGHT SEAL
�AFP��S I I
APPROVED J OW T A ( I APPROVED JOIIJTr
W1 C. PIPE OR Tank construction i 'll W /C.2. PIPE
shall comply with - ALARM
ILHR ('13.15 and 83.20
• ( I ou
C I I
LLEV. S fL
PUMP OFF
y
D COLJCRETE
tf�E'u 9 y . V d 9LOCK -
R15EK EXIT PERMITTED OIJLy IJ
IF TAK MAIJUFACTURCR HAS SULH APPROVAL 3gCflpIP F:
SEPTIC f SPECIFICATIONS
DOSE M 1 p 1'J P- eJ P \': �-I� S
TA�.1K MA �JUFACTURCR: - f.I11MilER OF DOSES: 3`1S PER OAy
TANK SIZC; 1 P30U GALLOU D05E VOLUME r
ALARM MAIJUFACTURER: S'J �- 3�f5`l�`}I IMCLUDIIJG OACKFLOW: 1 b$'y GALLONS
MODEL ►JUMBCR: 1 W Nw CAPACITIES: A_
— \01 IAICHCS OR L A DC GALLOIJS
SWITCH TUPC: 1`1 g = IuCHWOR L I G�LLOiJS
PUMP M MUFACTURCK: G UV L S C. 8 I u CHES OR
GALLous
MODEL MEJABER: au-) I 0 y D IMCHES OR I � S GALLONS
SWITCH TYPE � }( IJOTE: PUMP AUD ALARM O 6E
MIIJIMUM DISCHARGE RATE 31 • 4 Y GPM IN5TALLED OW 5EPARATE CIRCUITS
VERTICAL DIFFERENCE DETWEEIJ PUMP OFF AuD.DISTRIBUTIOIJ PIPE.. B``1S FEET
+ MIIJIMUM NETWORK SUPPLY PRESSURE , 2.50 FEET
+ SO FEET OF FORCE MIN X " F 00fT.FRICTIOM FACTOR.. �.3� FEET
TOTAL Dy1JAMIC HEAD = �?`�O FEET
Pump chamber DIAMETER -
IJJTERIJAL OIME1JStO1J�i OF TAIJK: LEIJC,TH ;WIDTH —=-.- ;LIQUID DEPTH 3 _g
BOTTOM AREA - 231= GAL /INCH
AS PRR MANTTFArTTTVL-V 1 n C . (_AT /TT7!`T.T
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Pa of
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner Septic Tank Capacity (� jj a l 11 NA
Permit #ll' Septic Tank Manufacturer �� ❑ NA
DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA
Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA
Number of Public Facility Units ❑ NA Pump Tank Capacity a l ❑ NA
Estimated flow (average) al /day Pump Tank Manufacturer 1 e,—,_ ❑ NA
Design flow (peak), (Estimated x 1.5) ( gal /day Pump Manufacturer �� ❑ NA
Soil Application Rate g al/day/ft- Pump Model 4 ❑ NA
Standard Influent /Effluent Quality Monthly average* Pretreatment Unit ❑ NA
Fats, Oil & Grease (FOG) :530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter
Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aera❑ Wetland
Total Suspended Solids (TSS) :5150 mg /L ❑ Di sinfection ❑ Other:
Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA
Biochemical Oxygen Demand (BOD 530 mg /L In- Ground (gravity) ❑ In- Ground (pressurized)
Total Suspended Solids (TSS) _ :30 mg /L ❑ NA ❑ At -Grade ❑ Mound
Fecal Coliform (geometric mean) 510° cfu /100ml ❑ Drip - Line ❑ Other:
Maximum Effluent Particle Size Y in dia. ❑ NA Other: ❑ NA
Other: ❑ NA Other: ❑ NA
* Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
Inspect condition of tank(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA
ear(s)
Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA
Inspect dispersal cell(s) At least once every: 3 0 9Donth(s) (Maximum 3 years) 11 NA
years)
Clean effluent filter At least once every: yea t j(s) ❑ NA
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) ❑ NA
❑ year(s)
Other: ❑ month(s) ❑ NA
At least once every:
❑ year(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 hardware, 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 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 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 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 (4/01)
Page of
START UP AND OPERATION
For new 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 um tank.
p P
Do not drive or park 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 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 effect at that time.
❑ 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 -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
i
POWTS INSTALLER POWTS MAINTAINER
Name �� �a Name
Phone ZS _ 9 s Phone
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name Name �} C(a;y ��� d 2,
I
Phone Phone 716- _ q6
This document was drafted in compliance with chapter Comm 83.2212)(b)(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code.
7 1 8 7 m 6
VOL 17 PAGE 4502
KATRLEM H. ALSH
REGISTER OF DEEDS
ST. CROI X CO., WI
RECEIVED FOR RECORD
04/24/2003 11:00AK
CERTIFIED SURVEY MAP
OPY CERTIFIED SURVEY MAP PAGES: FEE
LOCATED IN THE SE 1, OF THE SW I i4 OF SECTION 22, T28N, R 18W, TOWN OF
K 1 NN I CK 1 NN I C, ST. CRO I X COUNTY, WISCONSIN.
N 1i4 CORNER OF
SECTION 22. (FOUND
NOTE: BEARINGS ARE BERNTSEN CAP MONUMENT).
REFERENCED TO THE SOUTH
LINE OF THE SW 1-4
(ST.CROIX COUNTY w — —' —
COORDINATE SYSTEM).
c DR. .l.
NET PROJECT AREA:
2.5 ACRES +i— 1 68' I
INGRESS AND EGRESS
EASEhFNT RECORDED IN
—�� I
VOL UNE 2196, PAGE 26 1 QD g z
PREPARED FOR ml o+
THOMPSON TRUST APPROVED c ,1 u%`•
ST. CROIX COUNTY rn -.!1 A%. H
P181N11nn �n�� "� •��' Oerks Cnmmi"" - I ot
T
APR 2 4 2003 -.4— UNPLATTED LANDS
1 66' f
11 Aol feooro+u Wddri SJ ddO dt "' " 1 I e'I.
amm" dab approval shall be x
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478.20' 66.00'
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SOIL TEST SITE m
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2103.6 ' --
N89 ° 25' 08 'E S89 0 25' 08 "W 544. 16' '
SOUTHWEST CORNER OF SECTION 2647.78' S 1i4 CORNER OF SECTION 22.
22. (FOUND I' IRON PIPE). (FOUND BERNTSEN CAP I a
MONUMENT).
.UNPLATTED LANDS i n
v
O " SET I" O. D. X 18" IRON PIPE GO ~+�ti I
WITH I NG 1. I3L BS PER LINEAR
JAWS M.
W�VALLsr.
O 50 100 250 SHEET I OF 2
2002107 THIS INSTRUMENT DRAFTED BY JIM WEBER JAMES
Vol . 17 Page 4502
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of 3
Division of Safety and Buildings
in accordance with Comm 85, wis. Adm. Code
Attach complete site plan on pa less than 8 1/2 x 11 i hes i � � County �'Y0 -,.)e include, but not limited to: vertical and h I referenc iE v �
ce nt (BAMIr tlon and Parcel I.D.
percent slope, scale or dimens• rth arrow, a tion and distance to nearest road.
Pleas` pr' al ation APR 1 1 2006 Revie by Date
Personal information you provide maybe used for econ urpose (Privacy Law, s. 15.04 1 • (�)1. /� ��
Property Owner IIVV �1 YY
Q Property Location p
1 /4sw 1/4 S �. T- f3 N R
Property Owner's Mailing Address Lot # Block # Subd. Name #
City State Zip Code Phone Number
Cl city ❑Village ATown Nearest Road
/ 7 ?IS
New Construction User Residential / Number of bedrooms 3 Code derived design flow rate 4s v p {- O O GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material S Flood Plain elevation if applica I ft
General comments R �/ ss. s 7'��•, i ` 1 v us d7� /� / c c 4 /� -
and recommendations:
s tir c o 47 t v u a s^ d f J e p .gr
,.x � • ,�//% � � try:, -, a �! f'e � � d ' 7 �/� .
Boring # Boring D D
Pit Ground surface elev. + ft. 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 I - Eff#2
S ,, ,�� Cur a'1,. p. 1 0.6
0 -4 a- 7
t . Boring # El Boring
1 Pit Ground surface elev. �p �- ft. 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 I - Eff#2
-16 1v: des / q. a -P o- ' _ o, 7
16 -3 9 2 s
Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L
CST Name .(Please Print) Signature CST Number
C4 a� /;s
Address Date Evaluation Conducted Telephone. Number.
Al � &13 7 70 ::4 s' ee`r �'`�f, � ��S_ Z73 3 4 3 0
Property Owner ��— Page of O -G j C�
Parcel ID #
D Boring # ❑ Boring
Pit Ground surface elev. /O/ ft. Depth to limiting factor ✓;n
Soil A lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2
bo
Boring # ❑ Boring ` --
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure C,: Boundary Roots GPD /fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
Boring
Boring #
El Pit Ground surface elev. ft. Depth to limitirg factor in.
Soil A liption Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPO /ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 'Eff#2
Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg /L ' Effluent #2 = BOD <. 30 mg/L and TSS < 30 mg/L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an format, please contact the department at 60£- 266 -3151 or TTY 608 -264 -8777.
SBD -8330 (R 07.'00) .. -
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ST. CROIX COUNTY, WISCONSIN 31
4 /4 f relatively long periods in spring and after heavy plains. These are sandy soils underlain by loose, fine
still ' ra i n s, sand. Native vegetation was oak savanna.
stru This soil is well suited to corn, oats, and alfalfa. It is In a representative profile the surface layer is very
frequently used for corn. Controlling erosion is an im- dark grayish brown loamy fine sand about 6 inches
oate portant factor of good management. Capability unit thick. The subsoil is about 24 inches thick. It is dark
p IIe-1; woodland group 1o1. brown, dark yellowish brown, and brown, very friable
oot F o B— Freeon silt loam, heavy substratum, 2 to 6 loamy fine sand. The substratum, to a depth of about
is b P e rcent slopes. This soil is on low ridges of ground 60 inches, is brown fine sand that has bands of dark
un moraines. Most areas are oblong and range from 5 to reddish brown fine sandy loam.
40 acres in size. Available water capacity is low, and permeability is
4/4 This soil has a profile similar to the one described as rapid. Natural fertility and the organic matter content
trop Tepresentative of the series, but the substratum con- of the surface layer are low.
era tains more silt and clay and the subsoil and substratum Most areas of these soils are in pasture. Some of the
tur` are saturated with water for longer periods. gently sloping soils are used for corn, soybeans, and
s g Included with this soil in mapping are a few areas garden vegetables. Where irrigated and fertilized, these
lm where the soil is underlain by shale residuum. Also soils are well suited to potatoes and other special
fra included are small areas of Arland, Renova, Santiago, vegetable crops.
2 / Skyberg, and Vlasaty soils. Representative profile of Gotham loamy fine sand, 2
a A Runoff is slow, and the hazard of erosion is slight. to 6 percent slopes, in a cultivated area, 370 yards north
Available water capacity is very high. Permeability and 200 yards west of southeast corner of sec. 13, T.
4/ ranges from moderate in the subsoil to moderately, slow 28 N., R. 20 W.:
o ithe substratum. The lower part of the subsoil is Ap-0 to 6 inches; very dark grayish brown (10YR
ro turated with water for long periods throughout the 3/2) loamy fine sand; brown (10YR 5/3)
tle Seasonal wetness delays tillage and plant growth. dry; weak fine subangular blocky struc-
u ost areas of this soil are cultivated. A few areas are ture; very friable; common roots;
s N gods. The soil is well suited to corn, oats, clover, and strongly acid; abrupt smooth boundary.
1 "ses. Controlling erosion is an important factor of 131 -6 to 13 inches; dark brown (10YR 3/3) loamy
management. Capability unit IIe-1; woodland fine sand; pale brown (10YR 6/3) dry;
cr jp 101. weak medium subangular blocky struc-
va QC2— Freeon silt loam, heavy substratum, 6 to 12 ture ; very friable; common roots;
nt slopes, eroded. This soil is on low ridges of strongly acid; abrupt smooth boundary.
1/ and moraines. Most areas are elongated or oblong B12 -13 to 24 inches; dark yellowish brown (10YR
li range from 5 to 20 acres in size. 4/4) loamy fine sand; weak medium
rn soil has a profile similar to the one described as subangular blocky structure; very friable;
1 msentative of the series, but the surface layer is common roots; medium acid; abrupt
er colored and the substratum contains more silt smooth boundary.
m lay; also, the subsoil and substratum are saturated B2t -24 to 30 inches; brown (7.5YR 4/4) loamy
water for longer periods. fine sand; moderate medium subangular
e ided with this soil in mapping are a few areas blocky structure; very friable; clay
o the soil is underlain by shale residuum. Also bridging between sand grains and in
+ed are a few areas of Arland, Renova, Santiago, pores; common roots; strongly acid;
g, and Vlasaty soils and a few areas where slopes abrupt smooth boundary.
t s than 6 percent or more than 12 percent. C-30 to 60 inches; brown (7.5YR 4/4) fine sand
g off is medium, and the hazard of erosion is mod- containing bands of dark reddish brown
Available water capacity is very high. Perme- (5YR 3/4) fine sandy loam; single
t ranges from moderate in the subsoil to grained; loose; medium acid.
r. tely slow in the substratum. The lower part of The solum ranges from 24 to 40 inches in thickness.
soil is saturated with water for long periods The A horizon is very dark brown or very dark grayish
out the year. Seasonal wet conditions delay brown loamy fine sand or loamy sand 6 to 15 inches
d plant growth. In many areas, erosion has thick.
he tilth to deteriorate and has reduced the The Bt horizon is loamy fine sand or light sandy
f organic matter in the surface layer. loam. The C horizon consists of fine sand that has bands
as of this soil are cultivated. A few areas are of sandy loam or heavy loamy fine sand. The B horizon
he soil is suited to oats, alfalfa, and a limited is strongly acid or medium acid, and the C horizon is
f corn and other row crops. Controlling erosion medium acid to slightly acid.
"twining tilth and organic matter content are Gotham soils are associated with Dickman and Plain-
factors of good management. Capability unit field soils. Gotham soils have slightly more clay and silt
oodland group 1o1. in the B horizon and they have a darker colored A hori-
zon than Plainfield soils. They contain slightly less silt
ries and clay in the upper part of the solum than Dickman
soils.
tham series consists of gently sloping and GoB— Gotham loamy fine sand, 2 to 6 percent slopes.
ewhat excessively drained soils on stream This soil is on stream terraces and outwash plains. Most
utwash plains, and areas of pitted outwash areas are irregular in shape and range from 10 to 40
AMMS Viewer Page 1 of 1
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i
Parcel #: 022- 1064 -50 -050 04/14/2006 10:41 AM
PAGE 1 OF 1
Alt. Parcel #: 22.28.18.348B 022 - TOWN OF KINNICKINNIC
Current D ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner
TIMOTHY G & STEPHANIE J RIPPIE O - RIPPIE, TIMOTHY G & STEPHANIE J
W9854 795TH AVE
RIVER FALLS WI 54022
Districts: SC = School SP = Special Property Address(es): • = Primary
Type Dist # Description 1247 RIVER DR
SC 4893 SCH D OF RIVER FALLS
SP 0100 CHIP VALLEY VOTECH
Legal Description: Acres: 5.000 Plat: 4502 -CSM 17 -4502 022 -03
SEC 22 T28N R18W PT SE SW CSM 17 -4502 Block/Condo Bldg: LOT 01
LOT 1 (5 AC)
Tract(s): (Sec- Twn -Rng 401/4 1601/4)
22- 28N -18W SE SW
Notes: Parcel History:
Date Doc # Vol /Page Type
03/12/2004 756443 2525/222 WD
02/11/2004 753959 2507/451 ORDER
04/24/2003 718706 17/4502 CSM
04/0412003 716034 2196/26 EZ -I
more...
2006 SUMMARY Bill M Fair Market Value: Assessed with:
0
Valuations: Last Changed: 08/11/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 5.000 80,000 0 80,000 NO
Totals for 2006:
General Property 5.000 80,000 0 80,000
Woodland 0.000 0 0
Totals for 2005:
General Property 5.000 80,000 0 80,000
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch #:
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
B v y e - R : T i�-1 R j
PF % /?ivep 4,1. S
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page / of 3
Division of Safety and Buildings
In accordance with Comm 85, Wis. Adm. Code County
ST• G/Zo�'�
Attach complete site plan on paper not less than 8 1/2 x 11 inches M size. Plan must
Include, but not limited to: vertical and horizontal reference point (BM), direction and P Q • 00 O
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. R F rr E I
Please print all Information. w Y Date
Personal Information you provide may be used for secondary purposes (Privacy L". s. 15.01(1) (m)). C 17 2 002
Property Owner 7�jL�11(43so /: :1r1Mi4Y T IJS r c/O Property Location ST gIXCjdJ�`iTY Q
,�q(f�' jet S0� Go�rt Lot 1/4 1/6 TOF ICEN R A (or) W
Property Owners Mailing Address Lot # Btoctc # Subd. r, ,4 4e S
Cly State Zip Code Phone Number ❑ City ❑ Village IN Town .Nearest Road
R flf 715 - 7007 c ;/D .
Now Construction Use: a Residential / Number of bedrooms 3 Code derived design flow rate Q oa GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material Y OU 1 y4if & Flood Plain elevation If applicable
General comments
and recommendations: \
*RE- 74 Sly /'Tjg/3 /.� Ft/'c /iv�rnp�/,�1� ��iavrSE�S
/ Boring # Boris 4 > / b
® Pit Ground surface elev. ft. Depth to limiting factor in. SoN Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW
In. Mursefl tau. Sz. Cont. Color Gr. Sz. Sh. `1201 1 'E11#2
GS 1 4" eiV 3 , - 7
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a # piting Ground surface elev. / ft. Depth to limiting factor in. Fff#2 Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots D/fF
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'E - g /ol/� 3/ ---- -- L.S' ! �• Z
16 , 311 7tis Y12 Y -- L 1 2-
Effluent #1 = BOD > 30 220 mg/L and TSS >30 1 150 mg/L ' Effluent #2 = SOD 1 30 mg1L and TSS 130 mg/l.
CST Name
0AER Z11L Dl // 7— Signature r 1 C5�T �xr�
Address I � � Date Evaluadori Concluded Telephone Number
Ulbricht & Associates D�, "b 2. 7/s' 3 Zo'
655 O'Neil Rd.
Hudson, Wis. 54016
;fC=` A L
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y
Property Owner Parcel ID # Z Z 7 Page / of
F-31 �� � ❑Boring
Pit Ground surface elev. • ft. Depth to limiting factor _ in.
Horizon Depth Dominant Redox Description Texture Structure Consistence Boundary ol Rate
ndary Roots GPD/If
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Etf#1 •Eff#2
v �? /0 We A S 144-I R Alil� Cw Z f .7 /. Z
a B,dng # ❑ Boring
❑ Pit Ground surface eiev. ft. Depth to limiting factor lo.
Sal Application Rate
Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/fF
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh.' 'Eff#1 'Eff#2
BodM a# earn
❑ Pit Ground surface elev. ft. Depth to N nbv factor in.
Sal Application Rate
Horizon Depth Dominant Color Redox Description. Texture structure Consistence Boundary Roots GPD/ff
In. Munsell Qu. Sz Cont Color Gr. Sz Sh. *011#1 'Eff#2
Boring F-I ❑ Boring Ground i
# roun surface elev. ft.
❑Pit Depth to kni6n9 favor in.
Sob Application Rate
Horizon Depth Dominant Color Redox Description. Texture Stftn Consistence Boundary Roots GPD/fF
In. Munsell Qu. Sz Cont Color Gr. Sz Sh. *E "I 'Efr#2
Effluent #1 = BOO > 30 < 220 mglL and TSS >30 < 150 mg& ' Effluent #2 = BOD < 30 nV& and TSS < 3o nVL
The Department of Commerce is an equal opportunity service provider and employer. if you need assistance to access services or
need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777.
3MM30ee.6roor
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M
Uihricht & Associates a
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