HomeMy WebLinkAbout026-1137-03-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building bivision
INSPECTION REPORT Sanitary Permit No:
395224
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:
P.C. Collova Builders, Inc. I Richmond Township 026- 1137 - 03-000
CST BM Elev: / Insp. BM Elev: B Descri ptio
CsD . 0 6D • v� = CS7 — �wc
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark 3. r
- u3.s�' � -�
Dosing U Alt. BM /
10. 90 1 o2-
Aeration Bldg. Sewer "o
9 :�.yr
Holding _ St/Ht Inlet 4 - s- �
—_ b S
TANK SETBACK INFORMATION St/Ht outlet �y r
gb•sl
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic ' r J Q Dt Bottom
Dosing 1 Header /Man.
Aeration Dist. Pipe lID
4.2o . '
Holding Bot. System
p
a.
PUMP /SIPHON INFORMATION Final Grade
Manufacturer _ Demand St Cover
GPM
Model Num r
TDH Lift - Rllction Loss System Head TDH Ft
I Forcemain Length Dist. to Well
SOIL ABSORPTION SYSTEM I
R H Width f Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS 3
SETBACK SYSTEM TO /L - JBILD6 IWELL LAKE/STREAM LEACHING Maanu u r:
INFORMATION Type Of System: / l CHAMBER OR X - S
� � —^ UNIT Model Number.
DISTRIBUTION SYSTEM
1 =nn Distribution x Hole Size x Hole Spacing Vent to Air Intake
Pipe(s)
Length Dia Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only
Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched
Bed/Trench Center Bed/Trench Edges Topsoil
Yes FE] No FIN Yes F11] No
COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: IL ( Inspection #2: t
Location: 1492 112th Street New Richmond, WI 5 (NW 1/4 NW 1/4 21 T3�0N R1 8W) Golfview A Parcel No: 21.30.18.929
1.) Alt BM Description
2.) Bldg sewer length = 1
- amount of cover =
;) zi S� � ve..� c�.vo
�� q-- 00 . —� —
Ian revision Required? No )Z—
O
Use other side for additions '
Date Insepctor's Signature Cart. No.
SBD -6710 (R.3/97)
1a- \A �.i.t,f —
Sanitary Permit Application Safety & Buildings Division
In accord with Comm 83.21, Wis. Adm. Code G 201 Was qx 302
See reverse side for instructions for completing this application lr y WI 53 ?07 -7302
V ksconsln Personal information you provide n ay be used for secondary purposes Madi or
Department of Commerce _� [Privacy Law, s. 15.04(i)(m)j (Submit completed forth to county if not
state owned.)
Attach complete plans (to the county copy only) for the system, on paper not less than $• 1/2 x 11 inches in size.
Coun n ' I State Sant Permit heck if revision to previous application State flan
I. Application Info r m ation - Please Print 9 .11 Information Location:
Property Owne 11 r Name Property Location — 2 r'
! . c d) a 4-- &_., � � � �' 1 A /4, S Z/ k7 V ,N. Vj (or)
Property Ownces Mailing Address Lot Number Block Numbe
City, State Lip Code one Number Subdtiv sion Name or CSM Number
; drc rrc - cw
II. ype of Building: (check one) ; r,. ❑ City
1 or 2 Family Dwelling - No. of Bedrooms: i* ; ❑ Village
❑ blic/Commercial (describe use):_ _ : '"• ZR- own of
❑ State -Owned
Nearest Road Z /
. ' P arcel T ax Number(s)
III. Type of P m it: (Check on ly one box on line A. Check box on line B if applicable)
A) I. w 1 ❑ Replacement 3. El Replacement of 4. 5. 6, C Addition to
System System Tank Only Existing System
B) P erinitNum be r D s
A Sanitary Permit was previously issued
IV. Type of POWT System: (Check all that apply)
on- pressurized In- ground U Mound ❑ Sand Filter ❑ Constructed Wetland
ressurized In- ground 0 Holding Tank ❑ Single Pass ❑ Drip Line
❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other:
V. Dispersal/Treatment Area Information: . D "-
1_ Design Flow (gpd) 2. Dispersal Area 3, Dispersed Area 4. Soil Application S. Percolation Rate on 7. Final Grade
Required Proposed Rate (Gals. /day /sq. ft.) (Min. /inch) Elevation
J��"5 37 -5 -- 7 ` Z- A,�.� � �-
VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic
Information Gallons Gallons f Tanks Con- Con- glass
New Existing crete structed
'Tanks Tanks
❑ ❑ [3 ❑
aa� Gv
❑ ❑ 13 ❑ ❑
VIII. Responsibility Statement
I, the undersigned, assume responsibility for into ation of tv4TS shown on the a ttached plans.
u�m " 1 s Name (print) Plumber (no /�!� No. l ,} Business no Number
'or : �
Plumber's Address (Street, City, State, ZiptW
1 92r �� ..t d1
IX. County/Department Use Only
Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature stamps
Approved ❑ Owner Given Initial Adverse Surch Fee) /
Determination • �'
X. Conditions of Approval /Reasons for Disapproval: ^
� t3 eD s
J L
SRII -639R (R 07 /00)
430/R T PLAN
PRd;;ECT P.C. Collova Builders InADDRESS 705 Countv Rd E Hudson Wi 54016
NW 1/4 NW 1/4S 21 / 18 W TOWN Richmond COUNTY ST. CROIX
MPRS Shaun Bird 226900 DATE 0/7/01 BEDROOM 3
CONVENTIONAL XXX IN -GROU PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE 1.2 ABSORPTION AREA 377 # of chambers 22
k BENCHMARK V.R.P. Top of 1" Iron Pipe ASSUME ELEVATION 100' Filter Zabel A -100
❑ BOREHOLE (DWELL sH Same as Benchmark
SYSTEM ELEVATION 96.5
Vent
> 12" Sidewinder High
of Cover Capacity Leaching Plans Designed Using
Chamber Conventional Powts
Manual Version 2.0
6" N
1
6' Long '~
Grade at System Elevation
34
a 2 -3' X 69' Cells with >3' Spacing B -3
Vents Vents
150' B -1
B -2 4029( '
80'
Pro 3
Bedroom
House
B.M #1
Property Line
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of
Division. of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code
County
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must ✓ D ^ x
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D.
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
Please print all information. Re ewed b� Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Z8�8
Property Owner pp DU ,^, Property Location f�
�. �fl ��� / -3G�V Govt. Lot AA11 jW1/4 So/ T N R / V E (or)o
Property Owner's Mailin Lo+ # Block # Subd. Name or CSM#
1✓tJGG
City State Z' Code Phone Number ❑city ❑ Village Town Nearest Road
P _New Construction Use: Residential / Number of bedrooms Code derived design flow rate Z Y - 3- 3 GPD
❑ Replacement ❑ Public or com ercial - Describe:
Parent material ��/ — C�/ Flood Plain elevation if applicable ft.
General comments
and recommendations: � ��vG'J� , `lv�✓ L ��
F�] Boring # Boring
it Ground surface elev. ft. Depth to limiting factor G in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz
in. Munse Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
2 •Z
F-1 Boring # ❑ Boring
❑ 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 /ftz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
* Effluent #1 = BOD > 30 < 220 mg /L and TSS > < 0 mg /L * Effluent #2 = BOD < 30 mg /L and T S < 30 mg /L
CST Na a (Please Print) S1 nature CST Number
Address Date Evaluation Conducted Telephone Number
SBD -8330 (R07 /00)
r '
Property Owner Parcel ID # Page of
F Boring # E] Boring
❑ 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 /ftz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2
F-1 Boring # ❑ Boring
❑ 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 *Eff#2
F-1 Boring # ❑ El Pit Boring
Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz
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 alternate format, please contact the department at 608 - 266 -3151 or TTY 608 - 264 -8777.
SBD -8330 (R.07 /00)
PLOT PLAN
PROJEt t CT P.C. Collova Builders Inc. ADDRESS 705 Countv Rd E Hudson Wi 54016
NW 1/4 NW 1 /4s 21 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX
MPRS Shaun Bird 226900 DATE 10/7/01 BEDROOM 3
CONVENTIONAL X00C IN- GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE 1.2 ABSORPTION AREA 377 # of chambers 22
BENCHMARK V.R.P. Top of 1" Iron Pipe ASSUME ELEVATION loo' Filter Zabel A -100
❑ BOREHOLE O WELL •H.R.P. Same as Benchmark
SYSTEM ELEVATION 96.5
Vent
> 12" Sidewinder High
Capacity Leaching Plans Designed Using vs
Of Cover Chamber Conventional Powts
1
Manual Version 2.0 C''
6 Long 6"
Grade at System Elevation
34
a�
a
�
2 -3' X 69' Cells with >3' Spacing B 3
-
Vents t
150' B -2 40' 80'
Pro 3
Bedroom
House
B.M #1
Property Line
FROhf :. F C COLLOVA BLDRS, 11AC' PHOIJE IJO, 715 - 5911 Hug. 2 2 O- : SEPI1 P2
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C� Os F- U)
Sanitary Permit Application Safety & Buildings Division
In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave.
# / PO Box 7302
® *&Co See reverse side for instructions for completing this application
Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302
Department of Commerce [Privacy Law, s. 15.04(1)(m)] (Submit completed form to county if not
state owned.)
Attach complete plans (to the county copy only) for the system, on paper not less than 8 -1/2 x 11 inches in size.
County / , i � State Sanitary Permit N ber ❑ Check if revision to previous application State Plan L D. Number
I. Application Info - Please Print all Info mation Location:
Prope Owner Name; Property Location / /�
G , L �1�Gr1li / )O k/4 (A /4, SRI T3Q,1i((P(or6
Pro erty Owner's Mailing Address Lot Number Block Number
City, State Zip Code hone NX Subdivision Name or CSM Number
57 U16
#UAAA1 W_� 1 1 ' II. Type of Building: (check one)' �� ❑ city
1 or 2 Family Dwelling - No. of Bedroo ms: 3 � ; A C ❑ Village
/ �t AT❑ Public /Commercial (describe use):_ own of t
❑ State -Owned Q C) )�C
J Nearest Rd
17' -14!!9 Paz `
Numbs)
III. Type of Permit: (Check only one box on line A. Check box on line B if applicable) C �
A) I. New 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to
ystem System Tank Only Existing System
B) Permit Number Date Issued
❑ A Sanitary Permit was previously issued
IV. Type of POWT System: (Check all that apply)
A Non - pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland
❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line
❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other:
V. Dispersal/Treatment Area Inform ation:
1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade
Required Proposed Rate (Gals. /da sq. ) (Min. /inch) Elevation
7 a �f �, so 00
VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic
Information Gallons Gallons Tanks Con- Con- glass
New Existing crete structed
Tanks Tanks
5 r ❑ ❑ ❑ ❑
❑ ❑ ❑ ❑ ❑
VIII. Responsibility Statement
I, the undersigned, assume resp onsibility for installatio of the POWTS show, the attached plans.
Plumber's Naule (print) PlumbSig at re (no stams4 P PRS No. Business Phone Number
Plumber's Address (Street, City State, Zi C e)
IX. County/Department Use Only
❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issue Issuing Agent Signature (No stamps)
><P proved ❑ Owner Given Initial Adverse Surcharge Fee)
Determination 1 -2-
X. Conditions of Approval /Reasons for Disapproval:
u G4U1.e__& L4� 6..
SBD -6398 R.07 /00
1 2 1 l 2- &0 w o ?
Sanitary Permit Application Safety & Buildings Division
In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave.
`�� See reverse side for instructions for completing this applicatio
PO Box 7302
Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302
Department of Commerce [Privacy Law, s. 15.04(1)(m)] (Submit completed form to county if not
state owned.)
Attach complete plans (to the county copy only) for the system, on paper not less than 8 -1/2 x 11 inches in size.
County r 4 State Sanitary Permit N ber ❑ Check if revision to previous application State Plan I. D. Number
711,717 I. Application Informat - ion - Please Print all Infof mation - Location:
Pro pe Owner Name '�(a. Property Location f
4)0 -h /4 (Jul /4, S I T3Q,1�4 ( � (or)(D
Property Owner's Mailing Address Lot Number Block Number
City, State Zip Code hone Nu d�WjX r Subdivision Name or CSM Number
#UAA� WX
II. Type of Building: (check one). ^ . ❑ City
1 or 2 Family Dwelling - No. of Bedrooms : 3 / \ Cj� ❑Village
❑ Public/Commercial (describe use):_
"" J �� 9 Town of
t
❑ State - Owned Q C)
ff — / o S Nearest R ad
1 ✓
� � Paz Numb
III. Type of Permit: (Check only one box on line A. Check box on line B if applicable) o? — //,3 — D
A) I. New 2. ❑ Replacement 3. ❑ Replacement of 4. 5. d 6. El Addition to
C lem System Tank Only Al. 3 O, 7 Existing System
B) Permit Number Date Issued
❑ A Sanitary Permit was previously issued
IV. Type of POWT System: (Check all that apply)
A Non - pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland
• Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line
• At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other:
V. Dispersal/Treatment Area Information:
1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade
t
Required Proposed Rate (Gals. /da sq. ) (Min. /inch) Elevation
ySD 3 7,5 - ' '� 6
VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic
Information Gallons Gallons Tanks Con- Con- glass
New Existing crete structed
Tanks Tanks
❑ ❑ ❑ ❑ ❑
VIII. Responsibility Statement
I, the undersigned, assume responsibility for installation of the POWTS show the attached plans.
Plum 's N e (print) Plu PRS No. Business Phone Number
x / �CG,i mb Si at re (nos s P �aa3s7 -7
Plumber's Address (Street, City State2Zi nCe)
/ate
IX. County/Department Use Only
• Disapproved Sanitary Permit Fee (Includes Groundwater Date Issue Issuing Agent Signature (No stamps)
proved
• Owner Given Initial Adverse Surcharge Fee) ^�
Determination
X. Conditions of Approval /Reasons for Disapproval:
(APpu - 0a'�2,c I �,Q r-_
� ��at�e( -� -fie c U�ctu�
SBD -6398 (R. 07/00)
Cr
71 � yD
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0/
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a f
y
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U
r
�r
131N --1
vt c�onsi Department of commerce SOIL EVALUATION REPORT Page of 3
' Divisib of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code County
Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must �� • YUI
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D.
percent slope, scale or dimensions, north arrow, and locatiortanddistance to nearest road.
Please pri►rt all Reviewed by Date
`\
Personal information you provide may be used for seconafjf purposes (Privy Law, s. 15: , 1) (m)).
r
�� l u
Property Owner .1i, -l j,r' Pro periyLocation
R icha rd e S n{ GovL L �(,) 1/4&(j 114 S Z I T N R E (or)
Property Owner's Mailing Address t # -_ ocl(# Subd. Name or CSM#
60 10(02 ST Cox.. �Ol�view Acres
wn
Nearest Road
Staff Pt►one ❑ Village [�To
�V
nY MSG OFF rt , �
® New Construction Use: ® Residential / Number of ' - Code derived design flow rate 4 5 Ca nn GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material t'7 V4 uja 5 V Flood Plain elevation if applicable _ d11 4- ft.
General comments S yS f(c vo J 9'Z So
and recommendations: �� J• ��. �'(�
F-1 I Boring # El Boring
® Pit Ground surface elev. d ft Depth to limiting factor / ZO in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 `Efl#2
I -1Z IO r31Z Sit 2 m c 5 l v g . 9
Z
. 17--,3(4 10 9) 5; / Z c - 5 — 5 8
3 X39 -12 9 o s ,r,-, I
l'i�nC
2 Boring # E] Boring
® Pit Ground surface elev. 100.10 ft Depth to limiting factor 1 / in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDAf
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 •Eff#2
I
0 i'U 3/L v-C 5 8
Z lv- y 041 — s; Zrmb rye
. - 7 /. Z
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
AiC oxn Sc 1�u ken — Z533dg
Address Date Evaluation Conducted Telephone Number
2lt3 8�'' -' �1• . SomerSe -4 w � 5�102� 5`�` � � G � C � Ig) Z�1 Z- �•4�0$
Property Owner N e I50 n Parcel ID # Page 2 of 3
F Boring # El Boring
® Pit Ground surface elev. _ ft De pth to limiting factor 118 in• Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Efl#2
I
0 - 1 2 . I D 2 S i l Z k ryl� C5
2 1 2 _3y 1h, r 4 114 5! Z mab k en-l= r
3 39-4/6 l -? !• Z
UV
' kc
F-1 Boring # ❑ Boring
❑ 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/ff
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2
Boring
❑ Boring # Ground surface elev. ft Depth to limiting factor in.
❑ Pit Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Stnu buure Consistence Boundary Roots GPD/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 alternate format, please contact the department at 608 -266 -3151 or TTY 608- 264 -8777.
SBD -8330 OL07/00)
r
s �
PAGE 3 OF 3
NAME U A c) ,n LOT# 3 LEGAL DESCRIPTION,VW /+Nw' /a,SZi T,3p N,R is E (or)R
SCALE: I "=
BM I ELEVATION ADO • Q
BM I DESCRIPTION p c s / 1 O.D e `� +
BM 2 ELEVATION 9g, G FS SCG. Z
BM 2 DESCRIPTION �" TQon h ,--'
SYSTEM ELEVATION / [e • .S O
ALTERNATE ELEVATION 9r • S
CONTOUR ELEVATION P70 S /off e
m
� + �o+ S►�P� tY� �°f'�
13 - 3
yQ
■ /iMary ■
GNATURE DATE
_
m�
y
Private Onsite Wastewater Treatment System Management Plan
Septic Tank And Gravity In- Ground Soil Absorption Component
Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment
System (POWTS) shall include information and procedures for maintaining the system within
the parameters of Comm 83 and 84, and the conditions of approval by the department, agent,
or governmental unit. The approved plans and permits for system are on file at the county
zoning or health department.
This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground
Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD-
10567-P (R.6/99).
Table 1: System Design Specifications
Sanitary Permit Number
Number of Bedrooms
Design Flow - Peak (gpd)
Estimated Flow - Average (gpd)
Septic Tank Capacity (gal) Q
Soil Absorption Component Size (ft
Type of Wastewater Domestic
Table 2: Soil Absorption Component - Limits of Reliable Operation
Septic Tank Component Soil Absorptio2 Component
Design Flow - Peak (gpd) 37
Maximum Influent Particle Size (in) 1/8
Maximum BOD (mg /L) 220
Maximum TSS (mg /L) 150 EE
Table 3: Maintenance Schedule
Septic Tank Inspect and /or service once every 3 years
Outlet Filter Inspect once a year and clean at least once every 3 years
Soil Absorption Component Inspect once every 3 years
Septic Tank
The septic tank shall be maintained by an individual certified to service septic tanks
under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with
NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease
Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable
Restrooms).
The operating condition of the septic tank and outlet filter shall be assessed at least
once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure
proper operation. The filter cartridge should not be removed unless provisions are made to
retain solids in the tank that may slough off the filter when removed from its enclosure. If the
Management Plan for a Septic Tank and Soil Absorption Component
filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously.
Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The
septic tank shall have its contents removed when the volume of scum and sludge in the tank
exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the
time'of an assessment, maintenance personnel shall advise the owner of when the next service
needs to be performed to maintain less than maximum scum and sludge accumulation in the
tank.
Manhole risers, access risers and covers should be inspected for water tightness and
soundness. Access openings used for service and assbssment shall be sealed watertight upon
the completion of service. Any opening deemed unsound, defective, or subject to failure must
be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by
an effective locking device to prevent accidental or unauthorized entry into the tank.
No one should enter a septic or other treatment or holding tank for
any reason without being in full compliance with OSHA standards for
entering a confined space. The atmosphere within the septic or other
treatment of holding tank may contain lethal gases, and rescue of a
person from the interior of the tank may be difficult or impossible.
Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the
tank is no longer used as a POWTS component.
Soil Absorption Component
The soil absorption component serving this structure is designed to accept domestic
wastewater from a residential facility. The limits of operation of this component are shown in
Table 2.
The longevity of a soil absorption component depends greatly on proper and timely
maintenance, and system use within or below the limits of reliable operation. Good water
conservation practices by all occupants and the installation of water conserving plumbing
fixtures are key factors in extending the useful life of this component.
The soil absorption component's operation must be assessed by inspection at least
once every three years. The inspection shall include recording the levels of ponding, if any, in
the observation pipes, and a visual inspection for any evidence of surface seepage or discharge
from the component. On steeply sloping sites, areas of erosion should be identified and
reported to the owner for repair. The surface discharge of domestic wastewater or sewage
from the system is prohibited and considered a human health hazard.
Traffic around or over the soil absorption component should be avoided particularly
during winter months. The compaction or removal of snow cover over the component may lead
to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or
impossible to repair until weather conditions improve. In general, soil compaction over this
component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to
more intense, and earlier, organic clogging of the soil.
2
Management Plan for a Septic Tank and Soil Absorption Component
Plantings of deep-rooted trees and shrubs directly over or within ten feet of the
component should be avoided since root intrusion into the component may obstruct wastewater
flow.
Off- 1.
N
C 7 .5)
aZ. y
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fi C/L-� 7 �7
h
. " FROM : P C COLLOQA BLDRS, 1140 PHONE NO. : 715 549 5911 May. 24 2001 02:40PM P2
ST CROIX COUNTY
SEPTIC TANK MAINTENANCH A0111.1 141?tV7'
AND
OWNPRSI CERTIFICATION DORM
c)VA A H (%'I ..0 c-
Mailt ig Address
llfoperty Address
(Verification ragltired front )'tanning Department for ucw cons(ntcitoti)
City /State N. -(,(] 4 t (.-(^o,✓A Parcel I(ientireatian 1 +1111
I'foperly Loctilioll '' /a, 101 '44, Sec. o� . T-3D I.(.•R. 'Town of rl tC(-l/V14 J
Subdivision 0 t T U1 .cv M65
Lot # - -
Certified Sutvcy Map i'f Volullic
3170 /� °75 �l
will-1-:111(y Aced It V01111110 7'h - - Page U
Spec house l] yes > 2'410 [,at lines idendrii able Xlyes CI no
lf§ 111T hfAINTErin CR
Iru(iroper Ilse and nialolcna 'Ice Of your septic systcal Could resulI 'Ill its premature failure to handle wasits. Proper Inaialeuance
consists of pumping out the septic lack every duce years or soollcr, if needed by a licensed pulllper. What you put into die system
can affect the fituctiou of ilia septic tank' as a treatment stage In the waste disposal system.
The property owner aareeS (o allbinit 14 , iloiX 'Loniog Depalllucltl a cerlifiealloll furtll, aiglrod by tilt owner Anil fly a
n III Star pluotbcr, Journeylrlanplulubcr, restricted piumbcror it licensed ptunpet verifying lhal (1) ilia on -site waslcwalardisposah sysleul
Is (n proper operating condition audlor (2) after laspclaiou And puogling (if necessary), ilia septic tank is Icss (hall 113 full of sil►dge.
Uwe, the uudcraigncd Have read ilia above ralptiremctlls cud API'co to maintain the private sewage disposal system wide ilia slandardi
set fulk heroin, asset by ilia Depargncnt of Commerce and the Ueparialent of Natural Rcsaurces, Slate of Wiscolisfil, Ceithftea(lon
Slating 111 "4 0111 acptle systcul 11as bceu irlahllained must be completed Gild rclulncd to tiro St. Croix County Zoning Office within 30
day o yCar explraliou daft. � ' � , 4
r;ltA�vt dr arrL °tcnrfl DATE
Q WtvriT C t TI jf f0tj
I (we) certify (hill all slalen► ems cu this form arc 11uc to like best of lily (our') knowledgd: I (we) aill (Arc) ilia owncl(s) of
ilia plopc ascribed ova, by V of a warranty decd lccurded in Ragisice of Deeds Office,
St 71l t]p AppL1CATfl l l)AT'f?
9""" .Any (ufurinadou that is mis•rcpresented nlay result in the sanitary permit being revoked by ilia 'Zoning Dcpariment. ""''
r• 111CIMIC Willi (1119 npplicataalr: a +1411111Cd walyailty 1lCOd ftom Ilia heLlilcr of UCcds ofllaq
a copy of the cpriined splvcy map if rcfcrcoce is made in ilia warranty deed
08!08/01 WED 08;01 FAX 713 980 4887 REGISTER OF DEEDS 91001
Y riz
STATE: BAR OC NSrTE 2 -1999 N.p7lfLEEhI }1, WALSH
WARRr'� ,TY E D REGISTER OF DEEDS
Document Number Na BT. CP.OI7( CO., WI
'
This Decd, made belweon Hillv pevelo REE FOR RECM p>yt L J p4tt�d, s
Min nesota Limited L iability'Part n ership, 08 -07 -2001 9:30 API
_ SARBFWTY DEED
EXEMPT h
Grantor, and P. C. Collovs Buil Inc., a M Corpora CRT COPY FEE:
— COPY FEE:
- -- TRANSFER FEEa 740.60
_.... RE FEE: 10.00
Gmtee.
Grantor, for a valuable consideration, conveys to Grantee the
following described real estate in 5t. C County,
State of Wisconsin Cif more- space ii; needed, please attach addendum):
Recording Area
Nome and dictum Address
Lots 1, 2, 3 6, 7, 29, 30, 31, 32 artd $3,
Golfviev i1c es, Town of Richmond, St. Croix
Country, Wisconsin. 3
DA p4LO CUST ?EN
HUDSON, Wl 54016
Pt 026 - 1 _
Parcel Identification Number (PIN)
This is not homestead property.
N) (is not)
Exceptions to warranties:- Easements, restrictions and rights -of -way of record, If any.
Dated this _ �` day of June _ 2001
litllvale Development Limited
_ • By: D ie-hard Nelson
* -
AUTHENTICATION ACKNOWLEDGMENT
Signaturc(s) — STATE OF WISCONSIN )
) ss.
— St. Croi County )
authenticated this day of _ .,_. , ,.
I'crsonttlly came before me this day of
Junt: —, 2001 the above- named
HIllvale elo me Limited, a Li mited Linbili
e Kri stian O lan -
>; .... _.,. i Partn +a �p �Ricitard Nelson,
TITI. H: VIEMBEA STATE BAR OF WISCONSIN to l � � rson(s) who cxGCUted tl:c f0m90ing
(If not, in aged the same,
authorized by $ 706,06, Wis..Stuts,)
THIS INSTRUMF.N'I' WAS DRAT rED BY
:n
L .. .
Attorn Kristi Og land TV consin
kl.udso n �U My I aricnt. (If not, state expiration date;
(Signature% mar be uuthanticated or ucknowlcdgcd, Both are not necessary.) 'rNrsinN•• _ ... � . —')
Names orpersons signing hi any aupadty must be typed or printed below their signature. euonstom Prof isione -s comPPM. Fend au Lea tM
STATE BAR OF WISCONSIN e�esszost
WARRANTY DEED PORM No, 3.1099
X , TRUNK HIGHWAY
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