HomeMy WebLinkAbout026-1119-05-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division .3
INSPECTION REPORT Sanitary Permit No: 420497 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)].
Parcel Tax No:
Permit Holder's Name: City Village X Township i
Ulrich, Mark Teresa Richmond Township 026 - 1119 - 05.000
CST BM Elev: Insp. BM Elev: BM Description:
/0V - a "60 ` Zj
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Ot�OA Benchmark
,1
Dosing I t Alt. BM \ a b /
Aeration LO�wvi'd� Bldg. Sewer ) /
Holding St/Ht Inlet
c
St/Ht Outlet
TANK SETBACK INFORMATION
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic � � 1 /., t Dt Bottom
Dosing u r �` y 1 Header /Man.
v �•) a �. rS
Aeration Dist. Pipe
Holding Bot. System g 1aD
Final Grade
PUMP /SIPHON INFORMATION vW IZ "t o.+cr
Manufacturer Demand St Cover S" 1
GPM ``-- �19c•SSt
Model Number 5--
DH Lift .tom Friction Loss System Head TDH Ft
i �` �J
rcemain Length ®1 D a Dist. to Well
SOIL _ A Rftrm SYSTEM
MB EN rW Width Length t No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Depth
DIME ONS '3J z? S
SETBACK SYSTEM TO P/L BL G IWELL LAKE /STREAM LE HING pM
INFORMATION CHAM
Type Of System: r UN
3 � f t � 'y �--
DISTRIBUTION YSTEM
Header /Manif Distribution r t x Hole Size x Hole Spacing Vent to Air Intake
2M Pip9s)31 C /�` Di ' Spacing 9 �• 1 B 2 U _1
L Dia Len th _ate a ` S
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 L Yes [,*I No *Yes r ^ No
COMMENT=S: (Includ code discreppncies, persons present, etc.) Inspection #1: ( 7 t7 Inspection #2: �/ Z
Fit. � a,�-w ���� Parcel No:
Location: 1280 146t Av e New Richm d, Q -5- 40 (SE 1/4 NE 1/4 22 T30N R18W) Pondv[ ea ows 5 . 0. 8. 0
1.) Alt BM Description
e
2.) Bldg sewer length = IZ tl
- amount of cover = SSb
Contour —
I (� w.�_ � ° 1j
- -
P an revision Required? Yes No
Use other side for additional information.
Date Insepctors Signature Cent. No.
SBD -6710 (R.3/97)
[
Safety and Buildings Division County
'201 W. Washington Ave., P.O. Box 7162
N VISCOnsin Madison, WI 53707 - 7162 Sim Address ✓
De artment of Commerce /o - U - 40� 3 V-0 i y I-,2 / �✓
Sani
Sanitary Permit Application Permit Number
f Ia accord with Comm 83.21, Wis. Adm. Code, personal information you provide Check if Revision
may be used for Privacy Law, s15.040 m
I. AppUcetion Information - Ple Print All Information State Plan I.D. Number
ase
'X'WS � ?
Property owner's Name - Ei;L1`�' °� Parcel Number 046 -'(ly -0 s 0 0 V
\/ Y A
Property Owner's Mailing Addressp°m Location • 7Av
OCT 1 7 X007 s - A u;S 1� T 15 N.R /�
it S
7 IL
City Stara Zip Code �C�f 1 f Y Lot Number S Block Number
Z J N I N GN Subdivision None CSM Number
U. Type of Building (chock all that apply) City `
i or 2 Family Dwelling - Number of Bedrooms ❑viliagc
❑ PubWCommercial - Describe Use Q , `G`i /fir G✓v
❑ State Owaod w/ �2 diet. mlly .eA-,,A 3'.X 7S ct, - {� fS' Nearest Road
a.�e �i�► > T f4f 0 1 upiae ' cal/ 40 ' enrh14t / 3 T v -c
III. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line B V applicable)
A. For County tare
1 fNew 2 ❑ Replacement System 3 ❑ Replacement of 6 ❑ Addition to
Stela Tank Only m
B. C] Check if Sanitary Permit Previously Issued
Permit Number Due Issued
IV. Type of Permit: (Check all that apply)(n scheme is for Internal use)
44 ❑ Non - Pressurized la- Ground 2Mound 47 Sand Filar SO 13 Constructed Worland
22 ❑ Pressurized In-Gruuad 4 olding Tank 48 11 Single Pass Sl Drip Line
45 At�G:ade 46 ❑ Aerobic Treatment Unit 49 C1 Reci=W 3o D Other
� All — i
T ent Aron Information: _
De Fi Dbl iapersal Area Soil Application Z ation Ram System Elevation Final Grade
R Proposed Ram(Gals- MaY04 —Inch) Elevation v
Z2sb#' Z�(7 '/V qS� - < U� ls A&I ,
VI. Teak Info Capacity in Total Number ufacturer Prefab Site Steel Fiber plastic
Gallons Gallons of Tanks '(6ro o Concrete Constructed Glass
New 8sisdai ,Qr
Tadts Tasks
Sepdc or Hokft Teak
r
Dosias Chardw X G D -e v
VU. Ol Statement- I, the tad ,e=arner reaponsibWty for a of the POWTS shown on the attached .
ty Plumber's Name (Print) Plumber's Signature WOORS Number Business Phone Number
Plumber's Address (Sweet, City, State, Zip Code)
U c S'O .�/
VV1L evartment Use OW
Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater D d issued nt Signature Qqo Stamps)
Stir chuge Pee)
Owner Given Initial Adverse
Determination � d
Conditions of ApprovaUReasons for Dim+pproval � J S n ,, „ So ti /s f �1r
/�Qtin art v,. 6a ah �Slu � P(41
/o Z ��i�a
b
717
nom (to tsar 7) for on paper not lets than 814:11 r In size
SBD- 6398 (R. 05101)
PLOT PLAN
• -Page 3 of - 7
Scale 1 " =yQ '
a� x
6
Cut_ -ib� sn
►�o`re: � ��� s ty-��tfl BE
on VF"r OF
ATM
,>
Z.
2 zo o
B ..
�l 9S OF
z pv e r, . 3e � P W �l `► '�'C�, S t
rN \ - � 1��~f`1 S�2 E r�ln"Ip k 1 N P
An zo,_z ha'al Am rov
3 a o
0 T b ks'RAQ Tlfts
64" IV Afcy HSI
33
N
e l-) w► ►r�. gFI REST LJO T L11� 1E
LT 3M - �- 1 ov.o `� 12p� `�Ipi
LL. 38.1 C.)
NOTES for cU�_NQ
1. Elevations shown are existing ground elevations unless otherwise noted.
2. Install 4" observation pipes with approved caps. (__ required).
3. Septic tank to
p be o S a 11 -es p t
10 U g anu •a tured b
wl�S "1? Cpry C� � y H ! �� b
4. Bench markS : S� V
U
5. Divert surface water around system to prevent ponding at the uphill side.
1 Safety and Buildings
i 4003 N KINNEY COULEE RD
LA CROSSE WI 54601 -1831
TDD #: (608) 264 -8777
\Visconsin www
www.commerc .wis c ons
.wisonsin.gov
Department of Commerce
Scott McCallum, Governor
Philip Edw. Albert, Secretary
October 01, 2002
CUST ID No.267341 ATTN: POWTS Inspector
ARTHUR L WEGERER ZONING OFFICE
421 N MAIN ST ST CROIX COUNTY SPIA
PO BOX 74 1101 CARMICHAEL RD
RIVER FALLS WI 54022 HUDSON WI 54016 '
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 10 /O1/ Identification Numbers
a Transaction ID No. 789054
SITE: Site ID No. 650728
Mark &Teresa Ulrich q Please refer to both identification numbers,
h ! ( ��
1280 146TH Ave above, in all correspondence with the agency.
" `
Town of Richmond
St Croix County
SE1 /4, NE1 /4, S22, T30N, R18W
FOR:
Description: Three Bedroom Mound System
Object Type: POWT System Regulated Object ID No.: 871420
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in
chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements.
The following conditions shall be met during construction or installation and prior to occupancy or use:
General Approval Requirements:
• This system is to be constructed and located in accordance with the enclosed approved plans and with the
"Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01/01)
and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION
2.0" SBD - 10706 -P (N.01 /01).
• The mound area must be deep chisel plowed to help break up the weak platy soil structure that was reported at
the site. The county may, at their discretion, request verification of the plowing prior to continuation of system
construction.
• Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area.
Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal
Tonally are prohibited.
V • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption
area. chs. NR 811 & 812c
Of COMMERCE
T D iLDINGS e A Sanitary Permit must be obtained from the county where this project is located in accordance with the
requirements of Sec. 145.135 and 145.19, Wis. Stats.
ip6NDENCE , Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the
designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat
ARTHUR L WEGERER Page 2 10/1/02
• Comm 83.22(7) A copy of the approved plans, specifications and this letter shall be on -site during construction
and open to inspection by authorized representatives of the Department, which may include local inspectors.
Owner Responsibilities:
• Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and
maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s.
Comm 83.54(1).
• Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as
required under s. Comm 83.54(4) shall be considered a human health hazard.
• Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county
for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s)
utilized in the POWTS.
All permits required by the state or the local municipality shall be obtained prior to commencement of
construction /instal lation/operation.
In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should
conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review
shall relieve the designer of the responsibility for designing a safe building, structure, or component.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
q g P Y P
on this letterhead.
The above left addressee shall provide a copy of this letter to the owner and any others who are responsible
for the installation, operation or maintenance of the POWTS.
Sincerely, Fee Required $ 175.00
Fee Received $ 175.00
Balance Due $ 0.00
Charles L Bratz
POWTS Reviewer II , Integrated Services WiSMART code: 7633
(608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday
cbratz@commerce.state.wi.us
cc: Leroy G Jansky , Wastewater Specialist, (715) 726 -2544
i
TITLE SIIEET Page of
MOUND SYSTEM
FOR
A 3 BEDROOM RESIDENCE
This plan has been prepared in accordance with the Mound Component
Manual SBD -1057 P and the Pressure Distribution Manual SBD- 10573 -P
C tz . b! qq� C R. 6 14 C
LOCATED IN THE SG 1 /4 OF THE INS 1 /4 OF SECTION 2Z , T 3p N, R 1 g 6tT,
TOWN OF �Z1C1�Y)p�3� S'� Cri�tjlx COUNTY, WISCONSIN.
L S OF PDKA,)\� � S
INDEX
PAGE 1 of 7 TITLE SHEET
PAGE 2 Of 7 SYSTEM MANAGEMENT PLAN
PAGE 3 of 7 PLOT PLAN
PAGE 4 of 7 PLAN VIEW -CROSS SECTION
PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT
PAGE 6 of 7 PUMPING CHAMBER CROSS SECTION t�
PAGE 7 of 7 PUMP PERFORMANCE CURVE'
PREPARED FOR
1 � 1 S V �iV Dy 1zC S T1Z �
PREPARED BY
WEGEF:ZEFZ SOIL . TEST 2 NCG
AND.
DES Y C-3" I (__
P.O. Box 74 421 N.Main St.
River Falls, WI 54022
Phone 715 - 425 -0165 0
Fax 715 - 425 -6864. •••.,, /�r
v.EGERER
DctS ► �
cuswoRV� !
C ondz , �o O ....�. ,
ON of pF � Gj � 6 -C)
1 �N OF
SEE �oRR� 0 2 - ZD
JOB N0:
Mound System Management Plan P age Z. of 7
Pursuant to Comm 83.54, Wis. Adm. Code
Septic Tank J�L(jZ'Y� �� 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. Theoperating condition of .
the septialanLaad-
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 e tilter rartrid should not be removed unless provisions are to re air so e tank that
'"may slough off the filter when removed from its enclosure. If the 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 sludge and scum 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 a triennial 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. The addition of biological or chemical additives to enhance septic tank performance is generally not required.
However, if such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and
Buildings Division.
Pumo Tank
The pump (dosing) tank shall be inspected at least once eygnL 3
— Al itches, alarms, and pumps shall be tested to
verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary.
Mound and Pressure Distribution System
No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound
shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic
(other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the
infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather
installations (October - February) dictate that the mound be heavily mulched for frost protection.
Influent quality into the mound system may not exceed 220 mg /L 8005, 150 mg /L TSS, and 30 mg /L FOG. Influent flow may
not exceed maximum design flow specified in the permit for this installation.
k The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each
ateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be
test w en the sys em was installed o determine if orifice clogging has occurred and if orifice cleaning is
required to maintain equal distribution within the dispersal cell.
Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner,
and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring.
General
This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its'
component manual [SBD- 10572 -P (R. 6/99)] and local or state rules pertaining to system maintenance and maintenance
reporting. _
No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and
pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as
POWTS components.
Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access
openings used for service and assessment 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 a tank or component.
Contingency Plan
If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the
system in proper operating condition.
If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component shall be
immediately repaired or replaced with a component of the same or equal performance.
If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired
or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged adsorption
and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper
operating condition.
Questions about the operation or maintenance of this system should be directed to:
The County Zoning Office at 1S 3g � -4 �jS0 la�r- (-NM lX
The system installer at
The tank manufacturer at SOD =-� Z S _ $l�s 6 IN I. lz t2
The effluent filter manufacturer at Z]
The pump manufacturer at
PLOT PLAN - Page 3 of - 7
Scale 1 " =yQ '
6
Olt k �r of r- KuatZ,
Page Of - 7
Approved Synthetic Covering
QSTH C33
Medium. Sand Distribution Pipe
Topsoil _ - -- - - - -- H
--------- - - - =_� = ,-_ =-_ = _= F Elev'.l 4p,�
—1 a
3 p.
1
3 %. slope - -
p
r
T; Cell Force Main PI w
D_„tbution Ce 01 o wed
Z" to 2- Aggregate From Pump Layer
Undisturbed D O. S Ft.
Soil
- E Ft.
Cross- section of a mound system using F D•6 Ft.
2 cells for the absorption area
A 3 Ft.X 2
G 0- S Ft.
B H t • O Ft.
C, S Ft.
Ft.
Linear Loading Rate= 3,0 GPD /LN FT O Ft.
Design Loading Loading Rate o Q FT
�� D / J 6 Ft.
K g Ft.
Fg L G 1 Ft.
W 3 Ft.
L
T
nervation
(� pipes
(anchor securely)
-
• Force
0 l? US i''�
W Main
Distribution `\
Pipe Cell of to' 21-
,
aggregate
j2
l
Plan view of a mound system usii;Ej
2 cells for the - absorption area
Distribution Pipe Layout PzQ S o f '
.o
Place the holes at the bottom of the distribution pipes
at* equal spacing. Remove all burrs from the pipe and holes.
Extend the end of each late -al up w turn or the use of long tu or 45° ftting to a point within six -
inches of the f iW grade. Term=-m= to the ends of the IateraLs with a valve, :threaded c: n or
• threaded plug. Provide access from final grade for the valve; threaded cap or threaded plus.
�vC
Lateral Maniiald Lateral
z x x x12 I xfI x x x x
Lateral Length — Lateral Length — P
Distribution line
e rr- L,
P 3 7 F Hole Diameter Jle) Inch -
S \ S Ft. Lateral " Inch(
X Z 4 Inches Manifold 7 Inches
Force Main " Z Inches
lof hales /pipe 1-9
Invert Elevation of Laterals %0).3 Ft.
Combination Septa-c: and
PUMP CHAMBER CROS5 SECTIOM AMD SPECIFICATIONS ' PAGE OF �
VEUT CAP WEATHER PROOF
JUUCTION BOX .
y'C.Z. VEIJT PIPC t APPROVED LOCKING
1 10 ' FROM DOOR. M'"NOLE COVER cvlV
.%tA100W OR FRESH wARNII.IG L.A6EC.,
3P 1oW P IPE ALIUTAKI S coucu�r
•wlPn.CLllsttT'r.�P �
FI tV 1SI}p
G zptD E
IMLET +" PROVIDE I - - -_
AtRTIGHT SEAL I I j I � s
Approved rov i z� �� A I II I Approved
joint w/ A-�6 I joint w/
PVC pipe ALARM PVC pipe
a ' i 1 ! •
I 1
c •i I
I I
CLEY. () 'O f?
I PJMP OFF
0
Q COQCRETE
C t 0'O 6LOCK
t
RISER EXIT PERMITTED O►JLy IF TAWK MAWL)FACTURI`R HAAS SUCH APPROVAL 3 " APPRo)"m
�8r<DO
SEPTIC F SPEC)FICATIOUS
DOSE
TAWKs MALJUFACTURCR: Cj-)�-�QTI. IJUM8[R OF DOSES: S`) PER DAB
TAMK S►ZE : _ l QUO 6S O GALLOUS DOSE VOLUME r
ALARM MAUUFACTURI`R: _S • J • tl-� S - I_S I BACKrLOW: 1 Z GALLON:
MODEL WUMSER: CAPACITIES: A= `a U1CHE5 GALLOtJS
SWITCH TtIPE: _ ZL lJ y 5= Z IfJCFIES'OR _ =-L_ G�LLOIJS
PUMP PlAQUFACTUREA: 60 V` -tS C= WCHES OR L� Z- CALLOUS
MODEL NUMBER* � 5 D= 12 INCHES OR GALLOIJS
SWITCH TYPE: �°—U MOTE: PUMP AUO ALARM ARE To ac
MINIMUM DISCKAR6E RATE 3 <' L� GPM INSTALLED ON SEPARATC CIRCUITS
VERTICAL DIFFERENCE BETWEEU PUMP 0 D•.DISTRIgUTI01J pIPE.. 11 3 O FEET
+ MWIMUM NETWORK SUPPLY PRESSURE SO FEET ` S • OX-I. 1>
+ _ g 5 FEET OF FORCE MAIN X Z ` O � Fj0FLFKICTI0LI•FACTOR_. 1 ' - � 8 1F ET
TOTAL E)!JUAMIC. HEAD = __S ET
As per manufacture . p gal /in. Liquid depth
Goulds iE - 7
Submersible
Effluent Pump
0
r'
3871 EPO4
EP
05
APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron
Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer,
following uses: • Capable of running lubrication and efficient strength, and durability.
• Effluent systems dry without damage to heat transfer. ■ Motor Cover. Thermoplas-
• Homes components. Available for automatic and Motor: tic cover with integral handle
•Farms manual operation. Automatic 'and float switch attachment
• Heavy duty sump • EPO4 Single phase: 0.4 HP, models include Mechanical points.
• Water transfer 115 230 V, Hz,155 Float Switch assembled and ■ Power Cable: Severe duty
• Dewatering RPM, , built in ovv erload with
automatic reset. preset at the factory. rated oil and water resistant_
SPECIFICATIONS • EP05 Single phase: 0.5 . ■Bearings: Upper and lower
heavy duty ball bearing
115 V, 60 Hz, 1550 RPM, , F EATURES construction.
Pump: EPO4 built in overload with ■ EPO4 Impeller. Thermo-
• Solids handling capability: automatic reset. plastic Semi -open design
3 /4' maximum. • Power cord: 10 foot with pump out vanes for AGENCY LISTING
9 Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal protection. SP• Canadian Standards Association
Total heads: u t with three prong
0 24 feet.
A P 9 —
• Discharge size: 1 1 /2' NPT. plug. Optional 20 foot ■ EP05 Impeller: Thermo- (CSA listed model numbers
• Mechanical seal: carbon- length, 16/3 SJTW with plastic enclosed design for end in 7' or "AC ".)
rotary/ceramic - stationary, three prong grounding plug improved performance.
BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged
• Temperature: thermoplastic design provides
104 °F (40 °C) continuous superior strength and
140 °F (60 °C) intermittent. corrosion resistance.
• Fasteners: 300 series METERS FEET
stainless steel. 10
• Capable of running i x,
dry without damage to s 30
5
components.
N_ I
Pump: EP05 a
• Solids handling 5 '
9 capability: - - -
'/' maximum. z
• Capacities: up to 60 GP
• Total heads: up to 31 f t. i .I
• Discharge size: 1 N a --
z 5
• Mechanical seal: carbon- > ;
rotary/ceramic - stationary, ° 15
4
BUNA -N elastomers. i ! ( 005
• Temperature: 3 10
104 °F (40 °C) continuous !
140 °F (60 °C) intermittent. 2
5
1
0 0
0 1 10 20 30 40 50 GPM
0 2 4 6 8 10 12 m-/h
CAPACITY
®1995 Goulds Pumps, Inc.
• - Effective May, 1995
83871
Wisconsin Ciapartment of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3
y Labor and Human Relations
Division of Safety &Buildings in accord with ILHR 83.05, Wis, ;Qo)de
OUNTY
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. P 4"Op ru5st incfra�le�Hut St. Croix
not limited to vertical and horizontal reference point (BM), direction and % e, scali •6r '' [REV AR L I.D. #
P
dimen sioned, north arrow, and location and distance to nearest road. 0 6 - 1065 -50 -000
APPLICANT INFORMATION— PLEASE PRINT ALL INFORMATION / r , , IE ED BY DATE
A�1
:r iQX
PROPERTY OWNER: PROPE TY L0"T*NN l
Richard Derrick �� L � i '` 1E 1 22 T 30 N,R 18 f W
PROPERTY OWNERS MAILING ADDRESS L #\ ;% ,BLQCK# $U8tX E OR CSM #
1310 Hy. #65 5 ' %hfa + ondview Meadows
CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑ OWN NEAREST ROAD
New Richmond, WI. 54017 (719 246 -5425 Richmond I 146th. Ave.
[x] New Construction Use [ Residential / Number of bedrooms 4 [ ] Addition to existing building
I ] Replacement [ J Public or commercial describe
Code derived daily flow 600 gpd Recommended design loading rate ng bed, gpd /ft .3 trench, gpd /ft
Absorption area required na bed, 112 500 trench, ft Maximum design loading rate n_ bed, gpd /ft . 3 trench, gpd /ft
Recommended infiltration surface elevation(s) 101.30 ft (as referred to site plan benchmark)
Additional design / site considerations system el based on contour line of el 100.30
Parent material glacial drift Flood plain elevation, if applicable na ft
S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK
U = Unsuitable fors stem ❑ S ®U :l S El ❑ S ®U El S ® U ❑ S ® U EIS ® U
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft
..................
in. Munsell Qu. Sz. Cont. Color G Sh. Bed Tmnch
.................
1 0 -8 loyr3 /3 none 1 2fpV mfr 9w 2f .3
................. 2 8 -20 10yr4 /4 none sicl lcsbk mfr gw if .2 .3
Ground 3 20 -52 5yr4/4 none sl lcsbk mfr gw if .4 l .5
4 52 -75 7.5 r4/4 c2d 7.5 r5/6 sl M na na na .3 .4
10 6 ft. y y
Depth to
limiting
factor
52"
Remarks:
Boring #
1 0 -9 10yr2 /2 none 1 2fp1 mfr gw 2f .3
2 9 -24 10yr4 /4 none sicl lcsbk mfr gw if
3 24 -84 7.5ry4/6 none sl lcsbk mfr na na .4 .5
Ground
elev. 1
1 00.4 ft.
Depth to
limiting
factor
+84
Remarks:
CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200
Address: 1554 200th. Aye., New RichrrWnd, WI 54017
Signature: Date: 4 -24 -99 CST Number: m02298
PROPERTY OWNER Richard Derrick SOIL DESCRIPTION REPORT Page '` of 3
PARCEL I.D. # 026 - 1065 -50 -000
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bajxlsy Roots GPD /ft
.................
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
..................
.................
1 0 -8 10yr2/2 none 1 lcsbk mfr gw 2f .4 .5
._.3...... 2 8 -16 10yr4 /4 none sic lcsbk mfr gw if .2 .3
Ground 3 16 -40 7.5yr4/4 none sl lcsbk mfr gw na .4 .5
9
e l La ft. 4 40 -60 5yr4/4 c2d 7.5ry5/8 scl M na na na np .2
Depth to
limiting
factor
40"
Remarks:
Boring #
Ground
elev.
ft. —
Depth to -
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD- 8330(8.05/92)
PROPERTYOWNER Richard Derrick SOIL DESCRIPTION REPORT Page 2 of 3
PARCK I.D. #t 026- 1065 -50 -000
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boor dary Roots GPD /ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. W31 TMr&
1 0 -8 10yr2 /2 none 1 lcsbk mfr gw 2f .5
2 8 -16 10yr4 /4 none sic1, lcsbk mfr gw if U-2 .3
Ground 3 16-40 7.5yr4/4 none sl lcsbk mfr gw na .4 .5
e 4 40 -60 5yr4/4 c2d 7.5ry5/8 scl M na na na np .2
Q8 L .8 ft.
Depth to
limiting
factor
40"
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
71
Remarks:
Boring #
Ground
elev. j
ft.
Depth to
limiting
factor
Remarks:
SBD- 8330(R.05/92)
i
1
STEEL'S SOIL SERVICE
Gary L. Steel 1554 200th Ave.
CSTM2298 Richard Derrick New Richmond, WI 54017
MPRSW -3254 sE4NE4 s22 T30N -R18w (715) 246 -6200
town of Richmond
lot #5- Pondview Meadows
This soil evaluation was conducted to satisfy a zoning requirement, it may or may
not be suitable for your use.
N
1 =40' - - - - - -
BM.= top of lot stake of lots 5 -2 -1 C el. 100.00
Alt. BM.= top of SW lot stake C el. 98.30'
w 10 c)- -
As
�
� D
C s o
Y
Gary L. Steel
-24 -99
ST. CROIX COUNTY
WISCONSIN
ZONING DEPARTMENT
1 / N / / N ■ N �� Mn�r ST. CROIX COUNTY GOVERNMENT CENTER
1101 Carmichael Road
Hudson, WI 54016-7710
Phone: (715)386 -4680 Fax (715)386 -4686
Fhx J--
To: Charles Bratz From: Jon Sonnentag
Fax: 608 - 785 -9330 Pages: Cover page
Phone: 608 - 789 -7893 Date: 10/01/2002
Re: Pondview Meadows — lot 5 CC: Art Wegerer
Gary Steel (Dave Steel)
❑ Urgent x For Review ❑ Please Comment ❑ Please Reply ❑ Please Recycle
0 Comments:
Dear Mr. Bratz:
On September 30, 20021 was on -site to evaluate a soil test conducted by Gary Steel on April 4, 1999.
Also present was Kevin Grabau (St. Croix County Zoning), Art Wegerer (POWTS Designer), and Dave
Steel (Steel soil testing). It was determined that a limitation due to moderate platy structure does not
exist
Numerous hand borings were dug to approximately 12 -16 inches. Soil conditions were consistently
1fgr parting to 1fpl between 7 -11 inches. It was Dave Steel's recollection that the site was traditionally
plowed before the soil test was conducted in 1999. However, a deep complex root zone now exists
and would likely have broken up any platy structure that may have previously existed. One isolated
boring did reveal the presence of a narrow band of 2mpl, but the location was on the upslope side of
the system area and was not indicative of the remaining site. I do not feel that the design of this system
is limited by any moderate platy structure.
If you have any questions please feel free to contact our office.
Jon Sonnentag
Zoning Technician
I
„m "" '°�- Safety and Buildings
! RECEIVED 4003 N KINNEY COULEE RD
LA CROSSE WI 54601 -1831
� i TDD #: (608) 264 -8777
�sconsn ' ~ 1 2002 www•commercestate.wi.us/sb
www.wisconsin.gov
Department of Commerce S
��� CO c Y Scott McCallum, Governor
`,ONIN�C; OFFICE
Philip Edw. Albert, Secretary
October 01, 2002
CUST ID No.267341 ATTN: POWTS Inspector
ARTHUR L WEGERER ZONING OFFICE
421 N MAIN ST ST CROIX COUNTY SPIA
PO BOX 74 1101 CARMICHAEL RD
RIVER FALLS WI 54022 HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 10/01/2004 Identification Numbers
Transaction ID No. 789054
SITE: S ite ID No. 650
Mark & Teresa Ulrich Please refer to both identification
1280 146TH Ave numbers, above, in all
Town of Richmond correspondence with the agency.
St Croix County
SE1 /4, NE1 /4, S22, T30N, R18W
FOR:
Description: Three Bedroom Mound System
Object Type: POWT System Regulated Object ID No.: 871420
The submittal described above has been reviewed for conformance with applicable
Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been
CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10),
Wisconsin Statutes, is responsible for compliance with all code requirements.
The following conditions shall be met during construction or installation and prior to
occupancy or use:
General Approval Requirements:
• This system is to be constructed and located in accordance with the enclosed
approved plans and with the "Mound Component Manual for Private Onsite
Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01/01) and the "Pressure
Distribution Component Manual for Private Onsite Wastewater Treatment Systems
VERSION 2.0" SBD- 10706 -P (N.01/01).
• The mound area must be deep chisel plowed to help break up the weak platy soil
structure that was reported at the site. The county may, at their discretion, request
verification of the plowing prior to continuation of system construction.
ARTHUR L WEGERER Page 2 10/1/02
• Per manual cited above, limited activities are allowed in the area 15 feet down slope
of the component area. Soil compaction, excavation, vehicular traffic and other
similar activities that impact the treatment and dispersal are prohibited.
• The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50
feet from the absorption area. chs. NR 811 & 812c
• A Sanitary Permit must be obtained from the county where this project is located in
accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats.
• Inspection of the private sewage system installation is required. Arrangements for
inspection shall be made with the designated county official in accordance with the
provisions of Sec. 145.20(2)(d), Wis. Stat
• Comm 83.22(7) A copy of the approved plans, specifications and this letter shall be
on -site during construction and open to inspection by authorized representatives of
the Department, which may include local inspectors.
Owner Responsibilities:
• Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for
ensuring that the operation and maintenance of the POWTS occurs in accordance
with this chapter and the approved management plan under s. Comm 83.54(1).
• Comm 83.52(2) A POWTS that is not maintained in accordance with the approved
management plan or as required under s. Comm 83.54(4) shall be considered a
human health hazard.
• Comm 83.55 The owner is responsible for submitting a maintenance verification
report acceptable to the county for maintenance tracking purposes. Reports shall
be submitted at intervals appropriate for the component(s) utilized in the POWTS.
All permits required by the state or the local municipality shall be obtained prior to
commencement of construction /installation /operation.
In granting this approval the Division of Safety & Buildings reserves the right to require
changes or additions should conditions arise making them necessary for code
compliance. As per state stats 101. 12(2), nothing in this review shall relieve the
designer of the responsibility for designing a safe building, structure, or component.
Inquiries concerning this correspondence may be made to me at the telephone number
listed below, or at the address on this letterhead.
The above left addressee shall provide a copy of this letter to the owner and any
others who are responsible for the installation, operation or maintenance of the
POWTS.
f
ARTHUR L WEGERER Page 3 10/1/02
Sincerely, Fee Required $ 175.00
Fee Received $
175.00
Balance Due $ 0.00
Charles L Bratz
POWTS Reviewer II , Integrated Services
(608)789-7893, 7:45 am - 4:30 pm Monday - Friday WiSMART code: 7633
cbratz @commerce.state.wi.us
cc: Leroy G Jansky, , Wastewater Specialist, (715) 726 -2544
08;'22/200:? 21:57 17153BL9880 PAULUSt+lt:D PAGE 03
FROM : �: chuma key P l , mM b i rnq FF;K K0. : 7153863121 Sep, 04 2w2 0 7: 43PM P3
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CE(LTIFICA11O1v FORM
Owr.cr/Buyer -J& rA
-4 4 U1 1 6k
MiLii rig Address „ 1.116 V L AI, Sr �J` b
Prop Addrttss OV �'f�o �'If2 :�lC YLt►10No� Amon k-c-p
(Verification required from plantuas Department for new eomtavotio /�
City'Stste 015c- . , Psrcal Identifi" ian Number o0 a 5- 0 - 0 60
LU
Prop etty Loudon: V-, h1k `�., Sac, P • T,a -R $ W, Town of ..- 914 fin
Subcavitsion llna M "Aw S Lot
Certified Survey Map t��_p - Volume —9 9 . Page tl
WArrenty Dead # & / ! 4 a a - — - . Volurno 25 Pegs #
Spec house 0 yes YM Lot lines identifiable )( 0 no
S W
Imp ww nee and maark 'aeaee of your septic system could sa'salt to Lu pia - failtue oo hsadle wastes. Proper maintenance
oansii:ts of purrrpitig aril the septic tank ry ry three you or seoasr, if n*adsd br s liaetusd proper. What you put bnto the systear
am 41%01 the 1l wtioss of t1W septic tank as a ereatmeat stars in the wads diep" syetern.
7be property owner &=ices to submit to $1. Robe zoning Dapartmazt a cettibleattoa [aka►, sigaad by the owasr and by a
ttsaasee plupsber, joutaeyetsttplarsbet. reatsictedplamber or a Uessod pumper veriirying that (1) be on -sits wastawstei diapasal system
is in proper operstb* condition sndlot (2) alter iaspection and pueipiW (d aecessuy), dw septic tank is lass dw,1/3 Rill of sludge.
V'", to mdessised kan mad the above mwitam is sad woo to uumtun the private sewass disposal system Math the mnduds
set fa'th, herei& as set by the Deparma nt atCommame and the Depumunt of Nam=L Rnnoareaa, State of Wisoms= Csrti3lntioa
tw4l that gout septic a wwm bas boos ruistsinedawst be completed sod »tamed to tae St, Croix County Zoning Of rrA witbin 30
dsye if the ibree yatc gpirps date,
�� 7,.._
Sit]N LTV OP APPLICANT DATE
QM jj;R QZ=WC CA11( kh
I (ws) Maly that all sis.taments on this fe= are true to the best of my (our) knowlsQyc. t (we) ass (sus) the OWWKs) of
the pr patty deeorfwA &b W, by Anuc of a wartsuy deal :*corded in Relsister of Deoda Me. p �-
SIGN s,7'M OF APPLICANT DATE
**sods Amy b& mati0n that is miurepreaeo*dway result ie the sanitary pesmit being revoked by the Zoning Depatttaent. ••••••
••
Iiv:iude with this aynliatior,: a sumpsd warrsn:y dad from the L+„egistsr of Desds ottice
a copy of the certifLed aawey rtutp if rdmrMae Is Studs in tte warranty deed
V.-1_G_P> '; t o
471
STATE BAR OF W,SGONSI FORM 2 - 1999 649425
Document Numher WARRANTY DEED KATHLEEN H. WALSH
REGISTER OF DEEDS
ST. CROIX CO., WI
This Deed, made between Itbaft J.. Derrick, individual) and as
attorney -in -fac for Loren D. Der, H. Der
Rose rick, Ric — RECEIVED FOR RECORD
rick
Derrick, Joa L. D errick a n d Robert J . Derrick, under Pourer of — 06 - 26 -2001 9:30 AM
Attorney record in Vol. 1454, page 425, as Doc. N o. 609877,
Grantor, and Mark J. Ulric and Teresa Ulrich, husband aad wife, EXEEMPPTTTI DEED
CERT COPY FEE:
_ — — —' -- COPY FEE:
_ -- — - - - - - -- TRANSFER FEE: 71.70
- -- — RECORDING FEE: 10.00
Grantee — PAGES: 1
Grantor, for a valuable consideration, conveys to Grantee the
following described real estate in St. Croix County,
>+►
r State of Wisconsin (if more space is needed, please attach addendum):
Lot 5, lat of PO"ll View Meadows in the Town of Richmond, St. Croix Recording Area
ounty, Wisconsin. Name and Reptra.Addrs OGLAND
E R S F T i R 1 E � E � IV N & OGLAND
304 L OCUSt
Hudson, WI 54016
026- II19 - 05 _
Parcel Identification Number (PIN)
This is not —_ -- homestead property.
Exceptions !o warranties: Easements, restrictions and rights -of -way of record, if any. Oil (is not)
Dated this 29 day of June - -- — 2001
—. J. indlviduall and as attorne -in -fact for
r r
— B RA KIN. in Vol 1454 122 425. as Doc Nb
AUTHENTICATION ACKNOWLEDGMENT
Signatures) Ili J. [1 2�divi d ually an as a STATE OF WISCONSIN )
in - fact for Lor en 1). Derrick, Rose H. Derrick, ch
Ri 1 D errick,
`- ) ss.
• Juae " " " ' u ed Arac -- -- _. —_ —.— County )
authenticate tAls w _2001
— Personally came before me this day of
— — — -- - -- the above named
. Kr�is�ppi��' liar)' �/ - --
#I : JNfBl!? ST" BAR OF WISCONSIN — - - _—
e 4if r �- - to me known to be the person(s) who executed the for. on
r'46th(qizcc`I+t �.i06,06. Wis. Stets.) instrument and acknowledged the same.
q TFP -\STRUMENT WAS DRAFTED BY
Attorney Kristine a lag nd
H udson, 54 016 — Notary Public, State of Wisconsin
- -- My Commission is permanent. (if not, state expiration date:
(Signatures may be : ihenticated or acknowledged. Both are not necessary.)
'Names of persons s mg in any capacity must be typed or printed below their signature. wro mst an wut..�o wa '
WARR,\NTY DEF.I)
STATE BAR OF WISCONSIN car, F 400 - a
FORM No. 2 - 1999
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