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HomeMy WebLinkAbout026-1119-07-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: GENERAL INFORMATION (ATTACH TO PERMIT) 395248 State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy La , s.15.04 (1)(m) ( Permit Holder's Name: City Village X Township Parcel Tax No: Scheidler, Theresa I Richmond Township 026- 1119 -07 -000 CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic IU-M b / Benchmark �• o t -�i I tsb • D Dosing Alt. BM 0 -clq I Io�•sy Aeration Bldg. Sewer o� 9y 1, Holding St/Ht Inlet �O• qLt 24 SVHt Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 1 t Dt Bottom I >5a 3� — f - 1�f6�- 90• tt Dosing f Header /Man. f Aeration Dist. Pipe Z•� o2 �jqf Holding Bot. System Z } loz. ll� Final Grade S S PUMP /SIPHON INFORMATION Manufacturer Demand St Cover aartQQ GPM Model Number t TDH Lift Friction Loss 4_ Head TDH Ft It -43- (I. - q 3.zr Zt•3`� Forcemain Length f I Dia. a Dist. to Wel�� ) ",• 3 2 SOIL ABSORPTION SYSTEM idth Length No. Of Tcer+ekes PIT DIMENSIONS No. Of Pits Inside Dia. �LiquidDepth IMENSIONS _S SETBACK SYSTEM TO P/L BLDG IWELL LAKE /STREAM LEAC NG acturer: INFORMATION CHAMBE Type Of System 1 l { V Model Number: DISTRIBUTION SYSTEM J Header /Manifold Distribution It I � I x Hole Size t x Hole Spacing Vent to Air Intake Pipe(s) t If Length Dia Length ' 3� a Spacing � 3 /�6 51Z SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over 1 j xx Depth of x Bed[Trench Center Bed/Trench Edges i Topsoil 1-1 Yes E] No ❑ Yes ❑ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:/ O / I nspection 0 ) P - 1.Z. i'Ct){im Location: 1276 146th Avenue New Richmond, WI 54017 (SE 1/4 NE 1�4 22 T30N R18W) Pondview Meadows Lot 7 Parcel IN 2.30.18.702 It 1.) Alt BM Description 2.) Bldg sewer length = -.. 47. 50;1 Gayer �tW f -�C yrna�►�np� t - amount of cover = ID 3. Contour= ° ?',` S - � "f ��� �'�� Pidn revision Required? ❑ Yes No Use other side for additional information 12 1 2.0v Z Insepctors Signature Cert. No. SBD -6710 (R.3/97) Date I t i � ^�� 4 �- 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 application PO Box 7302 '`Wis consin 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 1 I inches in size. Coun State Sams 2ertni umber ❑Check if revision to previous application State Ian �D�Number I. Application Information - Please Print all t Information Location: Property Owner Name Property Location A b r —esA a�q f2 �� 1/4 1/4, S22T E or Property Ovtner's Wailing Address Lot Number Block Number C 1& 7 Ci , State Zip Code Phone Number , _! $ ivision Name or CS umber ZiA A II Type of Building: (check one) °`; la s ❑ I or 2 Family Dwelling — No. of Bedrooms: P 1. a B Public /Commercial (describe use): �y )� ? ❑ Tcn f ❑ State -owned ' `- i i & mmd I T7 a n,,,..... •.. ir- i l i, •r i _ Ne oad aa T ypa^. vi . u�ia. �..Itsek onl GtiC vGX Gn llne A. CIIC( Gri llne B i iCal)leko 1TM _ Cj.lt� ZONPW r 1 1 _ A) 1. New System 2. ❑ Replacement 3. ❑ Replacement of �� Addition to cG ax Numbers) S stem Tank Onlv t B) Permit Number . 9 , Date Issued ❑ A Sanita Permit was reviousl issued IV. Type of POWT System: (Check all that apply' — Io0 O a ( I I ❑ Non - pressurized In- ground t l � -fi \J Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground irc(jbr.�DV! 1 (j Holding Tank ❑ Single Pass ❑ Drip Line a '3Q, �, 7O ❑ At - grade tTD f ❑ Ae`obic nit ❑ ecirculating ❑ Other: V Dis ersa reatment Area Information: 1. Design Flow (gpd) 2. DispersalArea 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate (Gals. /day /sq. ft.) (Min. /inch) Elevation VI Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con• glass New Existing crete structed Tanks Tanks . /'dc 0 lt�oca ❑ ❑ ❑ ❑ ❑ VII Res onsibility Statement I, Uie undersi ned, assume res onsibility for installation ofthe POWTS shown on the attached lans. lumber's Name (print) p Plumber's Sign a (no stamps): MP/MPRS No. Business Phone Number liCYt Plumber's Address ( ireet, City, State, Zip Code) ` -- LOT' ' A VIII County/Department Use Only ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued s g Agent Si Lure (No stamps) 1KApproved ❑ Owner Given Initial Adverse Sur arge Fee) ID r Determination � - 2oa ( lases., IX. Conditions of Approval /Reasons for Dis prov 1: ,.,/ - M •u ".a - n,�u a�F 6L_ � � - � �� � � •4ro� . �se a So At-� s�$..� v� w�a��-e�a� �s p� �c•�lt. � /�utces, �,►, w. `ems . 4cr �s C-GOL^dly cun_�zoQ ru mmm - ----------- rkt- lop -------- -- ---------- , Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 Nvisconsin www.w www.commerce.s i sin.gov isconin "gov Department of Commerce Scott McCallum, Governor Brenda J. Blanchard, Secretary August 14, 2001 CUST ID No.221471 ATTN: POWTS Inspector ZONING OFFICE < DENNIS J GILLE ST CROIX COUNTY SPIA 372 140TH ST 1101 CARMICHAEL RD AMERY WI 54001 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/14/2003 Identificati m rs Transaction ID No 662755 SITE: Site ID No. 633339 THERESA SCHEIDLER Please refer to both identification numbers, 146TH AV above, in all correspondence with the agency. TOWN OF RICHMOND ST CROIX COUNTY SEI /4, NEIA, S22, T30N, R18W LOT: 7, SUBDIVISION: PONDVIEW MEADOWS FOR: DESCRIPTION: THREE BEDROOM MOUND SYSTEM OBJECT TYPE: POWT SYSTEM REGULATED OBJECT ID NO.: 803513 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • 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.01 101) and the SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST_SAS (01/81) • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the Mound manual, and the pressure distribution component manual are complied with. A copy of this letter including instructions and information relating to proper use and maintenance of the system musrbe give#lo the owner and each subsequent owner upon completion of the project. R 4 • The changes made to this plan on 8/14/01 by this reviewer were acknowledged and approve Ay the system designer. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. • The mound area must be deep chisel plowed to help break up the 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. • Access to the filter for cleaning must be provided per Comm 84 product approval conditions. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required DENNIS J GILLE Page 2 8/14/01 • 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. • 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). In addition, 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. • 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 83.52(3) The activities relating to evaluation and monitoring mechanical POWTS components after the initial installation of the POWTS in accordance with an approved management plan shall be conducted by a person who holds a registration issued by the department as a registered POWTS maintainer. • r 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. Stats. 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. 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 on this letterhead. Sincerely, FEE REQUIRED $ 175.00 > r FEE RECEIVED $ 175.00 BALANCE DUE $ 0.00 Charles L Bratz POWTS Plan reviewer II- Integrated Services WiSMART code: 7633 (608) 789 -7893, Mon. -Fri. 7:45 AM to 4:30 PM cbratz@commerce.state.wi.us cc: THERESA SCHEIDELER I MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Theresa Scheidler Owner's Name: Theresa Scheidler Owner's Address: 1477 County Road K, New Richmond, WI 54017 Legal Description: Gov't Lot SE 1/4 NE 1/4, S 22T 30 N.R. 18 W Township: Richmond County: St. Croix Subdivision Name: Pondview Meadows Lot Number: 7 Block Number: Parcel I.D. Number: 026-1065- 50-000 Plan Transaction No.: Page 1 Index and title RECEIVED Conditionally Page 2 Data entry JUL 17 2001 APPROVED Page 3 Mound drawings Page 4 Lateral and dose tank SAFETY & BLOGS DNA DiEPARTMEMYOFCOMMERCE Page 5 System maintenance specifications 2: = =- - aut S Page 6 Management and contingency plan Page 7 Pump curve and specifications GEE CORRESPONDE CE S' Pl / 9-10-ii Designer: DENNIS GILLE License Number: 2214.71 Date: 07/13101 Phone Number: 715 - 268 -6637 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) Version 3.0 (03/01101) Page 1 of 7 II ' - Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R Residential or Commercial Design Note. Sand fill (D) calculations assume a 300.00 Estimated Wastewater Flow (gpd) Table 8344 -3 in-situ soil treatrnent for fecal 1.50 Peak! Factor e. . 1.5 = 150% coliform of r_ 36 inches. ►KJ ( 9 ) 450.00 Design Flow (gpd) 1.00 Site Slope ( %) 100.30 Contour Line Elevation (ft) 34.00 Depth to Limiting Factor (in) 0.30 In -situ Soil Application Rate (gpd/fe) Distribution Cell Information 100.00 1 Dispersal Cell Length Along Contour (ft) = 4.50 Cell Width (ft) 1.001 Dispersal Cell Design Loading Rate (gpd/fe) 11 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (c or e) C. Center or End Manifold 7 ` t-43 Lateral Spacing (ft) If N above, enter the elevation (ft) 4 Number of Laterals of the highest point. FJ 0:446 Orifice Diameter (in) (e.g. 0.25) 2.00 Estimated Orifice Spacing (ft) = r Ile /orifice EForc 2.00 emain Diameter (in) 125.00 Forcemain Length (ft) Does the forcemain drain back? Y 87.00 Pump Tank Elevation (ft) Enter Y or N 3.25 - 459 System Head (ft) x 1.3 20.39 Forcemain Drainback (gal) 13.30 Vertical Lift (ft) G 64.90 5x Void Volume (gal) 6.:Z 3 Friction Loss (ft) �a3 84:39 Minimum Dose Volume (gal) ;2 244.6 Total Dynamic Head (ft) s 4449 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x X 1.00 1.50 x 1.25 x x 2.00 x 1.50 x 3.00 2.00 x 3.00 x Gallons /Inch Calculator (optional) Treatment Tank Information 140.00 00 Total Tank Capacity (gal) 1000.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in) HUFFCUTT CONCR Manufacturer 00 gal /in (enter result in cell 1349) Dose Tank Information Effluent Filter Information 600.001 Dose Tank Capacity (gal) JZabel JFilter Manufacturer 12.001 Dose Tank Volume (gallin) IA100 Filter Model Number HUFFCUTTCONCR Manufacturer Project: Theresa Scheidler Page 2 of 7 Mound Plan View t 1/106• ......... . . . . . ... . . . .. s J Observation Pipe .0 — K �• •. tir x ,, � . W .................................. J ............... ................ . .. .. I .... ... ............................... .. :�... .. . . - ---------------------------- --- - --- L i Mound Component Dimensions Down slope toe extension made. A 4.50 ft E 6.54 in H 1.00 ft K A20.16 ft B 100.00 ft F 9.25 in z 10.50 ft L ft D 6.00 in G 0.50 ft J 5.16 ft W ft 450.00 (ft2) Dispersal Cell Area 1 1500.00 (ft Basal Area Available 4.50 (gpd /ft) Linear Loading Rate 10.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 102.57 (ft) ► I H rrrrrrrrr 2 G ` I rrrrrrrrrrrrrrh1 'rrrrrrrrrrrrr�r. _ F Dispersal Cell 101.30 (ft) Lateral 100.80 (ft)-a — Invert Dispersal Cell ::::::::: ::. : : ::::::: :::::::. Elevation E D �ryA { y M r�� { 100.30 (ft) Contour Elevation 1.0 % Site Slope Geotextile Fabric Cover Shading Key m °d. — Dispersal Cell See lateral details on Q Topsoil Cap c •a 1.5 ft :.•..• :•.;_:�, Page 4 for number, © rrrrr Subsoil Cap ° "•` ° °• • ®„, • size, and spacing of ASTM C33 Sand ». ° °•` °° ° "•° ° v •' . °•.•' F laterals. Laterals are Layer Tilled La d 0.5 ft Typical Lateral y c equally spaced from 05 ::•a:r. Aggregate w c : 5 • the distribution cell's — A centerline in the distribution cell (AxB). Project: Theresa Scheidler Page 3 of 7 Center Connection Lateral Layout Daigram Force main connection via tee of cross to manifold at any point. Laterals are identical i P s • = Turn -up wP ba l l valve or X --.) f F sf2 ad2 in Laterals 8 force ma of PVC Sch 40 cleanoutplug per COMM Table 84.30-5 Holes drilled on the bottom of the lateral. Number of Laterals 4 Orifice Diameter S11 04-25 in Lateral Diameter 1.25 in Orifice Spacing (X ;2 ft Lateral Length (P) yy. 3 5 ft Orifices per Lateral i Lateral Spacing (S) . z5 1,43. ft - Orifice Density 5, r 2 1orifice Lateral Flow Rate 'F630 I gpm Manifold Length - 7 y' a-"3 ft System Flow Rate sCi 441-19 gpm Manifold Diameter 1.25 in Total Dynamic Head 24.46 ft Forcemain Velocity +2+ ft/sec Dose Tank Information Locking cover with warning / label and locking device and .l sealed watertight ---► I Electrical as per NEC 300 and Comm 16.28 WAC 4 in. min. Disconnect _ Tank component is properly vented emate outlet location Forcemain diameter HUFFCUTT CONCRE Manufacturer 2 in. Ca:pacityl 600.00 Gallons Volume 12.00 gal /inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 28.16 337.92 B 2.00 24.00 C P� imp off e levation (ft) C 7.84 94.08 1 88.00 D 2.001 144.00 D Total 50.001 600.00 Dose tank elevation (ft) 3" Bedding un er tank. 87.00 Alarm Manuafacturer ILEVEL ALARM Alarm Model Number JDVL Pump Manufacturer IZOELLER Pump Model Number 1140 Pump Must Deliver s J 41 9 gpm at 72 46 ft TDH Project: Theresa Scheidler• Page 4 of 7 F .771 .. MS TOTAL D Amic mw TAD CAI 0,C' 11 CURVE PER MINUIt MODELS ''140/414()" EYFUNT AND DEWATCRING ­4 Ft. Meklors Goh Urs, 4 — htl � - -._ - — J •i.J:! _ - 9 9n9 � „Yj :i• ° j ` � 9 >/u 12 [a 20 140,414-0 Al Ida wr t44 443 4 tVIS r i:1: sxrttVan qq b 1 0 0 kid 1 Hn 240 ­7 1 320 PLOW PER MINUTE CO NSULT Cm 4 ) MY F CASPECIAL APPLICATOMIS tj 11 1 . I EkiddMialturriators, fb ffrs, alsatfallEibiL�andsLfppiladvvigI an alarm. M&VhRnIraI rurduPleduy3bomsars available With orwItilout corifi•cil alarm systems vA 1 avallable! tir I phase pumps used III slnlpjex ot b/i;j SYMtern. 880 FM0732. • Varlable level carIttal gvitlhes are SM1 1br clontrtilling single phase systems. DOLUS pIggybacherwid 1 IMI&BA AvItchas are available ibrvariable level Iciq OYcle writrals Ssaled Qwlk-Box svaHeiij: forr InsMWtbn& See FM1420. CU"PF99Yb9*V9&b1SI8vjI • Over 130 ° F, (WC.) apc lal POU go! n requiract. R RAI` W IPM0477. • Refer to Mangfm-2at F. apRiEkals. 100 utlemsta'WWC 1 10 ; or 1(� 0 I!L See PM0712 fortWout incidel of E Imhug •tkiqlatu• Sq 4, Variable Isvel i-xintrol swIM 14412 il i:icwd aa. wrilral ficlivatol apectry dupwx (• a r (4) * i a t syA m. '10 31 !ft - 5 UIL 4141) Series - 7.9 11its. ulmodonorvuIrwMnsfmfAux ur 2 purnp apainacuz, luna I&C ip : 14 00W Vol _p Ar14 W14G 115 —2 OMAMNI 2arS&4 40 AN Ito 7fte KUL. _160 OrliftkIMishouldbotictimby D i 't foldda a A & kA PE 8_4 k 619 41W' retDrUlt ti alit Sad* Widlia Laid nalf1 Sual J%ffhid1miUr11Q4t livnWO fi NEMA,i ar WWA U OwApOwd $ and Miami po! OXM). RESERVE POWERED BESIGIN F 31 unlisuri'Ondiffoyis a reserve agrety factor s engineered into the desigr, of every Zavt--i!:r pum 3. MAIL T& AD, WK lf&4y LOL641a, KY 402Zo347 MY TO. 3649 Ca j? Dried TO LOUISYM& X V 4V21 1.1901 1q) 7 %B- 27.19 . 1(800) vau-pulwij Mound System Maintenance and Operation Specifications Service Provider's Name DENNIS GILLE Phone 268 -6637 POWTS Regulator's Name PsLK COUNTY ZONING Phone 485 -9279 31 - ci -C n System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 118 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 fe Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test monthly Pressure System Laterals should be flushed and pressure tested every 1.5 years Moundl Inspect for ponding and seepage once every 3 years Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished • .............. ................ Grade 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box : : : : Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Theresa Scheidler Page 5 of 7 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD- 10691 -P (N.01/01) and SSWMP Publication 9.6 (01/81)] 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 cowers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be seated 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 Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Starts. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet fitter shall be assessed at least once by inspection. T r l be cleaned as necessary to ensure proper operation The filter cartridge should not be removed unless provisions are made to n ci 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 mmamum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. HaAev er, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, 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 as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 nmg/L BOD 30 mg/L TSS, 10 mg/L FOG, and 10 afu/100 mL for highly trued effluent. Influent flow may riot exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to 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 loll shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Continency Wan If the septic tank or any of its components became 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 carnponent(s) 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 dogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page)$ of this plan for the name and telephone number of your local POWTS regulator and service provider. 5" Project: Theresa Scheidler Page 6 of 7 l ® TT- - 2Z - - ..��� —boo. �' - - - - -- - __------ - - - - -- --- - - - - -- - -- -- - - - - -- r cT S as � - - - - -- -- - -- - - - - -- -- -- - - - - -- ---- - - - -- - - - - - -- - - - -- - - - - -- - -- - -- - - --- - - - - -- - - - - - - -- -- 400 s - -- - - - - - -- it pp. � r � UALU BUILDERS GILLS X103 La NuMM patatatiam "` b V I L A N U 0111 t t V A L U A I t yro ti t t li h r Wale" at strtry a 9uNtinpa raw —� of in accord with ILHR 83.05, Wis. Adm, Code Co"1um Attach aamPlete aite plan an papaw MCI! test than 8 1/2 x 11 inches in size. Plan must include, but S not limited to vorfieal and horiftrdml reference point (BM), direction and % of slope, scale or PARCEL 1 - dimensioned, north arrow, and IM;s(*m and detance to nearest road_ 026 - 108 5- 50 - -000 APPLICANT INFORMATION..P LEASE PRINT ALL INFORMATION REWEVIIEDBY DATE PROPERTY OWNER: PROPERTY LOCATION Richard Derrick _ GOVT. LOT SE 11 4 NE 1 1 4, 8 22T 30 ,N,R 18 tea) W AAOPt1 OWN6R':8 MAILING ADCIFI1�.:i; 1310 S LOT Bn StJBD. NAME OR CSM ar Hy. #65 _ 7 pondvie w Meadows CITY, SUITE ill" CODE PHONE NUMBER (]CITY [QVILLAGE MOWN NEATEST ROAD New Richmond, WI. !4017 I5 246 -5425 {7 ) Richmond I 14 ith. ave. ! New Constnrtdion use IX.7 Rmddental / Number of bedrooms 4 ( ! Addition to existing bm ding i [ ! Public or commerdid describe Code delved daily flow 400 opt' Recommended design loading rate nP bed, gpolt IIaarch, gpollt Absorption area required nP bid, b 500 trench, ft Maximum design biding rate nP bed. gpdflt • ; renth, gpdM Recommended in1krallm surface elmjakm(s) _ 101.30 fl (as referred to site plan benchmark) Addittonill design /side aonsideratioris sYStettl el. based on contour line of el. 100.30' Parent ml IWW _ ra LQ UIJ. dri Flood plain elevation, fI applcable na $ o $tlltabl@ fru gyg19(tt CONVErIT NAt MOUND 4d GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U unsuitable Ian stem O s u ®s D D s �7 u ❑ s ®u D s KL u 0S X) u �,w SOIL DESCRIPTION REPORT Depth Domlraanl Color Moues Structure Consistence Roots (3PDIft Boring p Horizon Texture in. Nd�hnsell Qu. Sz. Cent Color Qr. Sz. Sh. Bed TitlrlCh 1 0 -8 iclyr - 3/3 none 1 2fpl mfr cd 2f np .3 1 2 • 8 -16 I(a rA 4 y r / none sic lcsbk mfr gw If .2 .3 Ground 3 1 -44 7.5Vir44/ none sl lcabk mfr yw na .4 .5 elev. ID21-4t, 4 60 10y /4 7.5yr5/6 ail M na gyr na np .2 5 0--80 7. S r4 4 to .� / non sl lcebk Depth mfr as na .4 .5 IBM 441 Remarks: Boring off 1 0 - 10;y.I-�;;t /3 none 1 2msbk Mfr cd 2f .5 .6 3� 2 9 -18 - 10*4/4 none sic-1 2msbk mfr gw if .4 .'• .5 3 18 - ?. S,Irjt °4/4 none sl lcsbk mfr gw na .4 .5 Ground elev. 4 4 -70 7.5pA - ;Elf 7.5yr5/6 s1 M na na na .3 .4 100. 41. D" 10 _._. smiting factor ._._ Remarks: CST Name P)ease Print Ogg L., Steel Phone: 715 - 2466200 Address: 1554 200th. Ave. ew Richmond WI 40 7 Signature: Date: 4_23 -99 CST Nee alter: mO2299 tL,.� 7 - 03 -1996 1 :33AM FROM P. 1 ftpiR"6Wttp Ric'ur Merrick SOIL DESCRIPTiOH REPORT p 2 3 -AKILA a 026 -1065 50 -000 10flng # Horizon Depd 1 Dominant Color Moores Btrumre ,x GP13in IMI In. Munsell Ou. Sz, COQ. C4W Texfuts Gr. Sz. Slh, COnsislDlrtoe E+a,n r Roofs Hetl 7iand� 1 0 -12 10yr3 /3 none i 2msbk mf gv 2f _ S 2 12 -21 10yr4/4 none ei.c1 I*Bk r rafr g* 1! :2 .3 ;� 3 21--44 7.5yr4/4 non* al Inubk , mfr gOF na .4 .5 <11.5 ft, 4 44-75 7.5yr4/4 rme si M na _ na na .3 5 k!41h � u11fInQ _ + acts a4" Remsrks- doting # 1 0 -12 10yr3/3 noes L 2msbk mfr c +w 2f .5 ; .8 4 2 12 -16 10yr4 /4 none sit 1msbk mfr crw 1f'• ,2 � 1 _ "atotu� 3 16--26 7.5yr4/4 none sal 2mshk mfr +gia na .4 .6 -Nov. 7 [q.S40-6� /p04R . 5yr4/4 none sl 1csbk mfr .4 .6 Syr4 /4 noe s�' M )80 W na _flit na .3 r .3 agGr yo Remarks- rev sip &- _ A ]zj , 0 -10 10yr3/3 none L -- 2m3bk mfr c31, 2f ,5 : 5 2 10 -1 10yr4 /4 none s - C1 2msbk mfr ch, If .4 3 16 - 2 10yr4/4 none sic 1m$bk tnr crw If .2 �,3 4 23-4C 4 7.5yr4/4 if. no ge sl 2csbk mfr g na .5 .8 5 40 -6 5yr4/4 fif 2.-Syr5 6 g1 M na n.a na .3 . J-F actor _ . aouna - slot rIr 7A 7 ,.•,..:•, - r11�1Tti1'ln�J� 711TC1 /CggPq7CT/ Tn:A7 TAA7/CT /:�A 7 - 03 -1996 1:33AM FROM P-2 STJEEVS SOIL SERVICE _ Gcuy L Steel CS7Mx2P8 Richard Derrick 1554 Ave. SEtMj $22- T3ON -PUBW New Riohrnond. W1 54017 MPRSW -3254 town of Rictmasd (715) X46.6200 lot V-� view Mmows This soil eva. tuablon teas cMducbed to aatisf a r rain aiz�c+a�cerit tbt be eneitat�le for your use. Y 9 �1 i't or My a BM.= tAp of Nht lot stake ® el. 100.0 1 ► ,a c Alt. BM -= top *>f SW lot stake es II iJ • ,/ �� �gl k� 2 G�ti► n 3 Gary L. Steel 4 -23 -99 00(� H'I7fJ -a« StTq(T"TTf1A R'1^Teu C - nn-j C11JT`nri\Q1 71'lTC1 /CQQQ07CT/ Tt : TAA7 /CT /PA Wsconsirvtepartment of Industry SOIL AND SITE E V A L U AT " 1, E7POR T Page 1 of 3 Labor and-Human Relations Qivision of Safety &Buildings in accord with ILHR 83.05 Is`.Im. Code \� LINTY < <, ; .., �. � Attach complete site plan on paper not less than 8 1/2 x 11 inches in sizel must incfudw4 bilt:,!q St. Croix T not limited to vertical and horizontal reference point (BM EL I.D. # dimensioned, north arrow, and location and distance to i _ _ � 0 � *,�� _ 26- 1065 -50- -000 APPLICANT INFORMATION- PLEASE PRINT AL ('�`� [ 5e X ` "� EV l WED BY DATE �� t5 L,N c-�y(L M� 1, i PROPERTY OWNER: ��r �ff Richard Derrick 1 / 4 ,S 22 T 30 N,R 18 for) W PROPERTY OWNER':S MAILING ADDRESS D. NAME OR CSM # 1310 Hy. #65 Pondview Meadows CITY, STATE ZIP CODE PHONE I\ KFOWN NEAREST ROAD New Richmond, WI. 54017 (115) Richmond I 146th. ave. $ J New Construction Use [x] Residential / Number of bedrooms 4 [ ] Addition to existing building (] Replacement [ ] Public or commercial describe Code derived daily flow 400 g pd Recommended design loading rate np bed, gpd /ft trench, gpd /ft Absorption area required nP bed, ft 500 trench, ft Maximum design loading rate np bed, gpd /ft • 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 gal ci a1 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 for s stem ❑ S $7 U ®S ❑ U ❑ S �7 U ❑ S ® U O S O U ❑ S F&I U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Roots GPD /ft Boring # Horizon in. Munsell Gu. Sz. Cont. Color Gr. Sz. Sh. Bed Trend .................. ................. .................. ................. 1 ' >' 1 0 -8 10yr3 /3 none 1 2fpl mfr cd 2f np .3 2 .8 -16 10yr4 /4 none sic lcsbk mfr gw if .2 .3 • z Ground 3 16 - 44 7.5yr44/ none sl lcsbk mfr 9w na .4 .5 ..� 11L3t. 4 -60 10yr5 /4 7.5yr5/6 sil M na gw na np .2 - Depth to 5 0 -80 7.5yr4/4 none sl lcsbk mfr na na .4 .5 limiting factor 44" Remarks: Boring # S 1 0 -9 10yr3 /3 none 1 2msbk mfr cd 2f .5 .6 l< 2 2 9 -18 10yr4 /4 none sicl 2msbk mfr gw if .4 .5 3 18 -34 7.5yr4/4 none sl lcsbk mfr gw na .4 .5 .� Ground elev. 4 4 -70 7.5yr4/4 flf 7.5yr5/6 sl M na na na .3 .4 1 Depth to limiting factor 34 Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 200th. Av ew Richmond WI/$4017 Signature: Date: 4 -23 -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 Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 0 -12 10yr3 /3 none 1 2msbk mfr gw 2f .5 .6 :::3... »; 2 12 -21 10yr4/4 none sicl lmsbk mfr gw if .2 .3 Ground 3 21 -44 7.5yr4/4 none sl lmsbk mfr 9w na .4 .5 9 5 ft. 4 44 -75 7.5yr4/4 none sl M na na na .3 .5 Depth to limiting factor 44" 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) STEEL'S SOIL SERVICE Gary L. Steel Richard Derrick 1554 200th Ave. CSTM2298 SE S22- T30N -R18W New Richmond, WI 54017 MPRSW -3254 town of Richmond (715) 246 -6200 lot #7- Pondview Meadows This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. 3 00 N �a 1 = 40' BM.= top of NW lot stake C el. 100.00' 1 LY �. Alt. BM.= top of SW lot stake C el. 100.90' l \ � , � a VU Gary L. Steel 4 -23 -99 r ST CROIx COUNTY SEPTfC ';'A4NK MAINTEN AGREEMI'.NT AND OWNERSHIP CERTIFICATION FORM Owner /Buyer Mailing Address Property Address . 7 ( - (Verification required fro» i Planning Dopartrnmt for new construction) IC• City /State ` Parcel Identification Number f L E GAL DESCRIPTIO Property I,ocatiom 5`L_ ���, 1�� y,, Sc c. �o�, T .fit -R, - W, Town Subdivision o N�V �J .. _ _ , Lot # � Certified Survey Map # VoluMe �, Page # Warranty Deed # Volume _ Page # Spec house, ❑ yes X no Lot lines identifiable yes ❑ no SYSTEM MAMENXNCE Improper use and maintenanceof ywr sel ►ic system could result in its premature failure to bandre wastes. Proper zrta iurenaacO consists of pumping out the septic tank every tbv a yelm or sooner, if beaded by a licensed pumper. What you put into the System can affect the function of the septic tank as a rtes Irnent stage in the waste disposal aystern. The property owner ag= to submit to 3% Croix Zoning Department a cortifioation form, signed by the owucr and by a mastetplurabor, journeyman plutuber, restrictedpl amber or a liccturdpumper verifying that (1) the on -site wastewaterdisposal system is in proper operadug condition and/or (2) after in: �ection brad pumping (if necessary), the septic tink is lees than 1/3 full of sludge. Uwe, the undersigned have read the above requirci hunts and agnea the maintain the private sewage disposal system with tht standards set forth. here" as set by the Departmtttt of CoLr uam and the Department of Natural Resottrcta, Stato of Wisoorasin CF.tKiAdAtion stating that your septic system has been maintainer I must be completed and mturned to the St. Croix County Zoning Off" within 30 days of the three year expiration date. r C / A) sIGNATM OF APPLICANT DATE OW NER CE It C TA ION I (we) certify that all statomonts on this : ion are true to the best of my (our) kmow•ledge. I (we) am (are) the owner(s) of the property described above, by virtue of z wa tts qty decd recorded is Register of Deeds Office. _ 4 ( SIGNATURE Of APPLICANT )G •' "'' Auy information that is rais represented u ay rosult in the sanitary permit being revoked by the Zoning Department.'••••' Include with this application: a stamped warn inty doed from the Register of Deeds office a copy of the c rtifted survoy rntp if reference is made in the warra-aty deed VOL 1670P • r STATE BAR OF WISCONSIN FORM j 64 9665 Document Number WARRANTY DEE ICATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., WI This Deed, made between Robert J. Derri indivi dually attorney-in-fac for Loren D, De rrick, Rose H, ic RECEIVED fOk RECORD Derrick, Joan L, Derri k dose Robert J. Derrick, under Power o 06 - 27 -2001 3:20 PM ney recorded in V01. 1454, Page 425, as Doc. No. 60 9877, Grantor, and Theresa M Scheideler — WARRANTY DEED . EXEMPT N CERT COPY FEE• COPY FEE: TRANSFER FEE: 74.70 RECORDING FEE: 10.00 Grantee. --- GAGES: 1 Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix _ _ County, State of Wisconsin (if more space is needed, please attach addendum): Lot 7, Plat of Pond View Meadows in the Town of Richmond, St. Croix Recording Area County, Wisconsin. Name and Return Address DAVID J. ESTREEN 304 LOCUST ST. HUDSON, WI 54016 026 - 1119 -07 Parcel Identification Number (PIN) This is not homestead property. Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any, 06) ('s not) Dated this .2 7�! day of June 2001 Robert J. De ick, individually and as attorney -in -fact for H. Ck, ' in lk•sl 14 4xi as i7r ti� FI]9R - T7 ____ AUTHENTICATION ACKNOWLEDGMENT Signature(s) Robert J. Derrick, individually and as attorney- STATE OF WISCONSIN ) in -fact for Loren D. Derrick, Rose H. Derrick, Richard L. 1 1 ) ss. as T i W. n•,e- r • � 425 —Fg County ) authenticated this day of June ` -- 2001 - - -- Personally came before me this __ day of the above named + K ristin Ogland _ -- TITLE: MEMBER STATE BAR OF WISCONSIN — (If not, — to me known to be the persons) who executed the foregoing authorized by J 706.06, W is. Slats.) instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY A ttorney Kristina Ogland N udson, WI 5401 - — - -- Notary Public, State of Wisconsin (Signatures may be authenticated or acknowledged. Both are not necessary,) My Commission is permanent. (If not, state expiration date ' Names of persons signing in any capacity must be typed or printed below their signature. nrormatian PrWp,abM , om c ) WARRANTY DEED STATE BAR OF WISCONSIN �� F 800 � FORM No. 2 - 1999 L kvt, } of -------------- i S83HiO Aa G3NMO SQNb'1 Q311'd J U. c x ; W' Z. � 3❑ 3NII 1Sd3 X15 ci •BS � .LZ,ZI.00N (/"\- 6 9,II. 00 N) 110'868 M „L2,21 *OON , 6tb'26OI o `o 00 o co oriand 3H1 O1 (131VOIG3G - •-- •-- •-- • - -• -- - o -- -- -- - -•- �� _ LO c —� —. 2 a w 66Z SNV8i a3d . >IOVffi3S �{ a�oZ p ................ CV) ......... ri Z ao � �' ........... Lj LL- ix �- I cv) ^ S 0 ' C'3 M Z o "+ (U �s U 0 W LL- W i 00 M O ' �S of ^ N p 00 z � o� �X co If) Nn a ; 0 yo ON W LL- I ' a- C'S ZM Uv� i V' - n CC) Q OD o r. •i• . .. Z ° I .o . cu i M ' L , 9 T 8 0 M i Oj i DO - - - - - -- 0� Q •► � CM, q 00 o ,99 N co W ' O N M � . Lo ' I - zi _ cl , 79'668 3 „L9,9I.00S i Z'.