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HomeMy WebLinkAbout026-1127-09-000 I i@1RW;.rm6S /it, : y .in Department of Commerce PRIVATE SEWAGE SYSTEM County St. Croix and Building Division INSPECTION REPORT Sanitary Permit No: 479369 0 jENERAL 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: Klinger, Josh Richmond, Town of 026- 1127 -09 -000 CST BM Elev: Insp. BM Elev: BM Description: (( �� Section/Town /Range /Map No: 19. 1 O 6 - 3 GS 25.30.18.819 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark +9 1 D cf p Dosing / 3 AI� i 4 cl -� e on (� l Bldg. Sewer 15 - C l s . Holding St/Ht Inlet 1 7. TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet ` Septic 7 �Q) 2—zl / / _ Dt Bottom 26, 3 ZZI Dosing / //� Z' I / 2, I 'F / Header /Man. Aeration / t/I '� `T ` Dist. Pipe Holding Bot. System 3..3 goo -7 PUMP /SIPHON INFORMATION A Final Grade �f 1 �oZ •`� /.d Manufacturer Demand St Cover .go GPM � ;��e� l of 1 ok Model Number G ,, I /'� "� ov,, oar �•3 ��� TDH Lift Friction Loss System Head TDH Ft" - 7 , Zlo Z (o Forcemain Length Dia. ,/ Dist. to Well �� 2 2 SOIL ABSORPTION SYSTEM BED/TRENCH Width Length / No. Of Trench PIT DIMENSIONS No. Of Pits Inside Dia. Liquid _D epth DIMENSIONS - 7 SETBACK SYSTEM TO / P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer. INFORMATION CHAMBER OR Type Of S m: / 17-7 i /� I UNIT Model Number. o�� 33 /u DISTRIBUTION SYSTEM Header /Manifold / Distribution / I x Hole Size I x Hole Spacing V nt to Air Intake �( / Pipe(s) I 3 I/ / Z / v j Length ►" Dia 2- Length ,: Z Dia Spacing �: LO SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only D th Over xx Depth of xx Seeded /Sodded xx Mulched Depth Over / ep Bed/Trench Center Bed/Trench Edges \ Topsoil I Yes 1_ No es (° j No COMMENTS: (Include code discrepencies, persons pre sent, etc.) Inspection #1: 9 / / d 5 Inspection #2: Location: 1438 121st Avenue New Richmond, WI 54017 (SE 1/4 SW 1/4 25 T30N R1 8W) Richmond Hills Lot 9 Parcel No: 25.30.18.819 1.) Alt BM Description = i C-6JL"," P1 vLJ L 2.) Bldg sewer length = 3a 3 4 /3 "' 3 /' Q 4- 7 i / �"f �b J - amount of cover = �� 7 f� `�Z Plan revision Required? 1 !, Yes Xon o ` Z r 1 o5 �0 Use other side for additional inform Date Insepcto Signal a Cert. No. SBD -6710 (R.3/97) l - - - - -- - ------------------------------------ T Ems/A I �I /I % � %R %II � % common rWommod ramp %mmme M■ _ ■�, /./. ���,r���►i //� 88 ®B ©0000DD ©00008 . = EWNPIP-AWEEPAPIW so dMMEENINNINIONNON ■ ! • - ��� I����!i���� 808BBB08BBBBB0980 NONE@ ��!i /����� 8181818018188 ©000 ■�������������� BBB8188888818 ®� ®® .. No ���� BB818BBBBBBBBO ©DD OEM No���� . BBBBBBB88BBBB ©88 © - BBBBBBBBBBBB80��� '�- BBBBBBBBBBBBB ©�B0 BBBBBB8BB88 ©0000 ' BBBBB888B8B1 © ® ®B ® BBBBBBBBBB8B0D0 ©� . -88BBBBBBBBBB�BB00" 88 all 8880Dom 0on: 888888811880 ®0�0 .. BBBBBBBBOB ©09f�99 © BBBBBBBBBBB08 ®DD © 8888888 ® © © © ®��00� .BBBBBBBBB ®���0�90 : BBBBBB808 ®� ® ©�B ® ®• BB8888 ©0 can 0a8880 BBBBBBBBBQ © © © ©9O0 BBBBB00BB9990 ®0B ® BBBBBBBBBB088BB�© R 1111880© ®0888880 BBBBBBBB88 © ©�90DD angoon alloon a BBBBBBBBB ©8898990 BB 1100008 ®088- • r fj Safety and Buildings Division 201 W_ Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) Madis / 1 on, Wl 537 7162 29 3( q ' "cons (60$) 266 n 1 l I I State Plan I.D Number De artment of Commerce /// c2--/ : 7V_gNS !p ) Sanitary Permit App nation, roject Address (if different than mailing address) In accord with Comm 83 -21, Wis p`� oses Privacy Law, sl .04(1)( ) ` may be used for secondary PuTP _ 1. Application Information - Please -p Al] Information (I di Block if Parcel # Lot # ST. C ROIX COUNTY Name Y' A proypwncr'sN ZONING OFFICE � Property Location °s Mailing Add Section_ Owner d oe , PrprtY c Zip Code Phone umber irc one City, State T N, W her IL e, of Wilding (c e All that apply) Subdivision Name ily Dwelling - Number of Bedrooms i ❑ Vil o ice' lic/Comm ercial - Describe Use ❑City — ❑ Pub - C3 State C'"'� Describe Use if applicabl e line B pp box on line A. CO mplei won to Existing system e odtfi heck oni on ❑ other M it: C Y lII. Type of P rm ( Only lacernent System ❑ Treatment/14olding Tank Replac A. ew System El � List Previous permit Number and Date Issued ❑ Change of ❑ Permir Permit Renewal Transfer to New ❑ Permit Revision Plumber Owner g. ❑ 0 _ 0 00 / Before Expiration 2 - 112 ❑ that a ❑Single Pass Sand Filter IV. r of Pow TS S stem: <24 in of s Sand Filter >24 in. of sui Unit Recirculating uitable soil ❑ At (Trade ❑ table soil ❑ Mound ion Pressunzed In ❑ Peat Filter ❑ Aerobic Treatment a Wetland [] Pressurized In -G d ❑ Holding Tank ❑ other ( Constructed Line ❑ Gravel -]ess Pi a = /.0 /Z Synthetic Media Ft Ching Chamber D rip 5 () s Elevation irculating Synth X Dis persal Area Propos Rec p nformation• P _/ reatment is ersal Area Required (sf) 1/1� P r- V. Dts e w Design Soil pplication Rate(gP Prefa L�� 6 ow ) Site St Fiber Plastic ® s 0 �UManufacturr -r / /1 Ponce eel Glass Total Nu mber ota C' - C i't rKI Concrete Constructed Capacity in dons of Units V1, auk Info dons New Existing Tanks Tanks Septic or Holding Tank Aerobic Treatment Unit Dosing Chamber v of the POWTS shown on the B c e responsibility for installation Phone Number i V11. Responsibility Statement 1, the undersign¢ ure Mp/MPR Z Number /� ,r >, //— Plumber' i) (j" E7 Plumb Name (Pnnt) r ✓' , t- � J r / J T/� Plumber's Address (Street, City, State, / / 7 o Stamps) III V Conn /De rtment Use Onl Sanitary permit Fee (includes Groundwater Date issued ]ssuin gent Sign (ld Approved ❑ Di roved Surcharge Fee) L.. ❑ er for Denial A. Conditions o A rov val SYSTEM OWNER: 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code /ordinances. etc (to the County only) far the system on paP� not less than 8112 x 11 inches in sin e Attach compl pia ns SBD -6398 (R. 01/03) PLOT PLAN Klinger ADDRESS 547 K Woodchuck Dr. Woodbury Mn 55125 SW 114S 25 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX STEM ELEVATION 100.5 BEDROOM 3 NVENTIONAL AT -GRADE CONVENTIONAL LIFT HOLDING TANK MOUND ) SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 456 # of chambers none BENCHMARK V.R.P. TOp Of 1 pVC pipe ASSUME ELEVATION 100' Filter Zabel A -100 ❑BOREHOLE O WELL *H.R.P. Same as Benchmark B. M. * 522' Property Line Well is to meet all setbacks found in Comm. 83 100' 99.5' 99 B -1 A .M � 2% Slope Top of 1" pvc p @ Area 15' Below Grade 100.x' to remain undisturbed B -3 El Tank is to be properly bedded and provided with lockdown covers with Grading is to be done approved warning labels to divert run -off away from system N B -2� Pro 3 Bedroom House ComfboTank 131st. Ave 312' Property Line CO Safety and Buildings 4003 N KINNEY COULEE RD commerce .Wl.gov LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 www. commerce.wi. g ov /sb/ isconsin www.wisconsin.gov Department of Commerce Jim Doyle, Governor Mary P. Burke, Secretary August 01, 2005 CUST ID No.226900 ATTN: POWTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING, INC ST CROIX COUNTY SPIA 1008 192 ND AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/01/2007 Identification Numbers Transaction ID No. 1160727 SITE: Site ID No. 702293 Josh Klinger Please refer to both identification numbers, 1438 131ST Ave above, in all correspondence with the agency. Town of Richmond St Croix County SE1 /4, SW1 /4, S25, T30N, R18W FOR: Description: Three Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 1031395 Maintenance required; 450 GPD Flow rate; 31 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 /01), Pressure Distribution Component Manual -Version 2.0, SBD - 10706 -P (N.01/01); Biofilter 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. COiICIII No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. A P F" The following onditions shall be met during construction or installation and prior to occupancy g g P P Y or use: EPARTMENT Approval Requirements: ,1A P�l OF • This system is to be constructed and located in accordance with the enclosed approved plans and with the SEE CORRE "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01 /O1) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD- 10706 -P (N.01 /01). • 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 POWTS 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 s SHAUN R BIRD Page 2 8/1/2005 • 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. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 j 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 Jansk Wastewater Specialist, 715 Y Y� P � ( ) 726 -2544 I Cover Page Shaun Bird RECEIVED Bird Plumbing Inc JUL 2 5 2005 1008 192nd Ave SAFETY & BUILDINGS New Richmond Wi 54017 715- 246 -4516 Date: 7/19/05 Owner: Josh Klinger Location:SE1 /4 SW1 /4 S25 T30 N,R18W Lot 9 Richmond Hills Richmond System type: Mound System Manuals Used: Mound Component Manual Version 2.0 (01/31) Pressure Distribution Manual Version 2.0 (01/31) Page# 1. Cover Page 2. Mound Plot Plan 3. Mound Cross Section 4. Pipe Cross Section /Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve OFC�y{ME RCS 7 -8. Maintance and Conti enc p lan ` ! ;"I GS 9 Yp 4 _ 9 -11. Soil test SPO E Shaun Bird Signature License number 2 00 PLOT PLAN PROJECT Josh Klinger ADDRESS 547 K Woodchuck Dr. Woodbury Mn 55125 SE .1 /4 SW 1/4s 25 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX SYSTEM ELEVATION 100.5 3 BEDROOM CONVENTIONAL AT -GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 456 # of chambers none hk BENCHMARK V.R.P. Top of 1" pvc pipe ASSUME ELEVATION 100' Filter ZabelA -100 ❑BOREHOLE O WELL *H. R. P. Same as Benchmark B. M. * 522' Property Line Well is to meet all setbacks found in ` gyp Comm. 83 99.5' 100' 99 B -1 A M. 2% Slope Top of 1" pvc pipe @ Area 15' Below Grade 100.2' to remain undisturbed B -3 Tank is to be properly bedded and provided with lockdown covers with Grading is to be done approved warning labels to divert run -off away from system B -2� Pro 3 i Bedroom House Huffcutt 1 131 st. Ave Combo Tank 312' Property Line r Designer No Date Non -Woven Filter Fabric 4 Observation Pipe Perforated ,Distribution Pipe Below Filter Fabric AsTa C -33 Sand Topsoil \ .= i % Slope �. Force Main \Flowed Bed Of 4 j- 2 �Z La er Drain Rock From Rump Y� 'D �E.�a Cress Section of A wound S stem Usin F A Bed For The Absorption Area 6 f A � Ft. j Ft.. Ft. K Ft. L Ft' ,_ .. _.... _ . ✓/may )r .. W Lf Ft' L d.Observotion Pipe --� J ---- -- K e __- A Force Main —° ------- - - -_ -. ._--- ____------ - - - - -- From PumP - � 1 j o Distribution Bed 0f Pipe Drain Rack i \ 4 Observation Pipe = r =C 4 <-i Permanent Morker pipe or Rods Plan View Of Mound U61ng A Bed For The Absorption Area PAGE,.,,,,_ PF_.— i per4oro'.td pipe Oetoii End Vitt �Pertorated j + PVC Pipe moles totatee On 8011om. Are Equally Stsoseo iE + g PvC Force M ain Fttt5T 14OLL 14SI tics Gertnec }�cn i ` it PVC Monitosd Pipe Cistrioui.on Pipe '' .'i- Distribution Pipe L.o P Ft. l cc � — u�or - X I nches r Y nclles Hole Diameter I Inch Signed: Lateral Inch(es) License Number: ;Mani I Oate: Force Main Z Inches ,# of holes /pipe„ Invert E of L ateral s ��7 Ft. :� A141) SPECi ICATIONS SEPTIC TAI3�C "gyp CHA�i�SyR CROSS gECTx WE Ar"ERPR�F APFRQV ED •, pSZN . ABODE GRADE J� NCTION SOX BOLE COVER �ZPE }Z Tip CONDUIT W1 f- SENT WINDOW 4R W� i�1! �ADi.DCx r y ' FROM DOER. f�ARliIxG LABE FREa1" ! �- „..,.. HIM- o GRADE 8” s INLET � 4 VItPPRIIUED -�-- TIGHT = ; �Rovo PIPE wATER TIGHT SEALS A SEAL _ ALM _..-- =--_ 3' ONTO fIL - TEg $ N sMgp SOIL App1YSA J C `" i FF PIPE 3` - �` ._-- -- " ® FT. DIL SLID D SOIL pt#24P OFF EL£V DEVDING UNDM TANY' 1�vON ROTE PAD SPFCTf ICATIOi4s Hg�R Dfl5E5 ?£g DAY = Z ._-- ----�- gEpTC DOSE ! v FLOW pCK-•. > j GAL - r £R% �' E ,.ANN MANUFAC'IUR GAL. Dfls �� � U 6AL- �+ SEPTIC sc GAL . A �__,,i ;HCFiES T1 J . r- 1 ° - DOSE p �PACI'TI£S = _ 2 I3dCHES =�- ALA 1 $:: Es GAL. JINCH •rc l s c�►L Pu Hp swIICH �c P Z R 16' 2 WAC MODEL � � �gH i,dlRlisG TYPE= o P £ A - z2 FEET T£ y G PIPE F'£ RCQUZRF� DISCHARGE DISTftlW I - - - �I FEET 6 CE stgvEEN PUi�'iP fls F AND _ - d1+� FACTOR FEET VER'�ICAL DIFFER'EH PRESSURE - £g ;CT2 s TC Ii 1'Tf IQ D - FT - 17'lxA� MIN A FEE �FORC£MA�N x ?ORAL DIAMETER LENG F�1T£Ri�AL D IME3 LICESSE sBER S FGPIEt = — ""'� :f8� . TOTAL DYNAMIC HEAD /CAPACITY PER MINUTE HEAD CAPAC CURVE ' EFFLUENT AND DEWATERING MODEL 152/153 MODEL X52 153 W 50 Feet I Meters Gal. Liters Col. Liters 5 1.5 69 261 77 291 153 231 70 2Ei5 10 3.1 61 12 40 t52 15 4.6 53 201 61 231 20 6.1 44 167 52 197 s 30 25 7.6 34 129 42 159 U 8 30 9.1 23 87 33 1; %5 35 10.7 I -- 22 E5 a 20 40 12.2 -- I -- 1 t 42 r O Lock Valve: 38.0 Ft. (11.6m) 44.0 Ft. (13.4m) 4 10 0 100 - 20 4 60 so GALLONS 6 1/4 LITERS 0 SO 160. 240 320 3 27/32 FLOW PER MINUTE 3 27/32 CONSULT FACTORY FOR SPECIAL APPLICATIONS 0 I 3 27/32 • Timed dosing panels available. • Electrical alternators, for duplex systems, are available and supplied with an alarm. i in single •Variable level control Switch area controlling 9 le for 9 phase � systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. • Sealed Qwik -Box available for outdoor installations. See FM1420. • Over 130aF. (54 °C.) special quotation required. 12 1 / 8 1521153 Series • 1521153 MODELS I Control Selection 5 1/8 Model o hs-ph Mode Am Sim lex Du lex sKmea N152 115 1 on 8.6 1 2 or 3 ---� BN152 115 1 Auto 8.5 Included 2 or 3 E152 230 1 Non 4.3 1 2 or3 BE152 230 1 Auto 4.3 Included 2 or 3 N153 115 1 on 10.5 1 SELECTION GUIDE 814753 115 1 Auto 10.5 included 2or3 E153 230 1 Non 5.3 1 1. Single piggyback variable level floai switch or double piggyback variable level float BE1531 230 1 to 5.3 Included 2 or 3 switch. Refer to FM0477. a cauTloN 2. See FMO712 for correct model of Electrical Alternator E Pak. duplex (3) qu level control switch 10-0225 used as a control activator, specify b .a Variable done Vana Allinsta8ation of controls, protection devices and wiring should be do y Q 3. licensed electrician. All electrical and safety codes should be followed including the most o r (4) float system. recent National Electric Code ( NEC) and the Occupational. Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL 70: F.O. BOX 16347 Louisvile, KY 40256 -0347 Manufacturersof.. SHIP 70: 3649 Cane Run Road �? p ® Louisville, KY 40211 -1961 �QL(41/TY�!/MP9 �/ /NCE -PUMP 1.1 800 928 (5021778 -273 ( ) h>xp / /wwwaoe!!er cam !O FAX (502) 774 -3624 © Copyright 2000 Zoeller Co. All rights reserved. ERys MpUA1- A� AGEM EKT P' ` 9C) WT$ O � SYSTEM SPEClFlGATlONS � 0 NA �pbc Tank CaPa NA HcTank Mau L ❑ NA RMA�o_ e r r D v _._-- --�-'" Effluent filter Maurer p NA 30 5 --- "--� Effluent Fjer M°de1 3 D atom, 0 NA qty y �ry�t PA'RAI�T pumP-Tank CaFa �5L NA Of Units � pump Tank manufacturer �O��� c3 NA 0 NA N umb C°""nerr (� `� Pump "'fia`` N _3 � ��� aUd - m Mo P F del NA ent nit U Peat Filter ), ( EOM Prey Down 1fo+ Rate Monthly averag p Sa"dfGM F'l n p Wetland Mechanical Aer� 0 Other. Qua!"itY S3° mg1t.. D on G Q2o mg/ p DieMfdc Ir,fluentt�� Oil � Grease tEO ? rer Fets,r Demand (BOOS 5 iso m n- Manufa$ Cett(s) Q round (P� urbed) Bioct� �l O> d � rds CY S MonthlY average.. f7 ln�round (gravity) -m 0 n rode / C] Other At P led went QuaW ($ODs) X30 n_ m9n- p D l ine steMri�sr end ical Oxygen Darn ds {t55) 1 ooml very for a°mestc (++o Btu Total SusPen rnestt} 510` ctut ;Y went r. Fecal iforM (9eO Y, inchdiameter 5epcicsa�� for Pr 'E°°'waste ce effluent Paft cle Size .• values tYP M um Service Freclu , ncY g rs.) � (Maximum Y FA}p —OF sc*jpowe p m onths every r� (Y of tank votucne Service Event At feast once scum equals one-th 3 rs - sludge and r(s) (Maximum Y vVtien combined ❑ months pe� condition of tank(S) r(s) tns . Pump out c ontents of tan At least once every © e m onths tsar celf(s) At least once every Q most" ar( s) p NA Inspect disPPe ye ars} d NA At least once every [3 month Clean effluen fitter O NA contr°is & alarm At least once every 0 years Inspect ) pumP� Pump months 0 ye ars) 0 NA,,,, -- y��1s and P ro ,sure test At least once every C3 months Pruett At least once every od,er rcenses 1 - one of the fotTS Ma tatner• WWI lONS an indivldtial S i spector, PO M � I or broken u lNS�UC f l des shad be made by SOWer: PO �nK(s) to rdW* for an y bads P I�►lt of tanks and d- isPersa plumber Restti on of the m and chec t levels Ins; plumber: Mae - ter ust lndude a � insp ect Sludge and s10u to cheat the cilia 9n the oer : Master plu insPe Dons rn are the volume of shall be visually. rnsPe10 po nd of ef�uen $e .idng Qf� or leaks, rneas The dispersal 10611{s) ce• The u6a a uthoriv - nardware. iderift any r ound surface - of effluent on the Aroun s urfs lion of the tool fe9 lame. the pondiltg of efflu p d to check for a I d��qurres the imrnediate notific a or more of the t YO � i in the obsery ch ri an trd (� once NR es n to a faiTrn910ondtt3o uals on an of in accord groin � � may i d SCUM in any tank eq rato and disposed rnulation of slu ge a Septa9e any cl_ i ng OPe and When the °oMbined . W k sha11 be retreatFlent �ponents, Of the tan I�eR+°` �ntaainer. entire contests live Code ed POWFS c�mP °vents, P� a ed pOVYTS M 11 , Wtsconsin Admitirstra cue Brent. f e anical or pressuriz less sha11 be P?� complefion of arty Sem of filters, maedl 2 months ar. 'file &er�n9 nCe or mon'rtormg 1 r eg u l a tory allthOdlY within 1 � �� roducts or other ��� °� � of painting p ded to the local ervl�e report shall'be pf vi 0 o�►T PO s cic treatment tank(s) s) rsal C f f c oncur Uo 5 S are A s a e rabw prior to u F�MW oora N> wn Pn°r the t atment P> � b a ¢ ge servicing oPe - e L 1i that th oo � of the tankts'► rem / Page of e surface- ° cond are frozen at the infiltrativ is restrXed the e=ess all no t vAlen $ cQ When power s slant up t occu above Wormer txighvvater levels, the ceg(s) and ges pump tanks ett(s) in may result in the c one large dose . aveti0adng �p tank removed by a W e. Dua". Power vea't wig be �� f eMuent �° t� s�uation have me P or contact a P ltn o< POVYTS Matrrtairter LD cfl,�nJ er to the effluent pu taflk ba�F wig OperdocP�.161 t0 restore normal feYets within the pump Sepuge In rrtanuaW OPT "g the pump ., cefls. Do not drive or parK ovens or otherw tflsturb or compact, assist rk � over tanks and dispersal Do not drive or Pa f the fOifon or at -grade soil a b s orption area- tfotmance and prolong the e the area within 15 feet down slop of any im rove the pe dental floss; (Rapers; tion of from the wastewater stream n1aY p degreasers: Redact or erunina yy ip cigarette butts; condoms; cotton swabs; herbicides; meat water, fruit and and so vegetable peer, _ of the POWT gaSO s greases -9 antibiotics: d Y n - (sufnP p�P) , ns: fie. 'Wri ting pr►dt#S: t ides sanitary napkins: tempo be excavated and removed or their cove- shall be taken to Insure that the A g pO ENT taken out of service the folioyAn steps Witten the ME TS tails andfor is permanently Adminis en ou '�T Comm 83.33, IA/ n Code system i s Proproperly an safety abandoned in come ndoned pipe o penings seated d ifs shalt be disc onnected and tine aba di of by a Septage Servicing Operator_ . The piping to tanks t P and and the void space ' .. The contents of all tanks tt5 shaft tie removed and property in all tanks and pits shall ers rerrroved • Afbar pump g• filled with soft, gravel or another inert solid material_ as a soil and site sures have been, eva CONTINGENCY Pi At�t the foitawing mea or must be takers. to Provide a code If the POWTS fads and be rep aired be utilized for the location of a reptaeemerlt soil compliant repiacerr; tarea has been evaluated and may c Lion and should not t3 A sultabte replacemen. re place m ent area should be protected from disturbance and co absorpt i on system 9 sed structure. lot Fuzes and welts. to absorpt suit a tie infiiriged upon by requind setbacks from existin a nd propo wilt result in the need for anew luatiarr to e5fdb' a laceril area m s must comply with the rules in effect at that trrne Barring protect the rep R systems replacement area Ie replacement area is not ayaifable' resort tar place the failed POWTS- advances in PO C) A suitable be installed ology a holding tank may a suitable replacement area. Upon failure of the POWTS a available a to identify t area is available a The site has not been evakated ment area_ If no reptacemen Site evaluation must be Petfo►�n to }ovate a suitable replace ed as a last resort to replace the failed POWTS- of the biomat at olding tank may be install Li systems may be reconstructed in place foilo+nring removal r� ound and at -grade son absorption systems a such systems must comply with the rules in effect at that time_ tfie infittratNe surface Recon struction «WARNtN4> TANKS MAY CONTAIN LETHA;- �'�� AND10R INSUFFICIENT OXYGEN- SEPTIC, PUMP AND OTHER TRFJ�TME� TIVlENT TANK UNDER At�tY CtFtCUMSTANCES. DEATH MAY DO NOT ENTER A SEPTIC, PUMP OR OTHER TRH M THE INTERIOR Oi A TANK MAY BE DIFFIC RESULT: RESCUE OF A PERSON FRO t1LT OR [MPOSStt3 ADDITIONAL COMMENTS pOWTS NlAiWAINER POYV•TS INSTALLPR Name It �✓ y, ' Name ce- 1 Phone SERVICING OPERATOR PiJMP1r LOCAL REGULATORY AUTHORi'fY � SEPTAGE G a Agency L C f Name ?hone Phone er>S- This doaurrrent mesa the stafrs of the Given Lake, Marquette and Waushara CoontY Zoning and San a9 � of tfits document does not This d =,xotwasdratted by wsscons the minimum mqumnents of c!L Comm 83 2 ?!b'}(tXd7 (f1 83_S4(T). (2) & (3). GMW (1101) guarantee the performance ©f the PONVi•S- 1 Wisconsin DepartmentofCommerce SOIL EVALUATION REPORT Page 1 _ of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach ,omplete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must St. C rO 1X include, but not limited to: vertical and horizontal reference point.(BC 1�, direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and jt CaV6rWalfld distiiihmto nearest road. pendin Please print all infeM0 n. Re ewe d by Date Personal information you provide may be used for 5 @coif4ry purpose+riya Law, s. 15.II4 (7) (m)). . 12- Property Owner Prope(tj ,Location R J C Develo ment, I C Gov�Loti SE 1/4 SI /4 S T N R �(Or) Property Owner's Mailing Address 1 Lot Block # Subd. Name or CSM# st r 1868 Cty Rd. C ;A f 9 na Richmond Hills City State Zip Code Phone Number yF F'. CiUy ❑ Village ® Town Nearest Road yr-,tl �, New Richmond WI. 7 54017 (5),247 -5721 Richmond I 130th, ave. Rk New Construction Use: ❑ Residential /Number of t3ed?GOIn_ Code derived design flow rate 600 GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material = g lacial dri ft Flood Plain elevation if applicable tt• General comments and recommendations: mound @ el. 100.50', based on contour line of el. 99.50' Boring a Boring # ® Pit Ground surface elev. 99 ft. Depth to limiting factor 31 _ in. Soil Applicati on 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 1 0 -11 10 r 3/3 none L 2msbk 2 11 -22 1 0 r 4/4 3 22 -34 7.5 r 4/6 4 34 -55 10 r 5/4 c2 7.5 r 5/6 sl 2msbk mfr •5 • I ❑ Boring # E] Boring 99.70 31 2 ® pit Ground surface elev. ft. Depth to limiting factor __ -� in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots` CiPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 •Eff#2 3/3 none L 2msbk DSH QW if .5 .8 2 11 -21 10 r 4/4 none sicl 2msbk mfr qw if .4 .6 21 -31 7.5 r 4/4 none sl 2msbk mfr w if .5 .9 4 31 -60 10 r 5/4 c2 7.5 r 5/6 sl M n .3 .5 Effluent #1 = BOD > 30:5 220 mg/L and TSS >30 5 150 mg /L ent #2 = BOD 30 mg/L and TSS 5 30 mg/L CST Name (Please Print) Signature . CST Number Gar L. Steel 2298 Address �E,alu,tf,rn Co • ucted Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 10 -14 -2000 715- 246 -6200 i I � Property owner R J C Developmen Parcel ID # pending p age 2 of 3 a Boring # ❑ Boring Pit Ground surface elev. 99 ft. Depth to limiting factor in. Soil ligtion 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 1 0 -8 10 r 3/3 none L 2msbk DSH gw if .5 .8 4/4 none sicl 2msbk mfr 9w if .4 .6 3 20 - 7.5 r 4/ none sl 2msbk mfr 9w if .5 .9 4 36 -60 10 r 5/4 c2p7.5yr 5/6 sl M na na n •3 .5 F-1 Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil ligtion 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 E Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ pit 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 Effluent #1 = BOD, > 30:5 220 mg/L and TSS >30 < 150 mgA- • Effluent #2 = BOD < 30 mg/L and TSS 5 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 (8.60)) STEEL'S SOIL SERVICE Gary L. Steed RTC Development, INc. 1554 200th Ave. CSTM229$ SE4SW' S25- t30N - New Richmond, WI 54017 MPRSW -3254 town of Richmond (715) 246 -6200 lot #9- Richmond Hills fl " =40' �. = top of 1 " pvc pipe @ el. 1Q.0- W96 = top of 1" pvc pipe @ el. 100.20' CO 44 2� v5. Gary L. Steel 10 -14 -2000 ST CROIX C"N A Y SEPTIC TANK MAINTENANCE AGREEMENT . AND OWNERS' CERTIFICATION FORM Owner/Buyer 'J 0 Lou Mailing Address Property Address De artment for new construction) (Verifrcafion required from Planning P 9 - oq Parcel Identification Number 02.x1(2�-QOO� / City/State LEGAL DESCRR'TION r • 1/4 -lam r /4, Sec. � ,r N R'�T, Town of A L I Limon — Lot it Subdivision - r ______ , Page # Volume _.�-- C,rtified Survey Map # ) Z o 7 - 7 D2S Volume ZZIa� Page # Warranty Deed # ❑ no Lot lines identifiabl Spec house ❑ Y ° Pro aance $YSTE M MAINTENANC ti system could result in its premature failure to handle w was You p � the s swm ceof your sep b a licensed Pum per. What vnproper use and maurteaan �� y� or sooner, if needed Y ��� o f pimping out the septic tank every � sal system - caa a ff unction of the septic tank as a treatment stage in the wasp° by oar and by a cation form, signed owner agrees to submit to St Croix Zoning DePartznent a ceztifr t (1) the on�ite wastewater dispose sum The pTOPc� of sludge. lumber, restnctedplumber or a licensedpu � T v �)� the scp Ls less than I/3 full naaster plumber. journeyman tic tank is is pry operating condition and/or (2) after inspection and pumping ( with the standards agr to maintain the private sewage disposal system �y$catioa cmcnts and agr went of lgatural Resources. State of Wisconsin 1/ the gIIe have read the above requir to the St. Croix Co�9 Zoning sot fortb, herein, as set by the Depart within 30 ent of Co Commerce and the Department m maimed must be comp stat that your septic system has been %Sjjj— ee year expiration date. DATE APPLICANT CATION our knowledge. I (we) am (are) the own-'r(s) of true OWNER CER cert t Office. I (we) certif3' that all statements on this warranty deed recorded in R of Deeds the Tp es bed above, by virtue of a warranty OF APPLICANT ' resented may result in the sanitary permit being revoked by the Zoning �P� ent. s sst :« An information that is mis - re P d from the Register of Dee Include with this application: a stamped ty dee if reference " the deed a copy of the certified surveY map J 2 2 6 0 P 12 0 724025 ' STATE BAR OF WISCONSIN FORM 2 - 1999 KATHLEEN H. WALSH REGISTER OF DEEDS D ocument Number WARRANTY DEED ST. CROIX Co., WI RECEIVED FOR RECORD This Deed, made between RJC Development, Inc., a Wisconsin 06/02/2003 09:30AH Corporation, WARRANTY DEED EXEMPT ! Grantor, and Joshua B. Klinger REC FEE: 11.00 TRANS FEE: 102.00 COPY FEE: _ - - - -- CC FEE: PAGES: 1 Grantee. 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): Recording Area of 9 Plat of Richmond Hills in the Town of Richmond, St. Croix County, Name and Return Address Wisconsin. The First National Bank of Hudson Pat PO Box 187 Hudson WI 54016 026-1127-09-000 Parcel Identification Number (PIN) This is not homestead property. (9) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this 2 day of May 2003 RJC Development, Inc. Roberta J. on, Vice President AUTHENTICATION ACKNOWLEDGMENT Signature(s) RJC Develo Inc a Wisconsin Corporation, STATE OF WISCONSIN ) by Roberta J. Carlson, Vice President ) ss. County ) authenticated th' r day of May 2003 Personally came before me this day of the above named + Kristina Ogland — - TITLE: MEMBER STATE BAR OF WISCONSIN - (If not, to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY + _ Attorney Kristina Ogland Notary Public, State of Wisconsin Hudson, WI 54016 My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) _ , _ - _ •) ' Names of persons signing in any capacity must be typed or printed below their signature. Information ProressionaIs company. 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