HomeMy WebLinkAbout026-1127-32-000 Safety and Buildings
10541 N RANCH ROAD
HAYWARD WI 54843
TDD #: (608) 264 -8777
,\
Visconsin www.commerce.s i.us/s
Department of Commerce www.wisconsin.go
tt McCallum, Governor
Phili . Albert, Secretary
March 21 2002
p
q���FO
sT 0 1
CUST ID No.226900 ATTN: P0WTS Inspec Zp� y COQ 11200
SHAUN R BIRD ZONING OFFICE OFF %F�
BIRD PLUMBING, INC ST C,ROIX 1 W
1008 192 ND AVE 1101 CARMICHAEL RD
NEW RICHMOND WI 54017 HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 03/21/2004 Identification Numbers
Transaction ID No. 718794
SITE: Site ID No. 642150
Todd Marek Please refer to both identification numbers,
130 Ave above, in all correspondence with the agency.
Town of Richmond
St Croix County
NW1 /4, SW1 /4, S25, T30N, R18W
FOR: New mound, 600 GPD
Object Type: POWT System Regulated Object ID No.: 832965
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 Conditions:
• This system is to be constructed and located in accordance with the enclosed approved plans and with the
"Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD- 10691 -P
( N.01 /01) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment
Systems" SBD - 10706 -P (N.01 101).
• 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 component manual are complied with. A copy of this information must be given to the owner upon
completion of the project.
• 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. Slats.
• 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. Slats.
• The maintenance plan for this system must be given to the owner of the POWTS.
Reminder
• The orientation of the mound system must be such that the longest dimension is oriented along the surface
, contour per COMM 83.44(6)(a)2.
• Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual.
• Surface water drainage shall be diverted away from the system area per Mound Component Manual.
• r
SHAUN R BIRD Page 2 3/21/02
• Materials shall conform to the requirements of COMM 84.
• Maintain well and waterline set backs per COMM 83.43(8)(i).
• The designer proposes to install a state approve outlet filter to achieve the requirement of wastewater particle
size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner
of the POWTS explaining that periodic cleaning of the septic tank outlet filter is required. The access opening
used to service the filter shall terminate at or above finished grade with a watertight cover.
• Provide frost protection per COMM 83.43(8)(c).
• Holes must be drilled with a sharp bit and all burrs and foreign matter removed before installation.
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 /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 providb a copy of this letter to the owner and any others who are responsible for the
installation, operation or maintenal)�(e of the POWTS.
Sincer ( Fee Required $ 175.00
Fee Received $ 175.00
Balance Due $ 0.00
Patricr Shan do
POWTS Plan Revi er , Inte ted Services WiSMART code: 7633
(715) 634 - 7810, Fax: -5150, M -F 7:45 am - 4:30 pm
pshandorf @commerce.state.wi.us
cc:
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
404973 0
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No:
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)
Permit Holder's Name: City Village X Township Parcel Tax No:
Marek, Todd I Richmond Township 026- 1127 -32 -000
CST BM Elev: Insp. BM Elev: BM Description:
.b 3 - c ST
TANK INFORMATION V ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic
fit& ® Benchmark Q� , r7 .
Dosing oet Alt. BM ^1 / h 'C
Aeration Bldg. Sewer to /
- S 21 q.I
Holding St/Ht Inlet p
St/Ht Outlet Y'
TANK SETBACK INFORMATION 1 7 5 3 , ?, O- j
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Cl..Wl;W . -7 �'�c,l a _ 75.2 o. 1s
Septic , I Dt Bottom
/
4 2 om
, 22.S � — 00
Dosing 0 f/ / f F�3derlMan. / Z ' 3. V ',C , q (v
Aeration Dist. P ipe
T IC/
Holding Bot. S stem
— L_ 3' R 3. X13.
PUMP /SIPHON INFORMATION F inal Grade ' S � 1 q( Z3
Manufacturer Ci GP and St Cover 2 3
Model Number
O
TDH Lift Friction o System Head DH t
9
�7 �j.'
Forcemain Len Dia. ti Dist. to Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width (k, I Length No. Qf T has / PIT DIM IONS No Of Pits Inside Dia. Liquid Depth
DIMENSIONS
SETBACK SYSTE TO > P/L BLDG IWELL LAKE /STREAM LE HI Manufacturer:
INFORMATION Type 01 System: y / CHAM I OR Model Numbe .
DISTRIBUTION SYSTEM
Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Inta `S
Pipe(s) /
Length q Dia Lengt Dia Spacing
SOIL COVER x Pre ssure Systems Only xx Moun Or At -Grade Systems Only ,
Depth Over 115ep Over xx Depth of xx Seeded /Sodded xx Mulched
Bed/Trench Center Bed ench Edges / Topsoil
G / 0 Yes 0 No 0 Yes A No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / Zg N Inspection #2: l/ 0.
Location: 1416 133r e. New Richmond, 1 54017 (NW 1/4 SW 1/4 25 T30N R18W) Richmond Hills Lot 32 Parcel NO: 25.30.18.842
1.) Alt BM Description OM M OP �� �L,4 U t . �'_ �' i' It-a) ` _ss o
2.) Bldg sewer length = 22 f ��— 3 / 5 3 • Voua- rv/w`` G4tAi 1,2` (
- amount of cov r= 3 6 `0 GLvt d (Q "t v,u, gv W4 K -kn.- WOW .
3.) Contour=
��� �.
Plan revision Required?
Yes No � !' Z& �~
Use other side for additional information.
SBD -6710 (R.3/97) Date Insepctor's Signatur Cart. No.
Safety and Buildings Division County
201 W. Washington Ave.. P.O. Box 7162 ��r"% /'j2
/
V visic ,
onsin Madison, WI 53707 - 7162 Site Address f1
Department of Commerce 41 D& —#-- 141 (o _ • � C "
Sanitary Pe - t Application S pry P �D N
5�3
in accord with Comm 83.21, Wis. Adm. Code, personal information you provide ❑ Check if Revision
may be used for secondary ses Privacy Law, s15. 1 m
I. Application Information - Please Print All Information tale Plan I.D. Number
r, LVED $" q
Property Owner's Name arcel Number
nil
Property Owner's Mailing Address f P petty Location
TY
CI
✓ CJ ��' �� it O1XC OUN /A; S T
City, State Zip Code ne Yt Number L d lock Number
Subdivision Name CS Number
II. Type of Building (check-all that apply) s--5 ?a'" 5 """` Doty
or 2 Family Dwelling - Number of Bedrooms � ❑Village
❑ Public /Comme - scribe qse ownship �'
❑ State Owned �T A0 " Neares� l
►.o��12 /
III. Type of Permit: (Check only one box on fine A (numbering scheme for internal use). Complete line B if app 'cable)
A For County use
1 ew 2 11 Replacement System 3 ❑ Replacement of EE
Tan ' Addition to
stem k Only tis S stem
B. ❑ Check if Sanitary Permit Previously Issued Permit Number Date Issued
IV. Type of Permit: (Check all that apply) t>}imbering scheme is for internal use):
44 El Non - Pressurized In- Ground 47 ❑ Sand Filter 50 ❑ Constructed Wetland
22 ❑ Pressurized In- Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line
45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other
V. Dispersal/Treatment Area Information:
Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Fiiial.Grade
Required Proposed Rate(Gals./Days/Sq.Ft.) (Min./Inch) Elevation.
VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steef Fiber Plastic .
Gallons Gallons of Tanks Concrete Constructed Glass
New Existing
Tanks Tanks
Septic or Holding Tank 2
Dosing Chamber
VII. Responsibility Statement- I, the undersigned, a responsibility for installation of the PO shown on the attached plans.
Plumber's Name (Pont) l Plumber' r MP/IvIPRS� um, -1* 1 Business Phone Number L J
Plumber's Address (Street, City, State, ) i
/
VIII. Count /De artment se O
V Approved ❑Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps)
Surcharge Fee) OD
❑ Owner Given Initial Adverse °'
Determination 3 2 �
IX. Conditions of Approvfi/Reasons for Di r6 ovaiN^a f " C e Crew o l thdL(�91(CP�
fir UCf OL4
Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches In size
SBD -6398 (R. 05101)
PL " PLAN
La�Marek DRESS P.O. Box 148 New Richmond Wi 54017
/4 SW 1 /4s 25 /T 30 ! 18 W TOWN Richmond COUNTY ST. CROIX
1VIPRS Shaun Bird 226900 3/11/02 4
DATE BEDROOM _
CONVENTIONAL IN -GR U PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND X00C SEPTIC TANK SIZE 1260 gallons LIFT TANK SIZE DOSE TANK SIZE 805
HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 600 # of chambers none
BENCHMARK V.R.P. Top of NE Lot Stake
ASSUME ELEVATION 100' Filter Zabel A -100
❑ BOREHOLE O WELL H. R. P. Same as Benchmark
SYSTEM ELEVATION 93.4
JsA
Scale = 1/4 =1 0'
309' Property Line
4% p
Slope
ro
Area 15' Below `O
Tanks are to be properly bedded and provided A
System is to remain with lockdown covers with approved warning labels
undisturbed c
cu
r
92' m
Grading is to be done to divert runoff
away from system
9 3' B -
Well is to meet all
setbacks found in DT
Comm. 83 9 4''
Weeks
� N
Please note: Site is suitable for We e ST a At -Grade system, but due to the Pro 4
required length, there is not enough Bedroom
lineal distance to install a at- grade, and Ck/VL House
there is no manual for a mutiple cell at- leaf�
grade at this time ' &S,
Safety and Buildings
1054 N RANCH ROAD
HAYWARD WI 54843
TDD #: (608) 264 -8777
hs�:onsin N
w ww.cornrnerce.s tate. wi. us/sb
vnnr.wisconin.gov
Department of Commerce
Scott Mc Callum, Governor
Philip Edw. Albert, Secretary
March 21, 2002
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: 03/21/2004 Identification Numbers
Transaction ID No. 718794
SITE: Site ID No. 642150
Todd Marek Please refer to both identification numbers,
130 Ave above, in all correspondence with the agency.
Town of Richmond
St Croix County
NW 1/4, SW 1/4, S25, T30N, R18W
FOR: New mound, 600 GPD
Object Type: POWT System Regulated Object ID No.: 832965
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes PS
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in Con
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: �� p
General Approval Conditions: AR
• This system is to be constructed and located in accordance with the enclosed approved plans and with the d 4f
Private Onsite Wastewater Systems" SBD- 10691 -P
Mound Component Manual for Septic Tank Effluent for y
( N.01 101) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment '" SEE C
Systems" SBD - 10706 -P (N.01 101).
• 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 component manual are complied with. A copy of this information must be given to the owner upon
completion of the project.
• 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.
• The maintenance plan for this system must be given to the owner of the POWTS.
Reminder
• The orientation of the mound system must be such that the longest dimension is oriented along the surface
• contour per COMM 83.44(6)(a)2.
• Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual.
• Surface water drainage shall be diverted away from the system area per Mound Component Manual.
Il
SHAUN R BIRD Page 2 3/21/02
s '
• Materials shall conform to the requirements of COMM 84.
• Maintain well and waterline set backs per COMM 83.43(8)(1).
• The designer proposes to install a state approve outlet filter to achieve the requirement of wastewater particle
size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner
of the POWTS explaining that periodic cleaning of the septic tank outlet filter is required. The access opening
used to service the filter shall terminate at or above finished grade with a watertight cover.
• Provide frost protection per COMM 83.43(8)(c).
• Holes must be drilled with a sharp bit and all burrs and foreign matter removed before installation.
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 /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 provid6 a copy of this letter to the owner and any others who are responsible for the
installation, operation or maintenance of the POWTS.
Sincer Fee Required $ 175.00
Fee Received $ 175.00
Balance Due $ 0.00
Patrici S ando
POWTS Plan Revi er , Inte ted Services WiSMART codes 7633
(715)6 34-7810, Fax: -5150, M -F 7:45 am - 4:30 pm
pshandorf@commerce.state.wi.us
cc:
E
Cover Page
Shaun Bird
Bird Plumbing Inc.
1008 192nd Ave
New Richmond Wi 54017
715- 246 -4516
Date: 3/11/02
Owner: Todd Marek
System type: Mound System
Manuals Used: Mound Component Manual version 2.0 (01/31)
Pressure Distribution Manual version 2.0 (01/31)
Page# 5.
1. Cover Page ,jit>Lo
2. Mound Plot Plan
�pf NGS
3. Mound Cross Section AEWS ►.a►
saf /
4. Pipe Cross Section /Pipe Layout`"
N pENC
5. Pump Chamber Cross Section JRRE
6. Pump Curve
U
7 -9. Maintance and Contigency plan
10 -12 Soil test A
f .
Signature
License number 226900
3/11/02
J PLAN
PROJECT Todd Marek RESS P.O. Box 148 New Richmond Wi 54017
NW 1/4 SW 1/4s 25 /T W TOWN Richmond COUNTY ST. CROIX
MPRS Shaun Bird 226900 ' DATE /11102 BEDROOM 4
CONVENTIONAL IN- GRI166 PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND )= SEPTIC TANK SIZE 1260 gallons LIFT TANK SIZE DOSE TANK SIZE 805
HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 600 # of chambers none
IL BENCHMARK V.R.P. Top of NE Lot Stake ASSUME ELEVATION 100' Filter Zabel A -100
❑ BOREHOLE O WELL sH Same as Benchmark
SYSTEM ELEVATION 93.4
Scale = 1/4 =1 0'
1
309' Property Line l
p B -1
4% 0
Slope
N
Area 15' Below Tanks are to be properly bedded and provided A
System is to remain with lockdown covers with approved warning labels o
undisturbed
r
CD
92'
Grading is to be done to divert runoff
away from system
93' B -
Well is to meet all DT
se tbacks found in ,
Comm. 83 9
4
Weeks
Please note: Site is suitable for bT
a At -Grade system, but due to the Pro 4
required length, there is not enough Bedroom
lineal distance to install a at- grade, and House
there is no manual for a mutiple cell at-
grade at this time
Designer NO `
4" Observation ,pe Perforated Non -Woven Filter Fabric
i?
Below Filter Fabric ,D +stribviion Pipe
ASM C -31 Sand
a P`
Tapfcll
I
Slope I
Bed Of IYS- 2 %2 Force Main ���Plowed
Drain Rock From Pump Layer
'0
i
Cr oss Section . Of A Mound 'System Using J/
A Bed For The Absorption Area
A Ft. H /�
8 7�Ft.
Ft.�
J 7, 2 Ft.
,• L Ft.
�k n wP W
Ft. .
---�- L --- --�-�—
eObservolion Pipe -- K
yr A -
o 1
W �o -__. - -------- - - - - -- ----------- ----- r -_..- Force Main
.._..�. .�...._......__�_.._ ._._ From P ump
3
p Distribution Bed Of 'V .2k-
Pipe Drain Rock
I �
4 Pipe Permanent Marker
Pipe or Rods
210n Vitw Of Mound Utinp A Bed For The Absorption Area
Perlororra pipe_ONeil
!
CRO Vies
�/" Perro�orRq /'
PVC P-Pt
e
�.��°"� MNh �.00arad On Rorron�.
e t an Are Equally Sioorm
+ PP
r
p� tit
PVC Face Main
fIRl4T MeltL K�K'r is Gwnnet�'a
PVC
Monilold Pioe
�� sf O i e��,ouw�on
Pipe
rJ�X14
.;
7 cc ,
DiS 1 f butio Pipe Layout . Ft.
Fi.
X Inches
Y� Inches s
Signed: Noce Diameter — 5 1. -2 qnch
License Number: Lateral " Inch {es�
Date Manifold 'r v Inches
F o r ce Main Inches
# of hales /pipe
Invert Elevation of Lateral ,2,9 Ft.
ofor
is •44M QOCR, I :�fUC" 0 •ox '"'" f w•NAgvc p 604KINCG
'" weawOYA frARi�+ , a MANwO�s: QDVfZR
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is rROv,��
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Engine ring Details - SHEF40
Performance Data
40
30
Pump Characteristics
V620 baler
sere�►eibae
W40111112 Ilettttaelic Matleb SNEi4QAF SNIF49A2 10
4 la
Fsi teal 12 6.5 l
NMror go" PO4 4 Pale) �
"A lsso
p"" 1e i0 20 30 GPM 46 SO 60 70
! 15 230 T otal Hood Cwt 10 ? 14 17 Z 1 25 ZS 300 35
Nark 60 1
1 20" F N u. Fleld (m) I s. 4. 3. 3 6.1 . s 10.7
go Left A GPM {us GPM) 1 70 60 510 40 1 30 30 101 0
IeseMNM Class A ( a "c) 14.4 1. -- N
ftdnz sad+e we f 13 aM Dime nsional Data
28 111 s. 7 » &soe Mee.2n 1. All di m0aslo ns In inches. Writ for
POW Cant 18/1, UM 20 r ( dii 6" (1271 ildernQtf W Use).
*haw
( L H. 42 ) 2. Component dImnsiafts may
Materials of Constructi vary :t 1A Inch.
.... 11tA >F.�ttiL. ,_ _.. 3. Not for construction �
p
Iilchlt Of 4 .. D ts2�,Ar s unless unified.
-AM Mjdm Co Im FIAAT
hut ram 60 h" • sWITCM 4. Dimenslom and weights are
' approximate.
F9edta�kall swd has. W /c 5. We resor" the dghi t m ake
��
SliattSeal S.al logy: Anotiir;wl Sseai -~— rerr"�Otts to our
SMfeless Sled
,spedfkWionc wethout nonce.
kaw`
^^e�
x: is
H W 0 998 Hydromaric�° pumps, A n Ohio All Riq ts HYDROMATIC a cwr uriv local DisH r — a
1840 Bony Rocd Ashtarsd, Dhlo 44805 W. 410. 289.3042 Fox 419 - 281.40&7 j
Web Situ *Wpatti6rpump.com
SALES OFFICES IN All MAJOR CITIES AND COJIMIIS `
Refer to "Pumps" in the yellow polies Of your phone directory for pwr local Distributor
C
Item#: W- 07.6680 1198 5M 9oM�nte3`
Maintenance and Contingency Plan for a Mound System
Maintenance Plan
1. Septic Tank is to be pumped once every 3 years.
2. Dose Chamber is to be pumped at the same time as the septic tank.
3. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in
order to extend the maintenance interval of the filter.
4. Once every 3 years the mound is to be inspected via the inspections pipes in the at-
The I in
grade. laterals are to be inspected via the cleanouts .
5. Owner agrees to limit greases, garbage, and water conditioner discharge into the system.
6. Pump and electrical components are to be checked at the time of the pumping.
7. Owner agrees to leave the area 15' below mound undisturbed.
8. The owner agrees to save this plan.
9. Trees, shrubs, and other similiar vegitation are not be planted on system. The system is
not be driven over.
10. Effluent Quality is not to excede the requirements found in Comm. 83
Contingency Plan
1. Pump alarm goes off, call pumper and pump out dose chamber and septic tank if
needed, then bypass pump float and try pump without float. If this works, float is bad,
replace float. If pump still does not work, check power at the pump with a electrical device
such as a hair dryer. If no power, check breaker inside house and call a electrician. If there is
power, then pump is bad and needs to be replaced by a plumber.
2. If mound fails, determine cause of failure, test another area or remove pipe and sewer
rock, retill soil, install new mound system.
3. Replace any other failing components as needed.
Important Phone Numbers
Plumber: Shaun Bird 715 - 246 -4516
Pumper: Tom Mondor 715 - 246 -5148
St.Croix County Zoning 715- 386 -4680
Shaun Bird #226900
3/11/02
POV%rrS OWNER'S MANUAL & MANAGEMENT PLAN Po go or
FILE IN RMATI N _._ SYSTEM SPECIFICATIONS /Zg66
Owner Zy ' Septic Tank Capacity al 0 NA
Perrr�t Septic Tank Marndacturer
DOOM PARAMETERS Effhrera Filter Manufacturer Z 17, O NA
Nurttberof Bedrooms O NA Effluent Filter Model t] NA
Number of Commerdai Units 6A Pump Tank dapaol y a l O NA
Esarnilted flow (fie) PunW Tank Manufacturer Cs/ 0 NA
Design lbw (peals}. (Estimated x 1.6) Piffno Manufalclurer 17 NA
Boll APPS Rat , Q ai/d lw PUMP Model 0 NA
Infoiwa went Quality Monthly average' Pretrsatment Unit A
Fats,.01I b Grease (F(rG) S30 mg/L 0 SWKVGrBvel Filter " 0 Feat Fllter
Blodtombal O xygen Demand (BOD X220 mgr, 0 Meohartk;ol Aeration 0 Wetland
Tout Suspended Solids (T: M) 6150 O Dl *dktlon ❑ Other.
Manufacturer
Pretreated Effluent Quality 0 RN Monthly average'" Dispersal Cell(s)
Biochemical Oxygen Demand (8010a S30 mg/L 0 In ground (gravity) 9 in ground (pressurized)
Total Suspended Solids (TISS) 530 mg/L 0 Atjmde Pound
Fecal Colifarm etric me ; s10 cfu/100ml ❑ Other
Maximum Effluent Particle Size i{ Inch diameter ww" typlaal for domestic (non- ftmmerdap wastwntw ww
aepda tank afAciem
Valaea typical for preheated wastawatw.
MAWTENANCE SCHE
Service Event Service Frequency
Inspect condition of tank(s) At least once every 3 O months years) (Maximum 3 yrs.)
Pump out contents of tanks) When combined Mudge and scum equals one -third M of tank volume
lnspec3 dispersal cell(s) At feast once every 0 months r(s) (Maximum 3 yrs.)
Clean effluent filter At least once every O months years)
Ins"d pump pump controls & alarm At least once every o months years) O NA
Flush laterals and pressure test At least once every -n O months ar(s) 0 NA
ow. � � At least once every O months l7 year(s) 0 NA
pq At least once every O months Q years) O NA
MAINTENANCE INSTRUCTIONS one of the following Licenses or
lnspedlons of tanks and dispersal Cells $hall be made by an POWTS insp� POWTS MSIMS Septage
pg�ts: Master Mumt�er, Master plumber Restricted Sewer; the tartk(s) do identify any missing or broken
� 0�W, Tank Inspeatlons, must include a visual Inspection Of
a packs or teaks;, measure the volume of combined sludge anidtscum the affluent ►` s
WOWS. Y a ny of a effluent lue on the
or p�lng of effluent on the ground :rirfaae. The dispersal ( 1!(sj shall be nd urface. The pondin9
and to ehe d for an tte grow ul rity'
in this observation pipes n pOnding of effluent on t ulres the immediate notification of the local reg story autho
ground surface may indicate a failing oondWn and requires ets exte�hird (>S) or more of the tank volume, the
accumulation of sludge and scum in any tank equ of in accordance vdth ch, NR
When the Combined accu mulation Septage Servicing OPeraW and disposed
entire oontwas of the tank shall be re.movec! by r intainer.
ents, and any
113, Whmnsin Admrnistrative Dade ents, pretrest9mera compoo
cttanlcal ar pressurized POWTS ocNnpon by a oerttiled pOWTS Ma
The sOvidng of effluent fitters, at 1r�arvals of 12 months or less shall be pe service event
other fnairKenanoe or m°rtitorided to the iocat regutatorY authority vvithln 10 days of completion of any
A 8 e•PAge report Shan be provi
edc treatrnortt tank(s) for the presence of Painting Products or oth
UP ANO oP
START ERATOON of the POYeIT S 1 ceN(sj, it tugh wncc"tMtlOns are
For neW constriction, prior to use s and/or damage the d ater prior to use.
chemicals that may impede the treatment e� d by a septage servicing PO
detected have the contents of the tank(s)
•
v w
System start up shall not occur whan soil'OOnditions are frozen at the Infiltrative surfecse. Page J ot_,,,_
Dunng power oatages pump tanks may fill above' normal highwater levels. When power is ro WW the eK MM
wastewater will be discharged to It* dispersal oan(s) in one large dose, overloading the opp (ss) and may niaM in the
backup or ct d*M dlsaftarge of efe Nerd. To avoid this stluation have the Contents of the pump tank removed by a
SeptVls Ser*ing Operator Prior 0)" M*Wktg powrr to the ettiuent pump or contaot a Plumber or pOWT6 Madntalner to
j assist In rttanU* openialing 0* pump controls to restore normal levels wlrl* the pump tank.
Do not drive or park vehk*w Mw iaxslks and dlsperset oelie, po not drNe or park over, Of etherWrise disturb or oompaM
the area within 18 feet down 8100* , of any nvx;nd or at -grade 8011 aboOrptton area.
Reduction or MkMnation of the fot N trtg from the wastewater stream may Improve the perftxmarnce and proiM V the ft
Of the POWTB; pyt; bab e � e )bulls; ocxndoms; Cotton swabs; deyrbatnars; denilil floes; dlalpera;
disNnfectants; fad fotuidaitfort di n 1;steltp PUMP) **W, trust and vegetable poellrage; arras hatbtaldes; meat
nledkWom. Ot PaWng Psi pesdoddes; sanitary napkins; tampons; - and wain softener brine.
ABANDONOMW
When the POIAt'I'S We and/or' Is PlwrnaneMly taken out of service the folloyAng steps shall 4A taken to insure UM the
system is properly and safety abandoned In complietwe with ch. Comm 83.33, W000nsin Administrative Code.
a All Piping to tanks and pits tthall be disconnected and the abandoned pipe openings messed.
It The Contents of all tanks aad pits shell tae removed and properiy disposed of by $ 9eptage ggrvk*Q OpW&W
a After pumping, all tanks bbl pits shah be excavated and removed or their covers removed and the Vold space
Holed with edl, gravel or another Inert 9M material.
CONTINGENCY PLAN
If the POWTS fob and cannot be ropelred the 1`01101Wlng measures have been, or must be taken, to provide a code
compliant replaceiment system:
❑ A suitable roptacement'arlea has been evaluated and may be utilized for the location of a replacement soil
absorption system. The replacement area should be protected from disturbance and Compaction and should not
be hftiged upon by required setbacks from existing and proposed structure, lot lines and web. Facture to
protect the repisiow tent area vA result in the need for a new soil and site evaluation to establish a suitable
replacemennt area. Reploosinent systems must Comply with the rules in effect at that time.
❑ A suitable replacement area is not avaiable due to setback and/or soar limitations. Baring advances in POWTS
technology a holding tank may be InstOwd as a last resort to replace the failed POWTS.
sits has not beers evaluated to identify a suitable replacement area. Upon failure of the POWTS a soli and
mitt• evaftletlon must be perk:cmed to locate a suitable replacement area. It no replacement area Is available a
ng tank may be indalla l as a last resort to replace the faced POWTS.
and at -grads soli abs:otptlon systems may be reconstructed in place followft removal of the biomat at
the Witrallve surface. Reconstructions of such systems must comply with the rules In effect at that time.
«WARNING»
SEPTIC, PUMP AND OTHER TREATMOff TANKS MAY CONTAIN LETHAL GASSES ANDIOR INSUFFICIENT OXYGEN,
DO NOT ENTER A SEPTIC, PUMP 'I)R OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY
RESULT.. RESCUE 011 A PERSON iFROM THE INTERIOR OF A TANK MAY Be DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENft
POWTS INSTALLER POV TS MAINTAINER
Name S �2 ,✓ Name /
Phtx►e o Z mil' b Phone / f " / - �fJ�
SSPTAGE SERVICING OPERATOR !_a :UMPER LOCAL REGULATORY AUTHORITY
Na me
Phone -� ! - ? s • / ��
d` Phone
This document was dialled by the sieflk of the tkeee take, Marquette and Wauahwa Cowq Zoning and Sanitation agerwi . This document meow
the minimum Wukenw is of dr. Comm 83.2101N1iIWAM and 93."1), (2) b (3), Wisoonasn Admargs left Canis. Uei of fhb dtxxnnent does not
guarantee ft performance of the POWTS.
OMW (2101)
I
e Wisconsin Department ofCommerce SOIL EVALUATION REPORT Page 1 of _3_
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code
County
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must St. Cro ix
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D.
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. p endin ct
Please print all infvrinatipp. R viewed by Date
v a v pe � ( O( )) Z$
Personal information y p ma be used for aohds purposes Privac Law, s. 15.04 1 m .
Property Owner Property Location
R J C Development, Inc Govt, Lot NW 1/4 SW 114 S T 30 N R 18 FE (or) W
Property Owner's Mailing Address Lot Block # Subd. Name or CSM#
1868 Ct . Rd. C ! /) '` I `' - na Richmond Hills
City State Zip Code -Phone WaOEC X ity ❑ Village Town Nearest Road
New Richmon4 WI .1 54017 115 Richmond 130i Avg.
[R New Construction Use: ❑ Residential Code derived design flow rate 600 GPD
❑ Replacement ❑ Public or commerci r `
Parent material glacial ft Flood Plain elevation if applicable ft• Ila
General comments
and recommendations:
n and @ el. 93.40', based on contour line of el..92.40'
F-11 Boring # Boring
Pit Ground surface elev. 93.50 ft. Depth to limiting factor +96 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
no ne L 2msbk DSH cs if .5 .8
2 8 -28 10 r 4/4 none sicl 2msbk mfr qW if .4 .6
3 28 -82 7.5 r 4/6 none sl 2msbk mvfr QW na .5 •9
4 82 -96 5 r 4/4 none scl 2msbk mfr na na .4 .6
F- Boring # Boring
1 1 Pit Ground surface elev. 93.50 ft. Depth to limiting factor 70 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff #2
1 0 -8 10 r 3/3 none L 2msbk DSH cs if .5 .8
2 8 - 10 r 4/4 none sici 2msbk mfr qW if .4 .6
3 24 -70 7.5 r 4/4 none sl 2msbk mfr QW na .5 .9
4 70-90 7.5 r 4/4 n one sl M na na .3
Effluent #1 = BOD > 30 5 220 mg/L and TSS >30 < 150 mg/L ent 1#2 = B D < 30 mg/L and TSS < 30 mg/L
CST Name (Please Print) Signature _ CST Number
Gary L. Steel 02298
Address 4Daaluati Conducted Telephone Number
1554 200th. Ave., New Richmond, WI. 54017 10 -18 -2000 715 - 246 -6200
I
nC. pending 2 3
R J C Develo men p g Pa a of
P Owner Parcel ID # 9
Property
F —] Owner
# ❑ Boring
3 pit Ground surface elev. 91 .50 ft. Depth to limiting factor 48 in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft
in. Munsell Qu. Sz. Cont. Color Gr, Sz. Sh. 'Eff#1 I 'Eff#2
1 0 -8 10 r 3/3 none .8
2 8 -24 10 r 4/4 none Sicl 2msbk mfr QW if .4 .6
3 24 -48 7.5 r 4/41 none S1 2msbk mvfr UK na
4 48-
Boring # ❑ Boring
❑ pit Ground surface elev. ft. Depth to limiting factor in.
Soil A lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
Boring # ❑ Boring
El Pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 - 264 -8777.
SBD -8330 (R.6 /00)
STEEL'S SOIL SERVICE
Gary L. Steel RJC Development, Inc. 1554 200th Ave.
CSTM2298 NW4S6d4 S25- T30N - R 18w New Richmond, WI 54017
- 2 4 715
MPRSW 3 5 town of Richmond � ) 246 -6200
lot #32- Richmoond Hills
1 =40'
PM. top of NE lot stake @ el. 100.00' nr
Alt. BM.= top of 1" pvc pipe @ el 91 70'
1'
!o P
l
b
Gary L. Steel
10 -18 -2000
3 . ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
OwnerBuyer L I'YI C�2�tr
r IJ
Mailing Address t c &( y �l I
Property Address L H 3 3
(Verification required from Planning Department for new construction) /
City /State Parcel Identification Number 0
I
LEGAL DESCRIPTION
Property Location 11�t� '/., J V Sec. Zs�. T 3 N -R ( L W, Town of
Subdivision V_A_ -W"`*fjb 0-5 , Lot # 3 Z--
Certified Survey Map # Volume Page #
Warranty eed # /6 3i jage t y Volume #
Spec hour �csn(o Lot lines identifiables ❑ no
SYSTEM MAINTENANCE
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance
consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system
can affect the function of the septic tank as a treatment stage in the waste disposal system.
The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a
master plumber, journeyman plumber, restrictedplumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system
is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge.
Itwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards
set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification
stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30
days Of a three y ear "expiration date.
Acv lrq 10
SIGNATMM OF APPLICANT DATE
OWNER CERTIFICATION
I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of
the pr perry described ,above, by virtue of a warranty deed recorded in Register of Deeds Office.
3 / /0la
SIGNAtJkE OF kPPLICANT DATE
Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * **
** Include with this application: a stamped warranty deed from the Register of Deeds office
a copy of the certified survey map if reference is made in the warranty deed
t
w. M38PA E 579
STATE BAR OF WISCONSIN FORM 2 .1999 6 - 7:3L S 7
WARRANTY DEED KA (HLEEN H. WALSH
Document Number REGISTER OF DEEDS
Si". CROIX CO., WI
This Deed, made between RJC Development, Inc., a Wisconsin RECEIVED FOR RECORD
Corporation
02-19 -2002 9:30 AM
WARRANTY DEED
Grantor, and Todd Marek, EXEMPT N
CERT COPY FEE:
COPY FEE:
TRANSFER FEE: 163.20
RECORDING FEE: 11,00
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
Lot 28 and L 2.nsin. t of Richmond Hills in the Town of Richmond, St. Name and Return Address
Croix County, a Y r
026- 1127 - 28,026. 1127 -32
Parcel Identification Number (PIN)
This is not homestead property.
Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. pfi) (is not)
Dated this / 3 P7V- day of February 2002
RJC Befell
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN )
) ss.
SS'T- a-4d" ,C County )
authenticated this day of
Personally came before me this / tp 779 day of
February , 2002 the above named
RJC Development, Inc„ a Wisconsin Corporation by
TITLE: MEMBER STATE BAR OF WISCONSIN it 's Q /iSiaS^ T
(If not, to me known to be the person(s) who executed the foregoing
instrument and acknowledged the same.
authorized by § 706.06, Wis. Scats.) /�
THIS INSTRUMENT WAS DRAFTED BY a lr � --- - U
Attorney Kristine Ogland Notary Public, Stat
Hudson, WI 54016 t�'t�gttRi
My Commission is permanent. �� Onsl not, to expiration date:
(Signatures may be authenticated or acknowledged. Both are not necessary.) !2 _ ,)
" Names of persons signing in any capacity must be typed or printed below their signature. Wonsaon Pmfeuiomis company, F - 4 d. tae wi
STATE BAR OF WISCONSIN SOD-655-2021 WARRANTY DEED FORM No. 2 - 1999
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