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HomeMy WebLinkAbout026-1167-21-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division n' INSPECTION REPORT Sa nita ry P ermit No: 488045 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: Environmental Holdi LLC Richmond, Town of 026- 1167 -21 -000 CST BM Elev: , : BM Description: Jp No: .p e b 't = Cgr Qtµ ( 27. 30.18.1323 TANK INFORMATION ELEVATION DATA TYPE MA REfj,,,,, CAPACITY STATION BS HI FS ELEV. Septic W( lb n 0 Benchmark (a ?• O lam+ 3 02. as , Dosing U Alt. BM q� ' • qO 9s 31 t Aeration Bld ewer }• / • Holding St/Ht Inlet 13.59' TANK SETBACK INFORMATION St/Ht Outlet Z 31 93.3' TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic � �� ` �_ Dt Bottom Dosing Header /Man. 46 •Sa 70- - fl " Dist. Pipe 1 Holding Bot. System •3s 3� 8 /• 17 / Final Grade ` PUMP /SIPHON INFORMATION J , 01t l Manufac rer Demand St �ovwe�* to Q►_ • ( 3 t Model Numbe p, A 5�b� 1� ' 02- t l TDH Lift Fri ' Loss System Head TD Ft Forcerridin Length Dia. 1 — VVU11 SOIL ABSORPTION SYSTEM 3 044A „ = (a ENCH Width t Length t No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth °' 3 ! ao ea • (3) SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufact r: INFORMATION CHAMBER OR _• �•� Type O System: �,- UNIT Model Numb r' O t � v . 4 !> • DISTRIBUTION SYSTEM Header /Manifold IDistribution x Hole Size x Hole S Vent to Air Intake Pip > Se Length Dia Length Dia Spacing V SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil F Yes No Yes 7DNo COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: - TJW • O /� A Inspection #2: 5" Location: 1376 126th Street New Richmond, WI 54017 (N 1/Z NE 114 27 T30N R1 8W) Lundy's Preserve Lot 21 Parcel No: 27.30.18.1323 1.) Alt BM Description 2.) Bldg sewer lengthy S t - amount of cover = 1 �- 3 '�..�... ��an 'E°P rv til 'A"` 2.30 Plan revision qu�ed? Ffe ❑Yes mil/ No!, Use other side for additional information. •'� �� s2% $ 6710 (R.3/971 . �O WL UA4% J•^'. �` vs 1 � +""`^"` Date palti a No. Safety County V m 201 W. Washington Ave., P.O. Box 7162 scons Madiso f ® Sanitary Permit Number (to be filled in by Co.) Department of Comm Sanitary Permit Appl !nf' d o � State Plan I.D. Number In accord with Comm 83.21, Wis. Adm. Code, !„o q � personal anon va e may be used for secondary purposes Privacy Law, 5.14(1 xm) roject Address (if different than mailing address) COUNTY L Application Information — Please Print All Information ' Pa rty Owner's Nam Parcel # Lot Block # ✓'✓ K LL Property Owner's Nfailihg Address Property Location City, State U l�. S • N ' / Section Lip Code / Phone Number 1p '7('S 3 T e / II. Type of Build (check all that apply) T,)N, R�ir trcl or 2 Family Dwelling - Number of Bedrooms �%,,— Subdivision Name CSMNumbe� 0 Public/Commercial - Describe Use �_ It r% r ESQ! ❑ State Owned - Describe se ❑City_❑ illage Township of c-k rn �. III. Type of Permit: ( heck only one irb Ime A. Complete line B if applicabk) 6z(. z A ' New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner 1V. Type of POWfS System: Check sB that appl P/ Non - Pressurized In- Ground El Mound >_ 24 in. of suitable soil 11 Mound < 24 in. of suitable soil El At-Grade El Single Pass Sand Filter ❑ ( Constructed Wetland ❑ Pressurized In -Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑Leaching Chamber ❑ Drip Line ravel -less Pipe ❑ Other (explain) V. Dis aUTreatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation �fl ✓ a I--, ) 500 ✓ 500 VI. Tank Info Capacity in I Total Number Manufacturer Prefab I Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing I Tanks Tanks W l d� eptic Holding Tank 1 e erobic Treatment Unit Dosing Chamber VIL Responsibility Statement- 1, the naderskned assame possibility for is of the POWTS shown on the attached plans. umber's Name int) PI bet's Sig ture umber Business Phone Number Plumber's Address (Street, City, State, Zip Code) j '"N r �Q W 0 l 7 VIII. Coun /De Pa rtment Use On pproved ❑ Sanitary Permit Fee (includes Groundwater Date Issued Issuing A Signature o Surcharge Fee) rues Reason for vial ` �Z Z� IX. Conditions of Approval/Reasons for Disapproval 3' gra� et' ww6� 'J c � ✓1na� gna Qa SYSTEM OWNER: J t. Septic tank, enklettt NK and tl b M- ,J dispersal cell must all as per managernent plen provided by O nibaF. 5 e a • S B�OWL �•o0 N 4mi 2. AN se 'Sy��v��-• &.utsi- b nc(woaf Ufa . z-. ea�i ; .�.y as per apptic0b c6de / ordkianoaa. U 5) 1 4tLwo. ,AAo- nwd-1� Attach complete pham (to the County only) for the tem on paper not less than 81/2 x 11 inches in sin a AtW 6 � SBD -6398 (R. 01/03) Ua.leyS `�' o•` e.�-- (° ° �T,�y S Q�� Gp�' I I LL %��a N E 7q 3e N P2 2 w 76 I�ti. S Lu, � �s�� LoT -tfi a/ Pin 1 0 loc" 16-107S ` \\ ((�� S p � cab -. to 78- .3 l O� ,� © � COX S "iZ l` a (� W �. -P.S 'Q Y,S 1 od.( 100' ti I � e a I a a a g fly, RECEIVED o JUN O 1 2004 Lundy's Preserve Comments: ST. CROIX COUNTY ZONING OFFICE The soils in this subdivision are quite variable and differ across the 80 acres. Some consist of a clean outwash sand, other consist of glacial tills. In certain areas, the medium sands have a very deep red color unlike I have seen in all of St. Croix county. The color does not indicate high ground water because the color is so consistent. If you go through the red sands then the sands turn off white/yellow but not those of a sand stone. In talking with Pam Quinn from zoning, she commented that there could be a different chemical reaction with a sands. I believe this is the case for the sands have a consistent size, and no mottles were found above or below the sands. Sometimes bands were present, but were very slight, and were mentioned to have the systems sized a little bigger in order to accommodate for any inconsistencies in the soil. Also it is worth mentioning that the intersections of lots 6,7,8, and 9 have a extremely poor soil present not suitable for a mound system. The surveyor and I discussed this condition, and the resulting tests were spaced as far away from this area as possible. All the soils tests were done to the best of my ability and I hold no liability for anomalies and other oddities that can be found on this site. Shaun Bird CSTM #226900 5/28/04 I r Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code � • _ _ �. unty Attach complete site plan on paper not less than 8 1/2 x 11 Fnch (l i d Me ' include, ude, but not limited to: vertical and horizontal reference r dior� nif rcel I.D. -7 percent slope, scale or dimensions, north arrow, and locati and distance to nearest road. Please print all info nlr� JUN 0 1 2004 Date Personal information you provide may be used for seconds pu s rivacy Law, s. 15.04 (1) (m)). 21 Z 7 d Property Owner � 1 cation ONI T r ovt. of 1/4 '�/4 T N R E (o W Property Owner's ailing Address Lot # I Block # 906d. Name or CSM# City State Zip Code Phone Number ❑ City ❑ village wn Nearest R New Construction Use. Residential / Number of bedrooms Code derived design flow rat GPD ❑ Replacement � Public or commercial - D scribe: Parent material 7�' C.t/� p F(I� ;ai elevation if applicable ft General oorm�lerits s 0 8 7 , �p j °Q • -> ' and recommendations: ��P/�e! -Q/(/� t A, ring 7 O 1 pit Ground surface elev. ft. Depth to limiting factor in. Soil 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 'E r 3 ' 51 d YY1 C s— .� - 7 I N r -, J A na 0 Boring F1 Bori # pit Ground surface elev. 2 -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. n 'Eff#1 'Ef1#2 01 �. z- �n l O l y ►r Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 _< 150 mg/L ` Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number Bird Plumbing, Inc. Shaun Bird 226900 Date Evaluation Conducted Telephone Number Address 715- 246 -4516 1008 192nd Ave, New Richmond, WI 54017 �=� Property Owner Parcel ID # Page Boring 11-31 Ong # Boring L b0 ✓� 64", Pit Ground surface elev. ft. Depth to limiting factor in Soil 'cation YAO Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD1fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 0-1 ,-31� j ( �- rn 2 )Z- 1 b .-3 l'z� 5 arc_( ►'�^�- m !�f Ni - O Boring # l ® Pit Ground surface elev. 6 t 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 z L 1 S i 5 1, ''i , �. Ong # Boring Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Sod Application Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence. Boundary Roots GPDM in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I Effluent #1 = BOD > 30 1 220 mg/L and TSS >30 < 150 mgA- ' Effluent #2 = BOD 130 mg& 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. SOD-8330 (RAW Soil Test Plot Plan Project Name Environmental Holding L.L.P. Sha Bird Address 706 19th St. S. Hudson Wi 54016 TM #226900 Lot 21 Subdivision Lundy's Preserve Date 5/24/04 N 1/2 N E 1/4S 27 T 30 N/R 18 W Township Richmond Boring 0 Well PL Property Line County ST. CROIX IL BM or VRP Assume Elevation 100 ft. Top of Steel Fence Post System Elevation 88.9/88.6/88.3 *HRpSame as Benchmark Alternate Benchmark Top of Survey Iron @ 96.0' Please note:Soil was done to satisfy Scale is 1" = 40' county zoning AL unless otherwise requirement. Soil test may not be noted suitable for owners desired building location. 94' 190' Property 93' Line 10 113-2 6% Slope 5 ' B -4 30' AL B -3 45' 5 35' -1 B.M. 300' S B.M. 526' Property Line Sep 09 05 01:57p CRLVIN POWERS 715 - 246 -5135 p.1 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer 1' Mailing Address 1 S H-ul T-( - - �n. i i Property Address XXX X 1 / JS A � 1 ' (Verification required from Planning & Zoning Department for new construction.) City /State K ) K.1 Parcel Identification Number A 0 D O LEGAL DESCRIPTION Property Location f� ' /�, Y. , Sec. a , T W N R1A Town of �l lh l 0 ► t U Subdivision Lot # �• Certified Survey Map # r-� r , Volume , Page # 1 Warranty Deed # q to , Volume �2 (ob� , Page # _ � _• Spec house yes Lot lines identifiable �./ � no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenno a 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. Gamer maintenance responsibilities are specified in §Cones. 83.52(1) and in Chapter 12 - St_ Croix County Sanitary Ordinance. The property owner agrees w submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted phimber or a licensed pumper vcrifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 0 full of sludge. Uwe, the undersigned have read the above regwaemeats and agree to retain 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 most be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my /our knowledge. I/we amlam the owner(s) of the property described above, by virtue of a warranty deed recorded in Regist of Deeds Office. Number of bedrooms SIGNATURE OF APPLICANT(S) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Deparmunt. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed (REV. 08/05) DEC. 15.2005 3 :33PM CENTURY 21 WDSON NO. 134 P.2 =P &W A 2L ` • sTATt: it OF 715756 WAMU M DUD KATlilM L r Dftsseaitxumber ST. = aga r tA.� TWO Deed, made between Lft Ide m amd ice_// Rte V0 ssdo�ar, hatai>dtd aed �a _ FM MMRD Q7 /lif�1 •isi�ll t3raatotr, MARRA � ' . � L'�lV�.re�fsenftas grit Coatafrty, L?� -- CO1R FMS �•~ t?ratttee. _' 14. � Grantor, for it valuable consweradoa, eoawys to &aft the follm tt3 RAW teal sate in at. . _dells _ coatnty, Stato of RBBS t i W M000sitt (rte "ProperF rf,taats sp�oe a M064 please attar adden&=m Lou, 1 tltroufgh 33, it+e7 wl w, Za dy's Pa"esw, Town of Al dtaaatd. Raoordlns Ma WMM andPAIMMAd*= Title Ona, DreaLer Group 706 loth SUNMet south • Rudman, Wisconsin 34016 -l s- x—'0 026- 1970 - 3 ..l.. .i_ � ri ( l � ilr� /1. ■.I I . l�tt�.M�, Toledw wldt all appate» test riots, *Is and interacts. This is not bomadesd properly. (1s) (is trot) Gnaw wa r us that rile tide to the Property it. good, Wdefeasible in 6e simple and tree sad clear of eacwrabla m axeept Roadways, Masaaents, and laastriot ions of Record i Dated this 30 41 of it-Me , , 2004- �..� AUTHitiN't'ICATION ACKNOWLEDGMINT 8tgnt►ture(s} STATE OF WISOONSIN ) as. At_ L'reix - Cam►. ac andea day o , Personalty wane beibre ate thb _ 22th day of P �..■ , � ZODb the above named F gl�L6�Ar Mftd TMLS: MEMBPA $TATS SAR OF (if not, GP SSG ' m me known to be the pawn sathorizad by 1706.06, Wla. 8taraa dw for lastttiaat 1 dte scree. alts UUrt WNW WAS DRAFTED BY t...b i rl , Memoi Notary Public, State of Wlsmdn XPIAsixed My eomtbiaatoa to pennaneat. it not, atm expfrutott date: •Nuaee otwno�►: elaalna is era esaab nacre be grpsd w prieted below adek slp.aq.. WA1iitA1V iY blitia STA UR OP WINCOM I'1 PLOW tle.1,4M Acraa t7 Fl l i 1 3 412 o S M�t I lM 1. I H. f•�oM T446163&M ► neioM NMJo/ M�"' yr( a! FeA1Mitusa1A4afaMnraY0eµaY deft r&WA W M61110 4 .MORANINIM i /1 m • 7 J i 0Z c zG LLJ • .89E X ►_- e c z W C � z a z } o p N , � C► c p c ? CD CD T r J c a T C o Z LU 1 N C , o, It IN cr y n 1 i _ W o W Z 1 1 O Cl Y o- Z o o Z > 0- - u o � .• A, � 1 4c � Q Z v �Z LL, m w w ,. /. U- _ la J 1 l a dd ' J O LL v O p Z Z LO 1 1 1 I I I o 1 1 cy) 1 1 Cv 1 � d as N a t N as h - m T p u CD N N Go c: o (°� � c m In T m Xo _ o ... w ry m N = m 3 'J � 1 CD m 1 1 �� �i X / N 0 X ` /�/ �/ E � l N. s'- r' •— .06t 31•t. NOUDM vi 3HI t .3c 1 0) 0° X X �h v , ro � ►t►ti.p v!, n...P EZ1203H r vvovvv, vovvov � ,�-� ". tr = sesvvvo e v °rosa Att vvo F}• �� •. oov s 12' ev t v _ 4 LAS e4e .62a Pep vvs vao vvo OOP a P 11 vvs eov j 1/2 Circ. 18.84 oev o voo o V v o ve pp vo vvvvvv v r►sevsovv a vvvo vv evv vvovvvv o avvovv� OeeeOe oovvv s vvevsv erev 000 s 24 11 Bottom 361t vnld- - - 12-1 DIA. (typ•) Void Coefficie in Agee given at 57.4 %. Soli [n e_ rf_aee q_�ea 11 L Ft. O.D. of 4" S p• pipe = 4.625 inches Sidewali 2 Sidewails) 18.84in void volume per linear J125i11 ''�'= 3.i ar ft. = 3,14 • �� • 12in 12inlfi tft - 0,117 ft° Bottom Ift 0, D- of center cylinder - r2.5 inches 2.00 Total Soil Interface Area Void volume in aggregate 0 rcenter cylinder =r -'- Y c 3.1a 6 • _min �� J125 5.14SQ.1'T ilzi„�rt •.574 =.422 f � �� _ 12in / tt O.D, of outsidc cylinders - 12 inches _ m rs Void volume in outside cylinders - 2 •3.1� _ 6i_�� Projected Trench Area �Ilia/flJ 57a =_901 fN Sidewall Height - 12 in. •2 = 2.00 Sq.Ft. Void volume at bottom between cylinders 1 r, Bottom = " lain bin \ 36 in. = 3.00 S q•Ft. t2fnjf) 3.lat bin )) U,215ft' 1 l Projected Trench Area = Vold volume at outside bottom corners 1/2 5.00 SQ.Ft. Of void volume between cylinde 2 a i + Total void volume � 0.1 t 7 + 1 0.215. _ 0.108 R' 0.422 + 0.401 + 0.215 0.108 = Gallons 1.763 cubic ft / h I per ft = 1.763 X ?,48 = 13,E gallons ner linear it. I ? E S 49gregale enc S y s tem y tem EZ1203H f( Ring',(ndusfriol Group EZfl ow 65 Industrial Park Rd i Oakland, TM 18060 SCALE n>.E ttAAll'; tZ7203H -vst SHE):7: 1 of t tt -27 -Ot r POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION it Owner SYSTEM SPECIFICATIONS �- ,r Septic Tank Capacity # S Q qENA Septic Tank Manufacturer �� DESIGN PARAMETERS Effluent Fitter Manufacturer P v Number of Bedrooms ❑ NA Effluent Filter Model P� 5 ❑ NA Number of Public Facility Units ❑ NA Pump Tank Capacity al ❑ NA Estimated flow (average) 0 al /day Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.5) 0 gal/day Pump Manufacturer ❑ NA Soil Application Rate r gal/day/ft 2 Pump Model ❑ NA Standard influent /Effluent Quality Monthly 6verage * Pretreatment Unit Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter 11 NA Biochemical Oxygen Demand (BODd 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 1 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average {dispersal Cells) [7 NA Biochemical Oxygen Demand (BODS) 530 mg /L 'In-Ground (gravity) Q In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade ❑ Mound Fecal Cofiform (geometric mean) 510 cfu /100ml ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: Other: Other: 13 NA ❑ NA ❑ NA * Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: ❑ month(s) (Maximum 3 y ear(s) years) ❑ NA Pump out contents of tank(s) When combined sludge and scum equals one -third (Y) of tank volume ❑ NA Inspect dispersal cell(s) At least once every: ❑ month(s) years) (Maximum 3 years) ❑ NA Clean effluent filter At least once every: El month(s) p NA year(s) Inspect pump, pump controls & alarm At least once every: ❑ month(s) ❑ year(s) ❑ NA Flush laterals and pressure test At least once every: ❑ month(s) Other: ❑ year(s) ❑ NA At least once every: ❑ month(s) C3 NA other: ❑ year(s) ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. START UP AND OPERATION Page of For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell {s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring Power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable Peelings; gasoline; grease; herbicides; meat scraps; medications oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: A suitable replacement area 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 infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < < WARNING > > SEPTIC. PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Name Phone `r ` S Phone SEPTAGE SERVICING OPERA (PUMP LOCAL REGULATORY AUTHORITY Name Name 'S `(� �1 , ` as ` Phone Phone (S 3 g 4 & 9 0 This document was drafted in compliance with chapter Comm 83.22(2)(b)0 i(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. STA RTUP AND OPENATION Page _ of For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products oc other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power. Is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the ,pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides;. sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: rt A suitable replacement area 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 infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name ° Name Phone L S S - r Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name r , �O Phone Phone (-S 3 (O 9 0 This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.540), (2) & (3), Wisconsin Administrative Code. Parcel #: 026- 1167 -21 -000 12/27/2005 10:07 AM PAGE 1 OF 1 A Alt. Parcel #: 27.30.18.1323 026 - TOWN OF RICHMOND current X'. ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 06/29/2004 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - ENVIRONMENTAL HOLDING COMPANY LLC ENVIRONMENTAL HOLDING COMPANY LLC 703 PINE ST N HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): "= Primary Type Dist # Description " 1376 126TH ST SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST P 17 WIT S 00 C Legal Description: Acres: 2.331 Plat: 10 /12- LUNDY'S PRESERVE 026/04 LOTS 1/33 SEC 27 T30N R18W PT NW NE BEING LUNDY'S Block/Condo Bldg: LOT 21 PRESERVE ('04) LOT 21 (2.331AC) Tract(s): (Sec- Twn -Rng 401/4 1601/4) 27- 30N -18W NW NE Notes: Parcel History: Date Doc # Vol /Page Type 07/01/2004 767568 2607/589 WD 06/29/2004 767300 10/12 PLAT 2005 SUMMARY Bill #: Fair Market Value: Assessed with: 96949 35,100 Valuations: Last Changed: 06/21/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.330 30,100 0 30,100 NO Totals for 2005: General Property 2.330 30,100 0 30,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00