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HomeMy WebLinkAbout026-1167-33-000 r ry o Y y ° r� I �o I o 0 °� o (D m a 4 0 0 c y a N> y C O o u �� EN O o2 N O p C p E> S C Ile V N N f0 O t > oomE �U "Q y C O N p d E N O V C W 0 0 O. D y 2 O A c c af0i 0 Ew c �+ f0 N w N y 0 N O N v m C_w -tL o. N••U 7 O V C N 2 N N O CL E c4 7 0 C w N O N O S O 7 0 .L. E � �� E m E � c z -' C ID c Z mEo R� LL c C d� LL c m co . 3 C p 3 E 4) ° m ?� O : y Q� = M O N 'O N 5 f0 O T v C m -LJ C ` Q aoa >v, Q O (2 o N v It m (D ~ E I z t0 z ° o ` c ° W a m a m N H Z V O O Z d a v d Z '� c O O c cA F- m z c O ° 2 M - .0 E g d E N O N C L N o N C C N tm C � O L IL U C L C f� O Q C O N C Ol p Z� o Z J u` E z I E I N t0 E N lC E > E C p rr .. N E N `' N C H � ` O d N O _ d 2 N 2' fA f/) fA L u N N N L 7 M 7 t 7 J Cl) 3 d C D.I (n O z 0 0 0 z E 0 0 0 �o.aa ; H aan. CL 2 v I� �N p v rn v `t y 3 v V1 J U A N N Q} z N Z O m N ce) 0 M _ O 2 M O C 7 0 N 7 O 7 N O m e a N m c N (n L Q 2 v � Q A fn f6 O °f Q Z to C 7 3) Cl) �j V U) E IV = f - O 0 f0 U n. p U iw p CO) Ip l a N N C C N M E ` G O E C N Q� N C C N O O d O r y l M L Cl) w y v u N o o Lo N m • mil ' N W 0 v o z Y cn cn v o z a V� a € IL € L 3 �t 0 a :� m c `N y E m m co� o m 3 A vat oU)U 0U)0 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division Sanitary Permit No: INSPECTION REPORT 463214 0 GENERAL INFORMATION (ATTACH TO PERMIT) tate Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. O �I3 =TPJW t D Permit Holder's Name: City Village X Township arcel Tax No: Glen Johnson Construction I Richmond Townshi CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: cueQ S t 27.30.18. TANK INFORMATION EVATION DATA TYPE MANUFACTURER CAPACITY STATION 1 BS HI FS ELEV. p Se tic Benchmark f Dosing Alt. BM Bldg. Sewer /S Holdin St/Ht Inlet fS q r �� � t St/Ht Outlet Oc� / TANK SETBACK INFORMATION 1 1 ( 4 - (, %, - T TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic ? f V991t '3 r Dt Bottom q f Dosing u i Header /Man. ) / g 5� 2Y 35 mil' Aeration Dist. Pipe • l 3'f 3.1f (ol, Holding Bot. System 3 ` �° $S� Fi al Grade u PUMP /SIPHON INFORMATION M �,,:tIL 6 — )2 + � Manufacturer Demand St Cover GPM l ,90 Model Number �� �� ' �p TDH Lift Friction Lo System Head TDH Ft +1i�( s S �� )m ' mo o' orcemain Length 5 1 Dia. 2 Dist. to Well See_ ac SOIL ABSORPTI N SYSTEM , 6EDAR6#W Width Length No. Of UeaeHes PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth -15 IMENSIONS ( 1 f ) Go \ SETBACK SYSTEM TO P/L BLDG IWELL LAKE /STREAM LEACHING Manu tupor: CHAMBER OR INFORMATION Type Of System: UNIT Model Number. ` ° -- ( Q Cn 0 _._..__ DISTRIBUTION SYSTEM L�r,� i�•d• Header /Manifold /f I D istribution t x Hole Size / /� x Hole Spacing Vent to Air Intake t f P�pe(s) `L 1 /. (7 7 Length o Dia Length 37 �:+tia ( Spacing I 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 \ Yes [ No �] Yes 0 No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: n' o l ' ` Inspection # l 'Tr / Location: 1395 129TH St New Richmond, WI 54017 (NE 1/4 NE 1/4 27 T30N R18W) undys Preserve Lot 33 Parcel 27.30.18. / 1.) Alt BM Description = 5' � 2.) Bldg sewer length = 1 "+ f1 � I amount of cover = s 27 un`.u�tt •( . C� n W 4 - w F 't'* lam. ' o .,,�( V�L p'w`- ''l�•S 1, Plan revision Requ9d? E Yes No Use other si a for additional in / — Carl, e�.t y p s Insep at� Ct. No. /! SBD-6710 0/ wa.al pp�p C J t•0 -�t7� . �shlLC Gfi��+� / y 1 1 7V 1 / 0 ' qo — Sohn S�iomm c��orop• Pam or' Ares&r ✓e, Tn. of y wr�d, Q a � /00. ` �• � �� �5., S /owe. Propo3tcl reLou.nd aE.2403x u.� /G � Sao d,S�e�SL/ cell oclfrcts 5, at 2.53' Proposcd Lorestr Cc c�2 wt P 7a-r ?4 13 fd k 1"10 C-K4 it-,. \�\ � '�ie.Scr�'o ncrt.�e WLP-/�SOi+'frP Sept c & -a6aI A -/OO q 6wcC -cve -, �tnGhrvtorlr Tp OP10a re 54-er door 5,w. asumed Q lei = 1oo.t.v' 5° to /O Safety nd y B uildings Division County 201 W. Waon n Madison, I S nitary Permit Number (to be filled in by Co.) De artment of Commerce (60 26 3151 a t nit �1 � e Plan I.D ary Permit A o � � ._QOM Number ►S In accord with Comm 83.21, Wis. A r t r lion p 1 — / S Q 1 may be used for secondar ac s15 {1) Ui;TJ i �0 ;Or ojec Address (if different than mailing address) I. Application Information - Please Print Information 13 q S 102 Q A ' S r- Property Owner's Na me Parcel lot i/ Block A Property Owner's M ailing Address S UCTI P roperty Locatio AS O 7 - 710tj City, State Z Phone N m r ,�k,Section t� l� circle II. Type of Building (check all that apply) T 36f N RE o & )6-4 or 2 Family Dwelling - Number of Bedrooms Subdivision ':dame CSM Number ❑ Public /Commercial - Describe Use ❑ State Owned - Describe Use ❑City_ ❑tillage cTownship of III. Type of Permit: (Check only one box on Line A. Complete line Bn if applicable) A. —�— ;blew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only C Other Modification to Existing System i B • ❑ Permit Renewal �Permit� evision [l Change of Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber O ner ` J 3 /3 4 D s- IV. Type of POWTS System: (Check all that apply) ❑ Non - Pressurized In- Ground Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade D 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 ❑ Gr av WeAs Pipe Other (explain) t. V. Disp ersal /Treatment Area Information: _ Z Design Flow (gpd) I Design Soil Application Rat fj Dispersal Area Re fired (sf) Dispersal Area Proposed (sf) System Elevaf r sly '6 V l Cl- c/ VI. Tank Info Capacity in Total Number Manufacturer refab Site Steel Fibe.> Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks � Septic or Holding Tank l�S1J P7 / Aerobic Treatment Unit Dosing Chamber VII Responsibility Statement- I, the undersigned, assume responsibility for i Nation of the POWTS shown on the attached plans. Plumber's Na me (Print) Plumber's Si gnature P PRS Number Business Phone Number Plumber's Addre ss (Street, City, State, Zip Code) VIII. ount /Department Use Onl f Approved Disapproved Sanitary Permit Fee (igcludes Ground�vatet Date Issued suing Age t Si natur { Stamps) ) Surcharge Fee) ❑ Owner Gi ven Reason for Den X Conditions of Approval/ for,Disapproval l/k "ite 2 G� STEM OWNER: 1 ptic tank, effluent filter and D 3 ispersal cell must all be serviced / maintained as per management plan provided by plumber. �� j / 2. All setback requirements must be maintained C� as per applicable code /ordinances Attach complete plans (to the County only) for the system on paper t Icss than 6112 x I inches in ze CRIl_(,�4R (R W MI) Safety and Buildings C0111111 @CCe.W1.�OV 4003 N KINNEY COULEE RD LACROSSE WI 54601 -1831 TDD #: (608) 264 -8777 is consin www.commerce.wi.gov /sb/ Department of Commerce www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary November 03, 2004 CUST ID No.227990 ATTN: POWTS Inspector WILLIAM C SCHUMAKER ZONING OFFICE SCHUMAKER PLUMBING ST CROIX COUNTY SPIA 1070 SCOTT RD 1101 CARMIC14AEL RD HUDSON WI 54016 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 11/03/2006 Identification Numbers Transaction ID No. 1078013 SITE: Site ID No. 691920 John Schommer Please refer to both identification numbers, Town of Richmond above, in all correspondence with the agency. St Croix County NEIA, NE1/4, S27, T30N, R18W Lot: 33, Subdivision: Lundy's Preserve FOR: Description: Four Bedroom Replacement Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 990483 Maintenance required; 600 GPD Flow rate; 24 in Soil minimum depth to limiting factor from original grade System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.0 1 /01), Pressure Distribution Component Manual - Version 2.0, SBD- 10706 -P (N.01 101); 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. 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. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the approved plans, and the "Mound Component Manual for Private Onsite Wastewater Systems Version 2.0" SBD - 10691- P(N.O1 /O1). • The pressure network is to be constructed in accordance with publications SBD- 10706- P(NO1 /O1) "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems - Version 2.0" and/or the sizing methods of publication "SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/8 1)". • 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 area within 15 feet horizontally below the system shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • 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. P,p Cp • . S. '� A n ..�ditiO WAY WILLIAM C SCHUMAKER Page 2 11/3/2004 Owner Responsibilities: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • Comm 83.52(1)(a) - 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. 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. • 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. 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 Gerard M. Swim Balance Due $ 0.00 POWTS Plan Reviewer - Integrated Services (608)- 789 -7892, Mon. - Fri. 7:30 am to 4:15 pm jswim @commerce.state.wi.us WiSMART code: 7633 cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 • 1 s F� MOUND AND PRESSURE DISTRIBUTION COMPONE Sls l �i� Residential Application INDEX AND TITLE PAGE &e o� Project Name: John Schommer 4 bedroom residentail mound Owner's Name: John c ommer Owner's Address: Hudson, WI 54016 Prop. Add.: Pending Legal Description: NE1 /4NE1/4, Sec. 27, T.30N., R. 18W. Township: Richmond County: St. Croix Subdivision Name: Lundy's Preserve Lot Number: 33 Block Number: Parcel I.D. Number: Pending Plan Transaction No.: �+ Page 1 Index and title 1® Page 2 Data entry DEPARTMENT OF COMMERCE GS Page 3 Mound drawings DIVISION ID SAFETY AND BUILDW Page 4 Lateral and dose tank Page 5 System maintenance specification SEE CORR PONDENCE Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Site plan Page 9 Soil evaluation report Page 10 Supporting County documentation Designer: Bill Schumaker License Number: 227990 Date: 10/18/04 Phone Number: (715) 386 -3121 Signature: _- Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) Version 3.0 (03/01/01) Page 1 of 10 Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 400.00 Estimated Wastewater Flow (gpd) Table 8344 -3 in -situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150 %) coliform of <= 36 inches. 600.00 Design Flow (gpd) 4.00 Site Slope ( %) 100.86 Contour Line Elevation (ft) 24.00 Depth to Limiting Factor (in) ✓ 0.40 In -situ Soil Application Rate (gpd /ft Distribution Cell Information 100.001 Dispersal Cell Length Along Contour (ft) = 6.00 Cell Width (ft) 1.001 Dispersal Cell Design Loading Rate (gpd /ft 11 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution C - Y J Pressure Disribution Information network? Enter Y or N (c or e) c Center or End Manifold 3.00 Lateral Spacing (ft) If N above, enter the elevation ft) 4 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) 2.50 Estimated Orifice Spacing (ft) = 7.50 ft /orifice 2.00 Forcemain Diameter (in) 30.00 Forcemain Length (ft) Does the forcemain drain back? Y 92.70 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 4.89 Forcemain Drainback (gal) 8.91 Vertical Lift (ft) 40.24 5x Void Volume (gal) 0.69 Friction Loss (ft) 45.13 Minimum Dose Volume (gal) 16.10 Total Dynamic Head (ft) 32.95 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options I choice in. dia. options choice 0.75 1.25 x 1.00 x x 1.50 x x 1.25 x 2.00 1.50 x 3.00 2.00 x 3.00 x Gallons /Inch Calculator (optional) Treatment Tank Information 750.36 Total Tank Capacity (gal) 1250.001 Septic Tank Capacity (gal) 37.00 Total Working Liquid Depth (in) Wieser - Manufacturer 20.28 gal /in (enter result in cell B49) Dose Tank Information Effluent Filter Information 750.361 Dose Tank Capacity (gal) JZabel Filter Manufacturer 20.281 Dose Tank Volume (gal /in) AII 00 Filter Model Number Wieser IManufacturer Project: John Schommer 4 bedroom residentail mound Page 2 of 10 Mound Plan View T ' ' ' Observation Pipe 3 — I FIKK - VV . , = ......................... �. Mound Component Dimensions Down slop toe extension made. A 6.00 ft E 14.88 in H A6.03 ft K 8.61 ft B 100.00 ft F 9.00 in 1 ft L 117.22 ft D 12.00 in G 0.50 ft J ft W 21.03 ft 600.00 (ft Dispersal Cell Area 1 1500.00 (ft 2 ) Basal Area Available, 6.00 (gpd /ft) Linear Loading Rate 1 10.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 103.61 (ft) ----► f ,,, ..... 2 G ♦ H t rf�f�frr, ����r��f... j Z F ... r 102.36 (ft) Dispersal Cell Lateral 101.86 (ft)- - ► — Invert Dispersal Cell Elevation E D •. tir':�.•3.•:k .t_la�f./ • .•G': � { •:{ `� � 100.86 (ft) Contour Elevation 4.0 % Site Slope Geotextile Fabric Cover Shading Key �. T Dispersal Cell See lateral details on 10 — Topsoil Cap a 1.5 ft •ti Page 4 for number, Subsoil Cap 0 c : � 5 �, •,;:' • ; • size, and spacing of ® ASTM C33 Sand "• �'°:;•; °; • F laterals. Laterals are Tilled Layer ci H 0.5 ft :•' Typical Lateral •: equally spaced from ❑5 r.; .;. Aggregate v c the distribution cell's }--- A - -* centerline in the distribution cell (AxB). Project: John Schommer 4 bedroom residentail mound Page 3 of 10 • I I 1 k Center Connection Lateral Layout Daigram Force main connection via tee or cross to manifold at any point. Laterals are identical � P S i= Turn -up v ba II valve or IE X- --) I s12 l Laterals & force main of PVC Sch 40 cleanoutplug per COMM Table 84.30 -5 Holes drilled on the bottom of the lateral. Number of Laterals 4 Orifice Diameter 0.125 in Lateral Diameter 1.00 in Orifice Spacing (X) 2.53 ft Lateral Length (P) 49.34 ft Orifices per Lateral 20 Lateral Spacing (S) 3.00 ft Orifice Density 7.50 ft /orifice Lateral Flow Rate 8.24 gpm Manifold Length 3.00 ft System Flow Rate 32.95 gpm Manifold Diameter 1.50 in Total Dynamic Head 16.10 ft Forcemain Velocity 3.37 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and Comm 16.28 WAC Disconnect 4 in. min. Tank component is properly vented �— Alternate outlet location Forcemain diameter Wieser Manufacturer 2 in. Cap acityl 750.36 Gallons Volume 20.28 gal /inch A Weep hole or anti - Dimension Inches Gallons B siphon device A 20.03 406.30 C B 2.00 40.56 P ump off e levation (ft) C 5.97 120.98 93.45 D 9.00 182.52 D Total 1 37.001 Dose tank elevation (ft) 3" Bedding un er tank. 1 92.70 Alarm Manuafacturer ILevelA Alarm Model Number I DVL Pump Manufacturer JGoulds Pump Model Number IEP Pump Must Deliver 1 32.95 gpm at 16 - 01 ft TDH Project: John Schommer 4 bedroom residentail mound Page 4 of 10 r� GOULDS PUMPS Submersible r Effluent Pump T S MODEL EPO4 �,- 38 71 EP05 APPLICATIONS • Fully submerged in high ■ EP05 Impeller: Thermoplas- • Bearings: Uppe< ana Specifically designed for the grade turbine oil for tic enclosed design for heavy duty bal: bearing lubrication and efficient improved performance, construction. ollowing uses: Effluent systems heat transfer. ■ Casing and Base: Rugged • • Homes Available for automatic and thermoplastic design provides AGENCY LISTING • Farms manual operation. Auto- superior strength and corrosion SP • Heavy duty sump matic models include resistance. Canadian swndard, Assoc t on • Water transfer Mechanical Float Switch ■ Motor Housing: Cast iron • Deriatering assembled and preset at the for efficient heat transfer, Goulds PuniPs ISO you F.F� E factory. strength, and durability. SPECIFICATIONS ■ Motor Cover: Thermoplastic FEATURES cover with integral handle and • Solids handling capability: float switch attachment points. ' /4` maximum. ■ EPO4 Impeller: Thermoplas- 0 Power Cable: Severe duty • Capacities. up to 60 GPM. tic Semi -open design with rated oil and water resistant • Total heads: up to 31 feet. pump out vanes for mechanical • Discharge size: 1' 12" NPT. seal protection. • Mechanical seal: carbon - rotary/ceramic- stationary, BUNA -N elastomers. • Temperature: 104 - F (40�C) continuous 40 METERS FEET - `F (60'0 intermittent. • Fasteners: 300 series io — -- stainless steel. 9 30r - -- _. •�r —sari • Capable of running dry without damage to $ 2 s 7 (`,rotor: � 6 zo' • i EPO4 Single phase: 0.4 HP, 115 or 230 V, 60 Hz, 1550 RPM, built in overload with ;A + - a reset. J a 0 • EP05 Single phase: 0.5 HP, 0 3 to ! t EPUs 15 V or 230V, 60 Hz, 1550 '— RK1, built in overload with - -- - EPO4 automatic reset. 2 i • Pov'er cord: 10 foot 5;. standaro length, 16/3 S ro� diwith plug, Optional 20 0 �;�.__ z � -___ 9 g P g P 0 30 - o ,o OP r foot length, 16/3 S1TW with 31. 9sr /0 MA4,o wiuoi Skf,,o n !# d three prong grounding plug -- -- -- - -- - 0 2 4 6 8 10 � n�� h. (stanoard on EP05). CAPACITY Goulds Pumps _OC2Go.IdzPumps ITT Industries _r,at,e se;,iember, 2002 ��• ��`� -50'71 Mound System Maintenance and Operation Specifications Service Provider's Name Bill Schumaker Phone 1 (715)386 -3121 POWTS Regulator's Name St. Croix County Zoning Dep't. Phone 715 386 -4680 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg /L Septic Tank Capacity 1250 gal Maximum TSS 150 mg /L Soil Absorption Component Size 600 ft Maximum FOG 30 mg /L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu /100 mL Service Frequency Septic and Pump Tank Inspect and /or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test month) Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound Inspect for ponding and seepage once every 3 years Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn -up Detail Finished ............... Grade \ 6 -8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: John Schommer 4 bedroom residentail mound Page 5 of 10 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD- 10691 -P (N.01/01) and SSWMP Publication 9.6 (01/81)) and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet fitter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the fitter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent fitter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent fitter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October - February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD 30 mg/L TSS, 10 mg/L FOG, and 10 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: John Schommer 4 bedroom residentail mound Page 6 of 10 • Se,'/ t ✓R /u a f ' on ♦ EX�yE; ride �(e�/itfi'On S o hn Scl,omrne� Awe. kat 33 P/all� off' /.ccnd S 4 1-e5,crVC, Tn. of a / v /.coy 0 ` area �N N � � �J� LJ -4 vc er e / F'vc�r W d0 Q�i S C¢ // � 146el�als,tt P or 5,4a at 2.S3, Pry pe 5c.c1 LA r �� �um10 � Xi3Ei "nq Well o � �\t.JleScrConCrC6¢ Wt- � F- �- S k FF�' /uamE. Fil �� et,f cu.tJtt� EXiS�i�4 4 bedrdwr -, Qtnc-hif'brie' Top orpa- vZo rc5ic/anCG daor• Si!!. SSac1'M2c/ a 1'eO P_ e o�'fo 1856 Wisconsin Department of Commerce SOIL EVALUATION REPORT P age 1 of 4 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code A.C.E. Soil & Site Evaluations Attach complete site plan on paper not less than 8Y County x 11 inches in size. Plan muss St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. Pendin Please print all information. Reviewed B Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner /� '* � ll I // Property Location mmer 16LT N — 6 1'Q ST2. Govt. Lot NE 1/4 NE 19 S 27 T 30 N R 18 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 203 Pine St. North 33 1 Plat Of Lundy's Preserve City State Zip Code Phone Number J City _f Village ✓J Town Nearest Road Hudson WI 54016 1 Richmond 1 140Th Ave. ✓i New Construction Use: io/ Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement Public or commercial - Describe: Parent material Glacial drift Flood plain elevation, if applicable na General comments and recommendations: Install mound system at elev. 101.86' at 12" above 100.86' contour. Onsite soil verification of previous soil report by S. Bird completed 8/27/04 by Pam Quinn, St. Croix Co. F ✓j Boring # _J Boring Pit Ground Surface elev. 99.62 ft. 2 in. Soil Application Rate Depth to limiting factor pp 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 -9 1Oyr4/3 none sil 2fsbk mvfr cs 2f,1m 0.6 0.8 2 9 -19 1Oyr5/4 none sicl 2fsbk mfr cw 2f,1m 0.4 0.6 3 9 8 7.5yr4/6 none sl 1csbk dh cw 1 V 0.4 0.7 4 28 -40 1 Oyr4 /6 m2d 7.5yr5/8 s Osg cil - - 0.7 1.6 2 Boring # Boring I 1e Pit Ground Surface elev. 98.90 ft. Depth to limiting factor 33" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /f 2 in Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 1 0 -12 1Oyr3/2 none sil 2fsbk mvfr gw 2f,1m 2 12 -18 1 Oyr4 /4 none sil 2fsbk mfr j gw 2f,1 m 0.4 0.8 3 18 -33 1Oyr4/4 none sicl 2fsbk dsh cw 1 V 0.4 0.6 4 33 -46 7.5yr4/6 m2d 7.5yr5/8 sl Om dh cw 0.2 0.6 5 46 -52 1Oyr4/6 none s Osg dl - 0.7 1.6 1 Effluent #1 = BOD 30 < 220 mg /L nd TSS >30 < 150 g/l- t #2 = BOD -i mg /L and TSS <30 mg /L CST Name (Please Print) Signature: CST Number James K. Thompson _c__n r— 3602 Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola 1 54020 10/142004 715- 248 -7767 Property owner John Schommer Parcel ID # Pending Page 2 of 4 -_ F 3 ] Boring # Boring 100.83 ft. Depth to limiting factor 30" in. So Application Rate J Pit Ground Surface elev. it PP Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roofs in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -8 10yr4/3 none sil 2%bk mvfr cs 2f,1m 0.6 0.8 2 8 -16 10yr5/4 none sicl 2fsbk mfr cw 2f,1 m 0.4 0.6 3 16 -30 7.5yr4/6 none sl 1csbk dh cw 1 V 0.4 0.7 4 30 -44 10yr4/6 m2d 7.5yr5/8 s Osg dl - - 0.7 1.6 I Boring # J Boring J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P : _ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I I i i I Boring # J Boring ft. Depth to limiting factor in. Pit Ground Surface elev. P Rate Soil A lication Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots ' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 i I I Effluent #1 = BOD ? 30 <220 mg/L and TSS X30 < 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. SOIL AND SITE EVALUATION 856 i Page _ _ _ of • PROPERTY OWNER: John Schonuner PARCEL I.D.# Pei A.C.E. Soil & Site Evaluations REPORT MEMO Original Soil Evaluation report for this site was found to be unsuitable for system design and installation by the St. Croix County Zoning Dep't. Additional soil testing as reported in this evaluation completed to allow system design and installation. Area south and east of system area has been filled and terraced to create drainage way for stormwater retention area. System to be moved upslope of originally tested area to maintain mound within undisturbed area. System to be designed with 12" ASTM C -33 sand fill at 100.86' contour to extend dowslope toe and increase available basal area. 61" 84" 42" z r N m NI � D I I I D O \ \ �_ DSO\ m m 4 ., , ! 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JAN, 2004 800 -325 -8456 FLE:WLP750 -MR r 1856 SOIL EVALUATION REPORT Wisconsin e f C SOIL 1 of 4 Division o A.C.E. Soil & Site Evaluations in accorda Cofim 85, Wis. Adm. Code 06't County Attach complete site plan o paper not less thap8'�-x 1 inches ( size. Plan must St. Croix include, but not limited to: rtical rn h rizonta�r r int (BM direction and percent slope, scale or di sions, and to and diltance to nearest road. Parcel I. D. zp " "��kC . ending Please p hatjon. Reviewed y mate Personal information you provide may be used for secondary purposes (Privacy Lew, s. 15.04 (1) (m)). I I 6 Property Owner Property Location John Schommer Govt. Lot NE 19 NE 19 S 27 T 30 N R 18 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 203 Pine St. North 33 Plat Of Lundy's Preserve City State Zip Code Phone Number City _j Village t/ Town Nearest Road Hudson WI 54016 1 Richmond 1 140Th Ave. ✓� New Construction Use: ✓J Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD _f Replacement _f Public or commercial - Describe: Parent material Glacial drift Flood plain elevation, if applicable na General comments and recommendations: Install mound system at elev. 101.86' at 12" above 100.86' contour. Onsite soil verification of previous soil report by S. Bird completed 827/04 by Pam Quinn, St. Croix Co. - a Boring # J Boring ✓wl Pit Ground Surface elev. 99.62 ft. Depth to limiting factor 28 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. *Ef1#1 *Eff#2 1 0 -9 1Oyr4/3 none sil 2%bk mvfr cs 2f,1m 0.6 0.8 2 9 -19 1Oyr5/4 none sicl 2fsbk mfr cw 2f,1m 0.4 0.6 3 19 -28 7.5yr4/6 none $l 1csbk dh cw 1vf 0.4 0.7 4 28-40 1 Oyr4/6 m2d 7.5yr5/8 s Osg dl - - 0.7 1.6 Boring # J Boring 0 Pit Ground Surface elev. 98.90 ft. Depth to limiting factor 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 1 0 -12 10yr32 none sil 2fsbk mvfr gw 2f,1 m 0.6 0.8 2 12 -18 10yr4/4 none sil 2fsbk mfr gw 2f,1m 0.4 0.8 3 18 -33 1Oyr4/4 none sicl 2fsbk dsh cw 1vf 0.4 0.6 4 33 -46 7.5yr4/6 m2d 7.5yr5/8 sl Om dh cw - 0.2 0.6 5 46 -52 1Oyr4/6 none s Osg dl - - 0.7 1.6 * Effluent #1 = BOD ? 30 < 220 mg /L nd TSS >30 < 150 g/L t #2 = BOD < 30 mg/L and TSS < �O mg/L CST Name (Please Print) Signature: CST Number James K. Thompson 3- ---- Z 3602 Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola4 1 54020 10/142004 715 -248 -7767 Property Owner John Schommer Parcel ID # Pending Page 2 of 4 3] Boring # _j Boring 1/ Pit Ground Surface elev. 100.83 ft. Depth to limiting factor 30" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu, Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -8 1Oyr4/3 none Sil 2fsbk mvfr CS 2f,1m 0.6 0.8 2 8 -16 1 Oyr5 /4 none sicl 2fsbk mfr cw 20m 0.4 0.6 3 16 -30 7.5yr4/6 none sl 1csbk dh cw 1vf 0.4 0.7 4 30 -44 1 1 Oyr4 /6 m2d 7.5yr5/8 s Osg dl - - 0.7 1.6 F—I Boring # J Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ❑ Boring # Boring J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Effluent #1 = BOD 30 < 220 mg /L and TSS X30 < 150 mg/L * Effluent #2 = BOD 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. SOIL AND SITE EVALUATION 1856 Page -3 of 4 PROPERTY OWNER: John Schommer PARCEL I.D.# Pending A.C.E. Soil & Site Evaluations REPORT MEMO Original Soil Evaluation report for this site was found to be unsuitable for system design and installation by the St. Croix County Zoning Dept. Additional soil testing as reported in this evaluation completed to allow system design and installation. Area south and east of system area has been filled and terraced to create drainage way for stormwater retention area. System to be moved upslope of originally tested area to maintain mound within undisturbed area. System to be designed with 12" ASTM C -33 sand fill at 100.86' contour to extend dowslope toe and increase available basal area. SdI ♦ rc.de C I e ✓c.�o.� 5c-a ---- - A.-7 ,Qve• "t 33 ,[",alt's �reSer ✓e T. of �, c.A.rrnd, 66. 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CD ; § \ � /? � /E i o S E 8 E \ �r d 2639P 526 77].S..e+2 KATHLEEN H. VALSH t t A DAVIT O F EGISTER O F DEEDS COR MCTION CROI CO., V I Document Number RECORD (TYPE OR PRINT CLEARLY IN BLACK OR RED INK) :4 5PH AFFIANT, Jennifer A. Ferguson , hereby EICT V# AFFIDAVIT sw or affirms that a certain document recorded on die 7th day of — July , 2004 (year) in volume 2611 REC FEE: 13.00 page 507 , as document number 768132 which was recorded TRAMS FEE: in St. Croix County, State of Wisconsin, contained the following COPY FEE: CC FEE: error (if more space is needed, please attach addendum): PAGES: 2 a typographical error in the legal description. � O'v � ���.� uc31 C, Recording Arca AFFIANT snake s Affidavit for the purpose of correcting the above doe nt Name and Return Address as follows (if ore space is needed, please attach addendum): 13, 16, 17, 18, 19, 22, 33, Lundy's Preserve, RETURl�11'0: 'CIT>_E ONE Lots 1 Town o Richmond 70619TH STREET SOUTH HUDSON, WI 54016 Part of 026 -1078 -104 Part of 026- 1078 -30 -000 Parcel Identiricatlon Number (PIN) AFFIANT Is the (check one): O Drafter of the document being corrected. O Owner of the property described in the document being corrected. Other (explain: Title Company ) • Tlie original document ('in part'or whole) Ms 0 is not attached to this Affidavit (if original document Is not attached, please attach leg.•: description and names oPgrantors and grantees). Signed: ��J�uk'l.�- * Jenni r A. Fuson t State of Wisconsin ) ss. County of 5t. Croix ) Subscribed and sworn to (or affirmed) before me lhis ` day of Attgugit 2004 � MERII.EE J. � t ` RUNE tei iX ee J. Bune d} Notary Pdblic, State of Wi onsin a 1 ►: � y�ISC��� My Commission (expires) (is): 11- 20 -05 ,� TIIIS INSTRUMENT WAS DRAI°rfD nY: Jennifer A. Ferguson Title UnePremier Group This instrument (X is is riot (check one) a conveyance of real property as per s. 77.21(1) Wisconsin Statutes. (A Wisconsin Real Estate Transfer Return is required for instruments that do convey real prop erty. `Names of persons signing in any capacity must lx typed or printed below their signaotre. U 2611P 507 -7 E6E3 132 ST A TE BAR OF WISCONSIN FORM I - 2000 KATHLEEN H. WALSH Document Number WARRANTY DEED REGISTER OF DEEDS ST, CROIX CO., WI This Deed, made between Environmental Holding RECEIVED FOR RECORD Company, LLC 07/07/2004 01:26PH Grantor, WARRANTY DEED and Glen Johnson Construction EXESPI # REC FEE: 11.00 TRANS .FEE: 969.60 Grantee. COPY FEE: Grantor, for a valuable consideration, conveys to Grantee the following CC FEE: Y g PAGES: i described real estate in St. Croix County, State of Wisconsin (the "Property ") (if more space is n ded, ease attach addendum): Lots 12, 13, 16, 17, 18, 19, 2 , 23, candy's Preserve, Town of Richmond Recording Area Name and Return Address Title One Premier Group 706 19th Street South Hudson, Wisconsin 54016 Partof 026 - 1078 -10 -000 Partof 026 - 1078 -30 -000 Parcel Identification Number (PIN) Together with all appurtenant rights, title and interests. This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except Roadways, Easements, and Restrictions of Record. Date his 30th day of June 2004 , * Bi 1 Sherman * Jeff Warren Environmental Holding Company, LLC Envirionmental Holding Company, LLC * * AUTHENTICATI ACKNOWLEDGMENT Rr,, y * p * U * 6� S TATE OF WISCONSIN ) Signature(s) O �Ct ) ss. St. Croix County. ) authenticated this day o Personally came before me this _ 30th day of PALM June 2004 the above named Bill Sherman and Jeff Warren TITLE: MEMBER STATE BAR OF If not, ,��`������ ( to me known to be the person s who executed authorized by §706.06, Wis. Stats.) the foregoi g i ment d ed *same. THIS INSTRUMENT WAS DRAFTED BY *K lm Michael H. Forecki, Attorney Notary Piff5iic, State of Wisconsin Eau Claire, Wisconsin My Commission is permanent. (If not, state expiration date: ( Signatures may be authenticated or acknowledged. Both are not necessary.) December 12 2004 . *Names of persons signing in any capacity must be typed or printed below their signature. WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 1-2000 ttorney Michael H Forecki 3452 Oakwood Hills Pkwy Ste 1, Eau Claire W154701 -7928 Phone: (715) 835.3029 Fax: (715) 8354112 Michael P. Forecki T4632009.ZFX Produced with ZipForm TM by RE FormsNel, LLC 18025 Fifteen Mile Road, Clinton Township, Michigan 48035, (800) 383 -9805 . �J 22 P C � STATE BAR OF UgORSIN FORM 1 2 §00 - 7 6 7 S 6 6 WARRANTY DEED .� REGI`S� OF DEE Document Number This Deed made between John Schommer and Barbara ST. CROIX CO., MI _ Schommer, husband and wife IVED RECORD 0?/01/Z004 01:i5PM Grantor, and Environmental Holding Company LLC EXEIPT DEED REC FEE: 11.00 Grantee. TRAITS FE E: 2314.20 Grantor, for a valuable consideration, conveys to Grantee the following CC described real estate in St. Croix County, State of PAGES: 1 Wisconsin (the "Property") (if more space is needed, please attach addendum): Lots 1 through 33, inclusive, Lundy's Preserve, Town of Richmond. Recording Area Name and Return Address Title One Premier Group 706 19th Street South Hudson, Wisconsin 54016 o 26- 1078 -10 -000 026- 1078 -30 -000 Parcel Identification Number (PIN) Together with all appurtenant rights, title and interests. This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is: good, indefeasible in fee simple and free and clear of encumbrances except Roadways, Easements, and Restrictions of Record Dated this 30th dav of June 2004 *Jo Schommer * Barbara Schommer AUTHENTICATION ACKNOWLEDGMENT M� P STATE OF WISCONSIN ) Signature(s) P e ) ss. St. Croix County. ) authenticated this day of ' Personally came before me this 30th day of PALM June 2004 the above named John Schommer and TITLE: MEMBER STATE BAR OF - Sommer N Zo F W C (If not, �� ' to me known to be the person s who executed authorized by §706.06, Wis. Stats.) the forego instrumel =ac le ed the same. THIS INSTRUMENT WAS DRAFTED BY ` F * �Cv P = Michael H. Forecki , Attorney Notary Public, State of Wisconsin Eau Claire, Wisconsin My Commission is permanent. (If not, state expiration date: ( Signatures may be authenticated or acknowled ed. Both are not necess December 12 - 2004 •Names of persons signing in any capacity must be typed or printed below their signature. WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 1-2000 ttomey Michael H Forecki 3452 Oakwood Hills Pkwy Ste 1, Eau Claire WI 54701 -7928 Phone: (715) 835 -3029 Fax: (715) 835 -4112 Michael H. Forecki T4468638.ZFX Produced with 2ipForrn" try RE FonnshliK LLC 19025 Fifteen Mile Road, Clinton Township, Michigan 48035, (e00) 393 -9905 Safety and Buildings Division County _ .� . 201 W. Washington Ave., F.O. Box 7162 Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) De artment of Commerce (608) -31 ECEIV 7 ,/S3 ©5� Sanitary Permit Applicati Stag Plan LD. Number In accord with Comm 83.21, Wis. Adm. Code, personal informati you i* `' may be used for secondary purposes Privacy Law, s15.O4 )(m) Pro Address (if different than mailing address) I. Application Information - Please Print All Information , J 7 5 / -W to Property Owner's Na me Parcel Lot # Block # h Cr M e l Property Owner's M ailing Address a 3 openy n City, State Zip Code Phone Number ^ +_'',Section �w 0 p(circle Opp) II. Type of Bnilding k alI that apply) t/�i T _. N; R E o(D i �I or 2 Family Dwelling - Nu of Bedrooms 777"""" S ivision Name CSM Number ❑ Public /Commercial - Describe Use Gc ` T IIII — � �- ,u ST p-� crli -G t _ State Owned - Describe Use 4- - 7 � �� � � ❑City_❑Village Township of /f <� III• Type o A. f Permit: (Check only one box on line A. lete line B if applicable) New System ❑ Replacement System a Treatrnen ing Tank Replacement lily C1 Other Mod i ati t to Exis S em - -� B • ❑ Permit Renewal ❑ Permit Revision ❑ Change of I u it Tr er to New List Previous td ssued + n Before Expiration Plumber I Owner _T ype of POWTS System: (Check all that app!) Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound 4 in. of sui soil ❑ At- Grade ❑ Single Pass Sand Filter ❑Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ P ilter ❑ Aerobic atment Unit ❑ Recirculating Sand Filter R ecirculating Synthetic Media Filter R Leaching Cha mber ip Litre ❑Gravel -less Pipe 0 (explain I V. Dispersal/Treatment Area Information: p ) Design Flow (gpd) Design Soil A lication Rate N f� SO g PP (gpdsf) r Are equired (sY) Dispersal Area Proposed ( System Elevation Z4 3 i ' VI• Tank Info Capacity in Total + Number Manufacturer Prefab Site e? Fiber Plastic r I Gallons Gallons I of Units 1 ./ao Concrete Constructed Glass New Tacn ! — I Tanks Tanks -�! � At Septic or Holding Tank X /:Z Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement I, the undersigned, ass ne resp onsibility fur — � Plumber's Na me (Print) 1 „ /� I N attache plans. Plumber's Si gna e usiness Phone Number ' Pl u mber's mber's Addre ss (Str C o d e ) City, State, Zip Code) l S - VIII Count /De artment Use OnI Approved 0 Disapproved i Sanitary Permit Fee (inclui1 1 <� isuing ent "gna (" o Stamps) Surcharge lee) ll 1. ❑ Owner Given Reason fo iat O� i IX. Conditions of Approval /Reasons for isapprovai C e j( L' ( ` SYSTEM lIVVNER. RXJ73 lk4, "d_5 ����� u v eptic tank, effluent filter and 4- dispersal cell must all be servi d / maintained as per management plan pro ed by plumber, � 3 sa, d �� �•C ���� _. 2. All setback requirements mu be maintained JGnCeta, as per applica a code /ordin nces. te 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. 01/03) f � .i l i t i � i � l ��-��� g � � �'�� ���¢ � mo �_ A f� �M oozo v a o a v qo A 30 vi N I N s t t a i f o r c d fT N N O ° (n 0 .Z_01, V W 3 o 0 m o =r Lo m c 0 p N cn 3 3 O O N fD CL R :n r,. O � ! O r� O cn N N ' N O• ? 0 a Dzy a cn lj a c o <° C.) = O ° za � O o ° c CA Z f 3 Q �• Z ! 0 w r 3 V1 N CA w c 3 a C C o N V m ! pj 7 f 3 °T z v 0 'o 7. CD s cn 07 N C �• cr a co C6 — —1 N 7 a ? Z M CL z 7 z N a M m a z 0 ;o z - m ° ! f. � o O D _ o. CL fD .� �• CD ( N O N C O y � 0 z CL v ED. n 0 I 3 m c m 0 3 " i I CL o� D O a f Noon+ IP c C' 3 ac 8 a N 3 ti � 10 3 o CD M N OD W V � N p y ? O I 7 A < N N m �. CD ' O N o O N �q v, a i o° a � ti ►� ST. CROIX COUNTY 'Awl WISCONSIN �' ZONING OFFICE M I N W M ■ Nouns ST. CROIX COUNTY GOVERNMENT CENTER 1 101 Carmichael Road �•� �-- — Hudson, WI 54016 -7710 f• Ju nes•. �- f (715) 386 -4680 FAX (715) 386 -4686 COUNTY ON -SITE VERIFICATION FORM 8f a7 /oy Q Propidy Owner too Propertyl-ocalion l� l�� �f�01'h I1'1- Govt. Lot NE 14 �C�F4 S .2�I T 30 Fa R / p E ( W J Property Owners Mal ling Address Lot # I Block # Sdbd. Mama or CSfvt# 4vV pR�s vE City State Zip Code Phone Number ❑City ❑ Village Nearest Road �/ 52 Use: sidantial d Number of bedrooms Coda derived design flow rate _ _ __ GPD ❑ Replacement ❑ Public or commercial - Describe: W _ __ _ ---------- ..__._ Parent material _ — _... -.. -- — . , — — _.. -,_. _ — — _, —__ _ Flood Plain elevation if applicable _ _ _ M ft. General comments -7 O OY�" , :� 6�_�__ � k / he and recaimmendations: �� G �d h l h �/ SD ! �� / no 7' o ❑ Boring Boring # �/ 9Y • Ors i h Soil 01�E- , L� Pit Ground surface _._............-......._ft. Depth tolimiti factor_...__._._._.._._..in. _ Shc lication !Rt e Horizon Depth Dominant Color RsdoxDescription Texture Structure Consistence Boundary Rods GPDf1p t- in. fdunsell Qu. Sz. Cont. Color Gr. Sz. 5h. "EM "Eff#2 2 12 4 3 3o- 7. s R pe- C / om y P2 -7.5 R ,s 05 rh l r' rr• s �z' A r t Baing # ❑ Boring ❑ Pit Groundsurfaceela._u_ _ft. Depth to limiting factor___._,__,•_in. Soil Application Rats Horizon Depth Dominant Color Redox Descriptpn Texture Structure Consistence Boundary Roots GPDft in. fvtunsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 'Efw RECEIVED V o JUN 01 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 i as possible. All the soils tests were done to the best of my abilit a nd I hold no liabilit for anomalies and other oddities that can be found on this site. Shaun Bird CSTM #226900 i 5/28/04 Please print all information. vie Dat Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). T � 3 2`� Property Owner _ ) Property Location (� Govt. Lot IV r 1 /4 (- 1/4 S T N R E ( W Property Owner's Mailing Address 5 # Block # S . Na or CSM# City State Zip Code Phone Number ❑ City ❑Village own Nearest Road i 7,/`r�0tu� New Construction Use• Residential /Number of bedrooms Code derived design flow rate G GPD ❑ Replacement �Public or commercial - De cribe: Parent material J� S� Flood Ptai�n elevati if applicable ti! ft. General comments and recommendations: � J ' J -5 /O - 37 F71 Boring # Boring �i / ? �r CC. ^p 1,9 S 1Y . Pit Ground surface elev. ' -� ft. Depth to limiting factor / Ow in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. C Gr. Sz. Sh. 'Eff#1 •Eff#2 Colo a - - � r J 5/ Soong # Boring / 7 2 � V a �it Ground surface elev. ' ft. Depth to limiting factor � J in. Soil 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 r� n - ' Z - `i 1 2 1 C' / rn C� rY rn Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/—Effluent #2 = BOD 130 mg/l- and TSS < 30 mg/L CST Name (Please Print) Signatu CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 715- 246 -4516 1 I Property Owner SC (/Y� -� Parcel ID # Page 2 of 3 I Boring # ❑ Boring n / Pit Ground surface elev. � ft. Depth to limiting factor T 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 YKQ All 1 3 - 7:L F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil 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 F-1 Boring # ❑ Pit Boring ❑ 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 mgll- 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.6100) Soil Test Plot Plan /oject Name John Schommer Shau Address 703 Pine St. Hudson Wi 54016 TM #226900 w Lot 33 Subdivision Lundy Presserve pa 2/26/04 NE 1/4 NE 1/4S 27 T 30 N /R W Township Richmond Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Steel Fence Post System Elevation 93.5/93.2 *HRpSameasBenchmark Alt. BM Top of Survey Iron @ 96.6' Scale is 1" = 40' unless otherwise noted B -3 20' 45' 99' 45' 40' 15' B -2 15' 200 496' Property Line B -1 98' 3% Slope I Ave U- Al B. * M. t B.M. Mar 09 04 12:18p Dean Hauschildt 956 - 7 -8763 p.7 + ..�..'�i I ' • �F,�1Y `t �t'i � �M�� .'Z L1���� :�i. ii(': A'10 Carr - ! C AS' T K .�.. 4" CI VENT PIPE 12" MIN. ABOVE GRADE � �EarNER>'ROiaF >_ 25' PRO:"! DOOR, WINDOW OR JLNC ?I0;1 Box APPROVED FRESH AIR INTAKE 'r IprF- CONDUIT KANHOLE CO's ER FI�iISME:; GRADE W:! PADLOCK Ni 4" CI RISER —�� � ---� -- WARNING '.ABET 8 " �}► a N . 6 „ MAX. WA7rR T ae " _, •--� i i�nT SEfiLS GAS i TIGHT , ; PPROV£D A SEAL IVA JOI NTS W: Tr ,PPFij 1._ • ) 1PE 3 9 ..N. j APPROVED PRE iNTNr i C SO�10. SQTL ON N 3' ONTO ;�;� ; ; P UMP OFF I:LEV . FT. — w -�GF: I a� RISER EXIT I ' PERMY ^ aTLD C:V t IF TANK MANUFACTJ31:R 3" APPROVED BEDDING UNDER TANK HAS APPROVAL CONCRETE PAD :P EC1F1CAT :-NS SEPTIC % DOSE �AtiK MAIJUFACT'JRER: ✓� .�Y ..�.. NUMB DOSES PER DAY: INK SIZES SEPT'- lid GAL. DOSE VC'LUME INC LJD1NG DOSE 8pov GAL. FLOWBACK; t,S`? GAL. ;.LAR, MANUFACTURER: _ CAPAC� TIES: A SWITCH TYPE: MODEL NUY.3ER: p� � _ icr. g — B 3 2 Z CKES - _ _ GAL. 'EJt!P MANUFACTURER : G }lr C . N„ci�S 7 C' c l GA L. MODEL NUMBER: : E- � .-- .�.... SWITCH TYPE: � _, D = :Ncmrs 2 GAL,. EQ"'RED DISCHARGE R.AT Cp GPM PUMP f, ALARM WIRING AS .==-A ZLHR 16.ZJ WAC ERTiCAL D FFERE.VCE B$_ - x_pwI''1P OFF AND DISTP.IBUTION I MINIMUM NETWORX SUPPLY PRESSURE PIPE /� FEE_ 0 FEET FORCEMAIN X ; F T /100 . F:. •FRT.0 — F£iT T: c?N F ACTOP. / FELT T.O:*AL L2'IJAMIC uEAD = ff:z ;;'EI�NAIr DiM, CF rG'K? '"Al�k: m ;,D D..�y,..e, -i kI LIQ T '. ER DAT Mar 09 04 12:18p Dean Hauschildt 956 - 761 -8763 p.6 - - - -- • . _'r co b s 4r1EGE ',i�:.' 1L TE5 S imi PAZ- -3C GCulds ;V a Submersfble Effluent Pump t• e EPO4 3871 EPOS I A►'LfCAffONi • Fkttertetr 300 soles Fulk Wrnew In ■ MOW MOwigat CAM iron SPeorcatly designed for me • ><ie r*a sbat. pride drbNre gq /aP fa ellbNrdllet foAorwrrg wee' co " of rtirtlRq 10.1 tyan s!W tddcWt s>Artgth, end d , !<yiteRtS coomporo tti. ! Mft ONrr Firrnst Voter. AtnlloWN for mdawdlo inn It cover w M ft" H sah' dw sump 'EPOS M phew 0.4 Hp, manse! opre�M. AMerpetle end sw nab e1t>dmnt wwrOtiwshr 1 is ar V e0 kt.1S50 modern P 1e11o/e f o k • DeWelerfng RFU, NO in oreIW nhh Flod ierw aswrMM 'Id ■ M� Cade: Sevs,•e duty nub �k reaet. PrA1t sat? Of het". r5w Od ad yaw . d!'�lldAitiOp • Vol Ban M ON": 0.5 "P, ■ SOMYh: upper OW bwer f1'61 115 V, pit 1XQ IPM, itllTt S heevl►duly bW bearing bult in owimeed w" • n aea0bitty i t "Ic reset, • EPti1 lerpetyr- 7hsrmo Cwwt ' Pwer dard:10 foot D 6enr -e0sn drtgn �p AOE1CV LSTTIMA • ee: 1►D to 55 GPM. Imadud left, 168 SJTQ ' Pump 09 an br Tod! ba ads: ua 10 2e f WM throe prong grnun0;�p mechlldat see! Frobes m. �. OWN amew&A..W M M=!Slte: t 'llr W. - Out 00dond 20 toot • "a 11r�tpr. r"Me- eeii: GLUA- le 1p. t3 Law wRh Omsk wmnw 6ftn tx (CSA New mdN O numbers BUWA44 Wastwoflwi Thrie prprq groudIng Vug : O nCe, end to • f' or "AC ".) IT (rd an E � n CUW4 led 810L Rugged � l aand n uous the �rnOemMttO"t r�iets�Snor�. orovidee shlMMS Met sa+rMt rensre� e+�r ' aaWbNof funNrp _ J al� tilrttge to s 30 ; ' Paur+a/: tiff ` ' I t WMEOUnri 4pibNt)- r uP m GPM' 6 so ; = Ww 1101k aw on. s I , T��K M k illpOrreeri, i 4C'C eorNatrou: i o' i •lr.l s� '• to eo GPM O � 4 • • TO 10 A�1 C arse eft.t %Pnm rk, CAFAC" I o � 1� I 4 I �A s� I S� T� �1 e o Q o cy I Q W A I H C a D v � v Soil Test Plot Plan Project Name John Schommer Shau r Address 703 Pine St. Hudson Wi 54016 TM #226900 Lot 33 Subdivision Lundy Presserve pa 2/26/04 NE 1/4 NE 1/4S 27 T 30 N /R W Township Richmond Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Steel Fence Post System Elevation 93.5/93.2 *HRpSame as Benchmark Alt. BM Top of Survey Iron C& 96.6' Scale is 1" = 40' unless otherwise noted B -3 20' 45' 99' 45' 40' 15' B -2 15' 200 496' Property Line B -1 98' 3% Slope 1 h Ave Al B.M. ST CROIX COUNTY SEPTIC 'TANK MAINTENANCE AGREEMENT . AND OWNERSHIP CERTIFICATION FORM 'Owner/Buyer Mailing Address i - :4 // i Property Address 4 u dson LO) 5 � (Verification required from Planning Department for new construction) City /State a ud Sort Parcel Identification Number LE DESCRIPTION re�r�t�ed02�- 10'7j.. Nui1� 10 - 3D o Property Location 'LIE '/4, AZC- '''A, Sec. ate T 30 N R,1 - W, Town of _ Subdivision L , Lot # _3A Certified Survey Map # , Volume , Page # Warranty Deed # 4 1'7 R o L- , Volume q.- , Page # 1 Spec hous Y yes O no �tt n tifiable es 0 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, restricted plumber 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 I/we, 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 maintamed trust be completed and returned to the St. Croix County Zoning Office within 3C da tree year expiration date, ys oft / rl v`> SIGN OF APPLICANT DATE OWNER CERTIFICATION 1 (we) certify that all statements on this form are tnrc to the best of my (our) knowledge.. I (we) am (are) the owners) of the pr rty described above, by virtue of a warranty deed recorded in Register of Deeds Office. S1 NATURE OF APPLICANT DATE Any information that is m is. representcd 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 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page I of 2 KLE INFORMATION SYSTEM SPECIFICATIONS Owner � (� /G� Septic Tank Capacity /.,) -0 a l ❑ NA Permit # L463 J015 Septic Tank Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms Ll ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units �WNA Pump Tank Capacity S16 v a l ❑ NA Estimated flow (average) d gal/day Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.5) l00 gal/day Pump Manufacturer ❑ NA Soil Application Rate " al /da /ft' Pump Modell ❑ NA Standard Influent /Effluent Quality Monthly average` Pretreatment Unit A Fats, Oil & Grease (FOG) 5530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD :5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspende Solid (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cells) w/� W/4# 164-round (pressurized) NA Biochemical Oxygen Demand (BODJ 530 mg /L n- Ground (gravity) ) Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) 510 cfu /100ml ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ Nq Other: ❑ NA Other: ❑ NA Other: ❑ 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 years) ❑ NA 2 - ear(s) 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: Z _ 3 ❑ mon th(s) e (Maximum 3 years) ❑ NA Clean effluent filter S �� At least once every: ❑ month(s) ❑ NA ear(s) Inspect pump, pump controls & alarm At least once every: ❑ month(s) ❑ NA _ Z earls) ❑ month(s) ❑ NA Flush laterals and pressure test At least once every: ❑ year(s) Other: ❑ month(s) ❑ NA At least once every: ❑ year(s) Other: ❑ 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. Page 2 of ?_ START UP AND OPERATION ' For new construction, prior to use of the POWTS check treatment tank(s) for the piesence of painting products or other cheinicals 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. W/1� T aluat' a o ing tank be ' e ai a T'fZ D44IZ � f — ^/61,/ LaN S772clCTt o ❑ 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 E me C��f� Name ne S - —31(2-1 Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY E me Name sue(', C l bU ne Phone /S— 3WC0- q 4PSO This document was drafted in compliance with chapter Comm 83.22(2)(b)0)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. \ CA I r• PA I: OF WI5l ().vz IV 1W1 IP- E .�S PN FJ FOR NEC "'MD'': .1 ! • 4'7662 � � QUIT CLAIM DEED VOL I v; 3 REGISTER'S OFFICE ST. CROIX CO., W1 ...... - - ._ . ... Recd for Record Barbara Schommer ......... ct �E " 191991 m quit -cla g to - John and Barbara .Schommer, .husband - 11:10 A. M and wife, as marital, survivorship property ". F.eg►ster of 6 _. tiie 'o;l .cin, :Icsrrib r.al estate i St.. Croix Co•invy sEate of W'Ii ,,sin "Wall & Mi ller 522 Second St. Hudson, WI 54016 Tax Parcel No: .1tiLGT NW 1/4 of NE 1/4 of Section 27, Township 30 North, Range 18 West, St. Croix County, Wisconsin and NE 1/4 OF NE 1/4, except the east 413 feet of the south 288.6 feet of Section 27, Township 30 North, Range 18 4vest, 3t. Croix County, Wisconsin, approxinately 37.28 acres. This is not i:mmc;teau ;�rnl•• rty. i ,} op i- 1— ' �N M f rn '* awo �A v I ' r r 1w I 1 ' Al 1/ / r m t.► 4 tl C4) '" CIA f x 'i Z Id o m WL • ' f � ♦ ♦\ iO 111 A AOO I o r g0 a M „n c I `♦ r '�: >C � .L ~ Q ON I q '\ e tb � L eo L Z ca O Z �Sb a o ...... ... ...... . ....... . .... .............. v f . f � ML t ■�•i 60 3Jdd NOSNHOC N319 6L6698£5ZL 6£:01 b00Z /50/£0 c Pam Quinn 0'� Subject: 463214 (flexible 9:30 or 10:00) Schumaker /Schommer - PLOW Location: Richmond, Lot 33, Lundys Preserve Start: Tue 11/23/2004 10:00 AM End: Tue 11/23/2004 11:00 AM Recurrence: (none) New permit card issued due to transfer of owner & revision approved 11/22/04 - 1395 129TH St 2, ?jam i - G� Yl . O / 1 2 100 / r ✓/ 1 l