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HomeMy WebLinkAbout026-1294-20-000 ,artment of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix ,ilding Division INSPECTION REPORT Sanitary Permit No: 488192 0 :RAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: ,nal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m mit Holder's Name: City Village X Township Parcel Tax No: Smith, Gerald I Richmond, Town of 026- 1294 -20 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range/Map No: 10' m I G 28.30.18.1502 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER R :, CAPACITY STATION BS HI FS ELEV. Septic =A. Z Benchmark �GSes -- Q� - 7.75 /67, Z I C c, F' 1 , 1r� A la Alt. ` J �J . 7+� ) 6z . T V Aeration Bldg. Sewer " 8.`d /O.$7 Holding St/Ht Inlet 7. !$ & F , 57 TANK SETBACK INFORMATION St/Ht Outlet 9.SZ 77• 2 TANK TO P/L / WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic ! / _ Dt Bottom Z J1 _N.' Dosing Header /Man. Z .'� 2 4 7• `r3 Aeration Dist. Pipe 4Z$ ej • 9 7- Holding Holding Bot. System / .1b / Final Grade PUMP /SIPHON INFORMATION 6.75 /b Manufacturer Dem and St Cover �' t 5. n � dz.y Model Nurn TDH Li Friction Loss System TDH Ft Forcemain ength Dist. to well SOIL ABSORPTION SYSTEM BED/TRENCH Width �engtlh o. Of Tre nches PIT DIMENSIONS No. Of Pits Inside Dia. �,� Liquid D tgp h DIMENSIONS % t 3 ' 'C� SETBACK SYSTEM TO P/L JBLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: / UNIT Model Number: Gcnai o z 5 (dm S a DISTRIBUTION SYSTEM (,, e64 Header /Manifold Distribution x Hole Si x Hole pacing Vent to Ai ntak f .. / Pipe(s) ` \ Ze- � 4'''1Y( Length Dia Length Dia Spacing _\ 6� � rJ d-j SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over I Depth Over xx Depth of xx Seeded /So ed xx Mulched Bed/Trench Center Bed/Trench Edges \ Topsoll� / \ No COMMENTS: Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 1152 134TH AVE New Richmond, WI 54017 (NW 1/4 SE 1/4 28 T30N 5j 1 W) Ric C. Acres Lot 20 Parcel No. 28 30. 18.1502 1.) Alt BM Description = �' `� "Oe ' ( "tJU � - ' r D `, 2 i ' 4 4-o Ede' 44e.�_ - amount of cover 2.) Bldg sewer length = I - = �. :LS D � Plan revision Required ?❑ Yes o 1 , Use other side for additional information. SBD 6710 (R.3/97) Date Insepctor Signat Cert. No. I I I � V e 1 I Safety and RAQdings Division Coun ; 201 W. Washington A Box 7162 Madison, r37O - 7 Sanitary Permit Number (to be filled in by Co.) tc011 ( /¢ Department of Commerce VVs Sta Plan 1. D. Number S anitary Permit Applicati In accord with Comm 8 3.21, Wis. Adm. Code, personal informa �ld�l 2 � � may be used for secondary purposes Privacy Law, s15. Pr ect Address (if different than mailing a ddress' I. App hcation Information — Please Print All Information //6Z 2 1 ,37 1 Property Owner's Na me t �„, j . Parcel N Block /1 t 1) -0 Property Owner's M ailing Address r Property Location (� Z .13 ttl 'A S ' /a,Section Z b City, State Zip Code Phone Number N - -�. , claMb-9 Lk y 7 ')! 5 — 0 Xcle / 1502 T 3 0 N; R l� o W II. Type of Building (check all that apply) o f c ' ai 5J. (v„' 1 or 2 Family Dwelling - Number of Bedrooms 3 h J (� 1 C Subdivision Name CSM Number ❑ Public/Commercial - Describe Use /n� ff p " I L II mp �iz(S ❑ State Owned - Describe Use U e,[ L6 L�-) /Z f' /Z ►'� �nA ❑City_ ❑Village WT'ownship of m nA III. Type of Permit: (Check only one box on line A. Complete line B if applicable) C)2 A.. I New System ❑ Replaced System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit-Revision ❑ Change of Q Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner a. IV. of POWTS S stem: (Check all that a 1) Non - Pressu Ia G round ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter 0 �� Waland ❑ Ptessurived k-Ground ❑ Holding Tank 11 Peat Filter C1 Aerobic Treatment Unit 11 Recirculating Sand Filter ix ❑ R culatmg Synthetic Medu Filter [3 Leaching (umber ❑ Drip Line ❑ Gravel less Pipe 11 Other (explain) V. a'me'd Area ormadion: Design Son Application Rate(gl*f) Dispersal Area Required (sf) Dispersal Area (sf) System Elevation / I /z 1-1 .7 9 T - 5 ✓' Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gall Gallons of Units Concrete Constructed Glass New tsxtsti �6OC Tanks Tanks ng k / 6 1 0 .t v i (N t S t n (u cn rfi <- ✓ Aero bic Treatment Unit Dosing Chamber VII. Responsibility Stat I, the'1rii; ed, assume rlsponsihility for installation of the POWTS shown on the attached plans. Plumber's Na the (Print) Plumber' MPIRS Number Business Phone Number Pitpnbcr's Addre as (Street, City, State. 74 Code) r IV 62. 6 ) f� SIA ► AA 9 W 1 -5 �. VIII. Coun /De ent Use Onl Approvgd ❑ D' pprove Sanitary Permit Fee (includes Groundwater Date Issued I Agent Si tur o S ) I 9 /�� � Surcharge Fee) 66 .5115 ❑ Owae Reason for vial IX. Conditions of ApprovaUReasons for Disapproval 3\ (� Jh SYSTEM OWNER:, J 4� — V I . Septic tank, eff uo t f w end P G -- �v►tiDiOc✓ dispersal ceN must eN as per msnagemw t plan provided by O=bar. Z. AN sdbadt regt MMOnts must bs mskltairted as par sppk;sbie code / ordittatlros. Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size cYrir cnno iTi n� /!12\ to a cl,..a p. 4�.. - ¢ 4 v� t i t �... % ,9 r h _. N v `a ;e a :, 3 A O e • d CA a u} vj\ i--"' J oe tl v Y o Lr) — c F p i 3 H .o 0 a u C ali ZIL JD r r 2 � t N V t> chk 2— p Ln — fh Q � 1� f Wisconsin Department of Commerce J ' --= EVALUATION REPORT Page � of Division of Safety and Buildings ih�ccor ante with Comm 85, Wis. Adm. Code ounty St C go I 'A Attach complete site plan on paper not less than 8 1/2 x 11 ii ches; RE CE E D include, but not limited to: vertical and horizontal reference p int (BM), direction and arcel I.D. 021, 12 11. 21J _ 60C) percent slope. scale or dimensions north arrow, and to ratio and distance to nearest road. Please print all informatio AUG 3 �4 2005 l evi ew by Date Personal information you provide may be used for secondary purpos s (Privacy Law, s. 15.04 (1) (m)). Property Owner ^ ZON to I lion G C �a i SM n Govt. o /4St„)1 /4 S Q 30 N R E(or Property Owners Mailing Addre Lot # Block # d. Name or CSM# 1 9O e. N W D Sub a. a F R ich n wX A cre s City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road_ F-)K R�4C- R MN 30 ( ) . 8 R ;CA\ rn I v' ve , C9 New Construction Use: M Residential / Number of bedrooms Code derived design flow rate S 0 GPD ❑ Replacement ❑ Public or commercial - Describe: �P :1 _ Parent material .S2�i,, 1 ' i.LL_J�11► :� Flood Plain e!evation if applicable General comments - 4 S v r L 6 - 3 �"T �� , �,� *� � y F a r t. 0'. 0—%- 5 1 T l and recommendations: T. y ( 9 7,c,3 Jl-N 0 I.A.10 A> sJL "r 97.31.') T 4 9 L,.38' Boring# o Pit ng 79 OS _ 4 � + Ground surface elev. ! • y ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 a k -► 3 r r!�' 5/ L _ � _ F YI 4! � _ f i ea �'t 1 Y)- -S b N s ; 4 L . Boring # Boring 2 q Ft Pit Ground surface elev. _ / ,�$ ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft' In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 V . 1 - c g 1/ -- --- --�° S I to wt t :" i 1 v F i tit L CJ j to Llil10 7, 5 Yf" 5 / 5 A �. C t,�. � �` �4 "70 +0t U'(i b/ 7cx lam. My .. . Effluent #1 = BOD > 30 5 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD _< 30 mg/L and TSS < 30 mg/L - Name (Please PIM Signature CST Number J — Add � a O 7t M -14 - 7 Evaluation Conducted Telephone Number O we �°��` -a°� -n5 - 7 ay 35x8 I L Property Owner Gera S in +�' ` Parcel ID # Page 5Q _ of _Y- F-31 Boring # ❑ Boring �• pit Ground surface elev. �� �' I 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 a� - 75 Y "/to µ envy 5 b ,.� ir- H 3 - 1. s ��'�1 5 L -5 b K tn. 4"r �. I !o ► b 5 IoD 7.5Yi^ 5 / v 52 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 GPO /ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 F-1 ❑ Boring Boring # Ground surface elev. _ ft. Depth to limiting factor _ in. Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 Effluent #1 = BOD 30 S 220 mg/L and TSS >30 5 150 mg/L ' Effluent #2 = BOD 5 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 dep artment at 608 - 266 -3151 or TTY 608- 264 -8777. SBD -8730 (R.6/00) Property Owner Gera'QC 1, Page � _ of —_[__ 1-1-31 Boring # E] Boring P5 Pit Ground surface elev. � 11 Y 10 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 - 10 ant - L ; F L e& v� b LA" � � y 3 A 5L b V- n4r ti =' y2 F-1 Boring # ❑Boring E] pit Ground surface elev. _ __ ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 F-1 Boring # ❑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 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 5 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608- 264 -8777. SBD -8330 (R.6/00) Nw Oyu 6E- C n>o iot 1:h�� r , Sca. �Sd - r3vm� A t$ w - - � b y Coe' s •�- s+�.k�. �. la�g 100j sit 34,..1Ac. 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M .h: �• IMWwrx 4nu Luxx' wWM lF1 ,l yyy7 � V 1 VI Jlll .�N.d` Pr1Mp ° l iI ti *1IR"d�AWwm4MlPtk'Q9TIpN J j:�► 7411 y]Grtu,Ma faK«{ 7 'b;tF" Fd� dW 6919 /OIWOFW.:y1d911n .r- 05/11/2006 17:16 1 SUPERIOR AUTOMOTIVE PAGE 04 PRE'LIMI'NARY PLAT OT RICHMOND ACRES to eoarn P Al iw..w 1 •N .l rr Mwwt !N w w r..Mrrr N M lwlo. K M•A• A rM Ly..4 Wx llp sr w..•wt J- bd. IArvp i rrw -►• .... .. • .,. • f \ Y /- ` :� tom• -, ...c '� /� ► �!, of 4 op woo 1. •�- •, 1 � r � ` 1 ' /�• � I �f [� _ __\ ` � y. J ••w • Ime � I � .JI7 f 1 / i : w..rr �. 'let r 8" •rs• Je OWN ►.7.• �• 6 J r ) was I AM F2vr Air? a I f rl Syr ��, r.iw • �Esi• • � 1 �' 1 �1 j EiAt r l•'d= W" �rawy.►•• y YYYYwwww j / i _ r ea •aw ` •,M&I v L I P w.•.••.MaL•w .� ' ,ijl I , 1► J� } We �' �'. .� ;. .""�'�'1.� a �_� 1„t �,• f�N.d .r IN • M CW�bAO K ��•'„ Mw 7 s'N Iw Y xw �• 1 . n.rwr�.ww �rrl ••.._ "� Lwl ..... '�.t4+ci 05/17/2006 10:50 7634418727 PAGE 01 MAY.17.2006 11;08AM EDINA REALTY HUDSON N0,6351 P. 2/2 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AO1 :E� ; AND OWNERSHIP CERTIFICATION FORM owner/Buyer Mailing Address COC 3 Ilkf f 1,�f' Wil-104 � Propert Address (VeriSaadon mquntod ftM Phimming & zoning DcperWwnt for new coastructiOL) City /State ¢i`i.�. ilk P 1 Identification N=bCr ,QA f• — 1,2 ` Y — +�'y LFO�L DESCR,� �p f ftvaty Location �&a ' Sec. T.7!! N R U t W, Town Subdivision sf C� of �•�•.�� rvtor�cr Lo t# Certified Swmey Map # , Volunne Page # Wwcramty Deed # '7 `t ca G !j , volume Spec housoKwa 0 no Lot lines identW=bloXyw D no SYSTEWAJ&U�TENALiCE AND OWNER.ElilTIF�LCA'I'YON . iapioper use end Maintenance of your septic system could result in its premature failure to handle wastes, PtopQ ttlaipt�tapce oa mists of puunping out ffie septic tank every Have years or sooner, if needed, by a liccuavd pungw. What 3m Put into the system can anent the function of Me o phe =k as a treatment ataga in tbo-waste disposal system. Owrner %"lntemm= teepvtoNlides are specified in §Cow 83.52(1) and in Chaptrr 1.2 -'St. Grvnt CoaW Sanitaty,0rd4MklWA. The property owner agrees to submit to St. Croix County Planning & Zonbg Dqwammt a bcd1fieatioa fvtm, signed by the owner and by a master plumber, jouaacman phoibr, r, restricted phrmbar or a licensed pamper mrifying that (l)' the on-site WaStewater disposal sysmm is in proper op m ti>ag condition and/or (2) after inspection wd pus wh% (If may), tie sepfic teak is leas tibn 1/3 fhIl of sludgo. Uwe, the utdarmsood have toad the above regai rammts and agree to maintain the pdvato sewage dkooeal art= with The standards set 1;orth6 herein, as set by the Dgmt nmt of Comm*ye sad dw Depatxnemt of Natural ReKmmes, Stato of vvisconsin. Certification statbng duet you septic Mtmn has been maimained a=t be eamploW and xcft wd to the St Croix County Planning dt Zoning Department e►ithin 30 days of the three year aTingon dab. I/we certiff tbat all sts=c rib on this forth are true to the best of my /our ktcowdvdga. Uwe am/are &a ownet(s) of d w property dwonbed above, by virtne of a warranty deed recorded in Register of Deods 011lce. Numbe 4A40F APPLICANT(S) DATE 3 • +Any information that is misiep esenood may result in the sanitary permit being revoked by the Planning & Zoning DepertmcuL •'"• Include with this application a recorded warranty deed front the F.4sW of Dcods Office and a copy of the ca tfied survey map if reference is made in the wstranty doed. MXV. OW" Page___ of PRIVATE SEWAGE SYSTEM INDEX AND TITLE SHEET P'raperty Owner(s): 1p Jr. N Project Name: 5A rn C S 1 J H N l f C 1L S W n y w °, k l 3 Q C DA do �,-- Project lAcation: k I (k rn v No 0 (,R ('s, Stsoot Addross it SZ 13 y T w WvE ocmptkm N L.) s r- r . N E Z V 7 10 rrl R.) �O T own or Mumidp ' RiG t� mO��� S"f C2b�X C0vA) ` Couty Contents: Page I �N i> E Page 2: pl i PLAN Dn/ Page 3: PO L4! 1 0 tvGP kAA OA 4 Page 4: M!zrvn G 1'r)G+� Page s: C U Rl f Iry 6 t- C i Pi-A/ Pagers: Page 7: Name: rlr* 9 9 � � �. � � Siped: � Credential Number: P Date: MR 1 Z 2 pbg Address: N Slog `l w' z . !; o, 1) S473b � � - � S �6 Phone Number: 5 POWTS OWNER'S MANUAL MANAGEMENT PLAN Page .3 of FILE INFORMATION SYSTEM SPECIFICATIONS Owner Septic Tank Ca a ity / CC U g al ❑ NA Permit # Septic Tank Manufacturer W I (- S ( -6L ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer Z A BC- >, ❑ NA Number of Bedrooms I00 d/bedroom ❑ NA Effluent Filter Model A-100 ❑ NA Number of Commercial Units NA Pump Tank Capacity al J4 NA Estimated flow (average)* gal Pump Tank Manufacturer ❑ NA Design flow (peak), estimated x 1.5* gal/day Pump Manufacturer ❑ NA Soil Application Rate gal ft Pump Model El NA Influent/Effluent Quality (NA [I) Monthly Average ** Pretreatment Unit W NA ❑ Sand/Gravel Filter ❑ Peat Filter Fats. Oil & Grease (FOG) < 30 mg/L ❑ Mechanical Aeration ❑ Wetland Biochemical Oxygen Demand (BODs) _< 220 mg/L ❑ Disinfection ❑ Other: Total Suspended Solids (TSS) Manufacturer: Model: <_ 250 L Dispersal Cell(s) Pretreated Effluent Quality C3 Monthly Average * ** �Q In- ground (gravity) ❑ In- ground (pressurized) Biochemical Oxygen Demand (BODs) < 30 mg/L ❑ At -grade ❑ Mound Total Suspended Solids (TSS) :5 30 mg/L ❑ Drip-line ❑ Other: Fecal Coliform (geometric mean) 10 + cfW l 00m1 O Leaching Chamber Manufacturer 1 tv f 1 t, t R!)'iY Maximum Effluent Particle, Size 1/8 inch diameter Model '31 1 p Approval Stipulation *Wastewater Flow Verification on and calculations: Soil Application Rate , 4gpdW Area Req. 112_ ! � ft (Other than bedroom based) Absorption Area Credit per unit 3 ft Minimum Number of Chambers j '17 p Aggregate Desi Flow/Loading Rate= ft min ** Values typical for domestic (non - commercial wastewater Materials: all materials must comply with WI Adm. Code and septic tank effluent. COMM84 and be installed per manufacturers specifications ** *Values typical for pretreated wastewater. and approval letters. DESIGN CRITERIA ❑ "Wisconsin At -grade Soil Absorption System, Siting, Design & Construction Manual' (Converse et.a1.1990) ❑ "Wisconsin Mound Soil Absorption System: Siting, Design & Construction Manual" Converse, J.C. and E.J. Tyler, Publication 15.22 ❑ "Design of Pressure Distribution Networks for Septic Tank - Soil Absorption Systems" Publications 9.6 ❑ "Design of Conventional Soil Absorption Trenches and Beds ". R.J. Otis - ASAE Publications 5 -77 and "Design Manual - Onsite Wastewater Treatment and Disposal Systems ". EPA 625/1 -80 -012 October 1980 ❑ SBD - 10570 -P (R.6/99) "At -Grade Component Manual Using Pressure Distribution" SBD - 10567 P (R.6/99) "In Ground Absorption Component Manual" ❑ SBD - 10705 -P (N.01101) "In Ground Soil Absorption Component Manual" Version 2.0 ❑ SBD - 10628 -P (N.6/99) "Recirculating Sand Filter System Component Manual" ❑ SBD - 10656 -P (N.6/99) "Split Bed Recirculating Sand Filter System Component Manual" ❑ SBD - 10572 -P (R.6/99) "Mound Component Manual" ❑ SBD - 10691 -P (N.01 101) "Mound Component Manual" Version 2.0 ❑ SBD. - 10595 -P (R.6/99) "Single Pass Sand Filter Component Manual" ❑ SBD - 10657 -P (R.6/99) "Drip -line Effluent Disposal Component Manual" ❑ SBD - 10573 -P (R 6/99) "Pressure Distribution Component Manual" ❑ SBD - 10706 -P (N.01 101) "Pressure Distribution Component Manual" Version 2.0 ❑ Drip -line Effluent Dispersal Component Manual for Multi -flo Onsite Wastewater Treatment Units MAINTENANCE AND MANAGEMENT MAINTENANCE MONITORING SCHEDULE . Service Event Service Frequenc Inspect condition of tanks At least once every ❑ months 3 J W year Maximum 3 s. Pump out contents of tanks When combined sludge and scum equals one -third 1/3 of tank volume Inspect dispersal cells At least once every ❑ months M year(s) Maximum 3 s. Clean effluent filter At least once eve months ❑ year (s Inspect pump p ump controls & alarm At least once every ❑ months ❑ ears NA Flush laterals and pressure test At least once eve ❑ months ❑ year(s) ❑ NA Valves At least once every ❑ months ❑ ears ❑ NA Other: At least once every ❑ months ❑ ears ❑ NA Page 7 of START UP 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 u shall not y p occur when soil conditions are frozen at the infiltrative surface. OPERATION The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity and quality of the.wastewater stream will affect the perforriance and longevity of your POWTS. The installation of water- saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water softeners, iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground surface whenever possible. Note: this does not include laundry waste, showers, dishwater, etc. This system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable /fruit peels and seeds, bones, and food solids such as those produced by a garbage disposal should be minimized. Toilet tissue is the only paper that should be discharged into the system. Other non - biodegradable items such as baby wipes, tampons, sanitary napkins condoms, cigarette: butts, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, paint, disinfectants, pesticides, antibiotics, solvents, etc., should not be flushed into the system as they can seriously damage your POWTS and contaminate your drinking water supply. Maintain a regular steady flow by spreading laundry washing throughout the week. Avoid vehicle traffic over all system components. Compaction of snow over the dispersal unit may cause it to freeze up. ❑ Valves Valves shall be operated in the following manner: I 0 Alarms Alarms should be tested on a regular basis by the home owner. If an i alarrn sounds, contact an individual licensed to service POWTS, There is normally a 1 day reserve under regular operating conditions, however water should be conserved until any Problems with tht system' are corcected'to prevent back =dp of sewage into the dwelling or surfacing. . INSPECTIONS Inspection shall be made by .an individual carrying one of the following licenses or. certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule). * 'tip Septic Tanks Component Tank inspections must include a visual inspection of the tank 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 backup or surfacing of effluent. Access openings used for service or assessment shall be sealed and/or, locked upon completion of service. Any defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective locking device to prevent accidental or..unagthorized entry into .the tank: I When the combination of sludge and scum in any tank exceeds one -third (1/3) 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 NR113, Wisconsin Administrative Code. The outlet filter(s) shall be inspected and cleaned to remove an y accumulated solids according to manufacturer's specifications. Provisions are to be made to retain solids in the tank. Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating. ❑ Pump Chamber/Treatment Tanks Component The inspection must include a test of all electrical equipment such -as pumps, alarms and floats. -A visual. check_mustbe. made for leaks, backups; surfacing; missing or broken security devices and other hardware and the condition of the filter. Any service needs or repairs shall be promptly taken care of. Il Page - of START UP 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. OPERATION The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity and quality of the.wastewater stream will affect the'perfom ianee and longevity of your POWTS. The installation of water - saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water softeners, iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground surface whenever possible: Note: this does not include laundry waste, showers, dishwater, etc. This system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable /fruit peels and seeds, bones, and food solids such as those produced by a garbage disposal should be minimized. Toilet tissue is the only paper that should be discharged into the system. Other non- biodegradable items such as baby wipes, tampons, sanitary napkins condoms, cigarette .butts, dental floss, and cotton swabs should not enter the system Chemicals such as petroleum products, paint, disinfectants, pesticides, antibiotics, solvents, etc., should not be flushed into the system as they can seriously damage your POWTS and contaminate your drinking water supply. Maintain a regular steady flow by spreading laundry washing throughout the week. Avoid vehicle traffic overall system components. Compaction of snow over the dispersal unit may cause it to freeze up. p Valves Valves shall be operated in the following manner: p Alarms - Alarms should be tested on a'regular basis by the home owner. If an alarm sounds, contact an individual licensed to service POWTS, There is normally a 1 day reserve under regular, operating conditions however water should be conserved, until any problems with tht s'ystem are corrected to .prevent back -up of ewage into the dwelling or surfacing... INSPECTIONS Inspection shall be made by .n individual carrying: one of the. following licenses or. certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule). Septic Tanks Component Tank inspections must include a visual inspection of the tank 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 backup or surfacing of effluent. Access openings used for service or assessment shall be sealed and/or locked upon completion of service. Any defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective locking device to prevent accident4j, or_ unauthorized entry into the tank: When the combination of sludge and scum in any tank exceeds one -third (1/3) 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. The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. Provisions are to be made to retain solids in the tank. Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating. O Pump Chamber/Treatment Tanks Component The inspection must include a test of all electrical equipment such as pumps, alarms and floats. - A visual. check.must be. . made for leaks, backups surfacing; missing or broken security devices and other hardware and the condition of the filter. Any service needs or repairs shall be promptly taken cane of Pas of In- Ground Gravity Component Dispersal Cells The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding at depths greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. ❑ Mound, At- Grade, In- Ground Pressure The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding greater than 75 % of the height of the component ma y indicate overloading or impending hydraulic failure necessitating more frequent monitoring. The pressure distribution system is provided with an opening at the end of each lateral to be used for flushing. The laterals should be flushed at least once every three (3) years. Pressure checks of systems with multiple laterals should be done to ensure that equal distribution of effluent is occurring to promote the longevity of the system. REPORTS F orts for maintenance, inspection, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin Administrative de. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is properly and safely abandoned in compliance with Ch. 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 other 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 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 GASES 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 ^ &I5 r ELK - I Name I.1L PGI K6 Phone 71 S - 6') i- 2 6 Phone SEPTAGE SERVICING OPERATOR (Pumper) LOCAL REGULATORY AUTHORITY Name Agency ` C tt o j k u C v n )� e) ) Ll Phone lT �' K'y o w� Phone i - 3 6- IWO � M : Zabel A 100 Rand, Commercial Efg er . SPECIFICATIONS AMICATION& The A 100 is used in residers. dal and commercial e It --- i3etfecuvemmultifamilyh ,renalprerclr oo es attd here wastewater i sol - :ds conteric. gh auspetxled 3 FLOW RATE: 3 ,000 Rlter.lnstalitaroor monfilteninaPV n Cleta{4tc achievellowsof 6A0 armore. Checkwi k2abel FILTRATION: 26 Disc Darns 1,116 mch provide 198 lineal feet of ` ltration. 2. INSTALLATION: The fillet mar b� installed inside the tank or inmlled m a Zabel &M ner Assembly outside the septic tank. SSRVICI:: Service residenual ir-atallatxw whenever yon pump the tan& o it -M w -.— '�"' 3-0/11r . .. ua �. 1 q If : ' i •�' • .• --11-W DIA. - item. . . Maaettai Spedflcations 'a'' Daftdon Cases, Lids, Reducers Rigid Vinyl PVC 87371 M"79UL L - 26 pimduc Discs High Impact Polystyrene 3 Ow" Rod, Nuts High Density Polyethylene 4 3 Rod S. 1 3 1 ue U.S. Patent No. 4,710,295 Call 1 -800- 221 -5742 or Fax (502) 267 -8801 for further information. t • , t S .0 0 Maintenance The Interval for servicing septic tanks is set by state and local code Throughout the United. States there is a wide difference of o�'nion on what this interval should be, but Mott regulatory agenglOs suggest two to five years. The Zabel filter, which does not increase the frequency of servicing fbr the,tarik; should be cleaned when the septic tank is normally inspected and pumped. However, our filter is virtuail self- cleanlng. The continued action of the anaerobic drganisms on the Zabet filter causes lodged particies disintegrate and fall to the bottom of the tank. If your filter contains a SmartFifterw alarm, you will be notified by an alarm when the filter needs servicing. To service the fliter: •Servidng any zabel filter should only be done by a certified septic tank pumper or installer. Locate the. dotter of the ' So*-tank. Firmly the filter t and Wide cartrid9 M1 Remove the tank of the ;a and pump th 'Note: A tee ha m ay I necessary to t o b used !r deer b !I y gOi below. and lever escaping to th Contec� zaps! ror krfo ro when the names re White holding t e,, '► `* the access ., Insert tfle' cartridge with fr back in careful to rinse . f sure thila u ptol►l' I ' nrore: rt rs� completey 1 4 � ,peer n ` •► be hir on may ee dsass � � � h R Mk The product(s) shown are covered by one or more of the following patents: U.S. 5,762,793, 5,580,453, 5,591,331, 5,759,393, 5,683,577, 5,582,716, 5,779,896, 5, 593, 584, 5,795,472,5,736,035,4,710,295, 5,382,357, 5,482,621 U.S. Des. 386,241, 349067, 4605501,5098568, Des. 309007, Australia: 134440; Canada: 2,135,937; Israel: 111574; New Zealand: 264824, Other Patents Pending Call for a free ZABEL ZONE An Onsite Wastewater Magazine 1 - 800 - 221 -5742 • Website httpltmm.zabel.com A1001300- 1- M,61499 Maintenance The interval for servicing septic tanks is set by state and local code Throughout the United States there is a wide difference of opinion on what this interval should be, but moslr regulatory agendQS suggest iwo to five years. The Zabor filter, which does. not increase the frequency of servicing fbr the tank, should be deaned when the septic tank is normally inspected and purnped. However, our filter is virtuallyy self- cleaning. The continued action of the anaerobic organisms on the Zabel ff�ter causes lodged particics•to. disintegrate and fall to the bottom of the tank. If your filter contains a SmartFifterm alarm, you will. be notified by an alarm when the filter needs servicing. * T service the filter: 96n4dnq any zabel filter should only be done by a certified septic tank pumper or installer. Locate, the - duttef of the Sep�C-tanh F f` ` ; Firmly pun 0*11t h9 . and slide the cartrldg Remove the tank of the .' and pump the •Note: A tee ham man necessary to to be used a msalner Is any Solid ! belo plround level to escaping to th Contact zabel ror Into when the re While holding the access 9pe Insert Mitt 4 cartridge Vvi fr, bade In:th all y 1' refu I to rinse . � r sure the,�i,, Pte; Mlote: n nor letc ' i I may be Replace �DE IN USA The product(s) shown are covered by one or more of the following patents: U.S. 5,762,793, 5,580,453, 5,591,331, 5,759,393, 5,683,577, 5,582,716, 5,779,896, 5,593,584,5,795,472,5,736,035, 4,710,295, 5,382,357, 5,482,621 U.S. Des. 386,241, 349067, 4605501,5098568, Des. 309007, Australia: 134440; Canada: 2,135,937; Israel: M574; New Zealand: 264824, Other Patents Pending Call for a free ZABEL ZONE An Onsite Wastewater Magazine 1 -800 -221 -5742 • Website http•Jiwww.zabel.com A1001300- 1- M,61499 V 2 8 1 4 P 5 3 1 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIR CO.. MI DOCUMENT NO. WARRANTY DEED RECEIVED FOR RECORD 06/03/2005 12:06PH WARRANTY DEED EXEMPT • This Deed, made between David A. Ball and Kimberly A. Ball, husband REC FEEz 13.00 and wife and Dennis F. Ball and Nancy A. Ball, husband and wife. TRANS FEE: 3185.40 Grantors, and Gerald J. Smith, a married person, Grantee, CC COPY FEE: WITNESSETH, That the said Grantors, for a valuable consideration PAGES: 2 convey to Grantee the following described real estate in St. Croix County, State of Wisconsin:: RETURN TO: Parcel 1: The East Half of the East Half of the Southwest Quarter Loberg Law Office (E' /. 359 West Main Street /E' /2 Ellsworth, WI 54011 /SW%) of Section Twenty Eight (28), Township Thirty (30) North, PID #026 - 1082 -40 -000 Range Eighteen (18) West, Town of Richmond, St. Croix County, 026 - 1082 -70 -100 Wisconsin, EXCEPT Lot One (1) of Certified Survey Map filed April 026- 1082 -95 -000 24, 1990, in Vol. 8 of C.S.M., pg. 2199, as Doc. No. 457843, being 026- 1083 -10 -000 part of the Southwest Quarter of the Southeast Quarter (SW'/./SE%) and part of the Southeast Quarter of the Southwest Quarter (SE' /. /SW'/.), both in Section Twenty Eight (28), Township Thirty (30) North, Range Eighteen (18) West. Parcel 2: The West Half of the Southeast Quarter (WY: /SE %) of Section Twenty Eight (28), Township Thirty (30) North, Range Eighteen (18) West, Town of Richmond, St. Croix County, Wisconsin, EXCEPT the following described parcels: 1. Lot One (1) of Certified Survey Map filed April 24, 1990, in Vol. 8 of C.S.M., pg. 2199, as Doc. No. 457843, being part of the Southwest Quarter of the Southeast Quarter (SW' /./SE'/.) and part of the Southeast Quarter of the Southwest Quarter (SE' /. /SW'/.), both in Section Twenty Eight (28), Township Thirty (30) North, Range Eighteen (18) West; 2. Lot One (1) of Certified Survey Map filed August 13, 1981, in Vol. 4 of C.S.M., pg. 1093, as Doc. No. 372738, being part of the Southwest Quarter of the Southeast Quarter (SW %✓SE' /.) of Section Twenty Eight (28), Township Thirty (30) North, Range Eighteen (18) West; 3. Commencing at the Southwest corner of Lot One (1) of Certified Survey Map filed August 13, 1981, in Vol. 4 of C.S.M., pg. 1093, as Doc. No. 372738, for the point of beginning; thence N89*59'15" West 20.00 feet; thence NO'01'41" East 262.00 feet; thence S89 *59'15" East 224.00 feet; thence SO'01'41" West 15.00 feet; thence N89'59'15" West 209.00 feet; thence SO'01'41" West 242.00 feet to the point of beginning; 4. Commencing at the Northeast corner of the Northwest Quarter of the Southeast Quarter (NW' /./SE' /.) of said Section 28; thence South 16 feet; thence Northwesterly to a point 10 feet West of the point of beginning, thence East to the point of beginning. This is not homestead property. Together with all and singular the hereditaments and appurtenances thereunto belonging; And grantors warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions, covenants and conditions and will warrant and defend the same. U 2819P 532 Dated this 1 � / day of MMayy�, 2005- ' l/` - �(/"`^ (SEAL) v SEAL) David A. Ball Kimberly A. B 0' - �_ _ GC�� (SEAL) (SEAL) Dennis F. Ball �— Naficy A. Bair AUTHENTICATION ACKNOWLEDGMENT Signature(s) �'�lL� STATE OF MINNESOTA } ) SS. authen� ted this ay of COUNTY OF Personally came before me this 16th day of May, 2005 the above named David A. Ball ' Kimberly A. Ball and Dennis F. Ball and TITLE: MEMBER STATE BAR OF WISCONSIN Nancy A. Ball to me known to be the persons (If not, who executed the foregoing instrument an authorized by §706.06, Wis. Stats.) ackno the same THIS INSTRUMENT WAS DRAFTED BY LOBERG LAW OFFICE Notary Public County,MN My Robert L. Lobero Commission is permanent. , _.) (Signatures may be authenticated or acknowledged. Both are not necessary) (If not, state expiration date: 20 jb / SST1042 'n4o"w, NEWOM Nolwy r , : .... tdyCaatatt�MallriYti�,INlfl,>NN Parcel #: 026- 1294 -20 -000 05/19/2006 09:19 AM PAGE 1 OF 1 Alt. Parcel M 28.30.18.1502 026 - TOWN OF RICHMOND Current IXI ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 11/10/2005 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - RICHMOND ACRES LLC RICHMOND ACRES LLC 11160 190TH AVE NW ELK RIVER MN 55330 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1152 134TH AVE SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 1.850 Plat: 10/086- RICHMOND ACRES LOTS 3-49 026/05 SEC 28 T30N R18W PTS NW SE & NE SW Block/Condo Bldg: LOT 020 RICHMOND ACRES LOT 20 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 28- 30N -18W NE SW 28- 30N -18W NW SE ' Notes: Parcel History: Date Doc # Vol /Page Type 11/10/2005 811739 10/086 PLAT 2006 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 02/14/2006 Description Class Acres Land Improve Total State Reason Totals for 2006: General Property 0.000 0 0 0 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 I