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HomeMy WebLinkAbout026-1286-15-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No 506159 0 GENERAL'INFORMATION (ATTACH TO PERMIT) State Plan ID No Personal information you provide may be used for secondary purposes [Privacy Law, x.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No Ehman, Dominic & Susan I Richmond, Town of 026- 1286 -15 -000 CST BM Elev: Insp. BM Elev: BM Description: Section /Town /Range /Map No. /bd g ik i ins T 34.30.18.1437 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. //. 7-5 /t/, a • a Septic t ' u � Benchmark 3 . //J, V Dosing eR.iC. N t. BM Aeration Bldg. Sewer ') r yr c Vat b .73 12E.> f .: Holding SUHt Inlet it Po I .t �,/ , ✓! TANK SETBACK INFORMATION St/Ht Outlet I TANK TO P/L � BLDG. Vent to Air Intake ROAD Dt Inlet IZ„ Z7 Septic > t i It Bottom b 97. i JC)D Dosing , Ivly Hea der /Man. �U ,)q ' 7 GN / Aeration t o Dist P pe 0 K t y /• /� p Holding F y Bot. System / 7 Final Grade PUMP /SIPHON INFORMATION Manufacturer GPM Ialnd St Cov 40 3 � b / S /057.0 Model Number / 5 2 3V 4evy, TD H Lid � Frictiq, c�s� Syste e Ta C �. U `0 /• 2 Forcemain g D Len th (r / ia. Dist. to Well 79 l/ 2 ., SOIL ABS RPT19A SYSTEM BED/TRENCH Width C1 Length No. Of Trenches PIT DIMENSI o. Of Pits Inside Dia. Liquid Dept DIMENSIONS l o /�2 SETBACK SYSTEM TO P/L BLDG WELL Vf LAKE /STREAM LE HIN Manufacturer: INFORMATION CHAMB OR Type System: O r � r T Model Number: DISTRIBUTION SY EM ` SGE-1 O d Header! d `N� Distribution v % x Hole Size r x Hole Spacin ferlt to Air Intake Length C7i Length ^ Dia �• Spacing e SOIL COVER x Pressure Systems Only xx Mound r At•Grade 5 dems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded j xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil Yes No \'es No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:_ `/ .`/ 2 --i Inspection #2:(V! Location: 1219 121st St t New Richmond, WI 4017 (SW 1/4 SW 1/4 34 T30N R18W) Sunset Ridge L.ot Lot Parcel No: 34.30.18 143N - 7AI Vllt- S/tt� 1.) Alt BM Description - I 2.) Bidg sewer length = ZLA - amount of cover = I 'r Plan revision Required? Yes /No Use other side for additional information. Date Insepcto Signaturev� - - - -- Ce SBD -6710 (R.3/97) IL 10 YJ ev a , o I cotnmerce.wi.gov Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 O) sco n s 1 n Madison, WI 53707-7162 Sanitary Per Number (to be fill in by Co.) Department of Commerce Sanitary Permit Application State Transaction Number In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the pro pr rnmental �O unit is required prior to obtaining a sanitary permit. Note: Application forms fors owne WT re Project Address (if different than mailing address) submitted to the Department of Commerce. Personal information you provide may be d for dary f p urposes in accordance with the Piivac Law, s. 15.04(1 )(m), Stats. /� / Q /�� _ 5 1. Application Information - Please Print All Informati n ( r Property Owne4's Name Pa # Property Ow is Mailing Address ApR 2 5 LUUf Property Location / L 1 3-7 ) 7 r � 1=4lon-T 10 pide Govt. Lot Cit . State Zip Code hone umber J y,, Section 35 �� circle one i I. ype of Building (check all that apply) Lot # T �� -_ N; R � _ -_ E o i►d I or 2 Family Dwelling - Number ofBedrooms Subdivision Name (,Ye)Z) -2- / Block # sa J,. I / f e, ❑ Public /Commercial -- Describe Use ❑City of Cl State Owned - Describe Use CSM Number ❑ Village of P of I(l. Type o ermit: (Check only one box on line A. Complete line B if applicable) A ' New System y 11 Replacement System ❑Treatment /Holding Tank Replacement Only ❑Other Modification to Existing System (explain) B. El Permit Renewal El Permit Revision ❑ Change of Plumber El Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV. Type of POWTS System/Component/Device: teck uJI that n 1 ❑ Non - Pressurized In- Ground ❑ Pressurized In -Grow d At -Grade Mound > 24 in. of suitable soil El Mound < 24 in. of suitable soil El Holding Tank ❑ Other Dispersal Component (explain) ❑ Prgtreatment Device (explai V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gI d f) Dispersal Area Required (st) Dispersa Area Pr sed (st) System E �M p© � (� 0-3 fo 1 0 (0 l a C3 �3 I U 7 u 0 V VI. Tank Info Capacity in Ilotal # of Manufacturer Gallons Gallons Units a U New Tanks Existing Tanks Septic or Holding Tank [7 / Dosing Chamber O® / VII. Responsibility Statement- 1, the under ignect, respIVsibility for installation of the POWTS shown on the attached plans. Plumber's Name rint) Plumber: MP /MPRS Number Business Phone Number Plumber's Address (Street, City, State, Zip Code) a 0 " n/ Vlll. I epartijent Use Onl Approved Disapproved Permit Fee Date Issued n Iss tg Agent S' natu ❑ Owner Given Reason for Denial $ �b �Q •� / G^'t�r+� IX. Conditions of Approval/Reasons for Disapproval 3 fihr S S STEM OWNER: ) tank, effluent filter and <. dispersal cell must all be serviced / maintained as per management plan provided by plumber.�' 2. All setback requirements must be maintained '' 2 14 as per applicable code/dM1tfA !e plan, or t nolKless tha t/t x I I inches in size SBD -6398 (R. 01/07) Valid thru 01/09 r z - x"a6 - 7���w/e e%v rozr., lo ,CCJQG�GS, f Two RECTIQN N ED 1 C is o a 6 /%L X S�/. �S' �'/ %B 0+''� E CORRESP CE /��� �� ' ♦ � sp4 «d � ,. S � ��' .�o.o" , Sloes ```�� •� a c a t�; o,-� b3� ■� � Sevres y;IS�M �` ♦`.� 81 buy /c/r � ■♦ � SlScd�cDm Pi'gposc d c,J ce.E's C eti c . f L lT\ � I III TSB � ' cop Safety and Buildings 4003 N KINNEY COULEE RD commerce.wi.gov LA CROSSE WI 54601 -1831 : TDD #: (608) 264 -8777 iscons i n www.commerce.wi.gov /sb/ www.wiscbnsin.gov Department of Commerce Jim Doyle, Governor Mary P. Bu Secretary April 20, 2007 CUST ID No. 222904 ATTIC• POWTS Inspector JAMES W BOUMEESTER ZONING OFFICE BOUMEESTER & SONS EXCAVATING INC ST CROIX COUNTY SPIA 1070 HWY 35 N 1101 CARMICHAEL RD HUDSON WI 54016 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04/20/2009 Identification Numbers Transaction ID No. 1 386150 SITE: Site ID No. 724282 Domonic & Susan Ehman Please refer to both identification numbers, 120th Street above, it all correspondence with the ag ency. Town of Richmond St Croix County SW1/4, SWIA, S34, T30N, R18W Lot: 15, Subdivision: Sunset Ridge FOR: Description: Four Bedroom At -grade System / New construction Object Type: POWTS Component Manual Regulated Object ID No.: 1126775 Maintenance required; 600 GPD Flow rate; 36 in Soil minim depth to limiting factor from original grade; System(s): At -grade Component Manual, SBD- 10570 -P (R.6/99), Pressure Distribution Component Manual, SBD - 10573 -P (R.6/99) 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 enclosed approved plans and with the component manual(s) referenced above. • 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 irr accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • The area within 15 feet horizontally down slope of the dispersal cell 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 lans specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department which may include local rectors. Note: The plot plan notes the upslope edge of the cell following the 109.0' contour, not the lateral.n �Al -i positioning the dispersal cell approx. 2' upslope will solve this inconsistency. CondrtionaIly APPROVED DEPARTMENT OF COMMERCE JAMES W BOUMEESTER Page 2 4/20/2007 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 Balance Due $ 0.00 era rd M Swim POWTS Plan Reviewer, Integrated Services (608)789 -7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633 jerry.swffii@wisconsin.gov cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544, Friday, 7:00 A.M. To 3:30 P.M. RECEIV APR 12 2007 SAFE & BUI L DI NOS RESIDENTIAL AT -GRADE DESIGN Pressurized - Sloping Site INDEX AND TITLE SHEET Project Domonic & Susan Ehman 4- bedroom Residential At -Grade Owner Domonic & Susan Ehman Address 205 West Pine Roberts, WI 54023 Site Address: 1219 121st Street Legal Description SW1 /4 SW1 /4, Sec. 34, T.30N., R.18W. Township Richmond County St. Croix Subdivision Name Sunset Ridge Lot No. 15 Parcel ID Number 026- 1286 -15 -000 Plan Transaction Number Index sheet Page 1 Calculations Page 2 At -grade drawings Page 3 Laterals and dose tank Page 4 Specifications - Page 5 Management & contingency plan Page 6 Pump curve & specifications Page 7 Site Plan Page 8 Soil Evaluation Report Page 9 Designer Jim Boumeester License Number 222904 Signature n Phone Number (715) 386 -9020 Date 0 /06/07 Designed pursuant to: At -grade Component Manual for POWTS SBD- 10570 -P (R.6/99), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST - SAS (01/81) Version 4.0 (04/03) Page 1 of 9 DIVia+wr Ur QArr i r wwu oe,iL► JW1Jb q �CORRE NDEN CE EX /- S�i�7g ray✓? 044" • L4caz / pio ( o. SE A e 3 -r 312 v� DorooniG�- .Susa.r, �`.�n�n,or'y� -, d, S c rozr C c., co /. Qcre-s. 48 rl CGA 3 Ice c--n`.- ,4s5 ur. zz e- (4j,- : /X.10' -6 , Propctstd>(i-��adedsNerso-F /O � d' C as ( @ ,Z/ 0,r /,;-2. 0'4 / /;r 112 c 1. 1 CORRECTION NEEDED ' °8. °' gra �� 6cd. Two a E l %L x SS! 7S' SEE CORRESPONDENCE _ � � «d � /. s /oft o' s PraPo sac! L,,>e // / o c &L& py y "suc. you ✓.e. �- ` ` ba; /dr Se oe.- yAS7,rt 303 ' �. eV14 -17 '1 � - oPoStc/ y.Scd rCbm ` Pi c✓ cc) ee.E'.r C'e►, c . ` 12 40 y �v s.r. W /F�/ Lct' i z i I I ,:2 G� . 0 or y PRESSURIZED AT -GRADE DESIGN At -grade Design Worksheet - Sloping Site Flows and Site Data Entry. (r or c) r Residential or commercial? 400.0 Estimated wastewater flow (gpd) 600.0 Design wastewater flow (gpd) 8.00 % Site slope 109. r elev. belo lateral (ft) — kV 36.00 Depth to limiting facto 0.60 In -situ soil application rate (gpd /ft ^2) Distribution Cell Information (1 or 2) 1 Influent wastewater quality 10.00 Linear loading rate gpd /ft 9.00 Effective absorption width (ft) 10.00 9ax. effective width permitted (ft) 11 .00 Aggregate length (ft) Pressure Distribution Data Entry (c or e) c Center or end lateral connection 2 Number of laterals 0.125 Orifice diameter (in) e.g. 0.188 Not a final X , calculation 1.50 Estimated orifice spacing (ft) 2.00 Forcemain diameter (in) �b 3.10 Forcemain flow velocity (ft/sec) rte! 40.00 Forcemain length (ft) y or n j Does forcemain drain back? (�b 101.00 Pump tank elevation (ft) y or n Are laterals at highest point? 2 NA i 6.5 System head (ft) x 1.3 6.5 Forcemain drainback (gal) 7.50 Vertical lift (ft) 50.5 5x Lateral void volume (gal) 0.79 Friction l0 57.0 Minimum dose volume (gal) LP 14 Total dynamic head {ft) 30.4 System demand (gpm) 3 Lateral Diameter Selection Gallo /inch Calculator (optional) Pipe diameter Design options Design choice 805 1 Total Tank Capacity (gal) Designer 1 in I 37 1 Total Working Liquid Depth (in) must select 1.25 in x 21.8 Gal /in (enter result in cell G46) one lateral 1.5 in x x diameter 2 in x Treatment Tank Information 3 in x �1 tic tank capacity (gal) Weeks Co ncrete Manufacturer Effluent Filte I Dose Tank Information Poly ok Filter manufacturer 805.1, Dose tank capacity (gal) PL -525 v Fitter model number 21.81 Dose tank volume (gal /in) Weeks Concrete j Manufacturer Project: Domonic & Susan Ehman 4- bedroom Residential At -Grade Transaction Number: Page 2 of 9 AT -GRADE PLAN VIEW D —� 1/6 B Observation pipes (2 typical) A 9.00 ft D B 112.00 ft j-- 1/6 B 18.67 ft —+— C 11.00 ft W C D 5.00 ft 2.00 L 122.00 ft D B W 21.00 ft A x B 1000.00 ft "2 L Ems" Ca p Typical pipe. in th = Total aggregate cell A x B Slotted in the lower se and anchored U = Plowed area L x W securely. Itt s° AT -GRADE CROSS SECTION Svnthetic fabric cover 110.79 ft Finished grade Lateral elevation IRVQ�� 21QV� 109.50 ft O .�_ Observation pipe at aggregate toe 8 % Slope Surface contour 109.00 ft 2� C. and system D f 'Mw! _1 elevation T ® = 12 in. topsol and subsoil plowed layer over aggregate and tapered to toes. below L x W = 6 in. aggregate re ate below pipe(s), and 2 In. above pipe. Project: Domonic & Susan Ehman 4- bedroom Residential At -Grade Transaction Number: Page 3 of 9 PRESSURE DISTRIBUTION AND DOSE TANK Lateral Diagram - Center Connection I P IF X- -3I<- sr2 I 02 +I Laterals & force main of PVC Sch 40 Last hole drilled nest to end cap (per COMM Table 84.30 -5) Holes drilled on t he bottom of the lateral, equally spaced • = Turn-up mdball valve orcleanoutplug G y P Lateral Specifications Y I'' 0.125 Orifice diameter (in) Center Lateral connection point X 1.50 Orifice spacing (ft) 2 Number laterals 37 Orifices /lateral P 54.75 Lateral length (ft) 15.2 Lat. discharge rate (gpm) 1.50 Lateral diameter (in) 2.00 Forcemain diameter (in) 30.41 Sys. discharge rate (gpm) 1 40.001 Forcemain Length (ft) 14.79 TDH (ft) Typical Pump Chamber Layout Approved manhole cover with Weather -proof warning label and locking device junction box 10 Final grade 4., disconnect Tank component is y► Alternate properly vented outlet location 18" min. Electrical as per NEC 300 and /c Approved outlet Comm 16.28 WAC joint Tank full Inches Gallons JA Provide 1/4" A 20.3 442.9 Alarm on weep hole or antisiphon B 2.0 43.6 Pump on B device. E C 2.6 57.0 G D 12.0 261.6 102.00 ft c. d TotalsF 805.1 Pump off D 3" Bedding under tank ~ 101.00 ft Zoeller ! Pump manufacturer Zoeller Alarm manufacturer BN151 Pump model number A Pak #10 -1494 Alarm model number P /bJ c t: onic & Susan Ehman 4- bedroom Residential At -Grade Transaction Number: Page 4 of 9 N PUMP PERFORMANCE CURVE TOTAL DYNAMIC HEAD /FLOW MODEL 151/152/153 50 PER MINUTE 14 1 EFFLUENT AND DEWATERING 12 40 `\ MODEL 151 152 153 to 35- 152 Feet Melon Gal. liters Gal. Liters Gal. liters 5 1.5 50 189 89 281 77 291 t0 310 45 170 61 231 70 285 o a 25 151 15 4.8 38 144 53 201 61 231 20 6.1 29 110 44 167 52 197 8 25 7.6 16 81 34 129 42 159 f!( 30 9.1 — 23 87 33 125 36 10.7 — — 22 85 10 40 12.2 — — 11 42 Shut-off Head: 30 R (9.1m) 38 R (1I i;) 44 fi (13.4m) 2 5 0145098 0 10 20 40 80 80 90 1 GALLONS LnERS 40 80 140 260 240 2k 3 a 3o.4�a�Rwe , PER s�pP�yW'F d. Model 151 Models 1521153 CONSULT FACTORY FOR SPECIAL APPLICATIONS 6742 61A 37re 45e 3 nar 4 se • Toned dosing panels available. Electrical alternators, for duplex systems, are available and 3716 3 2742 supplied with an alarm. • Variable level control switches are available for controlling ® , 7 „ 32742 single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. Sealed Qwik -Box available for outdoor installations. See FM1420. Over 130'1 (54•C.) special quotation required. 15111521153 Series 11117 +a 1 12 151M621153 MODELS Contra Selection —� Model Volts-Ph Mode Ampe simplex Duplex 1 43M stre N151 115 1 Nan 8.0 1 2 6 3 BN151 115 1 Auto, 8.0 Included 2 or 3 E151 230 1 Non 3.2 1 2 6 3 BE151 230 1 Aub 3.2 Included 2 or 3 SK24M SK20e4 N152 115 1 Non 8.5 1 1 2 6 3 BN152 115 1 Auto 8.5 1 Included 2 a 3 E152 230 1 Non 4.3 1 2 6 3 BE152 230 1 Auto 4.3 Included 2 or 3 N153 115 1 Nan 10.5 1 2 6 3 BN153 115 1 Auto 10.5 Included 2 or 3 E153 230 1 Non 5.3 1 2a3 SELECTION GUIDE BE153 30 1 Auto 5.3 Included 2 a 3 1. Single piggyback variable level float switch or double piggyback variable level float ♦ I nOti switch. Refer to FM0477. Ail installation of controls, protection devices and wiring should be done by a qualified 2. See FM0712for correct model of Electrical Alternator E-Pak. licenser electrician. All electrical and safety coda should be followed including the most 3. Variable level control switch 10-0225 used as a control activator, specie duplex (3) recent National Electric Code (NEC) and the Occupelional Safety and Health Act (OSHA), or (4) float system. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO: P.O. BOX 16347 LoulsN119, KY 40258.0347 Manufacluvm of.. SHIP TO: 3649 Cane Run Road ® L 77847 (800) e, KY 1961 � 10av" SIMY /999 hrtp1/www. .,,W.COM " + PUMP !O. (6021 FAX (602) 77 ® Copyright 2004 Zoeller Co. All rights reserved. • 7a�' 9 At -grade System Maintenance and Operation Specifications Service Provider's Name Boumeester Excavating Phone (715) 386- 9020' POWTS Regulator's Name ( St. Croix County Zoning Dept. 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 1200 gal Maximum TSS 150 mg /L Soil Absorption Component Size 1000.0 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 ears P }./ 1 per-- Effluent Filter Inspect and clean at least once every 3 ears Ev " / 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 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 at -grade 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 at -grade structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. 6. Areas within 15 feet of the downslope toe will be protected from compaction. 7. All other construction details are as per the at -grade component manual SBD- 10570 -P (R. 6/99). i Lateral Turn -up Detail Finished ............... Grade 6 -8" Diameter Lawny Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral \ Long Sweep 90 or Two 109.50 ft --- 45 Degree Bends Same Diameter as Lateral Project: Domonic & Susan Ehman 4- bedroom Residential At -Grade Transaction Number: Page 5 of 9 At -grade 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- 10570 -P (R. 06/99) and SSWMP Pub. 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, Stats. 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 filter 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 filter 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 filter 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 filter is installed within the tank it shall cessa At -grade and Pressure Distribution System No trees or shrubs should be planted on the ade. Plantings may be made around the at- grade' ter, and the at -grade shall be seeded and mulched as necessary to prevent erosion an rom frost penetration. Traffic (other than for vegetative maintenance) on the at -grade 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 at- grade be heavily mulched as protection from freezing. Influent quality into the at -grade system may not exceed 220 mg /L BOD5, 150 mg /L TSS, and 30 mg /L FOG for septic tank effluent or 30 mg /L BOD5, 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 4 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 at -grade 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 renovating the biologically clogged absorption and dispersal media, installing new piping, and replacing other components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Domonic & Susan Ehman 4 -beds Transaction Number: Page 6 of 9 04/24/2007 12:30 7153865583 HOKE PAGE 01 .wn+►r��1t 72MVAM!i aL'iarW V. dw cam coom AND OWNWJW F VW ftAdam Ckpame ""'�°+�"'" � M18IeMbramb mh, plow 1,01006 jowt T — N. To" CIO Now B *vmr Aft 0 Lot 5 e %'!►Dw� 0 Vole MM1pM4�tiW eiab�� M%L Plow " w. aw rta'o;� f M9AsM t y lwlet� a"rrahro cir► kr drbft�'"4w�e bs. �Mptlef & u'e�p��reU �010is ��� "k ww ec,°e�e�uw rwlw„mi, neon Own rtw a • �'�1��le 6 I'Ie�mlY�rlMep�(�aitle �NATU� pp � Y00i'wdo�ner�,� APR 24,2001 12;26 MORENE83,JOt; Ju 7153865583 page 2 T Obed 6OL16WLSTLT 6Z:ZI L00Z'6Z )icN POWTS OWNER'S MANUAL & MANAGEMENT PLAN Pa _ of v FILE INFORMATION SYSTEM SPECIFICATIONS Owner d Septic Tank Capacity aqENA Permit # O / �j Septic Tank Manufacturer s DESIGN PARAMETERS Effluent Filter Manufacturer �A Number of Bedrooms ❑ NA Effluent Filter Model _ 10b 11 NA Number of Public Facility Units VNA Pump Tank Capacity Estimated flow (average) SAO al ❑ NA g al/day Pump Tank Manufacturer j1, ek El e l�2 ❑ NA NA Design flow (peak), (Estimated x 1.5) 6b gal /day Pump Manufacturer Soil Application Rate g al/day/ft' Pump Model Standard Influent /Effluent Quality ❑ NA Monthly average' Pretreatment Unit 1y,� Fats, Oil & Grease (FOG) 530 m /L 'NA 9 ❑Sand /Gravel Filter ❑Peat Filter Biochemical Oxygen Demand MOD,) <220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection 11 Other: Pretreated Effluent Quality Monthly average Dispersal Cellis) !" ❑ NA Biochemical Oxygen Demand (BOD 530 mg /L ❑ I n-Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids iTSS) S30 mg /L ❑ NA && - Grade ❑ Mound Fecal Coliform (geometric mean) 510" cfu /100m1 ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size 2 E E A 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) J5k earis) (Maximum 3 yeah) 13 NA Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA Inspect dispersal cell(s) At least once every: ❑ month(s) ED years) (Maximum 3 years) ❑ NA Clean effluent filter s IJZ✓ -� At least once every: monthls) 1 ❑ year(s) ❑ NA Inspect pump, pump controls & alarm At least once every: I ❑ month(s) ID year(s) ❑ NA Flush laterals and pressure test At least once every: ❑ monthls) Other: J% year(s) ❑ NA At least once every: ❑ monthls) E3 NA Other: ❑ year(s) ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank Inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to Check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of <12 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 tanks) 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 tankis) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. 'To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with : soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site, eva4tlon must be performed to locate a suitable replacement area. If no replacement area is available a holding tank e installed as a last resort to replace the failed POWTS. Mound and at -grade soil absorption -eystems 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 11twief11riA rle < <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 k PERSON FROM THE INTERIOR OF A TANK MAYBE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Name Phone J _ _ Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHOR ITY Name J " Name Phone 1 4 Phone ze This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &M and 83.5411), 121 & (3), Wisconsin Administrative Code. w Wisconsin Department of Commerce SOIL. EVALUATION REPORT Page of Di of safety and Buildings O in actor h mr i f - D ounty .� Attach complete site plan on paper not less than 8 1 e: in s¢e. Plan mus include, but not limited to: vertical and horizontal refer h!;, direction and arcel I.D. /- percent slope, scale or dimensions, north arrow, and 1 an i AEPT t9fb"r ,LL ff . O IrJ U tt11 viewed b Date Please print all informatio . T 3� 6 Personal information you provide maybe used for secondary purpo a (Pr § y CAQA5aW (uivfi)f. Property Owner _ lion S , , ` Govt. Lot W 1/ ��1 S T� ® N R E ( w ) f C. -! c ° „ Property Owner's Mailing Address l Lot # Block # Name or CSM# city py S Zip C ode Phone Number d City � ❑ Village own N est Road New Construction Use: esidential /Number of bedroom3 _ _ Code derived design flow rate GPO ❑ Replacement Public or commercial - Describe: - -- Parent material — Plain elevation if applicable _,.� ft• General comments and recommendations: Boring # Boring it Ground surface elev. "f . Depth to limiting factor in, ligtion Rate Horizon Depth Dominant Color Redox Description Horizon (Fxture Structure Consistence BPD Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. TY� 6 A l s � � r� Boring # 0 Boring Groun d surface elev. _ Depth to limiting factor in. f*Eff#1 olt ication Rate ® , / L De Dominant Color Redox Description _ 7exture Structure Consistence Boundary Roots GPDIfg Horizon p 'Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. .® 1Z _m ... 2MCAI L020— � � U K a ' = 30 mg/L and TSS 30 mA Effluent #1 = BOD > 30 < 220 mglL and TSS > 30 < � S: nxyl Effluent #2 BOD <_ CST Name (Please Print) wig CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 715 -246 -4516 i Property Owner _ Parcel ID # _ _ _ Page of Boring # ❑ Boring pit Ground surface elev. 101 ft. Deft: is Jaiiting factor in Soil Ap Rate Horizon P in Dominant Color Redox Description Texture n (.cure Consistence Boundary Roots GPDlf Munsell Qu. Sz. Cont. Color a;.. 3h. 'Eff#1 * EIf#2 7 - - nn a Boring # ❑ Boring ❑ Pit Ground surface elev. % Dept i o limiting factor I". Soil lication Rate Horizon Depth Dominant Color Redox Description Texture tr r Lure Consistence Boundary Roots GPDIfF in. Munsell Qu. Sz. Cont. Color f:' 3z. Sh. 'Eff#1 'Eff#2 El Boring Boring # Ground surface elev. ft. Dept -i o limiting factor in. ❑ Pit Soil ADMication Rate Horizon Depth Dominant Color Redox Description. Texture ^ `.qtr ucbire Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color < =r. Sz. Sh. 'Etf#1 '042 Effluent #1 = BOD > 30 < 220 mglL and TSS >30 < 150 mglL ` Effluent #2 = BOD < 30 mg1L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provide:- aid employer. If you need assistance to access services or need material in an alternate format, please contact the derar'ment at 608- 266 -3151 or TTY 608 -264 -8777. SBD -8330 (IL6(M) „ Soil Test Plot P n .Project Name Sunset Ridge LLC hau ird Address 838 Summer Pines Circle Hudson Wi 54016 STM #226900 Lot 1 __.5._ Subdivision Sunset Ridge pa 4/15/05 W 1/2 S W 1/4S 3 4 T 30 N /R18 W Township Richmond F] Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Survey Nail /Iron System Elevation 109.0' *HRPSame as Benchmark Scale is 1” = 40' 467' Property Line unless otherwise noted 140' .M. 106' 20' 110' B -2 14% Slope 456' Property 45' 100' Line B -3 0' IF B- 268' Property P Y Line 258'Pro a Line P rtY U 2 9 0 6 P 2 9 1 4992 Sl� Zs'� KATHLEEN H. WALSH STATE BAR OF WISCONSIN FORM 1 — 1998 REGISTER OF DEEDS ' WARRANTY DEED ST. CROIX Co., W1 RECEIVED FOR RECORD Document Number 10/10/2005 03:30PH This Deed, made between Sunset Ridge LLC Grantor, and WARRANTY DEED _ Dominic L. Ehman and Susan J. Ehman, husband and EXERT t wife ­ Grantee. Grantor, for a valuable consideration conveys to Grantee the following FEE: 11. 00 TRANS described real estate in St. Croix County State of TRA FEE: 170. 70 COPY FEE: Wisconsin (the "Property "): CC FEE: PAGES: 1 Recording Area Name and Return Address RE TURN TO: Bumet Title 7550 France Ave. S. First Floor Edina, MN 55435 ATTN; Poct Closing Central 026 - 1098 -30 -000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Lot 15, Sunset Ridge, Town of Richmond, St. Croix County, Wisconsin Located in part of the Northwest Quarter of the Southwest Quarter and part of the Southwest Quarter of the Southwest Quarter of Section 34, Township 30 North, Range 18 West, Town of Richmond, County of St. Croix, State of Wisconsin Together with all appurtenant rights, title and interests. Grantor warrants that the title to the Properties good, indefeasible in simple fee and free and Gear of encumbrances except Dated this 30th day of September 2005 (SEAL) (SEAL) upset Ridge L By Kenneth JA6evering, president (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, } ss. St. Croix County authenticated this day of Personally came before me this 3 of September 2005 the above named Kenneth J. Oevering, president of Sunset Ridge LLC to me known to be the person who executed the TITLE: MEMBER STATE BAR OF WISCONSIN foregoing instru nand acknowledge the same. (If not, authorized by §706.06, Wis. Stats) THIS INSTRUMENT WAS DRAFTED BY Notary Public, State of Wisconsin Coldwell Banker Burnet/Robert Nicholson 1301 Coulee Road My commission is permanent. (If not, state expiration date: Hudson, WI 54016 5-451 PAM A. SPENCER .) (Signatures may be authenticated or acknowledged. NOTARY PUBLIC Both are not necessary.) I STATE OF WISCONSIN ` Names of eersons signing in any ca aci must be ed or 2rinted below their signature.