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HomeMy WebLinkAbout026-1172-02-000 IF Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitar Permit No: 463295 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Marek, Todd Richmond, Town of le - / /7a in2 p CST BM Elev: Insp. BM Elev: BM Description: d�` Section/Town /Range /Map No: Z C:S r,} �-loti 35.30.18. 3 TANK INFORMATION ELEVATION DA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. 5 .66 1 Septic , 3Lo , ZC0 Benchmark J � G � �/ 6 Dosing Alt. BM y / 7 6 -79 9 3. z2 Aeration Bldg. Sewer I CO / z . Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet \ Septic r I I g J Dt Bottom 13 .77 Dosing , 56/ (< 1 r ' / Header /Man. 3.7 Aeration Dist. Pipe Holding Bot. System 4. S S S PUMP /SIPHON inal Grade MP /SIPHON INFORMATION Z , `I7'Zc1 Manufacturer Demand St Cover e C5 GPM �.`� �•I y 9 zZ G� Model Number Q Z I � 61 ✓r / �• TDH Lift Friction Loss System ead C) T D �Ft Forcemain Length Z9 a Dia. �� Dist. to Well Z SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of TrencheA PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS [i 67 1 ­1 ­_ '\ SETBACK SYSTEM _ I TO 13 � P/L BLDDG�� IWELL LAKE /STREAM LEACHING Manufacturer: .\ INFORMATION Type Of SOtem: r �� CHA UNER OR ^' \` Model Number: DISTRIBUTION SYSTEM Header /Manifold �I Distribution �� 1 x Hole Size I � x Hole Spacing Vent to Air Intake 0 ` �/ Z Pipe(s) (05 C3) 3 4( ✓ ...- �. Len Dia Length Dia Spacing i I SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only v Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center /,7/ Bed/Trench Edges \ Topsoil \ Yes No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 7 / /6 / 65 Inspection #2: Location: 1290 138th Street New Richmond, WI 54017 (NE 1/4 NE 1/4 35 T30N R18W) Sunset Hollc Lot 2 Parcel No: 35.30.18. 1.) Alt BM Description = (� GojeA . �(b5� F V 66 Plo'i ( 2. Bldg sewer length = zo 7 0 - amount of cover = y. s Plan revision Required? 11 Yes No Use other side for additional information. — L_ v - ✓ — - - -' - - SBD -6710 (R.3197) — Date �Insepctor ignatur Cert. No. r Safety and Buildings Division County l W. Washington Ave., P.O. Box 7162 St Croix �mOns n Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) Depa rt ment of Commerce (608) 266 -3151 � //_ "2 State Plan I.D. Number /� �/ Z sr, Sanitary Permit Application T In accord with Comm 83.21, Wis. Adm. Code, personal information you provide may be used for secondary purposes Privac Project Address (if different than mailing address) L Application Information - Please Print All Informath n R N L EECEIVED (1 0 138th street Property Owner's Name -' ! F 1 �� Parcel # Lot # Block # - -- ' Todd Marek 3 �__LL— 1 2 Property Owner's Mailing Address i C1 U U Property Location P. O. Box 228 ZONING OFt ICE NE ,, /a NE Y., Section 35 City, State Zip Code Phone Number New Richmond, WI 54017 715 - 377 -6240 30 1$(cireleone) II. Type of Building (check all that apply) T N; R r 4 Bedr Subdivision Name CSM Number [D 1 or 2 Family Dwelling - Number of Bedrooms ooms Public /Commercial - Describee Use n y Sunset Hollow ❑ State Owned -Describe Use / ' / �LUrJY &5J. a Z 0 fl (O x � Elcth' []Village Township of Richmond III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. 0 New syste ❑ Replacement System ys ep ys ❑ Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System B. [I Permit Renewal ❑Permit Revision ❑Change of 11 Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS System: Check all that appl ❑ Non - Pressurized In- Ground 0 Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ 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 0 Drip Line ❑ Gravel -less Ripc ❑ Other (explain) V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Ap lication Ra gpdsf) Dispersal Area Re uired (sf) Dispersal Area Prop ed (sf) System Elevation 600 0.4 , o 600 ,SOU 600.32 mA 95.50' VI. Tank Info Capacity in Total Number Kefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank 1200 1200 1 Weiser x Aerobic Treatment Unit _ Dosing Chamber 800 1 800 11 Weiser x VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plu 's Signature MP/MPRS Number Business Phone Number Roger Nelson MP226497 715 - 273 -4444 Plumber's Address (Street, City, State, Zip e) 122 East Summit Avenue Ellsworth, WI 54011 VI oun /De artment Use Onl Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued I ing A t Si o Stamps) Surcharge Fee) El Owner Given Reason for Denial 2 IX• Conditions of Approval/Reas for Disapproval Qq 1 al c U� yytlui Y STE M OW N E►z___ ��.�,�,�j�;�- K-�/Z. �rLG(�[%/ f 2�Z� � � � - / Septic tank, effluent filter and � • v G ��=� dispersal cell must all be serviced / maintained / as per management plan provided by plumber /3�CdY2�' dyi,d vy.�� 2. All setback requirements must as per applicable code /ordinances. Attach complete plans (to the County only) for a syste on paper not less than 8112 x 11 inche in size SBD -6398 (R. 01/03) r � ` GJ r , 's cr � 2oa /8'ca T , f.. / SG"0 02 tam = ToP o 7 s7e.--/ Fes., << pd� �` /ao, ae' 9s• oo :Sk.o'm 4-4 O 44`9' lo�- /c'ha- - c,GiAe,l-- � -� car N " /Va r 7'A drop t r t L c L, c r.� 4 L O WEI L 1` h v 3 t r 7' /r 83 43 <g m 2 I Safety and Buildings 4003 N KINNEY COULEE RD commerce.wi.gov LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 www•commerce.wi.gov /sb/ i scons i n www.wisconsin,gov Department of Commerce Jim Doyle, Governor Cory L. Nettles, Secretary January 24, 2005 CUST ID No.226497 ATTN: POWTS Inspector ROGER D NELSON ZONING OFFICE NELSON PLUMBING ST CROIX COUNTY SPIA 122 E SUMMIT AVE 1101 CARMICHAEL RD ELLSWORTH WI 540II HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 01/24/2007 Identification Number Transaction ID No. 1103124 SITE: Site ID No. 694236 Todd Marek Please refer to both identification numbers, 138TH Street above, in all correspondence with the agency. Town of Richmond St Croix County NE 1/4, NE 1/4, S35, T30N, R18W Lot: 2, Subdivision: Sunset Hollow FOR: Description: Four Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 1001237 Maintenance required; 600 GPD Flow rate; 24 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 /01); 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. ConAT4 No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, A PPR( stats. The following conditions shall be met during construction or installation and prior to occupancy or use: DEPARTMENT 01 Approval Requirements: N OF FTE1 • This system is to be constructed and located in accordance with the enclosed approved plans and with the SEE CORRESI "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD - 10691 -P (N.01 /O1) and the SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST (0 1/8 1) • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • The changes made to this plan on 1/24/05 by this reviewer were acknowledged and approved by the system designer. The tank is specified to be a Weiser WLP -1200 /800 -MR with 36 inches liquid level and 22.24 gallons per inch. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c • 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. ROGER D NELSON Page 2 1/24/2005 • 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. Stat • 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. Owner Responsibilities: • Comm 83.52 Responsibilities. 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. • Comm 83.55 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. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall 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 Charles L Bratz POWTS Reviewer II , Integrated Services WiSMART code: 7633 (608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday ebratz@conunerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Todd Marek 4 bedroom Mound system Owner's Name: Todd Marek Owner's Address: P. O. Box 228 New Richmond, WI 54017 Job address: 138th Street Legal Description: NE 1/4, NE 1/4, S 35, T 30, N R 18 W Township: Richmond County: St. Croix Subdivision Name: Sunset Hollow Lot Number: 2 Block Number: Parcel I.D. Number: Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings RECEIVED Page 4 Lateral and dose tank ►y��l y Page 5 System maintenance specifications JAN 19 2005 Page 6 Management and contingency plan N O Page 7 Pump curve and specifications CONME Page 8 Plot Plan AND RcE SAFETY & BUILDINGS i NCs , ONDENCE Designer: Roger Nelson License Number: MP 226497 Date: 01/11/05 Phone Number: 715 - 273 -4444 Signature: h, 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 4.0 (R. 04/03) Page 1 of 8 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 83 -44 -3 in -situ soil treatment for 1.50 Peaking Factor (e.g. 1.5 = 150 %) fecal coliform of <= 36 inches. 600.00 Design Flow (gpd) 7.00 Site Slope ( %) 94.50 Contour Line Elevation (ft) " 24.00 Depth to Limiting Factor (in) 0.40 In -situ Soil Application Rate (gpd /ft Distribution Cell Information 67.001 Dispersal Cell Length Along Contour (ft) = 8.96 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd /ft 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (c or e) a Center or End Manifold 2.99 Lateral Spacing (ft) If N above, enter the elevation (ft) 3 Number of Laterals of the highest point, 0.125 Orifice Diameter (in) (e.g. 0.25) 4.00 Estimated Orifice Spacing (ft) = 11.77 ft /orifice 2.00 Forcemain Diameter (in) 150.00 Forcemain Length (ft) Does the forcemain drain back? Y 81.00 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 24.47 Forcemain Drainback (gal) 14.17 Vertical Lift (ft) 40.03 5x Void Volume (gal) 1.50 Friction Loss (ft) 64.50 Minimum Dose Volume (gal) 22.17 Total Dynamic Head (ft) 21.01 System Demand (gpm) Lateral Diameter Se_ lection Manifold Diameter Selection in. dia. options 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 Total Tank Capacity (gal) 1200.001 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Weiser 800-325-84561 Manufacturer gal /in (enter result in cell B49) Dose Tank Information Effluent Filter Information 800.001 Dose Tank Capacity (gal) JZabel 1-800-221-57421 Filter Manufacturer -' ✓, y` 20.601 Dose Tank Volume (gal /in) IA100 I Filter Model Number Weiser Manufacturer Project: Todd Marek 4 bedroom Mound system Page 2 of 8 I Mound Plan View T : 1/10 B::: ....:........: 3:.:.. J Observation Pipe 3 l K L '1/10 -- — T W l 0] A . . :..... ... B ........ z .......................... ............................... . L Mound Component Dimensions Down slop toe extension made. A Al2.00 ft E 19.53in H 1.00ft K Aft ft B ft F 9.00 in z 13.43 ft L ft D in G 0.50 ft J 5.58 ft W 600.32 1 (ft Dispersal Cell Area 1 1500.00 (ft Basal Area Available 8.96 (gpd /ft) Linear Loading Rate 1 6.70 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 97.25 (ft) F .. " " Dispersal 96.00 (ft) Lateral atera 95.50 (ft) Invert Dispersal spersa Cell ........:.:.:.:.: t Eleva E D t .:.:.:.:.:.:.:::::::.. .. : 94.50 (ft) Contour Elevation 7 . 0 .0 /o Site Slope Geotextile Fabric Cover Shading Key c T Dispersal Cell See lateral details on 1� Topsoil Cap c a 1.5 ft Page 4 for number, " " " "' Subsoil Cap c d size, and spacing of 0 ASTM C33 Sand `-° 1d F laterals. Laterals are [� 0 Tilled Layer H 0.5 ft Typical Lateral equally spaced from the ❑5 Aggregate v c u I distribution cell's centerline in the 0 A distribution cell (AxB). Project: Todd Marek 4 bedroom Mound system Page 3 of 8 End Connection Lateral Layout Diagram Center the laterals over the A & B dimension Iv la .m'ball valve is snout lu P P 9 P All laterals are identical I<- X—}I Holes drilled on the bottom of the lateral equally spaced S Laterals & Force main of PVC Sch 40 S (per COMM Table $4.30 -5) Force main connection via tee or cross to manifold at any point. Number of Laterals 3 Orifice Diameter 0.125 in Lateral Diameter 1.00 in Orifice Spacing (X) 4.09 ft Lateral Length (P) 65.44 ft Orifices per Lateral 17 Lateral Spacing (S) 2.99 ft Orifice Density 11.77 ft /orifice Lateral Flow Rate 7.00 gpm Manifold Length 5.97 1 ft System Flow Rate 21.017ft gpm Manifold Diameter 1.50 1 in Total Dynamic Head 22.1 Forcemain Velocity 2.15 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and � Comm 6.28 AC in. min. 1 W Disconnect --ii -- Tank component is properly vented =:? F— Alternate outlet location Forcemain diameter Weiser 800-325-8456 Manufacturer —r 2 in. Capacity[ 800.00 Gallons I Vo ume 28:60 I/i h 9 a nc A , , :' Y Weep hole or anti - Dimension Inches Gallons B siphon device A r 23-48 yyl 488:30 B 2.00 41.20 C Pump off elevation (ft) C 7' 3 13 64:50 81.83 D 10.00 206.00 D Total 1 38.831 800.00 Do se tank elevation (ft) 3" Bedding under tank. 81.00 Alarm Manuafacturer IS. J. Electro Systems Alarm Model Number 101 HW Pump Manufacturer IMyers Pump Model Number ME40 �— Pump Must Deliver 21.01 gpm at 22.17 ft TDH Project: Todd Marek 4 bedroom Mound system Page 4 of 8 r — - 7 o t= 7 ME40 Series 4/10 HP Effluent and Drain Water Pumps Performance Curve MODEL ME40 EFFLUENT PUMP CAPACITY LITERS PER MINUTE O 50 100 ISO 200 250 300 350 40 IZ 35 10 W 30 IA- 2•/? N 25 e Z •r T 17 hf 20 6 J Q 15 Q 4 0 10 ~ 2 S i 0 H tj 0 0 10 2 30 40 50 60 70 80 90 100 CAPACITY GALLONS PER MINUTE 1101 Myers Parkway, Ashland, Ohio 44805 -1923 419/289 -1144 FAX 419/289-6658 Telex W7443 1'u 7 o K3326 7/91 Printed in U.S.A. � -A i--- --- '+r i �r scYr w+a—• vv„ ��.r .J eri n ir. •+—a e Mound System Maintenance and Operation Specifications • Service Provider's Name Installed by Nelson Plumbing Phone 715 - 273 -4444 POWTS Regulator's Name St. Croix County Zoning 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 600.32 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 ears 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 Valve Plug or Ball Valve rin S kler a ve B ox Sprinkler Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Todd Marek 4 bedroom Mound system Page 5 of 8 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, 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 finer 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 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. Continency 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 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Todd Marek 4 bedroom Mound system Page 6 of 8 r Sca /r / " = Yo' 43 M = To o � Sy mac/ 7,' p o T n S aryt�• .Z � ` j S_ 0 O ' S�,� -QGC � �J '�¢" /c'hO Ihy�/5�� � C' • /�c� 0 v O GUEL L {` V i� h► f nOk sC \ y C�c d�, v 3 � �'�� �•.�'' � wa y x t 7'Yr Sort- Q 3 917' dz d� X04 t14 8 13 2 Wisconsin Department of Commerce 011_ �It(L;0N R PORT Page _ I of Division of Safety and Buildings in accordance h Comm 85, Wis. Ad��mnn.nnC /'ode County Attach complete site plan on pape o s 8 2 ch in Pi. n4 34 � �` include, but not limited to: vertical re r int BM �,, d and Parcel I.D. percent slope, scale or dimension o and a��d�s (p(p1�Toad. Please print all informs ZONING O FFICE ew Date .�. Personal information you provide may be used for secondary purposes (Privacy Law, s. 55.04 (t) (m)). �0 Properly Owner Property Location ��! 1 6 / n /�/� Govt. Lot Z 1/4 1/4 S--5 T30 N R ! E Lot # (o W Property Own Address Block # Subd. Name or CSM# f- ter'St7� ZZ� City to Zip Code Phone Number 0 City C3 Village 297own Nearest Road t2i 5'60 ? 1 ew Construction Use: Residential / Number of bedrooms Code derived design flow rate G _ GPD ❑ Replacement /,� Public or com_merr escribe: _ - - -- -- - - - - -- - - - - — Parent material (/ �!lL�s� `�' !/ �[� fl> Flood Plain elevaton if applicable ��i - ft. General comments / and recommendations: 0 7�L 6 V_ �rjng Boring # t Ground surface elev. �� ft. Depth to limiting factor �n Soil f licabon Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPO/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff #1 'Eff#2 Boring # Boring /-J A Pit Ground surface elev. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff #1 'Eff#2 Jr Effluent #1 = BOD > 30 < 220 mg#L and TSS >30:5 150 ' Effluent ##2 = BO D < 30 mg/L and TSS < 30 rng/L CST Numbr CST Name (Please Print) ' �Oj Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephony Number 1008 192nd Ave, New Richmond, WI 54017 715 -216 -4516 I . Property Owner Parcel ID # Page of ® Boring # Boring ,7E5-pit Ground surface elev. ' © ft. Depth to limiting factor _3q in. Soil Applilat n Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 d fl l/ Z t6 3' ?.� . S r! i a Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. C EINplication 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 Boring ❑ Boring # El pit surface elev. ft. Depth to limiting factor in. Pit Soil Application Rate Horizon Depth Dominant Color Redox Description- Texture Structure Consistence Boundary Roots GPDAf in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 I `Eff#2 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ` Effluent #2 = BOD < 30 mg/L and TSS _< 30 mgtL 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. 580.8330 (RWOO) r 4 Soil Test Plot Plan Project Name Todd Marek Sha ird Address P.O. Box 228 New Richmond Wi 54017 C M #226900 Lot 2 Subdivision Sunset Hollow Date 10/29/04 NE 1/4 NE 1/4S 35 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 *HRPSame as Benchmark Alternate Benchmark Top of Survey Iron @ 95.0' v�WTKietid 4� 6,e 4 L4 G�'Lr ,, AL Scale is 1" = 40' unless otherwise noted AL 275' Property Line 70 Slope 45' B -3 50 , 93' 40' 30' B� 1 B -295 138th St. 5' *B 1t.B.M. 288' property Line RECEIVED • 1371 Wisconsin Department of Commer NOV j 3 200OIL VALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Co m 85, Wis. Adm. Code Steel Soil Service Attach complete site plan on r not I I in size. County Plan must St. Croix include, but not limited to: verfi t BM n and percent slope, scale or dimensions, north arrow, and location a is nce to nearest road. Parcel I.D. Pending Please print all information. Reviewed By Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 7 = n Property Owner Property Location R.J.C. Development, Inc. Govt. Lot na NE 19 NE 1/4 S 35 T 30 N R 18 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1868 CT Hwy " C " 2 na Sunset Hollow City State Zip Code Phone Number J City I Village 01 Town Nearest Road Somerset WI 1 54025 1 651- 488 -3051 Richmond 1 130Th Ave e New Construction Use: 01 Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD I Replacement I Public or commercial - Describe: Parent material Benches and large drainageways of ground moraines. Flood plain elevation, if applicable na General comments and recommendations: Mound design, system elevation 98.60ft based on contour line elevation 97.60ft. Minimum 12 "of ASTM C33 sand. Boring # I Boring 0 Pit Ground Surface elev. 98.20 ft. Depth to limiting factor 24 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fe in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I *Eff#2 1 0 -12 10yr3/2 none sil 2msbk mfr cs 2f .5 .8 2 12 -24 10yr4/4 none sicl 2msbk mfr cs 1f .4 .6 3 24 -60 10yr8/2 c2d7.5yr5/6 sand stone residuum mfr na na .0 .0 Boring # _j Boring 01 Pit Ground Surface elev. 98.20 ft. Depth to limiting factor 24 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -11 10yr3/2 none sit 2msbk mfr cs 1f .5 .8 2 11 -24 10yr4/4 none sicl 2msbk mfr cs lvf .4 .6 3 24-48 10yr8/2 c2d7.5yr5/6 sand stoni a residuum mfr na na .0 .0 * Effluent #1 = BOD? 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD <30 mg/L and TSS < 30 mg /L CST Name (Please Print) Signature: CST Number David J. Steel 248956 Address Steel Soil Service Date Evaluation Conducted Telephone Number 1564 CR GG, New Richmond, WI 54017 11/10/2003 715- 246 -5085 Property Owner R.J.C. Development, Inc. Parcel ID # Pending Page 2 of 3 3] Boring # J Boring Pit Ground Surface elev. 96.40 ft. Depth to limiting factor 28 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 -15 10yr3/2 none sil 2msbk mfr cs 1f .5 .9 2 15-28 10yr4/4 none sicl 2msbk mfr cs 1vf .4 .6 3 28 -60 10yr8/2 c2d7.5yr5/6 and ston residuum mfr na na .0 .0 F-1 Boring # I Boring �.f Pit Ground Surface elev. ft. Depth to limiting factor in. Sol 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 F-1 Boring # I Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture 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 >30 < 150 mg/L * Effluent #2 = BOD <30 mg /L and TSS < 30 mg /L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 -266 -3151 or TTY 608 - 264 -8777. Page 3 of 3 STEEL'S SOIL SERVICE INC. David J. Steel 1564 Cty Rd GG CST - POWTSM RJC Development Co. New Richmond,WI 54017 Lic. #248956 NE1 /4,NE1 /4,S35,T30N,R18W Bus.(715) 246 -6200 Town of Richmond, St. Croix Co. Fax.(715) 246 -9372 Sunset Hollow, Lot 2 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of this test may or may not be as shown, as permanent lot lines were not established at the time the soil test was conducted. Legend 1 " = 40' ♦ = Benchmark Ele. 100.00Ft Top of 1/2" pvc pipe • =Alt Benchmark Ele. 100.1 OFt Top of 1/2" pvc pipe ❑ = Borings Boring Elevations B 1 = 98.20Ft B2 = 98.20Ft B3 = 96.40Ft B4 = OO.00Ft 22 �aS Hof �o 13 Z 71 5' r56u�ti ' L V. * line of _OT _3, C.S C.S the NE 114 - --- TED LANDS Ri �- — 18 VOL. 9, PG. -2551 _� S8949'4 3"E 2606.6 =- - _ Cent ll _ S89'49'43 "E 966.32' L ' _� -_- - ---- _130 _7H_- - AVENUE - - _ - - - - ±'4 - � • � �- - _ti • � • ti --- X355'- � � , � - -.._ . - 208 --�,, v j�y`•w \ - ------ c - -- � -� -�` -- - - - -�. 33 x -79, 240 sq. ft. \ N \ I '1.82 acres ,\ LOT �} -82,410 sq. ft. z i 1.89 acres ,\_ - v .308 o I I j QI \ k I \: o , I �I 280' \ cn. �t� z I , 1. \I iv it \ 71,002 sq. ft. \ \ h \ 1.63 acres N -79 sq. ft. r 1.81 acres it LOT 7� ' o \ N o \ 288' \ 1 N r 74, 251 sq. ft. \ cw 1. 70 acres \ \ \ d- \ \\ : \ 275' \ o ^ LOT 3 N � `` \ 190' �\ 190' - \\ 0 N \79,319 sq. ft. i \\ \ \ `1.82 acres \ i � - ._ Jan 25 05 06:3 Sp ' Todd Marek 17152469341 p.l V /C7 /LVUO I MO inn IV Lis V444 i'{LL JUf1 V►e tfltto Wj VV 1 /VV I ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND 1 ! i OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address 1U eiJ k I C. L y✓lO.ti� Z SYa! 7 Property Address 5 f (Verification required from Planning Department for new construction) �f t City /State �IM, ( — Parcel Identification Number a&44 l ��y LEGAL DESCRIPTION Property Location !" � 'l., n/" Sec. , T,3aN - R /Y Town of !C G�4 M OAI Subdivision �LC4 /L,/,; 140 LC o LA J ( PIS) ,Lot # ' Certified Survey Map # Voltune J _ Page # Warranty Deed # tD / 'O 27 Voluano Z Page # 0 . Spec house J&yes O no Lot lines identifiable $ yes O no SYSTEM HAINTENA✓NCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance eansists 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 fluiction of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restrictedplumber or a liccnsedpumper 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 113 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 staring that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 d Voe three ear expiration date. SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all staternents on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the fop, desc bcd ove, by virtue of a warranty deed recorded in Register of Dceds Office. SIGNATURE OF APPLICANT DATE '""•" Any information that is mis- repfesented may result in the sanitary permit being revoked by the Zoning Department. ** •w Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is shade in the warranty deed U. 2564 P 607 761627 \` STATE BAR OF WISCONSIN FORM 2 - 1999 REGISTER OF DEEDS Document Number WARRANTY DEED ST. CROIX Co., WI RECEIVED FOR RECORD This Deed, made between RJC Development, Inc. 05!05/2004 09 :30AN Grantor, and Todd Marek WARRANTY DEED Grantee. EXEMPT ii Grantor, for a valuable consideration, conveys and warrants to Grantee REC FEE: 11.00 the following described real estate in St. Croix County, State of Wisconsin TRANS FEE: 546.00 (if more space is needed, please attach addendum): COPY FEE: Lots 2, 3, 7, S and 11, Sunset Hollow. St. Croix County, Wisconsin. CC FEE: PAGES: 1 Recording Area Name and Return Address KRIST111A OGLAND ATTORNEY AT LAIN P.O. 60)( 339 HUDSON, 1N1 54016 Part of. 026 -1099- 10-000 Parcel Identification Number (PIN) This is not homestead property (is) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this ! day of May , 2004 RJC Development, Inc. _ J * By: Roberta J. Car n * * - AUTHENTICATION ACKNOWLEDGMENT Signature(s) RJC D evelopm ent, Inc. STATE OF ) By: Roberta J. Carlson ) ss. County ) authenticated this d y of May 2004 Personally came before me this day of the above named * Krishna Oglan TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person(s) who executed the foregoing authorized by § 706.06, Wis. Stats.) instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY Attorney Kristin Og land Hud WI 5401 _ Notary Public, State of My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) ) * Names of persons signing in any capacity must be typed or printed below their signature. Information Professionals Co., Fond du Lac, WI STATE BAR OF WISCONSIN 8DD -655 -2021 WARRANTY DEED FORM No. 2 -1999 i I LOT 3 C S. M N., line of 'comer - - - -' - t , ".; _AT TED LANDS 30 -18 VOL. 9, PG. 2551 he NE ��4 ---- _- - - - - -- 49'4 2606.: -- - - � �_-- L S89'49'43 "E ' 966.32' co � ZZ= ___ �� _ 30 T -=208' VENUE== =208'' - T r--T ►�; -�. =-�— `355'- - f sq. ft. \ \ 79, 240 sq. ft. 89 acres : '1.82 acres \ �\ 1.58 acres = \ - \ `° \ \ ! 2 --� \ --►�.. \ � L.B. O. =10 3. O' t _ 1 308' Q ! Drainage \\ L, n \ Eosemen t ! . ,if 280 \ -1 c r fi \ :LOT 6, \ \ �; d 71,002 sq. ft. acres 1 �T i \, \ 79,060 sq. 2 ft. i N 1.81 acres - _ - (.' 1V3 A. `� - ^ =' 275' A ' 65..979 sq. ft. = - :`•, 1 i 1.51 acres = ® ® �" L.B.O.= 1023.0'f ' 288' [ SLOT 7 ' o ' r r° — `74,251 s ft. \'� N N \� 1.70 acres\ Wit - o I n LOT gin; _ \ r\ . <y 275' \ \ � �79, 3i 9 sq. ft. �``! �+ 190' 190' \ r \ 1.82 acres rl � �, �, - ' d T �E694�S T L T i{a..iew ppol dSZ : 60 SO SZ Uer