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HomeMy WebLinkAbout026-1172-10-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 488097 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 026- 1172 -10 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: J m I 1 81y\ ( G5`("• 35.30.18.1371 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER P CAPACITY STATION BS HI FS ELEV. rt Septic Benchmark '7.35107.3 Dosing 1i Alt. BM Comm `�� e14,,, (,1JCA_ A,93 Bldg. Sewer Q .41 q7, 4i" g olding St/ Ht Inlet S t/Ht Outlet TANK SETBACK INFORMATION Vent o Air Intake ROAD D ep 7 J 36 /30 .4 B ottom i�4L 41 •N osing / r� � f � Header/Man. 10 Aeration D Pipe o in Bo t. System 9.0`7 f1 . ZS PUMP /SIPHON INFORMATION Final Gracl 7, 35 /q manuf acturer pp eman over 9(0 • � Yp (I dr GPM / / �� �L u._ dfJ . X 13 Z. l k model um er PC 4 f 24 , �z, C� a�ou � �� •� � •� F riction LOSS systern ea q.5 1 0,3y (0 .56 &.(01 It-orcemain Leng a. 1 I z ' �114- SOIL A55ORPTION SYSTEM DIMENSIONS INFORMATION C' CHAMBER OR e� M,;,) 7t✓SV' UNIT Length 4 th b ' �D Dia 1 u pipes) i� . -7r 1 / • . ..... .. g J4 Length Dia / Spacing ! D x Pressure Systems Only xx Mound Or At - Grade Systems Only Bed /Trench Center / • - 7Z Bed/Trench Edges Topsoil `_ k'4es ' 1 No -�,__4'es No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1:��/ ZT/ oto inspection #2: Frb Location: 1398 128th Avenue New Richmond, WI 54017 (NE 1/4 NE 1/4 35 T30N R18W) Sunset Hollow Lot 10 , L _ A Parcel No: 35.30.18.1371 1.) Alt BM Description= �� 11-t� CoJ-w- Pl„ 6I: e , C O(/ 2.) Bldg sewer length = NO---sQ. - 0 ,1� J�- - amount of cover = -7 Z Plan revision Required? Yes > No Use other side for additional Information. l.- Date _ -___. ___ -__ins - Sigrra re - _ -- - -- — CertLNm SBD -6710 (R.3/97) ` p Safety and Buildings Division County m C j ` v 201 W. Washington Ave., P.O. Box 7162 St Croix , CO Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) J - 7 D partm (608) 266 -3151 - o merce // 9$ d Sjw'w' Pkrmit Application State Plan I.D. Number In ls�QaQh Comm 83 s. Adm. Code, personal information you provide ma or secondary Purposes Privacy Law, s15.04(1 xm) Project Address f / dutiling VUafh addres ppl ton In , mation - Please Print All Information # V + / pl 31 CV Property Own / Parcel # Lo Block #' Todd Marek ci.� Property Owner's Mailing Address Property Location PO Box L 2 $ NE �� NE ,�� Section 35 City, State Zip Code Phone Number New Richmond, WI 54017 30 1 $ ( circle one) I /, /3 L T of Building check all that apply) T N; R r ✓ 7 Type g ( PP Y) ✓ a/c as � 5..10 .M• C Na "e 1 or 2 Family Dwelling - Number of Bedrooms 4 pi c, Subdivision Name CSM Number Sunset Hollow �Pub] ic/Commercial- Describe ,� / pm Use /�/� x El State Owned - Describe Use // I 16 k � � r130tyJ[]viiiage ❑l Township of Richmond III. Type of Permit: (Check only one box on line A. Complete line B if applicable) 02(c - 1172 — A. ® New System ❑ Replacement System y p y ❑ Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System B. ❑ Permit Renewal ❑permit Revision 13 Change of 13 Permit Transfer to New List Previou s Permit Number and Date Issued Before Expiration Plumber Owner f IV. Type of POWTS System: Check all that appl ❑ Non - Pressurized In- Ground ❑ Mound ? 24 in. of suitable soil m Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter IJ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber 13 Drip Line 13 Gravel -less Pipe ❑ Other (explain) V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area R sf) Dispersa7Ar Pro sed (sf) System Elevation 600 / 0.4 / 600 /S60 600 5dp 98.13 VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Z abalC A-- / PA � Septic or Holding Tank 1200 1200 1 Wieser x Aerobic Treatment Unit Dosing Chamber 800 1 1800 1 1 Wieser x VIL Responsibility Statement I , the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's S) ature MP/MPRS Number Business Phone Number Roger Nelson MP226497 715 - 273 -4444 Plumber's Address (Street, City, State, Zip C e 122 East Summit Avenue Ellsworth, WI 54011 VIII. oun /De artment Use Onl Approved isappr Sanitary Permit Fee (includes Groundwater Date Issu Issuin gent Sign a a (N tamps) Surcharge Fee) .hl en Reason for Denial IX. Conditions of Approval/Reasons for Disapproval 3� SYSTEM OWNER: Q�+\ el� �p SvI„ 6v�naf ✓�na 1. Septic tank, effluent filter and dispersal cell must all be affftft / Mllintillned as per management plan provided by phlmbef. 2. AN setback requirements must be maintained as per appNaaltrle code I ordkta xm& Attach complete plans (to the County only) for the system on paper not less than 81/2 :11 inches in size SBD -6398 (R. 01/03) 'Todd Marek P.O. Box 228 New Ricknond, WI 54017 NE' /.,NE%, S35, T30N, R 18 W N Sunset Hollow Lot # 10 Richmond Township A Croix County Scale I"= 40' Weiser 1200/800 tank o wFt t BM #1= 100.00' top of % "PVC pipe BM #2 = 99.30' top of % "PVC pipe 25' of 2 "force main A67r f r ,,,, „ r iC{ /� bhr L w .i X 0 V � f .h W �3 aa Al 2 Page 8 of 8 " Todd Marek P.O. Box 228 New Richmond, WI 54017 NE %,NE I, S 35, T30 N, R 18 W 1 Sunset Hollow Lot # 10 Richmond Township St. Croix County Scale 1 " = 40' Weiser 12001800 tank o W61 I- BM #1= 100.00' top of % "PVC pipe BM #2 = 99 30' top of % "PVC pipe 25' of 2 "force main �f' ° _ • . y QC�raa� C Z v � h W � s l Q a2 as A o . o 2o0 ' - >.G 11t l.,� Page 8 of 8 Safety and Buildings 4003 N KINNEY COULEE RD commerce.Wl.gov LA CROSSE WI 54601 -1831 isconsin TDD #: (608) 264 -8777 www.commerce.wi.gov /sb/ Department of Commerce www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary March 13, 2006 CUST ID No. 226497 ATTIC• POWTS Inspector ROGER D NELSON ZONING OFFICE NELSON PLUMBING ST CROIX COUNTY SPIA 122 E SUMMIT AVE 1101 CARMICHAEL RD ELLSWORTH WI 54011 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 03/13/2008 Identification Numbers Transaction ID No. 1246859 SITE: Site ID No. 710054 Todd Marek Please refer to both identification numbers, 140TH Street 1 above, in all corres ondence with the agenc Town of Richmond St Croix County NE1/4, NEIA, S35, T30N, R18W Lot: 10, FOR: Description: Four Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID. No.: 1064452 Maintenance required; 600 GPD Flow rate; 20 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 101), Pressure Distribution Component Manual - Version 2.0, SBD- 10706 -P (N.01 101); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s. 145.06, C371 stats. o The following conditions shall be met during construction or installation and prior to occupancy or use: APPR Reminders +OF RTMENT • This system is to be constructed and located in accordance with the enclosed approved plans and with the SEE CORRE component manuals listed above. • 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 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. • Inspection of the POWTS 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 ROGER D NELSON Page 2 3/13/2006 • 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 c onstructionf 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 �j 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 charlie.bratz @wisconsin.gov cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIC*t Residential Application 2 8 200 INDEX AND TITLE PAGE SAF S Project Name: Todd Marek 4 bedroom Mound system Owner's Name: Todd Marek Owner's Address: P. O. Box 228 New Richmond, Wl 54017 Job address: 140th 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: 10 Block Number: Parcel I.D. Number: Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Plot Pla Y C OMbfERCE A su GS SPON Designer: Roger Nelson License Number: MP 226497 Date: 02/21/06 Phone Number: 715 - 273 -4444 Signature: T1 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 (01181) Version 4.0 (R. 04/03) Pagel 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 fecal 1.50 Peaking Factor (e.g. 1.5 = 150 %) coliform of - 36 inches. 600.00 Design Flow (gpd) 7.50 Site Slope ( %) 96.80 Contour Line Elevation (ft) 20.00 Depth to Limiting Factor (in) 0.40 In -situ Soil Application Rate (gpd/ft) Distribution Cell Information 60.001 Dispersal Cell Length Along Contour (ft) = 10.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd /ft 1 I 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 3.33 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) 3.00 Estimated Orifice Spacing (ft) = 10.00 ft /orifice 2.00 Forcemain Diameter (in) _ 25.00 Forcemain Length (ft) Does the forcemain drain back? Y 88.00 Pump Tank Elevation (ft) Enter Y or N 3!✓� 6.50 System Head (ft) x 1.3 4.08 Forcemain Drainback (gal) 9.80 Vertical Lift (ft) 55.93 5x Void Volume (gal) �v 0.34 Friction Loss (ft) 60.01 Minimum Dose Volume (gal) Z� 16.64 Total Dynamic Head (ft) 24.72 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x x 1.00 1.50 x 1.25 x 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) Weis 800 - 3 25 -8456 1 Manufacturer gal /in (enter result in cell B49) Dose Tank Information Effl Fil Info rmation 800.001 Dose Tank Capacity (gal) JZabel 1 -800- 221 -5742 I Filter Manufacturer 22.241 Dose Tank Volume (gal /in) IA100 Filter Model Number Weiser I Manufacturer Project: Todd Marek 4 bedroom Mound system Page 2 of 8 Mound Plan View ..................................... ... ................................. ........... * 1/10 B ............ .3 J Observation Pipe ... ... . . . . . . . . . . . . . . . . . . . . . . . . . . K - - - - - - - - 5 A -SW F18 W ... .................................. ..... .................... ................ * ................ ................................ ............................ ........... ........ ................... ..... ... ....... .......................................... ......................................... ......................................... ......................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . L Mound Component Dimensions Down slope toe extension made. A 10.00 ft E 25.00 in H 1.00 ft K 10.44 ft B 60.00 ft F 9.25 in 1 15.00 ft L 80.88 ft 6.38 31.38 D 16.00 in G 0.50 ft W M1ft J Eil 1 (fe) Dispersal Cell Area 600.00 1500-00 (ft) Basal Area Available 10.0 (gpd/ft) Linear Loading Rate 6.001 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 99.90 (ft) 2 G H F Dis'p' e r's' a 98.63 (ft) Lateral 98.13 (ft) — 11 10 - Invert Dispersal Cell Elevation E D .... .......... ... ............. ......... .............. ....................................... ............. ......... ............... ......................................... .. ............. ......... ................. ..................................... ............... ......... . .. ................ ...... ............. 4 4 96.80 (ft) Contour Elevation 7.5 % Site Slope Geotextile Fabric Cover Shading Key T Dispersal Cell See lateral details on Topsoil Cap -_o L 1.5 ft Page 4 for number, size, Subsoil Cap and spacing of laterals. Laterals are equally ASTM C33 Sand :6 F ® E= Tilled Layer Of ft Lateral spaced from the distribution cell's n5 M Aggregate et 0 1.,. centerline in the 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 4P= Turn -up wiball valve or oleanoutplug P _I All laterals are identical IE X — } 1 Holes drifted on the bottom of the lateral equally spaced S Laterals & force main of PVC Soh 40 3 (per COMM Table 84.30 -5) Force main ocnnection via tee or cross to manifold at any point. Number of Laterals 3 Orifice Diameter 0.125 in Lateral Diameter 1.25 in Orifice Spacing (X) 3.08 ft Lateral Length (P) 58.52 ft Orifices per Lateral 20 Lateral Spacing (S) 3.33 ft Orifice Density 10.00 fe /orifice Lateral Flow Rate 8.24 gpm Manifold Length 6.67 ft System Flow Rate 24.72 gpm Manifold Diameter 1.25 in Total Dynamic Head 16.64 ft Forcemain Velocity 2.52 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and - p Comm 16.28 WAC Disconnect in. min. Tank component is properly vented E-- Alternate outlet location Forcemain diameter Weiser 800 - 325 -8456 Manufacturer 2 in. Ca aci 800.00 Gallons Volume 22.24 gal /inch A Weep hole or anti - Dimension Inches Gallons B siphon device A 21.27 473.11 B 2.00 44.48 C Pump off elevation (ft) C 2.70 60.01 -t 88.83 D 10.00 222.40 D Total 1 35.971 800.00 Dose se tank elevation (ft) 3" Bedding un er tank. 1 88.00 Alarm Manuafacturer S. J. Electro Systems Alarm Model Number I 101 HW Pump Manufacturer JGolu Pump Model Number PE 41 Pump Must Deliver 24.72 gpm at 16.64 ft TDH Project: Todd Marek 4 bedroom Mound system Page 4 of 8 Mound System Maintenance and Operation Specifications Service Provider's Name Installed by Nelson Plumbing Phone 715 - 273 -4444 POWTS Regulators 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 ft Maximum FOG 30 mg /L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 efu /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 ears Pump and Controls Test once every 3 years Alarm Should test month) Pressure System Laterals should be flushed and pressure tested every 1.5 yea rs Moundl Ins ect 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 ............. • 000000000000000 Grade 6 -8" Diameter Lawn . . Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Todd Marek 4 bedroom Mounds stem Page 5 of 8 ed g J Y 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.01101) and SSWMP Publication 9.6 (01181)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be caned 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 fitter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October - February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD 150 mg/L TSS, and 30 mg /L FOG for septic tank effluent or 30 mg /L BOD 30 mg /L TSS, 10 mg /L FOG, and 10 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 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 L(F GOULDS PUMPS Submersible Effluent Pump PE MOW SMCWWATlONS mom RATURES P — General: General: ■ Corrosion resistant • Discharge:l'h" NPT • Single phase construction. • Temperature: 104 °F (40?C) • 60 Hertz ■Cast b - maximum, continuous when • 115 volts s Thermoplastic impeller and fully submerged. • Bait -in thermal overload pro- cover. • Solids handling: 'h" tectioa with autornadc reset. ■ Upper sleeve and lower maximum sphere. • Class B insulaition. heavy duty bail bearing APPLKATWmS • Automatic models include a • 01114led design. construction. float switch. • High strength carbon steel ■ Motor is permanently Specially designed for the • Manual models available, shaft lubricated for extended following uses: • Pumping range: see PEA Motor: service life, • Mound Systenis performance chart or curve. • .33 HP, 3000 RPM ■ Powered for cor+tinuous • EffkenVDosing Systems PE31 Pump: • 12.0 Maximum amps open. • Low Pressure Pipe Systems • Maximum capad . 50 GPM • Shaded pole design ■ AN ratings are within the • Basement Draining • Maximum head: 25' TDH PE41 Motor: woddng limits of the motor. • D wvate Sump) PE41 Pump: • .40 HP, 3400 RPM ■ Quidc disconnect power • Maximum capatf!y: 60 GPM • 7.5 Maximum ard, 20' standard m amps heavy �� 1fi13 �� with • M3ldmum head: 29' TDH • PSC design h duty 1, three prong, PFSt Pump PE51 Motor 115 volt grounding plug. • Maximum Capacity GPM • •50 HP, 3400 RPM ■ CoMpleft unit is heavy duty, • MBKiff {1 head: 37' TDH • 9.5 Maximum amps pow and compact. METERS FEET • PSC design s Mechanical seal is Carbon, 40 . ,.. ceramic, MM and stainless MODELS: M1. 1e41, PE!' Stlel. 35 ■Stainless Gael fasteners. 10 y � a ......:...,_ a T. 30 _ i .. FT AGIEKYUM" �C U s I _ , y _.... .. A 22. 10 ��.y.` . .r ..+... 1 "� .. t.. .. �,.. r ..T.. ;.. �{MIIY t1NMP 11{ 150 iWt A fill A ttt+ ...,._ ...1... ' - °- t r -•! r ,...1_ ..? - --- • r ._i.a. :.� .�._. OL O G 1 0 2G 30 40 � .__... 50 �. ...� i •t_� -- 7d GPM so 0 5 ay r7� 10 is m3# Goulds Astip6 0 2002 Goulds Pumps � 1b/ 1 CAPACMY Eff•ctiw Novemha, 2002 910131141, A> ITT Industries ' v RECEIVED 1379 Wisconsin Department of ommerce n OIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buil ings N 0 V 1 Aldan a ith Comm 85, Wis. Adm. Code Steel Soil Service County Attach complete site an on ape fpQ X11 inch in size. Plan must St. Croix include, but not limit to: verb nce po t (BM), direction and percent slope, scale nd distance to nearest road. Parcel I. . P nding Please print all information. Revi d By Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 7 D Property Owner Property Location R.J.C. Development, Inc. Govt. Lot na NE 1/4 N 19 S 35 T 30 N R 18 W Property Owner's Mailing Address L Block # Subd. Name or CSM# 1868 CT Hwy " C " 10 na Sunset Hollow City State Zip Code Phone Number iry J Village 1/ Town Nearest Road Somerset I WI 1 54025 651 -488 -3051 Richmond 1 140Th St 01 New Construction Use: 01 Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD 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 98.13ft based on contour line elevation 96.80ft. Minimum 16�of ASTM C33 sand. Boring # Boring 0 Pit Ground Surface elev. 97.30 ft. Depth to limiting factor 20 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -8 10yr3/1 none sl 2msbk mfr cs 2f .5 .9 2 8 -20 10yr4/4 none scl 2 mfr gw 1f .4 .6 3 20-48 5yr4/4 fl d 7.5yr5/6 scl om mfi na na .0 .0 Boring # J Boring 1/ Pit Ground Surface elev. 97.30 ft. Depth to limiting factor 22 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - Eff#1 - Eff#2 1 0 -8 10yr3/2 none sl 2msbk mfr cs if .5 .9 2 8 -22 10yr4/4 none sl 2msbk mfr gw 1f .5 .9 3 22-48 10yr8/2 c2d 7.5yr5/6 sandstone residuum mvfr 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 s30 mg /L CST Name (Please Print) nature: - CST Number David J. Steel ��� 248956 Address Steel Soil Service Date Evaluation Conducted Telephone Number 1564 CR GG, New Richmond, WI 54017 11/11/2003 715- 246 -5085 Property Owner R.J.C. Development, Inc. Parcel ID # Pending Page 2 of 3 3 ] Boring # F Boring V1 Pit Ground Surface elev. 92.60 ft. Depth to limiting factor m• Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -9 10yr3/2 none sl 2msbk mfr cs 2f .5 .9 2 9 -24 10yr4/4 none sl 2msbk mfr gw 1f .5 .9 3 24 -60 10yr4/4 none sl /scl om J mfr na na .0 .0 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 Structure Consistence Boundary Roots GP 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 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Etf#1 *Eff#2 I * 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. r 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 10 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. 99.30Ft Top of 1/2" pvc pipe ❑ = Borings Boring Elevations B 1 = 97.30Ft B2 = 97.30Ft B3 = 92.60Ft B4 = 00.0017t o" 9 6 U o1 P 75 b s1 "Z OCR, A l !} 71 ' 002 sq. ft. 00 ° o \ - 72 954 sq. ft. \ N u \ 1.63 acres \ \ i acres: \�I I f I 1\ ! I \ \ \ \ \ Joint &Yveway Easement 275' 305' q' W F : I o ;SLOT 7� / ^ . ;7 LOTH sq. 76,251 ft. o 1 CN 0 1.75 acres: \ h N ' C - 74,251 sq. ft. \ \ N \ 1, 70 ocres� \ 72,928 sq. "ft. \ \ \ \ \ 11.67 acres: I 1 \ \ = \ 275' X305' : \ O I 190' \ \ 190 200' \ WI 00 FZ N: \ L _ _ T _ '` LOS' 8 - LO_T 9 - h �L�Q�_ 0 \ N �W 78, 851 sq. ft._ ` _ 78,851 sq. ft. '83, 001 sq. ft.\ ao N - - \ 1.8 \ acres - 1.81 acres \ 1.91 acres \ 1; o �o - yy o 0 \ U) �-j jj • \ ( \ • '190 190 200 1 • l � \ _ _ -_ _6 46' 968' .128TH VENUE --�- -- i •. ti! I —\ ' 230' 245' 33' \tt / \ 1 I o 70 \ - - -- �- -�- - -- -- - U ST. CROIX COUNTY • SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer Mailing Address f &,V 41/ 5f017 Property Address a t u (Verification required from Planning & Zoning Department for new co truction.) City /State Parcel Identification Number ©z 6 ( f7 Z to D o 0 LEGAL DESCRIPTION Property Location NC '/a , N6 '/4 , Sec. 35 T N R W, Town of -.V O Subdivision 1N 'S� -� t t-t 'o , Lot # Certified Survey Map # q , Volume , Page # Warranty Deed # y / ( p ( , Volume " , Page # Spec house no Lot lines identifiable (0 no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my /our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms -� 9' �2wyy - 3 / SIGNATURE OF APPLICANTS) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) I 6 1 9969 State Bar of Wisconsin Form 2 -2003 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., WI Document Number Document Name RECEIVED FOR RECORD 03/06/2006 11:20AN WARRANTY DEED THIS DEED, made between RJC Development, Inc. EXOPT # REC FEE: 11.00 ( "Grantor," whether one or more), TRAITS FEE: 357.00 and Todd Marek. _ COPY FEE: CC FEE: ("Grantee," whether one or more). PAGES: 1 Recording Area Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ( "Property ") (if more space Estreen & Ogland is needed, please attach addendum): _ 304 Locust Street Lots 5,10 and 11, Sunset H1llow. St. Croix County, Wisconsin. Hudson, 1NI 54018 lh 0.2.6- 1172 -05 -000: 026- 1172 -10 -000: 026- 1172 - 11-000 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 _ 0'7L / Z RJC Development, Inc. (SEAL) 1 * *By: John Carlson (SEAL) (SEAL) * * i AUTHENTICATION ACKNOWLEDGMENT Signature(s) RJC Development. Inc. B a; MT Carism I STATE OF ) authenticated on ) ss. COUNTY ) *Kristin Oaland Personally came before me on , TITLE: MEMBER STA BAR OF WISCONSIN the above -named (If not, to me known to be the person(s) who executed the foregoing authorized by Wis. Stat. § 706.06) instrument and acknowledged the same. THIS INSTRUMENT DRAFTED BY: * Attorney Kristina Wand Notary Public, State of Hudson, WI 54016 My Commission (is permanent) (expires: ) (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED ® 2003 STATE BAR OF WISCONSIN FORM NO. 2-2003 • Type name below signatures. INFO -PRO"' Legal Forms 800 - 655 -2021 %wwJnfoproforms.oDm O I r�ar'�ra SEC. 35 T. Jclnt D�Ive ( TOWN OF RICHMOND, y Eossment � NOT TO • I S89 49 15 E 305.01' I o ion' O T C5 O T t N I r - 1 r4 Ln O N N I IO ft. o 0 0 's ° LOT12 0 IJI0 L 76, 251 sq. ft, I j 0) 1.75 acres o I � OD I� I� _ —jz— S89 "E : I Z I m 305.01' N 10 N N LOT # '7 O O N q. ft. 0 0 76, 251 sq. ft. o N I I Prepared for and 1.75 ccres o 0 the request of: :res d OWNER: 01 R.J.C. Developmer K) 1868 County T.H. _ _ _ Somerset, WI 54a •49'15 "E 580.01' m o F— 651- 488 -3051 305.01' I� 'i 190.00' 200.01' I� 00 1047.75 I � Ln � I r'' o I � o I� 1 cs 0o Ln LOT 9 LOfi 1D I c 78,851 sq. ft. Z 83, 001 * sq. ft. I . O 1, 81 acres O 1.91 acres I ^ p t�+ 0 -& 00 r -- — — — O �i O Lh Ln o I'a g 0 � I i I cn ................ IG) _ I i�l�lr I I ,33 z 10 cnI < I cal I p 1 200.01 I � I i— i .01' _ •�4 Parcel #: 026- 1172 -10 -000 0311712006 01:16 PM PAGE 7 OF 1 Alt. Parcel #: 35.30.18.1371 026 - TOWN OF RICHMOND Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 04/27/2004 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - RJC DEVELOPMENT INC RJC DEVELOPMENT INC 2028 100TH ST SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1398 128TH AVE SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 1.910 Plat: 10/02- SUNSET HOLLOW 026/04 LOTS 1/17 SEC 35 T30N R18W PT NE NE BEING SUNSET Block/Condo Bldg: LOT 10 HOLLOW ('04) LOT 10 (1.910AC) Tract(s): (Sec- Twn -Rng 401/4 1601/4) 35- 30N -18W NE NE Notes: Parcel History: Date Doc # Vol /Page Type 01/16/2004 751924 2493/129 WD 10/29/2003 745128 17/4640 CSM 07/18/2003 730816 2319/598 TD 07/23/1997 1238/544 TD more 2005 SUMMARY Bill #: Fair Market Value: Assessed with: 96997 32,900 Valuations: Last Changed: 06/21/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.910 28,200 0 28,200 NO Totals for 2005: General Property 1.910 28,200 0 28,200 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