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HomeMy WebLinkAbout030-2121-20-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix afety and Building Division INSPECTION REPORT Sanitary Permit No: 499251 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: Hillman, Brian St. Joseph, Town of 030 - 2121 -20 -000 CST BM Elev: Insp. BM Elev: BM Description: Section /Town /Range /Map No: /) Z C S- 30.30.19.984 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER ; N CAPACITY STATION BS HI FS ELEV. 5.'77 ioy, 9 Septic tyt 60 Benchmark 3 5 /6Z (A 9 12- Dosing \ Alt. BM Abratlort— / Bldg. Sewer 7,7(v y7, 25 ( Holding St/Ht Inlet '1- 9 S. 7 3 TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom /oL/ fig- 3r i 35 — z , s1 9z. 2-3 Dosing 1 -62, � 3 � ! ' 39 '�• y� i Header /Man. /aa • 3Cd N — Aeration Dist. Pipe S. L Holding Bot. System t. Z PUMP /SIPHON INFORMATION Final Grade `3 3 1-6 5 49Z aiC Manufacturer Demand St Cover GO GPM Model Number Zj,7Z (�7 .-7 TDH Lift Friction Loss System Head TDH Ft g.i5 0.37 (,,5d Forcemain Length I Dia. r r Dist. to Well Z SOIL ABSORPTION SYSTEM BED /TRENCH Width I Length � / No. Of_Tren es PIT DIMENSIONS No. Of Pits Inside Dia. ` Liquid Depth DIMENSIONS /Q l / 1 SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: /z / /� / UNIT Model Number: 1 DISTRIBUTION SYSTEM w -- Header /Manifold ti r � Distribution �3 1 �1 I x Hole Size I x Hole Spacing y Veno Air I ke Length �O• (o Dia t ( Pipe(s) n 5'8 • 5% Dia I 4 Spacing 3. 33 ✓ �-o. SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over I Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center / • Bed /Trench Edges Topsoil Yes No es No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: �/ / 15 / 0(n 0 Inspection #2: / Location: 373 132nd Avenue ' Unknown (SW 1/4 SE 1/4 30 T30N R19W) The Sanctuary Lot 2 5 d' 1 S �l Parcel No: 30.30.19.984 1.) Alt BM Description = 1 � CdJ C Z G OVA 6 5 w J s�o 2.) Bldg sewer length = 1 5 3 - amount of cover = 1 Plan revision Required? Yes No Use other side for additional information. Cert No Date Insepctor's i ature SBD -6710 (R.3/97) Safety and Buildings Division County NVI �� 201 W. Washington Ave., .O. Box 7162 St Croix Q/�0ns Madison, Wl 537 162 Sanitary P7 N l �` her (to befilled in by Co.) De artment of Commerce (�$) 266-3 ZSI State Plan I.D. Number Z - Z Sanitary Permit Application C7 - In accord with Comm 83.21, Wis. Adm. Code, personal information you pro may be used for secondary purposes Privacy Law, sl 5.04(1)(m) Proj (if different thaji mailing a7 I. Application Information- Please Print All Information REC E'VE 132 Avenue 2 Property Owner's Name t # J Block # 0 3 o... - Z(ZI Brian Hillman NU 1 0 2006 2J — ©oO 2 Property Owner's Mailing Address rty Location 984 Sherman Lane 01 CROIX COUNTY" Shy SE City, State Zip Code - _ - ' /., %. Section 30 Hudson, WI 54016 30 1 gcircleone) H. Type of Building (check all that apply) S t T n Name CSM Number R r Q I or 2 Family Dwelling - Number of Bedrooms q m S !^ Subdivision Public/Commercial - Describe Use The Sanctury ❑ State Owned - Describe Use 13City_Qvillage Orownship of St. Joseph III. Type of Permit: (Check only one boa on line A. Complete line B if applicable) - l Z( - U — Ov0 $ A. 0 New Syst 0 Replacement System ❑ Treatment/Holding Tank Replacement Only 0 Other Modification to Existing System B. 0 Permit Renewal 0 Permit Revision 0 Change of D Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner t K � 4" IV. T of POWTS S stem: Check all that a 46 !e* — 0 Nan - Pressurized In -Ground 0 Mound?! 24 in. of suitable soil At -Grade ❑ Single Pass Saul Filter 0 Constructed Wetland 0 Pressurized in -Ground 0 Holding Tank E3 Peat Filter 0 Aerobic Treatment Unit 0 Recirculating Sand Filter 0 Recirculating Synthetic Media Filter ❑ Leaching Chamber 0 Drip Line ® Gravel -less Pipe 0 Other (explain) i V. Dispersalffreat ment Area Information: Design Flow (gpd) Design Soil Application Rate(gpds spersal Area Required (sf) Dispersal Area Proposed (s System Elevation 600 0.5 (�, p Sw,Q 600 600 99.53' VI. Tank Info Capacity in Total Number 0 Manufacturer Prefab Site Steel Fiber Plastic Gallons ss Gallons of Units t.� y � t Q f� - 7rt107 oncrete Constructed Glass New Tanks Tanks Septic or Holding Tank 1200 1200 1 Wieser X Aerobic Treatmant Unit Dosing Chamber 800 1800 1 Wieser VII. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plum s Sign MP/MPRS Number Business Phone Number Roger Nelson MP226497 715 - 273 -4444 Ad Plumber's Address (Street, City, State, Zip Cod 122 East Summit Avenue Ellsworth, WI 54011 VIII. Coun /De artment Use On Approved ❑ Di ed Sanitary Permit Fee (i hides Groundwater Date Issued Issuing Ag t Signature o ) R Surcharge Fee) 2 eason ial DL Condition of A fro 1 SYSTEM OWNER: 1 Septic 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 as per applicable code /ordinances. Attach complete plans (to the Co ®ty only) for the system on paper not less than 81/2 x 111ncim in size SBD -6398 (R. 01/03) i l ' Brian h Xman 984 Sherman Lane Hudson, WI 54016 SW %,SE%, S30,T30N,R19W`sG N � The Sanctuary Lot # 2 Richmond Township �r St. Croix County Scale 1 " = 40' a <. Weiser 12001800 tank BM #1= 10&00' top of 314" steel pipe BM #2 = 99.11 top of 314" steel pipe 35' of 2 "force main ` q ' 3. V25 ACRCS °� 3 g6 �grn z Naw sG N ®wEt t 3 d �, ✓ s w � 1�1 .O O Y r 3 7 3. .2,:2' E4: Z- Page 8 of 8 Safety and Buildings 4003 N KINNEY COULEE RD Got'Y1t11erCe.Wl.gov LACROSSE WI 54601 -1831 TDD #: (608) 264 -8777 Isconsin www.coe.wi.gov/sb/ Department of Commerce www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary November 07, 2006 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 54011 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 11/07/2008 Idertificatian Numbers Transaction ID No. 1340226 SITE: Site ID No. 720349 Brian Hillman Please refer to both identification numbers, 132 Avenue above, in all corres ondence with the : a enc . Town of Saint Joseph St Croix County SW1 /4, SE1 /4; S30, T30N, R19W Subdivision: The Sanctuary; lot 2 FOR: Description: Four Bedroom Mound System / New construction Object Type: POWTS Component Manual Regulated Object ID No.: 1106654 Maintenance required; 600 GPD Flow rate; 14 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 /O1), Pressure Distribution Component Manual - Version 2.0, SBD - 10706 -P (N.01101) 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 10L0I(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 located and constructed 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 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. Stats. • The area within 15 feet horizontally below the system shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the tank/filter for maintenance purposes must be provided per Comm 84.25(7), Wis. Adm. Code. • Note: Comm 83.22(7) requires that a cony of the approved plans specifications and this letter shall be on -site duruig_construction and open to mspection by authorized representatives of th e Department, which ma v include local inspectors. P! OWT.S. Conditionally [V.Pk DEPARTMENT OF COMMERCE n1%1%C1n1d dnC QACETV A&M 01116 ni+.tre 1 r MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Brian Hillman 4 bedroom Mound system Owner's Name: Brian Hinman FjF cE1VED Owner's Address: 984 Sherman Lane sod Q 6 2��6 Hudson, WI 54016 SgS & BUILDINGS Job address: 132 Avenue Legal Description: SW 1/4, SE 1/4, S 30, T 30, N R 19 W Township: St. Joseph County: St. Croix Subdivision Name: The Sanctuary 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 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 Plan Designer: Roger Nelson License Number: MP 226497 Date: 10/31/06 Phone Number: 715 - 2734444 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SD &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 . V11 h.0 uv1�.uJ SEE CORR PONDENCE 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) 18.00 Site Slope ( %) 97.70 Contour Line Elevation (ft) 14.00 Depth to Limiting Factor (in) 0.50 In -situ Soil Application Rate (gpd /ft Distribution Cell Information 60.0 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) 35.00 Forcemain Length (ft) Does the forcemain drain back? Y 88.00 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 13 5.71 Forcemain Drainback (gal) 11.20 Vertical Lift (ft) 55.93 5x Void Volume (gal) 0.47 Friction Loss (ft) 61.64 Minimum Dose Volume (gal) 18.17 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) Weiser 800 - 325 -8456 1 Manufacturer gal/in (enter result in cell 1349) Dose Tank Information Effluent Filter Information 800.001 Dose Tank Capacity (gal) JZabel 1- 800 - 221 -5742 Filter Manufacturer 22.241 Dose Tank Volume (gal /in) JA100 Filter Model Number Weiser I Manufacturer Project: Brian Hillman 4 bedroom Mound system Page 2 of 8 Mound Plan View 1(� 1 U B Observation Pipe J K . T' ti. ti�. ti ti ti. ti.ti.ti.ti.ti..,.ti.ti.ti.ti.ti.ti.ti.•..• •,.ti.•..ti.• ti . ti .• . • ti . ti•ti.ti ti .,.,,.ti.ti.... 5 :.•. •. ti.ti....ti.•. ti . ti ... ti .. ti .• A •,.ti.ti. '. •'..'.. •,.ti.ti.•.. 1,.' ..ti.ti.'..•..ti.ti.'ti.ti.ti.ti.•..•�. •. t••,.'L. . • •'.. ;.•, f ', r ,." 1 ', f , f , 1 ,� , 1 ., j , f , f , f , f , f ,, f , f , r ,� . W .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B �. . . l;t . I L Mound Component Dimensions A 10.00 ft E 4 360 in H 1.00 ft K Eaft ft B 60.00 ft F 9.25 in I 31.98 ft L ft D 22.00 in G 0.50 ft J 6.05 ft W 600.00 (ft Dispersal Cell Area 2519.02 (ft) Basal Area Available 10.00 (gpd /ft) Linear Loading Rate 6.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 101.30 (ft) - -► 2 , 50, G H Z F :: 100.03 (ft) Lateral Dispersal Cell 99.53 (ft) — Invert Dispersal Cell t Elevation E ' D: . . ... . .. .. . . . . 4 4 97.70 (ft) Contour Elevation 18.0 % Site Slope Geotextile Fabric Cover Shading Key m $. Dispersal Cell See lateral details on Q — Topsoil Cap c °� 1.5 ft ti•ti• •ti• Page 4 for number, size, �•• • r•r• •j•j•f •� Subsoil Ca c 5 r�' ':. ~ ''r and spacing of laterals. © p r•r••'? • ?~• r �r�j Laterals are equall ASTM C33 Sand r �rti =� ti:� .; ,ti * F q y ® ® Tilled Layer m 0.5 ft : �:� Typical Lateral r ; };;' spaced from the Y (p ti•ti • •• ,•'.•1.1.1.1.1• f•� •- 'f'r'r'r'r'' •r•r distribution cell Aggregate V 0 ::r:: tiro fti� ti ti �ti �tirtir .5 ' centerline in the A distribution cell (AxB). Project: Brian Hillman 4 bedroom Mound system Page 3 of 8 End Connection Lateral Layout Diagram Center the laterals over the A &9 dimension •- Turn-up +m'ballvalva orolonnoutplup P All laterals are Identical IE- X —'ll Holes drilled on the bottom of the lateral 8 equally spaced Laterals & force main of PVC Soh 40 S (per COMM Table 84.30 - Faroe main connection 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 18.17 ft Forcemain Velocity 2.52 fVsec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and --► Comm 16.28 WAC 4 in. min. Disconnect Tank component is properly vented Alternate outlet location Forcemain diameter Weiser 800- 325 -8456 Manufacturer �T 2 in. Capacityl 800.00 Gallons Volume 22.24 gal /inch A Weep hole or anti - Dimension Inches Gallons B siphon device A 21.20 471.48 B 2.00 44.48 C Pump off elevation (ft) — t C 2.77 61.64 88.83 D 10.00 222.40 D Total 1 35.971 800.00 11 Dose tank elevation (ft 3" Bedding un er tank. 88.00 Alarm Manuafacturer IS. J. Electro Systems Alarm Model Number I 101 HW Pump Manufacturer JGoulds Pump Model Number I PE 41 Pump Must Deliver 1 24.72 gpm at 1 — 1 - 71 ft TD Project: Brian Hillman 4 bedroom Mound system Page 4 of 8 ^ t 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 Zonin 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 fe 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 Sprinkler Valve Box Plug or Ball Valve Distribution Lateral — Long Sweep 90" or Two 45 Degree Bends Same Diameter as Lateral Project: Brian Hillman 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 filter shall be assessed at least once every 3 years by inspection. The outlet fitter shall be cleaned as necessary to ensure proper operation. The fitter 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 130%, 30 mg/L TSS, 10 mg/L FOG, and 10 ofu/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 some 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: Brian Hillman 4 bedroom Mound system Page 6 of 8 r �. GOULDS PUMPS b i Su ens ble Effluent Pump 1 PE PYW SPEMCATIONS MOTOR FEATURES Pump — General: General: a Corrosion resistant • Discharge: 1 NPT • Single phase construction. • Temperature: 104 °F (44 • 50 Hertz ■ Cast iron body. maxhmum, continuous when • 115 volts n The mwphok impeller and fu submerged. • OA-in thermal orcrbad pro- cover. • Solids handling: W tecdon with autonhabc reset. ■ Upper sleeve and lower maximum sphere. • Claw - B insulation. heavy duty bail bearing APPLICATIONS • Aulomak models induce a • 0114led design. construction. float switch. • High strength carbon steel ■ Moto is permanently Specially designiec! for the • Manual models available. shat lubkated for extended following uses: • Pumping range: see PE31 Motor: service life, • Mound Systems performance cart or w". • .33 HP, 3000 RPM ■ Powered for cor+tinucnis • EffluenVDvJ% Systems PE31 Pump: • 12.0 Maximum amps operatim- • Low Pressure Pipe Systems • Maximum capacity: 50 GPM • Shaded pole design ■ AN ratings are within the • Basement Draining • Maximum head: 25' TDH PE41 Motor. waking limits of the motor. • Healey Duty Sump/ PE41 Pump: Quick diswrwaect p: • .40 HP, 3400 RPM Pow Dw'atering • Maximwn capacity, 60 GPM • 7.5 Maximum amps cord, 29 standard length, • Maximum head: 29' TDH • PSC design heavy duty 16/3 SJTW whh NEMA 5.15P, three prong, PES1 Pump: PE51 Motor: 115 volt ground'mg plug. • Maximum caps*.. 70 GPM • .50 HP, 3400 RPM ■ Complete unit is heavy duty, • Maximum head: 37' TDH • 9.5 Maiximum amps portable and compact. PSC design ■ Mechanical seal is carbon, METERS FEET ceramic, MM and stainless .M a 1. _ :. r MOOELS:1E31.1[�7. PES! steel. 35 ■ Stainless steel fasteners. .l..j... .i- i t.. 10 .. {. I �- .. - ° AGENt1f tlSlfiYAS I FT .. y�tl + ` f r r1• rK• x 25 - :.._ f zo *_ t Tested to UL 7713 and _.. , o :..:... a 108 SWW" , � L _...,... ..� . T.. a...� 1.*.. 1 _ y . Fb OLIUMM 10 1 *.. } .. y .. ....� .T..t.. } -p - _.r... _ �.......�.. A._i...,.._ 5 .. r_4 +... r,..._.. ,.. _ t 1 . i 4. �..� . - •{.... }.. 0- 0 0 10 20 30 40 50 60 ' TO GPM 80 pa�� �O t7 0 5 10 15 rn X7015 Pllt11p5 ps - 2y.72 C MCITv E f6c"WO vov ffAw,, 2002 G /�/� BPE31 /41 �TT Industries Brian Hillman 984 Sherman Lane Hudson, WI 54016 SW %,SE%, S30, T30N, R 19 W The Sanctuary Lot # 2 Richmond Township �sK St. Croix County Scale I"= 40' Weiser 12001800 tank �o BM #1= 10&00' top of 314 "steel pipe BM #2 = 99.11' top of 314" steel pipe 35' of 2 "force main q ' . L 25 Ac-PES 3 96 • g th Z 13 A�! / Q � � Q8'• Im . �7 G� ro a•+-% IV C R OWelt ��,' ✓c wRy 3 �I n 0 Y F 3 7 3. 02 2 E4 r L• r- L. ivr C Page 8 of 8 r— Wisconsin Department of Commerce SOI - .REPORT Page of .� Division of Safety and of in accordance with 85, Wi Code Attach complete site plan on paper not less than 8112 x 1 as in size. ` Include. but not limited to: vertical and horizontal referen t (B lion an .I?aroel I.D. � a percent slope scale or dimensions, north arrow, and nd dI ta�n@prest road. i p p — Z� '- ^ dt10(• o t"! Please print all Informs � ST Cgq,X2��� b Date Personal information you provide may be used for secondary riv (f) (m))- � Q.t1 , f Property Owner 1 4 114 S30 T N R 9 E (orj�p 1 Property Owner's Mailing Address Subd. Name or CSM# Ae City state Zip Code Phone Number ❑ Ciry ❑ Village PTown Nea Road New Construction User Residential / Number of bedrooms :4 Code derived design flow rate GPD ❑ Replacement ❑ Public or al - Describe: -- Parent material _,7 ,� rl, "/'- Flood Plain elevation if applicable ¢ ft• General comments and recommendations: � �' /^� - ) 7 7 Boring # Boring ® pit Ground surface elev. ft. Depth to limiting factor in. Sa'I 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 S •te 7 s' xz f ® Boring # Q Boring ' 9R / tau Pit Ground surface elev. it. Depth to limiting factor In.- Soil Appl ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF In. Munsell Qu. Sz. Copt Color Gr. Sz. Sh. •Eff#1 •Eff#2 7s > a2zi 7 • Efflyent #1 = BOD > 30 _' 220 mg& and TSS >30 < 150 mg& • Eqdent #2 = BOD 30 mg& and TSS 1 30 mg& Cyr pri ^� Signature CST Number Address _ Evaluation Conducted Telephone Number Property Owner ,mil) �� / {� Parcel ID # Page F2 Boring # ❑ Boring /O Pit Ground surface elev. ft. ; Depth to limffing factor in. Sol Application Rate Hormn Depth Dominant Color Redox Description Toxture Structure Consistence Boundary D/If In. Munsell Qu. Sz nt. Color Gr. Sz. Sh. •Eff#2 ^� r -3 F Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil AnDlication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDAT in. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. •EfI#1 'Eff#2 F-1 # ❑Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Apacillon Rate Horizon Depth Dominant Color Redox Description. Texture Stnxture Consistence Boundary Roots GPD/ff' In. Munseli Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ' Effluent #1 = BOD > 30 < 220 mgll. and TSS >30 _< 150 mgll. ' Effluent #2 = BOD 1 30 mgll and TSS _< 30 mg& 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. seossM"M) 4 �z a At /tea' r _ � ��•. _- _ ___ __ __ � _ -- --.- __ _ -- - -_ � .- __ - ____._ . _,�- r - _ _ . - - -- _� � __ -_ ��, �__ __ _ _ _ _, __ _ _.. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND �k OWNERSH IP CERTIFICA FORM OwnerBuyer _ 9/ L t MA - J Mailing Address -- -- �g -CA" ,AA A 1\I L AAf� Property Address Z N e v E to 42� (Verification required from Planning & Zoning Department for new construction.) City /State �f yam, Parcel Identification Number 30 — Z. / Z / — Z 0 — o do LEGAL DESCRIPTION ,\ Property Location 1 /a , �7 �� ' /a , Sec. 3 U , T 3 6 N R19� W, Town of �7� o Subdivision 49 /u , ::5 --r c tz y _ , Lot # Z. . r Certified Survey Map # , Volume , Page # Warranty Deed # Z 69 20 �— , Volume , Page # Spec house yes 6P Lot lines identifiable d1i 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. I/we 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 — g UNATUR I F 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/ 622062 State Bar of Wisconsin Form 1 -2003 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., W I Document Number Document Name RECEIVED FOR RECORD 04/84/2806 10:30A11 THIS DEED, made between RWP Investm LL C, a Minn limited _ WARRANTY DEED liability company EXEMPT # REC FEE: 11.00 ( "Grantor," whether one or more), and Brian Hillman and Michelle Hillman, TRANS FEE: 420.00 COPY FEE: husband and wife, as survivorship marital prope — _ CC FEE: -- -- - - -_ PAGES: 1 ( "Grantee," whether one or more). Grantor for a valuable consideration, conveys to Grantee the following described real Recording Area estate, together with the rents, profits, fixtures and other appurtenant interests, in Name and Return Address St. Croix County, State of Wisconsin ( "Property") (if more space is giver Valley Abstract & Title, Inc. needed, please attach addendum): 1200 Hosford Street, Suite 201 Hudson, WI 54016 Lot 2, The Sanctuary, Town of St. Joseph, St. Croix County, Wisconsin. �-- _0 2 -2 -0 Parcel Identification Number (PIN) This is not homestead property. (is not) Grantor warrants that the title to the Property is good, indefeasible, in fee simple and free and clear of encumbrances except: easements, restrictions, and rights -of -way of record, if any. Dated — - - -- RW STMENT 9-C (SEAL) li1L� - r (SEAL) (SEAL) (SEAL) * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) racy L. Tut i im ) ss. authenticated on Notary Public ST. CROIX COUN ) St ate of Wis Personally came before me on 4_r * the above -named RWP Investments, L , a Minnesota limited TITLE: MEMBER STATE BAR OF WISCONSIN liability company, by Roger W. Plath, its Chief Manager (If not, to known to be the erson(s) who executed the foregoing authorized by Wis. Stat. § 706.06) insti 1 s e. THIS INSTRUMENT DRAFTED BY: Brent R. Johnson - Lommen Abdo Law Firm ,o c, State of WISCONSIN Hudson, Wisconsin My co ssion (is permanent) (expires: ) (Signatures tray be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATION TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED 02003 STATE BAR OF WISCONSIN FORM NO. 1-2003 * Type name below signatures. INFO -PRO"' Legal form m s - (800)655;2021 • intoprofonns.co 1 of 1 P/26/06 THU 13:33 FAX 715 386 4686 ST CRX CO PLANNING wool z o 0 1 306.96' � z� ° o - o SOX o o rn • z ' ' W �X _ I z �w I o f I to cn w I ! w' NN q! O r? I J -• W V/ v 1 ;D * A I m i w ' .. ( cn= •%V ;�: Icn L13 mm '•6� - C)) N •�•7' 1 i (A (11 �� i 4•• i I vD �w �• I 0 � r5�• -n In orn � I 1� OD V G � 1 (! t` n (/1;o :11 rn o I l y CAI z , O 0 w �Z� I •� D _�• 0 L 1 1 0 _r : / L'72 1 1� m rn .•••'•• ` 8 1 O I D 5� 15 v , C rn i � „00 O w bo m CA CA z �1 � \ • n I I • -ia 1.2Z 0 Cb CO s w 3,o \ 2 ��• Aj � ow C4� w ` + S r1i CA I \ p v X 33• I � � I w t 'C2 w � f / .a re: /I � + 00 .� GI I` •n I 00 2 co I I cn � i to I v i m :71 rn f 331.16 !I 140.00 2 DRAINAGE L10 I r 409.16' T .I.. ..... I x j EAS N. t � ................. ... `I EMENTrn to DRAINAGE G 1n o EASEMENT to _ _ ' �` I 1 o L27 1 °- 160.00' 213.22' • • ...... i 00 ° 42 ' I N• 26 W 3 73.22 4' 06" E 18 - a o •s oU L7... -'c.' ..... ; . •• �� NC�.i tn� N Orn m cn • V