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HomeMy WebLinkAbout030-2113-90-000 Wisconsin bepartment of Comm. PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division .9 INSPECTION REPORT 1 Sanitary Permit No: 463301 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: Cory, Charles I St. Joseph, Town of 030 - 2113 -90 -000 CST BM Elev: Insp. BM Elev: BM Description: _ 1 S � Section/Town /Range /Map No: /,0 0 . 4 /D U • d / /� / 0 4- 9� 31.30.19.936 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic � Benchmark Dosing � 0 • � Alt. BM Aeration ►ri B ldg Se wer ' D Holding _ ;, St/Ht Inlet / c1q a St/Ht Outlet ' _.— TANK SETBACK INFORMATION TANK TO , P/� WELL BLDG. Vent to it Int ke Dt Inlet Septic ��/�/ /� ' cl Dt Bottom oVfi Dosing Uy Header /Man. S 3 S Aeration Dist. Pipe �• �J / O �+ Holding Lot. System • G J , c /D g Fin Grad PUMP/SIPHON INFORMATION 2..( D7.3 Manufacturer Demand St tdveF GPM 7 r vr" e Z 100-1 Model Number �s `-p) �,.o ta3.� TDH Lift Friction Loss System Head TDH Ft to , Forcemain Le^ 1 Dia- Dist. to Well � / L./ I I " / SOIL ABSORPTION SYSTEM BED/TRENCH Width �/ Lengt� No. Of Trenches PIT DIM NS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS Vo SETBACK SYSTEM TO I P/L BLDG WE LAKE /STREAM LEAQHlrit. Manufacturer: INFORMATION CHAM OR Type stem: m: 20 � � , � � S � / U Model Number: DISTRIJJION SYSTEM t l Heade i old �/ Distribution x Hole Size x Hole Spaci g t to e Pipes) l, n d eth Dia Length Dia Spacing ) ! SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over T Depth of xx Seeded /Sodded xx M th=Yes' Bed /Trench Center \ Bed/Trench Edges psoil Yes No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: 0 124-0 � ction #2:� / Location: 326 White Eagle Trail Houlton, WI 54082 (NE 1/4 NW 1/4 31 T30N R19W) White Eagle Lot 19 r[6' " Ecel No: 31.30.19.936 1.) Alt BM Description =.ST 2.) Bldg sewer length - amount of cover = Plan revision Required? Yes a No (/ Use other side for additional information. -- -- , �{ J / . -- 4 <� --- '_ -- DatC Insepctor's Signat a Cert. No. SBD -6710 (R.3/97) A ty Safe and Buildings Division Coun Safety g h m m � � 2 .Washington Ave., P.O. Box 7162 �scans�n adison, WI TOpnitaryermit umber ( to be filled in by Co.) (608) 26 Department of Commerce 3151 R CEIV 0 Sanitary Permit App mb r In accord with Comm 83.21, Wis. Adm. Code, personal inform provi dAPR '?, `'7 _ "�,J4AjS, /Q 40 may be used for secondary purposes Privacy Law, s15.04(1)( A ress (if different than mailing address) ST. CROIX CO Pec, I. Application Information - Please Print All Information ZO # 32_(, Property Owner's Name PjtrceI # Lot # Block # 1 r . Property Owner's Mailing Address Property Location C /IA ) , Section 3/ Ci State Zip Co Phone Number T 00r; H. T e of Building (check all that apply) Family Dwelling- Number of Bedrooms , t ubdivisionN a CSM umber ❑ Public /Commercial - Describe Use Lv / ❑ State Owned - Describe Use ❑City ❑Villa o ship of • fiJ III. Ty *Ne stem rmit: (Check only one box on line A. Complete line B if applicable) o30 ^ 2- 113 - D _ Q6p yr 9 3 A. y ❑Replacement System ❑ Treatment/Holding Tank Replacement Only El Other Modification to Existing System B. ❑ Permit Renewal rmit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner 3301 i—ts oz ?moo IV. Type of POWTS S stem: (C k all that apply) ❑ Non - Pressurized In- Ground d > 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 ❑ Dzip Line ❑ Gravel -less 'pe J Q Other (explain) tSteef V. Dis ersallTreatment Area Information: ��D = 0 103 cj Design Flow (gpd) Design S7 Dr rsal Ar Required (sf) Disper I Area Proposed (sf) Sy VI. Tank Info Capacity in Total Number Manufacturer Prefab Site iber Plastic Gallo ns Gallons of Units t, �' _I E Concrete Constructed Glass New Existing' Tanks Tanks l� Septic or Holding Tank Z J Aerobic Treatment Unit Dosing Chamber / VII. Responsibility Statem t- I b J P tY ,the undersig ssume responsibility for installation of the POWTS shown on the attached plans. Plr' Name (Print) Plumbe ature MP/MPRS Number Business Phone Number Plumber's Add ress (Street, City, State, Zip e) VIII. Coun /De artment Use Onl Approved ❑ Disa v Sanitary Permit Fee includes Groundwater Date Issued Issuin Agent Signature o Stamps) Surcharge Fee) / ❑ O v eason o Denial (O IX. Conditions pprova L-3 � r2 C-2,t� 1 �D I Tw�t�-'�•� � SYSTEM OWNER: (�`��-'� 1 Septic tank, effluent filter and -�o c - ou dispersal cell must all be serviced / maintained n as per management plan provided by plumber. 5 I Q a-l' 1 as 2. All setback requirements must be maintained rec -le 4 as per applicable code /ordinances. >`Fc U C�mC R �T� . Attach complete plans (to the County only) for the system on pap not less ihan 81/2 11 inch in size SBD -6398 (R. 01/03) 4� �� 1 - t -. • . PLOT PLAN A)00( es Cory ADDRESS 326 White Eagle Trail Somerset Wi 54025 1/4s 31 /T 30 N/R 19 W TOWN St.Joseph COUNTY ST. CROIX EVATION 104.9' BEDROOM 4 AT -GRADE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 600 # of chambers none BENCHMARK V.R.P. Top of Steel Fence Post ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL s H. R. P. Same as Benchmark Property Line (not to scale) Scale = 1/4" = 10' Tank is to be properly bedded and provided with Pro 4 Bedroom House lockdown covers with approved warning labels Huffcutt Combo Ta r 0 f Gradini o be 104 51 done t divert run - off from s -2 102.5' 6 -3 0 Well is to meet all setbacks found in 5% Slope 103.9' Comm. 83 Area 15' below system is to remain undisturbed B.M. * 001P Safety and Buildings t , 4003 N KINNEY COULEE RD y commercemi.gov, LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 isconsin www.commerce. o Department of Commerce www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary April 21, 2005 CUST ID No.226900 ATTN: POWTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING, INC ST CROIX COUNTY SPIA 1008 192 ND AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04/21/2007 Identification Numbers Transaction ID No. 1127147 SITE: Site ID No. 694477 Charles Cory Please refer to both identification numbers, 326 White Eagle Trail above, in all correspondence with the agency. Town of Saint Joseph St Croix County NE 1/4, NW 1/4, S31, T3 ON, RI 9W Lot: 19, Subdivision: White Eagle FOR: Description: Proposed Four Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 1002601 Revision; Maintenance required; 600 GPD Flow rate; 26 in Soil minimum depth to limiting factor from original grade System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 /01), Pressure Distribution Component Manual - Version 2.0, SBD- 10706 -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 approved changes become an addendum to the plans that were previously pproved on January 31, 2005 under Transaction I.D. No. 1105416. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official 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 filter for cleaning must be provided per Comm 84 product approval conditions. • 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: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in thiPago.T S, Conditionally "r- SHAUN R BIRD Page 2 4/21/2005 • Comm 83.52(1)(a) - The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 75.00 Fee Received $ 75.00 Gerard M. Swim Balance Due $ 0.00 POWTS Plan Reviewer - Integrated Services (608)- 789 -7892, Mon. - Fri. 7:30 am to 4:15 pm jswim @commerce.state.wi.us WiSMART code: 7633 cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715- 246 -4516 Date: 4 /15/05 Owner: Charles Cory Location:NE1 /4NW1/4 S31T30N,R19W Lot 19 326 White Eagle Trail St. Joseph System type: Mound System Manuals Used: Mound Component Manual Version 2.0 (01/31) Pressure Distribution Manual Version 2.0 (01/31) Page# 1. Cover Page 2. Mound Plot Plan 3. Mound Cross Section 4. Pipe Cross Section /Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7 -8. Maintance and C ntigency plan 9 -11. Soil test Shaun Bird Signature License number 900 DEPARTMENT OF COMMERCE DIVIS�oN pF TY D BUILDINGS f .� RECEIVED SEE CORRESP DENCE APR 1 8 2005 SAFETY & BUILDINGS PLOT PLAN PROJECT Charles Cory ADDRESS 326 White Eaale Trail Somerset Wi 54025 NE 1/4 NW 1/4S 31 /T 30 N/R 19 W TOWN St.Joseph COUNTY ST. CROIX SYSTEM ELEVATION 104.9' BEDROOM 4 CONVENTIONAL AT -GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 600 # of chambers none BENCHMARK V.R.P. Top of Steel Fence Post ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL *H.R.P. SameasBenchmark Property Line (not to scale) Scale = 1/4 = 10 ' Tank is to be properly bedded and provided with Pro 4 Bedroom House lockdown covers with approved warning labels Huffcutt Combo Tank Grading is to be 104.5 done to divert run- off away from system B -2 102.5' ❑ Well is to meet all B-3 setbacks found in 5% Slope 103.9' Comm. 83 Area 15' below system is to remain undisturbed B.M. * White Eagle Trail Designer No Date Non -Woven Filter Fabric 4" Observation Pipe Perforated ,Distribution Pipe Below Filter Fabric ASTK C -33 sand -� }H G Topsoil E % Slop Flowed Bed 0f f 2'�7 Force Moro �� � Z f From Pump Layer Drain Rock Cress Section of A mo System usin F A Bed For The Absorption Area C A Ft. j `_) _6' K a Ft.. _ j Ft. Ft. L 4: Observation Pipe -, K J �, A �j - Force Moin in �° �_------- - - - - -- ----------- - - - - -- _ From Pump C Distribution Bed Of /2 Pipe Drain RocK I 40tiservation Pipe = :ECG- Permanent Marker Pi pe or Rods Pion View Of Mound Inq A Bed For The Absorption Area I Perforated Pipe Oetoii / End Vier �Rerto�atta �, i' PVC P.pc yo4 . c e�Q rc o Baer totaled On 80t ;tfm. p�S / Are ERoodY Spt)E!d C Pv Force Win �, ! /( f � F[R�T tlotL titxT ro CannsG }gar PVC Manifold Pipe ��5�/111f�> CistriosrA�gn Pipe l L r / v p � , • I- Distribution Pipe t..oyout P (� Ft. R C=VV:� TO Win, ,-u• R. X tT Inches '` Inches Signed: Hole Diameter 5 Lateral �" Z Inch(es) License Number: Manifold Inches Date, Force Main Z Inches of holes /pipe invert ElevAtion of Laterals jft. A ND gPE"Ir ICATIOS F CP,QSS SL CT1G. ' � SEPTIC TANK L PUMP gfAnIERPWOFQ?t APPROV ED i lmow 14IN _ ABOVE GRA II� jU NCTION R y,4X COLE COY ER G V£NT PIPE I OR WITH CONDUIT W1 FAI)LOCK � y D. ROB DOOR. WARNING IASE- ,r 5li A IR _J ,-,..,, MTN- F III► : �0 GE Ir zY t8 i 3 INLET G AS - ppls4vED TIGHT = . aatnTS VITH WATER TIGHT SEALS � SEAT- A pps@ plFf 3* OM _ N SOLID SOIL APPROVE C FF P� S(?LID _ � T. — � - ' SOIL pump OFF ELEV - D AP1'ROy SEDD -ING UNDER TANK CONCRETE PAD SPECIFICATIONS Gw GAL. DOSE �HBER DO SES ?ER S DAY: EPTIC ME j:NCLOD 0 F L gpC W— ' � FACR£R : bL iAAiK MAW GAR.. g{ E 1C '! ' te ,�_ r -------- >GAL- TR11lC SI ZES: SEPTIC G� GAL . 8 ;26 '.S i3�1GHES DOSE MO CAPACITIF'S= ''B ----' GAL. = _2 INCHES = A J FAC Rr L ' /� J IN CF�ES = Io'Z .� GAL. MODEL IllliriBER = ...� '�+ C SWITCH TYPE: GAL. INCISES PUMP MAFACTitRER = /�/ � Z g 15.23 WAC M H TYPE v P s FEET s ALARM WTRIi� AS P£R GPI14 Ti'SP REQDZAED DISCHARE G RATE gIP£ FEET �.- 5 -FEE gISTgI _ 6�. CE SEE pv�4P off AND - _ f'ACTI �► FEET votTICAL DIFFER P RESSURE - F;q ;CTIBM �Yd��_ NETwostiC SUPPLY 3 FT/ lO Q • fT - DYNAMIC H �- MI F C.ET rORCV AIN x - -=--"_ TOTAL - DIAmETER - ; GT" TANK CIO r� I p2�tl�AL D L1�E N TONS 4L` SUP LAID D A7 £ = LICENSE SIGNER= _ TOTAL DYNAMIC HEAD /CAPACITY HEAD CAPACITY CURVE PER MINUTE EFFLUENT AND DEWATERING GO MODEL 152/153 W r MODEL 152 153 W 50 Feet Meters Gal. Liters Gal. Liters 153 5 1.5 69 261 77 291 12- 40 — %<, 10 3.1 61 231 70 265 152% 15 4.6 53 201 61 231 w 20 6.1 44 167 52 197 v 30 25 7.6 34 129 42 159 a 8 30 9.1 23 I 87 33 125 ° 35 10.7 -- -- 22 85 20— -- t t 42 0 40 12.2 -- 4 Lock Volve: 38.0 Ft. (11.6m) 44.0 Ft. (13.4m) 10 usasas 0 20 0 60 80 100 GALLONS I s 1 /4 LITERS Q 80 160 320 .. 3 27/32 a 5/8 FLOW PER - MINUTE 3 27/32 CONSULT FACTORY FOR SPECIAL APPLICATIONS _ I a 4 • Timed dosing panels available. ® 3 27/32 • Electrical alternators, for duplex systems, are available and supplied with s an alarm. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. • Sealed Qwik -Box available for outdoor installations. See' FM1420. • Over 130 °F. (54 °C,) special quotation required. 152J153 Series i2 t/s - 1521153 MODELS Control Selection Model Volts -Ph Mo Amps Sim lex I Du lex 5 1 /8 N152 115 1 Non 805 1 2 or 3 BN152 115 1 Auto 8.5 Included 2 or 3 f �_ s E152 230 1 Non 4.3 1 2 or 3 SE152 230 1 Auto 4.3 Included 2 or 3 N153 tt5 t Non 1 10.5 1 2or3 1 SELECTION GUIDE BN153 115 1 Auto 10.5 Included 2 or 3 E153 2� 1 Non 5.3 1 2 or 3 1. Single piggyback variable level float switch or double piggyback variable level float BE1531 230 1 1 Auto I 5.3 I Included — 2 0( 3 - switch. Refer to FM0477. o CAUTION 2. See FM0712 for correct model of Electrical Alternator E -Pak. All installation of controls, protection devices and wiring should be done by a. qualified 3. Variable level control switch 10 -0225 used as a control activator, specify duplex (3) licensed electrician. All electrical and safety codes should be followed including the most or (4) float system. recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL To. p.0. BOX 16347 Louisville, KY 40256-0347 Manufacturersof. . D SHIP TO. 3649 Cane Run Road p ® Louisville, KY 40211 -1961 QLq�yPU,Hpg SNCE �i7ili7 p hftpJANww.zo eff er. cam PUMP !O. (502) 7 FAX (502) 774 -3624 PUMP © Copyright 2000 Zoeller Co. All rights reserved. ENT PLAN Page ° — ' V1 TS OWNER'S MANUAL & MANAGP� IFICATIONS PO SYSTEM S Septic Tank Capacity 2, S S" al ❑ NA FILE INFORMATION C NA Septic Tank M� . owner ❑ NA Permit. Effluent Filter Manufacturers �- �- �117� ❑ NA DESIGN PA�� 0 NA Effluent Filter Model � 0 NA Number of Bedroorr>s NA p Tank Capacity Humber of Comrne� Units pump Tank Manufacturer 0 NA dmded floW (average) 6 0 o a da Pump ❑ NA Manufacturer Desig Raw (pew). (Estimated x - � al/da Pump Model 11/ /. �� / pretreatment Unit Soil AppC�t?on Rate Monthty average 0 ��Gcavel Filter 0 Peat Fitter irertt Quality S30 mgr- p Mechanical Aeration O Wetland IrifluelEftt G [3 Other (FOG) Fats, Olt &Grease (F 5220 mgr- [3 Disinfection en Demand (SODS) BiOChe�I Q� SS 5150 � Manufacture r TOW impended Solids ( SS) rsat Ceti (s) ressurized) Monthly average" Dispe round (gravity) ❑ n-ground (P PtettBated Effluent Quality 530 mg1L Lj fn d o Demand (8( L7 Dri .ne e C3 Other TOtatSUS Biochemical rocBiochemical xY9 ded Solids {TSS) 530 mgr- 0 Fri ir - pen mean) fg., t o` cfu /100m wastewaterano Fecal Co GfOrm (9eC'n'e Values typical for dWW5W (nog* 1T1e nc hdiameter _ Maximum Effluent particle Size •• Values typical for pretreated „,�terrater M a�NANCE SCHEDULE Service Frequency ❑ months r(s) (Maximum 3 yrs.) Service Event o f tank volume At least once every oats one - third (ys) Inspect con diti on of tank(s) When combined sludge and scum eCt ear(s) (Maximum 3 yrs•) tank ( Pump out contents of tan� months At least onoe every gars) dispersal oell(s) [3 months . inspect At least once every r(s ❑ NA Cfesn e ffl ue nt fitter D months At least once every s) O NA Inspect pump, Pump Controls & alarnn l once eve (3 months At east ry fl year(s) O NA Flush laterals and pressure test D months At least once every O year(s) 0 NA �. E] months At least once every other_ licenses or MAINTENANCE cel lls shall be made try an indiividual carrying one of the follow Maintainer, Septa9e r. POWTS Ma Ins of tanks and dispersal ks; missing or broken ter plumber Restricted Sewer POWTS Inspec identify any u • as of the n back P M a Master Piu tuber, on for Y certi ns must induce a visual ins a and scum and to check t levels Servicing Operator. Tank in, measure the volume of combined sludg I ns pected to check the e ffl u ent h � fe, �ft a ny cracks or leaks, Th dispersal cell(is) shalt be visually ins ndtng of effluent on the or pending of effluent on the for any po ground surface- nding o f effluent on the ground surface• The reg ulatory authontY i and to check tion of the local in the observation P Pes condition and requires the immediate notifica or more of the tank volume, the ground surface may indicate a failing equals one -third (y,) with When NR mutation of sludge and scorn in any tank of in accordance S eQ When the combined accu a Septage Servicing Operator and dispo . the tank shall be removed by an Y entire contents of corn rents, and _ e Code Ile F 113, WWOnsin Administrate a Pre ' ent Maintainer. anigl � Pressurized POW'rS comp onents. �orrned by a oert2he�d pOWTS The Servicing of effluent filters, me+yh c omp letion of any service event other ma intenance or monitoring at intervals of 12 months or less s h a ll D da days A of report shatfbe provided to the focal regulatory authority . servirs p roducts or other START UP AND OPERATION treatment tank(s) for the Presence of painting P are to use of the POVVTS check. eel Ce!!(s). if high ConCersi�t>o� For new aortstrudion. pri a the treatment process and/or damage the disp prior to use_ ma im a servicing oPe Ls that Y Ped a se tag s removed by P have the contents of the tank(? ._._ detected ha - Page of frozen at the infiltrative surface- is elCOeSS r wt►en soT onditions are fro n�lien p stad u p shall not Occu abo nom�ak highwa levels. the c ell(s) and may result in the System outages pump tanks rttay h� cell(s) in one large dose. tits o overloading the pip tank removed by a During ter tie d•�,ac9ed to the dlsl id this situation have the contents a Plum'�ber or POINTS Maintainer to backup i OILS r9ep � wer to the effluent pump � contact p . P tank.. settee S ung O � g the pc-P ��s to restore norm al levels' a um a in manualiY open Do not drive or park over, or otherwise disturb or compacx, �, tanks acrd dispersal csils• lion area- Do not drive or park vehrdes or at -grade s011 atksac p e th e performance and Prolong the life mom slo anSl ma imp within 15 feet dog � yvater stream imp rove the area the waste d dental floss; diapers; Reduction or-erunination of the tolloMrin9 clgar8� butts; condoms; cotton swabs; g aso li n e; grease; herbiddes; meat baby w1P fruit and vegetable peerings; g softener brine. of the POYt(TS: antibivtic�; {sump PUMP) water, n • and water d�sinfectiants' tat: founda5o er; p sanitary napkins; Campo CA path ti ng p sa'aPs: "' shaft iya taken to Insure that the ABANDONMENT Mty tdKen out of service the foilowlm steps Sin Administrative Code: When the POWTS fails andlor is perm trance with ch_ Comm 83.33, nings sealed abandoned in come . system is properly and sanely aban be disconnected and the abandoned pipe ope All piping to tanks and pits shall and p disposed of by a a Servicing re moved and t Operator. The- co ntents of aIr tanks aits shall be removed nd removed or their covers Sit tanks Snnd pd Pits shall be excavated a removed'and the v0 space After pumping. ravel or another inert solid material filled with soil. gravel provide a code If the POWTS falls PLAN aired t h e following measures have been, or must be taken, P ds ca be rep compliant replacement been eva l u ated and may u be utilized for the location of a replacement soil cement,ar�ea has p rotec t e d from disturbance t lines and wells nF and ailure to Id not p A suitable reply The replacement area should be p o Sect Struc setb ture, absorption system. from existing and Pr Po be infringed upon by required ed Iac;ement area vriU result in the need fo for the rules establish s effect at replacement area. Replacement that time. a surta e protect the rep ms must comply t ava lace th failed POWTS. area is not sy stem to setback and/or soil limitations Barring advances in POWT 0 A suitable replacement be installed as a last resort to ep -technology a holding tank may a suitable replacement area Upon failure of the POWTS a soH.and site has not been evaluated must be pe luated to identify tit area is available a site evalurf�'d to loca a suitable replacement area. If no replacement holding tank may be installed as a last resort to replace the failed POVplac removal of the biomat at ms may be reoonsinrcted i ( ply the following n effect St that time ound and at -grade SOU absorptio such systems must comp Y the infiMsWe surface. <<WARNIN©> TAN M AY CONTAIN LETHAL GASSES AN STANCES. I DEATH OX SEPTIC, PUMP AND OTHER TRE O p ENT _ ANY GIRCUMTANES DEATH MAY UMF I' SON FROM THE NTERIOR OF A TANK MA Y IFFtCULT OR IMPOSSIBLE. DO NOT EN MR A BEpTIC, R ESULT.. RESCUE OF A PER ADDITIONAL COMMENTS POWTS MAINTAINER n POWTS INSTALLER Name � (ti cv� ` Name Ea r r Phone Phone �! d by ERATOR PUMPER LOCAL REGULATORY AUiHOi�tTY SEPTAGE SERVICI OP A9encY j,_�i JJ t�J�I,f Name ,�,w� Phone o Phone's Z �— Jt doarment riles Marquette and Waushara County Zoning and Sanbdm agendas^ This This aoanne U was drafted the sMFs of the Green Lake. Marrs Coe. Use of ft don 't does not th e minimum requimmonts of dt_ Comm 83.22(2) (bXt)(d)&(0 and 83 & (3). Wisconsin AdmMWXafNe GMW (2JOI) guarantee the performance of the POWTS. r - 4 W isconsin Department of Com erce �" ALUATION REPORT Page of Division of Safety and Buildings A "cdi)nQin� Co 8 ,7Z, 'dm. Code County t t1 �t�� 1 Coun .5 f- Gf Attach complete site plan on p r not less than ��gt0inches s Ian must include, but not limited to: verb io la ' - 'N^ �poin ), direction and Parcel I.D. percent slope, scale or dimens s, no W) n and distance to nearest road. Pleas nt all information. Reviewed by Date �L Personal information you provide may be used for secondary purposes (Privacy law, s. 15.04 (1) (m)). G✓ d S Property Owner Property Location C q/ /U Z Govt. Lot �� 1/4 s3 / T3 N R/ E (o w Property Owner's Mailing Address Lot Block # Subd. Namp or CSM# City State Zip Code Phone Number City ❑ Village XTown Kearest Road rP K New Construction Use: Residential/ Number of bedrooms Code derived design flow rate GPD ❑ Replacement ❑ Public or commercial - Describe: _ _ __— Parent material Flood Plain elevation if applicable - - -- - - -- ft. General comments and recommendations: F/_1 Boring # Boring Pit Pit Ground surface elev. _a ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'E 40"1 r ® Boring # ❑ Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 — I 3 3/ L e A&A i2 IZ ' Effluent #1 = BOD > 30 220 mg/L and TSS >30 1 150 ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Si re CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 �r�- 715 - 246 -4516 Property Owner _ Parcel ID # Page of Boring # ❑Boring Pit Ground surface elev. ft. Depth to limiting factor �n 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 z- - s a w AI A14 MW ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ❑ Boring # ❑ Boring Ground surface elev. ft. Depth to limiting factor in. C1 Pit Sal ication Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff #1 'Eff#2 Effluent #1 = BOD > 30 1220 mg/L and TSS >30 < 150 mgA- ' 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. SOD -8330 (R.6100) r 'Soil Test Plot Plan Project Name Charles Cory sh d Address 326 White Eagle Trail Somerset Wi 54025 TM #226900 Lot 19 Subdivision White Eagle Date 4/15/05 NE 1/4 N W 1/4S 31 T 30 N /R19 W Township St. Joseph ❑ Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Steel Fence Post System Elevation 104.9' *HRpSameasBenchmark Property Line (not to scale) Scale = 1/4" = 10' Scale is 1" = 40' unless otherwise noted Pro 4 Bedroom House g 104.5 3 � ' � B -2 102.5' ❑ B -3 5% Slope 103.9' B. M. * White Eagle Trail 04/26/2005 07:24 17157237111 1 PAGE 01 4164123" St. • CMPPEWA FALLS, WI. 5`729 715.723 -7446 FAX 715 -723 -7111 Im ' .. :'�f : � ,�;,. � ` r a . ' ti. •,...,,,fit' ...... ..: .i .,, •,• yf ,......A:, .... M ..�.. .� .:, U''i.., i. .fi •,. .. .,. i � ��� '�. .. .. •. .. 'lir .. ,'��' 1 , ' i1': n.. April 7.6, 2005 RU: Shawn Bird/Cory Job Shawn Bird will be installing a 1250/750 Septic tank on Friday ,April 29, 2005 for the Cory job. This tank will exceed the state approved tank depth of 8'. A 1.250/750 has been manufactured with additional reinforcing and will be supplied to exceed the state approved depth on this job. Steve 01600 Preyfil:e�{t° .. , :.�:'� 1,1'.11 :'.M1 . •''�', ..��;:'� Iii ., e:l:.'I: ,; .1.1;'; .i.fiii ':i'tl�.i l, : • ,�i'� ,,:f•:�1i is i':`•���id :';!ii'�.�;I',':��'a1.1N,,,o n;i;lo-(� ": . . . . . . . . . . . . . . . 1: is "�� "'.''' 1 '�''�i. , iir�: ;d•i•:; ., .,, .,h. a.� 1 „G;� ;9: oSii '1' ' {:1��: tFJ '.,tilil'd "i� ... .:::.i: ":;', . •�Ii:' ... : ;I . ;N ;i1ti.l�li e , + D ivisioA Cour►tY sefuy aAa a ufldittgs 201 W. Wi n Ave. 7 SW� Pmt Number (w be filled in by Co.) mw 7 co 1" In ( 608) 26 Z 3 y yN ent of commerce Ad IBrIIllt ApPil do S anitarY P nal i on you Provide o t� Project Address (if t dm ruralist *delta:) 1n aawrd with Comm 83.21. Wis. m. Code ��, sl .t)a(1) - may be tuod for seoonduy P 32� w 6A L6 - re - A4 L L ApPLOII Informatioa — Please print All information 57. CROIX CAF ICE Block# Property ownces Name /J Property 2 SoGdon Z ° zip phone Number co City, State jj D �j_Q N Subdivision Name dU Numbs jy of Building (chi an that aPP I7) or 2 Panoly Dwau'E N" ar Seaves�• PublidComtitercial— DcsctftUsc Gty V Ttnvashtp state 0w,ted _ Dacribe Use p _ . 9 3re DL ') only one box an litre A. Com lira B if applicable) O f Permlt: ( O Oder w 8 T Tank A ew System Rcplaeeatent Sytrtem P Change of ransfer to New B. Permit Rcnowsl Permit Revision Plumber Owner Beforeagiu ion f PR ,.S all that a 1 M 4 {n, of suimblo soil -Grade Pass sand to soil Filter 24 in of suitab Rearculati+tg Sand L Unit Non - Pnssurizod Ia- Ground T� PC" Aerobic Tit Conatrueud Wedand Pressucrzed Ia- Groutrd _ Pi Odwr S Med� Filter S 12_0 • 0 � 1Ievstim rmstion: X Dispcad Amu Proposed �ytment Area Info Requitod Design Plow (t?d1 D Sol! Rs D �Pretab Site sw Fiber Plastic f 0 Number Mann COMM Coasmrdod Glans in Total YL Tank Info Gallons of Uoia u ,, e,Q t(`/a0 New valisft Tads Talcs 5 .�boyTo& �� r �o Trsatmmt Utu: c the shown on the attached tit S _ iG Plumber ility for ° Btrsiaess 1 um VIL pyumbers pt Address (Sheet, ccity. State.? Z Straps) se Ohl Sanitary permtt Fee C udes Grutmdwsur 1 Surtdratae EL Condltions o p SYSTEM OWNER: 1 Septic tank, effluent filter and dispersal cell must all be serviced f maintd . as per management plan provided by p 2. All setback requirements must be maintained as per applicable code /ordinances Attae!<ta�� pjW (to the Coast)' only) for tbo system "M paper O0t teg thus illl z tt iactres io s6oe y t � � �, � `' �. r �� � 4 �.,f.� • '! PLOT PLAN /CONVENTIONAL ADDRESS 326 White Eaale Trail Somerset Wi 54025 :NNW 31 /T 30 N/R 19 W TOWN St. Joseph COUNTY ST. CROIX ON 912.4' BEDROOM 4 AT -GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 600 # of chambers none BENCHMARK V.R.P. Top of 3/4" pipe ASSUME ELEVATION 912.3' Filter Zabel A -100 ❑ BOREHOLE 0 *H.R.P. Same as Benchmark Lot Line (not to scale) Sc = 1 /4" = 10' r Tank is to be properly Pr Bedroom. Hou bedded and provided with lockdown covers with approved warning labels B.M. #1 Hu utt Combo nk Well is to me II setbacks in Comm. 83 B -1 Grading is to be don to divert run -off away from system M. #2 O B - 2 of 3/4" pipe @ 12.7' 911.5' 911.4' o Slope 0 B -3 910.5' Area 15' below system is to remain undisturbed cop White Eagle Trail yY , 4v t 7 Safety and Buildings ♦ 4003 N KINNEY COULEE RD commerceml.gOV LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 isconsin www.commer t Department of Commerce www.wisco isconsin.gosin.gov Jim Doyle, Governor Mary P. Burke, Secretary January 31, 2005 CUST ID No.226900 ATTN: POWTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING, INC ST CROIX COUNTY SPIA 1008 192 ND AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 01/31/2007 Identification Numbers Transaction ID No. 1105416 SITE: Site ID No. 694477 Charles ry Please refer to both identification numbers, 326 White gle Trail aboyllin all correspondence with the agency. Town of Sain oseph St Croix County NE1/4, NW1 /4, S T30N, R19W Lot: 19, Subdivision: ite Eagle ` FOR: Description: Proposed Fou edroom Mound System Object Type: POWTS Comp nt Manual Regulated 'e D No.: 1002 Maintenance required; 600 GP low rate; 29 in Soil m um depth t g factor original grade System(s): Mound Component M 1- Version 2.0, SBD- 10691- ssure utisn Component Manual - Version 2.0, SBD- 10706 -P .01 /01); Biofilter The submittal described above has been revie for conformance lica sin Administrative Codes and Wisconsin Statutes. The submittal has been NDITIONALLY PROV owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsi for complian gi with all co quirements. No person may engage in or work at plumbing in the st unless ensed to do so b e Department per s.145.06, stats. The following conditions shall be met during construction o tallation and prior to occupancy or use: • This system is to be constructed and located in accor nce w the approved plans, and the "Mound Component Manual for Private Onsite Wastewater Systems Ve on 2.0" S - 10691- P(N.01 /01). • The pressure network is to be constructed in acc dance with publi ions SBD- 10706- P(NO1 /01) "Pressure Distribution Component Manual for Private O ite Wastewater Treat nt Systems - Version 2.0" and/or the sizing methods of publication "SSWMP Pu ation 9.6 Design of Press Distribution Networks for ST -SAS (01/81)". • A sanitary permit must be obtained fro the county where this project is locate in accordance with the requirements of Sec. 145.135 and 1 .19, Wis. Stats. • Inspection of the private sewage tem installation is required. Arrangements for ins tion shall be made with the designated county official . ccordance with the provisions of Sec. 145.20(2)(d), Stats. • The area within 15 feet horizontally below the system shall remain undisturbed. Vehicular tra c or soil compaction in this area is prohibited. • A state approved effluent filter is required. Maintenance information must be given to the owner of a tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be ovided per Comm 84 product approval conditions. PO.WTs. Conuliti o 0 nn■ ,p• r � ,� y :. q �� f � i1 �r�v}' a s `.:.. �`r r •�. � k . Y ., e } 1 � i s . y ��:._ �.. .r' -�! ��f(j �b i �' t 1 i SHAUN R BIRD Page 2 1/31/2005 • 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: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • Comm 83.52(1)(a) - The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Gerard M. Swim POWTS Plan Reviewer - Integrated Services (608)- 789 -7892, Mon. - Fri. 7:30 am to 4:15 pm WiSMART code: 7633 jswim@commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715- 246 -4516 Date: 1/27/05 Owner: Charles Cory Location:NE1 /4NW1/4 S31 T30 N,R19W Lot 19 326 White Eagle Trail System type: Mound System Manuals Used: Mound Component Manual Version 2.0 (01/31) Pressure Distribution Manual Version 2.0 (01/31) Page# 1. Cover Page RECEIVED 2. Mound Plot Plan JAN 2 7 2005 3. Mound Cross Section SAFETY & BUILDINGS 4. Pipe Cross Section /Pipe L out 5. Pump Chamber Cross Secti 6. Pump Curve 7 -8. Maintance and Contigency plan 9 -11. Soil test Shaun Bird Signature License nu er 226900 DEP TMENT OF COMMERCE IVISIQN F T BUILDINGS SEE CORRE ENE PLOT PLAN PROJECT Charles Cory ADDRESS 326 White Eaale Trail Somerset Wi 54025 NE 1/4 NW 1 /4S 31 /T 30 N/R 19 W TOWN St. Joseph COUNTY ST. CROIX i SYSTEM ELEVATION 912.4' 4 BEDROOM CONVENTIONAL AT -GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 600 # of chambers none IL BENCHMARK V.R.P. Top of 3/4" pipe ASSUME ELEVATION 912.3' Filter Zabel A -100 ❑ BOREHOLE O WELL *H. R. P. Same as Benchmark Lot Line (not to scale) Scale = 1/4" = 10' Tank is to be properly Pro 4 Bedroom House bedded and provided with lockdown covers with approved warning labels B.M. #1 Huffcutt Combo Tank found Well o meet all setbacks i omm.83 B -1 Grading is to be done t divert run -off awa from system N B.M. #2 B - 2Top of 3/4" pipe @ 912.7' 911.5' 911.4' 3% Slope 0 6- 910.5' Ar 15' below stem is to remain undisturbed White Eagle Trail - No Designer - -- Date Non -Woven Filte Fabric 4" Observal ion Pipe Perforated ,Dsslrit jtic Pine Below Y-1t r Fabric a- t4 C -33 $and —� _ { H ,}_�` _'1G Topsoll % slope i Force Moil \`Flowed ...� Bed Of /�- 2 s From Fum Layer Drain Rock A . E ! � S seem Usin L F 1 J Cress Section Of A Moundt`Qn Area A tied For The Absorption G Ft. h f 6 Ft. I , a Ft.. Ft. Y, Ft. f. Ft. },, F r� L _..' on Pipe - �. O b s e r v �1,,.-_- K I Force Main A ------------ From -- - - - - -- --- - - - - -- -;`� From PVmP = Bed o �C) st i ributian Pipe Drain Roc I ,• 4Obcervot' Pipe = ^C -c Permonenl Mc p i Pe or Rods �. Nlo Vi of Mound Using A Bed For The Absorplion Arita 1= 'AGE,_ OF Perforated Piet Det*" � End Vrew {Fef fora f to FJG P.Dc C NOles J led On EQ, 8o174m. �►ot �O� Are E4islty SDOCed PVC Force MdiR re CartAtC }`on % f R5T MOLL 14 �� •� PVC / Monilow Pips Pipe 4- - l ,�'y; DisIribufW QMe Layout P Ft. -� R R xa In:: has Y Int:hes Si ned: Hole Di, met.er %Inch Signed: --- Lateral inches) License Number Man i fol t Inches Date: Force Mi in Inches holy s / :ipe Ft. Invert ElevAtion of • te�,als�� S£� P_ TIC _TA M pUMp CHAMBER Cr�OSS S£ CT1QN AND SPECK IC! JIOMS WEATHERPROOF APPROV ED • IZ,+ MZN, ABOVE GRADE jUNCTION BE X WHOLE COVER VENT ' -ZF tTNDOW OR WITH C©NDU. T / PADLOCK E MOM I Oc tv FR ai� "IR Z �cTf CE � r � ......... WAR.KI�tG LA$E:. g, GR�.DI t c� F INS ' , �r►�„ . INLET GAS + TIGHT SEALS TIGHT , V E VITH WATER A SEAL + AL 4 APPROVED PIPE -.=�— + � E.R _...f. -- 3 OtiTO 9L 8 s ' Ot S13LI1D SOIL i APPROVED �— • PIPE 3` C F OI F OM SOLID IL pu 4P OFF ELEV - ®�`= T- SO D"�."_ � _..__ 3 UNDER TANY, ATE PAD � A RO VED BEDDING CR _ .G1 SP� r CATI0115 CI I ?£R DAY; ,r,_ ---- - I,tUi'fBER DOS SEPTIC DOSE E INCLDINC .j GAL - T NISK MAN�IFAC' DOSE V o l F Loy gwC N - �. GAL • _ J f Gl►L- TANK SIZES: S;: PT :C GAL -- H• 5 Di.ISE p ITI£ S : A QG ` g _ IN`' 2 ALARK MANIJFAM:Rf Z a �. MODEL Nurtsl - f • IN�.mEs = �� 'L SWI'fC8 ": YI E: C _ GAL• ANurACZtfR3 R • �� 15.23 WAC PS7P n I c,G I LHR K t}DEL Nt;'!'IB; R = � i,,lxRZI�iG S PER SWITC11 TY 'E = ', U • �„� PUKp £ A - ; j� �£EET DISCIthR .E KATE DIS -igZ FEET BU PIPE EE'T REQUIRF'3 EE yp OF AND - - - - • • _� F SETH , ACTOP FEET ME . QN VER'!'ICAL DIFFI:RE PFLY ESSURE g f • T , FgICTI HEAD B C SU TJ IQ I £T�� v , � � DyNAM MINIM`JM N .�- , )RCEliA.I ----- TO TAL � pT� � D ;gMETM PUM TANK: LEU • ' ' INTERNAL DIME ?tSI DNS £ LIQ LICENSE NUMBLB: :f�8 TOTAL DYNAMIC HEAD /CAPACITY PER MINUTE HE, :APACITY CURVE EFFLUENT AND DEWATERING L, 1,0 =L 152 M0 D_L 152 153 ``' S0 4. Fee: Meters Gal. Liters Gci. Liters 5 1.5 09 261 7 231 153 i _ 10 3. 61 l 231 70 2•:5 12 – 40 152 _ 15 4.6 53 1 201 61 231 ¢ . 1 20 6.1 44 167 52 ? l7 � 30 � 25 7.6 34 � 129 i 42 1�� 8 30 4 1 23 87 ! 33 1 ;{ 0 35 1 0.7 -- i -- I 22 5 Z0 i — o 40 122 -- -- 1 1 2 2 i i - ¢ Look V01yc: i 38. (11.6rn) 44.0 Ft. (` 3 4m) 10 uiaSna 0 20 0 60 80 100 GALLONS 6 1/4 LITERS p 8(; 160 240 320 - 3 27/32 5/8 f PER MINUTE — 3 27,':2 CONSULT FACTOI ;;Y :OR ECIAL APPLICATIONS • Timed dosing panels availat1:. f 3 27, '- -Electrical alternators, for duFl :x s; :ems, are avails nd supplied with an alarm. I • Variable level control switch( ; are vaiable for controlling le phase systems. • Double piggyback variable IE al fl t switches are available for v ble level long and short cycle cc trot: ? — I • Sealed Qwik -Box available f out for installations. See FM1420. • Over 130 °F. (54 °C,) special jot,: m required. 1 t � 12 1 / 8 152115: 3er! -- 7 1 Y/153 MODELS T C ntrol Sele 1 Model Volts,Ph Mode un� Simplex Duplex N152 115 1 Non 8_5 1 2 or 3 BN152 115 1 Auto 8_5 Included 2 or 3 SK2064 _1 _. E152 230 1 Non 4_3 1 2 or 3 BE152 230 1 Auto 4_3 Included 2 or 3 N153 115 1 Non 10.5 1 2 or 3 SELECTION GUIDE BN153 115 1 Auto 10.5 Included 2 or 3 E153 230 1 Non 5.3 I 2 or 3 1. Single piggyback ble level float switch or double piggybac variable level float BE153 230 1 Auto 5_3 Included 2 or 3 switch. Refer to FM o, c uTION 2. See FM0712 for correct el of Electrical Alternator E -Pak. All installation of controls, protect : n de as and wiring sho be done by a qualified 3. Variable level control Switch 225 used as a control activator, specify duplex (3) licensed electrician. Ali electrical a 1 sah i codes should b ilowed including the most or �¢� float system. recent National Electric Code (NEC)ndth Xcup4bonai. ty and Health Act tOSHA). RESERVE POWERED DESIGN into the design of every Zoeller purn . a reserve safe factor Is eng ineered 9 - Fo ,inu conditions y MAIL T0; R.O. BOX 16347 Louisville, KY 40256 - 0347 Manufacturers of.. SNIP TO; 3649 Cane Run Road o Louisville, KY 40211.1961 Q�gUTYP1 use p �s ,1 (502) 778 - 2731.1(800) 928 -PUMP http;11www.soe11er.c0m 1 �~ � /r�� �O FAX (502) 774 -3624 © Copyright 2000 Zoeller Co. All rights reserved. Page or . PLAN NUAL & MANACVMeN SONS P11 WTS OWNF - S 11t1A SYSTEM sprr.GIFICA D NA Sceptic TarK CaPa D NA n , j facmrar siL.E iNFOR1MATiON r septic Tank Ma �/ D NA Owner Effluent Flier Mane p NA Permit - Mode1 Effluent Etter at D NA DESIGN �•. —+"! " ink Manufacturer Pump Tank CaPa� NA Nurnber � �etr� Un 5— GTE AM p Ti Number of Co ' aVd Pump Man�� O NA Esdmatsd m ate a C3 Dd ine r Mod aVda /t`c� Pump nut Unit r Dean fkW (P�� Pretreatme Flier O Peat Fine Son ^RPM )n Ram Monthly avefSga t3 �ndlGrB+r A eon p Wetland f8uec►t Quality _,,30 rng/L p Mechanical t7 Other. tnfiuentlE Fats., Oil 3 ,re ►se O 5) : 5220 mg/L ❑Disinfection C ►:ml id (9Os st 50 m carer 8100 TO Offend,,; S lids '(TV .. oispersai CAW(s) ( pressuri¢ed) Tot$►suaP Montrily aysraags E3 In,9rpund (gravity) d p Effluent GlualitY 80 sl `� r"g/L C3 Atgrade p er ,m; ( l. �D,,Aste"tar nd I Oxygen C - SS) 530 m9 / B' gmics nds 1 S aids (r Sl cfull QOmI s SusPe ues tyPlp°i for d Total Fe w Coliform (9' — =tilt m Val Y . inch diameter sew rank aRfu au� , water. Maxim Eltluent Particle Siz ° .. values typal for p Servic requencY 1,1ApCE SCFiEDUI:_ r(s) (Maximum 3 yrs ) onths Service E, °_t of tank olume At tease once every a and m equals one -third (Yi) Maximum 3 y ) inspect conddion of tank(: J When combined siudg D months arts) ( rs. contents of tanl s) t least once every r(s) Pump out oo p months DNA inspect pe� ce ll(s) _ At st once every - r(s) p months D NA Can Qt1,ent filter At tea nos every D month earls) mp. Pump oont '!s , alarm least o ev s) O NA Inspect P� p months D Year( Flush 19"Iab and Pr�u 1 to t At least on cry D months ❑ Year(s) DNA Clow- _._- At least o eve Septsge otter an individual ng one of the f - Ma Licenses or intainer, MAlAiT61+MCE 1NSTRUt: 'rut 1S ils shalt be ma Inspe�r Pdeni misstn9 or broxen of fang and p of th ' isF :real' rated Sewer. PO nk(s) to ldenttfy check for any track is Inspeddlo Master Pit; mb - t1i r R a ftuai inspection and scum and to Is ns must tndu ed stud inspected check the effluent teve ti o"s• tor. T in: recx o u e volume of oombin , The pol ing of a ili on the OQe� any �� ► , : k : �r i aks, mess a disPe� 0811 shall be visas . hardware, identity round su t h e local regulatory authority. for an nding of effluent m Me g r ound noti 9 volume, the or pondin9 � effluent on p ip es ; ►nd .he round surface_ n and r eq uires the immed t5ca►ficn o ore Of file lank p check n tract (K) in the o y indl: ;tte fa o0 k uais ones - tt� in aa�rdan�'"' d'' NR ground a and scum in any tan tnu ' f st by a Septage Setting OPeratO When th Combined i and despot sa Rion o � l : s l ,Q b re nents', and anY onents, pfe�at#ment co S MWnffiUer. entire Contents of the tal b a �fied P 113, yyWoottsin Administrate -Cede anitsi or pressurized or less comp y event. ueni rite m 12 months o r less shall be performed letion of any s ?tie 80rVidng of eM intervals � authority within 10 days of come Other maintenance or n1U lit Ing to the local fegulatory er A $ef report shalt be l resence of painting products o i Oi ck treatment tanks) for the P if high concerttratwnS � START UP AND OPERA S the g e the dispe pri ur 1 use rW cell(s). n of the POD s an dam 9 razor pr►or to use. For new f�onstN err, E,le ,e treatment P b a septa9e servicing ope - c hemieals that may P remov deteaed have the nt ed Y oo�e,ts the tank(s) Page of�- r exc ative s Zen at the infttrurface - ,.conditions are frQ is restored 17te ess r when h' hv,rater levels. When P0**r�a(s) and may result in the system up small not xx fig above normal K v:nP tank removed by a p„ t,p ta<nlcs j eell(s) in one large dose, overfo nts o f tthei P to k removed Ma y atner to outages pu old this situation have the o a Plumber sv+9 P � r v�rN tae disch = r9e I the L. To gyr v,rastew or au�m di m ; rge �f eft<l on. po wer to the effluent pump P um tank- u s Se�``g p f :n m+ he p�mP'ap(s to re store normal severs w� over, or otherwise disturb or Compact, asses martuaity rioP� 9 land dispersal cells. Do not drive or Pa Do not drive or Pa�c V&' i over mound or at -grade soil a bsorption area- f ance l area yirttttin 15 feet d dope of a ny Irn rove the perorm and prolong the Gfe the m ter stream may P degnesS m; dentsd floss; diaper!;. Reduction or eriminatia i of to foiio'winQ the wastewa butts; condoms: cotton swae�N9 gasoline: grease; herbicides, meat erttibio :�� water, fruit and vegetable Pe ns; and water softener brine. d. the PO D : boi dr91n {sumR Pump , napkins: Campo sinfectaft; fat scraps' '0ns' oI ; Pe sting Prloducts� pestiudes: sanitary ch_ Comm 83.33, ITT taken out of service the following step° snarl he taken to Insure that the ASANDONSM falls i Ind )r is Pemaner�Y li with Wisconsin Ac1rnlNstrstive Code: When the POWTS act in Comp and the abandoned pfPe- openings Sealed. SY p . mod s ; rfel abandon nnected ed of by a Septa9e Servicing Operator. All piping to t1sA ; s a d plts shall be disco an d property dispos its shall be removed and the void space The mntsnts of 3A f nke end P . shall be excavated and removed or th A eir covers removed After P In tt > f or another inert solid *3 s and piffi e food y � �� g - avf material. and • nr �t be repaired the following measures have be If the POWTS en, or must be taken, to Provide- a 00de COMnNGENCY PLAM !ails an soil nt reple�ent " n utilized for the nce a c n a replacement ction and should not oomprrs g been evaluated and may ct : errr ��ent area should be protected from disWr� lines �� !!s. Fat7ure to O A suitable rePla' n U n. h P from existing and proposed strucxu setbacks site tuatio rt to establish a Suitab absorption albs and u s r anew ova soil a infri utx' i b3 � It in the need fo at that time be A nEjsu rules in eff e ct protect the repk :en mt aroa tams must comply with the n POWTS replacement are ; r. I epiaraeme far I. n t resort to replace t area is not stable due to setback and/or soil limitations- BaBalling a van O A suitable rep led as a las fhe failed fpaO re o th WTS a soil iechnologY a ho Ifni tank 'may b !den a suitable replacement area Upon rep area is available a The site has not XK evaluated loss a suitable replacement area_ If no me evaluation n I ,rst le pets Est re place the failed POVVTS rem of the Womat at holdng tank nta , be nstalled ms be r�nstructed i f Ply the in in effect at that time. Mound and alt gi ide roil absorPti°n systems such tams must comp Y e 1n5ttraWe su -Esc . Reoonst+'uOio TANKS MAY C AIN LETHAL SES AND/OR INSUFFICIENT OXYGEN. acYffARNJN ©> +ATMgNT T t11T K UND CIRCUMSTANCES. DEATH MAY SEPTIC, PUMP AND 01 iE TRIE OR O 13E DIFFICULT OR IMPOSSIBLE p TH o NOT smTER A 6901 IC, ?UMP RESULT.. RESCUE OF Pi RSON FROM lhiE INTERIOR OF A ANK ADornoNAL COMMENT — POVYTS N1AlNT ER POINTS INSTALLER Name LG Name Phone Phone ' ,f,� R LOCAL REWLATORY A ORrry , SEPTAGE SERVICING Of ; :[L TOR A9enCy Name J � / Phone j/ J /� Phone � /�' �'f �/ daarMrumeets C , of tiros t aJce, Marquette and Waushara County Zoning and SinRabort agtltldes nt does not >ltis aoarrtreu was disRed by a and 81 W ), (2) b (3). Wisconsin Admin �� use of this d xtxe� c� c,awcuo the rriinirttum rsquirsrruntf Of t7 . Cot m 69 �N guarantee the performance of th PC rrS. Wisconsin Department of Industry, Labor AndHurriah!Relations SOIL AND SITE EVALUATION REPORT Pa�e_of Division of Safety '& Builclings in acco with ILHR 83 05, ws. Adm: Code ` COUNTY ST • C �1X ! , �Qach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # C. dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION r EV�EWEDBY DATE �( /I PROPERTY OWNER: C/o D )%tj S PROPERTY LOCATION OW-4 JA) y _ �(Z,�S t�P�l�l� ��U �l.OPY1�VT c0�2 P• -661ff-t8fi ►J� 1/4 ww 1/4,S31 T 30 ,N,R 1 9 E( W PROPERTY OWNER':S MAILING ADDRESS LOT # I BLOCK # SUBD. NAME OR CSM # G S'v_� "6 9 e G6 BLVD . -- \"3M I 'ez Gl.F CITY, STATE ZIPCODE PHONE NUMBER []CITY ❑VILLAGE EWOWN NEAREST ROAD Pf� ST, N�.., WIN SS t01 (6s1) - GOLF 5T • aU S � P PCB c1�?o3 - R.O- P9 New Construction Use N Residential / Number of bedrooms ` ' (] Additfkn to existing building j ] R eplacement [ ] Public or commercial describe Code derived daily flow ' ' gpd Recommended design loading rate V ed, gpd/ft - 5 trench, gpd/ft Absorption area required - ' bed, ft . ? trench, 9 Maximum design loading rate • 4 bed, gpd/ft • S trench, gpolft Recommended infiltration surface elevation(s) — ft (as referred to site plan benchmark) Additional design/ site considerations . S ESL FJO 0>`1 PRS e" Z Parent material Q)x_NQj _ 1 \_L. Flood plain elevation, if applicable N A It S = Suitable for system CONVENTIONAL OUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN RU. I HOLDING TANK U= Unsuitable fors stem El ®U I XS ❑U ❑S Ou I ❑S ®U ❑S ®U ❑S ®U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Botnda►y Roots Bed rerxh zmsbk cA iqs , s 6 .. ;,......... Z q t 3 I V � s 1 �, ` S hk wt v `Fl- G,� _ • `L • S Ground 3 3 _71 -S 1 J IZ S// S u 1 - u S `� \ - • $ elev. 9\ l•`u ft. Depth to limiting factor Remarks: Boring # 2`FS S. 6 Zak Z q Z lo`trz3 /6 — st I Z,`�s�k yn �y. �S � • S `S Ground G -7 ft. Depth to limiting nT � Z g _ E9,98 - t S ti A. Remarks: Z C ) NI NG orFp T Name: - Please Print Phone: i l Arthur L. We erer 715- 425 -01 ress: egerer Soil Testing & Design Service - P.O. Box 74 River Falls,WI 540 Signature: l Date: CST Number: 1 48 -1Z3- ZO -Z$ -`� MOO 576 PROPERTYOWNER Py_ZMU O M PSOIL DESCRIPTION REPORT page Z - f 73 PARCEL I.D.# ��p)�1� Boring # Horizon Depth Dominant Color Mottles Texture Consistence Boundary Roots Structure GPD /ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench l 4 ab12 Y�`�h �-S — � •S Ground elev. 0 11, 0. ft. Depth to (uniting factor 5 62_ Remarks:- Boring # 13 o - �Gr nd u `elev: ft. Depth to limiting factor Remarks: Boring # ti NtJ S L.1 Iv t.. l A ! S Ground EbN tti Q eiev. _ft._ .. `� Y O O _ Depth to 4 S LbTS — 1 h1 1 limiting 1 — faFtor Remarks: Boring # v>J 0 Cam 6 S ; Ground'.. Cpl-- S s LG elev. ft. Depth to limiting factor Remarks: SBO- 8330 (R.05l82) , PL P LAN Page 3 'of 3 SCALE 1 "= 60 ' I I ? P L e a do i I E ,gVL.l - 7V"cvi, \ 31y `�T Pv P!Pe w / Lry \ Is3 T LO 2- N01�5 ; 1• `c ov S E 'M Be F LJ2� sT ZS ' FtZa M M ov►vb - Z. k k 4 At 5 0' K 4 3. O p � OT cC1 M.P 11" - r 0 Z b �STUR$ • T� - Wl Lp-b tNIM) oR `N� P�R�p, h t)�-V-D. (71 ) 14 00576 CST Signature Date Signed Telephone No. CST # _�v uv VT 11:.7pa nante Excavating 17151796 -2519 p.l ST CROIX COUNTY _ SEPTIC TANK MAINTENANCE AGRBEMENT 11-J -,3V -- �b l AND I OWNERSHIP CERTIFICATION FORM �I OwnerBuyer Mailing Address Property Address �--� �Uc' c. ✓ , (Verification required from Planning Department for new construction) City/State � � (' ` �� ✓-- Parcel Identification Number 030 -2113 `j0 --coo 6 93 � ) LEGAL DESCRIPTION Property Location fyF %, ' /., Sec. 3 . T 3',' N -R W, Town of . 1;, . Subdivision l�.� C G Lot Certified Survey Map # // �- -- Volume . Page # Warranty Deed # (v `� �� q Volume 2011 . Page # 0 SI Spec house - yes uo Lot tines identifiably yes 0 no SYSTEM MAINT)E✓NI CE Improper use and mainteuanceof your septic system could result in its premature failure to handle wastes. Proper [Hain tenancc 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 etage 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, Jowucyman plumber, restricted plumber or a liconsed pumper verifying that (1) the oa - site wastewater disposal system is in proper op condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the uadcmignod 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.. Ccrtificatior, slitting that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. L SIGNATURE OF APPLICANT" DATE l� OWNER CERTM ON i (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owners) c- the proMly described above, by �virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE OF APPLICANT',,," DATE "40" Any information th '� tnis- represented may result in the sanitary permit be' revoked b the Zoning • "' " m8 y Wing, Dcpa.- (meat. " include with this application: a stamped warranty deed from the Register of Deeds office 3 copy of the certified survey map if reference is made in the warranty decd J 2041P 051 STATE BAR OF WISCONSIN FORM 2 -1999 6 9 7 7 6 9 W KATHLEEN H. WALSH A Document Number WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO.. MI This Deed, made between Preservation Development, LLC, a RECEIVED FOR RECORD Limited Liability Company 11 -11 -2002 8:00 AN W IRRWTY DEED Grantor, and Charles M. Cory and Leah E. Cory, husband and wife EX?PT # REC FEE: 11.00 TRANS FEE: 457.80 COPY FEE: CERT COPY FEE: Grantee. PAGES: 1 Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area r Lot I , White Eagle, St. Croix County, Wisconsin. Na me and Re Add s lift 19 cm C S c�-t�.F-G Szl :3733'3 40 030 - 2113 -90 -000 Parcel Identification Number (PIN) This is not homestead property . N) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this — day of November 2002 Preservation D nt, LLC a # * t AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ) ss. County ) uthenticated this day of Personally came before me this day of November , 2002 the above named M M • Preservation Development, LLC, a Limited Liability Company .Iliac (o t TLE: ME 1 NSIN to me known to be the person(s) who executed the foregoing (If not, a instrument and acknowledged the same. authorized by § 706.06, Wis. Slats.) THIS INSTRUMENT WAS DRAFTED BY + _ irney Kristina Ogl and Notary Public, State of Wisconsin I son, WI 54016 My Commission is permanent. f not, st to expiration date: natures may be authenticated or acknowledged. Both are not necessary.) >�r ~ - � o .s of persons signing in any capacity must be typed or printed below their signature. trNormation Professionals company, Fond du lac, W1 STATE BAR OF WISCONSIN 80D-655-2021 WARRANTY DEED FORM No. 2 - 1999 75' say , .,,_S89'3518 "E 20.66' ® (WHITE EAGLE GOLF ` z o � ° S42'43'36 "E O 46 N cn o ° 78.14' s`SO A jir { r q Ul co %K Oo w ( m m w �� 66 ? �.s .,y�� SA r, 3 to OD m Gi 85' N \\ \\ s o r f- N89 35 18 W \ \ 18 m o 0 25.00' \/ l o m 9 y m 0 41 , m 0 S iS z -' OUTLOT 3 'op. rn m N74 "W 1,044177 SQ. FT. 2�F 100' k 85' C°- 22.73' 23. ACRES u ° - N74'35'18 "W 5.05' SOUTH LINE OF THE NW 1/4 OF THE s c ° NW 1/4 OF SECTION 31 or ti c6 AR, `A I °ZO o ;s p� cn I o ° Or N (o N z o (WHITE EAGLE GOLF COURSE) •z w � � ,r N y, c is �o N6 9 • , m M to S N O cD 2 Q „ a 3 H, Ul M OD - cc m Ln r3 Giq V`G • 40• r 0 130' z o o ( . m o \ 30:. Z N O COO