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HomeMy WebLinkAbout030-1093-70-230 I — WisconsifaDepartmentofCommerce PRIVATE SEWAGE SYSTEM County: St. Croix ,Safety arid Building Division INSPECTION REPORT Sanitary Permit No; 515150 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.16.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Studtmann, Wesley & my I St. Joseph, Town of 030 - 1093 -70 -230 CST BM Elev: Insp. BM Elev: BM Descriptio Sectionrrown /Range /Map No: 10 /00L D 32.30.19.342A20 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark /20 U 0.,-) v Dosing ro V Alt. BM T /4 ��3 % - g(� Aeration Bldg. Sew er Holding SttHt Inlet pp; 0 p ® SUHt Outlet 0 TANK SETBACK INFORMATION TANK TO P/ WELD BLD Vent to Air Intake ROAD Dt Inlet Septic /00 �� Dt Bottom � �� `� Dosin (��� Head Man. g ori- 3 2 �' . . 6 9 Aeration rq Dist. Pipe _ 916-7 go.33 ev Holding Bot. Systenil te 4 83 a• Final Grade PUMP /SI ON INFORMATION R ( Q✓ S A `� Manufacturer Demand St Cover GPM wAo k ( / 3 - 0 1� 0 5 Model Number 'n ,t 12 kTV6 TDH Lift Friction Loss System Hey T q, _ Ft 3 1. 0 ' F main igth Dia. f r Dist. 1:6 Wel S OR ION SYSTEM /'7 BED /TRENCH Width r Leng]h No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS I g-rV I Z, SETBACK SYSTEM TO PILVV JBLD EL LAKE /STREAM EACHING anufa rer: / INFORMATION T f S stem: 1 CHAMBER OR (� Y Y _ ' �+ / UNI Model Number: / DISTRIBUTION SYSTEM !" S Ldp Header /Man Hole ifpld Distribution x Siz x Hole Spacing Vey Air Intake 2 1/ Pipes 1 1-ength D Dia ngth Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only $ Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulche Bed/Trench Center / Bed/Tr nch Edges Topsoil 0 Yes � No 0 Yes 0 No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / 9/_0 Inspection #2: / ! Location: 467 Old E Eas HHudson, /W,II5 O16 (SW 1/4 NE 1/4 32 T30N R19W) NA Lot 8 Parcel No: 32.30.19.342A20 1.) Alt BM Description 2.) Bldg sewer length - amount of cover Plan revision Required? [] Yes I o Use other side for additional information. - �:- Date Insepctor's Si nature Cert. No. SBD -6710 (R.3/97) corrlrtterCe2.Wf.GoV Safety and Buildings Division County 201 W. Washingv 0111) St Croix 1 /1► / j' Madison, 51 Permit Number (to be filled in by Co.) Department of Commerce ■ 5 / 5 /�J G D Sanitary Permit Application State Transaction Number In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state -owned POWTS are Project Address (if different than rt�ailin address) submitted to the Department of Commerce. Personal information yy�e used for secondary �� fJ' purpo in accordance with the Privacy Law, s. 15.04 1 m , Stats. ou '�/ eV �/ ' I. Application Information - Please Print All Information (p r Property Owner's Name 200 Parcel 76 V �. 9 L�3D- /0�13- Property Owner's Mailing Address L1J /11 vut t 1 Property Location Z ONING 1243 Hwy 35 N J J cYT art N t,n� QFFICE qrG 8 Z Govt. Lot � City, State Zip Code Phone Number SW /4, NE 'A, Section 32 3 q2 26 Hudson, WI. 54016 715 -549 -6663 (check one) II. Type of Building (check all that apply) O Lot # T 30 N; R 19 ❑ E Q W ❑✓ 1 or 2 Family Dwelling - Number of Bedrooms f Subdivision Name ❑ Public /Commercial - Describe Use F City of ❑State Owned - Describe Use CSM ulrtber El Village of W +S � rte' � 20/5144 n Town of St Joseph III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ❑✓ New System ❑ Replacement ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit ❑ Permit Revision ❑ Change of ❑ Permit Transfer to List Previous Permit Number and Date Issued Renewal Before Plumber New Owner Expiration IV. Type of POWTS System/Compone Check all that appl ✓❑ Non - Pressurized In- Ground ❑ Pressurized In- Ground ❑ At -Grade ❑ Mound > 24 in. of suitable soil F1 Mound < 24 in. of suitable soil Holding Tank Other Dispersal Component (explain) El Pretreatment Device (explain) V Dis ersal/Treatmen Area Information: Design Flow (gpd)� Design Soil Appkication Rate(gpdsf) Dispersal Area Required (sf) / Dispersal Area Proposed � Sys! levation� 600 .7 ✓ 858 (35 ads chambers) J 35 ADS chambers G , VI. Tank Info Capacity in Total # of Manufacturer Material —'� Gallons Gallons Units New Tanks Existing Tanks �✓ ve �C�_ Septic or Holding Tank X 1200 combo Wieser Prefab Concrete Dosing Chamber X 800 combo I Wieser Prefab Concrete VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) r's Signature MP/MPRS Number Business Phone Number Plumbe Mike Rogers 225094 715 -235 -1132 Plumber's Address (Street, City, State, Zip Code) E4457 Hwy 12 Menomonie, WI. 54751 VII J. Court /De artment Use Onl Approved _ Di Permit Fee Date sued Issuing ent Signat e O er Giv eas or Denial $ `�-� e p Zl / O Q IX. Conditi EVVMLeasons for Disapproval �� �`O S�s e O �� b `, 3. S 1 Septic tank,, effluent filter and J dispersal cell must all be servtces I mainlained ` , t� ` � St Lao as per management plan provided by plumber, 2. 0 ee6ack ftquiCements must tte miirt fled Gee, e 5 D.'7 - 64 � Attach to complete plans for the system and submit to the County only on paper not less than 81/2 x 1 t inches in size n f SBD -6398 (R. 01/07) Valid thru 01/09 I Po I Z..4 d i 6pO e . 7 Alma S c l- 5� • 1 11111.111111'' "''�'�il 111611111 III1 IIlII! IIl� IIII 899044 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI CERTI FI EL'S SURVEY MAP RECEIVED FOR RECORD LOCATED IN PART OF THE SW7 /4 OF THE NE1 /4 OF 06/29/2009 03:45PM SECTION 32, T30N, R19W, TOWN OF ST. JOSEPH, ST. CERTIFIED SURVEY MAP VOL: 24 PAGE: 5635 CROIX COUNTY, WISCONSIN; BEING CERTIFIED REC FEE: 13.00 SURVEY MAP REC. IN VOL. 22, PG. 5436. COPY FEE: 3.00 OWNER _ PAGES: 2 2 WILEMAR STUDTMAN 1243 HIGHWAY "35" r O pa "E" _E AST f_ N. HUDSON, WI 54016 r-� 78 004' { Sg0'44 ,28 213.5 SURVEYOR EDWIN C FLANUM -' w �I NORTHLAND SURVEYING, INC. F »3 v� 0 Ica $pCK NE P.O. BOX 152 -� -' w -o ¢� S ° AMERY, WI 54001 o y W z 2 OT N E A D �' PROPOS Efl 0. I ~• c� pi o oH,VF . ' c9 O LOT 1 OF THIS CERTIFIED SURVEY MAP oo I O 46.5 i� jE F- � (C.S.M.) IS SUBJECT TO THE 66' WIDE °w [� - I x180 °44'29 E j�l t3 1 ¢ ACCESS EASEMENT AS SHOWN FOR Z g U INGRESS AND EGRESS TO LOT 2 OF THIS z C.S.M.. ° I ~ z I OWNERS OF LOT 2 SHALL BE GRANTED THE to 3.81 ACRES ESM w V 0 0 66' WIDE ACCESS EASEMENT FOR INGRESS (o) ^^ ^ w I 165,990 z p 3.09 ACRES MT AND EGRESS AS SHOWN ON THIS CERTIFIED I I ^ w U U SURVEY MAP. o w �c�i� u I 134,617 SO. o LEGEND CO c ALUMINUM COUNTY SECTION 9 CORNER MONUMENT FOUND v r `�� co z= m • 1.31" O.D. IRON PIPE FOUND . � Cc cc I 0 Z I Z m m 3/4" REBAR FOUND I N S �- cu O D 3/4" X 18" �l I IRON REBAR SET WEIGHING ° I W 1.50 LBS. PER LINEAR FOOT Uts I I Z N X X EXISTING FENCELINE a l 66.00' S88 48 " ` 1 00' ROADWAY SETBACK LINE °44 01 a 9s w ( ) PREVIOUSLY RECORDED DATA ^ hU C ;- v1�r' �5 " "W 8 T , SEPTIC VENT /�v O 5 0o4�F 2 SEE NOTE Z {h178 °5759 " �O� u �j © SHED o ° I oo I r HOUSE - I L40T 9 SHED NOTES: � I �� 5.85 ACRES LOTS MAY BE SUBJECT TO o 254,676 SQ. FT. FUTURE SPECIAL ASSESSMENTS O�YIII;lgpyn� FOR ANY UPGRADES AND G= rn NOTE B: �yvw xi IMPROVEMENTS TO THE ROAD. 0 Q O ► 9 i � l r' A MINIMUM DISTANCE OF 30' A SPECIAL EXCEPTION USE MUST BE MAINTAINED BETWEEN s c= 1 °� I r v THE EASTERLY SEPTIC VENT ' RDWIN C. _ s PERMIT IS REQUIRED FOR THE r ° T FLANUIi AND THE DRIVEWAY, PER s DISTURBANCE OF SLOPES 20% w p S -2487 = OR GREATER LOCATED ON THE N TOWN OF ST. JOSEPH. ,M,tE i ° I 1/4 CORNER Z c C.S.M.. THIS PERMIT IS APPLIED N cu w•wo OR THROUGH THE ZONING° I o SECTION 32 My y // OFFICE AND IS REVIEWED '�J ' �� THROUGH A PUBLIC HEARING 0 Mpp hgl PROCESS BY THE ST. CROIX c �'i� in z G 1 49 COUNTY BOARD OF r� I n SCALE IN FEET V = 100' S M 7, ADJUSTMENT. z 100 0 100 (S88 °10'56'W 600.081 r�2 (S88 °1 1'02"W 706.89') N ° "E 600 -0 N8 70688 6 "E d04 4 C ° (Mlo IJL V - IY S� Si /4 CORNER THIS INSTRUMENT DRAFTED BY MICHA IL ERICKSON 1 O SEGTION 32 SHEET 1 OF 2 SHEETS JOB NO. 09-25 DATE 04 -30-09 TL Vol 24 Page 5635 F �t Ja° S - PH VN V N k M kA 4 4 � M LU (S �. s � 5 1- s' 3,// 3 Z 5 ic/' ✓5 Alced 8- 9 1 9�5 13. 4 6consin SOIL EVALUATION REPORT #1792 Department of Commer in ic e: M. Code Page 1 of 3 Division of Safe a Steel's Soil Service, Inc. and n s , �-_. �- .; s� t ,. ty g County Attach complete site p on p of less than 8% x ze. Plan must St. Croix include, but not limited to. rtica d - ontal refer ) directjgn and parcel LD percent slope, scale or dime 'ons, arr w, and I tance to nearest r d. — 70 Please �nta rma iX Cr�UNTY Reviewed By 6 D * Personal information you provide may be u for secondary �IQ04 (1) ( ))• U Property Owner Property Location Johnson, Georganna Govt. Lot na SWIM, NE1 il S32, T30N, R19W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# ) ,,� ZL 465 old "E" East 1 na CSM Zp 5-) 1/ A �- Lv/ -'eS City State Zip Code Phone Number City [:]Village M Town Nearest Road 3 Hudson WI 1 54016 1 651 - 248 -9606 St.Joseph Old "E" Eas( ® Ne struction Use: ® Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD placeme ❑ Public or commercial - Describe na Parent material outwash Flood plain elevation, if applicable na ft. General comments Conventional system, system elevation 93.45ft. Trenches spaced and depth to code 4.00ft below grade. 1 and recommendations: /\ �j FT] Boring # ❑ Boring ✓ pit Ground surface elev. 97.45 ft. Depth to limiting factor 100 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *EffQ 1 0 -9 10yr3 /1 none I 2msbk mfr CS 1c .6 .8 2 9 -38 10yr4/4 none SO 2msbk mfr CS if .4 .6 3 38 -100 7.5yr4/4 none cos osg ml na na .7 1.6 J. 1 � a� 2] Boring # ❑ Boring pit Ground surface elev. 97.45 ft. Depth to limiting factor 100 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -10 10yr3 /1 none I 2msbk mfr f5 1c .6 .8 2 10 -30 10yr4 /4 none sicl 2msbk mfr CS if .4 .6 3 30 -100 7.5yr4/4 none cos osg ml na na .7 1.6 L i Ir 1 it * Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg/L * Effluent #2 = BOD <_30 mg /L and TSS <_30 mg/L CST Name (Please Print) CST Number David J. Steel 248956 Address Steel's Soil Service, Inc. ate Evaluation Conducted Telephone Number 994 200th St. Baldwin, W154002 9/7/2005 715 -760 -0347 SRD -8330 (R.07 /00) Property Owner Johnson, Georganna Parcel ID # Pending / Page 2 of 3 F 3 Boring # FI Boring ✓ g ® pit Ground surface elev. 91.45 ft. Depth to limiting factor 100 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 `Eff#2 1 0 -14 10yr3 /1 none I 2msbk mfr cs if .6 .8 2 14 -100 7.5yr4/4 none cos osg ml na na .7 1.6 F-1 Boring # Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff #1 "Eff#2 ❑ Boring # F1 Boring El 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/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 "EfW " Effluent #1 = BOD 30 < 220 mg /L and TSS >30 <_150 mg /L " Effluent #2 = BOD < 30 mg/L and TSS <_30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. SBD -833o at.071001 Sbcers SWI Service, Inc. STEEL'S SOIL SERVICE INC 3 of 3 David J. Steel Georganna Johnson 994 200 St. CST - POWTSM SW1 /4,NE1 /4,S32,T30N,R19W Baldwin, W154002 Lic. #248956 Town of St. Joseph St Croix Co. Direct 715- 760 -0347 CSM Lotj Fax 715- 684 -3449 Lt k --. S Legend N 1" = 40' I = Benchmark Ele. 100.00 ft l Top of 3/4" pvc pipe O3 __.... 3, 53� • = Alt Benchmark Ele. 99.30 ft Top of 3/4" pvc pipe Q = Borings Boring Elevations B 1 = 97.45 ft B2 = 97.45 ft B3 = 91.45 ft B4 = 0.00 ft 6 SC6 y 7 � Ar Private On -Site Wastewater Treatment System (POWTS) Index & Title Sheet Owner; f � J- i i. J Project Name and System Type: Location: Street Address 56,-) kV-7 s 3 t 30 q Legal Descriptio , Township /County Contents: Page 1: SanitM Permit Application Page 2: Plot Plan Page 3'Sr Page 4: pU,p "L.i°" °,i WeAz 64 �c Page 5: Septic Tank Maintenance Agreement Page 6: Warranty Deed Page 7: POWTS Owner's Manual Management Plan Page 8: POWTS Owner's Manual Management Plan Page 9: POWTS Owner's Manual Management Plan Page 10 Certified Survey Ma Page 11: Copy of House Plans Attachments: Plumber/Designer: Mike Rogers Signed Credential Number: 225094 Date: Chamber SAS SYSTEM ELEVATION AND SIZING CALCULATIONS Below Grade Soil Absorption Systems Studman Owner's Name 9/22/2009 Review Date �Y or N Highly Pretreated Effluent _ 3 ft Suitable Soil Below System 14 in Chamber /Unit Height 8 ft Maximum Bury Depth 3 PSA Bio Diffuser High Capacity 14" 600 gpd Estimated Daily Peak Flow 0.70 gpd /ft In -situ Wastewater Infiltration Rate 857.14 ft Chamber /Unit Area 31.50 EISA ft / Unit 28 # of Chambers /Units 94.O�ft Proposed SAS Elevation 15.50 Bottom Area ft / Unit Soil Surface Acceptable Finished Grade EL 4 (ft) Boring Grade Limitation SAS Elevation (ft) System Minimum Maximum Number Elevation (ft) Depth (in) Lowest Highest Elevation? 96.17 103.17 1 97.45 100 92.12 96.28 Yes 2 97.45 100 92.12 96.28 Yes 3 91.45 100 86.12 90.28 No Fill required 1. Depth of suitable soil required below the infiltrative surface for treatment. 2. Total height of chamber in inches. 3. Maximum bury depth as per manufacturer's recommendations. 4. Based on chosen system elevation, and chamber height. Top of chamber is equivalent to top of aggregate. The addition of fill for cover or the reduction of finished grade may be required to meet minimum or maximum code standards. Version 4.0 (04/03) TOTAL DYNAMIC HEAD CALCULATIONS Gravity or Pressure Dosed Systems Studman Owner's Name 9/22/2009 Review Date X x Gravity Dosed, or 600 gpd Design Wastewater Flow X Pressure Dosed ft Total Combined Lateral Length Y or N y Forcemain Drainback in Lateral Diameter Must. use 4 in. pipe with gravity dosed 75 ft Forcemain Length 2 in Forcemain Diameter 25 gpm System Flow Rate T 1.04 Ift ft Minimum Design Head ft Vertical Lift Forcemain Friction Loss 11.04 ft Total Dynamic Head 2.55 ft/sec Forcemain Effluent Velocity Choose Pump That Discharges At Least: 25.00 Igpm at 11.04 1 feet TDH Z 120.0 gal Maximum Dose 0.0 gal 5x Lateral Void Volume 12.24 gal Forcemain Drainback 12.24 gal Forcemain Drainback 132.24 gal Maximum Dose Volume 12.2 gal Minimum Dose Volume Dose Tank Information Locking cover with Warning /— — label and locking device and / sealed watertight Electrical as per NEC 300 and —% Disconnect i Comm 16.28 WAC �4 in. min. �__ E-- Alternate outlet Tank component is properly vented location Forcemain diameter Weiser Manufacturer 2 In. CapacitVI 600.00 Gallons —T Volume 16.76 gal/inch A Weep hole or anti - Dimension Inches Gallons B siphon device A 19.20 321.71 C B 2.00 33.52 P♦ ump off elevation (ft) C 4.60 77.17 _t j 89.83 D 10.00 167.60 D p Total 35.80 600.00 Dose tank elevation (ft) 3" Bedding un er tank. 89.00 Alarm Manuafacturer Iseptroni Alarm Model Number MJJ1 Pump Manufacturer Zoeller Pump Model Number IBN 152 PUMP PERFORMANCE CURVE TOTAL DYNAMIC HEAD /FLOW MODEL 151/152/153 PER MINUTE 5o EFFLUENT AND DEWATERING 14 153 12 w MODEL 151 152 153 `— ! 15z Feet Metes Gal. Liars Gal. titers Gal. Liters = 10 + 5 1.5 50 169 69 26t 77 291 $ 10 3.0 45 170 61 231 70 265 > s 1 85t 15 4.6 38 144 53 201 fit 231 3 20 6 1 29 110 44 167 52 197 a 25 71 16 61 34 Ei.) 42 159 9.1 — — 23 33 125 35 10.7 _ — 22 85 a + 40 122 — i t 42 3 Shut- ofit�d: 30 f . (9.1m) 381t. (1 44 a. (13Arn) 0145058 i 30 40 50 w 7o ea 90 too awam ffi 120 960 200 240 320 360 FWW PM MMUM e145OM Model 151 Models 152 / 153 SPECIA FACTORY FOR �6 7 61/4 APPLICATIONS 3 7 / 8 i — a 5/8 3 27/32 4 5/8 I I i s rmmd dusiV p anels available. I ) 3 7/8 3 27/32 *EbMcd aftffidn for duplex systems, are available and swpoed t an alarm. ® cxmil4rol switches are available for controlling ® 3 7/8 3 27 /32 p hase system- • variable level float switches are avail" f€1r variable level tang and short circle controls. I • Sealed Quit -8ax available for outdoor installations. See FW1420. I ' • Om 13D*F. (54 0 C.) special quotation required. FEE 11 11 /tb 12 1/8 151/1521153 Series � tstll52fl53 fNODELS Control Selection 1 5 � 4 3f6 Yode!' Vok>a•Ph (Node I AM x x N151 115 1 Nat 6.0 1 2or3 8N151 115 1 Auto 6.0 Included 2or3 EiSt 230 1 Non 32 1 2or3 sK2oea BE151 230 1 Auto 32 included 2or3 151 NI52 115 1 ion 6.5 1 2or3 BN152 115 1 Auto 6.5 Included 2or3 E152 230 1 Non 4.3 1 2or3 BE152 230 1 Auto 43 Irdxled 2or3 N153 115 1 Nan 10.5 1 2or3 BN153 115 1 Auto 10.5 IrncNded 2or3 SELECTION GUIDE E153 230 1 Non 5.3 1 2or3 variablelelrelfloat BE153 230 1 Auto 5.3 included 2.3 1. Single piggyback variable level float switch or double piggyback switch. Refer to FM0477. A CAUTION 2. See FMO712 for correct model of Electrical Alternator E - Pak. All installation of controls, protecfion devices and wiring should be done by a qualified 3. Variable level rxnntrol switch 104M used as a cardrol acdvatOr, duplex (3) licensed electrician. All electrical and safety codes should be followed including the most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). or (4) float RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. hWL T0: P.O. BOX 16347 LadwftKY 40256.0347 AfamAidurersof.. L` SHIP LoW KY 10: 3649 Cane Run 61 Road htrp✓/www.zoeffercom PUMP !O_ ( 7 , SM)774 START UP For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System startup shall not occur when soil conditions are frozen at the infiltrative surface. OPERATION The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity and quality of the wastewater stream will affect the performance and longevity 'of your POWTS. The installation of water - saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water softeners, iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground surface whenever possible. Note: this does not include laundry waste, showers, dishwater, etc. This system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable/fruit peels and seeds, bones, and food solids such as those produced by a garbage disposal should be minimized. Toilet tissue is the only paper that should be discharged into the system. Other non - biodegradable items such as baby wipes, tampons, sanitary napkins condoms, cigarette butts, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, paint, disinfectants, pesticides, antibiotics, solvents, etc., should not be flushed into the system as they can seriously damage your POWTS and contaminate your drinking water supply. Maintain a regular steady flow by spreading laundry washing throughout the week. Avoid vehicle traffic over all system components. Compaction of snow over the dispersal unit may cause it to freeze up. E3 Valves Valves shall be operated in the following manner: Q�9,larms Alarms should be tested on a regular basis by the home owner. If an alarm sounds, contact an individual licensed to service POWTS, There is normally a I day reserve under regular operating conditions, however water should be conserved until any problems with the system are corrected to prevent back -up of sewage into the dwelling or surfacing. INFECTIONS Inspection shall be made by an individual carrying one of the following' licenses or certifications: Master Plumber, Master Plumber Restricted` Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule). Septic Tanks Component Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any backup or ponding of effluent to the ground surface. Access openings used for service or assessment shall be sealed and/or locked upon completion of service. Any defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective locking device to prevent accidental or unauthorized entry into the tank. When the combination of sludge and scum in any tank exceeds one -third (1/3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with Chapter NRl'13, Wisconsin Administrative Code. The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. Provisions are to be made to retain solids in the tank. Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating. J<Pump Chamber/Treatment Tanks Component The inspection must include a test of all electrical equipment such as pumps, alarms and floats. A visual check must be made for leaks, backups, surfacing, missing or broken security devices and other hardware and the condition of the filter. Any service needs or repairs shall be promptly taken care of - Ground Gravity Component Dispersal Cells The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding at depths greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. Page _ of POWTS OWNER'S MANUAL MANAGEMENT PLAN FILE INFORMATION SYSTEM SPECIFICATIONS' Owner Septic Tank Capacity Zia v gal p NA Permit # Septic Tank Manufacturer / i eG - e c ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer / 0 NA Number of Bedrooms 100gpd/bedroom ❑ NA Effluent Filter Model 12 - ,PC' ❑ NA Number of Commercial Units NA Pump Tank Capacity gal DNA Estimated flow (average)* c.a gal/day Pump Tank Manufacturer , o r s i ,� El NA Design flow (peak ), estimated x 1.5* �� gal/day Pump Manufacturer Zm ❑ NA Soil Application Rate gal/day Pump Model �' Z ❑ NA Pretreatment Unit influent/Effluent Quality (NAO) Monthly Average ** O NA Fats. Oil &Grease (FOG) 30 m [3 Sand/Gravel Filter p Peat Filter ft p Mechanical Aeration Wetland Biochemical Oxygen Demand (BODs) El Other: Total Suspended Solids (TSS) 5 220 mg/L O Disinfection 5 250 mg/L Manufacturer: Model: _Pretreated Effluent Quality p Monthly Average * ** Dispersal Cells) Biochemical Oxygen Demand (BODs) 5 q In- 30 mg/L In-ground (gravity) C3 In-ground (pressurized) Total Suspended Solids (TSS) ❑ At -grade ❑ Mound Fecal Colifonn (geometric mean) 5 30 mg/L ❑ Drip -line ❑ Other: <10 +cfu/1 ooml f3Leaching Chamber Manufacturer Maximum Effluent Particle Size 1/8 inch diameter Model Approval Stipulation *Wastewater Flow Verification on and calculations: Soil Application Rate gp d/fe Area Req. - (Other than bedroom based) Absorption Area Credit per unit ft Minimum Number of Chambers p Aggregate Design Flow/Loading Rate= IE mil ** Values typical for domestic {non - commercial wastewater Materials: all materials must comply with WI Adm. Code and septic tank effluent. COMM84 and be installed per manufacturers specifications ** *Values typical for.pretreated wastewater. and approval letters. DESIGN CRITERIA "Wisconsin At -grade Soil Absorption System, Siting, Design & Construction Manual" (Converse et:a1.1990) ❑ "Wisconsin Mound Soil Absorption System: Siting, Design & Construction Manual" Converse, J.C. and E.J. Tyler. Publication 15.22 0 . "Design of Pressure Distribution Networks for Septic Tank -Soil Absorption Systems" Publications -9.6 ❑ "Design of Conventional Soil Absorption Trenches and Beds". R.J. Otis - ASAE Publications 5 -77 and "Design Manual -- Onsite Wastewater Treatment and Disposal Systems ". EPA 625/1 -80 -012 October 1980 [3 SBD - 10570 -P (8.6/99) "At -Grade Component Manual Using Pressure Distribution SBD - 10567 P (8.6/99) "In Ground Absorption Component Manual" ❑ SBD - 10705 -P (N.01101) "In Ground Soil Absorption Component Manual Version 2.0 p SBD - 10628P (N,6199) "Recirculating Sand Filter System Component Manual" Cl SBD - 10656 -P (N.6199) "Split Bed Recirculating Sand Filter System Component Manual" 0B-RD -: 30572 P (t.6 /99) Component Manual" ❑ SBD - 10691 -P (N.01 /01) "Mound Component Manual Version 2.0 p SBD 10595 -P (8.6199) "Single Pass Sand Filter Component Manual" ❑ SBD - 10657 -P (8.6/99) " Drip -line Effluent Disposal Component Manuar' ❑ SBD - 10573 P (R 6199) "Pressure Distribution Component Manual" ❑ SBD - 10706 --P (N.01 /01) "Pressure Distribution Component Manual" Version 2.0 Drip-line Effluent Dispersal Component Manual for Multi -flo Onsite Wastewater Treatment Units MAINTENANCE AND MANAGEMENT MAINTENANCE MONITORING SCHEDULE Service Event Service Frequency Inspect condition of tanks At least once every ❑ months year(s) (Maximum 3 yrs.) Pump out contents of s) When combined sludge and scum equals one -third (l 3) of tank volume Inspect dispersal cell(s) At least once every p months ea(A (Maximum 3 yrs.) Clean effluent filter At-least once every 2 ❑ months years) Inspect pump, pump controls & alarm At least once every E3 months ears) ❑ NA Flush laterals and pressure test At least once every ❑ months dye s) ❑ NA Valves At least once every p months ❑ year(s) NA Other: At, least once every p months 13 year(s) Imo' A Page of 0 Mound, At- Grade, In- Ground'Pressure The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface.seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. The pressure distribution system is provided with an opening at the end of each lateral to be used for flushing. The laterals should°be flushed at least once every three (3) years. Pressure checks of systems with multiple laterals should be done to ensure that equal distribution of effluent is occurring to promote the longevity of the system. REPORTS Reports for maintenance, inspection, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin Administrative Code., ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is properly and safely abandoned in compliance with Ch. COMM 83.33, Wisconsin Administrative Code. - All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. - The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or other inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replia . �c , qnent system: A suitable replacement area has been evaluated and may utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at thattime. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology holding tank may be installed as a last resort to replace the failed POWTS. ❑ 'The sitebas not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems maybe reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTIAN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR "OSSIBLE. ADDITIONAL COMMENTS POWTS' INSTALLER POWTS MAINTAINER Name mac, Name d- Phone � , Phone / SEPTAGE SERVICING OPERATOR (Pumper) LOCAL REGULATORY AUTHO Name Agency y` Phone Phone KMPDATMEMPOWTS OWNEWS•MANUAL.doe Page of ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner /Buyer W e6h , Q dl- 401 M4 ✓\ V\ Mailing Address 0 35 Property Address �t ( 7 d ' - 1�1 (Verification required from Planning & Zoning Department for new construction.) City /State Parcel Identification Number C 36 -16 93 - 2,6 - 230 LEGAL DESCRIPTION Property Location W '/4 , N>E '/4 ,Sec. 3 2 - , T j) N R I J W, Town of Subdivision Plat: , Lot # Certified Survey Map # , Volume Z , Page # Warranty Deed # ?6 /77`7 (before 2007)Volume , Page # Spec house G yes _:1 no Lot lines identifiable i- yes i-1 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. 1 /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 drooms _ OF APPLICANT(S) 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 Ililll lllli llill lllil lllll IIlII IIN 11111111111111 * 9 0 1 7 7 9 1 State Bar of Wisconsin Form 3 -2003 90 QUIT CLAIM DEED BETH PABST REGISTER OF DEEDS Document Number Document Name ST. CROIX CO ., WI RECEIVED FOR RECORD 08/10/2009 02:40PM THIS DEED, made between Double Star, Inc., a Wisconsin Corporation QUIT CLAIM DEED EXEMPT It ( "Grantor," whether one or more), REC FEE: 11.00 and Amy Studtmann a single person and Wesfley Studtmatm, a sin' le person as TRANS FEE: 180.00 joint tenants Jesk ✓ PAGES: 1 ( "Grantee," whether one or more). Grantor quit claims to Grantee the following described real estate, together with the Recording Area rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ( "Property") (if more space is needed, please attach Name and Return Address addendum): AMY STUDTMANN 1243 HWY 35 HUDSON, WI 54016 Part of the SW 1/4 of the NE 1/4 of Section 32, Township 30 North, Range 19 West,,,Town of St. Joseph, St. Croix County, described as follows: 1,04 of ,Uertified Survey Map recorded June 29, 2009 in Vol Part of 030 24, Page 56 ocument No. 899044. Parcel Identification Number (PIN) Together with and subject to access easements as shown on said This is not homestead property. Certified Survey Map. (is) (is not) Dated August 1 0* 1 , 2009 D—oublo Star Inc. (SEAL) //�/ � (SEAL) * * Vilemar Studtman, President (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) authenticated on 01711UGE1 K . ) ss. NOTARY PLIEstIC St. Croix COUNTY ) STATE OF WIS90 ,�,{ * Personally came before me on August 1U "'' ,, , 2009 TITLE: MEMBER STATE BAR OF WISCONSIN the above -named Wilemar Studtman, President of Double (If not, Star Inc. authorized by Wis. Stat. § 706.06) to me kno n to be the person(s) who executed the foregoing instru and ac owled d e. Ay 1A LA THIS INSTRUMENT DRAFTED BY: Wilemar Studtman 1243 Hwy 35 Hudson, WI 54016 Notary Publt , State of Wisconsin My Commission (is permanent) (expires: Z 3 1 1 3 ) (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. QUIT CLAIM DEED ® 2003 STATE BAR OF WISCONSIN FORM NO. 3-2003 ' Type name below signatures. 1 of 1 o P�06 pF,41 g.,u aP� ag'.L a�p'd x a SIA ;E I ;0s p4;® '10 Q 4 A : '� ccm 1• �s ae 4 y 0'�t a S-,Z t.-,9 4 Is {p a Gr,L a P • E 9 r t � - i � x 1 a t -• � 1 .f � 1 a Ol0110 atop pd,�. p P�1K MOWS t p F .o•,os �I •8 r i i ,O,CX AA'd'N r OfOi b ' 1 (! A r {J Y • , fi t t� i i SA A*W 0.11 W Ar LW Wm� Jill , 9" tD o" m • A'�: e� 6 •P,'91