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HomeMy WebLinkAbout030-2123-20-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 430159 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: Siebert, Shawn St. Joseph Township 030 - 2123 -20 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 100 / 00 , v brA l NW 1 L , cryl r la.1121 33.30.19.1000 TANK INFORMATION ELEVATI N bATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark /Y] / (�-(� a //,4/ Dosing 1 �7 Alt. BM tow, �LZ P / S O Aeration Bldg. Sewer Holding ' t UU St/Ht Inlet saW .4 TANK SETBACK INFORMATION SUHt Outlet f TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic /; Dt Bottom 7,5 0. 4 1q yy Dosing Header /Man. C - 2 06 Z o •3 Aeration Dist. Pipe I Holding B ot. System Final Grade - , L O r PUMP /SIPHON INFORMATION , Manufacturer Q Demand St Cover GPM 5 'r+s�✓ `� 3• a Model Number ,, TDH Lift Friction Loss ystem Head TDH t C j 3.3- S2=*t_t'Vj J_kiP4rk. Ln S� 11f !►,33 b.D Forcemain Length / Dia. „ Dist. to Well 1 y , [ , Z , too-01 81 vZ ✓l 0 Y - P. ? 0 SOIL ABSORPTION SYSTEM L BED/TRENCH Width Length No. Of Trenches PIT DI MEN S No. Of Pits r Inside Dia Liquid Dept DIMENSIONS 3 ,/ z 7 � / 7 r SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR r Type 01 System: ' UNIT Model Number: DISTRIBUTION SYSTEM EF6 4 N w< P Header /Manifold Distribution tak I x Hole Spacing I x Hole Size g i Vgnt to Air n n Pipes) % 4 I n F• l frrafaY / A �- � 13� ” Leng D i Len th (0 Spacing / 9 9 � P � SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over -►— ^ Depth Over xx Depth of xx Seeded /Sodded Mulched Bed/Trench r- Bed/Trenc s Topsoil es No L C J No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:01/2 / 0? In Location: 576 128th Ave Hudson, WI 54016 (NW 1/4 NE 1/4 33 T30N R19W) Perch L / 1�� o� 1 y� Parcel No: 33.30.19.1000 1.) Alt BM Description = VlSc � PN - fad - t ove, � e Estates Lot 2 � ^ / tA z v "L 4 2.) Bldg sewer length d \ it - amount of cover = TD T � � 3 r � S $ p C� Q� ce /rtit � V -2- r' � Ian revision Re uired . Yes No Qp d Use other side for additional information. W SBD -6710 (R.3/97) Date sepctor's Signature Cart. No. ,\ ST. CROIX COUNTY s WISCONSIN r _ ZONING OFFICE e 1 16900 ■ ion — r.. ■r ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road �• � ' —� Hudson, WI 54016 -7710 (715) 386 -4680 FAX (715) 386 -4686 Monday, February 23, 2004 Shawn Siebert 576 128th Ave Hudson, WI 54016 Regarding septic inspection for Shawn Siebert. Location of Property in St. Croix County: Municipality: St. Joseph Township Subdivision or Plat: Perch Lake Estates Certified Survey Map: Lot: 2 Address: 576 128th Ave Dear Applicant: A septic inspection of the above reference property was conducted on September 23,2003. This property is located in the NW 1/4 NE 1/4 of Section 33, T30N R1 9W, Perch Lake Estates (Lot 2 ), St. Joseph Township, St. Croix County, Wisconsin. At the time of the inspection, this septic system was found to be code compliant for a 4 bedroom home. Emily Lund inspected installation. System elevation lower by a foot, but still Okay for soils and depth of boring. If you have any questions regarding this, please contact our office at 715.386.4680. Si rely, am Quinn Zoning Staff cc: file I Safety and Buildings Division County iscoinsin 201 W. Washington Ave., P.O. Box 7162 Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608) 266 -3151 4 1 6 Sanitary Permit Application State Plan I.D. N In accord with Comm 83.21, Wis. Adm. Code, personal information you provide � A may be used for secondary purposes Privacy Law, sl5.04(lxm) Project (if different than mailing I. Application Information - Please Print All Information W o Property Owner's Na me r ell " Parcel y Lot x Block k 030 Property Owner's M ailing Address 1 i U u J Property Location e S l7d L!) l -A, %.Section LS �...- City, State Zip Code phonol+htaftier S?t9 ($` .. .-„se,' (circle o ) H. Type of Building (check all that apply) T ?0 N; R / 9 E o i1 or 2 Family Dwelling - Number of Bedrooms �/ 3 Subdivision Name CSM Number ❑ Public/Commemial - Describe Use '--"'// 11 State Owned - Describe Use (,(f Gvlln��'t� ell � ❑City ❑Village GiTownship of III. Type of Permit: (Check only one bog on line A. Complete line B if applicable) A' (9 System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑Permit Renewal ❑Permit Revision ❑ Change of ❑Permit Trarufer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. of POWTS em: (Check all that a ) 0' Non Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Weiland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dispersalfrreatment Area Information: .t Z " ,Y r A S Le•+� Design Flow (gpd) Design Soil Application Rate(gpis� I Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation a t / may VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks 2.0 i£'e IV Septic or 41oMi grT-w* 12 SV r- Dostng Cumber VII. Responsibility Statement- I, the assume for installation of the POWTS shown on the attached plans. Plumber's Na me (Print) Plum is Si - KUMPRS Number TB Phone Number ag .7 �0 s Plumber's Adoptp 14% City, State, Zip ode 28288 McKenzie Rd. VIII Only A PP roved El Disapproved Sanitary Permit Fee (includes Groin water Date Issued t Signature Surcharge ps) ❑ Owner Given Reason for Denial i IX. Conditions of Approval/Reasons for Disapprov p C U PJI�u7 -tA&1h Our non r 331 � z 3 Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size Fogerty Plumbing #221180 28288 McKenzie Rd. Spooner, WI 54801 (715) 635 -960 �p3 AE/ v LaT Z VL AWI X QI 1L R 3 - srRGE l,Kp . sPo.�sd�- I © r tr�cLf �S� � fi4r� ssfsr.Ei.�+ f 4/ wiFX. y IA'dx - -- GE�L LE,,diC7'A' .t'X d7S' Fogerty Plumbing #221180 28288 McKenzie Rd. Spooner, WI 54801 (715) 635 -960 2 v ' Lor# z ,ter /row f s�✓ tmr -444Wir- � ®= s r. /LJ. 6, •v Qo y ��x C-2 lso ,Z ry o `C O 0 N � M e ; Q- u II it C o A L CD y' `, W CZ (or CD ty q►l� s X �,C \ CD CD CD O A CD CD O .`• \�r� } _ a CL O � t♦ ti i � �. t=i C) iy } old 9 O a \S Z Pq �l �r CD a N ro 0 II II i` N 'v 8 0 3 1 CD (D .� X o � N � � y A h A l Fogerty Plumbing #221180 PAr.f GF j 28288 McKenzie Rd. PUt-%P CHAMBER CROS5 SECTIOIJ AKIO SPECIFICATIOUS Spooner, WI 54801 (715) 635 -9609 VEIJT CAP 4`C.I. jE.MT PIPE WEATHERPROOF APPROVED LOCKIAIG JUMCTIOAI BOX MAWHOLE COVER DOOR. !Q WIWDOW OR FRESH 12 "MIU. AIR IWTAKE I I GRADE I `i' MIAJ. I B" /r111J. COIJDUIT -- ____`___ 19 "M(AI.� ---- - - - - -- i PROVIDE I — -- — IAILET AIRTIGHT SEAL * / A I I i I I I I ALARM I I • *APPROVED C JOINTS WITH I L LEV. FT., APPROVED PIPE __� 3' ONTO Pump- OFF D SOLID SOIL COUCRETE BLOCK RISER EXIT PERMITTED OWLH IF TAAIK MAMUFACTURCR. HAS SUCH APPROVAL SEPTIC E SPECIFICATIOAIS DOSE TAWKS MAQUFACTUREK. 4i�3Fc'/E IJUMBER OF DOSES: S PER DAB TAWK SIZE: /Z- MZ7 -f_0 GALLOWS DOSE VOLUME —/-"- c _ ALARM MAWUFACTURER: IMCLUDIMG B eKIFLOW: �� "� 2 GALLONS �6i • ��ll MODEL WUMBER i /Dl CAPACITIES: A= 311 IMCAE50R t/ CALLOUS SWITCH TYPE' 15 = Z- INCHES OR Z P GALLONS PUMP MAMUFACTURER: "aGI C IUCHES OR .- a_6Y_ "" GALLONS MODEL HUMBER. D - 9 INCHES OR 114 GALLONS SWITCH TYPE: i*Cr4tCwr MOTE: PUMP AMD ALARM ARE TO DE MIWIMUM DISCHARGE RATE INSTALLED OM SEPARATE CIRCUITS VERTICAL DIFFEKEIJCE BETWEEM PUMP OFF ARID DISTRIBUTIOAI PIPE.. FEET + MIIJIMUM METWORK SUPPLY PRESSUfL . . . . .. .. - �"' FEET + — FEET OF FOR M X 1UIZ FACTOR.. FEET •� TOTAL Ot JAMIC. HEAD = //32 FEET �•�� IMTERMAL DIMEWSIOMS OF TAWK: LEIJGTH h ;WIDTH ;LIQUID DEPTH - �- L SIG►, 1ED� - -! �_�_ /?_ i i�c►Icc �ui►�aco• �7� ^• --. M ODEL DVP M OD EL Vertical 04 P0 • Pump I I Su bmersible • i UP Cella, Orainff i GOULDS � 3 4 _ c w 0. i Pump Specifications METERS FEET ' % HP o 40 GPM j '0 MODEL: 3871 I Discharge size 1 NPT 9 30 Solids: YB" maximum 6 ' 25 Motor - Single phase: 115V 6 20 Materials of Construction S2 5 Brass/thermoplastic ` a 15 EPOS Features and Benefits 4 ' i *Top suction eliminates a 3 '° impeller clogging. 2 5 EPOa • Corrosion resistant construction. O L 0 10 30 w to usaM • Float actuated switch. 0 2 < 6 8 10 12 1AW ' CAPACITY METERS FEET 25 Pump Specifications Features and Benefits MODEL DVP03 4/10 and' /2 HP • EPO4 impeller- semi -open design 620 Up to 60 GPM with pump out vanes to protect 5 mechanical seal. 15 — Maximum head to 32' ° Discharge size 1' /2' NPT • EP05 impeller - enclosed design 3 10 Solids: 3 /4 ' maximum for improved performance. a z Motor • Rugged glass - filled thermoplastic j , 5 All motors feature ball casing and base design provides j bearing construction. superior strength and corrosion i ° ° 0 5 10 15 20 25 30 35 ao U.S.GPM resistance. 0 2 a 6 a ,om'mr Single phase: 115V *Cast iron motor housing for ! CAPACITY Materials of construction Cast iron efficient heat transfer, strength, Thermoplastic and durability. Stainless steel • Corrosion resistant threaded stainless steel shaft. • Available for automatic and manual operation. • CSA listed models available. ',� All Models are designed for continuous operation and feature stainless steel hardware. ;L Wisconsin off Wisconsin Department of Commerce SOIL EVALUATION REPORT Page _ of 3 ♦ Division of Safety and Buildings in accordance with Comm 85, Ws. Adm. Code County St. Croix Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 0 3 percent slope, scale or dimensions, north arrow, and location and distancoto nearest road. pending Please print all information. iewed y Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Del =sam Govt. Lot NW 1/4 NE 1/4 S 33 T30 N R 1 g j (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 950 N. Knowles Ave. 2 na Perch Lake Estates City State Zip Code Phone Number ❑ City ❑ Village (aTown Nearest Road New Richmond I WI 5 4017 1(715)246-6707 St. Jos ® New Construction Use: ® Residential / Number of bedrooms 4 Code derived design flow rate :''" '`" 4 ' GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material oLtumgh Flood Plain elevation if applicabl T t- �,.1 ft• General comments f and recommendations: i trenches @ el. 100.40, spaced to code 3.50' below grade ` Boring Boring # ' a [ Pit Ground surface elev. 103.90 ft. Depth to limiting factor 90 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 I 'Eff#2 1 0 -9 10yr4/3 none sil 2msbk mfr cs 2f .5 1.8 2 9-1 8 yr4 /4 none sicl .4 .6 3 8 -90 .5yr4/6 none ms O.s ml na na 1-2 2- -;;;� 4- ' 2, y 52] Boring # � Boring Pit Ground surface elev. 103.9 Depth to limiting factor 96 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -10 10yr4/3 none sil 2msbk 2 10 -32 4/4 none si 1 2msbk mfr 9W If . 4 3 32 -96 7.5 4/6 none . Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/L uent #2 = BOD 30 mg/L TSS 5 30 mg/L CST Name (Please Print) Signature T Number Gary L. Steel 02298 Address Date Evaluation nducted Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 6 -13 -2001 715- 246 -6200 Property Owner Del Magsam Parcel ID # pending Page 2 of 3 ❑ Borin # Boring ❑ g ®pi Ground surface elev. 102.2 Depth to limiting factor 96 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 1 0 -10 10yr4/3 none sil 2msbk mfr cs 2f 5 8 2 10 -33 10yr4/4 none sicl 2msbk mfr CrW 1f 4 6 3 33 -96 7.5yr4/6 none ms Osq ml na na .7 1.2 F-1 Boring # F] E] ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil A plication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fF in. Munselt Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Etf#2 ❑ Boring # F] 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 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 please contact the department at 608 - 266 -3151 or TTY 608 - 264 -8777. alternate format le p need material m an , p SBD -6330 (R.6 /00) STEEL'S SOIL SERVICE Gary L. Steel 1554 200th Ave. CSTM2298 Del Ma9sam New Richmond, WI 54017 MPRSW -3254 NW4NE4 533- T30N -R19W (71.5) 246 -6200 town of St. Joseph lot #2 -Perch lake Estates This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of the test may or may not be as shown as permanent lot lines were not established at the time the test was conducted. N 1 " =40' BM.= top of mid -lot survey stake @ el. 100.00'. alt. BM.= top of 1" pvc pipe @ el. 101.40' �1 1 3 'Z ©� Gary L. Steel 6 -13 -2001 Jul 06 03 07s09p FOGERTY PLUMBING 171563552136 P.l 6s i.- �y3 --/7� ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Ownerffie "r Sf'.srirar/ L42id"i Mailing Address l .yF CD Sze, Property Address 574 " ,✓ (Verification required from Planning &partment for new construction)_ . City6tatc _ Parcel Idendfleation Number °2w13� — � L ECAAL DESCRIP11ON Propctty Location &/r/ %., &_ Y., Sac. 32 •• T _S j *__ N- R Town of � tano� .V Subdivision ,h ,rt&a 1j&C A% - ___ _ , Lot # Cerlitied Survey ^ Map # ,Volume-' , Page p __, Warranty Deed H ,�2 �O y� . VoIwne _ Page Spec house d yes Erno Lot lines identifiable f yp 0 no SYSTEM MAXNTI9NANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of paniping out the septic tack evcq three years or. sooner• if neededby a licensed pttrruper. Wbat you put into the system can affect /bc function of the septic tank as a treatment stage in the waste disposal syatCM. The property owner agrees to submit to St. Croix Zoning Department a eedifiCn6ou form, sigced by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying (hat (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumpiog (if necessary), the septic tank is less than 113 full of sludge. Uwe, the uodersigned have road the above requirements and agree to maintain the private sewage disposal system with the staudards set forth, herein, asset by the Npar(mcor of Commerce and the Department of Natwat Resources, State of Wisconsin. Certification slating (bat your septic system has been maintained must be completed and returned to the St. Croix County Zoaiug Office within 30 day" the three ve3r ►rnir „ inn A• f(o/OD 1GNA•fURE OF APPLICANT DATE Q UR, C.ERTIFI C Tl I (we) certify that all statements on this form true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the pro described above, by vinue of a warnnry deed recorded in Register of Deeds Office. SICNAIVRE OF APPLICAW DATE Any infom1atioa that is mis•representedmay result in Ib1C sinitary permit being revoked by the Zoning Department. •' "" •• Include with (his application: it stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed I d HLI H� Z19 'ON M Al S3I1MOdd 'S YV AV H1 NOW H -L -'IQf POWTS OWNER'S MANUAL & MANA©EMENT PLAN Page J of R X INFORMATION SYSTEM SPECIFICATIONS - Owner _ Septic Tank Capacity �3 —a a i ❑ NA Permit # Septic Tank Manufacturer Z 0 NA DESIGN PARAMETERS Effluent Filter Manufacturer _ DNA Number of Bedrooms 0 NA Effluent Filter Model 0 NA Number of Public Facility Units )(NA Pump Tank Capacity �— U gal Jf NA Estimated flow (average) ,5K) gal/day Pump Tank Manufacturer NA Design flow (peak), (Estimated x 1.5) pv and Pump Manufacturer ® L 10 NA Soil Application Rate al/da /te Pump Model Q.kA Standard Influent/Effluent Quality Monthly average` Pretreatment Unit ) , ( NA Fats, Oil & Grease (FOG) 530 mg/L 0 Sand /Gravel Filter 0 Peat Filter Biochemical Oxygen Demand (0013 5220 mg/L 0 NA 0 Mechanical Aeration 0 Wetland Total Suspended Solids (TSS) 5150 mg/L 0 Disinfection 0 Other. Pretreated Effluent Quality Monthly average Dispersal Cell(s) 0 NA Biochemical Oxygen Demand (BOD 530 mg /L A In- Ground (gravity) 0 In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L NA 0 At -Grade O Mound Fecal Coliform (geometric mean) 51W cfu /100m1 0 Drip -Line 0 Other: Maximum Effluent Particle Size a in dia. 0 NA 0 NA Other: 0 NA Other: 0 NA "Valdes typical for domestic wastewater and septic tank effluent. air 0 NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: 0 month(s) (Maximum 3 years) 0 NA Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume 0 NA 0 month(s) (Maximum 3 years) 0 NA Inspect dispersal cell(s) At least once every: fit year(s) Clean effluent filter At least once every: ❑ month(s) O NA Z year(s) 0 month(s) � MVA Inspect pump, pump controls & alarm At least once every: 0 year(s) 0 month(s) Q NA Rust- laterals and pressure test At least once every: 0 year(s) D month(s) LL NA Other: At least once every: D yeads) Other. Q. NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) 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 back up or ponding of effluent on the ground surface. The dispersal cells) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y 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 NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. Page 2 = - of _Z- f+NT UP AND OPE RATION For new constriction, 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 start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water, fruit and vegetable peelings; gasoline, grease; herbicides; meat scraps; medications, oil; painting products; pesticides; sanitary napkins; tamp bri tampons; and water softener ne. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter 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 another inert solid material. CONTINGENCY PLAN If the POMIT fails and cannot be repaired the following measures have been, or: must be taken, to provide a code compliant replacem system: A suitable replacement area has been evaluated and may be 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 fines 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 that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS t chnology a holding tank may be installed as a last resort to replace the failed POWTS. sitVas %een evaluat to . ntify a suit a re lacement ar . Up failure of the i a so and site ati orm to locate suitabl repiacem nt are If no replac ent ar available a holding tank a be sort to r eplace lied POWTS. Mound and at -grade soil absorption systems may be 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 CONTAIN 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 IMPOSSIBLE. � #221180 en Srtooner W154�11_ -- (715) 63 tGM POWTS INSTALLER POWTS MAINT Name I 4 v Name Phone S" 36 Phone t Ly ! SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name �> 1 OZ8(K CW' JT Phone Phones ` This document was drafted in compliance with chapter Comm 83.22(21(b)(11(d) &(f) and 83.5411), (2) & (3), Wisconsin Administrative Code- J 2229 P 368 STATE BAR OF WISCONSIN FORM 2 - 1999 KATHLEEN H. WALSH Document Number WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., WI This Deed, made between Delwin R. Magsam RECEIVED FOR RECORD 05/05/2003 09:45AN WARRANTY DEED EXEMPT II Grantor, and Shawn R. Seibert REC FEE: 11.00 TRANS FEE: 231.00 COPY FEE: CC 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 Lot 2, Perch Lakes Estates, St. Croix County, Wisconsin. Name W4 tarn Address���1_!�q�1D AT C AT La'j'! P.C' OX 359 HUDSON, Wl 54016 030- 109940 -006 _ Parcel Identification Number (PIN) This is not homestead property. Q$) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this 1 7, day of May 2003 /�D� ?�' �A * * Delwin R. Magsam w * AUTHENTICATION ACKNOWLEDGMENT Signature(s) Delwin R. Magsam STATE OF WISCONSIN ) ) ss. County ) albntica>>E11 � d of May 2003 Personally came before me this day of the above named #'Ifristrta dglau{I •� -- Tj1XI ' EI3EIC SF S ATE BAR OF WISCONSIN — `�' to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. 'by :706.06, Wis. Stats.) fS INSTRUMENT WAS DRAFTED BY Attorney Kristina Ogland Notary Public, State of Wisconsin Hudson, WI 54016 My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) _ , ) * Names of persons signing in any capacity must be typed or printed below their signature. Information Professionals company, Fond du Lac, wi STATE BAR OF WISCONSIN OW-655 -2021 WARRANTY DEED FORM No. 2 - 1999 ..,. .. _..... 6 Z f �c t t 0.0 s ko lo op logo � h I �. .0V9Z OIL CN V it % I �8Q�60.f4N 3 «e4 � ffi sow OCw�! e CON, v �! l i d M � SO'd 09ZZ999S U 41JOW uaiied Ad 90'8 EOOZ '9Z eunr 'Aepfun41