Loading...
HomeMy WebLinkAbout030-2123-40-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 0 453063 t l 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)]. 1� Permit Holder's Name: City Village X Township Parcel Tax No: Vorst, Garth I St. Joseph Township 030 - 2123 -40 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: l0O • d - D - o C C 33.30.19.1002 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY ATION BS HI FS ELEV. 7 70 6, I /D!o l Z /Do- o Septic Bench ark ! L L o Dosing O aD Alt. B .57 C o IV /off elf Aeration - Bldg. Sewer Q' O• 9 Z Holding _ St /Ht Inlet u .0 7. TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet q 2 Q � Septic 0 / 12 / 042f Dt Bottom � //� 3. "1 Dosing 0 ea er/M 7 Za c�iV 3•t OZ_q� Aeration Dist. Pipe 3. lo z— Holding pot. System GZ / l 3.1 /Q Z i final Grade 17 O /v / PUMP /SIPHON INFORMATION Manufacturer V Demand St Cover ' v g ( S ` 0s. Model Number Gl� 3 g • 7 Cyr, s. � � • d � i- y TDH Lift ,� Friction Los System d TDH 3 3 Ft Forcemain Lenq E- I, Dia Dist. to\ II�� SOIL ABSORPTION SYSTEM s d BED/TRENCH Width ��- / Length No. Of Tre nches PIT DIME o Of its Inside Dia. Liquid Depth DIMENSIONS D SETBACK SYSTEM TO P/L 6 JBLDG WELL LAKE /STREAM L C G Manufacturer: INFORMATION CHA OR Typ�pt,Syst�:m L / / / / t J � UNIT Model Number: DISTRI UT ON SYSTEM , Imo, Heade /Manifold I D istribution c/ x Hole Size !i x H e Spacing / e to Air nt 9 Pipes) rJ h 2 2 . S ��' o� L Dia 2 r Length Dia i . Spacing I + 'L SOIL COVER x Pressure Systems Only zx Mound Or t - Grade Systems Only Depth Over Depth Over x Depth of xx Seeded /Sodded Ic etl Bed/Trench Center Bed/Trench Edges Topsoil Yes No Yes No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: /� � _ Inspection #2:7/ 72 Location: 584 128th Avenue Hudson, WI 54016 (NE 1/4 NE 1/4 33 T30N R19W) Perch Lake Estatts 170t 4 Parcel No: 33.30.19.1002 1.) Alt BM Description = _ ( D / /f ��// 2.) Bldg sewer length = 2 z t C4t� 4-Q,e.44 led, awl. - amount of cover = /.�, �� ay-le- I w Plan revision Required? Yes No - - Use other side for additional information. .- SBD -6710 (R.3/97) Date Insepctor's Signature Cart. No. Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 5 C r U i X scons�n Madis to be on, WI 53707 - 7162 Sanitary Permit Number ( filled in Co.) Dep artment of Commerce (608) 266 -3151 ys3 6 . * e Sanitary Permit Application State Plan I.D. I./ Number In accord with Comm 83.21, Wis. Adm. Code, personal information you provide p an 7 ! - T 15- may be used for secondary purposes Privacy Law, s15.04(1)(m) Project Address (if different than mailing address) I. Application Information - Please Print All Information 5g� /o 1 � Property Owner's Na me Parcel _ 2 12 Lot d Block M C t PAID Property Owner's M ailing Address -,4 -- Property Location ? E -IVFP /oa Z City, S tate / G -_ 'A, ' 'A.Section 33 tY� Zip Code Phone Number u( ® ,� l 01 fo ' Y 2 0 2004 (circle one) II. T of Building T N; RE otV Type g (check all that apply) � � . CKVIXLUU(v .2r, or 2 Family Dwelling - Number of Bedrooms ZONING ZOFFICE Subdivision Name CSM Number -IC — ❑ Public /Commercial - Describe Use 3 3 /Z tti ,— - - --��� d ------ - - - - -- L des ❑ State Owned - Describe Use S 06� I_JCity I_jVillage IKITownship of III. Type of Permit: (Check only one ox on line A. Complete line B if applicable) A. New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal , Permit Revision ❑ Change of CI Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner ���,� /_•� ;/� �� IV. Type of POWTS System: (Check all that appl ❑ Non - Pressurized In- Ground ,Mound > 24 in. of suitable soil IJ Mound < 24 in. of suitable soil U At- Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank I_I Peat Filter I -I Aerobic Treatment Unit I_I Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line L) Gravel -less Pipe ❑ Other (explain) V. Dispersal/Treatment Area Information: S h Design Flow %pd) Design Soil Applicati n Rate(gpdi Dispersal Arei equh4d (sf) Dispersal Area Proposed s System Elevation VI. Tank Info apacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank / Aerobic Treatment Unit Dosing Chamber / VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plum Na me (Print) P her's Si ature MP /MPRS Number Business Phone Number .1 t o a =; c 71.�':��b - 13 bu Plumber's Addre ss (Street, City, State, Zip e) � o7o Am 4aJ5C J lb VII ount /De art ent Use Onl Approved ❑ Disapproved Sanitary Permit Fee (i eludes Groundwater Date ssued I , uing A nt ignatur mps) Surcharge Fee) (/D ❑ Ow en Reason for Denial " 2 Q IX. Conditions of pproval/ asons fob t,4l�c� , Attach complete plans to the County only) for the system on paper not less than 8112 x 11 inches in size SBD -6398 (R. 01/03) ■ .sO�IQ�Qlkafia. -� ♦ cy/ 7 de eIeU. • /o ca c e d / Orga. 56v< s/0 Pcrw 179/ da, der vers�Pr�. /oZ i/, A.-C -A Lame ES�a Ets n. of S�• �'�sep/C T > � o ° fo S /oPes 2t;zo; S/o o p 8anch ntaoe 7 ,o o!' Mid -foe- S Ke . o /133Ct m e Q/ A l�ca�' eie� = ioo.co: PreQ osad 1, �0 9a.P, �,cJ.ee �s C.vri e.r� 5.r. ,,,� /�a,bc1 -Ial eFF /uc F; 1f.er N pro po s M Bev i oy 4 / suf.s/ORde. wties corervEe I V o l bcCi Id:n9 Sa.acr' Pumlo chc,.nD� /' ,' to c ° p o Proposed �• r' i o 3 . ,off 1"CSict Pe Pro poscc,' rvLown d af. 19.0 / 95 o c) /S X 9O'a1,31ocrsa/ a.e. //. Four G /a sera /5 of /,a x S/ om -Y %8 ori'Fi'crs s,,o u ced a e Z. 53.. Sta ee .E/ev`- 93.4T' z V7 eel' �c o� y I s ' Safety and Buildings commerce.wi. OY 4003 N KINNEY COULEE RD g LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 i sco n s i n www.commerce.state.wi.us /sb www.wisconsin.gov tl epartment of Commerce Jim Doyle, Governor Cory L. Nettles, Secretary May 10, 2004 CUST ID No.222904 ATTN. Rod Eslinger ZONING OFFICE JAMES W BOUMEESTER ST CROIX COUNTY 1070 HWY 35 N 1101 CARMIC1 AEL RD HUDSON WI 54016 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/10/2006 Identification Numbers Transaction ID No. 997459 SITE: Site ID No. 671559 Garth Vander Vorst Please refer to both identification numbers, 584 128TH Ave above, in all correspondence with the agency. Town of Saint Joseph St Croix County NE1 /4, NEIA, S33, T30N, R19W Lot: 4, Subdivision: Perch Lake Estates RI`', : FOR: Description: New 3BR Mound Object Type: POWTS Co iiponent Manual Regulated Object ID No.: 957594 "C Maintenance required; 28 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 F (N.01 /01); Zabel A -100 Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. SEE C No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Reminders • This system is to be constructed and located in accordance with the approved plans and with the 'Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems Version 2.0" SBD - 10706 -P (N.01/01). • This system is to be constructed and located in accordance with the approved plans, the "Mound Component Manual for Private Onsite Wastewater Systems Version 2" SBD- 10691- P(N.01 /O1). 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. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. I s JAMES W BOUMEESTER Page 2 05/10/2004 Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on thi s letterhead. erhead. 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 ennis Sbr�enson Wastewater Specialist, Integrated Services WSMART code: 7633 (608)785 -9336 , dsorenson@commerce.state.wi.us 4A, * 1� 04 MOUND AND PRESSURE DISTRIBUTION COMPONENT DE 9y 7 Residential Application INDEX AND TITLE PAGE `O �s o, � Project Name: Garth Vander Vorst 3 bedroom residential mound Owner's Name: Garth Vander Vorst Owner's Address: 1331 4th Street #3 Hudson, WI 54016 Parcel address: 584 128th Ave. Legal Description: NE1 /4NE1/4, Sec. 33, T.30N., R.19W. Township: St. Joseph "E" County: St. Croix �S Subdivision Name: Perch Lake Estates k fd Lot Number: 4 Block Number: na a' y Parcel I.D. Number: 030 - 2123 -40 -000 Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Site Plan Page 9 Soil Evlauation Report Designer: Jim Boumeester License Number: 222904 Date: 04/30/04 Phone Number: 715 - 386 -1794 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) Version 3.0 (03/01/01) Page 1 of 9 Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R Residential or Commercial Design Note: sand fill (D) calculations assume a 300.00 Estimated Wastewater Flow (gpd) Table 83 -44-3 in -situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150 %) coliform of <= 36 inches. 450.00 Design Flow (gpd) 8.00 Site Slope ( %) 101.58 Contour Line Elevation (ft) 28.00 Depth to Limiting Factor (in) 0.40 In -situ Soil Application Rate (gpd /ft Distribution Cell Information 90.001 Dispersal Cell Length Along Contour (ft) = F____5__0_01 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd /ft 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (c or e) c Center or End Manifold 2.50 Lateral Spacing (ft) If N above, enter the elevation (ft Number of Laterals of the highest point. .1 6 Orifice Diameter (in) (e.g. 0.25) Estimated Orifice Spacing (ft) = 6.25 ft /orifice 2.00 Forcemain Diameter (in) 50.00 Forcemain Length (ft) Does the forcemain drain back? Y 95.00 Pump Tank Elevation (ft) Enter Y or N 4.55 System Head (ft) x 1.3 8.16 Forcemain Drainback (gal) 6.75 Vertical Lift (ft) 81.25 5x Void Volume (gal) 1.56 Friction Loss (ft) 89.40 Minimum Dose Volume (gal) 12.85 Total Dynamic Head (ft) 38.77 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x 1.00 1.50 x x 1.25 x 2.00 1.50 x x 3.00 2.00 x 3.00 x Gallons /Inch Calculator (optional) Treatment Tank Information 805.12 Total Tank Capacity (gal) 1000.001 Septic Tank Capacity (gal) 37.00 Total Working Liquid Depth (in) Weeks concrete IManufacturer 21.76 gal /in (enter result in cell B49) Dose Tank Information Effluent Filter Information 805.121 Dose Tank Capacity (gal) lZabel Filter Manufacturer 21.761 Dose Tank Volume (gal /in) JAI 00 Filter Model Number Weeks Concrete I Manufacturer Project: Garth Vander Vorst 3 bedroom residential mound Page 2 of 9 Mound Plan View T 1/10 B : :� J • Observation Pipe 3 s . ....�•.,•..• • ..,,ti,..' A . . . . . . . . . . . I . . . . . . • . . . . . . . • . . . 40 0 L 0 Mound Component Dimensions A 5.00 ft E 12.80 in H 1.00 ft K 7.98 ft B 90.00 ft F 9.50 in z 9.31 ft L 105.95 ft 0' ✓D 8.00 in G 0.50 ft J 4.74 ft W 19.05 ft 450.00 (ft Dispersal Cell Area 1287.83 (ft Basal Area Available ✓ 2s�''""'`" 5.00 (gpd /ft) Linear Loading Rate 9.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 104.04 (ft) ► H � frrrrrrrrr 2 rrrrrrrrf.. Z F : ::: r DispersaiCell 102.75 (ft) L rrrrrr rrr{ .. ateral 102.25 (ft) — Invert Dispersal Cell Elevation E D 4 ] } + 4 101.58 (ft) Contour Elevation 8.0 % Site Slope Geotextile Fabric Cover Shading Key T Dispersal Cell See lateral details on 1Q Topsoil Cap c 1.5 ft �, :;,,�• A; � p �;rrr; Page 4 for number, © } { {f Subsoil Cap 0 . 0 •. -. °: ^ma;(�:;'• • ` •,, � size, and spacing of 0 ASTM C33 Sand :�.• °� ° �� "•�••rr F laterals. Laterals are T ` ical Lateral Tilled Layer d 0.5 ft Y? equally spaced from Aggregate v o f a • •:'�•; the distribution cell's —A — * centerline in the distribution cell (AxB). Project: Garth Vander Vorst 3 bedroom residential mound Page 3 of 9 r Center Connection Lateral Layout Daigram Force main connection via tee or cross to manifold at any point. Laterals are identical P � i= Turn -up m'ba II valve or 1+ X �IExf2 I xf2�l Laterals &farce main of PVC Sch 40 oleanout pl u g per COMM Table 84.30 -5 Holes drilled on the bottom of the lateral. Number of Laterals 4 Orifice Diameter 0.156 in Lateral Diameter 1.50 in Orifice Spacing (X) 2.53 ft Lateral Length (P) 44.28 ft Orifices per Lateral 18 Lateral Spacing (S) 2.50 ft Orifice Density 6.25 ft /orifice Lateral Flow Rate 9.69 gpm Manifold Length 2.50 ft System Flow Rate 38.77 gpm Manifold Diameter 1.50 in Total Dynamic Head 12.85 ft Forcemain Velocity 3.96 ft/sec Dose Tank Info rmation Locking cover with waming label and locking device and sealed watertight Electrical as per NEC 300 and -► Comm 16.28 WAC Disconnect 4 in. min. Tank component is properly vented FZ Aftemate outlet location Forcemain diameter Weeks concrete Manufacturer 2 in. Capacityl 805.12 Gallons Volume 21.76 gal /inch A Weep hole or anti - Dimension Inches Gallons B siphon device A 18.79 408.85 C B 2.00 43.52 Pump off e levation (ft) C 4.21 91.63 � 96.00 D 12.00 261.12 D Total 1 37.001 805.12 D ose tank elevation (ft) 3" Bedding un er tank. 95.00 Alarm Manuafacturer ILe velArm Alarm Model Number I DLV Pump Manufacturer JZoeller Pump Model Number 198 Pump Must Deliver 38.77 gpm at 12.85 ft TDH Project: Garth Vander Vorst 3 bedroom residential mound Page 4 of 9 Mound System Maintenance and Operation Specifications Service Provider's Name J. Thompson, POWTS Maint'r #30021 Phone 715- 248 -7767 POWTS Regulator's Name St. Croix County Zoning Dept. I Phone 715 - 386 -4680 System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg /L Septic Tank Capacity 1000 gal Maximum TSS 150 mg /L Soil Absorption Component Size 450 ft' Maximum FOG 30 mg /L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu /100 mL Service Frequency Septic and Pump Tank Inspect and /or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test month) Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound Ins ect for ponding and seepage once every 3 years Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Tum -up Detail Finished •.........•••. ............... Grade ` 6 -8" Diameter Lawn �/- Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Garth Vander Vorst 3 bedroom residential mound Page 5 of 9 Mound System Management Plan Pursuant to Comm 83,54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals jSBD- 10691 -P (N.01101) and SSWMP Publication 9.6 (01181)) and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet finer shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to ruin solids in the tank that may slough off the fter when removed from its enclosure. If the filter Is equipped with an alarm, the fitter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verity proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October- February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg /L BOD 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODS, 30 mg/L TSS, 10 mg/L FOG, and 10 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in Its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. I Project: Garth Vander Vorst 3 bedroom residential mound Page 6 of 9 f f n- HEAD CAPACITY CURVE EFFLUENT MODELS 42 40 D CAUTION Model 185/4185 should 135 not be subjected to less than 30 feet TDH. ao 130 38 125 20 6 91 115 34 110 32 105 100 30 95 28 90 186, 26 85- 4,86 24 BO 165, 75 4i6 22 70 x 20 65 i 8 60 63, 4163 89, 0 55 4189 16 50 1 45 12 00 140, IBB. 35 4140 4188 10 30 37 185. 8 25 4185 6 20 to 161, 2 5 4161 57 98 0 U.S. GALLONS IO 20 30 tO 50 60 70 80 90 100 110 120 130 140 150 ,60 LITERS 80 160 240 320 400 480 560 640 0 FLOW PER MINUTE 38 77�.P.M. rn ;n ;mum Su.eo /y et r rea/ e � TOTAL DYNAMIC HEAD /CAPACITY PER MINUTE EFFLUENT AND DEWATERING ! Model 53/57 98 137 140/4140 161/4161 163/4163 165/4165 185/4185 186/4186 188/4188 189/4189 191 FL Meters Cc,. LI Gal. Llrs. Gal. lbs. Gat, Urs. Gd. Lt- Gal. Llrs. Gol. Ltrs. G.I. Urs. Gal. Llrs. at Llrs. Gal. Lvs. Gal Llrs. 5 1.5 4} 163 72 273 93 352 91 344 100 }79 61 231 61 231 58 220 145 549 145 549 45 170 10 31 34 129 61 231 79 299 84 318 93 1 352 61 1 231 61 231 58 220 140 530 140 530 45 1 170 1 1 15 4.6 19 72 45 170 64 242 76 288 85 322 60 1 227 61 231 58 220 134 507 135 511 45 170 20 6.1 25 95 36 136 68 257 79 299 59 223 60 227 58 220 128 484 131 496 45 170 25 7.6 8 30 59 223 70 265 57 216 59 223 58 220 122 462 125 473 ! 45 170 30 9.1 49 185 62 235 55 206 58 11'4 65 322 58 220 116 439 120 454 45 17C 40 ! 12.2 21 79 45 170 46 172 55 70 265 58 220 104 394 109 413 45 17G 50 15.2 20 76 33 125 50 51 193 58 220 90 341 97 367 45 170 60 18.3 15 57 39 32 121 58 220 71 269 85 322 45 170 70 21.3 23 9 34 52 197 51 193 69 261 45 170 80 24.4 10 38 45 170 28 106 51 193 ' 45 170 90 1 27.4 31 117 2 8 34 129 45 170 1 100 1 30.5 �., rb 60 17 64 40 151 110 32.0 - 7'° 4 IS 30 114 120 36.6 20 76 130 39.6 10 38 Lock Valve 19.3 T (5.91,) 23 II. (7m) 26 It. (7.9m) 46 ft. ( 1 ) (26.4.)l 73 ft. (22.3ml • 114 It. (34.7m) 91 IL (27.7 ,,) 110 ft. (33.5m)1 }7 ft. (41.8 ,,)! SSPMA / MEMBER ■ tit vy S� o SU P AND SEWAGE PUMP MFRS 4SSM1'. © Copyright 1998 Zoeller Co. All rights reserved. (1 • -7 o P O • ..SBA /Q ✓Q /kaL�iWJ ♦ EXi'S{ �radF e rev. S C4& n. of Sf . Tisepi( o p SenGh Yvla,,e: 7e�p cr -rv(e ' � s lo e � M,c! -/ot .5 �,e. A loca�� A..5"m G -/ Preposed 1, c1Ta 9a.Q. , v ee,lrs e e r e �e !? I e d` = ; S.r. Lo/oa, -1 al eFF/ueni: F; ffer a 0u,6 1 c6'. ,/ s a s/v A/ e. ugke Con crcke i , o buildin95Q��u^ pump chamDe/ �� ,+ 1 o�' Pro postd well 3bcd ,- oeM 63 -' fay co ol Proposed vvLound o 19.o5'x 95" cry /S'X 9d'd,:5/Oersa/ e.el/ Aa era /`S 1 Elec! •mot CO' Ile. P� 8 0� 9 1791 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page - I of _ 3_ Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code A.C.E. Soil & Site Evaluations Attach complete site plan on paper not less than 8%x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and parcel I.D. percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. 030 - 2123 -40 -000 _ Please print all information. Reviewed By Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Garth VanderVorst Govt. Lot NE 1 NE 114 S 3 3 T 30 N R 19 Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1331 4th Street #3 4 Perch Lake E states City State Zip Code Phone Number _j City _J Village ✓J Town Nearest Road Hudson WI 1 54016 1 715 - 381 - 8294 St.Joseph 1 584 128Th Ave. ✓i New Construction Use: _y) Residential / Number of bedrooms 3 Code derived design flow rate 450 i Replacement J Public or commercial - Describe: Parent material Glacial drift Flood plain elevation, if applicable na General comments and recommendations: Install mound system at elev. 102.25' at 8" above 101.58' contour. FT] Boring # I Boring bel Pit Ground Surface elev. 102.95 ft. 28" in. Soil Depth to limiting factor 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 I 'Eff#2 1 0 -12 10yr3/3 none sil 2fsbk mvfr Cs 2fm 0.6 0.8 2 12 -28 10yr5/4 none sil 2fsbk mfr cs 1fm 0.6 0.8 3 28-64 7.5yr4/4 f2f 7.5yr5/8 sl 1 msbk mvfr cw 1 vf,f 0.4 0.7 4 64 -72 7.5yr4/6 none Is 1 msbk mvfr cw - 0.7 1.2 5 72 -87 7.5yr4/4 none slAfs/fs 1 msbk mfr gw - 0.4 .07 6 87 -123 7.5yr4/4 Q fzd'i yr6 / & sl/Ifs/fs 1 msbk mfr - - 0.4 0.7 H# 4 & 5 consist of an unsorted mxture of 1 msbk 7.5yr4/4 sl, 7.5yr4/6 Ifs & 10yr4 /6 fs. a Boring # J Boring ✓ Pit Ground Surface elev. 100.20 ft. Depth to limiting factor 40" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fie _ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I `Eff#2 1 0 -6 10yr3/3 none sil 2fsbk mvfr cs 2fm 0.6 0.8 2 6 -17 7.5yr4/6 none scl 2fsbk mfr cs 2f,1 m 0.4 0.6 3 17 -40 7.5yr4/6 none sl 2msbk mvfr cw 1f 0.6 1.0 4 40-48 10yr4/4 f2f 7.5yr5/8 sl 1 msbk mfi aw 1 vf,f 0.4 0.7 5 48 -82 7.5yr4/4 Qf7.5y & slnfs/fs 1 msbk mfr - 0.4 .07 H# 5 consists of a so xture of 1 msbk 7.5yr4/4 sl, 7.5yr4/6 Ifs & 10yr4/6 fs. ` Effluent #1 = BOD ? 30 < 220 mg /L and TSS L30 < 50 mg /L fflu t #2 = BOD < 30 mg /L and TSS < 30 mg /L CST Name (Please Print) Sig ture: CST Number James K. Thompson 5 3602 Address A.C.E. Soil &Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, WI 54 4/29/2004 715 - 248 -7767 r Property Owner Garth VanderVorst Parcel ID # 030 - 2123 -40 -000 Page 2 - of __ 3 _ 3] Boring # I Boring ✓l Pit Ground Surface elev. 101.10 ft. Depth to limiting factor 33" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots I &W tf in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -8 10yr3/3 none sil 2fsbk mvfr cs 2fm j 0.6 0.8 2 8 -20 7.5yr4/6 none Sid 2fsbk mfr cw 1fm 0.4 0.6 3 20 -33 7.5yr4/4 none gr Is 0 sg ml cw 1vf,f 0.4 0.7 4 33 -44 7.5yr4/6 f2f 7.5yr5/8 sI/Ifstfs 1 msbk mvfr aw 0.4 0.7 5 44 -70 10yr5/6 none s & gr 0 sg ml gw - T 0.7 1.6 6 70 -88 10yr5/4 f1 d 7.5yr5/8 & VI's 0 sg mvfr - 0.4 0.6 l 1 H# 4 consists of an unsorted mixture of 1 msbk 7.5yr4/4 sl, 7.5yr4/6 Ifs & 10yr4/6 fs. 47 Boring # -� Boring ✓� Pit Ground Surface elev. 98.26 ft. Depth to limiting factor 38" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P /ft' ____ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -6 10yr3/3 none sil 2fsbk mvfr cs 2fm 0.6 0.8 2 6 -23 7.5yr4/6 none Sid 2fsbk mfr cw 1fm 0.4 0.6 3 23 -38 7.5yr4/4 none gr Is 0 sg ml cw 1vf,f 0.4 0.7 4 38-46 7.5yr4/6 f2f 7.5yr5/8 sl/Ifs/fs 1 msbk mvfr aw - 0.4 0.7 5 46-66 10yr5/6 none s & gr 0 sg ml gw - 0.7 1.6 6 66 -80 10yr5/4 f1 d 7.5yr5/8 & VI's 0 sg mvfr l 0.4 _ ", 0.6 H# 4 consists of an unsorted mxture of 1 msbk 7.5yr4/4 sl, 7.5yr4/6 Ifs & 10yr4 /6 fs. F-1 Boring # _l Boring I Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu, Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I I j ' Effluent #1 = BOD ? 30 < 220 mg /L and TSS >30 < 150 mg /L ' Effluent #2 = BOD , i _ 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. ♦ EXi'SE��� �rade elegy. da.., d er vcrstP��. of ccQ 7 L+ 5 > >_,2o9 S /off o p c3egch mare: T o' � /1 9 Su r"e -Q/ A loci -�i eiev i o41 pro postd. r u� well • Proposed ♦ 3btdraer►� , � �ii,�1 �' ,' / Ile 94.0 cp I"GSrdcn i i �� �' i r � qb . � V o G r� 1 6. .: T c loE 6taee ,E /e% �93yS� W ' le eve. P� , 3 of 3 1791 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code A.C.E. Soil & Site Evaluations Attach complete site plan on paper not less than 8'/ x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parcel I.D. 030- 2123 -40 -000 Please print all information, evi Dat Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner r Property Location C/fO Garth VanderVorst KFIVF�' Govt. Lot NE 1/4 NE 1/4 S 33 T 30 N R 19 W Property Owner's Mailing Add r Lot # Block # Subd. Name or CSM# 1331 4th Street #3 hAAY 1 7 MR 4 Perch Lake Estates City tate AF6de Phone Number _j City _j Village i0l Town Nearest Road Hudson NI 54 IX G7tA4081 -82 4 St.Joseph 584 128Th Ave. t1 New Construction Use: Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD J Replacement Public or commercial - Describe: Parent material Glacial drift Flood plain elevation, if applicable na General comments and recommendations: Install mound system at elev. 102.25' at 8" above 101.58' contour. D Boring # Boring Pit Ground Surface elev. 102.95 ft. 28 in. Soil ✓� Depth to limiting factor ° 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 *Eff#2 1 0 -12 10yr3/3 none sil 2fsbk mvfr cs 2fm 0.6 0.8 2 12 -28 10yr5/4 none sil 2fsbk mfr cs lfm 0.6 0.8 3 28-64 7.5yr4/4 f2f 7.5yr5/8 sl 1 msbk mvfr cw 1 vf,f 0.4 07 4 64 -72 7.5yr4/6 none Is 1 msbk mvfr cw - 0.7 1.2 5 72 -87 7.5yr414 none SlAfs/fs 1 msbk mfr 9W - 0.4 .07 6 87 -123 7.5yr4/4 Q Qd loyr6/ & sl/Ifs/1's 1 msbk mfr - - 0.4 0.7 H# 4 & 5 consist of an unsorted mxture of 1 msbk 7.5yr4/4 sl, 7.5yr4/6 Ifs & 10yr4/6 fs. a Boring # _j Boring Pit Ground Surface elev. 100.20 ft. 40 " in. Soil Depth to limiting factor 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 -6 10yr3/3 none sil 2fsbk mvfr cs 2fm 0.6 0.8 2 6 -17 7.5yr4/6 none scl 2fsbk mfr cs 2f,1m 0.4 0.6 3 17-40 7.5yr4/6 none sl 2msbk mvfr cW 1f 1.0 4 40-48 10yr4/4 f2f 7.5yr5/8 sl 1 msbk mfi aw lvf,f 0.4 0.7 5 48 -82 7.5yr4/4 Q Qd'i / sws/fs 1 msbk mfr - - 0.4 .07 H# 5 consists of a so ure of 1 msbk 7.5yr4/4 sl, 7.5yr4/6 Ifs & 10yr4/6 fs. * Effluent #1 = BOD y > 30 < 220 mg/L and TSS 30 < 150 mg/L fflu #2 = BOD <30 mg/L and TSS <,0 mg/L CST Name (Please Print) Sig ure: CST Number James K. Thompson I S 3602 Address A.C.E. Soil &Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, WI 5 2O 429/2004 715 - 248 -7767 i • Property Owner Garth VanderVorst Parcel ID # 030 - 2123 -40 -000 Page 2 of 3 3] Boring # Lj Boring 0 Pit Ground Surface elev. 101.10 ft. Depth to limiting factor 33" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -8 10yr3/3 none sit 2fsbk mvfr cs 2fm 0.6 0.8 2 8 -20 7.5yr4/6 none sicl 2fsbk mfr cw 1fm 0.4 0.6 3 20 -33 7.5yr4/4 none gr Is 0 sg ml cw 1vf,f 0.7 4 33 -44 7.5yr4/6 f2f 7.5yr5/8 sUlfs/fs 1 msbk mvfr aw - 0.4 0.7 5 44 -70 10yr5/6 none s & gr 0 sg ml gw - 0.7 1.6 6 70 -88 10yr5/4 f1 d 7.5yr5/8 & vfs 0 sg mvfr - - 0.4 0.6 H# 4 consists of an unsorted mxture of 1 msbk 7.5yr4/4 sl, 7.5yr4/6 Ifs & 10yr4/6 fs. a Boring # Boring ✓_j Pit Ground Surface elev. 98.26 ft. Depth to limiting factor 38" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -6 10yr3/3 none sit 2fsbk mvfr cs 2fm 0.6 0.8 2 6 -23 7.5yr4/6 none sic[ 2fsbk mfr cw 1fm 0.4 0.6 3 23 -38 7.5yr4/4 none gr Is 0 sg ml cw 1vf,f 0.4 0.7 4 38-46 7.5yr4/6 f2f 7.5yr5/8 sVtfs/fs 1 msbk mvfr aw - 0.4 0.7 5 46-66 10yr5/6 none s & gr 0 sg ml gw - 0.7 1.6 6 66 -80 10yr5/4 f1 d 7.5yr5/8 & We 0 sg mvfr - - 0.4 0.6 H# 4 consists of an unsorted mxture of 1 msbk 7.5yr4/4 sl, 7.5yr4/6 Ifs & 10yr4/6 ft. F-1 Boring # I Boring _J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * 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. v ■ 59 i�Q{/Qfkoc�iLr) ♦ • /o ca �� c1 �pr s6a�Se Sca/,f: dam., der vor•sf�r�° . of s ,6. g�sepA } �0 90 Slopes >,2og S /ope o ' p aenGh rrta�,E': Tp o!' M,d - /o- S &a Ke• � rgssume� A elect � o t 0 Proposed i � o Wtlf Proposed / � ♦ ,o b bede J"GSi 4k ,�/ �/ v � o �� S �� , ■ i ce/ ■ ' , - ay co Ve— G r� 1 P�.3 BOJMEESTER EXC 7199779620 09129104 06i01pm P. 001 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND >' OWNERSHIP CERTIFICATION FORM; OwnerlBuyer �� �`w' + Mailing Address 12,3 q P s� # f Sow, 1. sy0 Property Address 0� Pe Al (Verification required from Planning Department for new construction) City /State -(OwA) �� �f� �oeSah -- Parcel Identification Number 3 V Q 0 LEGAL DESCRIETLON • Property Location // t /4, � r/, Sec. ,33, T _ 1 0 N-R W, Town of �uladivition k -h , �&4 - ES �a S _ , Lot # . CerWed Survey Map # i� ; Volume _ Page # Warranty Deed # �6 , Volume 0� >) Page # -- -- sow house ❑ yes no Lot lines identifiable Ryes ❑ no Imps M use and maintenanceof your septic system could result in its premature failure to handle wastes, Proper maintensnce consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system "a affect the function of the septic tank as a Vestment stage 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 nosier plumber, journeyman plumber, w4trictodplumber or a 1 icensed pumper verifying that (1) the on -site wastewatcr disposal "tam e is in proper operaana condition and/or (2) after inspection and pumping (if necessary), the s eptic tank is less than 1/3 full of sludge. Uwa, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set Earth, heroin, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification Stating that your septic system bas bee in fined m ompleted and returned to St. Croix County Zoning Office within 30 days of the three year expiration da . 3 SKNATURB OF APPLICANT DATE j: .Q=R CERTIFYCATIQN 4; i {we) certify that all statements on this fornyare true to the best of my (our) knowledg e. I (we) am (are) the owners) of the pmp�dir y,described abo by v' a of arra deed rc a Register of Duda Office. SIGNATURE OF WLICANT *+ +++. A p Y information that is mis-rc resented ms result in the sanitary permit being revoked�y the Zoning Department. ++ + + ++ ++ Include with this application, a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed 03/25/04 THU 12:06 FAX 715 386 4687 REGISTER OF DEEDS 1,0001 U 2518P 349 755464 11 STATE BAR OF NISCONSIN FORM 2 - 1999 KATHLEEN H. WALSH Dueument Number WA RRANTY DEED REGISTER OF DEEDS ST. CROIX CO., W1 This Deed, made between Delwin Mat?sain RECEIVED FOR RECORD Grantor, aild 03/01/2004 M-300 �rtlt E. VataderVarst and Jennlfpr H. VaeAortlo - _ Grantee. WARRANTY DEED Grantor, for a valuable consideration, conveys and warrants to Grantee EXEItP i the following described real estate in St. Croix County, State of Wisconsin REC FEE t 11.00 (if mores CIS needed, please attach addendum): TRANS FEE: 261.00 Lot 4, Perc )Lake Estates. St. Crap County, Wisconsin. COPY FEE. _ CC FEE: PAGES: 1 Recording Area Name and Return Addross K1 =1.= ti 031 AND FT %: "�;Y AT LAW P. ^ ox 359 HU08 i-J, WI 54015 � 0,30- 2 123 -�0 -000 Parcel Ideatificadon Number (PIN) This Is not homestead Property (is) (is not) Exeep to warranties: Emetnents, restrictions and rights -of way of record, if any. Dated this C.�/� day of &4rw 20M ._.._ ._.__.. —.. — . —..- -_ ..l 1. S. ._— ,.- ,...... ._..._..... Delwi MagAaas AtITIi1d MCATION ACKN0W1.EDGN0M Si rtature(s) Delwin Ma STATE OF ) 6s. _.._ _. — - -------- -- ...�. - - - - -- County ) aureenticated t IS day of Febrttarz — _ — — — ' 2004 -- _.__..._.._.._ — .— PersoAally came before = this day of f the above niched + Krisdoo Ogiand 71TLE: MEMBER STATE BAR OF WISCONSIN _ (If trot, _ _ _ _ to me kttowo to be the persons) who oxccuta} the foregoing authorized by $ 106.06. Wis. Stars.) iostrurnutt and acknowledged the same. THIS INSTRUMENT WAS DRAFTED I;Y - Attorn Kristhia Ogland -- — — - — —, —, —. — H udson, '1 x $4016 Notary Public, Statc of My Commission is permanent. (If trot, State expiration rate: (Signswres may be sudienticaitct or aeknuwledged. Hoch are not necessary.) Names of petsons signing in any capacity must be typed or printed below their sigrtature. information Protbuto als Co.. Food du 1.4o, w I STATE 4AR OF wt5CONSW SOM55-202 t WARRANTY DEED FOKM me. 2 -JI " Safety and Buildings Division County t \ 2 01 W. Washington Ave., P.O. Box 7162 Consin Madison, WI 53707 N62 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608) 266 -3 1 3 3 Sanitary Permit Applieatio r State Plan I.D. Number In accord with Comm 83.2 1, Wis. Adm. Code, personal informa ' n you p�Y�de �1�0 Trans may be used for secondary purposes Privacy Law, s15 4(1)(V °. r t Address (if different than mailing address) T G 1. Application Information- Please Print All Information Q V Property Owner's Na me j � ' V' ; # 6 ap Z. of # Block # GagttA v rltslogg V ots 03crld) abao Property Owner's M ailing Address - Property Location 3 S (?_,t Nf ''A, 54,Section 33 City State Zip Code Phone Number t � V , 0 5() , o 0,, W j j b (circle one) H. Type of Building (check all. that apply) „D� T V N; R ( E or w ❑N or 2 Family Dwelling - Number of Bedrooms 'vision a CSM Number . ❑ Public /Commercial - Describe a y� a,t ,. y� e l kot s r ❑ State Own D l ess ' Use X 90 ` t ❑ _ ❑Village - 1Township of 5� Too� III. Type of Permit: (Check only one box on line A. omplet ine B if applic5ble) A. MNew System ❑ Replacement System ❑ Treatment/Hol Tank Replacement Onl ❑ Other Modification to Existing Syste B. [I Permit Renewal ❑ Permit Revision ❑ Change of El mil Transf to New List Previo a it Numbe l SW Before Expiration Plumber Owne t J IV. T ype of POWTS System: (Check all that appl ❑ Non - Pressurized In- Ground A Mound > 24 in. of suitable soil ❑ Mound 4 in. suitable soil ❑ At -Grade El Single Pass Sand Filter El Constructed Wetland El Pressurized In- Ground ❑ Holding Tank 11 Pe ilter erobic Treatment Unit ❑ Recirculating Sand Filter El Recirculating Synthetic Media Filter El Leaching Chamber El Drip Lin 11 Gravel -less P Other (ex lain) V. Dispersal/Treatment Area Information: A — IUD Design Flow (gpd) Design Soil Ap lication Rate(gpdsf) Dispersal Ar Required (sf) Dispersal A a Proposed (sf) „ System Elevation 4 i5o , d S SO `f � () 1 1 VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank _ I �0Q Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement- I, the undersi d, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Na me (Print Pl ber' gnature MP /MPRS Number Business Phone Number Plumber's Addre ss (Street, City, State, Zip e) 1b�1� � �, N VSa1. G sl. , 61 V VIII. County/Department Use Onl Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Is uin Agent Signatur (No Stamps) Surcharge Fee) � El Owner Given Reason for Denial 't� 3 �2 IX, Conditions of Approval /Reasons for Disapproval r rr SYSTEM OWNER 3� � '° � - -- �^ � I'-. ,' � t 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained A "' as per management plan provided by plumber. n,.� ZO 76 CgA4 ��w.2_ `}C 2. All setback requirements must be maintained as per applicable code /ordinances Attach complete plans (to the County only) for the system on Pa t less than 81/2 x 11 inches in size SBD -6398 (R. 01/03) a P/azz o •F EsdaE�s, Sf • c.rn �X LA)/. /off 5 ". Nty S fie. ,e4 sS ce.ne d alto S lopes ?202 pea S lopes >;.o' C A-!dv a F� la� w�estrw�- P7S�n��' � ! atocc�Y�G. P� . 2 --z (.yop.Vc. 62 P� po sed �vrcL start / , y Vo bccU." i+8 �es.deKCe t/ p�oposcd f � well ' 3 i i i 3 10,44 fkr Kg a Stew. ! .8. :To �' J v opos wt o k nd of /7,10 I0f<20',41 of / P. ✓.e. � pQ' � � 5 , � , �,Sp� s o./�✓ /w /�Gz� latc s " P �� � at ,�.� 69 I y a re � g I.Z8 de- - P BaF9 yY � Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 *Isconsin www•commerc .wis ons Department of Commerce www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary March 16, 2004 CUST ID No.222904 ATTN.- POWTS Inspector JAMES W BOUMEESTER ZONING OFFICE BOUMEESTER & SONS EXCAVATING INC ST CROIX COUNTY SPIA 1070 HWY 35 N 1101 CARMICHAEL RD HUDSON WI 54016 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 03/16/2006 Identification Numbers Transaction ID No. 976400 SITE: Site ID No. 671559 Garth Vander Vorst Please refer to both identification numbers, 584 128' Avenue above, in all correspondence with the agency. Town of Saint Joseph St Croix County NE1 /4, NE1 /4, 533, T30N, R19W Subdivision: Perch Lake Estates; lot 4 FOR: Description: Proposed Three Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 945969 Maintenance required; 450 GPD Flow rate; 41 in Soil minimum depth to limiting factor from original grade System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.0 1 /0 1), Pressure Distribution Component Manual - Version 2.0, SBD - 10706 -P (N.0 1 /0 1) The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: This system is to be constructed and located in accordance with the approved plans, the "Mound Component Manual for Private Onsite Wastewater Systems Version 2" SBD - 10691- P(N.01 /O1). The pressure network is to be constructed in accordance with publications SBD- 10706- P(NO1 /O1) "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems - Version 2.0" and/or the sizing methods of publication "SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/8 1)". • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of See. 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 mound system shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • Comm 84.25 (7) (c) - Anaerobic treatment tanks located below ground shall have a manhole opening over the inlet of the most upstream compartment, in each compartment, and over all treatment apparatuses. Coll 16011ah "w t P , I V E" D:". JAMES W BOUMEESTER Page 2 3/16/04 Conditions of Approval Continued: • 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 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 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 { MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN IYA INDEX AND TITLE PAGE Project Name: Garth Vander Vorst 3 bedroom residential mound Owner's Name: Garth Vander Vorst v , Owner's Address: 1331 4th Street #4 Hudson, WI 54016 Parcel address: 584 128th Ave. Legal Description: NE1 /4NE1/4, Sec. 33, T.30N., R.19W. Township: St. Joseph "E" County: St. Croix Subdivision Name: Perch Lake Estates Lot Number: 4 Block Number: na Parcel I.D. Number: 030 - 2123 -40 -000 s •`� a` t C 4 A C,C, r--r Plan Transaction No.:;rr r° 3 ca s t �,r�c� Page 1 Index and title r h ���[tst t�F ANA BJ `�p�NGS Page 2 Data entry c,r Page 3 Mound drawings Page 4 Lateral and dose tank SP NpENCE Page 5 System maintenance speci ica E Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Site Plan Page 9 Soil Evlauation Report Designer: Jim Boumeester License Number: 222904 Date: 03103/04 Phone Number: 715 -386 -1794 Signature: rye, rli; Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) Version 3.0 (03/01101) Or PARTMENT Of Page 1 of 9 DiviSION SAFETY AND WiLDi GS SEE CORRE ONDENCE Mound and Pressure Distribution Component Design Site Information R Residential or Commercial Design Note: Sand fill (D) calculations assume a 300.00 Estimated Wastewater Flow (gpd) Table 83 -44-3 in -situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150 %) coliform of - 36 inches. 450100 Design Flow (gpd) 3.00 Site Slope ( %) 97.05 Contour Line Elevation (ft) 44.00 Depth to Limiting Factor (in) 0.40 In -situ Soil Application Rate (gpd /ft Distribution Cell Information 90.00 Dispersal Cell Length Along Contour (ft) = 5.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd /ft 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? e Center or End Manifold 2.50 Lateral Spacing (ft) If N above, enter the elevation (ft) 2 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) 2.50 Orifice Spacing (ft) = 6.25 ft /orifice 2.00 Forcemain Diameter (in) 40.00 Forcemain Length (ft) Does the forcemain drain back? Y 90.00 Pump Tank Elevation (ft) 6.50 System Head (ft) x 1.3 6.52 Forcemain Drainback (gal) 7.05 Vertical Lift (ft) 81.25 5x Void Volume (gal) 0.76 Friction Loss (ft) 87.77 Minimum Dose Volume (gal) 14.31 Total Dynamic Head (ft) 29.66 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options j choice 0.75 1.25 x 1.00 1.50 x x 1.25 2.00 1.50 x x 3.00 2.00 x 3.00 x Gallons /Inch Calculator Treatment Tank Information 805.12 Total Tank Capacity (gal) 1000.00 Septic Tank Capacity (gal) 37.00 Total Working Liquid Depth (in) Weeks concrete Manufacturer 21.76 gal /in (enter result in cell B49) Dose Tank Information Effluent Filter Information 805.12 Dose Tank Capacity (gal) Zabel Filter Manufacturer 21.76 Dose Tank Volume (gal /in) A100 Filter Model Number Weeks concrete Manufacturer Project: Garth Vander Vorst 3 bedroom residential mound Page 2 of 9 Mound Plan View ----------------------------- ------- ................................. J .... 1/10 B - -' a * ' " ' ' * ' . . . . . . . . . . . . . . . . Observation Pipe ' * . . .7_ . ..... . . F Ob K 0 A ........................... W .................................... .......... B ................. .................. ........... ............................. .......... ............................... ............ ..... ...... ................................... ............ ......................................... .............. ........................... ........... * .......................... ............ ............................. ..................................... ..................................... ------------------------------------ L Mound Component Dimensions A 5.00 ft E 7.80 in H 1.00 ft K 7.10 ft B 90.00 ft F 9.50 in 1 7.50 ft L 104.20 ft 6.00 0.50 4.93 17.43 DEAin G Eilft J Aft WAft 450.001 (ft2 Dispersal Cell Area 1 1125.00 (ft Basal Area Available 5.00 (gpd/ft) Linear Loading Rate 1 9.001 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 99.34 (ft) G H 2 F 98.05 (ft) Lateral . . . Dispersal Ce 97.55 Invert Dispersal Cell ........ ........ ... .. .. ...... ............... ... D Elevation E . ............ ............. ...... ............... ............... ...... ............... ......... ................ ....... ............. .............. ....... I 4 1 F41 97.05 (ft) Contour Elevation 3.0 % Site Slope Geotextile Fabric Cover Shading Key T Dispersal Cell See lateral details on 1J= Topsoil Cap c rx 1.5 ft Page 4 for number, [2 Subsoil Cap a 0 0 r *0 T size, and spacing of ASTM C33 Sand 4 IN F laterals. Laterals are :a it Tilled Layer d 0 0.5 ft Typical Lateral equally spaced from Aggregate V 0 j the distribution cell's -A centerline in the distribution cell (AxB). Project: Garth Vander Vorst 3 bedroom residential mound Page 3 of 9 End Connection Lateral Layout Diagram Laterals centered over the A & 8 dimension f= Turn- upvdball valve orcleanoutplug� P AN laterals are identical x —�I Holes drilled on the bottom of the lateral S eq"bj spaced Force main connection Wa tee or cross to manifold at a1 point. Laterals & force main of PVC Sch 40 (per COMM Table 84.30 -5) Number of Laterals 2 Orifice Diameter 0.125 in Lateral Diameter 1.50 in Orifice Spacing pq 2.53 ft Lateral Length (P) 88.55 ft Orifices per Lateral 36 Lateral Spacing (S) 2.50 ft Orifice Density 6.25 ft /orifice Lateral Flow Rate 14.83 gpm Manifold Length 2.50 ft System Flow Rate 29.66 gpm Manifold Diameter 1.50 in Total Dynamic Head 14.31 ft Forcemain Velocity 3.03 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and Comm 16.28 WAC 4 in. min. Disconnect y Tank component is property vented ig E— Alternate outlet location Forcemain diameter Weeks concrete Manufacturer 2 in. Capacityl 805.12 Gallons Volume 21.76 gal/inch A Weep hole or anti - Dimension Inches Gallons B siphon device A 18.80 409.18 B 2.00 43.52 C P ump off elevation (ft) C 4.20 91.30 91700 D 12.00 261.12 D F� Total 37.00 805.12 ir Dose tank elevation (ft) 3" Bedding un er tank. 90.00 Alarm Manuafacturer LevelArm Alarm Model Number DLV Pump Manufacturer Zoeller Pump Model Number 98 Pump Must Deliver 29.66 gpm at 14.31 ft TDH Project: Garth Vander Vorst 3 bedroom residential mound Page 4 of 9 Mound System Maintenance and Operation Specifications Service Provider's Name J. Thompson, POWTS Maint'r #30021 Phone 715 -248 -7767 POWTS Regulator's Name St. Croix County Zoning Dept. Phone 715 - 386 -4680 System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg /L Septic Tank Capacity 1000 gal Maximum TSS 150 mg /L Soil Absorption Component Size 450 ft Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test monthly Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound Inspect for ponding and seepage once every 3 years Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn -up Detail Finished z1a...... . . Grade 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Garth Vander Vorst 3 bedroom residential mound Page 5 of 9 • Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD- 10691 -P (N.01/01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The fitter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the fitter when removed from its enclosure. If the fitter is equipped with an alarm, the fitter shall be serviced if the alarm is activated continuously. Intermittent finer alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October - February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD 150 mg/L TSS, and 30 mg /L FOG for septic tank effluent or 30 mg/L BOD 30 mg/L TSS, 10 mg /L FOG, and 10 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in W present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Garth Vander Vorst 3 bedroom residential mound Page 6 of 9 'G■■■■■■■■■■■■■■ ►e■■■■■■■■■■■■■ MEN MEMO EEiii■■Eiii ■■EE \ ■ ■NONE ■■■■■■■■■■■■■■■ ■ ■ \■ ■E■O� Ei� °■ °■ ■ ■ ■ ■ ■ ■■ . ME 1 95 ii►i ■ ■ ■ ■ ■ ■ ■ ■ ■■ . ■MOOD ■ \ \�■ ►�■���■■ ■ ■ ■■■■■■ MEMO ■ ■ \. NONE 1q, NEW S M■■■■■■■■ ° , MENNEN ■ ■� ■ ' MENNEN ONEVE �� ■ \`� III I\ ■ ■�� \NONE _■i iiff� r► i ■ ■ ■ ■■ A•_0141IN14,0■■■■►I■■ wMakv \1NEIN\\NNE ■\■ ■ NN RR1 ■1►8 ONO ■■■■ N SEWAGE/WASTE PUMPS NNEWEENEENEENE MEN mom No - AGRrd - uLTURE PUMPS NONE MENEM NNE mom �NOMMEM►■� ■■ ■■ a \ SEEN \mom ► ■E■ ■ mom � \ \�� ■■ ■ ■ \ ■■ ■ , ■■ \►I,►\',x aq O \ ■■ ■O ■E ISM0, ®\ \1 ■ ■■ ■�■ ■■■■■ = EMEMOMME o .. see. �. � . SOi�Q Yf2�aQf iO� Sf4X'e /off � P /c,� a•f' Re �c.�, �a� ES-6a��S, St• Cro �X G'o wn., LJ /. c1 a To/ op Arid. /ot 5 u.NtY S f'a/�Ct. �sSu.n2d elegy` = /00.0; 5 lopes > .2 02 1 °� f 5 /o pal >; 07. cJ'Nscr w[.p 75�ir(� fi i��t oglu•..£ r � , a 01.3 CA. 40p.d.e. �vnce �la;•t �z' ; Pow osed y'rxr(. vo 3 ,' ,' R ✓.e. bkridr� r�s, dence � �� � se..uar• ;/ t p�oPcscd weil J 1 . �. :To r Proposed w(occn of /7,t /OS(Zo'Lo/ ' w &. /a z` of i � P. ✓, e. pipe. � s'x9o' d,s,�, s�c�✓/ / Cx� �^n./s A�; g a a rt 11 g A de. P 94? i rcfi, ll.lUU4. ftiIyl t U I NP, ItAL nuuouiv • Wiisconsin bepartment of Commerce SOIL EVALUATION REPORT Page 1 of _3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code C Rity 31 Attach complete site plan on paper not less than 81/2 x 11 inches In size. Plan must t knclude, but not limited to: vertical and horizontal reference point (SM), *Wlon and Parcel L0. percent slope, scale or dirnensiorts, north arrow, and location and distshc o torAWest road, Please print all Jnforrtation. Reviewed by Date Porsonar fMonns6on you DrvvW* may bo ured roraaodndWy pprpps@y (Privsay Law, s. 16.04 t1) (ro)) Property Owner Property Location Del D1 qs Govt. Lot = 114 1X 114 S 33 T 30 N R 19 ) W Property Owner's Meiling Address Lot 0 Blool # • No1p or CSMI# 950 N. Knowles Ave. 4 rna Perch Fake Estates Goy State Phone Q Clry ❑ Wage Town Nearest Road New Richmond IWI 1 54017 1(715)246-6707 St. J , C) • • GPD NewGorzVuction Use:® ResidentlaliNumbe rns riv rofbedroo 4 Code deed design flaw m ` `""- ❑ Replacement ❑ Public or ctxnmef kil - Describe: -h• . R Parent mallotai Flood Plain elevation if a .1 General comments and recommendations: v 0; momd @ el. 98.05, based on contour line of el. 97.05' ��o�;• � f`vi Boring P El pit Ground surface elev. 97 35 it. Depth to limiting fades g o In,. Sod Application Rate Pit Ttroctuta Structure Consistence aoundwy Roots P g Horizon Depth Dominant Color Redo, Description . 'E8p2 In. Munson Qu. Sz. Cant. Color Gr. Sz Sh. 1 0 -10 1 OYr4 /3 none s 2 10 -2 10yr4/4 nom sicl 2msbk mfr 1f .4 .6 3 26 -7 7.5yr4/4 nom COS 08 titl Tl3 .7 1 2 4 76-90 7.5yr4L6 Boring 0 ❑ Boring 2 El Pit Ground s urf ace elev. 97 R. Depth to lirrritLly factor 44 in it ticution Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots _ GP in. M unson Cu. Sz ConL Color Gr. Sz. sh. 'Eff#1 'Etf#2 1 0 -10 10 4/3 mine sil 2r tobk mfr cs 2f 2 10-21 10yr4/4 none sicl 2msbk mfr if 4 _ 6 3 274 none 7.5yr4/6 no sl 2msbk mfr On 4 44 -65 .5 4 7 5 • Effluent #1 z B > 30 s 220 nrglL• and TSS >30 s 150 mgll = B00 _< ngll SS <_ 30 mglL Nurlrbrrr CST Name (Please Print) Signetwe 42298 i Gary L. Steel atua TeleDttone Number i Address L 1554 200th Ave., New Richmond, WI 54017 6-73 -2001 71 246 -6200 "Cb, 1 . lUV4 j: 11r'M kUINA hLALIY MUIJOUN IV.71I " Property Owner Del MagSM Parcel ID # _, , _Dowi 12Q Page ?— of 3 Boring # ❑ Boring F 3 Pit Ground surface elev.96.45 ft, Depth to iirrtiting factor 41 in Soil liption Rate Horizon Depth k 7.5yr4/6 Redox Description Texture Stnxsturo Consistence Boundary Roots OPDW IM Qu. Sz Card. Color Gr. Sz. Sh. 'EG#1 'EM2 1 0 -9 noce sil z sbk mfr CS 2f .5 .8 z -22 3 22 -41 zone s1 5 4 41 -60 wet fS sl 7 cs 5 60 -75 none v£s M ' Botirt9 # ❑ Boring ❑ Pit Ground surface D IM it OepUr to Amiting Solt ficaticn state Horizon Depth Dowdnant Redox Oescriptfon Texture Slruc ure Consistence Boundary Roots •Eff#t P' ff . . In, Munsell Qu. Sz Cont. Color Gr, Sz. Sh. Boring On g # Ground surface elev. R. Depth to limping factor in. ❑ Pit Soil Appamtiom Rate H000n Depth Ownirtant Color Redox Oestrlption Texture Sinicture Consistence Boundary Roots •E�it f 2 In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. + Etftmt 01 600, a 30 220 nV& and TS3 a30 :150 mglt. ' Effl #2 a BOO, <_ 30 mg/L and TSS 530 n19/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 depatment at 606- 266.3151 or TTY 608 -264 -8777• 500 "6(AAM) tfs. 11. lUU4 �; 11�M tUJNA XtNLIV hUM11 STEEL' SOIL SERVICE • Gary L. Steel 1554 200th Ave. CSTM2298 Del 9W New Richmond, WI 54017 533- MPRSW - 3254 town of St. aseph (715) 246 -6200 lot #4-Percb Take '!•states This soil evaluation was conducted to aittiary -a zoning requiren+ant, it may or may not be suitable for your use.. The iaca ion of the test nay or may not be as shown as perimaient lot lines were not establi had at tha time tha test was Conducted- 40' BM.- top of mid -lot survey stake W el 100.00' alt: BM T top of 1" pvc pipe 0 el. 99,15' V Gary - L. Steel 6-13-2001 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1_ of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County St Cr oix 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. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. pen Please print all information. Re 'ewes by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Del Magsam Govt. Lot NE 1/4 NE 1/4 S 33 T 30 N R 19 ,E (or) w Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 950 N. Knowles Ave. 4 na Perch Lake Estates City State Zip Code Phone Number ❑ City [:]Village [2Town Nearest Road New Richmond IWI 154017 (715)246 -6707 St. Jose h St ] New Construction Use: ® Residential / Number of bedrooms 4 Code derived design flow raW ° GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material qlaGial} Flood Plain elevation if applicjbfs n al drif General comments and recommendations: C ,. 2 mound @ el. 98.05, based on contour line of el. 97.05' =? . F -,I Boring # F] Boring C�Q M �i • M i Pit Ground surface elev. 97.35 ft. Depth to limiting factor 90 in. Soil Applicaton Rate E4�k. 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 10 4/3 none sil 2msbk •� 2 10 -2 10yr4/4 none sicl 2msbk mfr 9w if .4 .6 ,L{ 3 26 -7 7.5yr4/4 none cos Osg ml qw na .7 1.2 . 1- 4 76 -9 7.5 4 6 none Boring # n ❑ Boring 2 :ice Pit Ground surface elev. 97.35 ft. Depth to limiting factor 44 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 10yr4/3 none sil 2msbk mfr cs 2f ' 2 10 -2 10yr4/4 none sicl 2insbk mfr qw If .4 .6 • `� 3 27-44 7.5yr4/6 none sl 2msbk mfr aw na 5 •� 4 44 -65 7.5 4 6 f2d 7 5 5 6 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg /L 2 = BOD < mg/L and. SS < 30 mg/L e. CST Name (Please Print) Signature ST Number Gary L. Steel 02298 Address a valuation Codduct e Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 6 -13 -2001 715 - 246 -6200 Property Owner Del MagSam Parcel ID # =dim Page 2 of 3 ❑ Boring # E] ® Boring 96. 45 pit Ground surface elev. ft. Depth to limiting factor 41 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 1 0 -9 10yr4/3 none sil 2msbk mfr cs 2f .5 .8 2 9 -22 10 4 4 ' 3 22 -41 7.5yr4/6 none S1 2msbk mfr ClW na 5 9 •�v 4 41 -60 7.5yr4/6 wet fs sl 1csbk mfr 5 60 -75 7.5yr4/6 none vfs M na na na 4 6 •`� ❑Boring # E] 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 F] Boring ❑ Boring # Ground surface elev. ft. Depth to limiting factor _ in. 1:1 pit -- =Soil plication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fiz 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 need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 - 264 -8777. SBD -8330 (R.6 100) STEEL'S SOIL SERVICE Gary L. Steel 1554 200th Ave. Del Ma New Richmond, WI 54017 MPRSW - 3254 NE4NE4 S33 - T30N - R19W � � town of St. Joseph 715 246 -6200 lot #4 -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. =40' = op of mid -lot survey stake @ el. 100.00' alt. T top of 1" pvc pipe @ el. 99.15' Va d 0 0 V \ .. oS . Gary L. Steel 6 -13 -2001 Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In- Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567 -P (R.6199). Table 1: System Design Specifications Sanitary Permit Number to 06 Number of Bedrooms Design Flow - Peak (gpd) S Estimated Flow - Average ( pd) U Septic Tank Capacity (gal) vu 0 Soil Absorption Component Size (ft Type of Wastewater 'Domestic Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absorption Co onent Design Flow - Peak ( pd) 9 S P Iq 5v 6051, Maximum Influent Particle Size (in) r n 118 Maximum BOD (m /L) a a V 220 Maximum TSS (mg /L) 150 Table 3: Maintenance Schedule Septic Tank Inspect and /or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The utle Iter shall be cleaned as necessary to ensu pr oper opera tion. The filter cartridge sho not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the . Management Plan fora Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The tic tank shall have its contents removed ved when the volume of scum and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the when the next service time of an assessment, maintenance personnel shall advise the owner of w h needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or Impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 I - Management Plan for a Septic Tank and Soil Absorption Component Plantings of deep- rooted trees and shrubs directly over or within ten feet of the . component should be avoided since root intrusion into the component may obstruct wastewater flow. when system fails, we will replace with another system at owner's expense. Alternate area must be left undisturbed. St Croix County Zoning Office 386 -4680 Boumeester & Sons Excavating 386 -9020 li r � f i�c• iii � n lob � CCU 14 1 lit 'jQqQ WI PO � Ok Cot ��.►\�. +�� +.'., t \ l� �\ IiliR ISiti ;� \S# ?,.. ..�fa�lt 'f _ f .� 4 .t �� :i' ���� `lri +i ` + iR � �+1 �': ♦♦ O il +i r�R`a�� +1 i � :�+`�����. fi` \ 1 ' +����d + ' i � +ail` ti\ ��t��1l��r; �+`,� \�\ • + - .•., . r � .�':,e� t•�'���tl�\I, �l��l��l� � \l j ♦ � '' •� .1''.x'1 "' •i- :.fir titt.�� a' -r:: Mfr,';; / 1' ' < <; .. •.: • >: �:; ��w ti �: "- __ � i 6:r• • � 'i::'l ;' 1 f ::./•, , , /;'• /� 1, r � �f 1/ v % .� .a � • S f r r/ � !li+ Wit•' �.��' '� : ♦ \�iV��i =_ 1 . ♦ 1 t� y •l y/ +` .. .SG; +. `�.•�'\ .rv�`.+ :.•" , : _ _ _.✓; ,. J, fir:; i; ; ; : •: r,,. O �i•.�� ��� � ,♦ -. + a te` ♦ ♦. _• ���.f `+ � `. S.� � + :��r, • � ��- 1'1 �'= •'.r ;.�` +�`:� . �,�� '4 *`s"`'� +remit �;.� .•�.' a ,:_»,•J../ i \ta1�\` � � � L�t:,c_ii+w�il a��t.l}i + �:.>t � �'�M::+1r+�J��.�,'f'. ��+► -♦ •s♦ r i I PERCH LAKE ESTATES Pa.l of Lot 5 •f o Catiped Survey Map eeawded In Volume 12. page 316], BB hp Dal al the NwtA•oel Ouwlw o/ the Nwtheuet Ouwlw ohd pwt of the Nwlhwaet Q-1 of the Nwthmet Ouwtw WI M Secliw 33, TownMip 30 lh, Ranpe 19 Wel, Town of 51. Jaemh, Sl Croiv CounlY• Wleeoneh. ...._ ' �j A 8T. Cf109( COUNTY ILAT (C 5 M. V 0� 7 PAGE 2 0 B 1 Q5 M VOL 6 P AM 1700 s..• .. c� � m N. °Ne.e •• . W. DoctF 679053 i LOT : ..u,.,.••.e•..w. • Lor z i LOT 1 i - ---------- -- ------ °-- -•-- -- LoT� ..,° r 1 1 O A t 9 +L .•.°..° ow..�v q .. •eaN °7rr. r •.... •iwm o°yN°1 a dma7 .NU m .«m«o wc..•°w .IN•ve ' $ 0 •Ne nr ovAnw w n< meow oarMrwwr .Aa. V. Iz w tW> a n.w ra en ruv ,w wawn era , aeeacvaulo•a. �� ` r 1 `• Ken a:u°xm•a °I ew:.a rum wwni �e� ii- � r0.wp Y�Mw HrvT ..... ..................... LOT ? L � o m rr rr r n J 1O ° OT J LOT < LOT 5 1 C.S.M. VOL.10 PAGE 2770 8 rR «rA .n ewm .Nrm V 'PJ LOT 4 7" LOT 3 j w r.c. w.r •M rc- wx, ®y ,•` 'I w.� N2n7YY LOT y r r * Nlsas.er 1 W ROA •s-.� N._N6�p'9,"' - ( "n" w.\ ,r'pN'� _ " - � � � �� � of , d i N em'W Key ' • x \ rw ..Nw. a.,... r.r -- .- as - ._.._. ..K ._..�. .._.._w.m -- � . L 0 T 6 _ y� iv e 1 F er .cas rA ® /�: rurum 1 �TO{MJ R0AO1 • — — �.�'�..+5°°•_r+��•Je'wt 1i.e1 NseZpt7na a1xeY �+. oe °..... � '-- -__._.... ... U N P L A T T E D LAND S �E# VOL.4 PACE 929 .. •..�... o...w, LOT 1 mc SHEET 1 OT 2 SHEETS TOA'47 ALWANeM YpWAFWI d