HomeMy WebLinkAbout030-2131-42-000 Wisconsin Department of Commerce Count
PRIVATE SEWAGE SYSTEM St. Croix
Safety and Building Division -
' INSPECTION REPORT Sanitary Permit No:
1 � 479480 � 0
GEI`4ERAL .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:
Glen Johnson Construction I St. Joseph, Town of 030- 2131 -42 -000
CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No:
9( -ck I rA "L ,A-I 23.30.20.1096
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic II ,, . Benchmark 2 • q D �. � • 96
! bn to
c�
Alt. BM
a �� O _ �ol � F : Lam. C�:1 a•�., 50 • `4
Bldg. Sewer X3.'71 " ,, • S
Holding SVHt Inlet
/e� • a StS
TANK SETBACK INFORMATION SVHt Outlet \
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet \
Septic Dt Bottom
* l (o p / 5 /s IT Q Z • ib
Dosing 7 2,5 �f / 5 i If Header /Man. 97- Z
Aeration Dist. Pipe 7—. AP
Holding Bot. System ,
Final Grade • d7-
PUMP /SIPHON INFORMATION (.\off `�'Z
Manufacturer /` S Demand St Covertr C �
p � • 4, COd 5 •� / � 4 1 Z_
GPM
Model Number 3 7 - 0 •(9� 6 to �6 • 001
TDH L� 5 I` Friction L ` System ilea j T H
(p t (J
Forcemain Length, i Dia. Z jf Dist. to well
SOIL ABSORPTION SYSTEM ( A
BED/TRENCH Width Length j No. Of Trencilks PIT DIMENSIONS No. Of P its Inside Dia. Liquid Depth
DIMENSIONS 75
SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer.
INFORMATION Type System: CHAMBER OR
YP ys � � UNIT Model Number:
DISTRIBUTION SYSTEM
Header /Manifold / / Distribution / ( it I x Hole Size 3 t x Hole Spacing Veto Air Intake
Pipe(s) II
Lengt Dia Z Length 7�F Dia Spacing / 1 , / !1e �!�
SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only
Depth Over I Depth Over j xx Depth of xx Seeded /Sodded xx Mulched
Bed /Trench Center ' 5 Bed/Trench Edges Topsoil I / Yes [ No Yes No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1 �- � O / � tv Inspection #2: / !
Location: 114 Heritage Trail Houlton, WI 54082 (NW 1/4 SW 114 23 T30N R20W) S
ettler's Glen L/ Parcel No: 23.30.20.1096
1.) Alt BM Description = Coot.." 1 d O VN ,
2.) Bldg sewer length
- amount of cover = f
3 S
Plan revision Required? i M, Yes No
Use other side for additional information.
Date Inse; it#��ignat Cart. No.
SBD -6710 (R.3197)
* r
Safety and Buildings Division County e . F
201 W. Washington Ave., P.Q. Box 7162 �' _j X
vftconsin Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.)
De artment of Commerce (608) 266-3151 �q 7 94` 90
Sanitary Permit Application State Plan I.D. Number
In accord with Comm 83.21. Wis, Adm. Code, personal information you provide / Z 7 O T� 7 7
i
may be used for secondary purposes Privacy L Project Address (if different than mailing address)
I. Application Information - Please Print All Information /�� / ' / r
Property Owner's Na me P7 1 3 t 20uuu Parcel k Block #
T. CROIX COUNTY_
Property Owner's M ailing Address Property Location
'/a,�,Sectian -
City, State Zip Code Phone Number 14 14)
� �- ��� circle o /
II. Type of Building (check all that apply) 3 is ¢ o
W1 or 2 Family Dwelling - Number of Bedrooms f �?` 3� Subdivision Name CSM Number
>
❑ Public /Commercial - Describe Use , aAe j� o t � ( _ s � �•l � y s ��C�v
171 State Owned - Describe Use to 75 /1L OU� � ❑City_❑Village�Township of
i
III. Type of Permit: (Check only one box on line A. C omplete line B if applicable) a 3 p -- 2_ - �f Z _
A' XNew System 1 ❑ Replacement System ❑ TreatmentiHolding Tank Replacement Only ❑ Other Modification to Existing System
B. ❑ Permit Renewal Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued
Before Expiration Plumber Owner , —
IV. T of POWTS System. (Chet o f ( _�_� ���
�❑ Non - Pressurized In - Ground ound > 2 in. of suit able soil k �24 in. of suitable soil ❑ At Grade ❑Single Pass Sand Filter
E) Constructed Wetland El Pressurized In- Ground Holding TanPea t Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter
❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain)
V. Dis ersa /Treatment Ar ea Information:
Design Flow (gpd) Design Soil Appli ation Rate(gpdsf) Dispersal Area Requir Dispersal Area Propose f) System Elevation
z5
VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Units Concrete Constructed Glass
New Existing ^
Tanks Tanks i J ? 6 6c c
Septic or Holding Tank
Aerobic Treatment Unit
Dosing Chamber
VII. Responsibility Statement- I, the undersigned, assume for ' Wation of the POWTS shown on the attached plans.
Plumber's Na me (Print) Plumber's Si gnature i 6MPRS Number Business Phone Number
Plumber's Addre ss (Street, City, State, Zip Code)
VITP County/Department Use Only_
X Approved ❑ ysappro Sanitary Permit Fee (includes Groundwater Dat lssuin gent Signa re o Sta
} Surcharge Fee) �ir , Ot7 i
L1 en Reason fot�ertial r
IX. Conditions of Approval /Reasons for Disapproval n
SYSTEM OWNER: 3) 3 J, , 8A 5v
1. Septic tank, effluent filter and L k 6�-o t..) t? , �✓ t
dispersal cell must all be services / maintained M� �wv Gv� 60�
as per management plan provided by plumber.
2. AA seftwit requirements must be maintained (y t d'ln 0(I 9 J• �L� � �'�
as per applicable code / ordinances. �J I
Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size
SBD -6398 (R. 01 /03)
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Safety and Buildings
Co mm el'Ce.WI. ov RECEIVED 4003 N KINNEY COULEE RD
g LA CROSSE WI 54601 -1831
TDD #: (608) 264 -8777
isconsin 3 1 2006 www.commerce.wi.gov /sb/
Department of Commerce www.wisconsin.gov
ST. CROIX COUNTY Jim Doyle, Governor
Mary P. Burke, Secretary
May 24, 2006
CUST ID No. 227990
ATTN. POWTS Inspector
WILLIAM C SCHUMAKER ZONING OFFICE
SCHUMAKER PLUMBING ST CROIX COUNTY SPIA
1070 SCOTT RD 1101 CARMICHAEL RD
HUDSON WI 54016 HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 05/24/2008 Identification Numbers d
Transaction ID No. 1270877 Q
SITE: Site ID No. 704161
Glen Johnson Construction Please refer to both identification numbers,
2305 Heritage Trail above, in all correspondence with the a enc .
Town of Saint Joseph
St Croix County Q ty
NW1 /4, SW1 /4, S23, T30N, R20W
Lot: 42, Subdivision: Settlers Glen
J
FOR: �.,.
Description: 3 Bedroom Design, Revised Plans
Object Type: POWTS Component Manual Regulated Object ID No.: 1038312
Maintenance required; 34 in Soil minimum depth to limiting factor from original grade; System(s): Mound
Component Manual - Version 2.0, SBD- 10691 -P (N.01 /01), Pressure Distribution Component Manual - Version 2.0,
SBD- 10706 -P (N.01 /O1); 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 Tli4611 4stcte'i�t?e
and Icated., acorcice ttltcrvd plaranc w�lx tEie� cotnp��n�tr�"��Irce�l�v
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:
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, and the "Mound Component
Manual for Private Onsite Wastewater Systems Version 2.0" SBD - 10691- P(N.01 /01).
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. All permits
required by the state or the local municipality shall be obtained prior to commencement of
construction /installation/operation.
WILLIAM C SCHUMAKER Page 2 5/24/2006
In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should
conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review
shall relieve the designer of the responsibility for designing a safe building, structure, or component.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the
installation, operation or maintenance of the POWTS.
Sincerely, Fee Required $ 75.00
Fee Received $ 75.00
Balance Due $ 0.00
Dennis R Sorenson
Wastewater Specialist, Integrated Services WiSMART coder 7633
(608)785 -9336,
dsorenson@conimerce.state.wi.us
I
MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN
Residential Application
INDEX AND TITLE PAGE
Project Name: Glen Johnson Construction 3- bedroom residntial mound
Owners Name: Glen Johnson
Owners Address: P. O. Box 809
Hudson, WI 54016'�"`
Parcel Address: 2305 Heritage Trail
Legal Description: NW1 /4 NW1 /4, Sec. 23, T.30N., R. 20 W. s
Township: St. Joseph
County: St.Croix
Subdivision Name: Settlers Glen sPOtypENG�
Lot Number: 42 Block Numbee
Parcel I.D. Number: 030 - 2131 -42 -000
Plan Transaction No.: 11'7 01
;1J Page 1 Index and title
Page 2 Data entry
Page 3 Mound drawings /(9
Page 4 Lateral and dose tank N 1
Page 5 System maintenance specifications SA/C 206
Page 6 Management and contingency plan 84140
Page 7 Pump curve and specifications /Nft
Page 8 Site Plan
Page 9 Soil Evaluation Report
Designer: Bill Schumaker License Number: 227990
Date: 05/03/06 Phone Number: (715) 386 -3121
Signature:
Designed Pursuant to the
Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01101), and
SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81)
Version 4.01 (R. 09/04) 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)
5.50 Site Slope ( %)
86.00 Contour Line Elevation (ft)
34.00 Depth to Limiting Factor (in)
0.40 In -situ Soil Application Rate (gpd/ft)
Distribution Cell Infonmation
75.001 Dispersal Cell Length Along Contour (ft) = 6.00 Cell Width (ft)
1.00 Dispersal Cell Design Loading Rate (gpd /ft
1 I Influent Wastewater Quality (1 or 2) Are the laterals the highest point
in the distribution Y
Pressure Disribution Information network? Enter Y or N
(c or e) a Center or End Manifold
2.00 Lateral Spacing (ft) If N above, enter the elevation ft
3 Number of Laterals of the highest point.
0.125 Orifice Diameter (in) (e.g. 0.25)
2.50 Estimated Orifice Spacing (ft) = 5.00 ft /orifice
2.00 Forcemain Diameter (in)
50.00 Forcemain Length (ft) Does the forcemain drain back? Y
84.00 Pump Tank Elevation (ft) Enter Y or N
6.50 System Head (ft) x 1.3 8.16 Forcemain Drainback (gal)
12.08 Vertical Lift (ft) 70.12 5x Void Volume (gal)
1.43 Friction Loss (ft) 78.28 Minimum Dose Volume (gal)
20.02 Total Dynamic Head (ft) 37.07 System Demand (gpm)
Lateral Diameter Selection Manifold Diameter Selection
in. dia. options choice in. dia. options choice
0.75 1.25 x x
1.00 1.50 x
1.25 x x 2.00 x
1.50 x 3.00
2.00 x
3.00 x
Gallons /Inch Calculator (optional)
Treatment Tank Information 603.36 Total Tank Capacity (gaq
1000.00 Septic Tank Capacity (gal) 1 36.001 Total Working Liquid Depth (in)
Wie Concrete IManufacturer 16.76 gal /in (enter result in cell B49)
Dose Tank Information Effluent Filter Information
603.361 Dose Tank Capacity (gal) JZabel Filter Manufacturer
16.761 Dose Tank Volume (gal/in) JA1 00 Filter Model Number
Wieser Concrete I Manufacturer
Project: Glen Johnson Construction 3- bedroom residntial mound Page 2 of 9
I
r
I •
s
Mound Plan View
T
FK /10 -B
. • • • •
. .. . ........... . ® :. J
Observation Pipe
- - -- —+
A
W .... .................................. —
B
. I
------------------ - - - - --
L
Mound Component Dimensions
Down slope toe extension made.
A 6.00 ft E in H A4.56 ft K 7.31 ft
B 75.00 ft F in z ft L 89.62 ft
D 6.00 in G ft J ft W 19.56 ft
450.00 (ft) Dispersal Cell Area 1 1125.001 (ft Basal Area Available
6.00 (gpd /ft) Linear Loading Rate 7.50 (ft) 1/10 B Obs. Pipe Placement
Mound Cross Section View
Aggregate Dispersal Area
Finished Grade 98.27 (ft) —�
� rrrrrrrrr 2 rrrrrrrr ..
F Dispersal Cell
97.00 (ft) Lateral
96.50 (ft) — Invert
Dispersal Cell
Elevation E D
:
:k 'h_ {�
..,' •'-' � V
'4'•4'{,x. ••t;`+ ` {� {�, �` } '..�.- _,.,,�ti �, -.,'� . .'� .. ✓ ..
96.00 (ft) Contour Elevation
5.5 % Site Slope
Geotextile Fabric Cover
Shading Key �'.— Dispersal Cell See lateral details on
1Q ® Topsoil Cap = 1.5 ft Page 4 for number, size,
7 / 7
Subsoil Ca '� c 5 °° ° a and spacing of laterals.
ASTM C33 Sand :6 . R" ' °' F Laterals are equally
i= 0.5 ft ns" Typical Lateral spaced from the
any. Titled Layer d
05 :. fti Aggregate a 0 :� distribution cell's
"_ y° " ' "!* centerline in the
A
distribution cell (AxB).
Page 9
Project: Glen Johnson Construction 3-bedroom residntial mound Pa g
i
End Connection Lateral Layout Diagram
Center the laterals over the A &Bdimension •= Turn -up wd be li va Iva or of as n out pi ug
P .I
All laterals are i -dentinal Holes drilled on the bottom of the lateral s
equally spaced
Laterals & force main of PVC Sch 40 3
(per COMM Table 84.30 -5)
Force main oonneotion via tee or cross to manifold at any point.
Number of Laterals 3 Orifice Diameter 0.125 in
Lateral Diameter 1.25 in Orifice Spacing (X) 2.53 ft
Lateral Length (P) 73.37 ft Orifices per Lateral 30
Lateral Spacing (S) 2.00 ft Orifice Density 5.00 W /orifice
Lateral Flow Rate 12.36 gpm Manifold Length 4.00 ft
System Flow Rate 37.07 gpm Manifold Diameter 1.25 in
Total Dynamic Head 20.02 ft Forcemain Velocity 179 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 min.
Disconnect 4 in.
Tank component is properly vented -E Alternate outlet
location
Forcemain diameter
Wieser Concrete Manufacturer_ 2 in.
Capacityl 603.36 Gallons
Volume 1 16.76 gat /inch A
Weep hole or anti -
Dimension Inches Gallons B siphon device
A 18.33 307.20
C
B 2.00 33.52 P off e levation 8
C 4.67 78.28 84.92
D 11.00 184.36 D
Total 1 36.001 603.36
Dose tank elevation (ft)
3" Bedding un er tank. 84.00
Alarm Manuafacturer LevelArm
Alarm Model Number DLV
Pump Manufacturer lGoulds
Pump Model Number 13887 EPOS
Pump Must Deliver I 37.07 gpm at 20.02 ft TDH
Project: Glen Johnson Construction 3- bedroom residntial mound Page 4 of 9
Mound System Maintenance and Operation Specifications
Service Provider's Name Bill Schumaker Phone (715 ) 386 -3121
POWTS Regulator's Name St. Croix County Zoning 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 ears
Alarm Should test month)
Pressure System Laterals should be flushed and pressure tested every 1.5 years
Mound Inspect for ponding and seepage once every 3 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 Turn -up Detail
Finished • ............. • • • • • • • • • • • • • • •
Grade
6 -8" Diameter Lawn Threaded Cleanout
Sprinkler Valve Box Plug or Ball Valve
Distribution
Lateral
may. Long Sweep 90 or Two
45 Degree Bends Same
Diameter as Lateral
Project: Glen Johnson Construction 3- bedroom residntial mound Page 5 of 9
Mound System Management Plan
Pursuant to Comm 83.54, Wis. Adm. Code
General
This system shalt 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 84nches 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 filter cartridge should not be removed unless provisions are
made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the fitter is equipped with an alarm, the filter
shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm.
The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If
the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next
service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank.
The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are
used they shall be approved for septic tank use by the Department of Commerce.
Pump Tank
The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper
operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary.
Mound and Pressure Distribution System
No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded
and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative
maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow
compaction in the winter will promote frost penetration. Cold weather installations (October- February) dictate that the mound be heavily mulched
as protection from freezing.
Influent quality into the mound system may not exceed 220 mg1L BOD 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg /L
BOD5, 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.
Continency Plan
If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper
operating condition.
If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired
or replaced with a component of the 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 5 of this plan for the name and telephone number of your local POWTS regulator and service provider.
Project: Glen Johnson Construction 3- bedroom residntial mound Page 6 of 9
NGOULDS PUMPS Submersible
Effluent Pump
3871 EPO4
EP05
APPLICATIONS • Fully submerged in high ■ EP05 Impeller: Thermoplas- ■ Bearings: Upper and lower
grade turbine oil for tic enclosed design for heavy duty ball bearing
Specifically designed for the lubrication and efficient improved performance. construction.
following uses: heat transfer.
• Effluent systems ■Casing and Base: Rugged
• Homes Available for automatic and thermoplastic design provides AGENCY LISTING
superior strength and corrosion
• Farms manual operation. Auto ' Canadian Standards Association
• Heavy duty sump matic models include resistance. o
• Water transfer Mechanical Float Switch ■ Motor Housing: Cast iron
• Dewatering assembled and preset at the
for efficient heat transfer Goulds Pumps is I50 9001 Registered.
factory. strength, and durability.
SPECIFICATIONS ■ Motor Cover: Thermoplastic
FEATURES cover with integral handle and
• Solids handling capability: float switch attachment points.
3 14" maximum. ■ EPO4 Impeller: Thermoplas- N power Cable: Severe duty
• Capacities: up to 60 GPM. tic Semi -open design with rated oil and water resistant.
• Total heads: up to 31 feet. pump out vanes for mechanical
• Discharge size: 1'/2" NPT. seal protection.
• Mechanical seal: carbon -
rotary/ceramic- stationary,
BUNA -N elastomers.
• Temperature:
104 °F (40 °C) continuous
140 °F (60 ° C) Intermittent. METERS FEET
• Fasteners: 300 series 10 ► S GPM
stainless steel —
i
• Capable of running 9 30
dry without damage to $ � FT
components. 25 . r _ .
Q 7
Motor: ,t0 o2' _
• EPO4 Single phase: 0.4 HP,1.& . – o�
115 or 230 V, 60 Hz, 1550 a
RPM, built in overload with s
0 1s
automatic reset. 4
a
• EP05 Single phase: 0.5 HP, o C S
115 V or 230V, 60 Hz, 1550 3 1 0
RPM, built in overload with EPO4
automatic reset. 2
• Power cord: 10 foot 5.
standard length, 16/3
SJTOW with three prong
grounding plug. Optional 20 0 0 0 10 20 30 40 50 GPM
foot length, 16/3 SJTW with
three prong grounding plug
(standard on EP05). 0 2 4 6 a 1 10 12 m /h
CAPACITY 37.07 f -4M,m: o"i4 s"#
v Goulds Pump
n 2002 Goulds Pumps ITT Indust r'es
Effective September, 2002 �/ � � 7
B3871
'
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of �
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code Coun
Attach complete site plan on paper not less than 8 112 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.
Please print all Information. RevW& Rev' by Date
Personal information you provide may be used for secondary purposes (Privacy law, s. 15.04 (1) (m)). 64Z 1
Properly Owner Property Location �.
J c) S 0 y Govt. Lot 1/4 114 T N R E (or) W
Property Owner's Mailing AdTO Block # Subd. Name or CSM#
Q Q to _
City ... State Zip Code Phone Number Lyny []Village own Nearest Road
L
(..� S Uf (v ( ) c
se.
New Construction Use Residential /Number of bedrooms 3 — y Code derived design flow rate GPD
Replacement Public or commercial • Describe: _
Parent material �� L Flood Plan elevation if applicable
General comments
and recommendations: // /
�.d vo ��cJ �(p. U t
Boring
Baring # L J ft. De to limiting factor 7 in.
® Pit Ground surfa�ee elev. pt rig 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
Z
Boring # ❑ Boring " ✓ -
V1 Pit Ground surface elev. � t/� = ft. Depth to limiting factor G f � in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDiff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sl . '04 'Eft#2
0 16 10111--31Y .� 2 irJ C S U
' Effluent #1 = BOD > 30!5 220 mg& and TSS >30:5 150 mg/L ' Effluent #2 = BOD < 30 mg& and TSS < 30 mgA.
T Name (Please Print) Signature CST Number
Z53�a
Amass Date Evaluation Conducted Telephone Number
sv ? /0 -i 76 0 -00 -;;X.
I
Property Owner h' r ` Parcel ID #
Pape Z of
F3-1 Ong # Boring 9G
Pit Ground surface elev. z ft. Depth to limiting factor l .
• • • in Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/lf
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff #1 'Eff#2
la r
rT
2
r
Boring # Boring
F
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
- •r
Boring
Boring # Ground surface elev. ft. Depth to limiting factor in.
Pit Ground Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff #1 'Eff#2
I
' Effluent #1 = BOO, > 30 < 220 mgA- and TSS >30 < 150 mgA. ' Effluent #2 = BOD < 30 mgA_ and TSS < 30 mgA-
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 605- 266 -3151 or TTY 608- 264 -8777.
SBD 933Oreu (rto,roo) .
i
I
• PAGE O F
NAME J ° �` LOT# LEGAL DESCRIPTION 1 /4 1 /4,S T ,N,R E(OR)W
SCALE: I"
BM I ELEVATION X60.
BM I DESCRIPTION
BM 2 ELEVATION
BM 2 DESCRIPTION j
SYSTEM ELEVATION QcP ' QQ S
SYSTEM TYPE mc /
30
�.. Z 0
V
P�
ea r
B �
�GTU RE DAT
0 5 ^ Safety and Buildings DI li Co -�
,SC As 201 W. Washurgtun Ave., P. ,s � �� � _ f`/
N onsin Madison, WI 53707 - ;162 Sannitary Permit Number (to be filled by Co,)
Department of Commerce (608) 266 - 3151
We P! I.D. Number
Sanitary Permit Application - 12 D �
� In accord with Comm 83.2 1, Wis. Adm. Code, personal information y provide
may be used for secondary purposes Privacy Law, sl5,04(I)(W Project A rass (if different than mailing address)
I. Application Information - Please Print All Information�� /
Property Owner's Name @arcel#� of #
� � ,�
roperty Owner's Mailing Address Property Location
City, State Zip Code I Phone Number --
et- ��j ue j e)
I. Type of Buildin g (check all that apply)
I' ✓� R c� -
or 2 Family Dwelling - Number of Bedrooms _ l / Subdi ' ton Name CSM / Number
❑PubliclCommercial - Descri se ^ _ � (l/ S� e ��/
D State Oatted - Describe Use City ❑ f
Township o I
III. Type of Permit: (Check only one ox on line A. Complete line B if applicable)
A. New System ❑ Replacement S em D TreatmenVHolding Tank Replacement !y ❑ i od' c o stn Sy
? r� Lis nevi us it lvumber and Da
B- ❑ Permit Renewal ! ❑ Permit Revision D Change of a Permit Tr fer to New
Before Expiration I I tuber Owner /
IV. Type of POWTS System: (Check all that a t
D Non -- Pressurized in-Ground (Mound > 24 in. of suitable soil Mound < 4 in. of suitable soil ❑ At -Grade D Single Pass Sand Filter D
Consuucted Wetland D Pressurized In -C Holding Tank eat ter ❑ Aerobic'Tteatment Unit El Recirculating Sand Filter ❑
Recirculati Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line Gravel -I Pipe [1 er (explai) y //
V. Dis ersaffreatmentArea Information: i
De Flow (gpd) Design oil Ap Dispers tea Re " (sf) Dispersal Area Proposed sf) System Elevation �t
VI. Tank Info Capacity in Total Number anuface r Pre b Site Steel Fibe astir
Gallons Gallons of Un' Concrete Constructed Glass
New Existing
'ranks I Tanks
Septic or Holding Tank
lam/ i
Aerobic Treatment Unit _
Dosing Chamber
VII. Responsibility Statement - 1, the un rsigned, assume responsibility for Ing4ation of the POWTS sho it on the attached pl ans.
Plumber's Name (Print) P mber's Signet e P , PRS Number Business Phone Number
Plumber's Address (Street, City, Stat , Zip Cod ®/ oa
VII oun /De artme !se Onl
i Sanitary Permit Fee (includes CnoundwWr Da issu I ing Age St atur tamps) Approved D Dt"IlG oved Surcharge Fee) CJo
D Reason far Denial i g * ya S `�
IX. Conditions of pproval/Reasons for Disapproval
SYSTEM OWNER:
eptic tan , e uent Er la ,
dispersal cell must all be serviced / maintained . J�
a per management plan provided by pl umbe� ✓ 7 - L -d;, D �r�� � 6� ./�'� ( y
2. Aff setback requlr s mus a malnTaiPTeU'— �� Ticcr� , / • /�
as per applicable code /ordinances. I�/_e �Q�t. L(�?•a ��a'�'t'e ��Gyiul'
Attach complete plena (to the County only) fur he ayarem o4 pa er aot 6 sa t an 8112 1 irrchea ' s' � - -��
SBD -6398 (R. 01/03)
r
50;1 eva14Aa6*o�
11
N i s Cal
l� Tohn-5 or) CcnS
/o 2, /a 6 of
�`/fofe. Qr :�Q/ - ieliYl� 's 5e pis G(ej See. 23,
5-C . C/D
6 y , S c.Q./e 1 4-4 boy e doc.-� "et
onditionally
APPROVE
DEPARTMENT OF COMMERCE
PASION OF SAFETY AND ILDIN 9
SEE CORRESPONDENCE
PropMtd CA), esw Co C,-t�6 . wLA i oC01640, n
- Co rr)
% Z �o -5/ vo A 41
,' �s // 1�r•oposrc
9�5 k nce ma;n. 45 d ence
94.22 'h,�� Ord. aL ol.: S fe
• 3 �a�a�e loca ( r'Uh
ati
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+S{ormcr Eev� = 99 00
-J01
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Safety and Buildings
4003 N KINNEY COULEE RD
commerce .wl.gov LA CROSSE WI 54601 -1831
TDD #: (608) 264 -8777
It isconsin www.w www.commer isco t
epartment of Commerce isconsin.gov
Jim Doyle, Governor
Mary P. Burke, Secretary
September 07, 2005
CUST ID No. 227990 ATTN.• POWTS Inspector
WILLIAM C SCHUMAKER ZONING OFFICE
SCHUMAKER PLUMBING ST CROIX COUNTY SPIA
1070 SCOTT RD 1101 CARMICHAEL RD
HUDSON WI 54016 HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 09/07/2007 Identification Numbers
Transaction ID No. 1192081
SITE: Site ID No. 704161
Glen Johnson Construction Please refer to both identification numbers,
2305 Heritage Trail L above, in all correspondence with the agency,
Town of Saint Joseph
St Croix County
NW1 /4, SW1 /4, S23, T30N, R20W
Lo 42, Subdi vision: Settlers Glen
FOR:
Description: 3 Bedroom Design
Object Type: POWTS Component Manual Regulated Object ID No.: 1038312
Maintenance required; 30 in Soil minimum depth to limiting factor from original grade; System(s): Mound
Component Manual - Version 2.0, SBD- 10691 -P ure istribution Component Manual - Version 2.0,
SBD- 10706 -P (N.01 /O1); Polylok PL -52 or Zabel A -100 Biofilter
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes Q�
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:
l
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, and the "Mound Component
Manual for Private Onsite Wastewater Systems Version 2.0" SBD- 10691- P(N.01 /01).
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. All permits
required by the state or the local municipality shall be obtained prior to commencement of
construction/installation/o p eration.
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.
WILLIAM C SCHUMAKER Page 2 9/7/2005
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the
installation, operation or maintenance of the POWTS.
Sincerely, Fee Required $ 175.00
Fee Received $ 175.00
Balance Due $ 0.00
Dennis R Sorenson
Wastewater Specialist, Integrated Services WiSMART code: 7633
(608)785 -9336,
dsorenson@conunerce.state.wi.us
MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN
Residential Application
INDEX AND TITLE PAGE
Project Name: Glen Johnson Construction 3- bedroom residntial mound
Owner's Name: Glen Johnson
Owner's Address: P. O. Box 809
Hudson, WI 54016
Parcel Address: 2305 Heritage Trail
Legal Description: NW1 /4 NW1 /4, Sec. 23, T.30N., R. 20 W.
Township: St. Joseph
County: St.Croix
Subdivision Name: Settler's Glen
Lot Number. 42 Block Number:
Parcel I.D. Number. 030 - 2131 -42 -000
Plan Transaction No.: I J of ?--0 2 1
Page 1 Index and title
Page 2 Data entry �N: •
5) Page 3 Mound drawings d,001t �O
fecov Page 4 Lateral and dose tank Y�
Page 5 System maintenance specifications O� MEa
3 1 Z� Page 6 Management and contingency plan
AUK GS Page 7 Pump curve and specifications �1�pRSM�A��S`t t►
Page 8 Site Plan ` pSO N p( r S O�NGE
SPF� Page 9 Soil Evaluation Repo RS P 0N
R
A GE
Designer: Bill Schumaker License Number: 227990
Date: 08/18/05 Phone Number: (715) 386 -3121
Signature:
Designed Pursuant to the
Mound Component Manual for POWTS Version 2.0 SD &10691 -P (N. 01/01), and
SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81)
Version 4.01 (R. 09/04) Page 1 of 9
I
Mound and Pressure Distribution Component Design
Design Worksheet
S_ ite Information
(r or c) - R Residential or Commercial Design Note: Sand fill (D) calculations assume a
_300.00 Estimated Wastewater Flow (gpd) Table 8344-3 in -situ soil treatrnent for fecal
1.50 Peaking Factor (e.g. 1.5 = 150 %) of <- 36 inches.
450.00 Design Flow (gpd)
2.00 Site Slope ( %)
_93.00 Contour Line Elevation (ft)
30.00 Depth to Limiting Factor (in)
0.50 In -situ Soil Application Rate (gpd/ft')
Distribution Cell Information
90.00 Dispersal Cell Length Along Contour (ft) = 5.00 Cell Width (ft)
_ 1.0 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)
4 Number of Laterals of the highest point.
_0 .125 Orifice Diameter (in) (e.g. 0.25)
- - 2.50 Estimated Orifice Spacing (ft) = 6.25 ft /orifice
_ 2.00 Forcemain Diameter (in)
80.00 Forcemain Length (ft) Does the forcemain drain back? j Y
87.00 Pump Tank Elevation (ft) Enter Y or N
6.50 System Head (ft) x 1.3 13.05 Forcemain Drainback (gal)
6.00 Vertical Lift (ft) 36.11 5x Void Volume (gaD
1.52 Friction Loss (ft) 49.16 Minimum Dose Volume (gal)
14.02 Total Dynamic Head (ft) 29.66 System Demand (gpm)
Lateral Diameter Selection M anif o l d _D Selection
in. dia. options choice in. dia. options choice
0.75 - -- 1.25 x _
1.00 x r1.50 x
1.25 x
1.50 x 3.00
2.00 x
3.00 x
Gallons/inch Calculator (optional)
Treatment Tank Information 603.36 Total Tank Capacity (gal)
__ f60 _ 0 . _ 60 _ 1 Septic Tank Capacity (gal) 36.0 Total Working Liquid Depth (in)
Wiese Concr Manufacturer 16.76 gal /in (enter result in cell B49)
Dose Tank Information Effluent Filter Information
603 G Dose Tank Capacity (gal) Zabel Filter Manufacturer
163 Do se Tank Volume (galfin) A100 Filter Model Number
Wie C oncrete
Manufacturer
Project: Glen Johnson Construction 3- bedroom residntial mound Page 2 of 9
Mound Plan View
T
1/10 6 : 0 J
• .i _ Observation Pipe
K T ..5. A
.:
W 'J' F.
.. B .
� . I
. L!• ...... ..
.. .
...
L
Mound Component Dimensions
A 5.00 ft E 7.20 in H 1.00 ft K 6.90 ft
B 90.00 ft F 9.00 in z 5.90 ft L 103.80 ft
D 6.00 in G 0.50 ft J 4.95 ft W 15.86 ft
450.00 (ft Dispersal Cell Area 1 981.38 (ft) Basal Area Available
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 95.25 (ft) —►
F Dispersal Cell
94.00 (ft) Lateral
93.50 (ft) - ► — :: : :: ' Invert
Dispersal Cell 3 : ; :::::: .
..... D ::::::::
Elevation E
4.
93.00 (ft) Contour Elevation
2.0 % Site Slope
Geotextile Fabric Cover
Shading Key $ T Dispersal Ce See lateral details on
10 ® Topsoil Cap c a 1.5 ft . • •.••.••. • Page 4 for number, size,
Subsoil Cap 1 ° 0 5 and spacing of laterals.
ASTM C33 Sand 0 Laterals are equally
' " I Lateral s aced from the
Tilled Layer c m 0.5 ft YP� P distribution cell's
Aggregate c ' �'centerline in the
A
distribution cell (AxB).
Project: Glen Johnson Construction 3- bedroom residntial mound Page 3 of 9
Center Connection Lateral Layout Daigram
Force ruin connection via tee or cross to manifold at an point. Laterals are identical
any
S
31/- 0= Tum-up WbaII valve or ;x-----+ Laterals & force main of PVC Soh 40
oleanout plug per COMM Table 84.30 -5
Holes dried on the bottom of the lateral.
Number of Laterals 4 Orifice Diameter 0.125 in
Lateral Diameter 1.00 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 7.41 gpm Manifold Length 2.50 ft
System Flow Rate 29.66 gpm Manifold Diameter 1.50 in
Total Dynamic Head 14.02 ft Forcemain Velocity 3.03 ft/sec
Dose Tank Information 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 � F Alternate outlet kroation
Forcemain diameter
Wieser Concrete Manufacturer �_ 2 in.
Cap acity 603.36 Gallons
Volume 16.76 gal/inch A
Weep hole or arrti-
Dimension Inches Gallons B siphon device
A 19.07 319.56
C
B 2.00 33.52 P, ump off e levation (ft)
C 2.93 49.16 r— ' -- 88.00
D 12.00 201.12 D
Total
W.00[
6.00 603.36
iF Dose tank elevation (ft)
3" Bedding un er tank. �— 87.00
Alarm Manuafacturer LevelArm
Alarm Model Number DLV _
Pump Manufacturer Goulds
Pump Model Number 3887 EPO4
Pump Must Deliver 29.66 gpm at 14.02 ft TDH
Project: Glen Johnson Construction 3- bedroom residntial mound Page 4 of 9
Mound System Maintenance and Operation Specifications
Service Provider's Name Bill Schumaker Phone (715) 386 -3121
POWTS Regulator's Name St. Croix County Zoning 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 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 ..............
.............. .
Grade \1,14 : '
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: Glen Johnson Construction 3- bedroom residntial mound Page 5 of 9
Mound System Management Plan
Pursuant to Comm 83.54, Wis. Adm. Code
G eneral
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, 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 filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are
made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter
shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm.
The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If
the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next
service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank.
The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are
used they shall be approved for septic tank use by the Department of Commerce.
Pump Tank
The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper
operation. If an effluent fitter 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 B005, 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
its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related
piping, and replacing said components as deemed necessary to bring the system into proper operating condition.
See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider.
Project: Glen Johnson Construction 3- bedroom residntial mound Page 6 of 9
gr,,7G0ULQS,PUMPS Submersible
Effluent Pum
_ p
3871 EPO4
EP05
APP LICATIONS • Fully suhmerged in high ■ EP05 Impeller: Thermoplas- ■ Bearings: Upper and
grade turbine oil for tic enclosed design for heavy duty ball bearloc
ay Jcs�gned for the lubrication and efficient mproved performance construction.
` heat transfer.
�,�tems ■Casing and Base: Rugged
Available for automatic and thermoplastic design provicles AGENCY LISTING
manual Auto - operation. superior strength and corrosion
p resistance. SP Canadian StandardsAssoaanon
• ; -a: , d,11� sump matic models include
• �:nsfer Mechanical Float Switch ■ Motor Housing: Cast Iron
p for efficient heat transfer, Goulds Pumps a ISO Soot Registe eu
reset at the
• �;,n'iu assembled and
factory. strength, and durability.
SPE CIFICATIONS ■ Motor Cover: Thermoplastic
FEATURES cover with integral handle and
• os �a'�o 1ng capability: float switch attachment points.
max" ■ EPO4 Impeller: Thenrtoplas
■ Power Cable: Severe dory
e� ,p to 60 GPM tic Semi -open design with
r ated oil and water resistant.
• -ai up to 31 feet. pump out vanes for mechanical
---l' � s,ize 1 NPT. sea! protection.
• ai seal carbon-
ceramic- stationary,
_�.astomers.
continuous
C; intermittent. METERS FEET
thr
• nE rs -00 series
i_hout damage to
7,
" [)c E It; 25
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DEPARTMENT OF COMMERCE
IVISION OF SAFETY AND ILDIN S
SEE CORRESPONDENCE
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'` De artment of Commerce SOIL EVALUATION REPORT Page of
gVisdons in p
�Divisiori of Safe ty and Buildings
Comm 85 cos. Adm. Code
in acx;ordance with County
Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must Cry
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. �5 j
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
viewed b Date
Please print al infnior► ':
Personal information you provide may be used fic r secondary purposes (Privacy Low,: I 5.04 (1) (m)).
Pro perty , roperty Location
°+'w v ¢5 2 2 ovt. Lot !U 114 1 /4 S Z T 3 N R Z or E (or)&9
Property Owners Mailing Address of # I Block # Subd. Name or CSM#
City State Zip Code Phone Number ❑ City ❑ village ffi own Nearest Road
New Construction Use: ( Residential / Number of bedrooms - Code derived design flow rate Sa 16 00 GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material < < I Flood Plain elevation if applicable n
General comments y f r✓l 2 J yq S0 �rj �'4/ 0 S
and recommendations: L i v\ 4-v u .r U O
l
❑ Boring # Boring GG
�}- q' o' �U ft. Depth to limiting factor in.
pit Ground surface elev.
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
rn�T ( v S
z 1Z l 5L S
Boring # ❑ Boring
pit Ground surface elev. q9. 80 ft Depth to limiting factor 3 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Te Consistence Boundary Roots GPD /ft
h. 'Eff#1 'Eff#2
in. Munsell Qu. Sz. Cont. Color k-
1 6 ICS � 2- Z c
- m
> < Effluent #2 - BOD s < 30 mg/L and TSS 30 g/L
- d TS 30 150
Effluent #1 - BOD > 30 < 220 mg/L an S _ rr►g/L _ -
Signature
CST Number
CST Name (Please Print) \ , 9 ZS 3
�9 \Y
Address Date Evaluation Conducted Telephone Number
Property Owner I C �Q� Parcel ID . # 2 '
Page, ofd
Boring #• ❑
�f Pit Ground surface_elev. � ft. Depth to limiting factor In.
Horizon Soil Application Ra
Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots 3PD/tl2
In. Munself Ou. Sz Cont Color "°; Gr. Sz Sh. .
Eff#1 E(f#2
1 0 �o ro 14 r cs
Z - �I L r c �r-
CLPT,5 4I - c
F-1 Boring # ❑ Boring
❑ pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rai
Horizon Depth Dominant Color Redox Description.._ ., .Texture Structure Consistence Boundary Roots GPp /ft=
In. Munselt Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
Boring # ❑ Boring
❑ Pit ' Ground surface elev. ft. Depth to limiting factor In.
Soil Application Raft
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
- ' Effluent #1 = BODs > 30 < 220 mg/L and TSS >30 < 1 So mg/L ' Effluent #2 = BOD < 30 mg/14 and TSS < 30 mg /t.
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.
SarlQJO (RO7/00)
PAGE OF
A m OC rr� TOT# LEGAL DESCRIPTION /1/ Y4<w ` S z-5 T 3 o N R ZU E(orlQ
SCALE: T"= - / o l
BM I ELEVATION �� G
BM I DESCRIPTION
I3M 2 ELEVATION 9 i
BM 2 DESCRIPTION
SYSTEM ELEVATION q f So
I
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SYSTEM TYPE C ) o ��
CONTOUR ELEVA'T'ION
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SIGNATURE
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�v�
ST CROIX COUNTY
_ SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer 0 �1e_n an
Mailing Address Q
Property Address /& �/& r �� 7 c
(Verification required from Planning Department far new construction)
City /State 4V-k � j OT Parcel Identification Number 039 '021-3 /— X12
LE GAL DESCRIPTION 1
Property Location '/4, �_ '/4, Sec. J� , TjD N -R W Town of V
Subdivision �' � ! (Dien , Lot #
Certified Survey Map # , Volume , Page #
Warranty Deed # 7 ,Volume , Page # 4� ��
Spec house O yes 0 no Lot lines identifiable X yes O no
SYSTEM MAINTENANCE
Improper use and maintenanceof your septic system could result in its premature failure to handle wastes, Proper maintenance
consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper, What you put into the system
can affect the function of the septic tank as a treatment stage in the waste disposal system.
The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a
master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system
is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge.
I /we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards
set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification
stating that your septic system has been maintained must be completed and returned to the St, Croix County Zoning Office within 30
days of the three year expiration date.
S ATURE OF APPLICANT DATE
OWNER CERTIFICATION
1 (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of
the property described above, by virtue of a warranty deed recorded in Register of Deeds Office.
07RATURE OF APPLICANT DATE
* * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by 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
Parcel #: 030-21M-42-000 09/19/20 5 0 1 1 1
Alt. Parcel #: 23.30.20.1096 030 - TOWN OF SAINT JOSEPH
Current n ' X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner
O - GLEN JOHNSON CONSTRUCTION INC
GLEN JOHNSON CONSTRUCTION INC
PO BOX 809
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 114 HERITAGE TRL
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 3.000 Plat: 2443 - SETTLER'S GLEN LTS 1/45 030/03
SEC 23 T30N R20W PT NW NW SETTLER'S GLEN Block/Condo Bldg: LOT 042
LOT 42 (3.000AC)
Tract(s): (Sec- Twn -Rng 401/4 1601/4)
23- 30N -20W NW NW
Notes: Parcel History:
Date Doc # Vol /Page Type
12/08/2004 781968 2710/636 WD
06/24/2003 727056 2286/036 EZ -1
04/29/2003 719301 9/58 PLAT
2005 SUMMARY Bill #: Fair Market Value: Assessed with:
0
Valuations: Last Changed: 05/31/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 3.000 79,600 0 79,600 NO
Totals for 2005:
General Property 3.000 79,600 0 79,600
Woodland 0.000 0 0
Totals for 2004:
General Property 3.000 69,700 0 69,700
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch #:
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
•� U 2110P 636
STATE BAR OF WISCONSIN FORM I- 2000 '7,B 1 9 6 8
WARRANTY DEED KATHLEEN H. VALSH
Document Number REGISTER OF DEEDS
�rn I
THIS DEED, made between St. Joseph Development Corps fi Minnesota ST. CROIX Co., CO. ,
Corporation Grantor, and Glen Johnson Construction, Inc., Grantee. RECEIVED FOR RECORD
Grantor, for a valuable consideration, conveys to Grantee the following 12/08/2004 10:00AII
described real estate in St. Croix County, State of Wisconsin (the WARR�Ty
IT a'E�T EED
SEE ATTACHED EXHIBIT A C y F e
FEE:
PAGES: 2
Recording Area
Name and Return Address: G
Land Title Inc. !
1900 Silver Lake Road Suite 200
New Brighton Mn 55112
Together with all appurtenant rights, title and interests. 0 - 3 2 / 0 5 33 -20 -100
Parcel Identification Number (PIN)
This is not homestead property.
Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except
Dated this 30th day of November 2004.
St. lose Development CXporation
.
* ellei St. Martin, Vice President
* *
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF Minnesota )
WASHINGTON COUNTY. ) ss.
authenticated this 30th day of November, 2004 Personally came before me this 30th day of November
2004 the above named Kellei St. Martin Vice President of St.
* Joseph Development Cornnesota C orporation t o m e
TITLE: MEMBER STATE BAR OF WISCONSIN known to be the person(s) wh executed the foregoing
(If not, instrum and ackno dged ti es
authorized by § 706.06, Wis. Stats.)
THIS INSTRUMENT WAS DRAFTED BY * Nan entz
Notary Pu lic, State f Mihnesota
My commission is permanent. (If not, state expiration date:
Larry Mountain Attorney 1900 Silver Lake Road Suite 200
New Brighton Mn 55112
(Signatures may be authenticated or acknowledged. Both are not necessary.) NANCY J. LENTZ
NOTARY PUBLIC MINNESOTA
'Names of persons signing in any capacity must be typed or printed below their signature
r My Gomm. Expires Jan. 31, 2005
WARRANTY DEED STATE BAR OF WISCONSIN FORM 40.1-2000
y
V, 2710 P 637
EXHIBIT A
Lots 7 and 42, Settler's Glen located in the Town of St. Joseph, St. Croix County, Wisconsin.
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