HomeMy WebLinkAbout036-1079-30-000 (2)ale
PRIVATE SEWAGE SYSTEM
G..i
St. Cf01%
Sams and Rule no Oil
INSPECTION REPORT
yPsent ad
624888
GENERAL INFORMATION
(ATTACH TO PERMIT)
Case Neap No.
®
seasonal abandon You pruads may be used far .ee lG nay Lan a 15 N tpM➢
old
close
Can cIII
P rtaaNn
n & Roxanne O'Keefe
6m036-1
TOWN OF STANTON
07930-000
NHnw
nap 100
m
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I++ RO -5141
.31.17489A
TANK INFORMATION
ELEVATION TION DATA
TYPE
MANUFACTURER
"VIPACITY
STATION
ES
ELEV
!ol
aMors
l000
HEM
lV79C.sq
Ian
t3-P*
Man 6cwer
Ij14-1(
TANK SETBAG INFORMATION 1,Bal
su Ioa.I7.63
93. 93
TANKTO
L
LU
vgiiefl�in.ta
ROAD
9lwnne -Z47,(p3Bp'KFC
(7"`Only
aenMen
common
DST cps
aDIAv
IN System
POMPISIPHON IN FORMATION
Finn areas
t
a"t
Mannkmnre,
cP ana
ever
�e7
96. b9
Mods
'Glop
L.IHIN \X0
At
SOIL ABSORPTION SYSTEM
DIMENSIDI
5Ul
an
Ly.,,m
DIMENSIONSPea
addsD,,
Load Earth
NA wH
6Y6iEM i0
CCF
�M� H A l
P/L
RLO6
AKE/ REA
�e /�XI'aT� po�wi n les .,,
SOIL COVER
w a067
...s CM m �%115
COMMENTS(InGoaswaeal66awntles,perwnsprewm,m) Iap"wan 01 Imeim43
Location 103 JS5TL AVE
1)AIt BM Dewap1Ian— 5e f L"
2Iagaw�Hrl length
MM - �AIS'�N✓'S .a Bldg
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Plan related PooYes II ,e rerelatedUIrM+ aNele,Nathn.. ,fM, nn N
or �-1 19Po�61g
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ry and Bumm�ge DivisionBox
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ehing Box 7162
ureCrolux
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ury PomNNumhr(rohfillW mbr Co)
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Dan & Roennne O'Keefe
036-1079-30000
Flvlmry Mnne Mnlmg Aaamss
tmmnytovmn
1443185"Ave
GOA Lot
NW v, S_d.senm 31
clo sane
DaCked,
Pln,,Nu San
Now Kmhmond WI
54019
763 ]64-4]54
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N. TYpe of MINTS System/CompountNeeice ICpsk III that apply)
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Purner, S
MPTAPREFA,l
mmPpua NWW,
James Thom one
I
---------
]IS 248-]F6]
mw I Amw oW,f oy. Sue, mpC
340 Paulsen Lake Lane Osaolt WI 54MO
V 111 Conn Ne n end Uae Onl
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SYSTEM fl 3) �u"�S 'r""j P ,qu+ c Cbflat
1 STEMlank, emuent letar entl ".rt1 �.S16O00rr"
anpeatil rmare ement pMUSt be sem6lLNaf aeF9 �) r t➢. ,µ-r� t
oe meinteinear
2 Alll all eeenummentsMUl +0,-
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Conventional POWTS Index & Title Sheet
Pmlect Name
Ogees Filter Curator er Installation
Comers Name
Did @Roseanne Mesta
MmYr adbees
1443185N Are, New Richmord, W15G017
Site intends
Same
Ended Location:
Subi Lot q CSM Vol 03, Pe, 800
Legal Descnpnon. Nwl JSE 114, Sec lL TI IN., R. 17W, Tv of added, St Come Co, Wl
Parcel tog 0361079doA0o
Page I Index and Tole Shed
Paget Sue Plan
Pagel Loamg Dimmest Cell Sizing Calculations
Page 4 1 Iter l ank Cross Section
Pages Effluent Filter Specifications
Pagers Certification Settlement So- lltilaauon of an Existing some Tank
Pagel Segic Tank Mamtenance Agreement
Page System Management Plan
Page4 Certified Siwey Mq
page 10 Warrant Dead!
Maker PI Kwoul d 8mice James K amount, DSPS Continual p BD
Sides,= i Dne 30. �p
Page 10f 10
Wi almaccnt wmtmunA emi m4,1mlmn Comamentmuua In PnwT vvmm 2 0 t111)10705 P N did)
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e.ny i m.w
/f�.1rF/o
O'Keefe Evisfine Duoenal Cell Smisiz Cdaulafion
I (3be4 XIWplm:A 15 heipp bnor)-45oWGWtl pnow
2 Infilaurvegnnryafnmmmil-0 0
3 AL lion-= quie j� ft
4. AEsorylion ones mruWt1ed 04Wwft 2'x52'mveW
Yp 3 of 10
.IsO� 2 , 2021)
A.C.E. Soil & Site Evaluations
dames Pa. 9rhoroPcorr
840 Paulwn Lake Lane
0wro14N1 SIII211
I'dial xWxmxx.r, u... u.x 1 nnI...1 nnrx.e..
M,m, Plamler, (..rune a v..n'r. rrn. nn..nyr I nyrcnor
NRcriva.XSUMYn Rv primkd al(01 N%)pedid tans :Gains
n\n cw.fia emWl w.e � .0 lrl'1'GV\\YAmmm.m'smtn
To Kenn Gmbmv
St pmxCo Land use ma Convection Spm'Galm
RE Exmmg POWTS Evaluation,O'Keek propedy, 14431850AV, New Richmond, Wl, for O, CSM Vol 03,
Pg BCq To ofSlsl Sr Crolz Co, set, vocal computer 40361079-30000
I have condumW en evnluauon of One PCWTS serving the residential at the chose address ITe existing POWTS a a
conventional system consmiog ofa1,000gallen Powers wnerere septic arm and a mai l cell (manifold) M IY x 52'
sauced wing pmlommd pipe and gavel The system was do grind and Imralled in Ottober 1979 to wo ommo3s4 a
thrmbedmam home
The POWTS Is operating properly, and rr hydraulically groaning m this time
fracture are any que9mnsor persons that l car address, oral can be of Nnher service pleau feel free he call me at (715)
348-7767
James K Imountain
Cc file
DETAIL 13
FILTER
CANISTER
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Avvxoxiv'ATE��c
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SEE DETAILS l-x-o
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CONCRETE
SEALANTS TYP
'
/ OR EQUAL FOR ALL JOINTS
(SEE DETAIL
5)
TOP VIEW
;
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8
a
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SlTEL aAIN
zlxc P ATD
ICCx SEE DETAIIS. 1-2-3TT
H
rvno
�s
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CAST _,,psE0. T
aa5
CAST E DEETAiLEE
FILl R
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SIDE VIEW
EE o
1
�1
INS
a =7 °'"" � i tl•IN4 PL-525 Effluent Filterid
PL-525 Filter
The Pt 525 Filter 1s rated for Iq WO GPD (politics purl,)) making II one of the 1,,F t filters in us clad, It has
5251war feet of 1/16" filtration slots Like Me Polylok CI
-In, the Felt for PL-525 has an automatic shut off ball
insulted with "cry filter When the filter s removed for
cromng the ball will float up and temporarily shut off
the ay,h in so the efnumf won't leave to tank.
Features,
1/16" Filtration Slots
- Noted for 10,000 GPD dolocs per day)
an
® AldnenIndeed) h
- Ina mwar feel of 1/16" Shan on
- Accepts 4" and 6" XHD 40 PIP,
Arnto
uden.s�aI Lasalle
• look in gas deFlraor
• Automatic ahwbofl ball when filter Is removed
- Alone accessibility
found
founddie
• Accepts PVC eaemltin handle
PL.us msmlmon
Ideal for nafdemul and commercial w'ute Flows up m
525I n•^
I code gall.. per dry (GPO)
a If " Yw
1 Durbin the outlet of the septic nick
R Remove the tank cover and pump tmlk 9 neceaare
9 Clue the filter housing to the 4'or 6"outlet pipe If
error, 4 e
i s
the filter Is not centered under tie wards opening use a
Pnlybk CxNmd k Lek or piece of pipe to center filter
4 Inden the 11I.525 filtermto its housing
s rzerlme.rnd.cmmethe septic mN: rover
® NSF ANSI standard 46
PI-ss ma ... alo....
Do, PL-55 Pmuent Filters will operate eff¢femry for
se,eral lends, normal condoms rry Indeed, mmr
,cannot lens recommended that he filter be cleaned
cover e the tank Is pumped, or at least every three
Years. I(mhe tmulled filtermntains an npOnml alarm,
For owner will to mulled by an alarm when me filial,
weds oncoming 5ervemg should M done by a renewed
— I"' r
septa pink pumper or believe
Amernadw
1 I.oeae thrtiudel of th, were tank
s6vadi Had
9 Numwe tank mva and pump tnkff overri'ary
plumbing when
ehousin oved
4 Nit 1 ,52 th
4 PoII P1.5356artndge out oldie housing
5 I lose off filled over the septic tank Make sure all
solids fall back Into ,pit, tank
_
h InwrtlM blue carmdge Wh di Me housing mal,nµ
sore tuxher is Imilooly abgN and rumpkmn awarded
7 Replan and m m, serum used, cover
IN indoor ms...ac6 md.Inm kind, ranargunk.
Polyotmc JFirficidebd, WaWngfoma C[ 06I42 tun Pwe 8777659165 lac X32811E14 wwwpolylukalm
ST. CROIX COUNTY ZONING OFFICE
CERTIFICATION STATEMENT.
FOR UTILIZATION OF EXISTING SEPTIC TANK(S)
This is to certify that I have inspected the existing septic and/or dose tank
presently serving the following residence
(Street address) 143 185lo Ara, Nmffimh W. W17 located
at t+"t V4, RE 1/4, Section 31 Town sl N, Radge17_ W,
Town of sue^ St. Croix County Wisconsin
Upon inspection, I certfy that I have found the tank(s). W the best of my
knowledge, will conform to the requirements of SPS. 384.25, and it(they)
appear(s) to be functioning properly.
Most recent date of inspection or service am 29. ima
Did flow back occur from absorption system? Yes_ No x
(if no, skip next line.)
Approximate volume or length of time: NO gallons Na minutes
Tank Capacity: 1-0009ws
Construction: Prefab Concrete x Steel Other
Manufacturer (if known): Po..,ecaw�ele PAaua.
Age of Tank (if known): 41 sun. mamas oar 1% /ere
umber (if known) 10e
rem N.TMapam .
/tensed Plumber i (Print Name)
MPRS MPRaRWP
(Title) (License Number) MP/MPRS
Junew 20E0
(Date)
Form to be completed by licensed plumber (Dept of Safely and Professional
Services Chapter 305 and s. 145.06, Wisconsin Statutes) or licensed disposer
(NR.113 Wisconsm Administrative Code)
Rev 212012
ST. CROIX COUNTY
SEPTIC TANK NIAMTE1iANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Gromer/Euyer Dan & Roxanne O'Keefe
Marling Address 1443 185th Ave., New Richmond, WI 54017
Pmpetty, Address Same
(VmEunon requnod firm Plvinmg & Panm80epmtmem furnewcon.Msnon )
Clty/Smla ParcelldeuWiceaot Nimaber 036-1079-30-000
LEGAL DESCRIPTION
Pmpetty Location NW ,A, SE z,Sec. 31 T 31 NR17 w, Toavu of Stanton
Subdivision Plat Na ,Lotha D
Ce?rlifredISu�rvey Map N 3 5 G 90 () Voliane 03 Page k 800
waFaby DDedk 0a-1bI (befnre 2007)Volmne Na Pager Na
Spec house Elyes2ho Lot bins identifiable oyborm
SYSTEM MAINTENANCE AND OWNER CFRTDTCATION
Impmper use and mvntemccc of yom septic System Could result in its preserve(dime b movie shows Tani
consists Ofrunpmg Out the smile man every years or sourer, if micro, by a]reused pmnperVictorsic t you put
Ne syecmceen affect me Ponmmn of be rope, tank as eo-mwens a time in be waste disposal system Owner mumeranae
,amis,btWes are specified to PPS 383 52(1) and in Chapter 12. St Crorc County gathers Documents.
The Property Damon agrees to submit St Cmx Cowry Plaonsg& Zonmg Department a bralicatim 6tm, signed by the
owner and by a master plumber, journeyman plumbs, restricted plumber or a licensed pumper vmf»ng that(I)the savior
samwater disposal System is an prier monaWg condition tumor (2) after sryecnon and pmnphg (ifneassery), the septic pM is
less than I/ full of sludge
1/we, be wderetgnN gave reed the Move requmonmw mtl agree a mam an tM private sources tlupooel ayswm wim she
standards setboth, hues, ea act a Divehmvt of Sandy And nontechnical Services and be Department ofNuunal Rosevear,
State OfWucwum Cemfiwtnn$tying that Your, septic system has beet memW ed must be completed and reseed W me St Cron
County Plmmmg as Zonmg De car twithin 30 days of be Wee year expansion base
Iiwe cemfy fast all slasemenw on this four coo mum ofey/owknmvledge I/weaMem the owntt(a)ofhe
property described above, by value of a wav emy deed recorded on Register of Deeds Once
Numberofliedrooms 3
kepp,��: 6 /30/20
IGNA O APPLICAiJT(S) DATE
Any so amusing that is misrepresented may result in be amnesty perm beard revoked by the Planning & Zonmg Department "
Include wM the apphwurm a recorded wmsmty deed Gras me Register of Deeds Office and a so" of the cemfied ewvey map R
reference is made an Sae smarty deed
IREV.04112)
Conventional Septa System Management Plan
Pursuanuo 5P8383 W, As Add Code
Gee cal
The conventional septc system shall be opt an mcwdmtce with Site 382-334 Wiz Abu CWl aid shall So mhwWnM
aeco cewMeomp mimm"ISR610]05-PMOIVI) All local aitb'azlele mks pettmnmg to system
entl to Medeae rtponin6zhallm eempl aM1 15)24 on Nehe Cron gaining
sYuem
Moody ad directed to Me inwlhngplumber,tie Thdmpwnvpl5)248�]]a]athe SiSl Croix County] ing Cepvonmlat
QIS)386-0fi80
Stripe Took
Septic=it umcmg mechanics comply with 4P5381541 id) Septic tank to be lmvm wMm 150'of ssrvtu pad, wait
bottom of tank to be v 15Celow serves: used elevation The spending condition ofNe small tank and maid filer shell be
assessed at lent onu every No years by inspevmn The septic ask contents shall be removed when the sludge end uum in
the Tank exceed 1/3 Oe liquid volume of Me tick The Tanana of Me septic look shall be disposed of in accordance with NR
113. Wis, Adm Code, by In adsorbed amfed u service septic arks coder s. 28148, Many 1f Oe cnnlenn of be Jack are
nor removed at the time of a biannual ssuercard, maintenance worwnnel shall advise the owner of when vernier will be
needed to maintain less [Fan Ili scum and sludge acemnulvmn in the ank Me cutlet filter shall he diner u memory to
ensure proper operation . The flkr automatic should not be removed unless provisions and made to ream mFds in the tank
that may slough OR the Filter when removed Them its endeure If the filterurympped wnM1 en nlmm,tFe filter eFell be
drive if the alum is activated Septic Took manFola uses. access nseq and covers should he malteeted for water
tighti and soundness Access epenmgs used for service and instrument shall be sealed wnvmght upon the completed of
a Any opening deemm unsound. deleatve, or subject as failure must bt replaced Cxpauedaaessopemngsgreater
than 8 inches in damaer shall M tamed by an effective locking Morce topinmt murder or unnudmrned eery inn me tank
No individual should ever enter he septic tank To dmgemus gone maybe present that could cause dumb Septictenk
abandonment shall he in aaoMance with Cnmm83 33, Wis Abu CWe when the Jank is no longer used an e POWM
component Theadditimofbielegwlerchemaaladdime tomhmce a ctankperfomwceisgenemllynmmqucM If
such pmtlune ate ueM. they shares approval fan septic ank ex by Me DepWnent orCmmmeta, SRry and Isuddmga
om.add
Still Abwrofon Cell
Trees or sbmiss should not be planted Mostly car be sod absorytton system MeateaaMveaManuna Nezysearns uld
be seeded and mulched asp uty to prevent erosion and pre,l a wane degree of rest ptaemmirs Traffic (miter than for
signal communicate) war the system is to be avoided See compammn may hams, amnliw of tM mflani surface
weds and above the system and will promote fop pmeavmn during cold naNer month. ColdwmNe,isst rims
Camber -Much) mumb"the system be heavily mmmed for fion pmrabm
Influent quality at, Me system may not exazd 220mgv IM113, ISO MG T8s am 30 mg FOG mnamt now wry real
exceed minimum design flow seemed an the pemm for the insallmon
Obttnanns TimeswMmder dn'pnsal all shall be clacked for effluent pommg Pondmg lev<IssMll be rtlrortedmthe
owner libels above 4 inches manage an unprntlmg hydraulic failure nommng window, more frtqumt assuming
Commodity Else
Ifine septic Took or my of as component became defective be iced or component shall bee reduced or reptazm to keep be
system in popee op ting condition Excessive Pondmg wahm me didedowl cell AL11 be eliminated by ladling anew and
Most call to bring me system into pmperoperaung condition
of 8of 10
s
> 2
\ win::
AS BUILT SANITARY SYSTEM REPORT
':ER' j? n Yllicha�s , TowESHIPSEC.32 T3/ x, N ' -
y gBOAESS +' ST. CROIX COUNTY, WISCONCIN /Avr �
A6l_< Fk Mrrbels
]DIVISION nub�, LOT31LOT SIZE 3q/�14
PLAN VIEW /H/PAr/rk /-/n.n/ Nye
Distances 6 dimensions to meet requirements of H62.20 - 3124119xi
mom
Ir
M
OFF
■■
.M
:C:
"TIC TAN'K(S)U MFCR._� r �ULp CONCRETE STUM Indicate
S Cate Nort;h ytM1ow
N f rings on _� Depth a_0 DRY WELL
Y_
CRES NO. o - inch cover length
rea
no. of line $ width length_�j` area
::.£GATE /depth to top of pipe ]Y-
.ic: RA'TE,_ ABEq KLQUIRGD LILPOS AREA AS BUILT L^ZY
eelnlmen The inspection of this system by St. Croix County does not Imply complete
.aifame with State Administrative Codes, There are
other a that it is not Possible
nrpect at this point of c n uction. St. CroixCo+ncy e o liability for
:e v operation. However, if failure is noted the County ill ea eve, ff e4to i
ermine cause of failure. /!
.ASES AT) OILS SHOULD NOT BE DISPOSED THROLGH THIS SYST — make -
�I
DAT® /o-Id 7Y
PLLXRER ON JOB
LICENSE NUf®ER
A -
r
REPORT Or INSPECi10N_INVIVIVx AL SEWAGE SYSTEM
Sae{taay peaxat LQ
/I State Septic
RARE c %L �� / toy nahcp ,e fn w/ st Eho.LK Coanty
Lom{toe/ CQ$elian ��
SEPIIV TANK ��
Siee�d O-O ,Uon<. Numhey oq Lonp:n Xu_
Pu tance Iham WILL� C) _6G its ea gaeatea etape� 6l
Rantdtn9it Weltande "/— _it
Ni9hmoteA it.
DISPOSAL SYSTEM ��",
Daatnnee Fall Wetl__i�6L ILt VA 9Aeate4 sto Pt(t.
auiedtns A 6t Wettande It.
N.9hwateA6e
FIELD 019ENSIOx S.
Dadth o6 trench 6t. Depth 16 toch Letaw Late
tu9th o6 each Rne 6t. Depth 06 aoct oven t.te—
xvuhet v6 4ne4 ` Depth o6 Late 6etou 9iade_An�
Total te.9th 06 LnneA_it. stove 06 tetneh tK pen FOR it.
Dietanee hez cen knee�jt Depth to eedAo{h it.
Tot.t nee o An{:on a as / it? Depth to 9n0andwatge_it
Reyuined a. Y` tI Type od Cove.: raven 04 See"
PIT DIMENSIONS.
xawhu o 'ttt/66;44�
rOpth
.Dana vttn_yu_no
01
Oatd ada d`u�ne tow vntetdR.
Total .bAod[pyA.ea Ovo d ^
INSPECTED rrt LEq �L
AVPPJv Y ,DATE
REJECTED
y
r\
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