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HomeMy WebLinkAbout030-2037-30-200 , sin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix and Building Division i INSPECTION REPORT Sanitary Permit No: 408281 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Lozano, Louis & Tara I St. Joseph Township 030 - 2037 -30 -200 CST BM Elev: Insp. BM Elev: BM Description: ida,o 1 106 -U d o pa -S s 1 73 A l TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Z. / S / 0 /B-� - U Septic Benchmar q p Dosing / Alt. BM q O� o ! f. -7 Aeration �., Bldg. Sewer / 3, Sb. q I Holding 3VHt Inlet 14 8 7.3 1 TANK SETBACK INFORMATION St/Ht Outlet 87.1 TANK TO P L WELL BLDG. Vent to Air Intake ROAD Dt Inlet l 3 s� Septic. / / 3Q r C Dt Bot/ 0 Y 7f l9. D fl-y& Dosing 2" D� / Header /Man. , Aeration Dist. Pipe a/ - Holdi Bot. System oe PUMP /SIPHON INFORMATION Final Grade � 6W6 .¢.r� : 957, Gam/ Manufacturer Demand St Cover 10 LDS GPM 44.0 1( t - 7 Model Number V e-0 L _Z0. TDH LiftFriction oss System Head TDH Ft 1,�$ ,� V� Forcemain Len Dia �? Dist. to Well v tJ UT /" V67 F SOIL ABSORPTION SYSTEM BED/TRENCH Width Length - i No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS P is — C SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREA CHING anufacturer: INFORMATION CHAMB Type Of System: r � r,/ IT Mo D DISTRIBUTION Hea erlManifold Distribution x Hole Si e I x Hole Spacing Ve� Air Intake / �j Pipe(s) ,/ c/ l0 S Length Dia �/ Length S Dia . J Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Cr Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center 1 Beo/Trench Edges Topsoil S Yes Fjj� No ❑ Yes ❑ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:/ / 0 ec n #2: Location: 1392 County Rd V Houlton, WI 54082 (NE 1/4 NE 1/4 25 T30N R20W) NA Lot 2 Parcel NO: 2 0 1.) Alt BM Description = I Dp d� �h • l,�1a f / y�� V��� 2.) Bldg sewer length = 3 T - amount of cover = 3.) Contour Plan revision Required. F, Yes No E other side for additional information. - t s _ SBD - 6710 (R.3/97) Date Insepct 's Signature Cert. No. + Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 N visconsin Madison, WI 53707 - 7162 Site Address Department of Commerce X-- - z— 3SS 3S 7 ` Sanitary Permit Number Sanitary Permit Application In accord with Comm 83.21, Wis. Adm. Code, personal information you Provide ❑ Check if Revision ma y be used for secondary ses Privacy Law, s15,04(14 m State Plan I.D. Number 1. Application Information - Please Print All Information S (0 2 Parcel Numbe Property Owner's Name - -- roperty Owner's Mailing Address Pro rty Location JUL 2 5 � � 5f ' N City, State Zip Code Ph ne Number Lot umber Block Number • 7 7 " sT :_)iX �E: Su 'vision Name CS umber i II. Type of Building (check all that apply) ❑City I or 2 Family Dwelling - Number of Bedrooms ❑Village ❑Public /Commercial - Describe Use ❑Townshi ` Nearest Road / El State owned / r �/� d �' CdY1 �U7Ni/ � e v. � 3 • / 6 ' � � N , T e alum III. Type of Pe t: (Ch only one box on line A (numbering scheme for internal use). Complete line B if applicable) A. For County use 1 0 New 2 ❑ Replacement System 3 ❑ Replacement of 6 ❑ Addition to stem Tank Oni Exis ' stem B. C3 Check if Sanitary Permit Previously Issued umber Permit N Date Issued IV. Type of Permit: (Check all that ly)(nutnber g scheme is for internal use) 440 Non - Pressurized In- Ground 21Moutxl 47 El Sand Filter 50 El Constructed Wetland 22 ❑ Pressurized In -Ground 41 Holding Tank 48 ❑ Single Pass 51 11 Drip Line 45 ❑ At Grade 46 ❑ Aerobic Treatment Unit 49 DO Recirculating 30 ❑ Other V. Dispe rsai/Iteatment Area Information: tion Final Gradc Design Flow (gpd) Dispersal Area Dispersal Area Soil Applicad n Percolation Rate System Eleva Elevation Required Proposed / Rate(Gals./Da (Min./Inch) ✓ Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass VI. Tank Info New Existing Tams Tanks V Septic or Holding Tank _ { Dosing Chamber VII. Responsibility Statement- I, the undersigned, asquaie responsibility for installation of the POWTS shown on the attached plans. Plumber's Sig MP/MPRS Number Business Phone Number Plum s ame _ 1 ber's dress (Street, City, tate, Zip ode) �? ZI. b 64 VHI ount /De artment Use Onl Sanitary Permit Fee (includes Groundwater Date Issued I ing A m Signature (No Stamps) Approved El Disapproved Surcharge Fee) [I owner Given Initial Adverse Determination IX. Conditions of Approval/Reasons for Disapproval d - d 717-zfc - z. l ��� �'-A"F , v+c�cc.� /�frt -wt,d P /A4 • �- - '� ° �� � �i�. -�, �,; Attach complde Plana (to the County Daly) for ayrt on paper Dot leas than SV2 a 11 Iachea In Oze n P(�} �Q�, vnd� ( a• b� /W'y ►' - a� /�u t tM� d i.- Cmr�s�,, �3 3 _I WeIJ SBD-6398 ( 05101) lie ? 2S �rav " 1 > � ,,, wr tr .� a >/ / /o �. 1 a w � a ro � v o o i � CA CI II Safety and Buildings c 10541N RANCH ROAD HAYWARD WI 54843 TD #: (608) 264 -8777 erc Visc onsin www w ww.commerce.state.wl.uS/sb on .wisonsin.gov Department of Commerce Scott McCallum, Governor Philip Edw. Albert, Secretary July 22, 2002 CUST ID No.224263 ATTN.- POWTS Inspector KIM A O'CONNELL ZONING OFFICE ✓ K.O. CONSTRUCTION ST CROIX COUNTY SPIA 504 3RD AVE 1101 CARMICHAEL RD OSCEOLA WI 54020 HUDSON WI 54016 4 � `tD f ZS I CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/22/2004 Identification Numbers Transaction ID No. 762976 SITE: Site ID No. 646725 Louis & Tara Lozano Please refer to both identification numbers, Cth I above, in all correspondence with the agency. Town of Saint Joseph P. C) AA St Croix County NE1 /4, NE1 /4, S25, T30N, R20W C'o n d tj FOR: New mound, 450 GPD Object Type: POWT System Regulated Object ID No.: 857855 7MEN The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes 'f and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in of SAE chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: SEE CORRE General Approval Conditions: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD- 10691 -P ( N.01 /01) and SSWMP Publication 9.6, "Design Of Pressurized Distribution Networks For Septic Tank- Soil Absorption Systems." • 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. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 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 maintenance plan for this system must be given to the owner of the POWTS. Key Item(s) • A copy of this approval letter and index sheet shall be attached to plans that correspond with the copy on file with the Department. Changes to the approved plan must be submitted for review and approval. Failure to properly attach the approval and index page to plans that match the copy on file with the Department may result in enforcement action under s. 145. 10, Stats. • This mound s sy tem is no designed to be located on a concave slope. • The CST has confirmed that the slope in the area of the mound is 6% KIM A O'CONNELL Page 2 7/22/02 Note • The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater particle size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. • The bottom of the distribution cell shall be level per the Mound Component Manual. • The maximum finished slope of the mound surface shall be equal to or less than 3:1 per the Mound Component Manual. Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of COMM 84. • Maintain well and waterline set backs per COMM 83.43(8)(i). • Provide frost protection per COMM 83.43(8)(c). • Holes must be drilled with a sharp bit and all burrs and foreign matter removed before installation. 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. 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, opera ' or maintenance the POWTS. Sincerel Fee Required $ 175.00 ... Fee Received $ 175.00 Balance Due $ 0.00 atricia L Shan or POWTS Plan Reviewer, rated Services WiSMART code: 7633 (715) 634 -7810, Fax: (715) 634-5150, M -F 7:45 am - 4:30 pm pshandorf@commerce.state.wi.us cc: Leroy G Jansky , Wastewater Specialist, (715) 726 -2544 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: LOUIS - -TARA LOZANO Owner's Name: LOUIS --TARA LOZANO Owner's Address: 10903 BAZIN ST HOUSTON TX 77089 Legal Description: NE- NE-SEC25430N -1120W Township: ST. JOSEPH T.S. County: ST. CROIX onall Subdivision Name: CSM 1) )F co ME INCA Lot Number: 2 Block Number: Parcel I.D. Number: :SPOND CE 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 PLOT PLAN Designer: KIM A O C NNELL License Number: 224263 Date: 06 /1 6/02 ` Phone Number: 715 -755 -3145 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 8 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 coliform of <w 36 inches. 1.5o NeaKing Factor (e.g. 1.5 = 15U %) L I 450.00 Design Flow (gpd) c nn n:a„ nl_. _ ini x v.vv vrac dlV c iu Contour Line Elevation ft li to I imitinh Fan. or (in) 0.40 In -situ Soil Application Rate (gpd/ft) ✓ Distribution Cell Information 75.001 Dispersal Cell Length Along Contour (ft) = 6.00 Cell Width (ft) 100 Dispersal Cell Design Loading Rate (gpde) l� Influent Wastewater Quality (1 or 2) Are the laterals the highest p oin in the distribution Y Fressura "isribui ion infuriinsuon rteiwul k f Enter Y or N (c or e) Center or End Manifold I 3 nn 1 otoral Cnarinn /ft) If KI cSK %i antor the cloa_otinn /ff1 „ V ., . , 2 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.q. 0.25) 3.00 Estimated Orifice Spacing (ft) = 9.00 ft /orifice 2.00 Forcemain Diameter (in) / Zvi 25.00 1 Forcemain Length (ft) Does the forcemain drain back? Y WA 87.201 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 4.08 Forcemain Drainback (gal) 6.04 Vertical Lift (ft) 67.38 5x Void Volume (gal) 0.24 Friction Loss (ft) 71.46 Minimum Dose Volume (gal) 12.78 Total Dynamic Head (ft) 20.60 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. I options choice 0.75 _ 1.25 x 1.UU 1.5U 1.25 x 2.00 x A Gn 7 nn INV A A V.VV 2.00 x 3.00 x I Gallons/inch Calculator (optional) Treatment Tank Information 800 0 Total Tank Capacity (gal) 1000.001 Se ptic T ank Capacity (gal) 37.00 Total Working Liquid Depth (in) WEEKS !Manufacturer 21.62 gal /in (enter result in cell B49) Dose Tank Information Effluent Filter Information onn nn n., .,, r....i. n ,.,..,.:�.. i..,.n 7„r..,1 c.14... we.... s...,a...... VVV.VV VVJG Tan VGFIgVSLY 1yG1� I�PVG1 1 Vaal IYIg1lVlgaiaul Gl 21.761 Dose Tank Volume (gal /in) JAI 00 ] Filter Model Number WEEKS Manufacturer Project: LOUIS- -TARA LOZANO Page 2 of 8 Mound Plan View J Observation Pipe — ,........... :::::''B . I 3 :: Mound Component Dimensions Down slop toe extension made. A 6.00 ft E I 11.32 in H 1.00 ft K 7.67 ft B 75.00 ft F 1 9.501 in z 9.00 ft L 90.33 ft y 1 D 7.00 in G 0.50 ft J 4.77 ft w 19.77 ft O 450.00 (fe) Dispersal Cell Area 1125.00 (ft Basal Area Available 6.00 (gpd/ft) Linear Loading Rate 7.50 (ft) 1110 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 95.54 (ft - --� t I♦ G i i • 1 Dispersal Cell :;:' ::::::::::.... 94.24 (ft) Lateral is� 93.74 ( )—► -- Invert rs E D 3 Elevation d:•:•.•....:- . 93.16 (ft) Contour Elevation P.0 % Site Slope Geotextite Fabric Cover Shading Key — Dispersal Cell See lateral details on LJ i opsoii Crap _S I .j n Nage 4 for number, Subsoil Cap �' I I '^?+ size, and spacing of .r.! v.. Q� mr l r IaLci aw. aw arc Tilled Layer ll 0.5 ft Typical Lateral equally spaced from M Ap4_reoate d o (� II 1 5 I I the distribution cell's T — --- A ---fi centerline in the distribution cell (AxB). Project: LOUIS - -TARA LOZANO Page 3 of 8 End Connection Lateral Layout Diagram Laterals oeMered over the A & ion •= Turn- upYWbalIvalveoroleanoutplug P ,I 11 W All laterals are identical I<- x — } Holes drilled on the bottom of the lateral equalig spaced $ Force main connection via tee or cross t4 rnanifold at any point. Laterals 6- force main of PVC Sch 44 (per COMM Table 84.30 -5) Number of Laterals 2 Orifice Diameter 0.125 in Lateral Diameter 1.50 Orifice Spacing (X) 3.06 ft Lateral Length (P) Q73.44 ft Orifices per Lateral 25 Lateral Spacing (S) 3.0 ft Orifice Density 9.00 ft /orifice Lateral Flow Rate 10.30 gpm Manifold Length 3.00 ft System Flow Rate 20.6 pm Manifold Diameter 2.00 in Total Dynamic Head / Forcemain Velocity 2.10 ft/sec Dose Tank Information Looking oover with warniing 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 i F — Alternate outlet location Forcemain diameter WEEKS Manufacturer 2 in. Capacityl 800.00 Gallons Vnli ima 71 7t; nalfinr•h A Weep hole or anti- ' Dimensionl Inches I Gallons 4 B siphon device A 18.59 404.54 _T B 2.00 43.52 _ I 1 I Pump off e levation ^ C 4.171 9 0.821 T �88.2Q 1 F -- ` - t_ I�I� 12.00 261.121 D T _ � 1I� I�IV I i uteri l �, i of ovu.uul Do se tank elevation (ft) '2" Rarirfinn ii in_ar tank 1 A7 24 Alarm Manuafacturer JSJ ELECTRO Alarm Model Number I HW 100 Pumn Manufar turer r,0111 nS Pump. Model Number IWE0 1 L Pump Must Deliver 1 20.60 gpm at 12.78 ft TDH Project: LOUIS - -TARA LOZANO Page 4 of 8 Mound Svstem Maintenance and Operation Specifications Service Provider's Name KIM A OCONNELL I Phone 755 -3145 POWTS Regulator's Name ST. CROIX COUNTY ZONING 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 Freauencv Septic and Pump Tank inspec t 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 I Laterals should be flushed and pressure tested every 1.5 years mounal inspect for ponaing and seepage once eve ;j 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 11 .0.644044 • • •... Grade .... """".."�.'"" .. .� :................... 6 -8" Diameter Lawn Threaded Cleanout ......... Sprinkler Valve Box Plug or Ball Valve 11'�L.�'L. L... �•'•'•'•''•'•' '•� 1 . • . • • • • . • ••''''''••'' Lateral Lonq Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: LOUIS --TARA LOZANO Page 5 of 8 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 filter 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 finer is equipped with an alarm, the filter shah 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 shag 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 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 distributioh 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. Project: LOUIS - -TARA LOZANO Page 6 of 8 /0 f Performance S ubme rsible Effluent Curves P METERS FEET 90 25 MODEL 3885 80 SIZE 3 14" Solids 0 WE15FI Q 7P = 20 E10H 60 O WE07H 0 15 50 — WE05H 40 10 30 WE03 20 WE03L 5- 0 i 0 10 2 30 40 50 60 70 ff0 90 100 110 120 GPM � � 1 0 10 20 30 m'/h CAPACITY �GOULDS PUMPS, INC. 5&•ECA FAILS hEW Y 1 114r, METERS FEET 120 � M O DEL 3885 35 ' 110 WE15HH SIZE 1/4" Solids 00 — I 90 — 25 80 Q 7 0 I 20 J r 60 O 15 50 WEOSHH nn ;- -- ----j 11 20 5 10 30 ;': 90 10 !10 120 GPM 20 30 ml /h CAPACITY 'Iq.5 GouIt15 Pijrnm Inr EnecuveJuly ,qq•. �w \_ v ba �\ W \ v � 14 s U� b GO V � 0 o r ' 1094 " Wisconsin Department of Commerce SOIL EVALUATION REPORT Page t of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Tom Schmitt 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. Please print all information, d -30 � °�'� 3 �' .3� " �U U view By Dat Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). O 2� Property Owner Property Location Weiss, Tom & Donna Govt. Lot na NE 1/4 NE 1/4 S 25 T 30 N R 20 W Property Owners Mailing Address Lot # & P.O. Box 168 n Block # Subd. Name or CSM# ew lot na CSM Pending (pV?,�� q City State Zip Code Phone Number City Village ✓ Town Nearest Road Lake Elmo I MN 1 55042 715 - 549 - 6075 St.Joseph ? Rd. V ✓ New Construction Use: y Residential / Number of bedrooms 3 Code derive efiigri` r 0 GPD Replacement Public or commercial - Describe: Parent material Pitted glacial drift Flood elevation, if applicable 'I. - ha General comments �' I�! h► (� 7 l T07 f and recommendations: Area is suitable for a mound system . The system elevation is t 'be'based ci pf our line established at 93.16'. System area is on a 6% slope. � r Otltjy Boring # ✓ Boring Pit Ground Surface elev. 93.46 ft. Depth to limiting factor —�� In Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary" ` Dots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 - Eff#2 1 0 -10 10yr3/3 none sit 2msbk mfr cs 1f .5 .8 2 10 -19 10yr3/4 none sit 2msbk mfr gw - - - - -- 5 .8 3 19 -32 10yr4/4 none sicl 2msbk mfr gw - - - - -- .4 .6 4 32- 10yr5/6 m 10yc6 /j /4 sicl 2msbk mfr - - -- - - - -- 4 6 Fil Boring # ✓ Boring Pit Ground Surface elev. 93.56 ft. Depth to limiting factor 38 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - Eff#1 *Eff#2 1 0 -10 10yr3/2 none I 2msbk mfr cs 1f .5 .8 2 10 -24 10yr4/4 none sicl 2msbk mfr gw - - - - -- .4 .6 3 24 -38 7.5yr4/4 none sl 2msbk mvfr gw - - - - -- .5 .9 4 38- 0 7.5yr4/6 m 10yr6/2/6 si 2msbk mvfr - - -- - - - -- .5 .9 * Effluent #1 = BOD 5 > 30 < 220 mg /L and TSS >30 < 150 mg /L - Effluent #2 = BOD 1 mg /L and TSS < 30 mg /L CST Name (Please Print) Signatur : CST Number Thomas J. Schmitt �� Yb 227429 Address Tom Schmitt Date Evaluation Cor*uoed Telephone Number 586 Valley View Trail, Somerset, WI 54025 11/17/01 715- 549 -6651 Property Owner Weiss, Toni & Donna Parcel ID # Page 2 of 3 3 ]Boring # ✓ Boring III - -- Pit Ground Surface elev. 91.15 ft. Depth to limiting factor 29 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -11 10yr3/2 none 1 2msbk mfr cw 1f .5 .8 2 11 -21 10yr4/3 none I 2msbk mfr gw - - - - -- .5 .8 3 21 -29 1Oyr4/6 none scl 2msbk mfr gw - - ---- .4 .6 4 2 -35 10 r5/3 m3p 5yr4/6 sc1 1 msbk mfr w - - - - -- .2 .3 y 10 r6/ 1 g 5 35 -60 7.5yr4/6 1 Oyr6 /8 IO /I sl 2msbk mvfr - - -- - - - -- .5 .9 F-1 Borin Boring # Pit Ground Surface elev. fl. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots PD in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F-1 Boring # Boring Pit Ground Surface elev. fl. 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 * 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 „oa.1 fnR_7A4_'31 G 1 — TTV An4_7AA_2777 I T � _ 'f s e �, L i dle -3� Aim P I S � � q1 QY v T s s l��y c� C S TA, p?a 2 w 7 #�- Mn, , t,-� z s;%a� S S( ��� y- /V41: Al si Tear tzO?dv r Safety and Buildings 10541 N RANCH ROAD HAYWARD WI 54843 TDD #: (608) 264 -8777 Visownsin RECEIVED www.commerce.state.wi.us/sb Department of Commerce www.wisconsin.gov JUL 2 2 2002 Scott McCallum, Governor Philip Edw. Albert, Secretary ST. CROIX COUNTY ZONING OFFICE July 22, 2002 CUST ID No.224263 ATTN: POWTS Inspector KIM A O'CONNELL ZONING OFFICE K.O. CONSTRUCTION ST CROIX COUNTY SPIA 504 3RD AVE 1101 CARMICHAEL RD OSCEOLA WI 54020 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/2212004 Identification Numbers Transaction ID No. 762976 SITE: Site ID No. 64672 Louis & Tara Lozano Please refer to both identification Cth I numbers, above, in all Town of Saint Joseph correspondence with the agency, St Croix County NE1 /4, NE1 /4, S25, T30N, R20 FOR: New mound, 450 GPD Object Type: POWT System Regulated Object ID No.: 857855 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. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Conditions: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD- 10691 -P ( N.01/01) and SSWMP Publication 9.6, "Design Of Pressurized Distribution Networks For Septic Tank- Soil Absorption Systems." • 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. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section Vlll of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. « KIM A O'CONNELL Page 2 7/22/02 • 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 maintenance plan for this system must be given to the owner of the POWTS. Key Item(s) • This mound system is not designed to be located on a concave slope. • The CST has confirmed that the slope in the area of the mound is 6 %. Note • The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater particle size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. • The bottom of the distribution cell shall be level per the Mound Component Manual. • The maximum finished slope of the mound surface shall be equal to or less than 3:1 per the Mound Component Manual. Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of COMM 84. • Maintain well and waterline set backs per COMM 83.43(8)(1). • Provide frost protection per COMM 83.43(8)(c). • Holes must be drilled with a sharp bit and all burrs and foreign matter removed before installation. 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. 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. KIM A O'CONNELL Page 3 7/22/02 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 Patricia L Shandorf POWTS Plan Reviewer, Integrated Services (715) 634 -7810, Fax: (715) 634-5150, M -F 7:45 am - WiSMART code: 7633 4:30 pm pshandorf@commerce.state.wi.us cc: Leroy G Jansky, , Wastewater Specialist, (715) 726 -2544 Apr 21 02,04:5.7p Sta07O 2814816954 p.1 04121/2002 16:20 7155495679 DONNA J WEISS PAGE 02 94/19/2802 80:25 7152473038 EELISLE EXCAVATING I PAGE 81 ST CROIX COMW SEPTIC TANK MAINMANCB ACIREEMM . AND OWNERSHIP CERTIFICATION FORM IVlailitt� Andras _ [ 1 /j � �� \ •�1a P Property Address Veyl)los op ined tiate p n mu b Deper"w" for saw awactioa) city/State - - 1 Identifiesdon Number DUCHIMON Property Location tA, %, sec. .2L T-- L N -R ' W, Town of —T L A S ubdivisim �w..l ��.�I�.. X1 +•+.. 1 LM tf . Cerdfled Survey Map N f������ Volume ?"a 7 WttrrAMY Dad 0 Volume Spec house 0 yea j o no Lot line.+ identifiable yes ❑ no' AXE= MAMMA= ietpropwuse and mainumneeof your sepdc system CMM remit in )IS premo m railum to baswe wastes. Avper 60 000 Of puritPi ft out the ulpue toll every three years or sooner, if me4e4 by a liamsnd p�unpet. Wha you put 6110 *A system CM MM ttta in 041111 of the saytte taut a a tr=MW stage to die waste dis mJ systaw 1110 ptopeny owner spies to submit w St. cMx Zoning DepuM nt a endan*w flrtut, sipud by toe s n % ad by a PwrRb4r. jOtsrasyegn plwaba, rearWad plumber or a Iketued pumper verify4 dial (t) 69 ob4 to watewe ardisposal spun k its proper ope►uing conditlon and/or (2) ancr inspection met pumping (If neemory). Qw septic tads Is Im doe I!3 MII of sdtdga. U % dw wseerdgnad !lave read *4 above rognimments *W agree to tralawin dw pelvata airs"a dlspoal eysum watt dw suad"111 set tbrdU i waK a at by On Depasttnsat orCommem sod the Delmunent of Mural Rew reea. Sate of Wiseottaiw C101Wkstift SWIM drat your troptie syelem has bqN nwintained moat be 0omtpktsd and returned to the St: Croix Camay Ztatiet OlYicc *M111 30 days erE dMea year elate. . SMATA OP APPLICANT' DATE I (we) 0"U y tint wl stakma et on Otis ram ass uua to the bw at my (our) knowtoago. I (we) ores (aro) tube ownet(s) of 60 dtacribad Virtue of a deed mockled in Ketww of Debt dMOL 2L L SIGNATURE OF APPLIC DATR 0-000•4 Asy inrar msdon slut is tMs."pmentedMay raWt is tM sanitary per" bang, revolted by 00 24Wng Depnanent. 0 - 0 - 0 -' 0 -• a tnelade with this 4pplicafts, a staved wms,nty bw rcom an Register of Dads o1Eee a Copy of the cutifted nwey map if refersw is atads in tilt wuraaty dead 'd 1J27P 235 684191 KATHLEEN H. YALSH REGISTER OF DEEDS ST. CROIX CO., MI STATE BAR OF WISCONSIN FORM 2 -1999 RECEIVED FOR RECORD Document Number WARRANTY EED 07 -15 -2002 2:00 PN WARRANTY DEED EXDIPT t 8N REC FEE: 11.00 TRANS FEE: COPY FEE: CERT COPY FEE: PAGES: 1 Recording Area Name and Return Address (3 � W e /ss P c) a Y, lira zr,llwat AN 5 062 , ,T \ar311dent gp 2D /D 030,z 4 lQ This Deed, made between THOMAS J WEISS AND DONNA J WEISS, HUSBAND WIFE antor s convey and warrant to LOUIE LOZANO AND TARA LOZANO HUSBAND AND WIFE, as survivorship marital pro as Grantee(s), the following described real estate in St Croix COUNTY, County, State of W isconsin: Lot 2 of Certified Survey Map recorded in volume 16, page 4307, located in part of the NE '/4 of the NE '/4 of Section 25, Township 30 N, R 20W, Town of St Joseph, St Croix County, Wisconsin Exceptions to warranties: Dated: Jul 2002 Thomas etss / Donna J Weiss ACKNOWLEDGEMENT STATE OF /�'l!4%+tcs ysrry ) )ss. COUNTY OF S 6 Personally came before me on July !f 2002 , the above named THOMAS J WEISS AND e 4 "` DONNA J WEISS HUSBAND AND WIFE I to me known to be the person(s) who executed the foregoing instrument and acknowledge the same. Notary Pu6f Notarial Stamp or Seal R088T G. BRIGGS NOW PUBLIC-N This instrument was drafted by: MyCJt3 T2005 Attorney's Title of Stillwater 1835 Northwestern Ave. Stillwater, MN 55082 /3 680289 APPROVED VOL 16 PAGE 4307 !it CROIX COUNTY KATHLEEN H. WALSH Phhfdm tonino and Park= 0 ^' °' REGISTER OF DEEDS ST. CROIX Co., MI �A� 9 2QQZ RECEIVED FOR RECORD CE RTIFI �M : E MAP 05 -29 -2002 10:45 A IIWIlndvold CERTIFIED SURVEY HAP LOCATED I OF NE1 4 OF REC FEE: 13.00 COPY FEE: 3.00 TEE NE1 14 OF SECTION 25 AND IN PAGES: 2 o ° W PART OF THE SR1 14 OF THE SB1 14 OF w m SECTION 24, T30N, R20W, TOWN OF ST. PREPARED FOR: Z z ° JOSEPH, ST. CROIX COUNTY, WISCONSIN. TOM WEISS w o 1394 CTY RD. V HOULTON, WI 540 LL LINE DATA TABLE w Q NUMBER DIRECTION DISTANCE SURVEYOR: DOUGLAS J. ZAHLER 5 N L1 N89°O6'23'E 50.01' S & N LAND SURVEYING, INC. O NN Z r L2 S89°3e58 'E 17.01' 2920 ENLOE STREET W O t2 NOTE: L3 N22 7'38'E 37.98' HUDSON, WI 54018 w O b LOTS MAY BE SUBJECT TO L4 S82'3648'W 33.30 N3 wn s FUTURE SPECIAL ASSESSMENTS L5 S89'O6'39'W 33.01' EAST 1/4 FOR ANY UPGRADES AND CORNER IMPROVEMENTS TO THE ROAD. SECTION 24 d { 0 /� 4 1n7 L 9 _ � © ,77 [ � �� o � � i7 n o _ y O � G`W a non , -------- ( p - - 7 -- CSIJ tl_NJ_ a NB2 FOUND IRON IS g �? 91 &q S80 °40'56E 1.68' FROM (NaM'39'E 1289.119 COMPUTED POSITION N89 °06'23nE 1289.3 b a; 'P ENCE C RNER IS 0.7' 1239.30' FENCE INTERSECTION /-- 00 4 EAST OF FOUND IRON SEPTIC IS 13.5' NORTH OF I �1 Q LOT I SYSTEM PROPERTY LINE L 50 RO I C7 � w 22.447 ACRES (977,811 SQ.FT.) Y 2 W LL N INCLUDING RIGHT OF WAY O I d �I o O w ) NE CORNER OF co 22.033 ACRES 959,760 SQ.FT. Q Q It} w F EXCLUDING RIGHT OF WAY SECTION 26, O a r, a SE CORNER OF ° rp I N a O N O , ' -' \� � ®WELL SECTION 24 O N POND r�SHEDO .`� GARAGE CO z ' SOUTH LINE OF THE SE 4 O F SE N 24 '— NO ENE bF�RE NEfT4 N 25\ V 11 EASEMENT FOR JOINT ©% BARN/SHED ACCESS POND •RNG ORS OO iCENTFFIL EX IS �I) 40316' 3— A O Q1 9 w POND r- P � v Z r r�crl �O �J co ; . , � O w Q W m Z LL 7.001 ACRES (304,958 SCI-FT) O ` O (0* 7 p (� INCLUDING RIGHT OF WAY Z o' w' Z S84 °11 39.96' , LOT 2 6 10eo �� �? Im O w r7i sir (�I SOIL 6 W Z G ° ° +_ 3 BORINGS ' � !�S ; O r. Y Q:Z � N O �°I I N n 6.619 ACRES (288,325 SO.FF.) N $ EXCLUDING RIGHT OF WAY 1256.01' 733.27' 8 5I a 555.75' 700.26' d (FENCE IS 6.3' WEST 12 ' �I �OF FOUND IRON (N89'21'55'E 1289.039 NN do4 �_ o� .&HO_oa y LEGEND W@L. 7_Q ®o ?3ODC _- EAST /a � FOUND ALUMINUM COUNTY CORNER SECTION CORNER MONUMENT SECTION 25 FOUND V OUTSIDE DIAMETER PIPE O SET V OUTSIDE DIAMETER BY 24 LONG SCALE IN FEET 1 • = 200' IRON PIPE, WEIGHING 1.13 LBS. PER LINEAR FOOT 0 FOUND 2' OUTSIDE DIAMETER IRON PIPE 2w 0 200 ( ) PREVIOUSLY RECORDED DATA THIS INSTRUMENT DRAFTED BY: WES ANDERSON JOB FENCE NO. 6135-01 DATE: 2282002 ••••••••••••••••••100' ROADWAY SET -BACK REVISED:529102 - - -75' SET -BACK FROM ORDINARY HIGH WATER MARK SHEET 1 OF 2 SHEETS Vol. 16 Page 4307