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Home My WebLink About030-2149-10-200 sconsin DepaVent of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safetyynd Buying Division �► INSPECTION REPORT Sanitary Permit No: 499298 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)j. Permit Holder's Name: City Village X Township Parcel Tax No: Greiner, Wayne I St. Joseph, Town of 030 - 2149 -10 -200 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: / N\ I 36.30.20.3035B TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI I FS ELEV. i Septic � �- # Benchmark J Alt. B ,•� �� !� ��- G�,�L l 73 ids• i 3 Aeration °^ - -. Bldg. Sewer •c K Holding SUHt Inlet 7.4-1 �Q �� 35 TANK SETBACK INFORMATION SUHt Outlet 7-731 1 ��• ! 3 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet \ \ Septic / Dt Bottom Dosing Header /Man. Aeration Dist. Pipe N 9.95 9 f /!• 45 9 7 . to i Holding Bot. System W. AD f '77- Final Grade PUMP /SIPHON INFORMATION . 3 AZ• S Manufacturer Demand St Cover GPM 73 /67 -/3 Model Nu TD Lift Friction Loss System d TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED /TRENCH Width Len th / No. Of Tre PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS S 7- 1 re ' _ „ \ \�^ SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR ` Type. /A_f Olystem: t _ G 7 � i g 7 ' / UNIT Model Number: � DISTRIBUTION SYSTEM nom' 15+ IS =- 36 Header /Manifold ' Distribution x Hole Size x Hole Spacing Vent to Air In ke �f J Pi � % I- � Z V%. Length Dia 4 Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth oE xx Seeded /Sodded xx Mulched Bed/Trench Center 1 Bed/Trench Edges \ To soil ✓ J! p !Yes I '1 No Yes ;r. No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / 1 Inspection #2: / / Location: 255 123rd Avenue Somerset, WI 54025 (NW 1/4 SE 1/4 36 T30N R20W) Seven Oaks Lot 17 / Parcel No: 36.30.20.303513 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = uu � 1 Plan revision Required? ;, Yes No Use other side for additional information. Date Insepctor's Sig ture Cent. No. SBD -6710 (R.3/97) commerce.wl.goV Safety and Buildings Division County ��,�aa � 20l W. Washington Ave., P.O. Box 7162 St . Croix S� n �7 �'� Madison, WI 537# 7 1&7162 Sanitary Permit Number (to be filled in by Co.) Department of Commerce Sanitary Permit Application Transaction Number in accordance with s. Comm. 83.21(2 Wis. Adm. Code, submission of this form to the appropriate go unit is required prior to obtaining a sanitary permit. Note: Application forms for state -owned PO WTS ar'�" Project Address (if differed than mailing address) submitted to the Department of Commerce. Personal information you be used for secondary y purp in accordance withthe Privacy law S. 15.0 1 m , Stsis. J 255 1 23rd Ave. Jp L Application Information - Please Print All Jaktatation (f Property Owner's Name 3 Parcel # Pi MAR 0 5 2007 030- 2149 -90 -200 Property Owner's Mailing Address Property Location 400 S. Second St. ST. CROIXCOUNTY 3a3 5 Q Govt. Lot City, State Zip Code Phone Number NW y. SE '/ti Sim 36 Hudson, WI 54096 795- 386 -0252 (circle one) Type of Building (check all that apply) of �A Lot # T 30 N, R 2_�C9f W 1 or 2 Family Dwelling - Number of Bedrooms 3 r17 Subdivision Name Block Se Oa ks 5J - ❑ Public/Commereial - Describe Use a ❑City of ❑ State Owned - Describe Use CSM Number ❑ ,,//Village of L�sTownof St. Joseph z t't�- C.a.n, w 16 f- �s <632zg8 III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing SystemTexplain) B. ❑ Pernnit Renewal ❑Permit Revision E) Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date issued Before Expiration Owner IV. Type ofPOWTS stem/Com onent/Device: Check all that appl Non - Pressur In- Ground ❑ Pressurized In- Ground ❑ At -Grade ❑ Mound > 24 in of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dispersanreatment Area Information: Design Flow (gp Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation 450 0.6 / 750 ✓ 750 - 97.0/95.7 VL Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units g B d New Tanks Existing Tanks 4 � ' 1 : 9 m iT.O CL Septic or Holding Tank 9000 9000 9 Wieser Dosing Chamber VIL Responsibility Statement- I, the — d-,signed, assume responsibility for bistaDation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number Jim Hurlburt 1 li 222997 795 283 - 4859 Plumber's Address (Street, City, State, Zap Code . N 260 CTHW D, Eau Galle, WI 54737 VM Co un /De artment Use Onl Approved ❑ Permit Fee Date Issued Issuing l Signature $ ❑even Reas Denial DL Conditions of Approval/Reasons for Disapproval SYSTEM OWNWR: 3) � J, �dt.,a, Q� (off'`' da 0 0�� awe o J. Septic to(*, effluent filter and n't f I l )) dispersal cell must all be senes / maintained to" 4eo ✓act q.C-� QLb vtet~, as per management plan provided by plumber. 2. AN setback requirements must be maintained ✓� 5a, _ . as Pei comp OR o* the system and submit to the County only on papot not less than 8 W x 11 inches in size County Commerce Plumber Owner 0 �� !n i c1 J 4 Ot rr J _ LA rA V -:i s . d o Sl� 3 A �s v � t $ J s i a D r rq A cJ ' A ci !J ° CA J � � � •�! sD _ po � 6 U 13 J l p �S � Pr F' w� l3't'� `_ \' L � Zv \ � �.e�.; - �h oM-� �•�. �� T O O 34•s" '� a 0 / IL -Q O 34s" l rl l () 0 M v u pp - I rr Oj rA Y CJ o 3 � �Q h®py v clow S a .*- -- l y Q1 w 1 of o • 1tl.w �1oti J- 3 C1l n.,p V 'e SOIL EVALUATION REPORT #1845 Department of Commerce in accordance with Comm 85, Wis. Adm. Code Page 1 of 3 Division of Safety and Buildings Steel's Soil Service Attach complete site plan on paper not less than 8Y2 x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizo rence point (BM), direction and percent slope, scale or dimensions, north a rr w, an d-di to nearest road. Parcel I.D. Lion. pend' ' Please print all i formation. Re 'e d By Dat Personal information you provide may be used for eoond rp se (Privacy Law, s. 5.04 (1) (m)). Property Owner Prop rty Location Pirius, Terry ST, C Govt na NW1 /4, SE1 /4, S36, T30N, R20W Property Owner's Mailing Address Lot °dock # Subd. Name or C # 400 South 2nd ST. na CSM <.c,f 2 Fn O a A'S City State Zip Code Phone Number Ejle6 ❑ Village ❑ Town Nearest Road Hudson WI 1 54016 1 715 - 386 -0252 St.Joseph I 125Th St ❑ New Construction Use: ❑ Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD ❑ Replacement ❑ Public or commercial - Describe: na Parent material Knolls of pitted outwash plains Flood plain elevation, if applicable na ft. General comments Conventional system, system elevation 98.55ft. Trenches spaced and depth to code 3.75ft below grade. and recommendations: ❑ Boring # ❑ ❑ Ground surface elev. 102.30 ft. Depth to limiting factor 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fty in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -9 10yr3/3 none sil 2msbk mfr cs 2c .6 .8 2 9 -36 10yr4/4 none sicl 2msbk mfr cs lc .4 .6 3 36 -90 7.5yr4/4 none ms /sl 2msbk mvfr cs na .6 1.0 4 90 -120 7.5yr4/6 none ms osg ml na na .7 1.6 Stratified layer of sandy loamar through out horizon #3. ❑ Boring # El Ground surface elev. 102.30 ft. Depth to limiting factor 120 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 -6 10yr3 /1 none sil 2msbk mfr cs if .6 .8 2 6 -12 10yr4 /4 none sicl 2msbk mfr CS na .4 .6 3 12 -48 7.5yr4/4 none ms osg ml cs na .7 1.6 4 48 -120 7.5yr4/6 none cos osg ml na na .7 1.6 *Effluent #1 = BOD 5 > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD S30 mg /L and TSS s.30 mg /L 1 1. CST Name (Please Print) ignature: CST Number David J. Steel 248956 Address Steel's Soil Service Date Evaluation Conducted Telephone Number 994 200th St. Baldwin, WI 54002 4/25/2006 715- 760 -0347 SBD -8330 (R.07 /00) Property.Owner Pirius, Terry Parcel ID # pending Page 2 of 3 ' F Boring # ❑ ❑ Ground surface elev. 98.70 ft. Depth to limiting factor 120 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 -9 10yr3 /1 none sil 2msbk mfr cs 2c .6 .8 2 9 -19 10yr4 /4 none Sid 2msbk mfr cs 2c .4 .6 3 19 -94 7.5yr4/4 none ms /sl 2msbk mvfr cs na .6 1.0 4 94 -120 7.5yr4/6 none ms osg ml na na .7 1.6 �I 1 ►l Stratified layer of-gAdy through out horizon #3. ❑ Boring # ❑ Ground surface elev. ft. Depth to limiting factor in. El Ground 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 ❑ Boring # ❑ ❑ Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 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 a 30 mg /L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 - 264 -8777. SBD -8330 (R.07 /00) Steel's Soil Service i STEEL'S SOIL SERVICE 3 of 3 David J. Steel Terry Pirius 994200 th St. CST - POWTSM NW1 /4,SE1 /4,S36,T30N,R20W Baldwin, W154002 Lic. #248956 Town of St. Joseph St. Croix Co. Direct 715- 760 -0347 CSM # 1-o ` 2 .e 0 e , & A-S Fax 715- 684 -3449 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. Legend W 1" = 40' ♦ = Benchmark Ele. 100.00 ft Top of 3/4" pvc pipe • = Alt Benchmark Ele. 101.10 ft Top of 3/4" pvc pipe ❑ = Borings Boring Elevations B1 = 102.30 ft B2 = 102.30 ft B3 = 98.70 ft B4 = 0.00 ft 4j lit b Z' ij` � S POWTS OWNER'S MANUAL MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS � PFermit wner Septic Tank Capacity 1 &tro al 2 NA # Septic Tank Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer \.nr p NA Number of Bedrooms 100 d/bedroom 3 p NA Effluent Filter Model Cr o ❑ NA Number of Commercial Units >< NA Pump Tank Capacity al :9 NA Estimated now (average)* 1,— al /da Pump Tank Manufacturer n NA Design flow (peak), estimated x 1.5* 4�-�' al /da Pump Manufacturer 71 NA Soil Application Rate o .b g al/day ftz Pump Model [2 NA . - ... - fn(iuent/Ef(luent Quality (NAp) Monthly Average ** Pretreatment Unit C] NA p Sand/Gravel Filter Peat Filter Fats. Oil & Grease (FOG) < 30 m L `� Biocherrucal Oxygen Demand (BODs) O Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) < 220 mg /L ❑ Disinfection Other: S 250 m L ✓ Manufacturer: Model: Pretreated Effluent Quality Monthly Average *'* ` Dts�ersal Cell(s) Biochemical Oxygen Deman B s) Mqn- ground (gravity) O In- ground (pressurized) Total Suspended Soli SS} S 30 mg /L p At - grade O Mound Fecal Coliform (geo is mea) < 30 mg /L O Drip-line O Other: I0`cfWI00mI C) Leaching Chamber Manufacturer P fl Maximum Effluent Particle Size 1/8 inch diameter V Model V�Otr`;MPK 3 'O Approval Stipulation - I 'Wastewater Flow Verification on and calculations: Soil Application Rate b b gpd/ft Area Req. ft' !Other than bedroom based) Absorption Area Credit per unit ft Minimum Number of Chambers 3 O Aggregate Desi n Flow/Loading Rate= ft m,n " Values typical for domestic (non - commercial wastewater Materials: all materials must comply with WI Adm. Code and septic tank effluent. COMM84 and be installed per manufacturers specifications ` Values t ical for pretreated wastewater. and approval letters. DESIGN CRITERIA ❑ ''Wisconsin At -grade Soil Absorption System, Siting, Design & Construction Manual" (Converse et.al.1990) ❑ "Wisconsin Mound Soil Absorption System: Siting, Design & Construction Manual" Converse, J.C. and E.J. Tyler Publication 15.22 ❑ 'Design of Pressure Distribution Networks for Septic Tank -Soil Absorption Systems" Publications 9.6 ❑ "Design of Conventional Soil Absorption Trenches and Beds ". R,J. Otis - ASAE Publications 5 - and "Design Manual - Onsite Wastewater Treatment and Disposal Systems ". EPA 625/1 - 80 - 012 October 1980 SBD - 10570 -P (R.6/99) "At -Grade Component Manual Using Pressure Distribution" ❑ SBD - 10567 -P (R.6/99) "In Ground Absorption Component Manual" _SBD - 10705 -P (N.01 /01) "In Ground Soil Absorption Component Manual" Version 2.0 ❑ SBD - 10628 -P (N.6/99) "Recirculating Sand Filter System Component Manual" ❑ SBD - 10656 -P (N.6/99) "Split Bed Recirculating Sand Filter System Component Manual" ❑ SBD - 10572 -P (R.6/99) "Mound Component Manual" SBD 10691 -P (N.01 /01) "Mound Component Manual" Version 2.0 ❑ SBD 10595 -P (R.6/99) "Single Pass Sand Filter Component Manual" ❑ SBD - 10657 -P (R.6/99) "Drip -line Effluent Disposal Component Manual" ❑ SBD - 10573 -P (R 6/99) "Pressure Distribution Component Manual" ❑ SBD 10706 -P (N.01 /01) "Pressure Distribution Component Manual" Version 2.0 E] Drip -line Effluent Dispersal Component Manual for Multi -flo Onsite Wastewater Treatment Units ❑ MAINTENANCE AND MANAGEMENT MAINTENANCE MONITORING SCHEDULE Service Event Service Frequenc Ins ect condition of tanks At least once every C1 months ears Maximum 3 yrs Pump out contents of tanks When combined sludge and scum equals one -third 1/3 of tank volume Inspect dispersal cells At least once every p months (Rl ears Maximum 3 yrs i Clean effluent filter At least once eveg J b - 'months p year (s Insp P ump, - Pump controls & alarm At least once every O months p ears N'NA Flush laterals and pressure test At least once eve [3 months ❑ ears NA Valves At least once eve p months ❑ ears LK NA Other At least once ever ❑ months ❑ ears NA START UP Page z . of 3 For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or dame e.the dispersal cell(s). If hi h concentrations � . p. g are detected haveahe contents of the tank(s) removed by a septage servicing operator prior to use. ✓ System start up shall not occur when soil conditions are frozen at the infiltrative surface. t✓ OPERATION The property owner is responsible for the operation'and`nUffitenance of the POWTS and submission of required reports. The quantity and quality of the wastewater stream will affeathe performance -and longeirity of your POWTS. The installation of water-saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water softeners, iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground surface whenever possible. Note: this does not include laundry waste, - showers, dishwater, etc. This system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable /fruit peels and seeds, bones, and food solids such as those produced by a garbage disposal should be minimized. Toilet tissue is the only paper that should be discharged into the system. Other non - biodegradable items such as baby wipes, tampons, sanitary napkins condoms, cigarette butts, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, paint, disinfectants, pesticides, antibiotics, solvents, etc., sh not be flushed into the system as they can seriously damage your POWTS and contaminate your drinking water supply. Maintain a regular steady flow by spreading laundry washing throughout the eek. Avoid vehicle traffic over all system components. Compaction of snow over the dispersal unit may cause it to freeze up. p Valves Valves shall be operated in the following m e _ i I � ❑ Alarms j Alarms should be tested on a regular basis th me owner. If an alarm sounds, contact an individual licensed to service POWTS, There is normally a 1 day reserve a ular operating conditions, however water should be conserved until any problems with the system are correcte prevent bac up of sewage into'the dwelling or surfacing. INSPECTIONS Inspection shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule). X S Tanks Component Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any backup or surfacing of effluent . Access openings used for service or assessment shall be sealed and/or locked upon completion of service. Any defects shall be promptly corrected. Exposed openings greater than 8_ inches in diameter shall be secured with an effective locking evice to p revent accidental or unauthorized 8 p razed en into the to .. try a nk. .. When the combination of sludge and scum in any tank exceeds one -third (1/3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with Chapter NR1 13, Wisconsin Administrative Code. The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. Provisions are to be made to retain solids in the tank. Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating. ' I ❑ Pump Chamber /Treatment Tanks Comp nt The inspection must include a test of n a al equipment such as pumps, alarms and floats. A visual check must be made for leaks, backups, surfac' ' , ussin r broken security devices and other hardware and the condition of the filter. Any service needs or repai all be•promptly ken care of. STARTUP Page z of 3 For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have*the'contents of the tank(s) removed by a septage servicing operator prior to use. t/ System start up shall not occur when soil conditions are frozen at the infiltrative surface. OPERATION The property owner is responsible for the operation' and'trisiritenance of tlie-*POWTS and submission of required reports. The quantity j and quality of the wastewater stream will affeefthe performance tiid lotigeivity of your POWTS. The installation of water-saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water softeners, iron removal units, other clear water treatment devices and foundation drains should discharged to the ground surface whenever possible. Note: this does not include laundry waste, showers, dishwater, etc. This system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable /fruit peels and seeds, bones, and food solids such as those produced by a garbage disposal should be minimized. Toilet tissue is the only paper that should be discharged into the system. Other non - biodegradable items such as baby wipes, tampons, sanitary napkins condoms, cigarette butts, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, paint, disinfectants, pesticides, antibiotics, solvents, etc., A not be flushed into the system as they can seriously damage your POWTS ` and contaminate your drinking water supply. Maintain a regular steady flow by spreading laundry washing throughout th eek. Avoid vehicle traffic over all system components. Compaction of snow over the dispersal unit may cause it to freeze up. ✓ i p Valves t Valves shall be operated in the following m e i j O Alarms I Alarms should be tested on a regular basis th ome owner. If an alarm sounds, contact an individual licensed to service POWTS, There is normally a 1 day reserve a ular operating conditions, however water should be conserved until any problems with the system are correcte prevent bac up of sewage into'the dwelling or surfacing. INSPECTIONS Inspection shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule). Septic Tanks Component Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any backup or surfacing of effluent . Access openings used for service or assessment shall be sealed and/or locked upon completion of service. Any defects shall be promptly corrected. Exposed openings greater than a inches in diameter shall be secured with an effective locking device to prevent accidental or unauthorized entry into the tank. I When the combination of sludge and scum in any tank exceeds one -third (1/3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with Chapter NR1 13, Wisconsin Administrative Code. The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. Provisions are to be made to retain solids in the tank. Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep he s ystem ystem operating. D Pump Chamber/Treatment Tanks Comp nt The inspection must include a test of a al equipment such as pumps, alarms and floats. A visual check must be made for leaks, backups, surfac' , missin r biokensecurity devices and other hardware and the condition of the filter. Any service needs or repai all be�promptly ken care of. 3 3 M&- Ground Gravity Component Dispersal Cells Page of The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding at depths greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring, O Mound, At- Grade, In- Ground Pressure The inspection shall include reso =occurring vels of ponding, if any in the observation tubes and a visual inspection for any evide of surface seepage or diny discharge to t round surface must be promptly reported to the regulatory authority. Ponding greater than 7eight of the ponent may indicate overloading or impending hydraulic failure necessitating more frequent moni The pressure distribution system ith an o ing at the end of each lateral to be used for flushing. The laterals should be flushed at least once ev3) years. Pressu checks of systems with multiple laterals should be done to ensure that equal distribution of eccurring to promote the longevity of the system REPORTS Reports for maintenance, inspection, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin Administrative Code. ✓ ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is properly and safely abandoned in compliance with Ch. COMM 83.33, Wisconsin Administrative Code. All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil. gravel or other inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: �A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. C7) A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. O The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. O Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltranN e surface. Reconstructions of such systems must comply with the rules in effect at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name -Sx--. Name Phone - Z Z �- 48 sk Phone SEPTAGE SERVICING OPERATOR - (Pumper) LOCAL REGULATORY AUTHORITY Name A enc tea; Phone Phone _-tS- 1.8 --4-68 I 0 — M �— s J C- u a- SQL n � n � a o ° Cl J C? J � N t1 0 ° 9 � � � 8 0 / o cA d cr ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer ! %-e-- ( (C e, i A_Q' . Mailing Address ju% S � Property Address Verification req ired from Planning Zoning Department for new construction.) f City /State Parcel Identification Number 0 36- 214 - 1 6 - Zo LEGAL DESCRIPTION Property Location N+^ V,, 5E '/4 , Sec. 3 1e ' T 3D NR Zo Town of 6 Job Subdivision O n , Lot # Certified Survey Map # , Volume , Page # ty C �! U 1 , Warran Deed # Volume Page # ;ti � , f, Spec house yes no Lot lines identifiable 6yesno SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of 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. Owner maintenance responsibilities are specified in §Conan. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & 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 Planning & Zoning Department within 30 days of the three year expiration date. I/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. Number of bedrooms 2 _ _L, C.� _'� Y1 _/PY SIGNATURE OF APPLICANT(S) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. 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WALSH REGISTER OF DEEDS ST. CROIX CO., WI STATE BAR OF WISCONSIN FORM 2- 2000 RECEIVED FOR RECORD Document Number WARRANTY DEED 02/28/2007 10: 30AN THIS DEED, made between Pirius Development Company, LLC, a WARRANTY DEED Wisconsin Limited Liability Company, Grantor, and Wayne R. Greiner, a EXEMPT I single person, and Hui -Ling Yeh, a single person, as joint tenants, Grantee. REC FEE: 11.00 Grantor, for a valuable consideration, conveys and warrants to Grantee TRANS FEE: 468.90 the following described real estate in St. Croix County, State of Wisconsin: COPY FEE: CC FEE: Part of Lot 10 of the Plat of Seven Oaks, Town of St. Joseph, St. Croix PAGES: 1 County, Wisconsin, described as follows: Lot 17 of Certified Survey Map recorded August 16, 2006 in Volume 21, Page 5256 as Document No. 832288. Together with and subject to a joint driveway easement as shown on Certified Survey Map in Vol. 21 Page 5256, Document No. 832288. Recording Area Name and Return Address: Edina Realty Title, Inc. 400 S. 2" St. — Suite 115 Exceptions to warranties: Hudson, WI 54016 Easements, restrictions and rights -of -way of record, if any. 801958 030 - 2149 -10 -200 Parcel Identification Number (PIN) This is not homestead property. r Dated this 23rd day of February, 2007. Pirius Development Company, LLC, a Wisconsin Limited Liability Company B * n M. Pirius, ember * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) Pa m e la - No __ J. Goulet STATE OF WISCONSIN ) ST. CROIX COUNTY. ) ss. authenticated this 23rd day of February, 2007 Personally came before me this February 23, 2007 the above named Ryan M. Pirius, Member, Pirius Development * Company, LLC, a Wisconsin Limited Liability Company to me known to be the person(s) who executed the foregoing TITLE: MEMBER STATE BAR OF WISCONSIN hum and acknowledged the same. (If not, /� authorized by § 706.06, Wis. Stats.) T in ) ) m� 0' L 0& THIS INSTRUMENT WAS DRAFTED BY * Pamela J. Goulet Notary Public, State of Wisconsin Peterson, Fram &Bergman — Steven Bruns My commission is permanent. (If not, state expiration date: 50 East Fifth Street, St. Paul, MN 5510 1 10/11/2009 ) (Signatures may be authenticated or acknowledged. Both are not necessary.) *Names of persons signing in any capacity must be typed or printed below their signature WARRANTY DEED STATE BAR OF WISCONSIN FORM No.2 -2000 RECEIVED ' Wisconsin M'ordan L E A L REPORT #1764 JUL 2 Page 1 of 3 Department of Commerce 9 with Comm 8�. Adm. Code Division of Safety and Bull ngs Steel's Soil Service, Inc. i ST. CROIX COUNTY County Attach complete site plan on p er noklW 1 inche in size. Plan must St. Croix include, but not limited to: vertica a 7M n, (BM), direction and parcel I percent slope, scale or dimensions, north arrow, and location and distance to nearest road. pending Please print all information. R By Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). /L '7 65 Property Owner Property Ltation Pirius, Terry ovt. L t NtM/ , SE1 /4, S36, T30N, R20W Property Owner's Mailing Address BI k # Sut Na a o , CSM# 400 South 2nd ST. 1 na Seven Oaks City State Zip Code Phone Numb City ❑ Village ® Town Nearest Road Hudson WI 54016 715 - 386 - 02 St.Joseph 125Th St ® New Construction Use: ® Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD ❑ Replacement ❑ Public or commercial - Describe na Parent material Knolls of pitted outwash plains Flood plain elevation, if applicable na ft, General comments C onventional system system elevat 99.15ft Trenches spaced and depth to code 4.75ft below grade. and recommendations: Boring # ❑ Boring ® Pit Ground surface elev. 103.90 ft. Depth to limiting factor 100 `" 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 10yr3/1 none sil 2msbk dfr cs is .6 .8 2 10 -24 7.5yr4/4 none sicl 2msbk dfr cs if .4 .6 3 24 -39 7.5yr4/4 none sl 2msbk mfr cs na .6 1.0 4 39 -100 7.5yr4/6 none cos osg ml na na .7 1.6 a Boring # ❑ Boring ® Pit Ground surface elev. 103.90 ft. Depth to limiting factor 100 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 /1 none sil 2msbk dfr CS lc .6 .8 2 10 -32 7.5yr4/4 none sicl 2msbk dfr cs if .4 .6 3 32 -48 7.5yr4/4 none sl 2msbk mfr cs na .6 1.0 4 48 -100 7.5yr4/6 none cos osg ml na na .7 1.6 if a S7 ' Effluent #1 = BOD 30 < 220 mg /L a SS >30 < 150 mg /L ' Effluent #2 = BOD < 30 mg /L and TSS 130 mg /L CST Name (Please Print) gnature* — CST Number David J. Steel 248956 Address Steel's Soil Service, Inc. Date Evaluation Conducted Telephone Number 994 200th St. Baldwin, WI 54002 7/27/2005 715- 760 -0347 SBD -8330 (R.07 /00) 4 1 y Property Owner Pirius, Terry Parcel ID # pending Page 2 of 3 3 E] Boring Al' 9 ❑ Boring # Pit Ground surface elev. 101.50 ft. Depth to limiting factor 100 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 -12 10yr3/1 none Sil 2msbk dfr cs is .6 .8 2 12 -24 7.5yr4/4 none Sicl 2msbk dfr cs if .4 .6 3 24 -42 7.5yr4/4 none sl 2msbk mfr cs na .6 1.0 4 42 -100 7.5yr4/6 none cos osg ml na na .7 1.6 i� "51 F]Boring # ❑ Boring Pit Ground surface elev. ft. Depth to limiting factor El Pit 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 F-1 Boring # Boring f ❑ Pit Ground surface elev. ft. Depth to limiting actor 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 Effluent #1 = BOD 30 < 220 mg /L and TSS >30 <150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS a 30 mg /L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 - 264 -8777. SBD -8330 (R.07 /00) Steel's 5011 Smice, Inc. 5 ' STEEL'S SOIL SERVICE INC 3 of 3 David J. Steel Terry Pirius 994200 th St. CST - POWTSM NM /4,SE1 /4,S36,T30N,R20W Baldwin, WI 54002 Lic. #248956 Town of t. Joesph, St. Croix Co. Direct 715- 760 -0347 Lot, ( —1 Fax 715- 684 -3449 This soil evaluation was conducted to satisfy a zoning / requirement, it may or may not be suitable for your use. The location of this test may or may not be as shown, as permanent lot lines were not established at the time the soil test was conducted. Legend N 1" = 40' = Benchmark Ele. 100.00 ft Top of 3/4" pvc pipe • = Alt Benchmark Ele. 101.10 ft ❑ Top of 3/4" pvc pipe = Borings Boring Elevations �(� B1 = 103.90 ft B2 = 103.90 ft B3 = 101.50 ft B4 = 0.00 ft - - - 1�3 yz s 5 A , L , �-r � I 11 R .NN,1 dp V -um IR M Sam f �1 �ytwi. N l� • - j / pr � o