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HomeMy WebLinkAbout032-2132-80-000 , i Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix .,j Building Division INSPECTION REPORT Sanitary Permit No: 420518 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)]. 5 ZZ = 7-ivi,NS. p Permit Holder's Name: City Village X Township Parcel Tax No: Elkin, Jim I Somerset Township 032 - 2132 -80 -000 CST BM Elev: Insp. BM Elev: BM Descript' n: / no. o ono -o / (.30.12, TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing II Alt. BM _ Aeration Bldg. Sewer Q w'o f • / 3 Holding SUHt Inlet ' 7- St/Ht Outlet � „� � . TANK SETBACK INFORMATION l l TANK TO P/L WEL BLDG. Vent to Air Intake ROAD Dt Inlet o, 80 1 1 • C Septic } t� i Dt Bottom l Z ` T 93,, I Dosing �� ' Header /Man. [ 'T. ZD � . D Aeration Dist. Pipe 4 1 Z 3 1 D r / Holding Bot. Syste l �{• $ $ l0 2 / PUMP /SIPHON INFORMATION Final Grade ,S � Manufacturer Demand St Cover GPM %� • 2l D/ - Model Number Y. a � TDH Lift Friction Loss System Head TDH Ft o •� (o�sv IS i PFAW orcemain Length 1 Dia it Dist. to Well &rr 7 4•Zb SOIL ABSORPTION SYSTEM ( ; BEDITRENCH Width Length No. Of ifiRb� PIT DIMEI�ISJ9NS No. Of Pis Inside Dia. � DIMENSIONS SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM kEACWNG I nu urer: INFORMATION CH M R OR Typ� /C� /j System: ` � / " t (rV � lS� 7 �S• �, I yr NIT odel ber: DISTRIBUTION SYSTEM Header /Manifold tr Distribution �y t x Hole Size t � I x Hole Spacing / Vent to Air Intake 2 Pipe 2 s) Y 3. Length J' Dia Length � C'• Dia 2— Spacing © 5 �. SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bedfrrench Edges Topsoil ' Yes FZ_] No Yes [K No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: 1 � / 0 Inspection d 3 Location: 898 174th Avenue Ridge Lo t 9 P NNo nu e e o m r set, WI 54025 (NE 1/4 SE 1/4 1 T30N R19W) R ocky R 4.th e 6 Somerset, 1.) Alt BM Description = I f 2.) Bldg sewer length - amount of cover 3.) Cont 101-460 •Fcv .�`�" r� /3 Q L2 t'y�0 �� PI n revision Required? p i l Use other side for additional information. SBD -6710 (R.3/97) t � D`e S Insepctor's Signature Cert. No. Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 , Iscons'in Madison, WI 53707 - 7162 Site Address Department of Commerce Sanitary Permit Application Sanitary Permit Number 'f2o5r$ In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ❑ Check if Revision may be used for secondary purposes Privacy Law, s15.04(1 m I. Application Information - Please Print All Information $tate Plan I.D. Number Property is Name 1 Number Property Owner's Mailing Address U Property Location / - S T . `.: ,. ,;: i4 A: S N, R l 7 City, State Zip Code P _ Lot Number Block Number 7 Subdivision Name L <SM M- nibmer Type of Ituilding (check all that apply) w� G Deity 1 or 2 Family Dwelling - Number of Bedrooms - - v t iz r¢ ❑Village ❑ Public/Comme - Describe Vie ; bw o4ete "X-r owruhip 0 40 I ❑ State � wfr Neatest Road M )c(Lio , Mmuj ad) QQ "`P 5.0 (o-w III. Type of Permit: (Check only one box on line A (num scheme for internal rue). . 3 lomplete line B if applicable) A 1 JS New 2 ❑ Replacement System 3 ❑ Replacement of 6 ❑ Addition to For County use stem Tank Only Existing System B. ❑ Check if Sanituy Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that apply) (numbering scheme is for internal use) 44 ❑ Non - Pressurized In-Ground 204-Mound 47 ❑ Sand Filter 50 ❑ Constructed Wetland 22 ❑ Pressurized In -Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Lin 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Reti=culating 30 ❑ Other V. Dispersalrfrmtment Area Information• Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade Required Proposed Rate(Gals./Days/Sq � (Min./Inch) Elevation ((•° - s• 1,40 kl�y VI. Tank Info Capacity in T661 Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New E xisting Tanks Tanks Septic or Holding Tank G �� Dosing Chamber --- VII. Responsibr'lity Statement - 1, the undersigned, resp onsibility for installatio of the POWTS shown on the attached plans. Plumber's MI, / Flambe ZS MP/N1PRS Number Business Phone Number is Address (Street, City , tate, Zip Code) VIII. Coun /De artment Use Onl K Approved ❑ Disapproved Sani tuy Permit Fee (includes Groundwater Date Issued Ism Agent Signature (No Stamps) Surcharge Fee) ❑ Owner Given Initial Adverse Determination 3Z�- o 2GV2� EK. Conditions of Appro7al/Reasops for Disapproval ` Attach complete ratans oo : inchn In 5P e et 6IdS, SBD -6398 (R. 05101) Safety and Buildings Division Copy l ar 201 W. Washington Ave., P.O. Box 7162 Madison, WI 53707 - 7162 Site Address De artment of Commerce < Sanitary Permit Application Sanitary Permit Number In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ❑Check if Revision may be used for Law. sly. 1 m I. Application Information - Please Print All Information tate Plan I.D. Number r- - m o. , z M - # T%76 ?27) is Name 1 Number Property r Property Owner's Mailing Address Uk., Property I.Acation t4 P� 'A, 5X 'A; S I / T :?e N. R City, State Zip Code Phobri Lot Num r Block Number Subdivision Name GSM biarnber 1 fIL'Type of Eluilding (check all that apply) a Per .4 ❑City 1 or 2 Family Dwelling - Number of Bedrooms -- O t F cC. ❑VOlage ❑ Public/Cotmnersl�'be se . bw ..fir Jac. �C�) 0 7 ❑State (o �r�9noa .asf Nearest Road ` (70 s III. Type 4-Permit: (Check only one box on line A (num scheme for internal use). 9brnplete line B if applicable) A. 1 JS New 2 ❑ Replacement System 3 ❑ Replacement of 6 ❑ Addition m For County use stem I I Tank B. ❑ Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use) v_ B .{oo . 44 ❑ Non - Pressurized In -Ground 2;6Mound 47 ❑ Sand Filter 50 ❑ Constructed Wetland 22 ❑ Prmstuized hrGround 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line 45 ❑ At-Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other V. Disperulfrreatment Area Information: Design Flow (go Dispersal Area Dispersal Area Sort Application Percolation Rate System Elevation Final Grade Required Proposed Rate(Gals, (Min./I>xh) Elevation 16 VL Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanks Tanta Septic or Hokttat Tank a Dosing Cb=W er _ 1 VII. R 'bility Statement - 1, the undersigned, responsibility for Installation of the POWTS shown on the attached plans. Phmuber's a� )� Phmrbe a S' . WMPRS Number Business Phone Number is Address (Street, City, tate, Zip Code) J VIII . Coon /De partdient Use O nly Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Lssumv Agent Signature (No Stamps) Surcharge Fee) ❑ Owner Given Initial Adverse Determination 3z7 -- o �Z EX. Conditions of Approval/Reasops for Disapproval itpa Attach eomptete ptw ae = 11 hicbes in SBD -6398 (R. 05101) - z!/CGIG S,e y ae Z I /iv? j 1— a p / i aq3 {� ) lea O /OQ Sk1 �cK �iJ7. I ' • r Safety and Buildings . 10541 N RANCH ROAD HAYWARD WI 54843 TD #: (608) 264 -8777 ��c0h .s,n www.commerc . � ns ov www.wiscnsin.gov Department of Commerce Scott McCallum, Governor Philip Edw. Albert, Secretary i I October 15, 2002 i 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: 10/15/2004 Identification Numbers Transaction ID No. 795622 SITE: Site ID No. 651692 James Elkin Please refer to both identification numbers, 85TH St above, in all correspondence with the agency. Town of Somerset St Croix County NEIA, SETA, S1, T30N, R19W FOR: Description: Mound 600 Gpd. Object Type: POWT System Regulated Object ID No.: 874635 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: Correspondence Notes: • This plan action is subject to designer notes / comments on the plan. • 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" Version 2.0 SBD- 10691 -P (N.01 /01) and the "SSWMP Publication 9.6, "Design Of Pressurized Distribution Networks For Septic Tank- Soil Absorption Systems." • A copy of this approval letter and index sheet shall be attached to plans that correspond with the copy on Me with the Department. Changes to the approved plan must be submitted for review and approval. �L 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.'° s� • Comm 84.10, All materials used in this installation shall conform to the provisions of this chapter.z o A copy of the approved plans, specifications and this letter shall be on -site during construction and open to l -' 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. i • KIM A O'CONNELL Page 2 10/15/02 In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincer Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 omas E Devereaux Plumbing / POWTS Reviewer II, Integrated Services WiSMART cede: 7633 (715)634-3026, 7:45 am - 4:45 pm Mon. - Fri. tdevereaux@conunerce.state.wi.us cc: Leroy G Jansky , Wastewater Specialist, (715) 726 -2544 i i MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: JAMES ELKIN Owner's Name: JAMES ELKIN Owner's Address: 1217 WILLOW AVE NEW RICHMOND WI 54017 Legal Description: NE -SE -SEC -1 T30N -R19W Township: SOMERSET County: ST. CROIX Subdivision Name: ROCKY RIDGE ESTATES Lot Number: 9 Block Number: Parcel I.D. Number: 032 - 213 - 280 -000 Plan Transaction No.: Page 1 Index and title q.• Page 2 Data entry 1; a ly Page 3 Mound drawings -° Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan ` `'' 4 ttp b, 1 cttiDS 5 rF Page 7 Pump curve and specifications Page 8 PLOT PLAN Z Designer: KIM A OCONNELL License Number: 224263 Date: 09/25/ 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 400.00 Estimated Wastewater Flow (gpd) Table 83 -44 -3 in -situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150 %) coliform of «36 inches. 600.00 Design Flow (gpd) 5.00 Site Slope ( %) 101.60 Contour Line Elevation (ft) 27.00 Depth to Limiting Factor (in) 0.40 In -situ Soil Application Rate (gpd /ft Distribution Cell Information 100.00 Dispersal Cell Length Along Contour (ft) = 6.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd /ft 1 I Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (c or e) E Center or End Manifold 3.00 Lateral Spacing (ft) If N above, enter the elevation ft 2 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) 3.50 Estimated Orifice Spacing (ft) = 10.34 ft /orifice 2.00 Forcemain Diameter (in) 40.00 Forcemain Length (ft) Does the forcemain drain back? Y 90.60 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 6.52 Forcemain Drainback (gal) 11.58 Vertical Lift (ft) 90.43 5x Void Volume (gal) 0.51 Friction Loss (ft) 96.96 Minimum Dose Volume (gal) 18.59 Total Dynamic Head (ft) 23.89 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. o ptions choice in. dia. options choice 0.75 1.25 x 1.00 1.50 x 1.25 1 2.00 x 1.50 x x 3.00 2.00 x 3.00 x Gallons /Inch Calculator (optional) Treatment Tank Information 800.00 Total Tank Capacity (gal) 1260.00 Septic Tank Capacity (gal) 37.00 Total Working Liquid Depth (in) WEEKS Manufacturer i 21.62 gal /in (enter result in cell B49) Dose Tank Information Effluent Filter_ Information 800.001 Dose Tank Capacity (gal) Zabel -Filter Manufacturer 21.76 Dose Tank Volume (gal /in) A100 Filter Model Number WEEKS =Manufacturer Project; JAMES ELKIN Page 2 of 8 Mound Plan View T 1/1 B J Observation Pipe:; K Q A W — I , B . ... .. . ..... . ......... 3 :. .:... ... ...I........• .................. ............................. ............................... L Mound Component Dimensions Down slop toe extension made. A 6.00 ft E 12.60 in H Aft ft K 8.08 ft B 100.00 ft F 9.50 in z ft L 116.15 ft D 9.00 in G 0.50 ft J W 20.33 ft 600.00 (ft 2 ) Dispersal Cell Area 1 500. 00 (ft Basal Area Available 6.00 (gpd/ft) Linear Loading Rate 10.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 104.14 (ft) --► , , I H , ,,,, 91;x',,,,,,,,,,, G I F "•' s 102.85 (ft) Lateral Dispersal Cell 102.35 (ft) — Invert Di spersa l ersa ell i`�` •�: i�i`!�i�i`i�i� ��:::�:�: ��:���:�:�:�:`:�:��� ���:�:`'���``�'`'�`�����':. Elevation E D 3 :�. 101.60 (ft) Contour Elevation 5.0 %Site Slope Geotextile Fabric Cover Shading Key v T Dispersal Cell See lateral details on Q Topsoil Cap .a 1.5 ft Page 4 for number, " " " " ' Subsoil Ca 0 F2] -� P '" ° Q Q size, and spacing of ASTM C33 Sand 1. F laterals. Laterals are Tilled Layer 0.5 ft Typical Lateral equally spaced from © Aggregate 0 s ' the distribution cell's }--- A centerline in the distribution cell (AxB). Project: JAMES ELKIN Page 3 of 8 I End Connection Lateral Layout Diagram L aterals centered over the A te 9 dimension 0 = Turn -up w4ball valve or oleanoutplug E P All laterals are identical IE X—+I Holes drilled on the bottom of the lateral equally spaced S Foroe main oonneotion via tee of cross to manifold at any point. Laterals 4c force main of PVC Bch 40 (per COMM Table 84.30 - Number of Laterals 2 Orifice Diameter 0.125 in Lateral Diameter 1.50 in Orifice Spacing (X) 3.52 ft Lateral Length (P) 98.56 ft Orifices per Lateral 29 Lateral Spacing (S) 3.00 ft Orifice Density 10.34 ft /orifice Lateral Flow Rate 11.95 gpm Manifold Length 3.00 ft System Flow Rate 23.89 gpm Manifold Diameter 2.00 in Total Dynamic Head 18.59 ft Forcemain Velocity 2.44 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and ----1► Comm 16.28 WAC 4 in. min. Disconnect Tank component is property vented Alternate outlet location Forcemain diameter WEEKS Manufacturer �_ 2 in. Ca acit 800.00 Gallons Volume 21.76 gal /inch A Weep hole or anti - Dimension Inches Gallons B siphon device A 21.19 461.10 C B 2.00 43.52 P� ump off e levation ft C 5.57 121.30 —t 91.27 D 8.00 174.08 D Total 36.761 800.00 J1 Dose tank elevation ft 3" Bedding uncTer tank. � 1 90.60 Alarm Manuafacturer 1SJ ELECTRO —� Alarm Model Number HW 100 Pump Manufacturer GOULDS Pump Model Number WE0511 H Pump Must Deliver 23.89 gpm at I 18.59 ft TDH Project; JAMES ELKIN Page 4 of 8 I Mound System Maintenance and Operation Specifications Service Provider's Name KIM A OCONNELL I Phone 715 - 755 -3145 POWTS Regulator's Name ST. CROIX COUNTY ZONING Phone 715 - 3864680 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 118 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1260 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 ft 2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliformi >10E4 du/100 mL Service Frequency Septic and Pump Tank Inspect and /or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test month) Pressure Systeml Laterals should be flushed and pressure tested eve 1.5 ears Mound inspect for ondin and see a e once eve 3 ears 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 the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn -up Detail Finished ..����........� ............... Grade "'" 6 -8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: JAMES ELKIN 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.01 101) 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. $eyft Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stalls. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter Is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance Is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure DiWbution 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 distribution system Is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months, When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 Inches considered as an Impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by Increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. I Project: JAMES ELKIN Page 6 of 8 I ' . • i.�i� ....�CCCCCI='r'� ®COCCI O W OWN ■'�■■r■■ ■■r■N■ ■ O.WN�ii■■i�N`!�■N�■�NrNi■iNNi r� ■I�r�rrr ■► rNrrNNNrNN�NN�Nw�■ . r���.•iN■�ra�NN .�N���NN■■NNNN ■1 '''�r■N�� ■ ■1 \N��NNl�NNNN kMomi MINNOW M1111 3885 SIZE 1 /4" Solids' ��..��.�'�NNNN�NNN \1 \'�■■■NN • ■IN■N■■■■N■r ■ ■ ■r ■rrrr■ :C C�Ca ®CC®CC ' ■ ����■N�■�■r ■■■rrrrr■N NN■■NNN■NN •' ■■NNN�. ■NN■■ ■NNN■NNNNNNN :, ■rNNNN►�rNrNrNNN ■■NN■■NN No ' NN�::�:NNNN ■NNNNNNNNNNNN E ■rrN ■rrr ■rrrNN ■■ • ■ N■■r�N ■ ■ ■N NNNN ■■ .. ��NNNN ►`IN■ ■ ■■�■NNNNN■r ' • . ■ ■■r ■■NN■N■E ■iN NN�NNNN No MINK, INENEEMEMENNEM • � CC�CCCC Cii CC CCCCCCCCN r ii ,' CCI�� ®r ® ®C;�CC ®CCCCCCC ■rr■iNNN ■■NiNNr■r. �Ni■ N■Nrr■� NN rNiNiN NNCN���N N��NNi�N�risiiNiNiNiriN�N N N■N■NNNNN�� rr■ rrNr■NNNr . . NN�i ■ i■ NirN Nrr� ■ri■N�irri■i��■�■�rN��N�■�■�■Nr C• d1l> a r I i A / ao 3 rie �i00 0 Gc 'I �� C +'`,;sconsih Department of Commerce SOIL,AND SITE EVALUATION Division of Safety and Buildings Page of Bureau of Integrated Services in accgrdanGe With `s f :.ILMR$3.09, Wis. Adm. Code Attach complete site plan on paper not Tess than 8 1/2 County x 11 inches irt'Sio, Plan )rust include, but not limited to: vertical and horizontal reference point (BM), dlt6dt4o6'and , Gro /, per ent slope, scale or dimensions, north arrow, and location aftdirtance to nearest road: 'I Parcel I.D. # 20 /© APPLICANT INFORMATION - Please print all infornq# Reviewed by Date Personal information you provide may be used for secondary purposes (Piv Property Owner / Pi�detO. Location ` aoi Lot *,C 1/4 5� 1/4,S 1 T ?0 ,N,R / *,or& Property Owner's Mailing Address Lot Block# Subd. Name or CSM# 1 7.3/ �� / 1*f T hc4 /fid to te1 City State Zip Code Phone Number ❑ City El Village ® Town Nearest Road 1) �►� �'l �yo17 7 <s �- Zy�- S�ls .SC�r� errs �- �s'� .1 New Construction Use: Residential/ Number of bedrooms T Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow �d gpd Recommended design loading rate y bed, gpd /fi S trench, gpd /ft Absorption area required rb� bed, ft2 ADO trench, ft Maximum design loading rate Y bed, gpd /ft trench, gpd /ft Recommended infiltration surface elevation(s) Z 6 ft (as referred to site plan benchmark) Additional design/site consider �J Parent material t� a of a f • 27 ,+ Qn1 Q�� Sic k L04M Flood plain elevation, if applicable — ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ❑ S K U © S ❑ U ❑ S Rl U ❑ S CQ U ❑ S ® U ❑ S 9 U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 1 #7j,/k M U Z 2 - -27 5 t/T y 1 4 , 4 f / 1771h6 - In W, Ground 3 7 ?l 5 - 9 y/ l Depth to limiting factor �© in. Remarks: Boring # SL 2 in . �/ , s . 21- s Z,.Y /8 /V�4 S� ZmShk M Ground el v (o ft. Depth to limiting factor 7 SP' in. Remarks: CST Name (Please Print) SigrAture 7 Telephone No. /`f!!./1 �arn l/ 91 0 X c f /l - _25 _7Zo.i' Address Date CST Number PROPERTY OWNER R u J ' f e fj.V 1'9e-k,,,:f ° 't SOIL DESCRIPTION REPORT Page 'Z Of 31 PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 0-2 /D %Z m -s 2 -27 Ground 3 1Y ZW �Y C Y ,e r SGL 0; m f'►�' /n elev. e ft. Depth to limiting factor 27 Remarks: Boring # I Ground elev. tt. , I ' Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # ........................... ........................... .......................... ........................... .......................... ........................... Ground elev. tt. Depth to limiting factor in. Remarks: Boring # I Ground elev. ft. Depth to limiting factor � in. Remarks: SBD -8330 (R. 07/96) 4 7 r , L r — : 313 R1 Reis I E4o e 9� a 162 •�J r r ! , , I I i I s l r i I f � ' r r I , . �a , _I I _ p e ; t� 1 I : r ; , I , ` I , , _- --- -- r _�.��- ' - .��- ��-- �- �- �.�_Y.__. .r ..._. -_.} + _� -. � _ _ � �- , , , , , 1 1 _.__ -... , ._.�L.._.. �1- . - -,� a. , .---. '.- _�.+._...F_.�..�. i-.... .r .._ r.�........�._r- .••r..ro_�y _- ... -�-_. w....r_�.- t....�__ � t s � CCCCCCEV __M IF t t rX MR, At �" ..ti�P " Si;,� • '� • �J� 'f ::i'" .? {'rya: } }�!r ^ �f'• � "v •i. ♦ 1 - � � �• ♦� f � '{fit f '� °� e �,�� �!: w: a ... ? av ;'• • °. ti " e �' i i i v r •F +' Fi � a ' { ..:.. Fr WAMWEW {r rv'h. "� ga. , •K + 7 _ v d �[, •'#i9', law9••F`'�l� tee # ��'� p ::,•,,°•' ••' ° • •• 4' , . P {•:Syr .'�• �. s l � ~ � r U '�:: •..J• * 1 a , c'I ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address >- Property Address (Verification required from Planning Department for new construction) City /State ,S Parcel Identification Number Z� :�?8- ffi9190 LE GAL DESCRIPTION Property Location ' /,_ / Sec., T N -R gW, Town of Subdivision zw't�y Y&dz , Lot # C _. Certified Survey Map # , Volume , Page # Warranty Deed # �� , Volume , Page # Spec house O yes 30 no Lot lines identifiable yes O no SYSTEM MAINTENANCE 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 stem. stage in the waste disposal s g P Y The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I /we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 daykATURE ree r expiration date. SIG OF APPLIC ANT DATE OWNER CERTIFICATION 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 prop des 'beedd above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGN TURF OF APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department.****** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed U 1971P 05�f STATE BAR OF WISCONSIN FORM 1 - 1998 E' 6 9 6 S z WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO. , WI Document N r CORRECTIVE RECEIVED FOR RECORD This Deed, made between Timothy A. Riemenschneider a 09 -09 -2002 10:00 Ah married person, and Karl Skoalund a married person WARRANTY DEED EXEMPT 1 3 Grantor, REC FEE: 11.00 and James Elkin and Jackie Rae Elkin husband and wife TRANS FEE: COPY FEE: CERT COPY FEE: P Grantee. AGES: 1 Grantor, for a valuable consideration, conveys to Grantee the following described real estate in — St. Croix County, State of Wiscons (the "Property"): Recording Area Name and Retum Address >RR kin Elkin SD Q��n�t O I �VQ i Est�`10 , WI 032213280000 Parcel Identification Number (PIN) This is not homestead property. Lot Rocky Ridge Estat St. Croix County, Wisconsin (is) (is not) This Corrective Warranty Deed is given to correct the legal description on the Warranty Deed filed January 10, 2002 as Document No. 667820. The correct legal description is shown on this Corrective Warranty Deed. Together will all appurtenant rights, title and interests. none Grantor warrants that the title to the Property is good, indefeasable in simple fee and free and clear of encumbrances except Dated this 14th day of December . 20e C _ (SEAL) (SEAL) s imothy A. Riemenschtt 'der Kar Sk nd (SEAL) (SEAL) s � AUTHENTICATION ACKNOWLEDGEMENT Signature(s) State Of Wisconsin, Nl a Y PUBLIC St. Croix County. authenticated this , "!` � Personally came before me this day of r the above named Timothy A. Riemenschneider a married s Person, and Karl Skoglund a married person TITLE: MEMBER STATE BAR OF WISCONSIN to (If not, me known to be the person who executed the foregoing authorized by §706.06, Wis. Slats.) instrument and acknowled the same. THIS INSTRUMENT WAS DRAFTED BY Coldwell Banker Burnet 01 -42468 1301 Coulee Road • ¢ (�f Notary Public, State f Wisconsin Hudson, WI 54016 My commission is permanent. (If not, state expiration date: ( Signatures may be authenticated or acknowledged. Both are ) not necessary.) Names of verions siming in anX capacity mu t be ed or grinted below the signature. 51 AM BAR UY NS Wisconsin LegalBlank C ojnc. WARRANTY DEED FORM No. 1 - 1998 Milwaukee, Wis. q ' rA ts�artnac art av Nr ArMU ow art w a►s AM Ar"t ; x t U 1 = JIM NOR CO I I = • I = v � e w a� 1 'r - -- a y� '•% i Arm ...... N ......... ep Arl i I r o .isaott ' b �uc� toots f •• f' s / 'eo�tr t — _ IV Arm f ••y