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HomeMy WebLinkAbout032-2133-40-000 n § Q ic - � @ ' = = ; 8 $ % ; (E £ 2 - ' a m 0 ƒ/ 0 ° m& 0 e S , e ® , ] 2 } \ \ (D § c § j / [ ! \ 7 R t § ] E_ 2 g 3 K to ( i, o ° E E 0 © � \ C 0 E a A / \ f 7 $ § } 9 m % 5 CL CD Z § \ ƒ n r (1) m o = \ « ° c » cn CL CD z 0 0 0 3 ` J E § § 3 ( ƒ ° ` ° q 0 �(D £ {) � 2 CD �� C m rr Z } S z Q E 0 e §mo k' 0 Z3 CD ® CD �- § 2 ( I \] S. f N @�— $ E a C k} G' _�■ z f§� 6 ■ z m k % } / z ) / /E § [ w � § § {x l $2 C 0 co 8 f : ® � ® � ± ID CD »FREE ; cCl &c / c 0- �k'k� C' CD G �_ I /§ � »7/ � �§k ¥ E/% o % R ° ® ; a \ fa 2 U) % A _< , m o \ \ i 2 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division Sanitary Permit No: INSPECTION REPORT 463325 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Van Guilder, Kimberly Somerset, Town of 032- 2133 -40 -000 CST BM Elev: Insp. BM Elev: BM Descripti : Section /Town /Range /Map No' / "� /tad 1 N , / ( /41 01.30.19.1183 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Do in 3 d D Alt. BM Aeration 5 Bldg. Sewer Q Holding 1�, St /Ht Inlet 1 /p in?a 4_ /Z•$ �a• TANK SETBACK INFORMATION St /Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet I SM Septic / / { D Bo - 7 s > - 7s' �s. �- -7 �. 7- 8 7 3 Dosing —�. Ueade Man. IT aj Aeration Dist. Pipe /�+ Z , 7 f A. 7 7 / , n Holding Bohm Final Grade PUMP /SIPHON INFORMATION Z Manufacturer Demand St Cov r i GPM �p� #Z e sf- Model Number S A r /5- TDH Li ^, Friction Loss System Hq4 TDH Ft Forcemain Lengt,(, , Dia. 2 �, Dis . t j Well SOIL ABSORPTION SYSTEM (JZj " ,¢ - / VA-3 Sf. 17 - (6 3. 8Z- BED /TRENCH Widt 1 Length , No. Of Trenches l� PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth � DIMENSIONS 100 3 / SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Mapuf u / _ , O 7 INFORMATION CHAMBER O G TW Type Of System: , Model Number: to > > 200 DISTRIBUTION SYSTEM reader/ nifold� Distribution q .0 / x Hole Size x Hole Spacing VeN to it Intake sy Pipe(s) 2 `` Length Dia 2/ Length Di - t Spacing / v 3 SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over r Depth Over xx Depth of xx Seeded /Sodded Iched Bed/Trench Center 1 j Bed/Trench Edges Topsoil & 1 - 7- Yes j No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / 05 Inspection #2: ! / Location: 869 174th Avenue Somerset, WI 54025 (NW 1/4 SE 1/4 1 T30N R19W) Rocky Ridge Estates Lott15� Parcel No: 01.30.19.1183 1.) Alt BM Description = 2.) Bldg se _ j ''Wl/� 7 4 � �Jd � fv�iii l�ytCf��2t7I-e, . - amount of cover = - -�- - - Use revis for m ation No — Date Insepctor's Signature Cert. No. SBD -6710 (R.3/97) i I Safety and Build County , N V Irsconsin 201 W. Washington A Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608) 266 -3151 325 Sanitary Permit Applic f104 E.CEIV - State Plan I.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal inf you provide may be used for secondary purposes Privacy Law, )(m) jest Address (if different than mailing address) 1. Application Information - Please Print All Information �{ COU L7 Av6 . Property Owner's Name L Zo�fl�•`Varce]A Lot # Block # t , Property Owner's MailinpXddress Property Location '9.,' % <, Section - - City, State Zip Code Phone Number A- 4 141 - 9 6A V i A� p od 1 f' Q S I ^ - ai 8 3 (circl T N; R 44_ 1 Typ of Building (check all that apply) -D L9'1 or 2 Family Dwelling - Number of Bedrooms y geO Subdivision Name / CSM Number ❑ Public /Commercial - Describe Use ❑ State Owned - Describe Use ❑City_❑VillagtfR�ownship of I1I. Type of Permit: (Check only one box on line A. Complete line B if applicable) O 32 - - LID - am • / A. )€w System y El Replacement System ❑ Treatment/Holding Tank Replacement Only 11 Other Modification to Existing System B. 11 Permit Renewal ❑Permit Revision ❑Change of ❑Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner N. Type of POWTS System: stem: Check all that appl �gNon - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized hi- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculatng Sand Filter El Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line El Gravel-less Pipe ❑ Other (explain) V. Dis ersal/Treatment Area Information: o E. ;? • F dew (I .' `tt.. j S Design Flow (gpd) Design Soil Application Rate (gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) Syst Elevatio l ,, �vf� .'y Sa e Sao' E=2- e,, VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank 4 1 4e s Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement - I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumb rNe int) Plumber's Signature MP/MPRS Number Business Phone Number Plumber's Address (S t, City, State, Zip Code) - J ZL VIII. County/Department Us nl � Approved ❑ DisapprsYed __ _ Sanitary Permit Fee (includes Groundwater Date Issued Issui g Agent Signature (No Stamps) Surcharge Fee) � ❑ Owner Given Reason foi­ Denial _Ft* 2- IX. Conditions Appfov#R al SYSTEM 3) S �(S I e^ti- V104 q c oQ sts I s� , {fit .II r 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained as per management plan provided by plumber. tc -- - 2. All setback requirements must be maintained l2- S of I c are' o A E • F �6w' u-v\ S fi - -' as per4olicable code /ordinances. -- -``- Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size SBD -6398 (R. 01/03) vy� c C Y i z" sip: co le 14 A fro e�. 0 i0 � l ,O• , � d� T4 � Chamber SAS SYSTEM ELEVATION AND SIZING CALCULATIONS Below Grade Soil Absorption Systems Van Guilder Owner's Name 2/3/05 Review Date Y or N Highly Pretreated Effluent 3 ft Suitable Soil Below System , 12 in Chamber /Unit Height 2 8 ft Maximum Bury Depth 3 Ezfiow EZ1203HP & EZ102H � 600 gpd Estimated Daily Peak Flow -- 0.40 gpd/ft In -situ Wastewater. Infiltration Rate 1500.00 ft Chamber /Unit Area 50.00 EISA ft / Unit 96M sf 30 # of Chambers /Units 95� 9 I ft Proposed SAS Elevation 26.50 Bottom Area ft / Unit 95� A Soil Surface Acceptable Finished Grade EL 4 (ft) Boring Grade Limitation SAS Elevation (ft) System Minimum Maximum Number Elevation (ft) Depth (in) Lowest Highest Elevation? 98.50 105.50 1 98.60 90 94.10 97.60 Yes 2 99.80 91 95.22 98.80 Yes 3 98.70 91 94.12 97.70 Yes 4 100.50 92 95.83 99.50 Yes 5 98.90 93 94.15 97.90 Yes 1. Depth of suitable soil required below the infiltrative surface for treatment. 2. Total height of chamber in inches. 3. Maximum bury depth as per manufacturer's recommendations. 4. Based on chosen system elevation, and chamber height. Top of chamber is finished grade may be required to meet minimum or maximum code standards. Version 4.0 04/03 02/24/2005 09:36 2350867 ROGERS PLUMBING, INC PAGE 03 A i m Yq vi Cs u ld�e'r' u e�I :* 4 d 16d y � s� -tea 9 5. 9 as �de?oa AL ;q foe F l,l alp pd s ,F, ®, 4 w-, 5e�1e� y cop` 02/24/2005 09:36 2350867 ROGERS PLUMBING, INC PAGE 03 K r im Yi4 o (s u : may b Y Le '` ' eve spa 95. 9 M id. -5E, l d� -, AZI �►� to e, or Nt,J, S �, /� ,3rd, f � � �c�,� fz I .: �✓C3 f Wisconsin [department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page / of .� Burea4t of Integrated Services in accord 'with S;: 7L 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x. 1 inches irl-sizec must , County include, but not limited to: vertical and horizontal reference point (Bt�X d lrg lil and �� C�o i percent slope, scale or dimensions, north arrow, and Ibcation and distance fo r arest road:' Parcel I. D. # r -i 032 -(� a06 -/o APPLICANT INFORMATION - Please print all infornwt x Rev' wed by Date Personal information you provide may be used for secondary purposes (PrivacyaUa�,!t715.04 (1) (rry)). '� Q PropeitV Owner �n1 rg obtfy cation LJ It SSell /l (' f �, /Su1 Gpvt� t &,� 114 1 /4,S T �U ,N,R E (or )& Property Owner's Mailing Address tot # Block# Subd. Name or CSM# / 7.3/ - Y '" l IV plot.—.t id� ES7 te3 City State Zip Code Phone Number _ Nearest Road 7 / � ! .� 'YV J7 ( '71 5- ) Z (1G , El City ❑ Village ® Town ad PiE. /C is �i �.�..,� ,S G'r'h Pis t->' I YS S1; ® New Construction Use: Residential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: c/ Code derived daily flow gpd Recommended design loading rate ° / bed, gpd /ft ' 1 - 5 trench, trench, gpd /ft Absorption area required is ©O bed, ft 4 2 00 trench, ft Maximum design loading rate y bed, gpd/ft ° S trench, gpd /ft Recommended infiltration surface elevations) - / ft (as referred to site plan benchmark) Additional design /site considerations Parent material Cc�ery Ct�QJ Z o ^� Flood plain elevation, if applicable /V It S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system RS ❑ U ZS ❑ U ®S ❑ U 5d; U ❑ S S u ❑ S XU SOIL DESCRIPTION REPORT Boring Horizon Depth Dominant Color Mottles Structure GPD /ft g Texture Consistence Boundary Roots in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed Trench i iy /Gib 3 1 �2m f 1 y-3 . Z 75YR R A14 54 IM mutt C w lm . y s Ground 3 p2 7 y /1,4 SL W /rat elev. gAft. Depth to limiting vo X tor /0 in. Remarks: Boring # __R /0/1 }}'K�j /'_ / ll ..S G / s �f / , 77 f� c c� 2 m . 9, ; s S oli 75YR SL `� 1 n'► s b mat "i — — ,� -. �` Ground � lev . 9.8 ft. Depth to limiting fa, gg ,tor � m in. Remarks: CST Name (Please Print) Prature Telephone No. _ r Address Date CST Number PROPERTY OWNER RU SSf c�7 SOIL DESCRIPTION REPORT • , L / Page 2 L of PARCEL I.D.# 032- 1006 -10 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench /0 �/Z 1 % Ground / / �% lc' IV j� 5 � I l�S,b�( fY1vir 1 �f y elev. C �l 7 ft Depth to limiting f�Lqtor in. Remarks: Boring # I /V/f Z- c w 1t� S u tl a 9 �Si R 41 Sz Ground elev. I ©Q.s ft. Depth to limiting X t9f in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. 1 Munsell Qu. 4 Sz. C Color Gr. Sz. Sh. Bed , Trench Boring # V SL m -Sh K e r r C 2 M Y' ' e S 5 - 10) � N A 3 y' 7..5�`'1� N� S� sic` sbh !!►vii /vf S Ground ev y ft. Depth to limiting fac r / � in. Remarks: Boring # ........................ Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) I PROPERTY OWNER LSSell U &teg a`► SOIL DESCRIPTION REPORT � o • , - � O L �� Page f PARCEL I.D.# 032 00 6- / Boring # Horizon Depth Dominant Color Mottles Structure 2 in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed , Trench IVA - IVA WS b4- A6,-A, Gw / Al .2 3 Ground /,V /V 5� ��� Jms �r►vTr — 1 mil 7 ,. elev. C /9-1 — ft. Depth to limiting f for Remarks: Boring # -16 ld I VA SZ rn cu, .2M `s o= �oY1� �4 -s� n-► Sb/c C 4 v ; �s LM 3 9 7sYR 1114 Sb Ground elev. J Depth to 2 limiting f 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 # f © -/l A 3 ZY 4 2 ms blc I» v-'r C 1', 2 in . Y ' . j M S -33 /o R� / SL rn s °bk d C w �7.3�t S N,4 , °c IM sbk Ground ev i q • y ft. I & C s. Depth to , lim J Apr ' Remarks: Boring # Ground elev. ft. ' Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) 1 _ r . ' f CIP ' �Pr► C e / ►f��? �S� Lo C�c+ �h er' �0==� L� E { I -T.' -- t --. - '- { • ; , ! , —F 1 ; , i 1 j { s _ { 1 t - - s - - -- -- - - - -- - - 4 - 4 - j- ; --T--- 1 , , t , � ' 1 i I I { ! t } : � I , i f i ` I s 1 , 1 i ! TI i i i I � i � , � i i i i -- -fi- -- �• i t t _____ � F . __ . � ,. - . _� . _ . T _ , __ f ..__. � _�s�_+.___..f--_ -i•- -- �. -_.�.e ...- _._yam._ .�.....�._._ t_._..,{._ �..._.�. �, t i i 1 • , r i , C' • .; 'l , • � ' • ''. ••• r;'•• a %tf�l: }::tirrf {•4 .V,. %i 1 �. • •. r. "•• ,�{ ti • 7'�1yy,, � rr: r •: V i r. ; y� • �• r f ur. , , •r; + ,{' �/�:i,� r.•. .+�'{• i �y +� +'' ti r v + t a•,• Vi - •fir • + 4�P�� 4 •r+: Qom, � .C�'� { r , `1 . i, ���.' `�• .•: 7� %.{�;r: %• •• Sid {:; 4.'• Ti+�' . SF.. �,��. • .yti ~ ,rY r r. 1 r \♦ I � , , 1r•r 02/24/2005 09:36 2350867 ROGERS PLUMBING, INC PAGE 01 ROGLRS PLUMBING, INC. E4457 HIGHWAY 12 MENOMONIE, WI 54751 PHONE: (715) 235 -1132 FAX: (715) 235 -0867 FAX COVER SHEET Date: February 24, 2005 TO: Kevin Company: St Croix Zoning Fax #: 715 -386 -4689 qb $fe Re: Gregg and Kim Van Guilder Pages: 3 (including cover sheet) Comments: Kevin, Here is revised paper work for the sewer, the hard copy is going in the mail. From: 02/24/2005 09:36 2350867 ROGERS PLUMBING, INC PAGE 02 Chamber SAS SYSTEM ELEVATION AND SIZING CALCULATIONS Below Grade Soil Absorption Systems V ' a ' n Guild 1 0Wner's Name 2/3/05 Review Date � . � .1.. J Y or N Highly Pretreated Effluent 3 ft Suitable Soil Below System , 12 in Chamber /Unit Height 8 ft Maximum Bury Depth,, Ezflow EZIZ03HP & EZ102H 600 jgpd Estimated Daily Peak Flow " 0.40 gpd /ft` In -situ Wastewater Infiltration Rate 1500.00 ft` Chamber /Unit Area 50.00 EISA ft I Unit 30 # of Chambers /Units 19j . 9 Ift Proposed SAS Elevation 26.50 Bottom Area fi / Unit 9s. y Soil Surface Acceptable Finished Grade EL a (ft) Boring Grade Limitation SAS Elevation ft System Minimum Maximum Number Elevation (ft) Depth (in) Lowest Highest Elevation? 98.50 105.50 1 98.60 90 94.10 97.60 Yes 2 99.80 91 95.22 98.80 1 Yes 3 98.70 91 94.12 97.70 Yes 4 100.50 92 95.83 99.50 Yes 5 98.90 93 94.15 97.90 Yes t. Depth of suitable soil required below the inflltrative surface for treatment. 2. Total height of chamber in inches. 3. Maximum bury depth as per manufacturer's recommendations. 4. Based on chosen system elevation, and chamber height. Top of chamber is finished grade may be required to meet minimum or maximum code standards. Version 4.0 04/03 POWTS OWNER'S MANUAL MANAGEMENT PLAN FILE INFORMATION SYSTEM SPECIFICATIONS Owner , PA Septic Tank Capacity gal NA Permit # 3ZS Septic Tank Manufacturer / Q'.5 .e E-3 NA DESIGN PARAMETERS Effluent Filter Manufacturer p NA Number of Bedrooms 100gpd/bedroom p NA Effluent Filter Model 06- p NA Number of Commercial Units NA Pump Tank Capacity g al 4 NA Estimated flow averse * Pump Tank Manufacturer ( g) c g al/day r� -1`tA g y • Design flow (peak), . estimated x 1.5* a� gal/day P ump Manufacturer EXNA Soil Application Rate aUda Pump Model A Pretreatment Unit Influent/Effluent Quality (NA❑) Monthly Average ** A .Fats. Oil &Grease (FOG) 5 30 m E3 Sand/Gravel Filter p Peat Filter ❑Mechanical Aeration ❑Wetland Biochemical Oxygen Demand (BODs) Total Suspended Solids (TSS) 5 220 mg/L ❑ Disinfection ❑ Other: :5 250 mg/L Manufacturer: Model: Pretreated Effluent Quality ❑ Monthly Average * ** Dispersal CeII(s) Biochemical Oxygen Demand (BODs) �'groand. (gravity) El In-ground (pressurized) 30 mg/L p At -grade D Mound Total Suspended Solids (TSS) Fecal Colifonn (geometric mean) 5 30 mg/L ❑ Drip -line ❑ Other: 510 + cfu /100m1 ❑ Leaching Chamber Manufacturer E - 2 l -- Maximum Effluent Particle Size 1/8 inch diameter Model Approval Stipulation *Wastewater Flow Verification on and calculations: Soil Application Rate pd/fl Area Req. (Other than bedroom based) Absorption Area Credit per unit ft Minimum Number of Chambers �d p Aggregate Design Flow/Loading Rate= W min * * 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 typical for pretreated wastewater. and approval letters. DESIGN CRITERIA ❑ "Wisconsin At -grade Soil Absorption System, Siting, Design & Construction Manual" (Converse et.a1.1990) ❑ "Wisconsin Mound Soil Absorption System: Siting, Design & Construction Manual" Converse, J.C. and E.J. Tyler. Publication 15.22 O "Design of Pressure Distribution Networks for Septic Tank -Soil Absorption Systems" Publications 9.6 p "Design of Conventional Soil Absorption Trenches and Beds ". R.J. Otis - ASAE Publications 5 -77 and "Design Manual - Onsite Wastewater Treatment and Disposal Systems". EPA 625/1 -80 -012 October 1980 SBD 10570 -P (8.6/99) "At -Grade Component Manual Using Pressure Distribution" ❑ SBD - 10567 P (8.6/99) "In Ground Absorption Component Manual" 0 SBD - 10705 =P (N- 01101) "In Ground Soil Absorption Component Manual" Version 2.0 ❑ SBD 10628 -P (N.6199) "Recirculating Sand Filter System Component Manual" 0 SBD 10656 -P (N.6/99) S lit Bed Recirculating Sand Filter p g r System Component Manual " ❑ SBD 10572P (8.6/99) "Mound Component Manual" D SBD - 10691 -P (N.01 101) "Mound Component Manual" Version 2.0 SBD 10595 -P (R6/99) "Single Pass Sand Filter Component Manual" O SBD 10657 -P (8.6/99) "Drip -line Effluent Disposal Component Manual" p SBD - 10573 -P (R 6/99) "Pressure Distribution Component Manual" SBD - 10706 -P (N.01 /01) "Pressure Distribution Component Manual" Version 2.0 Drip -line Effluent Dispersal Component Manual for Multi-flo Onsite Wastewater Treatment Units ❑ MAINTENANCE AND MANAGEMENT MAINTENANCE MONITORING SCHEDULE Service Event S ervice Freq uency Inspect condition edition. of tank(s) At least once every p months years) U;wimu 3 yrs.) Pump out contents of tank(s) When combined sludge and scum equals one -third (1/3) of tank volume Inspect dispersal cells At least ast once every ❑months On year(s) (Maximum 3 yrs.) Clean effluent filter At least once every - p months IX year(s) Inspect pump, pump controls & alarm At least once every ❑ months ❑ year(s) ❑ NA Flush laterals and pressure test At least once every ❑ months ❑ year(s) '0 NA Valves At least -once every p months 1i M>NA Other: At least once every p months =❑ year(s) NA Page of START UP For new construction, prior fo 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. 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 maintenance of the POWTS and submission of required reports. The quantity and quality of the wastewater stream will affect the performance and longevity of your POWTS. The installation of water - saving - appliances and fixtures along with prnmptrepair ofleaks 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., should 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 week. 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 manner: C] Alarms Alarms should be tested on a regular basis by the home owner. If an alarm sounds, contact an individual licensed to service POWTS, There is normally a 1 day reserve under regular operating conditions, however water should be conserved until any problems with the system are corrected to prevent back -up of sewage into the dwelling or surfacing. INPECTIONS 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). C � Tanks Component Tank inspections must include a visual inspection of the tank to identify any missing or broken h y crack ardware, identify ans or leaks, measure the volume of combined sludge and scum and to check for any backup or ponding of effluent to the ground surface. 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 device to prevent accidental or unauthorized entry into the tank. 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 NR113, Wisconsin Administrative Code. The outlet filter(s) shall be inspected and vleaned 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. p Pump Chamber/Treatment Tanks Component The inspection must include a test of all electrical equipment such as pumps, alarms and floats. A visual check must be made for leaks, backups, surfacing, missing or broken security devices and other hardware and the condition of the filter. Any service needs or repairs shall be promptly taken care of. C M� C--G round Gravity Component Dispersal Cells 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. Page of E3 Mound, At-Grade, In- Ground Pressure 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 greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. The pressure distribution system is provided with an opening at the end of each lateral to be used for flushing. The laterals should be flushed at least once every three (3) years. Pressure checks of systems with multiple laterals should be done to ensure that equal distribution of effluent is occurring 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 incompliance 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 repl ce ent 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. ❑ 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. ❑ 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. Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. «WARNING» ' ' SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTIAN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEAT13 MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name i� c Name,, Phone Phone SEPTAGE SERVICING OPERATOR (Pumper) LOCAL REGULATORY AUTHORITY Name' Agency J7` n rt I N Phone Phone �, t KAWPDATAIEl"OWTS OWNER'S MANUAL.doc Page of Feb 01 05 Kimberly Van Guilder G51-493-6679 P.1 SEPTIC TAN4 - AGRII—SMENT rkND OW Nf-'ItSi 41 P AV (VIlinculion required from ftia=z Dcp:irwwal for "W Nvu U16L See. N-o, � fw) Town of R' 4 Lot # 1 5'1ArV4:y MAP ti Page V Deed # Volume 2 53 p age 31 s Uat ic 0 Yes �. no Lot "racy lde=Xifiablle M yi.s 0 ao Fa Rmpiausc audmaixitzmAxwoof your zscpcic Sy4Tc'1U';4u1d resole is iLS Pmw-U cure failure: to hAUAIC WaSWS- PrOPOrM 2amping out the scptk tank every WOO YeAll 0: sooArr, it atededbya licensed pwnper, YlUt you par into ""' u"k;er ' 1c runot of tb4 se r "k 6 " treAunbal stage, ut the waste disposal gysiarn. V ' poopoay 0%U= *&Z"• to aubaa ( to SE. Croix Zorumt; Deparunera A crrrific4dou tortz sigwj by the ow Plw ora (1) the aperat:Wg coadiriou aod! ®r (2) gfr"asPecdua and PIMPiU9 (if ae4xS tL* scptie, Qlak is loss tb= 1/3 fUU. the 11 demilucdbavo rcad the shove tcqu Aad agx6a m�ulxx the private sewage disposal SYMM with test: iunL6 b loin, as sat by the Dep-runc of Corar1l6tCa and Lhe Dapartmcw of Nzctaxj Pesoutcos, State *Msaonsi — Ca r urseP& sy3rcm toes bean tuaisaiai each luu3c be "inploEei and retumoa w ttia St, Cro;.x County Z O Y*Ar CXPU16111 I SIG Le CIA ZM DATB 4MaW 99RTjaC_A�f1QN D , I I . we,) "reify thar.all StAT On flus form are true lu We best of wly (our) kAowledgo' 1 (W4) am (ate) tLw u op rl crib ove, i► of a warra=y deed tceQ:clad in Register of Dat& Office, K Ke60 2—) A. y mfbrj=Lj4a ILAC 14 VAL3-MPi*0 ZDAy 14;SQ j , q, tiaolwy pccadc bouig covokod by dio Zoning DbparLuu, "" iaaclaadd W"tA this APPii"400- A buk=Pcd wumary doc46 Roth. tbt Re,&Lgor of J)ceds offi I 40 PY Of UU ocalfled survey MAP it TC&MA" '4 Madc in the waaliacy deed TO 39Vd ONI 'DN1HWt-1,4 h 1 Private On -Site Wastewater Treatment System (POWTS) Index and Title Sheet Owner: Project Name and System Type: Z�o Location: " - S %/��� Street Address 31 Z Legal Description Township /County Contents: Page 1: /Z Page 2: Page 3: Page 4• Page 5: Page 6: i r ti Page 7: Page 8• Page 9: Attachments /ice / -1— Plumber/Designer: Z, ia- Signed: U � 11 r --� f Credential Number: �"' Date: arc; 1 4 CIJ- ISp Dave i3t"aaht.fJcack Harrison 1-715 - •247 -4880 p UCI.' Y "liri U:1:iY� F'$ 714366" 62 btiUlttflSl' iiC'isS:CY: Ni6�Vu vt lit _ � tai '„ �# �� �t�`� � i s` ==�•` -Q,� l ..mnrZ .Yt• t 40RYgt � • 1 , i l l Y 1 1 t may, Tn . •� A y eEy.vww _ ma y' � .a1fNC • � j }iS � � d�i � • �� 1 .% .i U l wfto � i< • .i""' -'d �Ri'°- • � �� � � � l .».fin. 3 , su,. �� ay l t �r biE 1 t r .Ma }(J y 7t g 'i6 1 l all � x .'sret A l Awl �•u.,......r.+�'�' ai it � / fJ 1 ` ' � a fie, r � 1 .. 1100 ; P ik a Xar s.wpn u i ' 1 III 04 08 ;lsp Kimberly Van 651-493-667S a,k3 aw S aO r lit` � ;a.uwt �a v a.w' ai ti.i« a b V M&Y JEC '- r � ".`+ _ _ ��4:• ,aCel t SrL" 306 JlbP AW 4a0' _ 1 204 w r' (yi t` IOL40 lop- . . y ( ! 4c iv FM AN= WrAL LL i a 3 C14 C18a 2�p Kimberly Van Guilder GS1 49� - EE;79 �. 1G 1 W f n'-1 U 70.10 7T ... ._� . a M MC V-{ SIP S S. - 0.t 1 17d' y $7 I fl!' Y:7 1lSti ! 74 A tA! — - + ' . "• O4IW — F. -- H tavr t - 1 p K1 Ira ba -1 v -ari - - 4t:)3 -S67`3 p<� I ♦:,' � Y........- � � dS i10h9 _ _ C1 ►71^6. WA Ad - 3 a 7 et�' l id - -J L i I Fa _J I t t ' ri, I i ! row WxOWE FOMPAWI t 50 TO r L- - ----- f U 2753P 315 - 7 8 1 (t State Bar of Wisconsin Form 2 -2003 KATHLEEN 1. WALSH WA.RF_4NTTY DE ED REGISTER F DEEDS ST. CROIX CO., MI Moument Number Document Name RECEIVED R RECORD 02/22/200 10l:1541111 TMS DEED, made between Christopher A. Hoff and Stephanie I.. Boil', husband WARRANTY WED and wife EXEMPT ("Grantor," whether one or more), REC FEE: 11.00 and Greag J. Van Guilder and Kimberly A. VAn Guilder. husband and ruff¢ TRANS FEEk 195.00 COPY FEE: ("Grantee," whether one or more). CC FEE: Recording AGES: i Grantor, for a valuable consideration, conveys and warrants io Grantee The following described real estate, together with the rents, profits, SWUM and Other appurronant Title Recording Services, Inc. 450670 interests, in St. Croix County, State of Wisconsin ( "Propeny ") (if more space is 79 Western Ave N needed, please attach addendum): St. Paul, MN 55102 s6941W1 Lot 15, Rocky Ridge Estates. ST � CRO p I m X u 1 A 11 pgq I�1IpI NN�� AANp pp99II'''' ALPHA WALK �i ��I1� ���� 11111 II1� qIN 1111 W�� IY� 91 ql� WD LW i Pared tdcatiticado k Number(PIN) This I s honicatcad Proper . (is) (is not) Exceptions to warranties: Easements, restrictions and rights -ofway of record, if any. Dated (SEAL --- - (SEAL) rt *Christopher A. Hoff (SEAL L I (SEAL) * "'Stephan a L. Hoff AUTHENTICATION ACKNOWLEDGMENT Signatures) authenticated on STATF, O ) Ss. COUNTY r TITLE: MEMBER STATE BAR OF WISCONSIN Personally came before me (If not, the above-named Christopher A. Ho and Stepballue L. Ho authorized by Wis. Stat. § 706.06) Bill and wife to a known to be th taon(s) who executed the foregoing THIS INSTRLTMENT DRAFTED BY: ins eat and i e th Attorney Kristine Oaland Hudson, WI 54016 N odO Pub ' of My Commi on (is permanent) (expires: any be authenticated or acknowledged. Both are pet necessary.) NOTE: TIHS;$q ]j1P RM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDEN WARRANTY DEED' (a-' >� i}b�"' 0 2003 STATEr BAR OF WffiCONISIN .40.2-20W "Type name below signaW7lY. t �,�` 1 •�� J NF0.PR0*^ 1.a9ai Frnma 80D- 855.20] ww .inFeproronns.CtMn 7 6 - i 1 lair TO ft t G�• �� x 1 •`' s I A *r rt ✓.. x E t 05.52' N83'1 8 Z8'W LOT 116 aErvr x� t 5, 457. SO. FT. LOT 1 7.9 r x �:;' — 06 ACRES a ; .'. F. F. E. =963. 1 ,� ,' 165, 526. SO. FT. x k 3.80 ACRES w co MIN. F.F.E. =963.1 �h 1 � x f / &6 Oro SS15, LOr 14 v 1 0,3 316,438 S4. fT. k FA h 7 *26 ACRES F.F.£* =958.2 DRAINAGE EA SEMENT H.W.E. =952.1 Ir k• 'Id3p60 N75��,0b E aI p '�'IY�' i 9 4 l I r of � •I 7 ?f THE 51, 969.40 POND E1. =9&4,38 i - � # 1 1 noNb 'lam\ ,v wnt, „n�o samr..i, sr� c°rof er uw #mNNmR dlc Wdw � I '1.. � W \ aanw a m. Sowliaad wlxtar. ' rh+ owrNtt� aov6A•ae"Cin� .., o- •. 1 ] �. � < Wxar�•^. NN{ n rin d tlwt �wCOrnM t•uM t ;.. > 7F:F�r la \ � Fa "P � •\ ED TO „M]ONNf, 9NNE't � tr 1,'� a t S 5 , r i: r P �BII _ 2 'LOT 17 P •, i ' . ^ � � t9o�y _ -' 0E°,c= "_.b ,� EVE DATA tq \ y LOT 18 ra �I .. YN FlCa9!'1➢ M1 9.i, S. 1• 'ai' - ��� � LOT If 1 JJ UC. sa r> LOT 15 .. ° C • Y`"""x.,.,x]'°x°" rem I: ..: a.SJ nl U � ia° Ita(S f' ... r♦... it v -Slva L —�_ "" �•Y. a A {� .. 9 � • zx , . ] rs ] .q.� �n ` �s� , `• LOT 14 .ed -. ' >r. ) y \ tl0.ue sn. rr. •+Yw y,e.v. Ew 7..26 ACIrS � Yw. Ex.sw. a . �>% `�qa ° ® .�M°AM ti �•�x�+ l..i wpm' �. vs„' � � R � ZaNrq e� ((MM$$ nr 6F�M1�WIai�[Y[ GID aFIME149 �( p 1�)� // \` i i� 1 I t➢E V 1[CV� lOtl•�oEYtl x G 1 i 1 I �•(� Z i 1 UNP-A77ED -ANDS h i aMwM a cas�w+xwn d. CERiI�IDgS�U RVEY_MAP tl ND TH +w+Mv.w w„rM.e,a MwKr. VOLUM €,9 PAGF� 2@801 CERTIHFy SURVEY MAP ❑ 4 �' 6 x r.n °"` ' DOCUMftJ( NO 505226 1 J 4 fi ,.a ' �, z��'," �' � � VO-UME. 9 PA E' �68C j . 1 1 � a � " I • v�. x �' 1'.r� . 1 I 4k