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HomeMy WebLinkAbout032-2125-30-000 Wisconsia- Department of Commerce PRIVATE SEWAGE SYSTEM County. St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 384198 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 Holders Name: City Village X Township Parcel Tax No: LeQue Construction I Somerset Township 032 - 2125 -30 -000 CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark z s� 3.33 /43-3-33 to D ing Alt. BM Aeration Bldg. Sewer 1,46,, p 44 3 p� - Yo Holding S Ht Inlet 3 TANK SETBACK INFORMATION Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inl Septic yl0d , y Z , Dt Bottom Header /Man. `0 P 3 Aeratio Dist. Pipe - `1 9 .s6 4�.7? Holding Bot. System h 4 9 8& 83 I,y 92, 0A CZ Sa L PUMP /SIPHON INFORMATION Final Grade M 5 Man Demand St Cover PM Model Number TDH Friction Loss System ad J TDH Ft Forcemain Length Dia. Dist. to Well SOIL ORPTION SYSTEM ( 3 BE REN Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth SETBACK SYSTEM TO P/L JBLDG IWELL ILAKEISTREAM LE IN EModel c er. INFORMATION AMBER R _ Type Of System: } T� r > U umber: ! zU DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake { t( Pipes) / � / / Length Dia Length Dia / Spacing `I - 5 �/ 1 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 Bed/Trench Edges Topsoil E Yes � No Yes No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: 'q / 13 1 Inspection #2: / ! Location: 441 172nd Ave. New Richmond, WI 54017 (SW 1/4 SW 1/4 5 T30N R1 W) 0530191121 Cha�brree Lot 13 1,) Alt BM Description= Veto 0`h Yi)/MJe-- S u" �^� � "'�`z+. acettAfy'ew 2.) Bldg sewer length / / (� Sr'caLi, s � e fr,�, amount of cover = 7 Sr ,! IAti.O SW �t e ;l l G4( 3� o�Scr�ee�;w• � � r ;� ( � I - wSy� /reF tw Plan ��sion a ed'1 [ Yes tWo Q Use other side for additional information. ` d SBD -6710 (R.3l97) Date Insepctoe Signature Cert. No. Sawtatry Pawk Appllt:ation lh to taxond •M COI ra 021. Wb. Ache, Code 201 W. W Are. ' + See mvwn side hr b�utdoaa hr � app kedoa PO Boot 7302 YOU soap be toad for a000atdwy patpoaes Madison. WE 53707.7 ,42 E'At vicy . a, tS.O(ixau)) (fit omapkftd fora to amaty if m t!q oa act 1Mta i - t :sate owed. n L A !:canoe url taaaatiex _ py�„e Prltat s Intorertatioa ::teas Locatten: z 11 �y aaoa ss i Q M Th of Bsildkr. '(check one) �• i or2 Famtt?► Dwdft . Ard, ofBednOopas Q ymor 6 PAW 35 MA of Puxatt� Cteock oae boat on tine A. Chat* boot on tine B if tiabte A) t 3. 8j Teak S' to gg IV. a of PQWT : (C o* SU uppty) ` Q4 U O Taunt C] Sena � © C�ouusuva d WegaW D Aerobic t7gdt D Pea p ,� L V • t Area f»foraaatbtt• - r Lam ✓ CQro `7 4 :tats +� ej �; �`ank . 9 q b Tote{ Pxhb Slta Stesi Fbor- Pbak IttAlaaoatlea Aicitr Efaltoas Tanta Coe- Gout. t `��• • T cuetc snvcted D D D D O VUL tponstbiNty Statettuttt the for of POWfS aAauea end* aged home" NL i 7 I o S o c X. 4itttrt�otoa+t Use Uatty � AncovW p f y Poesy:tea �dudea Cn d~ Date seed Apt f P+I eta faWat Advetae �f • , , tbas'of APPrevai lRat"= fbr DW prgVal. twee S AL / ors 0 r zoy. Qh!!y 7Oo �Cr IN a or S4 Rc. K t$ s7 �t �'�� ��- s v� y� s s Tao tj R iq V3 � * 1 W _Jk S °,r+�mss;SC, ST crcX sk Ito w iL PcLeA 10 0 3 Z-a t a - s - ai r. ) 3 Try g�.as --o1 It U 3� c bps e � as Q Att eM y� 3 6 L � l I I I Oil C- � N ro ' Gin x M 1 X co vi x `rn N ' co cn t U p `J CL C) ` O LL 22x � � � C Z G e . fU N o •9 m a � J O,L i US t° m LL CL ZS V ` Y E t I! I � L � ,b �M 18 � o •k � ; : t a o w� 8� '7 V WisconsinDer'.orCommerce SOIL EVALUATION REPORT Page / of-3- Division of Safetylnd Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 11 ' . Plan must include, but not limited to: vertical and horizontal refer t t X fBf�A), i on and Parcel I.D. percent slope, scale or dimensions, north arrow, an yf1fiif 8itan d ° q arest road. Please print all i do •,� :, f Rev' d by Date Personal information you provide may be used for s purpo� (m))• Property Owner p� P ocaGon 2 4 2M L wt Sw 114,$'1 /4 S S T 30 N R/ 9 E (or) gj G c Q (re c . 21 ciay Property Owner's Mailing Address ly Lo Block # Subd. Name or CSM# e4 • ZONMO C rt City State Zip Code Pho N 0 ity ❑ Village [a Town Nearest Road .'C"' ,,t.n 4V/ I 5 (7 -) purs - 64 3.5 [P New Construction Use: 0 Residential / Number of bedrooms Code derived design flow rate G oU GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material 7LI Flood Plain elevation applicable �1 General comments Af O f/ and recommendations: 1' F-11 Boring # ❑ Boring ® pit Ground surface elev. 3 ft. Depth to limiting factor 0 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 16 y _-Z/Z — s,'l Zrvwhe l�P? 14 Ste' ✓ z • /a 3 /o � �- — S r'c / Zrrla�,� rrt -fir' c -- i . � ✓ Boring # ❑ Boring Z ® pit Ground surface eiev. fZ. ft. Depth to limiting factor '71_ in. Soil Applica tion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Ef1#2 L ?3: \10V pry_ Y ' Effluent #1 = BOD > 30 < 220 mg1L an TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name Please Print) Si t re CST Number �� Address Date Evaluation Conducted Telephone Number 0// �D% SrJ ile/ /S5'ozs "�'a C"/ 7/15 zy7 -lel- 0 � i Property Owner Parcel ID # A / 3 c S Page _� of F—S] Boring # ❑ Boring ® pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fF in. Munsell Qu_ Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 O /Z l0 �.� - S, • / Zrrtu r!'1 � r- C Ju r �S Z / 2 -1 /Z /.Ov �' Y S� ' rriab YY1 -�i1 L S - , S' ✓ ❑ Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. it Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Boring F Boring # Ground surface elev. ft. Depth to limiting factor in. El Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. *Eff#1 'Eff#2 Effluent #1 = BOD > 30 220 mg/L and TSS >30 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mglL 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) PAGE 3 OF_ NAME Le- 6 VV TOT# / 3 LEGAL DESCRIPTION c- %Sw X ,S .S 150 ,N,R, 1 E(or)W SCALE: I"= y0 BM I ELEVATION /QO • Q BM I DESCRIPTION {te �z • Odc e,;O< BM 2 ELEVATION 9� o BM 2 DESCRIPTION {�,,o Q�' �z �.D�G �•D t S "' SYSTEM ELEVATION s flZ a 6 C 0 I ALTERNATE ELEVATION 93, 4 0 CONTOUR ELEVATION RS. ao, 96.q!? 9 P. acJ jC I 1 3 T (3 -L (j- 3 70 O p e Q SIGNATURE D Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. PO Box 7302 y See reverse side for instructions for completing this application 1 %,1 co sin Personal information you provide may be used for secondary purposes Madison, W[ 53707 -73.02 oepa[iment:oF. Commerce (Submit completed form to county if not , (Privacy Law, s. 15.04(1)(m)] state owned. Attach complete plans to the county copy only) for the system, on paper not less than 8 -1/2 x 11 inches in size. Coun State Sam Petit Number O Check if revision t apioat State a n L D. Number I. Application Information - Please Print all Information cation: Pro rty Owner Name Property Location i AL Property Owner's Mai ing ddress ' �,� n Lot` umber Bock Ngmbec S`7 rR„ ., ., City, State Zip Code Pho a NtAnber X $ubdiyision Name or CSM Number COONTY 7 El II. Type of Building: '(check one) V;jj Village 1 or 2 Family Dwelling - No, of Bedrooms : `� ' r x . N Town of Public/Commercial (describe use) :_ n ❑ State - Owned �` rr Nearest Road .J 35 (_30 Parcel 7- Nu III. Type of Permit: Check only one box on line A. Check box on line B if applicable) 6. ❑Addition to A) 1. New 2. O Replacement 3. ❑ Replacement of 4. S System System Tank Only Existin S stem Date Issued B) Permit Number ❑ A Sanitary Permit was prcviou sl issued IV. Type of POWT System: (Check all that apply) ;gNoh- pressurized In- ground O Mound O Sand Filter O Constructed Wetland O Pressurized Inrground ❑ Holding Tank O Single Pass ❑ Drip Line j ❑ At-grade O Aerobic Treatment Unit ❑ Recirculating O Other: V.Dis ersal/TrcatmentAreaInformation: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Pcrcolalion Rate 6. System Elevalion 7. Final Grade Required Proposed Rate (Galslday/sq. tt.) (MinAnch) Elevation i s� s�� ,) ��.2) 1v A 9a,s % ,s Manufacturer - Prefab Site Steel Fiber- Plastic Capacity VII: 'l''''ank P tY in Total # of Information Gallons Gallons Tanks Con- Con- glass New istin crete ' structed Tanks O O O ❑ r� s /asp t PF 75-", ❑ 1 O O VIII. Responsibility Statement I, the undersigned, assume resp onsibility for instgM&on of the POWTS shown on the attached plans. Business Phone Number PRS No. Plumbers Name (p t) Plumber's Si atom stamps): -Al Plumber's Address (Street, City, State, Zip Code) L tom— Q.x f9 SC Q IX. County /Department Use Only O Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued i g Agent Signatu (No stamps) '�LAppr wed ❑ Owner Given Initial Adverse Surcha a Fee Determination S 3 2801 X. pndittons of Approval /Reasons for Disapproval: 010 qkLv VV*.* re t�tti._Inn�.v�4C0 5. ' I f 1 t 1 t E r i l y p µay,, 14 r It I\r N t p 1 + t r 1 z ' r r , y t , t i r i w 44 r s , I } r r 4 r E t E ` I (f : r i , i r= S r y i 1 1 ' f j r Y r ! I, a. r e' 4 + 1 v, _ i : Y '6 r r r r _ atC r , I i , i I ' : r i r , , _ r s ; r r 3 I r l Cc .1 '1 C c'•n v ri.�Lr!_ SC ; t� (y )C'�4 Y e S Department of Commerce SOIL AND SITE EVALUATION Page of [7ivisio ctf n t eg 4q ecl Buildings in accordance with Com Q9, Wis. Adm. Code �Bureat .st lntegra'ted Services County Attach complete site plan on paper not less than 8 1/2 x 11 inches in si^ Rlarr'must include, but not limited to: vertical and horizontal reference point (Bm�',, tection anql`�,,. KE" 5 }- C(ZO percent slope, scale or dimensions, north arrow, and location and cl 4t nce to nearest rostl 1, Parcel. LD. # APPLICANT INFORMATION - Please print all Inforiti Lion Reviewed by Date Personal information you provide may be used for secondary purposes (Privac Law, s. 15.04 ,01(0. Property Owner Priso(W, Location 2 i �\" �7 � —� Govt. Lot Cj G�J 1/45W 1 /4,S T 3d ,N,R /t? E (orW Property Owner's Mailing Address Lot # Block# ; Subd. Name or CSM# S � � \" C 'ni '�T'rv4 i \ I 1 3 -- G SA 6-E City State Zip Code Phone Number ❑ Cit ❑ Village e -0 Town Nearest Road �psc�ry ws I Sw jC (115 ) 6 6 7-3 1 2 P New Construction Use: tKPResidenfial / Number of bedrooms 7 3 - `( Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow 1. gpd Recommended design loading rate 7 bed, gpde - trench, gpd/ft Absorption area required bed, ft LVO trench, ft Maximum design loading rate �7 bed, gpd/ft trench, gpd/ft Recommended infiltration surface elevation(s) .S ft (as referred to site plan benchmark) Additional design /site considerations 9117-00 Parent material '�.' �� Flood plain elevation, if applicable ft S = Suitable for system I Conventional Mound In- Ground Pressure AT -Grade System in Fill Holdinnru u= unsuitable for system ® s❑ u ®s O u C� s❑ u 1 0S ❑ u ❑ s C� u El SOIL DESCRIPTION REPORT Boring Horizon Depth Dominant Color Mottles . . Structure GPD/ft h iW g in Munsell Qu. Sz Cont. Color Texture Consistence Boundary Roots Gr. Sz. Sh. Bed ,Trench hod{ i11n F LS G Z I ! b-30 't o y1z cS S 6 • y' Groun d a nd 3 _y ° l�? 3 L- ` C Depth to limiting 4- W -so factor , I Remarks: Boring # 1 3 — 5 , � Z nAA �� (o Z Z -3► . o j 3 — S[. Z W-Ae i C SC - S 5 3 I ti © x 7_ Ground elev. Depth to limiting factor , -q- - Remarks: CST Name (Please Print) ignature Telephone No, Address Date CST Number SOIL DESCRIPTION REPORT PROPERTY OWNER �`►�— PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 heW in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ,Trench odd p -fo- iG 'ya 3 11A, eyl Ground 3 teiv icy e ev. Depth to limiting Z 8 factor 49 - in. Remarks: Boring # o -y to V "? P\A y Z 3 — Z 8 v�-N i — 5 Ground f'Yl elev. `1 se tt ' Depth to limiting factor , I in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /fly in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring# l -3 O- 1 Z K htiC= 5 F 6 S IS 3 2i w VR s/ 3 — :St- ZmAok vwf i - 3 Dv 21 Ground elev. Af Depth to 3 lP limiting ; factor 96 � in. Remarks: Boring # �1 11 Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R.9/98) PAGE_OF_�_ NAME f�c�"� LOT #1 LEGAL DESCRIPTIONS ' /aS� /4,5 T Zd,N,R t� E (or� SCALE: 1 "= C) L2• ' BM 1 ELEVATION lUU • U BM 1 DESCRIPTION ; (,' n 1 W ud e r a4 66a BM 2 ELEVATION CC CZQ BM 2 DESCRIPTION A ,,,,; 1; nl; ",r,kvv- W /rla! SYSTEM ELEVATION Z �� + _ ALTERNATE ELEVATION Z • x r CONTOUR ELEVATION /1/` ,yS to z3v o° to UP �� S t3 ► q�-�o SIGNATURE DATE is G C) � T �. l �`, � �. :� . .. i 1 z a �I ., ..� ��� 3 i \ \. � ,,. a W ; tegf Department of Commerce SOIL AidO S T E`1ALUATION ` Safety and Buildings Page of ateli Services in accordance with s. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and S percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # 1/ / 7ir�: / 3 o�w� AL MA'✓: CINU✓ 30 -yo .. / Ja c7QnhP�J�ir -f ped APPLICANT INFORMATION - Please print allinformation. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. j 5. 11 ". Property Owner / Property Location Y S '� oia4 `� Govt. Lot 1/4 1/4,S T N,R E (or) W Property Owner's Mailing Address c 1 Lot # I Block# Subd. Name or CSM# ( 3� 1.- pr+' lli 1�� iz¢I.� C Al It �r City State Zip Code Phone Number ❑ Ci ❑ Village [2 Town Nearest Road y New Construction Use: Residential / Number of bedrooms �° Addition to existing building ❑ Replacement /! ❑ Public or commercial - Des�cr'be: P 14 Code derived daily flow 7S� /SdD Recommended design loading rate /ft trench, gpd/ft2 6� Absorption area required ft l 1 2,5- trench, ft Maximum design loading rate � trench, 9P Recommended infiltration surface elevation(s) ft (as referred t nchmark) Addit ional design/site considerations — 0 Parent material 1 -Away h Flood plain elevation, if applicable NJA ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ®S ❑ U ®S ❑ U Eg s ❑ U I 'A S❑ U I ❑ S ® U EIS O U # 13: SOIL DESCRIPTION REPORT Boring Horizon Depth Dominant Color Mottles Structure GPD/ft 9 Texture Consistence Boundary Roots a in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. trmm <44P e n b- 9 t o vg o tip Y — �5 1 cs Ground 3 22-3 S SL 2 elev. ft. 1 7 ? P•cke4 e YR r? L S v Depth to limiting factor }m in. Co 10 f Remarks: o; 6 L v r Boring # - 4 D -� 10 Yt 2 - 17 - y — S ' z Ground 3`j -S , - y L 5 ZGS l+►n v elev. Depth to limiting factor S in. Remarks: W eQ l CST Name (Please Print) Signature Telephone No. Address Date CST Number 1 L 01 - Cc,,r k e. �o f c�s &I S-40 114 a 00 " . r q a• / N c dn��. �r5 C CeU OL efva9 ,av— ho ui 0 � 44.1e 9� _6 B3 .9 90 . SS c N, a o- a q ,"6 1 E 1 g # (q{ 11Z1'o/ CIK -s Wf �JlW` SChliir�a�eY -fib UA t`vw` Nov�np 'oco�"w_5 d 44,*fe iS N* S�t �e� y' ootr. 4r R �d rr� heuj o�r� reri a«r.Ap.� SYS{rw, (e levo+, w e 4., w ; , 1, 6" ,`k Il�►t to CR la /. /y OG Sic�r o y Sly {Gt ✓e�� — ba6v- - - L ofJd- ke,J � �e ex1er.lfeG,� i c Chabre Lot 13 & Lot 14 History of Soil Information May 15, 2000 Adam Schumaker conducted original soil test. December 2000 Requested that additional soil borings be verified to determine whether a loamy sand texture was present — preliminary determinations were made by staff that would indicate that the soil texture was sandy loam. January 16, 2001 Staff met Adam Schumaker out at Chabre. An on -site was requested on lot 14. The information obtained was attached to the soil test and the loading rates on the original were reduced. March 2001 During review of the sanitary application for Lot 13, it was determined that the on -site verification may have been on lot 13 instead of 14. April 4, 2001 On -site confirmed that the on -site (1/16/01) was conducted on lot 13 instead of 14. The notes from January 16, 2001 were removed from the soil test for lot 14 and attached to the soil test for lot 13. The loading rates for lot 13 need to be reduced, but the loading rates for lot 14 will remain as previously adjusted to a .5, since it was never proven that a loamy sand texture existed. April, 2001 Adam Schumaker will be meeting with Cal Powers to complete additional borings in order to add additional system area for lot 13. Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In- Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567-P (R.6/99). Table 1: System Design Specifications Sanitary Permit Number Number of Bedrooms Design Flow - Peak (gpd) Estimated Flow - Average (gpd) Septic Tank Capacity (gal) 5 << 4 A M V Soil Absorption Component Size (ft) 5M ;W_ Type of Wastewater DoYmestic U�IS Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow - Peak (gpd) ZsU Z - a1 Maximum Influent Particle Size (in) 1/8 Maximum BOD (mg /L) 220 Maximum TSS (mg /L) 150 Table 3: Maintenance Schedule Septic Tank Inspect and /or service once every 3 years Ou tlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the se tic tank nd outlet filter shall be assessed at least once every 3 years by inspection. Th outlet filter s hall be cleaned as necessary to ensur p roper operation. The filter cartridge shou no 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 Management Plan for a Septic Tank and Soil Absorption Component 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 scum and sludge in the tank he liquid q exceeds 1/3 t volume of the tank. If the contents of the tank are not removed at the time of an 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. 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 the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely operation. Good water of reliable its o maintenance, and system use within or below the limits p the installation of water conserving plumbing conservation practices by all occupants and e 9 P 9 fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or i impossible to repair until weather conditions improve. In general, sell compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 r v s ' Management Plan for a Septic Tank and Soil Absorption Component Plantings of deep - rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. 3 r ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM ��.. t Owner/Buyer r S Mailing Address g 5_ R, rya L am[ 0 c Property Address �7� �. (Verification required from Planning Department for new construction) City /State -Se> hi -e r s wr S /o L ` Parcel Identification Number 1 -3 0 - oc�' C:1 LEGAL DESCRIPTION Property Location5 '/4, ­S k­3 ' /a, Sec. S T E N -R �_W, Town of �� M er Subdivision r`� Lot # L3 Certified Survey Map # Volume . Page # Warranty Deed # �{ D , Volume 0 f , Page # Spec house yes ❑ no Lot lines identifiable yes ❑ 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 stage in the waste disposal system. 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 day f the thre ear expiration date. SIGNA OF APPLICANT 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 pr perty desc ' ed a ove, by virtue of a warranty deed recorded in Register of Deeds Office. I NATURE F PPLICANT 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 r 4.1 STATE BAR OF WISCONSIN FORM 2 - 1998 6407$$ WARRANTY DEED KA-i4.EE?4 H. WALSH REGISTER OF DEEDS Document Number ST. ".Rf1IX CO., WI RECEIVED FOR RECORD This Deed, made between Oj- Ig -pODl 3:30 PM RICHARD 0. STOUT and JA NET_ P__STOUT,,, _ ._ _ husban and wife, WARRANTY DEED Grantor, EXEMPT A CERT COPY FEE: and �eQ 1 B T D .RS COPY FEE: TRANSFER FEE: 158.70 REC ^RD 14G FEE: 10.00 Grantee. PAGES: 1 Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate In St. Croix County, State of Wisconsin: Lot 13, Plat of Chabre, Town of Somerset, St. Croix County, Wisconsin. Name and Return Address KRISTINA OGLAND ATTOFINEN AT LAW P.O 359 MUDSC 4, t+V1 54016 032- 2125 -30 -000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Exceptions to warranties: easements, restrictions, rights -of -way and covenants of record. Dated this � 1 dth (� day of ` Ma y - r- h 2001 (SEAL) �.� / �CZx� -- - __._ (SEAL) w Richard O_ Stout Janet P- Stout (SEAL) __ (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, ss. St. Croix County authenticated this day of Personally came before me this 14 _ day of March ,2001 enamed Richard O Stout and P. Stout — V' TITLE: MEMBER STATE BAR OF WISCONSIN (If not, me known to be the person S N cued lheAegoirtt authorized by §706.06, Wis. Stars.) instrument and acknowledge the same. . , i.y,.9 p THIS INSTRUMENT WAS DRAFTED BY Janet P. Stout 1353 Awatukee Tr. Hudson, WI 54016 Notary Public, State of Wisconsin My commission is permanent. (If not, state expiration date: (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. STATE BAR OF WISCONSIN Wisconsin Legal Blank Co., inc. WARRANTY DEED FORM No 2 - 1998 Milwaukee. Ms. , , i 8 i I ——_i� , f C _ kk � t , , r j I J , 1 r I I ! t I f r } i I � i , • t } , ( t t ! t , ► i if • i r f s , • i 1 r "Pal JL -q-vj r 'COI -,3.b nin- . ... ...... . L �z k) , I I , I I : i I 1 ' � � I I t I I Y • - I r i I r ; r I I ( I • r i I I I ' • , I , I , I 1 _ I 1 , I I I I , ' i , I i 1 i I I : I 1 I I i f 1 ! i i i r I , : I i I r 1 , 1 i t I 1 : , I 1 I : Y 1 ` ; r 1 I _ 1 : i I I ' 111 : _ 1 I i I I � I t i � �;�- ----�� S EPTIC TANK E_ PUMP C AMBER CROSS SE C TI ON AND SPECIFZC:A'tivlv� 4" Cl VENT PIPE 12" MIN. ABOVE GRADE 6 WEATHER PROOF' ?:25 FROM.DOOR, WINDOW-OR JUNCTION BOX APPROVED FRESH AIR If4TAKE WITH CONDUIT MANHOLE COVER W/ PADLOCK 6 FINISHED GRADE 4 Cl RISER WARNING LABEL 6 MIN. ABOVE G ADE 4" MIN. 18" IN. 6 MAX. INLET 'WATER TIGHT SEALS GAS" �' TIGHT t � 4 BAFFLE A SEAL APPROVED CI PIPE •J_ i ALM JOINTS W/ CI B i PIPE 3' ONTO SOLID C TO —�— ON SOLID SOIL SOIL PUMP OFF ELEV . 93 FT. ---- Y OfF �,st RISER EXIT D PERMITTED ONLY IF.TANK . MANUFACTURER HAS APPROVAL 3" APPROVED BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS SEPTIC / DOSE TANK MANUFACTURER NUMBER •DOSES PER DAY: TAN SIZES SEPTIC 1 GAL. DOSE VOLUME INCLUDING DOSE GAL. FLOWBACK:. _ GAL. ALARM MANUFACTURER: SJ L , fsTP*i 5 CAPACITIES: A = 34.7 INCHES MODEL NUMBER: fo( /f!0 SWITCH TYPE: [lo-,:°t B = 2 INCHES = ^ o�`T GAL. PUMP MANUFACTURER: C = l 01,�. INCHES = !�d GAL. MODEL NUMBER: t,�fp i # (2 SWITCH TYPE: 5/6 D = _� INCHES = 9�, 2 GAL. REQUIRED DISCHARGE RATE GPM PUMP & ALARM WIRING AS PER ILHR16.23 WAC VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE /`/, FEET + MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . % 2.5 FEET + 130 FEET FORCEMATN X �/ FT /100 FT. FRICTION FACOR . ,% FEET TATAL DYNAMIC HEAD FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH r 7� ; WIDTH; DIAMETER _____•_ LIQUID DEPTH 5� �r 1•, /�� } SIGNED: _ LICENSE NUMBER: 2R DATE: 3 � 1 ti kJk kk kkkk I ST a) n n 1� 'p :xiaan . , 0 0 N �� IJ'J Ck. .............. . ................ N 0 r- C a (0 (o -0 c� c ��� 1 =r (o CD 0 --3 iz X - 7 CD =r (D LD X LA. S2 : C) . .. ..... .. a - U CD o . 0 cr r 0 - i c o 0 ai— Oo 1 0 0 o 0 N CD to r -4 0) X 5 2 8 0 — - Vo CD (0 C: C E3 Invert 1 1'- -? (T) N Goulds Subli'lasible Effluent Pump 3885 ,. APPLICATIONS •Overload protection must smooth operation Silicon can be operated continuously Specifically designed for the be provided in starter unit: bronze Impeller available as without damage. following uses: • Shaft: threaded, 400 series an option.;, ■Bearings: Upper and Homes stainless steel. ■ Casing: Cast iron volute lower heavy duty ball bearing Farms •Bearings: ball bearings . type for maximum efficiency. construction. • Trailer courts upper and lower. 2" NPT discharge adaptable ■ Power Cable: Severe duty • Motels • Power cord: 20 foot for slide rail systems. rated, oil and water resistant. • Schools standard length (optional a Mechanical Seal: SILICON Epoxy seal on motor end lengths available). • Hospitals CARBIDE VS. SILICON provides secondary moisture •Andustry Single phase: CARBIDE sealing faces. barrier in case of outer Jacket • V3 and %: HP -16/3 SJTO • Effluent systems Stainless steel metal parts, damage and to prevent oil with 115 V or 230 V three BUNA -N elastomers. wicking. prong plug. SPECIFICATIONS • 3 /4 -1'/2 HP -14/3 STO with m Shaft: Corrosion- resistan ■ 0 -ring: Assures positive Pump bare leads. stainless steel. Threaded sealing against contaminants • Solids handling capabilities: Three phase: design. Locknut on three and oil leakage. 3 /4" maximum. •' / :-1'/2 HP -14/4 STO phase models to guard • Discharge size: 2" NPT. with bare leads. On CSA against component damage AGENCY LISTINGS • t 128 GPM. listed models - 20 foot . `ti S: 0 on accidental reverse rotation M Capaci a Up SP Canadian standards Association • Total heads: up to 123 feet length SJTW and STW ■ Motor: Fully submerged in TDH. are standard. high -grade turbine oil for • Mechanical seal: silicon lubrication and efficient heat Uii Undetwrttets Laboratories carbide -rotary seat/silicon FEATURES transfer. carbide- stationary seat, 300 a Impeller: Cast iron, semi- ■ Designed for Continuous series stainless steel metal open, non -clog with pump- Operation: Pump ratings are parts, BUNA -N elastomers. out vanes for mechanical seal within the motor manufacturer's • Temperature: recommended working limits, 104 °F (40 °C) continuous protection. Balanced for 140 °F (60 °C) intermittent METERS FEET' • Fasteners: 300 series 90 stainless steel i _ _ _ _ _ SERIES: 3885 SIZE: WSOLIDS • Capable of running dry. 25 so 'WEt -� SGt — RPM: VARIOUS without damage to - - components. 70 WE,(t, sFr 20 Motor ° 60 Single phase: Y _ Eo — - - - --`-'- • % HP, 115 V, 200 V, 230 V, " 50 60 Hz, 1750 RPM; 1 /2 HP, Z - 115 V, 60 Hz, 3500 RPM; 0 4 EO H '/2 HP -1'/2 HP, 230 V, o to 30E0 60 Hz, 3500 RPM. • Built -in overload with. 20 weo automatic reset. 5 • Class B insulation. Three phase: 10 •' /2 HP -1'/2 HP 200/230/ 0 0 460 V, 60 Hz, 3500 RPM. 0 10 20 30 40 50 60 70 80 90 100 110 120 130GPM • Class B insulation. 0 1 20 30 math CAPACITY ©1995 Goulds Pumps Effective May. 1995 B3885 ry� ( O 101t>t M.1 t. ►1.00, a � 1 V Q V � dL'Nr M •l 1.1 tAO, A IC ' ,a/ 4 a t � 1 i s� rMeyt %t rzr�k� �(n .Oa'NbMA1.flAON . rd� +a _ a Ir Au L n Cal j p � I i 1001 001 a i S4 604,04V w W1.1w cc CE � 1 N Ell v Z' C 3 ��x a al•t'L, M OlA 1.00 N 8 0 r F o OD d Mf KL °� .0�•fibMA1.Y 1.00 - N / .lB'BS �/� \ - `M O� �, '1► 3 oz I NI a � A f cu = } a \ d \ 001 s r 1 V ` s • 3 $ S % El cu CL cc s \ cc io N3+1fl13S AtlAH91H .OS _611691 - _� - .001► r avow d w Awr a >u•nn