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HomeMy WebLinkAbout032-2144-30-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Cr oix Safety and BuJing Division INSPECTION REPORT Sanitary Permit No: 499148 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: Hayesjony Somerset, Town of 032- 2144 -30 -000 CST BM Elev: Insp. BM Elev: BM Description: Section /Town /Range /Map No: /4!> �V1 6-ST 07.30.19.1258 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER c CAPACITY STATION BS HI FS ELEV. .. 7.3-1 16Z -3 Septic Z Benchmark Dosing C T.,.- 1 Alt. BM c7kr._) �� 2.s �ooa i3e1}e.. o� 5: 3.$ /D j,.Y,S /./5 /isZ. Aacatien ,, nn A Bldg. Sewer 6 Za X I * ( .tp Holding _ St/Ht Inlet 4 g L 57.3 TANK SETBACK INFORMATION St/Ht Outlet Y •3� 9 (v• 1 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet t zq 94, • g� Septic (4C)l 0 1 A) A Dt Bottom ro.(� 924 Dosing I I 2 y 36 Header /Man. Z Aeration Dist. Pipe Z .70 Efy. 7W- -V Holding Bot. System PUMP /SIPHON INFORMATION Final Grade / •7 166 -.0 - 1 Manufacturer Demand St Cover 6 0j b !% GPM n, Z. O /C6 , Model Number G r 6 145 TDH Lif Friction Lgss System Hgad Ft S T a ou Forcemain Lengt Dia. ;Z. t Dist. to Well , ' SOIL ABSORPTION SYSTEM lP s 4 S. 7 BED /TRENCH Width h No. Of Tre Q PIT DIMENSIONS No. Of Pi is Inside Dia. Liquid Depth DIMENSIONS Lengt .74 T e nc s � -� SETBACK SYSTEM TO P/L V BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION f System ) CHAMBER OR Type ` .O I � i 1> 1� Ai � UNIT Model Number: O., — 1STRIBUTION SYSTEM Header /Manif Id 1 it Distribution /�y / x Hole Size x Hole Spacing / V t to Air Intake I Pipe(s) l f �3 � � L Dia Lengt Dia Spacing H • Z 4 SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over 1 xx Depth of 1 xx Seeded /Sodded xx Mulched Bed /Trench Center I Bed /Trench Edges Topsoil `. Yes No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / 3a / D-7 Inspection #2: Location: 1630 40th Street Unknown (NE 1 SE 1/4 7 T30N R19W) St. Croix National Estates North Lot 3 Me-Li Parcel No: 07.30.19.1258 1.) Alt BM Description = 2b � 153 -1 2.) Bldg sewer length = Z 9 n 1 - amount of cover = , f g 11G AJ Z Il 6k• G \,sL. 01• Plan revision Required? Yes No )se other side for additional information. 4 . Date Insepcye nature Cert . No. -6710 (R.3/97) commerce.wl.gov Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 �ji , r i scon s n Madison, WI 53707-7162 Sanitary Permit Number (to be filled in by Co.) Department of Commerce ca / Sanitary Permit Application to Transaction Number In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental / 3? / 5 7 unit is required prior to obtaining a sanitary permit. Note: Application forms for s oject Address (if different than mailing address) submitted to the Department of Commerce. Personal information you provide may be used for secondary t ye �h J7 purpo in accordance with the Privacy Law, s. 15.04 1 m , Slats. I. Application Information - Please Print All Inf do Property Owner's Name / Parcel # Property Owner's Mail g Addre APR 0 2 2007 Property Location / (✓j `� 'f! /yJl CCI, `y Govt. Lot ( ' I zS$ City, State Zip Code Pone u ei Section i(/ , £ , 7 � j � /a /'� /4 �l1+L' �!`" /�� 1 `C � (circle one) ` / / n `� ' T N; REorW H. Type of Building (check all that apply) A-i Lot # 1 or 2 Family Dwelling -Number of Bedrooms c_.. Subdivision Name St , t�/` 0 . 1C /l✓4 U.+va s 7a�rS , ❑ Block # Public /Commercial - Describe Use ❑City of ❑ State Owned - Describe Use CSM Number ❑ Village of t , JC 1/ �Townof a el -W e ._ III. Type of Permit: (Check only one box on line A. Complete line B if app licable) , A. aNew System y El Replacement System ❑ Treatment/Holding Tank Replacement Only 11 Other Modification to Existing System (explain) B. ❑ Permit Renewal ermit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Pri3vious Permit Number and 13 to Issued Before Expiration Owner / / 9 / v 3! �,� IV. Type of POWTS System/Component/Device: Check all that a I I .t ❑ Non - Pressurized In- Ground ❑ Pressurized In- Ground ❑ At -Grade -Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis ersal/Treatment Area Information: a C Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation . 0 O - b!' 7 /7 - 7rS11 ZZsL ' �U S VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units v c v o New Tanks Existing Tanks W Sep or Holding ank g 14,0 A iw sing Cha b w I. Responsibility Statement- I, the undersigned, assume responsibility for installation of the PO sbownvy the attached plans. PI mber's Name (Pri lumber's Signature /MP Number Business Phone Number ell. k 4 // 11 ft 's L ZZ- 87Z, � 7Z —2 S/Z( l im is Address (Street, City, State, Zip Code) VIII. County/ e artment Use Onl Approved ❑ D� Permit Fee Date Issue Issuin ent Signatur ❑ O en Re for Denial Permit . GO z a� IX. Conditions of Appr�ov UReasons for Disapproval SYSTEM01IVN It- 3�. 1. Septic tank, effluent finer and , dispersal cell must all be rvk / ma c.J � v% SC es intained i � Q >r'r'CC -,�' as per management plan provided by plumber. 2. All setback requirements must be maintained � C('� � � �+ ,t ttI-1'eCL__ 1 e o Yhe system and subm t to the County only on paper not less than s I/2 x l l inches In size SBD -6398 (R. 01/07) Valid thru 01/09 r V I CL Az 1 O ` �• $ it+ �DN s , � Crr� Q Q - U q n 4W / 44 . N t� o �.l v DkI %Y a r � Z b � as a 4c �s `� �• - ors o s a � � o 9 44 J _1 v L4 - b � n Safety and Buildings oV PO BOX 7162 commerceml. g MADISON WI 53707 -7162 TDD #: (608) 264 -8777 'sco ns' n www.commer www.wisconsin.gov www.wisconsin.gov Department of Commerce Jim Doyle, Governor Mary P. Burke, Secretary November 30, 2006 CUST ID No. 222872 ATTN: POWTS Inspector JACQUES M HAWKINS ZONING OFFICE HAWKINS SOIL TESTING & SEPTIC ST CROIX COUNTY SPIA 2659 150TH ST 1101 CARMICHAEL RD LUCK WI 54853 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 11/30/2008 Identification Numbers Transaction ID No. 1345710 SITE• Site ID No. 716768 Tony Hayes - Dwelling Please refer to both identification numbers, 40TH St above, in all correspondence with the agency. Town of Somerset, St Croix County NE1 /4, SE1 /4, S7, T30N, R19W Lot: 3, Subdivision: St Croix National FOR: Description: Mound Object Type: POWTS Component Manual Regulated Object ID No.: 1108719 Maintenance required; 750 GPD Flow rate; 24 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 /01), Pressure Distribution Component Manual - Version 2.0, SBD- 10706 -P (N.01 /01) The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance, with the enclosed approved plans and with the component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. P. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, cor stats. A P/ A copy of the approved plans, specifications and this letter shall be on -site during construction and open to Df inspection by authorized representatives of the Department, which may include local inspectors. All permits DIV1S TM N required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. S E C� In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should kRE, 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. I i JACQUES M HAWKINS Page 2 11/30/2006 Sincerel , Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 eter E Pagel Private Sewage Plan iewer, , Integrated Services WiSMART code: 7633 (608)266-2889, M - F, 0630 - 1500 Hrs pete.pagel @wisconsin.gov cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726 -2544 A RECENED NOV 2 0 2006 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application SAFM OWN, 1XV, INDEX AND TITLE PAGE Project Name: Tony Hayes 5 Bedroom Mound Owner's Name: Tony Hayes Owner's Address: 1910 Mahtomedi Ave. Mahtomedi MN 55115 Legal Description: NE1 /4 -SE1 /4 Sec.7 T30N -R19W Township: Somerset County: St. Croix Subdivision Name: St. Croix National Lot Number: Lot 3 Block Number: NA Parcel I.D. Number: 032 - 2144 -30 -000 Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Plot Plan tt j �� l� Fr ° r MM Designer: Jacque Hawkins License Number: MPRS# 222872 p R� Date: 11/13/06 Phone Number: (715) 472 -8446 Signature: '�ONpE 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 3.11 (R. 06/01) Page 1 of 8 i I r 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 Table 3-44 -3 in -situ soil treatment for fecal 500.00 Estimated Wastewater Flow d a S (gP) _ 36 inches. o 1.50 Peaking Factor (e.g. 1.5 = 150 <- colrform of 750.00 Design Flow (gpd) 5.00 Site Slope ( %) 97.65 Contour Line Elevation (ft) 24.00 Depth to Limiting Factor (in) 0.60 In -situ Soil Application Rate (gpd /ft) Distribution Cell Information 93.751 Dispersal Cell Length Along Contour (ft) = 8.00 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) c Center or End Manifold 4.00 Lateral Spacing (ft) If N above, enter the elevation (ft) 4 Number of Laterals of the highest point. 0.156 Orifice Diameter (in) (e.g. 0.25) 2.17 Estimated Orifice Spacing (ft) = 8.93 ft /orifice 2.00 Forcemain Diameter (in) 80.00 Forcemain Length (ft) Does the forcemain drain back? Y 90.00 Pump Tank Elevation (ft) Enter Y or N 4.55 System Head (ft) x 1.3 13.05 Forcemain Drainback (gal) 8.15 Vertical Lift (ft) 84.64 5x Void Volume (gal) 3.31 Friction Loss (ft) 97.69 Minimum Dose Volume (gal) 16.01 Total Dynamic Head (ft) 45.23 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 lj (� 1.00 1.50 x x 1.25 x 2.00 x 1.50 x x 3.00 1 2.00 x 3.00 x Gallons /Inch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1600.001 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Skaw Precast I Manufacturer gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 1033.68 Dose Tank Capacity (gal) JZa Filter Manufacturer 28.32 Dose Tank Volume (gal/in) IA100 Filter Model Number Skaw Precast IManufacturer Project: Tony Hayes 5 Bedroom Mound Page 2 of 8 Mound Plan View 1/10 B . Q • J .1 Observation Pipe K T n� W A :B .. ... I L Mound Component Dimensions A 8.00 ft E 16.80 in H Aft ft K 8.98 ft B 93.75 ft F 9.50 in z ft L 111.70 ft D 12.00 in G 0.50 ft J ft W 23.48 750.00 (ft Dispersal Cell Area 1 1640.63 (ft Basal Area Available 8.00 (gpd /ft) Linear Loading Rate 1 9.38 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 100.44 (ft) —► ffff ff... 2 G * H ff}f }f }ff j F .. 99.15 (ft) ff } /ff! }f } } Dispersal Cell Lateral 98.65 (ft) — Invert Dispersal Cell .D Elevation E 1. J J • J ' ! , J. ! ! • • i - i i .. - _ _ y -_. '__! -_ -_! -. ` -'.{ -,'.:. i. _'. - , i w - �'__i .. - -_ -_ _., .� J : ' -.� . •V t ! .l i i - 1 l ! 1 4 l " i 1 -` i r { _i, . _i ?._ }.. i, i i, i, ,i ], i �i,� ! J ! r ! J J �i _ �, ,i, � i- ■ t i a - .: , . 97.65 (ft) Contour Elevation 5.0 % Site Slope Geotextile Fabric Cover Shading Key $_. T Dispersal Cell See lateral details on Q 10 _ Topsoil Cap - 1.5 ft Page 4 for number, size, 7 © }f } }} Subsoil Cap 0 0 4 ( and spacing of laterals. ASTM C33 Sand 1° `�° � F Laterals are equally •ti _ :i.�;.. Tilled Layer 0.5 ft Typical Lateral spaced from the distribution cell's �5 Aggregate .r o centerline in the �— A —� distribution cell (AxB). Project: Tony Hayes 5 Bedroom Mound Page 3 of 8 Center Connection Lateral Layout Daigram Force main connection via tee or cross to manifold at any point. Laterals are identic all I P S AL •= Turn- vd ba I I valve or I[- X- 4 �f K+2 I 02 +I Laterals & force main of PVC Soh 40 aleanautplug per COW Table 84.30.5 Holes drilled on the bottom of the lateral. Number of Laterals 4 Orifice Diameter 0.156 in Lateral Diameter 1.50 in Orifice Spacing (X) 2.25 ft Lateral Length (P) 46.13 ft Orifices per Lateral 21 Lateral Spacing (S) 4.00 ft Orifice Density 8.93 ft /orifice Lateral Flow Rate 11.31 gpm Manifold Length 4.00 ft System Flow Rate 45.23 gpm Manifold Diameter 1.50 in Total Dynamic Head 16.01 ft Forcemain Velocity 4.62 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and --► Comm 16.28 WAC Disconnect 4 in. min. Tank component is properly vented iz y Alternate outlet location Forcemain diameter Skaw Precast Manufacturer 2 in. Capacityl 1033.68 Gallons Volume 28.32 gal /inch A Weep hole or anti - Dimension Inches Gallons B siphon device A 19.05 539.51 C B 2.00 56.64 P ump off elevation (ft) C 3.45 97.69 91.00 D 12.00 339.84 D Total 1 36.501 1033.68 iF- Do se tank elevation (ft) 3" Bedding uncTer tank. 90.00 Alarm Manuafacturer IS.J. Electro Alarm Model Number 101 -01H Pump Manufacturer JGoulds Pump Model Number EP05387 �� Pump Must Deliver 45.23 gpm at 16.01 ft TDH Project: Tony Hayes 5 Bedroom Mound Page 4 of 8 Mound System Maintenance and Operation Specifications Service Provider's Name Tri -County Sanitation Phone (715) 386 -0114 POWTS Regulator's Name St. Cr Co unty Zonin Phone (715) 386 -4680 System Flow and Load Parameters Design Flow - Peak 750 gpd Maximum Influent Particle Size - 1/8 in Estimated Flow - Average 500 gpd Maximum BOD5 220 mg /L Septic Tank Capacity 1600 gal Maximum TSS 150 mg /L Soil Absorption Component Size 750 fe Maximum FOG 30 mg /L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu /100 mL Service Freguency Septic and Pump Tank Inspect and /or service once eve 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 monthl Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound Inspec for po nding and seepage once every 3 years Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn -up Detail Finished •.........•••. ............... 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: Tony Hayes 5 Bedroom Mound Page 5 of 8 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD- 10691 -P (N.01/01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet fitter 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. Puma 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 Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October- February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg /L BOD 150 mg /L TSS, and 30 mg /L FOG for septic tank effluent or 30 mg /L BOD 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. Continency 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 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Tony Hayes 5 Bedroom Mound Page 6 of 8 ' Page 7 of 8 N GOULDS PUMPS Submersible Effluent Pum 3871 EPO4 EP05 APPLICATIONS • Fully submerged in high ■ EP05 Impeller: Thermoplas- ■ Bearings: Upper and lower grade turbine oil for tic enclosed design for heavy duty ball bearing Specifically designed for the lubrication and efficient improved performance. construction. following uses: heat transfer. ■ Casing and Base: Rugged • Effluent systems thermoplastic design provides AGENCY LISTING • Homes Available for automatic and superior strength and corrosion • Farms manual operation, Auto- Canadian Standards Association • Heavy duty sump matic models include resistance. • Water transfer Mechanical Float Switch ■Motor Housing: Cast iron (CSA fisted model numbers end • Dewatering assembled and preset at the for efficient heat transfer, in "C" or "F ".) factor strength, and durability. SPECIFICATIONS ■ Motor Cover Thermoplastic cortasftnPsisisoMR80sered. FEATURES cover with integral handle and • Solids handling capability: float switch attachment points. 3 /4" maximum. ■ EPO4 Impeller: Thermoplas- a Power Cable: Severe duty • Capacities: up to 60 GPM. tic Semi -open design with rated oil and water resistant. • Total heads: up to 31 feet. pump out vanes for mechanical • Discharge size: 1'/i' NPT. seal protection. • Mechanical seal: carbon- ' rotary/ceramic - stationary, BUNA -N elastomers. • Temperature: 104°F (40°C) continuous 140°F (60`C) Intermittent. METERS FEET 10 • Fasteners: 300 series stainless steel. 9 30-- 5GPM • Capable of running dry without damage to $ 2.5 a components. 25 a 7 Motor: _ el —_ • EPO4 Single phase: 0.4 HP, v_ 6 20 115 or 230 V, 60 Hz, 1550 RPM, built in overload with Z 5 8 15 --'� -- automatic reset. a 4 EPO • EP05 Single phase: 0.5 HP, o —� 115 V or 230V, 60 Hz, 1550 '- 3 10 RPM, built in overload with EPO4 automatic reset. 2 • Power cord: 10 foot s standard length, 16/3 SJTOW with three prong grounding plug. Optional 20 0 0 0 10 20 30 40 1 50 GPM foot length, 16/3 SJTW with three prong grounding plug o 2 4 6 a 10 12 rn (standard on EP05). CA PACITY Goulds Pumps ® 2001 Goulds Pumps ITT Industries Effective May, 2001 83871 I Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. O - L q 4- I s Please print all information. Review by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). L a 7 Pro perty Ow ner Property Location l d/- N k S Govt. Lot ti c 1/4 1/4 S 7 T 3 U N R E (or) W Property Owner' Mailing Address Lot # Block # I Subd. Name or CSW Iq akt0- - 3 I 15 K / ;,6 a 1 C /I State Zip Code Phone Number E] city El Village ® Town Nearest Road En -- . C4-� / N 1 1 5- 5-11 5 - ( ) 3v €/L5Ct I ( � 0 - ~ 5't" ( New Construction Use: KResidential / Number of bedrooms Code derived design flow rate -7 SU GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material Flood Plain elevation if applicable ft. General comments and recommendations: F 71 Boring # r] Boring Q U J Pit Ground surface elev. `8• ft. Depth to limiting factor T 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 3 Boring # El Boring F1 Pit Ground surface elev. ?- O ft. Depth to limiting factor L U in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots. GPD /fF in. Munsell Qu. Sz. Cont. Color / 7 Gr.. / Sz. Sh. *Eff#1 I 'Ef - 5 /� Z oZ 2 y 3 - 7 S'1 "!� l 5 x - S1 8 S 1 ., -, ,. j r �� 3 - S * Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg /L and TSS < 30 mg/L Came (Please Print) Signature CST Number C 04 L C rt w � Z2 - Z97 2— Addre I Date Evaluation Conducted Telephone Number 2 - 65 - o St �.uc 5 Y S 3 // / - v Y Y L I Property Owner Parcel ID # Page Z of .� Boring # ❑ Boring ® pit Ground surface elev. 91 .6 ft. Depth to limiting factor z J in. — §o — ilApplicabon Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff in Munsell Qu. Sz. Cont. Color 7 Gr. Sz. Sh. *Eff#1 *Eff#2 � V �Q � /G 3 �'d•_ --'— S / L�cSIJ l C �•,7 �.0 (� w Z i++., J - P Z- G ZS �0 76 ti� Y / -� S'�� 5 � 8 S I v�- - !v F -1 Boring # El E] ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Applii bon Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F Boring 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 /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I *Eff#2 * Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 - 264 -8777. SBD -8330 (R07 /00) Property Owner Parcel ID # Page Z of 3 ❑ Boring # Boring ,. ® pit Ground surface elev. 7 ft. Depth to limiting factor Z J in. Soil Applicatim Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 8 /oil /- - 5 /a - — S.' / Z �bic i ,.,., - �c c Z.,,., . – Z3 '� �. h � ti'e- F-1 Boring # F1 Boring El 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 I *Eff#2 F - 1 f-1 Cl Pit Boring Boring # Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/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 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. SBD -8330 (8.07(00) L._. i V 3 U n v w o� e h w V3 r w � � w a s o Z a --c � d i r I Safety and Buildings Division County lVi 201 W. Washington Ave., P.O. Box 7162 _, t sconsin Madison, wI 5370 162 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608)266 -3 C� 2T Sanitary Permit Application a Plan I. D. ? Number ,/ In accord with Comm 83.21, Wis. Adm. Code, personal information you provid 13 b C 1 may be used for secondary purposes Privacy Law c D roject Ad (if diffe��than } mailin dress) L z a `t I. Application Information - Please Print All Informat on �� 1 Property Owner's Nam �� , J - f ---- Parcel # Lot # 3 Block # .. u £ .S OUNTY a - Z/ - - o Property Owner's Mailing AXIess roperty Location '/4, '/4, Section �_ / City, State ) Zip Code Phone Number 1 / { Q,f j t 0/,- e c l f I /� IV • ss) / 5 3 � (circle one) II. Type of Buildin g (check all that a T N; R E or W ly) S 6k �, 3.. ,' Subdivision Name CSM Number I W1 or 2 Family Dwelling - Number of Bedroo 4a J a 6 w �! A 11 Pubiic/Commercial - Describe Use A -o r - o �, (S N om t!e i e f ` (,/- .O; >t / `� Q"t ^i •` �+ i ❑ State Owned -Describe Use b x93•y5 ❑City,❑Village (BT'ownship of III. Type of Permit: (Check only one box on line Complete liyiB if applicable) A. New System ❑ Replacement System tmegIolding Tank Replacement Only ❑ Other Modification to Existing System B. El Permit Renewal 11 Permit Revision ❑ C of ❑Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration PI r Owner IV. T of POWTS System: Check all that a 1 D ov . oC� ❑ Non - Pressurized In- Ground )�Mound > 24 in, of itable soil ❑ Mo < 24 in. of suitable soil ❑ At -Grade El Single Pass Sand Filter ❑ Constructed Wetland El Pressurized ln- Ground olding Tank ❑ Peat Fi ❑ Aerobic Treatment Unit 11 Recircul ting Sand Filter ❑ �� Recirculating Synthetic Media Filter ❑ Leachin hamber ❑ Drip Line ❑ Gra -less Pipe ❑ Other (explain) �Ja V. Dis ersaVfreatment Area Informatio I Design Flow (gpd) Design Soil Applicatio gpdsf) Dispersal Area RequjrcO Dispersal Area Propos System Elevation VI. Tank Info Capacity in Total Number Manufacturer 1 Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Exis ' 7 a Tanks T c r Holding Tank f? 0 1? Il o I Gf. �6!/ ✓ Aerobic Treatment Unit ing Clam r d� 140 0 VII. Responsibility State nt- I• the undersiened, assume resnonsibility for instglaliag of the POWTS shown on the a ched plans. P tuber's Name (Print lumber's Signature P Number Business Phone Number 4 L 8 Z- Pl umber's Address (Street, City, State, Zip ode) VIII. Coun /De artm ent Use Onl ;kr Approved ❑ Isapp Sanitary Permit Fee (includes Groundwater Date sued Issuing nt Signatur (No ps) Surcharge Fee) g ,3 ! dfo ❑ k wne, Qi4en Reason ial IX. Conditions of Approval/Reasons for Disapproval nn SYSTEM OWN FR: 3J Go,�� d o.n5 �• (0�)c�11_ �C. 1. Septic ta- - f , ,ent filter and dispersal r .: t all be servit:es / maintained 4'!L' t /� �sQ L'G� W as per ma +q - plan provided by plumblef. / 2. All setback rt!gt.a n, must be maintained as per applicable coder 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) 0 3 o 0 2 6 0 3 o Z tl � r p h W � / �, 1 ,� L � � �► i / � � v � h � h C o 0 'Ai S rl Q -t- r Q cz O I Lj VJ i b f U �c T � 1` a o � iC Ily, € " t j L v 1 v � V h S r1 c kw 1 w 1� tj �.. �. . � VJ 9002 � u end a�n����� ..., ,. Safety and Buildings PO BOX 7162 commerceml.gov MADISON WI 53707 -7162 TDD #: (608) 264 -8777 i s c o n s i n www.coe.wi.gov/sb/ sb, Department of Commerce www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary August 15, 2006 CUST ID No. 222872 ATTN.• POWTS Inspector JACQUES M HAWKINS ZONING OFFICE HAWKINS SOIL TESTING & SEPTIC ST CROIX COUNTY SPIA 2659 150TH ST 1101 CARMICHAEL RD LUCK WI 54853 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 08/15/2008 Transaction ID No. 1309499 SITE: Site ID No. 716768 Tony Hayes - Dwelling Please refer to both identification numbers, 40TH St above, in all correspondence with the agency. Town of Somerset, St Croix County NE1 /4, SETA, S7, T30N, R19W Lot: 3, Subdivision: St Croix National FOR: Description: New Mound System / 750gpd Object Type: POWTS Component Manual Regulated Object ID No.: 1091436 Maintenance required; 750 GPD Flow rate; 22 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 101), Pressure Distribution Component Manual - Version 2.0, SBD - 10706 -P (N.01 101) The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed .O.1 and located in accordance with the enclosed approved plans and with the component manual(s) referenced above. con Ij The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code AP requirements. DEP No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, DIVISI E71 stats. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to S F CORRESF inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. I t ` JACQUES M HAWKINS Page 2 8/15/2006 Sincerel Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 C� r' eier Pagel Private Sewage Plan fewer , Integrated Services WiSMART code: 7633 (608)266-2889, M - F, 0630 - 1500 Hrs pete.pagel@wisconsin.gov cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 i MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Tony Hayes 5 Bedroom Mound Owner's Name: Tony Hayes Owner's Address: 1910 Mahtomedi Ave. Mahtomedi MN 55115 Legal Description: NE1 /4 -SE1 /4 Sec.7 T30N -R19W Township: Somerset County: St. Croix Subdivision Name: St. Croix National Lot Number: Lot 3 Block Number: NA Parcel I.D. Number: Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank "V Page 5 System maintenance specifications iOl'`S• Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Plot Plan CC 4ND f )oN �FIN Designer: Jacque Hawkins License Number: MPRS# 222872 Date: 08/01/06 Phone Number: (715) 472 -8446 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 3.11 (R. 06/01) Page 1 of 8 R EGE'VED AUG 0 4 2006 SMEY SLOGS,: DIV, 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 500.00 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. 750.00 Design Flow (gpd) 12.00 Site Slope ( %) 101.00 Contour Line Elevation (ft) 22.00 Depth to Limiting Factor (in) 0.60 In -situ Soil Application Rate (gpd /ft Distribution Cell Information 93.751 Dispersal Cell Length Along Contour (ft) I 8.00 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) c Center or End Manifold 4.00 Lateral Spacing (ft) If N above, enter the elevation ft) 4 Number of Laterals of the highest point. 0.156 Orifice Diameter (in) (e.g. 0.25) 2.00 Estimated Orifice Spacing (ft) = 8.15 ft /orifice 2.00 Forcemain Diameter (in) 75.00 Forcemain Length (ft) Does the forcemain drain back? Y 94.00 Pump Tank Elevation (ft) Enter Y or N 4.55 System Head (ft) x 1.3 12.23 Forcemain Drainback (gal) 7.67 Vertical Lift (ft) 84.64 5x Void Volume (gal) 3.68 Friction Loss (ft) 96.88 Minimum Dose Volume (gal) 15.89 Total Dynamic Head (ft) 49.54 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 1.00 1.50 x x 1.25 x 2.00 x 1.50 x x 3.00 2.00 x 3.00 x Gallons /Inch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1600.001 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Skaw Precast IManufacturer gal /in (enter result in cell 1349) Dose Tank Information Effluent Filter Information 1033.681 Dose Tank Capacity (gal) JZabel I Filter Manufacturer 28.321 Dose Tank Volume (gal /in) lmoo I Filter Model Number Skaw Precast IManufacturer Project: Tony Hayes 5 Bedroom Mound Page 2 of 8 Mound Plan View ...... ............................... 1/10 B . 3 J 1. . Observation Pipe ❑ ' rK A W . �. S - — L Mound Component Dimensions A 8.00 ft E 25.52 in H Aft ft K 10.32 ft B 93.75 ft F 9.50 in z ft L 114.38 ft D 14.00 in G 0.50 ft J ft W 29.45 750.00 (ft) Dispersal Cell Area 2252.20 (ft Basal Area Available 8.00 (gpd /ft) Linear Loading Rate 9.38 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 103.96 (ft) I F . ; . ; ' 102.67 (ft) Lateral Dispersal Cell 102.17 (ft) —111 — Invert Dispersal Cell t Elevation E D ' R: A. 5. 101.00 (ft) Contour Elevation 12.0 % Site Slope Geotextile Fabric Cover Shading Key 'a ° o'. Dispersal Cell See lateral details on 10 ® Topsoil Cap 1.5 ft Page 4 for number, size, Subsoil Cap 0.0 and spacing of laterals. ASTM C33 Sand 4 0 , F Laterals are equally Tilled Layer = 0.5 ft _ Typical Lateral spaced from the ❑5 distribution cell's Aggregate C ,W, centerline in the * ^ A * distribution cell (AxB). Project: Tony Hayes 5 Bedroom Mound Page 3 of 8 Center Connection Lateral Layout Daigram Force main connection via tee or cross to manifold at any point. Laterals are identical P S •= Turn -up rrrbalI valve or It- x�IExf2 I x12++ Laterals & Force main of PVC Sch 40 clean out pl u 9 per COMM Table 84.30.5 Hales drilled on the bottom of the lateral. Number of Laterals 4 Orifice Diameter 0.156 in Lateral Diameter 1.50 in Orifice Spacing (X) 2.05 ft Lateral Length (P) 46.13 ft Orifices per Lateral 23 Lateral Spacing (S) 4.00 ft Orifice Density 8.15 ft /orifice Lateral Flow Rate 12.39 gpm Manifold Length 4.00 ft System Flow Rate 49.54 gpm Manifold Diameter 1.50 in Total Dynamic Head 15.89 ft Forcemain Velocity 5.06 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and - ► Comm 16.28 WAC 4 in. min. Disconnect _ Tank component is properly vented 1E Alternate outlet location _ Forcemain diameter Skaw Precast Manufacturer 2 in. Cap acityl 1033.68 Gallons Volume 28.32 gal /inch A Weep hole or anti - Dimension Inches Gallons B siphon device A 19.08 540.32 B ^ 2.00 56.64 C P ump off elevation (ft) C 3.42 96.88 95,00 D 12.00 339.84 D D Total 1 36.501 103168 Dose se tank elevation (ft) 3" Bedding uncl tank. 94.00 Alarm Manuafacturer JSJ Electro Alarm Model Number I 101 -01 H Pump Manufacturer JGoulds Pump Model Number EPO543871 Pump Must Deliver 49.54 gpm at 15.89 ft TDH Project: Tony Hayes 5 Bedroom Mound Page 4 of 8 li i Mound System Maintenance and Operation Specifications Service Provider's Name Tri -Coun Sanitation Phone (715) 386 -0114 POWTS Regulator's Name St. Croix Cou Zo ning Phone (715) 386 -4680 System Flow and Load Parameters Design Flow - Peak 750 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 500 gpd Maximum BOD5 220 mg /L Septic Tank Capacity 1600 gal Maximum TSS 150 mg /L Soil Absorption Component Size 750 ft Maximum FOG 30 mg /L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu /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 System Laterals should be flushed and pressure tested every 1.5 years Moundl inspect for ponding and seepage once every 3 years Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn -up Detail Finished • ............. ............... Grade 6 -8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve ... Distribution Lateral may. Long Sweep 90 or Two .......... ....... 45 Degree Bends Same Diameter as Lateral Project: Tony Hayes 5 Bedroom Mound Page 5 of 8 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code i General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBDA0691 -P (N.01/01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. 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 113 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 Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October - February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg /L BOD 150 mg /L TSS, and 30 mg /L FOG for septic tank effluent or 30 mg /L BOD 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 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Tony Hayes 5 Bedroom Mound Page 6 of 8 Page 7 of 8 MGOULDS PUMPS Submersible Effluent Pump 3871 EPO4 EP05 b„ APPLICATIONS • Fully submerged in high ■ EP05 Impeller: Thermoplas- ■ Bearings: Upper and lower grade turbine oil for tic enclosed design for heavy duty ball bearing Specifically designed for the lubrication and efficient improved performance. construction. following uses: heat transfer. • Effluent systems ■Casing and Base: Rugged thermoplastic design provides AGENCY LISTING • Homes Available for automatic and superior strength and corrosion • Farms manual operation. Auto- Canadian Siandards A elation • Heavy duty sump matic models include resistance. _ • Water transfer Mechanical Float Switch ■ Motor Housing: Cast iron (CSA listed model numbers end • Dewatering assembled and preset at the for efficient heat transfer, in "C" or facto ry strength, and durability. SPECIFICATIONS ■ Motor Cover: Thermoplastic Gaids Prps is ISO Soot FEATURES cover with integral handle and • Solids handling capability: float switch attachment points. '/4" maximum. ■ EPO4 Impeller: Thermoplas- 0 power Cable: Severe duty • Capacities: up to 60 GPM, tic Semi -open design with rated oil and water resistant. • Total heads: up to 31 feet, pump out vanes for mechanical • Discharge size: 1 1 /2" NPT. seal protection. • Mechanical seal: carbon- rotary/ceramic-stationary, BUNA -N elastomers. • Temperature: 104°F (40cC) continuous 140°F (60 intermittent. METERS FEET • Fasteners: 300 series 10 stainless steel. 9 30 — s G • Capable of running dry without damage to 8 2.5 Fr components. 25 a 7 a Motor: _ • EPO4 Single phase: 0.4 HP, `—' 6 20 J 115 or 230 V, 60 Hz, 1550 5 RPM, built in overload with e 15 automatic reset. a 4 • EP05 Single phase: 0.5 HP, o EPOS 115 V or 230V, 60 Hz, 1550 3 10 RPM, built in overload with EPW automatic reset. 2 • Power card: 10 foot 5 standard length, 16/3 1 S1TOW with three prong grounding plug. Optional 20 0 0 0 10 20 30 40 so GPM foot length, 16/3 S1TW with three prong grounding plug (standard on EP05). 0 2 4 6 8 10 12 mlih CAPACITY Goulds P ® 2001 Goulds Pumps ITT Industries Effective May, 2001 B3871 f Wisconsin Department of Commerce SOIL EVALUAT�WCFORT Page , of 3 B'�ision of Safety and Buildings [�� in accordance with Comm 85, Agdm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. tAt �dd County S-i— II—V-3 LX Include, but not limited to vertical � . ve ' reference point ( cal and horizontal r �( dist dire ction and P G percent slope, scale or dimensions, north arrow, and location and dista � r � ' ( I.D. 32 21 y &0 125T) Please print all information. Re A wed wed by Date Personal information you provide maybe used for secondary Purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner • IT zm ZS • h. 60 l.� 1J1f iP �' " l r� 1_I Property `ocatip E G l�Ir�` n" 6evt -6e . N # S : 1 /a s i 4 7 T - N R) 9 E (or W Property Owner's Mailing Address i t # ', [lock # Subd. Name or CSM# 6p ! LLiL CLL'� c,j �Eij ��4 3 1 — ST"- c�1.x city State Zip Code P one'Number ; „�;.� ; , ,. ❑ City , ❑Village ®Town Nearest Road NN Ss3Y 3 ( - "�g� 3)`1 l_1Z SE 4O `TN- 57' [a New Construction Use: ® Residential / Number of bedro ms Code derived design flow rate b cy E] Replacement ❑ Public or commercial - Describe: GPD Parent rpiterial L U LAS' UV (Zl� t Ll, Flood Plain elevation if applicable General comments ft and recommendations: M U v1-.,Z> 1,1 q 'x b� D V% T1 l By F-t L L a Boring # ❑ Boring ® Pit Ground surface elev. q B. -7 ft. Depth to limiting factor in. — T Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 l0 `21 -317- — s� Z�sbFz ve cw Z q -'l I 1p� 316 M'f^1• 3 �l - )o�li 316 �l� - ) - s Slg si L�Sbh rYt � — -Z - 3 •� F] Boring # ❑ Boring ® Pit Ground surface elev. ft. Depth to limiting factor Z Ze n, ` Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 � 6 1p-ttZ. 31z — s t l 2- `�Sb wt'F1 - �g �-'�' _ S • 8 . _ 3 �z -zz �.s yrzr3�y L 5 'Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Sign ture CST Number Arthur L': *Wegerer a ��- � 220254 Address W e g e r e r Soil Testing & Design Service Date Evaluation Conducted Telephone Number 421 N. Main St. River Falls, WI 54022 715 -425 -0165 Property Owner S• P• GOLr M RJ R ca (C3uT Parcel ID # P a ge Page Z of 3 Boring # ❑Boring ® Pit Ground surface elev. ' D 3 ft. Depth to limiting factor Z -'4 in. Soil Application Rate Horfzon. Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD 1ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 0- tc,�t a 7 -lS 1`12 3Lb SO I Z`f's Mel^ C Lu 3 1 S -ZY 10 2 3A — s l eSbt -L vrf v-�l- 0,:, ❑ 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 /ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 F-1 Boring # ❑ Boring Cl Pit Ground surface elev. ft. Depth to limiting factor in. Sail Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg/L • Effluent #2 = BOD < 30 mg /L and TSS < 30 mg/L Tlie 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. SOD-8330 (a.NOO) PLOT PLAN Page 3 of 3 a Scale V= SO' r g Z A, b� tivoi"` u► IP��T /`s' 32' �� /V�TR1.�y LOT 11h►E oz vi3tta,s TN1s MZ" epiJ �ZU c7lbry / 69 / o tb i f / 5.3 E3M it- 0 O" r; J 0 n{ N IV 41 J v 44 0 ttv aCz aE AT �-s'r is , mou)D 715 425 - 0165 22 0 2 54 CST Signature Date Telephone Ito. CST No. Job NO. 08/30/06 WED 15;02 FAX 715 386 4666 111101 ST. CROIX COUNTY '-..PTIC TAINIC MA *K TEN ANCE AGREEMENT Sl AND OWNERSHIP CERTIFI( FORM Owner/Buyer L - t—i I I -EV, /j- Mailiti- Address �91,o A4 &I Property Address 3 to . o & Nuid em _ _ 14__ �i,,,_twent for nc- �7nsii�ctionY I (Verification required from ory 4Z"1 D City/State Parcel identification Nuniber - 0 VV 3 0 _ 0 0 LEGAL DESCRIPTION PTOPCfty.f,ocation Set- 7 T _ d N R 9 W, Town o CA k, 4,; a t,,o, Lot* 3 Subdivision Certified Survey Map 9. ne Volui , Page Warranty Deed 4 Volume Pa ;t S house yes 00 Lot Illics idrntifiablc yc5 an SYSTE-INI MAINTENANCF AIND ('FRTIFICAIION Jrripf0l-.eT USC and mainterikilme Of YUUL' SentIC %Vbtcm could rcbu;t i i p failure to handle wzstes- Proper maintenance consisls of Pumping Out the c'eptic tank evety till Years or sooner, if needed, by a licensed jAimper. What you put into (lit System can :affect the fimcfioi, o r a septic tattle as a. ri-catmient stage in the waste disposal systwo. Owner maintenance responsibilities artwecifiud ii,1§Conini.,Q3.52i!) and in Chapter 12 - tit. Crui.� (',ounLv Sanitary Ordinance. 'Tile propeiv owrici agrees to sutimitto St. C couray Planning & Zonin gr L)epaTtincrit a certification form, siened by die ownei: and b t] taster pluaihcr, journeyrnan plumber, restricted plumber or a licensed pumper verifying that (1) the un-site Was disposal system is in piropLi- operating conditjon andiur W after inspection and pumping (if necessary), the septic. tink is l ess titan 1,13 lull of sludge. T/wL, the undersigned hav,-, rr. id the above requirements and agree ro maintain the private sewage disposal systen, with the slanda-rds, Set forth, licreill, as set by the T)cpaTutient ofConktrexec and the Department of Nmiral Rextcces, Statc of Wisconsin, Cortificarinil Stating that your septicsystexii has bcen.trinintained must be completed and retuned to the St. Croix County Planllir.g & Zoning Department within 30 da (if the dirtc- Year expiration. date. Vvvc certify that all statements on this fotjn are Inte to the best of illyfouf ky'Owledge IIwcam/Ul! the 0 wIItj.(-%)ofthe property descrihcd abuve, by virtue, of a Warral decd recontedri Re'.IiStff of Deed Office. Number of bedrooms 130 /'010 AZZ DATE URE APPLI(jrA.NT(S) ***Any information that is inisrepresented tivay I'MU11 in the sanitary perrair being revoked by the Planning JL Zoning OePartrrictit. Include with application a ret warranty deed itoffl the Register of Deeds Office and LA c opy of the certified survey Mal) tf ref is made .in the �ktafraiity deed. (RIEV. 08/05) 08/30106 WED 15:03 FAL 715 386 4686 Q002` POWTS OWNER'S MANUAL & MANAGEMENT PLAN Pane of FILE INFORMATIOU SYSTEM SPECIFICATIONS Owner S Septic Tan CaPOCO A e U O gal © NA Permit # Septic Tank Manufacturer 57 j 4 t.-.- ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedro ❑ NA Effluent Filter Model p U Q NA Number of Public Facility Units )&NA Pump Tank Capacity /00 U al 0 NA Estimated flow (average) 7SO Pump Tank Manufacturer c+ �--� 11 NA gai /day Design flow (peak), (Estimated x 1.5) ga lJda Pump Manufacturer l d s NA NA Soil Application Rate �. O aI!day /ftx Pump Model CAW j� ?� ❑ standard Inflt:ent/Effluant Quality Monthly average" Pretreatment Unit Fats, Oil & Grease (FOG} X30 mgiL ❑ Sand /Gravel Filter 0 Peat Filter Biochemical Oxygen Demand IE00 x220 mgil- fdNA 0 Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) :150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average: Dispersal Cell(s) 11 NA Biochemical Oxygen Demand (60DJ ,30 rng /L ❑ In- Ground (gravity) [3 In- Ground (pressurized) Total Suspended Solids ITS$) s30 m91L, A�NA ❑ At-Grade 4?!Wound Fecal Goliform (geometric mean) <10 cfu / 100m l ❑ Drip - Line ❑ other: _ NA Maximum Effluent Particle Size Y,, in dia. °NA Other: 11 Other. �~ NA Other 0 NA "'Values typical for domestic wa and septic tank effluent. Other: ❑ 4A MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition o f tanks) At least o nce ev ery: Q yea�(s1(s) ( Maximum 3 years) ❑ N4 Pump out contents of tank(s) —* When combined sludge and scum equals one -third %) of tank volume 0 N4 At least once every: ❑ month(s) (Maximum 3 years) &0"NA Inspect dispersal cells} ❑ year(s) . At least once every: 3 O month(s) 0 NA Clean effluent filter - &Tear(s) ❑ month(s) 0 NA Inspect pump, pump controls & alarm At least once every: - 19 - years) -- 0 month(s) 0 NA F)ush latera and pressure test At least once every: 1 -8-year(s) Other: -- — - - -- [3 month(s) 0 NA At least once every: ❑ ysar(s) Other: — 0 NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal celis shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tink inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or lea ks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surfe ce. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any pone ing of effluent on the ground surface. The ponding of effluent on the ground surface may Indicate a failing condition and requires the immediate notification of the local regulatory authority, When the combined accumulation of sludge and scum in any tank equals one-third (Y or more of the tank volume, the ertire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, 1Nisconsin Administrative Code. All other services, including but not limitod to the servicing of effluent filters, mechanical or pressurized components, pretreatrr ent units, and any servicing at intervals of X12 months, shalt be perfofined by a certified POINTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW la / ?t) 1 A "'NLEEV H. WALSH EGIS=ER OF DEERS T. CROIX CO.. WI State Bar of Wisconsin Form 1 - 2003 r �C: EI V EIt FOR ftECC1RI> WARRANTY DEED 08t!0/2006 10:20AN Document Number Document Name WARRANTY DEEIt r . THIS DEED, made between JP Golf Management, LLC, a Minnesota Limited F EC FEE: 11.00 _Liability Company flea JP Golf Management, Inc., a Minnesota Corporation T OAKS FEE COPY FEE: ( "Grantor," whether one or more), CC FEE: and Anthony Hayes PAGES: 1 ( "Grantee," whether one or more). Grantor, for a valuable consideration, conveys to Grantee the following described real Recording Area estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ( "Property") (if more space is Name and Return Address needed, please attach addendum): River Valley Abstract & TiUe, Inc. Lot 3, Plat of Saint Croix National Estates North in the Town of Somerset, St. Croix 1200 Hosford Street, Suite 201 County, Wisconsin Hudson, WI 54016 File #: 2690504 This deed is given in satisfaction of land contract recorded November 18, 2005 as Doc. No. 812408 032- 21443 Parcel Identification Number (PIN) This is n ot homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: Easements, restrictions and rights-of-way of record, if any. Dated JP 1 a t, Inc. �� 11814,, (SEAL) * *Richer A. Hassel ' �'•% .• t10TARV •• (SEAL) RL,IG f AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF � t SCUn 5 ►-/) authenticated on ) ss!,, " "' $%ta,,`,'• 7 COUNTY ) * Personally came before me on - F , TITLE: MEMBER STATE BAR OF WISCONSIN the above -named e, t J P Golf Marlag , (If not, to me known to be the person who executed the foregoing authorized by Wis. Stat. § 706.06) instrument ac nowle ge sa TIES INSTRUMENT DRAFTED BY: * er t Attorney Doug Berg Notary Public, Stat of Wisconsin 1200 Hosford Street, Suite 201 Hudson, WI 54016 My Commission (is permanent) (expires: — 7- 1 (Signatures may be authenticated or acknowledged. Both are not neceaaary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED ® 2003 STATE BAR OF WISCONSIN FORM NO. 1-2003 * Type name below signatures. 1 of1 NATIONAL ESTATES NORTH OF SECTION 7, TOWNSHIP 30 NORTH, RANGE 19 WEST, TOWN OF SOMERSET, ST. CROIX COUNTY, WISCONSIN Found.Weet Quart•, Comer Sec. 7 Aluminum Monument ^ II LEGEND ce O 2" X 30" IRON PIPE (3.65 LBSAIN. FT.), SET Z Q• SECTION CORNER, FOUND Becringe Raterenced to I I GAd Nortfi, St County I CawdMata System I I - ROADWAY SETBACK LINE --- - - - - -- 12' UTILITY EASEMENT p ' C ALL OTHER LOT CORNERS - GRAPHIC SCA t "X24" IRON PIPE (1.68 LBS/LIN. FT.), SET � 2 I WISCONSIN DEPT, OF TRANSPORTATION APPROVAL ( of FEET ) DOCUMENT NUMBER 55 -35 -3164 -2000 1 Mch - 200 ft. I ro I I Q I PROPOSED CSM I\ I (Ld I ' NE 1 /4- OF f ; I I ' I„II q�z THE SE 1/4 + olo I i I I^ PROPOSED CSM N 0 "W N75 y9?y f UNPLATTED LANDS N0099'39 "E I 2 3.74 I I WI I ?) 1 �01. I 3 4 3 I.M. I go 4 3� 2 g� 1 ► I ni y 130,670 Sq. Ft. r ' I 130,696 Sq. Ft. 130,594 Sq. Ft. m 130,541 Sq. Ft. 9 3.00 Aerae 3.00 A— 3.00 Acme H 3.00 Acres . N24'14'24 "E C.&A. 3.00 Aaee I C.B.A. 100 Acres C.B.A. 3.00 Acres C.B-A. 2.99 A.,•e JB 64.07' I I 1 I X97 G� itt c. I l o I J W I I mM - - - - 244.79' - - - - - - - g--- 25 ts 8 - - - - -- ---- - - - - -- 446.14•--- - - - - -- r % 1 - - -- NOO'42'00 "W 381.46 --IJ, --- 2077.71• -- - - -- DEDICATED TO PUBLIC 33.01, �r � -- - - - - -- 2552.06 --- - - - - - -- -- - - — — — — — — — — — - _ — — — — — — -- rr lv 9 l i LOT 3 Y LOT 2 C._S.M. — - - - - -- SOO'42'00 "E 2613.21' - - - - -- Volume 6, Page 1620 C. - — — — — - Volume 6, Page 1620 .R MELCMRT WAI.KKY ize s__d street iandscape architecture Hudson, Wisconsin 54016 civil engineering Phone (715) 386 -7736 Instrument Drafted by J. Vo9e1 IHnd sill'yinlg Fax (,1 51 386 -7689 SHEET 2 OF 2 Dravm: 11/28/00 'Parcel #: 032 08/31 /2006 11:02 AM 2144 30 000 PAGE 1 OF 1 Alt. Parcel M 7.30.19.1258 032 - TOWN OF SOMERSET Current _X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner ANTHONY HAYES O - HAYES, ANTHONY 1910 MAHTOMEDI AVE MAHTOMEDI MN 55115 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description ' 1630 40TH ST SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 3.000 Plat: 2497 -ST CROIX NATIONAL ESTATES N SEC 7 T30N R19W NE SE LOT 3 SAINT CROIX Block/Condo Bldg: LOT 3 NATIONAL ESTATES NORTH Tract(s): (Sec- Twn -Rng 401/4 1601/4) 07- 30N -19W NE SE Notes: Parcel History: Date Doc # Vol /Page Type 08/10/2006 831364 WD 11/18/2005 812408 2930/556 LC 07/23/1997 1200/189 OC 07/2311997 1117/415 WD more... 2006 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/24/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.000 105,000 0 105,000 NO Totals for 2006: General Property 3.000 105,000 0 105,000 Woodland 0.000 0 0 Totals for 2005: General Property 3.000 105,000 0 105,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00