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Home My WebLink About032-2136-70-000 � Wisconsin Department.ofCommerce PRIVATE SEWAGE SYSTEM County: $f. CCOIX Safety and Qvilding Division INSPECTION REPORT Sanitary Permit No: 4r 430252 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Johnson, Wayne I Somerset Township 032 - 2136 -70 -000 CST BM Elev: Insp. BM Elev: , Description: Section/Town/Range /Map No: $. /Z 95'. a o•fr 13.30.19.1209 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic - OtYb // (c, 6b Benchmar 41,29 2, t 991.1b Q�. (Z Dosing Alt. BM i Aeration Bldg. Sewer �. / Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht outlet B• TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet � Septic � �Ct �S r Dt Bottom Dosing ' IA Header /Man. L .\ Aeration Dist. Pipe 4 Z Holding Bot. System o 400 IS• Final Grade \ PUMP /SIPHON INFORMATION � &cL 49 Manufacture De nd St ver GPM 5•� 9 , IO Model Number i TDH Lift Friction Lo System Head TDH Ft i Force in Length Dia. well i SOIL ORPTION SYSTEM ENCH Width ( Length No. Of T nches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMEN SETBACK SYSTEM TO /L BLDG W LL t LAKE /STREAM LEACHING INFORMATION CHAMBER OR Type Of System: t / _ UNIT Model Number: Z II 0 DISTRIBUTION &VkM W as� Head Ima fol gistribution x Hole Size �Hole pa cing Vent to Air Intake Le th °M Dia Lene Dia Spacin �f (� S r SO OVER 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 �-� Yes f No , j Yes % No C (Include cod disrKrepenci�s, person pre nt, etc Inspection #1:_. rt•.!!J 71J� Z Inspection #2: Location: 1956 84th t Somers6t, WI 54025 (SE 1/4 NW 1/4 119W) Stonewood Lot 7 Parcel No: 13.30.19.1209 1.) Alt BM Description = 1 2.) Bldg sewer length= 39 - amount of cover = 4 z ��f�t*^'�ti'� Plan revision Required? ' 'Yes ', No Use other side for additional information. L-101 SBD -6710 (R.3/97) WDate , Insepctors Signature Cert. No. Safety and Buildings Division County AA ` m m 201 W. Washington Ave., P.O. Box 7082 isevnsin Madison, WI 53707 - 7082 Sant Permit Number (to be filled in by Co.) Department of Commerce (608) 261.6546 0 Z Sanitary Permit ApplicatiAE State Plan I.D. Number In accord with Comm 83.2 1. Wis. Adm. Code, personal ini mmation you provide may be used for secondary purposes Privacy Law, s I5.04(1)(m), Project Address (if different then mailing address) A ; i, o fi 3 2003 I. Application Information - Please Print All Information Property Owner's Name Parcel # Lot # Block # I&I ,t, c o�A,sQ 032 - Z - 70 - bad Property Owner's Mail' g Address Property Location Ci State 5-6 % ,) ' %, Section /•3 b+ Zip Code Phone Number crrck one ) 1°V S�U T 0 N, R ` EorW H. Type of Building (check all that apply) C 2 Family Dwelling - Number of Bedrooms J Subdivision Name CSM Number ❑ Public/Commercial- Describe Use s� /^-Cl.4� G C) d ❑ State Owned - Describe Use ❑City ❑Village MTownship of IIL of Permit: (Check only one box on line A. Complete line B if applicable) - - - - n e Z-5 A New System ❑ Replacement System ❑ TreatmattiHolding Tank Replacement Only ❑ Other Modification to Existing System B• ❑ Permit R Permit Revision Change of ❑Permit Transfer to New List Previous Permit Number r Before Expirati lura Owner �3 // U IV. Type Of POWTS S stem: Check all that ap 1 ef° S _ K /, 9 SZ ,VNon - Pressurized In -Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized in -Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Send Filter ❑ Recimulafing Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. DispersalfIrreatment Area Information: Design Flow (bpd) Design Soil Application Rate(gpdsf) ispersal Area Required (s� Dispersal Area Proposed (s System Elevation 7J2) 0 7 07/ Y3 //� 9. 40 83. SZ VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks or Holding Teak (i /( Aerobic Treatment Uuk /� � Dosing Chamber VII. Responsibility Statement- 1, the andersigned, assume responsibility for installs he POWTS shown on the attached plans. lumber's Name at) lumber's Signature MP PRS her Business Phone Number a� k . Xt.s Z 2 Z Z y �z - z'/ Z um 's Address (Street, City, State, Zip e) L,c Z14 C , 3 VIII. Court artment Use Onl proved ❑ Disapproved Sanitary Permit fe (includes Groundwater Date Issued Issuing ignatum (No Sure Fee ❑ Owner Given Reason for Denial barge ) 5O I� 2Z IX. Conditions of Approval/Reasons for Disapproval I ` C4,&4Af Attack camrplete plans (to the County ealy) for the system on paper mot less this 9112 x t I inches In stae SBD -6398 (R. 08/02) vu1N �3a z &Y -xi ' �L STG�C ��, t �' L TP a �S'�F�/ P �< ��fG• 93, /L � l v�ed cS b ' 106 9..)l / G'cti A c.c ' k 1 /Z q 6 c/ O4 /da v �S• a ------------ d a� 3 U Sys' s� Z L Z 67Z 130 Z 0 �L 4 w 4L w L f GI 5 - (3 0 M -, v It '�/ Z a b L / t1 / V & O ❑ G aF 3 U zz � 87Z f � _ t } POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of Z FILE INFORMATION SYSTEM SPECIFICATIONS Owner a if N r Septic Tank Capacity a l ❑ NA Permit # 2 Septic Tank Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ,(�� ` ❑ NA Number of Bedrooms 5 ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units ❑ NA Pump Tank Capacity a l ❑ NA Estimated flow (average) S a U g al/day Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.5) 7$-G) g al/day Pump Manufacturer ❑ NA Soil Application Rate 7 al/day /ftz Pump Model ❑ NA Standard Influent/Effluent Quality Monthly average* Pretreatment Unit ❑ NA Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (SOD :5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD,) :_30 mg /L ❑ In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) :510 cfu /100ml ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y. in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA * Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: M ea�(s;(S) (Maximum 3 years) ❑ NA Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA Inspect dispersal cell(s) At least once every: 0 Yeast )(s) (Maximum 3 years) Cl NA Clean effluent filter At least once every: ❑ year() [3 NA . f �ear(s) Inspect pump, pump controls & alarm At least once every: [3 year( month earl )(s) ❑ NA ' ❑ month(s) ❑ NA Flush laterals and pressure test At least once every: ❑ year(s) ❑ month(s) Other: At least once every: ❑ year(s) ❑ NA Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells 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. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding 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 entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. Page .of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high conoentrataons aii detectt4 have. the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) drid may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or.must be taken, to provide a code compliant replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. �A ❑ T he site has no o• *� ' : Q t.t . -�- a.,ra of r OVJT§ a gnu[ and s ite e ,, ., �• _ _s _ + �__ t.� nt�r•nmpnt araa If nn ro� +1 t hta a hnldtnfl t ank I ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name CIC 1 3 (.(E dw ids Name e7w/�'�S �.0 Phone J am— VIZ - Z YZ Phone 1 s - Y7z SEPTAGE SERVICING OPERATOR (PUMPER) 1 LOCAL REGULATORY AUTHORITY Name ' — C —oa... vd ��i /. J�✓ Name 5 I� O�.v� �•v Phone _ j G - 0/ / Phone �/ L �BC� �G This document was drafted in compliance with chapter Comm 83.22(2)(b)0)(d) &(f) and 83.5411). (2) & (3), Wisconsin Administrative Code. I a pp l 79 w� U o li w H ''C� Fes-+ \�\ \� \� , .. • . � 4 1 \ �\ 1 \ �'• � ^ q : .i \ x a� II f r, , h � ... w • I � vi H � � Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: • 430118 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you prol4e mat be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Johnson, Wayne I Somerset Township 032 - 2136 -70 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range/Map No: 13.30.19. ) TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing 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 J Yes No ]Yes Ed No I COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 1556 84th St Somerset, WI 54025 (SE 1/4 NW 1/4 13 T31 R1 9W) Stonewood Lot 7 Parcel No: 13.30.19. 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? Yes [] No Use other side for additional Information. SBD -6710 (R.3/97) Date Insepctorrs Signature Cert. No. Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7082 N*Isconstn Madison, WI 53707 — 7082 Sanitary Permit Number (to be filled in by Co.) �30 � � O' Department of Commerce (608) 261 - 6546 ( 0 State Plan I.D. Number Sanitary Permit Application In accord with Comm 83.2 1, Wis. Adm. Code, personal information you provide � may be used for secondary purposes Pri s 15.04(1)(m) Project Address (if different than mailing address) w _ I. Application Information — Please Print All Informal ion - — 1 Property Owner's O' Name Par Lot # 7 Block # � . .� 'N 2 3 2003 _ Property 0;w ier's Mailing Address S Location JIX Property ,W Section J_ City, State Zip Code Phone Number >� (ci o rcle o�g) II. Type of Building (check all that apply) s ,,,, t T N; R or 2 Family Dwelling - Number of Bedrooms Subdivision Name CSM N■t ❑ Publ' ial - Describe Use 01 State Own Describe Use Z 3 9 (p S ❑City ❑Vil ge 16Iownship of f III. Type of Pe (Check only one box on line A. Comp lin B If ap able) - A ' New Sys ❑ Replacement System ❑ Treatment/Holdin T Ys eP ys g eplacement Only er Modification to Existing System B . 0 Permit Renewal ❑ vision ❑Change of it Transfer revious Permit Numb" and Da u /so it Re erm to Before Expiration Plumb" " IV T of POWTS System: Chec that a 1 Non - Pressurized In -Ground 11 Mound > in. of suitable soil ❑ ound < 24 ' . of suitable soil ❑ At -Grade ❑ Si P S Filter ❑ Constructed Wetland 11 Pressurized In Ground Holding Tank Peat Filter eaten it ul g end filter Recirculating Synthetic Media Filter ❑ beaching " ❑ fine ❑Gravel -less Pipe (e in V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) D' rsal Area Required (so Dispersal System Ele 3 -2 . Tank Info Capacity in Total Nu Manufacturer Prefab Site Steel stic Gallons Gallons of its Concrete nstructed Glass New Existing Tanks Tanks Septic or Holding Tank Aerobic Treatment Unit Dosing Chamber VII. Respo sibility Statement- 1, the unde ed, a ume responsibility for installs f the POWYS own on the at Plumber's 7rint) P lum Si to . MP/MPRS b" Busi Ph 2 Plumber's Address (Street, City, rate, Zip WS AV �j VIII. Court /De artment Use O Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Wd I in gent Si o Stamps) Surcharge Fee) / ❑ Owner Given t for Denial IX. Conditions of Approva sons for Disapproval \ o c irl cv$ t oR Q..Q�t414..tom ` c to o the Comily e■ for the system an paper met less than 8112 : t ac es ra • SBD -6398 (R. 08/02) �r 1 E I r : I V/ I I ! I I ' ! � r t 1 , I I i i i i i ; i Q4 el -- , r i I i , i -- I j I I -- r K i � s � 1? , rte � � t� �� .." 4 �' a ��; �!' . w � a � .:,, -.,fi.. f ,�1.^ (e liti�� N� 'J.9 Law c ,/,? jeV ��aP�eSi 16// nn /lA�ca� 0 A, � �D• L7ml.'.J�s 30� .3�s�ia/ar -cd a a ri524r2761 1AUKTHILAHL! LJ; HLIVt om PACE a4 un PLATMD LAfJD LOT '1 1 WES tiI GR�Ain �ASE�rr�- s�+�a pFtpri n A(� �' r►I�nr � ta "1 � s5c� - 84roa d� w r � 5�t o►'1 �totiSE r� `G LD-r % Lor (o , Wisconsi, Department of Commerce SOIL AND SITE EVALUATION Division of,Safety and Buildings Page _� of J� 96reau of Integrated Services in accordance with Comm 83.09, Wis. Adm. Code Attach complete site plan on pgper 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 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I. D. # APPLICANT INFORMATION - Please print Re 'ewed by (�/ Personal information you provide may be used for seconds u Property Owner p PrCQerty Location 1I /Fo Oov� Lot - 1/4 1 /4,S T ,N,R �(or) W Property Owner's Mailing Address Le" Block# Subd. Name or CSM# C - � ,, Z City Stat Zip Code cP Ohone Nu Wq IX iity � ❑ Village ® Town Nearest Road k 14 New Construction Use: Residential / Naha Wo8WI' Addition to existing building El Replacement ❑ Public or commercial - Describe: Code derived daily flow K60 gpd Recommended design loading rate y 7 bed, gpd/ft trench, gpd /ft Absorption area required 05 bed, ft 7 rench, ft Maximum design loading rate 7 bed, gpd/ft gpd/ft Recommended infiltration surface elevation(s) 177' ft (as referred to site plan benchmark) Additional design /site considerations Parent material ZZ Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system S❑ U JK S ❑ U [As ❑ U ® S ❑ U ❑ S U ❑ S D. U SOIL DESCRIPTION REPORT Boring Horizon Depth Dominant Color Mottles Structure GPD /ft g Munsell Texture Gr. Sz. Sh. Consistence Boundary Roots in. Qu. Sz. Cont. Color Bed ,Trench Ground — — elev. Depth to limiting , S Z factor Remarks: Boring # S u - S Ground elev. Depth to limiting factor Remar s: CST Name (Please rint) Signature Telephone No. Address } Date CST Number SOIL DESCRIPTION REPORT ' PROPERTY OWNER !} 7 Page of PARCEL I.D.# •/� Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ,Trench Ground elev. Depth to limiting factor ; Remarks: Boring # Ground elev. Depth to limiting factor > /m in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD 1 ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # - 1 , s Ground , elev. Depth to limiting ; factor Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R.9/98) PROPERTYOW14ER �x�R�cc�i� (�e,I SOIL DESCRIPTION REPORT - ,/�� 7 Page of PARCEL I.D.aw , Boring # Horizon Depth Dominant Color Mofles ure Texture Structure 2 in. Munsell Qu. Sz. Cont. Color Gr. uct Sh Consistence Boundary Roots �.� . Bed ,Trench I Ground ' elev. Depth to limiting factor Remarks: Boring # Ground elev. Depth to ; limiting factor Remarks: Horizon Depth Dominant Color Mottles Structure in • Munsell Qu. Sz. Cont. Color Texture Consistence Boundary Roots GPD Gr. Sz. Sh. Bed , Trench Boring # A h Ground elev. I Depth to limiting factor . >) _ LT— ' n • Remarks: Boring # I 13 Ground elev. Depth to limiting factor � Remarks: SBD -8330 (R.9/98) 3d �y /tcY�cr,�if — - - 3_ ___ __ __ __ _ _ ___ __ _ i' - __ f �. '. 'r '.. I _ _ - _ '.. __.._ ___ '�,, __, __ __ I '. '. �. i ', ',, ___. j _ __ _,_ _. � i ._ - _ ___. �__ _ _. r_ +__ �i POWTS OWNER'S MANUAL & MANAGEMENT PLAN PageZ.f -2 FILE INFO ATION SYSTEM SPECIFICATION Owner Se ptic Tank Capa city al ❑ NA Permit # 130 Septic Tank Manufacturer o NA Effluent Filter Manufacturer o NA DESIGN PARAMETERS Effluent Filter Model o NA Number of bedrooms o NA Pump Tank Capacity al % NA Number of Commercial Unit 0 NA Pump Tank Manufacturer ta-NA Estimated flow (average) gal/day Pump Manufacturer efiNA Design flow (peak), Estimated x 1.5 gal/day Pump Model ANA Soil Application Rate gal/day/ft' Pretreated Unit Influent /Effluent Quality Monthly Average* o Sand /Gravel Filter ❑ Peat Filter Fats, Oils & Grease (FOG) <30 mg /L rr Meclwnical Aeration ❑ Wetland Biochemical Oxygen Demand (BODs) <220 mg /L o Disinfection ❑Other: Manufacturer Total TSS tal Suspended Solt L o ( ) <150 m P - — l C Dispersal s ) p ( 7 Monthly Average 't O NA In- ground retreated Effluent Qualit � In- ground (gravity) ❑ In ground (pressurized) Biochemical Oxygen Demand (BODs) <30 m L ❑ At -grade ❑Mound Total Suspended Solids (TSS) <304mg/L ❑ Drip-line ❑Other: Fecal Coliform (geometric mean <10 cfu /100rnL \Iaximum Effluent Particle Size '/K inch diameter V alues typical for domestic (non - commercial) wastewater and septic tank effluent, ** Values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Event Service Fre uenc ` nspect condition of tank(s) At least once every `❑ mo nths olyear (s) (Maximum 3 yrs) )urnp out contents of tanks When combined slut) ge and scum equals one third ('/3) of tank volume ins ect dispersal cell At least once every _❑ m onths�7 cKyear(s) (Maximum 3 yrs) 'lean effluent filter At least once ever ❑ months - �> cLyear(s) i nspect purnp, pump controls & alarm At least o nce every - i_t months o year(s) o NA ('lush laterals and pressure test At least once eve ca months o year(s) ANA Other; I At least once every ❑ months ❑ ear(s) ®NA Other: I At least once every ❑ months ❑ ears 2-NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells 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. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding 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 (' /s) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with ch. NR 113, Wisconsin Administrative Code. The servicing of effluent filters, mechanical or pressurized POWTS components, pretreatment components, and any other maintenance or monitoring at intervals of 12 months or less shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event, START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other _hemicals that my impede the treatment process and /or damage the dispersal cell(s), If high concentrations are detected have the contents of the tanks(s) removed by a septage servicing operator prior to use. Owner: A ,��s,�t/ Page_�2of,_ System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal high water levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact. The area within 15 feet down slope of any mound or at -grade soft absorption are. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers, disinfectants; ('at; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONEMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with ch. Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect'the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at the time. <<W ARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLIM POWTS MAI NTAIN ER Name Name _ Phone _ - Ph SEPTAGE SERVICING OPERATOR PUMPER) LOCAL, R14:GULATORY AUTHORITY Name Name r Phone Phone -_ 06/10/20e3 11:03 7152472761 NORTHLAHD LOG HOMES PAGE 06 �k 6� �i33 1 2 3 72ta8 i A STATE OM � SRY DEED z 2000 - Z KATHLEEN H. WALSH Iumant T3omber REGISTER OF DEEDS ST. CR01X CO., MI Dee trade {yetwcett T — r • - RECEIVED FOR RECORD T d, P»lt<4d it i ta Liabl l]Jlot otnsz (3 and Johnh_bband anr1Hl1lt �'�, 05/09/2003 t719 t 30AN Grantor, for a vsluable comideration, convoys and ovarrants to teC WARRANTY DEED the following described real estate in �r� County, Sbsu of W isconsiu Of EXOPT 1 nacre space is needed, please attach addctxto0- REC FELT: 11. 00 of 7 St Town of Somerset, St. Croix County, Wisconsin COPYSFEE: t 159.00 CC FEE: PAGES: i CC ., 0 RocoMmi; ara name and Rttma Address Heywood, Carl & Aadersee. S.C. 1200 Hosford St., Suite 106 P.O. BOX US Hndsoa, Wl 54016 032 - 2136 - 70 Pueel Identification Number (PIN) This is not homestead pioperty (is not) Exceptions to iwTanties: easements, covenants and restrictions of record. Dated this 20' day of Asrli _ X003 • .— • Barbsrs Gering for Hermle Eaftirpem AUTHENTICATION AC"OWLEDGMEI� - -- T Signature(s) Ba rbara Gowlog STATE OF WISCONSIN ) ST. CROIX County ) authrnticatetP this 2� 1 April 2003 Personally oonw before me this 29 _ day of =003 the above named ' �/ �g / • _ Barbara Gering -- TI71.E' MbMBER STATE BAR OF WISCONSIN (li ° not, to an Down to be die perion(s) who executed the foregoing authorized by 786.Ob, Wis. Stats.) — instrument and acknowledged the same. INTS NE STR.UMENT WAS DRAMD BY H" ood, Cart & AAttmOa, S•C -, 1200 Hosford St., Suite 106 " P.O. Box 125,1Iudson, W1 54016 Notary Public, State of Wi scons i n (Si a�zti�res My Corrnnission is penria nt. Of not. state expire ion da ta: d" maybe autbenbcated or aclmawledaecl. Both see not r100l88sry.) • Names of tw'+aons signing in any capacity Must be typod or Ixinud below their aignarrro. � ) ?rATRam Oft WISCONSIN fNF4Vtt0 (s00>63SaoYt www.sropnefaraseetgm WAatR �N ry rlagp FORM Ns. 2 - Ji ves I \j DRAINAGE 'ASEMENT OD NO'�3_ i' 37.19' I � I I I I I I C I N� 5 �D Fq I 238, 385 So FT. z i 5.47 ACRES i� - MINIMUM F.F.E. = 915.7' : A U7 v.0 � � tfx 00 Go / - cb � r ly ` 80.58' 94.03 632.77' I w Ann 131.52' \� / r � UNPLATTED LANDS 6 ti R IMAGE EASEA1FNr pccT , RI nrDNg 80 RADIUS TE Iv I 1 c�j r� NO GRADING OR CONSTRUCTION PERMITTED WITHIN y n THE DRAINAGE EASEMENTS SHOWN HEREON. COL -DE —SAC TO BE REMOVE O BEARINGS ARE REFERENCED TO THE NORTH LINE OF EXTENSION OF O c j NORTHWEST QUARTER OF SEC11ON 13, T.30N., R,1 TME C WHICH IS ASSUMED TO BEAR N89'55'58 "E. 9W. NOTE: THE PARCELS SHOWN ON THIS MAP ARE SUBJECT TO STATE LAWS, RULES AND REGULATIONS (I.E. WETLANDS, MINIMUM LOT SIZE, ACCESS TO PARCE I N O Z ETC.). BEFORE PURCHASING OR DEVELOPING ANY PARCEL, CONTACT THE STY CROIX co( - �j ZONING OFFICE AND THE APPROPRIATE TOWN BOARD FOR ADVICE. ALL LINEAR MEASUREMENTS HAVE BEEN MA COl HUNDREDTH OF A FOOT. ALL ANGULAR MEASUR MENTES NEAREST ONE (1) THE NEAREST FIVE (5) SECONDS AND COMPUTED TO THE VALUES SHOWN. E MADE TO I N ST. CROIX COUNTY GLOBAL POSITIONING SYSTEM NETWORK MONUMENTS. YERTI A nen1M. ST. CROIX COUNTY GLOBAL POSITIONING SYSTEM NETWORK MONUMENTS.