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HomeMy WebLinkAbout032-1020-40-570 (2) irtmentofCommerce PRIVATE SEWAGE SYSTEM County: St. Croix ling Division INSPECTION REPORT Sanitary Permit No: FF _ � 1 0 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: Hankes, Jason I Somerset, Town of 032- 1020 -40 -570 CST BM Elev: /i Insp. BM Elev: BM Descripti Section/Town /Range /Map No: / ' 6 / d d + Q 7wnl, e S 08.31.19.99A75 TANK INFORMATION ELEV ION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmar Dosing n y� ` (O Alt. BM 5 f Aeration Bldg. Sewer > 2" 3.3 V, 35 Holding Ht Inlet TANK SETBACK INFORMATION S t , Ht out TANK TO P/L WE BLDG. Vent to Air Intake ROAD Dt Inlet Septic / Dt Bottom 2-0 Dosing Header /Man. Aeration N Dist. Pipe 10 Holding Bot. System tt G _ 3' t Final Grade �-�y�, �" h,' 0 DI PUMP /SIPHON INFORMATION t/t' - /����$% - 5jop -a n 9 a Manufacturer Demand St Cover / q GPM rj S f \� 1 3 / Model Number ZZ TDH Lift Friction Loss stem Head TDH Ft Forcemain Length Dia. Dist. ell SOIL ABSORPTI YSTEM BED/TRENCH Width Length No. OfT ches i PIT DIMEN ]NSS N o. jPits Inside Dia. Liquid Depth DIMENSIONS IlJ1 C �� /'IW SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREA Manufa INFORMATION , H Model Number: Vv DISTRIBUTION SYSTEM 5 b Header /Manifpl Distribution / t x Hole Size x Hole Spacing Vent to A Intake N 2 Pipes) / / n �T Length a Lengt Dia Spacing SOIL C VE 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 ik No es No J COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 1 / Inspection #2: / / Location: 2260 40th Street SOMERSET, WI 540255 (SE �.1� � /4 NE 1/4 8 T31 N R19W) NA Lot 4 f �_ Q Parcel No: 08.31.19.99A75 ,q 1.) Alt BM Description �''�"`- u v`� v — -i� SdU/ 2.) Bldg sewer length = / U M4!, �(!yO - yt, 5al2A Gxal - amount of cover = I � b ,� � /D Plan revision Required? Yes m, No 9 F �o 10 lPd Use other side for additional information. _ Date Insepctor's Sign ure Cert. No. SBD -6710 (R.3/97) L -A-JLD colTmterce.WI.gov Safety and Buildings Division County' e�/ 201 W. Washington Ave., P.O. Box 7162 7/ . C/ l� l uco n s i n Madison, WI 53707 -7162 Sanitary Permit Number (t be filled in by Co.) Dehartmertt of Commerc Z/g3 �g Sanitary Permit Application State Transaction Number In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental A_ unit is required re q u prior to obtainin g a sanitary Pe Application it permit. Note: A licati fors for state -owned POWTS are iz; 'diff P Address Brent than mailing g address ) submitted to the Department of Commerce. Personal information you provide may be used for secondary p urposes in accordance with the Privacy Law, s. 15.04 1 m , Stats. I. Application Inform ation — Please Print All In ation ' N J Property Owner's Name P ircel # J ,� sin, & ©�� - 1d0 2 O Property Owner's Mailing Address operty Location �C 5 S ST. CROIX COUNTY vt. Lot _ City, State Zip Code , / +, Section ircle on II. T pe of Building (check all apply) Cam' Lot N; R_ E W 2 Family Dwelling — NumberofBedrooms Subdivision Name El Public /Commercial — Describe Use�_.�_ / 4D r �G►��• �` ❑ City of �'i ❑ State Owned — Describe Use 7i CS M Number ❑ Village of a V/Q )' 2 L. own of� III. Type of Permit: (Check onif one box on line A. Complete line ft igapplicable) A. ' w System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) Y P Y g P Y g Y ( P ) B. El Permit Renewal Perit Revision Change of Plumber El Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner I IV. Type of POWTS S stem /Co onentlDevice: C heck all that a t n- 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/Trea ent Area Information: Design Flow (gpd) Design Soil Application Rate( sf) Dispersal Area Required f) Dispersal Area Propos s ystem Elevati n tf . - 7 VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units & o 4 y C1 _ New Tanks Existing Tanks o a L41 Qes� l a U Qa W 0 w Septic or Holding Tank Dosing Chamber Q� t VII. Responsibility Statement I , the undersigned, assu a onsibility for installation of the POWTS shown on the attached plans. PlV er' Name (Pr" t� Plumber' rc MP /MPRS Number Business Phone Number �.. � ✓= -a ny,. Plumber's Adddr�esss Str tty, State, Zip Code VIII. County/ e artment Use Onl Approved ❑ y Permit Fee Date Is ued Issuing A Signature ner n Reason for enial IX. Condit 011111wo"sons for Disapproval 1. Septic tank, effluent fAter tlittd rJ dispersal cell must all be servkes /maintained I as per management plan provided by pkimbef. L,d1 i 00 r-N p 2 All setback requn`emeMs must be maintained Attac o complete plans for the system and submit to the County only on paper not less than 8 ill x l I Inches in size SBD -6398 (R. 0t /07) Valid thru 01/09 Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715- 246 -4516 Date: 9 /17/10 Owner: Jason Hankes Location:SE1A NE1A S8 T31 N,R19W 2260 40th St. Somerset System type: In- ground absorbtion system (conventional) Manuals Used: In- ground absorbtion system (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross Section 4 -5. Maintanance and Contingency Plan 6. Filter Specifications et Signature License num #226900 PLOT PLAN PROJECT Jason Hankes ADDRESS 515 Polk /St.Croix Road Somerset Wi 54025 SE 1/4 NE 1 /4S 8 /T 31 N/R 19 W TOWN Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 9/17/10 77 GPD CONVENTIONAL XXX IN- GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 165 # of chambers fi BENCHMARK V.R.P. Bottom of Shed Siding ASSUME ELEVATION 100' Filter BEST Filter ❑ BOREHOLE O WELL H. R. P Same as Benchmark SYSTEM ELEVATION 93.8'3 bel ow qrade Well is to meet all 40th St. setbacks required by ' WDNR \ \4W/ Scale is F = 40' Property Line unless otherwise noted of Buildin No bedrooms, no livin quarters,no commercial, being sized for 1 flo •— /S %� drain and two people occuping the unit Plans Designed Using during the day. Conventional Powts Manual Version 2.0 40' 3 303 y Weeks St 10 f 2tO1515 B -1 25' 11 slope thus no contours B - 2 Y' ,,v 25 Vent sh s Quick4 Standard -W 1 -3' X 34' cell >6 " Leaching Cha - Ven B -3 of Cover with 20.0 ft2 50' 4' Long 12" 5.8ft ^2 /pair o 3419 Grade at Sy 25' (j Property Line PLOT PLAN PROJECT Jason Hankes ADDRESS 515 Polk /St.Croix Road Somerset Wi 54025 SE '114 NE 1 /4s 8 /T 31 N/R 19 W TOWN Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 9/17/10 77 GPD CONVENTIONAL )OCX IN•GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 165 # of chambers 8 IL BENCHMARK V.R.P. Bottom of Shed Siding ASSUME ELEVATION 100' Filter BEST Filter ❑ BOREHOLE O WELL * H. R. P. Same as Benchmark SYSTEM ELEVATION 93.8 3 below qrade Well is to meet all 40th St. setbacks required by WDNR Scale is 1" = 40' Property Line unless otherwise noted Acessory Building No bedrooms, no living quarters,no commercial, being sized for 1 floor drain and two people occuping the unit Plans Designed Using during the day. Conventional Powts Manual Version 2.0 40' 30' Weeks St 15' B -1 25' 1% slope thus no contours B -2 25' Vent >6„ Quick4 Standard -W 1 -3' X 34' cell Leaching Chamber Vent TAL B -3 of Cover with 20.0 ft2 of Area 5.8ft ^2 /pair of end caps 50' 4' Long 12" 34 Grade at System Elevation 25' Property Line ,Cross Section of Quick 4 Standard -W Leaching Chamber Typical cross section for 1 of 1 cells Intial Grade Elevation Quick 4 Standard -W To be >1' above grade Leaching Chamber 97 0 ' with 20.0 ft2 of Area per Chamber 5.8ft ^2 pair of Finish grade elevation end plates 97 n' Typical Installation Vent Grade 4' 4" A�30/34 From Septic Tank 4' Long 2" 34" Grade at System Elevation 1 -3' X 34' Cell Same on other end Observation tubeNent 5' A 8 chambers per cell System elevations: A__93.8 Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of the cells. 4. Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 5. The owner agrees to save this plan. 6. Do not plant trees nor park nor drive over system. 7. Watershed is to be diverted away from system. 8. Discharge into system is not exceed those required as per Comm. 83 Contingency Plan Option #1. if system fails, determine cause of failure, use alternate area and install new ( ,Oem in "tested replacement area. Option #2. stall system at a lower elevation, by removing chambers, removing biomat, andittall new system. Option#3. No adequate area is suitable for replacement area, and system elevation cannont be lowered. Install holding tank as last resort. 3. Replace any other failing components as needed. Plumber: Shaun Bird 715- 246 -4516 St. Croix County Zoning 715 - 386 -4680 Pumper Tom Mondor 71 5- 246 -5148 Shaun Bird #226900 • Z O N (D F v Q / LL c Q O M tz U co C � C�7 p w o 0 0 V U1 z Lu H O o Z � LL. � LU = mn m LL J O LL LLI EL N ti O N Z O SLL W LL J iz •o tz r � N O O c _- N ti O] H 0 O a �--- � pz— N ❑ � V � ti r V 0 R d� a� 4. � W • ma • � O of PAI REGEI EV D Wisconsin Department of Commerce SOIL EVALUATION REPC R SEP 1 0 2010 Pag of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code C FFICE 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. S 0 Please print all information. Re vie by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 1 7 ! Property Owner Property Location SLA ( _X Govt. Lot S� 1/4 L'114 T N R �E (o W Property Owner's Mailing Address Lot # Block # Subd. or CSM# S/5 /- 0 //� /:�� �, zJ City State Zip Code Phone Number ❑ City ❑ Village own Nearest Road SCI aas ( ) 5 Construction use Residential / Number of bedrooms Code derived design flow rate GPD ❑ Replaoement C3 Public or 90mercial - Describe: Parent material G�� Flood Plain elevation If plica ft. General cornments i[ / cQ rIDU / /cGJ✓v and reoorrrrriendations: System Type �L�(� System Elevation 5 Boring # [] Boring 0 pit Ground surface elev. t z! ft. Depth to limiting factor Z) 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 FIV i ® Boring # t Boring Ground surface elev. �! Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDN in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 rl / • Effluent #1 = BOD > 30 < 220 mg1L and TSS >30 < 150 T Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Nano (Please Print) CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 715- 246 -4516 I Property Owner _ Parcel ID # Page of Boring # 2 ❑ Boring /�,' �it Ground surface elev. _1-- - 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 1 �Izv 0, 1 1 ❑ 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 GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 Boring F Pit Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Soil icafion Rate Horizon ')epth 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 mgll. • Effluent #2 = BOD < 30 mg/L and TSS 130 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. 580.8330 (8.6/00) Property Owner _ Parcel ID # Page of Boring # ❑ Boring Ea Ground surface elev. �- ft. Depth to limiting factor in. Soil Applicatio Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDKf in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 Ozv r tu Boring F-1 Boring # E] � ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDKf in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 Boring # ❑ Boring 11 Pit Ground surface elev. ft. Depth to limiting factor in. Soil ication Rate Horizon ')epth Dominant Color Redox Description- Texture Structure Consistence Boundary Roots GPDKf in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 Effluent #1 = BOD, > 30:5 220 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 -9330 (R.6=) Soil Test Plot Plan Project Name Jason Hankes Shau trd Address 515 Polk /St.Croix Rd Somerset Wi 54025 TM #226900 Lot 4 Subdivision ----- ---- Da 9/17/10 SE 1/4 NE 1/4S 8 T 31 N /R W Township Somerset Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Bottom of shed siding System Elevation 93.8 *HRPSameasBenchmark 40th St. Scale is 1" = 40' Property Line unless otherwise noted Acessory Building No bedrooms, no living quarters,no commercial, being sized for 1 floor drain and two people occuping the unit during the day. 40' B -1 25' 1% slope B -2 thus no contours 25' B -3 50' 25' Property Line -- --- - - PAID "tIW QtsVr Saf and &Mko DivWoa , coq MtaU", W1 A ve. , ,7 - PAm 7162 �L sanksty pier ail iVumber (to be MW in 6y Co.) SI5 /l/ Sanitary Permit Application sISM baroodkol Mttaaber 1n accsadattce with s. Comte. 83.21M VM, Adze. Coda, Aubmimioa of this form to the eppopriste emit I mquhed prior to obtaining a senFtsry ptxttalt. Application "bat submitted to the Dep4rtmalt of C thraua for 4611 weed POoiu a dn�sa (dditibtent Htdon mailhg oddness) nnxtia' Personal i Ad aforttdtimt (,ttL�7' � 000atdirtee with the Ptt Law s. ) s. 1 m Ow P / 1. A Itaforenattoe►. Please Prht Ail Taforssatinet ; 7 2 z b O 4t � �1 roperty eer's l8'a tne s JUL 312009 5 Property Owner' M111011 Addn�s ST CROIX COUNTY Property L cation / ��� �� ` PLANNING &ZONING OFFICE ll / J \ ily, Stela 7.ip Cade Phone N "tttbtx Govt. i.ai v- ' V., w"4 . 4 Section I.I. Typo o BtiikNstq ( eMeek +aN fltait apply) / N; A / 9 ❑ E W I or2 Family I>welliag- IVUmtwerof �P- Y Snitdiv ollouNanu 'EI Public/C ial - newribe Us l I � `J'I '� ° Of 9Mte owned Describe �eC,M I,✓I 1114 �- a fe a CSMMum Vilbraf' U pr; or � 7 � �e of ,sd r�� �s � 7" III. Tye of PasnlMt; (CA k only am Ifont on bw A. Ca Ma B Ilf A ' New system M�lsocttdtl tl 8ri0em �B k Raplrcement Only Other Moditiatioo so Bdoing symn (ergtlun) 1t. Permit Permit Revision Chaiga of Ptxmit Tnwsfer M Lost Pmviwsr Paatit ilmobor std Dote Iswed Rennal iielbre Plumber owner Lion IV. ofPOWTa swolessic tMevke: Citeakall tkft Non- ftwuriaed in -orowd Ptemudwd 1n 0=nd Moun ?A in. afwipdtie soii Mound <7A fit. SfMMMe soil HoldinB Tsnk OOMDisporad Compntrent(arplaut) EIPw+dnp OM V. D 'fr at Am lt>nfortnatloot S 2? Q 0-08" 171ow (BPd) Design Soil Application R t) U3 , 1049 I ,Anep itequined ( (0) Systtsn Iileva"M VI_ Tout inia Capscily in TOW II of Mua'lal Gpl sllotis Una o lak.5 NOW Tasks Exiging Tanks Stptic or Htdding'fank 1 LIP . Gs e Y s �✓t e twsiwg ch.,nber �C a0 1 /� Se t ol VII, R ib1 Btate oteot - I, tMe tmds�aed al11latlise far hta of He M]IIIY'T19 M the Isttaeree plutut s's Name (Print) Pl s Signntaue MS Nwobw Business Phase N wabor Plumber's Addrav9 (Street, City, State„ zip Cole) VII . Cots ;De Use QPR - -- ARpMycd ass Permit It ,ate ow Isllmbag aiBltti►tn 0V7 Gi for 11)10011"1 s 4 06 q L/ �7 M. Cnr11dit OWNWAR rods for Disapptnvol (! 7 t � • r 1. Septic tank, ef Utnt filter and f dispersal cell must all be services I maintainer! et 2. as per management plan provided by plumber. rT �'°v U 2. Atl seiltraclt raquireme►tts must be maintained i a (- to mom sNeew s0a snMsat ro CpAty ssb w parr Oat Iiws Aso a tisx 11t 10 Y�OtrSs2 . sR1) -6398 (It. 01/07) Valid thnt 01/09 1 ea 7ad 83 c 'A "Al !N /64 e to �3irI�Z ToP�f �,�osl aT et , '7' C 6.3 t. ' • D . Wisasin Department of Commerce SOIL EVALUATION REPORT Page ( of 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 C � include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I,D. �} n and distance to nearest road. l/ — ' ns north arrow. and IocaUo a � ) percent slope, scale or dimensions, .e` Please print all information. Review y Date Personal information you provide may be used for secondary purposes s. 15. (1) (m)). Property Owne . p Prope location I` ovt. L tS� 1/44,x'1/4 S T 3� N R22 E( W Property Owner's Mailing Address Z of # Block # S or CSM# z / 0 City State Zip Code P e N ORO C' ❑ Village r NAAF est Road New Construction Us <Residenfial / Number of bedroomsZXV Code derived design flow rate GPD ❑ Replacement C] Public or comme 'al - Describe:— _ --___ — PareM material d ��'7`�1c� c Flood Plain elevation if applicable General Comments and reoommendations: System Type System Elevation Boring J� J El a # it Ground surface elei / ft. Depth to limiting factor T / U in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/If in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff# I `E 2, 2- li ® Boring # � n� n 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 ------ - ILE q1 1 / • Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 1 1 ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name I Print) re CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 5 17 715- 246 -4516 L property Owner — Parcel ID # Page of ❑ Boring © Boring # / in. t it5l Ground surface elev. � -�— ft. Depth to limiting factor Soil Application Rate Redox Description Texture Structure Consistence Boundary Roots GPDO Horizon Dept 'Eff#1 '042 i Qu. Sz. Cont. Color Gr. Sz. Sh. - Z b- s r� S u• a� c h El Boring # ❑Boring ❑ Ground surface elev. ft. Depth to limiting factor in. Pit Soil Application Rate Texture Structure Consistence Boundary Roots GPD/fP Horizon Depth Dominant Redox Description 'Eff#1 'Eff#2 in. Munsell Qu. Sz. Cont Color Gr. Sz Sh. Boring # ❑� Ground surface elev. ft. Depth to limiting factor in. EJ ❑Pit � Appl ication Rate Texture Structure Consistence. Boundary Roots GPD/f Horizon '')epth Dominant Color Redox Description. -F-01 *042 in. Munseil Qu. Sz. Cont Color Gr. Sz. Sh. Effluent #1 = BOD > 30 1220 nxyL and TSS >30 _< 150 ffV& ' Effluent #2 = BOD _< 30 mglL and TSS <_ 30 mgIL 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. ssD4330 (R-6(00) Soil Test Plot Plan Project Name Denise Gunderson Sha ird Address 333 Rice Lake Rd Somerset Wi 54025 CS #226900 Lot 4 Subdivision - ------- Date 6106 SE 1/4 NE 1/4S 8 T 31 N /R W Township Somerset Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Survey Iron System Elevation 93.4/92.8 *HRPSame as Benchmark Alternate Benchmark Top of steel Fence Post C /O.�? ' 699' Property Line Scale is 1" = 40' unless otherwise noted B.M. 80' 20 ' 6% Slope 90' B -2 343' Property Line B -1 97' 30' 45' B -3 99' Rice Lake Road h0£S a2sd ZZ TOA _ Z 1 t LAI war o g o F x Q Z 30 L 133HS °1 `.ft M.99. 0 N � - 0 CIO t i3S�� ►-�o: «MR CL U r- - - --- �f H.L SP F . 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Tuts 3�JYd �- S Q� v3 � ZZ 9 -,� n '� 03AI30BU POWTS OWNER'S (MANUAL & MANAGEMENT PLAN Page � of FILE INFORMATION ' �- ' ST'YN 7 _Sp XZL X T M SPECIFICATIONS Owner eptic Tank Capacity /.2-5'0 gat ❑ NA Permit # ` septic Tank M anufacturer k_0 o e�Se,R. ❑ NA DESIGN PARAMETERS �dy effluent Filter Manufacturer �' " /f ❑ NA Number of Bedrooms 0 NA Effluent Filter Mod ��.�°'' ❑ NA Number of Public Facility Units Q NA P Tank Capacity g O t'� al ❑ NA Estimated flow (average b p p Pump Tank Manufacturer U3 ,e S e ft, ❑ NA Design flow (peak), (Estimated x 1.5) f 000 i Nr Manuf actur e r © �1 ❑ NA Soil Application Rate it Jf 100 p Model ❑ NA Standard Influent /Effluent Quality Monthly av ert ►iA ". Ptatreatment Unit ❑ NA Fats, Oil & Grease IFOG) S30 mg /1 P Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mglL Q NA Q, Mechanical Aeration ❑ Wetland Total Su spended Solids ITSS) 5150 mgji 0 01 Infection ❑ Other: Pretreated Effluent Quality Month ;y average pispersal Cellls) ❑ NA Biochemical Oxygen Demand (BOD,) 530 mg /l� Q ih (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /i, 4 NA 0 At -Grade 13 Mound Fe Coliform (geom etric mean) 510" cf /100M P brio - Line ❑ Other: Maximu Effluent Particle Size Ya in dial Q NA Sher` ❑ NA Other ❑ NA *Values typical for domestic wastewater and septic tank effluent Other: Q NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At toast cnae every; I month(s) (Maximum 3 years) 0 NA Ail earls) Pump out contents of tank(s) When combilioll llldp0 and saum equals one -third (Y of tank volume D NA Inspect dispersal cell(s) At legvt once $Very; ❑months) (Maximum 3 years) ❑ NA 15� year(s) Clean effluent titter At least once every: d month(s) ❑ NA yearls) ` ❑ month(s) ❑ NA Inspect pump, pump controls & alarm At le WOO, every; ❑years) O month(s) ❑ NA Flush laterals and pressure test At least pno$ e very, ^-� ❑ Other: tines eY19 [3 month(s) ❑ NA At least rY: 0 years) Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by pin individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer, POWTS In oectbr; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(o) to identify any missiing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum arid.to c�lck for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check` tale I�ffluent 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 affluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be porfPrmod 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 eh(l'pii`ti"p ii "I tl041rl fir the presence of p aintin g Products or other chemicals that may impede the treatment process and /or dam" �Rr�4 A![t�lol: If high concentrations are detected have the contents of the tanklsl removed by a septage servicing optlltfil $} (t `:U System start up shall not occur when soil conditichs *41 "too #t thlp i il#wive surface. During power outages pump tanks may fill above titirritpl II h prP Iilltf0 GlFhen power is restored the excess wastewater will be dfacharged to the dispersal cefllal in one large do60� �*)d may result In the backup or surface discharge of effluent. To avoid this situation have the contents Q C�IfVII .by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber F . � $ W 10 assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispef�p yI ,400 1 '4 >'w(;!t 011vp 0if d ark over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grads ppjj 6q . '10 li 0 . Reduction or elimination of the following from the 1At i �l> fJf+ fN l FI 4 1improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts) ,pi! s I degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and v q 0 4 pi Illi I �0; grease; herbicides; meet scraps; medications; oil; painting products; pest sanitary napkins; to nY;} " `i t, r _ dYiF'rine. , . �,. �' ABANDONMENT When the POWTS fails and /or is permanently takelt ilU #' tf$ wii8 i f!! ► #a11' J"g steps shall be taken to insure that the system is properly and safely abandoned in compliance with di"'toi:04 11! t. 40+ i 51 *gnsin Administrative Code: • All piping to tanks and pits shall be disco nrli to Ilhld j P pl§lA ipe openings sealed. • The contents of all tanks and pits shall be reiliSStlil� iltri(drktpllhl diiltiposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be 4) p t ll {} rem 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 f0lh0 i40 1740 f�E� .hovll k -l�n, or must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evft1111At1i . ftt�l'k' NI��Ii+H! for the location of a replacement soil absorption system. The replacement area should be pi! tteld Mrih lpi'►ttiil , #nd compaction and should not be infringed upon by required setbacks from existing and propotrll liGfsl >wrells. Failure to protect the replacement area will result in the need for a new soil and site eva,llii tp.lil�flllq�(l liable replacement area. Replacement systems must comply with the rules in effect at that time ❑ A suitable replacement area is not evailat t; u Ip ,k 0holpr soil limitations. Barring advances in POWTS technology a holding tank may be installed q. spot r I01iipl�` a fled POWTS. �1 QIa The site` as not en evaluated to identl ,,� �0i, �11t'.atea. Upon failure of the POWTS a soil and cite evaluetion be performed to locate a 440,0 If no replacement area is avallable a holding tank may b ails s a last resort to replace ❑ Mound and at - grade soil absorption systertld lti+Y i�fFslY In place following removal of the .biomat at the Infiltrative surface. Reconstructions of such bytph�itltl #t Vp4 t h the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS Nf`. !' SES AND /OR INSUFFICIENT OXYGEN, 00 NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT . T I OTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE ADDITIONAL COMME POWTS INSTALLER FAINTAINER Name `IA Phone - 7 SEPTAGE SERVICING OPERATOR IPUMPER) I;ATORY AUTHORITY Name Phone + 715 - 3$ - to This document was drafted In compliance with chapter Comm II$441 (bil 11 0) sho 4 IIAll I, (2) a 431, Wisconsin Administrative Code. I SEPTIC TANK PUMP CHAM3 F4 M IIN AND SPECIFICATIONS „ r+" CI VENT PIPE 12 MIN, ABQY +pgi 4 WEATHERPROOF JUNCTION BOX APPROVED ? 25' FROM DOOR, WINDOW OR WITH CONDUIT MANHOLE COVER FRESH AIR INTAKE W/ PADLOCK & -- WARNING LABEL FINISHED GRAD 4'' CI RIS 4" MIN . 16" IN 6,� MAX. �•� INLET + _ r , WATER TIGHT SEALS 1 TIGHT t + \4PPROVED SEAL ' JOINTS WITH z ; ALM APPROVED PIPE kPPROVED r ON 3' ONTO 'ZPE 3' r , SOLID SOIL )NTO SOLID + ' ** RISER EXIT TOIL PUMP OFF ELEV . 'I' OF ` PERMITTED ONU.. IF TANK MANUFACTURER HAS APPROVAL 3" APPROVED BEARING UND94 CONCRETE PAD SP'' SEPTIC / DOSE D�? &E5 PER DAY: r TANK MANUFACTURER: -� TAN SIZES SEPTIC 1 GAL. IQ uOM INCLUDING GAL. DOSE GAL. FLOWBACK: MANUFACTURER: A = �_ INCHES = y„._ GAL• ALARM 1 = MODEL NUMBER: D L d B = 2 INCHES = GAL • SWITCH TYPE: C = INCHES = , PUMP MANUFACTURER: Gr MODEL NUMBER Pin D = � INCHES SWITCH TYPE: REQUIRED DISCHARGE RATE ) GPM / PI�M' 8 ALARM WIRING AS PER ZLHR 16.23' WAS 02,. FEET VERTICAL DIFFERENCE BETWEEN PUMP A' 1 il) DI$TR1PUTION PIPE 2—� FEET + MINIMUM NETWORK SUPPLY PRESSURE " "" �'7 FEET T. FRXQTION + �_ FEET FQRCEMAIN X o FT� y�NAMIC FACTOR -FEET WIDTH �• DIAMETER INTERNAL DIMENSIONS OF PUMP TANK: Lr -NOTH pee 1` �� iL ,�. ---- LICEN NUMO % ! �_v DATE: SIGNED: _ ..u.s. ., [QGOULDS PUMPS Submersible Effluent Pump 387 EPO4 EP05 II 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- resistance. Q' Canadian standards AssodmW • Heavy duty sump matic models include M Motor Housing: Cast iron (CSA listed model numbers end • Water transfer Mechanical Float Switch for efficient heat transfer, in "F" or "C ".) • Dewatering assembled and preset at the strength, and durability. SPECIFICATIONS factory. ■ Motor Cover. Thermoplastic Goulds Pumps is ISO Soot Registered. FEATURES cover with integral handle and • Solids handling capability: float switch attachment points. W' maximum. ■ EPO4 Impeller: Thermoplas- N 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 eiastomers. • Temperature: 104°F (40 continuous - -- 140°F (60°C) intermittent. METERS FEET _. ..__ .... . .- _,..... ..._. , • Fasteners: 300 series stainless steel. y 30 , .....__., i.__.._.. __; _..____._.._ __...._ � * 2_5 t —SGPiu .._. . .. _. • Capable of running . - dry without damage to s Fr __ components. 25s ..._..... 2 } Motor. U 6 20' • EPO4 Single phase: 0.4 HP, — i ..... 115 or 230 V, 60 Hz, 1550 a RPM, built in overload with o 5 15 automatic reset. -. - - EPOS a 4 _ ..... J • EP05 Single phase: 0.5 HP, c 115 V, 60 Hz, 1550 RPM, '' 3 10 r built in overload with EPO4 ._.. automatic reset. 2 ...... 1 _ _ j • Power cord: 10 foot 5 ..._... , standard length, 1613 _.. .. SJTOW with three prong _ ._ grounding plug. Optional 20 0 00 ___._ ._. __....10 zo 30 40 50 GPM foot length, 16/3 SJTW with three prong grounding plug 0 2 4 6 8 10 12 m)/h (standard on EP05). CAPACITY Goulds Pumps ®2000 Goulds Pumps <T ITT Industries Effective February, 2000 83871 ST. CROIX COUN'T'Y C14) ' SEPTIC TANK MAINTENANCE AGREEMEN AND OWNERSHIP CERTMCA.TION FORM OwW/Buyer _r _. lwing Addre�s Property A('Idress � .._ _ �'?� (VoriSication regtsincod from Planainpt 'gym°t for new cddtrwtion.) City /Stat+� Yh 0 ` 59 Parcel Identification Number �AI�T►�bf:R�P'1'���, 3 � N' R. �� �, Town of.., Sv tr 25� property Loc-Won S `/� , `/. ,Sec' $ ' T •- --- - .__..._ ..� � Lot # SuMvision T".ertiified Survey MSP # Vol .�-- - y..� --- ume - - .._► Qage # • _,_,�.,r,,,, ~�:..1�- ...-' �8� 3 0 , Volume , Page # Warrtuaty Deed # � -- - -- ._,,..�- _.•.._._.. Spec house Yes ® Loot huts idontit iable (F no MAN W O Improper use aril m untcnance of your septic system could roeuit i n its premature 0t we to handle WW ft- - ft of u into tank every flue" years or sooner, if nemd�d, by a licanacd � pu � p ��tenanec � msrinteasncc cpnsists of pumping out the W* _ the eyown can affect the unction of the septic tank 0 a Uvatnavn 1 in d* rite ) 8anit�Y Ordinance. n*q onsibilities arc epocittod in §Como+• 83,520) ,at d its ChaPtcr arinreat a rc•rtitication fern►, signed by the 1'hsa property owner agrees to sttddrnit tie Si. , re s icte tY Pltrbcr a licensed ptusspet' verifybt tiled (1) the on im & Zoning owner sand by a ,aster plumber, jo ph estticotd and/or or (2) � after insp •ow and Pub"$ if Oaacceeaary), the septic tank's wastewater disposal system is in proper Operating condition (z) less these 113 fan of sludge. th the sa Vwe, the , hac sigrscd lwve road a tits ab t OrCAnur er and the partmerst a the private MwAgs di 1Naautral R*80ur , S 'tats O Wi Standards asst > , as set by the 17ap mom be �� and returned to the St. Croix county Plawmg & C'•attirkation cueing *M your septic system has boon mamuia+ed ;sing Aeparttz=t within. 30 days of the tutee YOU "Pi VOW date Uwe rectify that all Stotemeats oft this f mare tn�ha t H of / " Deeds Olic$ce Uwb amlate the owner(s) of dk property described above, by •virtm of a warranty 1 � ��7 d SwF Number a �P . X ? .�.��. SIGN A OF APP Y ANTM DATE ** *Any intoemtltinn ftt is mfstepresetuc8 nuay tasult in tttr Sanitary pctmn being revoked by the PlarmbW & Zoning Departnwnt. * *" tnck�de with thist apt►lic$*ion a recorded warrhatY dce4 *001 the ltrgister of Deeds Ot'8t a t • copy of tt►a cptiliad survey maxi if re&jence is mode in the warranty deed. ("V. 08105) 'Gr,-SCA 6 ✓ti/� 2009.07 -03 u.07 SCFNIMAKEP WM Page 2 II{ Illilllllllll{ Illiilllllifllllll {ilil{Ilillllll State Bar of Wisconsin Form 2 -2003 8 8 6 3 0 5 1 WARRANTY DEED 886305 BETH PABST Document Number Document Name REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 01/07/2009 03:OOPM THIS DEED, made between Denise Gunderson, a single person WARRANTY DEED EXEMPT !I ( "Grantor," whether one or more), REC FEE: 11.00 and Karla I. Kunzweiler and JanpJJ. Aankes, husband and wife TRANS FEE: 135.00 ( "Grantee," whether one or more). PAGES: 1 Recording Area ;1 Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant Name and ReTaAV Estreen interests in St. Croix County State of Wisconsin Pro e St • i rt s needed, please attach addendum) ( p y ) ( if more spac s 304 Locust Street That part of Southeast Quarter of the Northeast Quarter (SE 1/4 of the NE 1/4) of Hudson, W! 54016 - "Section 8, Township 31 North, Range 19 West described as follows: Lq4 4 of Certified Survey Map recorded in Volume 22 of Certified Survey Maps, Page 5304 �] y as Document No. 838137, St. Croix County, Wisconsin. 032- 102040 -570 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated ` �' ii' / cc (SEAL) Aniiw_ �ZG�9'Ill(l�LfYI (SEAL) * *Denise Gunderson (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) Denise Gunderson, a single person STATE OF ) authenticated on > ) ss. !' COUNTY ) *Kristina O land Personally came before me on , TITLE: MEMBER STATE BAR OF WISCONSIN the above -named (If not, to me known to be the person(s) who executed the foregoing authorized by Wis. Stat. § 706.06) instrument and acknowledged the same. THIS INSTRUMENT DRAFTED BY: s Attorney Kristina Ogland Notary Public, State of Hudson WI 54016 My Commission (is permanent) (expires: ) (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY tDENTWMD. WARRANTY DEED ® 2003 STATE BAR OF WISCONSIN FORM NO. 2-2003 " Type name below signatures. 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