HomeMy WebLinkAbout008-1072-80-000Wisconsin Department of Commerce
PRIVATE SEWAGE SYSTEM
..„.y. St. Croix
Safety and Building Division
INSPECTION REPORT
Sanitary Permit No
GENERAL INFORMATION
(ATTACH TO PERMIT)
633935
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 Township
Parcel Tax No
Adolf Johnson Trust
I TOWN OF EAU GALLE
008-1072-80-000
CST BM Elev:
I Insp. BM Elev
BM Description: n I
SecbonfrownlRange/Map No
TANK INFORMATION 2 f4 r ; h, S b rt Gi
TYPE
MANUFACTURER
CAPACITY
Septic
J)'e
Dosing
((
O lMJ
vJ
M.
&sZs
Holding
TANK SETBACK INFORMATION C.00 �r, G G11�„ y C
TANK TO
,P/j'
WELL
Vent to Air Intake
ROAD
Septic
7Z5 y
//BLD/G
Dosing
(O
!
Aeration
Holding
PUMP/SIPHON INFORMATION M 4 O --?7,
Manufacturer Demand -
(�pJ �C�
GPM
Model Number
t yy
TDH
Lyft b
Frictiop Loss
System Head �
(ttoo
Tt 6 ` t
'J
Forcernam
Len�� r
Iola �7 •`
Oist Well��a •
SOIL ABSORPTION SYSTEM
ELEVATION DATA
STATION
BS
HI
FS
ELEV.
Benchmark
`� I
J
O
Alt B1v1( r ONc✓
-
1
!
)f
!b� • 44
Bldg. Sewer
y,ss
/00.7b
SVHt Inlet
y zs
9 / Z 6
SVHt Outlet
Dt Inlet
Dt Bottom
izb7
9z.8
Header/Man.
V
q8 p B
Dist. Pipe
67
*?41
But System
98 z-G
Final Grade
St?,71f/
q1
�o o Aou r
B.Bf
9G•7
BEDrrRENCH
DIMENSIONS
Width U
/ . 5 `
Length
I �
No-
Z 10-�� Is
PIT DIMENSI
No Of Pits
Inside Dia
Liquid Depth
SETBACK
SYSTEM TO
PIL�
BLDGI
WELL
LAKE! T EA
L ACHIN
Ma acturer
INFORMATION
Typ f System'
�I�ou
��•
��Or
��•
C AMBER R
UNIT
Model Numbe
DISTRIBUTION SYSTEM
Header/Manifold •
Dia
'3Length
Dstnbut r
Pipe(s (I
Dia Spacing
x Hole Size
p
Hale Spacing
%%NrLength
Vent to Air Intake
70
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only fle I- P/17 ,.- %, r
Deg{p-9ver---
Bed�ry -�eq r 8 ••G Y
I
Depth Over
edfrrench Edg -
xx Depth q`
Topsoil J z rn
nr Seeded/Sodd d
-
xx Mulched
y
I / Tq-
Yes �:_� Na
/, Ves No
-[__
COMMENTS: (Include code discrepancies, persons present, etc )
Location: 2637 12TH AVE 191
{� 1.) Alt BM Descnption = 1l�a CDwlr
2.) Bldg sewer length= -a 32' e?%,'4lr� 7 3l• 6,y -amount of cover = y z H Oh fq'i 1 a I 5 �') I Co L Cmj
Plan revision Required? ] Yes X No )O n 7-1 1
Use other side for additional information. / r
Date
SBD-6710 (R 3/97)
Inspecti flow I D/ I Z'nspection #2
40� /cDll aPud .
Insepclor's Signature
Can No.
—�fr �� i-.t 7--v I
a -
Safety and Buildings Division
t //
/ - C -e/ r
' �� 2021
201 W. Washington Ave, P.O. Box 7162
Sanitary Permit Number (to be filled m by Co.)
SEP
Madison, WI 53707-7162
tiO2nanv� St. C,'ox i.o„a�me
t
con "
a Permit Applicat
State Transaction Number
In accordance with SPS 383.21(2), Wis. Adm Code, soof this form to the ap r �vemmrntal and
z
d g2(O /0'7- G
Project Address (if different than matting address)
is required poor to obtaining a sanitary permit Note. Application forfor stated ed POW ub ed [o
fo
the Department of Safety and Professional Serves. Personal information you pro be pA co my
/�
12 71/(:�.
purposes m accordance with the Privacy Law, s. 15.04 l m , Stals (i
Z 63
1. Application Information - Please Print All Information
Property Owner's Name V(r •E•vgo.-,
�Ip
/
Giurr'a �z+rrS�
O o g^ /072 8 0-000
j
Property Owner's Mailing Address /
bAL4E,3bh
Property Location
263^? /2yE�1 e V
Govt Lot
$� y$_. y,, Section 2�
City, State
Zip Code Phone
Number
Gt�6'O dVI/et w/
S'�U2�
7/s-Y9593-��
T -2;? N: R t&ctrclE one
�D—
11. Type of Building (check all that apply) Lot
u
Name
SubdlnsZol
A or 2 Family Dwelling -Number of Bedrooms 3
q
Block
❑ City of
❑ Public/Commercial - Describe Use
CSM
❑ State Owned - Describe Use
❑ Village of
�y
i¢TOwn of C�C 4
Number
�
III. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A,
❑ New System
placanent System
❑ Treatment[Holding Tank Replacement Only
❑ Other Modification to Existing System (explain)
F
R.
El Permit Renewal
ElPcrmit Revision
❑ Change of Plumber
El Permit Transfer to New
List Previous Permit Number and Date Issued
Before Expiration
Owner
/
tV.Ty of POWTS S stem/Coin onent/Device: Check all that apply)
❑ Non -Pressurized In -Ground ❑ Pressurized In -Ground ❑ At -tirade ❑ Mound > 24 in. of suitable soil Mound < 24 in. of suitable soil
❑ Holding Tank ❑Other Dispersal Comporirn (explain) ❑ ant Deviee ( plain) I it
V. Dis ersal/Treatment Area Information — '
Design Flow (gpd)
Design Soil Application te(gpds0
Dis Required (st)
Dis mat Area Proposal (so
System Elevator
'{gip
t Z
25n
223a
�,/%
VI. Tank Info
Capacity in
Gallons
Total
Gallons
M of
Units
Manufacturer
nor � • l�.�s �.
8
y
V
.VL
1• ti(1Jil f 1 �^
u p
h
.moo.
B'
Z V
New Tanks
Existing Tanks
a` U
,.,
rn
Septc or Holding Tank
Dosing Cbambcr
1. _e L,)
VI 1. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the PORTS shown on the attached plans.
Plumber's Name (Print
P tuber's Si re
MP/MPRS Number
Business Phone Number
%
p/5-21oZY//5
Plumber's Address ($tree City, State, Zip Code)
VIII. Coun /De artment Use O I
Approved
❑ Disap v
Permit
Date ued
sin Agent Signature
❑ rven Reason or Denial
yFleeye
�j
CEO iTEM
(_epee
IX. Condition of Approy I \a:01,
OWNER
tank, emust filter andnispersal
cell must be servLced I maintained `kA p> ,( ,,,i,,,,r�,(� , — s per management plan provided by plumber. \f J 44& `III
setback requirements must be maintained-1
as per app complete plains for the syst�,i, mit to t County on on "Pt. ot les�rhaa 8 x 11 ts in na
h J1r c - V0CUivl,
SBD-6398 (R. I I/11)
CHECK BOX AS APPUCAS E CHECK BOX AS APPIL CABLE.
❑ SOIL EVALUATION Scale: to =40• 0✓ SYSTEM PAGE 2 OF 6
SITE MAP I 4D PLOT PLAN
PROJECT NAME: (tBa) 10' DESIGN FLOW: 450 GPD
Adolf Johnson Trust Attach design flow calculations for Commercial plans.
PROJECT ADOREss: 2637 12th Ave, Woodville, W I Pipe Material / ASTM Standard (Tables 384.303 & 384.30-5)
swft y Sewer. PVC / ASTM D3034
BM Symbd'� BM Devadon: 10— FFTN Force Maln: PVC / ASTM D2665
@ wost fieldate
SM Descdptlon: grade west pg
WkWe mnh by IMPORTANT:
Slope Gradient % ) t 3% Well symbol (B appnrable): p draabg an anq Show ground elevation contours at suitable intervals.
of Tested Area: on the appnaprM fine.
K--- S'!o •
L— — pew L--(I&.,
August 27, 2021
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 2023-08-27
Plan Review: PWTS-082102107-C
MICHAEL J MYERS
2943 130th Ave
Glenwood City WI 54013
SITE: Adolf Johnson
2637 12th Ave
Town of EAU GALLE
St. Croix County
Total Amount: $250.00
FOR:
Description: 450 GPD (3 Bedrooms — Replacement)
Maintenance Required
DIVISION OF INDUSTRY SERVICES
2331 SAN LUIS PL
GREEN BAY VN 54304-5211
Contact Through Relay
http:ildsps.vA.gov/programsfindustry-services
waw.wisoonsin.gov
Tony Evers - Governor
Dawn Crim - Secretary
Conditionally
APPROVED
DEPT. OF SAFETY AND PROFESSIONAL
SERVICES
DIVISION OF INDUSTRY SERVICES
SEE CORRESPONDENCE
Mound Component Manual — Ver. 2.0, SBD-10691-13
(N.01/01, R 10/12)
Pressure Distribution Component Manual — Ver. 2.0,
SBD-10706-P (N.OI/Ol, R 10/12)
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 any component manual(s)
referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance
with all code requirements.
No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06,
stats.
The following conditions shall be met during construction or installation and prior to occupancy or use:
• Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site.
• Any tall grasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to
prevent matting under the dispersal area. All loose organic material to be removed from POWTS Dispersal
Area.
the site is too wet to prepare If it crumbles site preparation can proceed If the site is too wet to prepare do not
proceed until it dries.
• Abandon Existing System per SPS 383.33
• Pump Floats to be set and serifed per approved plan Am changes mas result in vamp resiziri to meet
'1-Dll and GPNI Specifications.
• Divert surface water from POWTS Area.
• All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5
• Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c)
• Tank Installation to follow all manufacture's recommendations.
• Verify property line(s) prior to installation.
• Well setbacks to meet chs. NR 811 & 812.
• kreas that are occupied pith rock tmgmcnts. tree roots, stumps and boulders reduce the amount of soil
❑eadable for proper treatment. It no other ,ite is a\ ailable. trees m the halal vea ul the 1'0%i TS Dispersal Area
must be cut off at ground loci 4 Iaeer fill area is necessary %Olen am_ of the abo%c conditions are
encountered. to provide sufficient Infi II rati%C area
Owner Responsibilities
• The current owner, and each subsequent owner, shall receive a copy of this letter including instructions
relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation
and maintenance manual and/or owner's manual for the POWTS described in this approval SPS 383.54(1).
• In the event this soil absorption system or any of its component parts malfunctions so as to create a health
hazard, the property owner must follow the contingency plan as described in the approved plans.
A copy of the approved plans, specifications and this letter shall be on -site during construction and open to
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 Industry Services reserves the right to require changes or additions should
conditions arise making them necessary for code compliance. As per state scats 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 and the POWTS management plan to the owner and any
others who are responsible for the installation, operation or maintenance of the POWTS.
Thanks,
�9
divr U,n,�r�eest
POWTS Plan Reviewer — Wastewater Specialist
Department of Safety & Professional Services I Division of Industry Services
email: tin- u•,Jerleeu ct �si�eonsm uo�
Cell: 608-516-6134
PAGE 1 OF 6
Mound Plan
Index & Cover Sheet
Component Manual Design References:
Version 2.0, SBD-10691-P (N 01/01, R. 10/12) & Version 2.0, SBD-10706-P (N.01/01, R. 10/12)
Pg 1 of 6
Index & Cover Page
Pg 2 of 6
Plot Plan
Pg 3 of 6
Mound Cross -Section & Plan View
Pg 4 of 6
Distribution Network Specifications
Pg 5 of 6
Pump Tank Specifications
Pg 6 of 6
Management Plan
Pump Curve POWTS Application for Review
Soil Evaluation Report & Site Map
Project Name / Description
Adolf Johnson Trust
Owner Name(s): Adolf Johnson
Owner Address: 2637 12th Ave, Woodville, WI
Project Address: SAME
Govt. Lot: SE 1/4 of SE
Township: Eau Galle
Project Parcel ID #:
Phone:715 495
Zip: 54028
9376
1 /4, Section 25 T 28 N-R 16 E ❑ or WWI
County: St. Croix
Designer Information
Designer Name: Michael Myers Phone: 715 -265 -4115
Designer Address: 2943 130th Ave, Glenwood City, WI
E-mail: mcmyers@centurytel.net
Condrtmnally
License Number: 267985 APPROVED
DEPi. OF SAFETY AND PROFESSIONAL
SERVICES
DIVISION OF INDUSTRY SERVICES
Remarks:
Zip: 54013
SEE CORRESPONDENCE
Signature: " Date:'- 2 26 7 /
Ongmal signature�requin4 on each submitted copy.
CHECK BOX AS APPUCABIE
❑ SOIL EVALUATION
SITE MAP
PROJECT NAME:
Adolf Johnson Trust
CHECK BOX AS APPLICAELE.
Scale: 1" = 40' 60 0✓ SYSTEM PAGE 2 OF 6
0 40 60 80
PLOT PLAN
(•;ph grd) iD+ DESIGN FLOW 450 GPD
Attach design flow calculahons for Commercial plans.
PROJECTADDRESS.
2637 12th Ave, Woodville, WI
Pipe Material /ASTM Standard (Tables 384.30-38 384.30-5)
BM Symbd)'.�)
(`
BM Elevdmn 100.00 FT
�—
N
Sanitary Sewer PVC / ASTM D3034
PVC ASTM D2665
aM Deacnption.
grade A west post field gate
Force Mann- /
Slone Gradient(%)
of Tested Area
13% well Symbol (tt
Inai er,onh by
d, .m n, arro.v
IMPORTANT'
Show ground elevation contours at suitable intervals
on,rc ap;rwme ern
i
�f------ sip
1'fa r
5WA,,to
0.5' TO 2.5' WASHED AGGREGATE
(min.6.W beneath distribution Npe-min.2.0'
MIN. 6.0' OF TOPSOIL COVER
averdiarbutim pipe, and covered with
approved synthetic Tatum)
mir. 1.0 If
L
ASTM C-33 SAND FILL min. 0 5 It
I
I
p
Z ft
Plowed SuRace
Surface Contour
13
%Sloper
Elevation =
96.67 I
W = 30.1 ft
(Show force main manifold and flush valve beaters on plan view )
1 112 ' 0 Schdl 40
PVC Lateral
_ (lypcal)
—
1- B = 100 IT
Bend as necessary to follow contour
DOWNS[ OFF TOE
L= 121.6 «
III
SINGLE -CELL
MOUND DISPERSAL AREA
D= 1_5 ft
E = 2.09 It
System Elevation = 98.17 It
Lateral Invert Elevation= 98.85 if
CROSS SECTION VIEW
(No Scale)
PLAN VIEW
(No Scale)
1
3 = 61 it 16.67 ft
ltM-y�
Vk'°SrPkall_
_—___—_--.—.—.
Prohibit disturn,mre and vehicular traffic
within 15 feet of downslope toe.
Reset Page
I= 19.5 I K= 108 ft
twPlral
DISTRIBUTION NETWORK SPECIFICATIONS
(No Scale)
ti 2 '0 Schdl 40
$.' PVC Force Moir
(slope to punt, tack
FLUSH VALVE DETAIL (riser pipes fordralnsarx)
(No Scale) + opliooal) F
Ord" in _ _ _ Lateral Spackg
Valve Box
Center of Threaded Cep \ � $ = 3 it
for Head Testing (Insulation optional)
(opllonaq \ 2 '0 sd 40 First Orifice,
I \ Shed onho, fa PVC Manifold (typical)
Ball l 1 \ grevelless applrabors
(optinnlare Laterals to be level
(p ) Q .v` \ Schdl40 PVC Lateral O = 1112 in
(typal)
Lateral Length(P)= 99 0 Numberof Orifices per La" = 45
au:,es equally spared
[uht, kl m OR b) belov4 _ \
a) alag bonom of 1'leral Orifices equally spaced Orifice Discharge Rate = .41 gpm
-- Flush Valve along bottom of lateral
L b) l slag tap of lateral Assembly Number of Laterals= 2
valh every_ th hole (lyplrai - sec decal) se
Mowg dove
LAI ERAL INVERT ELEVATION = 95.85 ft
(typical)
OBSERVATION PIPE DETAIL
(W Scab)
Screw-Tyye or
Si'q Cap (larse(
FFlhhed Grade
(mulched a seeded)
4'0 PVC Ppe
Topsol Cover
Top of pipe to team ete
(mini. 1 foot)
at or above finished grade '
(4) 1/4'-i l2- x b' Sb6
V 90 'part
Anchoring Device
Infiltration
Surface
Last Orifice Lateral Discharge Rate = 18.54 gpm
(typical) Orifice Spacing (X)= 27 in
pypkal)
TOTAL DISCHARGE RATE = 37.07 GPM
Orifice Diameter= .125 In
(lyw-l) First Orifice
(typical)
x( wi —�
END MANIFOLD
Check lya�al) CONNECTION
applicable box. Man@old
Frsl Orifice (riser pq» optional) D
typical) G)
m
4— x— I -xn xn—}—x —{ j,
urlx uypr2
❑ CENTER MANIFOLD n
Manifold CONNECTION rn
ne er pipe optional)
PAGE 5 OF 6
"A".= 19.9 Inches = 338.3 Gallons
"Crr = 6.3 Inches = 107.1 Gallons
SEPTIC / PUMP TANK SPECIFICATIONS
4'0 Vent Pipe (No Scale)
> 10 9 lrom
Building Eleclncal must comply wit,
12' Min. or 20 ft above SPS 316 and NEC 300
Established Flood Elevabon WealnarProof Extend manhole riser as necessary.
(hronl) Approved Junction Box
Vent Cap Approved Looking Manhole
IMPORTANT: with Warning Label Attached
Anchor tank(s) a1383.43(8)(g)
ssary I (bmm )
Conduit
pursuant to SPS 4' Min. or 2.0 ft above
Established Flood E"hon
�Ainight Seal
Finished Grade
CAPACITIES @ 17 gaVin
Depth (in)
Volume (gal)
A
2"
_354-7-
2.0
34
((B
[C]
5.4-
iji-.-3
D
10
170
*Pump Tank Liquid Level = 38.2 in
Force Main Diameter = 2 in
nnect
1B' Min.
(bplual)
pp/Oved Jdnls withproved
Pipe 3 fl onto
JA�
TBlock
Solid Ground
(lypio9l)
VATIOEVATION = 86.8 ft
Concrete
IDE BOTTOM
VATION = 86 ft
100 ft 3' Approved Bedding Material BeneaN Tank
Force Main Length = �
2(
Force Main Void Volume = 17.4 gal
�
Vertical Head =
12.0
ft
+ Min. Supply Head =
6.5
ft
(CI Total Dose Volume (TDV) 107.4 gal/dose
+ FM Friction Loss =
2.87
ft —
(5X total lateral void volume S TDV < 0.2X design flow)
-
+ (force main drainback volume)
+ Fitting Loss' =
1.95
ft
'(min. supply head x 0 3)
MIN. PUMP DISCHARGE RATE = 37.1 gpm
= TOTAL DYNAMIC HEAD =
23.32
ft
PUMP TANK:
SEPTIC TANK(S):
Volume = 650 gal
Total Volume = 1000 gal
Manufacturer. Wieser Conctrete
Manufacturer(s): Wieser Concrete
Pump Manufacturer: Goulds
Install approved effluent filter at the septic tank outlet
Pump Model: PE51 P1 (See attetlred pump verve 1
immediately immediately upstream of the pumptank inlet.
Filter Manufacturer: Polylok
Controls/Alarm Manufacturer. SJE Rhombus
Controls/Alarm Model: PSP120V6H150P17A
Filter Model: 525
Float switches containing mercury are prohibited
PAGE 6 OF 6
Mound Management Plan
IMPORTANT:
The owner of this mound system shall be responsible for its perpetual operation and maintenance pursuant to
requirements of SPS 382-384, Wisc, Admin, Code. Pursuant to SPS 383.52 (2), Wisc. Admin. Code, this system shall be
considered a human health hazard if not maintained in accordance with this approved management plan. Furthermore,
all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in accordance with SPS
383.52 (3), Wisc. Admin. Code.
Maximum Dispersal Area Operating Limits:
Design Flow =
450
gpd; BODS <_ 220 nrl TSS 5 150 mgL-'; FOG <_ 30 mgL"
Inspection Checklist INSPECT EVERY 3 YEARS
o type of use
c age of system
o nuisance factors (i.e. odors, user complaints, etc.)
c mechanical malfunction (i.e., pumps, valves, switches, floats, etc.)
c material fatigue (i.e., leaks, breaks, corrosion, etc.)
., solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution / drop boxes)
o neglect or improper use (i.e.. exceeding design capacities, prohibited activities, etc.)
c extent of ponding in distribution cell prior to dosing
o dosing irregularities (i.e., pump re -cycling, float switch settings, etc.)
o electrical components (i.e., wiring, connections, switches, controls, timers, alarms, etc.)
o distribution lateral or lateral orifice plugging (measure lateral distal pressure — compare to design specification)
o surface discharge of effluent or sewage back-up into structure served
Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary)
o Septic and dose tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis.
Stats. when the volume of solids in the tank(s) exceeds one-third (1/3) the liquid volume of the tank(s) or
as required by local ordinance. Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code.
o Effluent filter(s) shall be inspected every 3 years and shall be cleaned when necessary to remove any
accumulated solids according to manufacturer's specifications. A servicing period will always be greater than 12
months.
o Distribution laterals shall be flushed once every 3 years or when necessary.
System maintenance reports shall be submitted to the proper local government unit In accordance with
SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to:
Name of individual or company: Northland Plumbing Inc Phone: 715-265-4115
Local government unit: St. Croix County
Local government unit address: 1101 Carmichael Rd, Hudson, WI
Phone: 715-386-4680
zip: 54016
Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wisc. Admin.
Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wisc. Admin. Code.
No product for chemical or physical restoration of the POWTS may be used unless approved by the department in
accordance with SPS 384, Wisc. Admin. Code.
Contingency Plan
In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to
a plan submitted to the appropriate agency for review and approval. A failed mound dispersal component may be
re -constructed within the originally approved area after removal of all failed components.
System Abandonment
If use of this POWTS is discontinued. it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code
JOULDS PUMPS
APPLICATIONS
Sceciai'y des'gned for the
`odow ng uses:
• Mound Systems
• Effluent/Dosing Systems
• Low Pressure Pipe Systems
• Basement Draining
• Heavy Duty Sumo/
Dewatering
SPECIFICATIONS
Pump — General:
• Discharge: 1'h NPT
• temperature: I 040p (400C)
maximum, continuous when
fully submerged.
• Solids handling:'h"
maximum sphere.
• Automatic models include a
float switch.
• Manual models available.
• Pumping range: see
performance char or curve
PE31 Pump:
• Maximum capacir: 53 GPM
• Maximum head: 25:TD�
PE41 Pump:
• Maximum capacity: 61 GPM
• Maximum head. 29' TDH
PE51 Pump:
• Maximum capacity: 70 GPM
• Maximum head: 37' TDH
VETERS FEET
a0 ._.
' PE51
r 35I
10—'—
.--'�—
n
z
25 `FE-
20
Submersible
Effluent Pump
MOTOR
General-
• Single prase
• 60 Hertz
• 115 a^d 230 volts
• Sulr•:^ t-e,^al ovedoac oro-
tect,on Ivni aL20matic reset
• Class 9 ins labor
• Od-filled design.
• r?ah st-e,oth carbon steel
shaft.
PE31 Motor:
• .33 HP, 300C RPM
115 vcs
• Shadeo role des,gr
PE41 Motor:
• .40 HP, 3400 RPM
• 115 and 230 volts
• PSC des:gr
PES1 Motor,
• .50 �iP, 3400 RPV
• +' 5 arc 23C vci's
• PSC desigr
------ YODELS PE31 PE41 PE51
33 4C 5D
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5
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If
O 2004 ;TT water Technebgy. Inc
ENecn.e lure 200•
B'E31/41
5 •o 15
CAPAO-v
FEATURES
■ Corroslcs resista^t
construction
■ Last 'rc^ 000y.
■ Tl-ermoD astir impeller and
cove.
■ UDoer sleeve and lower
heavy duty ba' Dearng
construction.
■ %lotor is permanentiy
�jbncated for extended
service life.
■ Powered for cent nuous
coeration.
■ A;i ratings are w't`•,n the
working lim"s of the mote.
■ Cuzk aisconnect cower
cord, 20' standard length,
^eavy duty 1613 SJTW with
5 or 230 vo:t gn:urc'ng
o:uc
■ Compie:e unit is heavy duty%
cortable arc Compact
■ Mechanical seal is arbor,
cearric, BONA and stainless
steel.
■ Stainless steel `aste ie,s,
AGENCY LISTINGS
0a
.:S
Tested to UL 778 and
CSA 221 108 Standards
By Canadian Standards Assoda0on
File *LA38549
Goulds Pumps is ISO 9001 Registered.
Goulds Pumps
<X> ITT Industries
w
Ws Dept o` Safety ano Professona: Services SOIL EVALUATION REPORT Page / of
Div!son of Safety anc Buildings
m accoriance, with SPS 385 Ws Aden Code
County
Attach complete site clan on paper not less than & V2 x 1' inches insize. Plan must I S�- 674c4K
include, out not limited to verficaf anc horizontal reference ooim (BM) eirectior. and Parce I D
oercent slope scale or dimensions. north allow anc IOcatior and distance to neares! roac. i
Please print all information. I Reviewed by Date
'ersonai information you oroviae may be usec for secanoary purposes (Privacy'_aw. s. -5,04 (t) {m))
Property Owner
j (( Property Locabon .� V
.4d' ? �/.+-K.s� 7V'LL $+- GOAL Lot S� 114S4C1114 S Zis2- T U N R ((Q E (ori N
I Property Owners Mail= Address Lot # I Blocx # Sum Name or CSM#
2,m37 (2Act
City Stale Zic Cooe Phone Number ❑ Cary ❑ Village [Town Nearest Road
Li a¢rlU; 4 1 'I-Syr,4, (Zf5) fY5 937G
'_j New Constructor Use x ,Resioen ial i Number of bedrooms 3 Code eenvec cesign flow rate ySO GPD
ZReolacement PubPublicor commerda! - Describe
Parent material d 1p-LL- .i 4 L( R000 Plain elevation if applicable
General commems
and recommenoauons
Bonric # M Boring
p,r Grouno surface elev tl �% (✓ �l f nenth tr, llr„.fl ll ;.-t—
I Soil Ao licatior, Rate
Hgnzon
f
Dept^,
in
i Dominant Colo-1
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Cu Sz Cont Color
I V Structure
r Sz. Sin
consistence
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` pit Ground surface elev 3 YI ft Depth to lim�ung factor
Horizon of
In
Dominant Colo• Reoox Descnpbor Texture
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onsistence
am
Bounoary Roots GPDtf(
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i
_men: e i = nQtl , ' Sl < L U mg/L anc 155 13, < 150
:3 1267�.
/L ' Effiue,a #2 = BDD . < 30 mo_/L and TSS < 30 mot;
e CST Number
Date Evaluation Coneuceeo Telephone Numt
3 ?'/l020� ?r5 2Gry,
PropertyOvmer �ol...-c�.r�, Parc=:IDft
�r—� Boring # ® Borino
i ❑ pit Ground surface e!ev_ l-20 f:.
Depth to limiting `actor i-
Page Z of 3
Hodzan
' Deptr.
Demmant Color
Muns=11
Redox DescnpLor. ; extura Strud wire bormstenoe
Out Sz. Conn cotor " Gr Sz. Sh.
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t_I ❑ pit Ground surface elev. ft Deptn to limiting factor In.
Horizon
( Depth
' ir.
Don:mant Colo
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in. j Munsell Ou Sz. Con:. Colo, ! Gr Sz. Sh_ I
oundary I Roots I GPD/f;
j 'ct`C.' tf92
' Etiuent tt = BOD , > 30 - 220 mglL and TSS >3J < 150 mgl_ ' Effluent #2 = BCD : < 31-'mg/L and TSS < 30 ny.L
The Dept. of Safety and Professional Services is an equal opportunity service provider and anployer. if you need assistance to
access services or need material in an alternate format. cronmot the department a: 608-266--151 or T-IN through Relay
SaDd33 (al III:)
CHECK BO%AS A?PLICABLE.
✓0 SOIL EVALUATION
SITE MAP
PROJECT NAME:
Adolf Johnson Trust
CHECK BOX AS APPXABLE.
Scale: 1"=40' SYSTEM PAGE 2 OF-3
o ao so so
PLOT PLAN
t,C tl goal 1D' OESiGN FLO'N GPD
Attach design flow calculations for commercial plans.
PROJECT ADDRESS
2637 12th Ave, Woodville, W I
Pipe Material 1 ASTM Standard (Tables 384.30-3 8 384.30-5)
N
SanM y Sewer
BM Symw
100.00
OO.�
eM Elevatlon FT
Force Main: 7
BM Doscdwn
grade Q west post field gate
i�.aKam noon o-r
IMPORTANT
Gradient(!6)
SlopeArea (
3o Wen Symed(Vappscaole): O
/o
arawinv an a.o.,
Show ground eletion contours at suitable intervals
va
of Teslerted
on Ida approprNe M
i
t=e-wcr Its _
9lr 4•t`— —,— —
—B
Ac IC --o" o.lTrusf
s6 vY Sw 'ly S 25 2-8 Al jii�
haw C�er� T s'P
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Ii0 --I
ST. CRo UNTY SANITARY SYSTEM Filece
Office Use Only
OWNERSHIP/ADDRESS FORM Created 212021
Community Development Department will utilize this information to provide the property owner with
information regarding operation and maintenance of your new or replacement sanitary system! This
information will be provided as part of our ongoing efforts to protect public health, your well, groundwater,
surface water, property values, and county resources. Once approved, this completed form and educational
information will be sent to you by email. If you would like to view your issued sanitary permit online, you can
do so by using the Property Files Scanned weblink.
OWNER/BUYER INFORMATION
Owner/Buyer t'q41'f1X f,4elt 4ce5-
Mailing Address 2637 (2v`�A� �-
City/State/Zip /,(jael"& J-YpZ�
Phone Number (required) :1 r S - tf%5— %3 %40
Email Address
Parcel Identification Number 00g'- 1672 - $ o -Ooa
(found on the property tax bill)
NEW SYSTEM: LEGAL DESCRIPTION
Property Location 515 1/4 , S� t/4 , Sec. J T 28 N RAW, Town of
Subdivision Plat: 4 c a Cw
Lot #
CTertifYed S B ey M a # S _ Volume Page #
Warranty Deed # l l2 $11 O (before 2006)Volume —� -Page #
Number of bedrooms (2 Spec house CI yes R( no Lot lines identifiable JKyes a no
OFFICE USE gNLY
/�
New Property A ress �%�03 /Yk' Z Z�f^ Ae- -'Cr%i QRt' GcC s
Nenficatio of new address required from Community Development Departent for new construction.)
�4 0/
(stiff Initials) (Date)
This form must be submitted with all Private Onsite Water Treatment System (POINTS) applications.
New System: Include with this form a recorded warranty deed from the Register of Deeds Once and a copy of the certified
survey map if reference is made in the warranty deed.
Community Development Department - Land Use Division
715-386-4680 St. Croix County Government Center
cddPsccwi.gov 1101 Carmichael Road, Hudson, WI 54016
715-245-4250 Fax
www.Scaingov
Parcel #: 008-1072-80-000
Valid as of 09/30/2021 05:28 PM
Alt. Parcel #: 25.28.16.380
Owner and Mailing Address:
JEFFREYJ JOHNSON
DARLAJJONCAS
N534 RIVERVIEW DR
SPRING VALLEY WI54767
Districts:
Dist# Description
5586 SCH DIST SPRING VALLEY
6100 CHIP VALLEY VOTECH
Abbreviated Acres:40.000
Description:
SEC 25 T28N R16W 40A SE SW EXC N 1 RD
TOWN OF EAU GALLE
ST. CROIX COUNTY, WISCONSIN
Co-Owner(s):
HARMON, DEBORAH L
JOHNSON, DALE E
JOHNSON, DIANE M
JOHNSON, DOUGLAS S
more...
Physical Property Address(es):
* 2637 12TH AVE
Parcel History:
Date Doc #
Vol/Page
Type
04/19/2021
1128110
/
TI
04/19/2021_-128111
/
QC
10/09/20_17
;1055233
;/
COINS
08/31/2017
10 4-
_
WD
more..
Plat
Tract (S-T-R 401/4 1601A GL)
Block/Condo Bldg
* N/A -NOT AVAILABLE
25-28N-16W
2021 Valuations:
Values
Last Changed on 08/31/2021
Class and Description
Acres
Land
Improvement Total
Gl-RESIDENTIAL
2.000!
12,000. 00',
94,400.00 106,400.00
G4-AGRICULTURAL
17.000
2,000.00
0.00 2,000.00
G5-UNDEVELOPED
18.000;
19,600.00,
0.00 19,600.00
G5M-AGRICULTURAL FOREST-
- -�
3.000
_ 3 900 00'
0.00 3,900.00
Totals for 2021
General Property
40.00�
37,500.00
94,400.00
131,900.00
Woodland --',
0.0001
0.00
0.00'.
0.00
Totals for 2020
General Property
40.000
37,600.00
94.4.0. 0.00
132,000.00
_
—_
Woodland
_
0.000
O.001
0.00
0.00
2021 Taxes
Taxes have not yet been calculated.
Key
* - Primary
Ws Dept. of Safety and P fessiona� viQl9 2p21 S IL E TION REPORT
Division of Safety and Bwldi gs
Jr yi15p,,c »nCe ' S 385. Wis. Adm. Code
eve�op County
Attach complete site plan o p r;vaoP 112 x 11 inches in size. Plan must
include, but not limited to. v horizontal reference point (BM), direction and Parcel I.D.
percent slope scale or dimensions north arrow and location and distance to nea res t d
roa
Please print all information. Re Wed. by
Oersonal Information you provide may be used for secondary purposes (Privacy Law. s 15.04 (1) (m)) ,J/nw
Page I of-j -
-8,O^000
Date
hd,t sLl1l4 S ?5T N R /(q E (or)
Property Owner's Mailing Address Lot # Bbck # Subd Name or CSM#
I 2,&;'7 (2 Av-t-
City State Zip Code Phone Number ❑ City ❑ Village (aTown Nearest Road
WilluedutIAt
I Wf I-SYvZ 8 1 (71S )'f15-93761
$v,o. Qaat/e.
1 /2-1* "
❑ New Construction
Use Residential / Number of bedrooms
3
Code derived design flow rate
ZSO GPD
replacement ❑ Public or commercial - Describe
Parent material _ q L"-,L,4 L( Flood Plain elevation if applicable
General comments
and recommendations
0
i Bonng # 16! Boning /
❑ pit Ground surface elev. 4,1. ft Depth to limiting factor / In. C^, z^)
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description
Qu. Sz. Cont. Color
Texture
Structure
Gr. Sz. Sh.
onsisboundary
Roots
GPD/ft, 2
((#i
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/� # Boring
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❑ Pit Ground surface elev .5. 83 ft. Depth to limiting factor // in 1r-7 ---7-1
Horizon
Depth
m.
Dominant Color
Munsell
Redox Description
Qu Sz. Cont. Color
Texture
Structure
Gr. Sz. Sh.
onsistence
oundary
Roots
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a. �
3
Emuent S I = uvu , > su < z2U mg/L and I SS >30 < 15() mg/L • Effluent #2 = BOD , < 30 mg/L and TSS < 30 mg/L
CST Name (Pl/leasas (P'nt S�nature CST Number
i ttCAtt, t-cc.I/rii.r7<X// up'/ S
Address Date Evaluation Conducted Telephone Number
Z`!'/3 /36 �h�-�i �f ,ss®� �i Ski 3 7 /!0 2m Z-11" -7 e S 265 y//5
Property Owner J*"-41.41—
Parcel ID #
pan. Z ,.f _�?
1157 Bonno # ® Boring
❑ pit Ground surfaceelev. Z - ZO P. Depth to limiting factor in.
Soil Ao liafion Rate
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description
Qu. Sz. Cont Color
Texture
Structure
Gr. Sz Sh.
onsistence
Boundary
Roots
GPDKI a
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ff#2
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❑ pit Ground surface elev. fL Depth to limiting factor in. r-----m
Hor¢or,
Depth
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Redox Description
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Gr. Sz. Sh.
Consistence
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11#1 -
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a
❑ Boring # ❑ Boring
❑ pit Ground surface elev. ft. Depth to limiting factor in.
a�u n�I-i
Horizon
Depth
in
Dominant Color
Munsell
Redox Description
Qu. Sz. Cont. Color
Texture
Structure
Gr Sz. Sh.l`tg11
onsistence
Boundary
Roots
GPDRt a
-
ff#2
Effluent #1 = BOD , > 30 f 220 mg/L and TSS >30 1150 mg/L ' Effluent #2 = BOD 3 130 mglL and TSS f 30 mg1L
The Dept. of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to
access services or need material in an altemate format, contact the department at 608-266-3151 or Tn' through Relay.
38"339(RI Ill 1)
CHECK BOX AS APPLX:ABLE.
CHECK BOX AS APPLICABLE
Q✓
SOIL EVALUATION
Scale: 1"-40'
SYSTEM PAGE 2 OF
°
40 BD
SITE MAP
PLOT PLAN
PROJECT NAME:
10'
DESIGN FLOW: GPI)
(101
Adolf Johnson Trust
Attach design flow, Calculations for commercial plans.
PROJECT ADDRESS: 2637 12th Ave, Woodville, WI
Pipe Material 1 ASTM Standard (Tables 384.3M & 394.30-5)
f oo.oa FT
N
Sanitary Beer
BM symnol BM Elevation
Force Maln: /
BM Descdglon, grade Q west post field gate
Indkaro noun M
IMPORTANT:
Slope Gradlera (%) 1Well Symbol (dappicaole). 0
drnulrg an anon
Show ground elevation contours at suitable intervals.
of Tested Area:
on tine appropdta als
F=exce Ifs _
9e4'7- —
— 14`rG SIcPa
q 5.85'
— — q 3 '78'
EIIA4l,
!"5k ,
— — 93 - — — f2." I
'I
A&Ifr''316" f
s6 Y.{ sK 'ly S 25 7— 28 A/ K / o w
Cow qdAite— -Ts'P
3 t = 9?. lv -/
r3z = 95 33'
33 9z. Zo
( 9q(4e&,q&T ' ^
STIWI)e couNrr NO. 633935
STATE SANITARY PERMIT
TOWN OF K. .4LLB
SEC�,T N, R.��
AND/OR LOT BLO
SUBDIVISION
NO.
STATUTES
(a) The purpose of the sanitary permit is to allow installation
of the private sewage system described in the permit
(b) The approval of the sanitary permit is based on
regulations in force on the date of approval.
(c) The sanitary permit is valid and may be renewed for a
specified period.
(d) Changed regulations will not impair the validity of a
sanitary permit.
(e) Renewal of the sanitary permit will be based on
regulations in force at the time renewal is sought and that
changed regulations may impede renewal.
(1) The sanitary permit is transferable.
History: 1977 c. 168; 1979 c. 34,221; 1981 c. 314
Note: If you wish to renew the permit, or transfer ownership of
the permit, please contact the county authority.
ISSUING OFFICER - DATE
I r,2,,A,.Z /
UNLESS RENEWED BEFORE THAT DATE
POST IN PLAIN VIEW
VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION
SBD-06499 (RI1/20)