HomeMy WebLinkAbout032-2167-46-000 t
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
463332 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:
Hartman Homes Somerset, Town of 032-2167-46-000
CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No:
26.31.19.1426
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
i . C
Septic Benchmark .A
2.68 loZ.b~ ~GO.o
Dosing Alt. BM
Rtrnfien Bldg. Sewer' I I 7Y • Z-I>
Holding St/Ht Inlet, I i 1-7,7
TANK SETBACK INFORMATION St/Ht Outlet r JZ 7-, 77. `~Z
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
ccla~- 1L.33 77. 3Z
Septic , /t f 7 . Dt Bottom
73.7
: I J Header/Man.
Dosing 2-1
Aeration Dist. Pipe Ci1~ rC]
Holding Bot. System C
PUMP/SIPHON INFORMATION Final Grade
'r
Manufacturer t Demand St Cover_ t:.
J
GPM I AI "AV 7 Z_
Model Number r
Q r
Z 7, (Ck
TDH Lift f Friction Lo sh System 1Vd . TDH .E~
2, zl~
Forcemain Lengtb, Dia.Z Dist. to Well)
SOIL ABSORPTION SYSTEM
BED/TRENCH Width / Length j No. Of Tren s PIT DIMENSIONS No. Of Pits Inside Dia Liquid Depth
DIMENSIONS (0 1 /60
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
INFORMATION CHAMBER OR
Type-Of-System: , r UNIT Model Number:
DISTRIBUTION SYSTEM
Header/Manifold Distribution ; t J x Hole Siz t x Hole Spacing Ve Air I
p(s) CG~ `
Length Dia t~Z Length ~~•`J~ Dia t Spacing I D (t K,
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 \ ~ ,
Yes No Yes No /'(03
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: QCt7.26,/W,~ Inspection #2: / /
_aL 144
Location: 645 196th Avenue Somerset, WI 54025 (SE 1/4 NW 1/4 26 T31N R19W) Pinecliff d Addition Lot 46 Parcel No: 26.31.19.1426
1.) Alt BM Description F2 U f' 5
2.) Bldg sewer length = q , i
- amount of cover
Plan revision Required? I ' Yes No Use other side for additional information. 11KLL/// , ` /
Date Insepctor's S nature Cert. No.
SBD-6710 (R.3/97)
COMPOSITE CURVE
ST, RITE'
■ 4 Q s
•
CAPACITY LITRES PER MINUTE
0 50 100 150 200 250 300 350 400 450 500 550
I 90
F
26
.~yA
80 24
22
70 F
Cg
Fcj~~ X2,5, zo
I ~ gyp
so 18
F
FCjs y~so
16 00
t-u H10 yo FF
Lu 50
z 14 z
c ~
~ L&6' 14 a
40 F %y
cIr y
off, .i? 10
'O yo
30
F s
C? 'INN
20 tiA 8
zk 4
~y 1i3/fA
10
~
2
/Y10
0
I 0 25 50 75 100 125 150
i CAPACITY GALLONS PER MINUTE
11
Safety and Buildings Division County
O1 Washington Ave., P.O. Box 7162
` M ison, W 53707 - 7162 Sanitary Permit Number (to be filled in by Co.)
isconsin 8) 66-31
De artment of Commerce
4rb3 33Z-
Sanitary Permit Ap:L n Stat Plan I.D. Number
In accord with Comm 83.2 1, Wis. Adm. Code, persoinformati n you s c ~J1 , 40 -
S 1 is 0 ?&V0
may be used for secondary purposes Privacy w, s15. 1)(m) Proj ct Address (if different than mailing address)
1. Application Information - Please Print All Information
ZCi~INb OFFic,
Property O er's Nam azcel # Lot # Block #
Property wner% ailmg ddr s Property Location
City, Sta Zip Code Phone Number Section 7/5 (circle o )
N; RJ" o
II. Type of Building (check all that apply) 1.4 an.
ubdivision Name
1 or 2 Family Dwelling -Number of Bedrooms _
❑ Public/Commercial - Describe Use ~.Ad~
❑ State Owned - Describe Use ❑City ❑VillageZTownship of
III. Type of Permit: (Check only one box on line A. Complete line B if applicable) ® 3 Z ^ 216-1 _ `/6 _ CV0
A. kNew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System
B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued
Before Expiration Plumber Owner
u lr
IV. Type of POWTS System: Check all that a 1 "TD
CA1 ti = 0
❑ Non -Pressurized In-Ground ❑ Mound > 24 in. of suits soil A Mound < 24 in. of suitable s il ❑ At-Grade ❑ Single Pass Sand Filter ❑
Constructed Wetland ❑ Pressurized In-Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑
Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel-less Pipe ❑ Other (explaA)
V. Dis ersaVrreatment Area Information: -1 Of j
. I O
Design Flow (gpd) Design Soil Application Rate(gpdsf) ispersal Area Required (sf) ispersal Area Prop ed (sf) rstemElevation
VI. Tank Info Capacity in Total tuber Manufacturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Units Concrete Constructed Glass
New Existing
Tanks Tanks
Septic or Holding Tank
Aerobic Treatment Unit T
Dosing Chamber
VII. Responsibility Statement- 1,'the undersigned, a ume responsibility for installation of the POWTS shown on the attached plans.
Plum er' a ( int) Plum is S MP/MPRS Number Business Phone Number
~i
P9 -a' I ~
Plumber's Address (Street, City, State ip Code)
VIII. Coun epartment Use Only
Approved ❑ ppro Sanitary Permit Fee Fildes Groundwater Date Issued Iss in gent Sign Stamps)
Surcharge Fee) e)~
C1 Owner teen Reason menial KJU
IX. Conditions p rovaU 1 3) Na 1,=~it 4r4 dlu~^'"-'C
SYSTEM ER: / ,
1 Septic tank, effluent fitter and z"~ Q o
dispersal cell must all be serviced / maintained "7► ,
as per management plan provided by plumber.
2. All setback requirements must be maintained
as per applicable code/ordinances.
Attach complete plans (to the County only) for the system on paper not less than 8112 x 11 inches in size
SBD-6398 (R. 01/03)
37
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74
Safety and Buildings
- 10541 N RANCH ROAD
commerce.wi.gov HAYWARD WI 54843
TDD (608) 264-8777
isconsin www.commerce.wi.gov/sb/
www.wisconsin.gov
Department of Commerce
Jim Doyle, Governor
Mary P. Burke, Secretary
February 18, 2005
CUST ID No.224263 ATTN: POWTS Inspector
KIM A O CONNELL ZONING OFFICE
K.O. CONSTRUCTION ST CROIX COUNTY SPIA
504 3RD AVE 1101 CARMICHAEL RD
OSCEOLA WI 54020 HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 02/18/2007 Identification Numbers
Transaction ID No. 1108000
Site ID No. 694842
SITE:
Mike Hartman Please refer to both identification numbers,
196TH Ave above, in all correspondence with the agency,
Town of Somerset
St Croix County
SE 1/4, NW 1/4, S26, T3 IN, RI 9W
Lot: 46, Subdivision: Pinecliff
FOR: Description: New mound, 4 bedroom residence
Object Type: POWTS Component Manual Regulated Object ID No.: 1004440
Maintenance required; 600 GPD Flow rate; 19 in Soil minimum depth to limiting factor from original grade; C0114 4h
System(s): Mound Component Manual - Version 2.0, SBD-10691-P (N.01/O1)
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes DEpART!JI` N'
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in F 5Af
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 SEE CO'' tF
stats.
The following conditions shall be met during construction or installation and prior to occupancy or use:
General Approval Conditions:
• This system is to be constructed and located in accordance with the enclosed approved plans and with the
design manuals noted above.
• 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. In addition,
the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of
the mound component manual are complied with. A copy of this information must be given to the owner upon
completion of the project.
Key Item(s)
• A copy of this approval letter and index sheet shall be attached to plans that correspond with the copy on file
with the Department. Changes to the approved plan must be submitted for review and approval. Failure to
properly attach the approval and index page to plans that match the copy on file with the Department may result
in enforcement action under s. 145. 10, Stats.
• The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater
particle size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to
the owner of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening
used to service the filter shall terminate at or above finished grade with a watertight cover.
f -
KIM A 0 CONNELL Page 2 2/18/2005 +
C.
t
Reminder
• The orientation of the mound system must be such that the longest dimension is oriented along the surface
contour per COMM 83.44(6)(a)2.
• Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual.
• Surface water drainage shall be diverted away from the system area per Mound Component Manual.
• Materials shall conform to the requirements of COMM 84.
• Maintain well and waterline set backs per COMM 83.43(8)(1). Consult the Department of Natural Resources for
well setbacks and exceptions to the setbacks.
• Provide frost protection per COMM 83.43(8)(c).
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 Safety & Buildings reserves the right to require changes or additions
should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this
review shall relieve the designer of the responsibility for designing a safe building, structure, or component.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
~ The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the
installation, operation or maintenance of the POWTS.
Sincerely, Fee Required $ 175.00
Fee Received $ 175.00
Balance Due $ 0.00
Patricia L S r
POWTS Plan Reviewer , Integ to Services WiSMART code: 7633
(715) 634-7810, Fax: (715) 634-5150, M-f 7:45 am - 430 pm
pshandorf@commerce.state.wi.us
• Leroy G Jansky, Wastewater Specialist, (715) 726-2544
cc.
I
MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN
Residential Application
INDEX AND TITLE PAGE
Project Name: MIKE HARTMAN
Owner's Name: MIKE HARTMAN
Owner's Address: 744 RYAN DRIVE
HUDSON WI 54016
Legal Description: SE--NW--SEC 26--T31N--R19W
Township: SOMERSET
County: ST. CROIX
alrty
1012
Subdivision Name: PINECLIFF
a
Lot Number: 46 Block Number: o ANp E INS
Parcel I.D. Number: O~
~-SPOND
Plan Transaction No.:
~Joo~
Page 1 Index and title //0 O
Page 2 Data entry
Page 3 Mound drawings
Page 4 Lateral and dose tank
Page 5 System maintenance specifications
Page 6 Management and contingency plan
Page 7 Pump curve and specifications
Page 8 PLOT PLAN
Designer: KIM A OCONNELL License Number: 224263
Date: 02/08/05 Phone Number: 715-755-3145
Signature:
Designed Pursuant to the
Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and
SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81)
Version 3.0 (03/01/01) Pagel of 8
Mound and Pressure Distribution Component Design
Design Worksheet
Site Information
(r or c) R Residential or Commercial Design Note: Sand fill (D) calculations assume a
400.00 Estimated Wastewater Flow (gpd) Table 83-44-3 in-situ soil treatment for fecal
1.50 Peaking Factor (e.g. 1.5 = 150%) coliform of - 36 inches.
600.00 Design Flow (gpd)
9.00 Site Slope
97.10 Contour Line Elevation (ft)
19.00 Depth to Limiting Factor (in)
0.40 In-situ Soil Application Rate (gpd/ft)
Distribution Cell Information
100.00 Dispersal Cell Length Along Contour (ft) = 6.00 Cell Width (ft)
1.00 Dispersal Cell Design Loading Rate (gpd/ft2)
1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point
in the distribution Y
Pressure Disribution Information network.? Enter Y or N
(c or e) E Center or End Manifold
3.00 Lateral Spacing (ft) If N above, enter the elevation ft
2 Number of Laterals of the highest point.
0.125 Orifice Diameter (in) (e.g. 0.25)
3.00 Estimated Orifice Spacing (ft) = 9.09 ft2/orifice
2.00 Forcemain Diameter (in)
250.00 Forcemain Length (ft) Does the forcemain drain back? Y
73.00 Pump Tank Elevation (ft) Enter Y or N
6.50 System Head (ft) x 1.3 40.78 Forcemain Drainback (gal)
25.35 Vertical Lift (ft) 90.43 5x Void Volume (gal)
4.04 Friction Loss (ft) 131.21 Minimum Dose Volume (gal)
x 35.89 Total Dynamic Head (ft) 27.19 System Demand (gpm)
a 1
Lateral Diameter Selection Manifold Diameter Selection
in. dia. options choice in. dia. options choice
0.75 1.25 x
1.00 1.50 x x
1.25 2.00
1.50 x x 3.00
2.00 x
3.00 x
Gallons/Inch Calculator (optional)
Treatment Tank Information 1260.00 Total Tank Capacity (gal)
1260.00 Septic Tank Capacity (gal) 58.00 Total Working Liquid Depth (in)
WEEKS Manufacturer 21.72 gal/in (enter result in cell B49)
Dose Tank Information Effluent Filter Information
800.00 Dose Tank Capacity (gal) Zabel Filter Manufacturer
21.76 Dose Tank Volume (gal/in) A100 Filter Model Number
WEEKS Manufacturer
Project: MIKE HARTMAN Page 2 of 8
r
Mound Plan View
T
. . . J
1/10 B Observation Pipe 3
O A
W 1: B
I
3
L
Mound Component Dimensions
ft
A 6.00 ft E 23.48 in H i1ft ft K Aft
B 100.00 ft F 9.50 in z ft L ft
D 17.00 in G 0.50 ft J W 600.00 (ft2) Dispersal Cell Area 1934.93 (ft2) Basal Area Available
6.00 (gpd/ft) Linear Loading Rate 10.00 (ft) 1/10 B Obs. Pipe Placement
Mound Cross Section View
Aggregate Dispersal Area
Finished Grade 100.31 (ft) ►",a--
G T
♦ W.
F Dispersal cell 99.02 (ft) Lateral
90.52 (ft) a ~r Invert
3
1
Dispersal Cell
D d
Elevation
0
97.10 (ft) Contour Elevation
9.0 % Site Slope
Geotextile Fabric Cover
Shading Key T Dispersal Cell See lateral details on
Topsoil Cap a 1.5 ft Page 4 for number,
I,?1 R7,779 Subsoil ra c
O ! I size, and Spacing of
_p Ci 0 M
ASTM C33 Sand I II I I F laterals. Laterals are
Tilled Layer 0.5 ft Typical Lateral equally spaced from
® Aggregate o ( L51 the distribution cell's
- A centerline in the
distribution cell (AxB).
Project: MIKE HARTMAN Page 3 of 8
End Connection Lateral Layout Diagram
Laterals centered over the A & B dimension * = Turn-up vdbe11 valve or oleanoutplug
f P .l
All laterals are identical IE 1{-~I Holes drilled on the bottom of the lateral
equally spaced S
Force main connection via tee or cross to manifold at any point. Laterals & Force main of PVC Sch 40
(per COMM Table 84.30-5)
Number of Laterals 2 Orifice Diameter 0.125 in
Lateral Diameter 1.50 in Orifice Spacing (X) 3.08 ft
Lateral Length (P) 98.56 ft Orifices per Lateral 33
Lateral Spacing (S) 3.00 ft Orifice Density 9.09 ft2/orifice
Lateral Flow Rate 13.59 gpm Manifold Length 3.00 ft
System Flow Rate 27.19 gpm Manifold Diameter 1.50 in
Total Dynamic Head 35.89 ft Forcemain Velocity 2.78 ft/sec
Dose Tank Information Locking cover with warning
label and locking device and
sealed watertight
Electrical as per NEC 300 and
Comm 16.28 WAC 4 in. min.
Disconnect
Tank component is properly vented > E Alternate outlet
location
Forcemain diameter
WEEKS Manufacturer 2 in.
Ca acit 800.00 Gallons
volume 21.76 gal/inch A
Weep hole or anti-
Dimension Inches GaljM
B I + ( siphon device
A 20,47 4B 2.UU 43.52 Pump off elevation (ft)
C - I I I I 73.67
D ov.VAn 4 %J i74.^vc or D
Total 36.76 800.00
Dom Se tank PIPVation (ffl
3" Bedding un er tank. I 73.00
Alarm Manuafacturer SJ ELECTRO
Alarm Model Number HW 100
Pump Manufacturer GOULDS
Pump Model Number WE0511 H
Pump Must Deliver 27.19 gpm at 35.89 ft TDH
Project: MIKE HARTMAN Page 4 of 8
Mound System Maintenance and Operation Specifications
Service Provider's Name KIM_A_OCONNELL_ Phone 715-755-3145
POWTS Regulator's Name ST.CROIX COUNTY ZONING Phone 715-386-4680
System Flow and Load Parameters
Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in
Estimated Flow - Average 400 gpd Maximum BOD5 220 mg/L
Septic Tank Capacity 1260 gal Maximum TSS 150 mg/L
Soil Absorption Component Size 600 ft2 Maximum FOG 30 mg/L
Type of Wastewater Domestic Maximum Fecal Coliform >10E4 du/100 mL
Service Frequency
Septic and Pump Tank Inspect and/or service once eve 3 ears
Effluent Filter Should inspect and clean at least once eve 3 ears
Pump and Controls Test once eve 3 ears
Alarm Should test month)
Pressure System Laterals should be flushed and pressure tested eve 1.5 ears
Mound Inspect for ondin and seepage once eve 3 ears
Other
Miscellaneous Construction and Materials Standards
1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight cap,
and are secured in as shown in the mound component manual.
2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code.
3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code.
4. Tillage of the basal area is accomplished with a mold board or chisel plow.
5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion
and help reduce frost penetration.
Lateral Tum-up Detail
Finished
Grade
6-8" Diameter Lawn Threaded Cleanout
Sprinkler Valve Box Plug or Ball Valve
I
Distribution
Lateral
Long Sweep 90 or Two
45 Degree Bends Same
Diameter as Lateral
Project: MIKE HARTMAN Page 5 of 8
Mound System Management Plan
Pursuant to Comm 83.54, Wis. Adm. Code
General
This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component
manuals [SBD-10691-P (N.01/01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and
maintenance reporting.
No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death.
Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as
POWTS components.
Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used
for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to
failure must be replaced. Dosed access openings greater than 84nches in diameter shall be secured by an effective locking device to prevent
accidental or unauthorized entry into a tank or component.
Septic Tank
The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank
shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at
least once every 3 years by inspection.
The outlet filter shall be cleaned as necessary to ensure proper operation. The fitter cartridge should not be removed unless provisions are
made to retain solids in the tank that may slough off the fitter when removed from its enclosure. If the filter is equipped with an alarm, the filter
shall be serviced if the alarm is activated continuously. Intermittent fitter alarms may indicate surge flows or an impending continuous alarm.
The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank.
If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next
service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank.
The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are
used they shall be approved for septic tank use by the Department of Commerce.
Pump Tank
The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper
operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary.
Mound and Pressure Distribution System
No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall
be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative
maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow
compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched
as protection from freezing.
Influent quality into the mound system may not exceed 220 mg/L BOD5, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or
30 mg/L BOD5, 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow
specified in the permit for this installation.
The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed
of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the
system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the
dispersal cell.
Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels
above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring.
Contingency Plan
If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system
in proper operating condition.
If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately
repaired or replaced with a component of the same or equal performance.
If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in
its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and
related piping, and replacing said components as deemed necessary to bring the system into proper operating condition.
See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider.
Project: MIKE HARTMAN Page 6 of 8
Submersible Effluent
erforma c e
Curves Pumps ~
METERS FEET
- MODEL 38Fs5
--r- -t-----;-t
25 w _t--fi- SIZE 3/4" Solias r
-t- --j
WE 15H
i !
20 WE10H"
O • WE07H-T
15 50
WE05H
40
10 WE03M
20 W E 00 4
5 - 1 -t-
10 f --1-r---}
I
C_ J
0 10 20 30 k0 G 60 70 6G 90 100 110 120 GSM
0 10 20 m 1/h
L -L
CAPACITY
~GOULDS PUMPS, INC,
y Se~G Fats raw 1CFx
METERS FEET
j 120 :---j--r-~ - MODEL 3885
05 - -r- - -i_-~ _r SIZE 3/4" Solids
I Ic r-WE 15hH -t r-
_-1 t - 1
90 --{-r r-
25 80 - - -+-r- r--r t
y~ 70 - .-T- r- r-
I 20 i--- r---r- f~ r-,---t-- t--fit-,
60 . . .
60 WEQSHn
1
40 - r--j--
o 30
20 ~_--1- --±---F_ _ --r-*
0 10 20 00 4r, ) 70 80 90 100 110 120 opm
G 20 3v m'/h
CAPACITY
9 1985 OOW103 -,Vmps, Inc. E119QUY9 ww, ,o>
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Wisconsin 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
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.
Please print all information. Re ewed by Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).
Prope Owner j P"roprty Location
Govt Lot w ' 114 1/4 S T31 N R E (or
Property Owner's Mailing Address Lot Bloc # Su7")
ame or CSM#
jb
C
ity State Zip Code one Number Q ity ❑ village L Town Nearest Road
New Construction User Residential / Number of bedrooms Code derived design flow rate 65~ GPD
Replacement ~j Public or commercial - Describe:
Parent material eky,, ~ Flood Plain elevation if applicable ft.
General comments
and recommendations: L--2~ Y7 l
F71 Boring # I❑ Boring
lCl Pit Ground surface elev.. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
Boring # ❑ Boring
JM Pit Ground surface elev. ft. Depth to limiting fact r
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Con ' Boundary Roots GPD/ftz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
9
3 - L/ s - c
G> 6
* Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L
CST Nam (PI se Pr' t) Signature CST Number
Address ate Evaluation Conducted Telephone Number
SBD-8330 (R07/00)
r ~
Property Owner Parcel ID # Page 7 of
F Boring # ❑ Boring i-` P
Pit Ground surface elev. ft. Depth to limiting factor ~ in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz
in. Munsell Qu. Sz. Cont. Color Gr. Sz//. Sh. *Eff#1 *Eff#2
/ Sb ~1 i c
t
1 S
f
TV 7 -~rZ/ J/
6. 1. -
'a 7
s ,5 Z717 11 2ZL _ o Q
❑ Boring # ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
F-1 Boring # E] El pit Boring
Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
* Effluent #1 =GODS > 30 < 220 mg/L and TSS >30 < 150 mg/L Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
SBD-8330 (R.07/00)
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ST. CROD: COUNTY
SEPTIC TANK MAINTAINANCE AGREEMENT
AND
OWNERSSIP CERTIFICATE FORM
Owner/Buyer 4L.& ~ f1L:T s ~~r
Mailing Address S
Address
(Verifrcatic a requized fry Pla»rg Dgwbnmt far new omaeructim)
City/State ~Iy.V_- Parcel Identification Number
LEGAL DESCRIPTION "
Property I,ocat[on~/.. Idd '4 Sec.T_~LN'Rr Town of
Subdivision e-61" Lot# 476
Certified Survey Map# Volume ~ Page :
Warranty Dee& 52Q 3 Volume /121 Page 13
Spec house yes no Lot lines identifiable ~es --no
SYSTEM MAINTENANCE
Improper use and maintenance of your septic system could result its premature failure to handle wastes.
Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed
pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste
disposal system
The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the
owner and by a masterplumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-
site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary),
the septic tank is less than 1/3 full of sludge.
Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with
the standards set forth, herein, as set by th Department of Commerce and use the Department of Natural Resources,
State of Wisconsin Certification stating that your septic system has been maintained must be completed and returned to
the St. Croix County Zoning Office within 10 days of the three year expiration date.
SI NATC RE OF APP IC.~`PI DATE
OWNER CERTIFICATION
I (we) certify that all statements on this form are true to the best of my (our) knowledge I (we) am
(are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of
Deeds Office.
SIGNATURE OF PLICANT DA'T'E
Any mforniA m that is mur preaored may remA m the sanitary pama being revokedby the Zmma Deparaitmt'""'
• Include with this applic-an a tamped warrmty deed from the Regina of Deeds office
a copy of the certd ed survey mW if rake i rmstde in the wreranty deed.
.z State Bar of Wisconsin Form 2 - 1982 I
S'~3~
WARRANTY DEED°-' UfSfMS QFIFICE
St CRCU Ca. vj f ~
DOCUMENT NO.:~ VAI 121 b;4 491.1
MAY 8 199b
Geor sg T• Pennock' a/k/a George Pennock, at~ LA11:04 5 ~•l
conveys and warrants to -Rineclif f Partnershl.A_:
p~ to'
THIS SPACE RESERVED FOR RECORDING OATA
NAME ANO RC'URN ADDRESS
the following described real estate in St. cmix- Y
County, State of Wilsoatsin:
_I
(Parcel Idendrxation Number)
W1/2 of NWl/4; SEl/4 of NWl/4; NE1/4 of SWI/4; all that pert of NW1/4 of SW1/4
lying Ely of Apple River and that part of SE1/4 of SW1/4 lying Ely of Apple River;
all in Section 26- and all that part of NE1/4 of SE1/4 lying Ely of the Apple
River of Section y7; All in Township 31 North, Range 19 West, St. Croix County,
Wisconsin.
SF~
This is not ~ante~esd
XW(is not)
Exception to warranties: Easements, restrictions and rights-of-way of record, II
if any.
Dated this h day of May
(SEAL) (SEAL)
• • George Pennock, a/k/a George ~ennock
(SEAL) (SEAL)
AUTHENTICATION ACKNOWLEDGMENT
[ Mlr,_
T. PenriOCk 8/k/8 STATE OF WISCONSIN
0C IS.
Q r.' May 95 county.
day of y , 19_ Personally came before me this day of
i , 19_ the above ^amed
~i land `
TI 86 STATE BAR OF WISCONSIN
(If n
authorized by §706.06, Wis. State.) to me known to be the person who executed the
II'` foregoing instrument and acknowledge the same.
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