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Safety and Buildings
10541 N RANCH ROAD
commerce.wi.gov HAYWARD WI 54843
Contact Through Relay mm
i sco ns i n www.co www.m(isconsin.gov
Department of Commerce www.wisconsin.gov
' Jim Doyle, Governor
Richard J. Leinenkugel, Secretary
October 22, 2009
CUST ID No. 231346 ATTN.• POWTSInspector
JOHN HERBERT PELKE ZONING OFFICE
PELKE PLUMBING ST CROIX COUNTY SPIA
N 6298 ST HWY 25 1101 CARMICHAEL RD
DURAND WI 54736 HUDSON WI 54016
CONDITIONAL APPROVAL
Identification Numbers
PLAN APPROVAL EXPIItES. 10/22/2011
Transaction ID No. 1726197
SITE: Site ID No. 752366
Ben Vandewiele Please refer to both identification numbers,
72ND Ave above, in all correspondence with the agency.
Town of Springfield
St Croix County
NW1 /4, SE1 /4, S28, T29N, R15W
FOR:
Description: Mound, 3 bedroom residence
Object Type: POWTS Component Manual Regulated Object ID No.: 1244854
Maintenance required; 450 GPD Flow rate; 15 in Soil minimum depth to limiting factor from original grade; Systems)
Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 101), Pressure Distribution Component Manual - Version
2.0, SBD- 10706 -P (N.01 /01); Effluent Filter
r.
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Cods`
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constru ed
and located in accordance with the enclosed approved plans and with any component manual(s) referenced abo . J
The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all c
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:
Key Item(s)
• 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.
• Care must be taken to preserve the bench mark during construction.
• The proposed pump is near its limit with the proposed total dynamic head. If upon installation, the total
dynamic head increases, the proposed pump must be reevaluated and may be inadequate.
• The bottom of the distribution cell shall be level per the Mound Component Manual. The "D" dimension shall
be a minimum of 21 ". The maximum finished slope of the mound surface shall not have a slope ratio steeper
than 3:1 per the Mound Component Manual
• 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
JOHN HERBERT PELKE Page 2 10/22/2009
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.
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 other regulations and exceptions.
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 and the POWTS management plan to the owner and any
others who are responsible for the installation, operation or maintenance of the POWTS.
Sincerel , Fee Required $ 250.00
Fee Received $ 250.00
Balance Due $ 0.00
atricia L Shandorf -
POWTS Plan Revie er, , grated Services W iS MART code: 7633'
(715) 634 -7810, F (7 ) 634 -5150 , M -f 7:45 am - 4:30 pm
pat.shandorf@wisconsin.gov
cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544, Monday, 7 :00 A.M. To 3:30 P.M.
Notice: Starting July 1, 2009, no person or entity may engage or offer to engage in construction business in
Wisconsin unless they hold a Building Contractor Registration, or equivalent, issued by the Safety and Buildings
Division of the Wisconsin Department of Commerce.
"Construction business" means a trade that installs, alters or repairs any building element, component,
material or device that is regulated under the commercial building code, chs. Comm 60 to 66, the uniform
dwelling code, chs. Comm 20 to 25, the electrical code, ch. Comm 16, the plumbing code, chs. Comm 81 to
87, or the public swimming pools and water attractions code, ch. Comm 90. The term does not include the
delivery of building supplies or materials, or the manufacture of a building product not on the building
site.
For further information, go to our website: www.commerce.wi. Gov/ SB/ SB- Buildin�ContractorProgram.html
1
1
JOHN HERBERT PELKE Page 2 10/22/2009
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.
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 other regulations and exceptions.
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 and the POWTS management plan to the owner and any
others who are responsible for the installation, operation or maintenance of the POWTS.
Sincerel , Fee Required $ 250.00
Fee Received $ 250.00
Balance Due $ 0.00
atricia L Shandorf
POWTS Plan Revie�Ver , grated Services WiSMART code: 7633'
(715) 634 -7810, Fa:(7 ) 634 -5150 , M -f 7:45 am - 4:30 pm
pat.shandorf@wisconsin.gov
cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544, Monday, 7:00 A.M. To 3:30 P.M.
Notice: Starting July 1, 2009, no person or entity may engage or offer to engage in construction business in
Wisconsin unless they hold a Building Contractor Registration, or equivalent, issued by the Safety and Buildings
Division of the Wisconsin Department of Commerce.
"Construction business" means a trade that installs, alters or repairs any building element, component,
material or device that is regulated under the commercial building code, chs. Comm 60 to 66, the uniform
dwelling code, chs. Comm 20 to 25, the electrical code, ch. Comm 16, the plumbing code, chs. Comm 81 to
87, or the public swimming pools and water attractions code, ch. Comm 90. The term does not include the
delivery of building supplies or materials, or the manufacture of a building product not on the building
site.
For further information, go to our website: www.commerce.wi.gov/SB/SB-BuildinjzContractorPrograin.htrnl
1
Private On -Site Wastewater Treatment System (POWTS)
Index and Title Sheet
Owner: d J Ei1/ �R�I,O�'�✓!Ea E —
Project Name and System Type: �EN �A�JAE�J /ELE - .�• . /� w�✓,o °c✓ -
Location: 7'•2 �a /��E -
Street Address
Legal Description
. o �►✓ of .S��ti fie-iy� Sr C�wx Co.
Township/County
Contents: Page 1:
Page 2: o r A low
Page 3: C/!o ss S�re rii .� Dt ,/ �r✓ . i •••✓o
Page 4: // J - --
� G RO SS• 3�'irio.J �:i -.�vv_
Page 5: 1.,4�.or.� I/R.✓.r��iiir/ C,�/ ,I�,r�rc
Page 6:
Page 7: DD s✓ rs O ,v.✓r s 's y...✓w,�A, �,o•✓.�s.r rs.✓r ��.�✓
`(
Page 8:
Page 9:
Attachments: rio.✓ . r
,� lr�,r�c ✓�',�—
Plumber /er: Signed:
_ �N -
Date:
Credential Number: f1/�-
G1Sd0 .SBO + /o` 9 /•P'� � av0 CO y I�ONt'N r /'y .✓a./L ~ l�ERJa.✓ •?• O
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Page S Of
-SEPTIC TANK &-PUMP CHAMBER CROSS SECTION'AND SPECIFICATIONS
4" CI VENT PIPE 12" MIN. ABOVE GRADE 6 WEATHERPROOF
y /p" FROM DOOR, WINDOW OR JUNCTION BOX APPROVED
FRESH AIR INTAKE WITH CONDUIT MANHOLE COVERS
. . W/ PADLOCK &
.Azv �-rweo WARNING LABEL
GiC.00� y .r dEs.,r dAdAr 4 " MIN.
INL t
WATER TIGHT SEALS GAS" TIGHT t APPROVED
A SEAL JOINTS WITH
APPR - ._.. ; ALM APPROVED PIPE
PIPE � .. ON 3' ONTO - ONTO t. SOLID SOIL
SOIL PUMP OFF ELEV . 84.8 FT. --— t OFF `'� RISER EXIT
D PERMITTED ONLY
IF TANK
MANUFACTURER
HAS APPROVAL
3" APPROVED BEDDING UNDER TANK
CONCRETE .PAD
SPECIFICATIONS
SEPTIC./ DOSE �
TANK MANUFACTURER: c Ao r NUMBER DOSES PER DAY: s 07.. 7
TANK SIZES: SEPTIC Ooo GAL. DOSE VOLUME INCLUDING 887 ,cos
DOSE Goo GAL.. FLOWBACK: / a_9._Z _ .GAL.
ALARM MANUFACTURER: .S X jr gfl ee rt v CAPACITIES: A = ao INCHES r - 3„ �G GAL.
MODEL NUMBER: " ,� �� r
SWITCH TYPE: c /C B a 2 INCHES = 33.6 GAL.
PUMP MANUFACTURER: ZoQ'tct -.t Av C = 6.S INCHES = 0 9.2 GAL.
MODEL NUMBER: /s/
SWITCH TYPE: �rt�aRr D . = 7S INCHES = G G AL .
REQUIRED DISCHARGE RATE _ ��. �/ GPM PUMP 8 ALARM WIRING AS PER ILHR 16.23 WAC
fvERTICAL'DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE 4 FEET
+ MINIMUM NETWORK SUPPLY PRESSURE . . . .3 FEET
+ / FEET FORCEM IN `X /S FT /100 FT. FRICTION FACTOR . /J T FEET
TDTAL DYNAMIC HEAD = FEET
INTERNAL DIMENSIONS OF PUMP TANK: LENGTH S3 ; WIDTH y8 ; DIAMETER
LIQUID DEPTH �C
i
""q
TOTAL DYNAMIC HEAD/FLOW
LL PUMP PERFORMANCE CURVE PER MINUTE
MODEL 15111521153 EFFLUENT AND DEWATERING
w
14 153
1z 40 a.
MODEL 151 152 153
Fed Meters Gal. Liters Gal Liters aw Liars
152 5 1.5 50 189 69 261 77 291
10 10 3.0 45 170 61 231 70 265
4 30
" T », 15 4.6 38 144 53 201 61 231
8 25 151 20 6.1 1 29 110 44 167 52 197
25 7.6 16 61 34 129 42 159
6 30 9.1 — 23 1 87 33 1 125
35 10.7 — — — — 22 1 65
15 40 122 — —
4 y,
10 slata8 Head 30 IL (9.1m) 36R (11.6m) 44 R (13.4m)
014500B
5
Model 151 Models 1521153
10 70 30 4o so 60 70 eo sb 100 _
GALLONS 67A2 67132
LtIERS 0 40 80 170 160 700 240 280 3711 360
374 4518 3781 45e
RDW PER MNUrE
0145061/
374 374
.. .�.. _ `.. do }€�. �' ..� — ®•— — —
® ( 374 i 374
• Timed dosing panels available
• Electrical afterrlators, for duplex Systems, are available and
supplied with an alarm. ! ( I
• Variable level control switches are available for controlling
single phase systems. l �
• table piggyback variable level float sw t hes are available
for variable level lorxl and short cycle controls.
• Sealed Qv& -Box available for outdoor installations. See 11,v,6
FM1420.
• Over 130 °F (54 °C) special quotation squired.
-- 41 5318
SK2064
151H52M53 YODELS Control Selection
Yodel Vot"h Mode
N151 115 1 Non 6.0 1 2or3
BR151 115 1 AIAo 6A k11kided 2or3
E1511 290 1 Non 3.2 1 2or3
BE151 230 1 Auto 32 6lduded 2or3 "Easy assembly"
N152 115 1 Non 8.5 1 2or3 (1—P 8 Poe
BN152 115 1 Auto 8.5 Included 2or3 nil elcimled.)
E152 230 1 Non 43 1 2or3
113E152 230 1 Auto 4.3 i1d11ded 2or3
N153 115 1 Non 10.5 1 2or3
8Ni53 115 1 Auto 10.5 included 2or3
E153 230 1 Non 5.3 1 2or3
BE1531 230 1 Auto 5.3 W-W 2or3
1. Single piggyback variable level float switch or double piggyback variable level
float swtich. Refer to FMB477. • Reduces potential dogging by debris.
2. See FLW12 for coned model of Electrical Allenuft E -Pak - Replaces rocks or bricks under the pump.
3. Variable level ax*d switch 10-0743 used as a control activator, specify duplex • Made of tumble, fro b ott o m f ABS.
• Raises pump 2' off bottom of basin.
(3) or (4) float system. • Provides the ability to raise irrialte by adding sections of 1 %2
or T PVC piping.
® CAUTION Attaches securely to pump.
Accommodates sump, dewatering and effklent applications.
NOTE: Make sure float is free from obstruction.
For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump.
0 Copyright 2008 Zoeller Co. All rights reserved.
POWTS OWNER'S MANUAL AND MANAGEMENT PLAN
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner Sep tic Tank Capadty gal ❑ NA
Permit # Septic Tank Manufacturer Allzx4•a Lo.oc . ❑ NA
DESIGN PARAMETERS Effluent Fitter Mamthw urer Z n drc O NA
Number of Bedrooms 100gpdtedroom 3 ❑ NA Effluent Filter Model A /00 ❑ NA
NumberofC.ommercial Units — NA Pam Tank Loo p NA,"
Estimated flow {avrr. V)* 360 da Tank Manufacturer A / self - . 0 NA
Design flow (peak), estimated x 1 vs gaVday Mm ffacturer o ez i pe C1 NA
Soil Application Rate �. o da Pam Model S/ O NA
Pretreatment Unit K NA
Innuent/EBiuent Quality (NAo) Monthly Average **
Fats. Out & Grease E3 Sand/Guavei Filter ❑Peat Filter
tea'') 5 30 mg/L ❑ Mechanical Aeration ❑ Wetland
Biochemical Oxygen Demand (BODs) ::5 220 mgt ❑ Disinfection . O Other:
Total Suspended Solids M Manufacturer: Model:
5 250 mwL Dispersal Cells)
Pretreated Effluent Quality p May Average*** ❑ In—ground (gravity) ❑ InVound (pressurized)
Biochemical Oxygen Demand (BODS) 5 30 mg/l. ❑ At- grade X Mound
Total Suspended Solids t"I'38) 5 30 mg/L ❑ Drip-line Drip-line O Other:
Fecal Coliform (geometric mean) 5 10 cfa/1001111 _ 0 Leaching Chamber Manufacturer
Ma --imam Effluent Particle Size 14 inch diameter Mme Laying Length/Chamber
*Wastewater Flow Verification and Calculations: Soil Application Rate _gp dIW Area Req. f
(Other than bedroom based) Infiltrative Surface/Chamber -ESIA Ratin f
Minimum Number of Chambers .
❑ Aggregate Design FlowAmding Rate= fe min
* Values typical for domestic ( non - commercial wastewater Materials: all materials must comply with WI Aden Code
and septic lank effluent. COMM84 and be installed per manufacturers specifications
** *Values for pretreated wastewater. I and approval letters.
DESIGN CRITERIA
❑ "Wisconsin At grade Soil Absorption System, Siting, Design & Construction Manual' (Converse et-al -1990)
❑ "Wisconsin Mound Soil Absorption System: Siting, Design & Construction Manual" Converse, J -C. and E.J. Tyler.
Publication 15.22
p "Design of Pressure Distribution Networks for Septic. Tank -Soil Absorption Systems" Publications 9.6
❑ "Design of Conventional So i.Absoroon Tranch es and Beds". R-J. Otis - ASAE Publications 5-77 and' Design Manual -
Onsite Wastewater Treatment and Disposal Systems''. EPA 625/140-012 October 1980
❑ SBD - 10570-P (8.6199) - At -Grade Component Manual Using Pressure Distnbutioe
p SBD - 10567-P (R -6199) - In Ground Absorption Component Mannar
❑ SBD - 10705 --P (N.OW 1) "In Ground Soil Absorption Component Manual' Version 2.0
Cs SBD - 10628 -P (N.6/99) "Recirculating Sand Filtw system Component Manual°
❑ SBD - 10656-P (N-6199) "Split Bed Recirculating Sand Filter System Component Manual'
O SBD - 10572-P (R -6/99) "Mound Component Manual'
fig(SBD - 10691 -P (N.0110 1) "Mound Component Manual° Version 2.0
❑. SBD - 10595- P (8.6199) "Single Pass Sand Fitter Component Manual"
❑ SBD - 10657-P (8.6199) "Drip4ine Effluent Disposal Component Manual
E3 SBD - t0573 - (R 6149) "Pressure Distribution Component Manual"
{SBD - 10706 -P (N 01101) "Pressure Distribution Component Manual" Version 2.0
❑ Drip -lire Effluent Dispersal Component Manual for Multi-flo Oasft Wastewater Treatment Units
MAINTENANCE AND MANAGEMENT
MAINTENANCE MONITORING SCHEDULE
Service Event Service Frequen
Inspect condition of tank s At-leasl once ❑ months 3 s Yimum 3
Pump out contents of (s) When combined sludge aad scum equals one-third W of tank volume".
Inspect &
spersal cells At least once every a months .3 ® earls 3
Clean effluent filter At least once every months ❑ s
Inspect, pwnp, pump controls & alarm At least once every 0 months 3 Cl NA
Flush. laterals and pressure test -. At least oncezvery months 3 -tO. yea*) C] NA.
Valves At least once- El- months. ❑ ygpqo NA
Other: At lest once every O months ❑ s C7 . NA
- Page 7 of
START UP
For new construction, prior to use of the POWTS check treatment tanks) for the presence of painting products or other chemicals that `
may impede the treatment process andfor damage the dispersal cell(s). If high concentrations are detected have the contents of the
tank(s) removed by a septage servicing -operator prior to use.
System start up shall not occur when soil conditions are fiamen at the infiltrative srufaoe.
OPERATION
The property owner is "responsible for the operation and fiance oaf the POWTS and submission of required reports. The quantity
and quality of the wastewater stream will affect the performance and longevity of your POWTS. The installation of watcr saving
appliances and fixntres along with prompt repair of eaksreduees the wastewater volume. Also the brine or waste from water
softeners, iron removal Waits, other dear water treatment devices and foundation drains should be discharged to the ground surface
whenever possible. Note: this does not include laundry waste, showers, dishwater, etc
This system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable /fruit
peels and seeds, bones, and food solids such as those produced by a garbage disposal should be minimized. Toilet tissue is the only
paper that should be discharged the system. Other nor - biodegradable items such as baby wipes, tampons, sanitary napkins
condoms, cigarette butts, denial toss, and cotton swabs should not eater the system. Chemicals such as petroleum pvducts paint,
disirrfedants. pesticides,, antibiotics, solvents, etc., should not be flushed into the system as they can seriously damage your POWTS
and contaminate your drinking water supply.
Maintain a regular steady flow by spreading laundry washing throughout the week. Avoid vehicle traffic over all system components.
Compwdoa of snow over the dispersal out may cause it to freeze up.
p Valves
Valves shall be operated in the following manner:
Alarms
Alarms should be tested our a regular basis by the home owner. Ifan alarm sounds, contact an individual licensed to service
POWTS, There is normally a 1 day reserve under regular operating eondiidons, however water should be conserved until any
problems with the system are corrected to prevent back - of sewage into the dwelling or swfacin&
IN�PEC'VTIONS
inspection shall be made by as individual cariying one of the following licenses or cedifications: Master Plumber, Master
Phun ber Restricted Sewer, POWTS Maiatainar or Sep<age Servicing Ups (pa the attached Maintenance Schedule).
Septic Tanks Component
Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware, identify any cracks
or leaks, measure the volume of combined stodge and scum and to check for any backup or ponding of effluent to the ground
surface, Access openings used for service ur assessment shall be sealed and/or to dwd upon completion of service. Any
defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective
locking device to prevent accidental or unauthorized entry into the tank.
When the cotabinaian of sludge and scum is my tank exceeds one-third (113) or more of the tank volum;, the entire contents
of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with Chapter NRI 13, Wisconsin
Administrative Code.
The outlet 51tex(s) shall be inspected and dleaned to remove any accumulated solids according to manufacdnrer's
specifications Provisions are to be made to refrain solids in the tank. Filter cleaning may be necessary at more
frequent intervals than stated in the maintenance sdned de kep the system operating.
0 Pump ChamberiTrestmemt Tanks Component
The inspection must include a test of all electrical equipment such as pumps, alarms and floats. A visual check must be
made for leaks, backups, surfacm . missing or broken sectaky dances and other hardware and condition of any filters.
Any service needs or repairs shall bepmmptly taken care oL
C3 In-Ground Gravity Component Dispersal Cd1s
The itnspectiogidwU indnde recording the levels of pondin& if any in the observation tubes and a visual inspection for any
evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory
authority: Pending at depths greater tlian 75% of the height of the component may indicate overloading or impending
frequent
i hydraulic failure necessitating m ore monitoring.
Page . 8 of 9
START UP
For new construction, prior to use of the POWTS check treatment tanks) for the presence of painting products or other chemicals that '
may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents of the
tank(s) removed by a septage servicing operator prior to use.
System start up shal not occur when soft conditions are ft own at the infiltrative surface.
OPERATION
The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity
and quality of the wastewater stream will affect the performance and longevity of your POWTS. The installation of water- saving
appliances and fixtures along with prompt repair of leaks-reduoes the wastewater volume. Also the brine or waste from water
softeners, iron mrnoval units, other clear water treatment devices and foundation drains should be discharged to the ground surface
whenever possible. Note: this does not include laundry waste, showers, dishwater, etc.
This system a designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetabldfruit
peels and seeds, bones. and food solids such as those produced by a garbage disposal should be minimized. Toilet tissue is the only
paper that shadd be discharged - into the system Other hems such as baby wipes, tampons, sanitary napkins
condoms, cigarette butts, dental floss, and cotton swabs should not enter the system Chemicals such as petroleum products, paint,
dishiWarns, pesticides, anu'bioties, solvents, etc-, should not be flushed into the system as they can seriously damage your POWTS
and contaminate your drinking water supply.
Maintain a regular steady now by spreading laundry washing throughout the week. Avoid vehicle traffic over all system components.
Compaction of snow over the dispersal unit may cause it to freeze up.
p Valves
valves shall be operated in the following manner:
�('Alurtna .'
Alarms should W tested on a regular basis by the home owner. If an alarm sounds, contact an individual licensed to service
POWTS, There is normally a 1 day reserve under regular operating condrtiow% however water should be conserved until any
problems with the system are corrected to prevent back -rep of sewage into the dwelling or surfacing.
INSPECTIONS
Inspection shall be made by an individual c mying ace of the following licenses or certifications: Master Ploa>bm Master
Plumber Restricted Sewer, POWTS MaWainer or Septage Servkcing Opwatce (par the attached Maintenancre Schedule)_
Septic Tanks Component
Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware, identify any cracks
or inks, measure the volume of combined sludge and scum and to creek for any badtup or ponding of effluent to the ground
surface. Access openings used for service or assessment cull be sealed and/or locked upon completion of service. Any
defects shall be promptly correcle& Exposed openings greater than 8 inches in diameter cull be secured with an effective
locking device to prevent accidental or unauthorized en uy into the tank
When the combination of sludge and scum in any tank exceeds one4hird (113) or more of the tank volume, the entire contents
of the tank shat! be removed by a Septage Servicing Operator and disposed of in aeeordanae with Chapter NR113, Wisconsin
Administrative Code.
The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to mammict uees
spedfiadionL are tm be made to retain solids in the tank. Filter deaning maybe necessary at more
frequent intervals than stated in the maintemanoa schedule keep the system ctperating-
pump C hamberlTra t u t Tanks Component
- The inspection moult include a test of all electrical egWpment such as pumps, alarms and floats. A visual checdc must be
made for leaks, backups, suuacing, missing or broken security devices and other hardware and condition of any filters.
Any lei Ace, needs or repairs sdrall be-prompdy taken are of;
p In - Mound Gravity C omponent Dispersal CAls
if m the observation tubes and a visual inspection for any
-shall irrddrde repo the levels of pending. any
The �
. evidence of of an tfam seepage or disdorge, Any discharge to the pound stufaee must be Promptly reported to the regulatory
authority: Ponding at depths greater than 75% of the height of the component may indicate overloading or impending
hydraulic failure necessitating more frequent monitoring. S of 9
Page
. �'l4iwmd, At -araa� Pressure
The hvection shall include recording the levels ofpanding if my in the observation tubes and a visual inspection for any
evidence of surface, seepage or Mwhft& Any discharge to the Second swfaea must be prompfly reported to the regulatory
andu rity. Paneling Smatw than 7S% of tha height of the component maYkAcate ovrrlob ft or impending hydraulic failure
necessitating.
The pressure distribution system is provided with an spa ft at the end of each lateral to be used for fushiug. The laterals
should be hushed at least anon avert' three (3) years- Pressure checks of systems with multiple hs<e mb should be done to
ensure dot equal dUnIbution of is ooctmdag 7b pmomota the lamgevgy ofthe system.
RBPORTS -
l is form oe, mapaxion, and monitoring shall be au>mnitted is a000rdanca wide COMM 8353 Wisconsin �
C ode. ►e
ABANDONNOW
When the POWTS fiffis and/or is taken out of service the AM be
Poly and �Y abandoned Ply following taken m ensure, that the system h compliance wrth CL COMM 8333 Visconsm Aftinishatim Code.
- All Piping to tanks and pits shell be died and the abandoned pipe openings sealed.
- The contents of all tanks and pits" be removed and properly disposed ofby a Septage Servicing Operator.
- After pumping: all tanks and pits shalt be excavated and removed or their covers removed and tha void space Wed with
sots, gravel or othariumt=M material
.
CONTINGZNCY PLAN
if the POWTS fails and cannot be repaired the following mews have bean, or mug be takes, to provide a coda compliant
r3 A suitablorephicement wm bas boa evahsbed and may be aged fortis location of a replace soil absorption system.
Thereplacament area shouldbe protected fix au dishatence and couopactim and should not be infringed neon by required
sdbacks fmm edstiog and proposed sauctme lot lines and wells. Far'hrt io protect the replacement areawtil result is the
need far a new sari from adding and proposed skoctme, lot lines and wells Fariure to protect lira reps area win
result is tha need fw anew soft and site evaluatiow* establish a suitable replacement area. Replacement Off$ must
comply with the rules in effied at that time.
D A sayable arlecema t area is not wan" due to selback and/or soil immmtioos. Barring advances in POWTS technology a
holdiog tanknuty be iusmlled as alastresortto replace dw failedPOW M
The site has not been evaluated Ib identify a suitable sqlaommt sea. UPoa hilum of the POWU a soil sod slta evaluation
must be performed so locate a snM940 replacmemt area. Ifoo rephomm tanks is available a holdiog tank may be installed
as a last resortto nphmx the f fled POWTS.
Maud and at sots absorption systems way be reconstructed in place following removal ofthe bimv t at the infiltrative
. surfaoa. R "ons of'such systems must comply wi& do rules in effect at thIttime.
<<WARNMG >> .
SEPTIC, PUMP AND OTMM TRFATIYINT TANKS MAY CON LAN LBTUAL GASSES APID,IOR INSUMC EM
OXYGEMI)ONOTXNMASEMqPUWOROMMIUUIMMTARKUMMANY CHtC[A�STANCES.
D$A.TH MAY RUMT. RSSCUB OF PERSON PROM THE Dn MOR OF A TANK MAY ]BE DIMCOLT OR
OR OSSOLL
ADDITIONAL CObZ9CNU
POWTS INSTALLER POWTS MAINTAIl�IEB
Name -ral EGKE /�J / -aai3y TD�i/N E'LkE E E LuiyQ„WL
Plums /s e 7,? - S.?6 6 /S G7.T - S .7 LG
SIKPT SERVICING OP=ATOR (Pm L/„i L4DCAL REGULATORY AUTHO
Name Age w r. efw Lo
Phone Pleura �iS 386 - 1✓6 8a
IG\WPDATAUMWOWTS OWNER'S KANU"oc
Page 9' of 9
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OFFIO EVALUATION REPQRT_��
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need mataiai in an alkfe foomat, please canted &va *=W at 608-266-3151 or TTY 508-2648777.
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SAFETY AND BUILDINGS DIVISION
commerce.Wi.gov Integrated Services Bureau
INSPECTION REPORT 13 East Spruce Street Ste 106
iscon Chippewa Falls, WI 54729
sin www.com ( ) • 72•-2 726 -2 544
V V V
Department of Commerce Richard J. Leinenkugel, Secretary
Date of Inspection: September 4, 2009 Plumber Name and Address:
Project Name: Vandewiele na
Use: Residential
Legal Description: NW, SE, 28, 29, 15W
Site Number: Pending
Subdivision: na Certified Soil Tester Name and Address:
Municipality: Town of Springfield Mike Hassett, CST 224974
County: St. Croix 1503 Fairway St
Eau Claire, WI 54701
Plan ID Number: Pending
Sanitary Permit Number: na Owner Name and Address:
Ben Vandewiese (buyer)
Wastewater Flow: 450 gpd
Persons Present: M. Hassett
This onsite soil and site verification was requested by the CST to help determine if a standard mound design might
be installed. Two soil borings were reviewed to make this determination.
T -1 (CST B -4)
00 -03" 10YR 3/3 L, 2fgr, mvfr, ac.
03 -10" 10YR 3/3 L, 2mgr, mfr, aw.
10 -13" 10YR 4/3 sl, 2msbk parting to 2mpl, mfr, cw.
13 -15" 7.5YR 4/4 sl, 2msbk, mfr, cw.
15 -30" 5YR 4/4 sl, 1 msbk, mfr with f2d 7.5YR 4/6 rmfs.
T -2 (SW end of area)
00 -09" 10YR 3/3 L, 2msbk, mfr, as.
09 -12" 10YR 4/3 L, 2csbk, mfr, cw.
12 -17" 5YR 4/4 sl, 1csbk, mfr.
The two soil borings evaluated indicate that this site does have slightly better than A +4" conditions and therefore a
standard mound design may be used. It is recommended however, that linear loading rate not exceed 6 gpd /ft to
help ensure toe leakage will not occur even under the most adverse conditions or loading and seasonal saturation at
15 -17 inches.
If there are any questions regarding this report please contact me.
Leroy G. Jansky, RPSS, Wastewater Specialist cc: ® County ❑ Plumber ® CST
leroy.jansky @wisconsin.gov E -mail ❑ Owner ❑ Other
(715) 726 -2544 Voice (715) 726 -2549 Fax
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ST. CROIX COUNTY
. SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
ti
owner/Buyer J ch /�� h I)c j Q t
Mailing Address
Property Address
(Verification required from Planning & Zoning Department for new construction.) -
City /State Parcel Identification Number 0 t0 (0 2- — 000
LEGAL DESCRIPTION
,
Property Location W 1 /4 , 1 /4 , Sec. 2 -g , T Z 1 N R 1S W, Town of
Subdivision , Lot #
Certified Survey Map # , Volume , Page #
Warranty Deed # '90Y S Q `7 , Volume , Page #
Spec house yes no Lot lines identifiable yes no
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
I
Improper use and maintenance of your septic system could result in 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. Owner maintenance
responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance.
The ro erty owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the
P P
owner and by a master plumber, 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 113 full of sludge.
I/we, 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 the Department of Commerce and 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 Planning &
Zoning Department within 30 days of the three year expiration date.
Uwe certify that all statements on this form are true to the best of my /our knowledge. I/we am/are the owners) of the
property described above, by virtue of a warranty deed recorded in Register of Deeds Office.
Number of bedrooms
h
SIGNATURE OF APPLICANTS) DATE
***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department.
Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if
- --lice is made in the warranty deed.
. 08/05)
.r
s FR,CM !JRAR.EY[NG FAX ND. t7152654M Sep, 17 2M 07:4SAM P2
MAP OF SURVEY
THE NORTHWEST QUARTER OF THE SOUTHEAST
North 1/4 Corner QUARTER, SECTION 28, TOWNSHIP 29 NORTH,
Section 28 -29-15 RANGE 15 WEST, TOWN OF SPRINGFIELD PREPARED FOR:
1' Steel Survey NOR ST.CROIX COUNT Y,WISCONSIN
. Daniel Marta:
Y 8671 Flamingo Dr
Chanhassen, N.N 55317
O I iMP AT MD
L G1ID3
f N84'39'18'E downed fene° ty16.6Z' fence 1
— 440.00' 496.62' _14' 380.00' .1.0• - --
N
U
• Ui�IAtfTBD �
LAAIDS -` $ N
N 1
� ~ s PARCEL 1
w 1,139,?75 sq.ft.
39.93 acres
incl. r -o -w �e
T N
x -- 1,695,851 sq ft o ��
a 38.93 acres
not inc[ r-o-w e
a property line
G' runs 6 east
of fence line
A
+ A
N m
1� �p
�- soil tests
building setback line
- -- -- -- -
a 33.00' contaline
— — S8 — �— 1 — — _ —
z t 72th Ave
81 �,
�In Lot 1 CSM
C; :p - - -- -- DRAFTED BY
41 — Joel A Brand'
l SCALE 1" = 250' JB 5URYEYING LLC
South I!4 Corner 0, 250' SW ��G0
Section 28 -29 -15 s""�•,, .j,
I' Steel Survey Nat LE GEND
t
0---.Found Government Corner (as noted) jl
o_._.Set Ibs .xn Iron rebar weighing
tbs. ,,,,.• '
1.502 llilinea[ ff.
"PK" nail
SURVEYOR'S CERTIFICATE
W 1, Joel A. Brandt, Registered Land Surveyor, hereby certify
that I have surveyed and mapped the shown parcel and that
tnis map is a correct representation of the boundary thereof.
y '
North is referenced to
the North -South quarter line
of Section 28- 29 -1S, Joel A. ndt R..S . S -2603
which dears NOC'16'37 - W \ !
ISt C: oix County Grid System) Dated this j d� . �f `rn�cmktf Inna
d a aline URA auuea a Aa
S' b�iZ- S99 -S1G i � C[ A C TS =TT 60 ET N
t
I
I flfl�l flfll 11111 Illfl fill{ Ifilf ilf� ffflf I flfl Iffy
State Bar of Wisconsin Form 1 -2003 9 0 4 5 0 9 1
WARRANTY DEED 1 1 9 1 04509 5 ��
BETH PABST
Document Number Document Name REGISTER DF DEEDS
If ST. CROIX CO., K
RECEIVED FDP. RECORD
THIS DEED, made between Daniel C. Mertes 09/ 1 2 9/2009 10 :45
! ARRAHTY DEED
EnENPI' ii
FEE: 1 ?.OG
REC
( "Grantor," whether one or more), and Benjamin D. VanDeWiele, a single person TRANS C FEE 1.00 0
PAGES: 1
( "Grantee," whether one or more).
Grantor for a valuable consideration, conveys to Grantee the following described real Recording Area
estate, together with the rents, profits, fixuires and other appurtenant interests, in a_ f%
Name and Itetum Address
St. Croix County, State of Wisconsin ( "Property") (if more space is / t
needed, please attach addendum): � `'�Y"'''' -D `L =�JL �'�� �e�'
THE NORTHWEST QUARTER OF THE SOUTHEAST QUARTER (NW I/4 i j `:s
OF SE 114), SECTION TWENTY EIGHT (24 TOWNSHIP TWENTY NINE �
(29) NORTH, RANGE FIFTEEN (15) WEST, TOWN OF SPRINGFIELD.
Subject to 72 Avenue right of way. 034 -1062 -70-000
Such description is also intended to include any additions, thereto by reason of the Parcel Identification Number (PIN)
vacation of any alley or street lying adjacent to said parcel This is not homestead property.
i4iq (is not)
Grantor warrants that the title to the Property is good, indefeasible, in fee simple and free and clear of encumbrances except:
easements, restrictions, and rights of way of record, if any.
Dated " / ;�
(SEAL) ._ ` �-' (SEAL)
*
* Daniel C. Mertes
(SEAL) (SEAL)
s *
AUTHENTICATION ACKNOWLEDGMENT
Sigxtature(s) STATE OF LV ( )
) ss.
C OUNTY)
Personally came before me on Z V, G% c/
:." the above -named Daniel C. Mertes
T.. E: ME BFF, ATE BAR OF WISCONSIN
� � to me known to be the person(s) who executed the foregoing
t• ., a y Wis. Stat. § 706.06) instrume ac owled th s ' e.
�rc t 'V - A o CHARLEM A. LARSON
THIS IN'S'TRUMENT DRAFTED BY: Notary Public s
Joseph D. Boles - Attorney at Law Sta of wiscoasin r
Notary Public State of
River Falls, WI 54022 -0138 My commission (is permanent) (expires: I � )
(Signatures may be authenticated or acknowledged. Both are not necessary.)
NOTE: THIS IS A STANDARD FORM. ANY MODIFICATION TO THIS FORM SHOULD BE CLEARLY IDENTIFIED.
WARR NTY DEED *2003 STATE BAR OF WISCONSIN FORM NO, 1-2003
*Type name below signatures. NFO•PROI Legal Form • (eoo)e55-2021 • intopmcrms.con
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