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HomeMy WebLinkAbout034-1072-95-050 GENERAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR01 REAL ESTATE TOWN OF SPRINGFIELD COMPUTER NUMBER 034 - 1072 -95 -050 Parcel Number 32.29.15.491 B Claimed Date Re- certified / / Relate Number: OWNER NAME: First ERIC J & TRACI K Last SKOG CO -OWNER Mailing Address 629 CTY RD NN City WILSON State WI Zip 54027 - Type Vol Page Doc # Rec.Date Type Vol Page Doc # Rec.Date HISTORY WD 2475/259 749271 12/16/2003 855/244 PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name- Type SD Apartment Post Office 629 CTY RD NN School District: 231 - BALDWIN- WOODVILLE AREA Special District: (1) 1700 - (2) - (3) - W ITC Plat Code: Last Changed on: 06/02/2004 Book Number: 1 SECTION 32 TOWN 29N RANGE 15W '/4160 SW '/440 NW Map Number: 00 - Sales Area: Parcel Control 0 TAXABLE Number of Units: ZONING: Permit Number: Type: Bank Numbers: F4 -Prev, F5 -Next, F6- Legal, F7- Value, F8- History, F10 -Exit, F12 -More Wisconsin Department of Commelce PRIVATE SEWAGE SYSTEM County' St. Croix Safely and Building Division 1 INSPECTION REPORT Sanitary Permit No: 430622 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: Sko , Eric & Traci I Springfield Townshi CST BM Elev: Insp. BM Elev: IBM ++ Description: Sectionrrown /Range/Map No: Gov. v /vv . v� Vruv. resod �' t ¢ ✓C, .G r� c.J �r :t n�,c S /� , 32.29.15. TANK INFORMATION ELEVATION DATA /.pa TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. .� Septic l�v iZo W ?� Benchmark tlJ /to. A oo_ eta .erg Dosing Alt. BM J- Aeration - Bldg. ewer >K g 8,7 /CX •(o Holding ~- -- St/Ht Inlet 1 Z v 9e,3 TANK SETBACK INFORMATION St/Ht,Ou I TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic r+ -(lu, Dt Bottom I(D.'� 93• S Dosing I Header /Man. Aeration Dist. Pipe ;�.v iJ L5 7S _.,� Holding Bot. System - 7 1 �. 9 Final Grade P /SIPHON INFORMATION Manufacturer f Demand C St Cover 3 GPM Model Number j y. j<-, TDH IlLift _ Friction Loss System Head TDH Ft `) •� + S C L z > ? ^s i 3 _3 C, ist Forcemain Len th Dia. Dist. to Well `T Sj C 1 SOIL ABSORPTION SirsTEw -_y BEDfTRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 61 SETBACK SYSTEM TO P/L BLDG IWELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Numbe DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake 77 Pipe(s) '3/ f Length 3 Dia L Length '5 C-) Dia ��— Spacing .� SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over r Depth Over xx Depth of r; j xx Seeded /Sodded xx Mulched Bed/Trench Center / Bed/Trench Edges ( Topsoil , ! c r -! Yes Y�No L j Yes I o COMMENTS: (include code discrepencies, persons present, etc.) Inspection #1: L / O Inspection #2: S / Cam_ ��1 Location: 629 County Road NN Wilson, WI 54027 (NW 1/4 SW 1/4 32 T29N R15W) NA Lot 2 ► ,,,L Parcel No: 32.29.15. w / 1.) Alt BM Description = S T (" "'`' 2.) Bldg sewer length = '5_C - amount of cover = Plan revision Required? °_I Yes No Use other side for additional informa ' n. I C J \ 1710 (R.3/97) Date Insepctor's Signature Cert. No. R ECEIVED 10, Safety a Buildings Division C ` �sc�ns�n Madison p 4 z 201 W. Washi ton Ave.. x,�)¢¢ l� WI Bi LIl L uJ star Number (to be filled in by Co.) 8 266 -3151 y Permit Department of Commerce ( ) Q nkx c 7 q30 6 2 - 2- Sanitary Permit Applica ZONING OFFICE fate Plan I.DI.�N�( umber S Sys In accord with Comm 83.21, Wis. Adm. Code, personal information you provide may be used for secondary purposes Privacy Law, sl5.04(1)(m) Project Address (if different than mailing address) I. Application Information - Please Print All Information ' 7 N IV Property,Owner's Na me Parcel #_ Lot # - $doer Pr rty O er's Mailing Address Jroperty L&Aon �s �,1 , `y`�`�' , k, � 1 A,Section ?kZ— C' State Zip Code Phone Number q 9 4� 6� �`�— 1 2L� I ircle o e) II. Type of Building (check all that apply) �; c, T ` N; R E o w.. or 2 Family Dwelling - Number of Bedrooms \ 3 - �C�XIA� 7 ( c - Number ❑ Public /Commercial - Des i e U e ► `�P' ❑ State O ed - DescrN - N-- - ❑City_❑Village'� ownship w 6 'X 102- M kt3 III. Type f Permit: (Check only one box on line A. `.Complete line B if applicable) 0 3 - A" t;I� New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement my ❑ 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 IV. Type of POWTS System: (Check all that appl " -0 ( 12 ❑ Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil )44,lound < 24 in. of suitable soil ❑ 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 (explain) V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) I Dispersal Area Required (sf) Dispersal Area Proposed (st) System Elevation I,4 tol 1 VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks V 1-11 Septic or Holding Tank T . ill Aerobic Treatment Unit J Dosing Chamber VII. Responsibility Statement- I, the unflersi assume responsibility for installation of the POWTS shown on the attached plans. Plumber's a m int) Plumber' St nature M / N Business Phone Number oe Plumber's Addre ss (Street, Ciry, State, Zip VIII. Count /Department Use O Approved El Disapproved Sanitary Permit Fee (' cludes Groundwater Date Issued I u' Agent Signature Qfp Stamps) Surcharge Fee) �-q� r . El Owner Given Reason for Denial 35V 23 � IX. Conditions of Approval/Reasons for Disapproval SYSTEM OWNER: 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained 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 Sl/2 x 11 inches in size 3D -6398 (R. 01/03) k ' o v _ � � o i O V M v cam. G J ti � M � 4 b S a J a r C C' � '�► � p � � i k M: C OPI e Safety and Buildings t ` 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 Visconsin TDD #: (608) 264 -8777 www commerce. s i www.wiscon isconsin.g n.gov Department of Commerce Jim Doyle, Governor Cory L. Nettles, Secretary October 28, 2003 CUST ID No.3412 ATTN: POWTS Inspector HERB J PELKE ZONING OFFICE PELKE PLUMBING ST CROIX COUNTY SPIA N6298 STATE HWY 25 1101 CARMICHAEL RD DURAND WI 54736 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/28/2005 Identification Numbers Transaction ID No. 934883 SITE: Site ID No. 667345 Earl & Tracy g Sko Please refer to both identification numbers, County Hwy NN above, in all correspondence with the agency. Town of Springfield St Croix County NW1 /4, SWIA, S32, T29N, R15W FOR: Description: Proposed Four Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 927580 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01 /01) and the 'Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD- 10706 -P (N.01 /01). • Limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • Comm 83.22(7) - 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. P. 0. 'stT. ally HERB J PELKE Page 2 10/28/03 Owner Responsibilities: • Comm 83.52(1)(a) - The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. 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. • The owner is responsible for submitting a maintenance verification report per Comm 83.55, that is acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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 Gerard M. Swim POWTS Plan Reviewer - Integrated Services (608)- 789 -7892, Mon. - Fri. 7:30 am to 4:15 pm jswim @commerce.state.wi.us WiSMART code: 7633 cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 5lox t s� Private On -Site Wastewater Treatment System (POWTS) Index and Title Sheet Owner: ! .4,46r Project Name and System Type EA /G f �'dAL Y �ie0(i - 5� �o�,�o �✓oe✓ rs Location: Co �� `ids✓ Street Address tip✓ .5�,/. 30? ,? 9 �/. /S�/ Legal Description �i✓.✓ o F �/'ni.✓lfi�t D �r Croix Co Township /County Contents: Page 1: lAlA ,o,ro fir« JSl Arr Page 2: Page 3: A" Page 4: 1a r�ir �� L .6rer r Page 5: ��- ,�r.L,r,� /��.YP C/✓iN,OI•t CAoJJ • ��� r. <.� Page 6: e4,40a.y.foeve eWAVd' - Page 7 : OD w rs O ,V.✓ra f 2,"1 46 "Y�.✓ r Ot..✓ Page. 8: it Page 9:a< (�! 'ARTMENT OF CO3 CE Attachments r' io.✓ 1146A.101 r- D ivIsioW OF SAFE Y AND BUILDINGS • PlumberMesig wr: /D`Ei1Q A5 K'r Signed: Credential Number: 1�- .?Iwz Date: G�SEO SBQ -Jot 9 / -P /`fuwo Co.yeo.vrvr I'�.✓asG ~ l�dat�•.� .T 4 '� �/tf.ri , A �is r., r.,.r LO ,yPe rlN �AWN.I i " Al - r Z � �a t F" L c L� c °. a 3 0 o ti R A a � w ;fl °e h u i \ IN n� L o 4k a N 04 Q z y ri ' . co �r � l 1 rr n n �► u H Vk d� 4 A O W y O . •d h ( 0.' ti ry td qq td H � x rt Id N. I \ : C tv o H. d � ►b W r IS, p (� o p N rA •I I I �I • } - a C a` l 1 6 4 •� a tAj p a l r � 0 . \o Page S Of 9 SEPTIC TANK E'PUMP CHAMBER CROSS SECTION'AND SPECIFICATIONS 4" CI VENT PIPE 12" MIN. ABOVE GRADE WEATHERPROOF ?' p' FROM DOOR, WINDOW OR JUNCTION BOX APPROVED FRESH AIR INTAKE WITH CONDUIT MANHOLE COVERS W/ PADLOCK E f ♦,v�.rydd WARNING LABEL b l _� 4 " MIN. y v .✓.rP 'r'e !':e,✓ cal 18" IN. �. INLET - S GA �► , • WATER TIGHT SEALS Z.va�� ►► —�-- i ► crr� � A SEAL TIGHT � ► vAPPROVED �_ JOINTS WITH APPROVED ; - AL M APPROVED PIPE PIPE 3' ON B 3' ONTO 0 {TO SOLID SOLID SOIL SOIL' ►� RISER EXIT PUMP OFF ELEV . 9X4 FT. —f— OFF D PERMITTED ONLY IF TANK MANUFACTURER HAS APPROVAL 3" APPROVED BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS SEPTIC / DOSE TANK MANUFACTURER: NUMBER DOSES PER DAY: //7.5 TANK SIZES SEPTIC /o?so GAL. DOSE VOLUME INCLUDING DOSE 7so GAL. FLOWBACK: 8 GAL. ALARM MANUFACTURER: S. �Bcr�o CAPACITIES: A = 30 INCHES = y83 GAL. MODEL NUMBER: ,orr o&r„rz' SWITCH TYPE: /y6irc..nr B = 2 INCHES ,�,�.? GAL. PUMP MANUFACTURER: ✓PY,pito,rori� %���'�' C = .X INCHES = xm s GAL. MODEL NUMBER: SWITCH TYPE: �1rc�N�r D = $X INCHES = 1-?7 GAL. REQUIRED DISCHARGE RATE 31/.3z GPM PUMP & ALARM WIRING AS PER ILHR 16.23 WAC NERTICA L DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE . . 8.o FEET + MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . 3.3 FEET + ao' FEET FORCEMAIN X w. FT/100 FT. FRICTION FACTOR . . FEET TOTAL DYNAMIC HEAD = �i ' 8 FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH $ W " ; WIDTH 8/ ; DIAMETER LIQUID DEPTH y8 " A- 7 -7 77777 : rr, �r SW/S D/VS25 ► Typical Application' Sump /Effluent pump Typical Application" Sump /Effluent pu mp (opacities SW /SDNS25 - to 44 GPM (2.8 I /s) (opacities SW /SD/VS33 - to 48 GPM (3.0 Vs) Heads SW /SDNS25 - to 24 ft (7.3 m) Heads SW /SD/VS33 - to 26 ft (7.9 m) Electrical SW /SD/VS25. 115V, le, B.O 60Hz _ Electr SW /50/VS33 - 115V, le, IO.OFIA, 60Hz Motor SW /SD/VS25 - 1/4 HP shaded pole w /thermal overload — Motor SW /SD/VS33. 1/3 HP shaded pole w /thermal 1550 RPM _ overload 1550 RPM Minimum Recommended SD/VS25 =12" (304.8mm) Minimum Recommended SD/VS33 =12" (304.8mm) Sump Diameter SW25 =18" (457 mm) Sump Diameter SW33 =18 "(451 mm) Automatic Operation SW = Wide angle float Automatic Operation SW = Wide angle float switch (manual available) SO = Diaphragm pressure switches (manual available) SO = Diaphragm pressure switch VS = Vertical float switc VS = Vertical float switch Mat erials of Construction Cast iron and e ngineered thermoplastic Mo terials of Construction (ast iron and engineered thermoplastic Impeller Thermoplastic vorte Impelle Thermoplastic vortex Discharge Size 1 -1/2" NPT(38.lmm) Discharge Size 1.1/2" NPT(38.1mm) Solids Hand 1/2" (12.8 mm) Solids Handling 1/2" (12.8 mm) Power (ord 10' , SJTW, (20' optional) Power Cord 10', SJTW, (20' options) Superior Features • Carbon /(eromic mechanical seal J Superior Features • Carbon/(eramic mechanical seal • Oil filled motor w /automatic reset thermal overload • Oil filled motor w /automatic reset • Uses single row ball bearing construction thermal overload • Piggy -back plug available for easy maintenance and • Uses single row ball bearing construction replacement • Piggy -back plug available for easy maintenance and replacement 9 30 SD3 SW33 S33 W6 -a 20 b ackSwit ChA'4 IZ g o Q 9 a SD25, SW25, VS25- 0 0 (opacity -U.S. G.P.M.0 10 20 30 40 50 Liters /Second 0 1 2 3 3 f POWTS OWNER'S MANUAL AND MANAGEMENT PLAN FILE INFORMATION SYSTEM SPECIFICATIONS Owner 2 _ 5 'x0 , & Septic Tank Capacity S6 g al ❑ NA Permit # 30&zz Septic Tank Manufacturer &-,s A ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer E4 ❑ NA Number of Bedrooms 100 d/bedroom ❑ NA Effluent Filter Model ❑ NA Number of Commercial Units — NA Pump Tank Capacity sa al ❑ NA Estimated flow (average)* gal /day Pump Tank Manufacturer ❑ NA Design flow (peak), estimated x 1.5* ado g al /day Pum Manufacturer ito,,.gria ❑ NA Pump Soil Application Rate . 1 ,o g al/day ft Model �i✓ d3 [:3 NA Pretreatment Unit JErNA Influent/Effluent Quality (NA❑) Monthly Average ** ❑ Sand/Gravel Filter ❑ Peat Filter Fats. Oil & Grease (FOG) < 30 mg/L ❑ Mechanical Aeration ❑ Wetland Biochemical Oxygen Demand (BOD5) < 220 mg/L El Disinfection El Other: Total Suspended Solids (TSS) Manufacturer: Model: <_ 150 m Pretreated Effluent Quality ❑ Monthly Average * ** Dispersal Cell (s In-ground (gravity) ❑ In- ground (pressurized) Biochemical Oxygen Demand (BOD < 30 mg/L ❑ At -grade Mound Total Suspended Solids (TSS) < 30 mg/L ❑ Drip -line ❑ Other: Fecal Coliform (geometric mean) _<10 cf i/100m1 ❑ Leaching Chamber Manufacturer Maximum Effluent Particle Size 1/8 inch diameter Model Laying Length/Chamber � *Wastewater Flow Verification and Calculations: Soil Application Rate _ gp d /ft Area Req. (Other than bedroom based) Infiltrative Surface /Chamber -ESIA Ratin ft Minimum Number of Chambers ❑ Aggregate Desi n Flow/Loading Rate = iFmin ** Values typical for domestic (non - commercial wastewater Materials: all materials must comply with WI Adm. Code and septic tank effluent. COMM84 and be installed per manufacturers specifications ** *Values typical for pretreated wastewater. 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 ❑ "Design of Pressure Distribution Networks for Septic Tank -Soil Absorption Systems" Publications 9.6 ❑ "Design of Conventional Soil Absorption Trenches and Beds ". R.J. Otis - ASAE Publications 5 -77 and "Design Manual - Onsite Wastewater Treatment and Disposal Systems ". EPA 625/1 -80 -012 October 1980 ❑ SBD - 10570 -P (R.6/99) "At -Grade Component Manual Using Pressure Distribution" ❑ SBD - 10567 -P (R.6/99) "In Ground Absorption Component Manual" ❑ SBD - 10705 -P (N.01 101) "In Ground Soil Absorption Component Manual" Version 2.0 ❑ SBD - 10628 -P (N.6/99) "Recirculating Sand Filter System Component Manual" ❑ SBD - 10656 -P (N.6/99) "Split Bed Recirculating Sand Filter System Component Manual" � BD - 10572 -P (R.6/99) "Mound Component Manual" BD - 10691 -P (N.01 101) "Mound Component Manual" Version 2.0 ❑ SBD - 10595 -P (R.6/99) "Single Pass Sand Filter Component Manual" ❑ SBD - 10657 -P (R.6/99) "Drip -line Effluent Disposal Component Manual" ❑ SBD - 10573-P (R 6/99) "Pressure Distribution Component Manual" M(SBD - 10706 -P (N.01 101) "Pressure Distribution Component Manual" Version 2.0 ❑ Drip -line Effluent Dispersal Component Manual for Multi -flo Onsite Wastewater Treatment Units O MAINTENANCE AND MANAGEMENT MAINTENANCE MONITORING SCHEDULE Service Event Service Fre uenc Inspect condition of tank (s) At least once every ❑ months 3 ears Maximum 3 s. Pump out contents of tanks When combined sludge and scum equals one -third 1/3 of tank volume Inspect dispersal cells At least once every ❑ months ,3 p' ears (Maximum 3 s. Clean effluent filter At least once eve y EP-Months ❑ year (s Inspect pump, pump controls & alarm At least once ever ❑ months „� ears ❑ NA Flush laterals and pressure test At least once ever ❑ months 3 ears ❑ NA Valves At least once ever ❑ months ❑ ears ❑ NA Other: At least once every ❑ months ❑ ears ❑ NA Page_7of� START UP For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high 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 frozen 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 reduces the wastewater volume. Also the brine or waste from water softeners, iron removal 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 is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable /fait 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 into the system. Other non - biodegradable items 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, disinfectants, 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. Compaction of snow over the dispersal unit may cause it to freeze up. ❑ Valves Valves shall be operated in the following manner: Alarms Alarms should be 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 conditions, however water should be conserved until any problems with the system are corrected to prevent back -up of sewage into the dwelling or surfacing. INSPECTIONS Inspection shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per 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 sludge and scum and to check for any backup or ponding of effluent to the ground surface. Access openings used for service or assessment shall be sealed and/or locked 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 combination of sludge and scum in any tank exceeds one -third (1/3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with Chapter NR113, Wisconsin Administrative Code. The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. Provisions are to be made to retain solids in the tank. Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating. Pump Chamber /Treatment 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, surfacing, missing or broken security devices and other hardware and the condition of any filters. Any service needs or repairs shall be promptly taken care of. ❑ In- Ground Gravity Component Dispersal Cells The inspection shall include recording the levels of ponding, 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. Ponding at depths greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. Page__d__of�' Mound, At- Grade, In- Ground Pressure The inspection shall include recording the levels of ponding, 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. Ponding greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. The pressure distribution system is provided with an opening at the end of each lateral to be used for flushing. The laterals should be flushed at least once every three (3) years. Pressure checks of systems with multiple laterals should be done to ensure that equal distribution of effluent is occurring to promote the longevity of the system. REPORTS Reports for maintenance, inspection, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin Administrative Code. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is properly and safely abandoned in compliance with Ch. COMM 83.33, Wisconsin Administrative Code. - All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. - The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. - After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or other inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ,1 The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTIAN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Fea IvoO- .fVI2- Name Phone is' t 7w - s.7« I Phone /s c 71- sttt SEPTAGE SERVICING OPERATOR Pum er - L/,drvo',,j LOCAL REGULATORY AUTHORITY Name Agency j 4 D'o filer Phone Phone iS JIP4 - y68o KAWPDATA\EFLPOWTS OWNER'S MANUAL.doc Page__Lof 9 • Z e an m o mercla uen ter SPECIFICATIONS APPLICATIONS: The A100 Is used In residential and commercial septic systems. It ® ----�6 is effective in multfamilyhousi ater has high %rentalprolxrry,schooti offices ! and everywhere wastew suspended solids content. 3 ROW RATE: 3,000Bpd perfllter. Install two ormore filters in a PVCorconcrece mani to achieve flown of 6.000 gpd or more. Check with•Zabel for details. FILTRATION: The 26 Disc Dams 0 1116 inch provide 198 lineal feet of ` filtration. 2 INSTALLATION: The filter may be installed inside the tank or installed in a Zabel Container Assembly outside the septic tank. =VICF- Service residential installations whenever you pump the tank.' O 50 O.D. 4-1n' I.D. p I � � 4 .-- 11.13/16' _.� • • ' DU 3.9116• �• i • i i �. 11 16' : f ill 1 11 - • n 1 f i l l: ��....� ' Item On& Deicri tion )&tcrW Spectf1catimis Cases, Lids, Reducers Rigid Vinyl PVC 87371 u 2 26 Film duc Disc High Impact Polystyrene tzsT 3 i CD," Rod, Nuts High Densiry Polyethylene 4 3 Rod S 3 Nut U.S. Patent No. 4,710,295 Call 1 -800- 221 -5 or Fax (502) 267 -8801 for further information. 1 f r a Maintenance The interval for servicing septic tanks is set by state and local code. Throughout the United States there is a wide difference of opinion on what this interval should be, but most regulatory agencies suggest two to five years. The Zabel'" filter, which does not increase the frequency of servicing for the tank, should be cleaned when the septic tank is normally Inspected and pumped. However, our filter is virtually self - cleaning. The continued action of the anaerobic organisms on the Zabel filter causes lodged particles to disintegrate and fall to the bottom of the tank.. If your filter contains a SmartFilter alarm, you will be notified by an alarm when the filter needs servicing. To service the filter: 'Servicing any Zabel filter should only be done by a certified septic tank pumper or installer. Locate the outlet of the septic tank. :t Firmly pull the filter handle and slide the cartrldgO out of the ca99s:' ' Remove the tank V:Q` ; . ti and pump the tttll • Note: A tee handle may hA : "; ; Vi' to be used !t the Ater Is tLQ necessary to pr �iM + d below ground level to any S011 escaping to th Contact Zabel for Into ' when the fi rem i s4 i . �— While holding the carttidg6 "6991 the access opening:Hrge >25Nt1lf "` Insert the fjlteP�$t�tfrldgo- cartridge with fr99tT „ t6i ME �. back In thw6ag3'.f AY(In careful to rinse all.' A sure the filt �! km I b t proper) < *Note It is not neces completely I 'spo"ess'. The bloma ti ' h etreatm e T nt e aides � W fn n he filter. ! be left o t ( , • r Replace t maybe disass ` 5 uAOE W USA The product(s) shown are covered by one or more of the following patents: U.S. 5,762,793, 5,580,453, 5,591,331, 5,759,393, 5,683,577, 5,582,716, 5,779,896, 5,593,584,5,795,472,5,736,035, 4,710,295, 5,382,357, 5.482.621 U.S. Des. 386,241, 349067, 4605501,5098568, Des. 309007. Australia: 134440; Canada: 2,135,937; Israel: 111574; New Zealand: 264824, O ther Call for a free ZABEL ZONE An Onsite Wastewater Magazine 1- 800 -221 -5742 • Website http: / /www .zabe 6o m RECEIVED Wi W NOV 1 7 "'; OIL sconsin Department of Com rce OI EVALUATION REPORT Division of Safety and Buildings ��i1j � S ZON W FICE� Co S5, Wis. Adm. Code County Attach complete site plan on paper not less than x 11 inches in size. Plan must P ` e 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 'awed by (Q _ Date Personal information you provide may be used for secondary purposes (Privacy law, s. 15.04 (1) (m)). Dom• 2 - 3 Property Owner �.I vio Et t rFs••✓ - a u../ rc Property Location Z;jle '` � c o G .©' a s Govt. Lot A I A I 1/4 �6✓ 1/4 S _fa T ,� 9 N R /,S A (orj Property Owner's Mailing Address Lot # I Block # Std Nwne or CSM# D, �ox 8S -- —• City State Zip Code Phone Number �}tip .E�- own Nearest Road arms I LL I ur AM?I I ( 2V 3 ) 7 - 9..7J rli✓t i o moo, eo, r" d New Construction Use:0 Residential/ Number of bedrooms 6 Code derived design flow rate Goo GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material Flood Plain elevation if applicable ft. General comments and recommendations: /yau�✓D �o�/ P / sA,i4 LiGT �ecor,.Yndo S. Lft, - /a /, a r o�✓ /do, o r G,0 u ro�.s. DN�✓ SOY�lA.d f /�'6D M Boring # E] Boring / �r [",pit Ground surface elev. -_ /oo. D ft. Depth to limiting factor _ iS� in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont Color - Gr. Sz. Sh. •Eff#1 •ETf#2 o- zo Yt ?s — p q Z - 3 /o Y 3 1i - e S 1✓1- .6 3 - JA 7 s s' r h S Iry c 7 4 2 S Y-f s/8 n c cq S/� n/A t Lod � tJ'a !' .✓ - �'.? Boring # [ ] ' Borin g L r N � Pit Ground surface elev. J 8 ft. Depth to limiting factor in. Solt Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDAf in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 0 o -12J '- u ,, r Vie J / S v J 12 Effluent #1 = BOD > 30 220 mg/L and n!9 < 150 mg/L • Effluent #2 = BOD < 30 mg/L and TSS < 30 mglL CST Name (Please Print) ig a CST Number �c r 4 Address Date Evaluation Conducted Telephone Number SD3 �•vii[s✓,v ,5'r �• �� t3" o - .�S -o3 7/S 6'.Tt/ -�lDd r Property Owner viii L f P-R.Ot Y .5 re s �,sa Yr4) Parcel ID # Page .? of .� 121 Boring # r ❑ BBoring .. 1� Plt Ground surface elev. 9 7 S ft. Depth to limiting factor <T.S in. 5a1 Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF In. Munsell Qu. Sz. Cont. Color 7 Gr. Sz. Sh. "Eff#1 "Eff#2 A, G S S ra - s /✓ . L .as z 7s- ,-,t a I .. ✓ s s r..Jr F Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. 19o,I Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. "Eff#1 "Eff#2 F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 "Eff#2 Effluent #1 = BOD > 30:s 220 mg/- and TSS >30 _< 150 mg/L ' Effluent #2 = BOD 5 30 mg/L and TSS < 30 mg/- The Department of Commerce is an equal opportunity service provider and erpployer. 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) r c. C-4 C n H H cn tzj v, o •• � H O t a a Ilk Z a a p �w Z rZ J I 1 f I N ab � b i V o x � 1 0 � N � O a� r A ' p d O L N � D a o R a ,z .q a � � Z a�� a • o ao ° w l� ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer�� Mailing Address i`. Property Address N ilk 50 DO (Verification requireb from Planning Department ior new construction) City /Stat Parcel Identification Numb DD LEGAL DESCRIPTION Property Location Out %a ' / 4, Sec. , TAN -R t!5� Town of n r. , r 0- Subdivision , Lot #. Certified Survey Map # 1'1 I r � , Volume Page # 44 r Warranty Deed # Volume Z Page # z Spec house ❑ yes no Lot lines identifiable yes ❑ no SYSTEM'MAINTENANCE 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. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restrictedplumber 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. 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. Certifica-tion stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. N SI . , A� TUR YER4&TION F APPLIC DATE a OWNER I (we) certify t ja 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. Antif I ik /0 . I . IGNAt QF A" CANT CANT ATE * * * * ** y in orma n that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed L_ r1AR -67 -2003 69: FRCM: CHUCK A. /BRIAN A 715 389 1212 T0:1715B35096'oQU�1Pn no 6 Aavte /NG aRTCMFT A Product Of W Bullding Systems, VC, Home! $ ^,FaT_6nlerOrtlar.rpi CO. Box 530 - Marsbneld, W1 54444 - 387.2551 Attach Print on thl$ Pago i I S. r r ¢'� • B► b � , � J 4 � 9 a "' a T �JJ • w i 0 49 3 b , l Q� +r eq i i i i .. - r. ❑T a;3CgQC T JT AA m4 8L:II LOP DEC -17 -2003 11:18 FROM:KNAPP 17156652018 T0:17156725267 P:3/4 � eu ru L& LI L., Val 1 5 � I ►n c ,► ixt _ .. I w D •ra� C 7 !:CA C .an e31 [ •L� I " ou z o in 51 1►i: C F i° � •2 /t ►RR► a m � u `.lit r oe N zz z j � ° � � i .1►ti2t ,� � 5 lu 1 " AC � ee M � g r 0 1 3p ' ...... m 1 p a I b i 1 N 14 a0� f 1 12 2 at T y ,r/t tRl1 i 4m QLRa. n h r Ail IOA w •e 11.7 T W h =0 i W las s R 1 ,•� � ♦ r A. 4p r b _ � .611 �� •E � e � n Al A fit 1 I r 9y W Y r � r J `` I !P � N Z 1 � c�a da ��� d_j U U � 7 -v. a,xn Z p'F� y„ ' E - - -- -- ---- - -- -- _ ._. 1 n• �WW p C I r- I I I l JvU xq^ r 0�6�tU� J II I I y� " ■5 I I Y � I I �'f I �- "Y I W •.'' V I l u �� I l_____ J I A I y ^ rj r Y E� j �y �efyp i��jj�•lyF� Q � o i I I I "aa I N 2i�. Aw w •� I I �� 94 Y� � 1 ��' .e rn •' 1 in I I 1 S M I I FY • 11 I I x�tl I I I I I • 1 ,off: i i e yq� M]LLMY ISHI A S� it e ', e.tib ,•_ .. s. 2�9Sj tia�.QL`: 8S02S99SS4t ddUN)PWOad 6T:TT 2007 DEG -18 -2003 11:19 PM P.02 U 2475P 259 c a-71 aTATE BAR OF WISCON FORA! I .3000 WARRANTY DEED XAATTHLREN H. WAL gT Doalaunl Nwnbar . I CROI X co. S MI This ]Deed, made between Llsvid L. ililfs�s„ RSCRIYRD FOR RECORD �lierlson. Lnaband and wits � , 12/16/2093 11:30AM mot 11ARRANTV D88D REC PCB: 11.80 (trarltee RAMS FEE I 131,18 OPY Mgt Onatltor, for a valuable consl&radon, cow/We to Grantee the folbwfi4 CC FE CI t described real $#aka in st. Csoix County, State of PA01'sSl 1 e "pety r") mo p ace is aoeded, lease tt eddeutn); !L Cart Pro iiied 0gz v Map raaosd i a V Ie 1 nd 6 on page 4662 as Do�nt Mo. 747907 being a part of the orthWeat Quas z o soath"Ot Quarter 0014 Recording AM of 21141, section 32, Township 22 North, Range is Nans cad RrewnAAdna Nest, Town of iplrtngtield Title one Premier aroup, Inc. 706 19th 2tzeat South tttsdsaae, 11ist;tensin 54036 start of 094 - 1072 -95 - Perael Ideadfieatloe Number (PIN) Together with an appurtenant rigbts, title end ialemm, This is net homestead property. (i0) (is act) Grantor wwants that the title to the Pmperly is good, iWdeaalble In fee simple and free and clear of encumbrances except Aoadreays. Nasoomeats, and VAstriotiona of Record. Dated Ode day of beeembor 20_0_3_ . " David L. etllo sou • 1 lesson AUT1E1tR14MCA ACIOVOWLSDGNMNT STATE OF WISCONSIN ) Stgtlatule(s) ) ss. {r ■ t . . rseiat Cpunjy. ) authemi�cated this — .day day of • , PersoMlly came befon me this day of 2s2md : , .,2goa the above named David L. 9110&= f Ch�rvi .�. =li�l�Oa w ww. TMX; MEMBER STATE BAR OP WISCO (It not, to me known to be the person , ,a, who executed authorized by ¢706.06, Wis. State.) the f i lnstrum an acknowledged the same_ 71116 INaTR MENT WAa ORAFTBD BY • Rol Michael N. 8*oaraki , 1lttesl>•y w , N tary Public, State of Wisconsin N&U - Cl_aira , t/isooasin my Commission is peraasnent (If not, 0% expiration date: Bi Inn bo widunbGsW or odmowl . both us not nawu combat 12 o IdMrIN Or pasoor ergalag is any aapsa{ty lunar 1K typed or printed below 4141, Iigae111re. WAitRANTY D91D aTATE BAR OF WISCONON FORM Na. 7.2000 array Michael N Foreekl 1130 Bracken Ave, F.ae Claire WI 547014627 Phone: (71 8333424 Pax! (715) 135.41 t2 Title Out Plamler (Troup 141012M.M Orodue" wM ZIpR -- N lW Fa"irNK LW is= Rases here Rose, omftn rowsuw, aaWw+ resod, pool =3-M - 7 .4 - 7 aa-7 VOL 18 PAGE 4662 R M. DEEM CERTIFIED SURVEY MAP RECEIVED WORD 12/01/2003 10:30AM LOCATED IN THE NW1 /4 OF THE SW1 /4 OF CERTIFIED SURVEY MAP SECTION 32, T29N, R15W, TOWN OF REC FEE: 13.00 SPRINGFIELD, ST. CRODC COUNTY, WISCONSIN. COPY ES& FEE-. OWNER SURVEYOR DAVID & CHERYL ELLEFSON EDWIN C FLANUM 835 COUNTY ROAD'NN' NORTHLAND SURVEYING, INC. WILSON, WI 54027 IN%A HWY W EIA CORNER ROBERTS, WI 54023 SECTION 32 U H[p VV[ED L� [iflD@ OOI�'In H(1(o ®rl 04G�GGi� 3 ,. ` 50 1/4 CORNER ------------------------------------- - - - - -- - ' SECTION 32 N89°37'22'E 1327.73' 1287.73 T /4 NE Li Y ' x I . I w I �1 LOT 1 0: 8i 1 33 4a I 27.28 ACRES INC. RAN C�' o I I 1,19e,357 SO. FT. �I I � a — x+- ■� 28.48 ACRES EXC. R/W yy 1.152,577 SO. Fr. W�1 �i ^ T oo I a O, o;� � \ co I � u+ N I MOUND ut O p ; I- ZL--- .DSl HOUSE& SYSTEM ED `� .__._ GARAGE _ $ � i I 40.00: WELL 'n Q SHED + \ Q I �I SEPTIC VENTS (TYP.) 1287.98' n° S89°39SOYV 1327.98 , �I p' � APPROVED I I ST. CROIX COUNTY �' I( LOT 2 DEC o 1 W a' i a- PROPbSED 570.181 SO. FT. B not rsoo:dsd wWM 30 days Of i D 9' I I DRIVE Mp WW dab "pwW shd be 12.70 ACRES EXC. RAW nW1 snd void 553,007 SO. FT, i .40.00: ® SOIL BORINGS(l) S8W39'50"W 1328.06' I- N LEGEND SW CORNER e SECTION CORNER POSMONED I SECTION 32 52 X FROM WITNESS MONUMENTS OF RECORD O 1'X 24 IRON PIPE SET WEIGHING 6i 1.13 LOS. PER LINEAR FOOT O SCALE IN FEET 1 • = 200 tg MASONRY NAIL FOUND Lu ■ 200 0 200 400 iE Q 1' IRON PIPE FOUND SHEET 1 OF 2 SHEETS �j ....... 100 ROADWAY SETBACK LINE Vol 18 Page 4662 i