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HomeMy WebLinkAbout038-1215-20-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 487985 0 GENERAL INFORMATION State Plan ID No: Personal information 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: Campeau, Kevin I Star Prairie, Town of 038- 1215 -20 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: cj , 56 B Z (L ( 11.31.18.1183 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic - 7 Benchmark zbb S g s /05,35 991 a D *Holding i ✓ a gaC� A 1 B o � �- FJ J Bld . Sewer 13. o qz: 3 S St/Ht Inlet l � 4 10 . - 75 ` TANK SETBACK INFORMATION St/Ht Outlet ---^ TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 27 i 7 /aQ i �/ Dt Bottom Dosing t > J 0 b i O _ Header /Man. I , ZS 27 Aeration Dist. Pipe Holding Bot. System PUMP /SIPHON INFORMATION Final Grade 7 Aj Manufacturer Demand St Cover 11 G eV GPM Model Number TDH Lift Friction Loss System Head T Ft Forcemain Length j I Dia. z , Dist. to Well 30 �b0 SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Tre nches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 gad 9Z, Z v% SETBACK SYSTEM TO P/L JBLDG WELL LAKE /STREAM LEACHING Manufacturer: ---- ,/ �-� INFORMATION CHAMBER OR Type , 0r ^ (p 1 Z I - / UNIT Model Number. J; �>_ t 1L./ /�/ DISTRIBUTION SYSTEM 7 5o Z 7Z _Z -r `;s d Header /Manifold Distribution I x Hole Size x Hole Spacing Vt to Air Intake / Pipe(s) Lengt Dia_ Length_ Dia \ Spacing 0. SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over J Depth Over xx Depth o1h xx Seeded /Sodded xx Mulch d Bed/Trench Center 3 cs Bed/Trench Edges Topsoil Yes ] No Yes I No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 2239 124th Street Sta Pr 'rie, WI 54026 (NE /4 SW 1/4 11 T31 IN R1 8W) River Place Lot 22 Parcel No: 11.31 18.1183 1.) Alt BM Description = J � � o 2 35 Dfb Gba 1'4 a� 2.) Bldg sewer length = '3 G , Cob amount of cover = i I ll1 b r�' "`Q'�` 6 ►QUO Plan revision Required? I ' "] Yes No I X31 Use other side for additional informa on. I___1___ l___ - - - - - -� - Date Insepctors i ature Cart. No. SBD -6710 (R.3/97) RECEIVED v ote P--- A T .� ST. CROIX COUNTY Safety and Co h :77 , 201 W. Washington Ave., P.O. Box 7082 S V visconsin Madison, WI 53707 - 7082 Sanitary Permit Number (to be filled in by Co.) De artment of Commerce (608) 261 -6546 -T$ 7 T9 5 Sanitary Permit Application State Plan l.D.Number In accord with Comm 8311, Wis. Adm. Code, personal information you provide maybe usod for secondary purposes Privacy Law, sl5.04(I xm) Project Address (if different than mailing address) I. Application Information - Please Print All Information 22 3� /Z Tti :54- -. Property Owner's Name Parcel M Block M Property Owner's Mailing Address � "� .0 Pr Location Ot a/ 3 — l � S7` NE %, S K, Section City, State Zip Code Phone Number / YD / 7i - � 8 33 T 3 J N; R ! 9 cE W) ' E W l., IL Type of Building (check all that apply) 6k a5 e f' J�U&A 1 I or 2 Family Dwelling - Number of Bedrooms P 1 Subdivision Name CSM Number ❑ Public/Commercial - Descnbe Use ❑ State Owned - Describe Use Z GeAk L,) I Z C ❑City ❑Village wnshjp o IIL Type of Permit: (Check only one box on Hae A. Complete line B if applica A New S tem ys C1 Replacement System ❑ Treatment/Holding Tank Replacement Only ❑Other o tfication 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 1KNon - Pressurized In -Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 tn. o 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 9 Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpds Dispersal Area Require st) Dispersal Area Proposed System Elevation p© v- 0 7 ✓� VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Exictin� Tanks I Tanks Scptic or Holding Tads �at7O "' 0 Aerobic Treatment Unit Dosing charnber n5 �Q VII. Responsibility Statement- I, the undersigned, assume responsibility for!29allation of the POWTS shown on the attached plans. Plumber's Name (Print) Plum igna e M PRS Number Business Phone Number Plumber's Address (Street, Ciry, S te, Zip C I I C VIII. County /De artment Use Onl pproved Sanitary Permit Fee (includes Groundwater Date sue Issuin nt Signature (No s � � Surcharge Fee) ❑Own en Reason r Denial 3W �b s IX.. Conditions of Approval/Reasons for Disapproval SYSTEM OWNER: 1, 'Septic tank, effluent finer and dispersal cell must all be services / maintained SO per managernent plan provided by pkunber. Z AN setback its must be rte WMWrNd as per apps ccds / adranoss. N6 � r /goo l U� ys q - y ly eF v� Of" 13A .s� 9s.so f �aO�s 9A - / '/(,/ L r - so �P ysq - yam r /h A loll 03 5 0 r Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 _ of 3 Division of Safety arld Buildings in accordance with Comm 85, Wis. Adm. Code County St. Croix 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. pending Please print all information R iewed by Date A4o, Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04(1) (m)). 3 Property Owner Property Location LaCaSSe DeV 1 Govt. Lot NE 114SW 114 S T N R Sr) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 57 " City State Zip Code Phone Number ❑ City OVillage Town d Hudson IWI. 1 54016 H ) - 112 ® New Construction Use: [2 Residential / Number of bedrooms 4 Code derived design flow rat PD ❑ Replacement ❑ Public or commercial - Describe: b 1 Parent material 011 t wo Sh Flood Plain elevation if applicab 'ift• General comments r and recommendations: �(ik .� / 311 1 , 1 1 � STY 0 trenches @ el. 95.50' ` Boring # Boring 9 S14N — l F il ® pit Ground surface elev. 98.20 ft. Depth to limiting factor 160 in. r ff#1 il Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fg in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#2 1 0 -9 10 cs 2f .5 .8 . �. 2 9 -30 10 4/4 none s il 2msbk mf gW if .5 .8 •O 7-.53M none Vc_OS Osq ml gw na .7 1.2 .} none COS osq ml na na • 7 1'2 •�- F- Boring # Boring 21 ® Pit Ground surface elev. 99.50 ft Depth to limiting factor 120 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 in 4/3 none sil 2msbk mfr CS 2f .5 .8 no ne sil 2msbk mfr qw if .5 .8 .fo 3 7 -12 7 5 4 4 none 4jr cos oscf ml I na na •7 1.2 •� Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg /L We t #2 = BOD 0 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number Gary L. Steel 02298 Address ate Evaludtion Conducted Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 6 -23 -2001 715 - 246 -6200 Property Owner LdCasse De , In c. Parcel ID # WildinU _ Page 2 of — 1 Boring ❑ Boring n g ® pit Ground surface elev. 98 ' $ Tt. Depth to limiting factor 120 in. 1 Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -6 10 4/3 none sil 2msbk mfr Cs 2f .5 .8 Ae 2 6 -25 1 ' S' F-1 Boring # F] Boring � ❑pit Ground surface elev. ft. Depth to limiting factor in. Soil -- A - pplication 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 ❑ Boring # Boring Ground surface elev. ft. Depth to limiting factor in. F] Pit Soil A lication 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 I 'Eff#2 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg /L ` Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 - 264 -8777. SBD -8330 (R.6 /00) Property Owner " ILaCasse Dev. , In c. Parcel ID # pendin Page 2 of 3_ F- Boring ❑ Boring n 31 g ® Pit Ground surface elev. 98 ' $ ft. Depth to limiting factor 120 in. Soil Application Rate .Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 1 0 -6 10 4/3 none sil 2msbk mfr Cs 2f .5 8 •�P 2 6 -25 1 none .� F71 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 F] ❑ Boring Boring # Ground surface elev. ft. Depth to limiting factor in. Pit 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 I `Eff#2 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ` Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 - 264 -8777. SBD -8330 (R.6 /00) STEEL'S SOIL SERVICE Gary L. Steel LaCasse Dev. Inc. 1554 200th Ave. CSTM2298 NE'SW S11- T31N -R18w New Richmond, WI 54017. MPRSW -3254 town of Star. Prairie (715) 246 -6200 lot #22 - River Place This soil evaluation vas conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of the test may or may not be as shorn as permanent lot limes were not established at the time the test was conducted. ,1 11 =40' top of 1" pvc pipe @ el. 100.00' top of 1" pvc pipe @ — ef 7 Old r A 3 Gary L. S eel 6 -23 -2001 f ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address v� li N� 511` /U,e U, Property Address ,- T j (Verification required from Planning Department for new construction) City/State Parcel Identification Number 6 3 /S ^ 30 — 6 ,00 LEGAL DESCRIPTION Property Location ' S I j , P �y .� /,, _ f�- /., Sec. . T�N -R lg W, Town of U�� Subdivision c Lot # a7c Certified Survey Map # Volume . Page # Warranty Deed # 6 (0 5 Volume � -� Page # Spec house ❑ yes ❑ no Lot lines identifiablgl 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 propertyowner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal 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, here* as y the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that our ptic ystem has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days o thr ` ye expiration date. GN OF LICANT DATE OWNER CERI VICATHIN I (w a fy th t all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the erty 'bed ove, by virtue of a warranty deed recorded in Register of Deeds Office. GNA VE OF A LICANT DATE * * * * ** Any information 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 11/02/2005 13:46 17152483248 CAMPEAU CARPENTRY SU PAGE 01 Ynl PAGI 162 I I STATF. BAR OF W ISUP13 N ROAM 2 • 19" 6 1S 13 t&.3� y �INCIMIeA1 Number — W ARRANTY D REGISTER OF DEE ST• CROIX CO., ux This Dow. made be tween I.ACast� ^e De rclopme a t� (pe n — 1� F D WNe nroln C o rstlnp�� •..... -�- -- ••- •..._._— �.. Ul•i!4 -2uD� 1:30 Rn Cirsntnr Rnd KeYfn PAtrl!N CRmm u Jeffre Allen Ce�ce end 7 YARNRFi1 oEED a 7 c :. N �— --' CERi COPY FEE: n to Mkhpel t am eea, es tenants In common, _ _ _ _.___..._....... __._.. EUP) +it: 2.00 Grantor, for -i Valanblo carside Conveys 19 Grantcc the rol lowing described real ec1At9 hr S Croll _ County, Stan Of Wtseunsin (if morn so tee Is nettled, Pleosa 81111911 Addendum): Lot 22. Plat of Rivet- Place, Town of Star Prairie, Sc, Croix County, ReCINJing Arco- V11conxin; ANO NA:ec mad RennA Aehhess as )•� ;,,,�A,( S+ � S4 c 11 1 ` 10 00 1 hletnificxiion Number (PIN) This _ Is not la mesa ed pnrperty. Excep00ns to worrlmtica: Beser11911b. restrictions ARd fights-of-way of record, if airy, 0S1 to Anti (7Rted this 1'L day of . iinu `� • ]092 �L^A�CA7SSe Is fit, Inc. -- • - • UT_ Rieb W, LRCAAS P eithlertt A1JT}IENTICATtI)N ACKNOWLEDGMENT STATE OF WISCONSIN ) St. Crnist nulhenticaled rhi:. day or r 2 PersOnnlly came bcfiMe me this e�ey nf. dense ]007 -*48i;ve gnnmr LnCassO DrVet otarni Inc., n Wisconsin lei iylt ...___,._.�_ tueem w. LAtnasa. rresnten � •. . •. • T • • 'TITLE: MEMBER STATI: BAR Of WISCONSIN mC knower 1`V he 8110 perrnn(sI who execured ttre lirriguing duthorind by § 706.106. Ws, St «rs.t — instrument and Acknowledged the I*mc. THIS INSTRUMENT WAS nttA): m HY �` '- — AHnracy Wistins 011and — ti ITgd'n - - -- _ NWnry Pa 1i0, Stpte o1' Winonxln l.Sigearures rnny be a,lhenneRUyl or 1rel:enwicdged, 410th Rre not Oe"ary.) My Co taeron I.1` pertnancnt, (1 nut, store expiration dare: Names of prrxmt tign)n& in arty cepAetty mVA1 b1` typed or Prinlcd below their sipnraure, tAmmWan r4lo araa r .mgnx asaear «. >w WARRANTY nF.Fp STATE BAR OFwt.Rt;'ON91h rec.cee•sm, FORM Na. 2.1979 W�� POWTS OWNERS MANUAL & MANAGEMENT PLAN Page I of 2 FILE INFORMATION SYSTEM SPECIFICATIONS Owner Septic Tank Capacity I �p al 13 NA Permit # Septic Tank Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model _ ❑ NA Number of Public Facility Units ❑ NA Pump Tank Capacity g oo g al ❑ NA Estimated flow (average) 7 00 O al/day Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.5) 600 g al/day Pump Manufacturer � ❑ NA Soil Application Rate < 7 gal/day/ft' Pump Model ❑ NA Standard Influent /Effluent Quality Monthly average* Pretreatment Unit ❑ NA Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD.) 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD 530 mg /L In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) 510• cfu /100ml ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: ❑ NA Other: Other: ❑ NA ❑ NA "Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: a month(s) (Maximum 3 years) ❑ NA y ear(s) Pump out contents of tank(s) When combined sludge and scum equals one -third (Y) of tank volume ❑ NA Inspect dispersal cell(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA year(g) Clean effluent filter At least once every: / ❑ month(s) ❑ NA jid y ear(s) Inspect pump, pump controls & alarm At least once every: ❑ month(s) ❑ NA y ear(s) Flush laterals and pressure test At least once every: ' ❑ month(s) ❑ NA ❑ ear(s) Other. At least once every: C3 month(s) p year(s) ❑ NA Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) 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 back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually Inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. .The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification t on of the local regulatory to authority. 9 rY ty When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any'servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. START UP AND OPERATION Page 2 of ?/ 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 defected 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. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; 9 P g , one, rease• herbicides; me 9 9 at scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter 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 another 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 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. T 4d6Mif . alua ' t low b Maw a 1 PRN4 08 MZ, �fi2- A/6*.,,) a& j 5- Mticart 0 tank ❑ 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 CONTAIN 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 �� Name Phone 71 j — b g — � Phone - SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name 15 �' l 2&J11i Phone Phone This document was drafted in compliance with chapter.Comm 83.22(2)(b)0)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. START UP AND OPERATION Page 2 of Z For new construction, prior to use of the POWTS check treatment tank(s) for the presence of aintin roducts or impede the P g P other chemicals that may P e 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. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the - dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup r surface ce discharge of effluent. T re To avoid this situation have the contents of the um tank removed b p ump y a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; tics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter 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 another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been or-must be taken, replacement system: to provide a code compliant ❑ 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 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 61 W hae not beem evaluated to a alua ' 1 aft&-sitB b e ai a R�� -118 rr �b�2 Nom✓ Co�vS7x�cai o _tank ❑ Mound and at -grade soil absorption systems P y s ma be reconstructed in lace following Y p o owing 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 CONTAIN 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 / �U Name Phone 7/5 - a b g - 6 Phone - SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name :j ( 2olJr�cJ Phone Phone — 7/S"— This document was drafted in compliance with chapter.Comm 83.2212)(b)(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. COMBINATION SEPTIC/DOSE CHAMBER TANK & PUMP SPECIFICATIONS PER COMM 84.25 CODE CHANGES 2/1 /2004 Access Opening, not top of coyer, Access Opening, not top of cover, must erdend to a point no greater must adend at least than G" Below Finished Gr de 4" Above Finished Gyade Coveridth Loekiagg Device A j � �,� f -$qX peed'� � F (typical] Finished Grade Ft: �, a /a Min. > en 30 7 Access Opening O� TM j � Min. 23" Access Opening /N Oulet Effluent Filter Gv /77/ Union )4wg !P P /PE 3 M Inlet Baffle ON`Ta .SOS -/a i Pu p 3 or ravr:/ to unde w/ �en�er /acuerQh Qd g ps Two ComparFment Septic/Pump Tank /4 L_ _� mn offside ✓GC��) SPECIFICATIONS TANK MFR: DOSES PER DAY: 3 TANK SIZE: SEPTIC ADO GAL. DOSE VOLUME: 2 O GAL. DOSE T GAL. (INCLUDES FLOWBACK & <20% OF DWF) ALARM MFR: R."L� CAPACITIES: A = o?0 1CHES = GAL. MODEL # Switch type: B = — 2—INCHES =GAL. PUMP MFR: _ C = D� INCHES = GAL. MODEL #: o SWITCH TYPE: D = S INCHES= GAL. REQUIRED DISCHARGE RATE o?S GPM PUMP & ALARM WIRING PER COMM 83.43(8)(e) VERTICAL DIFFERENCE BETWEEN PUMP OFF & DISTRIBUTION PIPE (LIFT) = O FT. MINIMUM NETWORK SUPPLY PRESSURE (DISTAL & NETWORK PRESSURE) = + a-- FT. 1a© FT. OF FORCEMAIN x /,S FT. /100 FT. FRICTION FACTOR ...... = + FT. TOTAL DYNAMIC HEAD (TDH) _ FT. INTERNAL TANK DIMENSIONS: LENGTH ; WIDTH ; LIQUID DEPTH 3 R _ MP/MPRS SIGNATURE: LICENSE NUMBER: do? 0.357 [(5] GOULDS PUMPS Submersible Effluent Pump E PO4 & EP05 S er i es APPLICATIONS •Fully submerged in high ■ EP05 Impeller: el Specifically r let, T P all designed grade tut P hermo Y gned for the g turbine oil for tic enclosed plas- � Bearings: Upper and lowe u l ubrication d esign for followin e uses: catl 9 s on a 9 n� efficient Improved performance. heavy duty ball bearing • Effluent systems heat transfer, construction, • Homes ■ Casing and Base; Rugged •Farms Available for automatic and thermoplastic design provides AGENCY LISTING • Heavy duty sump manual operation. Auto• superior strength and corrosion • Water transfer matic models include resistance. $A -File Canadian Standards Assopauon • Dewatering Mechanical Float Switch 11 Motor Housing: Cast iron # LR38549 assembled and preset at the for efficient heat transfer SPECIFICATIONS , factory, strength, and durability. Goulds Pumps is 150 9001 Registered FEATURES X Motor Cover: Thermoplastic • Solids handling capability: cover with integral handle and 3 /4" maximum. float switch attachment points. • Capacities; up to 60 GPM. I EPO4 Impeller: Thermoplas• • Total heads: up to 0 feet. tic semi-open design with ■ Power Cable: Severe duty • Discharge size: 1' /z" NPT Pump out vanes for mechanical rated oil and water .resistant. • Mechanical seal: carbon.' seal protection. r otary/ceramic-stationa ry , BUNA•N elastomers. • Temperature: 1 04 O F (400C) continuous 140 (60cC) Intermittent. METERS FEET • Fasteners: 300 series 10 - ---- -- stainless steel. ............:. ' Capable of running 9 30 dry without damage to components. 8 � f— 5 GPM 0 25 � 2.5FT Motor: a 7 .......... 04 Single phase: 0.4 HP, v s zo a� 1 15 or 230 V, 60 Hz, 1550 , RPM, built in overload with Z 5 automatic reset, o is • EPOS Single phase: 0.5 HP, 4 115 V or 230V, 60 Hz, 1550 ° ;......... A -'- RPM, built in overload with 3 10 EPOS automatic reset. • Power cord: 10 foot z EPO4 i Standard length, 16/3 5 SJTW with three prong t grounding 9 Optional ZO o 0 i foot length, 16/3 SJTW with 0 10 three prong grounding pl 0 g p 30 - (standard on EP05). g ao 510 GPM 0 2 4 6 8 0 2 m' /h CA PACITY 2 2003 Goulds Pump, Goulds Pumps EHecl`e July, 2003 83871 b p�a� � — ITT Industries j m a N"'� I I ...... ............I...... - - - 270.33' p — - --- --- 352:2?' - S89 °64'56' W 628.18' PUBLIC ROAD — • Z N89 °54'S6'E 628.18' — m - 328.33' - - - - - - ACRES o I (' p H.W.L. = 9 6.50 00 Fr _ A i LOT 21 2.500 ACRES N H.W.L. 938.50 i : 1 108,879 SQ FT �° LOT �i 0 3 3i °56, 30' DRAINAGE N AREA TO MEA 42 ys EASEMENT op W, 3.434 A NOING AREA �� �' C1 �� 4 f 41 1 1 S W 149,595 -------- n+ C br W AREA TO t - / 30--_ N 4.5 ACS 1 • • `— 11 2-27' ES 88 RI' a h O $ Ov 41pa a � 3 • r r Qe. � � 153.10' � 282.99' •' '� 0. 1 S89 0 51'46' W 436.09' ' ,,� Q.�2 �' • p oi LOO `� � �� � i �° .• � C��GYI_��1_�IOdo_f14� •• / y C°�LaC�C� �3� � � . / _ ------- - - - - -- I 02 O O� C7 f i A z I LOT 22��., / 88 • I 1.514 ACRES •Wa �► � ' 65,942 SQ FT �� S7 Q'7 I 8 @ 3 28,a y , i / ♦� LOT 23 AREA TO MEANDER LINE 1.639 ACRES 71,390 80 FT AREA TO O.H.W.M. 2.0 ACRES MEANDER LINE NUMBER 0 2' .; A� E3 ae,4j, D 4& V p ' ji*QT 24 Parcel #: 038 - 1215 -20 -000 11/09/2005 10:08 AM PAGE 1 OF 1 Alt. Parcel #: 11.31.18.1183 038 - TOWN OF STAR PRAIRIE Currgnt w `X': ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner KEVIN &JEFFREY CAMPEAU O - CAMPEAU, KEVIN & JEFFREY 2213 122ND ST NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): " = Primary Type Dist # Description ` 2239 124TH ST SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 1.514 Plat: 2397 -RIVER PLACE LOTS 1130 038/01 SEC 11 T31 N R1 8W PT NE SW LOT 22 RIVER Block/Condo Bldg: LOT 22 PLACE Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 11-31N-18W Notes: Parcel History: Date Doc # Vol /Page Type 05/20/2003 722209 2248/048 QC 01/29/2002 669655 1825/162 WD 2005 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/13/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.514 27,900 6,500 34,400 NO Totals for 2005: General Property 1.514 27,900 6,500 34,400 Woodland 0.000 0 0 Totals for 2004: General Property 1.514 27,900 6,500 34,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00