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600 3° 016 �j ! �� A- FIELD INSPECTION & SERVICE REPORT INSTALLATION AUTHORIZED SERVICE PROVIDER installationAddress: ; -3 �• � � �� C. Name: � Owner Name: DIC .,A- Street: 3 . C-4- alai! Addr ss: Mail Address:`Da,"g- / State CJ/, Zi p city CQVC206L State L4;)l Z p SWZO Phnr: /5�7fj'�-S ax Phone (T/to-tioLmrFa e ma;i e-mail �c (• 036 -/,2 CO-30—aZ INSTALLATION INFORMATION Model N'o. Blower Brand and Serial No. Date of Installation Date of last pump-out /1 iC�0 3`E 0. Size ��SS 0 j p3 EQUIPMENT DETAILED COMMENTS OF SITE CONDITIONS - OPERATION YES NO MAINTENANCE PERFORMED OR REQUIRED Electrical Panel(s) \`isual Alarm Operating __ -- \udio Alarm Operating ------ (if resent Blo��er(s): Air Inlet Filter Clean dower Hood Vents Clear _ i:xcessive Noise Z�xeessive Vibration Treatment Unit(s): ,,usual Odor Svstem Vent — - _PUrnI out Required: 1 _ Pnmar Settling Zone - Aerobic Treatment Zone EFFLliENT: LIMIT RESULT _ Estimated Daily Flow H (Standard Units) 6-9 S.U. Color Clear e0. Temperature Dissolved Oxygen effluent 2 m /L Odor Slightly Musty odor (not se tic) l�Qe LO OWNER SIGNATURE TEC NICIAN SIG URE SERVICE DATE n V1 p w 0 d d con n CD ... ^ �A �' `° \ (D 3 = cn 7 z m z z cn 7" z v z ti z o w e C/) wo . 3 Dg < O N O N 6 � y 3 as O N O N O O O N pp o a o p 3 m o a c CD to A N a c O m p m p c O p p p N w o C A o 0- z 3 c 3 y o o 3 c 3 a � co o w O r m ID o r m CD w o rn 3 D c m m c m p N 0 J 00 C CL a i a a i �1 '� z cr> z D U z U) z A m a v D N CD D (6 D N a OJ m [7 xx Co m CD 3 cl z o C CD CD ., CD co r � n N N N CD CD CD N N O Ow U) O C 0 0 0 z , c c c c 3 t! N y Z1 o o 9 3 cr o m m m m °_' o O M - CD a x N o O � D o J O O C c CL t� m m � �• m C C o Cn N IC I m CD y �' t ' ui N cn 3 c 4' Z 0 }' C 3 CD N W � CL z 0 IAA o cn y z O A Ca � N�DC_Djs =h a D N DCOD� p^ D N O NN -i�•�� O c ( Z Cv �� d C0 C CO � a CC li N _O _. G y ] 3 n (b N N '0 N N 8 0 0 0 N y '0 N y 0 0 n -� C - 0 CD 'O -0 W O .-1 0 '0 CD - 0 - O �. W v O I S o O a ID � N � - O D r 0 n Cl N _ �3 3�ocoo vc ° 3 v o a N� c 6 3 0.0 m 6 D p Q > > as m y y 0 O 0 .6 O p CD j n 0� � 0 p (D 9 CD 3 N 'O N N 5 CD 3 01 -0 N C 6 (D n N C 7 6- n N ��mmmZ W n �m�8D n np�in fi l c < n m< < w a(D aka 6 c a o ° aka -0 a a (D CD n p fD t0 n p a d ID CD 0 0 C 7 N (`t N 7 a y y z 0 J N K p Z 0 J N O n• ' O 60 K O n O O (D K n CD J y p N J y p I I f D - 0 N ` c > O '00 w j N n �O N 7 N 3 n 7 O �• 7 0 '7 Q 0 b N CD dQ b O 0 0 O 0 0 r J a 0 0 O *- O 0 *. N iy n y }r. . ill ST CROIX CUWd i 6 3 0 /Z6 ` 3 a Q� FIELD INSPECTION & SERVICE REPORT ia57 INSTALLATION AUTHORIZED SERVICE PRO'ID E R - -. ;--/03— � Address: �63 �— s�• Name:--;j� game: DZL e Street: 3 Aa,,,,4s !-•t. ddr ss: Mail Address:`4_C"g. / 35,3 //-- State LJ/. "Lip 551d�6 City QSccO�L State e.y( Zip �)W-ZL e-mail L�GtSO' �o'�'►�i�l G� _ f ( 036 -1,2 uJ-.0-ac INSTALLATION INFORMATION Blower Brand and Serial No. Date of Installation Date of last pump-o,: �r"e. Size ;z,7a SS a 3 EQUIPNIENT DETAILED COMMENTS OF SITE CONDITION'S - OPER.-MON YES NO MAINTENANCE PERFORMED OR REQUIRED Electrical Panel(s) Operating -:. , Alarm Operating / present) V 13 I v .e r(s): � -- r:iet Filter Cleans Hood Vents Clear ✓� ----� — < e�s ve Noise — --- _ _es;ive Vibration ! rcanncnt Unit(s): — s u a l Odor ✓ —� fix 7u 2,6&C O �✓ ---- — Ssstcm Vent -Pumpout Required: r SenlinL Zone �� - o'oic T re fitment Zone LI-1- r FFLL:ENT: T LIMIT I RESULT Estim:ricd Dai!v Flow I �1 •j �j --- H (Standard Units) 1 6.9 S.U. Color Clear f 0 —t T - lernuerature Di_sol�etl ONN en (effluent) 2 mr-)/L V ----_ Odor I Slightly 4 -- --�---- — -----..--- odor G� I t sept' I OWNER SIGNATURE 1 TE INICIA ' ATURE SERVICE DATE RECEIVED 30 ~ 000 JUL 0 2 2009 � 8� 3/. ✓ 8. /a57 ST CROIX COUNTY FIELD INSPECTION & SERVICE RE 'FORT ING &ZpNINGOFFICE 0 .,w Pta ( INSTALLATION AUTHORIZED SERVICE PROVIDER Installation Address: d�Z Name: �neS om Owner Name: 4 C/ eS 6•e- C• Street: -- Mail Address: / Mail Address: Q_ city / �'1 State U)l Zip S�/O /( city Q6'C26 to State IJ/ Z p -V66ZO Phone Fax Phone (7 /5J .7-f& Fax e -mail e -mail 67 INSTALLATION INFORMATION Model No. Blower. Brand and Serial No. Date of Installation ate of last pump -out Size EQUIPMENT DETAILED COMMENT OF SIqE CONDITIONS - OPERATION YES NO MAINTENANCE PERFORMED OR REQUIRED Electrical Panel (s Visual Alarm Operatin Audio Alarm Operating' / (if resent ) ✓ Blower(s); Air Inlet Filter Clean Blower Hood Vents Clear Excessive Noise Excessive Vibration Treatment Unit(s): Unusual Odor - System Vent Pum out Required: Primary Settling Zone Aerobic Treatment Zone EFFLUENT: LIMIT RESULT Estimated Daily Flow 4S-O G H Standard Units 6 -9 S. D. Color Clear Temperature Dissolved Oxygen effluent 2 m L Odor Slightly Musty odor not se tic OWNER SIGNATURE TEC NICIAN SIG RE /SERVICE DATE INCORPORATED 8450 Cole Parkway • Shawnee, KS 66227 • Phone: 913 - 422 -0707 • Fax: 913 - 422 -0808 e -mail: onsite @biomicrobics.com • www.biomicrobics.com ■ 800 - 753 -FAST (3278) FIELD INSPECTION S ECTION &SERVICE REPORT FAST® Wastewater Treatment Systems D $ - / zw • - t3op INSTALLATION AUTHORIZED SERVICE PROVIDER Installation Address:,2./ 03 8 0 4 nrLre e_7L Name: Owner Name: .v_, ,-Y C4 eS- bcK Street: Q S-I-) (q Mail Address: /3s3 4 T/u;l 5U Mail Address: City ov-dScNI State LJ /• Zip S city 0SCcn State Zip 5 Phone Nit) 5'9 -673 /Fax Phone C &7Fax e -mail e-mail INSTALLATION INFORMATION Model No. Blower Brand and Serial No. Date of Installation Date of last pump -out Size /O r a3 D 7 - / , Yen A p i Cc 3 2 EQUIPMENT DETAILED COMMENTS OF SITE CONDITIONS - OPERATION YES NO MAINTENANCE PERFORMED OR REQUIRED Electrical Panel (s Visual Alarm Operatin Audio Alann Operating (if resent) Blower(s): Air Inlet Filter Clean Blower Hood Vents Clear Excessive Noise Excessive Vibration Treatment Unit(s): Unusual Odor -System Vent Pum out Required: Primary Settling Zone LO 771 �r Aerobic Treatment Zone a �i EFFLUENT: LIMIT RESULT Estimated Dail) Flow 0 ' Od. H Standard Units 6 -9 S1T . Color Clear - Temperature Dissolved Oxygen effluent 2 m /L Odor Slightly Musty odor not se 'c OWNER SIGNATURE TEC NIC N SIG RE SERVICE DATE 1/ -9�0� Cc= -- 7 Commercial Test ing L In c. ORS 514 Main Street 6 P.O. Box 526 Colfax, Wisconsin 54730 WWW.CTLCOLFAX.CO M Phone: 715 - 962 -3121 Phone: 800- 962 -5227 Fax: 715-962 -4030 ANALYTICAL REPORT Jim Thompson Report Number: 08008344 Page: i A.C.E Soil & Site Evaluations Report Date: 4/16/08 340 Paulson Lake Lane Date Received: 4/11/08 Osceola WI 54020 Sample Date Number Sample ID Test Results Method LOD /LOG Analyzed --- - - - - -- --------- - - - - -- ------------------- - - - - -- ----- - - - - -- --- - - - - -- --- - - - - -- -- - - - - -- 08- W10860 Stout BOD (5 Day), mg /L ( 30 SM5210B 4/11/08 02.04.10.08 NOTE: Insufficient oxygen depletion. 4/11/08 pH (Lab) 7.2 SM4500H+ 4/11/08 Tot.Suspended Solids,mg /L 23 SM25401) 4/15/08 WI DNR Laboratory Certification Number: 617013980 y ( Means "LESS THAN" Detectable Level Approved by: fU Commercial Testing Lkorat6ry 514 Main Street P.O. Box 526 Colfax, Wisconsin 54730 WWW.CTLCOLFAX.COM Phone: 715 - 962 -3121 Phone: 800 - 962 -5227 Fax: 715 - 962 -4030 ANALYTICAL REPORT Jim Thompson Report Number: 08004738 Page: i A.C.E Soil & Site Evaluations Report Date: 340 Paulson Lake Lane Date Received: 2/29/08 Osceola WI 54020 Sample Date Number Sample ID Test Results Method LOD /LOQ Analyzed ------- -------- ------------------- - - - - -- ----- - - - - -- --- - - - - -- --- - - - - -- -- - - - - -- 08-W6281 McMurrin BOD (5 Day), mg /L 3 SM5210B 2/29/08 #01.28.02.08 pH (Lab) 6.6 SM4500H+ 2/29/08 2/28/08 Tot.Suspended Solids,mg /L 3 SM2540D 3/ 4/08 08 -W6282 Stout 2103 BOD (5 Day), mg /L 77 SM5210B 2/29/08 #01.29.02.08. pH (Lab) 7.0 SM4500H+ 2/29/08 2/29/08 Tot.Suspended Solids,mg /L 27 SM25401) 3/ 4/08 WI DNR Laboratory Certification Number: 617013980 Approved by: �`� Peterson Resources LLC PO Box 340 427 Wheeler Ave. Fredonia, WI 5302] -0340 To whom it May Concern: Richard O. Stout of New Richmond Properties, LLC has requested that I assume the responsibilities of inspection of the Bio- Microbics 0.5 Micro -FAST wastewater treatment apparatus installed to serve the residence located at: 2103 80 Street, known as: Lot 6, Plat of Rolling Oaks, SW` /4 SW' /4, Sec. 18, T. 31 N., R. 18 W., Tn. of Star Prairie, St, Croix Co., WI, Parcel # 038 - 1200 -30 -00 Please accept this correspondence as Mr. Stout's official written notification to Peterson Supply that the agreement between Mr. Stout and Peterson Supply dated September 15, 2003 is herby cancelled. Mr. Stout has entered into a new service agreement with A.C.E. Soil & Site Evaluations, LLC as of Feb. 15, 2008. have any questions or concerns that I can address for you, I can be reached at (715) 248 -7767. Sincerely, James K. Thompson Dep't. of Commerce Credential #30021 Cc: Richard O. Stout St. Croix Co. Zoning Dep't. File r POWTS SERVICE CONTRACT The proper operation and maintenance of the components listed below will significantly influence the performance and life expectancy of the POWTS (Private Onsite Wastewater Treatment System). This agreement authorizes A.C.E. Soil & Site Evaluations, L.L.C. personnel (Service Provider) or their representative access to the POWTS components during regular business hours to perform regular inspections and routine maintenance of those components. It is herby agreed by and between Owner and Service Provider that in consideration of the payments provided for herein, Service Provider will provide a manufacturer trained and State licensed inspector to perform periodic inspections of the POWTS components as set forth below. Service Provider will prepare a written inspection report after each inspection containing any recommendations for the operation, maintenance, and or repair of the POWTS deemed appropriate by the Service Provider. A copy of the report will be provided to Owner and the appropriate Governmental Unit. Service Provider will supply additional services, parts, or labor only after authorization by purchaser. This agreement does not assume any responsibilities or obligations that are normally the responsibilities and obligations of the Owner and does not cover any costs associated with operation, maintenance and or repair of the POWTS. In no event shall Service Provider be responsible for any special or consequential damages, including but not limited to, loss of time, injury to person or property, or incidental economic loss due to equipment failure for any reason whatsoever. This agreement will be automatically renewed each year unless amended or cancelled by either party with 30 days written notice. This agreement may be cancelled by Purchaser only if replaced by a service contract with another service provider authorized to inspect and maintain the specific POWTS components in question. Purchaser agrees to pay Service Provider the sum of 100.00 Der inspection. One (1) inspection will be provided per calendar year, with inspection fees billed at the time of inspection. Any additional fees for effluent quality testing (if needed) will be approved by POWTS owner prior to sample collection and submittal to lab. POWTS DESCRIPTION: Wieser Concrete W 1425/975 Bio tank with Bio- Microbics "Micro -fast 0.50" pre - treatment unit, pre - treated effluent discharge to Mound dispersal component constructed in compliance with Mound Component Manual, SBD- 10691 -P (N.01 /01). POWTS LOCATION: 2103 80' Street, known as: Lot 6, Plat of Rolling Oaks, SWIA SW' /4, Sec. 18, T. 31 N., R. 18 W., Tn. of Star Prairie, St. Croix Co., WI, Parcel # 038 - 1200 -30 -00 Owner name and address: New Richmond Properties, LLC Richard O. Stout 1353 Awatukee Trail Hudson, WI 54016 , (Owner signature) q� (Date) '- e��� t _l L Service Provider: A.C. oil & Site Evaluations, L.L.C. 1 ames K. ompson 340 PaulsonlLake Road Osceola, W� 54 (Se Provider signature) (Date) Instrument Drafted By: James K. Thompson CQ� ..N C ° NY�J ppQ`` Q � O ?� tO ° N CNILcoM O. Q� Q o CM iACO� W OD d +r Coco O m t a, o t V d d u� X Q C C °' ° � en ~ LL r co m y � O C ° LO LO LO co N o 2 V ^ � m o E E H c Q J5 c o U) 3 d> fa Q Z c L- Z U c 0 c N c C=) u C N m m (n N a Z O. O a N in 1— I— o 2 U Oz C Q Q d O 6. U a 0 W W 0 0 p N N 9� m g � E� y `° •q o 9 d; 3 0_a90 .a v O Q•� p ar r p ��py > t y V II � V y y1• .a . �a N ti v 7 's V oMi Q W �' a r �Z O� � v a aS3 0. v A iy w o v > m ®° N r d x 6 g V a o ' iC <+ pG V O q 06, G c o e° 6 3 �3 ¢ a °n �n w o00 F 0 O y s y w� OR > V ie� °� �°.� � '9h ° '�'o 0 O 0 u °. •o �' � •�$' � °.3 u o . ii u � o o m q Q � >, � 'I.' a .9 d :� ' avo.8o`oom 'uq waa .a° m e W w UD ` Ww Oa. 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E m m z 0 0 0 e e 9 9 a a a 0 U CL Cl) m 2 � \ § ƒ ƒ ƒ ƒ ƒ § \ \ \ \ & a = E = E o « _ . _ 2 \ E 2 2 \ R J § % < 2 < .0 f < 2 < T $ _ %= 4 z= z e A < z m z z A ■ ° § W 2 f § '$ E c E o [ R S 2 j k - \ c j § % 6_ 0 7 @ ® 2� 2 2 2 ) f @ C-4 ) ' 2 E �� o § d / 2 a �) \/ @ E 8 7 . 3 §§ 2 7 = o a. ' § § k m Cl) o z / I ) ) \ z f � } \ O ® , CD % D a E E� k . / J a 2 o U) 0 SG [711 ROS CONST FAX NO. 7155496731 Sep. 15 2003 03:12PM P2 Sop 15 03 10:40a petersert 202- ES2 -241A {°• ' � t Pete D C@8 POWi'S INSPECTION SERVICE AGREEMENT Tree career apwWW of ft below equipment spF"nY "M"90 of the cystern. periodic irapectlotts wN h* 04W the We Of the SYGWn and prevent the need for 00* aoo"to Mr P Wn aquiproent durtn4 dayf4M ham by s tWnW and Potaraen ropAw ftpedlons and mudns nulntenanoe ID help wears the equipffierit iit Roix c ourv r ,y st is hereby sW@W by and W' , Won Pu d=W W 4 Petersen WaeteweW 6ervioee Z � INi Th of Vie pertodo p�enh pmWded for heroin. Swvke Prouder vAl provide the services of a perlorrn Mspeeiions a tf+e eqt rrisrtt awaeit id below. SeMos PWAder vA s report saw sacs+ inapedion and P Ate a copy of fe report to to Purctmor. This report wB eartlawt raooiemendaltons for and operatic+ WW maMerwnw deemed appropriate by Vw irtapl 0W. Thb speenisntdoes not assume aria► rosporteumse or otr "Wre that we nwroaly the resAor+stiiWW d Purduocr and dose jW egg to cover "+ ousts Mist may be sssocWW with any 10 0 emendS*M MM under No a4resrrient• to 114 event oW ssrvioe Provider be respo WAW to► ;IAY special er oonse4uentid dam944A indudw0 but not *f*W tor. lass Of Urns. iri�ryeW person or prei"v er fncldenW eoorm is toes due * equipment hbjm or for arty ovier room whatsoever. Service pra4der may sw*add ms aarvlWee. pwb or low only aft su"orioatiart 0yftm heasir. % f T1Ms aprswrient ehse remain Ln *ne fora period of 1 ywus. bs4lriniri4 � .�� I la�� s h , 20„__ WW «il aule i p My mrd w ouh year Viareaf ier far orrr year urdess a n wed by side► vwv * tih st teams b0 "Wooten rtoioe. ,'t+iW s4t+serrierit map► Ire caeoated bytM Pi,.vl+.a�.� ority x repaoed by* servKie rt�e�nant wi an aadtroriaed s�srvioe prodder for VM evuipmerrt tinted below Service Pto�ider may derby or ee; A,hutir in If peyrrse U bvOw►= at Nast 1 3 deers peat due. Pwteue biepeollwts: The Purd"We apnea to pay Service Provider S,_ Per impaction ftr far (4) inepecuars Vts tit tw�0 years at sbe rna+V+ iritervads and t (one htepeceion Been yore► Vienliafter. Payrnerttf�o�a+elimt two ys" of irap$M" is due at the time of k*Woft : addeioru upon k4peedon. Any addrdotW waling or eavioes muked by Purdwaar vA to bHW based on a" ourtie. f . Service Provider: Patnreen WeetawaW Servicee Petersen ' , ` 0,.*t ane la s 1 ' r A10 007 ! 'r � .- evse_T i.Uf J`tUa� �.O'i' !e fat' Q liirq�Oates YvD�; v i e 5i . Croi �o . t 135 3 _ S o+d►ar t ak �.! S o rt i.V t o f J oao P" _Wt 7Ywc ON* Cash AMWean R*rsae VNe NhslerCard tltlrer Caft Coo No.. iq j Dg s S' N ww err CmK% Cmd t►r.as.werer«.efN Tai: SMA566W.262492 -Ulf PgWW R9sD01afM LLC Floc: 8004M123Z. 2624"18 r+o sac sro, nRt wr ww. R�doni, wn asaat o uew E.Mart ��l- li f- n". og f.OUG 7'o SERW owr Csafti a QU4Lf1Y PA0DLid'!'d! illflfCE 1914 SAFETY AND BUILDINGS DIVISION commerce .wl.gov Integrated Services Bureau 13 East Spruce Street isconsin INSPECTION REPORT C hippewa F alls, 547 www. commerce.state.wi. us /sb Department of Commerce (715)726 -2544 Date of Inspection: April 20, 2004 Plumber Name and Address: Project Name: Stout William Schumaker, MP 227990 Parcel ID: 038 - 1200 -30 -000 1070 Scott Rd Legal Description: SW, SW, 18, RX/V udson, WI 54016 Site Number: 6627760 RECE'V�e�'� Subdivision: Lot 6 Rolling Oaks rtifie Soil Tester Name and Address: Municipality: Town of Star Prairie kdam Schumaker County: St. Croix JUN 0 7 2004 Plan Transaction Number: 8942 S r. cv O0j COON1�'� Sanitary Permit Number: 4302 ZONING OFFi lame and Address: Richard Stout — mawz� Wastewater Flow: 450 gpd �o ev Persons Present: This inspection was completed pursuant to s. 145.20 (3) (b) Wis. Stats., as part of the annual audit of the St. Croix County Private Onsite Wastewater Treatment System program. Issues for the installing plumber /maintainer include: 1. There is no record of the initial and 6 -month service required for the FAST unit as per the manufacturer's requirements. The installer /maintainer shall complete the required maintenance immediately and submit reports to the county and the manufacturer's representative, Peterson Supply. Note that this property may have been very recently occupied. 2. A deed notice shall be recorded indicating th t d for maintenance as per Comm 83.21(2 Wi . Adm. Code. Contact the county for details. � ' P� f� 0,4 tt&6 Mr7 M 3. The up p er most o��vs manhole riser on the dose tank appears to leak, and needs to be reset a watertight by the installer so as to protect the system from overloading. If yo have any questions regarding this report, please contact me. /d Leroy G. ofansky, Wfistewaterttpecialist Ljansky @commerce.state.wi.us E -mail 715/726 -2544 Voice 715/726 -2549 Fax cc: WCounty ® Plumber ❑ CST ❑ Owner ❑ Other Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building division INSPECTION REPORT Sanitary Permit No: 430342 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)). F9 -(ZCJ S = • /6 Permit Holder's Name: City Village X Township Parcel Tax No: Stout Richard Star Prairie Township 038- 1200 -30 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: /06. 1 1 06 -0 18.31.18.1057 TANK INFORMATION ELEVATION DATA TYPE MANUFACT R CAPACITY STATION BS HI FS ELEV. ID Septic 5 �. nti: Benchmark co EL � l�L `� r /Yt IOC •`� Xa Dosing 0 - r S Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht outlet q� TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet • 35 Septic r Dt Bottom Dosing `< <r rte Head /Man. ,� 9 O fo l !rte 3 / Aeration Dist. Pipe Z'S 0 Holding Bot. System 01 Ct S/. o Ox. t�'f'c • V At. OZ Final.rade PUMP /SIPHON INFORMATION s✓ q�. -7 -7 Manufacturer nn Demand St Cover O S . GPM Model Number E��s �, � �•�• �� • DH Lift Friction Loss System Head TDH Ft t / S•? l � b 3.25 0 . � ` S ' 7 3 `F GD•b I mo \• Forcemain Length ( Dia. tt Dist. to Well 2 (� SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Tr cheg PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS i' Z S r '� SETBACK SYSTEM TO P/ / LDG WELL LAKE /STREAM L CH G M acturer: INFORMATION CHA R OR Type Of System: / / M e Number: DISTRIBUTION SYSTEM C t - 4-1 3 Header /M anifold � Distribution / x Hole Size x Hole Spacing V o 7lntake r �. Pipe(s) (/J '. Z� � 2 3 d Length Dia Length Dia Spacin _ I � 1 4 � SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only C/ VqaWIX Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes No Yes No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1:�/ � Ins ZNo: #2: / 10 / Location: 2103 80th Street Star Prairie � WI 54026 SW 1/4 SW 1/4 18 T31N R18W ollin Oaks Lot 6 18.31.18.105_ 1. p Alt BM Description �12as�v>Cc �rX o C Srt✓ r tc� vv�a��A er.J 2.) Bldg sewer length = of t f�� v�at� -. �4- C� ;tti�c� amount of cover Plan revision Required? �' Yes No 17C7 7 Use other side for additional information. _ Insepctor's Signature Cert. No. SBD -6710 (R.3/97) l _J Safety and Buildings Division County � 0 t 791 W. Washington Ave., P.O. Box 7162 . �Ye , r���O S�i� Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in b 92..) Department of Commerce ( cos) 266 - 3151 3 2 - / Sanitary Permit Application State Plan I. Number C4 J L In accord with Comm 83.21, Wis. Adm. Code, personal information you provide Y 2 may be used for secondary purposes Privacy Law, s15,04(1)(m) Project Address (if different than mailing a ress) I. Application Information - Please Print All Information ®� Property Owner's Na me -` 7 s 71 ?, s k Farcel Lot k �� Block sd 0 30 � 14 0 perty Owner's M ailing Address i J E,7 Property Location /bs L.let 7 c T tra r �� � � '.4 , .5 - * 1A , Section City, State Zip Code Pho(ie iPr�,' IVGr1dS'a' .r/ G . -ry J (circle one) T � � N; R_,�EE or W II. Type of Building (check all that apply) / 3 `J Subdivision Name CSM Number �or 2 Family Dwelling - Number of Bedrooms Public /Commercial - Describe ,�� Use � ! ❑ State Owned - Describe Use r'��ltlnd IZ2,a . X t+� ❑City_ ❑village Township of I h (/ e I III. Type of Permit: (Check only' one box on line A. Complete line B if applicable) A ' New system C1 Replacement System C1 TreaunentlHoldin& Tank Replacement Only ❑Other Modification to Existing System List Previous Permit Number and Date Issued B. ❑ Permit Renewal ❑ Permit Revision El Change of ❑ Permit Transfer to New Before Expiration Plumber Owner IV. Type of POWTS System: (Check all that apply) Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil J&Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter �hI l ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank 11 Peat Filter Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculat4 Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Oth r (explain) V. Dispersal/Treatment Arau Information: k- E2 jA Design Flow (gpd) DesibilSbil Application Ra (� s rsal Area Required Of) Dispersal Area Proposed System Elevation VI. Tank Info apacity in To Number Manufacturer Prefab Site tee t lastic j Gallons Gallons of Units Concrete Constructed Glass I New Existing Tanks Tanks Septic or Holding Tank Aerobic Treatment Unit k Dosing Chamber � Sd VII. Responsibility Statement I, th6 undersigned, assume responsibility for _ jAgailation of the POWTS shown on the attached plans. Plumber's Na me (Print) Plumber's Si &nature M PRS Number Business Phone Number Plumber's Addre ss (Street, City, State, Zip Code) 7`" � VIII ount /De artment Use Only ` Saniy Permit Fee( 5udes Groundwater Date Issued ssuing A Si lure (N s) A tar pproved Disapproved Surcharge Fee) ❑ Owner Given Reason for Denial — C /Reasons for Disapproval �j / (,�,; Y1 v� Z _ Septic an c, el ruent filter and t-0� r'�• g 3 SZ Qom ` "' /��, � vx dispersal cell must all be serviced / maintained s LnaU� as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code /ordinances. P(43 Ceti s Q (l� nt til a plans (to the Co�ty �) forrm�n paper no less than 81/2 x i_ 1 Inches size / the D- 6398 O l l Use $� �u ov�&d , / / s�' c s ys � U L Ll./ L LC.1V Scale 1"=30" Page y of T f hLpF eL . qc° • 3 - W -U 1 8k� > 50 {�Z()1�I w1UV �'>1� ? 2 a _ KJJ1 _ LOT L [ )\J � 1'.�ZCRA�3T 3 M� G I ' D °f �'V C F•�"1. �J or b; >>O SOT C OM a Y� t " S tl g:1 i n C�vc �ls�llVz B `�1� 115 fl1Z� ; Etc �Z+� -O`° lNl _ -- � s of CA i 0 rj NOTES: 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pi es with approved caps. ( Z, required). 3. Septic tank to be q gallon capacity manufactured by WU�SM CUk w°L- 1 /�<[ZS Bl� Sou'`GP� w �$10 `b't lC'RAB1C4 MLCU Ar3T o SlVk TV , )gj7 tv,.iX . 4. Bench mark Pt�oV@ 5. Divert surface water around system to prevent ponding at the uphill side. Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 Visconsin www.commerc . i o �� RECEIVE � -�_� wwwwisconsnsin. n.gov Department of Commerce Jim Doyle, Governor AUG o 6 20n3 Cory L. Nettles, Secretary ST, CROIX COUNT r August 01, 2003 3 7U 11 INS O F I(" CUST ID No.267341 ATTN: POWTS Inspector ARTHUR L WEGERER ZONING OFFICE WEGERER SOIL TESTING & DESIGN SERVICE ST CROIX COUNTY SPIA PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 PMlm,�t 4 X30 3 qz CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/01/2005 Identification Num bers Transaction ID No. 894295 SITE• Site ID No. 662760 Richard Stout Please refer to both identification numbers, 80TH St above, in all correspondence with the agency. Town of Star Prairie Condid St Croix County pp( SW1 /4, SW1 /4, S18, T31N, R18W DEFARTMEK Lot: 6, Subdivision: Rolling Oaks OFUAIFTEV FOR: Description: Three Bedroom Mound System SEE CORRESF Object Type: POWT System Regulated Object ID No.: 914001 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: General Approval Requirements: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD- 10572 -P (8.6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD- 10573 -P (R.6/99). • The Bio - Microbics MICROFAST 0.5 unit must be installed in accordance with the manufacture's printed ins ction and system sizin g cri e ria o un m omm 3, Wis. Adm. o e. etween the manufacturer's instructions an3 tl e p an approva , e p an approval and code requirements will take precedence. • A maintenance and monitoring contract for the Bio - Microbics MICROFAST 0.5 unit is required for the life of the system. A copy of the initial contract signed by the owner(s) must be submitted to the county for review prior to issuing of the sanitary permit. • Per manual cited above, 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. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c ARTHUR 1,, WEGERER Page 2 8/1/03 • 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. Stat • 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. Owner Responsibilities: • Comm 83.52 Responsibilities. 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. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 7 Fee Received $ 175.00 Balance Due $ 0.00 Charles L Bratz POWTS Reviewer II , Integrated Services WiSMART code: 7633' (608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday cbratz @commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 ' TITLA SHEET Page i pf ii for A mound system with pre - treatment for a 3 bdrm home. This plan has been prepared in accordance with the Mound System Component Manual SBD- 10572 -P (R.6.:'99) and the Pressure Distribution Component Manual SBD - 10573 -P (R.6`99) and with the Biomicrobics Microfast manufacturer specifications. LOCATED IN THE 'Sk) 1/4 OF THE S� 1/4 OF SECTION ) 6 ' T 1 ) N, R ICS W, TOWN OF y L tV COUNTY, WISCONSIN. INDEX RECEIVED Page 1 of 11 TITLE SHEET Page 2 of 11 MOUND MANAGEMENT PLAN JUL 2 1 1003 Page 3 of 11 MICROFAST MANAGEMENT P�T��� � ����� Page 4 of 11 PLOT PLAN ��++��''11 Page 5 of 11 MOUND PLAN VIEW '�. Page 6 of 11 DISTRIBUTION PIPE LAYOUT Page 7 of 11 TANK SPECIFICATIONS Page 8 of 11 MICROFAST 0.5F SPECIFICATIONS Page 9 of 11 MICROFAST 0.5L NOTES an y Page 10 of 11 PUMP CHAMBER Page 11 of 11 PUMP PERFORMANCE CURVE C oMMERC E � NGs PREPARED FOR ON p ENCE` \j AAlFg14 l WEUEREIi � p91SI fitL3WORTN. PREPARED BY WECCER< �FR S3 C3 I L_ TEST I NG �S G � AND . DES I IS" SEFRV I CE P.O. Box 74 421 N.Main St. River Falls, WI 54022 Phone 715- 425 -0165 Fax 715- 425 -6864 JOB NO. -ZLJ7- G Mound System Management Plan P age -? of i Pursuant to Comm 83.54, Wis. Adm. Code Septic Tank z t The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and oeti4tt& shall be assessed at least once every 3 years by inspection. wo die fiftei sl a be teusfy� tisteuuitten! f lte _ swsr as imPer�dinsor tiat►safar�sr The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 113 the liquid volume of the tank, If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed (o maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. _Puma Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October - February) dictate that the mound be heavily mulched for frost protection. Influent quality into the mound system may not excee - ��9 / L 800 .39 .N1 /L TSS not exceed maximum design flow specified in the permit for this installation. Influent flow may The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manual [SBD- 10572 -P (R. 6/99)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and Pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and openings used for service and assessment shall be seaed watertight upon the c comple completion services Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Contin�enc Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, m P p p controls, alarm or related wiring becomes defective the defective component shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced In Its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. Questions about the operation or maintenance of this system should be directed to: The County Zoning Office at \ S _ 38 6 - X16 8 o ST aR.v u The system installer at 1 3$- LZ _Sc U"f -h63T? The tank ma ufacturer at i �4T manufacturer at M .Ta 1 QS The pump manufacturer at 1_ 70 =�� R <2ou ,\ S MICROFAST MANAGEMENT Page 3 of 1 � Management and maintenance of this system is critical to its proper operation and longevity. The system owner must be provided with a complete set of plans including this management section. GENERAL Proper functioning of this system is dependent on the amount of water (not more than 450 gal /day) and the quality of the water. Influent quality must not wxceed 220 mg /L BOD5 and '150 m L TSS. MAINTENANCE Maintenance and monitoring of the Biomicrobics MicroFast system is to be performed by the MicroFast System dealer or an operating and maintenance agent of the dealer. The maintenance agent will determine when the septic tank needs scum and sludge removal. A licensed pumper shoul then be contacted. CONTINGENCIES If the MicroFast system becomes defective, the component must be repaired or replaced. QUESTIONS ABOUT THE.OPERATION OR MAINTENANCE OF THIS SYSTEM SHOULD BE DIRECTED TO THE SYSTEM DEALER AT 262 692 - 2416 OR THE MANUFACTURER AT 800 -753 -FAST. PLOT PLAN t , Scale 1"=30 pale of Z — LPG - W ��- �O `�� . 7- _ S C�' l�'-,Uf"1 ►"�1�J� t�7 ? 2 a ' F�2.�1'� 'Ty�1v12 .. Z. Z lcIZZ T-paT 3 �R co ►A t'ttZT r1 ii i - 3 L) 2'� M > >v % P p Yo 5 ° ' o i a f�►2 b�g`jUR B `T�15' i i c� CA 2 rx,� of IYWL ate. NOTES: 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pies with approved caps. ( Z. required). 3. Septic tank to be gallon capacity manufactured by Wl�'SeZ Ct _\-j°i-lS /I �I ZS $t) -So�'G t'�. w�$lp `Nt�CR4B1C4 r'I ICR.0R�3T o S 4. Bench mark S : Z-v7 _ S� PtSoU@ 5. Divert surface water around system to prevent ponding at the uphill side. F:ce C- Ar,croved c'T u.Et-1C CCver .'ing - ASTH C \l e Distribution Pipe F Medium Sand I Tcpscil —� c-=_ = __ c 1 t o 3 � b S °a Slope Di stributior. Cell of Force Main Flowed 2" to 2-2" Aggrecate From Pump Layer © S F. CROSS SECTION OF A MOUND SYSTEM F D • B Ft. G 0• S R. Q H 1.p Rt. Linea Loading Ra =1 -0 -n r•�T FT Desicn Loaeine Ramie p,g6 :n�c0 FT � J S Ft. S? K 8 Ft. _n L y l Ft. Form in w Ft. I -Observation Pipe F - K 3 s' NZ - - -- - - -- --- - --- -- - - --� "�' A --------- --- - - - - -- -------- - - - - -- --- - -- W - -- /bB - - - - -- - -- ---- --------------- - - - - -- oorL a�ifr Distribution , k " Pipe Cell of -� to 2� i I zggregate Observation. Pipe -- (+1ac*.or secarelyJ PLAN VI O A MOUI D SYSTEM Distribution Pipe Layout Pace Place the holes at the bottom of the distribution pipes at equal spacing. Remove all burrs from the pipe and holes. Extend the end of each Izrw :2I ua with the case of long n= or idP firdng to a poll rr7th?:Z s jx t t t hreaded the . naI Bade. Te: -==,e the ends of the late. raid± a valve,:Shreaded cap or —de Plu°. Provide access from final gade for the valve, threaded can or tbreadQ plc:_ Lateral Manifold x x x x x2 Lateral Lencrth S s g- - ►'� Pr�1 r-o L_b / S�' f f ?. 4.3 P Ft. ;`Ole d1ctI1C`�:' 4 l 1nC�51 _ .. s Ft. " 7 t. �Inch(es) X Z Inches Manifold " } a Y-Z "Inches Force Main " Inch I � es 1 of hol 3 es/ i e � PP Invert Elevation of.Laterals R� Ft. 76$ 598" 0 c m ' 79 TIT Trr m 5 5" • i I I ' I i t I no t I I Nn I I I I 4 I In I 1 1 t ® m r I I I y I o I m 0 f 1 N i � $ 1 - - - -- arcs ? 41 It I I ' < 68 �" I I I z -- i I 65 z g m < -1 m z 0 r r � n c� z z c 0 m r r Z 0 --4 G� C: C: CO M K 0 co N Fn D �0 z�0 ? ==HMO' V n/ �•• 0 =O m00 c mriZ•l m w OC _ Z � N< rc0 V .. - /� �0 7 �� a) N W ♦J w 000 O o pp Zm n�rr*i prr i�U ? Dn r o �N D 7,m W yA (�(� O 00 DNI r-.. - ��p a0. A ®W v O l JGJ N �� m m� ��v� 0 NN O A N co A \ W�� N N a -H m 00 N cli o I v 0 00 Ln m 0 °z r O m w 0 DT °c rA z �. 0 m o of 11 � -34� 49 50 . 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C0IJDUIT � -- IWAIM. �l NIJLET , PROVIDE -- AIRTI6HT SEAL • i II' � 1 APPROVED JOINT/ A I I A PPROVED JOIAI � II II ALARM 8 ( 1 I ON _ C I I -- LLEK� PUMP --� OFF D COWCRETt DLOCK RISER EXIT PERmnrr6D OWL'J IF TANK MAIJUFACTURCit HAS SUCH APPROVAL 3,•00 1 nI� PS2G 8ED0 SPECIFICATIOUS oos6 C�� CRS TA1JK MAIJUFACTURCR: UUMbER OF DOSES: S � Z PER DI►y TANK 51Z'L: W `�' 7 SO GALLOWS DOSE VOLUME z �-!�R _ .. UFACTURS`R: S S � I1 Sri% T L" --IS INCLUDING OACKFLOW: - `' 3 MA>y ._ _ GALLONS MODEL WUMUR: l� ` Ems) - CAPACITIES: A- `S WCHE50R 3o y' Z GALLON3 3WITCH TUPE ��- g = Z INCHES OR y b' 6 GSLLOL15 PUMP MAIJUFACTURER: 6kj U�_b_s C = L L /Z 1WCHE5 OR �'� " GALLOWS MODEL NUMBER: —)�'Z� S D 1I; INCHES OR 30Y' Z GALLOAIS 3WITCH TYPE: eL ! DOTE: PUMP MUD ALARM ARE TO DE MINIMUM DISCHARGE RATE y_GPM INSTALLED ON SEPARAT>` CIRCUITS VERTICAL DIFFERENCE DETWEEIJ PUMP OFF Au0,015TRI8UTi0w PIPE.. FEET + mJAIIMUM NETWORK SUPPLY PRESSURE , , • , 3-2S FEET �- Sx t. �� + _3S FEET OF FORCE MAIN X IoofLFRlCTIOIJ FACTOR. - FEET TOTAL DtfUAMIC. - ' ---- -FEET As per:manufacturer - "t0. Zg - gal /in. ~ Liquid depth 8-) GouldsE r _ — Submersible Effluent Pump 3871 EPO4 �= EP05 APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. • Effluent systems dry without damage to heat transfer. ■ Motor Cover. Thermoplas- • Homes components. Available for automatic and tic cover with integral handle • Farms Motor. 'and float switch attachment • Heavy duty sump • EPO4 Single phase: 0.4 HP, manual operation. Automatic points. • Water transfer 115 or 230 V, 60 Hz, 1550 models include Mechanical RPM, built in overload with Float Switch assembled and ■Power Cable: Severe duty • Dewatering automatic reset. preset at the factory. rated oil and water resistant. EP05 Single h SPECIFICATIONS • 9 phase: 0.5 HP, ■ Bearings: Upper and lower . 115 V, 60 Hz, 1550 RPM, FEATURES heavy duty ball bearing Pump: EPO4 built in overload with construction. • Solids handling capability: automatic reset. ■ EPO4 Impeller. T - 3 /a° maximum. • Power cord: 10 foot Plastic Semi -open deesign sign AGENCY LISTING �. • Capacities: up to 55 GPM. standard length, 16/3 SJTO with pump out vanes for • Total heads: up to 24 feet. with three prong grounding mechanical seal protection. SP. Canadian standardsnsswMon �" • Discharge size: 1 NPT. plug. Optional 20 foot ■ EP05 Impeller: Thermo- Mechanical seal: carbon- length, 16/3 SJTW with plastic enclosed design for (GSA listed model numbers • rotary/ceramic - stationary, three prong grounding plug improved performance. end in "F" or "AC".) BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 104 °F (40 °C) continuous superior strength and 140 °F (60°C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET stainless steel. 10 • Capable of running dry without damage to s 3o I components. ! + Pump: EP05 8 • Solids handling capability: a 25 l . W maximum. a _ I • Capacities: up to 60 GPM. _ • Total heads: up to 31 feet. s 20 • Discharge size: 1V NPT. • Mechanical seal: carbon- } 5 I ' ! rotary/ceramic - stationary, a 4 15 - I - BUNA -N elastomers. Epos' • Temperature: ' 3 10 I i s 3 _ 104 °F (40 °C) continuous 1401(60°C) intermittent. 2 — 5 1 0 0 0 10 20 30 40 50 GPM' 0 2 4 6 8 10 12 M CAPACITY ®1995 Goulds Pumps, Inc. Sep 15 03 01:23p Petersen 262 -692 -2418 p.1 Petersen D AB _' S �— Fax Cover Sheet COMPANY rej k c , FAX NO. S " 3g ' y (C& ATTENTION: P owv. a PROM: NUMBER OF PAGES TO FOLLOW: l o 1l%w�n � % t T!a wouIAnm CoNTAmm W Tm MAcmao! c Y rot'n FIASMU, AM COMPIN AL U= OF TM 021MWOM A6L1ll�t= NAMM wBgvA R Tis RGDae OR Tl4S USiSAG� s ulpt 71iB al fxND®!lCKr of ANY AOSN f L�1f41{� QOM Ct010 R TO its O�R�O 1u rMa You Au MU r NOT M TMT YOU MAVQ OSCMM TM =UMM M VXOk AND THAT ANY UVMW. Dlf300"rAK M MMMON m �OlYDIO OS TNg NaStAQ9 $ TRACTLY �, w YOU NAva awaww wo caboa r-Arim M m NOTW Y Us V 4 WAMY AY 7ZUNPH Ne APO Rl7tJRN TN! OR�CNNAL MxdS�W! 70 u5 by MAC iNANI(YOld FCML l W Pox SMALL aw Sw w a" WE,COVE To SERVE QUALM PRODUCTSMCE 1916 PO Box 340 Tel; 262- 692.2416 421 Wheeler Ave. pax: 262 692 -2418 Frc"ia, W153021 -0340 USA F.wl mail@petcr=,Cc i 09/10/2003 11:28 17154256864 WEGERER SOIL TESTING PAGE 01 WEGERER SOIL TESTING and DESIGN SERVICE' SOIL TESTING - SEWER SYSTEM DESIGN ATTN: DATE CC: SUBJECT: Ls)T Q ) ZO L-L.,jAj6' O THE FOLLOWING ITEMS ARE - M , 6 - t4foab 0. OF DESCRIPTION COPIES 3 9 UK) ) � wU U - s T SENT TO YOU FOR THE FOLLOWING REASONS; L.-FOR YOUR USE FOR REVIEW AND COMMENT INFORMATION DESIRED WEGERER SOIL TESTING AND DESIGN SERVICE iTi P.O,BOX 74 421 N.MAIN ST, RIVER FALLS,WI 54022 PHONE 715- 425 -0165 09/10/2003 11:28 17154256864 WEGERER SOIL TESTING PAGE 02 _ YjNOUrsin Mprretrd d ConruMaa SOIL EVALUATION REPORT Popp / d Olriaion d 8iry snd mrldhr� i "m cw" 45, vaL Adm. Cady tat* ' ty nm,d, mrrgta1 sa■ pi@n ce poprar nor 1.. rv" A V2 x„ t dry Mt . d hlarr Md pamm ka do. but not tin�M W Im v.fdi.ne lert�orad ri l (M bft � A - parear� I abp�, eua6r yr d twnm ma. nerd+ , and loesbn ara dl�nrs �' 1°'d Oi pftme Prat v h bnodo . a srr 7a Poo' mw 4 mme rar eem+nf pwo lPd--w 4w, a f!-a v; PIS r """ ptop�ryOrAir Pfq�WVLocmdon GcvL La W W S T N R IF (e) w ,e iG r SA Las 8lodc s � fm r w cow F%Wmtlr Owmft �p Nam. 4� ' ❑ col vow Town N�rr U� on W� A/ 7l / � rQ•(1 � t r ru. Carrntctlon tistat Q R.ed.rdau / aumb.r d con. d..w.++ d.ra we. ►.� _ y sty - BPD ❑ Regla =md ❑ Pubic or W mmdd - oaWR•: P.r.r,t _ I'll V and widwomw s y sEe�►. e / cu. 9d. � a � b 0 �'"° G�� eiav, � � R � o ifIAM°4 �r � b'. ypi Role wwb= Doplh Dambwbm Cdw Pad= D oWWW r Tombse Sin• t a ffih a sawwm l im munsei cu. Sz Cam. Color Cir. az Sn. 'EIRt 'Ella G r of Cl ® ® pit i Grand *UMm ray. OU R Cepdi ID Uritrq Scfor Z Soi Res Horton l7,rir DwnWWK Rei. Caro�a+ T�mrs 80iu Cerwirrno 8eund�ll Room 6PDl� In. MUrdWO Ga. fie. Cant Qdw Gr, 8L 9n. d - AO - S bk -f� LS � o r ..S - tbrr.rr[ I tip Cw 1 A " taD not ar Tu O � 130 °!� • EIR.R Rt.� dCD � 90 ragll erd T= � 9D rrbA. ueb+r cs NUM (P�rr Pm+iD S D Ad" Oi E.aYMtiar Candteld Toteilsra N1rab�r 09/10/2003 11:28 17154256864 WEGERER SOIL TESTING PAGE 03 varoel ID fi pmpoav Oaw. Bad" / 0 BoMg O�oud avifaao dev.1 =_ IL Dam ° %� Sid �r �• paplh Dandnant C.eter Redoec chwalplb^ Texre $b�mm C nsburm Oa+ndswy 'E1R1 'EIIM� M� Mums" Gu. � Can. Gob► Car. ffi. SA zN 3 z (� 13"ing E ❑ BoMs .Irw_ 1l Depl+ b omanY �r — in. Soil don Fats I L J 0 Pit Grwmd wAa�+ Boob GppA! Hed Oopw twn+inant Color Rod&x DsA#Aan To&" Can.iotsr� a'7� in Mum Qo. ffi. ConL Color Gr. SL sh. 'Elfin 'EIA1w2 F -1 Borbv E 0 �ring t3M WW suftm eiw. IL Depth b 0 a ter Sd TifOas soucom Ca1� BaM�y Root Horimn Depw Dmnkw t Color Rewx De &Wbn 'EIpl1 E Y► (runeeil Cn. U CmL Cow Or SL Sh. • EMUM iZ BOO 30 mpll and TSS 5 30 MOIL < 22D aigiL and Tt38 sip c 150 m�plt- �! – The Dvp*foaet of CODUMI e is = equsl oPPottmdiy scr*i m pmvidar:iittd CM Ploysc. If you poed o as 4c"" szni� or wed matoW in so altem�de C pWme ooata¢t dte doprart WA at 60b M -3151 or 1W 60>;-265•�7TI• esu.o»te.ni.n 1 09/10/2003 11:28 17154256864 WEGERER SOIL TESTING PAGE 04 PAGE_3 OF N AM�F _ s-� OT# lv Y F DFS�"RIP2ION !4 X 5 r N om_ E(or)�D' SCALE: 1 "= ( ` I I i BM 1 ELEVATION Ann, O BM 1 DESCRIPTION BM 2 ELEVATION , BM 2 DESCRIPTION SYSTEM ELEVATION SYSTEM TYPE 1�D10 v I i i CdNTOUR ELEVATION q-; qo ' I S. < � �1 6 _ r b" 0 OL L SIGNATURE ,_ 0 2ll �ll�. DATE _ WsconSii1 Department of Commems SOIL EVALUATION REPORT Page l of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Cade Courtly i Attach comple site plan on paper not less than 81/2 x 11 inches in size. Plan must te include, but not limited to: vertical and horiwntal reference point (BM), direction and Parcel ID. percents", scale or dimensions, north arrow, and location and c+istance to nearest road. Date -� Please print a# Inibnnadon. R Persoast intmmatim you provide may be used for secondary PwPosas (Privacy Law. s. 15.04 (1) (0)). Property Owner Property Lo Govt. Lo 114 114 S T N R E (or) Property Owner's Mailing Address Lot # Subd. Name or CSM# City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road HuGQ '1 /(o (7/5- (' P ro: rl't I , New Construction Use: Residential / Number of bedrooms � ^ ` Code derived design flow rate 4- � � O O GPD ❑ Replacement ❑ Public or commercial - Describe: Flood Plain elevation # applicable A' ft Parent material — V11 - General comments S� sf� rr., z l c V, 9 ,�• and recommendations: l Barin # o _Z Pit Ground surface etev. �� L tt. Depth to limltit►g factor _ m. Soi tied Rate Hor¢on Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD1f- in. Mansell Qu. Sz Cont. Color Gr. Sz. Sh. •Elf #1 Eff#2 Q -tv s 3l3 Z- 16-3Z 9 Boring # Boring q ® Pit Ground surface elev. l oU ft. Depth to limiting factor Z in. Applica Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlft in. Mansell Qu. Sz Cont. Color Gr. Sz. Sh. - Eff#1 - Ef #2 a - /d 5 m4 GS Z A P -Z-6 /d,/,,-3/(/ 5 2s►'i L -S . • Effluent #1= B00 > 30 < 220 ffq& and TSS >30 < 150 mg& • Etfhcerrt #2.= BOD < 30 mgIl and TSS <_ 30 mgt CST Name (Please Print) Signature — CST Number Address Date Evaluation Conducted Telephone Number ''Gvisc�Rsin Department of ComrL�e(ce Division of S4` iNy and Buildings SOIL AND SITE EVALUATION Page ► o f .3 Bureau of Integrated Services in accordance with Comm 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size ,01ar,.must County include, but not limited to: vertical and horizontal reference point (BM), drrection and ,ST percent slope, scale or dimensions, north arrow, and location and distpincor to neareP f road: parcel f:p. # 03 36,-t)06 APPLICANT INFORMATION - Please print all information. iewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). { Zp Z60 Property Owner 1 Prgpery,- Lpc�at�an, 'C /J 1 Ctrl S�CT>� Govt Lot S( tM w1/4,S l� T 31 ,N,RC E (or)( Property Owner's Mailing Address Lot # 151ock 5ubd. Name or CSM# 1353 uoa4o k e 7 70 ��-� �o llln City State Zip Code Phone Number ❑ City ❑ Village- >0 own Nearest Road X New Construction Use: E / Number of bedrooms 3 "y Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow 0 gpd Recommended design loading rate _ bed, gpd /ft trench, gpd /ft Absorption area required 1 7(- bed, ft O a trench, ft Maximum design loading rate bed, gpd /fie & - trench, gpd/ft Recommended infiltration surface elevation(s) /0/, 0 ft (as referred to site plan benchmark) Additional design /site considerations 4W r 1 .� v_ ic6<U. Parent mat �� Flood plain elevation, if applicable /� n S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ❑ S [ U [� S❑ U ❑ S [au El S U G,. S - 0 U ❑ S U SOIL DESCRIPTION REPORT J�l.,w Q, 1 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 a r in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed ; Trench I ► o -('D lo / -5 i ► 2rnabk, YY)fir cs 14 .s e 2- 10-&4 10 5 11 2 k tn -F , C S 5 (0 Ground 3 24-3 ( r `1 lD �' `I• _ ( 5 ✓n (A M-G • to •'- elev. ��- / -0 ft• Depth to limiting factor 2 in. Remarks: Boring # I � �Z Ib �3/ ---- S.1 r c Ivy •S . � - S E l Z /z -38 I r S I `t ► rn�' C - - b s — t 2 � , 3 yI(n CZP _1•J r 11(0 Sll �; c — Ground elev. gy a ft. Depth to limiting factor 3 in. Remarks: CST Name (Please Print) ature Telephone No. c - AInrn 5c by -f-'r ' , - Z- I1 -tivo$ Address Date CST Number Z_ 3 80 "-`' S� . S ei W I j`I c) 253309 SOIL DESCRIPTION REPORT w `� -♦ PROPERTY OWNER �� , Pagea of 3 PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 3 0-13 (O r z l 13 -2 S 10 vr31 - 5 Z k rn c S — 5 (o , S� Ground 3 is& CLP • •s r`i 1 Z mc,b c elev. 1 _ ! /•30 ft. Depth to limiting factor ZS in. Remarks: Boring # l Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # q wvx Ground , elev. ft. Depth to limiting factor ' Remarks: Boring # s.aI Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R.9/98) SOIL DESCRIPTION REPORT ' PROPERTY OWNER ,�. U� `� Page z of . 3 _ PARCEL I.D.0 I Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench -3 1 6 10 r 3 Z 1 C-S J-P •'5 2 13- 10 vr3) 5' 1 2-m cb k. rn Pr Ground 3 2S 3� C Z P S r `I I co I Z McsS k _ el ev. G 9? 8 0 , Depth to limiting factor S in. Remarks: Boring # 13 Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Structure GPD/ft Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # r Ground elev. ft. Depth to limiting factor in ' Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R.9/98) II 1 4 PAGE OF 3 NAME S J �" LOT# G LEGAL DESCRIPTIOl 'Gz N FJT (009 t SCALE: I"= BM I ELEVATION 4 [-o d BM ESCRIPTION ,&-- • BM 2 ELEVATION /" BM ESCRIPTION It,, a4 SYSTEM ELEVATION 0 �. ALTERNATE ELEVATION /U CONTOUR ELEVATIO ei 1 �Z or ti o •b, TM 5 4. SIGNAT DATE l _ „�i c_nunc7�:ar riUYC ] -,q rd]. .' 5X1 1 x iL cl C1 Jc 'ST C1[ OIX CUUNTY S +�I'iiC ' A-NK MAINTENANCE AQUEMENT AND OWNE:RuHIP C.ERTIFICA.TION FORM 1VJruiiin Addyrttea _ �:��� il�G✓a -�u �e � � �.� P f .�....,. ,�.._.. Warit =e = required Isom Pit"Ag Depattmaat jo: new C* /State Parocl Idcri;i ficatian Numtwr L'�.3s' laoo -- 3ILI—000 LGAI n rp rout PTOP y LoOation '✓�, - sue fit. Sac. , T Z/ ,,,N•R %WOTown of Subdiviazorr ��.�...� ..� �. /QalP q .�1. . Lot Corditd Survey Map 0 , Volume , . Pager 4 _ ._ ......�..._. Warratty Desd # �! 5 a— 'V o lume , Page # v _. Spec hGwA yas 0 no Lot lines identifiable f yes ❑ no AY111M MC6=:1 "r-& xstptoper u&s had s�aiatwa,auscaof your septic system couldxesult isa xts praam&t=v t'siTurs to bArdic wassaa. Fwp .r Goss= of ptit3q* WA to eeptit =k oveiy throe yearn or Omer, if go&d by a Loeuwed p=Ver WbAt you n::ti to &am *A bud= of the septic tok sa a tt+ew=ut tango its the which d vad eystam 0 ?`i5C prqperty 011iwr is"$$ to aubrait to St. Croix Zoning Devoment a Certl$Citim Eli m, listed t;y IM Moselplumb&s, joutneyatmanphm 1w, rraatrrattdplu m-l-W oa! (1) the ean•cite is is proper opbca* etandid*a & &w (2) aafter iwati=sad pumpaas ac,Pku ts:3k is less that V3 3.1 v:° ]V%v the W1hnis ted have read ttce above requiteusents and agree to m,ainul a tho psivats a"c dispasal system %Vle. >av j , ... set lbw, hmin. a w by the Depsrtuten: of C tstarae wd the Dsparwal of Natua<1 Resoisress, S4t:* of wiwonsia Sk* thu VOW 6000 6yst+esal bans bean zotaintxined mwt b e t:Mplrsd atsd :etumsd to the St. Croix Co =±y+ 2vri 4 4 ;T cue of 00 em You eqsir" dsw 8101 A OF APPLICANT DA17E I (vice) en* that 411 a Urotaiss Oa tt is fo= wv it o to the be st of my (ma imowtatdSt. 3 (we) a ir (wo) the propmy dmtibad above by vitt= of a wLrmuty deed recorded m Rrgistor of Dceds Ofte. r g H r� SIGNATIE OF APPLICA DATE �.-� -- 0 w MraY «e Any lat4'oematietr that is tr::e- repYeaaat4d may result in ill a sanitw Vm't being revoked �y zba Zoaitsg ;Der a�:c =.a; :. es nalrsde wltb Ws a "Heat en! u stumped warran7 deed 16om tha I.alistet of D66de afYlee a copy of the certified jwvey map if reference is mad& in the waitzts^.ty doe, I 93uwA70 L STATE BAR OF WISCONSIN FORM 2 - 1993 16, 1. 9 1 1 -5:2 Cr y tj (N,! x;11 Document Number WARRANTY DEED f1r.DF This Deed, made between Gavle K. Callahan and Rosemary K. Callahan, husband and wife ;OP qCopq A3-9-201V 0:45 0 Grantor, conveys and warrants to Richard 0. Stout and Janet P. Stout. hus and and Wife rj)Dv ;•;- Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the 1344SFF FEF.- i 125.00 following described real estate in_ St. _Croix County, State of Wisconsin (Ile REL-1014i FEE: '0'00 "Property"): Recordlex Area Nam and Return Address r F I, �- 038-1077-70 Parcel Identification Number (PIN) This Is homestead property. SW 'A of SW 'A of Section 18, Township 31 North, Range 18 West, Town of Star Prairie, St. Croix County, Wisconsin which includes Lot I of Certified Survey Map in Vol. 13, Page 3750, Doc. No. 612266. Exceptions to warranties. Easements, restrictions and rights-of-way of record, if any. Dated this day of February, 2000. Gayl Callahan settlary K. C ACKNOWLEDGMENT STATE OF WISCONSIN ) AUTHENTICATION )ss. County Sigroure(s) Gavle K, Callahan and Rosemary K. C allahan. Personally came before me this _ day of February, husband and wife 2000, the above named to me known to be the authenticated this ��day of February, person(s) who executed the foregoing instrument and acknowledge 2000. L � a the same. • Kristina 0gland I TITLE: MEMBER STATE BAR OF WISCONSIN Notary Public, State of Wisconsin (if not, My Commission is permanent. (If not, state expiration date: authorized by § 706.06, Wis. Slats.) THIS INSTRUMENT WAS DRAFTED BY Attorney Kristin Ogland Hudson, WI 54016 (Signatures maybe authenticated or acknowledged. Both are not necessary.) *Names of persons signing in any capacity should be typed or printed below their signatures WARRANTY DEED STATE ZAK Of WISCONS[N FORM N.. 2 - IM INFORMATION PROFESSIONALS COMPANY FOND OU LAC. Ile 111004165-2021 AIA - 470 STATE BAR OF WISCONSI -t- 9 IL IN FORM 2 • LW C7 C,' 11 I-W! qli Document Number WARRANTY DEED I This Deed, made between Gayle K. Callahan and Rosemary K. Callahan, husband and LAffe I'LA KURD .-I-r.3-2060 1(1 A0 Grantor, conveys and warrants to Richard 0, Stout and Janet P. Stout, hus and wife T 0 rX., ;7H; Grantee. 6�� F- Grantor, for a valuable consideration, conveys and warrants to Grantee the -3AiSFF: FcF: 1 125.00 following described real estate in St. Croix -County, State of Wisconsin (The qf!38DN'f FEE: InArl "Property"): RccordhW Area Name and Return Address F Ft, 4- 039-1077-70 Parcel Identification Number (PIN) This is homestead property. SW 'A of SW 'A of Section 18, Township 31 North, Range 18 West, Town of Star Prairie, St. Croix County, Wisconsin which includes Lot I of Certified Survey Map in Vol. 13, Page 3750, Doc. No. 612266. Exceptions to warranties. Easements, restrictions and rights-of-way of record, if any. Dated this day .f F 2000. • Oayl . Callahan ACKNOWLEDGMENT STATE OF WISCONSIN ) AUTHENTICATION ) ss. County Signature(s) Gavle K. Callahan and Rosemary K. Callahan. Personally came before me this _ day of February, husband and wife 2000, the above named to me known to be the 2000. authenticated this_ day of February, person(s) who executed the foregoing instrument and acknowledge k� � the same. Kristina 0gland I TITLE: MEMBER STATE BAR OF WISCONSIN Notary Public, State of Wisconsin (If riot. My Commission is permanent. (If not, state expiration date: authorized by § 706.06, Wis. Slats.) THIS INSTRUMENT WAS DRAFTED BY Attorney Kristina Ogland Hudson, WI 54016 (Signatures may be authenticated or acknowledged. Both are not necessary.) *Names of persons signing in any capacity should be typed or printed below their signatures WARRANTY DEED STATE BAR OF WISCONSIN FO" No. 2 - 1998 INFORMATION PROFESSIONALS COMPANY FOND DU LAC. WI 800-655-2021 ty4 L ' C)GA71s0 IN THE ";W114 Of THE SWl 14 OF SFCTIOH 18 T,91 M, R18w, TOWN or, klmovk � LOCATION SKETCH Sr. CROIX ,COUNTY, WISCOM,3;I1M INCLUDIAV FART OF 1,07' 1 OF CERPMA'O �Wii EY Ai.11* � Tt�A11 IiY � VOLUME 13, PACE 3750 . b%tl 1"14A xx .4W1 NEt /7 1 ,a wx vsw' •ivWw ,ww. :.,av w $ •w::ew r wr «vxv w asaa•, w Miw i•wa y a w n '-- :• uv wrr• • x rmv W 1 j I.NL S FI /4 ! a _p r - s f 'N n B !erus.+rEk t.v » „.... r. a . ,... ,,.`«c .v.. wm res r. ....x. '• nN S 1 3 �— , 1 SECTION 18 MIN, R18W _ is 1a j yy ' � { r � `, MIN{MVM BUIUMNb v /2 • n i% —, z El¢itATibN8 uuu VoLN, H.5B,3R t waa r J:✓..J >!.. I - � F , u .V X nawn � \.��.'� I \S: � 7 dY � v 35S A N'E '.R•t. N ,... N � � .� .ra >... �I � •'r \ j \ � .:� *��� i o �„ 8 .•mow ,� � '!.. x A 18 .r b•.. � f u. 3 ♦ ' is �� •� < , f 4 w.w • «..,awn 1 w. CnR Ct. 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SWAM rrwisr: flaw Mbelarrr &rA= iw�e r �'I Ip� Sik�►S' q.+.• r Sa. W7ri I two Cm . i 1 "~VMW CIO& too Aas/cmzwr ateame %. glsrt f4S 10,4 t sw,er_; I 1 t��f�IdaM taw � taa �M�VJT/1�pp(�N�i i Standard Erosion Control Plan i for 1- & 2- Family Dwelling Construction Sites According to Chapters Comm 20 & 21 of the Wisconsin Uniform Dwelling Code, soil erosion control information needs to be included on the plot plan which is submitted and approved prior to the issuance of building permits for 1- St 2- family dwelling units in those jurisdictions where the soil erosion control provisions of the Uniform Dwelling Code are enforced. This Standard Erosion Control Plan is provided to assist in meeting this requirement. 'r Instructions: 1. Complete this plan by filling in requested information, completing the site diagram and marking appropriate boxes on the inside of this form. 2. In completing the site diagram, give consideration to potential erosion that may occur before, during, and after grading. Water runoff patterns can change significantly as a site is reshaped. 3. Submit this plan at the time of building permit application. PROJECT LOCATION �"f �d� I - � oa rI -� Please indicate north BUILDER da k4Ooe d �ov%ct- OWNER Ili(�ndk-L 1-J by completing the arrow. WORKSHEET COMPLETED BY 1�>Ich u_ DATE S2p _ Z , 03 —N— SITE DIAGRAM Scale: 1 inch = feet EROSION CONTROLPLAN LEGEND PROPERTY LINE EXISTING —' DRAINAGE TD TEMPORARY DIVERSION FINISHED —� DRAINAGE LIMITS OF GRADING i SILT '- - }� FENCE STRAW BALES ®o GRAVEL O VEGETATION SPECIFICATION TREE PRESERVATION E STOCKPILED SOIL t f I i W a EROSION CONTROL PLAN CHECKLIST V a Check (✓) appropriate boxes below, and complete the site diagram Q with necessary information. I— z Site Characteristics North arrow, scale, and site boundary. Indicate and name adjacent streets or roadways. e Location of existing drainageways, streams, rivers, lakes, wetlands or wells. X Location of storm sewer inlets. Location of existing and proposed buildings and paved areas. The disturbed area on the lot. ctr20. L,,iwI & �AOWv% Approximate gradient and direction of slopes before grading operations. Approximate gradient and direction of slopes after grading operations. ❑ Overland runoff (sheet flow) coming onto the site from adjacent areas. tlo - Gow f-,n„ a l av�g Erosion Control Practices Location of temporary soil storage piles. Note: Soil storage piles should be placed behind a sediment fence, a 10 foot wide E vegetative strip, or should be covered with a tarp or more than 25 feet from any downslope road or drainageway. Location of access drive(s). Note: Access drive should have 2 to 3 inch aggregate stone laid at least 7 feet wide and 6 inches thick. Drives should extend from the roadway 50 feet or to the house foundation (whichever is less). ❑ Location of sediment controls (filter fabric fence, straw bale fence or 10- foot -wide vegetative strip) that will prevent eroded soil from leaving the site. �fJ Location of sediment barriers around on -site storm sewer inlets. Location of diversions. Note: Although not specifically required by code, it is recommended that concen- trated flow (drainageways) be diverted (re- directed) around disturbed areas. Overland runoff (sheet flow)from adjacent areas greater than 10,000 sq. ft. should also be diverted around disturbed areas. Location of practices that will be applied to control erosion on steep slopes (greater than 12% grade). Note: Such practices include maintaining existing vegetation, placement of additional sediment fences, diversions, and re- vegetation by sodding or seeding with use t of erosion control mats. Location of practices that will control erosion on areas of concentrated runoff flow. Note: Unstabilized drainageways, ditches, diversions, and inlets should be protected from erosion through use of such practices as in- channel fabric or straw bale barriers, erosion control mats, staked sod, and rock rip -rap. When used, a given in- channel barrier should not receive drainage from more than two acres of unpaved area, or one acre of paved area. In- channel practices should not be installed in perennial streams (streams with year round flow). Location of other planned practices not already noted. r f J t m t Q ' V a Indicate management strategy by checking (✓) the appropriate box. CL Q Z Management Strategies Temporary stabilization of disturbed areas. Note: It is recommended that disturbed areas and soil piles left inactive for extended periods of time be stabilized by seeding (between April 1 and September 15), or by other cover, such as tarping or mulching. Permanent stabilization of site by re- vegetation or other means as soon as possible (lawn establishment). • Indicate re- vegetation method: A Seed ❑ Sod ❑ Other • Expected date of permanent re- vegetation: pct a5 • Re- vegetation responsibility of: n Builder n Owner /Buyer • Is temporary seeding or mulching planned if site is not seeded by Sept. 15 or sodded by Nov. 15? ,9 Yes ❑ No Use of downspout and /or sump pump outlet extensions. Note: It is recommended that flow from downspouts and sump pump outlets be routed through plastic drainage pipe to stable areas such as established sod or pavement. Trapping sediment during de- watering operations. Note: Sediment -laden discharge water from pumping operations should be ponded behind a sediment barrier until most of the sediment settles out. Proper disposal of building material waste so that pollutants and debris are not carried off -site by wind or water. i Maintenance of erosion control practices. • Sediment will be removed from behind sediment fences and barriers before it reaches a depth that is equal to half the height o f the barrier. • Breaks and gaps in sediment fences and barriers will be repaired imme- diately. Decomposing straw bales will be replaced (typical bale life is three months). • All sediment that moves off -site due to construction activity will be cleaned up before the end of the same workday. • All sediment that moves off -site due to storm events will be cleaned up before the end of the next workday. • Access drives will be maintained throughout construction. • All installed erosion control practices will be maintained until the disturbed areas they protect are stabilized. EROSION CONTROL REGU IONS Erosion control and stormwater regulations can be complex. Local, state and, in some cases, federal regulations may apply. Before construction make sure you have the appropriate permits. LOCAL ORDINANCES Check with your county, city, village, or town for any local erosion control ordinances including shoreland zoning require- ments. Except for new 1- & 2- family dwellings, local ordinances may be more strict than state regulations. They may also require erosion control on construction projects not affected by state or federal regulations. UNIFORM DWELLING CODE (DEPT. OF COMMERCE) CONTROLS REQUIRED FOR MORE INFORMATION, CONTACT: • Silt fences, straw bales, or other approved perimeter • Local building inspector measures along downslope sides and side slopes. o Department of Commerce, Safety and Buildings Division, • Access drive. P.O. Box 7162, Madison, Wis. 53707, (608) 267 -5113. • Straw bales, filter fabric fences or other barriers to protect on -site sewer inlets. • Additional controls if needed for steep slopes or other special conditions. STORMWATER PERMIT (DEPT. OF NATURAL RESOURCES) CONTROLS REQUIRED FOR MORE INFORMATION, CONTACT • Erosion control measures specified in the Wisconsin • Department of Natural Resources, Storm Water Permits, Construction Site Best Management Practice Handbook. P.O. 7921, Madison, WI 53707 -7921, (608) 266 -7078. • Measures to control storm water after construction. For more assistance on plan preparation, refer to the Wisconsin Uniform Dwelling Code, the DNR Wisconsin Construction Site Best Management Handbook, and UW— Extension publication Erosion Control for Home Builders. The Wisconsin Uniform Dwelling Code and the Wisconsin Construction Site Best Management Handbook are available through the State of Wisconsin Document Sales, (608) 266 -3558. Erosion Control for Home Builders (GWQ001) can be ordered through Extension Publications, (608) 262 -3346 or the Department of Commerce, (608) 267 -4405. A PDF version of Erosion Control for Home Builders (GW0001) and Standard Erosion Control Plan are also available at http: // clean - water.uwex.edu /pubs /sheets This publication is available from county UW- Extension offices or from Extension Publications, 45 N. Charter St., Madison, WI 53715. (608) 262 -3346 or toll -free (877) 947 -7827. A publication of the University of UW Wisconsin— Extension in cooperation with the Wisconsin Department of Natural Resources and the Wisconsin A ftEnsion Department of Commerce. ©1999 by the Board of Regents of the University of Wisconsin System. Send inquiries about copyright permission to: Director, Cooperative Extension Publications, 201 Hiram Smith Hall, 1545 Observatory Dr., Madison, WI 53706. University of Wisconsin- Extension is an EEO /Affirmative Action employer and provides equal opportunities in employment and programming, including Title IX and ADA requirements. GWQ001A Standard Erosion Control Plan for 1 & 2 Family Dwelling Construction Sites � Printed on DNR WT- 458 -96 R- 02- 02- 211l Editing and design by the Environmental Resources Center, University of Wisconsin- Extension. � recycled paper F v us 36 o �n a +ro. c�,t 4A� , 6 �u 9c? , a T-30 � Of � d, s � �� •fie Uc, e. ' all s I� . mccko 1 o � 1no wee, �IPJtt�,c�, ocze 0 I Ab co O R • . �S+ a aIN EP 40 .- 3 � a � t V 01-1 W *- 0.0� VIM r b.o0 � wu co 1 1�o' fc ' • R EDEIVED ST. CRW( COUNTY ZONING OFFICE � 1 Vo , '�7. c�.iro. a e � v�Q 4r OL