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HomeMy WebLinkAbout038-1200-60-000 msir, Department of Commerce PRIVATE SEWAGE SYSTEM County St. Croix ety and Build Division INSPECTION REPORT Sanitary Permit No: 506395 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information YOU provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Lepper, Christopher I Star Prairie, Town of 038 - 1200 -60 -000 CST BM Elev Insp. BM Elev L BM Description: 't 1 Section /Town /Range /Map No'. 18.31.18.1060 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark / ,3 � W85 ilosina Alt. BM � s 9 b- Aeration Bldg. Sewer 6 . Holding St/Ht Inlet t TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom `s3 Dosing Header /Man. 7. �� • ` s Aeration Dist. Pipe � 7.8'S Holding B Sys * PUMP /SIPHON INFORMATION ,� Final Grade // 77 Manufacturer /I� Demand St Cover / l 2�0 r /� o.� �j �j GPM -- f3 . 7 Model Number 6Pa� ` / J G7. y� ys0 S TDH Lift Friction Loss System Head TDH Ft �Za z• �vco ,sc� � c� �vc.ctt. �S � 9 �'"3- 3 . Forcemain Leng�, D Dist to Well ' i •33 SOIL ABSORP`T'ION SYSTEM >S a �,� 2. ( 19 9( sb BED /TRENCH Width Length / No. Of ench s PIT DIMENSIONS . Of Pits Inside Dia. Liquid Depth DIMENSIONS 5, 5 $Z, Of SETBACK _ TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATIO CHAMBER uBET Model Number: OR r ;FTMtem: 4 �� 18' k �?ISTRIBUTION SYSTEM / Header /Manifol ,TD istribution �� # x Hole Siz i t x Hole Spacing . I Vepo Air Length Di a Length! Dia Spacing o Z S SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only p Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed /Trench Center I , 2 Bed/Trench Edges Topsoil I Yes No Yes F_ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:_(L/ ` / / Inspection #2: Location: 2104 81st Street Somerset, WI 54025 (SW 1/4 SW 1/4 18 T31N R18W) Rolling Oaks Lot 9 Parcel No: 18.31.18.1060 1.) Alt BM Description = 2.) Bldg sewer length = 1 - amount of cover f Plan revision Required? CJ Yes ! o - Use other side for additional information. Date Insep tor's Sig cure Cert. No. SBD -6710 (R.3/97) Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 St. Croix isconsn Madison, WI 53707 — 2 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608) 266 -315 / _ 3 c7 J < Sanitary Permit Application care Plan I.D. NumtNumber Z In accord with Comm 83.2 1, Wis. Adm. Code, personal information you provide jest Address (if different than mailing address) may be used for secondary purposes Privacy Law, sI5.04(1)(m) I. Application Information — Please Print All Information # Z/ 0 '7 / RECEIVED Same Property Owner's Name / Parcel # 110 Block # Christopher & Debra Lepper NOV 13 2007 038 - 1200 -60 -000 9 Na Property Owner's Mailing Address Property Location / 2104 80 Street ST. CROIX COUI�ITY Gov't lot SW' /4, SW' /,, Section 18, City, State Zip Code (circle one) Somerset, WI 54025 15 247 -4893 T 31_ N; R -!�_ W II. Type of Building (check all that apply) X 1 or 2 Family Dwelling — Number of Bedrooms �lJ�1a� Subdivision Name CSM Number ❑ Public/Commercial — Describe Use Rolling Oaks ❑ State Owned — Describe Use 4< < _ �,� ❑City ❑Village X Township of Star Prairie III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ❑ New System X Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and r1ate Issued Before Expiration Plumber Owner 3 ! 3,i / 5 TO IV. T of POWTS System: Check all that apply) l0 10 ❑ Non — Pressurized In- Ground X Mound > 24 in. of suitable soi ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter / [ ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) 5 fz V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate (gpdsf) Dispersal Area Required (sf) Dispersal Area Pro (sf) Elevation I.Ggpd/sq.ft ASTM C -33 sand 1 j LS Z 5 Z`t 90.43' 12" above 450 gpd 0.4 d/s .ft native soil ✓ 4S0 sq. ft. 451 sq. ft. ' contour VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Bolding Tank 1,000 1,000 1 Midwestern Pre -cast Concrete X Aerobic Treatment Unit >.r Z 41sclZ i4- / Dosing Chamber 600 600 1 Midwestern Pre -cast Concrete X VII. Re sponsibility Statement- I, the undersigned, assume responsibility for Installation of the POW'I'S shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number William Schumaker lcJ MP #227990 1 (715) 386 -3121 Plumber's Address (Street, City, State, Zip Code) 1070 Scott Rd., Hudson, W1 54016 VIII. Conn /De artment Use Onl Approved Sanitary Permit Fee (includes Groundwater D,/, /WI sued Issuin t Surcharge Fee) �} O� ; 7 �GivenReasn ial (� OL Conditions of Approval/Reasons for Disapproval SYSTEM OWNER: 1. Septic tank, effluent finer and dispersal cell must all be servlces / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per appho" code / ordeuk m. Attach complete plans (to the County only) for the system on paper not less than 81f2 :11 inches in size SBD -6398 (R. 01/03) ' • So,/ e ✓�uu- �'or -, p oi � • /ac a.�e.d,o�a,o. S� 5 ca /e. '_ !/O' - Pe�'zs Cl��, - Q D.�.�.c� L�pP�' Lctt9 p rop 0 nioa,nd a6 ,-� ozes 3s 04l -io %. 93'aailtti sw`� Swiy, 7c 18, 5.5X h /8u) Tn.of'S C e// Fo- 6w(y)la*r" & 5f. C /oi,Y Co ..0/. "oricES S /act 388, Bz Mi o(cves&iQ P�CC�. S f {eru,,vkb n. � o a• Comb. s.T. /•�?c. w`tt. oao, 2 sue.. Ko 3 ejl 6-v 6e 44AP14N b 54. t Sicr'anCe � � o 4tcK EkiSfi rot % /ad � d � P so�8 I - w � A EXi SL a ir radG ek,v' Lc�aP�.- �ioPGr`E y, lot 9, prop 0SCd m 0 ",Zd a£ 0 /ate o f �n� C2('s, 3SO /V /.93' 64 Swy�,Sc,�%y, c. 5. S / iQ /B44- Tn. o SfwPra.i P, ' pc/. 038 - 1.2CO - 4 - a /.S46 acie5. ct,E ,2.3p' G 3 43. Bz Z/("So 9.P pia/ wtS�e /Q �r'CGaSf P. dC.{e�cti✓+Q.�'J. � 'o Comb. S.T. /P,C. �'tt. c � � �• •�, � iS' U 3 p4�y'O C z SuC. flp .` •�` 1 8ara9e � R �Xisfr`� 9Y. GB' ' ' reef 3 d t cK CO ec// f e 6• be a 4w #d w - 3e•7 a t&l P,'ti E,lis�r by Se. Gto�x Co. B2 D ��y r v u.n,w,L-. rN� \ �� WETLAN 121,373 8o F 5� / 2.786 ACRES 1 2 C '�a, 38 �m � 2.271 ACRES 88,8 so FT ®� 2 � i I � a 1.860 ACRES �N 81.006 SQ FT lr 10 / od r a �^ 10 78 786 80 E FT S ; w L. = 1 2.78' , 1 OW6P 0 9 `�.� 18 ��u b 08 ACRES SO FT 2.417 ACRES I' ro 105,288 SQ Fl " r 1 N 213 .08. 8 7Z„ E 4p I N 89 7 \ ` so' 443 \ 7 _ 183.87' 28 ® \ \ 66,432 so 19 �f N 4*4 + m Z 1.276 ICRES �y " r 55 ,579 So FT W 1. 4' V cs , o. 1.511 ACRES f 85824 SQ F r I l lV 7 I 2 1 w w 1, � E� � , � ,�, , � � 4 4 ' Safety and Buildings 4003 N KINNEY COULEE RD commerce.wi.gov LA CROSSE WI 54601 -1831 in TDD #: (608) 264 -8777 sco n s i www.commerce.wi.gov /sb/ www.wisconsin.gov Department of Commerce Jim Doyle, Governor Mary P. Burke, Secretary October 03, 2007 CUST ID No. 227990 A7TN: POWTS Inspector WILLIAM C SCHUMAKER ZONING OFFICE SCHUMAKER PLUMBING ST CROIX COUNTY SPIA 1070 SCOTT RD 1101 CARMICHAEL RD HUDSON WI 54016 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/03/2009 Identification Numbers Transaction ID No. 1468621 SITE: Site ID No. 730947 Christopher & Debra Lepper Please refer to both identification numbers, 2104 81 ST Street I above, in all correspondence with the agency. Town of Star Prairie, 54025 St Croix County SWIA, SWI /4, SI8, T31N, R18W Lot: 9, Subdivision: Rolling Oaks FOR: Description: Mound / Three Bedroom / Sloping Site Object Type: POWTS Component Manual Regulated Object ID No.: 1154971 Maintenance required; Replacement system; 450 GPD Flow rate; 24 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 /01), Pressure Distribution Component Manual - Version 2.0, SBD - 10706 -P (N.01 /01); Biofilter 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. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, cta "I) stats. fk i G i The following conditions shall be met during construction or installation and prior to occupancy or use: G pARTt.. -9T Reminders N SA M ks • This system is to be constructed and located in accordance with the enclosed approved plans and with the SCE C Ee:RE component manuals listed above. • The existing septic tank must be inspected for structural soundness, size and baffles and must be brought into conformance with the requirements of ch. Comm 83, Wis. Adm. Code. If it does not conform, a state approved tank must be installed. • Access to the filter for cleaning must be provided per Comm 84 product approval conditions. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required • 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. WILLIAM C SCHUMAKER Page 2 10!312007 • 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 POWTS 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 Fee Received $ 175.00 Balance Due $ 0.00 Charles L Bratz POWTS Reviewer 11, Integrated Services WiSMART code: 7633- ' (608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday charles.bratz@wisconsin.gov cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544, Friday, 7:00 A.M. To 3:30 P.M. I MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Christopher & Debra Lepper 4- bedroom residential moun Owner's Name: Christopher W. & Debra J. Lepper CT Owner's Address: 2104 81st Street c © Somerset, WI 54025 > o L!1 ,.., Site Address: Same 0 LOU Legal Description: SW1 14SW1 /4, Sec. 18, T.31N., RAW C) CIO Township: Star Prairie County: St. Croix Subdivision Name: Rolling Oaks Lot Number: ' 9 Block Number: na Parcel I.D. Number: 038 - 1200 - 60 Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications 'r*Jjgrr -y Page 6 Management and contingency plan Page 7 Pump curve and specifications —E® Page 8 Site Plan co�wrkERC� Page 9 Attached soil evaluaiton report Page 10 Attached Interprabve Determinatio Report 1 �t�ONDE Designer: Bill Schumaker License Number: 227990 Date: 09/27107 Q Phone Number: (715) 386 -3121 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01/01), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD- 10706 -P (N. 01/01) Version 5.1 (R. 06!06) Page 1 of 10 f I Mound and Pressure Distribution Component Design Design Worksheet S ite Inf ormation (R or C) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 300.00 Estimated Wastewater Flow (gpd) Table 83.44 -3 In -situ soil treatment for fecal o 1.50 Peaking Factor (e.g. 1.5 = 160%) coliforrn of - 36 inches. 450.00 Design Flow (gpd) 20.00 Site Slope ( %) 89.43 Contour Line Elevation (ft) 24.00 Depth to Limiting Factor (in) 0.40 In -situ Soil Application Rate (gpd /ft Distribution Cell Information 82.001 Dispersal Cell Length Along Contour ft = 5. 50 Cell Width ft 1.00 Dispersal Cell Design Loading Rate (gpd/ff) 1 I Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (C or E) C Center or End Manifold 2.75 Lateral Spacing (ft) If N above, enter the elevation ft 4 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) 2.25 Estimated Orifice Spacing (ft) = 6.26 ft /orifice 2.00 Forcemain Diameter (in) 140.00 Forcemain Length (ft) Does the forcemain drain back? F Y 83.10 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 22.84 Forcemain Drainback (gal) 7.25 Vertical Lift (ft) 51.29 5x Void Volume (gal) 2.66 Friction Loss (ft) 74.13 Minimum Dose Volume (gal) 0.00 In -line Filter Loss (ft) 29.66 System Demand (gpm) 16.40 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 _ 1.25 x x 1.00 x 1.50 x 1.25 x x 2.00 1.50 x 3.00 2.00 x 3.00 x Gallonslinch Calculator (optional) Treatment Tank Information 646.00 Total Tank Capacity (gal) 1000.00 Septic Tank Capacity (gal) 38.00 Total Working Liquid Depth (in) Midwestern recast Manufacturer 17.00 gal/in (enter result in cell B49) Do Tank Information Effluent Filter Information 646.001 Dose Tank Capacity (gal) Poi Lok Filter Manufacturer 17-001 Dose Tank Volume (gat /in) PL -525 Filter Model Number Midwestern precast Manufacturer Project: Christopher & Debra Lepper 4- bedroom residential mound Page 2 of 10 Mound Plan and Cross Section Views .. 1� 10 B - Observation Pipe J j Z. W 7. B ,. I L Mound Component Dimensions A 5.50 ft E 25.20 in H 1.00 ft K Aft ft B 82.00 ft F 9.25 in z 25.28 ft L ft D 12.00 in G 0.50 ft J 4.26 ft W 451.00 (ft Dispersal Cell Area 2524.06 (fe) Basal Area Available 5.49 (gpd/ft) Linear Loading Rate 1 8.20 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 92.20 (ft) ---► � four }rii a G F Dispersal Cell 90.93 (ft) Lateral 90.43 (ft)-1 — Invert Dispersal Cell 3 Elevation E D ✓ .� + `] .. te a. ' 1 t' 4 89.43 (ft) Contour Elevation 20.0 %Site Slope Geotextile Fabric Cover Shading Key $ Dispersal Cell See lateral details on Q - Topsoil Cap 1.5 ft Page 4 for number, size, © ����• Subsoil Cap c ti fti ti rtirti % and spacing of laterals. ' a _ . . ::�• �• �• ASTM C33 Sand i° Z %ti fti% _ •ti' r %�•j�••ti:;: F Laterals are equally ® Tilled Layer m 0.5 ft :Typical Lateral spaced from the ,p ,: ;;:,: 5 distribution cell's f.j. Aggregate a C :::• :. -.% 1,;.: — 40 A � centerline in the distribution cell (Ax6). Project: Christopher & Debra Lepper 4- bedroom residential mound Page 3 of 10 Center Connection Lateral Layout Diagram Force main connection via tee or cross to manifold at aM point. Laterals are identical - 7�- "I' P S • =Turn- upwfbellvalveor `4 X— .�IErt2 I 102 +1 Laterals& force main of PVC Sch40 oieanoutplup per COMM Table 84.30.5 Holes drilled on the bottom of the lateral. Number of Laterals 4 Orifice Diameter 0.125 in Lateral Diameter 1.25 in Orifice Spacing (X) 2.30 ft Lateral Length (P) 40.25 ft Orifices per Lateral 18 Lateral Spacing (S) 2.75 ft Orifice Density 6.26 ft /orifice Lateral Flow Rate 7.41 gpm Manifold Length 2.75 ft System Flow Rate 29.66 gpm Manifold Diameter 1.25 in Total Dynamic Head 16.40 ft Forcemain Velocity 3.03 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and -► Comm 16.28 WAC 4 in. min. Disconnect Tank component is properly vented f--- Altemate outlet location Forcemain diameter Midwestern recast Manufacturer 2 in. Ca aci 646.00 Gallons Volume 17.00 gaIArich A Weep hole or anti - Dimension Inches Gallons B siphon device A 24.64 418.87 B 2.00 34.00 C Pump off elevation (ft) C 4.36 74.13 83.68 D 7.00! 119.00 D Total 38.00 646.00 Dose se tank elevation (ft) 3" Bedding uncTer tank. 83.10 Alarm Manuafacturer ! Le 41km Alarm Model Number DLV Pump Manufacturer Gouids Pump Model Number 3871 EPO4 Pump Must Deliver 29.66 gpm at 16.40 ft TDH Project: Christopher & Debra Lepper 4- bedroom residential mound Page 4 of 10 Mound System Maintenance and Operation Specifications ker l Service Provider's Name Bil Schuma 1 Phone � (715) 386 3121 _ . .. -- - - -. - POWTS Regulator's Name St Croix County Zoning Dep't Phone! (715) 386 -4680 System Flow and Load Parameters i Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg /L Septic Tank Capacity 1000 gal Maximum TSS 150 mg /L Soil Absorption Component Size 451 ft' Maximum FOG 30 mg /L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu /100 mL Service Frequency Septic and Pump Tank Inspect and /or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test month) Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound Inspect for ponding and seepage once every 3 years Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Tum -up Detail Finished •.........•.•. ............... Grade 6 -8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Christopher & Debra Lepper 4- bedroom residential mound Page 5 of 10 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD- 10691 -P (N.01/01), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD 10706 -P (N. 01/01)) and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. 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. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet fitter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the finer when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filer is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution Svstgm No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October - February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD 150 mg1L TSS, and 30 mg /L FOG for septic tank effluent or 30 mg/L BOD 30 mg/L TSS, 10 mg /L FOG, and 10 cfu /100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months.. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning Is required to maintain equal distribution within the dispersal cell, Observation pipes within the dispersal cell shall W checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Continency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. Project: Page 6 of 10 �GOU LDS PUMPS Submersible Effluent Pump 3871 EPO4 EP05 rI!u APPLICATIONS • Fully submerged in high ■ EP05 Impeller: Thermoplas- ■ Bearings: Upper and lower Specifically designed for the grade turbine oil for tic enclosed design for heavy duty ball bearing following uses. lubrication and efficient improved performance. construction. • Effluent systems heat transfer. ■ Casing and Base: Rugged • Homes Available for automatic and thermoplastic design provides AGENCY LISTING manual operation • Farms superior strength and corrosion . Auto- Heavy duty sump matic models include resistance. c SP Canadian Standards Association • Water transfer Mechanical Float Switch ■ Motor Housing: Cast iron Goulds Pumps is ISO 9001 Registered. • Dewatering assembled and preset at the for efficient heat transfer, factory, strength, and durability. SPECIFICATIONS ■ Motor Cover: Thermoplastic FEATURES cover with integral handle and • Solids handling capability: float switch attachment points. " maximum. ■ EPO4 Impeller: Thermoplas- M Power Cable: Severe duty • Capacities: up to 60 GPM. tic Semi -open design with rated oil and water resistant. • Total heads: up to 31 feet. pump out vanes for mechanical • Discharge size: 1'12" NPT, seal protection. • Mechanical seal: carbon - rotary/ceramic- stationary, BUNA -N elastomers. • Temperature: 104 - F (40 °C) continuous 140 - F (60 ° C) Intermittent, METERS FEET • Fasteners: 300 series 10 + stainless steel 9 30 ��. s GPM • Capable of running dry without damage to 8 2.5 FT components. ----- - - - - -- - - - -__ 25 0 7 Q Motor: _ • EPO4 Single phase: 0.4 HP, LI 6 20 115 or 230 V, 60 Hz, 1550 RPM, built in overload with > automatic reset. ° 4 15' • EPOS Single phase: 0.5 HP EP05 115 V or 230V, 60 Hz, 1550 01 3 10; RPM, built in overload with automatic reset. 2 EPO • Power cord: 10 foot 5, standard length, 16/3 1 SJTOW with three prong grounding plug. Optional 20 0 0 0 10 20 0 40 50 GPM foot length, 16/3 SJTW with GG S three prong grounding plug 0 2 6 a 1 o min (standard on EP05). CAPACITY Goulds Pumps 2002 Gou ds Pumps ITT Industries Effective September, 2002 7 ��� 83871 7 ST. CROIX COUNTY WISCONSIN ZONING OFFICE / N / / N N • ��•r+r ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016 -7710 (715) 386 -4680 FAX (715) 386 -4686 COUNTY ON -SITE VERIFICATION FORM Properly t - ropedy ocation (; 4"d v�4_ LG e-J' Govt. Lot 61- 196W 1/4 8 I$ T 31 N R � j r O E (ar PropertyOvmer's Mailing Address a I Lot # Blodr# Subd.NamaorCSM# 21 0 5+T�,�- Cl RDLI: --' ckjr_ City state Zip Code Phone Number []City ❑ Village Wown J Nearest Road $oitaJbe W S r, y 4 9 t5�- cam, ❑ wConstruction Use: ❑ Residential 1 Number of bedrooms ----Code derived design flow rate _— �-- - - - - _ GPO RepW:ement ❑ Public or commercial - Describe: — _._-- - - - - -- W.---_---,.--.------- Parent material -- _ _ _ Rood Plain elevation I applicable -------- ., - - - -- ft. Germ Bratearrrrt and recommendations: ndatbns: � oa' C� `) k e. -M.. ar - T _q Boring `aJr Boring tl .�_y cam s�rcFac+a Pit Ground elav: -- � - - -ft. Depth to Nm favor - - - -- or - - - �Z -- in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Rods &D in. Muns€tl Qu. Sz. Cont. Cola Eff l 'Ef Gr. Sz. Sh. 'w i o -Z. id 'JA q i 5 L. Z 4 k n% ; G . (o /. o Z— 2- 9Z 7 6 YR. -- L., k m c. 5 — o. 0 . `7 3 yz 7. tt v e. 4PA G z n 5 L. - - Boring # ❑ Baring ❑ Pit Ground surface elev. _ —_ ft. Depth to limiting factor _ _ - -_ in. Soil ADDlication Rate Horizon Depth Dominant Color RedoxDescription Texture Structure Consistence Boundary Rods GPDfV In. Munsell tau. Sz. Cont. Color Gr. Sz. Sh. `E1flf1 `Eff#2 J 2095 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code A.C.E. Soil & Site Evaluations Attach complete site plan on paper not less than 8' %x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest ro Parcel I.D. 038-12O P-60-000 Please print all information. v B Date Personal information you provide may be .04 (1) (m)). Property Owner Troperty Location Christopher W & Debra J Lepper ovt. Lot SW 114 SW /14 S 18 T 31 N R 18 W Property Owner's Mailing Address OCT t # Block # Subd. Name or CSM# 2104 81 st Street 1 9 Rolling Oaks City State Z Cod6lPQA@ J City J Village 0 Town Nearest Road Somerset WI Star Prairie 81St Street J New Construction Use: 1e Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD 61 Replacement J Public or commercial - Describe: Parent material Glacial till Flood plain elevation, if applicable na General comments and recommendations: Site suitable for mound system with 1 of AS TM -C33 sand placed on 89. 43' contour. System elevation = 90.43'. Ol rtllo 4 ❑ J Boring Boring # 0 Pit Ground Surface elev. 90.83 ft. Depth to limiting factor 24" � in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - Eff#1 - Eff#2 1 0-8 10yr412 none sil 2fsbk mvfr as 2fmc 0.6 0.8 2 8 -17 10yr4/3 none sit 2f &msbk mvfr cw 2fm,1c 0.6 0.8 3 17 -24 10yr4/4 none sicl 2f &msbk mfi cw 2f,1m 0.4 0.6 4 24 -38 1oyr4 /4 f2f 7.5yr5/8 sit 1csbk mfr gw 1f 0.4 0.6 5 38 -42 10yr5/4 f2d 7.5yr5/8 sit 1 csbk mfr cw - 0.4 0.6 6 42 -50 7.5yr5/4 m2d 7.5yr5/8 sl Om mfi - - 0.2 0.6 J Boring 2 Borin # 0 Pit Ground Surface elev. 89.13 ft. Depth to limiting factor 21 ✓ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - Eff#1 - Eff#2 1 0 -10 10yr4/2 none sit 2fsbk mvfr as 2f 0.6 0.8 2 10 -18 10yr4/4 none sicl 2msbk mfi cw 2vf,lf 0.4 0.6 3 18 - 10yr514 none sic 2f &msbk mfi cw lvf 0.2 0.3 4 26-31 10yr5/4 f2f 7.5yr5/8 sicl 1 csbk mfr gw 1 of 0.2 0.3 5 31-40 5yr4/4 m2f 7.5yr5/8 & f2d 10yr6/2 fsl Om mfi - - 0.2 0.6 - Effluent #1 = BOD 30 < 220 4/1 and TSS 40 < 150 m /L Effluent #2 = BOD s30 mg /L and TSS < 30 mg/L CST Name (Please Print) Si at, CST Number James K. Thompson 3602 Address A.C.E. Soil & Site Evaluation Date Evaluation Conducted Telephone Number .,�: " id 54020 o-1"27/2007 715 - 248 - 7767 Property Owner Christopher W & Debra J Lepper parcel ID # 038 - 1200 -60 -000 Page 2 of 3 31 Boring # Boring ./ Pit Ground Surface elev. 84.46 ft. Depth to limiting factor 28" in. Soil Application Rate lorizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD `` in. hunsell Qu. Sz, Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 I 0 -9 1Oyr3 /3 none sil 2fsbk mvfr as 2f 0.6 0.8 2 9 -14 1Oyr4/3 none sil 2fsbk mvfr cw 1vf,f 0.6 0.8 3 14 -22 1 Oyr4 /4 none sicl 2fsbk mfi cw 1 of 0.4 0.6 4 22 -28 7.5yr4/6 none sicl 2f &msbk mfr gw - 0.4 0.6 5 23 40 "C�.�l6 ...2f r:; /8 sicl ,,.�,bk mfr cw - 0.2 0.3 6 40-48 7.5yr4/6 m2d 7.5yr5/8 gr fsl Om mfi - - 0.2 0.6 F-1 Boring # I Boring J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1-1 Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 DODS 30 _22C �y/L oi�d TSS >30 < 150 mg /L * Efflueiit #2 = BOD 30 mg /L and TSS <30 mg/L S i — Y employer. ice fo er and em to er. 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 (K,07!0n) A.C.E. SO &- Si«. E•::!:::"_':'_ • /aca.L•edlo�o,0. S� 5 Cal e UV O A /a-e, Ol 02 swyf! swiy, SEc. /B, 7 /4, / AP /B10 Ti►.o�'�A�vi�e, 5f• c,-o, Co •� /• pcl• ,ff 038 - 1.2CV - 60 - a a c ie s. 3 �3. Bz SO 9.0 c i �E,h� z •�s�.l4Q A -ccasf c., 3 o RIC 6 /oaf' wux+a,,4 3 ZrOM ' ' ♦ �`, reef olQe Sio/goet 1 o b • E• be oGar der�ed Se.q er/a� �o.'f. '� � ; well -Q y � �gYi FP f , 9o- i P 3ol,3 ST CROIX COUNTY SEPTIC.' 'TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Cii4z 4? Lzo Mailing Address SRS 57 d ; - lZ S5owi,'s� 42Z SyDas' Property Address !2 - 2b2J (Veri t ation requ d from nning Department for new construction) City /State Parcel Identification Number —1,077- 76-00 LE GAL DESCRIPTION Property Location 54) '/ SGT 'A, Sec. /_, T ,Z/_ N -R IF W, Town of - Subdivision Lot # V �_ Certified Survey Map # '�- Volume , Page# Warranty Deed # 4 v 4� 4 �rG _ ,Volume / , I - ;?? , Page # Spec house Q yes 9 no Lot lines identifiable Al. yes O no SYSTEM MAINTENANCE, Improper use and maintenanceof your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposaI system is in proper operating condition and. %or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I /we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 (lays o three year expiration date. l 4, � *'� 7 / l % / Ofd SIGNATURE 01 DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office, SIGNATURE OFA 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 !' STATE BAR OF WISCONSIN FORM 2 - 1998 6�21Eara01 WARRANTY DEED KATHLEEN H. WALSH _. 152,E �00 kEGISTEk OF DEEDS Document Number V��. , PAGE ST. CROIX CO., WI RECEIVED FOR RECORD This Deed, made between 07 -18 -2000 3:40 PM RICHARD O.--STOUT and JANET P STOUT, husband and wife EARRANTY DEED EXEMPT # Grantor, CERT COPY FEE: and HRTSTOPHP.R W T P.PPER and T)FRRA J T EPPER -, COPY FEE: husband and �Ti fa _ TRANSFER FEE: 108.00 RECORDING FEE: 10.00 PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St _ C'roi x County, State of Wisconsin: Recording Area Lot 9, Plat of Rolling Oaks, Town of Star Name and Return Address Prairie, St. Croix County, Wisconsin. G'liri' -�' LGp�c✓ G7 sow,cysc�, w 1 SyOaS 038- 1077 -70 -000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Exceptions to warranties: easements, restrictions, rights -of -way and covenants of record. Dated this 1 7th day of fi July 2000 IVl .1/�9►x�( G • (SEAL) (SEAL) Richard O. Stout Janet P. Stout (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signatures) State of Wisconsin, ss. St. Croix County.' thenticated this day of r Personally came before me this 1 7th day of y Y 2 0 0 0 , the above named Richard O. Stout and Janet P. Sto R OF WISCONSIN to !' �RYi 3AC0g me k own to be the p erson S who executed the foregoin GH pubiio P g g tats.) NO . 15con ent and acknowledge the same. State of y Notary Public, St e of Wis nsln My commission is permanent. (If not, state expiration date: Both are not 3 .) eir signature. TE BAR OF WISCONSIN Wisconsin Legate" ORM No. 2 - 1998 r T a 0 ° a v o0 a v m 0 IDIOM .` • Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM y: Safety and Buildings Division Count INSPECTION REPORT St. Croix GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 363965 Permit Holder's Name: ❑ City ❑ Village ❑ T6wn of: State Plan ID No.: Lepper., Christopher Star Prairie Township CST BM Elev.:- Insp. BM Elev.: BM Description: Parcel Tax No.: / 2 00 _ & p — p �p a.� 03 8- 1097-7fr699 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ( Benc q S"'0 -C � << Alt. BM C om k n Dosing Lai 2.(04 q(o •9D Aeration Bldg. Sewer Z, 0 r Holding St/ Ht Inlet I I Z ya g 7 jD r TANK SETBACK INFOAMATION St/ Ht Outlet TANK TO P / L WELL BLDG. Ae Ittake ROAD Dt Inlet Septic > S -1, za �"— NA Dt Bottom t(,•l �.} l$ $• �"3 3 S� Dosing I -L ( NA Header/ Man. Z8 I t F. Z Z Aeration NA Dist. Pipe Holding Bot. System 7 rja,crp PUMP/ SIPHON INFORMATION Final Grade Manufacturer a S Demand St cover -oS 3 , ,K' Model Number O GPM �'16 DH Lift q ,`Ili Friction 1.3 / System _. TDH )o.5�t H ead Forcemain I Length D I Dia. 2 " I Dist. To Well y (,b SOIL AB ORPTION SYSTEM BW / REN Width r Le h No Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIM EN N DIMENSION SYSTEM TO P/ L BLD6 WELL LAKE /STREAM LEACHING Manu acturer: SETBACK CHAMBER AP,ac6'r INFORMATION Type Of , i ,/� Moe Number: m Syste: C, • � y ''10� `� OR UNIT — L q G DISTRIBUTION SYSTEM Header / ni old u Distribut e(s) x Hole Size x Hole Spacing Vent To Air Intake Length te/ Dia. Length Dia. Spacin SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS (Include code discrepancies, persons present, etc.) z q Inspection #1:0a /2V CD Inspection #2: ' 1 1 Location: , (SW 1/4 SW 1/4 1 8 T31N R18W) - Rolling Oaks -Lot 9 1.) Alt BM Description= 6�" e '16 ��,p� 2.) Bldg sewer length= 2q• a L - amount of cover = IS t °+ 7`� ra' fa, r Plari revision required? ❑ Yes No Use other side for additional information. p15 0 d o p I I V0 L1A_6&::Et I 1[ 1 1 � *, SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: se m,a. �. �_ ..� m L Al i M� x E ; a _ p r { 1 a { E a r i[ gp � � t a i 55 tt 777 S n E g Sg l s t a ¢ a I ' Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21. Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 ��SCOnSl Personal information you provide may be used for secondary purposes Madison. WI 53707 -730^ Department of Commerce [Privacy Law, s. 15.04( (Submit completed form to county if r 1 m state owner Attach com lete plans (to the county cop) only) f s , skjhLoh pwxr ot less than 8 - 1/2 x 11 inches in size. County State Sanitary Permit Number C if rev�Cion top i s plication State Plan 1. D. Number ti► , ,✓ I. Application Information - Please Print all Informatio - Location: Property Owner Name Property Location c_/ I- Co -I � / C 1 /4. /4, S'T (,N,R�bt or Property Owner's Mailing Address - ST Lot Number Block Number g City, State Zip Code Phape Number Subdivision Name or CSM Number o �1� ° S II Type of Building: (check one) �/ / 3 0e &s., a ❑ City faT- 1 or 2 Family Dwelling — No. of Bedrooms: lb�*e.tf ❑ Village • Public /Commercial (describe use): J.Town of • State -owned :"1 �` .' V__ III Type of Permit: (Check only one box on line A. Check box on line B if applicable) Nearest Road / ;S -/' ry A) 1. KNew System 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Addition to Parcel Tax Number(s) 03� System Tank Only Existing System $) Permit Number _ _ Date Issued ❑ A Sanitary Permit was previously issued 0 +60 -OO /$ IV. Type of POWT System (Check all that apply) .Non- pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade CJ tt -Itt� z�r• -�,..Q Aerobic Treatment Unit ❑ Recirculating ❑ Other: rwo�.P o��J V Dis ersat/Treatment Area Information: 1. Design Flow (gpd) 2. DispersalArea 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate (Gals. /day /sq. ft.) (Min. /inch) � IQ Elevation 4,' Y3 9 e7 r a VI Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks ❑ ❑ ❑ ❑ cy /�d 4 l e �� � � ❑ ❑ 13 ❑ Tv VII Responsibility Statement I, the undersigned, assume responsibility f ^r installation of the POWTS sho . n the attached plans. Plumber's Name (print) Plumber's Signature (no tamps): &PIMPRS No. Business Phone Number dtl.'ll,`a yu s�hu n 'A"el da ?! �` 3 9c Plumber's Address (Street, City, State, Zip Code) C3 6 G p I a.J VIII County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) X Approvcd ❑ Owner Given Initial Adverse S harge Fee) 2 Determination ` IX. Conditions of Approval /Reasons for Disapproval: � 4 Z. SBD -6398 (R. 07/00) a � 4 u Y 3 rye h op n � \ a . 3 u H N PAGE GF PUMP C HAMERR CROSS SECTION) AI`IG SPECIFICAT10kiS VEQ7 CAP 4`C.I, VENJ7 PIPE { WEATHERPROOF APPROVED LOCKIAIG ,IUUCTLOn� BOX �MAIJHpi.E COVER � z5' FRO!'", DOOR, 12 "MiU. wiMDOW OR FRESH AIR INTAKE GRADE 1 I 'i" MtiJ. � IerMlu. COAIDUIT -- --- - - - - -- PROWDE I - --- -- 1lJL'E T _T AIRTIGHT SEAL I I I * I 1 I II I I ALARM I e I I *APPROVED JOINTS WITH j I ELEV. FT APPROVED PIPE PUMP � __j , 7� 3 ONTO OFF D SOLID SOIL COI�ICRETI< BLOCK RISER EXIT PERMI'1TED 01.1L'ti IF TAIJK MAIJUFACTUKF.R HAS SUCI4 APPROVAL~ SEPTIC a SPEC. IFI CAT IOAJS DOSE TAWKS M AWLIFACTUR M ER. , d{�s�e �� �JUDER OF DOSES: PER DAB TAWK SIZE: �S� GALL0IJS DOSE VOLUME ALARM MAIJUF'ACTUKCR: � � /� �� IMCLUDIMG BACKFLOW. 62 l GALLON: MODEL LfUMBER: /J� // CAPACITIES: A= a� IAICRES OR —.� GALLON° SWITCH T!i t<,: Yh ekC g =- = INCHES OR 3 � GAi LOAi: PUMP MANUFACTURER: S C = 8 I NCHES OR — 3 � GALLOAI' MODEL NUMBER: aa��/ D= INCHES OR GALLO 51,JiTCH TYPE: �iCt��;� iJCTE. IN A LARM b STALLED SEPARATE SE RATECIRCUITS MIMIMUM DISCHARGE RATE GPM, VERTICAL DIFFERENCE bETWEEAI PUMP OFF AND 018TRIbUTIOAI PIPE.- . 49 —. FEET + MIAI IMUM NETWORK SUPPL'l PKESSUKE�� . . . . FEET t {- ._ FEET OF FORCE MAIM X bz F /ppfLFRICT1 0 W FACTOR. '� FEET TOTAL OtMAMIC. HEAD FEET ti INTEKKJAL DIMEAISIOWS OF TAQK: L.EM&TH _;WIDTH — .LIQUID DEPTH LfCEQSE WUMBER: W 25;' g 42 DATE: 21 '&Z& ) 31GUE D: i CUZ G '0 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. h heat transfer. . .._. _ i *Effluent systems -- dry wr{ out damage to ■Motor Cover:l'hermoplas • Homes components. Available for automatic and tic cover with integral handle • Farms Motor: manual operation. Automatic and float switch attachment •Heavy duty sump • EPO4 Single phase: 015HP, models include Mechanical points, • Water transfer 115 or 230 V, 60 Hz, Float Switch assembled and ■ Power Cable: Severe duty • Dewatering RPM, built in overload with preset at the factory. rated oil and water resistant. automatic reset. ■ Bearings: Upper and lower SPECIFICATIONS • EP05 Single phase: 0.5 HP, FEATURES heavy duty bail bearing 115 V, 60 Hz, 1550 RPM, construction. Pump: EPO4 built in overload with ■ EPO4 Impeller. Thermo- • Solids handling capability: automatic reset. plastic Semi -open design 3 /4 maximum. • Power cord: 10 foot with pump out vanes for AGENCY LISTING r^ • Capacities: up to 55 GPM, standard length, 16/3 SJTO mechanical seal protection. • canadlm tandardsAvAdetion ''• Total heads: up to 24 feet with three prong grounding • Discharge size: 1 NPT. plug. Optional 20 foot ■ EP05 impeller. Thermo- (CSA listed model numbers perf • Mechanical seal: carbon- length, 16/3 SOW with plastic a design for and in "F" or "AC ".) rotary/ceramic - stationary, three prong grounding plug improved perfor mance. BUNA -N elastomers. (standard on EP05). a Casing and Base: Rugged n the rmoplastic design provides • Temperature: superior strength and 104 F (40 C) continuous p g 140 °F (60 °C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET stainless steel. 10 �.::.. • Capable of running Y dry without damage to s 30 - s components. Pump: EF05 s • Solids handling capability: o z 25f i f 14 maximum. • Capacities: up to 60 GPM. _ • Total heads: up to 31 feet. a 20 ' • Discharge size: 1 NPT. 49 5 • Mechanical seal: carbon- c is rotary/ceramic-stationary, � a 4 BUNA -N elastomers. • Temperature: 10 i 104 °F (40 °C) continuou (fl •S i EPQa. 14 O F (60 intermitt t 9 ,� 2 5 Q 0 10 20 30 40 50 GPM 0 2 4 6 8 10 12 m /h CAPACITY '� Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page ` of 3 Bureau of Integrated Services in accordance with Cam' 3.19 Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in sizPlari mu t County, include, int ki rection an ` s c but not limited to: vertical and horizontal reference po ( BM i ), Goo .fit percent slope, scale or dimensions, north arrow, and location and disiWnce to nearest road. Parcel I.D; # s APPLICANT INFORMATION - Please print all information. Reviewedby Date i Personal information you provide maybe used for secondary purposes (Privacy Law; S. 15.04 (1) (m)). Property Owner Property Location Govt. Lot 1/4SCj 1/4,S T ,N,R E (or)60 Property Owner's Mailing Address Lot # "" _ Block# Subd. Name or CSM# C \ I R_0�oq a City State Zip Code Phone Number ❑ City ❑ Village Town Nearest Road ,, mop') (3) S M New Construction Use: Residential / Number of bedrooms 3 Addition to existing building Replacement ❑ Public or commercial - Describe: Code derived daily flow (o�U gpd Recommended design loading rate y bed, gpd/ft trench, gpd/f1 Absorption area required CS bed, ft 2 trench, it Maximum design loading rate bed, gpd/ft trench, gpd /ft Recommended infiltration surface elevation(s) oe f c 3 7 U L0 ` ` 93. �0 it (as referred to site plan benchmark) Additional design /site considerations k k - 4 r4 1. ) IV r /.ow r � �/ U O Parent material 4; t i Flood plain elevation, if applicable �^ ft S = Suitable for system Conventional Mound In- Ground Pressure AT- Grade, System in Fill Holding Tank U = Unsuitable for system S U I WS ❑ U S U I as d U I ❑ S 1�3)U ❑ S ICU y SOIL DESCRIPTION REPORT j cA� Boris # Horizon Depth Dominant Color Mottles Structure GPD /ft2 tom" g Texture Consistence Boundary Roots ,<.. in. Munsell Clu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench va^�'= IL VIA )s - lC) 3 -' LS Ground -r2r l0 y y 6�5 l ,.. C , �' ;.Ss 3) elev. S•s� ft, ' Depth to limiting 3 7 — y 6g. y factor ' AO in. Remarks: 1 - Boring# ' 0 -16 I0 V 3� Z 2 l6 -�f(l 1 3` Ls 2 +�. rn G < . �) Ground elev. gS70 ft. Depth to limiting ie in. Remarks: CST Name (Please Print) Si gna Telephone No. \ Pry S C_ � oar Address Date CST Number Z t 13 kin }= �-- E yvZ 1 -1-16— 00 S 0 Cl ". 1 PROPERTY OWNER -)-S SOIL DESCRIPTION REPORT Page Z-- of. , PARCEL I.D.# j 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 - 7q tO R 3 Z — -A-b►ti CS �► r S 1 14y to (L Ground �fy n3 (i y — V"� ►•r.1 t g . }� elev. t 2 0 ft, ; Depth to limiting cf3 factor 61- i n. 3 - z- Remarks: Boring # 1 0-7-j tO (L 3 ''L — tMAC3Y� f:VZ c S v •�/ 3 c9 -�I� 1 b 4 — htis O C., Ground elev. 9 boft. ; Depth to limiting - 30 factor Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # 0-30 t� 3 5C aR �S (J� y T OR -k r, to tz `t `i ►� cS �) Ground elev. QS y0 ft• ' Depth to limiting ; factor =1'- in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R.9/98) 1 1. PAGE S OF3 NAME <, w c LOT# ! LEGAL DESCRIPTION 540/6��, S / ej 3l ,N,R r rE (or) SCALE: I "= /(` o j BM 1 ELEVATION 0 Cam' U BM I DESCRIPTION ti« , BM 2 ELEVATION S ' 3 S 4M 2 DESCRIPTION }oq v S Iz, ,, P'pc lat k TIlF SYSTEM ELEVATION «car 93.7V Goa✓ e r �3•l6 t — fi — ALTERNATE ELEVATION uy0er43 7QLow � 93 Q Qp r CONTOUR ELEVATION • 3 I AC A y • I �m SIGNATURE DATE