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HomeMy WebLinkAbout038-1080-40-100 Wiscona41 Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 463072 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: Wiederin, Brian Star Prairie TownShi 038 - 1080 -40 -100 CST BM Elev: Insp. BM Elev: BM Description: SectionlTown /Range/Map No: /� i 1� \ �. c j ^ 19.31.18.332A TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic 14 � (� Benchmark Dosing Alt. BM Aeration /� Bldg. Sewer Z c ` Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet \ TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic ' , r i Dt Bottom Dosing 1 Header /Man. 9� 5 j6o J6 Aerations �, } Dist. Pipe , t - `� '3 H ing � ti Bot. System PUMP /SIPHON INFORMATION c___ Final Grade e 9 Manufacturer mand St Cover G 240 e-1 GPM -Oq Model Number f � c � q5r TDH Lift Friction Losp System ead TD t 2— 1 TZ� (, .1� . s9 Forcemain Leng, i Dia. .1 Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width i Length /� No. Of Trenches PIT DIMENSIONS NQ Of Pits Inside Dia. Liqu+d Depth DIMENSIONS `J ,64 �` '�`•� `� Ito +.7 � e'er. •'._ SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacture 0� INFORMATION CHAMBER OR IS Type Of System: r / i UNIT C ° (�� --i5 . / Model Number. t / /\J DISTRIBUTION SYSTEM S�eA 4q Header /Manifold Distribution x Hole Size x Hole S acing. L Vent to Air jntakg \ L e )� ` Ike w v� Length Dia Length Dia Spacing ` Env. 1 ��•� 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 D No � Yes Fq No F ► ".� COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: 1 / Inspection #2: / i Location: 834 205th Avenue Somerset, WI 54025 (SE 1/4 NW 1/4 19 T31N R18W) NA Lot 1 Parcel No: 19.31.18.332A 1.) Alt BM Description 2.) Bldg sewer length = amount of cover rte' Plan revision Required? !Yes Use other side for additional information. No "�� C __- "' _ SBD -6710 (R.3/97) Date Insepctor s Sigrture Cent. No. Sanitary Permit Application Safiety & Buildings Division In accord with Comm 83.2 1, Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 1 14 sco nsin . Personal information you provide may be used for second p urpose s Madison, WI 53707 -7302 Department of Commerce p Submt completed form to county if not [Priv w, s. 15.04(1)(m)] ( i p ty state owned.) Attach complete plans (to the county op y) r the system, on paper not less than 8 -1/2 x 11 inches in size. County State Samtary Permit Nn her ❑ heck if re vision to previous ap plication State Plan I. D. Number l"o ` > 7 Z I. Application Information - Please Print all Information Location: Property Owner Name Property Location J�' i s c A Q � 1/4 AW14, S& T,3 ,N, R� Property Owner's Mailing Address Lot Number 8�aelettxber ZONING OFFI';F City, State Zip Code Phone Number Subdivision Name or CSM Number 50 /71L e- Z'IT � ( 71:za4 qq 7 f- x v� /'w 2 P'2 n !% II. Type of Building: (check one) ❑ cit K 1 or 2 Family Dwelling - No. of Bedrooms : ❑ Village Public/Commercial (describe use):_ �� /" gTown of ❑ State -Owned lb ,� q �f l o Nearest Road , o lJ ImoV" Parcel Tax Number(s) III. Type of Permit: (Chec line A. C heck box on line B if applicable) — 1 0 — — 1 0'0 6 33 ?_ A) 1. ❑ New eplacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System System Tank Only Existing System B) Permit Number Date Issued ❑ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) .121'!Non- pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating Other: 3 so 1� V. Dispersal/Treatment Are Inform 2 4 1. Design Flow (gpd) 2. Dispersal Area 3. Disper a 4. Soil Application 5. Percolatic —' Rate 6. System Elevation 7. Final Grade--' Required Propose 15,3 . I Rate (Gals. /day /sq. ft.) (Min. /inch) rt- , / �q Elevation /S eve T ,, z._ yY s 7 VII. Tank Capacity in otal # of Manufacturer Prefab Site Steel Fiber- Pl Information Gallons Gallons Tanks Con - New Existing crete structed Tanks Tanks O �, VIII. Responsibility Statement I, the undersign assume res ponsibility for installation of the POWTS shown on the attached plans. Plumber's Name (print) r J Plumber' ignature (no stamps): MP/MPRS No. Business Phone Number P s m Address (Street, City, S , Zip Co e IX. Count epartment Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issu ipk Agent Signature To stamps) P 4 Approved ❑ Owner Given Initial Adverse Surcharge Fee) k Determination 25 7ft X. Conditions of Approval /Reasons for Disapproval: 3),�Cw a , SYSTEM OWNER: co� 1 Septic tank, effluent filter and dispersal cell must all be serviced i maintained as per management plan provided by plumber. 0+- �� � nn .[�_ 2. All setback requirements must be maintained g 3 , SISei t $3 racQe a �zo►� °=�' T a� D. 2 yr aoQ2 . SBD -6398 (R. 07/00) I � _ PLOT PLAN PROJECT Brian Wiederin ADDRESS 834 205th ave Somerset Wi. 54025 SE 1/4 NW 1 /4S 19 /T 31 N/R 18 W TOWN StarPrairie COUNTY ST. CROIX MPRS Byron Bird Jr. 220527 DATE 9 -21 -04 BEDROOM 4 CONVENTIONAL -Grade CONVENTIONAL LIFT XX HOLDING TANK MOUND SEPTIC TANK SIZE 1250 gal combo LIFT TANK SIZE750 gal combo DOSE TANK SIZE HOLDING TANK SIZE a LOAD RATE •4 ABSORPTION AREA 1500 # of chambers 49 BENCHMARK V.R.P base of steel fence post ASSUME ELEVATION 100' ❑ BOREHOLE O WELL *H.R.p„ Same as BM Vent SYSTEM ELEVATION T -1 =94.7 T -2 =94.5 T -3 =94.3 > 12" Of Bio Diffuser with Cov 3 1. 1 ft ^2 per chamber 6" Long 34" Elevation Shed B2 2A BM � -%, 75' Alt BM 100' 94; k 30' "� L O ob pipe 100' 75' 9F well 40 45' , Old septic 4 bed house 205th ave 'I 1 � . PLOT PLAN PROJECT Brian Wiederin ADDRESS 834 205th ave Somerset Wi. 54025 SE 1/4 NW 1 /4S 19 /T 31 N/R 18 W TOWN StarPralrie COUNTY ST. CROIX MPRS Byron Bird Jr . 220527 DATE 9 -2 1 -04 BEDROOM 4 CONVENTIONAL -Grade CONVENTIONAL LIFT XX HOLDING TANK MOUND SEPTIC TANK SIZE 1250 gal combo LIFT TANK SIZE750 gal combo DOSE TANK SIZE HOLDING TANK SIZE a LOAD RATE .4 ABSORPTION AREA 1500 # of chambers 49 hk BENCHMARK V.A.P base of steel fence post A SSUME ELEVATION 100' ❑ BOREHOLE (D WELL *n.R.p„ Same as BM Vent SYSTEM ELEVATION T -1 =94.7 T -2 =94.5 T -3 =94.3 >12" Of Bio Diffuser with Cove 3 1. 1 ft ^2 per chamber 6 6' —Gradent System Long 34" Elevation Shed B2 ..._ 2^, BM 75' ' �yy" Alt BM 100' 943 30' tik, PL O ob pipe 100' 75' 9f well 40' 45' , Old septic 4 bed house 205th ave R1 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. R iewed by Date / Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04(1) (m)). (- 2 Z70 `F Property Owner ` Property Location �� R/115' 1 Govt. Lot �� 1/ 4 S T/ N E Property Owner's Mailing Address Lot #/ Block # Subd. Name or CSM# City State Zip Code Phone Number ❑ City [I Village Town Nearest Road o rx %� • ° o?® f/ f ❑ New Construction Use: sldential 1 Number of bedrooms Code derived design flow rate � ® ,rte GPD $KR eplacement ]Public or commer ' er Parent material G cc. 4 � Flood Plain elevation if applicable ff. General comments 7 and recommendations: F I Boring # Boring Pit Ground surface elev.. 3L 4 ft. Depth to limiting factor 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 O --t D r G qq- 7o (oo U Boring # Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Or Y 91 31D Z`f o * Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (PI se Print) i , Sig CST Number ,.. 4 ;0 r -7 Ot;v Address Date Evaluation Conducted Telephone Number Alf ,, S Property Owner kL Af e Par Page of Boring # Boring Cfb 5 _ E] pit Ground surface elev. ft. Depth to limiting factor 7� in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlfF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F—I Boring # E] Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I *Eff#2 F—I Boring # ❑ Boring El Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I *Eff#2 * Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 150 mg/L * Effluent #2 = BOD, < 30 mg /L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 - 264 -8777. SBD -8330 (R.07 /00) L Soil Test Plot Plan Project Name Brian Wiederin Byron Mird Jr. Address 834 205th ave Somerset Wi. 54025 CST #220527 Lot 1 Subdivision Date 9 /21/2004 County CROIX SE 1/4 NW 1/4 S 19 T 3 N/91 W Township Boring a Well PL Property Line# Alt. BM top of steel fence post ,BM or VRP Assume Elevation 100 ft of steel fence Post System Elv T -1 =94.7 T -2 =94.5 T -3 =94.3 H.R.P Same as BM SCALE 1" = 40 ` Unless otherwise Noted Shed 24' BM 75' 501 slt 50' Alt BM 94 30' PL 100' 95' well 40' 45' Old septic 4 bed house 205th ave PAGF GF PUMP CHAMBER CROSS SECTIOIJ AUD SPECIFICATIMS VEIJT CAP 4`C. I. VENT PIPE WEATHERPROOF APPROVED LOCKIAIG '. 25' FROM DOOR, JUNCTIOAJ BOX MANHOLE COVER WINDOW OR FRESH 12 "MIN. AIR INTAKE I GRADE I 4" MIIJ. CONDUIT - ---------- 18 "MIN. �\\\ ---- - - - - -- IAILET PROVIDE I — - -- AIRTIGHT SEAL *� A I I i i i I I III ALARM d I II I I o *APPROVED I ow JOINTS WITH I ELEV. FT. APPROVED PIPE I 3' ONTO PUMP OFF D SOLID SOIL CONCRETE BLOCK RISER EXIT PERMITTED OWLS IF TANK MAOUFACTURER HAS SUCH APPROVAL. SEPTIC f SPEC IFIGATIOh.IS DOSE l TANKS MAN UFACTURER: IJUMBER OF DOSES: PER DAB TAWK SIZE: r.24 GALLOWS DOSE VOLUME ALARM MANUFACTURER: /.cc s G7ct -tom INCLUDIMG 6ACKFLOW: GALLONS MODEL AIUMBER: A C CAPACITIES: A= NICHES OR GALLOWS I SWITCH TYPE: INCHES OR i 6 = � GALLOWS PUMP MANUFACTURE '� `� C = INCHES OR GALLOWS MODEL NUMBER: ✓ D= INCHES OR GALLOWS j SWITCH TYPE: ( '� MOTE: PUMP AUD ALARM ARE TO BE MIMIMUM DISCHARGE RATE GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFEREMCE BETWEEN PUMP OFF ANO DISTRIBUTION PIPE.. FEET O + MIIJIMUM IJETWORK SUPPLY PRESSURE . . . . . ' FEET + A �! FEET OF FORCE MAIN X _ =� F /Ipp FxFRlCTIO J FACTOR.._ FEET TOTAL Dy1JAMIC HEAD = f' FEET IWTERAIAL DIMEWSIOWS OF TANK: LENGTH ;WIDTH ;LIQUID DEPTH 7 d 51GUED: LICEMSE WUMBER: �/ DATE -2 • 2 TOTAL DYNA C HEAD /CAPACITY HEAD CAPACITY CURV }; P MINUTE EFFLUENT D DEWATERING N MODEL 152/1.53 w MODEL 152 153 50 "� Feet Meters G Liters Col. i s I 153 5 1.5 60 261 77 i 12 40 10 3.1 61 231 70 152 0 15 4.6 5 201 61 x 20 6.1 4° 167 52 30 ' 25 7.6 3 129 42 >_' a 8 30 9.1 23 87 33 ? 5 0 a 20 35 10.7 w — 221 '5 o.. 40 12.2• 4 Lock Volve: 38 'Ft. (0.6m) 44.0 Ft ( gy 10 *. 014505 r 20 40 60 80 100 ' GALLONS LITERS ' 81/4 0 80 160 240 320 3 27/32 4 5/8 FLOW PER MINUTE 3 2, CONSULT FACTORY FOR SPECIAL APPLICATIONS ' • Timed dosing panels available. 3 2 • Electrical alternators, for duplex systems, are available and supplied with 1 an alarm. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level, float switches are available for variable level long and short cycle controls. • Sealed C!wik -Box available for outdoor installations. See FM1420. • Over 1317F. (54°C.) special quotation required. ry. 1521153 Series 12 1/8 -- - I 1521153 MODELS Control Sele ction Model Voi t •PP Mode Amps Simplex Duplex N1 52 i 11 1 Non 8.5 1 2 or 3 BN152 115 1 Auto 8.5 Included _ 2 or 3 1 i E_152 230 1 Non 4.3 1 2 or 3 r BE152 230 1 Auto 4.3 included 2 or 3 LN153 115 1 Non 10.5 1 2 or 3 { i B N153i 1`E5 1 Auto 10.5 Included 2or3 SEC it E153 230 1 Non 5.3 1 2 or 3 1. Single piggyback variable level 1f switch le plggyba:.K variable level ri()a! B E153 230 1 Auto 5.3 Included_ 2 or 3 switch, Refer to FM0477. I A CAUTION 2. See FMO712 for correct model Electrical for E -Pak. Ail installation of controls, protection devices and wiring should be done by a qualified 3. Variable level Control Switch 105 used a trol activa� specify dup*�' licensed electrician. All electrical and safety codes should be followed including the most Or 4 float sys ' recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). () RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of a Zoeller MAIL TO: P.O. BOX 16347 --- •••��� touisvi8e, KY 40256.0347 Manta ' of . . Zo • SHIP TO: 3649 Cane Run Road Loulsville, KY 40211.1961 Queu MPS S X91179 (502) 778-2731 - 1 (800) 928-PUMP PU /V // FAX 774- 3624 s http: / /www:zoeller.com © Copyright 2000 Zoeller Co. All rights reserved. f POWTS OWNER'S MANUAL & MANAGEMENT PLAN Pa of FILE INFORMATION SYSTEM SPECIFICATIONS Owner f ^ Septic Tank Capacity a l ❑ NA F �lt # 9 3 Septic Tank Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer k b ! ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units NA Pump Tank Capacity 2 4 — a l ❑ NA Estimated flow (average) 4t.> gal/day Pump Tank Manufacturer 1 4 NA Design flow (peak), (Estimated x 1.5) O d al /day Pump Manufacturer ❑ NA Soil Application Rate - al /day /ft' Pump Model ❑ NA Standard Influent /Effluent Quality Monthly average* Pretreatment Unit ❑ NA Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD :5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) _:150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD 530 mg /L `%In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) 510 cfu /100ml ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y. in dia. ❑ NA Other: ❑ NA Other: 0 NA Other: ❑ NA `'Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: month eaarrls) (s) l (Maximum 3 ears) 11 NA Y Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume A NA Inspect dispersal cell(s) At least once every: ❑ yea�(s)(s) (Maximum 3 years) ❑ NA Clean effluent filter At least once every: ❑ month(s year(s)) ❑ NA Inspect pump, pump controls & alarm At least once every: ❑ month(s) ❑ NA ❑ year(s) Flush laterals and pressure test At least once every: ❑ month(s) ❑ NA ❑ year(s) Other: At least once every: ❑ month(s) ❑ NA ❑ year(s) Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire disposed of in accordance with chapter NR 113, contents of the tank shall be removed b a Se to a Servicing Operator and p P Y P 9 9 P Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (4/01) I � , Page of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are'detectod have the contents Y P P 9 P 9 of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. • The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. • Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name ; Name Phone Phone SEPTAGE SERVICING OPERATOR (PUMP ) LOCAL REGULATORY AUTHORITY Name Name Phone 5" Phone This document was drafted in compliance with chapter Comm 83.22(2)(b)0)(d) &(f) and 83.540), (2) & (3), Wisconsin Administrative Code. ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM owner/Buyer Mailing Address r A Properly Address (Verification required from Planning Department for new construction) City /State Parcel Identification Number Q 35 -- log ~ 4 - ao f 3 3 Z A) L E GAL DESCRIPTION Property Location ' /4, ` /., Sec. L N -R W, Town of 41X6r h Subdivision . Lot # Certified Survey Map # q W , Volume fi . _Page # 2 0 19 Warranty Deed # (p 7,2 l , Volume /A Page # 20° Spec house ❑ yes [1 no Lot lines identifiable Y yes a no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a mastorplumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 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 days of the 99ce year ex iration date. SFG OF APPLICANT 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 owners) of the propeA described above, by y of a warranty deed recorded in Register of Deeds Office. /O SIGNATURE OF APPLICANT ATE D « « « « «« Any information that is mis- represented may result in the sanitary permit being revoked by the Z eP artment. " "" •« 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 1.50I9PAr.1 286 6227Q1 STATE BAR OF WISCONSIN FORM 1 - 1999 KATHLEEN H. WALSH Document N4ber w TY DEED REGISTER OF DEED This Deed, made between Brian J. Wlederin and Rita M. RECEIVED FOR RECORD Wlederin, husband and wife, 05 -09 -MO 10:00 AM WARRANTY DEED -- - -- ._._... - -• . - - _- - - - EXEMPT t 16 Grantor, and Brian Wietterin atad Rita Wiederi '1Ytes or th eir EXEM COPY FEE: __ ... successors in trust, U er a an ll;ito I �fivin frost, COPY FEE: datedll�srch - T,O, sand aeueo� t fs roreio. _. -- -- TRANSFER FEE: RECORDING FEE: 10.00 PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described heal estate in Saint Cro ix County, f Wisconsin (if more space is needed, please attach addendum): Lot " ' of Certified Survey Map, filed May 18, 1989 in Volume 7 of Lot Survey Maps, Pi�e 209�8 document No. 44 7928, being a part of the Recording Area Southeast Quarter of the Northwest 1 /4 of NW 1/4) of Section Name and Return Address Nineteen (19), Township Thirty -one (3 1) North, of Range Eighteen (18) Joseph P. Earley West. 539 South Knowles Avenue New Richmond, WI 34017 And: Part ofNW1 /4 of Section 36 -31 -19 in the Village of Somerset described as follows: Lot 2 of Certified Survey Map filed June 3, 1988 in Volume "7 ", page 1979, (NO. 51) EXCEPT the West 120 feet thereof, now tl038 1080.100 is homestead do 181 - 1001 - 43 is being Lot 9 of Certified Survey Map filed March 12, 1993 in Volume "9 ", not homestead. page 2599 (No. 62). - - -- Parcel Identification Ntmrbcr (PIN) Together with all appurtenant rights, title and interests. This shove _- „ homestead property. shave - -- (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except easements and other encumbrances of record. Dated this day of 2000 • Brian J Wlede • Rita M. W iederin • AUTHENTICATION ACKNOWLEDGMENT Signature(s) [m J. Wiede and Rita M. Wiederlo, husband STATE OF WISCONSIN ) and wife, ) ss. -- County ) a Fhenli this - day of 10 / 2000 - - - - "' Personally came before me this _ day of -- 2 000 the above named ' arl ey TITLE: MEMBER STATE BAR OF WISCONSIN ..-- -.-_ —_ -. -...... _._ .. _ - (If not, to me _ -- -- -. own to be the persons) who executed the foregoing instrument and acknowledged the same. authorized by ii 706.06, Wis. Stets.) THIS INSTRUMENT WAS DRAFTED BY + Joseph P. Farley, Attorney - - - Notary Public, State of Wisconsin My Commission is permanent. (If not, state expiration date: (Signatures may be authcnticated or acknowledged. Both are not necessary.) .- - -.— - _ - -_. __ -_ - __ _...... . , _ - - - -- ._ . ' Names of persons signing in any capacity must be typed or printed below their signature. mronn.tim vruraww,rr cmw Fond du Lac, vin STATE BAR OF WISCONSIN 800 WARRANTY DEED FORM No. 1 - 1999 �aY a 8 0 81g8g� Q 9 441928 o CERTIFIED SURVEY MAR ..Located in the SE 1 /4 of the NW 1 /4 of Section 19, T3 IN, R 18W , Town of Star Prairie, St. Croix County, Wisconsin. Surveyed for: Pat. Belisle Rt . 1 Box 124H Somerset, Wi. 54025 __VX RL A_T-T F-D — L.AllD.a _ S 88'41'38 0 E 484.02' [ BARN W Z m LOT I cj c o 198295 SO. FT. ( 4.552 AC.) z� J1 eN o INCLUDING RIGHT - OF - WAY _ O! J) W W 182640 SO. FT. ( 4.193 AC.) ti F • M EXCLUDING RIGHT -OF -WAY a1 M o F- N HSE. / W + A ZI . �I o q_ DRIVEWAY / o _1 z GA POND N o ( / M �� 1 ' o � S 89 31' 21 "E 9 M S 89'445' 52'E 498.96' 1 n 4 _ 879.92 -in 3063.41' N _ M ;h � N 89'31'21 "W 500.13' CENT A VE. WEST I/4 COR. E I/4 COR. SEC. 19 T31N,R18W EAST - WEST 1/4 SECTION LINE SEC. 19 iE NOTE = SECTION CORNER z 3 LOCATION FROM TIES. F ' o- N W W M1 LEGEND W x t•- o z SECTION CORNER MONUMENT o W o F. W 0 I "X 24 ° IRO N PIPE kEIGHINGt. o Z2 1.68 LBS. /LIN. FT. SET. W'�U N --A FENCE LINE w o a • z ~ 3 U. Wco SCALE IN FEET 1" = 100 ' it N FM j 100'75' 50' 0' 100 200' Z •' UHF' !y W W . HARVey m 3 °_' JOHNSON S 8_f898 WIS N ft qk0 S APPRO I MAY 1 1989 489- 1555 Sr.CROIXCOUNiY DRAFTED BY JWG VOLUME 7 &.GE 2098 wE PARKS PtAN�V 4G NVOZ0N 1NGCOMWTrFF PUM PERFORM PUMP •' �1 I� .. PI" . N■ \ ■ ■ ■■I ° °e ° ° °ee° ° ° ° °o ° °ee ® ° ®® ■OLIN ■ ■ ■I� ® ° ° ° °e °e °° °e °eases °ee ,� \ ■ ■ \ NNOI� ® Mme ° ° ° ° e ° °o ° ° ° e ° ee ° ° e ° o0 N \■LI■■■�� °e0 ° °e °ems■ ° °e °oeeeeeee ' O LIO N■■■ ���m ° vem ° ° ° e ° °e ° ee ° e ° e ° e ° e ° e ° a ° e ° ee NEW \1 \ ■ ■I���vee°° °awe ° vem°°°°°° °e°° °e °e °e°° :, \ \ \ \i��N ■iiiiiiii i \ \il\ \ \ ■ ■ ■ ■ ■ ■ ■ ■■ \ \ \ \11 \�NNN\ \OLIO■ a ®� 0��0 \\ \1111 \ \ ■ ■ \ \ \iiOO �C �o �����►�n■MNN►RNNN ■ ■■ ® ®�ie� ©mom 121 a% L IEEE ■\N\ ilk IxIa V \\NNN�■ a a al C L% 0 1, a a m, 0 0 0 M ILI Model 185/4185 should not be subjected to 5J iii ®iii ■ii ■ ■ ■ii less than 30 feet NOTE: For Pump P erformance on Model 11 2, Industrial column ' proof pump, see FMO21 9 SEWAGE AND subjected to less than 15 feet TDH. ®���■ ®�os��0omo0oa ® ©���mv00�v0� ®0s��0 ®�s0��m ®vm ®�m0o ©� ®gym ©ms��� ®ass�s�0�s�a�o ®mom ®m�v m ®0s�s�ss0��ass�ss0ov0om ®� a ®as��s�as�s�s���ss�osoo0® 11 r - - SUGGESTED METHODS OF FLOAT INSTALLATION On some installations it may be desirable to install an independent hanger for the level control switches to avoid possible hang ups on the pumps, piping, valves, etc. Float hangers are available from Zoeller Company on Catalog Sheet FM0526 or can be fabricated from standard pipe and fittings. ACCESS COVER STANDARD PIPE FLANGE Li . 10 -1457 FLOAT TREE WITH 3 FLOATS SHOWN f PVC OR LIGHT WEIGHT PEAGRAVEL STAINLESS STEEL PIPE SK1217 TYPICAL FLOAT HANGER ON CONCRETE PITS SK1218 TYPICAL FLOAT HANGER ON STEEL COVER PITS OR SEPTIC TANK RISERS "EXTRA PROTECTION SYSTEMS" TWO PUMP SYSTEM ALARM The "Extra Protection" Two Pump system is an economical solution to the costly duplex alternating PIN B OX A ILLUSTRATED pump system and it's easy to Install. WUNCTION BOX AND PLUG NDT INCLUDED) The "Extra Protection" Two Pump Systems consists of: a. The two nonautomatic pumps with VLFS of your choice b. One Alarm System c. Two Unicheck Valves as required ADVANTAGES (1) The Two pump systems offers high pump performance without the high price. It is a system that PEAGRAVEL fits your needs and your budget. I (2) Delivers more dependability than a single pump system and greatly reduces the chance of costly and time consuming problems associated with wear out or damages and the resulting system failures. <; AARM ON PUMP 2 O •/ r PUMP ON (3) Affords greater satisfaction and peace of mind to all concerned by providing state of the art protection UM P 2OFF for costly and expensive surroundings. ® PUMP I OFF VARIABLE LEVEL FLOAT SWITCH (4) Ability to change lead and lag positions by changing pump plug connection. it SK878 (5) Easy and economical to Install. 'MINIMUM DISTANCE 2' BETWEEN PUMPS THE BASEMENT SENTRY 12 Volt backup sump pump system model 507 & model 510 Application - For Clear Water, emergency backup usage when power is off or primary pump fails. Extra Protection - When the primary AC pump fails due to power outages or system problems. • Storms • Brownouts • Wiring or electrical problems Extra Protection - When the primary pump fails to keep up with excessive water due to rain or overloading. Includes: Pump and control MODEL 507 MODEL 510 a . F tting TDH (ft) Flow (GPM) TDH (ft) Flow (GPM) g s r Battery Case 5 23.2 5 33.8 - (Battery Not Included) 10 12.5 10 21.6 14 Shut -off Head 15 10.6 For submersible or pedestal installations. 1 1 19.9 Shut -off Head See FM 1311 (507) or FM 1139 (510) for information. Suitably sized basin required. © Copyright 2004 Zoeller Co. All rights reserved. 5