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038-1095-60-200
Wisconsin D artment of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and 64ddmg Division • 1 INSPECTION REPORT Sanitary Permit No: 405141 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: Schaffer, Tim Star Prairie Township 038-1095-60-100 CST BM Elev: Insp. BM Ellev: BM Description: eo • fl/ W E • 8 TANK INFORMATION I ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic e t 5 _ cob 4,00 Benchmark tom/ 0b Dosing ,t r Alt. BM 6 � s 9Z 1 Aeration Bldg. Sewer Holding St/Ht Inlet !� • ���/ St/Ht Outlet � TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic > S-D I k ' Q / Dt Bottom � •� � Dosing u Header /Man. Aeration A16 +crS Holding Bot. Systefn f Final Grade PUMP /SIPHON INFORMATION taw - Manufacturer Demand St Cover p GPM �•�� (Z�Z.t� Model Number U Igo 31 l L-_. TDH Lift Friction Loss System Head TDH Ft Forcemain Length D 1 Dia. t t Dist. to well M� SOIL ORPTION SYSTEM 1 jwo(rRENc idth Length INo. Of Trench s PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIM s 3 �`� SETBACK SYSTEM TO P/L L G WELL LAKE /STREAM LEACHING Man cturer: INFORMATION CHAMBER OR 1000 �1"� Type Of System: _ 1 � — UNIT Model Number: {' D � DISTRIBUTION SYSTEM j r ?-1 31 , Header /Manifold �l Fistribution x Hole Size x Hole Spacing Vent to Air Intake . Length Dia ength Dia Spacing 7 SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over IDepth Over xx Depth of V xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes ❑ No ___ Yes Li No COMM EENTS' (Inc de cco c4screpenci pseerrso ❑ent, eetcn)r(1�� lns Ltion y Inspection #2: Loca 0 1298 20ve New Ric o t�40� ( /4 114 23 T31N R18W) NA L Parcel No: 23.31.18.399C20 1.) Alt BM Description 2.) Bldg sewer length = V - amount of cover = 3.e4AQ,4 -00 E ' -4`l44". Plan revision Required? f a Yes ;K No Use other side for additional Information. �^ '� 1 ___ • _ C "_ SBD -6710 (R.3197) Date Insepctor's Signature Cert. No. Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 405141 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: Schaffer, Tim I Star Prairie Township 038 - 1095 -60 -000 CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold I D istribution I x Hole Size x Hole Spacing Vent to Air Intake Pipes) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of ded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil xx Seeded /Sod Yes E] No D Yes : No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 200th Ave Unknown (SW 1/4 SW 1/4 23 T31 N R1 8W) NA Lot 4 Parcel No: 23.31.18.399C 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? r] Yes ❑ No Use other side for additional information. Date Insepctor's Signature Cart. No. SBD -6710 (R.3/97) Safety asd RMHAW Divmm 201 W. Who. Art.. P A. Box 7162 ,x _ !!B Madbmw W[ - -1112 rite Addirm Dep artment of ComnWwCee 6 �o� Z� 2 J &MUR" Paemit APO on smiWa ' m a000rd %ja Comm 83.21. Wis. Adm, cods. peraoaal b tsmodom Yom ptv"U 0 Cheep i< Ravision my bt reed for Law, 215. 1 L AppSoMon b0nusdaa - PMase Td a AN Wormadom SUM Pis LD. Nvmbar Pnoperw owm s Nasse Parcel Nm<ber 23. 3!• !F. 1qqC, S . e .,, - r -.,9 -toD _ Q O M k owner's MWW Addraa U,IV3002 Location lari owne S 1 , ;, C,a �u-:�u5 cw+A• s T31 N. R 1 li (yip, zip Cade Lot Bloch mater FILE Na (Q me ' c s�� to II. Type of Btu (ektek sB SO tyrp4►) Ott K 1 ar 2 Pe* DweHkg - Namber at BeBrooms ✓ 2 . ovvkw — 0 State owned // f' Nearest Road � IIL Type of pwoft (Cho* o* ottt: bw oe Em A ( seMote toe WMW asc). COMOSOF&W E it WBOMO A. 4�7 2 0 Ugbc s M Symms 3 0 Repiooasomt of 6 ❑ Ad8'ioiW 0 P ` CNN* m 15mic Date Issued NINON B. 0 cma it Saaitmy P Pnvbm* howed Parruit 1V. Type at rw=k: %3k** an am ePpm <tclsesse is hr 6adertsd tme) // �� z 4s - Prssotrimsd �oamd 210 Mamd 47 0 Sand 1�4er Caestrocted wtdand �l�n med m-0romnd 410 Holdiud Tart 48 0 go& Pats SI ❑ Drip Lime Mko; . 43 0 Aatir+rds 46 0 lueobic Tleatetsss Quit 49 0 30 0 odw V. Ards teLeuediso: D� Pt, t� Ana D� Ana App�os t+eisatrtis. Rote Systaom Fflevatios Find evade Ro*d d rrapa ea� RaWGwJs- lDaystSq^) *AkLnoclt) 2 l 1 1 a. ! a C Ptebb Sits Sled Fiber Plastic VL Tsok Info cwmdw its Tad Numbir der Gall ( Wbm ofTanb /�' _ n d �( j 31/� Comm Communed oloss Now RtSlft C �Q1.cJlu Tab tmb Srptle CT 1�<k c 2 I Daunt CMN*w VII. lsottoome - 16 of t>te Pown aYos+s m de uUmebad s v mt a f1dPf S Nmsber Bnsb= Pboae Nrimba s Address (SWOM City. State, 24 Cade) mom, C� VIIL Use ollb A Sanimy Par m& Pat (Wchwes cwx dwm" Dm broad Si vm sm"ps) Pet) 0 owed Gmm lsod Admw '1'l � �l 0 a Dstsrooie0000 Ob` G cRtlfiZQft tR t)VOI ) m S c h �e e c.- / oZl ohm ' rte- OYY\� k� - l cs. " LO 5X& l 7 A 8m m ��� w�� ��� � � � an a I re�nc�, 6S,75 e / 9l 4 aa.._ C 0 r � S— i 3 I N v 1 � X117' __ G% �}to i m - ���---- -. SEPTIC TANK E PUMP CAAMBER CROSS SECTION AND SP£CIFI TI Y 4" CI VENT PIPE 7.2 MIN. ABOVE GRADE £ WEATHER PROOF • 25' FROM.DOOR, WINDOW OR JUNCTION BOX APPROVED FRESH AIR IfiTAKE. WITH CONDUIT MANHOLE COVER __- W/ PADLOCK & 61, CI RISER . RISER _ z WARNING LABEL 6 � --•- -� --- ABOVE G AD E — �--�__ 4 t+ MIN. 1 11 T1 I N TIILET s t t WATER TIGHT SEALS GAS- TIGHT E 4 11 r� loo A SEAL l APPROVED CI PIPE ---- i ALM JOINTS W/ Cl 3' ONTO B ON PIPE 3' ONTO SOLID - _f i f SOLID SOIL r�99 C SOIL PUMP OFF El.EV.. FT �-- -- r OfF �c�t RISER EXIT D PERMITTED ONLY IF. TANK . MANUFACTURER HAS APPROVAL 3 APPROVED BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS SEPTIC l DOSE TANK MANUFACTURER: iQ5 Qr�s NUMBER'DOSES PER DAY: ` TANK SIZES SEPTI b GAL. DOSE VOLUME INCLUDING DOSE a oc> GAL. FLOWBACK:. GAL. ALARM MANUFACTURER: EA leC rt�l CAPACITIES: A = INCHES = dr GAL. MODEL NUMBER: f►�,.� �� SWITCH TYPE: B = 2 INCHES = GAL. PUMP MANUFACTURER: C = Q q INCHES = j�� GAL. MODEL NUMBER : w SWITCH TYPE: D = 7 ( INCHES = J/ S;S� GAL. REQUIRED DISCHARGE RATE GPM PUMP 6 ALARM WIRING AS PER ILHR16.23 VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE � ( FE�T + MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . 2.5 FEET + — FEET FORCEMATN X /, T /100 FT. . � FRICTION FACTOR " . �,� FEET 2,' aF-3o' _ 2S T.OTAL DYNAMIC HEAD = FEET INTERNAL MENSIONS OF PUM TANK: LENGTH ^ ; WIDTH ; DIAMETER LIQUID DEPTH Be tter Way ♦ 8 ap o er UtIIL'S: " X1 t ♦ lltux s °i �8� � ♦ L ouvers vc � " O pen " - ♦ S idev ra U ♦ Very CCO P �ce Alax1mkes "Mn Sh 9voc Y Id �+e, ct in Sine of unmasked provides the o a blective is �fe lea�g Surface um amount I o design mashed side�+►all toia low en bott and pillary action In effl to chieved all directions. This flow via SPECIRCq g by combining the tra � ,- o n °m with a has been d ffluent series of to ditional, ope Le ngth........:.. 7 &. Prvfiie Unit °n8 thee the chamber flows tong the sides. wh..... .....34r J. Length . ... .. 76.. o uncom +yht ...........14" i' W>c� ..... a f l 34 e designed to h of each l�cted co allow effluent ide. The louvers !'nVert ...............9 , H81ght ........... 11 mPacted backfill ent to pass into the 8100ifft Invert...........6.5- Orating into the chambers , while preventing it from J�� of eithe size when iEE '! O 2" or 17", withsta to h n`el H t Q - 20 ver tors 31,1 Goulds a Effluent Pump 3885 R i r r r APPUCATIOINS • Overload protection must smooth operation s l icon can be operated continuously be provided In starter unit: brumm Impeller available as without damage. follo designed for the a Shaft: threaded, 400 series an op Homes tion , m e s uses: stainless steel. -., ■ Hearings: Upper and * ■ Casing_ Cast iron volute lower heavy duty bail bearing Farms • Bearings: halt bearings type for maximum efficiency, construction. • Trailer courts • upper and lower. 2' NPTdischarge adaptable ■ Power Cable: Severe duty • Motels Power cord: 20 foot for slide rag systems. rated, off and water resistant. • Schools standard length ( o ptional ■ Mechanical Seal: SILICON Epoxy seal on motor end Industry Single phase; • Hospitals lengths a CARBIDE V. SILICON provides secondary moisture - • Effluent systems • % and % HP —1613 S,ITO CAABIK seating faces. barrier in case of outer jacket with 115 V or 230 V three Stainless steel metal parts, damage and to prevent oil prong plug BUNJ1 N elastomers. wicking. SPECIFICA7MRS • Y % HP —14/3 STO with ■ Std Corraslon- resls#aM ■ 0 -ring: Assures positive Pump bare leads. stainless steel. Threaded sealing against contaminants • Solids handling capabilities: Three phase: design. t_oc'fmut on three and oil leakage. %, maximum. • %-1 % HP —1414 STO phase models to guard • Discharge size: 2" NPT, with bare leads. On GSA against component damage AGENCY USTINGS • Capacities: up to 128 GPM. fisted models 20 foot on accidental reverse rotation, • Total heads: up to 123 feet length SJTW and STW ■ Motr : submerged in r �atlaards TDH. are standard. high -grade turbine oil for • Mechanical seal: silicon lubrication and efficient heat Undowdtm Laboratwft carbide -rotary sptlsillcon FUTtMES transfer. carbide - stationary seat, 300 tmpetter: Gast Iran. semi- • Designed for Gorrtlrwous series stainless sleet metal open, non -dog with pump- Qperatlom Pump ratings are Parts, BUure: ure etastomers. within the motor manufactr's • Temperature: - out vanes for mechanical seal 104 °F (40*C) continuous protection. Balanced for recommended working limits, 140-F (60•C) intermittent FEET • Fasteners: 300 series rs stainless steel. SEFKS:3B S • Capable of running dry . 25 80 5 4 size: 3e sor.ros without damage to - 1N1Et RPM: VARIOUS SCPM components. 70 rkEt srT 20 Motor � 60 Single phase: • X HP, 115 V, 200 V, 230 V, 0 60 Hz, 1750 RPM; %i HP, x 'r- 115 V, 60 Hz, 35M RPM; is 40 %HP -1 230 V � 60 Hz, 3500 RPM. S t0 30 • BuOt t #n overload wi automatic reset 5 • Class B insulati 0 On. Three phase: • % HP —1% HP 2001230/ o 0 460 V, 60 Hz, 3500 RPM. 0 10 20 30 40 • 5o 60 70 80 90 too 110 120 130GPM • Class B Insul ation. u anon. I- 0 10 20 30 mKh CAPACITY 01995 Goulds Pumps E11eCdive May, 1995 VVisoonsin Depwornent of Commerce SOIL. EVALUATION REPORT Psge m Dnaalonafsvand in aooaNanoe with comm 8S, Wls. Adnn. Code Gouty ST \ All ca�nplaie sire Man on paper not!ares � 8 V2 z 11 indm in stag. Ptsn asAst induft but pot ll il Parcel I.D. pencentslope.ecaleardlawadons . o+a mayaw.witkmatim d 4noeiopa rots 0 P'im" prA t_ kWWme k m by Date F0001.tb a..ama rlA� w•a►wasedow oee IpwPO M Lams.1satertau prapeell►t)rmer Pr~jbGs6ap c r` tic Let cv W 1S i s T 3 H R t g r' w 1 PICIPWOMMSIMMIgAiliftes LAX l mm** l &ftl§ , lmwarC9AW f a otoo�'^ n u A °�► ` ® aty d (PT OM Nearest Road' 5 4 or - 1 IS 3 40 Ff ` c� ` Q— 1 uo� rFV 2- t+ W CCW p Used Raddanlei / l&mntw ct bedrooms coda derived design flow rata O GPD 0 R10 , m 0 or at] e IN d - Dsacrae -- _-- Pareawtpsrleefet _ 4 1a.4..� Flood Ppin if appiatbie IJ / 1 A c WASBiaommst� 5 �d ❑ so ft s pi t Gmunclumboodw 9s 9 & Depth ID &W o Sd lkdw Dept On 'wMakir Radm Dnsat " Tudum sr Gorsetdapaa sawdary Amis in, mLrA a0 Qt. SL com color Or. SL sw • "EM '-7 0 Z 57 , -9r ot a / d S S6 m34 M 0 s s m r S O rn S /d 3 s 0r-s m Y �•� 5 ` 0 swim ! ❑ Pb Gmundsufaaealenr. .S. .2— a Depth to iwifnp tecM0r / LOk R h kx mn Depth Danilmupf FbWb x Qa ion Tom" &l<acom ca"Wenoe 8andow Foots t ln. Is 10 vu. sz Cant. valor or. sz WL 4 "1/ d Z '5 am Sbk. /, Z • wept ttt _ > < T•EO aapR. aM 7ras > aryl • lit 92 = am 1 w "v& and TSS _< w WC& a AdMm Date E ailm Caeduded T -171a I t - SI * r M IM MM 730 r so " A �Q \ULC�� v� ^P ©r� p .3 aOO- A - k r rCl l r o e, P ' ,CN\Pf of%kj W:r SYO' 7 4 A) � .r -ao53 A Alter �7, v / A 96 5° ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer , tm zS Mailing Address c l 2u Property Address (Verification required from Planning Dep rtment for new construction) City /State Parcel Identification Number LEGAL DESCRIPTION Property Location Ste• T-3J_N -R _&W, Town of �✓�� Subdivision , Lot # _ Certified Survey Map # •__��� 3 , Volume _ , Page # Warranty Deed # - 3 s O ( o , Volume 7 , Page # Spec house ❑ yes �& no Lot lines identifiable Af yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper - What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, sign ed by the owner and by a master plumber, journeyman plumber, restrictedplumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 113 full of sludge. Uwe, 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 year expiration date. Oct _ SIGNAtM JIVAPPLICANT 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 thrproAescribed above, by virtue of a warranty deed recorded in Register of Deeds office. SI FLICANT 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 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE MIFORIM/►TION SYSTEM SPEGIRCATU Ms Owner Septic Tank Capacity al ❑ NA r . Permit Septic Tank Manufactures © NA DESWN PARAMETERS Effluent Filter Manufacturer O NA Number of Bedrooms 3 0 NA Effluent Filter Model O NA Number of Public Facility Units 0 NA Pump Tank Capacity Do ai O NA Estimated flow (average) 308 gat/day Pump Tank Manufacturer O NA Design flow (peak), (Estimated x 1.5) 5 gal/day Pump Manufacturer S ❑ NA Soil Application Rate „ al /da /ft2 Pump Model O NA Standard Influent/Effluent Quality Monthly average' Pretreatment Unit 0 NA Fats, Oil & Grease (FOG) 530 mg/L O Sand /Gravel Filter O Peat Filter Biochemical Oxygen Demand SSOD 5220 mg/L 0 NA ❑ Mechanical Aeration 0 Wetiand Total Suspended Solids (TSS) 5150 mg /L O Disinfection 0 Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) O NA Biochemical Oxygen Demand (SOD 530 mg /L Kin-Ground (gravity) 0 In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ NA 0 At -Grade O Mound Fecal Coliform (geometric mean) <1W cfu /10Om1 O Drip -Line O Other: Maximum Effluent Particle Size Y in dia. 0 NA Other: 0 NA Other. ❑ NA Other` 0 NA * Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tanks) ) At least once every: 3 O ear(s► (Maaudrrrum 3 years 0 NA Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume O NA aspect dispersal celiis) At least once every: O s) �rrt 3 years} NA �j earls} ax lean effluent filter �r At least once every: 0 rithis) ❑ NA (s1 aspect pump, pump controls & alarm At least once every: 13 month(s) Al ' 5 0 NA Flush laterals and pressure test At least once every: 0 month ❑ yea r r(s) 1 (s1 Other: At least once every: 0 month(s) 0 years) El NA Other: O 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 cells) 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 contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW 14/01) ZTrART UP AND OPERATION . pacie of For new construction, prior to use of the POWTS check treatment tank(s) for the Presence of painting products or other chemical that may impede the treatment process and/or damage the dispersal cali(s). If high concentrations are det ected by a septage servicing operator prior to use. �� have the content of the tank(s) remove 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 win b discharged to the dispersal celi(sl in one large dose, overloading the call(s) and may result in the backup or surface discharge o effluent. To avoid this situation have the contents of the pump tank removed by a power to the effluent pump or contact a Plumber or POWTS Maintainer to assist inmanu Servicing Operator um to co ntrols tt restore normal levels within the pump tank. the Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or comp�t, the areF 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 mss; dis infectants; the life of the POWTS: antibiotics; baby wipes; cigarette butts, condoms; cotton swabs; d foundation drain (sum degreasers, dental floss; diapers; disinfectants; fat; P 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 shah be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: e 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, avel or sI< another inert (" so rid 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 replaccemenFstern: 1 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 BASSES 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 E M E Name S Phone - aw 11 1 SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REQULATORY AUTHORITY Name Name Phone Phone This document was drafted in compliance with chapter Comm 83.22i2l {bii1)1d) &ff) and 83.5441), (2) & (3), Wisconsin Administrative Code. DOCUMENT NO. STATE BAR OF WISCONSIN -FORM T 578 X31 ■ R ED F DEED V O � � � � �M �' t T HIS SPACE RE IIECOIIO�NO DATI A Lorn D. Pracht and Lynda Lou Pracht T. C -m OOFFICE S hu sband and wife, as joint tenants, RCIX CO., WIS. Recd. for Record His _ _ doy of A =-ust A.D. 193,8 conv�eys�nf�ra�rantato Timothy Schaffer and Candys:e = a � _ P•30 M. husband and wife, as joint tenants A"Istal of UTUFA TO the following described real estate in St Cr County. State of Wisconsin: Tax Key No. Lot Two (2) of the Certified Survey Map recorded in the St Croix County Register of Deeds Office in Volume 2 of Certified Survey Maps on Page 517 as Document No. 345062, being a part of the Southwest Quarter of the Southwest Quarter (SWh of SW of Section Twenty -three (23), Township Thirty -one (31) North, Range Eighteen (18) West, This warranty deed is given in satisfaction of that Land Contract recorded in Volume 566 page 526, Document 345453 in the office of the Register of Deeds on the 19th day of December 1977, St. Croix County, Wisconsin. T,I MSFER $--fi FEE This Not homestead property. (is) (is not) Exception to warranties: Dated this 28th day of July 0C//,0W A I i `'" 73586 V L - ,L — PAGE 4263 KATHLEEN H. MALSH REGISTER OF DEEDS ST. CROIX CO.. NI RECEIVED FOR RECORD 03 -14 -2002 2:00 PM CERTIFIED SURVEY MAP REC FEE: 15.00 CO PY FEE: 4.00 BEARINGS ARE REFERENCED TO THE c WEST LINE OF THE SW1 /4 OF SECTION 0 y r 23, ASSUMED TO BEAR N00°23'09"E. r. no�> M m m 0 o M_[�n_1P c 33' 3 7o Z I 3' 1 - -° Z m 3 ------------------- 0 I� 9 A `y m 0 g 0 m _� p I WEST. LINE OF THE SW1 /4 r o ��� N c (� IN ,� on o N00 °23`09"E� 450.00 N00°23 " m m � .00 NR `�; 4,7 �; I 33.00 F 2161.95' O`�7° °� ao *m to = �} c m Z� O - 0 O Z D _..� Ol mW z c�c N� P wig �ca mZ pO 439.9 A S00°23 09"W 472.91' 40 , Z 33 � ' .00' 1' p o ' I^ N O A � ^�• M ��l w O m �, A % ; d ° m � C ,� N m N o ? m _ cn ' ° r— 0 ® \ / AN T 01999 Cloud Caruadrophics. /ac. St. Claud. NN 56301 '"•.'.' :r PO LK COUNTY I i • • • MaBaM jie A " PC 972 � 65 Run �,a 10 Arkn6 c a . >R V. rnon cam. & Lehman Randall Asa 3 1 � Ph His M L� S T A & Rub Dernuning & Judith & Mary Douglas D s^'"o Tra Menke P R A I R I E Teske c ar p °" Demulling Rivard 261 ` 2 a 5 n 82.3 IM 59 65.4 • r • 79.3 201 79 Joan 4 • Allen Wright. Small T.- u i `ate S o Gregory 124 Russell Allen & Lavaun Sandberg • 9 ° • 3 Dennis enn s Ds c s & t c c • & Linda 126.6 Rodney Cynth a mistad Bradley Raddatz • 8.5 1 N tx. uwa r Nelso Strohbeen Y mpea etal • Robert 4 Peterson • VinDeTlt • c 74 t a Rivard so • 64.1 o Annene ,& +a • & Mary 40 156.6 128 • so Ise 6 Noak 70.1 Ba'r ° &Doreen 80 £ • 3 JS 2 Berker . 62 4o d Wilson Ti, 39 • omas i R45 D� " • • � =seven& D 20 Hunting on _ w 375 IMF& 5& j T &E Mm&Gaa SUSan 599 Cedar Rachel RaddatzI -. 37.5 H ,.6 Gene & Alva Hei.. 39.6 EL RC K, henM N 60 Am.h.a. Meeds i:ke C-Wt Bruce Allied a N6 J ^ 3 .-H as 12 '°" 33 43 Rlbert• speedw 64.a & M & Alice & Gary Inc • Mary RH Nelson Rich am • ; SmTla o Norman 80 Cook Caudy Larson G °^' a _ �•Y y He6mtz Earl& 6. Jahn N N 49.9 889 BB 60 239.2 4o Jlanne Dt a Z 3 Nelson 5 a b 9a M s Schwan •rs�ia 34.5 ra • e 4 9.9 D &L•20 Tr Lw • m C. Fein •1 &R • Kevin R°Ser ofw Clifford & 1 Pa�tne M 5a _. &85 549 9 � v Norman e Pra Messner M�'n5O "'-a Daniel " &t.an= Bverley irie n.- Sias & D�aaa V N le Y J &D N- R&C P&C•20 8 w ETirhenor •MedcN11 l� N & Ce Fstat¢ Gary• •Ah1neSS &John 22 EI &Leon 39.4 40 etal rt Licht • 71 Charlsrd a 5.1 3a C� i Y J4� Campeau Orr Bruce Mewin & laniel rod • m Keith a • s Su7E s 1&c t Mante Duane & 39.3 117 A tred m. zJ B Emerson Y L-11 _ Dean 32 Krttovka Vogel 14.0 &Alice 4p 96.5 Fdv+ 3 Volkert !la e0r1 46.2 S 0 L � KaOvyn 3 larson • s 40 • I 551 2.8 D 2.3 1.7 C&AK Richard 1] 1W Measrar 1 &D • L &B Ort 14 a 6 Na M.lmie M5 • &IarM • qp Chule 40 ' 2 Hai.ersan �"6'.a. 3.8 warren William sl wd, CrlShclOme o f N • Kris smW I &w Richard e • 8 P cry at is • Sandor &Janet �� a Anderson etal Add E 13 d : Mal .5 47q Laren • e .9 Vogel E .. „ s.... Nemeth A 77'4 115 Farm i 25.9 29 c 10.6 Hansen ` Norman • CC n • 9 I. :. 76.99 a. z6 w ~ B 9.6 Eric 46 &Joyce E a B Kevin a; • S<ott Richard 6w Harlan Eam one 2 George & Mari • 4° woR Mante 9 °° Herola stout Mari Blrkholz a 155.9 ` irglnla T&M 9 Keith I &D - m''� Counter Q Vehrs Dosedel • Keith l+me+ 19.3 90 loll a 35 12.5 l BQ)1 B re�m.1 • Vogel • lz.a ch C 53.6 Wallri 1 D&7.20 RI w&c &n+ard Lois _ Greenwood Thomas Brian & Wendt Small Jos 9 tug : • M 16 &Susan KO�ri Sanerlund Apple Joyce 139.9 Estates Inc . Ent etsl 40 11.7 140.5 Tracts w Patric, h D&K Marks &Patsy qp Rive loemesrld 75.4 63 Monica 1� i 1 w 10 40 Larson M es 791 I.r6.y. Alice 7 m SOS � &Price • J David eas x Rs u Berl im r. Emerson 155 4k.ra &Betty K t Clarence T &R m &S zo 2 Dons. 100 Rivard Crkhtan A - Armreon • Cook Sub cac E4rE 37.7 ss s Ca9ry r &PP 133 Soden &Leona • sin c&P • 4 • Drsz x7. R u s. • E&M • Rw RM &L Ramie 5 Q � • L7 : Neumann 3 M& o C w KeidL 40 Dupre 20 9.9 8 3 14 2 x a c �... Everett& ° ° 3 Rlbert George& :^#rw sin Trs 38.7 Af • 39z • Bruce 80 7 &Gage oel Patril • Talmage rY NMI 3a.7 CC Emerson Thovua tD rde w '3�aid Dc 5 Adeline 77 ,,,, r R ' 0 10 i u.. �. aroaier r h - n n e u r g .8 Jones 11ea�w.y .B u ,alse & 40 eTa J. a Cloutier Tr „ r ... 54.9 37.7 M3 Darrell & 'rgkJ eql s � Ruth .� 78.6 Cven M I 71.4 Rivaled 1 • Cynthia Folie Germain Tn &Nang' • Asplund 34s �Be & Wirkenhauser 4.5 z 10. 78 78S 3. nA ot4on „ 1c ° II 1a1de 7daa & 429 • K&Lm Stan 701.7 t4euawm 142.5 M.an 6.] p w.yru & antes. Joyce Ge M wu 3o.s o BOnestro0, Ralph & n' leldem • PhilliP Lake Dav d 9z M ax in e 36 eate.l • d 73.7 R .ra & Mark Tc ce m.m x Rosene & • m n• Mary Mondor D S A & Arirla Rai�sback II se awB�a can & 4o KlemesNd g0 Cloutier 2 oAa cots 40 2.4 18.4 C121t1n Volk V n _ Anderlik x a.A Robert, Fritz a 3 x Ronald 50.5 eph & Mary Lemoyne & 265 77 s o s 157 2s a^ T . „ Wolllers -,pet small Eva Halvorson • Dc s. & Assoc EH & Violet Asplund • g0 „- Tea 60.6 Tract, 85 FamTr 80 Z " r 6 w &IS9 wD6 Pl'�`c 4 75.1 s.2 T � 80 cl s r t & Small 97.2 Gary &Bonne 65 �gmire erald & arce G Marcel ' Tram Steven & Genevieve 63 BaiB 3 0 • la R&DH GOIIlItry SmN1 Ap D&!y Francois Qp trael Inc 1 D &L�a °utg: Trod. Backes Tr • 33.s K 9 CtTSty • S1A II P�. 185.5 ° _ : Pine A.d�y Douglas Wickenhauser 100 Daniel s "° ~ • .& Agrees & Joni 2218 212.9 .� y C a 4 ' . Tama ha 0 Olson 160 .¢' „Staff ales "DF C &KB .o. .0 39.1 I S., 10.5 u Daniel Gerald arLeiB & Prairie h Gael a `< �l K o Baillargeon C y of & Hatfield o Ltd x.aua.1 x a 2 s.w .°_n L. Lake 19.6 sin & Vrieze 78.4 Ri 1 120 40 40 iatdor Prul cmw . < E +`� - 1„ • Tn KM9 BM 2 Sin rs - p s9 St Croix Helene 4 M e.B:L �' • Car s.1 Tn Victor 103.4 =•.s 80 Houle 71.5 D 16 • Gunton 25 -y 1 &L11rown Myers III s • " County .r 64 • u 38 uA y 2 fk Marc at MargarK eeOl Robert mr • Joiners �°°°� C uno ter St Croix ew 0194 43 Plourde MrEroer & �eO G c,v �' ' & mrbo Scott - 120 sag'g cess 4o Newb County CC • 39a C 36.x B o °" X 40 � 271.3 & M l ary & Jean Sherman y N E W 4z2 • Mondor Boucher NR G;,,a & 80 R I C H M O N D Jam & ° - D- Russell 156.9 A ' Inc Newby 40 DL6 i boas°"" Flandrick 120 • w K Ittrani 2 . Gr ac 5&I ea B &M L 9.9 C o1 N R 2 New Rich LTD 136.2 Lindalou st N 2 eedl s .m • D&w 1a st to.� n3 Friday ucwb 3e.6 64 • • •Jensen 74.7 • ,B s 1 Michael Canning R 6 1.9 0 „ J Robes & - x r "' 92.4 &Kathleen Corp G 65 . 9 K RC 12.2 1 Alice a Mark & CodY 1F ♦', IilC 1 , GD q =Carol Duffs Kathie Cellotti 116.2 • sin r 212.6 K �4 K L� 153 1 mTrs 49 64 '' • T� 2 1300 1400 SEE PAGE 60 900 + 1000 1100 SEE PAGE 46 1200 1 s 8 • IS r � � �* � �= t� i r sin 41 4 ° a Over ' a century of Laaliilrty t� a le�kh ha is Gf $.00,W and rep insure vinth Y in the ni8urance ° business insuring Farts, Residential and Commercial Property For more irioxtnation contact our office: Phone:' (715) 2943186 or 755-3186 fax (715) 755 -2998 OR CALL YOUR DIRECTORS OR AGENTS: ` k John Heintz Edward Sontag Richard or Sharon McCurdy David Neidemire Henry Heintz 294 -3692 357-3244 248 -3833 549- 6579 646 -9303 Phyllis Clark George Setter Stack Insurance Agency Paul Hedlund Agency Tom Heintz 265 -7079 269 -5481 265- 4614 643 -3311 265 -7394 Sep 19 02 07:45a CALVIN POWERS 715 - 246 -5135 p.2 stay aad ea9d'..p Dinar �` C 201 w. waiiigm Ave.. P_O. Bo:1162 wae.�as i sco�tsiR ' loth ' ° w ` SM - "� AMID z400A Dep artment of Commerce y Par.ir Nrmbar Smeary permit Application 0 lr la a,wd .a C� U.21. VJ& Ado ia . Code, p=wd letamdm ym F aaaa Iaw. s15. 1 }� LD. FAUMM r L bataaenmdm - Fiarw Fr)e Al raftmaidm • Few+ � 2 3. 3 �• I �. 3 qRG S (GC7 _ O o c7 J � � � 0 3 002 1p ... I —ly 0.003•. Wfadia AAftew [ y J:i M IJ c+J • S� 3 T 3 I N. R I li tar Blatt[ C,, zip cod ICE riaa Name w IL Type o[ BunieL (elt xk aQ 1bs1 R*tf) ' we K, or 2 INuaay Dwatlai - Naarba of 6ad�aamr roltliraCoa�mnral - Dcm=fee un ❑ s.ar owned !� F7"`'��� Nei" Road n. T� i #"W ( sb r.e b a. � A tambw t whom for lo�rnrl ow)• c -• tt s ![.p�Seble) A ] ❑ � of 6 0 #Add= o For Camay ONE, ! New = Tank u.bo tawrad a. 0 aback it qty rropoit pnwim* b —d Ferri Nambar IV. 'type of Fw=k (Cisek an lb" lopply) t schune la for iaaerarl are) // z cmwwclod wahaa k - Fre.aad is4iroima 210 Mound 47 O st 0 Dry lme s.oa zf ❑ � m bAccma *1 11 Homing Taos .a 0 swo *il* /�7G�+ . / as 0 A"I=ft e6 0 Anode Tlamrer uea d9 0 3U 0 Odfes O. Aawa tam , free FJesioo Find Orra& DasDa 14°" Ma ]h DhWevod v ti) neck) pnbb yhc gyx, [der p,asrie Tank late Capoft in Tad Naaebar VL am Galtaaa Gaoaa. d'loeib Ci/ ° �E,p 3ti ea.r�eae Cmetraceed rim � A Tomb Tomb fljc afire x—sTook o Darbw caarr: Plum V>i._ ti .rao FawTs r.w. s �e.u.�.+ b rliare Number a xase •s l2i"Pas M-6- r 5 •. Addem csaeR Cw. soft. MP Coda) �- un outr Dane laced sijaenre stivmpr) s.adry Fula: rba (iael.daa Graoedwalr�► _ 7 n ❑ Dimppravad PAC) 0 owner Given lent Advwvc ��', — 00 -- �l 0 UL C of App" l iz� for Dbappreval a. cue ceard t< .. ow bra dM an a U o.dbw r ' r� pL�t, C� can -Aqa: m ns/n l /"_ Sep 19 02 07:45a CALVIN POWERS 715- 246 -5135 p.3 ��� - \c `- J 03c' -i D Bm �v 1 v ,n Alt TV " 1 97.5 1 reri c�-� 68.7 s E / 91. !� SC�� yQ ;S- i ! 3 & hoorr- A ! Sep 19 02 07:46a CALVIN POWERS 715 -246 -5135 p.4 wetter W r c��.1�� �, ( � � •�� P�..� ' B�oDlfft,�s � vacs; 34 X76 -zII• I .� ♦ pPen bo vole omw chw Oftdo ♦ si o pcoinip ♦ Zmprbvcd ♦ 'try aon,.,., Cf,0,rM ancc Ma x m tes v The of unmas qtr*. provides the o surface 'blective i " leaching s OPt Mum amount 'nmasked is to provid an o e. its design aPillary actioewall to allot► efflu and --hieved n in all d irections. t° flow via SPECIFfCgT�y �rtorr� with combining the This has been ��[ �°�rd unit a series of louv traditional, L+n 9 [ h...........76' L ourPrt�ltfeU n h � iamb ers along open Wir Length 9th uent inside the S the sides. -- 34 ..........76- along the full l enM f flov� to unco Height ._....... 1q wid th ..... designed to all eaC sid mPacted Invert.........._. :ornPacted ow efflu o Si e. he louv g ., i ►'l e*ht ...34" ...........11 rah backfill while Pass into th BiODe1� ry • Invert 6.5„ ng into the chamber. p it from Pro peq graded °f sifts size, w en installed � h yyirh m of 12. Or 17-, wa and W i ds�, to dept r eSPec�tn a over H - 20 ! factors 3l, � Sep 19 02 07:46a CALVIN POWERS 715 - 246 -5135 p.5 ��---� SEPTIC TANK 6 - _ PU MP CHAMBER CROSS SECTION AND SPECIFICATIONS N n C l VENT NT PIPE 12 1 1 MIN. ABOVE GRADE F. WEATHER PROOF . 2:25 FR OM WINDOW OR JUNCTION BOX APPROVED FRESH AIR • INTAKE . WITH CONDUIT MANHOLE COVER 4 Cl RISER W/ PADLOCK E 6" MIN. WARNING LABEL ABOVE G ADE r _4" MIN. 1Q t � INLET 1' \ 'WATER TIGHT SEALS GAS- TIGHTi , v Ll It AIoc> A SEAL � � APPROVED CI PIPE --�- , ALM JOINTS W/ CI 3' ONTO B i PIPE 3' ONTO _ -�-' t- ON SOLID S OI L S 0 LI D // � SOIL PUMP OFF ELEV .. FT. ►- - C -#— 1 Y Off °'t RISER EXIT D PERMITTED ONLY IF. TANK . . MANUFACTURER HAS APPROVAL 3" APPROVED BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS SEPTIC / T FACT l�1JK MANU � ,Q_ NUMBER 'DOSES PER DAY: • TANK SIZES SEPTIC C; GAL. DOSE VOLUME INCLUDING DOSE GAL. FLOWBACK:. GAL. . ti ALARM MANUFACTURER: S.• CAPACITIES: A = �O I 3d� S Z._t I NCHES = GAL. c��-� N MODEL NUMBER: ' S i 1 43 5 WITCH TYPE: ��� II = 2 INCHES = � GAL. PUMP MANUFACTURER: �n..� jd - C = 9 INCHES = /�`� GAL_ ED MODEL NUMBER : S4JITCH TYPE: D = 7( INCHES = fu GAL. REQUIRED DISCHARGE RATE• GPM PUMP & ALARM WIRING AS PER ILHR 16.23 WAC VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE FEET + MINIMUM NETWORK SUPPLY PRESSURE . . . ... . . . . . . %. 2.5 FEET FEET FORCEMAIN X /� FT /100FT. FRICTION FACOR. ,5 FEET TOTAL DYNAMIC HEAD = p FEET T INTERNAL DIMENSIONS OF PUMP TANK: LENGTH WIDTH ; DIAMETER LIQUID _ 3 {p �, 7� �A Sep 19 02 07:46a CALVIN POWERS 715 -246 -5135 p.6 Goulds P0. su IF - sibte ue nt Pump p IMIDU 3885 APPLICATIONS • Overload protection must smooth operation. Silicon can be operated continuously Specifically designed for the be provided in starter unit. bronze Impeller available as without damage. • Shaft: threaded, 400 series an option. sz : following uses: p C -, III Bearings: Upper and • Homes stainless steel. ■ Casing: Cast iron volute lower heavy duty ball bearing Farms • Bearings: ball bearings type for maximum efficiency. construction. • Trailer courts upper and lower. 2• NPT discharge adaptable ■ Power Cable: Severe duty • Power cord: 20 foot sys rated, oil and water resistant. • Motels for slide rail terns. • Schools standard length (optional n Mechanical Seal: SIUCON Epoxy seal on motor end • Hospitals lengths available). P CARBIDE VS. SILICON provides secondary moisture Industry Single phase: • Effluent systems • h and h HP -1613 SJ70 CARBIDE seating faces, barrier in case of outer jacket with 115 V or 230 V three Stainless sleet metal parts, damage and to prevent oil prong plug. BUNA -N elastomers. wicking. SPECIFICATIONS • i4 -1 % HP -14/3 STO with m Shad: Corrosion - resistant ■ 0 -ring: Assures positive Pump bare leads. stainless steel. Threaded sealing against contaminants • Solids handling capabilities: Three phase: design. Locknuton three and oil leakage_ %* maximum. • %-1 % HP -14/4 STO phase models to guard • Discharge size: 2• NPT. with bare leads. On CSA against component damage AGENCY LISTINGS • Capacities: up to 128 GPM. listed models - 20 foot on accidental reverse rotation. CSJ • Total heads: up to 123 feet length SJTW and STW ■ Motor. Fully submerged in GanadtanStandudsAsi TDH. are standard. high-grade turbine oil for • Mechanical seal: silicon lubrication and efficient heat till Underwriters taboraiwics carbide -rotary seat/silicon FEATURES transfer. carbide- stationary seat, 300 tor mo the are g ratins Impeller. Cast Iron, semi at Designed for Continuous series stainless steel metal Parts, BUNA -N efastomers. open, non -clog with pump - Operation: Pump p ratings are • Temperature- out vanes for mech seal recommended within the motor working limis, 104 °F (40 °C) continuous protection Balanced for 140 °F (60 °C) intermittent. METM3 FEET • Fasteners: 300 series 90 Stainless steel. _ SERIES 3885 • Capable of running d SIZE. WSOuos Pa g ry 2s B0 RPN! v>+Rtous without damage to - wEr _.► scPrr components. 70 ' wEll sFr Molar a 20 - -- Single phase: 60 _ • 'r4 HP, 115 V. 200 V, 230 V. 60 Hz, 1750 RPM; 'A HP. = l s 50 — 115 V. 60 Hz, 3500 RPM; o' 40 'h HP -1h6 230 V. S to 60 Hz, 3500 RPM. • Built -in overload with automatic reset. s 20 w '� • Class B insulation. - Three phase: f0 9 • 'A HP -1'A HP 200/230/ 0 0 I I 460 V, 60 Hz 3500 RPM. 0 10 2D 30 40 50 60 7o so 90 100 110 120 130GPM • Class 8 insulation_ I I � ' a fo 20 30 mNh CAPAC 4'1 1995 Goulds Pumps EllmOro May. 1995 Sep 19 02 07:47a CALVIN POWERS 715 -246 -5135 p.7 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page _ of FILE INFORMATION SYSTEM SPECIFICATIONS Owner Septic Tank Capacity al ❑ NA r` Perrnit # Septic Tank Manufacturer S ❑ NA Effluent Filter Manufacturer ❑ NA DESIGN PARAMETERS ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model U Number of Public Facility Units O NA Pump Tank Capacity M) gal ❑ NA ❑ NA Estimated flow (average) �b� gal/da Pump Tank Manufacturer P Manufacturer ❑ NA um Design flow (Peak), (Estimated x 1.5) 5 U ai /da P Soil Application Rate „ 7 ,11da /W Pump Model ❑ NA �' Standard Influent/Effluent Quality Monthly average' Pretreatment Unit ❑ NA Fats. Oil & Grease IFOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (ROD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids ITSS) 5150 mg /L ❑ Disinfection ❑ Other: Dispersal Cell(s) ❑ NA Month) averse P Pretreated Effluent Quality Y 9 . - ( in -Ground vt Biochemical Oxygen Demand (BOD 530 mg /L In - Ground (gra v i ty) y) round P ressurized) ❑ Total Suspended Solids (TSS) s30 mg /L ❑ NA ❑ At -Grade O Mound Fecal Coliforrn (geometric mean) 51(r cfu /100ml ❑ Drip -Line ❑ Other: Other: ❑ NA Maximum Effluent Particle Size Y in dia. ❑ NA _ Other: ❑ NA Other: O NA Other: ❑ NA 'Values typical for domestic wastewater and septic tank effluent. MAINTENANCE SCHEDULE Service Fre Service Event quenry ❑ monthls) !Maximum 3 years) ❑ NA Inspect condition of tank(s) At least once every: ❑ yearisl Pump out contents of tank(s) When combined sludge and scum equals one -third W of tank volume ❑ NA D monthls) ❑ NA least once eve ya l$ lMaxhrtum 3 years) Inspect dispersal cell(s) At 1 e every: ❑ e ( ns P D ❑ monthls) ❑ NA Clean effluent filter At least once every: ❑ year(s) ❑ month(s) ❑ NA Inspect pump, pump controls & alarm At least once every: ❑ year(s) ❑ monthls) ❑ NA Flush laterals and pressure test At least once every: ❑ year(s) 13 month(s) [I NA Other: At least once every: ❑ year(a) 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; ware. identify any cracks or leaks, e Servicing Operator. Tank inspections must include a visual inspection of the tank(sl to identify any missing or broken harddware, 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 cellis) 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. of the tank volume, the entire When the combined accumulation of sludge and scum in any tank equals one-third IY,1 or more contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (4101) Sep 19 02 07:47a CALVIN POWERS 715 -246 -5135 p.8 2- ART UP AND OPERATION Patio of _ For new construction, prior to use of the POWTS check treatment tankfs) for the presence of painting products or other chemical that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the content 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 b- discharged to the dispersal cells) in one large dose, overloading the call(s) and may result in the backup or surface discharge o 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 rc 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: e 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. e 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 biomet 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 : E. Name Phone — -� SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name aName Phone This document was drafted in compliance with chapter Comm 83.22(21(b)fIl(dla(f) and 83.5411), Ili b (3). Wisconsin Administrative Code. Sep 19 02 07:48a CALVIN POWERS 715 -246 -5135 p.9 vrmuwmm Depwwwtofcwnmeoe SOIL EVALUATION REPORT P"a M t im ar Sdw end 9dld}gs In raoo.denoe.M Comm aS. tMs Adm. coop C L.* AMMM ab pan an popar not teoo than s V2 s 1 t t to ame. Mw wmm ` 6v*Al *. &And Mrd ft vmrrst wd hak=,wo oft wpm p** (m ). awl ow PwW Lt). psna�ntatomemberdteotMlona.noft 0" ,wWftMW t MMdfM noelowaistnarl Plsese print.,a// Jhrtlurnwabrr. Rawftwed by t7.ne P... wti..�a...�.e.w.�s.....er...n.d r/i......tl++..w Low. a , io,I -H. peWWII � L amm �11t^ e r . Gw& lot 5w t L MM S T 3 N R g f W P'wwtyo m "aww* *d lot / I tt odc a csm 1 1 a aoo�` 4 v �e ca ❑ (�T awn w..rr.l t:o d CRY �Yls :c_ , 54017 1 c.5 aoo mm Qm*ucflon lhm RmMmMM I Numbs d bebmns code dadrad do*n wow role .� GM ❑ ar eanwwatai - o.wea Pwwt Rood Min d.wiian r a omme Al a l�.t�..t s s Ei 9i.,� a p! a (� c� PR tAand aafea. irr_ / S / ft Da. b .bmmft / kL ' 8d Amftobn Ram Rubm ck*a D. , - Rados Teaw MOMM CWnkhnl a eo..Na.y Atat: h munma Oita SL OWL cdw Gr. SL. Sh -ml 'lGm2 —7 /o 51 r ,7 - ,25 1 If p S - sDo o -- .S o , j 7. Z ® tta o ! a. p% Qmmdmm*m m. s• Z R u.pnie. Kimon am& oowamt Re rift r oe.afaffm Tomm amcme cenwmwm sonftY tmoft lR 1+...+ t� 8L oar. cdw Gr. sz ak Gem S !1- S „�y.)K ln r aL- LA a /� Z - 0ma w7 • > M = =D wc& and TSt's _ eip1L - t31l.rt 1Q • 9oC = ao nolL end T8S _ iD o 5 Mowa &ft . l s :N. We ll-, Qi cg 5 o i 5 -► 7- Sep 19 02 07:48a CALVIN POWERS 715 -246 -5135 p.10 s r— Parai O • Baitw o ❑ t3a,lq afar. A �� to bwom" 8aa Ram PR G..,da�alats / r fO 7rallia �alw C Uk% , aa ttta�l/ 1baf� Ftodmn O� Oanit�d Radac OraaolMOn 6L aau..a (UL S r- cda WN or. s S1t �§ S 1 0- 4 �� r 3b 5 P^ fi ; 7 Z q Ai o — 2. � 9 F-1 tt " - $ ❑ awftp tl DapM b tinaahfi } _ fn. Sol Re1e ❑ flit �,a oat.oa ate,. faPGr! t�tam D� Dba+rR Rados Drrtss�aon Ta w 9tfudtw QtriM■� ba.a+d7 IBM t]a Ss. Do * Coat tom. s sn 10 01009 TWA- bL "Mae EJ 0 ps Firrttaon DaO�� Dm l - I Ra " Domm ttf m Tabafa studio � Bdt/tdly 'm &L Ol�a+aata Co_ S2 Cod. t dar or. St ;,1► Ey&wea M W0 s 30 7M nM& and T5S a!p a 150 rtyll ftt? gpp c 30 eta and r S 130 aO'L The Department of Cotnotaroe is an equal opportnoigr service pc A&w —d - M'Yar, If you need asalwnce to aooasa mrvim or mead emerial in am altamate Rom,. pleam comma die depaet nW at 60&266-3151 or TTY 608- 264 -8777. aoaa�peMrl Sep 19 02 07:49a CALVIN POWERS 715 -246 -5135 p.11 ti }/ n 1 r �rcx, 5 A _v -� o 5 3 Alt Af do f a "s sr ?7 y - a 3 ��a Sep 19 02 07:49a CALVIN POWERS 715 - 246 -5135 p.12 J �73586 V L 4263 KATHLEEN H. VALSH REGISTER OF DEEDS ST. CROIX CO., VI RECEIVED FOR RECORD 03-14 -2902 2:80 PH I CERTIFIED SURVEY HAP REC FEE: 15.08 COPY FEE: 9.00 BEARINGS ARE REFERENCED TO THE r WEST UNE OF THE SW1 /4 OF SECTION -n n D 0 23, ASSUMED TO BEAR NODsL9wE. m m 64 mom m v_ ` 33 33' , �oMn L� �___�GG3g N Z in 0 m I m $ 0 ••� Oo I WEST U=SmW1 C o 0 3mm mg NOO 23ME m0 NOO°23'09�E 450. N Q m z m 9 1 33. 417.ar ®F 2161.95' U) z ; , o I OQ = � o C a O C .i z y m z� .� G) m n � 0 N — 'mil ^� , . m O `p N �t �' N , v. In , OI I° T m Y 9 0 Z ;�� > T U3 cn 10 , �C) �n N ;���Qo =0 e a° v Q; m m �Snl AI ily W a . U) z,o — � i m � soor23'osw a7a9r a � � � .w a 439.91' m ww p n ° m T S N N w � 0 m m m� Z�� N m A _, N �> g> 0 O_ q C o � E -1 N 0 0 O 0 N _ rn z Z W:0�m y I$ m m. �9 � O Z N O 4OP3 fib �1 '1 �n (461.6N) � _ - 4 461.71' fq p Q m r 409.26 o $ 90 2 ? so S00e1 W30"W 494.71' K m C I (SOW00 E 494.69') / {� ,r� 2 2nn o 0 O� `+ I I I lS� IJ ; m - @)[F - � -JoWUa "n N . m ON w@&. P-9M.fficace � m em o o Z � I m I --------- - - - - -- m Z ------- m, I O I v w.vZ g1 Z;" =1 0 ir x OC "� mm z flo ca O o n rn y n C Z m m a f, m Z ^ ?� O s rn � 9 0 g � z ° Z9 a �i v ° z D G) .r Vol. 16 Page 4263 Sep 19 02 07:50a CALVIN POWERS 715 -246 -5135 p.13 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer �; vn � C' s.�: t� •^ Mailing Address c ),1 �) �C� rt v -� A) .o QU mn na ILL S `/ O i Property Address fJ� (Verification required from Planning Department for new co auction) City /State Parcel Identification Number LEGAL DESCRIPTION n Property Location S ; - %,, Sw %, Sec. ��, T 3,L - R - �W, Town of 5 � T✓�ct . Subdivision , Lot #. Certified Survey Map # (o'7 3 �o , Volume LP , Page # '-! a (v3 . Warranty Deed # _�� O(S' , Volume S �,� . Page # Spec house 0 yes ;& no Lot lines identifiable X O no S_ Y_STEM 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 wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, 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 thwe year expiration date. ' S /vTA Gc3 SIGN • 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 (art) the owner(s) of Upro Acscribed above, by virtue of a warranty deed recorded in Register of Deeds Office. PLICANT 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