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040-1293-60-000 (2)
r wiscon'Fn Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and &gilding Division INSPECTION REPORT Sanitary Permit No: 499247 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: Sherman, Tami I Troy, Town of 040 - 1293 -60 -000 CST BM Elev: Insp. BM Elev: BM Description ( Section /Town /Range /Map No: 160 I(1J� bb .28.19.1681 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER " CAPACITY STATION BS HI FS ELEV. Septic, 2 3 Benchmark i ems, F: %", ' ZOD c 9 3 Dosing 3 ' Alt. BM o a . 8S /v7 .3 t4e*t+oi1 Bldg. Sewer /e L/, 64j Holding St/Ht Inlet St /Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic - 7 0 3 3 /13 / Dt Bottom J �o , - 7 Dosing LS / Header /Man. /„ /,3 1 13 A 5. 37-- Aeration Dist. Pipe 5 Z bl . V3 Holding Bot. System 6. - 62- / tv , -C! Final Grade 1, 16 7- - � I , c// PUMP /SIPHON INFORMATION Manufacturer 2c) p a Demand St Cove 3 1 P , 12 , t 7 11V GPM z &4. b Model Number 151 3 3. 7 TDH Lift Friction Loss System Head TDH Ft �.4s o.19 z.5 S.l Forcemain Lena ! I Dia.. Z // Dist. to well ` ^ SOIL ABSORPTION SYSTEM N � BED /TRENCH Width / Length No. Of Tr hes PIT DIMENSIONS No. Of P its Inside Dia. Liquid Depth DIMENSIONS 1� /1 SETBACK SYSTEM TO V P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type O System: Z t 1 / Z /� ,V ,t I � UNIT Model Number: (YI DISTRIBUTION SYSTEM E Header /M f anifold t 1) Distribution / / t3 t �� x Hole Size // x Hole Spacing �� Ver(I to take Length 1A.(o Dia t �� P ipe(s) ength �� Dia Spacing /�! 3. SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over / Depth Over xx Depth of r Seeded /Sodded xx Mulched Bed /Trench Center ' Bed /Trench Edges \ Topsoil �� es 1 No 1 1 No t COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: / f / 2 - -7 1 o _�O Inspection #2: Location: 488 East Cove Road Hudson, WI 54016 (SE 1/4 NE 1/4 16 T28N R19W) Piney Woods L ot 6 . Parcel o: 16.28.19.1681 VS� 1.) Alt BM Description = � c.• PI 2.) Bldg sewer length = j / �.or✓� - amount of cover = / - - - -- - Plan revision Required? Yes > <No —7 Use other side for additional information. -- - l Date Insepctor's Sig ature Cert. No. SBD -6710 (R.3/97) Safety and Buildings Division County � 1 , 201 W. Washington Av .O. 4x 71 S C� `sc0ns,n Rladison, tits 53 7 nitary Permit umber (to be filled in by Co.} Department of Commerce (608) 266 992 V i to Plan I.D. Number Sanitary Permit Application In accord with Comm 83.21, Wis. Adm. Code, person eu pr - -;A. 33 2 2 3 = t F., 4 WS. /A, may be used for secondary purposes Privacy -aw, s 1 roject Address {if different than mailing address RECEIVED g ) (j. Application Information — Please Print All Information t9 k- Property Owner's Name Parcel # , / Lot # Block # �__.__!_!71 ST. CROIX C OUNTY G OX P9Y& Property Owners Mailing Address Property IAeatlon y y rove 4d _ ICii :State Zip Code Phone Number +, ? %+, Section > U d s ( C ,S (� Circ Ik. Type of Building (check all that apply) 5 N, RF 'C 1 or 2 Family Dwelli s Subdivision Name CSM Number y g - Number of Bedrooms , ❑ Public /Commercial - Describe Use a ❑ State Owned - Describe Use ^O++ a City ❑vila eATownship of r- - -- g! r c Q 111L Type of Permit: (Check only box on line A. Complete line B if applicable) A New System ❑ Replacement System ❑ Trea1ment'11o1ding Tank Replacement Only ❑ Other Modification to Existing System i 15- ❑ Permit Renewal El Permit Revision El Change of ❑ Permit 'Transfer to New List Previous Permit Number attd Date Issued Before Expiration Plumber Owner iv. T e of POWTS S stem: Check all that a ly i -- i�t+�n - .Pressurized In-Ground �Vlound > 24 in. ofsuitahie so ❑ Mcwtxl 24 in. of suitable sail AY -Grade Single Pass Sand Fitter J C'onstructed Wetland ❑ Pressurized ht -Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip line ❑ Gravel -less Pipe ❑ Other (explain) V. Dispersal/Treatment Area Information: Desi Flow {gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation j C�a � j / � —I VT.Tank.Info Capacity in Total ur her Manufacturer Prefab site Steel Fiber Plastic Gallons Gallons of Lniis I Concrete Constructed Glass New Existing Tanks Tanks Septic or Bolding Tank aC0 - Cc�l Aerobic Treatment Unit Dosing Chamber VI I• .Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Phr be' Name (Pr t) Plum er's Signatur MP /MPRS Number Business Phone Number s i .... __ 0 7/ Plumber's Address (S eet, City, State, Zip Code) VIII. County/Department Use Onl pinoved Disapproved Sanitary Permit Fee 1 dudes Groundwater "Datelssued is suing ent Signature {N Surcharge Fee) e ❑Own n 1 for Denial IX Conditions pprov 1 ? \ Pv ` e1y�dC f 1 w i l 4k 6 — SYSTEM OWNER. > / J 1 Septic tank, effluent filter end -A C0. dispersal cell must all be serviced / maintained I as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code /ordinances. Attach complete plans (to the County only) for the system on paper not less than 81/3 x I I inches in size D -63 SB 1/ 98 (R. 0 03) I Divine Custom Homes - SE1 /4,SW1 /4,S17,728N,R19W Town of Troy, St.Crotx Co. M Pule Woods, Lot 6 Legend N I � l 1 " -40' .ir A - Bencbmark Elo, 100.00 "ft Top of 3/4" pvc pipe Alt Benchmark Ele. 100.00 ft Top of 3/4" pvc pipe / O - Bos'bogs Boring Elevations B 1 - 100.00 ft B2 = 100:00 ft B3 - 96.80 ft 134— 0.00 ft V v e, w L �� v \4. \C0 �\ z . LO s y J / 1 Zi Ol 3 Z Vv i sconsin SOIL EVALUATION REPORT #2014 Department of Commerce in accordance with Comm 85, Wis. Adm. Code Page 1 of 3 Division of Safety and Buildings County Steel's Soil Service Attach complete site plan on paper not less than 8% x 11 inches in PI us St. Croix include, but not limited to: vertical and horizontal reference point (BM), �nce r an percent slope, scale or dimensions, north arrow, and location and ton t ro Parcel 1. D. Please print all information. v pending ' ed B� Date Personal information you provide maybe L sed for rivacy aw, s. 15.04 (1) 01 1 Property Owner Property Location Divine Custom Homes Govt. Lot na SE1 /4, NE1 /4, S17, T28N, R19W Property Owner's Mailing Address ` 1 1 LUUD Lot # Block # Subd. Name or CSM# 484 E Cove Rd 6 na Piney Woods City State Zip Co e - on b r ❑ City ) Village Fx� Town Nearest Road Hudson WI - - 4D - f 8 - - -- I 10 7 60 Troy I East Cove Rd Lx] New Construction Use: C Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD [] Replacement Public or commercial - Describe na Parent material Loess over till Flood plain elevation, if applicable na ft. General comments Mound design, system elevation 100.50ft based on contour line elevation 100.00. Minimum 6 inches of and recommendations: ASTM 33 Mound Sand. 1 Boring # T a 6j. ` 9 � Ground surface elev. 100.00 ft. Depth to limiting factor in. ISoil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consisten Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -8 10yr3 /1 none sil 2msbk mfr cs lc .6 .8 2 4 - 17 10yr4 /4 none sl 2msbk mfr cs 1c 6 1.0 3 -34 7.5yr4/4 none scl om na gw na 4 34- 10yr8 /2 fld 7.5yr5/6 ,andstom residuum na na na .0 Boring # Ground surface elev. 100.00 ft. Depth to limiting factor 33 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -10 10yr3 /1 none sil 2msbk mfr cs lc .6 .8 2 10 -33 7.5yr4/4 none sicl 2msbk mfr cs if .4 .6 3 33 -55 5yr4/4 f2d 7.5yr5/6 sl om na gw na .0 .0 * 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 (Please Print) - at CST Number David J. Steel 248956 Address Steel's Soil Service Date Evaluation Conducted Telephone Number 994 200th St. Baldwin, WI 54002 10/21/2006 715- 760 -0347 SBD -8330 (R.07 /00) Property Owner Divine Custom Homes Parcel ID # pending Page 2 of 3 3 ] F Boring # El Ground surface elev. 96.80 ft. Depth to limiting factor 39 n. El Ground Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -8 10yr3 /1 none I 2msbk mfr Cs 1 .6 .8 2 4 -29 10yr4/4 none sl 2msbk mfr Cs na .6 1.0 3 29 -39 7.5yr4/4 none sl om na gw na .2 .6 4 39- 10yr8/2 f2d 7.5yr5/6 andston residuum na na na .0 .0 Boring # Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F-1 Boring # Ground surface elev. ft. Depth to limiting factor in, Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft _ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *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) Steel's Soil Service i 3 of 3 STEEL'S SOIL SERVICE David J. Steel Divine Custom Homes 994200 th St. CST - POWTSM SE1 /4,SW1 /4,S17,T28N,R19W Baldwin, WI 54002 Lic. #248956 Town of Troy, St.Croix Co. Direct 715- 760 -0347 Piney Woo ds, Lot 6 Fax 715- 684 -3449 Legend N 1" = 40' = Benchmark Ele. 100.00 ft Top of 3/4" pvc pipe / 4) r� �? � � -e� � • = Alt Benchmark Ele. 100.00 ft Top of 3/4" pvc pipe I ❑ = Borings Boring Elevations ;� I5 BI = 100.00 ft �( B2 = 100.00 ft B3 = 96.80 ft B4 = 0.00 ft i J S/ ziz- r Safety and Buildings c commerce .Wi.gov LA CROSSE WI 5 60EE8 D i TDD #: (608) 264 -8777 sco n s rn www.commerce.wi.gov /sb/ www.wisconsin.gov Department of Commerce Jim Doyle, Governor Mary P. Burke, Secretary November 03, 2006 CUST ID No. 225094 ATTN.• POWTS Inspector MICHAEL P ROGERS ZONING OFFICE ROGERS PLUMBING ST CROIX COUNTY SPIA E4457 HWY 12 1101 CARMICHAEL RD MENOMONIE WI 54751 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 11/03/2008 Identification Numbers Transaction ID No. 1339223 SITE: Site ID No. 720241 Divine Custom Homes Please refer to both identification numbers,, East Cove Road above; in all correspondence. with the agenc Town of Troy St Croix County SEl /4, NE1 /4, S17, T28N, R19W Lot: 6, Subdivision: Piney Woods FOR: Description: Mound / Four Bedroom / Sloping Site Object Type: POWTS Component Manual Regulated.Object ID No.: 1105926 Maintenance required; 600 GPD Flow rate; 33 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 101), 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, stats. The following conditions shall be met during construction or installation and prior to occupancy or user Reminders ' ON � • This system is to be constructed and located in accordance with the enclosed approved plans and with the CCa;; , component manuals listed above. • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c • 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 i . MICHAEL P ROGERS Page 2 11/3/2006 �t • 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 II, Integrated Services WiSMART code: 7633 (608)789 -7893 , 7:45 am - 4:30 pm Monday -Friday charlie.bratz@wisconsin.gov cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 Henry F Grote, Certified Soil Testing m Divine Custom Homes -Mound 0 W � z Construction Materials and Techniques All maters must comply with Comm 84 and be installed in accordance with manufacturer's specifications. Construction methods must comply with the following Component Manuals: Pressure Distribution, SBD- 10706 -P (01 /01) Mound, SBD - 10691 - P (01 /01) Location: Lot 6, Piney Woods SE '/4, NE '/4, Sec. 17, t 28 N, R 19W Town: Troy County: St. Croix Date: November 6, 2006 Owner: Divine Custom Homes Address: 484 E. Cove Road Hudson, WI 54016 Plumber: Mike Rogers Signature: License: M- P 139462 L- p Attachments: SBD -10577 - Plan Approval Application SBD -8330 CJt'VGS Page 1: cover 2: design criteria & calculations ` 3: plot plan 4: system cross section 5: plan view, lateral detail 6: pump tank exit detail 7: pump curve 8: system management page 1 of 8 I ' F 1 t Design Criteria Residential Wastewater Contaminant Load: 30 mg/L < BODS < 220 mg/L Anticipated septic tank effluent 30 mg/L < TSS < 150mg/L Fecal Coliform > 10,000 cfu/100 mL Fats, oils, grease < 30 mg/L 4 Bedrooms x 100 gal/bedroom/day x 1.5 gallons /day hydraulic load Design Calculations In situ designed loading rate gallons /sq. ft. per day Depth to estimated high ground water in. Depth to bedrock in. Cross slope at system l ,4' % Force main length ft. of Z- in. Manifold/header length ft. of `/ 4 in. o 43 Drain -back gallons, Lateral length ft. of �� �- in. Lateral elevation 1 ° ft. @ bottom of lateral Lateral hole size 3 ��� in. @ Z ° in. ( 3 • < ft.) Spacing holes /lateral S holes total Lateral volume gallons Total lateral discharge rate gallons /minute @ 2 S� ft. head Network pressure compensation losses Elevation difference Friction loss ,S z- ft. @ 3 S� gallons /minute Total dynamic head t ° off' ft. Pump /sip aon %'E gpm @ t �� ft. of head Manufacturer o 9.A< a,, Model # 15 � Dose volume I:e ' to gallons Lift /sipxon tank gallons Septic tank gallons Effluent filter ` (a -k a'a Measurement pump on and off S1 o in. Height alarm from tank bottom , b' in. Reserve capacity 4g-r" gallons specs.calcs.res Page Z of 8 1 Divine Custom HoMes o SEI /4,SWi /4,SI7,T28N,R19W Town of Troy, St.Croix Co. — .,,,, --- hney Woods, Lot 6 Legend N i 1" - 40' .� A - Benchmark Flo. 100.00 'ft Top of 3/4" pw pipe Alt Bench=Tk Etc. 100.00 ft Top of 3/4" pvc pipe 1 p� Boring Elevations B 1 - 100.00 ft B2 = 100 ft B3 - 96.80 ft 134 = 0.00 ft C 0 Cp.. w. 1 8z;1 0 (t��(O 2, 7 n 3 1 fL Vf 4 6 c lk ( b•t1 items � ; nn r . w►o� ` \ t i�bco;1 z i 1 f ............ o � ,i IS,q' r ego %b4. �^ �ip 0 -4. lo •— I S 3,5 t� \�N�, �/ T�, �'ML COL L1,yy � C1 K4/i �J►b0�ii. O"' 1 4L o 0 O �.► ` i •o `fiZ O ` A O+A c rU b b --� _ (o r, � •.1 2�� Y� .� k \T T 1L , WEATHERPROOF — LOCKINGCOvER JUNC.Tics + 6ca [t/ lI lvMJ6 .C ,WBElC . GWICK DI�C.GMViCT"'�\ c' a■e , A FI v e' 3' n� OWTU 71.5'TuReED SOIL. 24" %.D, I a„ �o wuwun� • YEKT • � '� •. W LL D z��. GIiSK>rT �urJ �FLE 3' owTo Au. Pin 'T rj aDUuo ow •o PAP CoArucE . SEPTIC t SPEGIFI'CAT10QS DOSE TAIJKS MA►JUFACTURC. IJUJMbER OF DOSES: g PER DAZ TAQK SIZE . \ tiYb �� GALLOWS DOSE VOLUME � b ALARM MAAJUFACTUKER' S. F \ aa.t.ro INCLUDING CACKFLOW: o�' GA'�� ON$ MODEL WUMDCR: tot law CAPACITIES: A= 31 ' ° WCHES OR i4 '� C.AI,LOUS SWITCH Ty /[, Z 11JCNES OR IL Z GALLOuS PUMP * FACT UKCit \fir C ■ S ' WCMES OR C,AL,OU5 MODEL, QUMDER; t Da 9.0 INCHES OR g ;,ALLOuS SWITCH TYPE; "� ►DOTE; PUMP AWD ALARM ARE TO CIL MIQI MUM DISCHARGE RAT _GPM INSTALLED OW 5EPARATE C1RCU.TS VERTICAL DIFFEKEKICC DETWCCIJ PUMP OFF AWO 013TRIDUTIOW PIPE_ �'�` FEET + MIUIMUM QETWORK SUPPLY FKt6SURE .. 2 ' FLCT +O - S ' 7✓ i + 2 FEET OF FORCC MAIW X � F/oo►zFRICTIOU FACTOR. �'�Z FEET V� j- — TOTAL Ob'WAMIC. HEAD = \ a ° FEET IUTERWAL. DIMEWS►OWt OF TAWK: LEW&TH `?., g - Q A ;WIDTH � 9 ; LIQUID DE PT H e � "� •' w PUMP PERFORMANCE CURVE MODEL 151/152/153 TOTAL DYNAMIC HEAD /FLOW 56 PER MINUTE 14 a5 153 EFFLUENT AND DEWATERING i 12 40 MODEL 151 152 153 10 35 1 52 Feel Meters Gal. Liters Gal. Liters Gal. Liters 30 5 1.b 50 189 69 261 77 291 10 3.0 45 170 61 231 70 265 o B 26 151 15 4.6 38 144 53 201 61 231 20 8.1 29 110 44 167 52 197 ° g 20 25 7.6 16 61 34 129 42 159 15 1 1 30 9.1 - 23 87 33 125 y 35 10.7 - - 22 85 10 40. 12.2 - - -- - 11 42 2 Shut -off Head: 30 fL 9.1m) 38 ft. (11.6m) 1 44 ft. (13.4m) 5 0145086 0 10 20 30 40 50 80 70 90 96 160 GALLONS LITERS 0 40 80 1 0 180 260 240 2k 310 FLLOWPERM 01 4SM Model 151 Models 152 / 153 C ONS U LT F ACTORY R 6 7 3 7 /a /32 SPECIAL APPLICATIONS 4 s/e 6 1/4 -{.�.- 3 27/32- 4 5/8 ---{ T • Timed dosing panels avable. ail 3 7/6 • Electrical alternators, for duplex systems, are available and supplied with an alarm. - 07. • Variable level control switches are available for controlling ® 3 7/8 P 99y single phase systems, • Double I back variable level float switches are available for variable level long and short cycle controls. • Sealed Qwik -Box available for outdoor installations. See FM1420. • Over 130 °F. (54 °C.) special quotation required. I 11 11/16 1 I 12 l/8 151/15211.53 Series -� 151/1521153 MODELS Control Selection Model Volts-Ph Mode Amps Slm lex Du lex 4 3/8 N151 115 1 Non 6.0 1 2 or 3 8N151 115 1 Auto 6.0 Included 2 or 3 E151 230 1 Non 3.2 1 2 or 3 BE151 230 1 Auto 3.2 Included 2 or 3 151 SK2064 N152 115 1 Non 8.5 1 2 or 3 BN 152 115 1 Auto 8.5 Included 2 or 3 E152 230 1 Non b.3 1 2 or 3 BE 152 230 1 Auto 4.3 Included 2 or 3 N 153 115 1 Non T 10.5 1 2 or 3 BN 153 115 1 Auto 10.5 Included 2 or 3 E153 230 1 Non 1 5.3 1 2or3 SELECTION GUIDE f3E153 230 1 Auto 5.3 Included 2 or 3 1. Single piggyback variable level float switch or double piggyback variable level float switch. Refer to FMO477. o CAUTION 2. See FM0712 for correct model of Electrical Alternator E•Pak. Aii In6iauauon or controls, protection devices and wiring should be done by a qualified 3. Variable level control switch 10 -0225 used as a control activator, specify duplex (3) licansad electrician. All electrical and safety codes should be followed including the most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). or (4) float system. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO: P.O. BOX 16347 Louisville, KY 40256.0347 Q ® SHIP T0: 3649 Cane Run Road Manufacturers of . . Louisville, KY 40211.1961 Q7Y PU�as SINCE 1999 (502) 778.2731 •1(800 o ) 928 -PUMP http✓ /wwwzoeller.com UMP !O. FAX (502) 774-3624 ® Copyright 2003 Zoeller Co. All rights reserved. System Management Management of this system is critical. As a condition of approval of these plans this system management section must be reviewed with the owner, and the owner must be provided with a complete set of plans including this management section. If problems develop with the adsorption system or any other system components, the installing plumber, Rogers Plumbing, 715 -235- 1 132, or the St. Croix County Zoning Office, 715- 386 -4680, should be contacted for assistance. General Proper functioning of an on -site disposal system, "septic system," is significantly dependent on the volume of water which flows into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the better and longer the system will function. Typical system components include a septic tank or compartment to settle out solids and contain greases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a dose tank or compartment to allow a dose to be accumulated, a pump and controls or automatic siphon, and finally some type of soil adsorption cell to recycle the water in a manner to protect ground water quality and public health. 1. If the septic tank is installed prior to sheet -rock and/or painting, um the septic tank before normal use begins to ensure p p P g pump P adherence to contaminant load design criteria. 2. Install water - saving appliances whenever and wherever possible. 3. Repair even small water leaks as soon as possible. 4. Never pour grease or oil down any drain or stool. 5. Garbage disposals are not recommended; if you must have one, use it sparingly 6. No paper products other than tissue should go into the system. 7. No chemicals should go into the system. 8. Avoid surge flows of water; try to spread laundry throughout the week. 9. Septic tank effluent must be less than or equal to the design criteria specified in page 2 of these plans. 10. If septic or dose tanks are no longer used, they must be properly abandoned. 11. If construction timing and weather could create a frozen infiltration system, weather - proofing with plastic sheeting and heavy mulching may be required to maintain a functional system at start-up. 12. The upslope toe of the mound system must be landscaped with additional fill to blend this area into the upslope natural grade; this will minimize the possibility of the system trapping surface run - off; final settled slope should be 2 -3% over the system or 2 -3% diverting surface run -off around the ends of the system. Maintenance 1. The septic tank must be inspected every three years by a properly licensed person. 2. If necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids volume equals one third of the tank volume. 3. When the septic tank is pumped, any solids in the bottom of the dose tank must be pumped, and the filter must be back - washed into the septic tank to remove accumulated material. System use may require more frequent filter cleaning; initial inspections of the filter should be made every 6 months until a minimum time sequence is determined. 4. Periodic observation pipe inspections should be made by the owner to examine the state of the in -situ soil adsorption cell. Quarterly inspections are recommended; a licensed plumber should be notified if effluent is consistently ponded in the adsorption cell. 5. If this system contains specific treatment components other than those mentioned here, maintenance requirements will accompany their specifications. 6. The pumping components for this system include an alarm which must be installed and remain on a separate circuit from the pump. If the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allows reserve capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or two days should pass before any necessary repairs can be made. 7. Avoid compaction such as vehicle traffic within 15' down -slope of the adsorption system. 8. Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system. 9. Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth. 10. Surface drainage must be diverted around the system; avoid landscape changes which might send surface run -off into the system area. 1 1. Warning: Do not enter septic, dose or other treatment tanks; death may result because they may contain lethal gases or insufficient oxygen. Contingency Plan Wastewater monitoring of volume and quality is not a normal requirement for low effluent strength systems; such monitoring may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83.54 (2). Pumping and hauling of wastewater may be necessary while analysis and repairs are implemented. Additional testing, designing, and /or installation of additional treatment components or conversion to a holding tank may be necessary. Page 8 of 8 . © GRUX COUN zonong Fax Memo Date: s To:� Code Administratzo`� 715- 386 -4680 Fax Number: /^ Land Information ?`j`Qt ��7 / Planning From �~ �� l "G�cc?- -7 ( 1 715-386- J { Fax Number: 715 - 386 -4686 Real erty Phone Number: r , s�� 7 6 -4677 R, cling 386 -4675 Number of pages, including cover sheet: Re: -�x a r R, 1 l000r lo _ . vvi r � O !' Noun w 1 ? A,,,,� G, 1 . ...�, a7 ` 7 ' v 2 - o Ar. R: 1 1 4.41 M 'Wmiconsin Department of Commerce SOIL EVALUATION REPORT Page 1 - of 3 Division of Safety and Buildings r in accordance with Comm 85, Wis. Adm. Code _ , Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County 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 Rev i wed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location S3 N qI " MO L L iE P.O1JQt 14 L GG%4- of SE 1 /4Ne 114 S T ZZj N R lot E (o W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# p y Nj�iA W 0 r S say c-I NN� c1 -� l�)e h - City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road zt� Fi'cLlS k,►1 sqL) ( �lS) 425 6 �Z � ` L-�A�i' Sul 1Zo. New Construction Use: ® Residential / Number of bedrooms Code,derived design flow rate s f GPD ❑ Replacement ❑ Public or commercial Describe: P Parent material L O (EI - 'n i.1.- Flood Plain elevation if applicable ?,` ft . Pon General comments 7�+ and recommendations: MOUpvp W !q 'yam LSBv`(1U►J e -t?LL, - M t!) LMU N ►� rs fl ? � (? , ST CFK)(Y. cflt�w Boring # ❑ Boring a Pit Ground surface elev. 0 1 - 1- 5 ft. Depth to limiting factor 3 Z P 9 in. T ' mcation Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Effn1 _ •Eff#2 'Z lo`'1231 — sti I Zwl s bh rti�1- ew - -s 3 Z6 - )(3 1 1 fZ -31 - s)1 bk y �tti — Z- - • `� LL 3 z- 1 o`'L¢.. S 1 P S ou a Boring # ❑ Boring ft. [� pit Ground surface elev. l �- a Depth to limiting factor 3 v in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 I •Eff#2 s S 3o -y lok(Z 3t� �LF�•s� D- S)b S1 O rn.N e – •O -_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 CST Name (Please Print) Sign CST Number Arthur L. Wegerer 220254 Address W e g e r e r Soil Testing & Design Service Date Evaluation Conducted Telephone Number 421 N. Main St. River Fa WI 54022 1 _Zp 715 -425 -0165 Property Owner Parcel ID # 1 ) , l G Page Z of 3 Boring # ❑ Boring ® Pit Ground surface elev. '1q. 3 ft. Depth to limiting factor y S in. on Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP Soil Applicati ati In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff #1 •Eff #2 3 l z - L Z 6 -lb l 316 - S1 ZW3bk n1Ut1- s . do 3 �{ -4S 1D`-12. 316 - St I C wt's . �w • Z . 3 ,� S L 3 -L3 lny t 16 E'L Z.S `� 2 S18 g , �� _ _ .v Z MIAU t L ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. fl. Depth to limiting factor irr. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 F '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 /ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 • Effluent #1 = BOD, > 30 < 220 mg /L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg /L ai id 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 60,E -264 -8777. SOD -8770 (R.6/00) • PLOT PLAN Page 3 of 3 - Scale 1' = 5o' 9.7 / L 0 1 Vj B • 6Wl Z �T. q' 7 gQYY'M 1 OF c L pv C PLPLZ. w! 0 cil a� m M L.0 T s Lu i b Lor 1 lZ -Z� -O 715 - 425 -0165 220254 - 1 c7� -3t� 6 CST Signature Date Telephone Ito. CST No. Job NO. 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 sire. Plan must S �' C lx Include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. �C - tiVO 1 G percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location GOIA -Lot SE 1 /4Ne 114 S 11 T Z�j N R I E (o W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# p LyV W 0 DD S 2 1 7 CW1 NNc) � �� e 6- — City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road R WIS2. SUS I ki I sgozZ 1S) LIZS- L�qZ New Construction Use: ® Residential / Number of bedrooms ` Code derived design flow rate E1 OO GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material L O L- S - 'n I.l. Flood Plain elevation if applicable p %, ft_ General comments and recommendati ons: M pUKj D y-j lg �Y- D LStz L8 W h 0IJ C-ErL L . M IlQ b 4 vr— s> r-1c (. . Boring # ❑ Boring Pit Ground surface elev. ° t. - 7 - fL Depth to limiting factor 3 Z In. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff:2 Z 4\1t-?-�6 0� R-3IZvn o`?tL31 — J l.a-sbk &AAJ >n Ll �j`1e S1'i a Boring # ❑ Boring [� Pit Ground surface elev. fL Depth to limiting factor 3 in. Soil Application Rate Horizon Depth Dominant Color Redcx Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff #1 +Eff#2 lb-1 tZ 3 l z — S O Z` q 4- m y 'Qti- C° bJ - • S 2 l� -30 10 %123Ly s11 Z \0 VT S , -t It- S)b S1 p 11n`�- e - •O Z 46 -0 l0`12 /b 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 (Please Print - Sign g lure CST Number Arthur L. We ere 01 - -31 g r ,�- � 6 220254 Address W e g e r e r Soil Testing & Design Service Date Evaluation Conducted Telephone Number 421 N. Bain St. River Falls, V I 54022 1 Z_ - ZA -d, 715 -425 -0165 r � , Property Owner _ \-� d X H L Parcel ID It 1 )%j G Page Z of F�] Boring # ❑ Boring [� Pit Ground surface elev. 'L4. 3 ft. Depth to limiting factor y S In. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff #1 •Eff #2 1 a- b L�`l IR- 3 Lz — L Z`4' q mu-h- CL Z 6 - lo�t 316 — S1 Zwtsbk rv.&` - C - 3 1 -3y l w4p- - .LIZ S'b k 3 -4S w-i 2. 316 1l? sb1? wl'� -. �SL�." • Z . 3 . S tIS_63 Lb `11 16 PR 518 Lvf — _ -O ; Z F-1 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 1ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 F-1 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 I GPD 1ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 • Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = 13013 : < 30 mg /L at id 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 6011 -264 -8777. SBD -8330 (X6/00) PLOT PLAN Page 3 of 3 Scale 1'=50' `l7 2 7 ' QOT V4PFr� 0V bLSY fZ$ u j . awitf-Z 2 ?, CI - 7 BO�hj11 OF c L L JVIM _ - -- 0 N m � M L U T S i Lu r_ _ 2),sr_ -�, 2 or� - 7 - 425 -0165 2 - CST Signature Date Telephone No. CST into. Job NO. POWTS OWNER'S MANUAL MANAGEMENT PLAN FILE INFORMATION SYSTEM SPECIFICATIONS Owner T Septic Tank Capacity G O gal ❑ NA Permit # Z Septic Tank Manufacturer Gc./ ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms 104gpd/bedroom ❑ NA Effluent Filter Model Q ❑ NA Number of Commercial Units NA Pump Tank Capacity ev Q gal ❑ NA Estimated flow (average)* p gal/day Pump Tank Manufacturer / ❑ NA Design flow (peak), estimated x 1.5* gal/day Pump Manufacturer the ❑ NA Soil Application Rate �J gaUday Pump Model El NA Pretreatment Unit lnfiuentlEfftuent Quality (NAL7) Monthly Average ** [3 0 NA Fats. Oil &Grease Sand/Grave! Filter ❑Peat Filter Biochemical Oxygen Demand (BOG ODs) 30 mg/L m ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids {TSS} � 220 mg/L ❑Disinfection ❑ Other: < 250 mg/L Manufacturer: Model: Pretreated Effluent a i li ❑ Monthly * ** Dispersal Cell(s) Biochemical Oxygen Demand (BODs) y erage [3 de (gravity) El In-ground (pressurized} Total Suspended Solids (TSS) 5 30 mg/L ❑ At -grade 4azMound Fecal Coliform {geometric rneanl 5 30 mg/L ❑ Drip -line ❑ Other: <_1 O cfu/100m1 ❑ Leaching Chamber Manufacturer Maximum Effluent Particle Size 1/8 111 diameter Model Approval Stipulation * Wastewater Flow Verification on and calculations: Soil Application Rate �gp d/f� Area Req. (Other than bedroom based) Absorption Area Credit per unit ft Minimum Number of Chambers ** ❑ Aggregate Design Flow/Loading Rate= min Values typical for domestic (non - commercial wastewater Materials: all materials must comply with WI Adm. Code and septic tank effluent. CON M84 and be installed per manufacturers specifications ** *Values typical for pretreated wastewater, and approval letters. DESIGN CRITERIA 0 "Wisconsin At -grade Soil Absorption System, Siting, Design & Construction Manual" (Converse et.al.1990) ❑ "Wisconsin Mound Soil Absorption System: Siting, Design & Construction Manual" Converse, J.C. and E.J. Tyler. Publication 15.22 ❑ . "Design of Pressure Distribution Networks for Septic Tank -Soil Absorption Systems" Publications 9.6 ❑ "Design of Conventional Soil Absorption Trenches and Beds ". R.J. Otis — ASAE Publications 5 -77 and "Design Manual — Onsite Wastewater Treatment and Disposal Systems ". EPA 625/1 - 80 - 012 October 1980 ❑ SBD —1057" (8.6/99) "At -Grade Component Manual Using Pressure Distribution" ❑ SBD — 10567: P (8.6/99) "In Ground Absorption Component Manual" ❑ SBD — 10705 -P (N.01101) "In Ground Soil Absorption Component Manual" Version 2.0 ❑ SBD — 10628 —P (N.6199) "Recirculating Sand Filter System Component Manual" ❑ SBD — 10656 —P (N.6199) "Split Bed Recirculating Sand Filter System Component Manual' ❑ SBD 1 —P (R.6/99) "Mound Component Manual" dSkSBD - 10691 —P (N.01101) "Mound Component Manual" Version 2.0 ❑ SBD - 10595 —P (86/99) "Single Pass Sand Filter Component Manual" 0 SBD - 10657 —P (8.6/99) "Drip -line Effluent Disposal Component Manual" ❑ SBD - 10573—P (R 6/99) "Pressure Distribution Component Manual" ❑ SBD - 10706 —P (N- 01/01) "Pressure Distribution Component Manual" Version 2.0 ❑ Drip -line Effluent Dispersal Component Manual for Multi -flo Onsite Wastewater Treatment Units MAINTENANCE AND MANAGEMENT MAINTENANCE MONITORING SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every 03 months et-year(s) (Maximum 3 yrs.) Pump out contents of tank(s) When combined sludge an scum equals one -third (113) of tank volume Inspect dispersal cell(s) At least once every ❑ months year(s) (Maximum 3 yrs.) Clean effluent Iter At least once every ❑ months JB year(s) Inspect pump, pump controls & alarm At least once every D months ®, year(s) ❑ NA Flush laterals and pressure test At least once every ❑ months M year(s) ❑ NA Valves At least once every ❑ months ❑ year(s) ❑ NA Other: At least once every ❑ months ❑ year(s) ❑ NA Page of > START UP ` 0 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 detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. OPERATION The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity and quality of the wastewater stream will affect the performance and longevity of your POWTS. The installation of water - saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water softeners, iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground surface whenever possible. Note: this does not include laundry waste, showers, dishwater, etc. Ibis system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable /fruit peels and seeds, bones, and food solids such as those produced by a garbage disposal should be minimized. Toilet tissue is the only paper that should be discharged into the system. Other non - biodegradable items such as baby wipes, tampons, sanitary napkins condoms, cigarette butts, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, paint, disinfectants, pesticides, antibiotics, solvents, etc., should not be flushed into the system as they can seriously damage your POWTS and contaminate your drinking water supply. Maintain a regular steady flow by spreading laundry washing throughout the week. Avoid vehicle traffic over all system components. Compaction of snow over the dispersal unit may cause it to freeze up. ®'Valves Valves shall be operated in the following manner: Alarms Alarms should be tested on a regular basis by the home owner. If an alarm sounds, contact an individual licensed to service POWTS, There is normally a I day reserve under regular operating conditions, however water should be conserved until any problems with the system are corrected to prevent back -up of sewage into the dwelling or surfacing. INPECTIONS Inspection shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule). Septic Tanks Component Tank inspections must include a visual inspection of the tank 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 backup or ponding of effluent to the ground surface. Access openings used for service or assessment shall be sealed and/or locked upon completion of service. Any defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective locking device to prevent accidental or unauthorized entry into the tank. When the combination of sludge and scum in any tank exceeds one -third (1/3) 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 NRI 13, Wisconsin Administrative Code. The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. Provisions are to be made to retain solids in the tank. Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating. EPPump Chamber/Treatment Tanks Component The inspection must include a test of all electrical equipment such as pumps, alarms and floats. A visual check must be made for leaks, backups, surfacing, missing or broken security devices and other hardware and the condition of the filter. Any service needs or repairs shall be promptly taken care of. E] In- Ground Gravity Component Dispersal Cells The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding at depths greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. Page of V Q%:Mound, At- Grade, In- Ground Pressure The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. The pressure distribution system is provided with an opening at the end of each lateral to be used for flushing. The laterals should be flushed at least once every three (3) years. Pressure checks of systems with multiple laterals should be done to ensure that equal distribution of effluent is occurring to promote the longevity of the system. REPORTS Reports for maintenance, inspection, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin Administrative Code. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is properly and safely abandoned in compliance with Ch. 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 other 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: 0 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 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. 0 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. M 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 CONTIAN 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 EMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTA1NER, Name Name O Phone - 7 /,$S ��s - j � � Phone / SEPTA TV SERVICING OPERATOR (Pumper) LOCAL REGULATORY-AUTHORITY Name Agency Phone Phone / U KAWPDATAIEH\POWTS OWNER'S MANUAL.doe Page of J. ' ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND • OWNERSHIP CERTIFICATION FORM Owner/Buyer c 1p► 1 k ey 6ic1 y Mailing Address ' O�W- ` - v �o h S Property Address c - coo ( OJ (Verification required from Planning Department for new construction.) City /State „ 4k"Jso t W Parcel Identification Number C AZ LEGAL DESCRIPTION / Property Locatio V. , %. , Sec. , T c;��) N R 9 W, Town of Subdivision P1 V W , Lot # (. Certified Survey Map # �� , Volume , Page # Warranty Deed # < `1 , Volume , Page # Spec house yes no Lot lines identifiabl 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. Owner maintenance responsibilities are specified in § Comm 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County 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 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. Itwe, 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 Department within 30 days of the three year expiration date. SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION we certify that all statements on this form are true to the best of my /our knowledge. Uwe am/are the owner(s) of the prope escribbe� d above—bby virtue of a warranty deed recorded in Register of Deeds Office SIGNATURE OF APPLICANT DATE • * * * * ** Any information that is misrepresented 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 and a copy of the certified survey map if reference is made in the warranty deed. .r.�. 8:34D 454 It ~!► KATHLEEN H. WALSH State Bar of Wisconsin Form 1 -2003 REGISTER OF DEEDS WARRANTY DEED ST . CROI X Co., liI RECEIVED FOR RECORD Document Number Document Name 07/25/2006 10: 20AN WARRANTY DEED THIS DEED, made between Jason Swavely and Jessica Swavely, husband and ExEWT I wife REC FEE: 11.00 TRANS FEE: 375.00 COPY FEE: ( "Grantor," whether one or more), and Tam! A. Sherman, a single person CC FEE: PAGES: 1 ( "Grantee," whether one or more). Grantor for a valuable consideration, conveys to Grantee the following described real Recording Area estate, together with the rents, profits, fixtures and other appurtenant interests, in Name and Retum Address St. Croix County, State of Wisconsin ( "Property") (if more space is S&C Bank needed, please attach addendum): 1150 N. Main Street River Falls, WI 54022 Lot 6, lat of Piney Woods Subdivision in the Town of Troy, St. Croix County, onsin 040 - 1293 - 60-000 Parcel Identification Number (PIN) This homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible, in fee simple and free and clear of encumbrances except: easements, covenants and restrictions of record, if any. Dated July l4, 2006 (SEAL) (SEAL) * son Swpvel (SEAL) (SEAL) * * 2Wca Swavely AUTHENTICATION ACKNOWL NT Signatures) Jason Swavely and Jessica Swavely STATE OF WISCONSIN ) ) ss. authenticated on July 14, 2006 ST CROIX COUNTY) Personally came before me on July 14, 2006 ttutgp� * the above -named Jason Swavely and Jessica Swavely TITLE: MEMBER STATE BAR OF WISCONSIN (If not, ` ��.�J ► �� ER t i%iown to be the person(s) who executed the foregoing T authorized by Wis. Stat. § 706.06 e an acknowled ed the same. } � J+ . Z AFI"� THIS INSTRUMENT DRAFTED BY: _ 'K s � Ryan C. Cari, Heywood, Cari & Anderson, S.C., b* 0 i, ' lic, State of WISCONSIN Dominion Drive, Suite 100, Hudson, WI 54016 A s • . , , - �ission (is permanent) (expires: / / - O ) (Signatures may be authen F edged. Both art not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFI THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED Ci2003 STATE BAR OF WISCONSIN FORM NO. 1-2003 *Type name below signffiures• INF04 L"W F— • (aoopss i • itoprotwm mm loft EAGLE 9!. UFf �►NTWA3r CQR ES SEC I F - f0tA a' ALUYIA(W CAP MW #MTN LINt OF riff SE ►ti W T09 ME ►E4, SVCTI !r N88 ° 42' Q6" E 1271- 10' Of IiS. Cf3' 138. 23 ►3a.t3 ►3a. -•--•x x- ►33.... x 130 ,....... LOT 3 4 _ a � .L� - 08 ACRES 1. 06 ACRES "' R S "` ~'� ' 334 $a F r ia, 325 30. F r t . . 17 A 1.20 ACRES 1. g0 ACRES 1.19 fir, at3 !0. F T. w 30 90. f T. w. 3t, t 3a f T. w 02, 203 $0. Fr. it 3t, 034 L : +4r NM'Od' f ��� f - -�;� y� ..._...... W. ir r• / �.�sar 3 +3a. t3' r3a. t.3' 130 T3 ''�• -� e�. r� �� �• O� / 36 T I C. S. F —� o