The URL can be used to link to this page

Home My WebLink About040-1260-00-000 O C n ommerce PRIVATE SEWAGE SYSTEM County: St. Croix JiYisio Pr_ • INSPECTION REPORT Sanitary Permit No: 405070 0 INFORMATION (ATTACH TO PERMIT) State Plan ID No: armation you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Perna. Aer's Name: City Village X Township Parcel Tax No: Erdman, June I Troy Township 040- 1260 -00 -000 CST BM Elev: Insp. BM Elev: BM Description: •� l ._ - OI � = CST � * � TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI I FS ELEV. Septic Benchmark Dosing V Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet / T K SETBACK INFORMATION St/Ht Outlet �z•� TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic t i 23 Dt Bottom Dosing $o • Header /Man. Aerati Dist. Pipe l s 5. / I . 8 ys:�v Holding Bot. System Y'.� O to . at. ( • PUMP /SIPHON INFORMATION Final Grade 20 8•$'a / Manufacturer Demand St Cover O Model Number TDH Lift riction Loss System Head T Ft Forcemain Length ell SOIL ABSORPTION SYSTEM o BED/TRENCH Width Length J No. OfTrenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 2 So` .Pot' ( A SETBACK SYSTEM TO P/L BrLDG IWELL LAKE/STREAM LEACHING Ma a INFORMATION CHAMBER OR ri�(}4 Type Of Systee : J ' t S ` ' I UNIT Model Number: I 1( cri b DISTRIBUTION SYSTEM Head Lti Distribution x Hole Size x Hole Spacing Vent to Air Intake LDia Leng Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes �� No ❑Yes ❑ No C t COMM g N TS• (Include code discrepenci s, e erso T prese etc.) Inspection 1: 4 IT/ 12 / c> Inspection #2: � v1,. 'L c11.e' 11 0 4 4v S tt&k. . - c,� dr. Location: 393 Deer VaI Drive Hudson, WI 5,,401��[]6 --(N 1/4 NE 1/4 8 T28N R19W) I� r Valley Lot 10 Parcel No: 18.28.19. 1389 1.) Alt BM Description = 1:x.52- S.T. ho.% 1p�4• tstr4! 2.) Bldg sewer length = �. Z 1 - amount of cover = 110 ,,,, I (irtr C7T� _ Plan revision Required? 4 Yes <No Oq�I 17- �Z T Use other side for additional informat of n. I L ____ J _ __ -_ -___ _ ___ -___J ____ _____ 1p Date Inse SBD -6710 (R.3197) pctor's Signature Cert -e SdAy and BWIMW DWkM 2ol w. wmtjogm Ave.. P.O. Hex 7162 V6 WWW*. wi SM - 7162 Sift Ades t� De rtment of Commerce .. ssoienv Pttavk 1Vhamler In at000ed - Aft. coda. PO=wd Pa" Check N Revidan "mot 0 So -7 C ee.ssa Y 1a. , sl5.04( L Apptkadian PrW All htlotsadess Sties Pied LD. Muni m N A �.s Now prod Number _1 bo —6o -env 1 1 14 IQ Pn owases blediag AadseO bra iaration +� 3 0 7002 AX u 1 X Ta N R City, Stine tip Code "root ,o trer Mack N g `' �- ssbdirseism Namc CSM Number IL Tyrpa of DAdft (e3eelc A ding MW OCy4r 1 or 2 Ply D - Number of Bubac ass DvM Cl P Describe use !'o 0 seas 0-m d/ ,5� Road ,t Y 13L Type eC fir (Cbm* *Wtr so em A vollimat for AmOw ad sae)• Cam�k� its E if ) A. 1 KMW 2 0 Rapim ssses 97��Il O Rep i memeor or 6 0 Admito d iRor y use T1mic -a. 9CM* if sasymy permit previo no ha sw DS 7� Pbasit Number o �` S -13-0o IV. Iyvpe of rtrxalt (aim& an me >ppb)a is ier w0arad on) 44,4 i m - ple�mimd 1*4kand 210 Mound 47 O Sand Piper SO O Cmeotocmd Wedsed 22 O Rr.:sriaed in-0romad 410 Heldit Tack 48 O sieple Pass St O Drip Lion 43 O A*Gsft a 46 O Awabir. TfasMM unit 49 0 30 O 0dw V. Am Ldot�faos Dulp New (00 Dbpand Arn DOperval Area Sod APPWOM PaeAiadoa Rasa symem Flewdos Red Grade Regaimd Proposed RaelQais./DeyslSq R-) (each} mevwm 57 � 3 3 , .� N-A �-5 ? 9, s VL Tank mf C¢C4 in TOW Number Maadadseer ham oft S Fiber Has& Gdkms OsOoas Of Tads Coocrese Canaractid tRsas rim ftk is Tints Lets K last) Daft C]rteber VII. SYaRetaamt I. lints far *f dW PC)WTs aleenra aoc tits altaeised Plaetbm's Novae a Pleoere Nnesber �` OW CS - -J Phimbses Addems (krises. Chy. Suk*.' Code) IQ toci A- Q .Q i WS t�l VDIL ZJae Only 0 seaway Ptstooit Pee (inches" Qroaa water D Issued ) smcbwv ) O orrer cl;rar bind Adverse � p ")- EL Camewieos of Approral/Ressoees for Disapproval No &h. 4n -1- 6y$4e- � l a-Ga t rr , 4-19i 04r. &-'v 5y�R4" 5 3 - e & . t � AM& ampide phra a. Net (',Orly wiy) M de I « popr mW Lr Irmo suss 2 11 rtrraa Is arc Caan.A*;QR fR Ogtm ) : Md I i C j s ' Otto to _ gheo CIV\ � _ iw -- , I i d 1T e I pp o it, - ~- • I 1 i I : I I ' i I I , I , r I , i � 1 I 1 : I I I ' � 2 ' I , I 1 ' : , r I i , i 2 I , { I I I I i I III : I i I — 1 1 ' � I i I J �t�Q E4 0 , r ,. OO- VoAter puts ,Q� �l ��{ A!£Y, S'•'C. S T �s^i /�Lq1_w 3 $w� -rm P�' 1 i � ` pot t Safety and Buildings Division a. 201 W. Washington Ave., P.O. Box 7162 -�T � onsln Mtslismt, WI 53707 - 7162 Site Address ^ n ; to Department of Commerce .�— Z 0/ 5� 3 UcR U Number Sanitary Permit Application I accord with Comm 83.21, win. Adm. C ode, personal you al ❑ Check if Revision Mg be rued for socoodarY Pu p os es privac Law, sl 5. 1 m I. Application Informadon — Please Print AD Information State Pfau I.D. Number r J A Property Owners Name EIVED Nummbor o o -�a -00_ � Property t7�arW a Ma;fieg AY 0 7 Loanom 2002 N . tI5.; S 1 T Q N. R I q 9L ID �OV COUNTY Number BlockNuglber l Cit y, Stan Cow ING OFFICE //t} Name CSM Number S14 o I Lc IL Type of BW&ft8 (Check A that &PPIY) ✓ � Ocity 1 or 2 Family Dwelling — Number of Bedrooms u — ❑Village Public/Commereial — Describe Use o f 0 � Narest Road .Q rS e ❑State Owned III. Type of Permit: (Check only one bur on One A (numbering scheme for hsternal sase). ComPlete line B if applicablo) A ' 1 New Z ❑Replacement System 3 ❑ Rtpkc�t of 6 County »se Tarok Only Permit Number Dave Issued B. ❑ Check if Sanipmy Pe B . Issued IV. TnW of Permit. (Check alt that appty)(numbering scheme is for intalud me) 131'0 d+ sir 14 �'"` K — T i- K/ , 44 IAN. — Psessrulaed h Groaad 210 Mound 47 ❑ Sand FUM 50 ❑ Constructed �edand �� 22 0 p In- Ground 41 ❑ Holdmg Tank 48 ❑ Smgk Pass 51 ❑ Drip Lime �l �/ HT, 45 ❑ At -craft 46 11 Aerobic Treatment Unit 49 ❑ Ric' 30 ❑ otter d = V. Area IntornmaRio®: Percolation Rate System Elevation Final Grade Design, Flow IW*dred Proposed (> Arta Area SOB xtioa Elevation Rate((Ia1s./DaYs/S9.FR.) (M�•linclt) � ? 57 ✓ `� 3 5 t/ , 7 �� 9 5 . ('9, 5 csT VI. Tank Info capacity m Total Number Manubcom Prefab Site Steel Fiber Plastic C1allons GsUons of Tam Concrete Constructed Glass New Biiseroa Tanks Tads Se Hotel %Tank 1 � ( . Z Q lob Dosing Chunbez VEL Responsibility Statement- T, the for wstauatlon o f the Pown shown on the attached plans. Phtmber's Name I ftunbe S' MPIMPRS Number Business Phone Number `l9 ✓� 1 Oc t �� 5 -o� J� .513 Pbmbees Address (Street, City, State, Zip Cade) `` `` �~ v IV�� c (m ✓1 �� 17 Use Only rA p roved ❑Disapproved ye Flee) Fee (indodes Groundwater Date Issued Ag� Sign UM (No Stamps) ❑ owner Gmu Initial Adverse 01D Detetmimtiott Conditions of Approvat/Reasons for Disapproval (, 1141. 3 • �f 3' 4 Ar I Attach � Pf it0 60 1 y ) > of PPG* d— at/= = 11 to Q'QT"LF,ZQR (R nsml ) �k lh� U0. IC�,�n�orS 'l t,� � l / s. FS T a� N r t ago 06, —r-�o / s7 C,ro? / C�o�• See N /za6kQ, A tot) -- 3 43 ✓ �`T'ho�� 3t �s � �r qs ✓ 0 roc -1 Aft 6, m S / ' 0 gy p, 3� t� P � Q U 3j2,`\ I Sol II� ° I S z ao � y 1+1 Wisconsin -DepartmentofIndustry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor and'tiuman Relations [ Vision of Safety &Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 1 iin_s1ze. Plan must include, but St. Croix not limited to vertical and horizontal reference point ),'dtlection Vin?! °(a of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and dist . to,nerarest road.' ' ,\ 040-1070- I ��%° l � REVIEWED BY DATE APPLICANT INFORMATION - PLEASE P t / ALL 4 MATI0 DATE a -t . PROPERTY OWNER: �R. PERTY LOCATION .�u 1 , GOVT. LOT 1/4 NE 1 /4,S 18 T 28 N,R 19 g or W Derrick Construction, Inc. _.. () PROPERTY OWNER':S MAILING ADDRESS ST Ck ' LO1 # BLOCK # SUBD. NAME OR CSM # 1505 H #65 - A, CouN 1A na Deer Valle CITY, STATE ZIP CODE -P EFf9CE CITY [ VrOWN NEAREST ROAD New RiaMSLnd, . 54017 i 246-2320 Troy E. Cove Rd. [x] New Construction Use [K ] Residential / Number �r 4 [ ] Addition to existing building I ] Replacement [ ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate .7 bed, gpd /ft .8 trench, gpd /ft Absorption area required 858 bed, ft 750 trench, ft Maximum design loading rate ___,7__ gpd /ft trench, gpd /ft Recommended infiltration surface elevation(s) 95.00 ,/ ft (as referred to site plan benchmark) Additional design / site considerations na Parent material outwash Flood plain elevation, if applicable na ft r 7-=Unsuitable ble for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U for system ® S ❑ U �tS ❑ U ®S ❑ U ®S ❑ U ®S ❑ U EIS C U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bo xxlary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench _.....1....< 1 0 -8 10 r 3/3 none 1 2msbk mfr cs 2f .5 I .6 2 8 -15 10 r 4/4 none sil 2msbk mfr gy if .5 .6 Ground 3 15 -44 7.5 r 4/4 none cos osg ml 9W na .7 .8 elev. 9 9.5 ft. 4 44 -96 7.5 r 4/6 none ms 0SCI ml na na .7 .8 Depth to limiting factor a •d' Remarks: Boring # 1 0 -9 10 r 3 3 none 1 2msbk mfr cs 2f .5 .6 2 2 9 -18 10 r 4/4 none sil 2msbk mfr qW 2f .5 '•..6 Ground 3 18 -96 7.5 r 4/6 none ms 0sq ml na na elev. i 9 9.6 ft. n Depth to Y n limiting o i ,6 factor S z Ic a. 2 +96 Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 200th. New R" hm d WI 54017 Signature: 2 Date: 6_3_9 CST Number: m02298 PROPERTYOWNER Derrick Constructio SOIL DESCRIPTION REPORT Page 2- of 3 PARCEL I.D. # 040 - 1070 -10 ` Depth Dominant Color Mottles Structure GPD /ft Boring # Horizon Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 3 1 mfr cs 2f .5 .6 2 17 -38 7.5 r 4/4 none cos osg ml gw if .7 .8 Ground 3 38 -96 7.5 r 4/6 none ms osq ml na na f .7 .8 elev. 98. Depth to limiting fact S 0 r , (-1 I. Remarks: Boring # 1 0 -13 10 r 3/3 none 1 lcsbk mfr cs 2f .4 .5 4 2 13 -24 10 r 4/4 none sil 2msbk mfr 9w if .5 `:.6 ................. none cos os ml na na .7 .8 Ground 3 24 -84 7.5 r 4 6 g elev. 97.7 ft. — Depth to - limiting factor +84 Remarks: Boring # 1 0 -15 10 r 3/3 none 1 lcsbk mfr cs 2f .4 .5 S 2 15 -30 10 r 4/4 none sit 2msbk mfr gw if .5 .6 Ground 3 30 -88 7.5 r 4/6 none cos osg ml na na (.7) .8 t'K 8 ft. Depth to limiting 33.6/( y factor T- +88 Remarks: Boring # 13 Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) STEEL'S SOIL SERVICE Gary L. Steel Derrick Construction, Inc. 1554 200th Ave. CSTM2298 NE4NE4 S18- T28N -R19w New Richmond, WI 54017 MPRSW -3254 town of Troy (715) 246 -6200 lot #10 -Deer Valley This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of the test may or may not be as shown as permanent lot lines were not established at the time the test was conducted. _1 " =40' —BM.= top of 1 pvc pipe C el. 100.00 Alt. BM. top of 1 pvc pipe C el. 97.65' Ob b •� L Gary L. Steel 6 -3 -99 • �► nere Is A getter � � u � - �ram�. � � � � f VQ \ Q weY• � va1�� t-0- to t BjoCDiffuSet�. Units: 34» r � 34 � 76 .x greater storage volume t OPM g ' as � or shadow OW t Louvers pr�ect " Open s�'Cta ♦ Sidcwaii °Pesli n surface and inMtrat�iye tprova °mac n t PcrforMance + Very cconomieaj maximizes unmasked lea ch The 81oDi��rTm mg surface Provides of unmasked effective leachm a optimum amount objective is t g surface. Its design unmasked o p an open bottom and sidewall to allow ct on h to Clow capillary action In all dire SPECIFICq This via o�l� Standard U nit i ' y combining as be via Proifte Unit achieved b bottom with a g the traditional, open L _ series of louve Leng Effluent • 'de th ers a! g the ��........... 34" th ..........76~ ;0- a long the full length flo t° ncom lades. Height ...........14" + Width ............34 desi n h ch side. Patted nvert ...............g" Height .....II° /% g ed to a!!ow The louvers Invert ncomp effluent to pass into the Bi4 Diftusersn of eithe .. ...6.5" backfll while preventing site, when installed ugrating into the chamber. g it from of graded and co or 17", withstand sods, to depths o over respectively H- t 0 H- tors 3t.1 �f �, ST CROIX COUNTY SEI 'elC TANK MAINTENANCE AGREEMENT AND . OWNERSHIP CERTIFICATION FORM Owner/Buyer . ) U t-s;z E1 U M �/ ` �� VA- c E y A e & Mailing Address fO o HUd S O Property Address 3 92) VA- " (Verification required from Planning Department for new construction) City /State # 0.1. off, k Al/ Parcel Identification Number `�O �' �Z�'� O� ` Q 0 LEGAL DESCRIPTION Property Location 5c %4, I' '/4, Sec. l . T N -R /9 W, Town of T aY Subdivision ` i Lot # �L Certified Survey Map # ^1 - , Volume . Page # Warranty Deed # S r . Volume 3 . Page # 6 -�5 Spec house )<yes ❑ no Lot lines identifiableXyes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and' by a masterphunber, journeymanpljpmber, 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 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification . stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 e ee year a ion date. . S_ I OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of rope : d above, b irtnCfwarranty deed recorded in Register of Deeds Office. IGNA 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 _L of FILE INFORMATION SYSTEM SPECIFICATIONS Owner U J Septic Tank Capacity S a l ❑ NA Permit # O Septic Tank Manufacturer �S ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer Z a ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units RNA Pump Tank Capacity gal ❑ NA Estimated flow (average) 0 al /da Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.51 Q al /da Pump Manufacturer ❑ NA Soil Application Rate 7 al /da lft2 Pump Model ❑ NA Standard Influent /Effluent Quality Monthly average" Pretreatment Unit ❑ NA Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BODJ 530 mg /L In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) 510 cfu /100m1 ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA * Values typical for domestic wastewater and septic tank effluent. MAINTENANCE SCHEDULE Service Event Service Frequency L7 rr�jopnth(s) (Maximum 3 years ❑ NA Inspect condition of tank(s) At least once every: � C�ear(si Pump out contents of tank(s) When combined sludge and scum equals one-third (Y of tank volume ❑ NA ❑ month(s) (Maximum 3 years) NA Inspect dispersal cell(s) At least once every: 3 (li- iarls! ❑ nth(s) k Ui ❑ NA can effluent fitter At least once every: Q- iear(s) ❑ month(s) ❑ NA Ins p, pump controls & alarm At least once every: ❑ year(s) ❑ month(s) ❑ NA Flush laterals and pressure test At least once every: ❑ year(s) ❑ monthlsl ❑ NA Other: At least once every: ❑ yearls) Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer, POWTS Inspector; POWTS Maintainer, Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire 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, m echanical or p ressurized components, pretreatment Maintainer. units, and any servicing at intervals of <_12 months, shall be performed by a certified POWTS M a A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (4/01) a FART UP AND OPERATION Page � of Z 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. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the call(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong th Y Pm Perf P g e life of the POWTS: antibiotics; baby wipes; cigarette butts; condom n Y P r9 s, cotton swabs; degreasers; dental floss; diapers; " 9 ape , disinfectants; fat; foundation drain (sump pump) water, fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < < WARNING > > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name / %, Name Phone d J r f 3s Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name s G ` " �^ Phone Phone 4 (, This document was drafted in compliance with chapter Comm 83.22(2)Ib)(I)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. 2 1 w E .2 T z _j r il cy) 0 f l E fr 'E f'- Oz E a z rj (L m c Im D i 00 S T__ It- --- - __ E 2 I a: 0 CL 0 0 ni IL ANL p rj C, 0. t o E 4. o- Cr Z c go 1 20 , L) IL IL z 0 RPM U) — z , -4 Cr- AL 0 w twl af < (-j Q T cn rIj CL M X 4' 1 j) .9 0 1 WE ffi 6 lt w P.) fi- I.J I (D rn C c a 43 10 i o W Q I t 01 r u rj_ r W Er 0 b") 1 r_ t- -4- Et w Ix Ct :`4 O)v CA (10- CC to 0 w It) .10 8 01 2 41 61 ED Et U) W ' 1 .,n 'D � C W. < <f -t 0) -CCU M 9 >1 3 D") 3 M Z> =j :z w(_IUO 0 - I Y) OZ) B 'd 0 j> 3COW >--O:) 0 rt N w G)S . r� L 01 0 E x LL 0 0 L K U J ZECO p Ld 0 F_ lw_ z z U Cc r'j :3 3:r F- $ o p I UF- - lr*l 1 0 0 U J3 1 to- CO 0 WUF-w3 U3 a J WARRANTY PEED (Former statutory Form). 9TATF. OF WISCONSIN Miller-Davis (O., Minnrnnnt s, fl:inn. l , Form No. D W. 259154 ZZ-his fnbenture, Made b1! Archie J. Waxon and Lois Waxon, his wife, grantors , of St. Croix County, Wisconsin, hereby convey and warrant to' Jack J. Erdman and June M. Erdman, husband and wife as joint tenants granterr, , of St. Croix County, Irisconsin for the aunt of One dollar and other good and valuable consideration the follotviny tract of land in St. Croix County, State of TPisconsin: Northeast quarter of Section Eighteen (18), Township Twenty -eight (28) North, Range Nineteen (19) West, (NEI 18- 28 -19). REGISTERS OFFICE ST. CROIX Co.. wits. t?ec'd for H&cOrd this. _ _ 17th dey of - _ 9u UZ;t - A. D. l � . 59 A*. Deputy In Witneon TUIlerraf, The .seiirl �t;r,rntor S haveltcrcunto ,ert their hurl(! Srtcctl .v 11 s thi 14th r! „y of August .1. 1,. 19 59 SIGNED AND SEALED IN PRESENCE OF C r _ Archie J . WaXyn - Lois Waxon A � ,�._ %�.L.� - ..1'/ {sr •. l 1. , Harold ._:Valhrandt �fiti�L' D� �iSfQnSirt, St. Croix Coctnlyj Personally cainc brforr ntr, this 14th 1111 of August ✓1. D. 19 59 the ubor(! naotrd Archie J. Waxon and Lois Waxon, his wife, to nic kn4wen to br I /tc prrso)i it ho c.LrcctIrd Ihr forgoing i nst ri t tit cnt and arknoivled,cd tit sau,r. Hugh �. (Votary Public,--- Saf_ CrIIix CountJ, Wis. I-Ify co"Itiission expires S ept. 1 2 , „1. 1). 1cI 60 (. •7 yprwrite Name under eorh Siqnorure ' P(tOK 360 f” "E �.,1 CO RD F a Z M m Oro CA mom y O cm p � N � co ;* o a Q z o -b A w y !4 ch im w G p, a a 0 Ch a OM -` a o to m y "'a a° !