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HomeMy WebLinkAbout040-1288-60-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix INSPECTION REPORT � Safety and Building Division ` _^ Sanitary Permit No: 463492 0 GENERAL INFORMATION (ATTACH TO PERMIT) 1D ` State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. �g ° Try• /b•+ Permit Holder's Name: City Village X Township Parcel Tax No: Mark Anthony Homes, Inc. I Troy, Town of 040 - 1288 -60 -000 CST BM Elev: / Insp. BM Elev: BM Description: Section/Town /Range /Map No: G • LID • 0 C-51- B / 31.28.19.1641 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ZW Bench ar b a? Z, lC am- l02•1 .0 1 Dosing �-D t t Alt. B . \ 7 /D 3 O Aeration Bldg. Sewer ZA O. ck Holding St/Ht Inlet c /AN 2Z1 G 3. . St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic z3 r Dt Bottom Dosing r t `� 1 u Header /Man. s }� � • // r Aeration H`CJ I Dist. Pipe • 8v s q� • (3 Holding Bot. System (i • y L / Ftial Grade �/[ PUMP /SIPHON INFORMATION �w1A 1,t a� +Sm� - l' Manufacturer Demand St er LL fu GPM ` Model Number ^� �`•O �d � 3a •br!► H Lift Friction Loss System Head TDH Ft I p. Iv3 0 .4 4. s Forcemain Len th 1 Dia. ?_ rr Dist. to Well SOIL ABSORPTION SYSTEM p • Sfl 4 O�DrRtMCH Width / Length / No. Of Tienekes PIT DIMENSIONS No. Of Pits inside Dia. Liquid Depth DIMENSIONS 4� I no , s SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING cturer. INFORMATION Type Of Syst�� : r � CHAMBER OR M DISTRIBUTION SYSTEM V9 {.o ror:�L- Header/Manifold IDistribution x Hole Size �� x Hole Spacing Vent to Air Intake ID I r Pipes) � I/ / Length �' Dia Lengt / Dia ' u s pacin g l- • C 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 E Yes [ No [id Yes F ] No CO ENTS p�d discre In ' ,tso s present, etc.) Inspection #1: * / Inspection #2: 1P Loca ion: 3 3 Indigo Trail H uds 54 16 /4 NE 1/4 3 T28N R19W) East Meadows Lot Parcel No: 1.28.19.1641 -• �--- 1.) Alt BM Description � 2.) Bldg sewer length = 4 IN ` - amount of cover = K Plan revision Required? _] Yes XNo Use other side for additional inf�rma ion. Date t Insepctor's Signature Cert. No. SBD -6710 (R.3/97) Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 St. Croix l im�� Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) Department of Cbmmerce (608) 266 -3151: 9 Sanitary Permit Application LD. N tuber ' 7 In accord with Comm 83.21, Wis. Adm. Code, personal information you pr l Of may be used for secondary purposes Privacy Law, s15.04(1)(m) O < roje4y ildress f different than mailing address) I. Application Information - Please Print All Information IX C i I Trai 3 -73 - .Z;J7 ,� Property Owner's Name 2 z P 1 Lot 4 Block # Homes Inc. , Mark Anthony 3 & o'^ , 6 .I Property Owner's Mailing Address Property Location P. O. Box 1074 NW NE City, State Zip Code Phone Number fie, %, Section 31 Hudson, W1 54016 715 - 386 -2928 28 1 Ycircle one) T N; R r ✓ 11. Type of Building (check all that apply) DK end 1 ^�� 4 1 or 2 Family Dwelling - Number of Bedrooms 4 No Y Subdivisl Name CSM Number ® Public /Commercial - Describe Us East Medows -7 ❑ State Owned - Describe Use �� `, k / City Village Qlbwnship of Troy III. Type of Permit: (Check only one box on line A. Complete line B if applicable) _ lo - &C) - �b A, 0 New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permitltenewal ❑p Revision ❑Change of 11 Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV Type ofPOWTS System: Check all that appl ❑ Non - Pressurized In- Ground 0 Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In-Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirc Sand Filter Recirculating Synthetic Media Filter ❑ Leaching Chamber 13 Drip Line Cl Gravel -less Pipe 11 Other (explain) J/6 ulatipg O i V. Dispersal/Treat ent Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (s Dispersal Area Proposed System Elevation 600 0.5 600. 600 (Z 98.50' VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units /may Concrete Constructed Glass New I Existing Tanks Tanks Septic or Holding Tank 1200 1200 1 Weiser x Aerobic Treatment Unit Dosin chamber 800 800 1 Weiser x VIL Responsibility Statement - 1, the undersigned assume respoiVibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number Roger Nelson MP226497 715 - 273 -4444 Plumber's Address (Street, City, State, Zip Code 122 East Summit Avenue Ellsworth, Wl 54011 VII oun /De a rtment Use Onl pproved 11 isapproved Sanitary Permit Fee (includes Groundwater Date su Issui gent Sign o Surcharge Fee) !' 25 7 y� ❑Own eason for Denial "( G(J OJ IX. Conditions of Approval/Reasons for Disapproval 3 ) n 1� J,`�� YSTEM OWNER: � �/B,ez,,j vt ¢ d t Septic tank, effluent finer and P dispersal cell must all be services / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained V as per applicable code I ordinances. - Attach complete plans (to the County only) f the system on paper not Id than an 81/2 x 11 inches in size ' 57 Cow �-to A-s -' A- SBD -6398 (R. 01/03) �Oe, �• r i Mark Anthony Homes Inc. P. 0. Box 1074 Hudson, WI 54016 NW %,NE%, SR, T28N,R19W East Meadows Lot #6 Troy Township St. Croix County Scale 1"= 40' Weiser 12001800 tank BM #1= 100.00' top of PVC pipe BM #2 = 98.35 60' of 2 "force main �0 VI �o- .G .f pia v o we u i � 7 pie I .S7'Br' -I GJ.� �►r /� [182. „ C 7 en7",'ri ►1 8x+11 D D ►'� 2 5 0K f h Y33. 38'• --�� i Page 8 of 8 A Mark Anthony Homes Inc. P. D. Box 1074 Hudson, WI 54016 NW %,NE%,S31,T28N,R19W 1 • East Meadows Lot #6 Troy Township St. Croix County Scale 1 " = 40' Weiser 12001800 tank BM #1 = 100.00' top of PVC pipe BM #2 = 98.35 60' of 2 "force main � � 4 r A ') 0 v� �a , G Qs � o we u Sk. i � 7 pie I C7g2 2 C �'cn v� 0 ew►1 dM2 y33. 38'' Page 8 of 8 Wisconsin department of Commerce SOIL EVALUATION REPORT Page -- of Division of Safety and Buildings * in accordance with Comm 85, Wis. Adm. Code County S Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road, rD 40 _ ) Zg — ( Please print all Information Review d by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location ff M n n J I 4A1 0 Govt. Lot VI 0 1/4 h E-1/4 1 T Z N R E (or) W Property Owner's Mailing Ad Lot Block # Subd. Name or CSM# 1 j 6 C' State Zip Code Phone Number []City nVillage WYown Nearest Road M New Construction Use Residential / Number of bedrooms Code derived design flow rate U _ S l7 GPD ® Replacement Public or commercial - D rite -' 3 Parent material l op 55 (U / 1=1'6tyd,e�i / evation if applicable ft. General comments and recommendations: r^o !r- t�Eld L Whir 7 QQ� Boring p�,t \, ❑� # ©t Ground surface elev. r' R� Depit� "ding facto in. ` \ Sal Amlication Rate Horizon Depth Dominant Color Redox Description /T ' j ure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color r. Sz. Sh. `Eff#1 `Eff#2 q-%) 7, — 05c, 7 1 ® Boring # 0 Boring 0 Pit Ground surface elev. 3 .? Q ft. De to limiting factor 3 Z- in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 *Eff#2 [ 0 - a0 10W - 0 2- Z �S 4� thl C �,J `4�J 0 I"fr 3 C 2 �s is S 05cl pi I — , 7 /, .2 " Effluent #1 = BOD > 30 220 mg/L and TSS >30 5 150 mg/L " Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (P1nse Prin — , � � � Si a � 3 um . iloota Address l /� Date Evaluation Conducted Telephone Number I Property Owner Parcel ID # Page 2 of 3 F-3-1 Boring # Boring Pit Ground surface elev. q; i ft Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fF in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. *Eff#1 "Eff#2 ra 2 e— S. jl k r CO 2- 1.5 r s Lo Sd )h s fl m1i ck1 /U imp/ 41 CIA) 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/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Efr#1 `Eff#2 Boring Ground surface elev. ft. Depth to limiting factor in. F Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. "Eff#1 "Eff#2 i Effluent #1- BOD, > 30 < 220 mg/L and TSS >30 1150 mg/L * Effluent #2 a BOQ, a 30 mg/L and TSS 130 frgfL 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. SW433(Y A(R.9710fY)- b 9 &q8 Q I top 0( Qvc. V,v e Q �2 9: 3 s 6 99.yo C33 q,qs Le, 1 �e- y b Si, e- - 7 3 Z7 Safety and Buildings commerce.�vi. OV' 4003 N KINNEY COULEE RD g LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 isconsin www.wisconsin.go isco sin.go e partment of Commerce isconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary April 29, 2005 CUST ID No.226497 ATTN: POWTS Inspector ROGER D NELSON ZONING OFFICE NELSON PLUMBING ST CROIX COUNTY SPIA 122 E SUMMIT AVE 1101 CARMICHAEL RD ELLSWORTH WI 54011 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04/29/2007 Identification Numbers Transaction ID No. 1131718 SITE: Site ID No. 697473 Mark Anthony Homes Inc Please refer to both identification numbers, Indigo Trail above, in all correspondence with the agency. Town of Troy St Croix County NW 1/4, NE 1/4, S31, T28N, RI 9W Subdivision: East Meadows; lot 6 FOR: Description: Proposed Four Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 1014984 Maintenance required; 600 GPD Flow rate; 32 in Soil minimum depth to limiting factor from original grade System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.0 1 /0 1); Pressure Component Manual - Version 2.0; SBD - 10706- P(.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 use: • This system is to be constructed and located in accordance with the approved plans, and the "Mound Component Manual for Private Onsite Wastewater Systems Version 2.0" SBD- 10691- P(N.01 /01). • The pressure network is to be constructed in accordance with publications SBD- 10706- P(NO1 /01) "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems - Version 2.0" and/or the sizing methods of publication "SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/8 1)". • 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 private sewage system 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. Stats. • The area within 15 feet horizontally below the system shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. P. 10I -. J. Conditionalty AWE ROGER D NELSON Page 2 4/29/2005 • 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: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • Comm 83.52(1)(a) - 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. In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • 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. Note: The installer shall verify with the property owner that the routing of the sewer line through stormwater drainage easement is permissible. 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 &x4off�-� Balance Due $ 0.00 Gerard M. Swim POWTS Plan Reviewer - Integrated Services (608)- 789 -7892, Mon. - Fri. 7:30 am to 4:15 pm WiSMART code: 7633 jswim @commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Mark Anthony 4 bedroom Mound system Owner's Name: Mark Anthony Homes Inc. Owner's Address: P. O. Box 1074 Hudson, WI 54016 Job address: Indigo Trail Legal Description: NW 1/4, NE 1/4, S 31, T 28, N R 19 W Township: Troy County: St. Croix Subdivision Name: East Meadows Lot Number: 6 Block Number: Parcel I.D. Number: Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings RECEIVED Page 4 Lateral and dose tank Page 5 System maintenance specifications APR 2 2 2005 Page 6 Management and contingency plan Page 7 Pump curve and specifications SAFETY & BUILDINGS Page 8 Plot Plan Designer: Roger Nelson License Number: MP 226497 Date: 04/20/05 Phone Number: 715 - 273 -4444 Signature: //V Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) Version 4.0 (R. 04/03) u�-A}AKIMEN1 OF cot "'MERCE Page 1 of 8 6 v1swN OF TY D BUILDINGS 9 SEE CORRESP NDENCE I Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 400.00 Estimated Wastewater Flow (gpd) Table 83 -44 -3 in -situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150 %) coliform of - 36 inches. 600.00 Design Flow (gpd) 7.00 Site Slope ( %) 98.00 Contour Line Elevation (ft) 32.00 Depth to Limiting Factor (in) 0.50 In -situ Soil Application Rate (gpd /ft) Distribution Cell Information A I Dispersal Cell Length Along Contour (ft) = 8.96 Cell Width (ft) Dispersal Cell Design Loading Rate (gpd /ff) Influent Wastewater Quality (1 or 2) Are the laterals the highest oint in the distribution Y Pressure Disribution Information network? Enter Y or N (c or e) a Center or End Manifold 2.99 Lateral Spacing (ft) If N above, enter the elevation ft 3 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) 4.00 Estimated Orifice Spacing (ft) = 11.77 ft /orifice 2.00 Forcemain Diameter (in) 60.00 Forcemain Length (ft) Does the forcemain drain back? Y 83.00 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 9.79 Forcemain Drainback (gal) 15.17 Vertical Lift (ft) 40.03 5x Void Volume (gal) 0.60 Friction Loss (ft) 49.82 Minimum Dose Volume (gal) 22.27 Total Dynamic Head (ft) 21.01 System Demand (gpm) Lateral Dia Sele Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x 1.00 x x 1.50 x x 1.25 x 2.00 1.50 x 3.00 2.00 x 3.00 x Gallons /inch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1200.001 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Weiser 800 - 325 -8456 1 Manufacturer gal /in (enter result in cell B49) Dose Tank Information Effluent Filter Information 800.001 Dose Tank Capacity (gal) JZabel 1-800-221-574,fl Filter Manufacturer 22.241 Dose Tank Volume (gal /in) IA100 Filter Model Number Weiser =Manufacturer Project: Mark Anthony 4 bedroom Mound system Page 2 of 8 Mound Plan View .......................... ... ................................. 1 /10 B Observation . . . . . . . . . . • . . . J rvation Pipe ' ' ' , * , %*" 3 . . . . . . . ............. . . . . . . . . . . - 7 - -� K 5 A W ........ ... ............... B ... * * - ................................... ­­ . .................. *­* .................. ......................................... ........................................ * .... ................................... ..... ................................... . . . . . . . . . . . .............................. ............................. .......................................... ................. ........... ...... ............ * ... ........................................ ...................................... L Mound Component Dimensions A 8.96 ft E 13.53 n H F1 .00 ft K 7.69 ft B 67.00 ft F 9.00 n F 4:0 ft L 82.38 ft 22.33 ft 6.00 0.50 t J 4.34 ft W DAin G I F (W) Dispersal Cell Area 1 1205.151 (ft) Basal Area Available (gpd/ft) Linear Loading Rate 6.70 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 100.25 (ft) H �2 G ........... I ............ ..... F Dispersal Cell 99.00 (ft) Lateral ....... ....... ....... ....... ....... ....... 98.50 (ft) —00. Invert : --,. .. .. -, .. -.:4 P.. ........ ..... ... ..... . ............. .. . .. ......... ..... Dispersal Cell . . . ............ .... ........ ...... ..... . Elevation E ......... ............... ........................... ............... ................ 4 4 98.00 (ft) Contour Elevation 7.0 % Site Slope Geotextile Fabric Cover Shading Key c T Dispersal Cell See lateral details on Topsoil Cap 0 CL 1.5 ft . • . • . %. • • Page 4 for number, size, .0 Subsoil Cap 5 .� M "e and spacing of laterals. . % Laterals are equally • ASTM C33 Sand F ME= Tilled Layer 0.5 ft spaced from the I Lateral I %%. distribution cell's Aggregate a 0 centerline in the A distribution cell (AxB). Project: Mark Anthony 4 bedroom Mound system Page 3 of 8 End Connection Lateral Layout Diagram Center the laterals over the A & B dimension • a Turn-up wf ba l l valve or of as n out pl u g E P All laterals are identical IE X —�l Holes drilled on the bottom of the lateral equally spaced S Laterals & force main of PVC Sch 40 S (per COMM Table 84.30 -5) Force main connection via tee or cross to manifold at any point. Number of Laterals 3 Orifice Diameter 0.125 in Lateral Diameter 1.00 in Orifice Spacing (X) 4.09 ft Lateral Length (P) 65.44 ft Orifices per Lateral 17 Lateral Spacing (S) 2.99 ft Orifice Density 11.77 fe /orifice Lateral Flow Rate 7.00 gpm Manifold Length 5.97 ft System Flow Rate 21.01 gpm Manifold Diameter 1.50 in Total Dynamic Head 22.27 ft Forcemain Velocity 2.15 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and ----► Comm 16.28 WAC in. min. Disconnect ----1111--- - Tank component is property vented x E--- - Alternate outlet location Forcemain diameter Weiser 800 - 325 -8456 Manufacturer 2 in. Cap acityl 800.00 Gallons Volume 1 22.24 gal /inch A Weep hole or anti - Dimension Inches Gallons B siphon device A 21.73 483.30 B 2.00 44.48 C Pump off elevation (ft) C 2.24 49.82 1 83.83 D 10.00 222.40 D Total 1 35.971 800.00 11 .4 Dose tank elevation (ft) 3" Bedding uncTer tank. 83.00 Alarm Manuafacturer IS, J. Electro Systems Alarm Model Number I 101 HW Pump Manufacturer Goulds Pump Model Number I PE 41 Pump Must Deliver 1 21.01 gpm at 22.27 ft TDH Project: Mark Anthony 4 bedroom Mound system Page 4 of 8 Mound Svstem Maintenance and Operation Specifications Service Provider's Name [— Installed by Nelson Plumbing Phone 715 - 273 -4444 POWTS Regulator's Name St. Croix County Zoning Phone 715- 386 -4680 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg /L Septic Tank Capacity 1200 gal Maximum TSS 150 mg /L Soil Absorption Component Size 600.32 ft Maximum FOG 30 mg /L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu /100 mL Service Frequency Septic and Pump Tank Inspect and /or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test month) Pressure System Laterals should be flushed and pressure tested every 1.5 years Moundl Ins ect for ponding and seepage once every 3 ears Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn -up Detail Finished ............... Grade 6 -8" Diameter Lawn .. Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution . Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Mark Anthony 4 bedroom Mound system Page 5 of 8 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD- 10691 -P (N.01/01) and SSWMP Publication 9.6 (01181)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 84nches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet fitter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent fitter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. if an effluent filter is installed within the tank it shall be inspected and serviced as necessary. I Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October - February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L ROD 30 mg /L TSS, 10 mg/L FOG, and 10 cfu /100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contimencv Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. I Project: Mark Anthony 4 bedroom Mound system Page 6 of 8 I I I • � MOULDS PUMPS Submersible Effluent Pump PE SPECIFICATIONS MOTOR FEATURES Pump — General: General: ■ Corrosion resistant - Discharge: 1 NPT • Single phase construction. • Temperature: 104OF (4K) • 60 Hertz ■ Cast iron body. maximum, continuous. when • 115 volts ■ Thermoplastic impeller and fully submerged. - Buik -in thermal overload pro- cover. • Solids handling: '/" wcdon with automatic reset. ■ Upper sleeve and lower maximum sphere. • Class B insulation. heavy duty bail bearing APPLICATIONS • Automatic models include a • Oil - filled design. construction. float switch. • High strength carbon steel ■ Motor is permanently Specially designed for the • Manual models available. shaft. lubricated for extended following uses: • Pumping range: see PE31 Motor: service Ile, • Mound Systems performance chart or curve. - .33 HP, 3000 RPM ■ Powered for cor tinuous • Effluent/Dosing Systems PE31 Pump: • 12,0 Maximum amps operation. • Low Pressure Pipe Systems • Maximum capacity: 50 GPM • Shaded pole design ■ M ratings are within the g PE41 Motor. working limits of the motor. Basement Draining Maximum head: 25' TDH • Heavy Duty Sump/ PE41 Pump: • .40 HP, 3400 RPM ■ Quick disconnect power Dewatering • Maximum capacity: 60 GPM • 7.5 Maximum amps cord, 20' standard length, • Maximum head: 29' TDH • PSC design heavy duty 16/3 SJTW with NEMA 5 -15P, three prong, PE51 Pump: PE51 Motor, 115 volt grounding plug. • Maximum capacity: 70 GPM • .50 HP, 3400 RPM ■ Complete unit is heavy duty, Maximum head: 37' TDH • 9.5 Maximum amps portable and compact. METERS FEET • PSC design ■ Mechanical seal is carbon, co ceramic, BUNA and stainless MODELS• PE31, PE4,, �ESt steel. 35 Ht 3a, .ao, so ■ Stainless steel fasteners. 1 10 2 GPM 30 ! t - t _ ,_ .. AGENCY usnNGS i i 1 Fr j. 1 1 u7 25 I } f s I , i �c us 1 UL 778 and CSA 22.2 108 Standlard5 . ..- + m -• s ,- ;.: + fan Standards Association _ Flo AR39549 _ — -- _ Goulds feu a ISO 9001 r P } Y t ..... ... }.. f . HIPS " RE�CtIRd 10 F- f i f r r + �...F...t.._ J 71 0 0 10 2 30 4 50 60 ` 70 GPM 80 0 5 10 i s M CmIds Pumps 4 2002 Goulds Pumps CAPACITY �Q�, / Effective fu'ovember, T002 BPF31/41 G Y X ITT Indust 02/07/03 FRI 08:49 FAX 715 386 4686 ST CRX CO ZONING Q001 ST Own COtmy SB nc TALK MAIN'1BNA M AOMMbMT AND OWNARSM CMTMCATION FORM pl - 7 3 T 2 (Vaffiamim mgWmd Roue vlsnniog Depafftm c for sew C ty/Stabe ,� t i i � F 6-L L 5„ L" t Pa vd Idcarifi adon Numbfw 0 4D - l ZSS - ( o - ao i CG4&L MACR1�ON ply Location ILL y &w. -It-, T-L-N R-d- w , Town of Sdx1vis C-�' jS i 12' L&4au >e . Lot # • testified Survey Map # V f' L,iA # Wummly lDeod # 55 2 5 v olume Z`6 D Page # .(I Z-- -• Spec bonne to you ❑ no Lot lines ideadable tR yes ❑ no AY�1tiAII!IT�IANCE Imp9oparUw=dmo aoeofYmsap*symmawldnttiaits p .,chilmato lasaftwaetee.IkoWm b m lm =ado of p= O* at dw sepia taak every lase years or soamg� it' need by t 0000014ub Wbat 7'Q Pd Wo dw Wd= am atfeot dw Emotion of ffie aepeic taah as a anmtima m ~ in the waste disposal syacem. M. pMpwW oww apm is submit to St. Cmk Zo0mg Depatmum s smo. by dw oases and by a moWphmebes .joma do spoodwwo is in peeperapua t6 000dMm and/orM &ftw impeodmsad pm giag (if tteommey), Vwe. dw tmdaaipsod Ern read ftc slave regal and agme m m bftk the pdwob wmp disposal ayso • A& des set teeth, beceia, as sec by Rte Depstt oM of C7omm m and fire Dqu mat of NatuoI RaomM sate of Wisooma5a. Cudsoldoa staftegymsoptksysftmhubcmnuiuftbwdgoobecon3plMd=dvctomdtodkcgLCWkCkmW7AIMrMO25M thla 30 dqs of the one yeas =Vhvdm daft. DATE OF APPLICANT CSIC TINICATION of I (we eatft that aU statements on this timm are tine m do best of mp (0w) lmowis*- I (we) am (ere) tiro o aaec(s) dw peopeety desa *W above, by vuum of a wm aty deed reooeded in 'RRegi W of Deeds Ofoe. SIGMT R8 OF APPLICANT DAM s««««« Any ikon that is rank in dte asaibuy pmdt b'eht8 eovolmd by the Zsaiaft DVKURN& +e ludWs with this appHcW m a stamped wm =W dead from 66 RqPWr of Deals Off" a *W of the ocdM d gamy asap if setimmoo is made in dw wmaaty deed i� IT 2 8 0 6 P Z S 2 7'9 t5 52.3 KATHLEEN H. WALSH State Bar of Wisconsin Form 1 -2003 REGISTER OF DEEDS WARRANTY DEED ST. CROIX CO., WI RECEIVED FOR RECORD Document Number Document Name 05/20/2005 11:15AN WARRANTY DEED EXEWT I THIS DEED, made between Glen M. Wiese ( "Grantor," whether one or more), TRANS FEE: 11.00 TRA FEE: 256. St+l and Mark Anthony Homes Inc. COPY FEE: ( "Grantee," whether one or more). CC FEE: PAGES: 1 Grantor, for a valuable consideration, conveys to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. [recording Area Croix County, State of Wisconsin ( "Property") (if more space is needed, please attach Nam turn Addres addendum): Lot 6, Plat of East Meadow in the Town of Troy, St. Croix County, Wisconsin " 6:11 /D7� 040 - 1288 -60 -000 Parcel Identification Number (PIN) This is not 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, restrictions and reservations, if any, of record. Dated May , 2005 �r 6YJi�_ (SEAL) (SEAL) *Glen M. Wiese (SEAL) (SEAL) * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) authenticated on STATE OF WISCONSIN ) ) ss. ST. CROIX COUNTY ) * TITLE: MEMBER STATE BAR OF WISCONSIN Personally came before me on May 20 , 2005 , (If not, the above -named Glen M. Wiese authorized by Wis. Stat. § 706.06) to me known to be the person(s) who executed the foregoing instru nt an owledged the same. THIS INSTRUMENT DRAFTED BY: Kristina Oaland, Estreen & Ogland 304 Locust Street, Hudson, WI 54016 Notary Public, State of My Commission (is permanent) (expires: �G (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED © 2003 STATE BAR OF WISCONSIN FORM NO. 1 -2003 * Type name below signatures. Roger D. Bever: INFO- PROT" Legal Forms 800- 655 -2021 www.infoproforms.com Notary Public State of Wisconsin W ! i z xn 6�+ �6` 111 e f ig, I fit 1 s , .Lf'!tf �+tlr0a.'O11 i 111 ,1 - -`� H i H 1511 .. W .� � V i ii i _ In b .!$ 000 208 ` I L 1 I CAR gas 2.. Sig .00'i0Y i r -- / L O � o ----- - - -� r ---- - - - - - -� 1 1 I 1 E t t E ki arts - �"t I Rig > G • I r� C� q D - _ _ _ a 3 1 b � > ��jj • g s .d. 'H S ',L'J `� e► a►ee6 4tOIpV I ►- ro - id me Wes G3Wv 1 55 c U+aGV aan 8QN117 a]1 L�1�If 1 srn wt wnoQ- waaN , Parcel #: 040 - 1288 -60 -000 05/20/2005 04:00 PM a PAGE 1 OF 7 Alt. Parcel #: 31.28.19.1641 040 - TOWN OF TROY Current k ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner GLEN M WIESE * WIESE, GLEN M W12491 890TH AVE RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 2.506 Plat: 1927 -EAST MEADOW 01 SEC 31 T28N R1 9W NW NE LOT 6 EAST MEADOW Block/Condo Bldg: LOT 6 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 31- 28N -19W NE NE Notes: Parcel History: Date Doc # Vol /Page Type 11/25/2002 699805 2059/403 WD 08/23/2002 688019 1957/17 LC 08/22/2001 654452 1703/586 QC 06/21 /2001 649000 1665/308 R9 mo ... 2005 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/23/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.506 90,000 0 90,000 NO Totals for 2005: General Property 2.506 90,000 0 90,000 Woodland 0.000 0 0 Totals for 2004: General Property 2.506 90,000 0 90,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 %2 95 ��fs