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HomeMy WebLinkAbout040-1256-50-000 ONcornin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Slaty end Ehuilding Division ° INSPECTION REPORT Sanitary Permit No: 420717 0 GLNI'RAL 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)]. f j 53 Permit Holder's Name: City Village X Township Parcel Tax No: Stillwell, Guy Troy Township 040 - 1256 -50 -000 CST BM Elev: Insp. BM Elev: 75M Description: Section/Town /Range/Map No: / 00'0 oo , 0 S !'v 6-r- 24.28.20.1359 TANK INFORMATION ELEVATION DAT ) • Z TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic /.� �l Benchmark d Dosing Alt. BM At . / pj•y n 5 2�� • �� g . 2� Aeration K J a D / ✓ Bldg. ewer �� F Holding I St/Ht Inlet �St/Ht Outlet TANK SETBACK INFORMATION TANK TO P(L V L Bk G. Vent to Air Intake ROAD Dt Inlet Septic / t 2-5 , ,'S Dt Bottom �> 12. Dosing Head an 33 _ Aeration -- -- Dist. Pi ihs%oC¢- R 123 •S71 Holding / Bot. System / ` 3 43 2v o 8 Final G e PUMP /SIPHON INFORMATION Manufacturer / Demand St over L p p(/y GPM t J t . 0 10q- Model Number • S TDH e may ,{ Frict'on coq Syst( H TDH t Forcemain Lent Dia. / r Dis o Well • / i S )_ J` s7 SOIL ABSORPTION SYSTEMS D S , !` e BED/TRENCH Width Length. , No. Of Tfenc es PIT DIME NS No. Pits nside Dia. Liquid Depth DIMENSIONS r ` SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREA LEACHWO Manufacturer: INFORMATION !��R OR Typ Of ystem: ` v / �� f U Model Number: DISTRIBUTION SYSTEM ! mown l Heade r/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Inta i n Pipe(s) r Lengt Dia 2 Length Dia Spacing l 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 / «e F r Bed/Trench Edges Topsoil Yes No 0 Yes j No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: 110,3 Inspection #�� Location: 258 St Annes Pkwy Hudson, WI 54016 (NW 1/4 SE 1/4 24 T28N R20W) Troy Village Lot 99 Parcel Noy' 24.28 0.6 1.) Alt BM Description= br • C(Nai 7 2.) Bldg sewer length =3 - amount of cover = 3.) Contour Plan revision Required? El Yes l No �1 Use other side for additional information. _ Date Insepct is Signature Cert. No. SBD -6710 (R.3/97) of GeV �� WINNOW sod! ry PCs E3cm**ftmimim z now raw � L �ilntrlw► Via_ �Mr 18 �.�.d► a�...ti... i - 5 cw 7 t 13� F ?003 Nw � a er It as s zip coa S ,; of. sm oNwG, oFFICE t tow H IL ibis iar• i am sow O I � :s�+.�►e ■.tee- �..�..�ra.�.... � -- - -____ — C3�r� 4 YIO ONE" •o D (� A n h e 1''a r W __� ' G �. lon � -- 2z� w s r.�ir'w oo ins ♦ bumbuft !MINOR �r tMwri CMrrItiE 0 s O AT mor AIIIIIIIIIIIIIIIII � Nw s Q i�•rrlt�r Drs rwa s Q cas+ca.rrs w.r wn+w.iM r..+ wa■rit� lip 41 ANK as O . e�..�.+ �ru...a sr.r a ©ar now so O Comoro m.+ w�.+ .a O some UO a O *I* low st Q I* Lim sit d lwr dear..+ � Q a� -__ -- a D Ash 4s O Arils Urds • Q _ — WIND spew rwAw lwt arse rr� 1Nb11 t� ram R br alw r c. °"'go" alms Goon Now soft sc� r es I Ate X !mss - 7 1 5 a Sl ._ Disc's Aiior MOM Ofti►. s>ru� cow �Aft�mWMO�wm(Ml � 0000 � O ate...1"~ �a.�. � 3 T-- Qtbl d+rslrir Mr1ip'i""' oM� c�9aA ! crtcQ.es . A-l� l � b 17 03 11:281 CALVIN POWERS 715 246 -5135 p,2 T Ho V, V w > >y S� ��y S a � 0 7 I � � i anti Ra } L 11 - N - 9 - w �.c��o�nb,� syo t 7 � / � Ln - t - � �fo` l s�, C rOi , y 1 t n LAcx Vie. T wo (Ail .ec P r-f 77$6 S (2b v` \, oo �a r-0 7* q � j Y Z C�O=� OR-� SGC�!o�s y�kj G/ 9 a K - ..._.._.._ _ . to 1 W) e .. :,I'- - - b 17 03 11:281 CALVIN POWERS 715- 246 -5135 p.2 f�( Or 1 14 a u 4 i a &I ti Raow ro o` � S C.ro,x y (2bvy \ ( oo . (&)i-67 /i` r _.. (o. X/oz� • � Z f /o:� ' _ ab Sae�� 30 .� >6G�ks Gl 9�.5. " _ /,rte uD _ 6►,, - .rip - f K;; 0 m £l 9019 r 3� $0 � r ' i `.�, �� •ice I 1 — ' _ _ -- �r4ei( ta z 2 5 I i f b./ ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer ULt y 5X> 1-L- cu c Z- L-- Mailing Address 3 / `� �- �/�/ 040 aO C 0 .17 A( a 5 � Property Address XXX S ff., F4 u�b (Verification required from Planning Department for new construction City/State r k4t r Parcel Identification Number © 1 4 3 Z S to - Sd - O G ';Z LEGAL DESCRIPTION Property Location /LI %,, y,, Sec. . T ZL N -1 W, Town of / ' w y Subdivision Lot # 99 Certified Survey Map # �- . Volume . Page # Warranty Deed # 9 �� . Volum Page # 1 �' Spec house ❑ yes�no Lot lines identifiable )(yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and' by a m asterplumber, joumeymanplgmber, restrictedplumberor a licensed pumper verifying that (1) the on-site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification . stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the thr xpira ' n date 'A /7xd 0 '7 S Off 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 thXA es a , b virtue warranty deed recorded in Register of Deeds Office. SI OF A PLIC ANT 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 r • U 2006P 126 KATHLEEN H. WALSH STATE BAR OF WISCONSIN FORM 2 - 1998 REGISTER OF DEEDS WARRANTY DEED ST. CROIX CO.. WI Docunw+t Nwtw RECEIVED FOR RECORD 10 - 09 -2002 2:00 PM This Deed, made between WARRANTY DEED oy Development Corpora o t n, a Minnesota Corporation yF - # Grantor, REC FEE: 11.00 and uy W. an Jul K . T we TRANS FEE: 899.70 COPY FEE: CERT COPY FEE: PAGES: 1 � Grantee. h Grantor, for a valuable consideration, conveys and warrants to Grantee the following �i described real estate in St. Croix _ County. State of Wisconsin: Lot 99 of the Plat of Troy Village 3rd Recn ° " npa °' Addition in the Town of Troy, St. Croix County, Name and Return Address ii Wisconsin. Guy W. & e l 313 1 SW Subject to Declarations of Covenants, Conditions and Oro co, MN 55960 Restrictions for Troy Village, recorded in Vol. 1241, Page 256, as Doc. No. 559964, and the Declaration of Golf Course. Covenants, Conditions and Easements, recorded in Vol. 1241, Page 301, as Doc. No. 559969, �i all as appearing in the office of the Register of Deeds 040- 1256 -50 -000 for St. Croix County, Wisconsin, and such other Parcel Ioerdiketion Number (RNI easements, restrictions and reservations of record, This is not homestead property or in use, and the "Buyer" obligations contained in (is) (ls not) the Purchase Agreement for this lot. ,I I I 'I b 1 G ii if fi Exceptions to warranties: Dated this 30th day of September 2002 r (SEAL) (SEAL) • _Charles S. Cook, President Troy Development Corporation (SEAL) (SEAL) j i� AUTHENTICATION ACKNOWLEDGMENT i Signature(s) Minnesota State of Wiscorrs}n, lI i Anoka J County II authenticated this day of Personally came before me this 36th day of September � ahovenamed I Charles S. Cook, President Troy Development Corporation • I. TITLE: MEMBER STATE BAR OF WISCONSIN !' to f not. me known to be the person _who executed the foregoing : authorized by §706.06, Wis. Stats.) instrument and acknowledge the same. y THIS INSTRUMENT WAS DRAFTED BY TROY DEVELOPMENT CORPORATION R ick A. Johnson Notary Public, Swe-sif -WIuRs *Anoka County, Minn. Charles S. Cook, President My commission Is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not January 31 2006 .) j necessary.) li ' Nan- of person signi In any capacay must b, typal w printed below this alanture. ti STATE BAR OF WISCONSIN it WARRANTY DEED ttCnnsot Lp h Co.. Inc. FDRM Nn.2 -laa9 A.�+ mow. w". NDPNFUK C -Mtgs= MY GOrvNYSSION EXF'M JANUARY 31, 2008 Troy u-Vveidpment' CbrMratiba 17311E Central Avenue AE Blaine, MN 55434 (612) 757 -7568 OUTLOT 3 COMMON AREA — PARK 4� Ac 4 9.405 ACRES 1323 AC 45 1 AC n J �1. LEGEND 1.1 AC F 1.642 AC UTILITY EASEMENT. 10' WIDE 0 9 1 of — . —' —.. UNLESS OTHERWISE SHOWN. 41 m 42� �- 2 __... ..... _ ............. DRAINAGE EASEMENT. 10' WOE a UNLESS OTHERWISE SHOWN. w ,.6n Ac- 1.t06 c 48 49 — — — UNLESS OTFERWISELSHOWN _ t.642 AC i 1 , " A STS +c 1 O 6 ^^ r ee c 1 3 °_ 1.291 AC .r w' 1 3�f 3 39 AC (< . I 34 $ 1 .000 31 A' 4 ,.036 Ac g 2.2 I GOLF COURS c''••• d • ?40. ook ACN 1.02d AC^o8 1 =9 & f. H < 11 - 2 AC I 38 y � 2 N 2..246 AC 3 .''• -•� _ 1. Ac og' 29 , 313 c . 10 g ' AC R ,y � t, OUTLOT 12 N a AC d 7 AC y �3' , 28� / '? H 103 Y 1.236 Ac/ COMMON AREA— ,.s49 Ac � / 1 PARK ' 9.044 C 10 A ? ?5 ¢ 2 i 5 ` 1575 ry I a o ^ 1220 AC/ ,� I 1. AC �. � / �g ti� � 51 ' , / 51 ^ ° 1390 107 o` 1.000 c 50 N — 1 01 AC of ,.300 Ac ,o'v . �? ��' S0' 100 �y '� . tea 13 a oz6 31271• ?Jy 108 .? 1.365 AC 5• 100 00 ' y ,.059 AR 1. 6 Ac 109 `' � 9 •1'' 1� 1.o4a Ac 99 � i,�561 Ac 111 s -� GOLF COURT ♦ ,. 01 A \ N 11 } ?' .... 1.4 �Y3>S:2' v 276 1 0 AC 1 �0 Q of 98 Ac }off •. -• ip 1.425 AC ? 1.004 A • -' },, 1 t 632 AC j•..� }� J ? Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 *isconsin www.commerce.state.wi.us /sb wwmwisconsin.gov Department of Commerce Jim Doyle, Governor Cory L. Nettles, Secretary February 17, 2003 CUST ID No.220537 ATTN: POWTS Inspector CALVIN W POWERS JR ZONING OFFICE POWERS EXCAVATING, INC ST CROIX COUNTY SPIA 1969 185TH AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 02/17/2005 Identification Numbers Transaction ID No. 837534 SITE: Site ID No. 655851 Guy Stillwell Please refer to both identification numbers, St Armes Parkway above, in all correspondence with' the agency. Town of Troy St Croix County NW1 /4, SEI /4, S24, T28N, R20W FOR: Description: Four Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 891987 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. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Requirements: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD- 10572 -P (R.6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD - 10573 -P (R.6/99). • ✓The EZ flow EPS Aggregate Trench System, Model 1203H, must be installed in accordance with the manufacturer's printed instructions, the plan approval and Comm 83, Wis. Adm. Code system sizing criteria. If there is a conflict between the manufacturer's instructions and the plan approval, the plan approval and code requirements will take precedence. • Access to the filter for cleaning must be provided per Comm 84 product approval conditions. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required c • Comm 83.44(6)(a)2.The orientation of the cell is to follow parallel to the surface grade contours on sloping APPF sites. The_ypper effective- edge� cel to follow the 924.0 foot co ntour. DEPARTMEW • 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 ' SEE CORRI 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 CALVIN W POWERS JR Page 2 2/17/03 • 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. Stat • 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 /instal lation /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 11 , Integrated Services WiSMART code: 7633 (608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday cbratz@commerce.state.wi.us cc: Leroy G Jansky, , Wastewater Specialist, (715) 726 -2544 T 1ME,,SHEE'r DATE: , PAGE___�_OF - 7 MOUND SYSTEM FOR A BEDROOM RESIDENCE Th p p p � In accordance with the Mound Compa�rt Manual CR. 6!} L►i±stributan mmW SBD- 10573 -P. (CR- 6/99) V LOCATED IN THE W 1/4 OF THES E - 1/4 OF SECTION ,T N, R TOWN OF 1p , ST. CROIX CO WISCONSIN.' Tray v ► � Ttin, � �. Q.� :o�. L� I N E� 4 PAGE 1 OF 7 TITLE SHEET PAGE 2 OF 7 PLOT PLAN PAGE 3 OF 7 PLANVIEW CROSS SECTION PAGE 4 OF 7 DISTRIBUTION PIPE LAYOUT PAGE 5 OF 7 PUMP CHAMBER CROSS SECTION PAGE 6 OF 7 SYSTEM MANAGEMENT pLAN PAGE 7 OF 7 PUMP CURVE PREPA_R FD FQR y N � w P ARE PO RS EXCAVATING INC. a�QS 1909185 AVE. NEW RICHMOND, WIS. 54017 PHONE: 715 -246 -5135 FAX: 715- 246 -5135 `i��ally ,D vEn OF COMMERCE =U►VDENC Feb 17 03 11:28a CALVIN POWERS (( 715- 246 -5135 p.2 ` � a Plc l^ 1Jy 5� r/ a o ��- 7 0. IVwy . S a a � 1 a � cc T��: VY � V0 � 7#- -.. (o. X/oz� • � Z C /a:� ' «10 Sce ?.o� 3a S�'� =mow' �'% 9�S•. °. am .-ro ( " 9,011 a n� a qD - Ina � t to \4 � j2 /... fir► b - P a `o Synthetic Covring &Tm- C33 Distribution Pipe Medium Sand Topsoil Let s ' el $ % Slope Bad Of 2 ( Force Main Plowed Aggregate Layer D 4A Cross Section Of A Mound System Using �5.6 1+l;� A Bad For The Absorption Area F /07 �•�^ 6 i`v it .tt^ A � Ft. H Design - uoadirt� R c,te x�Lt�a� 3'T � Ft. K q.5 Ft. L //9 Ft. j L.4 Ft. of Position z 9, 9 Ft. *- Force Main if aQ Ft. i L Observation Pipe G ----- / 6,6, - 77 -------- - - - - -- --- -.:�,- A �- v Distribution ±e of 2 Pipe 1 Aggregate Observation Pipe QACl7o r � c.a r+.,.l Pion View Of Mound Using A Bed For The Absorption Area Distribution Pipe Layout Poge of 7 Place the holes at the bottom of the distribution pipes at equal Spacing. remove all burrs from the pipe and holes, tla*O the ead of each UOUM qp wft the uao of tenS a= or 43' ft=* m a point witWn six ` �ueaded pigg, Ftovide ap mm�a the aodf of n6t k aril a Salve.: cap or Pak fw tbe- valve; t6te w 4ip or t mww pl* kcC�ss teams v - 4atMrr JAN" aPv G tat" on fun h0cexx Sao. s PLwf�1 V �®w P Ft„ 1J Ftoie Viewer- /9 Inch Ft. Lateral " 4� Inch(es) x ---�_ IScha►S Manifold ' _ inches Force Main # of holes/pipe--!;, Invent Elevation of teteraIsft. =^'Y —v aa.a a. .a,•. 1l114t� 4 ["VI'IC' 1..[1t11'i1�L 4lSVJJ JL411.V1Y t�1YL a /'a...• •.,•.._.._ Pa 7 4" CI VENT PIPE 12 MIN. ABOVE GRADE b WEATHER PROOF 25' FROM WINDOW OR JUNCTION BOX APPROVED FRESH AIR INTAKE WITH CONDUIT MANHOLE COVER CI RISER W/ PADLOCK & 6" MIN. r WARNING LABEL ABOVE . �..,. _�...4 MIN. I , INLET , 'WATER TIGHT SEALS GAS- TIGHT: f ' �l A ion= A SEAL + + APPROVED Cl PIPE .--F._ i ALM JOINTS W/ CI 3' ONTQ B i ` PIPE 3' ONTO SOLID �� SOIL ON SOLID SOIL PUMP OFF ELEV. W5, - 'T. -- + r pF RISER EXIT D PERMITTED ONL`� IF, TANK . rl MANUFACTURER HAS APPROVAL 3" APPROVED BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS SEPTIC f DOSE S TANK MANUFACTURER: • * --s NUMBER'DOSES PER DAY: TANK SIZES SEPTIC t �,Sc AL.�� DOSE VOLUME INCLUDING . DOSE -r 50 GAL. FLOWBACK: GAL, ALARM MANUFACTURER: CAPACITIES: A » v�5•/ INCHES = GAL. MODEL NUMBER: SWITCH TYPE: = 2 INCHES = GAL. PUMP MANUFACTURER: CoLt0 C = /e INCHES = ��GAL. MODEL NUMBER: W v© SWITCH TYPE: D= 9)5 INCHES= j '� GAL. REQUIRED DISCHARGE RATE _ GPM PUMP & ALARM WIRING AS PER ILHR16.23 WA( VERTICAL DIFFERENCE BETWEEN PUMP OF AND D STRIBUTION PIPE o�� PEE 2I N I + MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . .5 FEET + a"I EET FORCEMAIN X 31,3 FT /104 FT. FRICTION FACTOR , ' 57 FEET Gf TOTAL DYNAMIC HEAD = FEET IN MENSIONS OF PUMP TANK: LENGTH ; WIDTH ; DIAMETER - 7 LIQUID DEPTH POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of ILE tll+ OF&AAMON ` sirslrewl r ►Ti is Ovrruer k J�� 1t 2 �� Tank Manufactwrst W ' �eS e, r5 _ 0 vM ° ❑ NA Permit WSapdc D Dose 0 Holding Vol. l a, S C3 gal t PAN UMETERS Tank Manufacturer WI - s � D NA om! Nunbar of Bedroom Cl NA E3 septic JWDose 0 Holding vol. - y S p _ gat f+(tturrduetr of public f-acIlty Units 0 NA Effluent- 4tar Manufadtur 7 a to ❑ NA tested (average) f�► p Effl>ent Ater Model l o o Design (peak} flour - (Estimated x 1.5) 0 Pump Marmfectuuer u�a 5 0 NA Soil Application Rate lowe Pu `p Model Wr=07 '- a Io v °t� standard Mf ientlEtfluent Mo�Y Fre"M rnerst Unit 13 NA Fats, oil & Grease (FOG) 530 mg/t. a SandMravd Fkw 0 Peat Filter 8i0crerrr(cai oxygen Demand (BOD 5220 mg/i. ❑ NA (3 Mechanical Aeration ❑ Wetland Totai Suspended Solicb CM) s150 mg/l. 0 Diskoeetion ❑ ntf►ar: Pre reated Effluent Ona ty Monthly average Manufacturer Modwnical o xygen Demand (BOO 00 mgti Diapered elite) ❑ NA Total Suspended Solids (TSS) 00 mgIL 0 NA U tri- Ground fgnrvity) 0 in- Ground fprassuurbed) Face God (94om6tft m"r) 510 cfu/10Grni 0 At -Grade P(Mound Maximum Effluent Particle Size Ki in dia. 0 NA ❑ Drip -Li(W 0 0 NA 0 N •Vskms typi for domestic vrastewsrter and septic tw* afttuerit. ❑ NA ti#Ail�[ [I:NANCE SCHEDULE Service Event Se+aies, (s) (lillndrrutM 3 yw*} ❑ NA Inspect condition of tank(a) At best once every: } ❑ When combined sludge and acuan equals One (YJ of tank volume ❑ NA Pump out contents of tanks) 0 When the high yu oW mourn is activated Inspect dispersal come) At least once every. © n>att )( 3 } ❑ NA ts) ❑ NA Clean effluent filter At feast once every: D morrth O (s) ❑ NA inspect pump, purrs controls &. alarm. At toast once every: D ) O NA Push laterals and prima teat At beat once every. t3 (s) D months! 0 NA At least once every: 0, NA NllMltTt NARCE WiSTRIJCTKNO Inspections of tanks and dispex'sai cells shalt be made by an indWidusl CWWV ona of the following licensee or certifications: Master Pkurnbet, Master Pk nber Restricted Sewer. POWTS impactor, POWTS Maintsiner. Septage Serves Operator (pumper). 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 a crack for any back up or p of effluent on the ground surface. The diape mal cell(s) shall be vbual(Y :W to check the effluent levels In the observation pipes and to check for any ponding of effluent on the ground surface. The potudtng of effluent on the ground surface may indicsfie a falling condition and requ"es the irmnerliete notification of the local regulatory wAl ontY. When the combined ac cumubtbon of sludge and scum in any cm treatment tank equals e -third fY more of the tank volume, the entire contents of the tank shall be removed by a St~ SenAdng motor and disposed of in accordance with chapter NR 113. Wisconsin Adrolnistrative Cods, Ali other saniucee, including but not limited to the servicing of effluent filters. Pressurized components, pretreatmen units, and any seMoing at intervals of 512 months, shall be p by a certified POWTS Maintainer. A service report alas bs WOVId9d to the local regulatory authority 10 days of comp"On of any service event. G(NW (21021 Feb 17 03 11:29a CALVIN POWERS 715- 246 -5135 p.3 START UP AND OpERgT10N For new construction, ri Page chemieafs that may Pot to use of the POWTS check treatment tanks for the r Y impede the treatment () P esence of painting products, solvents or other have the contents of the tank(s) removed by a mass � /or damage the soil dispersal celtI) If hi �Pta9e servicing operator gh concentrations are detected System start up shall not occur when soil conditions are frozen at the infiltrative surface. During extended power outages .wastewater will be discharged to t pu heme al tanks may fill above norm highwater levels. When Power is discharge of effluent. To avoid this situation have the contents of the pump tank removed by a SeA Be n th res 9 Op �e excess rsal cell(s) in one large dose and may overload them resulting (n the backup a surface to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to operating t controls to restore normal levels within the um the he pump ump assist in m Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; foundation drain (sump pump) discharg degreasers; dental floss; diapers; disinfectants; fat; Painting products; ki fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; P esticides; sanitary napkins; tampons; and water softener rine b. medications; oil; ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shell be taken to insure that the system is Property and safety abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code; 0 All Piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. w The contents of all tanks and pits shag be removed and properly disposed of by a Septage Servicing Operator. 0 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 system. The replacement area should be protected from disturbance and compaction and should i not be infringed upon ion acemet required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the 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. replacement area will ❑ 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, 1 Mound and at -grade soil absorption systems may be reconstructed in place following removal Of the infiltrative surface. Raconstructions of such systems must comply with the rules in effect at that time, biomat at the < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAI ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER N LETHAL GASSES AXD /OR INSUFFICIENT OXYGEN, DO NOT PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMpO g TANCES. DEg7t! MAY RESULT. RESCUE OF A ADDITIONAL COMMENTS POWTS INSTALLER Name POWTS MAINTAINER e'rs Name Phone ESZLO: Jr f Phone SEPTAGE SERVICING OPERATOR (PUMPER) Name LOCAL REGULATORY AUTHOR Phone Name 5 , This document was drafted by the staffs of the Green Lake, M arquette and Waushara County Zoning and Sanitation agencies In compliance with Phone chapter Comm 83 . 2 2(2)(b)(1)(d) &(f) and 83.64(1), (2) & (3), Wisconsin Administrative Code. n • Goulds C `�X Effluent Pump 3885 APPUCATIONS • Qrvsrioad protection must smooth � • Specifically designed for the be Provided in starter unit bronze operation Silicon can be operated continuously following uses: • Shaft: threaded, 400 series an optio without damage. • Homes stainless steel. • Bearings' Upper and • farms • Bearings: ball bearings ■ Casing: fast iron volute lower heavy duty ball bearing • Trailer courts upPer and lower. tyre for maximum efficiency, construction. • Motels • Power cord: 20 toot 2 NPT discharge adaplable ■ Power Cable: Severe duty • Schools standard length (optional fdr slide rail systems, rated, oil and water resistant. • Hospitals lengths available), ■ Mechar" Seal: SILICO or end N Epoxy seal on motor Industry Single phase; CARBIDE VS, SILICON - provides al on t moisture • Effluent systems and HP — tti/3 SJTO sealing fa cm barrier in case of outer jacket with 115 V or 230 V three Stainless steel metal parts, damage and to prevent oil SPECIFICATMNS prong plug. BUNA N elastnmer& wicking. Pump • %-1 % HP —14/3 STO with ■ Shall: Cornoslon-reslstard ■ 0 -ring: Assures positive • Solids handling capabilities. Three phase: stainless steel. Threaded sealing against contaminants Y4 maximum. . 34-1 r A design. Locknut on three and oil leakage. HP —14/4 STO phase models to guard • Discharge size: 2' NPT. with bare leads. On CSA against component damage • Capacities: UP to 128 GPM, listed models — 20 foot on accidental n:verse rotation. AGENCY LISTINGS • Total heads: up to 123 feet length WW and STW TOH. are standard. ■ Motor. Fully submerged In 0"WIN Stan"M%lls wisdon • Mechanical seal: silicon high -grade turbine on for carbide -rotary seat/sillcon FERTUAES lubrication and efferent heat undenmins Lsbwawies carbide -stado transfer. series stalnlM steell metal ■ 1poger, Cast iron, semi- W Designed for continuous Parts, BUNA -N etastomer& OPW non -clog with pump- OPeratlmr. Pump ratings are • Temperature: out vanes for mechanical seal wfihin the mot+ornlaflukturees 104 ° F (4M) continuous protection, BalancW for co mmended working omits. 140OF (606C) intermittent. • Fasteners: 3()o series MMT stainless steel. 90 • Capable of running dry. zs sEMM- Sees without damage to - s0 ww1;1 SIZEWSOLIDS components. scams 70 Motor 20 ' s� Single phase: 3 so _ • �S HP, 115 V. 200 V, 234 V, r 60 fk 1750 RPM; % HP. is so ' 115 V, 60 Hz, 3500 RPM; % HP -114 HP, 230 V, 40 60 Hz, 3500 RPM, 10 • in overload M Ith 30 automatic reset. 20 Class B insulation. s Three phase: 10 • % HP —1 % HP 20Gt230/ 460 V. 60 Hz, 3500 RPM. 0 0a 10 Class 8 insulation. 70 8o 90 100 110 120 130GPM ° 10 1883 Gou is Pumps CAPAC 20 30 m , m Enecuve May, 1995 ! EZ 1203H 1203H !!!lids 70 !7780' •P a riT •: � •r irltl! y !ii 'L r ri rriR 24 " Orr M ! •'1 ,, ri• ♦R0i �� 4.6 rs* �`tt !ir •it sri irr rir •t tt t'rr Mai #wv 711 rlri irrii i! iirf • i 0r0 R i0i � �t•i ♦tii0iii ri iii � �• !� tR0'Y lMit7f i *i ►i Rr tiiRriiiii ♦liitii sriir 24 11 ?Let JV 36 ►' 12 - 1 E 2 iT Dbv (typ Void CoetTictent to A Art I �ga� given atS7.4"f In. 12 EL � r• i O.Q. of 4" pipo - 4.625 inches Sidewall (2 Sidewallsj 1 j 18.84in (( ;Zen Vold voliune per linear h. 3,14 �{ 2.J 121; td2h,rRJ •i t` Bottom — 1 — ft �.Qfl U, Q. ofccnccrcydinder 4 t_5 ;"tics T OW Soil Interface Area f Void volume in a$XMSAte at Centel cylmder =+ J_ir • s,z1,n 1 s t21m t S.I 4 Sil, t't' 022 W � } 12mtfR� 'J'�4•i _ '.SI4. (, 12ia e fl Q -Q of outside cylinders . 12 inches t Vold vol Projected Trtacp ,4 rea volume to outside cylinders >, 2 t12ini t1 ft, Sidewatl Height = 12 in. •2 = 2 Oo Sq.Ft. f Vold volume at Iwnom between cvluuders 41tT bottom R 3b Irs. = 3.00 Sq.Fl. om l 6n �l2alfi • 12inlft� _ X0,10 FV t 121ni li Projected Treace Area 5.80 Sq.Ft. ' 1 old volum at outside bottom corners (d +'? of void volume 1 ( betweerT cylinders) U.3 t5 : 2 . O.IttB t1' I Total void volume = 0.! !? * 0.422 , 0901 + 0.213 + 0. tog s 1 i Gallons per ft = 7.4 crux h t ft 1,7 b3 X � {I EPS Aggregate Trend System E?1203H Rin � '-Wo w g 'tndustriai Group 65 Industrial Park Rd. Oakland, TN 18060 sc�E � r+�: ¢tzoa►�l -.,t _ t at l � << - 2> - a, V1 isconsin Oe parvrient of Industry. SOIL AND SITE EVALUATION REPORT Page of labor and Human Reianons Division of Safety s Bwldmgs in accord with ILHR 83.05. WiS. *\ (',r90 COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. P as ' roust u� . not limited to vertical and horizontal reference point (8M), direction and ,% f pe, s Qii�� ELI.O. at dimensioned, north arrow, and location and ciistance to nearest road. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATI tk.. +° ` R DBY OATS lvta~c" PROE5PTY OWNER: �yy PERTY Q@.0" G i' LO1()tx'O�d `t/ , sZ¢ T L S ,N.R Z D %E-* W PROPERTY OWN '•S MAILING ADORE L X ff ME 0 CSM 230/ r rizV4- ADORE NE r.� R44-0. � T•GeD /ADO. CITY, STATE ZIP CO QE PHONE NUMBER QC TY OWN N EST AD n Sr. /yJN �S¢3� /a 7 s! CGS 1 -.5r. ' 0 4 'AZ*"V New ConsutxtIon Use CKI Residential / Number of bedrooms ( Addition to existing building l ► Replacement ( J Public or , commercial describe Code derived daily flow 6 gpd Recommended design loading rate D, bed. gpd/ft � trench. gpd/ft Absorption area required 25 bed. ft . r trench, ft Maximum design loading rate D. — bed, gpd/ft D,b trench, 00 Recommended infiltration surface elevation(s) _ 0Y ��- , /lyNJ! 5 5L _ tt (as referred to site plan benchmark) Additional design I site considerations /✓D TES ON 3 Parent material 401 iTe Flood plain elevation, if applicable /U It S ;* Suitable for system I CONVENTIONAL MOUND IN-GROUND PRESSURE AT GRADE SYSTEM IN FILL HOLDING TANK u= Unsuitable for sys 0 S 0 U I Ks O U O S ®U O S CRU Os ZU O S OU SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistertce Roots GPD /ft Boring # Horizon in. Munsell ` Du. Sz. Cont. Color Gr. Sz. Sh. Bed ITmnch 'r 14 0 -8 /P)- ¢�3 — 5/1 ZMS6k 071 C w I8 ZS /D Yc .Sl Si l Z.-M.4k /yj -Ar C w v7 0,3 D.G Ground !3Z ZS-3 'S Y2 1 4 Z.SY 5 �C � 6k fr e - /1// D. ¢ 0-5 elev. y ZZ-7 ft. Z, 3Z- /oY/Z B i3 �157 r Depth to limiting f actor Remarks: Boring. # �/ • DY,e S b rio — 01/ 00""k M C w /t/f •Ground �Z 4 ZL Dye � �� C SY�'S 8 Sic /cs,6k I'h Ck/ ffy�' NP`N�° elev. 7� , ?Z Z. Z ft. Depth to limiting I .i Remarks: CST Name: — Please Print JAME 0. FILMS Phone: (715) 425 -7631 Add ress: OGDEN ENGINEERING CO., 113 WEST WALNUT ST., RIVER FALLS, WI 54022 Signature: — Data Z 9 CST Numoer:222952 ./ 'PROPERTYOWNER /fir Ey Coen' SOIL DESCRIPTION REPORT Page Z of 3 PARCEL I.O. _ I in. Munse Ou. Sz. Cons Color Depth Dominant - I Mottles Structure Roots GPO /ft Boring # Horizon Texture I Gr. Sz. Sh. Bed ITrenctt -MIMMIN '09 tl p- o ¢ — sl ZISls h! r' w - .510. G z o � Ground � 6 -Z S /Y z: I L 9 eft. �3 -32 7SY2 y� f/i SY�eS s/ C�6,� �7rr cw lvf o•¢�D.S Depth to orni6ng i rig„ Remarks: Boring # � D�� ��Y� .3 S�� ZA'lsdk h'J�i^ C 5 Z ✓� O. D. G ,IZ 2 �• S i2 (� �/� ZSY ` 6 s / /c sb,� rti�'r G 5 /V elev. - 9Z Depth to limiting f,� Remarks: Boring # Yx S �: — 5•'/ Z.�►s6k G w v� D,Sa • r', Grou el ZL .SY� G Zak /DY S� e 56k /y1 w / ✓� 0 • �` D.5 ft. Z • s/ e Depth to limiting ,e -5c, D Y/Z 0 3 5 —' — — — factor Z 7 Remarks: Boring # 13 Ground elev. ft. Depth to limiting factor Remarks: S1313- SM(RAtsl M PAGE 3OF3 SITE PLAN ST. ANNEY PA A e -220 \ LOT 97 \ yo 5I 004 8-65 B -219 N rn B -221 �/ p < 0 G d B -99A ;A LOT 99 BENCHMARK: TOP OF 1" IRON PIPE L O T ELEVATION =904.92' 100 SCALE 1 = 40' BENCHMARK: TOP OF 1" IRON PIPE ELEVATION - 905.64' OGDEN ENGINEERING CO. Civil Engineers & Land Surveyors 113 W. Walnut St., River Falls, WI 54022 �. ((7 155)) 425 -7631 JARS D. FILKINS, 222952 DATE: NOTES: PROVIDE ',C3LHUM OF ' SAND BETWEEN 30TTOM OF BID AND MSTING GROUND. MOUND TO 3E a HINIMUM OF: 25' FROM DWELLING; 50' FROM IAML; 5' FROM LOT LINE. 1 ` Q o 0 0 M o 0. O � L — a0 U -° O C O 3 2 V 2 (a Q H . C@ O Y L � 3 0 T `V a) E C ° N C ° C Q 4: N O N . O. 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