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` Wi:..onsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 453482 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Dan Lan Homes Troy Township CST BM Elev: Insp. BM Elev: BM Description: n Section/Town/Range/Map X693 o k X93 cat C,-5 V P; 19.28.19. TANK INFORMATION ELEVATION DATA -2/i 21r, 21:e~ TYPE MANUFACTURER CAPACITY STATION BS 141 FS ELEV. Septic tAij Z, J r Benchmark 19 13. 6 Dosing Alt. BM 66 '756 AeM ion I Bldg. Sewer Holding St/Ht Inlet .35 W1 -t TANK SETBACK INFORMATION SVHt Outlet _-11 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic ' / Dt Bottom Sri I'S Dosing Header/Man. 3S Aeration Dist. Pipe i Holding Bot. System PUMP/SIPHON INF TION final Grade (p.lclP ~qZ ein Manufacturer DePlmand St Cover LA~ 0. 7 Model N ber C Z5 TDH Li Friction % Loss S Head 5H T Ft Forcemain Le Dia. Dist. to Well 44~~ SOIL ABSORPTION SYSTEM BEDITRENCH Width + Length / No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 2. 8 C A C \ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: \ INFORMATION CHAMBER OR 11W Type Of System: i / UNIT Model Number: t,vw v, z y DISTRIBUTION SYSTEM 1 S = p Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intalte Zb A L] Pipe(s) ` _1*1~ I--, Ve " : , ✓N _ Length Dia 7 Length Dia Spacing 4-,) L SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over j Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil \ Yes [T] No `_'Yes Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 214 Murfield Trail Hudson, WI 54016 (SW 1/4 SW 1/4 19 T28N R19W) Troy Village 6th Addition Lot 162 Parcel No: 19.28.19. 1.) Alt BM Description = F, till C,~~ 2.) Bldg sewer length = /5-- amount of cover = ' j j Al- T ? L 1 Yes No Use otherl q side forAadditional information's Date Insepctor ignatu Cert. No. SBD-6710 (R.3/97) a b~ ~,°~l b ff lp Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 5T ezviy Madison, 53707 - 7162 Co. Sanitary Permit Number (to be filled in by ) NVIsconsin (608) 266-3151 ~ p~ Department of Commerce S3 D Sanitary Permit Application State Plan I.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal information you provide I may be used for secondary purposes Privacy Law, s15.04(lxm) Project Addmss (if different than mailing address) ` rf• 4. 1. Application Information - Please Print Ali Information 141,C_ Property Owner's Name Parcel Lot Block # A/ Lip/ E'S LTD 6/4r:L- - Property Owner's Mailing Address Property LOME1011 ZZ-/ ST/~c?' 'V., Section City, State Zip Code Vhooe3imnber 5J, 5, ol R,LL / fEtncle H. Type of Building (check all that apply) ~ taAV, ` t'I i or 2 Family Dwelling - Number of Bedrooms ~Q S 'vision N - ❑ Public/Commercial - Describe Use ?S~ ❑ State Owned- Describe use ❑City_❑Viltage J*bwnship of J.H. Type of Permit: (Check only one box on line A. Complete line B if applicable) A New System ❑ Repiac emeart System ❑ Tmatmeat/Holding Tank Replace Only ❑ Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New list Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. T~ype of POWTS System: Check all that s 1 r J'Non -Pressurized In-Ground ❑ Mound 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil At-Grade ❑ Single Pass Sand Filter ❑ ' Constructed Wetland ❑ Pressurized In-Gro and ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating ' S thetic Media Filter ❑ Leaching Chamber ❑ Drip Inc ❑ Gravel-less Pi ❑ Other (explain) V. Dispersal/Treatment Area information: Design Flow (gpd) Design Soil Application Rate(gpdat) Dispersal Area Required (sf) Dispersal Area Proposed (std Sys w 1100 •7 S' 877 VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel YQ= Plash ' Gallons Lallans of Uni 'yE C- Concrete Constuuted G Ncw Existing ~ (T Y. J Tanks Talcs Septic oamew.0 Vieka Z,S"o ZSa TT Acrobic Trcatm or Unit Dosing Cbambcr i/ x-I VH. Responsibility Statement- 1, the under v ss aibiXiXtty~f~or installation of the POWTS shown on the attached plans. PPi s Name (Print) P i MPWRS Number Business Phone Number ~flai S 'r z- P /.XF34 Z 7- zss- Z6 zAe, Plumber's Address (Street, City, State, Zip rl.O 08' pY!/ Gt/~ ~t VUL Coon /De -t Use Only Approved ❑ Disapproved hermit Fee includes G otmdwater Date issued Iss ' Agent Si (No Stamps) Fee) ❑ Owner Given Realm for Denial IX. Conditions of ApprovaMasons for Disapproval 3 > S~ o ,4 a SYSTEM OWNER; 9 Septic tank, effluent filter and ~ Cam-- ~ Q~ r dispersal cell must all be serviced / maintained C & Ik*e.A Q as per management plan provided by plumber. .Q 2. All setback requirements must be maintained as per applicable code/ordinances. Attach complete plant (to the Comely for the system ea papa not less than 81/2 111 inches V sire SBD-6398 (R. 01/03) L~itl9m~s T ru, r r~T~~ Sr,J l~ 5 ! 9 TZ S ~ ~ 9 lcJ Tr,~o✓ arm wt 891. D lo~ or- I` Sr2~~ ~I(JE Apr 1j2un"~C. I FT. REAR SETBACK PER+P'LAT I I I I 1 I , 1 nt 1 1 QJ~c- IL T-N h (4Lr:FOt.4 S 45 scw 1 0- r 1 1 I I L6V 1 Y a: 36 61 11y~~ ..i' •1; 1r i~WW y,~ ..,1. H Bd 0 7 O w . I ~ f-r /fE --42, 42,50 --@v 37.50 g • PR POSED h OUSE ~ 10.00 } 1150 " 8q3 ELLS .1 - cr- %f) I i to ~f 28. 52.00 r SE~ C PLAT by 1 1'L , 893 t poi 3 l i ~cr-~ - ~y.1. 1.`. 12' 5 r I - O =~;o; 1 T Pf#R PLAT urlurr EAs 134.0,11 a Q ''88e N89°28'1 e9 . illIX;~r-CATCH BASIN - RIM 886.92 f:. MUR 1E- TRAIL 1• L,rnv9 ~FrntES ~T-D s~ S l 9 TZ S'4~ l 9 w 7owA/ Or- G~T goy V<((Asie;D. 1 O f 06- I` TepIli v ~~G 2~. ET. REAR SETBACK PE,lF6T I I I I ~I ~(L ~ ~N~ l}r:r01f.2J I ~ a) L 1 4 F . 45 5t+r-i-t 5~sr~ L~ I k a 7 o Mfr ~tjGt=Cvrr /2So/7So lJwrBd r: -42_50 -~!@v W., I ' ~~r ~ 37.50 F PR POSED n OUSE 10.00 t 13.50 5 A3 3~ f• = -a v co j i 1 28. -__52_00___ ~y PLAT _ wSE C ~ by I 893 L..o..l ~r 1 „ x 90 t., . y p ' c' CL y + -~12' - UTILITY EA 7 P9R PLAT o 134.0 888 N89°28 1 889 ' iEX+'~CATCH BASIN RIM' = 886.92 _ MUR LQ TRAIL s asoonsin Department of Commerce SOIL EVALUATION REPORT Page t Division of Safety and Buildings ; In accordance with Comm 85. Wit, Adm. Code Colxtty r ST. C t Attach complete site plan on paper not less than 8 112 x 11 Inche In sizt include, but not limited to: vertical and horizontal reference point ( M), dl IV E p I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. C 10 ENOfN C. t Re d T by Date Please print all Information. O C T g 200 .2~ Psnonal informauon you P•ovids may ba used tar secondary purposes (a h•acy taw, s. 15.0-t( I) (m)). ) 1hd? Y Property Owner S .Rf4lf49* 1145 AJ 114 5 1q T ZS N R 1~1 ~w ' CONT 1 NE1J"CL OE El:OPM ENT CO{~P. Lot # 01odt a 5ubd. Nana or CSM# Property Ovmer's Melling Address 11'100 R EKD 6T. E SUITE 100 1(0 Z -TRO`{ U t LL.RG.C 1"+ fl ID City State p Code Phone Number ❑ City ❑ Village 5j3 Town Nearest Road 1.t41NE 5544 (71x3) 7'"1$(oFf oy uIKFIw_.c.ri T12At1- ' ' pp New Construction User Residential / Number of bedrooms Code derived design now rate GPD I Rep)acument Public or commercial - Describe: Parent material - t7 VIW f f)" 8 L1-1CU l A 1 Flood Flain elevation r(applicabis i General comments ~ n and recommendations: C0N d1rJ.JTwp L, TN--fote0LW0 S ! ~ tom. r 6,1 lpflDWri Ri> CE K)EW e+lS (V IAQ 1 F~l ❑ Boring 3oring # Oep1h to Ilmttin fader > fZC in. Pit around surface elev. ft. g So;l iwuon Rate F Hodzon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots •Efff1GPDEn#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ; 1 0_-5 IOU 0- Z~i - t-- &C--m ak:K - ,S o t d sot CL -c0 t~ S 0.3 t 5-1t to z/I - L ~ _ s r r Z U 3J , g S as 3 - 4 Lt-31 t0 y S~ di Z_ 1 i z I 5 31-1Z.0 - s t 40 ki W,&L5 IAA s ~10q i ❑ Boring Boring # Pit Ground surface elev. T~ n. Depth to IIrNUng tailor 1 Z in. Sol{ ' )catlon Rate c Horizon Depth Dominant Co Redox Description T suture Structure Consistence Boundary Roots GPOftf Eff#1 'Eff#2 . 5z Cont. color Gr. Sz. Sh. Muns U Qu in. e 0.~ . I 0- o zl L dsh Cb y S 0. Z - L - I f I . 1q 1 to I Q-2fo e 0.5 3 3 s• dh Z 1 44 Z6 10 14 it :5 S d u ZA 3 -4not%7j-u\ 44 H a e- 3 10 oto 3 2 Effluent a1 = 800> 30 < 220 mgfL and TSS >30 < 150 ,ngk • Effluent X2 a BOD 30 n-g1L and TSS 130 rnglL CST Name (Please Print) Ignature CST Number M JO HOWL sTE ZZ Address Date Evetuadon Conducted Telephone Number W9a75 eQa~``AVe,~ F \j Au-S, W1 Stiozz 045 3 L-7 is 1-42-6 ~S r ' t (LO Parcel 10 Pale F.Lp"e4or -of Property Owner CONI1fMA~ Mil )d'S ❑ Boring ~RPggZ.O r t l ❑ Boring # i n. Depth to limiting factor l Z n. Soil ication Rate t 1 pit Ground surface elev. =>Z~o. 1V1 1 Horizon Uepth Dominant Color Redox Description Texture Structure ECoonnssistence Boundary Roots GPO/fF in, Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#2 b O-K ~t - bK Z- q'2 IC 3~ Sti _ 6L5 Zv 5 i ` k' i z i• i 3 z4-3Z 7-5 v1k s 5 1 e - -7 y N.-11Z y 3 S OS 1 ' .l 1~ ! 1 1014 i r L7 ❑ Boring i Boring # pit Ground surface elev. it, Depth to limiting factor _ in. Soil Application Rate 4 ❑ Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlfP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eft#1 Eff#2 I 1 i f ' ❑ a Boring # Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor Soil A iication Rate Horizon Depth Dominant Colo Redox Description Texture Structure Consistence Boundary Roots GPOlfP in. Munsell Qu. Sz. Cont. Color Gr, Sz. Sh. 10#1 'Eff#2 Effluent #1 = 8005 > 30 1220 mg/L and TSS >30 < 150 mg& Effluent #2 = BODS < 30 mg1L and TSS < 30 mg/L { i The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or 1 need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. ` I SBU•Bll01R.4r001 - r i G~Nn: D = I pROf'EktY 0'WN~~: CQ1.aTl*IZJT~f1L-- D~yr~t cPnn~7r CoRP• 3M- 'Ta D /"ti 7 'RIPION OT 1 Z; AMU v w-~ -boa - Ex~-riN6 -ta, e~ -t dy, st e-KO W cI ~ pogo °o o r 5G(L ockIM6 W/ DAcq a r I 1Z COMM 83 56TDKK PPOLUM5 ' j I ~ C li ELEV. 891.02 i t s 89-28,14" E 1021. W ELEV. 993.01 I e r M P, 1 4. i I Y t ~ 8182A l' I E1EV 94.8 B 163A j ELEV. 8196.4 i , IN The site as gt tiled after soil craluattons were w W complctul (sec page N>ith final grade cle\ations). R16 2B Svstem clc, utions should not be affected, but t I _I to - depth belo,, grade vmill need to be cletenntned based on the amont of cut or till. BM ELEV193.3 u n `nelcvations should ba\ c rcmatncd constant. e' N c 1 ' 95 f I w r w LOT U) 162 W w: a ; c5f Aga z ; ZZ4y32; a r Leaw: f'RJOP~RIYOWl~~: COXtT1~tENSRL ~E~_Df~- 717,041 -50L ij ONC1 W/ P r i,yAL GRADt eLV--%4 AT10N S B162A ELEV-JqZ. / B163A / 2A ELEV. ~a rn OD W W B 1628 78 ELEV~91.3 =r o t IL~I C ~N OM O 17 O z z LUr 162 The Standard Inf i1tratore Chamber The Standard Infiltrator Chamber I F- 1' Overlap at Latching Mechanism K -T 12' n > ❑ MM mom 75' Effective Length Specifications Chamber End View Posit-ock'" End Plate Size (W xLxH) 34"x75"x12" (85 cm x 191 cm x 31 cm) O O Storage Capacity .............77.5 gal (293 L) 12' O O 0®~ Weight ..................:.........26 1bs (11.8 kg) L ® 34' Louvered Sidewall Height ..........6" (15 cm) INFILTRATOR SYSTEMS ING STANDARD LIMITED WARRANTY INFILTRATOR SYSTEMS. MIC.. rkfoattrl STANDARD LIMITED WARRANTY FOR SEPTIC PRODUCTS W Thestrmormrd ntegrly d each chamber and and plate mararfecared by Inlarator kalacovay referred to as'lxdtsl, when i staaed and operated iI a IeaditW of an unite septic system In aocordence with •iftrators irwaration instructions. Is warranted to the c;= purtltasa rHaklerl against detec- We materiels and vionanaretry or one (1) year eam the date upon which a septic permit is issued for the aiiirg the thus; provded. tls date Mat however, to f a sgttic p«ma 5 rot regrwed for the septic system b1l aPPI law, Me one (1) YZ=== bp Q ista•aton or the septic system tx"ritttermces. M order o exerose warrarcy rights. Folder mat ratty •it'arar« h writirmg ar its corporate Headquarters in 1 001,111 to] e Old Saybrook CamecacuL within Rteen (15) days a Nit ateged eared. Kdrratar wit soppy replacement Units lbr dace Units determined by efxtrat« to UrAS. li THE LIMITED WARRANTY AN0 REMEgES M! SUBPARAGRAPH W ARE EXCLUSIVE. THERE ARE NO OTHER WARRANTIES WITH RESPECT TO SYSTEMS I NC THE t/N1TS, LNCLUDING NO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. kJ The Limited Warranty does not axrend to wicideritel, cansequenad. special or w,dvect damages. Wilamor shat not be fable for perialties « kPAdated Environmental Onsite Wastewater Solutions"' damages, irmcLndng bss a pr«xrctan and poNS boor end rreterief5, overhead costs « other asses « expenses imcrrred by the Ioder « erry thwd Party. Spacficaey "Kdegad nom L. ad Warr arxy coverage is demege to the Units due to ordinary wear and tear. alteration. acClUrvk. misuse, abuse « neglect or the Units; am Ures be"g srA*oed to vWvc* traffic or other conditions which are not permitted by the fatafatim Insinxtais; failure to main- 6 Business Park Road • P.O. Box 768 lea the rrtrminxrtr groud covers set forth in the ihstalatfan Insatmc[ions: the placernem of Improper materials into the system conairwg the lMts; fakre of the (fits «Me sepk sygem due to in proper sorry, hrsh, b sing, excessive water usage. o prdpar grease disposal « Irrrpraper cparation « any Old Saybrook, CT 06475 other event not caused by 1MIo-M«. THB fJmied Wanaay sMl he void I do Holder (amts to comply with of a Ire tams set f«N in this Umaed Warranty. Furtlrer, In no event shat Infiltrator be respaWble for arty ioss or demaga to the Hadpony res sing from irmilefi«m or sliprient. 860-577-7000 - FAX 860-577-7001 be eocardancce MNdm al sae « from arty product eabntp dafms a folder aarry Mtd perry. F« this Limtred -X=X= conditlors regmrred by state and Iocel codas. d athar appfcable laws and HNUetor§ ireta•ation istuctiore. C kA No representative of kf&eor ties the amklarky o dmarge cite Limited Warranty in any manner whatsoever, or to extend this Uenited Wertemy 1 ~~.221 YY36 No weneray eppfes to any party orbs than the origirol Fodor. The above represents the standard Lkriked Warranty akred by Infiltrator . A forked cumber of states and counties haws dlleent waif" requrements. www.inflitratorsystems.com Any purchaser a Unu slmauld conkau Mtratars mporate I>eadquerters to Did Saybrook. Camecticut. prior to such purchase, to oHtain a copy a the appfrede warraxy and shewd carenity rod Net warraity prior o the purchase of Units. Infiltrator Systems does not recommend isleeig (rake systems under pavement. Chenbars mat be inualed wmrditg to manufaMserls instructions. Fafkre to instal accorerg to manulacaaer5 instructors ova void watranty. Infiltrator Systems recommends the mite of septic tartk etas and laundry fifers with as oske septic systems. System sing is detamied by goverment raguet«s. For technical assistance, installation instructions or customer service, call, Infiltrator Systems at 1-800-221-4436. U.S. Patents: 4,759,661; 5,017,041; 5,156,488; 5,336,017; 5,401,116; 5,401,459-.5.611,903; 5,716,163; 5.588,778: 5,839.844 Canadian Patents: 1,329.959:2.004,564 Otter patents pending. Infiltrav. Equalizer and Sidewinder are registered trademarks Of Infitrator Systems Inc. Inliffrator is a registered tradef lark in France. Infiltrator Systems Inc. is a registered trademark in Mexico. Contour, Micrd eaching, PolyTuff, SnapLock, ChemberSpacer, Posil ock, QuickCut wrarif ERP(ta~>F LQ,C1Ctl~I[ii ~pViR 3i7«1CTWlt GvR,~iv, Lr~B~".~, iR7t Q~uG1G C~sco~~act-•-1 ` ~ ~i" C.T. t*+~~t.rartpOwN+IG \ I - r J7fIlr~7~ P1 PG. nDWTU 24° x.'D. VkWT auv ~Llpyg ~ YE at~N. twtsr ' ~Pw7v~.R A CT ~bMrt3 ~FE..~.S ~ 3' wrro pig` EG'i'10>N~► ~ G~yrcO 4 t~ cw* b b„ Co~uGtrE•t~t _ - v..+. &tcGK ;FPTkC s P aTi o►~ 1: 13 MAVUFACYURER* ijL bm or ©OSCS: - f'ER GAS TA" SIZE: ~ Z ~cc • -b'Z7 GAf..LOLIS .,cost WOWML INCLUDING 6ACKFL0W: GALLOAIS ~L.ARM /'U4AtIFAC1'-t4ilil'i: A00r- . WW4atjt: CAPAcrr►Cs: g .Z9.a 508 IuCHCS OK GALLO►JS 3WITGN TJPR: O a tt.iCKCS OR GALLOxJ$ LIMP lAWUPACTt,1RF.C. _.,~,J • yy~~I IrI~L C ft T•Zr 14CHES 09 GALLOWS MODEL. mumbrI R: c- IKCHES OR iatAz. GAlt01~5 SWITCH T'tiPE: `0`'SA"c~"' KTE. PUMP AND ALARM ARC TO OC MI$4t#ALi^ OISCNAAGC RATE Z;,,~...GPP1 1r~tSTR1.LE0 OW SEQARATE CcKCUsTS KKTICAt. DtiFtRMCC SETWCCIJ PU" 09F AUG 013TRIbUTIou PiPc...,,,. BEET MIAMIAUM NETWORK SUPPL! PK6S6URC . . . . . . . .sue. FE CT f C It T OF rORCt M114 X .Lt.~L.....P% • r tl~` y~ ..1 aal<tFK~tttou ~i►c~oR..-....,...... CET QD- ~(1 TOTAL 0VkJAMlt HEAD w ..-3 PECr TtraUAt. OiMCiJ5tQlj4 Of TANK: LEN(r'rr{ kgsrt -41" k.DTH ,LiQUJD DCPTH tk,tL u- Td Wd00:60 ti00Z ZZ "hpW 8620 22Z SQL 'ON Xdd ONUSSl 'LIDS QSIAIINSO : WOII-3 oducts Page: 6350-1 Perforrnanc e Pq3j4n Wholesale Pr DMta Section: Performance Data Dated: January 2001 RPM: 1660 Discharge: 1-1 /S" 12 40 9 30 W Z g 6 c°Wr 20 o SHEF30 3 10 0 0 Capacity-U.S. G.P.M. 10 20 30 40 50 Liters/Second 0 1 2 3 _ The curves reflect maximum performance characteristics without exceeding full load (Nameplate) horsepower. All pumps have a service factor of 1.2. Operation is recommended in the bounded area with operational point within the curve limit. Performance curves are based on actual tests with clear water at 70° F. and 1280 feet site elevation. Conditions of Service: GPM: TDH: I~ HYDROMATIC POWTS OWNER'S MANUAL ax MANAGEMENT PLAN Page of FILE INFORMATION • SYSTEM SPECIFICATIONS Owner Septic Tank Capacity 2'•,S'O al ❑ NA Permit # 5-3 Z Septic Tank Manufacturer ~ jr ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer elp T X ❑ NA Number of Bedrooms ❑ NA. Effluent Filter Model rDgZL'/Ys#-NA Number of Commercial Units /1'NA Pump Tank Capacity S-6 gal ❑ NA Estimated flow (average) gal/day Pump Tank Manufacturer A0**V;7" ❑ NA Design flow (peak), (Estimated x 1.5) &,0O gal/day Pump Manufacture oj+ NA Soil Application Rate ,-7 gal/day/ft' Pump Model ja ❑ NA Influent/Effluent Quality Monthly average* Pretreatment Unit A Fats, Oil 8Z Grease (FOG) s30 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter ❑ Mechanical Aeration ❑ Wetland Biochemical Oxygen Demand ( BODs ) x220 m L ❑ Disinfection ❑ Other: ~ Total Suspended Solids (TSS) s150 mg/L Manufacturer Pretreated Effluent Quality ❑ NA Monthly average** Dispersal Cell(s) Biochemical Oxygen Demand (BODs) s30 mg/L -ground (gravity) ❑ In-ground (pressurized) Total Suspended Solids (TSS) 530 mg/L ❑ At-grade ❑ Mound Fecal Coliform (geometric mean) si04 tfu/100m1 ❑ Drip-line ❑ Other: Maximum Effluent Particle Size A Inch diameter Values typical for domestic (non-commercial) wastewater and sepuc tank effluent. * If Values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every Pla ❑ months year(s) (Maximum 3 yrs. ) Pump out contents of tank(s) When combined sludge and scum equals one-third (Y3) of tank volume Inspect dispersal cell(s) At least once every &S ❑ months 4-year(s) (Maximum 3 yrs. ) Clean effluent filter At least once every I.Z ❑ months 'year(s) GaC. A% Ak'tdwwP Inspect pump, pump controls ar.alarn At least once every ❑ months ❑ year(s) ❑ NA Flush laterals and pressure test At least once every ❑ months ❑ year(s) ❑ NA Other: At least once every ❑ months ❑ year(s) ❑ NA Other: At least once every ❑ months ❑ year(s) ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to Identify any missing or broken hardware, Identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cells shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may Indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Ys) 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 ch. NR 113, Wisconsin Administrative Code. The servicing of effluent filters, mechanical or pressurized POWTS components, pretreatement components, and ,any other maintenance or monitoring at Intervals of 12 months or less shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. START UP AND OPERATION 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 J I_ . _r..-...,. I[An- nnmM~fnY nriew to ncC. Page of System start up shall not occur when soil conditions are froien at the inflltradve surface. During power outages pump tanks may fill above normal highwater fevels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) In one large dose, overloading the cell(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 the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; .disinfectants; fat; foundation draln (sump pump) water; fruit and.vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONEMENT 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 ch. Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall,be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material CONTINGENCY PLAN If the POWTS falls and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system:. X 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. O 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. O 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 IMPt1.ttl R1.F.. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER NameNL /r N~. Name Phone KE TIE' 24 Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name cC Agency 4fl; o~... , Phone ?(,S = 3810 ` 4 bfo 08/10/2004. 15:36-,FAX, 7152352592 T L SINZ _PLUPI , _INC Q003 ST CROIX COUNTY SEPTIC TANK M ~AN~ AC.RBFMEtq T OWNERSMP CEKTIMCA1'I011 FORM ~,©.s~•J L,~.N Cam- ~'c' M'~~S , ~ . pwner/Buytr S f~ itwu ~ • MN Mailing Address Z r Proporty Address t for ucor coasttuccion) (Vcrificatioa iequired from Planning Dcpartmco 0 I v Parcel Identification Number ! 2- S b c5 O City/State CIAL T)FSCF aN Sec. T N-RIYCO " "own, of ProPOM Location subdivision volume Certified Survey Map # ri, page it Volume Lp # 'Warranty ))eed # Spec house yes ❑ no Lot lines idecttiflable, g yes ❑ no SYS'~'_E~~ NAN-CE tic could resale in its prem11tun fo= to ] =&r'W&stM Proper maintmmec 1m roper use and mainte anreaf your sap ' cyst°m liccased PumPtr. Float you put into the sysccw consists of pu=pjug out the ecFdc tank every tbrce yeasa or sooner, if uecdedby s c~fl elfW the coon of the septic t8ak as a t-atmcnt stage in the waste disc l system. by a ~ s r~catiaa farm, signed by the te<ai owacr al s and system ,M4 property owner agrczs to submit to St. Cvoix ZoainS Dapartw~~ tat (I? the on-Ate, wasbcwa spas h 113 full ofsludge- masmrpiumbOl, jotunc}'zstaaPlttat$t'x, restrictedpltun~aec or s liCCUSed~g ft aO~a~), the septic, ta4lC s9 less tan is is proper o'P°radug wndidou and/or (2) agar hupcction and pump ed gave toad the above r oquimmcat s and agree to m ainoLiu the pdvata sewage disposal system with the steaderds Tlwc, the acrein. ~ of Con~nsaree and the Dcp*tncot ofNatmsl Resourcw, Sttc of WiscowuL certitieatioa r4t sufaith, you. s set by the Dapatt completed andreUmbd to the St Croix County Zouin6 Office v &Z' 30 tatasgthat t your septic systtm has bceca en u~aiataincd must be days of Lbe tw= yw expLration data, ! ` j t o DATE I MkTI E OF ~ O ~ pt ~AN ear >asawledgc. 1(we) am (sre) the oancdS) of i (we) certify that all statements on this fomi~cd~~ to ~ Rcg£stner of Deets Ottlca the propctty desc bad about, by virtue of a wxrtaDty I l t ! 6 q T) ATL S1 ATURJZ OF APP N7 • Any irtformatio that is mis-tcprtseated may result is the sanitary permit being rcvukCd by the ZoaLag D*px' tcut, Xrdude with this application- a stamped wattaaty decd &vos the Rester of Llcads office a copy of the certified swvcy MAP if refenAft is tasda irs tJ,te w&u%nty dead 77~3cb6 V_._2628P 0 6 3 XATHLEEA A. WALSH STATE BAR OF WISCONSIN FORM 2 - 1898 REGISTER OF DEEDS WARRANTY DEED ST. RECEIVED FOR RECORD Document Number 87/30/2084 02:45PM This Deed, made between WARRANTY DEED Troy Development Corporation, a Minnesota Corporation EXEMPT t Grantor, REC FEE: 12.80 t and an Lang Homes, 'Cjp-7.77 TRANS FEE: 269.70 I: COPY FEE: CC FEE: PAGES: 1 Grantee. Grantor; for a valuable consideration conveys and warrants to Grantee the following described real eamte in St. Cr4i;~ County, State of Wisconsin: ; !j Recordng Area 3 Lot 162 of the Plat of Troy Village 6th Narnmand RetunAddress Addition in the Town of Troy, St. Croix County, n fang H 5, I C. 21 East yrtle treet Subject to Declarations of Covenants, Conditions and S w 55082 Restrictions for Troy Village, recorded in Vol. 1241, Page 256, as Doe. No. 559964, and the Declaration of 1 Golf Course, Goverlantra, Conditions and Easements, recorded in Vol. 1241, Page 301, as Doc. No. 559969, 1 311 as appearing in the office of the Register of Deeds Part of 040-1251-90.200 i~ for St. Croix County, Wisconsin, and such other Parosi noation Number (PIN) easements, restrictions and reservations of record, This is not homestead property. ; or in use, and the "Buyer" obi igations contained in (is) (to not) E the Purchase Agreement for this lot. it ji .i it 1 t' ii 1 it I Exceptions to warranties: ~I Dated this 29th day of July 2004 i' ~ (SEAL) {SEAL} if I; » Ri hard Hal upt o J, Vi ce-Presi dent Troy Development Corporation (SEAL) (SEAL) j# AUTHENTICATION ACKNOWLEDGMENT r Minnesota Signature(3) :i State of Wfs %svr:s+v. ss. Anoka Jt Coun authenticated this day of Personally cagielbefore ma this2t______ day of --2004 JJ Y the above named Richard Ha uatzok, Vice-President - Troy Deneiohalient Corporation » TITLE: MEMBER STATE BAR OF WISCONSIN to (If no4 me known to be the person who executed the foregoing , authorized by §706.06, Wis. Stats.) Instrument and arkrwwledge the same. r! lilt THIS INSTRUMENT WAS DRAFTED BY ~(jhfj~~jJJ 01, 7 ! TROY DEVEWPM10" CORPORATION • Carrie A. Albrecht i~ Notary Public. Sates e&W Anolt:a County, Minn. 'I Cklarles S. Cook, President my commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not 34A2- 00's > ~t .ii necessary) • Nemw of pwv, m sisru* In eny cap=" must be typed or printed blow their aWwurs 14 • STATE BAR OP WISCONSIN wwna.arn Lgd awnu oo.• inc. WAUANTY DESD FORM Nu. 2 - i sae howsukse, wre. CARRIE A. ALBRECHT NOTARY PUBLIC - (`MINNESOTA AMY COMMISSION EXPIRES JANUARY 31. 2005 s THIS 22NO DAY of DECEMBER, ; ~ REVISED w U 91'110 t S 69.28' 14'' E 102 IM . 1 . 69'Z6' s a" E t _ .32` t I t r . t t ~r t 1 t ! g l ! { f t~ ~ f t 't ! r i I[ 163 _ 164 ~wl 15 160 161 r . . 9 t r . t t. . 162 , t w 8{ U44 ACRE 1.000 ACRD 1.000 ACHE ;.000 ACRE I 1.000 ACRE 15,45 ACRES 3rS66 51~. *3.,.%G S.F. 43.568 S.F. a ~ 43FS66 &F. 43.566 SF. ~ J 45.500 S:F. # t~ t { t t t I z 't , r I y •WW~ 134•CS' 134.Q,_ 134.05' 134.05' ; 14.05, 144.00' N 69'28' 14" 1277.69` ' ipt WIRF1ELD TR41L 10, r SAFETY F WARNING - Risk of electric shock. This pump is SAFETY GUIDELINES supplied with a grounding conductor and/or grounding 1. Read all instructions and safety guidelines type attachment plug. To reduce the risk of electric j thoroughly. Failure to follow the guidelines and the shock, be certain that it is connected to a properly instructions could result in serious bodily injury j grounded grounding type receptacle. and/or property damage. i 2. DO NOT USE TO PUMP FLAMMABLE OR Your 115V effluent pump is equipped with a 3-prong EXPLOSIVE FLUIDS SUCH AS GASOLINE, electrical plug. The third prong is to ground the pump to FUEL OIL, KEROSENE, ETC. DO NOT USE IN prevent possible electrical shock hazard. Do not remove EXPLOSIVE ATMOSPHERES OR HAZARDOUS f the third prong from the plug. A separate branch circuit is LOCATIONS AS CLASSIFIED BY NEC, r recommended. Do not use an extension cord. ANSI/NFPA70. FAILURE TO FOLLOW THIS WARNING CAN RESULT IN PERSONAL INJURY When a pump is in a basin, etc. do not touch motor, pipes AND/OR PROPERTY DAMAGE. or water until unit is unplugged or shut off. if your ~ installation has water or moisture present, do nottouchwet 3. During normal operation the pump is immersed in ~ area until all power has been turned off. If shut-off box is water. Also, during rain storms, water may be j not accessible, call the electric company to shut off service present in the surrounding area of the pump. to the house, or call your local fire department for Caution must be used to prevent bodily injury instructions. Failure to follow this warning can result in fatal when working near the pump: electrical shock. a. The plug must be removed from the receptacle The flexible PVC jacketed cord assembly mounted to the prior to touching, servicing or repairing the pump. pump must not be modified in any way, with the exception of shortening the cord to fit into a control panel. Any splice b. To minimize possible fatal electrical shock hazard, between the pump and the control panel must be made extreme care should be used when changing within a junction box and mounted outside of the basin, and fuses. Do not stand in water while changing fuses comply with the National Electrical Code. Do not use the or insert your finger into the fuse socket. power cord for lifting the pump. 4. Do not run the pump in a dry basin. If the pump is The pump motor is equipped with an automatic resetting run in a dry basin, the surface temperature of the thermal projector and may restart unexpectedly. Projector pump will rise to a high level. This high level could tipping is an indication of motor overloading as a result of cause skin burns if the pump is touched and will operating the pump at low heads (low discharge restriction), cause serious damage to your pump. excessively high or low voltage, inadequate wiring, incorrect 5. Do not oil the motor. The pump housing is sealed. motor connections, or a defective motor or pump. A high grade dielectric oil devoid of water has FLOW- LITERS/MINUTE been put into the motor housing at the factory. Use o eo 160 240 320 of other oil could cause serious electric shock 60 and/or permanent damage to the pump. 15.0 6. This pump's motor housing is filled with a dielectric lubricant at the factory for optimum 40 12. s motor heat transfer and lifetime lubrication of the bearings. Use of any other lubricant could cause w Li 3o 10. 0 w damage and void the warranty. This lubricant is non-toxic; however, if it escapes the motor 5 housing, it should be removed from the surface Q 20 Q quickly by placing newspapers or other absorbent w d material on the water surface to soak it up, so = 5.0 = aquatic life is undisturbed. io -2.5 7. In any installation where property damage and/or personal injury might result from an inoperative or 0 T=~-61.~11111111 fill 111) fill 1111111111 0 leaking pump due to power outages, discharge 0 20 40 60 80 loo line blockage, or any other reason, a backup FLOW- GALLONS/MINUTE system(s) and/or alarm should be used. PUMP PERFORMANCE CURVE 115V 60HZ 3 INSTALLATION Pump must be installed in a suitable gas tight basin which REMOTE FLOAT SWITCH is at least 18" in diameter and 24" deep, and vented 'in LEVEL CONTROL accordance with local plumbing codes. Pump features a 1/ female NPT discharge. NOTE: DO The RFS series pumps are equipped with a remote float switch level control. This level control is sealed in a NOT OVERTIGHTEN DISCHARGE PIPE INTO PUMP polypropylene float cylinder. For automatic operation, the VOLUTE DISCHARGE. pump must be plugged or wired into a remote float switch. Pump can be installed with ABS, PVC, polyethylene or Pump will run continuously if plugged directly into an galvanized steel pipe. Proper adapters are required to electrical outlet. connect plastic pipe to pump. When the level rises in the basin, the cylinder floats up with Pump must be placed on a hard level surface. Never place the level. When the cylinder position is at an angle of about pump directly on clay, earth or gravel surfaces. 45 degrees, the switch activates and starts the pump motor. A check valve must be used in the discharge line to prevent the level draws down, the cylinder floats down and back flow of liquid into the basin. The check valve should when it is again at an angle of about 45 degrees, the switch be a free flow valve that will easily pass solids. deactivates, and the pump motor stops. CAUTION: For best performance of check valves, when NOTE: BE CERTAIN PUMP IS SECURE IN BASIN AND handling solids install in a horizontal position oratangle of CYLINDER FLOATS UNOBSTRUCTED WITHOUT no more than 45°. Do not install check valve in a vertical TOUCHING THE BASIN WALLS OR PLUMBING. position as solids may settle in valve and prevent opening REMOTE FLOAT SWITCH on start-up. INSTALLATION When a check valve is used drill a 3/16" hole in the 1. The float switch consists of four parts: discharge pipe approximately 1" to 2" above the pump a) switch; discharge connection and below check valve to prevent air b) cord clamp; locking of the pump. c) clamp screw. WIRING d) cable tie NOTE: If screw is lost, use a #10-16 X 1/2" long Check local electrical and building codes before tapping screw, longer screws can crack the cover. installation. The installation must be in accordance with their regulations as well as the most recent National 2. Attach cord clamp to pump cover as shown in the Electrical Code (NEC). switch instruction manual packaged with the switch. The clamp and pump handle must be To conform to the National Electrical Code all pumps must positioned as shown to allow free operation of be wired with 14 AWG or larger wire. For runs to 250 feet float. Be sure to locate pump and switch power 14 AWG wire is sufficient. For longer runs consult a cords away from switch float. qualified electrician or the factory. 3. A 2}2' tether length is recommended. When a Pump should be connected or wired to its own circuit with tether length of 2y2" is used, a minimum basin no other outlets or equipment in the circuit line. Fuses and diameter of 18" is recommended. The tether circuit breaker should be of ample capacity in the electrical circuit. See chart below length is measured as shown in illustration at right. . 4. After desired tether length is established hand tighten clamp screw. H.P. VOLTAGE FUSE OR CIRCUIT 5. TESTING: Without water in basin plug pump BREAKER AMPS power cord into switch in-line-plug. Plug switch 4/10 115 20 into outlet. Lift float and watch for pump to operate. 4/10 230 15 Do not run pump for more than 5 seconds. 4 r i Z oc~ WU J oin~ `3 Z O Z - a' °N2o Z '6 V 1 O 0 2 W O~ w LL N 2 J W V/ ' LO In O L.Li m u Y w F- d D 2 z2 u o d w Ld) CO CO In OONU OV L U j z 2 g LL z ^ s ° U M N x 7 J W Q Q Z U- W LL dZ4 z +e c m 1 U w ~F.,QLU (A utV) O o z zoo°~-^oo~ o u~_0LL LL -JN U~ J Q' d o ~~~ZD U Wlnd N W o Z Q z Z Q p~ V) z v g F- lto in g- e - Q C) 1~~ J Z) O 2=~Up F- OF- U N CL WoooooCLL g N CL 0 ce- ~ut_ W JW ZO~~ o 0 w~W ~ d ~oooooov~ W U X N Z W U -J i " O ON 4. CO 2 z a Z ui x F-pU WU~ F-~Z F- w F-00 Z O z~gQmOu oz~~ zoa oz-Z j • ®6~ O z a J~ ~ x I ~ ~ Ug I ~ F I "06~ -"6~ o ck~z /0 tD LL~ f I \i/ _ LL m 1 I f ~ 1 9"Lb9 r } 17 1196,1£000NI, 00.92'£ o01 2 I IJ lvld aid NDe81311 30s 13 sz rj6 `Y- any (a < _Q o~ l Q t' OD _ £k -----Cl- - ,ti91 FF'titi I _1 a ~I Q LO w r- 31I~J0 ~S s 'Poad N I - U) C) 00 T N O w~ CO p i 11~ CIO C\? 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