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HomeMy WebLinkAbout042-1029-30-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Budding 13 vision INSPECTION REPORT Sanitary Permit No: 399529 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)]. ' PT tAws - I + — Permit Holder's Name: Village X Township Parcel Tax No: Yatchoske, Douglas City Warren Township 042 - 1029 -30 -000 CST BM Elev: Insp. BM Elev: BM Description: coo . 01 1 1 cm- o ma TANK IN ORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing ' n Alt. BM Aeration V Bldg. Sewer r I o S b6 1 1. 2 0 Ry �f6 Holding St/Ht Inlet 'Sy r St/Ht Outlet ( l .oZ TANK SETBACK INFORMATION J 93.6 4 r TANK TO P/L WELL BLDG.. Vent to Air Intake ROAD Dt Inlet / �\ 1 p 6 r l�J 43• s 8 Septic fi t N 0 S _ Dt Bottom /Q� C � 8t t Dosing ? 3 - r l'l ! a , -J0I Header /Man. l 3 3 � t o , .7 ✓✓ .�. � by .'3� Aeration Dist. Pipe 4 Z 3 .:t( 100•3`f Holding Bot. System L PUMP /SIPHON INFORMATION Final Grade C SC' 4 e Manufacturer Demand St Cover 1 GPM Model Number .0 0 S TDH Lift Friction Loss System Head r TDH Ft °' .347- 1 Vti �t.lZ 1.9 '{• Force - main Length I Dia. Dist. to Well , �S Z`� ► SOIL ABSORPTION SYSTEM BfW M Width Length No. Of Trelrel w PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth �IW ENSIONS r �K 1_, SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufa urer. INFORMATION CHAMBER OR Type Of System: r r � UNIT Mod mb DISTRIBUTION SYSTEM ­105 'F k Z. q. I � Header /Manifold Distribution ( it x Hole Size x Hole Spacing Vent to Air Intake — a� 11 f(' Pipes) ' I 1 �{' 3 .0 t 3�Ib .2, / r, r -' Length ✓fo Dia _ Length S acin is p g Jb SOIL COVER x Pressure Systems Only — xx Mound Or At -Grade Systems Only Depth Over IDepth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil ❑ Yes ❑ No Fjj� Yes ❑ No �CQMMENTS: (in c code dj 1,AQ ncie� ,persons present, etc.) Inspection #1: Q � / � � � Inspection / t 01 Location: 1328 100th Avenue Roberth, WI 54023 (SE 1/4 SW 1/411 T29N R18W) NA L Parc $ham ©3 2015 1.) Alt BM Description = 0 2.) Bldg sewer length = 15 , a - amount of cover = y /yZn 54k _ l03 3.) Contour = �� '[ l b,` 'C "'f o > s� � M�lc►w�"' `� a E Plan revision eFt quired7 [� Yes _I N Use other side for additional information. O Z.M SBD -6710 (R.3/97) Date 'Insepctor's Signature r Cart. No. f Safety & Buildings Division + Sanitar rmit Ap 201 W. Washington Ave. �' lll� PO Box 7302 In accord with Comm 83.21, Wis. Adm. Code "' Madison, WI 53707 -7302 Personal information you provide may be used for secondary purposes (Submit completed form to county if not [Privacy Law, s. 15.04(1)(m)] _ state owned.) Attach complete pl ans to the county copy only) for the system, o not less than, 8 - 1/2 x 11 inches in size. County State Sanita rmit Number 0 Check if revis* o r s application tale Plan I. D. Number S4. Grog x S ��- 1. Application Information - Please Print all Information I,6 tion: Property Owner Name L ^ r t ` ` P(oppV Location pe r✓ p "L1. l Q S _ C f L 1 o S rl e- n i Lt S, sW 1/4, S! I T i` �p ,N, R/` ` �) W Property OwrVes Mailing Addre s �',t 5T `. "fix Lc)Tu ber Block Number 44 rX City, State Zip Code Phone N ivision Name or CSM Number b �,-4- w." ���o a3 (716 11 Type of Building: (check one) 0 City 0 I or 2 Family Dwelling -No. of Bedrooms tt ,... 0 Village U Public /Commercial (describe use): 11 ).. 11 Town of 0 State-owned W Ov�J1Jt/Y`o III Type of Permit: (Check only one box on line A. Check box on line B if applicable) Nearest Road /o o A �ue , A) 1. ❑ New System 2. ,Replacement 3. ❑ Replacement of 4. ❑ Addition to Parcel Tax Number(s) p System Tank Only Existing System 0 y, - /ooZ - / B) a�A , Permit Number Date Issued ❑ A Sanitary Permit w previously issued IV. Type of POWT System: (Check all that apply) 2 Sa ❑ Non - pressurized In- ground XMound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V Dispersal/Treatment Area Information: (; 111#j 8. 1. Design Flow (gpd) 2. DispersalArea 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate (Gioe/ ay /s� (Min. /inch) 4 / Elevation A15-0 N so0 A) g_ .5' /, 6 /V Q . P 9, 502. / o/. 3 ;7,, VI Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks S 0 IOoO W 1iAJI— P C , O w dos ❑ ❑ ❑ ❑ ❑ VII Responsibility Statement I, the undersigned, assume res on ibility for installation of the POWTS shown on the attached pl ans. Plumber's Name (print) Plumber's Signature (no stamps): MP/MPRS No. Business Phone Number 0 C t4,_-►- dCeVj.' I L, ) - 1 - 7 - 7lS - q7- 33A Plumber's Address (Street, City, State, Zip Code) 4 N b A " 5410 VIII County /Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued g Agent Signature (No stamps) Q A roved ❑ Owner Given Initial Adverse Surcharge Fee) r pp Determination 3PS " V160 L 3 � �� X. Conditions of Alp oval /Reasons for Disapproval: �; l �,r � lw..11,1n� ,�..«,��.t1�� ,Qa' ►µa,v, u ' l - �..�..e�,s ,g�e,c.: p� c� lie �ra�tK b �"� !•G w h . L- S— �{ -�rot+� e Po rr`� Fnw FL o., p� cy.K, . r� so- Pt P,+e tuffoy f trsv W <-- 4e .e v - tm I S Q�.�.� G-t ✓u ai,. Q,� t U'� , C o� () "P S�'�:�, -� U r( bo d z6Ae, - W K, Jc Zoxe ~c', WAF'R,,NT`? DEED �� C r� ` ,��.., r:LL Individual (s) Individual (s) 11 �:' -155 No delinquent taxes and transfer entered; Certificate of Re - 1 Estate Value ( ) files ( ) not required Certificate of Real f:stite Value No. - 1996 t. JAN 1 a i 96 By County Auditor 10.00 A Deputy STATE DEED TAX DUE HER''DN: $ 15.00 T'CJ Date: January 3 , 1996 $ _ 1 i 3R V­LU ALE CONSIDERATION, - L,ESTER YATCKOSKE AND MILDRED M. YATCKOSRE, Husband and Wife, - Grantors, hereby convey and warrant tj - DO UGLAS A. YATCK Grantee, real property in ST. CROIX County, Wisconsin, described as follows: A parcel of property located in the Southwest Quarter (SW}) of Section Eleven (11), Township Twenty -nine (29), Range Eighteen (18), described as follows: Commencing at the intersection of the West (W) 1 /5zh line of the center of the East -West (E -W) town road; thence North (N) 370 feet; tlience East (E) 330 feet; thenc^ South (S) 370 feet to the center of said towa road; thence West (W; 330 feet to the point of beginning, subject to existing easements and right of ways of record; together with all hereditaments and appurtenances belonging thereto, subject to the following exceptions: NONE. ester Yatckoske Mild e . Yatckoske STATE OF MINNESOTA ) SS COUNTY OF MILLE LACS ) The foregoing instrument was acknowledged before me this 3rd day of January, 1996, by - LESTER YATCKOSKE AND ILDRED M. YATCKOSKE, Husband and Wife - Grantors. t NOTARIAL STAMP OR SEAL) c nr rank) IGNA RE OF f' SON 4T ACKNOWLEDGMENT f 6 a CS y 1 mm MDa 4S1 vo C - �� z �� � p O rfl —4 0 mid � n Z ' a► OL r m�v, � o poi moo co C � J a m c co o f - m S . °- co L — — — P N 1 N-5 � o � w Safety and Buildings PO BOX 7162 MADISON WI 53707 -7162 *isconsin TDD #: (608) 264 -8777 www.commerce.state.wi.us /sb Department of Commerce www.wisconsin.gov Scott McCallum, Governor Philip Edw. Albert, Acting Secretary October 10, 2001 CUST ID No.226375 ATTN: POWTS Inspector ROBERT W ULBRICHT ZONING OFFICE LBRI T U CH &ASSOCIATES CO ST CROIX COUNTY SPIA 655 O'NEIL RD 1101 CARMICHAEL RD HUDSON WI 54016 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/10/2003 ideDh Transaction 1D o. 677977 SITE: Site ID No. 6367 DOUGLAS ease', refer to both identification numbers, G - RESIDENCE 1 U LASYATCHOSKE S ENCE TOWN OF WARREN, 54023 above, in all correspondence with the agency. ST CROIX COUNTY SE 1/4, SW 1/4, S11, T29N, RI 8W FOR: DESCRIPTION: NEW MOUND SYSTEM / 450 GPD OBJECT TYPE: POWT SYSTEM REGULATED OBJECT ID NO.: 814322 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. 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. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation /operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerel ' FEE REQUIRED $ 175.00 y FEE RECEIVED $ 175.00 ` BALANCE DUE $ 0.00 P TER E AGEL POWTS PLAN REVI R II , INTEGRATED SERVICES wis (608)266-2889, M - F, 0630 - 1500 HRS PEPAGEL @COMMERCE.STATE. WI.US cc: DOUGLAS YATCHOSKE ULBRICHT & ASSOCIATES CO. 655 O'Neil Road • Hudson, WI 54016 Reg. Designers of Engineering Systems 715-386-8185 Private Sewage Consultants REae p PROJECT IND X SEP Er 2 4 2001 Y � EL D G s. DIV. Plan I.D. # / Date Owner Tob 5 L S y 7- t:It0 sh • Phone 7/5 • 7y.5 • 3 20 -j— Address /3ZY /00 1`1 /2M&'i?i TS CTS• Sy0 Z ,3 Legal Description Sl7e 11pv, 13 Z9 X00 d'L„ nUe P /V 04V3-- /oaf • 30 .s� yfr , SwAr S. //, T LOFN . /z /o w Town of �� County S T• GROi' 4 C.S.T. Sf10EI. Z7 Installer Local Authority/ Supervision PROJECT DESCRIPTION CAf0 Utp . we v • 601>k : SA44t 1k, PROAAI� 1f13,4A- &-D R ov u /ek, 3 At" . /3� /•L, �-� Si� �l ory � ySr'o &�,s, � ,r�.� s�' /o� � %c� So %�S 0 6 - /���'�� �`��•�- /� v T S� �SD .rJ�T/ S,jTCGig7� -e� C � ys . ff " LD ✓v G— �/Y/�'/�lt� / -S j�sT. 2/S�',c> l Y o �w l aMINC q IQ ter• '?' w. ll NON -CONFO ,� p A S1 = ROBERT �k MENT TANK SH ALL - ULB�ICHT o� � - TREAT ED pROpEALY ��ccC` F� r� _y Dsom, BE ABANDON PER COMM. 83.33. o \ q , HUDSON D �� '' . � .... 4q, IG Pg.1 PLOT PLAN VIEWS Pg.2 SYSTEM CROSS SECTIONS & SYSTEM PLAN VIEWS (REVERSE SIDE DETAILS INSPECTION PIPES & FABRIC /TOP FELL DETAILS) Pg.3 PIPE I:.ATERA LAYOUT (REVERSE SIDE SHOWS DETAILS OF LATERAL CLEAN OUTS Pg.4 DOSING CHAMBER CROSS SECTION & SPECS. Pg.5 PUMP PERFORMANCE SPECS (REVERSE SIDE SHOWS PUMP DETAILS) Pg.6.OPERATION, MAINTENANCE REQUIREMENTS (REVERSE SIDE SHOWS SITE & SPECIFIC PROJECT DETAILED INFORMATION,UNIQUE TO LOCALE AND GOVERNMENTAL UNIT AREA) The attached plans and specifications are based on the following approved manuals: "Mound Component Manual For Private Onsite Wastewater Treatment Systems It (Version 2.0 SBD- 10691- P(N.01 /01) and "Pressure Distribution Component Manual For Private Onsite Wastewater Treatment Systems" (version2.0) SBD- 10706- P(NO1 /01). OF Q0 `I 1 mm p :o >a'' 451 -n z B i Z-4Z 0 �_ 9N O �°imnD0 W n 68 O �i Z Z cn p `0 -, O O 0 � N '0 CA r' > O -0 lo P O r N 07 CA � C T :3. p a% o co CD L Ln -� y 0 �\ a I y i - N1 I ZI N IN d c� .w P� Z o� CROSS SECT -100 of MouAj D -- w i r ti 13eD Bev F 1 vist(ti(3v'1•�o,V ' 1` A39Qc5ATE• G, TN i�kaFSS pip ° T °P so(L w/ -ra..A /,UAL- s ysr�M Uu 1 Fo M -roe l,, 672. E • Mao. � 3) . g plowV, o T opso1 u 1a i Fo N R ,U40 % S I o P E FORCE- S t TWAT 1 0 0 () PEIR AW REP .1 /.0 Fr. — F- LE 5 -- i E /.O Fr. • INVERr OF IATERA(S 1 60 ' 192-. go FT. /� - Top of Rock. /OD• 32- H /.O FT. • Top OF lAr is j i I A W VIEW OF MouK)D •- Wi rtt BED F aRc iz MAixJ A c FT• Fr •- 13 FT W /2- �o w Fr O 3o a F r N Bev o f !/2'� To I a „ PVC- CAP�'ED q 99RE5hTE � d f3SE R VAT10 p r P E s /ocA riOW6 : g FT•• (5C4 '40 N P F -PHAAJ ENT M Ae KERS REcquiREp BASAL. AQeh ` 'D Ai�y SOIL 10 IrPAT)OF C Afnci ry 5 sa. Fr, PRoposed BA SM AReN = B A t 1 �� 1 F Observation pipe Distribution cell 1 I s .. Fill material -r` Cover material (ASTM C33, fine aggregate) r r� Tilled area �--- -Slope Force main Figure 6: Cross - section of a Mound System Water tight cap Top of 4" min. dia. leaching Repair couplings chamber Slot a 6" 6" min. min. 14" mill.. ' Infiltrative surface Water Closet Collar Bat (3/8" min. dia.) Figure 8 — Observation Pipes C014�. ' V t Y� 14; e 4 C C C Mlf7"4, I ;w 57--"-1 C 33 �r 6 ail/ 5016 r i/ 5�o/tR- a� 3 d� IAYOUT CEOTIRAL, MAC Fo , -a P P � � A, F r R f: n c X --3 � IIUCNEs CEORAL t2 E MAW Fr. of PVC Y 1�1cH S VARI _ c)TA I. VOID V O l w- G Al 'P ^,J Cft IvN� / 5 15T N o l � �,� /� N E TE` R F CENTRAL MAID POLE 2, Fopce- MAw ,� 2 luc.l{ES Jp or NOIEs PE /3 I.uvERr E LEVspoo SEA PtL)f-=PSE SIDE Vo /00-0 TIERM iNAL coo b8-4 _ of t 'Fi cA CAER Fop, ATE d • REtitouF- All DR M f3uRR5 � NODS IOCATEb o,J B0Tr0 gUAlly 5 p ACE D �I'STRi du1'ION 'UISchARLt� RATS PoR eAch LA'"ERq L I A L /MIA1. TOTAL 1 D (5 'TRi(3UTIoO 'Di5cHAR &E' RATE r-O 0. � �VEr woR k 3 �. 3 Z GAL /MI's. a.5' M��N� Mv�+ 14 EA1 . IDE TA i L-- 6 F C/o I- OWE 7 LAS DF .464� �i,v�s ff�D �o U�vp 9iP�1 D� A "Plat" Rox _ o Gu i i9 - CU S S ShieePs 61 elf1 _ 1 tVU /34 // P4 /UE yam. PUMP' CHAMBER CROSS SECTION AND SPECIFICATIONS A E `f of Co l��� S� •� —VENT CAP I Pi PE ov/NoocJ, J7a�,E'� ,P iu VENT PIPE WEATHER PROOF APPROVED LOCKING �j ► JUNCTION BOX MANHOLE COVER ��E ��17 /oN gjNPt GRADE I `i "MIN. COIJDUIT -- .O ---- - - - - -- �I fi' oti I PROVIDE I ---- -- _- �- - - - -- AIRTIGHT SEAL t tn1 I \� APPROVED JOINT A INy � h� K� I i i i � APPROVE PIPE PIP EXTENDING 3' p� Q I I ALARM EXTEN 3' ONTO SOLID SOIL B 0�a.ti � i i I ONTO SO vO� � 3.3 i I o N . 1 0 ,( 0 0 C i I ELEV. F T. — t 2 All + ! / PUMP - -J OFF ZrSE ,j O�Q D , �D 1-1045 �F �� N K iOl✓ BLOCK /e VA f RIStR EXIT PERMITTED ONLY IF TANK MANUFACTURER HAS SUCH APPROVAL ! 1f -�( SEPTIC E SPECIFICATIONS li<� DOSE TANKS , MANUFACTURER: IVIIff& L14A16cl �• IJUMBER DOSES: PER DAy TAMK SIZE: - 7 S 0 GALLONS DOSE VOLUME �0 P ALARM MANUFACTURER: LFI ei, /gl/fAM INCLUDING BACKFLOW: /OV GALLONS MODEL HUMBER: - L?U CAPACITIES: A= INCHES OR . GALLONS SWITCH TYPE: B= C Z INCHES OR GALLONS + PUMP MANUFACTURER: ' "'G�'"" S I C= 53 INCHES OR 1 GALLONS MODEL NUMBER:� D = •� INCHES OR 3 GALLONS SWITCH TYPE: 1P ' - � j f f r/.7 / �� & Ae— F MOTE: PUMP AUD ALARM ARE TO BE MINIMUM DISCHARGE RATE 3 GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.7 / O FEET - rAA�k ! PPEC ' + M NETWORK SUPPL9 PRESSURE . . , , , . . . , . ? . FEET. EAGLI of 3{ Pitt. ' + LSLK FEET OF FORGE MA X 2•54 f F Y oFT. FRICT1O1J FACTOR - 2-254 ? FEET t TOTAL 09MAMIC HEAD = �S `i — FEET INTERNAL. DIMENSIONS OF TANK: LEM&TH ;LIQUID DEPTH THIS POWT SYSTEM SHALL INCORPORATE PER COMM. 83.44(2)c A PROPER ZABEL FILTER MODEL #., 1 S 1 ! - SEPTIC TANK, per Comm.83.44 (2) (c) shall be equipped with an outlet attached approved filter device (Zabel fliter). Tank shall have an approved above ground locking manhole cover for regular (every 12 months or less) inspection & servicing by a licensdd service pamper. I ME40 Series MVWW 4/10 HP Effluent and Drain Water Pumps Performance Curve MODEL ME40 EFFLUENT PUMP CAPACITY LITERS PER MINUTE 0 50 100 150 200 250 300 350 40 12 35 10 In W 30 lL H 25 6 Z .._ ............... , H 20 6 o\ Q J \ 0 4 0 o V ~ 10 2 5 0 0 0 10 20 30 40 50 60 70 90 90 100 CAPACITY GALLONS PER MINUTE F.E. Myers, A Pentair Company • 1101 Myers Parkway, Ashland, Ohio 44805 -1923 419/289 -1144 FAX 419/289 -6658 Telex 98 -7443 K3326 7/91 Printed in U.S.A. ME40 SERIE 4/10 HP Effluent and Drain Water Pumps POWER & FLOAT CORDS PLUG DIMENSIONS Quick -connect, watertight Replaces switch assembly fittings are interchange- for manual operation. able, replaceable from I W NFIr pump exterior. (3 roe MECHANICAL FLOAT -_ SWITCH Imo* Mercury -free. 90° angle _ operation. ® , - -� - -- —� wt s.66 I - -- (144mm) -- --I 11.68 (296.5mm) - - - - - -- MOTOR HOUSING Cast iron for efficient } \ heat transfer. O OVERLOAD SWITCH Built -in to protect against _ overload condition. 4/10 HP MOTOR a, OFF 8 1600 rpm, 60 Hz, 115 or 230V, single phase. Oil- v cooled and lubricated. ROTART SHAFT SEAL Carbon, ceramic faces. i o co l � PERFORMANCE CUM CAPACITY LITERS PER MINUTE 1 0 50 100 ISO 200 250 300 350 40 12 VOLUTE/IMPELI.ER SEAL 35 RING Maintains high efficiency � 30 10 , and reduces recilaulatiom replaceable. zs e b ENCLOSED TWO VANE � zo IMPELLER 6 High efficiency, passes MG H EFFICMNCT ABS 1 s 3 /4 " spherical solids, with VOLUTE 4 stainless steel wear ring. Corrosion resistant. Passes TM WASM SLEEVE 3 /4" spherical solids. l fit" 5 z BEARINGS NPT discharge. Enhance smooth operation 0 0 and extend pump life. O 10 20 3o 40 50 60 70 90 90 100 CAPACITY GALLONS PER MINUTE K3319 5/92 Printed in us.A M" F. Myers, A Pentair Company 1100 1 Myers Parkway Ashland, Ohio 44805 -1923 419/289 -1144 FAX: 419/289 -6658, TLX: 98 -7443 _. _. Pg. 6 of 6 • Mound System Management Plan _ ` Pursuant to Comm 83.54, Wis. Adm. Code 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 filter 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 filter 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, Safety and Buildings Division. 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. 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 for frost protection. Influent quality into the mound system may not exceed 220 mg /L BOD5, 150 mg /L TSS, and 30 mg /L FOG. 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 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component - p manual [SBD 10572 -P (R. 6/99)J 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 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Contingency 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 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 adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. n Questions on the operation or maintenance of this system should be directed to your county zoning or health inspector. SEF REVERSE SIDE Pg.6 FOR MAINTENANCE REQUIREMENTS SPECIFIC TO TNIS SITE, DESIGN, AND COMPONENTS z y i PAGE REVERSE SIDE OWNER's MAINTAINCE OF SEPTIC SYSTEM POWTS (landowner) is reponsible for proper operation and maintenance of this system. Regular periodic inspections and servicing is necessary for the safe healthy operation of this system. The owner is required by code to submit all necessary maintenance /inspection reports to the controlling authorities. SPECIFIC CONTACT AGENTS 57• * Governmental authority/ inspectors: zow/�v 6— 3oOo� • y( o *.Licensed installer, responsible for providing an operation/ maintenance "Users" manual: „ * Licensed service / inspection agent other than installer: C ry. 5,1,1 / T.9- "k) 3,P6 D-130 * Electrician, for pump, electric controls, wiring units: w ",P TC`ZVi v /ce- �o �zS • 7 3 . IMPORTANT OWNER MAINTENANCE REQUIREMENTS 1. Winter traffic (sledding, shoveling, etc.) across the area shall not be permitted, or frost can /will penetrate into the cell, freezing up the system. Discontinuos use in the winter (a vacaction trip, resulting in no water use) can also lead to freeze ups. 2. Water conservation needs to be exercised! Or system can be hydrolically overloaded and destroyed. This system was designed for a maximum wastewater flow of �Jt gals. daily. 3. POWTS are not designed to accomodate wastes from a garbage disposal unit, or any other unnatural sources of waste. Any introduction of such waste materials will overload and destroy this system. a ' 4. If a power outage occurs, or a pump fails, it may result in a temporary overload of effluent being pumped into the i cell, which may adversely impact the cell (leakhge). It is recommended that a licensed pumper empty the dosing tank, allowing the pump to return to dosing the correct amounts. Consult your installer immediately for advice. 5. Neglect of the vegetative cover (the cells insulation & erosion preventive) can lead to failure. Compaction or heavy traffic also can destroy t he system. It IS NECESSARY TO REGULARLY WATER THE VEGETA`['ION OVER A SYSTEM!!'Effluent in the system beneath IS 140T sufficient alone tO maintain a grass cover. 6. Periodic inspections by the owner, or his agents, is necessary. Inspection pipes a orated Y P p p and ports have been incorporated i P into the system: on the mound basal area (effluent level inspection pipes), cleanout terminals on the pressurized laterals, at each tip - for flushing and cleaning the laterals out. The filter system in the tanks (via a locked above ground cover /manhole). Only a licensed properly qualiBied person should be performing this work which involves health & severe safety risks. Evidence of effluent ponding in the system's treatment cell shall also be regularly inspected. A-s I w -onsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor,and Hurnan Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site Ian on paper not less than 8 1/2 x 11 inches in size. Plan must include, but St. Croix P P PP not limited to vertical and horizontal reference poi ction and % of slope, scale or PARCEL I.D. # ' ft e, - dimensioned, north arrow, and location and d' tflad. 042 - 1029 -30 ,. LIEW&D " ' "" 8Y DA E APPLICANT INFORMATION —PLEA ALL I NF "RMATION PROPERTY OWNER: PROPERTY LOCATION Lester Yatchoske h s GOVT. LOT SE, , 1/4 SW 1/4,S 14 T 29 N,R 18 for) W PROPERTY OWNERS MA!I.ING ADDRE , LOT # BLOCK # SUBD. NAME OR CSM # 1328 100th. Ave. " '. na na na 2.5 acres CITY, STATE ZIP fiODE., "P E N1`NU R > ❑CITY ❑VILLAGE MOWN NEAREST ROAD Roberts, WI. 54023 ( )749 =32p i Warren 100 th. Ave. [ ] New Construction Use [ x] � Residenti �tlf dt"rs � 3 [ ] Addition to existing building (xJ Replacement (] Public or commerq Code derived daily flow 450 gPd Recommended design loading rate ' S bed, gpd/ft ' 6 trench, gpd/ft Absorption area ronUirorl 375 bed, ft 2 375 1, nch, ft k4ax mum design loading rate ° 5 , grd�"t .6 trench, gpdr'ft Recommended infiltration surface elevation(s) 99.52 ft (as referred to site plan benchmark) Additional design / site considerations na Parent material glacial drift Flood plain elevation, if applicable na. ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN ALL HOLDING TANK U = Unsuitable fors stem ❑ S ® U (3 S ❑ U [3 S (3U CIS ®U ❑ S ®U ❑ S ® U SOIL DESCRIPTION REPORT Boring # Horizon Depth I Dominant Color Mottles Texture Structure Consistence lBoundary Roots GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench 1' 1 0 -13 10 r3/3 none 1 12msbk mfr qW 2f .5 .6 OMEN 13 -2 10yr4 /4 none sil 2msbk mfr gw if .5 .6 Ground 3 20-25 10 r5 6 none scl lfsbk mfr aw na .2 .3 elev. 98 ft. 4 25 -4 Q 10yr5 /2 c2p7.5yr5/8 scl lfsbk mfr gw na .2 .3 Depth to limiting factor 25" Remarks: Boring # 1 0 -10 10 r3/3 none 1 2msbk mfr qW 2f .5 .6 2 10 2 10 r4/4 none sil 2msbk mfr qW if .5 �.6 3 122 -2 7.5yr4/6 none scl lmsbk mfr gw na .2 .3 Ground elev. 4 26-50 7.5 r4/6 c2 7.5 r5/8 scl lmsbk mfr na na .21.3 98 ft, Depth to limiting factor Remarks: — CST Name:— Please Print Gary L. Ste 1 Phone. 715-246-6200 Address: 1554 2 Ave. , New Richmond, Wi. 54017 9 -14 -95 Signature: Date: CST Number: � l PROPERTY OWNER L. Yatchoske SOIL DESCRIPTION REPORT Page? jif 3 PARCEL I.D. A 042- 1029 -30 ' Boring# Horizon Depth Dominant Color Mottles (Texture I Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed iTrad, 1 0 -10 10 r4/2 none 1 2msbk mfr gw 2f .5 .6 3 2 10 -24 10yr4 /4 none sit 2msbk mfr gw if .51 .6 i Ground 3 24 -32 7.5yr4/4 none sl lmsbk mfr gw na .4i .5 98ele�r.2 ft. 4 32 -50 7.5yr4/6 c2p7.5yr5/8 scl lmsbk mfr na na . 2` .3 Depth to limiting factor 32" Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # +:•i4 X{ i}i: ................. Ground elev. j ft. Depth to limiting factor F i Remarks: SBD- 8330(8.05/92) PAC 1- , t STEEL'S SOIL SERVICE Gary L. Steel Lester Yatchoske 1554 200th Ave. CSTM2298 SE4SW4 S14- T29N -R18W New Richmond, WI 54017 MP 3254 town of Warren (715) 246 -6200 t N 1 " =40' BM-= top of nail in post @ wl. 100' Alt. BM. = top of post C el. 103.00' to e p & , 48' ►3• � J Q Gary L. Steel 9-14-95 I I ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM E - —uyer to Mailing Address l vZ 8 v o / >4,tre Property Address 13 o`Z 8 10 0 R 'Ve , (Verification required from Planning Department for new construction) City /State /l W Parcel Identification Number ©Y a LEGAL DESCRIPTION Properly Location S E i/4, 50 1 /., Sec. l 1 , TI_N -R / 8 W, Town of ( a ) 0 "►. Subdivision /U . Lot # Certified Survey Map # . Volume . .Page # Warranty Deed # 5 $ . Volume 1 f 5" 8 , Page # Spec house ❑ yes 19 no Lot lines identifiable MQ 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 mastor plumber, journeyman plumber, restricted plumber or a li censed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. U we the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards gm set forth, herein, as set by the Department of Commerce and Natural Resources, State of Wisconsin. Certification d e Department th Dep stating that your septic tern has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 davvet the three � S�I GNA OF APPLICANT DATE OR CERTIFICATION I (we) certi that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owners) of the(M)perry desc abo , by v' tue o warranty deed recorded in Register of Deeds Office. rjWd '3! I I � Id OF APPLICANT 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