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HomeMy WebLinkAbout042-1053-30-200 C o i 3 o I o . O cn M 4 0 uj a t� a ca v I N N LO ECO N_ ow 3 � c N v = aE °� t V N n Lo O O cn i M O M co cm Y ol m'.U--. m-0 aO .-M N.. O C O m Z c comma L m 0 rn� trC� c0 o c Q Q N N 3 � I v a� Z w °o N :: 00 rn N w a m �- z I O Z c v z o o w N H v o r 04 N L_ N_ U) I N N O •N d N O N OO w Q N Zc E M d S v M E o 0 12 .. R i u�i Y .��• a °r' e °' E o o a z co > I!n � N j (/ L o. cn • 00 d a d a (D > or 0 U)I 'I Q o o U E \� M N N O 'O N N M N '—" Z O a N 0 0 0 00 b N m C d 0 Np d Q A (n ld 1� O� O O r- °,6 0 C i+ O N O 75 .2 2 .O M M O N M O N C O) a 0 0 VM N M D O �O °r c t M - >o- } N N 0) O N M Ul ++ 'O �. h� ' N •� N .� 3 N N C LO • � p � � �, Q to O .Z N �' 2 .� cn O � w � #6 a ; Lam �j• a .� _1 Q c A 0 a � '. 0 ai0 1 1111111111111111101111111111 8242269 Document Number Document Title Tx:4198272 St. Croix County BE H$PA ST REGISTER OF DEEDS .Occupancy Affidavit ST. CROIX CO., WI RECEIVED FOR RECORD Wx {'� �,� 07/09/2014 10:40 AM Name — (Owner) T ed or printed EXEMPT #: being duly sworn , states, under oath,that: REC FEE: 30.00 PAGES: 1 He/she is the owner/part owner of the following parcel of land located in St. Croix County,Wisconsin, recorded on 2/25/2010 in Document Number 912350 St. Croix County Register of Deeds Office: Recording area A parcel of land located in the NE %of the SE %of Section 19, T 29 N— Name and Return Address R 18 W,Town of Warren St. Croix County Wisconsin, being duly Russel C.&Danielle Albright 992 83rd Ave. described as follows(include lot no. and subdivision/CSM or detailed legal Roberts,WI 54023 description): 042-1053-30-200. Being CSM 194931 Lot 6(2.24 AC) 992 83`d Ave. Parcel Identification Number(PIN) As owner of the above described property, I acknowledge that the private onsite wastewater treatment system (POWTS)serving this residence is sized for a four(4) bedroom home or a design flow of 600 gpd. Design wastewater flow(DWF) is calculated assuming 150 gal./day for 2 individuals per bedroom. A maximum of eight(8)occupants are permitted based on the DWF; there are currently 9 occupants living in this residence. Therefore the POWTS serving this residence is code-compliant at this time. However, I understand that if the number of finished bedrooms or the number of occupants exceeds the DWF, the POWTS may be subject to premature failure and/or will need to be modified to accommodate the increased wastewater flows and/or contaminant loads. I also acknowledge that I will make this information available to any future parties interested in purchasing this property. Dated this day of J I Zo UTH ICA71 ACKNOWLEDGMENT Signature s). STATE OF WISCONSIN ) `tart )ss. -aA St.Croix County. ) authenticated this ay of Personally came before me this day of �—�--- po l N the above named to me known to be the• erson(s)w ro execytgd4t eforegoing TITLE: MEMBER STATE BAR OF WISCONSIN instrument and ackrtp dge the Ua e. V �11 (If not, _))r O 117 authorized by§706.06,Wis.Stats.) THIS INSTRUMENT WAS DRAFTED BY: Pamela Quinn Land Use Specialist Community Development Department �.��ifs L •�e,�s�7.e l Notary Public,State of Wisconsin (Signatures may be authenticated or acknowledged. Both are not My Commission is permanent. If not,state expiration date: necessary.) Date: - "THIS PAGE IS PART OF THIS LEGAL DOCUMENT—DO NOT REMOVE" This information must be completed by submitter: document title.name&return address and PIN(if required). Other information such as the granting clauses,legal description,etc.may be placed on this first page of the document or may be placed on additional pages of the document.Note: Use of this St.44Y61)eWef*99M71pAV go&rnlent and$2 00 to the recording lee. Wisconsin Statutes,59.43. Wisqonsih Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix r Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 515233 0 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). Permit Holder's Name: City Village X Township Parcel Tax No: Albright, Russel I Warren, Town of 042 - 1053 -30 -200 CST BM Elev: Insp. BM Elev: Section/Town /Range /Map No: T7 escription: a0 - 6T 1 .29.18.302A20 TANK INFORMATION n ELEVATION DATA TYPE MANUFACTURER ; � CAPACITY STATION BS HI F ELEV. Septic , y Benchmark Po �� 5 z ..7 15 Alt. BM ira Z • /Q �/ Aeration U Bldg. Sewer 1 7-6 140 Holding St/Ht Inlet %. St/Ht Outlet 5$ + n o ' • s TANK SETBACK INFORMATION O 7 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 7 25 Dt Bottom Dosing / Header /Man. Imp Aeration Dist. Pipe p b /p , 5 Q (� • s Holding I. System /J •S g5 •• / Z • 6� PUMP /SIPHON INFORMATION Final Grade G •7 5 /a d Manufacturer Demand St Coved J ' b GPM a . Model N r TDH ift Friction Loss System He TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length INo. Of Tre PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS �lr. '� z 13 1 / 4� SETBACK SYSTEM TO KJ P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer: ^�(� INFORMATION Type Of System: CHAMBER OR n/ , 4 [D , 1 A /JA- UNIT Model Number: u . � �7 'T JvVCr DISTRIBUTION SYSTEM i- 25 f Z:5 5 d 4a46Q_ Header /Manifol� �� Distribution x Hole Size I x Hole Spacing Vent to Air Intake i Length /Z Dia Pipe(s) Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center ti Bed/Trench Edges Topsoil ' N Ye � No es t No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 992 83rd Ave Ro WI 54023 (NE 1/4 SE 1/4 18 T29N RI 8W) NA Lot 6 Parcel No: 18.29.18.302A20 1.) Alt BM Description = �'•t G 6J.R,�_ GL.�.:f. 4 1 Q 2.) Bldg sewer length = 2 - amount of cover = 1 S w , Tinsepcto Z• 6 Plan revision Required? FE Yes , \ Use other side for additional information. Zb SBD - 6710 (R.3/97) Date Signa re Cert. No. commerce.wl.gov Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 4� , i s,can s;' n Madison, WI 53707 -7162 Sanitary Permit Number (to be filled in by Co.) t ospartmenit of CoMmeme i 5/ S Z 3 3 /o mb Sanitary Permit Applicatio State Transact Nu er In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropria governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state -owned POWTS are Project Address (if different than mailing address) submitted to the Department of Commerce. Personal information you provide may be used for secondary p urposes in accordance with the Privacy Law s. 15.04 1 m Stats. # 9 �j 2 I. Application Information — 'Please Print All I rmation / � Property Owner's Name Parcel # Property Owner's Mailing Address 10 Property Location 347,4 �\ • J 2 /4( l GL ��0� / *1:' F- A — t1R Govt. Lot City, State Zip Code Pto5(0 of y,, �_ Y4, Section Act (circle one)_., Db � , ✓��Q1 NNIf'6 T 2!y' A N; R _ EorW/ II. Type of Building (check all that apply) 9 1 or 2 Family Dwelling - Number of Bedrooms Subdivision Name Bloc < �%yl ❑ Public /Commercial - Describe Use ❑ City of CSM Number Q9 El of ❑State Owned - Describe Use Z Cc d 05 Yal I Town of III. Type of Permit: (Check only one box on line A. Complete line B if applicab e A. %New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Chan of Plumber ❑ Permit to New Change List Previous Permit Number and Date Issued Before Expiration Owner IV. T e of POWTS S stem /Com neut/l)evice: Check all that appl J@ Non- Ptessurized In- Ground ❑ Pressurized In- Ground 11 At-Grade El Mound > 24 in. of suitable soil 11 Mound < 24 in. of suitable soil El Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis ersaVrreatment Area Information: r�rea. A ' t Design Flaw (gpd Design Soil Application (gpdsfaD equired (sf) Dis persal Area Pro ed (sf) System Elevation � lG6 /o�Z Z/. .5" Vl. Tank Info Capacity in # of Manufacturer Gallons Galons Units ;? v N New Tanks Existing Tanks 4 2 V A r, � a Septic or Holding Tank Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS sk9wn on the attached plans. Plumber's Name (Print) Plumber's Signature P RS Numbe r Business Phone Number `'lt`G�7lil ��.fizGY✓1 .Z .Z? 4�d -1 J Plumber's Address (Street�City State, Zip Code) �� 0 1 z lid VIII. County /De artment Use Onl Approved Disappro it ee,\ 7., Isssuejd Issuing t Signature Own en Reason for . 1 7 �v IX. Conditiglsg1WplglY Wf 4sons for Disapproval 3 � / 4s'�Q „ Cw �.� 1 Septic tank, effluent filter and / /V dispersal cell must all be services / maintained as per management plan provided by plumber. 2. AN setback requirements must be maintained cafe 1 &**nM- Attach to complete plans for the system and submit to the County only on paper not less than 8 1/2 x I I inches in size SBD -6398 (R. 02/09) Valid thru 02/11 /V R qb, r C � 5 �i GL S'a' .��- h � : �i � �--D ! �i S / `� ��GtJ�J lJ � �1 v�.►- a .✓ -- U �sz nn 4 oil zr� V it o -s- C � d_ 1 1 �7 qv 1 r RECEIVED 1304 Wwonsin Department of Comme ce UU 1 2 200JOIL EyAk UATION REPORT page 1 of 3 Division of Safety and Buildings in accordance with C is. Adm. Code Tom Schmitt ST. CROIX COUNTY County Attach complete site plan on ape, not �e�4 hes in si e. P row include, but not limited to: ve ' direl percent slope, scale or dimemsions, north arrow, and location and distance Parcel I. . d 10 3 — Please print all infonnadon. Reviewed B n Dat Personal information you provide may be used for secondary purposes ()ivacy Law, s. 15.04 (1) (m)). Property Owner Property Location Albright, Robert And Sandra Govt. Lot NE 1/4 SE 19 S 19 T 29 NR 18 W Property Owner's Mailing Address L Block # Subd. Name or CSM# 962 80th Ave. 6 - YFoq 31 City State Zip Code Phone Number I City _j Village 16 Town Nearest Road Roberts I WI 1 54023 715 - 749 - 3218 Warren I 96Th St. e New Construction Use: t/ Residential 1 Number of bedrooms 3 Code derived design flow rate 450 GPD I Replacement J Public or commercial - Describe: Parent material Outwash Plain Floo plain elevation, if applicable na General comments and recommendations: Area is suitable for a conventional system wit a 0.6 gpd/sgft rat . ossible system elevation for Area 1 is high trench 100.40', low trench 98.40'. Slope i ° . Boring # J Boring 01 Pit Ground Surface elev. 104.43 ft. Depth to limiting factor 1 96+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft *Eff#1 *Eff#2 1 0 -7 1Oyr3/3 none I 2mgr mfr as 2f .6 .8 2 7 -14 1Oyr5 /4 none scl 2fsbk mfr gw 1f .4 .6 3 14-44 7.5yr4/4 none sl 2msbk mfr cs 1f .6 1.0 4 44-96 10yr6/4 none ms Osg ms — .7 1.6 2 Boring # Boring Pit Ground Surface elev. 104.23 ft. 98+ th to limiting factor in. Dep g Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz *Eff#1 *Eff#2 1 0 -8 1Oyr3/4 none I 2mgr mfr as 2f .6 .8 2 8 -17 1Oyr4/6 none scl 2msbk mfr gw 1f 4 .6 3 17-60 7.5 r4/6 none sl 2msbk mfr gw 1f .6 1.0 4 60 -98 1Oyr6/4 none ms Osg ms - -- - - -- .7 1.6 * Effluent #1 = BOD ? 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature: CST Number Thomas J. Schmitt / 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 1595 72nd St., New Richmond, WI 54017 10/9104 715 -247 -2941 Property Owner Albright, Robert And Sandra Parcel ID # Page 2 of 3 Boring # Boring f Pit Ground Surface elev. 99.40 ft. Depth to limiting factor 100+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM *Eff#1 *Eff#2 1 0 -6 10yr3/4 none I 2mgr mfr as 2f .6 .8 2 6 -15 10yr4/6 none scl 2fsbk mfr gw 1f .4 .6 3 1548 7.5yr4/4 none sl 2msbk mvfr cs 1f 6 1.0 4 48 -100 10yr5/6 none ms Osg ml — -- .7 1.6 F-1 Boring # Boring I Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP *Eff#1 *Eff#2 F-1 Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 * Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < . 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608- 264 -8777. Page 3 of 3 Conducted by: Conducted For: Schmitt Soil and Site Evaluations Name: Robert and Sandra Albright Thomas I Schmitt, CST 227429 Address: 962 80th Ave. 1595 72nd St. City, State, Zip: Roberts, Wl. 54023 New Richmond, WI. 54017 Phone: 715-247-2941 Subd.Name: CSM A ^ 9 -d C/ Lot No.: 6 Legal Description: NE 1/4 SE 1/4 S 19 T29N RI 8W �� Township of Warren, St. Croix Cty. Bench Mark El. 100.00' top of 2" pvc pipe Alternate Bench Mark El. 98.84' top of 2" pvc pipe Slope= 15% Scale 1" = 40' d� �, �,� ►�� boa' 1�� aS � i � I qs I tQ #f C,4 l sil° 5tw 3q' i I z I� &J de 7 Z ,, W V O Cn A W N f C C W Q 17 G_ C 07 01 0 S O W W O p O. 0 y D � A Z Z w / G ca m 1 O p r� g g g S S D► i w r W m D D m w w a a m _ p 177 (�1 C7 D r Z I < C O A N i N A Z v o l O v A O Q C F m °' m O O O z A r cn D cn oo z fV D Z 0 m K m D r, 0 70 z Z0 Z < cn Q BEARINGS ARE REFERENCED TO THE cn m - -n m -n m z ST. CROIX COUNTY GPS NETWORK \ cn cn cn ct) z z z n D :0 Q C z Tm NAD 1983/91 co = ^ O co a ^' ni orn = ww Q Q � 1 . 111 \ / Q O) A OD C$ V A Z 8 : O Z o U2 7,4 N y m Ln � m � G7 MATCH Z R1 � OD m z LINE c , - j Q c SEE w— a) M D SHEET 1 I w °' j •� Z 'n rno CD CD C En, = y N (WO m Q I Z M 0 I O m r r 133' 1 33 ' O O z Om = 0 -n iO I * M -n n -n M C Z O N W cn D I I W -1 C I O 0 m m m 77 1'7 io 0 cn z I� m m I m111 _ � ° `� Z mm �� IIa w iO I =y A A _ o� o ;rn N ^ id I � m N� A Z Z N N D N ° I� I i Z ` IUfI I Z v N-i V Z m I Q I l I 0} nn m O A W N A O I I m Z j 0 W C? W A �W�,7 � (ODD m °mac N W O� 00 OO - I I o I �l In W mmmz X q � 0 A N$�z I t I i� 0-,101 CQpn1 -It W 4I' T /� N N I, N m Imo I I &D I 3 O♦ M -1 W N W W m 02 IW p I I j 0 id I I� to I I� X I� I@ I I O m ..� I 6 ' 6 I� I � I� C D I� I o Z a43 O I� �r0 r In ° �Z� m �� I N00 ° "E ' o m m 0 Z I� N00 295.00' N 196.4 ' Z C m Iln�n ► y0j ° i z •► m ZZA m w cp i W • ►, pN z . � W I1 u I� A r • ► .O .pp. V N r, ni I j V 0 - W fJ7 A 0 N C ° w c n X01 W N A V % 4 _ m w A i V m S00 °20'03'E V S00 °20'03 "E ' A 0 n 330.37' 273.03' --f n O S00 0 20'03 "E 603.40' z m z z 1321.41' 718.01' z cc M EAST LINE OF THE SE 1/4 m MflvlpdLQ44C�D dQGrJD� Vol 19 Page 4931 ST CROIX COUNTY SEPTIC TANK MAINMANCS AGRBEMENr AND OWNMISM CBRTIFICATION FORM O . M . s s Gam, ar�i��% I vl, l Mailing Address 83 AA-, Address Rq Z (V«im fman pynmg De for new ooh Ci /State Parcel Identification Number y - 10 5 3 - 3 a - ZOO �' b Rn�AT DE:SCRIP7TION t S� Ys, Sec. Town of Property Location — Y� Lot # � Subdivision - Certified Snrvep Map # Volume —, Page # ` 3 q 12 3 C 13 . Page # 34q 6 Warranty Deed # Volume house ❑ Yes 9 no Lot lines i&wifi&blr-)�yes ❑ no �vc��ur ors A,NC � �y�.pmperma� use and of year system coWd rc= t m its What yon pmt into the tbrx years or s000e� if needed by a ficewed coasiscs of hefiw out the septic y m Me waste can affect the fivartim of *a septic as a tceatmmt stage The propedy owner anbomtt to St. (koix Toning D d al sysbcm on4iW agt ar&Hcm edp=Pa masterphwabet; Plain P , the septic tonic is less *Mn 113 fall. of shdlge. in condition (2) afa boa and C is op�8 PuP� with the standards U the mod have rend the at m req and a to wboonsm- Cardfication S tda set forth, herein, as set by go Depa of ComMce and the DepS e . rwil Cou�Y ZoainB 30 stating that your systemhas =W be, da f the ]� 3 1 15 11 D DATE ATURB OF APPLICANT OMMR CER1�AUO do best of my (oar) knower I (we-) am (at) the owners) of I ( )f on this foam are tree tR is of Deeds Offux. the by i of a deed `, DATE OF CANT E * ++ «* Aay infoanation that is may resalt m the Y 1 I by tide �8 ' s�sss« deed firma ft Rq&W of Dodds office ** Include with this application: a fe w =rM maP if is made in @tea nt3► dam POWTS OWINPR �`• & I4ANAC3EMENT PLAN Page of FILE INFORMATION SPECIFICATIONS / Fi font ank Capacity ,Q d ai DNA Owner � � Permit # ank Manufacturer DNA Filter Man ufacturer 13 NA DESIGN PARAMETERS Number of Bedrooms t Filter Model O NA 52 �{ Number of Public Facility Units, Tank Capacity al O NA E3 NA Estimated flow (average) Pump 'rank Manufacturer res e Design flow (peak), (Estimated x 1.5) ��D is ill Manufacturer 0 NA Soil Application Rate f!p Model O NA Standard Influent/Effluent duality Monthly �4Wiw , pkttl�t+atment Unit ❑ NA Fate, Oil & Grease (FOG) 530 mQf Rks"d /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (B04s) 5220 rrgtj. P `NA i Mw hanicai Aeration ❑Wetland Total Suspended Solids ITSS) 5160 nl t� 0 D isinfection ❑ Other Pretreated Effluent duality Monthlyod Collis) 0 NA Biochemical Oxygen Demand (BOD 00 moil!. 1 Ground (gravity) C} In- Ground {pressurized) Total Suspended Solids (TSS) 530 mill, I [�ATCirade O Mound Feast Coliform (geometric mean) 5104 cf ,olQ QOmi t,ip -Line D Other: n die: 0 NA Maximum Effluent Particle Size ys i r Other, r' DNA : ❑ NA *Valuestvpicel for dameetic wastewater and septic tank AfHt MAINTSUME $CffwWLE Serwioe Event Service Frequency At Ioit 3 years) ❑ NA Inspect condition of tank( 3 pp} 7 $ , and scum equals one -third (Y of tank volume © NA Pomp out convents of tank(s) hlut. y ! . month {s} (Maximum 3 years} © NA Inspect dispersal 0,811 At 4 �; aart>rf C3 month a) El NA Clean effluent filter A month {s) 0 NA Inspect pump, pump controls & alarm A> i ! p ear(a) month(a) DNA Flush laterals and p►essurs test At f Iinq �Wa D yearial O monthis) O NA Other: At 1 1f IMF: O axis} 0 NA Other MAINTENANCE INSTRUCTIONS or certifications id carrying one of the following Iloensss Inspections of tanks and dispersal cells shall be nil�tl� Iftt+ T 11+ �toi a Servicing Operator. AI Master Plumber; Master Plumber Restricted SewM; l �f't II�II ctait) Pa W'1 S Maintainer, har dware , inspections must include a visual inspection of thq fA!11ttf f4 Ids spy Inissinp or broken hardware, identify any crooks or leaks measure the volume of combined sludge and scum tI< t I'(sl18Ak 1� f effluent an the ground sur facc Y hack up or pending o ndin The dispersal cents) shall be visually inspected tc Q�4iI�� ��� p�fi�latlt Il}vpla in the observation Pipes and to check � a ny equi�res th of effluent on the ground surface. The pond ing of illlilht ofi,orarface may indicate a failing conditlati immediate notification of the local regulatory autli+', When the combined accumulation of sludge and 4041 �11 flt1�+ �t 14 +duels one -third (A) or more of the tank volume, the entir 9. contents of the tank shall be removed by a Sep* i ptrrt� d disposed o f in accordance with chapter NR 11 r an < Wisconsin Administrative Code. retreatmer All other services including but not limited to the forv}IlIn Of offl4on't filters, mechanical or pressurized components, P units, and any servlc ft at intervals of 51 mantha' sRhelll fif► ( � t+y` a certified POWTS Maintainer. pietbn of any service event. A service report shall be provided to the local regulatory #ws�h9r}i�l► W". in IQ days of corn pr ce of painting etWtOo other have the e conte START POWTS c UP AND OPERATION neck treatment s anklsl for th h concentrations are detect For new construction, Prior to use of the e the dispersal celltal• If high c that may impede the treatment process andlor damag of the tankts) removed by a septage servicing operator prior to use. the exc pow er is restored or surface discharge of System start up shad not occur whe n soli conditions anal ghwater levels - Whl p° ess Wastewater will be It in the backup During power outages pump tanks may fill above norm to a Servicing Operator p rior to restoring um g the pump controls to discharged to the dispersal ceUts) in one e / of the pdinp tank removed by a Se p effluent. To avoid th the cellls) and may rasa operating is situation have to the effluent pump or contact a plumber or POWTS Maintainer to assist in manually � or compact, the area P °war restore n ormal levels within the pump tank. ark over, or otherwise rata absorp area. pro long the 1'rfa of the Do not drive or.park vehicles y or at mount-grade calls. Do not drive or ormance ad within 15 feet down slop rove the pert diapers; disinfectants; fat; Reduction or elimination of the following from the condoms; cotton swabs; degreasers; dental : ; baby wipes; cigarette butts; line; g wastewater stream maY imp herbicides: meat scrap s, medications; oil pOWTS: antibiotics aso foundation drain (sump Pump{ water: n t napkins; amponsla d water�softener brine. painting products; pesticides; sanitary ANDONMENT taken out of service the following steps sh istr�at t aken cdetnsure that the system is AB ermanently Wisconsin Ad When the POWTS fails ad /or is p ith chapter properly and safely abandoned in compliance w n the ab a bandoned pipe openings .sealed a All piping to tanks and pits shall be disconnected a a Septage Servicing Operator. disposed of by and th e void space filled with o The contents of all tanks and pits shall be removed and properl um ing, all tanks and pits shall be excavated and removed or their covers removed • After p p soil, gravel or another inert solid material' taken, to provide a code complian CONTINGENCY PLAN repaired the following measures have bee "' or "tu If the POWTS fails and cannot be b of s replacament Soil absorPtt° replacement system: be utilized for the location not be infringed upon b action and should a fee infri nged area w E3 suitable replacement area has been evaluated and may t senems mul and p roposed ant result in the need for a new soil an area. Replacemer► � ro osed structure, lot line's and wells. Failure to Protect system. The replacement area hould be Protected from disturbance an co required setbacks from e at d r t e v a l ua t i on to establish a suitable rep limitati Barring advances in POW' comply with the rules in effect A suitable replacement area is not abed as a l resort to r Placethe failed POWTS- s ❑ to technology a holding tank may be in ❑ T t— oito has not �A e removal of the biomat at wrmx—r be reconstructe s must comply with in place foilaw�9 strsori do of such systemh the rules in effect at that time. ❑ Mound and at-grade soil absorption systems maY au infiltrative surface. Recap RESCUE O <WARNING> > T TANKS MAY CONTAIN LETHAL DEA H MAY RESULT. . SEPTIC. PUMP AND OTHER TREATMEN TA CULT OR IMPOSSIBLE• NK UNDER ANY CIRC U MSTANCE S - ENTER ER A SEPTIC PUMP OR , OTHER TREATMENT PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFI ADDITIONAL COMMENTS pOWTS MAINTAINER pOWTS INSTALLER Name Name f„Jt`ll "et G _ Phone Phone ? l _ a -- .3 .� LOCAL REpULATORY AUTHORITY SEPTAGE SERVICING OPERATOR (PUMPER) dame ! } Grog ZOO Name Phone Phone 7/✓�- 3��- �{{0 v Thls document was drafted in compliance with chapter Comm 83.22(2)(b)f1)(d) &ff) and 83.54(11, 42) & 431, Wisconsin Administrative Code. J w�-11W SEP TIC TANK F PUMP CHAMD ION AND SPECIFICATIONS WEATHERPROOF 4 +f Cl VENT PIPE 12" MIN, ABOVEIA JUNCTION 80X APPROVED ? 25' FROM DOOR, WINDOW OR WITH CONDUIT MANHOLE COVER FRESH AIR INTAKE W/ PADLOCK & WARNING LABEL FINISHED GRADE 4 ,. GI RIS1 4" MIN. r� 19" IN. 6" MAX. , ; i � + INLET i `+ SAS i + vA WATER TIGHT SEALS �' �TIGHTi � PPROVED SEAL F JOINTS WITH ALM APPROVED PIPE � tPPROVED ""'"• ON 3' ONTO SOLID SOIL 'IPE 3' i ' ** RISER EXIT INTO SOLID OFF' ;OIL PUMP OFF ELEV . FT • PERMITTED QNL' IF TANK MANUFACTURER :,.... HAS APPROVAL 3" APPROVED BEIPP190 TANK CONCRETE PAD DOSE S E SEPTIC / I�i,1��1�� �Q &E S PER DAY: TANK MANU F AC TU R ER : � l9an=& ---�- SIZES SEPTIC 1'J,�a f} GAL. IQ1"'Vp11 INCLUDING I9 GAL. TANK GAL, FLOWBACK: DOSE GAL ^ l INCHES = ,. a � r� C�F�►�,� T� ��� ? A of ALARM M MANUFACTURER; 1 �i, 4 a,. GAL MODEL NUMBER: t) — 8 r 2 INCHES SWITCH TYPE. GAL G INCHES =_ PUMP MANUFACTURER: CT INCHES o � ^ GAL MODEL NUMBER: �' d D = SWITCH TYPE: 16.23 WA GPM PWM$ p,IRM WIRING AS PER ILHR REQUIRED DISCHARGE RATE )a" FEET VERTICAL DIFFERENCE BETWEEN PUMP off �11�1A p���15UTION PIPE • ---2 5 FEET E — 1 - F EET + MINIMUM NETWORK SUI'A� XR?~S (o ORFT�3.GQ'''. *FI�NON FACTOR FEET + FEET F0IZCEM �..... -- 1aT yNAMIC HEAD = INTERNAL DIMENSIONS OF PUMP TANK: L 146TH ; WIDTH �_+ t. DIAMETER SIGNED: aw �,._.. LIUNS� NU!4�gilk : - `-'- DATE PUMPS Submersible [QGOULDS Effluent Pump ON600 3871 EPO4 EP05 P las- ■ Bearings: upper and lower i • Fully submerged In high ■ Ep051m im peller for n wnArud3o rmop heavy ball bearing APPLICATIONS grade turbine oit for tc enclosed desi improved performance. Specifically designed for the lubrication and efficient i and Base: Rugged AGENC1f LIS (ING following uses: heat transfer. th design provides • Effluent systems Available for automatic and superior strength and corrosion c smndmds Assoda*it • Homes manual operation. Auto- resistance. • Farms ma * models include a Motor Housing: Cast iron (� listed mom numbers end • Heavy duty sump m nt heat transfer, ical Float Switch in - F• or "C ".) • Water transfer for effiae • Dewatering assembled and preset at the streoglh, and durability is ISO "red. factory. ■ Motor cover: Thermoplastic SPECIFICATIONS cover with integral handle and FEATURES $oat switch aukhment points- •Solids handling capability: m EPO4 impeller. Thermoplas m Power Cable: Severe duty 31 maximum en design with rated oll and water resistant. • Capacities; up to 60 GPM, dim p out vanes for mechanical •• Total heads: up to 31 feet. P P • Discharge size - , Ili " NPT• sea] protection• • Mechanical seat: carbon - rotarylmramic station BUNA -N elastomers. i .............. • Temperature: 104OF (40°C) continuous METERS FEET 4 - ._i 140 - F (60 intermMent• 10 _....._ 1 _.__.. i s • Fasteners: 300 series_____ i stainless steel. zs rt • Capable of running dry wWithout damage to compo 1 - Motor. 6 tot • EPO4 Single phase: 0.4 HP, � r r ... , 1 115 or 230 V, 60 Hz, 1550 s t 15 ,_ � RPM, built in overload with EP05 c _.._.._ - -�- ,- automatic reset. • EP05 Single phase: 0.5 HP, o , ..... _ ' _, . _ ' i 115 %, 60 H2.1550 RPM, 3 10 ! ,! .__..__._____.'•_.._.._ --- -EPO!E i bulk in overload with 2.. _ . automatic reset 5 - .. • Power cord: 10 foot ....... _ 1. _ ' . - G standard length 1613 GPM S1TQW with three prong 0 0 20 30 Optional 20 0 __ .. t o grounding plug. foot length. 1613 S1TW with 2 4 6 8 10 12 rn'Ih three prong grounding plug o (standard on EP05). CAPACITY Goulds PUMPS ® 2000 Goulds Pumps ITT Industries Effective February, 2000 83871 lflllf 11111 !1111 1111! I IIIIIIIIIIIIIINII111111111 State Bar of Wisconsin Form 3- 2003 * g 1 2 3 5 0 1 QUIT CLAIM DEED 1� Docuumat Numb Doanno t Name BETH PABST THIS DEED, made between Robert L. Albridh t and Sandra REGISTER OF DEEDS J. Albrig ST. CROIX CO., WI ( "Grantor," whedw one or more) RECEIVED FOR RECORD and Russel C. Albright and Danielle J. Albright 02 /25/2010 11:30AM QUIT CLAIM DEED ( "Grantee," whether one or more). EXEMPT E s REC FEE: 11.00 Grantor, quit claims to Grantee the following described real estate, together TRANS FEE: 30.00 with the rents, profits, fixtures and other appurtenant interests, in PAGES: 1 St . C roix County, State of Wisconsin ("Property ") (if more space is needed, please attach durn): SEC 19 T29N R18W PT NE sE BEING CSM 19 -4931 LOT 6 (2.24 AC) 992 83RD AVENUE R Name and Rdmn Address Russel C. Albright p 314 Wildpood Circle Roberts, WI 54023 042 - 1053 -30 -200 parcel I cdffica icn Numbs (PIN) This is not homestead property. (is) (is not) Dated February 24, 2010 _ (SEAL,) if" � (SEAL) * * Robert L. Albright (SEAL) (SEAL) * * Sandra J. t AUTHENTICATION ACKNOWLEDGMENT Signature(s) ETA OF WISCONSIN ) authenticated Personally (tee before me on �— the above -named TITLE: MEMBER STATE BAR OF WISCONSIN to known to p erson(s) who execauted the (, foregoing acknowledged thepad. �,,,�. R not, authorized by Wis. Stat § 706.06) �O�' JONA THIS INSTRUMENT DRAFTED BY: # _ s Sandra Albright Notary c, State of Wisconsin My Commission (is permanent) (e (Signshwm mmq be andwadeded Or adnowkfte& Be& are cart mcesary.) NOTE: TMS IS A STANDARD FORK ANY MODIFICATIONS TO THIS FORM WOULD BE CLEARLY A QUIT CLAIM DEED STATE BAR OF wISC7ONSIN *Type name below signativ= ��t141 nttttt Af& Reahy. LLC 962 SM Ave Roberts. 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