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HomeMy WebLinkAbout042-1086-80-300 I n N 0 n n 3 d o d o O Q e � � I cn��z z 'r R ', �� � 0 y O Yi�i O v 0 O O C O O O m m y �° z z a�i 00 Ste° c rl N a 3. y q c U) N o °° o c m to I °D3 a Rio O c c co cn z � I D D c a CD Is O0� IW °�I se y f it C71 I ° co co z 000 000 Y �� co w Z 1 w c! c D I o 3 cg I m W m CL aa N _ A I OZ 3 o CD CA ' •• ffDD l��iil W X y p 7 01 w A a Z m (6 m w c6 to CD I 9 = A a C z I � I z w oov imT mom' I $. $z ;o CD » $ c0 0 w go I v m a D 3 a D I I I m a c') c 3 m c I z ° O I y I 7 7 N CD I I � I I b I I I I � i c v I Fl: a I o I o b ti i I m I m I 0 0 o b 0 � --COWNER9IAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715 -962 -3121 600 - 962 - 5227 ST. CROIX ZONING REPORT NO0 16155/01 PAGE- 1 ST, CROIX COUNTY REPORT DATES 1/06/92 COURTHOUSE DATE RECEIVERS 1/03/92 HUDSON, WI 54016 ATTNS THOMAS C. NELSON OWNERS Walter Longen III LOCATIONS 639 93rd St., Roberts COLLECTORS Jim Thompson SOURCE OF SAMPLE: Outside tap COLIFORMS 0 /100 ml INTERPRETATION: Bacteriologically SAFE NITRATE —NS 4 ppm Above 10 ppm exceeds the recommended Public Drinking Water Standard. Coliform Bacteria /100 ml Nitrate — Nitrogen, mg/L cl� r !� � Q. <? N LAB TECHNICIANS Pam Gane T, "'� a i WI Approved Lab No. 19 S m r' �► �.UWlOFNe.. Y ( Means "LESS THAN" Detectable Level Approved by'. ® PROFESSIONAL LABORATORY SERVICES SINCE 1952 r �q -Q/ &0- tV Ito one -h0 �,,L, ST. St CROIX COUNTY ZONING OFFICE . Croix County Courthouse 911 4th Street S Hudson, WI 54016 lephone - (715)386-4680 The St. v Croix County Zoning Office offers the service of septic and water inspections to Lending Institutions, Realty Firms, and private individuals. Completion`of this form is essential so that the property can be located. Please provide the following information, enclose appropriate fee made payable to St. Croix County Zoning Office, and mail, along with form to the above address. Testing will be done as soon as possible after fee and form are received. WATER TESTING--------------------- - - - - -- -FEE: $ 25.00 (For nitrates and coliform bacteria) WATER TESTING FEE: $127.00 (For VOC'S) SEPTIC SYSTEM INSPECTION---------- - - - - -- -FEE: $25.00 o Z S -o (Determines if system is properly functio n time of inspection) I��CAS-P,r C_ - �3 a 13Wq�_3 9Z Property owner's name \ �o Property owner's address 3 - 9 3 V'd -6, , j Legal Description -' of the k 1/4 1/4 of Section E ( , T -?! N -R t Town of LJarre Lot Number Subdivision Name FIRE NUMBER LOCK BOX NUMBER Color of ho �, Ir(sWY1 Realty sign by house? btu If so, list firm: PLEASE INCLUDE, IF AT ALL POSSIBLE, A MAP,i.e,COPY OF PLAT BOOK, WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET. Testing of residential water requires a sample that is fresh. If the home is vacant, and has been so for some time, the water line must be purged by running the water for several hours before the test can be conducted. WINTER TESTING: Many times water lines are turned off, or sill cocks are turned off, making access to the home necessary. If this is the case, please make proper arrangements with this office to ensure time when entry may be gained. Firm or individual re guesting services: r-t V IJCL+ ( b Telephone Number 34S-SS 1� �p�1 REPORT TO BE SENT TO: 5-4-_ I ` ,S (NI I ( S 4 O L ( _�TY'- e.QiY1 W�� Closing date \Z - Z Signature s f q A A� l� � • K y .•� ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 _ (715) 386 -4680 Jan. 2, 1992 Doreen White First National Bank /Hudson 307 2nd St. Hudson, WI 54016 Dear Ms. White: An inspection of the septic system on the property of Walter C. Langen III, located at 639 93rd St., Roberts, WI, was conducted on Jan. 2, 1992. At the same time a water sample was obtained for testing. The results of that test will be sent to you as soon as we receive them back from the laboratory. At the time of inspection, the sanitary system appeared to be functioning properly. The inspection of this sewage disposal system was based upon a surface inspection of said system, and did not involve any excavating or chemical analysis. Accordingly, there is the possibility of hidden defects in the system not discoverable by this inspection. This does not in any way warrant or guarantee the continued proper functioning or operation of this system. It is recommended that the system should be pumped once every three years. Therefore, the prolonged life of this system may be dependent upon proper maim ce of the system. incerely, Salti s K. Thompson Assistant Zoning Administrator NOTE: Some ponding was noted, however septic system seemed to be functioning properly. c7 apartment of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix 3uilding Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 479451 0 NERAL INFORMATION State Plan ID No: arsonal 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: Xion , Andrew Warren, Town of 042 - 1086 -80 -300 CST BM Elev: Insp. BM Elev: I BM Description: Sectionlrown /Range /Map No: Rg. 13— C-ST 31.29.18.484F TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic y Benchmark 3. IdZ• 3 Alt. BM ��tt Ffo Aeration _ _ Bldg. Sewer Holding St/Ht Inlet 4 - 7 - S C1 7 5 St/Ht Outlet TANK SETBACK INFORMATION S � 3 5 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet ` \ Septic - 75 �r� / t / „� / Dt Bottom Dosing _ - - - Header /Man. 7 Aeration Dist. Pipe / 0 z l, 5 Holding �" Bot. System ° 1 , 1 r j J3 is alb PUMP /SIPHON INFORMATION Final Grade 65 Manufacturer Demand St Cover GPM r� Model Number TDH� Lift Friction Loss System Head TDH Ft Force in Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED /TRENCH Width i Length No. Of Trenched PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 7 SETBACK SYSTEM TO U P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer. INFORMATION CHAMBER OR ✓� T V Type Of System: )1 Z / 1 1 7 ' 1 7 • UNIT Model Number. � / - DISTRIBUTION SYSTEM Zto -L7-7 =S Header/Manifold i / Distribution x Hol Size x Hole pacing Vent.to A, irintalk / y Pipe(s) L Length Dia 1 Spacing ' 1 i SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over IDepth Over xx Depth of xx Seeded /Sodded T Mulched Bed/Trench Center,- 5 Bed/Trench Edges Topsoil \ - Yes J No I _._ Yes COMMENTS Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 639 93rd Street Roberts, WI 54023 (NE 1/4 SW 1/4 31 T29N R18W) NA Lot 3 P rcel N 31.29.18.484F 1.) Alt BM Description = F, l C-1.011— ''t � 5kV - CC 'oa. V N474 I 5 2.) Bldg sewer length - amount of cover = C� n g �— c .0 -- - _ -- - -- -- _ - Plan revision Required? [ =j Yes (0 3 7 Use other side for additional information. I I _— d J Date Insepc is Sign re Cart. No. SBD -6710 (R.3/97) i r - s D X �.- -�--�" Safely and IN IsiOn O, fix 1162 . � to be fitted in b { a , _ r - ---- �~ 2W W. Washi e 1 � 7 I salutary Yermit Nume b ( _—I Madison. W1 7 U`" 7 1 T3 3 (608) 266 -3 _ Stale Plan I.D• Nurn er i pepartment of comm - - -- - - Sanitary Permit APP HC Q favide ____ _ - - In accord with Comm 63.21 W is. Adm, Code, Pe rsonai inf Lion you p , (�y pro act Address Of different than maws address) may be used for secondary purposes Privacy Law, avr, s1 ,(M(1} ( I'' ) I I. Applic,�tion Information - Plea" Print All Irtformatipn CF -- ---- --- -_1 Pa 1 X of p Block # Properly Owrwr's Na me Property Owner's M ailing Address 1 4, .� ,'k,Sectior , City, State Zip Code Phone Number t 1 E > (circle o db� _ __ T N: R / ? _� or 11, Type of AuildblQ (check all that apply) - -- —' tic ( 'Sm Numb�1 i 9, or 2 Family Dwelling -Number of Bedrooms -�__ 10l G Public /Commercial - Describe Use J State Owned - Describe Use -� _ _ ' - "City Xownship Qf III, Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ❑ New System Replacement S s y'tgm ❑ TmitmenVII.Iding Tank Replacement Only !.' Other Modification to Existing System - list Previous Pennir Number and Date Is::ued B. E Permit Renewal Permit Revision r Change of C Permit Transfer to New Before Expiration i Plumber Owrier -- IV. Type of PUVVTS System: (Check atl that apply) Non - Pressurized In- Ground ❑ Mound > 24 in, of suitable soil Lj Mound K 24 in. of suitable soil At -Grade L Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized in-fsround ❑ Holding Tank ❑ Pest Filter G Aerobic Treatment Unit D Recirculatin and Filter ltt sa S nthettc Media Fitt Leach[ C l[amtx —� `' — �- fie _I [ti (explain) � nti 7 ng C1 Drig Line L Graveblrss Pi C' o V. Dls Ar Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area 5;qutrecl (sf) Dispersal Area Prnpnsed (sf System Ele lot 3� VI. Tank Info Capacity to local TNumber Manufacturer Prefab SW - 7 Steel Flbei PlasiiL Gallons Gallons of Units Concrete Constructed Glass New Existing Mks Tanks Sep[ic or FloldinQ Tank � � 1 �- -- "� -- ----- --? - -- -- i -�_.__ - -- � Aerobic Trearrr>ent Unit -- 'j ------- Dosing Chamber � / _ VIL - Res Responsibility Statement a, the Unders - -- -- � Po Y ' asstime res po n sibility for ' aliatton of the POWI'S shown_ on The attached Plumber's Na me ( - umber Si gnature r� PRS � N N umbe / r � Business Phone Num t F J9 r �7!'//fL A, // `! -- 1( 1 iC.!/•�_� - .: vC / 7 Cf �� � " � Plumber's Addre ss (Street, City. State, Zip Code) 670 c_ t:. VIII, Count /Department Use Only_ i� Approved I� Disaped / Sanitary Permit Pee (lr u¢es Groundwater Date Issued i Issuing Aetnt Signantre (ti Stamps) -- Surcharge Fee) _ Olil na-Ili Re ason for Denial S �D _7� I I A AA r IX. Conditions o pro /Re al SYM OWNER: 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained as per management plan provided by plumber. 111 �� ¢ n $� O C c 2. All setback requirements must be maintained -1 / SISI�^ ' - '�` - Tu as per applicable code /ordinances. j Attack toaaplata plan. ito the county only) roq the system on papor not )osE dma 81 /a r 11 inches in size — — p , � � c J a ry � /rte PX� M i 1 I slow co Scab. t v �I M ��- f (I l I 3 6 I I I i Wisconsin Department of Commerce SOIL EVALUATION REP . T Page of Division of Safety and Buildings in accordance with Comm Coun S C l�u Attach complete site plan on paper not less than 81/2 x 11 inch: 'n size Ian must induct:, but not limited to: vertical and horizontal referen ), directio n¢ a �O aM I.D. percent slope, scale or dimensions, north arrow, and loc tance r r0a Please print all informa i IX U J , I e`"e by Date n� Personal information you provide may be used for secondary pu Law-S' Property Owner tion ir s (f vt. Lot N 114 9 114 S 31 T Z N R E (or Property Owners Maili d F tot # Block # Subd. Name or CSM# k- I City State Zip Code Phone Number ❑ City ❑ Village 5 Town Nearest Road ( ) ,;t ✓Y s (� New Construction Use: Residential /Number of bedrooms — Code derived design flow rate 5 Q �a 0 GPD ❑ Replacement Public or commercial - Describe: Parent s material 0 �A g Flood Plain elevation if applicable GIs / ft General comments and recommendations: Vl f'rYv Y Boring # ❑ Boring a Ground surface elev. ft. Depth to limiting factor 160 in. Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eif#2 Z e" - rG Z r✓t b rn� r C 5 o �L, r _ I _ ` — r /, � 9s. So' .a �• �o 0 3 Z ® Boring # ❑Boring ® Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF In. Munsell Qu. Sz. Cont. Color Gr. Sz.. S I, h. C 'Eff#1 'Eff#2 to, r 3 - .shlL r C i L v1r� ��5 0 S Zrn o o - 5 U eq I\. m L4 t , 3 y* s - -� • Effluent #1 = BOD > 30 1220 mg/L and TSS >30 1 150 mgA_ • Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST 1 7rase F f � �CST Number `b Address Date Evaluation Conducted Telephone Number Property Owner Parcel ID # Page of J ❑ Boring //y) © Boring # Pit Ground surface elev. (� ft. Depth to limiting factor 6 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlfP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 -I Z /0 S G Zr / Y►'�r CS G 5 90 o !o 7- Xo3 z Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'EB#2 Boring F 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 •E GPD in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Effluent #1 = BOD, > 30 _< 220 mglL and TSS >30 1150 mglL • Effluent #2 = BOD 130 mglL and TSS 130 m91L 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 TIY 608- 2648777. sao-uw (L6(00) PAGE 3 O F NAME ��l�t1� LOT# LEGAL DESCRIPTIONk 31 TZM,N,R J E(OR t SCALE: I" = L IGI BM I ELEVATION 0 I I BM I DESCRIPTION BM 2 ELEVATION BM 2 DESCRIPTION Q I SYSTEM ELEVATION SYSTEM TYPE ori11 ✓� �'� toy : c i V 1 o� �v �2' 3 ,� I SIGNATURE ,/ r DATE _ --O S- : ` 1'� T ♦ • .r„ �•+rr +....- .... R c r 1 r .. 4" CI VENT PIPE 12" MIN. ABOVE fajADE S t2 5' FROM DOOR, WINDOW OR 4EATHERPR00F FRESH AIR INTAKE JUNCTION Box APPROVED WITH CONDUIT 4AJVH0Lr COVER FyNXSHEw GRADE W/ PADLOCK & 4 " Cl RISER �---+� ... -- ---• -- WARNING 1 A BE L i r s# MAx ._... .�4LLT WATER TIG SEA ' L� GAS—, TIGHT A SEAL li' ROVED ' JOINTS WITH 'IpE 3' t A LM i APPROVED P CAE ONTO SIL YD t - p i O N f 3' ,ONTO c I SOLM SOIL P U MP O ZLEV . F' T. � � tt � �� I 6* T OF r D PERMITTED CNLY t IF TANS ...""�"°•'"..• """ MANUFACT!J.RER 2 " APPROVED BEDDING UNkDER TANX HAS APPROVAL �w CONCRETE PAD ���C�r w�AT 14i�Y5 SEPTIC r DOSE TANK MANUF'ACrJRER: ��,.+ .�'�.... N MBER TOSES PER DAY: ANK Si2ES: SEPTIC 196 GAL. DOS: VCwmz INCLUDING DOSE 4v �""' GAL. FLOSvBACK; l.r GA 1,. �.L.AR<*� MAN'J 'ACTURER: � Lec ag CAPACITIES: A MODEL NUMBER: SWITCH TYPE: 8 s r 2 ItiCHE5 s w...... GAL . '„? MANUFACTURER MODEL NUMBER: ' ..,.� C = INCHES 2 t GAL. SWITCH TYPE: D = .�.r i:v�CFiES = .- j - !2a GAL !EQU'RED DISCHARGE RA PUMP 8 ALARM WIRING AS PER ILHR 16.23 wAC ERT+CAL DIFFr"IRE,10E B£. OFT AND DISTP PIPE , MINIMUM NETWORK SUPPLY PRESSURE FEET F'ORCEMAIN X :7.�'�1 FT . �; * FEET ,_.,.,..., 1AO F fR. T7'ON FACTOR FEET TOTAL DYNAMIC MEAD = p ErT �" "F -RNAL DIMEN TONS iEl' L «Q ID WIDTH ---- D � OCTER .b J urn STANDAR CHA UgEfl --52 Quick4 Standard Chamber 48" (EFFECTIVE LENGTH) 71 F 8n ti 34" SIDE VIEW SECTION VIEW MultiPort End Cap 16• 1 2" A SIDE VIEW TOP VIEW FRONT VIEW I MP, '"M —.1- , s ndard"C6 Ocallun W rUl X52" x 34"x16"x12* Effective Length 48"' 'Invert Height 8" or 1.25" Invert Height 8 LN1FUX aYST laa_INS,,STANDARQ!jM]MYARF:LARTY nor,isclow rdogr,ty of raui oaumw. onci plate, ,oscige arj cithe, arrar,'IIXV -allutactuild by 11-141lak., ( 'Gaul . s, vmen inistaflod aid operated in a le-hil ", , s"llp'.11 - for oneyear I the date War " W� sued MMII Q 1,,v the septic ;"trimcoritsi - ig o the U P W an ors =iie 5�g7tic system in aCf.0 with Inlitralot's rn Inutin�'¢:, t, warranted !o ilia oripinai p;' Ctk ea + ;'7Idrbr'( against Unlective II'M 'I a septic, par ill, I " "I wAjw by aowcaue taw, the wiranty p6rs1 W.4 begs. Frl Ina We that 4 uqPehavon . the serif. syster," o,r o"'s0ri To exwcsso its war i Holder 1�61! iXAffy Infifiralor in writing atq� (-�olporaje Heack4t 4) W� Saybmk. C�rssi within fifteen (15) cia yl � )[ the d'jageCl 6efi ;11h;1rW,1 wd smviy roplacerf— U"sS Ior Urris dejairristaci cry jnfij!raj�.ir I() be., cove go by trite I-kyrfleiiivarra" Y. ,fiilratoc S 17abil,ly *;PeOtk` Els We r/jifl of removal aml/or ristalialsw of the UrI (b) TI IJI�-DwApif AND F:M�iX-n IN SUBPARINGF R ESPECT 0 IM II APH(a)ARE LXGtLrUvt IIIC, R) T lL UN, NLLULi.MN', Ili ILL) INARRANT[ES' )f: MErj(�HAN[A[311.17Y OR ron A PAIA', ICULAI 'URPOSE ic) 1 Nis Lisrfsl-�d R""aWy lihAl bi void 1 : any Part of Inc. ch�srnbi �y6jer, �5 I'lanutalftoili Oy.,ayo�. arnor than f,r0nr1,,, The I mled waterol, d,*-, SYSTEMS INC I)c cAli to "I'deirc, swot Jy little'l ilarl)agni. Infilt'.W1 0141 he, { for W.,aslici, or Vµ s6afod donlagm incl loss -1 EnvillmmWbil' Onaft Wastewater Soludone wodi, Wll arid WOWS, jl-LUr ; )11 materwis. Ov(sllmiki wsts, of oth6f rn.%(;o- by pe lJoiter o, any hird jaty. speolfically rj'uN'dej litw— Lirlri tin ! Wwlolly oziveral,10 are damage to the Until& due tc or(Nw/ wear and a tilestali" NIKze. ab x w( tile Unit t rio aidai,,th. 6 Business Park Road • P.O. Box 768 "'11 [J.-d —ve"s w,1 fo-Il f) the Installation rnstFudirlirss: she pi—noi tif impel fflalarals rrito (ho &y-Mm otlritarliN Aug IjrW " laj_ f tire Units or th" �e-Ptl( %Y due � alo, in IrnIPMW SsIng or impmper sizirlig, oxcofA�" wate ­gI,, mWope gmase m or improper roper 5 . : orafio,% o, Old Saybrook, CT 06475 T' � any 0., elsent -1 - i ny Infill rlis 1 . 61 4W Vsi�ally shat no , -id it the 46dix fare to -Mlv all of t', to -6 6W, rosin h this Uniiied warraFty 860-577-7000 - FAX 860-577-7001 Further sr, no averil d ial, kifihf lor off rasponsible for ary loss or dawagoo In a lie Urits, of any third poly mull ng'roir, onstailatiorl or ship. men, (v from arw P'Wtj,',t liabAsiv riavn' of Hucor of any Nrid party. F t-r 1h, UrrifaiJ Wmarlly to apply, the JOT x(,%1 be irstalo n siccoroanw 800-221-4436 with ail site cond6wis rw4(,varil by state " local crAa.% or other apolc&,fe laws, rrd lefilrajors osl insirkKotiOM dl Ho mpesentaGvo cd Inldiraax t,as the :rulhndty io charrr)6 ur oa:er ¢I this ; nni;er/ Wan.lai y. No warranty apU�iee to easy pady other Ilan I've origi lal H(kle, the r )tardard 'fist'stia's g p LirrilieffWairarliyodweci llsarlls� My purchaser o' hats sri,)uld comas ouaja H� r�W ID e d" F� 0[lJ,&1V1jtWK. Cif)1`11WtiCU1, Prislif 10 SsXb PUrd—ri, to obIB", a copy of the applicable warranty. and should carefuty read that 'vsrr prior , to .e purchase o(Ungs. S. Patents: 4,759.661; 5,017,04 1; 5,1 56,488; 5.336,017; 54U1, 16; 5,40 1, 5 5 !,"7 5,716.163; 5,508,778; 5,835,844 Canadian Patents: 1,329,959; 2,004,564 Other patents pending. i00,1!or, Equalizer and SideVVinder are registered trademarks of INiltrator Systems Inc. infiltrator is a i% sterefJ trademark 41 France. Infiltrate Systems Inc. is a raq g stered traoenlark;n Mexico. Contour, Contour Swivel Connection MioatoaOinig, PolyTuff—SiupLock, ChamberSpacer, P0811-01,k, QulckCut, OuickPlay RECICLEDPAPER 'and Cli"— arA t,no,r�Alk.� 0 InfOrninr M 90M Infiltrator A [qGOULDS PUMPS Submersible Effluent Pump EPO4 f, 3871 EP05 APPLICATIONS • FutNy submerged in high w EPOS impeller. Thermoplas- ■ Beatings: Upper and lower Specifically designed for the g turbine oil for tic enclosed design for heavy duty ball bearing lubrication and efficient Improved performance. construction, following uses: heat transfer, ■ and gale: R • Effluent systems �� stic design provides • Homes Available for automatic AGENCY LISTING automatic and • Farms manual operation. Auto- superior strength and corrosion • Heavy duty sump snatic models indude nlaistonre' Dread w standards Assodation • Water transfer Medtankal Float Switch IJII Motor Housing: Cast iron (CSA listed model numbers end • Dewatering assembled and preset at the for 1efiont heat transfer, in "F" or "Cu.) factory, strength, and durability. SP ECIFICATIONS ■ Motor Cover. Thermoplastic moulds F"Ps is 50 9 W A4 • Solids handling FEATURES cover with integral handle and ng �b�: float switch attachment points. 1 /4 " maximum. ■ EPO4 Impeller: T ■ power Cable: Severe duty • Capacities: up to 60 GPM. tic Semi -open design with rated off and water resistant. • Total heads: up to 3 'I feet, pump out vanes for mechankal • Discharge size: 1 1 /2" NPT. seal protection. • Mechanical seal: carbon - rotary /ceramic - stationary, BUNA -N elastomers. • Temperature: 104°F OK continuous METERS FEET 140°F (50°C) intermittent. . . 1Q r — -- st Fas bie steel. pries stainless steel. 9 30 '"'" �-. rj ;� L2.5Fr r with damage e to a -f Components. r..., Motor. z {_ • EPO4 Single phase: 0.4 HP, a 20� . _ 115 or 230 V, 60 Hz, 1550 RPM, built in overload with s automatic reset. q EPOS �\ • EP05 Sin phase: 0.5 HP, 115 V, 60 Hz, 1550 RPM, 3 built in overload with EPO4 automatic reset. 2 • Power cord: 10 foot 5,. .. . i ..... .. .._. standard length,1 W 1 SJTOW with three prong grounding plug. Optional 20 ° °Q. 1p zo . _ . so 40 so GPM foot length, 16/3 SJTW with a three prong grounding plug o z 2 a 6 8 10 1 2 m , /h (standard on EP05). CAPACITY Goulds Pumps 0 UVOGou{ds Pumps W ITT Industries EHectfve February, 2000 ®3671 POWTS OWNER'$ MAN UAL & MANAGEMENT PLAN pa of FILE INFORMATION ST TIM SPECIFICATIONS Owner Permit M Septic Tank Capacity „� al D NA Septic Tank Manufacturer E3 NA DESIGN PARAMETt Effluent Filter Manufacturer Z , ❑ NA Number of bedrooms ❑ NA Eftkmt Filter Model a rk ❑ NA Number of Public Facility Unite, Pump Tank Capacity al 0 NA Estimated flour (average) a l/d a y Pump Tank Manufacturer r ❑ NA Design flow (peak), (Estimated x 1.5) li Lf ® sl /de Pump Manufacturer �,,,,, / ❑ NA Soil Application Rate 1 da. ,. a rump Model ❑ NA Standard Influent/Effluent Quality Monthly avers"# Protrgatment Unit p NA Fats, Oil & Grease (FOG) 530 mg /L Q Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand IBOD 5220 mg /L 0 NA Q Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L I7 Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Celils) ❑ NA Biochemical Oxygen Demand (SOD,) 00 mg /L Q In- Ground (gravity) ❑ in- Ground (pressurized) Total Suspended (Solids (TSS) S30 mg /L Q NA Q At -Grade 13 Mound Fecal Coliform (geometric mean) 510` cfu /10oml Q Wp -Line U Other: Maximum Effluent Particle Size Y In dia. Q NA tlNr: O NA 00w: Q NA ' ❑ NA "Values typical for domestic wastewater and septic tank effkrsm. a te: ❑ NA MAINTENANCE SCHEDUU Service Event Service Frequency Inspect condition of tank(s) At least once every; 3 CI eerie a (Maxinw+n 3 years) ❑ NA Pump out contents of tank(s) When combined sludge and scum equals one -third IV of tank volume ❑ NA Inspect dispersal cells! At lout once every; 3 month(s) IMaxhnum 3 yeas) O NA Clean effluent filter At least once every: Cl month ( ❑ NA Inspect pump, pump controls & alarm At least once eve month($) ❑ NA ever ID a) Flush laterals and pressure test At least onco every: months) ❑ NA © s1 Other: At !east once every: .._ Q monthfs! ❑ NA Other: ❑ NA MAINTENANCE INSTRUCTIONS inspection& of tanks and dispersal cells shall be mode by on 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 tasks, 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) shelf 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 iY or more of the tank volume, the entire contents of the tank shah be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing. st'intervals of , 512 months, shelf be parfcrmned by a certified POWTS Maintainer. A service report shelf be provided to the local regulatory authority within 10 days of completion of any service event. I _ Page _ w of START UP AND OPERATION For now construction, prior to use of the POWTS check treatment tank(si for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cellts). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to uqe. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal hiahwater levels. When power is restored the excess wastewater will be discharged to the dispersal call(s) M one large does cverloadinq the collie) 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 POWT (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 cobs. 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 drain (sump pump) water; fruit and vogetsole peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins tampons; .and water softener brine ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the systern is properly and safely abandoned In compliance with ohapter Comm 53.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. a The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. 0 After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material CONTINGENCY PLAN If the POWTS falls and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: C] A suitable replacement area has been evaluated a n d may be utilized for the location of a replacement soil absorption system. The replacement area should be proteeted from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot Linea and wells. Failure to protect the replacement area wil! 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. Q 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 ion resort to replace the failed POWTS. O TW site d site o tank 17 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 CONTA N LETHAL GASSES ANDIOR 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 00 CIFFICMT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER PO WTS MAINTAINER Name !fir a ��► ola�G -' 1^ Name Phone 7 l �. Phone SEPTAOE &ERVICING OPERATOR (PUMPER) OC L +3ULATORY AUTHORITY Name Name ST•tK C uTY �NiN GIr _ Phone Phone This document was drafted in compliance with chapter Comm 83.22(2llb}(i)fdI&(fl and 83.54(1), (2) & (3). Wisconsin Administrative Code. FROf t : SCHUMPKER PLUMB I NG FPX NO. :7153e63121 .Jun. 29 2005 09: 30AM P3 wjr CKOLX COUNTY SEPTIC 'TANK MAA&rMNANCD AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer % Mailing Address 7' � r` Property Address (Verificatlon required from Planning Department for new consttuotion) City/State Parcel Identification Number ©Z - - 1 �o - 79b b:FG$L. . 4`F F Property Location %, %a, Sec. �?� . T 9 N - W, Town of -e 't/ Subdivision •-� _ Lot # J Cartflied Survey Map # 5 � Volume 1 _ . Page # Warranty Deed # �b I Volume Z 8S3 page # a Spec house C3 yes 7 ° Lot lines identifiable yes Cl no SYMM NAM Improrier use and maintenance of your septic system could result in its prcmxtum failure to handle w sAtes. Proper maintenance coaeig" of puaapiM out the septic taalt every three years or sooner, if needed by a licensed pumper. What you put into the system Cal affect the famction of the septic tank as a troatmeat stage in tho waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certlfiartion form„ signed by the owner and by a ataator phtmber, Jotaneyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewataerdisposal system is In proper operating condition and/or (2) after inspoctioa and pumping (if necessary), the septic tank is less than f f3 full of sludge. Ywe, the =darsigaed have mad the above requimments tad agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Itcsour+ma, State of Wiscowin. Cmfflcation stating that your septic system has been mait� must be completed and returned to rho St Croix County Zoning Office within 30 days a three year expiration daw SIGTIATME OF APPLICANT DATE !Oti'►�ioII;R CERMUCAUM I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(a)O the pr described above, by virtue of a wanuty decd recorded is Register of De*ds Office. -� V 71 1� -\0_ State Bar of Wisconsin Form 1 - 2003 WARRANTY DEED Document Number Document Name THIS DEED, made between Chery M. Lon en single person ( "Grantor," whether one or more), and Andrew G. Xiong and Ying Xioncg husband and wife as survivorship marital property kIV ER VALLEY , ( "Grantee," whether one or more). BY: Grantor, for a valuable consideration, conveys to Grantee the following IOS @r described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ( "Property") (if more space is needed, please attach addendum): Part of the NE 1/4 of SW 1/4 of Section 31, Township 29 North, Range 18 West, St. Croix County, Wisconsin described as follows: Lot 3 of Certified Survey Map Recording Area filed April 13, 1995 in Vol. 10, Page 2904, Doc . No. Name and Return Address 527694. Title One Premier Group, Inc. 706 19th Street South Abstract Hudson, WI 54016 042 - 1086 -80 -300 Parcel Identification Number (PIN) This is homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: Roadways, Easements, or Restrictions of Record Dated Jul 2 July 9, 2005 A�; �w • (SEAL) (SEAL) Cher 1 M. Lon en * (SEAL) (SEAL) * AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) / ) ss. authenticated on St. Croix COUNTY) Personally came before me on July 29, 2005 the above -named Cheryl M. Longen * CT7 N TITLE: MEMBER STATE BAR @Y CO ` ® Z to me k n e the per on(s) who executed the (If not, 0 foregoi ins tr ment d a o edged the same. authorized by Wis. Stat. § 70 THIS INSTRUMENT DRAFTED BY: sCONSII, *Kami els ow Michael H. Forecki , Attorney Notary Public, Stat isconsin Eau Claire, Wisconsin My Commission (is permanent) (expires: ) (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 1 -2003 *Type name below signatures. Attorney Michael H Forecki 3452 Oakwood Hills Pkwy Ste 1, Eau Claire WI 54701 -7928 Phone: (715) 835 -3029 Fax: (715) 835 -4112 Longen - Xiong.z Title One Premier Group Produced with ZipForrnT^ by RE FormsNet, LLC 18025 Fifteen Mile Road, Clinton Township, Michigan 48035, (800) 383 -9805 www.zipform.com �Q U 2853P 607 eQ) I7e(D �I State Bar of Wisconsin Form 1 - 2003 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS Document Number Document Name ST. CROIX CO., WI THIS DEED, made between Cheryl M. Longen, single person RECEIVED FOR RECORD 08/01/2005 10315AN ( "Grantor," whether one or more), and Andrew G. Xiong and Ying Xiong, husband and wife WARRANTY DEED EffE1PT # as survivorship marital property ( "Grantee," whether one or more). REC FEE: 11.00 TRANS FEE: 621.00 COPY FEE: Grantor, for a valuable consideration, conveys to Grantee the following CC FEE: described real estate, together with the rents, profits, fixtures and other PAGES: 1 appurtenant interests, in St. Croix County, State of Wisconsin ( "Property") (if more space is needed, please attach addendum): Part of the NE 1/4 of SW 1/4 of Section 31, Township 29 North, Range 18 West St. Croix County, Wisconsin described as follows: Lot 3 of Certified Survey Map Recording Area filed April 13, 1995 in Vol. 1 0, P age 2 Doc. No. Name and Return Address 527694. Title One Premier Group, Inc. 706 19th Street South Abstract Hudson, WI 54016 042 - 1086 -80 -300 Parcel Identification Number (PIN) This is homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: Roadways, Easements, or Restrictions of Record Dated July 29, 2005 (SEAL) (SEAL) *Cher3f M. ' Longen (SEAL) (SEAL) * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ) ss. authenticated on Are., St. Croix COUNTY) �>r Personally came before me on July 29, 2005 , ® the above -named Cheryl M. Longen TITLE: MEMBER STATE BAR CO i to me n e the per on(s) who executed the (If not, foregoi ins ment d a o edged the same. THIS INSTRUMENT DRAFTED BYO 1N `S * Kami els ow Michael H. Forecki, Attorney Notary Public, Stat isconsin Eau Claire, Wisconsin My Commission (is permanent) (expires: ) (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED STATE BAR OF WISCONSIN FORM No 1 -2003 *Type name below signatures. Attorney Michael H Forecki 3452 Oakwood Hills Pkwy Ste 1, Eau Claire W154701 -7928 Phone: (715) 835 -3029 Fax: (715) 8354112 Longen- Xiong.z Title One Premier Group Produced with ZipForm- by RE FormsNet, LIC 18025 Fifteen Mile Road, Clinton Township, Michigan 48035, (800) 383 -9805 www.zipform.com 3 1995 Z `1.$NH V:ALSH 52'7694 CERTIFIED SURVEY MAP LOCATED IN THE NE 1/4 OFTHE SW 1/4 OF SECTION 31 ,T29N, R18W, TOWN OFWARREN ST. CR01X COUNTY, WISCONSIN. PREPARED FOR: WALTER LONGEN :ZM l N89 0 08'32 "E 148.48' 47.02 101.46 • S 248T56 „E o ! sepric vents 33' 33' NOTE: BEARINGS ARE REFERENCED 0 YHE SOUTH LINE OFTHE SWI /4:. I A SSUM EDI. 1 . Ilous! S AD m y_ 0 0 CO Otly! - - } € 3.41 ACRES d ovr 0 I '148, 490 SO.F O R.O.W. I 1 132,150 SO, FT.) A 1012 A S3 0 ST. CROIX COi;0 - 1 al ^ t- amprehes)swe Plarnr w N ^ ( Zorrutg aefd S 1a! ^ Parks Caawrlitxe Air as. N86 °44'35•'W 577.23' 531 .43' « 100 - y Willfif 30 days 3 N_ �+ sEreacx Aapproval h � � y N L I N E LOT 4 o,r void Z 0 cli 3 2. 8 1 ACRE S O ( 122 609 SQ -FT.) m 2. 56 AC. EX C. E ASEMENT / R.O. W. q _W Z no I 111, 375 SO. FT.1 4J_ M �• n � p a5. to Ss.90 585 °26'0 -3 O a. ! �� 577 . 8 3 J. In Iro 5 32. 73 477.63• a• M 6 a�COMMON DRIVEWAY Z•• O1 EASEMENT. .'. 35.00 ° L O T 5 � N 2.41 ACRES I 33 33 I 1 O5, 083 SO. FT. 1 IJ 2. 13 4C. Ex C. EASEMENT / R .O. W. ( 93, 827 SO. FT.) o 44. O6. AD 442.89' S89 0 08'32 "W 486.97 487.03'1 °I I U LANDS wl _; � r � ' .:• ' ' ^,/. X9 0 O SET 1 "X 24•' IRON PIPE WEIGHING 1.13 LBS. PER LINEAR FOOT. N� • v i IRON PIPE FOUND. � Wtt3::R 2n - .��' S • t 8�4 x JAMFr M. COUNTY MONUMENT FOUND. p SPRING VALLEY o: SCALE !" = 1 00 WIS. s = S68.41'54 "W 1313.55' S88 .54 "W O 50 100 200' ' '��•+,, ..�....•••••�yS'�jo 735L28' R c 131 f . " W CORNER OF SI /4 GORNER OF SEC. 31. SEC. 3I. JAMES M. WEBER 5-1804 DATED SHEET I OF 2 94- 161 THIS INSTRUMENT DRAFTED BY JIM WEBER VOLUME 10 PAGE 2904