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030-2027-30-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 552382 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Beedle, Bruce A. & Paulette St. Joseph, Town of 030-2027-30-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 97, (GP l M1'~ GST 22.30.20.439F TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark S8, t w Dosing Alt. BM Aeration w ~C t Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom G 1 1 ( ' Dosing Header/Man. Aeration Dist. Pipe 7A '0/4,3Z lding Bot. System l7' Final Grade PUMP/SIPHON INFORM TION 'yb `1• Manufacturer / L Demand St Cover GPM 15•$27 1 97, OJ 7 Model Number Ql~ 4.3lp 9 7.65 TDH Lift Friction Loss System Head TD7' 3 Forcemain Length Dia. Dist. to well S J i SOIL ABSORPTION SYSTEM , a,r 3, 99 $`j BED/TRENCH Width Lengthy No. Of Trenches PIT DIMENSI S No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: / INFORMATION CHAMBER OR •g Type Of System: /x I UNIT Model Number: G~ a /S /ri 7/e DISTRIBUTION SYSTEM 64-, Glb;,t,r 4-7 = 13 p4a ¢o-yL, Header/Manifold, Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) \ Length_? _ Dia 'V- Length Dia_~Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only v Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mul e Bed/Trench Center Lt. 65 Bed/Trench Edges Topsoil ` Yes No 61s M,& No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 1438 Triangle Drive Houlton, WI 408 Gov't Lot 3 22 T30 R20W m s & bounds Lot Parcel No: 22.30.20.439F 1.) Alt BM Description = r • 2.) Bldg sewer length = -amount of cover =~j{~ ~ ~ ~ ~ i• ( ~ I Plan revision Required? M Yes -;~'s o Use other side for additional information. / I v v SBD-6710 (R.3/97) Date Insepctor's r naturCert. No. FM L O Law OPENS Q _ = li O ANA V 40 U) m - FL 43 J- U) ~J E > m 510101 O = 0. E v ` 0 e! t N o.. .N la- Q co H ODO m a o L 'a K ' O I- y- m as O y N v - ~ O MMMMI N y= LLJ a cn - m E Law _ o o a m Z L V V m •E M O E y -0 MOMIN C~c V O Wft LM Vi 12~ h o MINOR N O .W m _ ~ Somali A) 0 M C. SIMON f'Y Safety County Safe and Buildings Division 57 C e O/ ® R~`►~w 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) P~I Madison, WI 53707rN6 r 2, . , SaM to Transaction umber N~ Application A In accordance with SPS 3830"ts. Adm. Code, submission of this form to the appropriate govemmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (i different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary ~7 V u oses in accordance with the Privacy Law, s. 15.04 1 m , Stats. ` 6 t 1. Application Information - Please Print All Information Property Owner's Name Parcel # Ild L 6T-Te i= t)a _2_02 34 ~Q4D c Property Owner's Mailing Address Property Location , Lf2 q F l / 3 i ~lgNcoto Dj~ Govt. Lot • , / J J City, State Zip Code Phone Number NE ! V / y., Section Al S,/0 Z circle one II. Type of Building (check all that apply) Lot # J I Block Subdivisiop Name 1g 1 or 2 Family Dwelling -Number of Bedrooms yG w' # ❑ Public/Commercial - Describe Use `4 f ❑ City of CSM Number ❑ Village of ❑ State Owned -Describe Use ~ ❑ Town of IT J e54EFP III. Type of Permit: (Chec ne x A. Complete line B if applicable) A. ❑ New System Replacement System Treatment/Holding Tank Replacement Only Other Modifi ion to Existing Syst m (explain) ~k~ril1 4-e,v rSr/c1 Chan List Previo ermit Number and Date Issued B. ❑ Permit Renewal ❑ Permit Revision El Change of Plumber ❑ Permit Transfer to New qQ{~ Before Expiration Owner ~ZOQ 7OZ~Ql l l [d IV. T e of POWTS S stem/Com onent/Device: Check all that apply) Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank R6`ber Dispersal Component (explain) ❑ Pretreatment Device (exp ain) V. Dis ersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (s Dispersal Area Proposed (sf) System Elevation or L 8' 7-eJ 0 0.7 inV r 61/ VI. Tank Info Capacityi Total # of Manufacty;er Gallons Gallons Units 7U New Tanks Existing Tanks V 2 o Gil w U m A 2,2 t7 p. Septic or Holding Tank Q ! t K S C Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's ' at MP/MPI Number Business Phone Number a~nJ SC 14,Vn 7 AJM,~l ZZ376 © his-7l d r6Y& Plumber's Address (Street, City, State, Zip ode) lv/~ 1,07-9 Avg S©,-tt ele:5,j:511- lVI_ S Ya 2 s` VII . Coun epartment Use Only Permit Fee Date Issued I uing Agen ign tur ` Approved ❑ Disapproved l~ SyST iven Reason for Denial $ ( / -&122-11201 IX."n 9f FiMWiMDisapproval V-47-- St's'►l C< dispersal cell must all be serviced / maintained as per management plan provided by plumber. -710 2. All setback requirements must be maintained as per applicable code/ordinances. V ` Attach to complete plans for the system and submit to the County only on paper not less x i h io s' ~2_4~j _%z~s SBD-6398 (R. 11/11) 4v 44 -PaWa CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Beedle Replacement Septic System Owners Name: Bruce & Paulette Beedle Owner's Address 1438 Triangle Drive Houlton, Wi 54082 Legal Description: NE1/4, SW1/4, S22, T30N, R20W Township St. Joseph County: St. Croix Subdivision Name: NA Lot Number: 3 Block Number Parcel I.D. Number 030-2027-30-000 Plan Transaction No. Page 1 Index and title 2 Plot Plan 3 System Sizing & Cross Sectiom 4 Dose Tank Cross Section 5 & 6 Pump Specs & Curve 7 Effluent Filter Information 8 EZ Flow Instructions 9 Maintenance & Management Plan 10 Septic Tank Maintenance Agreement 11 Warranty Deed 12 Map 13 to 15 Soil Evaluation Report Designer: John Schmitt Licnese Number: MPRS 223760 Date: 6/19/2012 Phone Number: 715-760-0486 Signature: In-Ground Soil Absorption Component Manual Version 2.0 SBD-10705-P (N. 01/01) Page 1 of 15 i PLOT PLAN N Project Name: Bruce & Paulette Beedle Replacement Septic System Legal Description: NE1/4, SW114, S22, T30N, R20W P.I.D: 030-2027-30-000 Subdivision Name: NA Lot NA SCALE: 1" = 40' Township: ST. JOSEPH Parcel Size: 1.0 Acres County: ST. CROIX 4 inch Sch 40 -ASTM D2665 System Elevation: T1=95.41' 4 inch 3034 - ASTM D3034 Slope: 5% T2=95.41 2 inch Sch 40- ASTM D2665 A BM1 Elevation: 100.00' Bottom of siding on house T3=NA 0 BM2 Elevation: 97.61 To of 2' manhole cover on septic tank ■ Backhoe Pits: Existing soil absorption area to be used by switching force mains in the pump chamber utilizing the same um for both soil absorption areas. No2Ti~ P2ePc~r L~Ni= NEW 76' 9006AL-RC WI sir~~i" cl+ srf/oo Z1, t-0 rti 3KG5 EZ 1=Lou9 DO 6Ri S.T -r2L°NC~CS W 7 ® pLT' c'x/STrNL, ~9 o! az ` Z" rorZC~_ W1~►~ iiM ~ 3 Qraeoo ® WELL- J I► Q 3 GARA6c 63 ~ i EXIS ttJ ©R1V C 3XS6.L5 8/e0i,=F45, R 1 P-ENCN4E5 PkIVA-re ROAD SOIL ABSORPTION SYSTEM DETAIL / GRAVELLESS LEACHING UNIT Page_of Project Name: Bruce & Paulette Beedle Replacement Septic System 2 No. of Cells 6.5 Per Cell 3 ft Cell Width 13 Total No of EZ1203H 65 ft Cell Length 325 sq ft EISA Per Cell 3 ft Cell Spacing 650 sq ft Total EISA Manufacturer Model Laying Length EISA Rating Infiltrator EZ1203H-5ft 5.0' 25.0 EZ1203H-10ft 10.0' 50.0 Gravelless Leaching Unit Manufacturer: Infiltrator Gravelless Leaching Unit Model: 1203H Typical Cross Section Finished Grade 99 ft Observation Pipe with approved cap or vent Soil Backfill 36 in ■ Geotextile Fabric 95.4 ft Infiltrative Surface 12 in 0 93.4 ft Limiting Factor 36 in Slotted and Anchored Ventl Observation Pipe with Cap N/ 7 Plumber/Designer Signature: License 223760 Date: 19-Jun-12 DOSE TANK DETAIL Page _of Owner's Name: Bruce & Paulette Beedle 94.25 ft Inlet Elevation Weatherproof Manhole with Locking Device Junction and Warning Label Finish • rade Quick disconnect fitting G ; -Alternate forcemain outlet c_ oiC• G 4" stable & approved piping weep hole res (a) 4" stable & sePara O b approved piping y4 alarm on 4or dose Vol a (c) pump on a _ ~ pump off 40/ d (d) 90.85 Intake Elevation 3" Bedding Under Tank INTERNAL DIMENSIONS OF TANK Dimensions Inches Gallons Length 80 in dia in a 18.3 398 Width in b 2 44 Liquid Depth 37 in c 4.7 103 d 12 260 NOTE: Pump and alarm are to be installed on Total 37 805 separate circuits. w qg Tank Manufacturer Week's C P Pump Manufacturer Zoeller Tank Model 800 Pump Model 53 Tank capacity 800 gal Alarm Manufacturer Existing Tank Volume 21.76 gal / in Alarm Model Existing Filter Manufacturer Sim/Tech Filter Model STF-100 DOSE VOLUME CALCULATIONS TOTAL DYNAMIC HEAD CALCULATIONS Design Flow (DWF) 450 gal / day Min Network Supply 0 ft Number of Doses 5 /day Passive Vertical Lift 6.25 ft S n Max. Dose Volume 90 gal elev.) Drain Back 13 gal Friction Loss 2 ft j - (Foroemain Length x l7 Design Dose Volume 103 gal Friction Loss Fades)/100 Total Dynamic Head 8.25 Min Discharge Rate 20 gpm Plumber/Designer Signature: el-~4 U-01 License 223760 Date: 19-Jun-12 p SECTION: 2.20.010 QL/QL/TY PUMPB ,7iNCE ~,9~J FM0493 0311 des Product information presented Superse here reflects cation. o s kltw ® 0810 time of f publication. Consult factory regarding discrepan- cies or inconsistencies. MAIL TO: P.O. BOX 16347 • Louisville, KY 40256-0347 visit our web site: SHIP TO. 3649 Cane Run Road • Louisville, KY 40211-1961 www.zooller"com (502) 778-2731.1(800) 928-PUMP • FAX (502) 774-3624 COMPARE THESE FEATURES • Non-Clogging vortex impeller 53 - 57 Cast Iron Series • Float operated, submersible (NEMA 6) 2-pole mechanical 55 - 59 Bronze Series switch & variable level long cycle systems available • UL Listed 3-wire cord plug; 9 ft. standard for automatic, 15 ft. standard for nonautomatic (For Pump Prefix Identification see News & Views 0052) • Corrosion resistant powder coated epoxy finish • No sheet metal parts to rust or corrode L i ~ ~ • Stainless steel screws, switch arm, guard and handle MIGHTYmMAT E • No screens to clog SUBMERSIBLE PUMP • Watertight neoprene "0" ring between motor and pump housing U FOR DEWATERING SUMP • Solid buoyant polypropylene float Standard uiie. • Motor - 60 Hz, 1550 RPM, oil-filled, hermetically sealed, OR automatic reset thermal overload protected EFFLUENT (SEPTIC TANK SYSTEMS) • Upper and lower sleeve bearings running in bath of oil • Entire unit pressure tested after assembly PASSES SOLIDS ~SAP4b1 • Carbon and ceramic shaft seal ~1oUL77 CIP ~w _I=~ • Maximum temperature for effluent or cSA22.2108Standards) 1%" NPT DISCHARGE ---~dewatering-130°F (54°C) AUTOMATIC • Passes 1/2" inch spherical solids MODEL • 1 Y2" NPT Discharge. • On point-71/4" • Off point-3" • Major width-10 3/32" • Height-101/16" A SPECIAL MODEL FEATURES: MODEL 53 MODEL 55 Cast iron switch case, motor & Bronze switch case, motor & pump housing pump housing Engineered thermoplastic base Engineered thermoplastic base VORTEX TYPE Engineered, glass-filled, plastic Engineered, glass-filled, plastic IMPELLER impeller with metal insert impeller with metal insert Stainless steel guard & handle Stainless steel guard & handle Bearing - lower & upper oil fed Bearing - lower & upper oil fed cast iron bronze MODEL 57 MODEL 59 All cast iron construction All bronze construction Stainless steel guard & handle Stainless steel guard & handle Bearing - lower & upper oil fed Bearing - lower & upper oil fed cast iron bronze Cast iron impeller Bronze impeller ALL MODELS ARE COMPLETELY SUBMERSIBLE POWDER BN MODEL HERMETICALLY SEALED COATED TOUGH' Watertight - dust tight. Permanently oiled bearings. VARIABLE LEVEL CONTROL MODELS AVAILABLE • Automatic or Nonautomatic SYSTEMS AVAILABLE "53 - 57"-.3 HP, 115V or 230V "55 - 59" - .3 HP,115V or 230V Note: The sizing of effluent systems normally requires variable level BE53/BE57 & BN53/BN57 available packaged float(s) controls and properly sized basins to achieve required with Piggyback Variable Level Float Switch pumping cycles or dosing timers with nonautomatic pumps. 0 Copyright 2011 Zoeller Co. All rights reserved. TOTAL DYNAMIC HEAD/FLOW ~ ~ PUMP PERFORMANCE CURVE PER MINUTE MODELS 53/55/57/59 EFFLUENT AND DEWATERING 0 6 20- 1 MODEL 53/55/57/59 u~ Feet Meters Gal. Liters x 5 1.5 43 163 2 15 10 3.0 34 129 4 15 4.6 19 72 10 Shut-off Head: 19.25 ft.(5.9m) 0 l"- 2 009887 37/8 83118 5 4 518 1112 -11 12 NPT I 0 37/8 10 30 40 50 _ ® GALLONS OO, 4 LITERS 0 80 160 l FLOW PER MINUTE i ! I CONSULT FACTORY, FOR SPECIAL APPLICATIONS • Variable level float switches available • Variable level long cycle systems available i • Available with special cord lengths of 15', 26, 35', (50'230V only) 101/18 • Alarm systems available • Duplex systems available T- 3 3132 SELECTION GUIDE 3x858 1. Integral float operated mechanical switch, no external control required. 2. Single piggyback variable level float switch or double piggyback variable level float switch. Refer to FM0477. 3. Mechanical alernator "M-Pak" 10-0072 or 10-0075. 4. See FM0712 for correct model of Electrical Alternator. 5. Variable level control switch 10-0225 used as a control activator, with "Easy assembly" discharge pipe Electrical Alternator (3) or (4) float system. not included.) Single Seal Control Selection Listi s Model Voft Phase Mode Amps Simplex Duplex CSA UL M53/55 & M57/59 115 1 Auto 9.7 1 Y Y N53/55 & N57/59 115 1 Non 9.7 2 3 or 4& 5 Y Y ' BN53 115 1 Auto 9.7 Y Y BN57 115 1 Auto 93 N Y ` BE53/57 z3a 1 Auto 4.8 v Y OPTIONAL PUMP STAND P/N 10-2421 D53/55 & D57/59 230 1 Auto 4.8 1 Y Y • Reduces potential clogging by debris E53/55 & E57/59 230 1 Nat 4.8 2 3 or 4& 5 Y Y ' Single; piggyback switch included. Replaces rocks or bricks under the pump • Made of durable, noncorrosive ABS ° ` • Raises pump 2" off bottom of basin All installation of controls, protection devices and wiring should be done by a qualified Provides the ability to raise intake by adding sections of 1 W licensed electrician. All electrical and safety codes should be followed including the most recent National Electrical Code (NEC) and the Occupational Safety and Health or 2" PVC piping Act (OSHA). • Attaches securely to pump For information on additional Zoeller products refer to catalog on Piggyback Variable Level • Accommodates sump, dewatering and effluent applications Float Switches, FM0477; ElectricalAfternator, FM0486; Mechanical Aftemator, FM0495; Sump/ NOTE: Make sure float is free from obstruction. Sewage Basins, FM0487; and Single Phase Simplex Pump Control/Alarm Systems, FM0732. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. 0 Copyright 2011 Zoeller Co. All rights reserved. - rol Toll Free 888-999-3290 Mailing Address Office 231-582-1020 1455 Lexamar Drive, Boyne City, MI 49712 Fax 231-582-7324 Email simtech@freeway.NET Web www.gag-simtech.com INSTALLATION & SERVICE INSTRUCTIONS INSTALLATION: When installing an STF-100, screw filter into discharge port of any pump that has a 2" National Pipe Thread. Pumps with a smaller discharge port may be adapted to fit. When installing an STF-100A2 a tailpiece and male adapter will need to be added to the inlet end of the filter to the desired height and a 2" union will need to be added to the outlet end of the filter. Always install the filters in a position where they can be easily serviced. "Always use caution when starting threads to avoid cross threading". Plumb force main into the 2" sch 80 PVC union. "We recommend that the union remain together during gluing to insure that glue or cleaner does not ruin O-ring or sealing surface". SERVICE: Service of filter screen is dependent on usage as every system is unique. For most residential systems we recommend inspecting the filter within the first year to determine the necessary service intervals for the filter. In high volume systems we recommend inspection within the first 6 months to determine necessary service intervals for the filter. Once the service interval is determined it should be consistent unless something changes in the system. Always inspect the filter screen for any damage or corrosion and replace if necessary. If our STF-101 service alarm switch has been installed and adjusted properly it will alarm when the filter requires service. It should be serviced no less than when periodic pumping of the septic tank and pump chamber is performed. Servicing will be more frequent if using any one of our optional filter socks (600 micron, 150-190 micron, and 100 micron). Check your local health department for septic system servicing recommendations. If the screen becomes clogged before the periodic pumping requirements, a high level alarm or light will indicate the need for service. If system is equipped with a "pump on light" that stays on longer than normal, this also may indicate a need to service filter. To service filter screen, unscrew the 4" cap. Pull filter screen from canister and wash out thoroughly in appropriate location with proper protection. In some cases an additional filter screen allows quicker service allowing the dirty filter to be washed later at the shop. Note that in c oid condilins Oo tii116 eap may f* d ffou t to femove Keep Me filter in a warm area or pour warm water over the cap before rem wV Once Mt-lamer w installed in Me tank It maintains a stable ten peretrye and ►enx*M die cap w#l not be a problem. If the system is equipped with our Service Alarm Switch, the filter screen does not need service until the Service Alarm Switch activates a light or audio alarm. We still recommend that the filter be inspected once a year for damage or corrosion. NOTE: The total dynamic head loss of the system must be increased by 0.5 feet of head to overcome friction loss through the filter. - SERVICE ALARM SWITCH The alarm switch is available in three pressure ranges, low head, medium head, and high head. Installation is simple, on SIM/TECH FILTER systems, remove W plug from base of filter chamber and connect tube fitting. Next, run the tube up into the tank riser and connect to service alarm switch. The alarm switch is fastened to the side of the riser via the nylon strap provided. Run alarm wire to alarm box. The service alarm switch can be wired with its own alarm or with the high water alarm. Pressure adjustment is made by removing the end plug, and inserting the 7/32 alien. Clockwise increases pressure. One turn equals approximately 3 PSI. The low head alarm switch comes factory preset at 8 PSI and is completely field adjustable within it's range (3 to 24 PSI). We recommend the use of a ball valve when using an alarm switch. Once you have installed the filter and alarm switch, the ball valve can be closed off to simulate a plugged filter so that you can make sure the alarm switch is working correctly. ****TRY OUR LID/SCREEN REMOVAL WRENCH. Our wrench holds filter lid firmly and hooks screen for easy removal and installation. Made of PVC plastic. Installation Service Instructions.doc Installation Instructions for VAEZfl E ZAw Systems in Wisconsin FILTRwTOR . Wisconsin Department of Commerce, Safety and Buildings 5. The Absorption area (SF) necessary for a given site shall Division, has reviewed the specifications and/or plans for this be sized based on maximum daily sewage flow (GPD) and product and determined it to be in compliance with chapters the Permeability for the site. If certain criteria is met, the Comm 82 through 84, Wisconsin Admin. Code, and Chapters EISA sizing can be used in Wisconsin, resulting in a 40% 145 and 160, Wisconsin Statutes. All sites must meet the Site smaller drainfield. & Soil Conditions & Locations & Isolation distances as noted in local regulations. : 6. Place EZflow bundle(s) in the EZflow configuration ap- proved by system design permit specified for the particu- The approved products are 1203H (3-12" bundles with pipe in lar site. The top or center-most bundles containing pipe center bundle in 5' or 10' lengths) and 1203HP (3-12" bundles are joined end to end with an internal pipe coupler. Any with pipe in each bundle in 5' or 10' lengths. additional aggregate only bundles that may be required, should be butted against the other aggregate-only bun- A single pipe bundle contains a four inch perforated pipe sur- dies and do not require any type of connection. rounded by EPS aggregate and is held together with poly- ehtylene netting. A single aggregate bundle contains aggregate : 7. The top of each GEO cylinder contains a filter fabric pre- only and is held together with polyethylene netting. manufactured in between the netting and aggregate. The fabric is inserted to prevent soil intrusion. The installer Materials and Equipment Needed : shall make sure the the GEO is positioned upward and is • EZflow Bundles in contact with the fabric contained in the adjacent cylin- • EZflow Geotextile Fabric der before backfilling. • EZflow Internal Pipe Couplers • Pipe for Header and Inlet 8. The EZflow Drainfield Systems should be installed in a • Backhoe/Excavator level trench in all directions (both across and along the trench bottom) and should follow the contour of the ground Installation Instructions surface elevation (uniform depth), with all continuous The instructions for installation of EZflow products are given adjoining 10-foot cylindrical bundles placed end to end, below. This product must be installed in accordance with state with central bundle distribution pipe interconnected, rules defined in chapters Comm 82 through 84, Wisconsin Ad- without any dams, stepdowns or other water stops. ministrative Code, and Chapters 145 and 160, Wisconsin Stat- utes, as well as the local health department's current design : 9. The trench top shall be graded such that water will not manual. pond. Backfill should be seeded or sodded immediately after completion to reduce erosion. 1. After the local health department has determined sizing, configuration, and layout for the EZflow systems, stake 10. EZflow EPS bundles are flexible and can fit in curved or mark with paint the location of trenches and lines. Be trenches as may be necessary to avoid trees, boulders, or careful to set correct tank, invert pipe, header line or dis- other obstacles. tribution box and trench bottom elevations before instal- lation of pipe bundles. : 11. EPS aggregate is lighter than water, therefore, it might be expected that natural buoyancy forces would tend to 2. Remove plastic EZflow shipping bags prior to placing cause EZflow assemblies to float out of ground when bundles in the trench(es). Remove any plastic bags in the ponding occurs. Field experience has shown, however, trench before system is covered. that this is not a problem when systems have a minimum of 6" of soil cover as recommended by manufacturer. 3. This product must have geotextile fabric that meets re- quirements of s. Comm 84.30 (6) (g), Wis. Adm. Code, installed directly on top of the product and extending 1203H-GEO down along the sides of the product to a point at least six inches from the bottom of product. : Geotextile Barrier Material 4. When installed in a trench, the trench should be dug to a width of 36 inches. This not only saves labor in excava- 12" tion, but also provides better load-bearing capacity after backfilling is complete. 36- o . . . . . . . . . . . . . . . . . . 0 . . . . . . . . . . . . . . . . . . . . v o o o o 6 o I I I * I o e o 6 f e 6 o I I I o o I POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page-of , FILE INFORMATION SYSTEM SPECIFICATIONS Owner: Bruce & Paulette Beedle Tank Manufacturer: Week's Concrete Prodi F NA Permit # 9 Septic E~ Dose Holding Volume: 1000 gal DESIGN PARAMETERS Tank Manufacturer: Week's Concrete Prodl r NA Number of Bedrooms: 3 r NA Septic M Dose Holding Volume: 800 al Number of Public Facility Units: IN NA Vertical Distance Tank Bottom (s) to Service Pad:-NA ft Estimated (average) Flow: 300 gal/day Horizontal Distance Tank(s) to Serivice Pad: NA ft Design (peak) Flow = estimated x 1.5: 450 gal/day Specific servicing mechanics must be provide if vertical is>15 feet or if In Situ Soil Application Rate: 0.7 gal/day/ft2 horizontal is > 150 feet. Specific instructions to be provided on back. Standard Domestic Influent/Effluent Monthly average Effluent Filter Manufacturer: Sim/Tech r NA Fats, Oils & Grease (FOG) s30 mg/L Effluent Filter Model: STF- !00 Biochemical Oxygen Demand (BOD5) :5220mg/L r NA Pump Manufacturer: Zoeller r NA Total Suspended Solids (TSS) S150mg/L Pump Model: 53 High Strength Influent/Effluent Monthly average Petreatment Unit Fats, Oils & Grease (FOG) s30 mg/L Manufacturer: Biochemical Oxygen Demand (BOD5) 5220mg/L NA r Mechanical Aeration r Peat Filter NA Total Suspended Solids (TSS) :9150mg/L r Disinfection r- Wetland Petreated Effluent Monthly average r Sand/Gravel Fitter r other. Biochemical Oxygen Demand (BOD5) <_30mg/L Soil Absorption System Total Suspended Solids (TSS) :530mg/L H NA 11 In-Ground (gravity) r In-Ground (pressure) r NA Fecal Coliform (geometric mean) !5104cfu/100m1 r At-Grade r Mound Maximum Effluent Particle Size: Ye in dia. r N r Drip-Line r Other. Other: f Other: F NA MAINTENANCE SCHEDULE Service Event Service Frequency When combined with sludge and scum equals one-third of tank volume Pump out contents of tank(s) When the high water alarm is activated month(s) Inspect condition of tank(s) At least once eve : 1.1 year(s) (Maximum 3 ears) r NA r month(s) Inspect dispersal cell(s) At least once eve : 1.1 year(s) (Maximum 3 ears r NA r month(s) Clean effluent filter At least once eve : 1.1 year(s) r NA month(s) r NA Inspect pump, pump controls & alarm At least once eve : 1.1 pf year(s) r mo s r year(s) NA Flush laterals and pressure test At least once every: Wo month(s) Rest old drainfield for 3 ears Is year(s) r NA Alternate drainfields Monitor drainfield and switch annually if possibly MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Insepector; POWTS Maintainer; Septage Servicing Operator (pumper). Tank inspections must include a visual inspeciton of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and a check for any back up or ponding of effluent on ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicated a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumualtion of sludge and scum in any treatment tank equals one-third or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Admininistrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, petreatment units, and any servicing at intervals of 5512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 30 days of completion of any service event. (Rev.2/05) Page of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other chemicals or sediment that may impede the treatment process and/or damage the soil dispersal cell(s). If high concentrations are detected have the contents of the tanks removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During extended power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose and may overload them resulting in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) discharge; fruit and vegetable 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 system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks, pits and other soil absorption systems shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide the opportunity to obtain a sanitary permit for a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at the time of their permit issuance. ❑ A suitable replacement area is not available due to setback and/or soil limitations. If the soil absorption system cannot be rehabilitated and barring advances in POWTS technology, a holding tank may be installed as a last resort. ® The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ 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: TREATMENT TANKS AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES AND LACK SUFFICIENT OXYGEN TO SUPPORT LIFE. NEVER ENTER A TREATMENT TANK OR HOLDING TANK UNDER ANY CIRCUMSTANCE. DEATH MAY RESULT. ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK IS VERY DIFFICULT. ADDITIONAL INFORMATION: POWTS INSTALLER POWTS MAINTAINER Name: John Schmitt Name: John Schmitt Phone: 715-760-0486 Phone: 715-760-0486 SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name: Name: St. Croix County Zoning Phone: Phone: 715-386-4680 This document is intended to meet minimum requirements of Ch. Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. Use of this document does not guarantee the performance of the POWTS. (Rev. 2/05) 4. ' CROIX COUN'T'Y ZONING DEI AR`T' , AS BUILT SANI'T'ARY RETOR'T' ' Prof Owner /J6P!l~& E Address , r RG'~' City/State oi :yl c Legal Description: Lot V Block dim Subdivision/CSM iY,4 . *E 549, Sec. -4,2, T-JQN-RAW, Town of ST, o.s•4E~Dw PIN # 03o -gat?-7D SEPTIC TANK DOSE CLAMBER HOLDING TANK INFORMATION: Tank manufacturer Size ST/PC 10421,9Oo Setback from: House /S' Well ?O P/L 3 Pump manufacturer Z-a&-f en Model Ff Alarm location _ Floc,,ee7 OLDING TANKS ONLY) Setbacks: Service r to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM: Type of system: _ 7i e1yc/1E Width 3 Lengtb~ ' S Number of Trenches Setback from: House 73 Well /5.6- P/L .30 V t to fresh air intake 93 ELEVATIONS: Description of benchmark 67J-1 eyAl 1,16u rc Elevation 1061, o Description of alternate benchmark Lod o ArAw //61 6:- c o = 2 S~ Elevation ,9 / Building Sewer ST/HT Inlet ST Outlet ? %Y 3 PC Inlet Py 3 PC Bottom _M j'_ 7,7,1,;?- Top of ST/PC Manhole Cover 9 21 to Distribution Lines Q I ( 2) 9 ? 0 rS' ( ) Bottom of System g. (z) ( ) Final Grade (i) % (1) 9 ( ) Date of installation Permit number ZG State plan number Plumber's signature License number X22 / 7 y/ Date / 9,f- Inspector 01 64: complctc plot plan k Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: Safety and Buildings Division ST. CROIX INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Personal information you provice may be used for secondary purposes [Privacy L w, s.15.04 O1( m)1• 320267 Permit Holder's Name: aCity a fill gee Town of: State Plan ID No.: BEEDLE, BRUCE ST. J ri CST BM Elev.: Insp. BM Elev.: BM Description, Parcel Tax No.: a / 030-2027-30-000 TANK INFORMATION ELEVATION DATA A9800454 TYPE MANUFACTURER CAPACITY STATION BS HII FS ELEV. e Q i W 1 Benc r 7'D /O5~ /60 D Ing W Aeration Bldg. Sewer - fy Holding (9 Inlet TANK SETBACK INFORMATION Outlet 9 72f 9q 203 17-7 s oql l z TANK TO P/ L WELL BLDG Vent to ROAD Dt Inlet 77. . Air Intake Se X( NA Dt Bottom (3 . ~S X10. gS osing 3a v S 716, NA Header / Man. .qp 97 Aeration A Dist. Pipe 7.O e-? 7 Holding Bot. System 4•~') gi 's `~S 7/7 PUMP/ SIPHON INFORMATION Final Grade Manufacturer I Demand - Model Number it V GPM TDH Lift •2 Lriction g6 Systems TDH TjFt G Head Forcemain Length Dia. " Dist. To Well SOIL ABSORPTION SYSTEM BED -Width Length,, No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIM N tN I N SYSTEM TO P / L BLDG WELL KE / STREAM LEAC NG Manufacturer: SETBACK e ~3 2 Model Number: INFORMATION Typ CHAMB Sys e OR UNIT ~7D i DISTRIBUTIONS STEM //"a, Header / M nrfold Distribution P S;s) , x Hole Size x Hole Spacing Vent To Air Intake Length Dia- ~ Length V•t~Dia. _3YI Spacing G ys '~//p 0~ 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 Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: ST. JOSEPH 22.30.20.439F,NE,SW 1438 TRIANGLE DRIVE ~4• 64th 1 a vtw 5 -be llev- -8 ~~s~Cu 53 Plan revision required? ❑ Yes eNo Use other side for additional information. 474 SBD-6710 (R.3/97) Date Inspector's S nature ArtN Safety and Buildings Division NV SC0I1S%11 SANITARY PERMIT APPLICATION Po ~w~~9gtonAve. Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code Madison, WI 53707-7969 • Attach complete plans (to the county copy only) for the system, on paper not less County ('1 than 8 112 x 11 inches in size. J7 - cro% • See reverse side for instructions for completing this application State Sanitary Permit Number -37,0 information you provide may be used by other government agency programs ❑ Check if revision to previous [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATI N Propert Owner Name Property Location E L1 &-1 /4 1/4,S 2 T~~ ,N,R,to E(oriLj Property Owner's Mailing Address Lot Number Block Number C State Zip Code Phone Number Subdivision Name or CSM Number ,622 e c < ) -4$757 City ll Nearest Road II. TYPE BUILDING: (check one) E] State Owned C] ViI age . Public 1 or 2 Family Dwelling - No. of bedrooms -3 Town of <5 7, TIP/ /VGLC r III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo 99. so. a o. 939 -30 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash 5 ❑ Hotel /Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. ❑ New 2. 'Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an ,------System System Tank Only______________ Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 410 Holding Tank 1214 Seepage Trench 22 ❑ In-Ground Pressure t! / . 42 ❑ Pit Privy 13 ❑ Seepage Pit 1.14 144r E4004r;~s ;!-3 A67 43 ❑ Vault Privy 14 ❑ System-In-Fill j J7 [WA-014 CAA"~ VI. ABSORPTIONS STEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3_ Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) Elevation Y-5-0 5-7z"/ 18 fS.8 Feet Feet VII. TANK Capaclt in gallons Total # Of Prefab. Site Fiber- Plastic Exper. INFORMATION New Existing Gallons Tanks Manufacturerrs Name concrete Con- Steel glass App- New T nks Tanks Septfc Tan olding Tank 15 11 11 El 11 El iftPumpTank iphonChamber Q0 `c IR ❑ ❑ ❑ El El -goo I Will. STATEMENT I, the undersigned, assume responsibility for installation of the onsite sew! stem shown on the attached plans. Plumber's Name: (Print) Plu r Signature: (No Stam s) /MPRSW N Business Phone Number: Plumber's Address (Street, City, State, Zip Code): I- L - c - ~-yaz s -6-,94 OA IX. COUNTY / DEPARTMENT USE ONLY (Includes Groundwater ate Issued Issuing Agent entSignature NoStamps ❑ Disapproved Sanitary Permit Fee 9 9 ( ) INApproved El Owner Given Initial Surcharge Fee) 0 Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD-&W (R 1 fJ96) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber f i j , PAAML- - TT ' I A TO IA(4b~A 14. r L , I I - c941 ° yo 7 /`7__SlDln~Gz onc.u_ _ L AIc.T'~/`q T~p(z~ ~`lA.vfl~L~ C- CJ 0 c`2 Sri cL. 9.7.G/ - r I ELK aws i i I * - 5 77i I 1 I I : r r I I p/?~ vary /(BA D I , : , Q~ I I • PAGE OF PUMP CHAMBER CROS5 SECTION ARID SPECIFICATIONS' VENT CAP 40C.I. VENT PIPC WEATHER PROOF APPROVED LOCKIING JUNCTIOW box MANHOLE COVER 25' FROM DOOR, 12~MIU. WINDOW OR FRESH I AIR INTAKE GRADE ( y"MIN. I 1 O" MlN. CONDUIT-- 10'ININ. PROVIDE I . INLET AIRTIGHT SEAL I III I III v APPROVED JOINT A I III APPROVED JOINTS W/C.I. PIPE I III W/C.I. PIPE EXTENDIN4 3' ) II ALARM EXTEWOIW6. 3' OwT0 $0610 %OI L I I I ONTO SOLID 601L 0 I I I I ON C . I LLEV. FT. PUMP OFF 0 CONCRETE BLOCK 3" APPRovtO RISER EXIT PERMITTED OWLd IF TANK MANUFACTURER HAS SUCH APPROVAL~%&WING SEPTIC E SPEC.IFICATIOKIS ~~~LL......... DOSE TANK MANUFACTURER: GUS /r `S NUMBER OF DOSES: PER D" TANK 5IZr6: A00 GALLONS DOSE VOLUME ALARM MANUFACTURER: LeLe" INCLUDING OACKFLOW: U4 GAULONS MODEL NUMpER: AIA CAPACITIES: A=-./2 INCHE5OR d1~1.LSGALLONS SWITCH TyPC: RC 4,',P / • 5 =INCHES OR 1. c/31 7 7 G(►LLOL15 PUMP MANUFACTURER-..ti 4 EA C=INCHES OR _LL~t.l GALLOWS MODEL NUMOER: -5 3 0 a INCHES OR - 'nn~.d' GALLOIJ6 SWITCH TYPE: / MOTE: PUMP AND ALARM ARE TO BC MINIMUM DISCHARGE RATE - r. Fm INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEN PUMP OFF AAID..OISTRIBUTIOM PIPC.. ~O FEET t MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . FILET ♦ FEET OF FORCE MAIN X Lsy FYo rtFKICTt0U FACTOR.. FEET 0 TOTAL OSWAMIL HEAD = 4L FEET INTERNAL DIMENSIOW~ OF TAWK: ;WIDTH 001 ;LIQUID DEPTH 3 i LICENSE NUMBER; 22 7 y~ GATE:-2ZlZ2; SIGNED: w SEWAGEMASTE PUMPS 4 GRINDER PUMPS _ _ 10 V111l II N IMI'I II III IR F'0 32 '.I MI..I•IN IIA'"1 If 100 Sr, ~Iflll J I/] ~(111f1 I'A`:`~Iflf'I'111N1 tit If1WN Ir,li 90 ~„IV I'. R40 l1 I~~1 10 Z U_ 60 - Z 1 o 16 50 - 2', o 40 30 4 8 f/Gfi60 20 40 5 16 620 730 740 651 660 760 F650 10 r 630 I1.S. GAI I FINS 40 80 120 160 200 240 280 320 360 400 440 480 520 5fi01 610 6111 680 120 760 1111) 0 f❑r-RS 1 I - _..I - U.S. GALLONS 5 I IS 20 25 10 35 40 45 n s,o 100 lnr,o Innn Iro 2vm 2nnn 2NU" LITERS FLOW PER MINUTE 0 40 FLOW PER80 INUTE 120 160 A00388 009960 AGRICULTURE PUMPS EFFLUENT $ DEWATERING q In " WARNING: Model 18514185 should not 40 be subjected to less than 30 feet TDH. 0 11' a 38 125 NOTE: For Head Capacity on Model 14 I ,.'10! i~ Izo 112, Industrial column-explosion proof - „ fi 91 pump, see FM0219. 3 115 12 34 11U-- t 10 32 105 100 8 1) I 60I17 30 75 95-_ 28 411 26 85- 4186 A I!7 21- 80- 165, _ 4165 - - 22 -4)90,501Ir 4290,60112 o- I) 11.5. GAII()NS I!J 701 1U 4(1~ ,0 601 10 901 90 1001110 120 1130 140 1750160 1170 180 1190 200 20 65 I ITT RI; I iv 60- R 163, 0 0 160 240 320 40)O 180 5160 640 720 18 9t6J 189. rI OW PTR MtNU1F 1,- 14- 010652 6 50- 45- 40- w w SEWAGE DEWATERING PUMPS 12 35- 4140 1 416 10-- 75 _ 137, 22 25- 1165 6 20 20 65 WARNING: Model 293/4293 should not be subjected to less than 15 feet TDH. 4 Is- k IB 0- t 55 16 411 53.59 99 881 50- 0 U. S. GALLONS IO 20 30 10 50 70 80 90 100 110 120 1.10 140 150 180 14 45 LITERS 60 160 240 320 400 480 560 640 0 FLOW PER MINUTE 009922 12-40_ 35- 11 ~ JO 8 293, 6 20 282428 25 Sk . S210. ±LL IS 4 O 2 5 284, 294, 295, 405 0 4284 4294 295 1 1+1 1406 i U.S. GALLONS 10 20 30 a0 50 60 70 80 90 100 110 120 130 140 150 160 170 180 190 200 210 220 230 240 250 260 270 280 290 300 310 320 330 340 350 360 370 380 390 100 410 LITERS - ~-15-- 0 80 160 210 320 400 480 560 640 720 800 880 960 0 1040 010 1120 1200 1280 1360 1440 1520 I FLOW PER MINUTE 009904 11 1 I i Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page of Bureau of Integrated Services inwith s. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper nof'ies -than 8 ~''4't i hes l size Plan must County include, but not limited to: vertical and~ho►izontal r~nt (B; f9ir ction and, percent slope, scale or dimensions, f%gitfl'arrow, and location and distant o nearest road. Parcel I.D. # F ' ? ''9~ ' APPLICANT INFORMATIONi PAease phbtftDlihform [I© Reviewed by Date tu..w. n Personal information you provide may be u` d-fbi'~secoqi'ivacy9~w`; 15.04 (1) (m)). K 9 L 2,1 c~ 8 4 N+ y r Property Owner ` Property Location Govt. Lot - 1/4 i✓ 1/4,S a~ T30 'N'R (:20 -JJW) W 1-14 C 19 Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# BI -38 e city tate Zip Code Phone Number El City El Village R Town Nearest Road S-W-d Pry L ~e ❑ New Construction Use: Residential / Number of bedrooms Addition to existing building 52 Replacement ❑ Public or commercial - Describe: -7 Code derived daily flow b1010 gpd Recommended design loading rate gybed, gpd/ftz--if trench, gpd/ft2 Absorption area required _bed, ft2 75-0 trench, ft2 Maximum design loading rate C~ g bed, gpd/fi2~trench, gpd/ft2 Recommended infiltration surface elevation(s) yr. 86 ft (as referred to site plan benchmark) Additional design/site considerations Parent material Ooc4 L.Jtt S `f Flood plain elevation, if applicable IYA ft S = Suitable for system Conventional Mound In Ground Pressure AT-Grade System in Fill Holding Tank U = Unsuitable for system S❑ U 5d S ❑ U Ns ❑ U ®S ❑ U ❑ S [K U ❑ S U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Ground 7 6ny ri 7 ~ellev.. Depth to limiting factor ~ ~ - ln. Remarks: Boring # 3 13313' 7Pve9A9( 06 M/ Ground elev. ft. Depth to limiting factor +ff-in. Remarks: CST Name (Please Print) Signature f Telephone No. LhM~ Address / Date CST Number ~.'T. 0?5=1~ Z27 A~~ le 4 PC, 9. , i , ~ I ~ i ~ _ - - ff r t rt s~.Jf,2 7~~ old- - - ~Z t, : , t i I ~ I .~T~,1., ~ d cwt ©eet~/~ _ _ ~!'ct~.~7~~~ ° or?a~ . _ • _ _ . _ TAI' le ve - - ~T-°?-- - - - e 1, spa O.zS- 7 T- S ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify that I have inspected the septic tank presently serving the DR UC& 13EE~ie= residence located at: ~WL---114, ''W 1/4, Sec. , T-?0 N, R_.W W, Town .2 2- of s fi ~St°D Upon inspection, I certify that I have found the tank and baffles to be in good condition, and it appears to be functioning properly. Last time serviced_ 9 ~y-98 Did flow back occur from absorption system? Yes No,C(if no, skip next line) Approximate volume or length of time: gallons minutes Capacity: `C-300 Construction: Prefab Concrete Steel Other Manufacurer (if known): wL=4F~4r'`$ Age of Tank (if known): y Oily !1/N r///`/ 4 Z: T (Signature) (Name) Please Print (Title) 1 L » V 1 (License Number) 9 (Date) Form to be completed by licensed plumber (s.145.06, Wisconsin Statutes) or Licensed Disposer (NR 113 Wisconsin Administrative Code) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Plumber (applying for sanitary permit) Certification: In accepting the above statement regarding existing septic tanF condition, I certify that the tank to the best of my knowledge will conform to the requirements of ILHR-83, Wis. Adm. Code (except for inspection opening over outlet baffle). Name s/A,- CSI/ //'fIr7 Signature - M 5/88 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer. _ 13ft ac Mailing Address Z !Z,39 % /i4AVG-L,6=- 2/E . Property Address / 36 ' Z2 L NG 2& (Verification required from Planning Department for new construction) City/State flaw i ®n/ Z//` _ Parcel Identification Number -030 -.20-2-7 -30 LEGAL DESCRIPTION Property Location,&C- '/4, 5&/ '/4, Sec. , ~ . TJN-R,9-0_W, Town of 57' , &Zs"'11 Subdivision Lot # Certified Survey Map # AA , Volume Page # ~ . Warranty Deed # 3 y V3 ij , Volume S7S- , Page # . Spec house ❑ yes U no Lot lines identifiable jo 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 master plumber, journeyman plumber, restricted plumber or a licensed 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. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date.. S-1 -6N- OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE 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 f OOCUMEtIfT NO. STATE MR OF WISCONSIN-FORM 2 A, ?45 WAMA14 DEED ucl~ -575 THIS SPAC4 RESERVED FOR RECORDING OA!# -y ' 3491 jj •2 RECAST&,,S OFriCE ST. CRO'X'&' Wk" Sc-he tl _Orvlle Bernard Schettle. ~I►$i'~t~nce t Pr------ 42ec'd. fur R --wrd _ fhis 5 husband-.and wife, - aY of June A.D. 19 7p conveys and warrants to_ Bruce Beedle and P Ulette-J - t_ 8:30 A Bee31e, husband and tipbtor of CN.1 RETENIN TO - St. Croix count Bruce A. Beedle the following described real estate in - y' 14715_ S5th Street :North State of Wisconsin: Stillwater, 55082 The South 127 feet of the North 63S feet of the East - - 340 feet of Government Lot 3, in Section 22, Township 30 Tax Key N North, Range 20 West, according to the Government Survey thereof, subject to an easement for right of way and driveway purposes as now existing over said described premises, for the benefit of other owners or occupants of said Government Lot 3. .~jlF j1 vR w. LO e FLE This deed is given in fulfillment of a certain land contract between the parties, dated February 22, 1978, and recorded in the Office of the Register of Deeds for St. Croix County, Wisconsin, on February 24, 1978, in Vol. S70, Page S8, Document 346821, said land contract being in the original amount of $4,000.00. This is not homestead property. (is) (is not) Exception to warranties: F Dated this 2nd day of 19 78 . (S AL) s P /i-_tlgt1 (SEAL) _ ORVILLE BERXARD (SEAL) SEAL) } AUTHENTICATION ACKNOWLEDGMENT Signatures authenticated this__ 2nd d27 of STATE OF WISCONSIN June I9 78 t SS. e County. ~ i Personally came before me, this day of _ SAMUEL R_ CART the above named - - TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats.) - - This instrument was drafted by HEYW'OOD AND CARI, by 3A4JEL R. CARI to me known to be the person who exeruted the fore- n N O 0 to O! 3-0 n d c 3 r° _1 Q M n 'v .o c T CD lot Cn N O n d O [c:n O Z C4 O N (WD O m p O (D N W o 3 rn m C- coQ mw 0 zo ° o o ro y v 0 (D 0 0 (D (a ~j CD O N [ 1 v N N N d 07 7 W y 07 :P. 2 ?r c, 0 CD C: M y0w in w = O o o d c ° cn D eo a v> D a CD cn m cn a Di cn m (o C. D) N W CO ~ ry (D (D CW (O CL m 3 0- O F:p W N 0 W; o NO N 0 0 O L O N w w= ~ CVO = cc O C rn cc 00 W C m O CD C » Q 0 0 ~ ~ ~ ~ ~ ~ ~ ~ COT ~ • oA °A A o O O O O 00 aaaSa 0 1 0 a) (D - Q m o co ca =r ca (a co CD OIQ N N N o p°p Q 'fl ODD O ((A ch u°l ~ 0 ~ ~ d 'Q N 0 ~ N S7D o=i 3 o'yi < 3 d c n, < Q f y N z T z z~ z zG o D D a ~r v O _ O -b l~l 0 :r o o m m• CD (gyp 2 j. O N c OD c ( CD =r CD o n a CL 3 5 c z (D D1 fG (D (p -1 N O y O-~ N A n r K 4 CL A O E5' CL ~ c - z °O p ° N co C° y y ;o z < CD W p/ W O (D _ O rn CL a~((DD0 m ° m c ~v•o o SD 11 CD CD o a N z (D c o C N O CD fD d rn 7C ~a~a m (p CD N O~ p O D) x D A O q ACC J cc CD co CD 0• a co fD O ti ^''O 7 p (D N O OD CD A O O (D CD (0 O Q O Q ti CD (D CD Parcel 030-2027-30-000 06/10/2005 09:34 AM PAGE 1 OF 1 Alt. Parcel 22.30.20.439F 030 - TOWN OF SAINT JOSEPH Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner * BEEDLE, BRUCE A & PAULETTE BRUCE A & PAULETTE BEEDLE 1438 TRIANGLE DR HOULTON WI 54082 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1438 TRIANGLE DR SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 1.000 Plat: N/A-NOT AVAILABLE SEC 22 T30N R20W PRT GL 3 S 127 FT OF N Block/Condo Bldg: 635 FT OF E 340 FT Tract(s): (Sec-Twn-Rng 401/4 1601/4) 22-30N-20W Notes: Parcel History: Date Doc # Vol/Page Type 2005 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/09/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.000 50,000 203,300 253,300 NO Totals for 2005: General Property 1.000 50,000 203,300 253,300 Woodland 0.000 0 0 Totals for 2004: General Property 1.000 50,000 203,300 253,300 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 203 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 AS BUILT SANITARY SYSTEM REPORT :.WNER , TOWNSHIP SEC. TN, R W .0. ADDRESS" / , ST. CROIX COUNTY, WISCONSIN. UBDIVISION , LOT LOT SIZE 030 ~ ~o .2--7 _ "34)-ac30 PLAN VIEW 3 Ir -Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM t F oil _ PTIC TANK(S)_ ' MFGR. ~-_5 CONCRETE _ STEEL N b. rings on cover f Depth .`r DRY WELL _!ENCHES NO. of width length area _D no. of lines width /t length JOE area e y6f . depth to top of pipe, 'GREGATE / za zc,4r* o .:RK RATE AREA REQUIRED AREA AS BUILT '.sclaimer: The inspection of this system by St. Croix County does not imply complete ,mpliance.with State Administrative Codes. There are other areas that it is not possible inspect at this point of construction. St. Croix County assumes no liability for stem operation. However, if failure is noted the County will make every effort to _--termine cause of failure. :EASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. --INSPECTOR DATED _ ?e - ~f PLUMBER ON JOB LICENSE NUMBER &44 I ` REPORT Or ITISPECTION--U.-MVIDUAL SEI-)AC,E DISPOSAL SYSTEM Sanitary Pernit ~n 4 In' • • r State Septic ;7„ze IE ' T61,114SHIP • t -Croix County SEPTIC TAMI Size gallons. Number of Compartments Distance From: Well ft. 12% or greater dope ft Building' ft. Wetlands f: 11ighwater ft. DISPOSAL SYST:1 Tile Field or Seepage Pit(s) Distance From: Well ft. 12%.or greater slope* ft Building l S ft. Wetlands J` f FIELD lighwater. ft. Total length of lines r Length of ft. Humber of lines Yj each line ft. Distance between lines- ft. Width of the trench ft. Total absorption area "l5 < sq, ft. Depth of rock below the L~in, Depth of rock over the Z' in.. Cover -nver.rock,, A--1 Depth of tile below grade -in. Slope of trench in per 100 ft. Depth to Bedrock ft, Depth to .,round water ft. PITS Number of pits Outsi'e ~i eter ft. Depth below inlet ft. Gravel around p' : es no. Total absorption area sq. ft. i -Square feet of seep a trench bottom area required Square feet of s epageJpit area required • . Inspected by: Title*:-. j' Approved -1• Date~~ r~ 197 C' en____~_j % _ State and County State Permit # PLB67 Permit Application County P it d - for Private Domestic Sewage Systems Count *DENOTES STATE APPROVAL REQUIRED Date Approval Receivbd from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: B. LOCATION: Section ZL T 30N, 13,70 g (or) ot# City _ Subdivision Name, nearest road, lake or landmark Blk# Village Township + C. TYPE OF OCCUPANCY: Commercial *Industrial *Other (specify) *Variance Single family X_ Duplex No. of Bedrooms No. of Persons D. TYPE OF APPLIANCES: Dishwasher C. YES NO Food Waste GrinderYES-,&NO # of Bathrooms Automatic Washer AYES NO Other (specify) E. SEPTIC TANK CAPACITY /Qc90 Total gallons No. of tanks *Holding tank capacity Total gallons No. of tanks New Installation Addition Replacement- Prefab Concrete *Poured in Place Steel Other (specify) F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) 2-2) 2-3) 2-Total Absorb Area q. ft. New Addition Replacement *Fill System a.,J-.a' -0a,., Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of_ Trenches Seepage Bed: Length r6Width /X" Depth Tile Depth No. of Lines Seepage Pit: Inside diameter _ iqufd Depth Tile Size Percent slope of land `T die-(Y /jw Distance from critical slope 5)~, S I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared i ed Soil T r, by the CV NAME . C.S.T. # S'2~=15"79 and other information -4 A" obtained from owner Plumber's Signature MP/MPRSW# Phone #Tjr-AJIW-349~e.3 Plumber's Address PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20, including well. • ~ro~ot~~ l.cti2 /1 6 3~' N SN' EH 115 / WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES ! ! DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH P.O. BOX 309 J MADISON, WISCONSIN 53701 f REPORT ON SOIL BORINGS AND PERCOLATION TESTS LOCATION: ~'a SW'/a, Section-2&L., T~~I, R•®0 (or) ~ Township or Municipality Lot No. , Block No._ y County S Z• ~~yl~r • Subdivision Name Owner's Name: 1 Mailing Address: •v/ Z' TYPE OF OCCUPANCY: Residence No. of Bedrooms -3 Other EFFLUENT DISPOSAL SYSTEM: NEW X ADDITION REPLACEMENT 7 a DATES OBSERVATIONS MADE: SOIL BORINGS Tag"' 7gV PERCOLATI N TESTS SOIL MAP SHEET /Z 0' SOIL TYPE LU^rc~~C PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL BER 1ST WETTED SWELLING IN MINUTES PERIOD" 1 PERIOD 2 PERIOD 3 MIN/IN P I ( .See- !o e_ 4" P-2 / gof See- e re /tk s- 5- Z- P_ 3 Y~ '~j SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES OBSERVED ESTIMATTEDD HIGHEST ~ (DEPTHrTO BEDRROCK IF OBSERVED) 7 IO Iyc: j N 1F V r~ 70 ' S~f I^. B- 1 9 cf ! Z Q'6-e 26 " S G*-, B_ -3 2116 Aieoe e- > P. 71Y B- S' Q6N cute p`~ ti y« sL V-Gr 7S" s 111- G6- e0 PLAN VIEW (Locate percolation tests,soiI bore holes and suitable soil areas.) Indicate on the plan the location and square feet suitable areas. Indicate u r of square feet of absorption area needed for building type and occupancy. r dicate s le or distances. Give horizontal and vertical reference points. Indi e s ' pe. R ~ >d ~ os 1 ~ N t IQ C79", 3 r EH 115 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH P.O. BOX 309 MADISON, WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION TEST LOCATION: jAf_'/a,c /a, Section*2A , P.&IO(ord2ownship or Municipality ,.Q Lot No. BI k No. County 2,!A Subdivision Name Owner's Name-:. Address: TYPE OF OCCUPANCY: Residence ~k No. of Bedrooms Other EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT DATES OBSERVATIONS MADE: SOIL BORINGS 2PERCOL TIO TESTS//Q- -7P SOILMAPSHEETSOILTYPE ['s7A"~~'~ PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN P_ 30 P Z " ,2o 30 P- 3 ora 30 SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) B- 01t 17IFY`t /2'' 73, due e P It I'L a, 5414 '.2 B_ 3 ~y ,f 7~Y.. /O ~S. l.2" S~- ? Y H~~~S . ~~"Qo~i .'I'iS7G _50 do - B- S 'y `f~ 7~Y" Syr' l~v~S~3y.~a~co~ 91 6:~ I/ Axe -e- PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of s itable areas. Indicate number o uare feet of absorption area needed for building type and occupancy. 19/ S Ind' to scale or distances. Give horizontal and vertical referen p s. I cate slope. 3 q ° 1 ~ N 'O M 1 O ' State and County State Permit # 2210 • Pt. g 6 7 Permit Application County Permi for Private Domestic Sewage Systems County *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: y 21's"foeee s-5- o e B. LOCATION: SCE Section ~Z- T_©N, R 2 8 (or) t# City Subdivision Name, nearest road, lake or landmark Blk# Village Township C. TYPE OF OCCUPANCY: Commercial *Industrial *Other (specify) *Variance Single family _ X Duplex No. of Bedrooms -No. of Persons D. TYPE OF APPLIANCES: Dishwasher _ YES NO Food Waste Grinder YES XNO # of Bathrooms Automatic Washer YES NO Other (specify) E. SEPTIC TANK CAPACITY /000 Total gallons No. of tanks *Holding tank capacity Total gallons No. of tanks New Installation ?Addition _ Replacement _ Prefab Concrete *Poured in Place Steel Other (specify) F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) 3~0 2) 20 3) Total Absorb Area s f ft. New Addition Replacement *Fill System Seepage Trench: No. L'n. Feet Width Depth Tile Depth No. of~Trenches Seepage Bed: Length Width Depth " Tile Depth No. of Lines Seepage Pit: Inside diameter Liquid Depth Tile Size i Percent slope of land ` 1,zvo1,Ar4e A ance from critical slope I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared by the Certified Soil ester 1014, C.S.T. # S $=~9 and other information NAME obtained from ct Q _ p- owner 1; IV* Plumber's Signature P/MPRSW# Phone Plumber's Address PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20, including well). NU At Cil e-1 Awc e- /so' B