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HomeMy WebLinkAbout020-1439-11-000 Wisconsin <)epaµ7hen+.9fCommerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 538750 / T GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No' I Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. V ` Permit Holder's Name: City Village X Township Parcel Tax No: O'Neil, Keith I Hudson, Town of 020 - 1439 -11 -000 CST BM Elev: / Insp. BM Elew BM Description: Section /Town /Range /Map No: � d 106.1/) ZAA is 25.29.19.2737 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic n _ Benchmark 2�, 2 . 08 L)gCly Dosing / 1, ./ s „ q _ ` Alt. BM /tG�i� (AIM C� P�&j A% A Aeration Bldg. Sewe 0 Holding rr /HtHt Inlet Q t h I VY\ - 4 >!C �. Z 10 (® TANK SETBACK INFORMATION Y S St /Ht Outlet , . �3 10 2, lo.� TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet ,A Septic , � 3�"� r M Dt Bottom Dosing / Head /k- 8 fv o 0 '7 1 Aeration Dis . Pipe { Holding Bot. System . OY q9. qy, 0 PUMP /SIPHON INFORMATION Final Grade �p t3 .33 40 2•!a Manufacturer I GPM St Cover/ g /, rsry I Z /9 3 Model Number TDH Lift Friction Loss ystem Head TDH Ft Forcemain L Dia. Dist. to well SOIL ABSORPTION SYSTEM BEDITRENCH Width Length I No. Of Trenches PIT DIMEN NS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS S� SETBACK SYSTEM TO V 1 P/L BLDG WfLj, LAKE /STREAM ACHING Ma rer. INFORMATION Ty Of System: / " OR / UNIT Model Number: S /e DISTRIBUTION SYSTEM 2A-G �iY Header /Ma Distributio t x Hole Size x Hole Spacing Vent to Air Intake Length ' " Dia Length "� Dia ' / r h ' Spacing /� , SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only S o qbj Depth Over Depth Over xx Depth of xx Seeded /Sodded Mulched Bed/Trench Center Bed /Trench Edges Topsoil, Yes 7N7. Yes No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: G / 3 Inspection #2: / / Location: 798 Sumac Trail Hudson, WI 54016 (NW 1/4 NE 1/4 25 T29N R1 9W) Indigo Ponds Lot 11 I u(, Parcel No: 25.2919.273 1.) Alt BM Description = t �S► LL�Gt w7 — 2.) Bldg sewer length - amount of cover = f i� S r ' `i ` S i W . Plan revision Required? R Yes No Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor's Si u e Cert. No Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 538750 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: O'Neil, Keith Hudson, Town of 020 - 1439 -11 -000 CST BM Elev: Insp, BM Elev: BM Description: Section /Town /Range /Map No 25.29.19.2737 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt, BM Aeration Bldg. Sewer Holding St /Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED /TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Fuid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: LIN Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed /Trench Edges Topsoil Yes 0 No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 798 Sumac Trail Hudson, WI 54016 (NW 1/4 NE 1/4 25 T29N R1 9W) Indigo Ponds Lot 11 Parcel No: 25.29.19.2737 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? I' Yes H No Use other side for additional information. - Date Insepctor's Signature Cen No SBD -6710 (R.3/97) N visconsin Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608) 266.3 IS 153 75 0 State Sanitary Permit Applicatio Plan I.D. Number Z2t7 accord with Comm 83.21, Wis. Adm. Code, personal information you rovidc may be used for secondary purposes Privacy s p� p gy Project Address (if diffcrent than mailing address) I. Application Information - Please Print I Info a on A !f A.lr - Property Owner's Name Parcel N � Lot � '•0 � + Block is 0 '�1 ST. cizOlx COU NTY ZL'lD - a2f / 7 �000 Property Owner's Mailing Address PLANNING &ZONING OFFICE Property Location 'q& A 1444 !/ A "' 'A, h i �F 'A, Section a5 Ciry, S tate Zip Code Phone Number (circle ) / , 27 3 H. Type of Building (check all that apply) T N; R ! or�w (, e� 1 Subdivision Name CSM Number I or 2 Family Dwelling - Number of Bedrooms O'1 ` .j �t� ;Kl `� � ❑ Public/Commercial - Describe Use / d ❑ State Owned - Describe Use 5 X (In O ✓ C ❑Ciry_❑Vill ge Arownship of 11(�t, II1. Type of Permit: (Check only one box on line A. Complete line B if applicable) A New System - ys ❑Replacement System ❑ Trcatmcnt/Holding Tank Replacement Only ❑Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS System: Check all that apply) 6 ❑ Non - Pressurized In -Ground Mound > 24 in. of suitable soil ❑ Mound < 24 in, of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding ank ❑ Peat Filter El Recirculating Sand Filter ❑ j g ❑Aerobic Treatment Unit I Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less P ipe ❑ Ot her (explain) V. Dis ersaLrrreat nt Area Information: Design Flow (gpd) Design Soil A plication atc(gpdsf) Dispersal Area Rcqwrc sf)f Dispersal Area Proposed System Elevation —� 360 81 ' 0 7.0 � O 9 0 ', 0 0 VI. Tank Info Capacity in Total Number Manufacturer Prefab Site VV// Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass Ncw Existing y Tanks Tanks O �a /r- Septic or Holding Tank C P oo / X Aerobic Trcatmcru Unit Dosing Chamber / P VII. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown o.n the attached plans. S Plu Z, (Print) Plumbc 's Signature MP /MPRS N umbcr Business Phone Number a ka 7i5 �77Z-3zi Plum 's Address (Strut, City, State, Zip Ccdc) �S a-�-h &)71 �� )- VIII. County /De artment Use Onl Approved IsapprOV Sanitary Permt Fec (includes Groundwater V sued issuing nt Signa c S p ri Surcharge //- iven Reason enial to S - CC' f / IX Conditions of ApprovaUReasons for Disapproval 3) Q�� G � 5 p /ems 6 SYSTEM QW. N ER: ! q r e.�re ,. 1.. Septic tank, effluent lifter and ✓ �, J ( Pe a /''t toe- dispersal cell must all be services / maintained �Dwe�e�a 4 a as per management plan provided by plumber. c; 0 �— Z d CJ_1 a a1 0 / l a �dJ �f 3� ✓/ 11 cz,. 2. All sef lSick requu`ements must.be maintained �� a ss per applioabk coda /ordinances. L,J r 4 Y ✓ � Atuch complete plans (to the County only) for the system on paper not less than SU2 x I I inches in size SBD -6398 (R. 01/03) Safety and Buildings 3824 N CREEKSIDE LA CommerCe.Wl.gov HOLMEN WI 54636 Contact Through Relay isconsin www.w www.coe.wi.gov/s sin.go / iscosin.gov Department of Commerce Scott Walker, Governor Paul F. Jadin, Secretary March 31, 2011 CUST ID No. 226524 A7'TN.• POWTS Inspector ROGER L TIMM ZONING OFFICE TIMM EXCAVATING ST CROIX COUNTY SPIA 3128 20TH AVE 1101 CARMICHAEL RD WILSON WI 54027 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 03/31/2013 Transaction ID No. 1924220 SITE: Site ID No. 765751 Keith Oneil Please refer to both identification numbers, 880 Highland Trail above, in all correspondence with the agenc Town of Hudson St Croix County NW1 /4, NEIA, S25, T29N, R19W Lot: 11, Subdivision: Indigo Ponds FOR: Description: Mound / Two Bedroom / Sloping Site Object Type: POWTS Component Manual Regulated Object ID No.: 1308227 Maintenance required; 300 GPD Flow rate; 24 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 /01), Pressure Distribution Component Manual - Version 2.0, SBD - 10706 -P (N.01 /01); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Reminders • This system is to be constructed and located in accordance with the enclosed approved plans and with the component manuals listed above. • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. Condit • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption AFIFIR area. chs. NR 811 & 812c ,WMEW . 06 SAF1 • A Sanitary Permit must be obtained from the county where this project is located in accordance with the v requirements of Sec. 145.135 and 145.19, Wis. Stats. SEE COHRI • Inspection of the POWTS installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat MOUND AND PRESSURE DISTRIBUTION COMPONENT DE9I6N' a 1_i_'41 Residential Application v - BUILDINGS INDEX AND TITLE PAGE Project Name: Owner's Name: Keith O'Neil Owner's Address: 880 Highlander Trail Hudson WI 54016 Legal Description: NW/NE sec 25 T29 R19 W Township: Hudson County: St. Croix Subdivision Name: Indigo Ponds Lot Number: 11 Block Number: NA Parcel I.D. Number: 020 - 1439 -11 -000 Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Designer: Roger Timm License Number: 226524 Date: 03/29/11 Phone Number: 715 - 772 -3214 Signature: hlz;oAll� �jrally Designed Pursuant to the OVED Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01/01), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD- 10706 -P (N. 01/01) Ey .. Version 5.1 (R. 06/06) Page 1 of 7 SPQNDENC` Mound and Pressure Distribution Component Design Design Worksheet Site Information (R or C) _R Residential or Commercial Design Note: Sand fill (D) calculations assume a 200.00 Estimated Wastewater Flow (gpd) Table 83 -44 -3 in -situ soil treatment for r 1.50 Peaking Factor (e.g. 1.5 = 150 % fecal coliform of 36 inches. 300.00 Design Flow (gpd) _ 6.00 Site Slope ( %) 97.00 Contour Line Elevation (ft) 24.00 Depth to Limiting Factor (in) 0.40 In -situ Soil Application Rate (gpd /ft Distri bution Cell Information j 60.001 Dispersal Cell Length Along Contour (ft) = 5.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd /ft 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (C or E) C 1 i Center or End Manifold 2.50 Lateral Spacing (ft) If N above, enter the elevation (ft) 4 Number of Laterals of the highest point. 0.1881 Orifice Diameter (in) 2.75 Estimated Orifice Spacing (ft) = 6.82 ft /orifice 2.00 Forcemain Diameter (in) 26.00 Forcemain Length ) (ft) Does the forcemain drain back? 90.00 Pump Tank Elevation ' Enter Y or N -' 3.25 System Head (ft) x 1.3 4.24 Forcemain Drainback (gal) 7.83 Vertical Lift (ft) 53.76 5x Void Volume (gal) 0.47 Friction Loss (ft) 58.00 Minimum Dose Volume (gal) 0.001 In -line Filter Loss (ft) 28.84 System Demand (gpm) 1 1 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x 1.00 x 1.50 x x 1.25 x 2.00 1.50 x x 3.00 2.00 x -- _ 3.00 x � - - - - G Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 800.00 Septic Tank Capacity (gal) I Total Working Liquid Depth (in) Weeks Concrete Prod Manufacturer gaVin (enter result in cell B49) Dose Tank Information Effluent F Information 800.001 Dose Tank Capacity p ty (gal) Poly Lock ;Filter Manufacturer 22.22 Dose Tank Volume (gal /in) PL 525 Filter Model Number Weeks Concrete Prod' Manufacturer Project: Page 2 of 7 ti . Mound Plan and Cross Section Views 1/10 6 . • ........ ... • .......Observation Pipe J K 1: — l ti T 5 A W C. — : .. B L Mound Component Dimensions A 5.00 ft E 15.60 in H ft K 8.83 ft B 60.00 ft F 9.50 in z E ilft ft L 77.65 ft D 12.00 in G 0.50 ft J ft W 20.31 300.00 (ft) Dispersal Cell Area 868.90 (ft) Basal Area Available 5.00 (gpd /ft) Linear Loading Rate 6.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 99.79 (ft) — 0 t H G j F ...... 98.00 (ft) —► — Dispersal Cell 98.50 (ft) Lateral Dispersal Cell Invert Elevation D I / -. .- -. i ...:.... .. .. 1. • i • . 1. 97.00 (ft) Contour Elevation 6.0 % Site Slope Geotextile Fabric Cover Shading Key m T Dispersal Cell See lateral details on 0 _Topsoil Cap o 1.5 ft Page 4 for number, size, fs Subsoil Cap 0 . 0 ti:: and spacing of laterals. ❑ ASTM C33 Sand `-° �°:' Laterals are equally t : :: ;:: F Tilled Layer m 0. ft TypicaI Lateral spaced from the distribution cell's © Aggregate c centerline in the r --- -- A distribution cell (AxB). Project: Page 3 of 7 ti Center Connection Lateral Layout Diagram Force main connecoon via tee or cross to man4old at any point. laterals are idenric al � 4 p S • - Turn -up W ball valve or IE X X1+02 I xt2 +I Laterak & force main of PVC Sch 40 aleanoulplug per COMM Table 84.30.5 th Holes drilled on e bottom of the lateral. Number of Laterals 4 Orifice Diameter 0.188 in Lateral Diameter 1.50 in Orifice Spacing (X) 2.79 ft Lateral Length (P) 29.30 ft Orifices per Lateral 11 Lateral Spacing (S) 2.50 ft Orifice Density 6.82 ft /orifice Lateral Flow Rate 7.21 gpm Manifold Length 2.50 ft System Flow Rate 28.84 gpm Manifold Diameter 1.50 in Total Dynamic Head 11.55 ft Forcemain Velocity 2.94 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and --� Comm 16.28 WAC 4 in. min. Disconnect Tank component is properly vented Alternate outlet location Forcemain diameter Weeks Concrete Prod Manufacturer 2 in. Ca aci 800.00 Gallons Volume 22.22 gal /inch A Weep hole or anti - Dimension Inches Gallons B siphon device A 23.39 519.80 B 2.00 44.44 C Pump off elevation (ft) C 2.61 58.00 90.67 D 8.00 177.76 D Total 36.00 800.00 Dose tank elevation (ft) 3" Bedding under tank. ~— 90.00 Alarm Manuafacturer Septronics j Alarm Model Number _ 2501 Pump Manufacturer G ould Pump Model Number I EPO 4 _ Pump Must Deliver 28.84 gpm at 11.55 ft TDH Project: Page 4 of 7 Mound System Maintenance and Operation Specifications Service Provider's Name _ _ _ Roger Timm _ Phoney 715- 772 -3214 POW TS Regulator's Name _ Polk Phone( 715 386 - 4680 ) System Flow and Load Parameters Design Flow - Peak 300 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 200 gpd Maximum BOD5 220 mg /L Septic Tank Capacity 800 gal Maximum TSS 150 mg /L Soil Absorption Component Size 300 ft Maximum FOG 30 mg /L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu /100 mL Service Frequency Septic and Pump Tank Inspect and /or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test monthl Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound Inspect for ponding and seepa once every 3 years _ Other -- Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Tum -up Detail Finished ............... Grade 6 -8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Page 5 of 7 System Management .Management of this system is critical. As a condition of approval of these plans this system management section must be rep sewed with the owner, and the owner must be provided with a complete set of plans including this management section. If oroblems develop with the adsorption system or any other system components, the installing plumber, Roger Timm, 715- 772 -3214, or the St. Croix County Zoning Office, 715.3864680, should be contacted for assistance. General Proper functioning of an on -site disposal system, "septic system," is significantly dependent on the volume of water which ows into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of ;ontaminants, the better and longer the system will function. Typical system components include a septic tank or compartment to senle out solids and contain greases and oils, a filter on the outlet of the septic tank to retain small panicles of the same density as water, a dose tank or compartment to allow a dose to be accumulated, a pump and controls or automatic siphon, and finally some type of soil adsorption cell to recycle the water in a manner to protect ground water quality and public health. I If the septic tank is installed prior to sheet -rock and/or painting, pump the septic tank before normal use begins to ensure adherence to contaminant load design criteria. 2 Install water- saving appliances whenever and wherever possible. 3 Repair even small water leaks as soon as possible. 4 Never pour grease or oil down any drain or stool. 5 Garbage disposals are not recommended; if you must have one, use it sparingly 6 No paper products other than tissue should go into the system. 7 No chemicals should go into the system. 8 Avoid surge flows of water; try to spread laundry throughout the week. 9 Septic tank effluent must be less than or equal to the design criteria specified in page 2 of these plans. 10 If septic or dose tanks are no longer used, they must be properly abandoned. I I If construction timing and weather could create a frozen infiltration system, weather - proofing with plastic sheeting and heavy mulching may be required to maintain a functional system at start-up. 12 If possible, the upslope toe of the mound system should be landscaped with additional fill to blend this area into the upslope natural grade; this will minimize the possibility of the system trapping surface run -off; final settled slope should be 2 -3% over the system or 2 -3% diverting surface run -off around the ends of the system. Maintenance The septic tank must be inspected every three years by a properly licensed person. f necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids .o!ume equals one third of the tank volume. When the septic tank is pumped, any solids in the bottom of the dose tank must be pumped, and the filter must be back - washed into the septic tank to remove accumulated material. System use may require more frequent filter cleaning; initial inspections of the ,!!ter should be made every 6 months until a minimum time sequence is determined. Periodic observation pipe inspections should be made by the owner to examine the state of the in -situ soil adsorption cell. ;)uarterly inspections are recommended; a licensed plumber should be notified if effluent is consistently ponded in the adsorption e11 If this system contains specific treatment components other than those mentioned here, maintenance requirements will accompany their specifications. 5 The pumping components for this system include an alarm which must be installed and remain on a separate circuit from the Gump If the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible The system allows -eserve capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than ,D -e or two days should pass before any necessary repairs can be made. - Avoid compaction such as vehicle traffic within 15' down -slope of the adsorption system. S Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system. Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth 0 Surface drainage must be diverted around the system; avoid landscape changes which might send surface run -off into the system area Warning: Do not enter septic, dose or other treatment tanks; death may result because they may contain lethal gases or nsufficient oxygen. Contingency Plan Wastewater monitoring of volume and quality is not a normal requirement for low effluent strength systems; such monitorinZ may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83. =) Pumping and hauling of wastewater may be necessary while analysis and repairs are implemented. Additional testing, designing, and. or installation of additional treatment components or conversion to a holding tank may be necessary. Page 8 of 8 ��A GOULDS PUMPS Submersib Effluent Pump MODEL 3871 EPO4 & EP Series APPLICATIONS • Fully submerged in high ■ EP05 Impeller: Thermoplas- ■ Bearings: Upper and lower Specifically designed for the grade turbine oil for tic enclosed design for heavy duty ball bearing following uses: lubrication and efficient improved performance. construction. • Effluent systems heat transfer. ■ Casing and Base: Rugged • Homes Available for automatic and thermoplastic design provides AGENCY LISTING • Farms manual operation. Auto- superior strength and corrosion Canadian Standards Association • Heavy u resistance. AM * ' File # LR38549 • Water transfer Mechanical Float Switch ■ Motor Housing: Cast iron • Dewatering assembled and preset at the for efficient heat transfer Goulds Pumps is 1509001 Registered. factory. strength, and durability. SPECIFICATIONS ■ Motor Cover: Thermoplastic • Solids handling capability: FEATURES cover with integral handle and 3 / <" maximum. ■ EPO4 Impeller: Thermoplas- float switch attachment points. • Capacities: up to 60 GPM. tic semi -open design with ■ Power Cable: Severe duty • Total heads: up to 31 feet. pump out vanes for mechanical rated oil and water resistant. • Discharge size: 1' /2" NPT. seal protection. • Mechanical seal: carbon- rotary/ceram ic-stationary, BUNA -N elastomers. • Temperature: 104°F (40°C) continuous 140°F (60°C) Intermittent. METERS FEET io • mess: 3 series - ------------ - - - -- ---- - - - -- - - - - -- --- - - - -- stainless • Capable of running 30 ►�.—s GPM dry without damage to - -j - - - - - - $ - - 2.5 Fr - components. 25 Q -- — - -- Motor: W - - r --------- - + -- - ---- - ----- = i • EPO4 Single phase: 0.4 HP, 6 20 115 or 230 V, 60 Hz, 1550 z 5 - - - - - - -- - - - ------------ - - - F - -- RPM, built in overload with > automatic reset. ° 15 4 • EPOS Single phase: 0.5 HP, o - - }- --- - - - - -- -- - - - - -- -- - - - - -- - -- -- ------------ ' - - - - - EP0 --- --- 115 V or 230V, 60 Hz, 1550 3 ° RPM, built In overload with -- - .- ....... _- ... t.._ j automatic reset. 4 -- ------ - - - - - -- ` - - - - -- ---- 2 EPO • Power cord: 10 foot 5 S1 wrth length, t hee pro /ng - - - - - -- - -- -- --- .-- - - - - -- - - - - - -- i grounding plug. Optional 20 ° ° 0 10 20 30 40 50 GPM foot length, 16/3 SJTW with three prong grounding plug (standard on EP05). ° 2 4 6 8 10 12 m3 /h CAPACITY G Pumps C 2003 Goulds Pumps Effective July, 2003 ,__ , + E , ! ji- PI j L 10 VIP r i� p Q. NGJ /r✓£ .S'i ?1 - rZ'"T low ly lV7 . 1 i Von g� o 9w L _ Q . 8 6 3D. 5th 1312 Wisconsin Department of Commerce SOIL EVALUATION REPORT P age I of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Steel Soil Service Attach complete site plan on paper not less than 8'% x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. V P 2�, / 1-6 /n Please p //�ry Review y g � Date U U Personal information you provide m be used �Ibs� �vacy , s. 15.04 (1) (m)). Property Owner Property Location ROSAMJI, L.LL MAY 1 3 200 Govt. Lot na NW 1/4 NE 1/4 S 25 T 29 N R 19 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 2141 Cty Rd. C ST. c' 'ik COUNTY 11 na Indigo Ponds City Sta fiber J City __] Village W1 Town Nearest Road New Richmond WI 1 54017 1 715 - 248 -7071 Hudson I Prairie Meadows Drive ✓0 New Construction Use: &I Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD J Replacement I Public or commercial - Describe Parent material Sream terraces and pitted outwash plains Flood plain elevation, if applicable na General comments and recommendations: mound design, system elevation 98.60 ft, based on contour line elevation 97.60 ft Boring # I Boring [/ Pit Ground Surface elev. 98.10 ft. Depth to limiting factor 43 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDKt in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -6 10yr2/1 none I 2msbk mfr cs 2c LA .8 2 6 -16 10yr3/2 none scl 1 csbk mvfr gw 1 c .6 3 16 -26 7.5yr4/4 none scl 2msbk mfr gw 1 c .6 4 26 -43 7.5yr4/4 none sl 2msbk mfr gw na .5 .9 5 43 -72 8 /10ygley c2d7.5yr5/6 sicl om mfr cs na .0 .0 ❑ 2 Boring # I Boring 2 0 Pit Ground Surface elev. 98.10 ft. Depth to limiting factor n. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtW in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 *Eff#2 1 0 - 10yr2/1 none 1 2msbk mfr cs 2c .5 .8 2 6 -12 10yr3/2 none sicl 2msbk mfr gw 1 c .4 .6 3 12 -24 7.5yr4/4 none scl ?2msbk msbk mfr gw 1 c .4 .6 4 24 -57 7.5yr4/4 c2d7.5yr5/6 sl mfr cs na .5 .9 5 57 -72 7.5yr4/6 none Is 2msbk mvfr cs na 7 1.2 6 72 -96 8 /10ygley c2d7.5yr5/6 sicl om mfr na na .0 .0 Effluent #1 = BOD? 30 < 220 mg /L and TSS >30 < 150 mg /L Effluent #2 = BOD < 30 mg /L and TSS < mg /L CST Name (Please Print) Signature: CST Number David J. Steel 248956 Address Steel Soil Service Date Evaluation Conducted Telephone Number 1564 CR GG, New Richmond, WI 54017 5/8/2003 715- 246 -5085 Property Owner ROSAMJI, L.L.0 Parcel ID # pending Page 2 of 3 3] Boring # Boring vi Pit Ground Surface elev. 94.85 ft. Depth to limiting factor 51 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots PD in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -8 10yr3/2 none I 2msbk mfr cs 1 c .5 .8 2 8 -21 10yrr4 /4 none scl 2msbk mfr gw 1 c .4 .6 3 21 -38 7.5yr4/4 none scl 2msbk mfr gw 1f .4 .6 4 38 -51 7.5yr4/4 none sl/Is 2msbk mfr gw 1f .0 5 51 -64 7.5yr4/4 c2d7.5yr5/6 sicl 2msbk mfr gw na .0 .0 6 64 -96 7.5yr4/6 none Is osg ml na na .0 .0 F-1 Boring # J 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 PD in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F-1 Boring # Boring I Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots D in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD -S.30 mg /L and TSS < 30 mg /L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608- 264 -8777. Page 3 of 3 STEEL'S SOIL SERVICE INC. David J. Steel 1564 Cty Rd GG CST - POWTSM ROSAMJI, L.L.C. New Richmond,WI 54017 Lic. #248956 NWl14,NE1/4,S25,T29N,R19W Bus .(715) 246 -6200 Town of Hudson, St. Croix Co. Fax.(715) 246 -9372 Indigo Ponds Lot i i This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of this test may or may not be as shown, as permanent lot lines were not established at the time the soil test was conducted. Legend 1 " =40' ♦ =Benchmark Ele. 100.00Ft N Top of 1/2" pvc pipe e = Alt Benchmark Ele. 99. l OR Top of 1/2" pvc pipe ❑ = Borings Boring Elevations BI = 98.10Ft B2 = 98.1 OR B3 = 94.85Ft B4 = 00.00Ft /o-Fv � I2 loo. 00 0000(ir 4 i bOr /06 r /)d66 h o K0 ' s� u A UVW At J ' y (2.007 AC.)..' w� (1.251 At N.B.P.A.) " ; (1346 AC. N.B.P.A.) r ; 524.70' �7v ` 0 4 . 77 k- j ) - f �251.4J j 'X� r� \ . � 4:' J7• — _�_ - i` N . A. 10 j . ✓ 88400 ' S.F. 2.029 AC.) `rte',. IN 2 AC. t N.B.P.A. M f ;�' C ` 87123 S.F. ` o i !, �! . t, - -- •(2.000 AC.), '' o �.� '' (1.406 AC. N. / >� _ � B.P.A.) 125.52' , 97854 S.F. - 246 C / (1.002 AC. N.B.P.A.) CA ,, rte, - s --'� 1 , . r- - -� ._ �'` - 1 ~l `.�'' � /�, � • i - ' w ' 9.63 ,; • �`�` •`�, >' a . ,� i � cn � � - 1 � '"`• �- - A ' L 'L• - � S lk gr 97744 S,F. (2.244 AC.) 6►� NQ _ I 5 / 1.058 AC. N �'' �•. '-`� �: 92458 t.F..% / ( .B.P.A.j d` O (2.123 AC.) [ )(1.578 � , 89 1 s W78A ( AC. N.B.Pa f ` a i I CIS (3.071 AC.� ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner /Buyer KeH k 0 We ; I Mailing Address , l r Property Address "° 01 (Verification required from Planning & Zoning Department for new construction.) City /State k w_ E Parcel Identification Number LEGAL DESCRIPTION Property Location 4 1 %,, l/ JF '/4 , Sec. 2-S T ZEN R_ I�W, Town of Subdivision Plat: (�� l� dN , Lot # fl . Certified Survey Map # , Volume , Page # Warranty Deed # q 3 6,P:7 (before 2007)Volume , Page # Spec house ❑ yes © no Lot lines identifiable A yes ❑ no SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & 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. I /we, 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 Planning & Zoning Department within 30 days of the three year expiration date. 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. Number of bedrooms 2 - 3 1 1 - 7 SIGNAT OF APPLICANT(S) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if + reference is made in the warranty deed. (REV. 09/07) i 8021479 Tx :4015659 STATE BAR OF WISCONSIN FORM 1 - 2000 932687 BETH PABST Document Number WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., WI THIS DEED, made between Rosamji, LLC, a Wisconsin Limited Liability 02/23/2011 1:29 PM Company, Grantor, and Keith O'Neil, a single person, Grantee. EXEMPT #: N/A Grantor, for a valuable consideration, conveys to Grantee the following REC FEE: 30.00 described real estate in St. Croix County, State of Wisconsin (the TRANS FEE: 90.00 "Property "): PAGES: 1 Lot 11, Plat of Indigo Ponds, Town of Hudson, St. Croix County, Wisconsin. Recording Area Name and Return Address: Land Title Inc. 1900 Silver Lake Road #200 New Brighton, MN 55112 -1789 Together with all appurtenant rights, title and interests. 020 - 1439 -11 -000 Parcel Identification Number(PIN) This is not homestead property. Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except Easements, Restrictions, Reservations, Roadways, Rights of Way, if any, of Record. Dated this 15th day of February, 2011. R amji, LLC * Sandra GM e�hrke, President * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ST. CROIX COUNTY. )Ss. authenticated this 15th day of February, 2011 Personally came before me this 15th day of February, 2011 the above named Sandra M. Gehrke , the President of Rosamji, * LLC , a Wisconsin Limited Liability Company, to me known to TITLE: MEMBER STATE BAR OF WISCONSIN be the pers who ecuted the foregoing instrument and acknowle sa e. (If not, KEtIY� authorized by § 706.06, Wis. Stats.) ,•,� THIS INSTRUMENT WAS DRAFTED BY *Kelly J. Nelson Notary Pub ic, Stat of Wisc sin D� .fl �, ;z My mmi s p anent. If not, st xp�ion ti�te -C Larry Mountain, Attorney, 1900 Silver Lake Rd #200, New B ) Brighton, MN 55112 (Signatures maybe authenticated or acknowledged. Both arc not necessary.) *Names ofpersons signing in any capacity must be typed ur primed bclm their signature 1 of 1 WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 1 -2000 WIA 1 00 I ~ I. 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