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HomeMy WebLinkAbout010-1024-10-050Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No 648407 Personal information you provide may be used for secondary purposes [Privacy Law. s.15.04 (1)(m)) Permit Holder's Name City Village Township Parcel Tax No. DENNIS & DORIS BERENDS I TOWN OF EMERALD 1 010-1024-10-050 CST BM Elev Insp. BM Elev: BM Description: Section/TownMange/Map No: 10.30.16.150A TYPE MANUFACTURER CAPACITY Septic Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well JUIL At3SUKF I IUN STS 1 tM ELEVATION DATA STATION BS HI FS ELEV. Benchmark All. BM Bldg, Sewer SVHt Inlet SUHt Outlet DtInlet Dt Bottom Header/Man. Dist. Pipe Bot. System Final Grade St Cover BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR UNIT Type Of System: Model Number. UIJ 1 KIt3U 1 IUN JTJ I LM Header/Manifold x Hole Size x Hole Spacing Vent to Air Intake IDistribution Pipes) Length Dia Length Dia Spacing SOIL COVER x Pressure Svstems Only xx Mound Or At -Grade Svstems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bedrrrench Edges Topsoil Yes No Yes No COMMENTS: (Include code discrepancies, persons present, etc.) Location: 2466 160TH AVE 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? Yes - No Use other side for additional information. Inspection #1: Inspection #2. Date Insepctor's Signature Can No 1. 2.� 20 Industry Services 3 .�YECEIV Sr. C�(oix l 1 ti =�s 11 St. Croix Coun M.pia eon �� iggRS37e7_71� E6 072 Sasitmy, P®it limbo (to be filled is by ) 2: ��a� yCOMM11nit" Salutary ernu lication ST. cROlx COON � Namba io secmda= with SPS 39321(2)6 vrd Adaa Cods. submission of" bem to #A aYPas/dift rovetm■.trt asit Ts — I ZZZ 0 2 g 0 �— is required prior to "'a* a anlWy Pemf NOW Application b®s for 5b*4Wasd POW 1S are ssimbeed to Projaet Adios (f -11 eat d= Moors addles) the Dopabnent of Safety and Pm6rdotd Soiots Personal idet ndn ytw peadile mtq be used br secoadmy PXPOM inaoomtlssesw%der Ptivay Latr a IS 1xm , Ststt, O � [ Appillindmit L- Propwty Osruces Name Pocal Y 6.Vr1S * ,QaArS E,cEN O/O - /Ol ✓- /O- oSO Property Owner's bbil" Address Proputy Location P14 !0 u' Al/E. COWL Lot City, State Zip Code Phone Number EP E Al,O &JI 1 5Y0 /3 S[J %, .3 E y(� seeden /O T 30 14 R 14 godp n. Type of Bundling (tenet as that apply) Lot Y ©Ior2Fern ilyDwelling -NmoberofBadtoams 3 Subdivision Name �IidCommecial - DesctibeUae f Q G� Block Y me Owned - Describe use d d CSar Number `��, L�l=X EM£,tAlD ram QL Type of POW S POEM (Cheek ddW or " RepLrxment" and otbr ap}tlahle as II= A. Cbek emu has non ie H Compieb las C applicable.) A. ❑Now System �( System ❑Nher 14odtfiadon to R system (explain) Prmbcmk m Unit (eapiam) B. [3Ho(ding Task Z� kd'ividtml She Dssip Type (esptea) C. Renown! Badaa F�itstjoa OR.W. Elciesworriambar Elrmdwie New 0W2tX its Previous Pe mdtNambrasdDow bond FY. inspitrissUrresdimak • tf Anse ad TankDesip Flow l� Sell Application 11+4(�dhQ DLpaal Aran Required (d) Disprrasl Ater Pttrptts.d 00 sys= Ekvadoa y50 /.O S/SO q5d 97.51ar 97.61earraae Capacity in TaW Y of M=Wbcw r Task bdxmsdon Capon (idlons Units !- # B $2 Now '[lulus Q Tif n ni perpt.' Se--LL ine 1: /0700 — /,BOO (.f/ESEt �orLt rlE nouns Chamber V. Responalbitky Slatmengl- L the asMmalpsd, smaasa taspMiflBy for titre shewa as the s mehed peas. Plumber's Name (Prim) ' / e MPliB'!i S Nmbv Faovioess phone Number >`EArr %>/oKE ,7J y/ 99 7/S 9,cz- Y/S.S Plumba's Address(Sttcct. Csty, Stele, Tp Code) o s Tao v1 u.. Appaowd O Dim PermitpFee Dons Issued 6m Aseet Si�tsnaa O rvee Reason ne,re s 6 O 3 Z condidons s� S &4 eCa-k� SYSTEM OWNER: S • r ptic tank, effluent filter and dispersal cell -jS�1 �F Coh s must be serviced / maintained as �--�pr„ per t 3 VL I) � � ��N nagement plan provided by plumber. I setback requirements must be maintained 1— acnor nnnlirmre%AnAla -----.....v.��--�_�__,__ _-rr--- SBD-6399 (IL GMI) q1.o ago' J Y�at I <x. S•r ielf I /,tdol8eo a,rN YI+K 1 9Ar p�e�t •�( ,0 J ®<< U� 3-JA. N5C. furs �e4 0 .ror. of JiDi.✓G If I ` X 7S /1eLK LECL A x 9/ � Hoard i°oars .Srs. Ec. - 97Sr n,I 970r zowra„a /4r. /ii E.. 98.0 •7yl8 /ld 4* Aar. A� /J EieldlS ij Est fnlOS - .7 S'G8 Ad 4twAus .541, .56, /o, 3o,v /6 4J of E-^YZ,(4lJj Sr, C,tonr fa T w N / = Yo' rs/ 3A S Ac<! /A« S#ds 383,yi Srrercrr err �/EXIsr"„'g /°ewrs re es' AOA�oa.vao� IANWll0 oar '0 /,j Wisconsin Depsnnxni of Safety and Professional Services Division of Industry services 4622 Madison Y" Way PO 1 idx 7302 Madison, WI53707 December 6, 2022 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 2024-12-6 Plan Review: PWTS422202887-C Kent Hoke 200 Bremer Ave, Ste D Colfax, WI SITE: Berends 2468160' Ave Town of Emerald St Croix County SW % SE X S10- T30N — R16W FOR: Description:3 bedroom-450 GPD mound-35" to limiting factor- Effluent Filter - Maintenance required. Phone:608-266-2112 Web: ht�p 'ti Email: 4;iMawiti in soy' Tony Evers, Governor Dan Hereth, Secretary Conditionally APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES ID 0 SEE CORRESPONDENCE Mound Component Manual — Ver. 2.1, SBD- 10691-P(5/22-5/27) Pressure Distribution Component Manual — Ver. 2.1(May 2022-2027) Verify proper dose is achieved and system is not being over dosed. —J The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. 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 The site shall be properly prepared prior to plowing. Any grasses longer than 6" shall be cut short and removed. To avoid matting, any leaves or loose organic matter shall be raked up and removed. Cut trees and shrubs flush to the ground and leave stumps. Avoid operating equipment on the Mound site. If necessary, use only tracked equipment, during dry conditions, with minimal passes, to avoid compaction. Components and soil removed from an existing drain field shall be properly disposed of so that there is no risk to public or environmental health. • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec.145.19, Wis. Stats. • Inspection of the private sewage system 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. Stats. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. • A copy of the approved plans specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department. which may include local inspectors. Owner Responsibilities The current owner, and each subsequent owner, shall receive a copy of this letter. Owners shall also receive a copy of the appropriate operation and maintenance manual(s) and be responsible for ensuring that POWTS is operated and maintained in accordance with this chapter and the approved management plan under s. SPS 383.54(1). In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, J' )?&Wks Joshua Rowley POWTS Plan Reviewer, Division of Industry Services (715)634-5124 Joshua.rowlev@wisconsin.Aov Private Onsite Wastewater Treatment System Page 1 of 9 Index and Title Page Project Name: _6 - NN/S E.lpS - 3 /S,t / /eu.da i�aurs /rE/lACl,.r�.v r� Owner's Name: f 'wars Ear.+ps Owner's Address; Legal Description: Municipality: County: Lot Number. Subdivision Name: Parcel I.D. Number. Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 Page 9 Name of Designer. Signature: Town, age. City of E�/E.crra — Sr �.coirr Block Number CSM Number. /Lo uE_ Conditionally - /6..7Y- iA - AND PROFESSIONAL Index and Title Page bt!Kvtt,t_a — DIVISION OF INDUSTRY SERVICES Plot Plan Cross -Section & Plan View A�'"� /U4�' Pipe Lateisl Layout Septic Tank I Pump Chamber Cross -Section & Specific'�ORRESPONDENCE Pump Performance Information POWTS Owner's Manual & Management Plan POWTS Owner's Manual & Management Plan Filter Information E License #: 1W - .?d ,tl/ 99 Date: -Mound neat Manual for r D .Pressure D' 'btrtion Com Went �F Veraton 2.1 (May 2022- Po Mandel for POWTS" Version 2.1 (May Attachment Soil Evaluation Report IV/ Pl1r/j " 1"V �js"'vprYAY !F vl ftno�I h+i1 S/¢�' 1!Y rrrrrllp F�i'tPf t/S' 77� 7IrYY/ ir�Y S7£ Irs Id =a /0.4 �r0/,r, P�/ S�,iC-ron�rlsl s/rr�U Grp/ Mf C�/ �n I o'P6 - •rg Wry [ rr Ywrl rv;P I P Z6 ~P i-V Z6 - ' 17 'fits` flnPd PC."V ✓ /6 Y PIP I I 71l7 �►�vy SL x i I I ;'rioir y v :reF v bv/ , y,,•4, I , .ash, AWO 'c31 rwb ,; ppg/o0!/�rlfll/`/ I �sr/ r'Mv7 olb o•Lb rib alb Ploy D = S ft E = $ ft B' = .9 ft G = .S ft x=ft A = 4 ft B = _75' ft Z = 9 ft J=_5 ft K=8_ft L=91ft W=170ft 4' $ch. 40 PVC obbservenon pipe Ilk TO-6 ft GEOTEXTILE FABRIC COVERING ASTM C33 SAND FILL I TOP SOIL TOE CR03"ECTION OF MOUND Page 3 of 4 UPTURNED LATERAL a ACCESS BOX TOP BOIL OBSERVATION PIPE & WATERTKU4T CAP DISTRIBUTION LATERAL ( / t in. sch. 40 PVC D2015) Lateral Invert El.= 98 o ft - . - • . • .. - . - .: .-r ' +'` PLOWED SURFACE %SLOPE j . ^ FORCE MAIN (2- soh. 40 PVC D26M .... ^ . • DISTRIBUTION CELL R x 7.f ft ■ Ysb M (w-2w aggregate) ANn. Required = 9—O. Z a = fSo 112 Observation pipe r 7s B- tree ■ Dislrit> tion Cell /.i.S ft (W-2%, aggregate) L',g 7Sr OX= Upturned Lateral YAM Access Box OUwVatlon pipe DWAmbon pipes I, 11SB (�In. sch.40) R System El.= 75' ft Contour El. 97 o ft er K- Prohibit disturbance and vem:w treftic * * 16 R of do"Wops I". r I E L 9/ , Basel Area = _eft x 75"_ft = /?S ft 2 Min. Required = 'yso + 'Y _ //.7S R' 7 Force Naln Me bid (At. sch. 40 PVC D26eti) PIPE LATERAL LAYOUT OF MOUND (End Manifold with Aggregate) HOLE DIAt4ETER = .3 in. LATERAL DIA. A in. MANIFOLD DIA / f/ (sch 4 s _� in. 0 PVC d FORCE MAIN DIA. �pipe D2685)e�e P , _4 in. `e0\4GS`��e ft. mep� a. P s = 3 Pt. oe X - 4/ ft. Y - �_ ft. +�YAo~Xy ',MANIFOLD ( / > In. Kh. 4o PVC D2665) FORCE MAIN R' Bch. 40 PVC D2665) rAccess Box Q� Page of 9 HOLES LOCATED EVENLY ON BOTTOM OF PIPE. Minimum Number of Holes =_ Byrd ft' + 12 = 3S Holes 1� Holes/Lateral x 2 Laterals = 38 (3/16') Holes x 0.66 9P►n / (3/160) Hole = ,7508 GPM =SYSTEM FLOW RATE PIPE VOLUME _ /YS/ ft, Laterals (total) x 0.092 gal/ft. —.1 �S x 5 = 4C JS -L— GAL = MINIMUM DOSE VOLUME PIPE INVERT ELEVATION = 98.0 g MANI�OLE RISER b CovER Ib.r•Fa�.20r .,.. 'Y'l Tank Manufacturer; _ (� f�ESf.0 �a [ •rrE 5eptitlPump S¢e or pep Alarm Manufacturer E rce,, es Model Number. w1JT1 Switch Type_ 1�Ecalwicit Effluent Pump Manufacturer L�rrc� La�w,vr Model Number. 9EG Minimum Discharge Rate ,?S o$ GPM Vertical lift (pump off to lateral in Vert)_..........•_ /O a ft SYstem head (distal pressure .11.5 x 1.3 ft): _ 3L3 R aS ft Force main x pp {ram factory FRw friction loss ............... ft Total Dynamic Head (TDH): /3.7 page of C? 4' WrL Sdt 40 PVC Tw* Vwn dvn ig�w lonaf- Ebwtloo FORCE MAIN OPTIONS DW1Y ftwblral•rFlow (DyWF). V56 GPD Number of d* dww S. ,? (/ y �7 9a Form Mob VWWM_ 7�Rx_ ./��3/per=—=�•�_9al gW ftwd°••vuw—*-ro r'neof dti mmin) 8 gal DOSE TANK CAPACE a Reserve above alarm d o. gal Alarm float above on float (Di R► = 3. S gal (C) OnJOff float measurement 5. i in = 9G' S gal (B) Off above tank bottom in = gal (A) QQKE TANK D �wc•+••S. Mgt _ /JO in Width ay Quart Imiytrt 9i in in Gallonsfinch L, 74 9K SERIES — 4/10 HP mmammonk W-OkSFS off �J ., �:-�--,moWEEll, "I t, UAW-im - x 0 A a ® ahmeric j�ujmm 1 wwOwwm %C-0A-v -o.f�gaKr�eaire EFFLUENT PUMPS POWTS OWNER'S ENT MANUAL AND MANAGEMPLAN ?dQe —Z of 9 1tDumUMisast Quality (O NA) Monthly Avsraga Fats on t thsase (FOG) Biagi OXYM Demand 530 W Total Suspended solids MA S 220W :5 ISO MWL Bloehetnial Oxy Demand AMODs) Mist 30 AvtsraOtt Total Suspended Solids (Tgq) Fecal CoGfarm �k myL � � �I m®) S 10 OOmL Mmimnm went Particle Sim 1/8 itch di metier Cakub least — --- - -tea.,... i oSr. Soil Dispersal End Cap AtDLoWn Rate Arm Reeuired - EISA + ySe � a o YSo SYSTEM SPECIF CAnoNS (Dispersal Unit ELSA) - �v O `DWO of Presauie r.... a� true is" or UnI vity. Version 10 (May 2022^2027) O 'EZ Flow Mound COW Mau Vefur n3 �'W 17� Phu Systems." Publication 9 6 (SSprlyp MMUNO O "Itt-0nnnd Soil Abaorptian C h(MM EW pOWfS` V�mian2.1)(M' 2022-2027) �Iotmd Component Mamial 13 fhrPOWTr Varian 2.1 (May 20222027) 1] odwr. C�p00eltt Manual EDr POW M- Version 21 (May 2022_2027) 0 NA •—• .. o a u montm ® 3 O NA TART ilP A O ♦ r rust Foc new Vim, p� to using the POWTS check PaWft ploducts a other chemicals that may =pede the treatment psnoessand/or titsmaye the >tes�em tea) P of the contents of the tatrk(s) removed by a sepoya ""star Prier to ere sal tea)• If high c==Wadaos tar detac ed have at the iaMfredve swam B�OOsaaam m dollausear wM =6 cadtlan are lksome The property owner is tesponnble for the operation and amintcasnce of tloe�he POyourWIS and sPOWMubmissioinsn of required rt The quantity, and quality of the wastewater stream will effact the performance and fixtures along with prOmPt repair of kaimnea>ment devices f -tde should � oAlso the brim or wasb Dom wuatallatim o softremovaleners, _sffving appliances and other clear water include laundry wmte, showers, diahweter eta arged m the �ovnd aut3oe whenever possble iota: this does tint This system is designed to handle domestic strength waskwaier, however, the disposal of food based seeds, bongs, and food solids, such as those produced by a garbage �1 trh a di be !furs' oils, vegetable/huit peels, be discharged into the system Other nonbiodegradabie items, ,rich as minimimd Teulettissoe is the only paper first should denial floss, and cotton swabs should not enter the system. Chemicals�soch�sa ��f1Oe. Unitary napkins condoms, cigarette boas, antibiotics. solventaetc...Mnldmtboth>.,hcd;nwtTKsyr>oemhpens�y� Petroleum , I I P`6Dr. 4Wn*-tauts, PC Cldes, drinking water MPP1Y. Mairrtam a regular steady flow by Y �O°�° Yew�WlB and De your all system eonTomats, Compaction filar steadysnow over the �readmg �Y �d the WOOL Avoid vehicle traffic over dispersal unit may cause it to Se= up. drinkingvmersupply. Maintainer Page 8 of 9 allsystem components. Compaction ofsnow t6ed spreading laundry washing throughout the week. Avoid vehicle traffic ova dispersal unit may cause it to freeze up, �ISPECTION & MwtNTENANCE: Ins certifications: Master Plumber, M Inspection shall be made by an individual carrying one of the following licenses or Maintenance Schedule). Tank i plumber Restricted Sewer• POWTS Maintainer, or Septage Servicing Operator identify peetiorrs must include a visor inspection of the rank to iden ' (per the attached or leaks, measure the volume of combined sludge and scum and any missing or broken hardware, ground surface and test all electrical the Voem such as check for any backup or ponding of effluent to the ground than 8 inches in diameter shall be equipment pumps and alarm' Any defects shall be promptly corrected. Exposed openings with effbwve locking devices to Prevent accidental or unauthorized entry the tanks. When the combination of sludge and scan in any tank exceeds tank shall be removed by a Septa>:e ServicinE ODaaone-third (1 /3) or more of the tank volume, the entire contents of the oor rind d' Specific Servicing mechanics must be provided if vertical is >15 feet isfof in accordance with Ch. NR 113, Wisconsin Admin. t�pde. horizontal is>1So fat and instructions to be provided below. The edf filter(s) shall be ll beCted and cleaned n remove any accumulatedsolidsaccordingtomanufactura'sspecifications.Solids washed fi ce the filter shell the retained in the tank. Filter cleaning may be solids according at more manufit i rcess s than stated in the maintenance schedule to keep the system operatingfivq Alarms should be tested on a regular basis by the home owner. If an alarm sounds, contact an individual There is normally a I day reserve under regular operating conditions, however water should be conserved unbnosed to service POWTS, system are conccted to prevent back-up of sewage into the dwelling or surfacing ti nay Problems with the AHANDONMRtvr- When the POWTS fails and/or is perma nentlysafely Ch taken out 3,service the following steps shall be taken to ensure that � �Y and safe abandoned in compliance with Ch_ SP$ 3g3.33, Wisconsin Admire. Code: All piping to tanks and pits shalt he diseomected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of a Septag e Servicing • After pumping. all tanks and pits shall be excavated and removed or their by removed and the operator. s gravel, or other inert solid material. spree filled with soil, CONTINGENCY Pi ♦N If the POWTS fails and cannot be repaired the followin m $ easttres have been, or must be taken, to provide a code compliant replacement system; ❑ A suitable replacement area has been evaluated and maybe utilized for the location of a replacement area should be protected from disturbance and compaction and replacement soil absorption system. The from existing and proposed 1 should not t infringed upon u required setbacks structure, lot lira and wells. Failure to protect the replacement area renders it unusable. Replacement systems must comply with [lac cola in ef%et at the time of replacement, ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. IN 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 locane a suitable reptecerment 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 surfacer Reconstructions ofsuch systems mustcomply with the rules in etrectat that time. WARMNErrrr SEPTIC, PUMP, AND OTHER OXYGEN. DO NOT ENTit7t A SEPTIC, PUMP, GENT TAB MAY CONTIAN LETyAL GASSES AND/OR INSUFFICIENT MAYRESULT.RESCUEOFAPERSONFROM THE INTI?RIORURFATA NT TT BK UNDER ANYLT IRCU STANCES. DEATH ADDITIONAL COMMENTS; POWTS INSTALLER Nwe POWTS MAINTAINER / Name: E Phone: / / t/iv i„r Phone: SEPTAGE SERVICING OPERATOR ? Name: LOCAL REGULATORY AUTHORITY Phone: Name: , "",r ,rrry i it. Phone: 7/,f IS4C - yd to Maintenance Instructionsas =2psr 1-a0a-31b-96t3 Biotube° Effluent Flter How to Clean Your Effluent Rlter To ensure your effluent filter is functioning properly, it should be inspected every year. Under normal conditions, your effluentfiltar will function for several years before cleaning is necessary. The filter should be cleaned when it becomes clogged enough to restrict normal flows out of the septic tank. At a minimum, the fiber should be cleaned whenever the tank is pumped. Most people prefer to have a septic tank service provider take care of filter maintenance and cleaning. You can find a septic tank service provider in the Yellow Pages, under 'Septic Tanks & Systems.' or you can contact your coumy health department for a list If you wish to inspect and/or clean your effluent fitter yourself, be sure to dress properly. Wear full-length pants and shirt, shoes, gloves, and goggles or glasses. Then follow these instructions - I. Remove the access lid to your septic tank by unscrew- ing the stainless steel lid bofts with hex head wrench provided. If your lid is above ground, it will he easy to find. If it is buried below ground, find the marker that indicates its location. 2 Remove the filter cartridge by grasping the tee handle and lifting it out of its housing (see photo 1). 3. Spray the cartridge tubes with a hose to remove any material sticking to them (see photo $1. Ensure the three orifices in the optional flow modulation plate inside the filter are clear of arty debris. Make sure the rinse water nets back into the tank, but do not allow solids material to fall irrto the open filter housing. 4. Firmly place the cartridge back into the housing. 5. Some effluentfihers come with an alarm that activates when the filter needs cleaning. ifyou have an alarm, check to make sure it is working by lifting the float with a stick An audible horn should sound_ The alarm panel is normally mounted on the side of the house or in the garage. Note: If your effluent ffbr doesn't have an alarm system and you would Eke one, call your local septic system installer. 6. Record the date that you inspected and/or cleaned your filter on the form that follows. If you checked the alarm or made any other observations aboutthe tank or system, include that information under'Notere 7. Attach access lid by placing it on the riser, matching the openings in the Ed with the bolt catches. Insert rid Dolts into catches and tighten with hex head wrench provided. Phofe 1. Remove the fdrar cartridge by frfdng it out of its housing. Photo 2 Spray the cartridge tubes with a hose. WM*T4t.t Mr. LL 7M ft"3.ra n Ap I j a aelha "'s.re.'r'r•id� IwAw ` sou. EVALUAT ON rdrM tsa000lefnfOSVMWS3WV.NL Ada (bum CM*, w� o° ��,�t Ti Mu ra.rs Pbe moot kdwk S �' ro " 4 mush w °n'ap U�.°°hb�p "�.�� aap., aMaetlo. Pmnptatmtn mom&L illillilbsumdowpmaMYoWrMr by Da 2 n i -n POP" L=ft �Psr�rownsrr Addgs n� "tLot X X s T Qa D 4t�g Lot* sue! ss6dNsnNar fl)M R E (a) W aft�COds. PIIOtililfmsr C1pd ' "'-p..¢j �� � TWAft j Q ►iwca.a�eeon ao.d u e L t2� sC R.Ptc �coe,de, t�R.etn �,gnnwd,t—w,,, �bnsowmt. ' r S 5 S(�, itt� ft q p�oumsmf�ft _ (7 �a�� yv h ►am„ kL __ 'Qr. OM m*m 9&AdMy >+oat. s c p d` a `t2 Y / S •►n — � soft 0. soft Pit =ti . ttahun . pspd WinOF Jk PAR NPINAM i� ..I I' • '0.40 I � 7f �,a X0 CYG� �y 4V ly"It ti8g6-619 55Lip5 IM 'InopuolN p908 AoolweH 669CM Bull sal iloS IPIGH IIIM klIr ClAlbnot�a end iha6aaaidnd 6MYbM BOIL VALUVAI ATION Et�ORT jAft i+ •p•adI[W43KWIL Ada Costa Ca[nb r"�„�, aoc W. n■.a �� rpdeswo...er�ma., C r .aU ar dta�nMrati ooml aaft rad bo m mdta d dddi =M wwmmi& Pfi00e1 LD. � Plr �Utaltlgfioaspgp, PMvuy OWW 2 n � Ptop.r�r Loo�tbn Roa.tbowimt ��''� ontLot AddMs ^ a T . N R j CRY 11 1 blc! dtbd. NmNx F{ 2}►COdra - Phomjk npR �A t 13 ct, �14� Town Do ❑ a L,Ww 13 t Nwa°erf'�°d°" ummhrtMtlW � Ue i-Z51 ¢ to Rrap0f b�00m�- c1O4 duNw! P*Wmdww' L�°0-DwodbaK dwbnllowrrat� Pbw Pbo obwon it Nft IL , j f c, rnrrrla n� 6�� 0.,�.��, ►'ma � C . ' r I -�Mm owurd M�m OF:.... 0 =� El BOO �swim Grid mb" olac �� OWN III�1�lor3=�, fir. 8L st Si OEMiOMRIM 192M `6 r�Vol Oroartl surf�or soft# Soft aft. � R p"m to ft" ftw I f �olmoo mftdo � Qanhm�tCmo ebr Qa. kz. Cant {liar I T� � Edna potnfd�ry Rood I ❑� 8 PR Around iurfia �Nr. _ �. • p�pth yQ � fio0or__ tri.' F�Off=On coo am*" oww Rtdmc O�p� N anN� G¢ Jft GbnL Cakr Or. Bs Bh Rood mg&aMTM3-30St60mii. - *2: a OOD, Ja s 220 mplL tnd T8f3 a 30 s tOD n� ST. CR NTY SANITARY SYSTEM File#: Only OWNERSHIP/ADDRESS FORM �W021 . Community Development Department will utilize this information to provide the property owner with information regarding operation and maintenance of your new or replacement sanitary system! This information will be provided as part of our ongoing efforts to protect public health, your well, groundwater, surface water, property values, and county resources. Once approved, this completed form and educational information will be sent to you by email. If you would like to view your issued sanitary permit online, you can do so by using the Propar(y Files Scanned weblink. .1, : I •. 11 �: .�,; • . Owner/Buyer _ V n n I� 4 Mailing Addre City/State/Zip Phone Number (required) _ — I I S -yip -LI K 1 a Email Address (required) No P - ma o Parcel Identification Number O1 D ML4 —/0 - p (found on the property tax bill) NEW SVSTM LEM DESMpMON Property Location _ t/4 , _ 1/4 , Sec. . T _N R_W, Town of Subdivision Plat: q0 cuIfe S Lot # Certified survey Map # Volume . Page # Warranty Deed # _ 5g 4 Zs O&D e (before 2006)Volume 112c) .Page # Number of bedrooms Spec house i] yes O no Lot lines identifiable O yes O no New Property Address (Staff Initials) (Verification of new (Date) OFFIIM 11SE ONLY Development Department for new construction.) Ines form must be submitted with all Private Onsite Water Treatment System (POWTS) applications. New System: Include with this form a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is mode in the warranty deed. Community Development Department — Land Use Division 715-386-4680 St. Croix County Government Center cdd0sccw' 1101 Carmichael Road, Hudson, WI 54016 715-245-4250 Fax wwwsccwi aov DOCUMENT NO WARRANTY DEED �q STATE BAR OF WIS41ONSIN FORM 2— IBM, �284.25 Orville H. 1.:ittmer, and Eleanor M. j, WGtme>c,.. h>,I$bancl and wife eouveyd and wrrrnntl to .4e nnis D. Berends. and II enG.0... huIII A ,. and..wife.. as...._.,.... s.urvi.va�sh�.p. ^tfx.itax...propex.CY �I . . ........ ... . I the Following described real estate in _. ,.,., St. CroiX County.I� ..... —. State of Wisconsin: `— ...• .rn.. .c.u.rsa I.R Rc<otc.vq on.n #U ST CROIX CJ.,1`,I Rsdd for Rt.�,;.J 1• MAY 2 1996 , At : • : 9: 30 A. fj �I '«.%R- ttJ4,r�^ (Ii R�. anw.& f n—'_ j Tax Parcel No: .......... ................... The Southeast Quarter (SE 1/4) of Section Ten (10) excepting therefrom the South Forty (40) rods of the East Sixteen (16) rods of the Southeast Quarter of the Southeast Quarter (SE 1/4 of SE 1/4) of Section Ten (10), Township Thirty (30) North, Range Sixteen West (16 W)I and the South One -Half of the Southeast Quarter IS 1/2 of SE 1/4) of Section Four (4), Township Thirty North (30 N), Range Sixteen West (16 W), Excepting therefrom the East Thirty-four (34) rods and the West Sixteen (16) rods of the South Twenty (20) rods of the East Forty -One (41) rods of the Southwest Quarter of the Southeast Quarter (SW 1/4 of SE 1/4) of said Section Four (4) . This deed is given in full satisfaction of that certain land y~� contract between the parties hereto dated January 30, 1976 and recorded in Volume 534 at page 607 and 608 as Document No. 331978. This homestead ................ property. (is) (is not) Rxcertion w warranties: municipal and zoning ordinances, easements and restrictions of record and any lien created by act or omission of Grantee. Outed this .. .. (p day of April IB 95 .. .. .(SEAL) _. ,. )t•tr�' Ib'EA L) _ ..... _................ _... JR VILLE H.�, W`ITTMEY. ... .. .(SEAL) ` �' K )r ' ISEA1.) --... ELEANOR M. WITTMER II AUTHENTICATION II` Signature(&)........................................................... ..................................................................... . .......... authenticated thin ....... A&Y of ........................... 19 ..... T[TI�E:�MEM 8ER�8TATE BAR OF WISCONSf N.. I� (If not. , _ authorised b ........... ................ Y 5 708.08. Wis. Ctats.) I� TV:a INSTRUMCNr WAS DRAT Er: ■V (2$MINGTON.,,LAW__OFFICES. Judith A. Remington New-. Richmond,...W.1... .... 5.4017 . (StRnaturos may br authenticated or sick nmrlydgrd. Roth are not nectesnry.) i ACKN3WLRDGN4ICNT STATE OF WISCONSIN ST.. '...C.............County. ROIX as. ............I� Personally came beforo the than f Apr 1.1............... 19..95 Orville H. Wittmer EleanMittmer tl' ..................�nd wifear W to ma known to be the Persian ....5. �••d•ihe I; foregoing instrument and neknow'.ed qSg••" �, +-i. A . Re r Ni "4o rx NIA:.'y Puhlic St. Croix Cml n: r, LYis. My t'nmmipion if perinm+ent.(If not, at ntn r, pirrt;n, dn't•: f0 .1 •Na.n•d sir reran n+ rfx+.int ••. our .'n Pw•itY-1... vl.1 he •h. ....r•I . . r r p• n4.A 1..1..: i .:, no..n.... N•ARRANTT DEED f RtArR BAR 0Y RIFCON9IY FORM N. t — q.., P.. ..•• C� M Awa..•.•. W.•. •na�n LOON WUwnsln DeparbflenEBda oifly and ProfoaaldnalServicesSeces Page _L ofDlvlalonofindustryS J4N � 1SOIL EVALUAREPORT • - h u/ W G In accordance with SP8 3E5, C O i Attach complete 46 plan on paper not less than 8 V2 x 11 Inches In size. Plan must Indude, but not smiled to vemcat and horizontal reUrenca point (W, direction and percent elope, Parcel I.D. scals or dlmanslorls, noM arrow, and location and distance to nearest road Q 0 ^ CaLf -10 -- oso Plan" print all Intormatlon. R"od by e n pate Property Owner Property Location 13 GovL Lot �„/ v. SE Y.s e T 30 1v R« (or w Property Owners Mqn4 Address D Lot # BloYk # Build. Name orC8NpY D k'e'�' City Gtate ZIP Code . Phone Number ❑ City �❑'Micas, Town Neepast Road pf R. U NOwConaWMft Use: N Rasidandal/ Numberof bsdroome -VCade dedvad daiDn flow me _SUOPD Replaxwmant ❑ Publ o or commercial - Describe: Parent material « Flood Plan elevation If applicable N ft. General Commli nd recommendations, \ i' c.o v 1MMQ_ rv4. �t a�.� �l� rm a � J 0 L{ t'b �J-�o�� % S Ili p�'l� I�'�S �• rj 5 � ' 'ate SP-tr e- s Qsoling Al Boring Pit Ground surface elev.V5� Depth to limiting factor Y irC tSLL1 ]0 Ifa CI7:rl. ®®� ®�®® WA mar . m E WM BIN�I�!l 0 MP» Boling;q i U eoArtg #. R pti Ground surface slsvJ 7s n. Depth to limiting factor fSln. Horizon Depth In. Dominant Color tlAumell Redox Deaariptlon Qu. A7_ Coral Color Texture Structure Consistence Boundary Roots Sou Application GPD/W Rate Gr. Sr- all. f5 Z b r ) r� CS Z b 'C-fffF2 Z I3 Si 5 r,.` r— r L s-so s y l S— C_ at7r G G z a Y > r > r >QOsna n C13T Name (Pleas Prfit) CST Number �J !J (2— O�OS Address Will Heidt Soil i' Date slustlon nduCted DU CP ��1)LZ hlaphoneNumber��7 2y�jpi� ll y ,Ni. t Mondovi, M 54 i (715) 579 '�84 tltlU-a330 (RO4H0) Boring J PR Ground surfaoe elev. LIL Depth to gmdtngitetor FBI VA MR Im i� 5o Depth to Ilmuing f Pit Ground surface alev. _: ft. ee6or _+,.In. Q 9odnp s 9orinp Horloon Depth Dondnantcolor WOxDeacrlpfon t Texture ! Structure Conaletenee Boundary Root !n Maneeli Qu, Az. Cont. Color 1 Gr. Sz. Sh. ------------- , j ! t 71, B*Mw # ❑ Borinp ❑ Pit Ground surface alay. _ ft. Depth to llmttlnp factor_ in.- sort Aodioatlon Ra31 f Conalatence Boundary 2hlnent 01 ■ BOD, > W 5 220 atp1L and TSS > 312 9 150 mg1L • Effluent #2 = BOD, > 30 6 220 mglL and TSS > 30 9 150 mplL &n- a f-I -rtv r�-s'l� QQ-f� n,S �Q R r e rblj( s Will Heidt Soil Testing W3503 Hemlock Road Mondovi, WI 54755 (715) 579-9584 60ay�nb� i� aoZz 36a�� yvbu,sp- w V449"k icec—or—KCOUNTY�~�5 No. 648407 STATE SAND n %* 2q" K OWNER PLUMBER, TOWN OF SEC 9 jW N, R !4LOT ftoo� t S R PERMIT PREVIOUS NO, LIC.#29y199 SUBDIVISION CHAPTER 145.135 (2) WISCONSIN STATUTES (a) The purpose of the sanitary permit is to allow Installation of the private sewage system described in the permit. (b) The approval of the sanitary permit b based on regulations in force on the date of approvaL (c) The sanitary permit is valid and may be renewed for a specified period. (d) Changed regulations will not impair the validity of a sanitary permit. (e) Renewal of the sanitary permit will be based on regulations in force at the time renewal is sought, and that changed regulations may Impede renewal. (Q The sanitary permit is transferable. History: 1977 c.168;1979 c. 34,221; M c. 314 Note: If you wish to renew the permit, or transfer ownership of the permit, please contact the county authority. G OFFICER - DATE 3 S RENEWED BEFORE THAT DATE POST IN PLAIN VIEW VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION SBD-06499 (R11/20) Julie A. Peterson From: H&H Plumbing, LLC<handhplumbing,colfaxwi@gmail.com> Sent: Thursday, February 2, 2023 11:30 AM To: Julie A. Peterson Subject: Re: St. Croix County Sanitary Permit Application for Berends-Emerald WI Thank you Julie, Kent said the Register of Deeds Office told him there is no CSM for that property. Thank you for getting back to me! Haley H&H Plumbing, LLC On Thu, Feb 2, 2023 at 11:24 AM Julie A. Peterson <Julie.Peterson ftsccwi ¢ov> wrote: Haley I did find the deed for Behrends in with Newgard- thanks for the heads -up to look there. I did not find a copy of the lot of plat/CSM for Behrends — was any other paperwork brought in that day I can look through? I have copied Kevin on this as I am not sure what a contingency plan is- it is on the checklist for us to receive with a permit H Hope this helps you, Julie Julie Peterson I Community Development - Administrative Services Supervisor ST. CRO pP.NTY From: H&H Plumbing, LLC <handholumbina colfnwt i; email com> Sent: Thursday, February 2, 2023 10:48 AM To: Julie A. Peterson <Julie,Peterson osccwi sov> Subject: Re: St. Croix County Sanitary Permit Application for Berends-Emerald WI