Loading...
HomeMy WebLinkAbout008-1076-70-000 County: St. Croix Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Buil Division Sanitary Permit No: INSPECTION REPORT 538767 0 I 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: Johnson, Diane M. Eau Galle, Town of 008- 1076 -70 -000 CST BM Elev: Insp. BM Elev: BM Description: Section /Town /Range /Map No C� r 26.28.16.399B TANK INFORMATION ELEVATION DATA TYPE MANUFACTURW CAPACITY STATION Z' BS / I FS E L�DV. r Septic ��.. '+ Benchmark 0 /00 Dosing Alt. B� / t— Z (v3 %% AN 17 Bldg. Sewer $( ej� 2 4 5P 7 Holding SUHt Inlet 74 '9�r Z4 TANK SETBACK INFORMATION St /Ht Outlet TANK TO P/ l WELL BLDG. Vep to Air Intake ROAD Dt Inlet Septic Dt Bottom / 1 ZAf > Z I 7 Header /Man Dosing / i . 5 3 T7 2SL /txs --� . 3• Aeration Dist. Pipe 54b 97, Holding Bot. System g Z 9 (o Z Final Grade j/ 3 9� 7 PUMP /SIPHON INFORMATION 4 Manufacturer Demand St Cover� Model Number Zj) ! �� t, a Z c t# TDH Li Frictio System jea�� TDB I t � J f j Forcemain Length , Dia. Z Dist. to Well Z�Z SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of Tr ches IT DIMENSIONS No. Of Pits Inside Di Liqui Uepth DIMENSIONS �� 1 7 / SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer. INFORMATION CHAMBER OR Type f y UNIT Model Numbe, . DISTRIBUTION SYSTEM Header/Manifold Distribution Z x Hole Size �.�! p x Hole Spacing Vent it Intake Pipe(s) , 7S D 3-6Z Lengt Dia_ Length Dia Spacin 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 I No Yes No t COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: Inspection #2: 16W met of Par el No: 26.28.16.39913 Location: 2556 10th Ave oodville, WI 54028 (SW 1/4 SE 1/4 26 T28 ) s & bounds F!a�d . - 4�tt., 6 % J 4— a �V, -'"SL 1.) Alt BM Description = i 2.) Bldg sewer length - amount of cover Plan revision Required? Yes No r ' I �$3�/� Use other side for additional information. /� Date Insep rs Signal Cert. No SBD -6710 (R.3/97) Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division Sanitary Permit No: INSPECTION REPORT 538767 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: Johnson, Diane M. I Eau Galle, Town of 008- 1076 -70 -000 CST BM Elev: Insp. SM Elev: BM Description: Section /Town /Range /Map No. 26.28.16.399B 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 BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer. INFORMATION CHAMBER OR Type Of System: UNIT Model Number. DISTRIBUTION SYSTEM Header /Manifold Distribution I x Hole Size I 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 No ] 7r' 7N o COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: ! / Location: 2556 10th Ave. Woodville, WI 54028 (SW 1/4 SE 114 26 T28N R16W) metes & bounds Lot Parcel No: 26.28.16.3998 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? 0 Yes F No Use other side for additional information. Date Insepctor s Signature Cert. No SBD -6710 (R.3197) 08/27/07 MON 15:28 FAX © 386 4686 wool • x;04 Alf 1, SOW T ' 201 W. • A �� ��` i',L� ISO �►� ®/1 wt aai�)62 SaartarylirmmuTluaber (tobeMWinbyCo.) '°'°"t° °� ° - 7 Sanitary P6 pfieafion SM Tva sectiaa Nmuber In aaoorbooe "a S. Comm 83.2l(n WiL A&L Code s sin. �dae than to we apprepriete ®a.er,mwnt l > 9 � ? S �I un is iegauod prior to a6maing a s>okety peradt IQate Appleatin forms for svwowm TOWTS are (rdr�e frsatdM ing ) wboafted to the of Comm aor erce: Personal inmdan you provide mar be used for secondary , Z � aocatd®oo.rith tier Law !S. 1 Sfttc. � �:- L hdmloa ion PlemPrWABltdWimadm Prnperwowneesib - Parse o 0 > 4 cfG�LinSv� &0' 109 7U GoU Pre party Owites Meiling Adder Psoperty Location S 5" fs l0 t 4 caw Lot f ( 3 ' / City state ZipQode Pboae t V.. T S'� A. section �LG �?�Y )k R 1lo EorW IL Type OrBolding (clack at gut apply) Lot# Plf'or2 For* DwdGag NootbvofBodre. � Subd isioal�me 0 Pubri ommocid — Deank .be 6 � k r�6. ,%.. El CILY Of 0 Stets Owned DescribeUx CS11 Number 11 Vim of vTbwn of �i / �[ 1, ,4 l L! lIL lygre of (GTteck tatljr use 6mc an �e A_ coaspieto irm B dslrpNabie) System ❑R %Mmr 13TMwQcw oltTM*ft*oeMM*Only 0 OaffMemication0Eistift m(mc*&I) W 17 ftn* ft ewal 11 Permit Revision I7 tbpeeffta*w 1I Permit Thworm to biew LarlRsrions Pbnrat Nr�ba arra n�a rsauoa adore Fmrpiw600 Orraar IV. T of POWTB s/ teat r 0 Non4mmuiaed mAkeend 0 rrtmutaed la -Gomrd O M4rade 6HAo=d Z24 iw of ie moo ❑ MoM0 < 24 vL oraMoble soil 1> HoldMTank n DupewtCampoawRl=WiM OP=VcRbwntDevioa Ae V. Ares Inbnwdians Dmign mqw (gpd Design Sob Dispersd Area Dkpmd area (SO %60110 -q ro �IQ U o • 5 3d o DD /, 0 23 q6 1 3 VL Took Info Capaaty in Tom! S of )Urnfaetorer COOM GaRoas Unis o NarTaoks F faETaaks , / � to 2 , W U m ii m a. C7 w SgweorttoltTada 'La f f.r/r r SL YII_ a- L dre ler bsO listiou efab MWlS sban ea the atescUed Pbaaba'sNana 06 Stpo" NuMber t fboaerkrmber S /CG e Plumber's Addrsss(Straet. � cane) Vn use kpp� e Permit Fee Veto !w �srww- 5/17/ J7 I/ !x_ Coatit WwrfrR"asoa I tsr Disapproval 3� (� fi e✓b'S r h 5 1 I. Septic tank, effluent filter and *, • •' 1 dispersal ceft must all to services / maintained �,,G Q • G t cis per management plan provided by "plumber. 2. AN40bock requVements must be maintained sad =dead to CM*O* "p4a tee t<,.. s j(r= t t in&" get GO CIM7) Vaud titan 01!09 08 -27 -07 17:35 TO: FROM - .715 3$5 {== gg e V yn _S tom n m E �� � ae Ac PtS 1 7 -j ge. s �, f sF o �► �� • 5 X1 G�� s �� � oog►_�u ?t- �� ©ov r� f tit na5� l op 30' �fe il. 3 s op 1 4 -2 i 4' d 1 v ra 1 /� �ll� t6 ;? Sed =QI 95:60 TT -ZT -S6 Safety and Buildings ' 10541 N RANCH ROAD commerce .Wl.gov HAYWARD WI 54843 Contact Through Relay i s c o n s i n www.commer isco sin.go / www.wisconsin.gov Department of Commerce Scott Walker, Governor Paul F. Jadin, Secretary May 13, 2011 CUST ID No. 223475 ATTIC• POWTS Inspector JOE STANG ZONING OFFICE STANG PLUMBING & ELECTRIC ST CROIX COUNTY SPIA PO BOX 263 1101 CARMICHAEL RD WOODVILLE WI 54028 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/13/2013 Identification Numbers Transaction ID No. 1937594 SITE: Site ID No. 766966 Gary Larson & Diane Johnson Please refer to both identification numbers, 2556 10TH Ave above, in all correspondence with the agency. Town of Eau Galle St Croix County SW1 /4, SETA, S26, T28N, R16W FOR: Description: Mound, 2 bedroom residence Object Type: POWTS Component Manual Regulated Object ID No.: 1313880 N Maintenance required; Replacement system; 300 GPD Flow rate; 14 in Soil minimum depth to limiting factor from Coln original grade; System(s): Mound Component Manual -Version 2.0, SBD- 10691 -P (N.01 /01), SSWMP Pub. 9.6; Effluent Filter APP ,RTA The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes, " N OF 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 - S� EE COI 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: Key Item(s) • 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. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • The float switch shall be a type that does not contain mercury. 2009 Wisconsin Act 44 prohibits the installation of float switches or relays that contain mercury. • The bottom of the distribution cell shall be level per the Mound Component Manual. The "D" dimension shall be a minimum of 22 ". The maximum finished slope of the mound surface shall not have a slope ratio steeper than 3:1 per the Mound Component Manual • The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater particle size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. JOE STANG Page 2 5/13/2011 Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of COMM 84. Comm 84.10. No fixture, appliance, appurtenance, material, device or product may be sold for use in a plumbing system or may be installed in a plumbing system, unless it is of a type conforming to the standards or specifications of chs. Comm 82 and 83 and this chapter and ch. 145, Stats. • The existing POWTS must be properly abandoned per s. Comm 83.33 Wis. Adm. Code. 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. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings 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, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 Patricia L Shand POWTS Plan Reviewer , Integrated Services WiSMART code: 7633 (715) 634 -7810, Fax: (715) 6 M -fr 8:00 - 4:45 pat.shandorf @wisconsin.gov cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 828-5902, Monday, 7:00 A.M. To 3:30 P.M. Notice: Starting July 1, 2009, no person or entity may engage or offer to engage in construction business in Wisconsin unless they hold a Building Contractor Registration, or equivalent, issued by the Safety and Buildings Division of the Wisconsin Department of Commerce. "Construction business" means a trade that installs, alters or repairs any building element, component, material or device that is regulated under the commercial building code, chs. Comm 60 to 66, the uniform dwelling code, chs. Comm 20 to 25, the electrical code, ch. Comm 16, the plumbing code, chs. Comm 81 to 87, or the public swimming pools and water attractions code, ch. Comm 90. The term does not include the delivery of building supplies or materials, or the manufacture of a buildingproduct not on the building site. For further information, go to our website: www.commerce.wi.gov/SB/SB-BuildingContractorPro--ram.html 4 , I MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Larson & Johnson Owner's Name: Gary Larson & Diane Johnson Owner's Address: 2556 10th Ave. Woodvil le, W isc. 54028 Legal Description: W1/2SW1/4 SE1 /4 S26 T28 NR16 W Township: Eau Galle County: St. Croix Subdivision Name: Lot Number. Block Number: Parcel I.D. Number: 00- 1076 -70 -000 ).W.T.S. itionally Plan Transaction No.: 0 Page 1 Index and title ENT OF MERLE CAF AND BUILD Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank iRESF` DE CE Page 5 System maintenance specifications Page 6 Management and contingency plan r Page 7 Pump curve and specifications Page 8 Plot Plan Page 9 Soil Evauation Report Designer: Joe Stang License Number: 223475 Date: 05/02/11 Phone Number: (715) 684 -5166 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) Version 4.01 (R. 09104) Page 1 of 9 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 1.50 Peaking Factor (e.g. 1.5 = 150 %) fecal coliform of - 36 inches. 300.00 Design Flow (gpd) 1.20 Site Slope ( %) 94.30 Contour Line Elevation (ft) 14.00 Depth to Limiting Factor (in) 0.50 In -situ Soil Application Rate (gpd /ft Distribution Cell Information 95.00 Dispersal Cell Length Along Contour (ft) = 3.16 Cell Width (ft) 1.001 Dispersal Cell Design Loading Rate (gpd /ft 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest po int in the distribution Y Pressure Disribution Information network? Enter Y or N (c or e) c Center or End Manifold 0.00 Lateral Spacing (ft) if N above, enter the elevation (ft 2 Number of Laterals of the highest point. 0.188 Orifice Diameter (in) (e.g. 0.25) 3.00 Estimated Orifice Spacing (ft) = 9.38 ft /orifice 2.00 Forcemain Diameter (in) 40.00 Forcemain Length (ft) Does the forcemain drain back? Y 83.00 Pump Tank Elevation (ft) Enter Y or N 3.25 System Head (ft) x 1.3 6.52 Forcemain Drainback (gal) 12.88 Vertical Lift (ft) 29.83 5x Void Volume (gal) 0.40 Friction Loss (ft) 36.35 Minimum Dose Volume (gal) 16.53 Total Dynamic Head (ft) 20.97 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 1.00 1.50 1.25 x x 2.00 1.50 x 3.00 2.00 x 3.00 x Gallons /Inch Calculator (optional) Treatment Tank Information 750.00 Total Tank Capacity (gal) 750.00 Se tic Tank Capacity (gal) 1 37.001 Total Working Liquid Depth (in) Wieser =Manufacturer 20.27 gal /in (enter result in cell B49) Dose Tank Information Effluent Filter Information 750.001 Dose Tank Capacity (gal) Best Filter Manufacturer 20.281 Dose Tank Volume (gal /in) GF10 -8 10x18 Filter Model Number Wieser Manufacturer Project: Larson & Johnson Page 2 of 9 Mound Plan View — J 1/ F K 10 B Observation Pipe 3 A W _:` ... — B .. . I L Mound Component Dimensions A 3.16 ft E 22.46 in H ft K 10.87 ft B 95.00 ft F 9.25 in z Elft ft L 116.74 ft D 22.00 in G 0.50 ft J ft W 21.93 300.20 (ft) Dispersal Cell Area 1 1229.14 (ft) Basal Area Available 3.16 (gpd /ft) Linear Loading Rate 1 9.50 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 97.90 (ft) ► H � . }rrrrrrrrr 2 rrrirrrr..- I F : ; : : } ai Cell 96.63 (ft) L atera l Dispers 96.13 (ft) — Invert Dispersal Cell 3 . t Elevation E D i i A �. i, i, i, i_ ). i, ;. r i, { { i i • , j ' i, i i i i i • i ,i i i i , .. .. .... .. .. : •._:..... .. .. ..v 94.30 (ft) Contour Elevation 1.2 % Site Slope Geotextile Fabric Cover Shading Key c. Dispersal Cell See lateral details on 10 ® Topsoil Cap c a 1 5 ft r Page 4 for number, _ size, and spacing of © rrrrr Subsoil Cap 0 c M C33 Sand Z F laterals. Laterals are AST ®0 6 m 0.5 ft Tilled Layer Typical Lateral equally spaced from the '� distribution cell's Q50 Aggregate a os ° � • centerline in the A distribution cell (AxB). Project: Larson & Johnson Page 3 of 9 I Center Connection Lateral Layout Daigram P ' I If X- --*I+M I x1231 Laterals & force main of PVC Sch 40 [per COMM Table 84.30 -5] Holes drilled on the bottom of the lateral, • = Turn-up vWballvelve orcleanoutplug equally spaced Number of Laterals 2 Orifice Diameter 0.188 in Lateral Diameter 1.25 in Orifice Spacing (X) 3.02 ft Lateral Length (P) 46.81 ft Orifices per Lateral 16 Lateral Spacing (S) 0.00 ft Orifice Density 9.38 ft /orifice Lateral Flow Rate 10.49 gpm Manifold Length 0.00 ft System Flow Rate 20.97 gpm Manifold Diameter 0.00 in Total Dynamic Head 16.53 ft Forcemain Velocity 2.14 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 Disconnect 4 in. min. Tank component is properly vented �— Anemate outlet location Forcemain diameter Wieser Manufacturer 2 in. Cap acityl 750.00 Gallons Volume 20.28 gal /inch A Weep hole or anti - Dimension Inches Gallons B siphon device A 24.19 490.57 B 2.00 40.56 C Pump off elevation (ft) C 1.79 36.35 83.75 D 9.00 182.52 D Total 1 36-981 750.00 Do se tank elevation (ft) 3" Bedding un er tank. 83.00 Alarm Manuafacturer I SJE- Rhombus Controls Alarm Model Number Tank Alert 1 Pump Manufacturer JGoulds Pump Model Number 3871 EP05 Pump Must Deliver 1 20.97 gpm at 16.53 ft TDH Project: Larson & Johnson Page 4 of 9 Mound System Maintenance and Operation Specifications Service Provider's Name Joe Stang Phone 1- 715 -684 -5166 POWTS Regulator's Name St. Croix County Zoning Phone 1- 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 750 gal Maximum TSS 150 mg /L Soil Absorption Component Size 300.2 fe Maximum FOG 30 mg /L Type of Wastewaterl 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 month) Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound Inspect for ponding and seepage once every 3 ears 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 Turn -up Detail Finished ,.�.�.........� ............... Grade 6 -8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Larson & Johnson Page 5 of 9 ITT GOULDS PUMPS Wastewater PERFORMANCE RATINGS COMPONENTS Total Head Gallons Per Item (ft of water) Minute No. Descri EPO4 EPOS 1 Impeller 5 53 — 2 Base - 10 46 62 3 Pump Casing 8 t5 36 55 4 Mechanical Seal 20 21 46 5 Ball Bearings 25 0 33 6 6 0 -Rings 9 7 power Cord 8 Oil Filled Motor 4 i s� 3 Motor Housing( , 9 Stator Assembly 1 ' ► r 10 Motor Cover 2 METERS FEET - -- - --- °- -- --- --- _,_�- - -__� - 10 9 30 --►E!]-*-5 GPM - - 8 2.5 FT 25'° o � _ W 6 2 0 7 V lb,-6 o 15 ___..___ Q 4 - - -- - - -- -- - -- - ' - EP05 10 3 10 __ a _ _._..__ _a _ _ -- - - - - -- EPO4 .._...__ _ 1 0 0 0 �-� 1�0 - i�2 � 30 40 50 J GPM 0 2 4 6 8 10 12 m CAPACITY C, lc� - I c Q 3 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD- 10691 -P (N.01/01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent finer alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October - February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD 30 mg/L TSS, 10 mg/L FOG, and 10 cfu /100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present Nation by increasing basal area if toe leakage occurs or by removing biologically dogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Larson & Johnson Page 6 of 9 RI WY oil t o ar. rp O F ac t Tr al oog- 1a ?G- �e_ ©nv o ld t -, 1 ALM r cod =QI 9E:60 TT -ZT -S@ Wisconsin Department of Commerce SOIL AND SITE EVALUATION Page - __1 of 3 Nvision ot*Safety and Buildings OR'G1with Comm 83.05, Wis. Adm. Code W �.� Certified Soil Testing Attach complete site plan on paper not less than 8 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (W), direction and St. Croix percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D.# 008 - 1076 -70 APPLICANT INFORMATION - Please print all information. - - -- /, - Rev' a D / Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). v1 / j4_7/ oep E ty Own Property Location n & ohnson, Diane, Govt. Lot �tI SW 1A SE 1/4 S 26 T 28 N 16 W ty Owner's ai i ress Lot # Block # Su d. Name or CSM# 3 23' 10 ve Nearest Road State Zi Code PhoneNumber ❑City L ] Village Town IOTh Ave. dville WI 5WO28 715- 698 -2316 E au Ga le t New Con sruction n to ex sting building - Use: Residential /Number of bedrooms ; j`j Addition il._ Gfl7r' 4y/_ ❑1 Re__pn E] Public or commercial describe Code Derived daily flow 450 gpd Recommended design loading rate • bed, gpd /ft' .6 trench, gpd /ft' 4 Absorption area required 900 bed, ft' 750 trench, ft' Maximum design loading rate - 5 _ bed, gpd /ft' .6 t rench, gpd /ft' Recommended infiltration surface elevation(s) ___ 9 6.3 ft as referred to site plan benchmar install 4' x 95' rock bed mound on 94.3 as upslope edge of roc�C w/ 2' sand iiii Vl7j ►� �D Additional design / site Considerations 1 — Parent material loe §s over till Z Ong Flood lain elevation, if applicable NA ft S= Suitable for system Conventional hround ►n- Ground Pressure AT Grade System in Fill Holding Tank U= Unsuitable for system 171 Z U b9 S El U [I S" U C 1 S D� U �, S U S �; U Depth Dominant Color Mottles Texture Structure ;Consistence Boundary Roots GPDIft' Boring# Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 - g- cs 1 f/m 5 6 1 0 -8 lOYR 3/2 sil m r mvfr 2 8 -18 IOYR 4/4 - sil 2 m sbk mvfr cs if .5 .6 Ground 3 - 1 OYR 4/4 c2d I OYR 6/2 sl 3 m sbk i dh cs - 5 6 el ft 4 29 -52 I OYR 4/4 - - c2d IOYR 6/2 s1 -- - O m r mf - 3 • -- � I Depth to - -- - -_ - - - - - -- - i 1 limiting I i factor 18" Remark OYR 3/2 - sil 2 m gr mvfr cs 1 f/m 5 6 2 6 -12 10YR 3/2 - sit 1 2 f sbk mvfr cs if .5 .6 12 -18 10YR 4/4 sit Ground 3 3 m sbk - -- -- -- dh cs 131 0 . 6 elev 94.3 ft- . 4 18 -35 l OYR 4/4 c2d I OYR 6/2 A 2 c sbk dvh ;� - I '� • - - - - - -- 5 35 - - - -- 63 Depth to 10YR 4/4 c2p 7.5YR 4/6,5/8 A 0 m mfi `- i rF>{ t 3 '' ' ".4 limiting - — factor -# i - - - -- -- -- - - - - -- - 1 8' �> GOB - Remar s: A 4 _ 1171 CST Name (Please Signature: - - Te Henry &e,N . I enry F. Grote - 7 15-66 -.. Address Certified Sotl'lesting Date CST Number Ref # P.O. Box 57, Knapp, WL54749 11/12/1998 222774 1193 PROPERTY OWNER: _Larson & Johnson, Diane, Gar _ SOIL DESCRIPTION REPORT s Page 2 of 3 PARCEL LD.# 008_1076 - 70 I —� 9 ._ ; f +w, C ertified Soil Testing Horizon Depth Dominant Color _Mottles Structure Consistence Boundary ° GPDlft in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Roots Bed Trench 3 1 0 -8 10YR 3/2 - sil 2 m gr mvfr cs 1 f/m .5 .6 - 2 8 -14 10YR 4/4 - sit 2 m sbk mvfr cs If .5 .6 Ground - -- -- elev 3 14 -21 l OYR 4/4 c2d l OYR 6/2 sl 3 m sbk mfi cs - .5 .6 - - - - - - -- - - - -- 93.7 - ft_ 4 21 -30 IOYR 4/4 c2p 10YR 6/2 sl 3 m sbk ! dvh cs - 5 6 - - - - - -- -- - - - - -- Depth to 5 30 -40 7.5YR 4/4 c 7.5Y -10 8 sl 0 m mfi .3 .4 limiting factor 14" I Rem s: + Ground - -- - - - - -- - -- - - - ._ ._ } elev Depth to limiting -- - - - -- — - - - - - -- - factor -- -- - - -- - - - - -- - - -- I_ I - � r i I ' 7_ � I f Remarks: i Ground - - -- - - -_ i elev - -- -. i Depth to limiting - -- — — factor Remarks: i Ground -- -- - - -- I elev: Depth to _ limiting .. .... . -- __ —_ -- factor - - - - - - 7_ Remarks: enr�. N sw - s\: - -t L 2 Lei-4- w �1\ M tirQA.-a IL jL �.� �. L� • j s low. ►mow \qO ti .arc' L/. �'' � 3 •� V-P � }) tK YL J U Y 05/27/08 TUE 09:32 FAX 715 386 4686 0001 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer t• (9 ��� Mailing Address vt /® / v z A A1 l t c" YV 0.2 Property Address 4-07 e (Verification required from Planning & Zoning Department for new construction.) CitylState ote, c/G F f ��� Parcel Identification Number UU �!U e, G LEGAL DESCRIPTION Property Location �4 , S� 'l4 . Sec. ` , T : e N R /l W, Town of L �'aL (/' Subdivision Plat: , Lot # Certifled Survey Map # , Volume , Page # Warranty Deed # S ° / ? '1 (before 2007)Volume �U �1 G , Page # S Spec house' yes no Lot lines identifiable j_` yes i') 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 ailed the function of the septic tank as a treatment stage in the waste disposal system. Omer 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 (t ) 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 113 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 ru datained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days ofthe three yew expiration date. Uwe certify that all statements on this forth 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 Deems Office. Number of bedrooms = -- a aqu' `'/- l 3G "YV 1 SIGNATURE O APPLICANTS) DATE ** *Any inforrmion that is misrepresented may result in the sanitary pertrtit bung 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 -Terence is made in rite warranty deed. (REV. 081051 5 -27 -88 11:48 TO: FROM:715 386 4685 P81 O ° TO� T m T V • H ® m z O V O A V V N 2 z = n 00 0 vn v OOD A r O O 0- C) Ell C U O :U 1 N O O V N t0 4I T T � � T T m T U) m O z 0 o v A � T n m T q �T Z O m m ci) ;a C) _ ' c7 = rn r 0 0 o p Cam) z N 0 A -+ T V /� y T t OAT > N N T T /v � N Q D 0 rn z i=:�er :4;Ee -i a i• ?G- STAT.0 i'A.R OF )4 iS ON'S I. FfOa,''1 1_ 1982 r..,e e,Pwee Resewveo Pow wecosn.r.0 ow rw WARRANTY DEED 0 ! VEii �t�IlP ►r,FT f.l _ _ _._ ___ -.. -- - - -. _.___:_ ._ ����J1 tr9�► .r �" . tom, i't ThAJ Deed, made between _ Atjoiph St: CRrjlx Co., Vq Ado)ph__11., Johnson,_ancf_Ruth_.Johnson a( - le /, zPuth - I p�'* Jam• ° 'M_f� �. tt it a SE �� ; P 2 6 19 - _- aw- n..C- tghx-- ------- -- ---••--- -- .._._.._.._ .._- ......................... .... __ Grantor. I, I find- _- C-)ianE- ,M_. and Darla_ J . . Joncas, an f �� 8• 0 �, � J. Jo lnteres* as tenants in common --• - -- . ------------ - - --- --- ---- -• - --- - ------ --- -- --------- -•--•--.... • -- w_ - > -w .� t; ,_. Wit17esseth, That the said Grantor, for a valuable consideration__.__ i{ ;{ •------ . - -------- -- -------------- ----- ----------------- -- �E .... . ... ...... .. ... .. .... •- . -_. -- •• _._ -. _.__ -_ It- RETURN TO _ _ d conveys W t;rant.ee the following described real estate m ----- S1- .- .GYa21X. _ '{ kl County, State of Wisconsin: i I I% II The West Nineteen (19) acres of the Southwest Tar_ Parcel -i No_ _ .. ............................... ? Quarter of the Southeast Quarter (SW} of SE-k) of Section Twenty -six (26) , Township Twenty -eight (28) li North, Range Sixteen (16) West. li fl II tE i; jf This ..... is not property. 1i (is) (is not) Together with all and singular the hereditamcnta and appurtenances thereunto belonging; 5 And. {i warrants Lhat the t(tle is good, indefeasible in fee simple and free and clear of enr_umbrancos except I { all easements, restrictions and rights of way of record. - 1 and will warrant and elefend the same. !I ti - 1; 1- 9.._.._..- -•- -••... September - __ 94 j; Dated this ...-- ---._._...._ _ .._. day of __..__ _.. -..... - -- -•--• .. .... ......... _ .. .......... . ........ ........... •-•_...I._._.......- () Imo`' -.�' - _... c u4: C:'�'..._.(SE'ALj j SEAL .......... - .•-- •• - - -• . . .. ... .... ....... ........ ••- ...... .... _. ,dalph..H.,`._.J.ahns .ten .:...... ................ . :. ........ ......... .-•--• ...... I ........ --•....... ....... --• --•----(SEAL) ...... .._ -. .. . ....... .......(SEAL) sl .................... .................................... - _.Rutl:t- i.._Johnspn { .. ........... ..... ..... .. I -- i ALIT fiENTICATTON ACXN0 W LEDIGMENT 1� Signature (s) ___ i J.�zt)._ I _.- .,1�1�nson__ l' .---- - - - -•- STATE OF Wis= rsiN ii i ( 3Lltl 1_,__ �iohn _svn <__.hut�ar�41_ _County. authenti a thi da of__ _eterrl�er - - _ -- 1q_ 94 personally came before we this ________________day of -- ------ e a named above i{ f 19 the ' ' ---•------• •--------- -------- ------- ----•- ...... -- --------- X__J_enr?.i_f_�r.. :A• tic _ ardson - ____..__.. TITLE: MEMBER STATE BAIL OF WISCONSIN if _°-------------- ---•---- - •-----•--- -----•--- •-- ----•-- ---•- •- ----- It (If not, -----•--•-• .... .. .........•---•-- -....--•---•. i' authorized by § 706.06, G[Tis. Staty.) to me known to be the person who executed the 'foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DR­ FT BY - .._.... JEN.N- IF- ��. -A- RDSOh _.__. ........ ......... •- •---• ---- .. -__- Attorne at Law « - - Spri.n a .- _5�4J+r. Noi:,ry Public -. .... ...... ............. County, Wis- iSi••n:,t.nra., m.,y h.. .� „tt,..,,t.;� „F.,.l �r n�k+,.,.�teAq�.i 71 r;, :MY Commission is permaront. (If not, state expiration are .. ^t .°_ccssar: -) date: .. ._.. .......... ... ... ...... ....... . ..... 19----- -..) _.�....... :r. .n� _.•.- ,.,..tom -. �_;, -, ,.._. -.� ,.. .. _:... _. _- .. �1.. >._ .__.. .__. -. : - . STATT. RAR nF w1:1!7017 ,t': ,� -. i_...._..1 fl :�•.L fn In.• FORAT No- 1 — 1982 _NI0r n k_. wt.. _ -------------------- - - - - -- I - 16-2" r i i. II N 4x 10 pantry Closet 48'-0 I � - 8x10 luandry Wash Freezer Dry 1 x 12 master Bedroom y 13'-4" 13'•1" 1. _l