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026-1167-17-000 (2)
Wisconsin Department of Commerce Safety and Building Division PRIVATE SEWAGE SYSTEM INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)], Permit Holder's Name: City Village Township Gary & Pam Freiberg TOWN OF RICHMOND CST BM Elev: Insp. BM Elev: BM Description: D C?o • ° C-- oaLl t TANK INFORMATION TYPE MANUFACTURER CaF - [fl CAPACITY Septic wtG SEAL Dosing L,-7 << Aerati Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic r Dosing �< << �� 3 z Aeration Holding PUMP/SIPHON INFORMATION �� nek Manufacturer Demand GOL4ACQ5 GPM B I C� Model Number 4f FK_ 0- I TDH Lift Friction System Head TDH Ft •-Losss Forcemain Length Dia. Dist. to Well 3O z L I SOIL ABSORPTION SYSTEM �z 3 ),�a � /A0 Gam„ ELEVATION DATA County: St. Croix Sanitary Permit No: 651349 State Plan ID No: Parcel Tax No: 026-1167-17-000 Section/Town/Range/Map No: 27.30.18.1319 STATION BS H I FS ELEV. Benchmark :jD Alt. BM Bldg. Sewer 4� St/Ht Inlet St/Ht Outlet Dt Inlet Dt Bottom O Header/Man. Dist. Pipe Bot. System Final Grade ,co ,&-- 9 0 q© o ©- :w St Cover Ct� f�SD .o BED/TRENCH Width C Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS Q� !! r2_� SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR UNIT t_41kV'aIc Type Of System. � Model Number: (3 DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pi e s Length Dia L gth Dia Spacing �j 0 SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No C MEN S: (nclyde code discrepencies, persons present, etc.) Inspection #1: �Z�9_/262 Inspection #2: Location: 1394 126TH ST 1.) Alt BM Description = 2.) Bldg sewer length = �� - amount of cover 3 r)bse atm /VavA/�ri Ie S ti-. �k c.%°�� --� eAS+"5 V'84Je � Plan revision Required? ❑ Yes X No ZZ Use other side for additional information. 2oZ Date k InOse,,ppc_tor's SignaVe ^ r l w - Cert. No. SBD-6710 (R.3/97) c�ri� ( . "'? 3. 0 r`L�� B-+� cv�.•e-Id ° i`� �•. -t, �t�J ��'VVId4) A4 lcaecQ f 5AJI 7 3 Industry SLrviccs Division County VC) ir 4822 Yards Way C', Madison, WI 53705 Sanitary Permit, Number (to be filled in by Co®) P.O. Box 7162 M ad IS011, W1 53707-7162 S46�iS ��anitary Permit Appfication S ra ns.�ic t ion Nu m ber In accordance with S I'S 3 8 3.21(2), Wj s, Adm. Code, submit,s ion cif th i s fbjTn W IJW ZLppropriatc governmental unit is required prior to obtaining a sanitary permit. Nute Application forms for sate-o-%ned POWI'S are submitied, to Project Address (if different than mail-Ing address) th-e Drpartment of and ProfeSSio[jal SerV=Sr Per-,�Lirial informauon you provide may be Ltwd t-Lir secondary 1! � ire core' th the 11,6v acy L-a l 5 o4 i. I �(m), S tat.s 1. • 1) 1 � I ica floe 1111,01. t ion — 1"lease Vvi n I k TT I n farrnafion Property Owner's Name ����� �. �r fit. � �, � , P FOre rtv ONv ner"s Mai I ing Address t cL —1 -Z LA2tf (-;oA. Lot CM, Slat", Zip Code Phone Number '/4 A V4, Section =11, Typt (if Huildikl�;,F. Lot N, R LOP Al or 2 Fun ily 1) Well ing N UMbCT- of b ej [0 0 111 S SIJI)LI-VIS1011 Na111e ub�xribe Use Block hc/Commercial - Des L2 Dc sc r ibe Use CSM Number Village of Fowri of I I I I pi" al`,0 NV I S 11 V r-All i I,' (('11,C L' 1, U 14 L'Y VVi r- 1) 1 A L't n i cn s i r d, L i I It c r- -A o plicable on, line 11: b L I j I I 11,C D 1; 111 j L' 1. L' I i F I C de- -Di PfctkLl'.�,�Jlc[,t I ]it (explain) "'Stem (C X I ai n) L4PCW Sys(, L:, M (:,j, cat I Q!l k. L -Ground llt-GradeMound Individual Site Design Other `Type (explain) on ventional) L .1st Previous llcrTnit NLijntvr and Date Issued C. 0 Renewal Before EIRcv1ston 'hange of PlumberD'ransfct to New Ovvricr x p I- ra ti t Q.i i ri d Ta n 1, Ij C I lf`f 11 11 1 (L. !�Slgn Soil Application Kaw(gpd/s;,- Dispersal AreRequired sf) .0 L) P C L.A;. a L'C L I I'VOposed (st) Systcrn Flcaj.non .9 72 Capacity in -1 "-d I/ Not Manuficturer Tank InforinaLion. Gallons Llof 1 s Units C a New T=Ls Exisi�ng Tatflks 4 0 U t; S e r ri � car 'LL i ol d i rig ']"aj Lk- 7, q: 1) 1 n sJbi [i Iv Slit I v, 11 e 11 t- 111 c Li 11 cfi,,rsigned, assu ine rtspoasi hility for insiall-a tion o.r ne POWTS shok�-n on the �i i i -,i c1i ed pl.i as. 7 N aw P �*natu re M i1m,"W" N' u m bL- r I" hone N um 1,,k- r eel L)cf% As (Street, City, State, Zip Code) s Ad + V1. Counly/Departillent Use 0"1V T 1' �.rr��; I �,�, Date lssul�! Issuing AgenL Si latur Z-Ap p ro I UV16 2� ILL::tik, o I��� r,� �a l Cond itions of A ppro i +i I - se fL� Fo Iller and oeli must b(� c,;erviced maintained Fis per rnanagerner.J plan provided by r-Ink.-r. 2- All setbuk roc u.reFl A:-�(- t,,:� must be n r, as per . A 1 r. q pj$ rode I ord 1,4-je 111.1 jjj ror the sv-stein and subai;i io the County ouly ori pikiter not jes--q jjj.kn 8 1.1 YL I i. SRD-63�)8 (R- 03-21 Property Owner/Client. Gary & Pam Freiberg Site Address: 1394 126TH ST, New Richmond, W1 54017 Pgw,2 SITE PLAN P9. 3 SOIL DISPERSAL COMPONENT Pg. 4 TANK SPECIFICATIONS Pg.. 5 DO'SING AND PUMP SELECTION Pg. 6 FILTER MAINTENANCE Pg. 7 MANAGEMENT PLAN Pg. 8 MANAGEMENT PLAN Pg. 9 SOIL TEST Wastewater Type: Resident,0 Esti m ated Wa stewate r F I ow , 100 gpd Design Flow: 450 gpd H A mm A& FAR mm 'Fil"7105 P POWTS Type: Non -pressurized Conventional Limiting Condition Depth: 8511 Maximum System Depth: 491t Contour Elevation: 90.70' Limiting Condition Elev: 83.62' Land Slopes 8% T026-1167-17-00f C 0 U 11 tyr: ST Cro ix Pg. 10 SOIL TEST P. 11 SOIL TEST Pg. 12 SO IL TEST' Pg, 13 SOIL TEST Pg. 14 SOIL TEST P. 15 SOIL TEST # Bedrooms (residential) - 1 # Occupants (p,er capita flow): - Public Facility Flow: NA Treatment Level, Effluent 1 Code Required Separation: 36'' Soil Texture: FS in -situ Soil Application Rate: 0.5 gpd/ft2, Dispersal Cell Loadiing Rate: NA PO WTS DESIGNED PURSUANT T6OM, In -Ground it Absorption CoMa nual(Version 2. 1) Comments: New 1 bedroom hours. System si ze being in r d to 3 bedroom capacity. No honle b us i i iess. (2 '94' 1 nfiItrator Q uik4+ STD try ii ches with "stepped" dosed -gravity distri bution. C 0 N RYAN G. ama 0 r_ n r_ D-2263-7 PRESCOT T 10/31/2023 ADVANCE .0 ENVIRONMENTAL LLC - S I G tA W119032 560TH AVE, PRESCOTT., W1 54021 (651) 327-0074 �Ilfnllm% 4 %1 NO I 1� S 2092 3 Advanced *All propetty lines nod SYSJ Designer, Ryan Bechel Benchmart Certified Soil Tester., 1330832 Envirov;nentW LLC. dravm are > 1 001t frorn r SeptiC I A F k L AV Soil Boring Designer of Engineering System.D 2263-7 Ail rights r�) s ei vc., d- system* ah k F L: -I ne, -i:ec-Nee r w) PA- —PA. - i I L;'W� D 0 1 tIffater sour= into sepk tan I route Al co . BM 96.00 91a 0 Iron pipe Ln ToP4 Pump Tank-, above grade) -f4gakm ---- *jabrscj,70 -PLrnp needs �e- C) •Move ** as rias 0 -RaWWatis ptrnp P ,5, ar�� -DH char it -Evo countef trna r, or tN? -,Aer rwxmmordW Borings 1-3 evaluated 8830 Sva I TTI V 11 t A 1 TW , ±351 2 :)IZ4104 by Shaun Bird oi I T i m� 0. 5gpA2 k*d rate -D trendw h 40 --�±25' 4 (2) 94' Infiltrator V'I7 '.;aLY6 ace, 90 70 ccr. -;r - - ---immhe s--face, W20 mc r PC sch 40 Qujk4+ STD Trenches �O 7V (23 chambers1trench) COPY a rage Distributlon Wieser 1000/650 PVC S- -W wl Best GF-10 or j Tay 80 -)p bmirs -ior. box, 0( j- op bwe,;, Sri h eu 0; };J, BM2 90.70 Top nail in 30" tree (16f' above grade) LOCATION MAP (not to Kde) **B4,. contours,. slope, & 140TH AVE mzCurrentgrade Bevaluated by g Advanced Environmental�- on 3123** OT 17 S Proposed PREPARED FOR. wel I Gary Et Pam Freiberg Ste Address, 1394 126TH ST New Pichmond, W1 54017 SCA 1 1: PIES; 026-1167-17-CM 1 - 1-.4 Acres 15 Leg al' Lot 17 Lundy's Preserve ON 30' LOT 18 NW 1/4 NE 1/4 S27 T,30N R18W --Town of Richmond C*tt%d ShAmyw* TW@ syshm hm b� dmAgmd wW ovdiumW In paw do oft Sban aM Locx� oodem The adil bqwbrwt *rvo munt mi pi from dhmbmt� mWor owrpoctbon bd*V Mid d%V FIMVb UOUL I e: 30 40 WARWWTY M WNX TW TM TMW WLL COMMM TO FUNCrKM ICEMUMY. 91dwn rm* be pmp" m***h@cL RIMM .)KXAF' @Fj*10M10 an prow WA 11MOANINX Scal I Uate, 4 %1 NO I 1� S 2092 3 Advanced *All propetty lines nod SYSJ Designer, Ryan Bechel Benchmart Certified Soil Tester., 1330832 Envirov;nentW LLC. dravm are > 1 001t frorn r SeptiC I A F k L AV Soil Boring Designer of Engineering System.D 2263-7 Ail rights r�) s ei vc., d- system* ah k F L: -I ne, -i:ec-Nee r w) PA- —PA. - i I L;'W� D 0 1 tIffater sour= into sepk tan I route Al co . BM 96.00 91a 0 Iron pipe Ln ToP4 Pump Tank-, above grade) -f4gakm ---- *jabrscj,70 -PLrnp needs �e- C) •Move ** as rias -RaWWatis ptrnp P ,5, ar�-DH ahv inftl -Evo countef trna r, or tN? -,Aer rwxmmordW Borings 1-3 evaluated 8830 Sva I TTI V 11 t A 1 TW , ±351 2 :)IZ4104 by Shaun Bird oi I T i ml� 0. 5gpA2 k*d rate sc -D tramvs h 40 --�±25' 4 (2) 94' Infiltrator VC 'I7 al Y 6 ace, 90 7 0 =*)ur - - ifte --face, W 20 =n1Q,.r P sch 40 Qujk4+ STD Trenches �O 7V (23 chambers1trench) aw I . N% Distribution + ow '190W Wieser 1000/650 C wl Best GF-10 box, 0( j- op bwe,?, Sri hau o; };J, BM2 90.70 414, Top nail in 30" tree (16f' above grade) LOCATION MAP (not to Kde) it **B4,. contours,. slope, & 140TH AVE Current grade mz evaluated by r%d Advanced Environmental�- on 3123** OT 17 S Proposed PREPARED FOR. well Gary Et Pam Freiberg Ste Address, 1394 126TH ST New Pichmond, W1 54017 SCA 1 1: PID: 026-1167-17-CM 1. 1-.4 Acres 15 Legal' Lot 17 Lundy's Preserve ON 30' LOT 18 NW 1/4 NE 1/4 S27 T,30N R18W --Town of Richmond C*tt%d ShAmyw* TW@ syshm hm t dmAgmd wW ovdiumW In paw do oft Sban aM LThe adil bqwbrwt *rvo muntrw mi p from mWor owrpoctbon bd*V Mid d%V FIMVb UOUL Sca e: 30 40 WNWWJTY M WNX TW TM SMW WLL CORR" TO FUNCrKM *JMY 5yoNm mw* be proWly ffw***%xL Pw*w.ymr rywWn P10 an prow WA 11MOANINX Uate, 1�[' Ja, 1 rr Plan View (no scaiel Quik4+ STD wi end cap (typ-) 3 PIP 6 94 WWJ 4 90.70' Dispersal Area Product: Dispersal Area Model: Product EISA Rating: Infiltrator Chambers Quik4 + STD Total Number of Components: 46 Distribution Method'. Branched Man'Ifold Minimum Required Dispersal Area: goo ft2 P ro posed Dis persa I Area (Incud Ing end caps) *. 932 ft2 Screw -type or slip -top cap Finished (mulched & seeded) 4" SCH 40 PVC pipe � Topsoil cover Top of pipe to terminate at or above finished arade (1' minimum) k - J" X 6" slots spaced 90apart Anchoring Device (Toltet flange) Cross -Section view (no scale) TOPSOIL & SEED 36" NATIVE BACKFILL (12" min typical) 121t Infiltrative surface .. . .................. ....................... Minimum System Depth: 48" Maximum System Depth: 49" 90101 ....................................... ...................................... NATIVE BACKFILL ('12 40 min. typical'y 00 P;ulp � TANK SCC4 NS • Minimum cover = 6 inches; Maximum cover = 8 feet (unless specified by maiiufacturer) • All maiihole covers all extend 4 inches above final grade tf the tank is within 2 feet of final grade. insulate the lid to an R-Value of 10 4P Mini r um 18 " of cover req uIred ave r building se wer, Inure te rf grea te r > 30' ion and < 4 2 " front rode o r if < 60 from g rode j n d e r a If high trafficls n o w cleared areas tdriveways etc-) 4 If force n w i i i w ii I ha ve a 7) 44 o ok " ass, e in b 1.yr df ill a weep hole 1 n the wh oo k" Building sewer: No 90's, keep 3 feet between 45's. maintain 1 inch in 8 feet (1%) slope, install cleanouts N1 ), bil ol v '. 4 " ab,. ?� e gt.41,r i,%Pth itlorc,iv'Vd Ou" Disconnecl Preve to rcpfnA i n I j "�( 11 Ob A i AV M 04 519 1 1 U I )d 1!* W &F-1 I I P44 1W IT I M K go - nm P Li ----------- ------------------------ �WWW�WWWW�Www llllllw ---------------------- Tank Manufacturer/Model: Wieser-WLP1000/65G-MR ----------------- -------------- F Ite- r M a n ufactu rer/Model: Best - GFm10 ---------------- - ---------- — --- — --- — ---- -- — ------------------------------ Panel Manufacturer/Model.- SJE Rhombus - Tank Alert I V .1� N 1 1 4' —3 _lj L L -11-vp FAD WLP 1000/6 TANK CIFICATI,ONS D d U L N WN S WALL 3" PQ r TtW T ;;0VEk -" Y,ANk+4D4_e, 2.A_ :.[) 0RECASS- CONCRETE P —E I ',-j4 112" C) J. —ENG T 146 , 0, 38- WU A-SLAL SOOT OR EOUA- A% qf Tff T P AF F AN4-e 9- Li TF R *V. SEE DE TA'L #"0 ':D'"f R % S'Af_S, SEE CHAR") L'OkAV, CAPAC TY 26-32 GAL "' /Ps (SEA C) 17 M CAL IN (P�WPN -0^,D NO OESJCpsli 8* C LJN5A,_r.RA1L0 504L. *ANK CAN K WAU, A$ SU-T1C/SEPTC. SU'!C/ F-,JMP ()R 5EPT1C/l;_:jPHQN Comp UIX OCSIC41. 08 140 FBER'l TANK 6IX DESIN #1C ,STRUC-URAL FIPFR) CUSKAkIre D 1ANXS_ �OR, CIJISTOM 'ANAISCONTA,,-'T NIESER DRAWINGS SUBMITTED PO R APPROVAL eL ri l- ;:6 I TANKS ARE MANUFACTOREV TO WE OR EXCEED AS'U C-1227 REOWREM ENTS P,Arw 4 DOSE SETTINGS &PUMP SELECTION PUMP PERFORMANCE ICE OUIREMENT Elevation Head: 6.5' 87.50' Dlstrl5ution Head-. 0.00' Equipriient Head Loss: 0a Force in Friction Loss: 0.5 ft ------- 0 TOTAL DYNAMIC HEAD 7.0 ft TDH 84.54 MINIMUM FLOW RATE 25.0 gom DOE EIEN� 'i I Minimum L)ose: 0.0 gallons 83.421 ----------- — ---- — --- — -------- Maximum Dose. � 90,0 gallons 305.3 gals A 18.0 A (RESERVE) Design Dose: 80.0 gallons 81.92t - - - - - 51.0 gals 311 -------- (ALARM) Forcemain Feet: 35' 81-67 85.7 gals S,011 C (DOSE) Forcemain 0: 2.0" 81.25 ------- Drainback: 5.7 gallons & TOTAL DOSE = 85.7 gallons 204.0 izals 12 D (PUMP COVER) FEET PE51 80.259 -------------- NOTE: Double floats, C-level Sensor, Tgnsducerf qLggy1valent rgouired when dose volume exceeds pumpinit range ofa sinsle [)UM13 fly Option 2.. Goulds - PE-1 Goulds - EP-04 A 5 GPM panes -% Installation Instructions for the GF10 Filter �1J Stop I ; Locate and rem cwe the septic tank cover r or. th e outlet sld e a' tank. �`J Step 2. Refore Installation, pi oc e the filter c a se on to the owlet pipe. Make 5,ure the case Is positioned so the filter c a n be removed from the tank for mainte nance and Service 4 5 L'J Stop 3: For installations that requ I re or desire add ftiona I support. (If additional s upport i� not roeeded, go to Step 4) Glue a sWlon of 1'Sch. 40 P11pe to the two hubs located on the bottom of the case and the hub located on the side of the c a se. Step 4- Give the -filter case onto 5ftp S., Fcx installations where it will the outlet 1>1 pe. Insert the filter be d Acult to reach the handle, Pla ce ca rt rid 9 e into the ca w. (Make 1. Schedule 40 pipe I nro the tee on the sure the fitter Is complet* hand le and extecid it to height that wl I I Insetted into the case.) nriake it easy to remove the filter. BEST TIECHINIMAWY InstaHation of an S..e os is new splem only the sWlic tank exisfing system. must be p u rn ped prior to Installation. no oft T z Maintenance of the G Filter A time frame to which septic tan Its are serviced is se by state and local rides Ahfvugh they may be diffekrent, most regul atory agend sug ges it two to Eve year& We recommend the GF1 ID fittet he cleaned when the sep 11 c ma n k is no rma I I y cleened and purnor as needed WARNING: If the liquid level in the tank is above the top of the fifter, pump the tank prior to removing the filter cartridge. 0 CAUTION: USE RUBBER GLOVES WHEN HANDLING FILTER Stop 1: Remove the septic tank cover and pump the tank, kf necena ry to prevent any solids from escapIN to the P. fie] d wh en the filters removed. Stop Z. Pull the fifter Stop 3-. While holding the Step 4-. Insert the cartridge hiindle and slide the filter filter cartridge over the bark Into the case making o Lit of the case. access opening of the tank, sure that ft Is prorpedy rinse the cartridge off with a higned and completely fresh, water. Take care to Inserted Into the case. rna ke s u rLn- a 11 s*IW matwial falls back into the ta nk .1) BEST' TECHNOLOGY 3 Fa Irfie4d EMvd, We I II n j f o rd. CT 0649 2 11-977-70 Fax- 203-28"514 Em AMN4GEMENTPLAN The owner of this Private Cnslte wastewater Treatment System (POWTS) shall be responsible for its perpetual operation and - maintenance pursuant to requirements of SPS 382-384, wisc. Admin. Code. This management plan identifies operation and maintenance activities necessary to ensure long-term system performance. Tasks that should be performed by the homeowner are identified. Professional management tasks shall be performed by a registered POWTS Maintalner in accordance with SPS 383.52 (3), Wisc. Admin. Cade, however, it is the homeowner's responsibility to ensure all tasks get accomplished in a timely manner. Pursuant to SPS 383.52 (2), Wisc. Admin. Code, this system shall be considered a human health hazard if not maintained In accordance with this approved management plan. ■ Keep this Management Plan with your Septic System Owner's Guide. ■ Keep copies of all pumping records, maintenance activities and repair invoices with this document. ■ Review this plan with your POWTS Maintainer at each visit; discuss any changes in product use, activities, or water -use. MANAGEMENTFREQUENCY DeWgn Parameters Systm spewcauOns Number of Bedrooms I Septic Tank Manufacturer Wleser Design Flow (gpd) 450 Septic Tank Capacity (gallons) 1000 Soil Loading Rate (gpd/ft) 0.51Effluent Filter Manufacturer Best Standard Effluent Quality Effluent l Effluent Filter Model GFN10 Biological Oxygen Demand (BOD) 220 nW4 Pump Tank Manufacturer Wieser Total Suspended Solids JSS) 1 Rn n4q Pump Tank Capacity (gallons) 646 Fats, Oils, Greases (FOG) 30 r ! Pump Manufacturer Per Installer Treated Effluent Quality Pump Model Per Installer Biological Oxygen Demand (BOD) M M&I Dispersal Cell Type Non-pressudzed Total Suspended Solids JSS) - mg// Conventional Fats, Oils, Greases (FOG) - M94 Pretreatment Unit Description NA Max Effluent Particle Size (in) 1/$ Homeowner Management Tasks Check (listen, look) for leaks in toilets and dripping faucets. Repair leaks promptly. Regularly check for wet or sponger soil around ,;your soli treatment area. Contact service provider If Issues arise. Controlburrowing animals (gophers, groundhogs, etc.) Keep bikes, vehicles, snowmobiles and other traffic off treatment area. Alarms - Contact your service professional If any alarm signals. Lint Filter - check for lint buildup and cyan when necessary. If you do not have one, add one after washing machine. Caps - Make sure that all caps and lids are intact and in place. Inspect for damaged caps often. Fix or replace damaged caps. o nal ant Tasks Effluent Screen - Check and clean per manufacturer recommendations. Liquid levels - Check sludge/scum/effluent levels in all system tanks. Recommend if tank(s) should be pumped. Pump all compartments every 38 months at a minimum. Inspect tank Inlet and outlet baffles (if applicable) Check drainfleld effluent levels (If applicable) Verity pump and alarm system functions (If applicable) Inspect wiring for corrosion and function (if applicable) Clean drainfield laterals (If applicable) Check event counter/elapsed time meter and evaluate water usage rate compared to system design flow. Check dissolved oxygen and effluent temperature in tank. Check for surfacing of effluent or other signs of problems. Verify Inspection pipes are capped and Intact. Provide homeowner with list of management results and any action to be taken. Sew - --- - a fir vrrr � ,eta cif applicable) N.N../..� N� � � � ��� . �� � ����� � �y��MMMM.w�...w.......MF..w....w...w..w....w.....NMF..MF..�MMMM.MF.....NMF.. N...r i/.r N/Nr►N.N/.r .iN....� r ADORE:. UOI 091mkftffiW RA, sum 1", Hrdrr, W 54056 40 (715) 3864680 PHONE A.Nw.�...MrMNMF.. r.arrNrw...wr►.r.r.w.r.w.r...ww...wr.w...rw..rwe.�Ns.�nr.rr. rr�N.rw.rw.w...wr..wwN.rw..rw..rww.r..rww..www��w.�w�►w�ww.w..w..w..w.r..rww.r. w.r.w.r..wwNw.r.w.r.w.r..wwNr.wwrw.r..ww...N..N.ww.r►....n....ww.N►rrw.►�w►rr.wr.r.wwrr Nwrr.wr..►NrN..►.►.wwr.wr.w.r..wwr Pane 7 START-UP & OPERA 77ON For nary,can= Prior to system operation, check septic/pump tanks for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cells. If high concentrations are detected, have the contents of the tank removed by a licensed septic professional prior to use. System start-up shall not occur when soils are frozen at the infiltrative surface. • Pump tanks may fill above normal high water levels for system utilizing pumps. when power is restored, the excess wastewater will be discharged to the dispersal cell in one large dose potentially resulting in overloading of the cells. Backup or surface discharge of effluent may also result To avoid this situation, it is highly recommended to have the contents of the pump tank removed by a licensed septic professional or have a septic professional manually dose the system to return the pump tank to normal operating levels prior to restoring power. Do not drive or park vehicles over any septic system components. Do not drive, park over, or otherwise disturb or compact the area within 15 feet downslope of any mound or at grade system or secondary septic system site. ►AM1A ff E VG4NC E' 1NSM1JG'170NS inspections of tanks and dispersal cells shall be made by an appropriately licensed individual or business. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum, and to check for any backup or ponding of effluent on the ground surface. Access openings used for service and assessment shall be sealed watertight upon completion of service activities. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. Ponding of effluent on the ground surface may indicate a failing condition that requires immediate attention by a licensed septic professional. Tanks must be pumped when sludge accumulation is within 12 inches of the bottom of the outlet baffle, or whenever the scum layer is within 3 inches of the bottom of the outlet baffle. In no case shall total sludge and scum volume occupy greater than 25% of the tank liquid capacity. The effluent filter shall be cleaned as necessary to ensure proper operation. The filter should not be removed unless provisions are made to retain solids in the tank that may slough off the filter during removal. if the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm and should be evaluated by a licensed septic professional. Pre-treatment components shall be maintained and serviced by a licensed septic professional according to the manufacturers recommendations. C VAN NS 0 If the septic tank, or any of it's components, become defective the tank or component shall be immediately repaired or replaced according to the original system design specifications. If a dosing tank, pump, pump controls, alarms, or related wiring becomes defective, they shall be immediately repaired or replaced with components of equal performance. If the soil treatment component fails to accept wastewater or discharges wastewater to the ground surface, it shall be repaired or replaced by; increasing basal area (if toe leakage occurs), rebuilding the component at the secondary system site (if identified), or removing and replacing biologically clogged absorption and dispersal media and associated piping. if repairs or rebuilding is not possible, a new soil and site evaluation must be performed to locate a suitable replacement area if one has not already been identified. If no replacement area is available, a holding tank may be installed as a last resort replacement PDwTS. AMNDON ENT If the septic system fails and/or is permanently taken out of service, the system shall be abandoned according to SPS 382-384, Wisc. Admin. Code abandonment regulations. Requirements include: - All piping to tanks shall be disconnected and abandoned pipe openings sealed. - The contents of all tanks shall be removed and disposed of by a licensed septic professional, - Tanks shall be crushed & fllled, or removed. - A septic system abandonment notifrcatlon shall be submitted to the appropriate local governmental unit. WARNING11 SEPTIC, PUMP, AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC TANK, PUMP TANK, OR OTHER TREATMENT COMPONENT UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ALWAYS CONSULT A LICENSED SEPTIC PROFESSIONAL BEFORE DOING ANY WORK. Pane 8 11 - ST. CRO�� ,U�NTY. SANITARY SYSTEM File #: "`�"""` OWNERSHIP/ADDRESS FORM ��aziioz�r�ty 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 grater, property values, and county resources. once approved, this completed form and educational information will be sent to you by email. OWNER/BUYER INFORMATION Owner/Buyer _&Ai 5-6- P.- (Q Mailing Address ZZ-11-_ �i � `-�E � � � � Q�►1� City/State/Zip dui)SO14. S 48) 0 Phone Number (required)_ "�1' 3u t%� l 1� �� Z L-� i�1 P+� � �oF�L �! b 3��,�%f�►� Email Address (required Parcel Identification Num er -4---oaL-JW (found on the property tax bill) NEW SYSTEM:. LEGAL DESCRIPTION Property Location NU) 1/4 , � � 1/4 , Sec. T N R , Town of AAbhib. Subdivision Plat: 1 U14, PRESE&Vif Lot# . 17 Certified Survey Map # Volume , Page # rw i -rr i _- r_r i • Warranty Deed # (before 2006)Volume Page # . Number of bedrooms - Spec house Q yes no Lot lines identifiable )(yes 13 no New Property Address (staff Iru tM) OFFICE USE ONLY (Verification of new address required from Community Development Department for now construction.) (Date) "his fora must be submitted with oi[ Private Onscte Woter Treotment System POWTS) opp[icotions. 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 made in the warranty deed. CommunIty Development Department- Land Use Divlsfon 715-386-4660 St, Croix County Government Center 71 s-245-4Z5o Fax add _ s w 1101 Carmichael Road, Hudson, wf 54016 WWW.SCCWi.g0z State Bar of Wisconsin Form 1-2003 WARRANTY DEED Document Number Document Name THIS DEED, made between -Bruce Sornmerreld and Nancy Sornmerfeld, husband and wife ("Grantor," whether one or more), and Gary Freiberg and Pamela Freiberg, husband and wife ("Grantee," whether one or mare). Grantor, for a valuable consideration, conveys to Grantee the fallowing described real -estate, together with the rents, profits, fixtures and other 4 appurtenant interests, in St Croix County, State of Wisconsin ("Property") (if more space is needed, please attach addendum). - Lot 17, Lundy's Preserve, Town of Richmond, St Croix County, Wisconsin. 1108290 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 07/30/2020 01:38 PM EXEMPT#: REC FEE 30.00 TRANS FEE 150.00 PAGES: 2 **The above recording information verifies that this document has been electronically recorded & returned to the submitter Recording Area Name and Return Address Title One Premier Group, Inc. 906 Dominion Drive Hudson, VIA 54016 02b-11b1_1-(-UuU Parcel Identification Number (PIN) This is not homestead property. (is) (is not) , Grantor warrants that the tine to the Property is good, indefeasible in tee simple and free and clear of encumbrance except: Roadways, Easements and Restrictions of Records. Dated J u t 7$ 2020 . . . . ..... ... j-, 4. t. � (SEAL) � (SEAL) Bruce Sordnerfeld Nancy Som erteld (SEAL) (SEAL) (Signatures may be authenticated or acknnvAedged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORS! SHOULD BE CLEARLY IDENTIFIED, WARRANTY ar=ED 2003 STATE BAR OF WISCONSIN FORM NO. 1-2003 * Type name below signatures. File No.: 36824 Page I of 2 .... St7-Gr-0iXt.GQ-Unr--11.08290-Page-1-..,.........___...___._.....�.._.......- _ Tmm I—P qpm ■ MIA It Mmm=W hu WIN WOMMIN MAM dWdMI p .0-A rpI Pm 1 6 I" Ap d&I Wd" 01 bI :7'd fo.ot I Ill w. 2 - Awe .VIA 44 wril oft III -Jl% W *,14 IP, -ft 4 1 IWO '.M,p AP a 00.1 W." Ift 4w:m 0 400m" "W dk" .9-4 M 11 e31n F) �!pa rtme n I of S a tot y and Processional S c n/ I I V1 -, I i f) f I n du St ry Se FV1CR- 5 SOIL EVALUATION REPORT In aGcx),Wanc�e with SIBS 385, V\A�, Adm. Code Counter Attar hi coriplete site plan on paper not less than 8 112 x I I inches in size. Plan must include, ST Croix bLA FlOt lirrited to, vertical and horizontal reference point (SM), direcfion and percent Slope, Parcel I.D, scale or dimensions, north arrow, and location and distance to nearest toad. 026-1167-17-000 Please print all info 'ern, Reviewed by Personal informat;on Y:DLJ �'r(JVidt' may be used fbf secondary purpo,,,es (Privac Law -5 15 04(1)(m)) Property Owner Pro[)erty Localmn-. Date I ]//6 �Z ) Gary & Pam rt4lbarg Gout. Lot-- NW 1/4 NF 4 d" T 30 N R 18 W Property Address b Lot # Ellock Subd. Name or CSM# 1394 1 26TH ST 17 Lu ndy"s Prose rve City State Zip Code Phone Nuniber city F1 Nage Town Nearest Road New Richmond 1] 154017 1 1 1 F1 i ch mond C 126TH ST New Construction Use-, Residential I Ntj niter of bedrooms Code de6ved design How rate 150 GPD Repiacernerat Public or commercial — Describe, Parent material Loamy drift over sandy and qravel utwash (Burkhardi-Sattra) Floodpiailn elevation if' applicable NA ft. G v n oral c om me nts a n d re om m en dab ons: Supp4emenlal boro g alijalW -5/24/04 by Shatin Rr'd LP 8,55" (Redoximuptiic teaftffeS) to r-,x lc-od mil I iest ay .., �,: v %C*Mrnend srs-gmrund=venijonar venche-,-; al 48" depth with 0.5gpciM2 loading rate. Boring # El Soling Pit Ground surface eley,91-10 ft, 85 Depth to limiting feet Q in_ qnil Annlination Ratt- Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Stru ctu f e Gr. Sz. Sh. stence Consi Boundary Roots GPD/Ft" "Eff#1 *Etf#2 0-6 7.5YR 3/3 7.5YR 313 1 S1 2fgr I fsbk mf r MVfr gs CW 3M-V1 2mM J% o.6 0,0 0.4 0.7 0. 7a 1 6a 0. 7a 1.6a 2 6-15 19 15-24 7.5YR 4/6 km Osg Ml ------------------- MI gs gw 1 M-vt 4 24-43 T5YR 4!4 Is-$ Osg 5 43-85 7 - 5Y R 5 /4 S-ts 0sq M I CW' 0 .5; 1'0 6 85-104 5YR 411* 11 1 10YR 4/6 SI 0 M mtr-mij 4 0.2 0.6 allorizon 6 allo contained 4-scoftnuous pocket� ol 7,5YFt 514 sand (Osg. ml) Boring # [71 Boring F1 Pit Ground surface elev. ft. Depth to limiting factor in, Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots I h I Munsell I Qu. Az. Cont Color I I Gr. Sz. Sh. I I I Effluent $1 = SOD, > 30:5 220 m /L and TSS > 30 5 150 mgVL * Ef6pent #2 = BOD :5 3 0 rn gj L a n d TSB �% 30 m2�L It F Soil ration Rate GPD/Fe ffiEff*1 I * E ff#2 CST Name (Please Print) Signature CST Number Ryan Bechel (Advanced Environmental I-M) 1330832 Address Date Evaluation Conducted Telephone Number W1 1932 560TH AVE, Prescott, Wl 54,021 10130123 1, (65 1) 327-0074 P,q n P C1 Designer- Ryan Bechel 2023 Advai)ced Certified Sol] Tester. 1330832 Enviro i; r r)e of at LL C Desigrier of Engineening Systeriis D 22-633-7 All 0-ghts reserved. 'All PrWettY Ifnes Mt BenchMaFk SYSTEM NOTES dra vm are > I 00ft from So'll Boring Septk Tartk- systefn* AN& P/L PA. PA. Aft. BM 96.00 CP cio Top,, Iron pipe Puntij Tank. (I duove yrdue) 131 Borings 1-3 evaluated Soil T rra tmen I Ares: 8830 5124104 by Shaun Bird -5up*m%rd4 tonq to "d sal lev area e4usmed 5124U by S*wi Bird 4000 Q ar ( Distribution: BM2 90.70 Ile -.11% 0/ N \1 /loop, 0.- 100 Top nail in 30" tree 01, ps (16 above grade) LOCAT713N MAP (nat to 60010) *_IF54, contours., slope, & 140TH AVE Current grade '50 BM2 evaluated by WeIR %% if Advanced Environmental a- ICY on 13123** SIT LOT 17 Proposed PREPARED FOR: well Gary Et Pam Freiberg Sft Addrfts-, 1394 126TH ST New Pm ichond, WI SQ17 S'C PID: 026-1167-17-OW 1.54 Acres 15' Legal' Lot 17 Lundis Prel5erve 3 0' 1 00 T 18 NW 1/4 INE 1 4 S27 T30N R18W _Town of Richmond w* TMff Pffftem, hm bm dmigrwW am moduded in oometkr" wo Sbft and L=W codim The na bmulworft orw mLmt "wridn pnYWutnd fuom dk*urbwm arul/or and aftv owwtucUm Scale: 1" 304 Date- 10/30/23 NO UWWY 15 MOE PW THrS Sn7EM WL WNTHK TD RMCWN WDUWMY "Wm mot be your wyewn"is mangwiart plian for-b-dOwnufmon on PrOW *we and rimAntwWMnOL "r C, k Wscor*ln Dopaftent of Commeme SOIL EVALUATION REPORT D Molon of Sa f r:s ty and Building s, Page Of in a=rdance mAth Comm 85, VAs. Adm. Code County f - co I Aftech complele site plan on paper flot logs then 6 112 x 11 Indhes in!52u� Plan must Include. btn not lim It to- vertical and hoftontail referco point (B M�, direction and paroel 1.01 pement islopo, scale or dirner*ions, roodh arrow, an d I I on and di dance to nee F a st ro ad. P100SO print off Info rfnatic m. Rwvftwed tDate Persom I Infonne bon Vem mvWs m my by used f o t:s econd a lry parr ass (Privacy Law, s, 15.04 (1) (m)), Pmperty Omer Prc>rmr1y La co -Mon kAf-a iv 'Govt. L01 1 14 S,� T N R W ftpefty Owe ailing Addren Lot # "FE—N6ii A i. Nxne c CSM s4 —1 0 cfty 0 V1; I age wn 'Nearest R L SUft Zip -fffi—one Numt>er ,Z , r, Now Con" kUCOM Liss. ResWlenft I Nun*w of bedrows Code dO&W design Raw We.:---420 -----GPD Replacement r Pub4c or comrnwdsl - Dpszrbe: Parent edel Fed'evation Pla leit ble 0 Cowmral oanym nts a nd recom rne nde don s: 65e Z 0 4�6, rig Ground surfamelev.ti- Pit to 11MIlIng llacw In. Hori� Depth Dom Inant Caw Radox OnCrIPUM Texture Stry ctura cormls-term Boundary Rom In. Mun3all QtL Sz. CoM. Color Sz. Sh. -ZZ/ 17 IJI ScAl NTftfon Rate GPDW "EMI NEM 0 odd (IV P,, QmundsurtboeelavO 11 E ffluani N1 z SOD, > 305 220 mgk wW TW �30:j 150 mo� 1008 192nd Ave, New Richmond,-4-TRO-14,017- --.- Dep4h t* krnl&V facwr - -W W- EffluentmgA- W Numbief 226900 Evaluafion Conducted Telephom Number pArpv- 1 1 pmPeily Owner _- - _ Parcel ID 0 PRgO - Of Boring # Bwft lirtift f8dW j Az IM Pit GMww4UffM*6kw- I ft. Depth to Sd &Vookn Rate 0, 4 1 11 Los M, Morw WA M Gerund surfoce elev. ISciOng # C Bing C3 pil, Gouid5urtco 0-�av- Diepilh to lwgry factor D"M to WrMV ftCkK In. v Efflued #1 r- BOD, > 30 � 220 n)WL and TSS>30 < 150 M91L * Efflueri #2 z BODS,:5 30 MG& VW TSS ! 30 V4L The ept &OunM der wd employer. If you aced assisUnce. to iccess SerViCCE Or Dartmenof COMMM is @A CqUI OPP'FlitY se *Cre Pt"I lietd Mledal its w Rkanate format, plew, contact the depdmat at 609-266-3151 or TTY 608-264-8777. w-aWk.6%) P;; rip 19 4 Soil Test P Project Name EnvironmenW Molding L,, L,, P. Spa Address 706 19th St. S. Hudson W! 54016 IffTM Lot 17 subtf vfs on LUndY's Preserve Date 8/24104 N 1 !2 NE 1 /4 S 27 T 30 N/R 18 W F:Ud nd ._._MMUMM .�.. .... ._.w.. .....�. ... .. Township mo Boring . Well PL Property Line count' ST, CRO X Bbl or VtP Assume Elevation 188 ft. Top of Steel Fence Post System Elevation 86.2185.4 * N R PS aM as Berdmark Alternate Benchmark T2p of Surge Iron a 96.010 F f W`M11,1 88" roF Me 100' 297" Property Line f 5' B-3 91' 3S' B-2 044 --- 45) Please note:Soil test was done to satisfy county zoning requirement, Soil test may not be sehable for owners desired bonding location. % Slope Qn i 451 B-1 Scale is 11' = A()' unless otherwise noted Pane 13 'Lwundy's Preserve Comments. RECEIVED � 0 ,IUN O 1 2004 ST. CROIX COUNTY ZtNNIPiG (SCE The soils in this subdivision are quite variable and differ across the 80 acres, Some consist of a clean outwash sand, other consist of glacial tliis. In certain areas, the medium sands have a very deep red color unlike l have seen In all of St. Crobc county. The color does not Indicate high ground water because the color is so consistent If you go through the red sands then the sands turn off whitetyeiiow but not those of a sand stone. In talking with Pam Quire from zoning, she commented that there could be a different chemical reaction with a sands, l believe this is the case for the sands have a consistent size, and no moftles were found above or below the sands. Sometimes bands were present, but were very slight and were mentioned to have the systerns sized a little bigger in order to accommodate for any Inconsistencies in the soil. Also It is worth mentioning that the Intemeefions of lots 6,7,8, and 9 have a extremely poor soil present not suitable for a mound system. The surveyor and l discussed this condition, and the resuCting tests were spaced as far away from this area as possible. All the soils tests were done to the best of my ability and l hold no liability for anomalies and other vddhles that can be found on this sfe. Shaun Bird CSTM #226900 5/2$/04 pane 14 STATE OF VVJ!j�ONSIN 211200 ate' ' 1 2 91 lw4 irlIA. V is wpr Alp g, �+rra�i.#!sr■ sr■ •iN�ii ts�rrarr •a�.ws - F*r fi t s � �.' . qppa !' % ` s do .'' 43 dob #4 ,, � . or .� 00 !r■ € { A alp IP jp MPPPP • dd§W • •� i+ to'+/ ..'� opm" ;� yr 409 ■ . • •s I 0 1 G 7 2 v tl •io LOW �ity b" Coal PMES LOT 17 1-10 1.9" AMM L QX� 074A IRMS SO. FT. ■ IN 4 1p �%%4e LOT I e3 1 4 �Z.70a 1,50. Ff. dp b % 0 2-203 ACME$ ip d"I 0 14 If V1 495, -SQ FT, k=41 r 1A.1 - I 03 a Af %4b 4 F." 134-41' a r4l V, *1 A 0.30 =w4 ,I - I - jib 000 1 sell. W04 PM■ IN Mem LOT R" w IA71 0" 1 A 'wx % % -9 Law uts IVAN SP. Ff. -8 LO.O. ID35.0 % /V it kw"dLj _5 L d.),& -- 11 � 7 . . . .......... . ....... .. . .. . . . . .. . .... .................... . . ... . . . . . . . . . . . ............. N - - - - - - - - - - - - - - - - - - - - - - - - - - - - - . .. .. RAN . ............ SFER/REN WAL r V qj U NO OWNER g�rAj Pc" Frers&erq NJ PLUMBER �f)�,er Nelsen .. . . . . . .... 46 164 (b QQ 0"I ?Q N sr-ju 9 IL I AND/I.L.IIIIIIIIIIIAXX dy $ 1'WSE�Ve tu IS MORMSMS M-4- SBD-06499 (RI 1/20) 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 is 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. (f) The sanitary permit is transferable. History: 1977 c. 168; 1979 c. 34,221; 1981 c. 314 Note: 1f you wish to renew the permit, or transfer ownership of # ca authority. t e erm�t lease contact he uu h permit, P ty . .. . .. ......... . . ...... ... ... ... . ...... . ... .. ............. . .. .. . ...