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HomeMy WebLinkAbout002-1027-20-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division . 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 X Township Mentink, Jeff Baldwin Townshi CST BM Elev: , Insp. BM Elev: ' BM ascription: ~~ ~~ pp CST gV1/1 ~ ~ , TANK INFORMATION U TYPE MANUFACTURER CAPACITY Septic ~~ i~ ~~ Dosing ~ K Aeration Holding ~, ~- TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ~ ~S ~ ~ ~ r ~~ Dosing u ~~ k ,~ Z g t Aeration Holding ~ -~~s~ PUMP/SIPHON INFORMATION Manufacturer ~ ~ 4.l!.~Q.~ ~ ~ Demand GPM `~ Model Number ~• DH Lift Friction Loss System Head TDH Ft Forcemain Lengt ~ lit Dia. 2 .c Dist. to Well /~ ` w 1 SOIL ABSORPTION SYSTEM ~-' ELEVATION DATA County: St. CroiX Sanitary Permit No: 399443 S to Plan ID No: rr-~..o ~ : ~~yuz rcet Tax No: 002-1027-20-000 STATION BS HI FS ELEV. Benchmark 2 •o tbz.o ~uv.a Alt. BM ]_~15 T 9 -~s'' Bldg. Sewer 1z• O f .~ SUHt Inlet X3.(,0 ~ . SUHt Outlet Dt Inlet Dt Bottom ~~ ~ f v `' Header/Man. / Dist. Pipe 2 . w • 39 f Bot. System / Z.g r 8-~ Final Grade ~' St Cover ,f . D B Width Length No. Of Trsaches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth MENSIONS ~ ( '7~-- f '~ J C SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHI anufacturer. INFORMATION CHAMBER Type Of System: ^ `~ ~ ~~( ~ UNIT el Number: DISTRIBUTION SYSTEM Header/Manifold ~ u o Distribution tt i, L ~~ II I~ ' x Hole Size 3/ u x Hole SpatcJing ~ `t Vent to Air Intake Length 3' Dia ~ Dia Spacing '^' ngth 3~ ~(o 1 SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes ~ No [] Yes ~ No COMMENTS: (Include code discrepancies, persons present, etc.) Insp ction #1:1~/~_/ Inspection #2: _~-1---~ ~~ ~~ ~Q, Parcel No: 13.29.16.193 Location: 941 260th Street Baldwin, WI 54002 (NW 1/4 SW 1/4 13 T29N R16W) NA Lot p! •~ o ~ ~.•r"~9--~+w ~ 6~ ~ gn~.~slo~~.,r,~ee~„~~ -l, ~~x ~ (2 + S '`• (l c..a+~-' 1.) Alt BM Description = ~ +d-o-:~p,,~ ,~J~,. ~'" 2.) Bldg sewer length = ~i uQ.al ~ ~ J ~'~`C ~" ~ ~ ~~"" . - amount of cover - ~' ~ ~ dL . 6) ~~ 3. Contour - ~ T ~ D ~ ~v14-~'~ fit, f'e~- ~tt~- ~~ ~~vQ,C~ ~a~ ~~ ~~ ~~ ~ Tan revision Required? ~ Yes ~,No th r ~['de for additio I i ~fT~ation. ~ 3l 1 ~~dG31~~C~ ~ ~ F~Gf. Date Insepctor's Signature Cert. No. ~,0 ~ll~D7 ~ Safety and Buildings Division Coun ~ ~2 ~ 201 W. Washingtop Ave., P..O. Box 7162 ~+ ~ ~ ,~~Onsl~ Madison, VVI 53707 - 7162 Address ~ ` G iJ ~ k ~.~- Department of Commerce / l . Sanitary Permit Application ~~' Permit N ~~~~ In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ^ Check if Revision ma be used for seco ses Privac Law, s15. 1 m I. Application Information -Please Print All Information State Plan I.D. Number 6 6 yz~ 2 Property Owner's Name J e. ~~ .~- ~ l ~+ `sue ~ e ~ +' ~ ~< Parcel Number f q , UU2 - l G 2 7 - 'L v --o c~ Property Owner's Mailing Address Property I, ocadon `L~ 3U z C4 ~U~ / // / N k/'AJ ~r/'k;S L T~ N,R `lOE Ciry, State Zip Code Phone Number Lot Number Block Number ~, ~ ~3 ~~~ ~ ~ Y~Z ~ I s~-~~~~z 75s Subdivision Name CSM Number ~ . ,~ II. Type of Building (check all that aPP1Y) ac ~5 """- ' ~ ~'""'e' ^Ciry C 0-i or 2 Family Dwelling -Number of Bedrooms ^Village ^ Public/Commer ' -Describe Use ownship 3 ,¢ lc. ~ ^J'~, ^ State ~,~ ``-~~f ~ q ~- • 0 ~ ~ t( Nearest Road f ~ III. Type of Permit: (Check only one box on line A (nttmbering scheme for internal use). Complete line B if ~ 'cable) A 1 ew 2 ^ Replacement System 3 ^ Replacement of 6 ^ Addition to For Coutriy use `' ~, + "'~; `~ ~ ~ 1 ~ S stem Tank Onl Eris ' stem B. ^ Check if Sanitary Permit Previously Issued Permit Number Issued ~ ]v. Type of Permit: (Check all that apply)( timbering scheme is for internal use) ~ ~ ` - '_ `~` ` gT ~ptX C,O+~^y~~ 44 ^ Non -Pressurized In-Ground 21 ound 47 ^ Sand Filter 50 ^ Cons tee Wedand >," ~~ ~ `` <"' 22 ^ Pressurized In-Ground 41 ^ Holding Tank 48 ^ Singie Pass 51 ^ Drip Line 45 ^ At-Grade 46 ^ Aerobic Treatment Unit 49 ^ Reciiculating 30 ^ Other 4 ; ~ ~`' V. D' ersal/lteatment Area Informati on: """~ Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade Required Proposed Rate(Gals./Days/Sq.FtJ (Min./Inch) Elevation ~1~~ ~~r, v ~~v 1 + v lit ? s' joo, ~~ VI. Tank Info Capacity in Gallons Total Gallons Number of Tanks Manufacturer Prefab Co~rete Site Constructed Steel Fiber Glass Plastic New Existing Taala Tanks Septic or Hokling Tank _ ) (~ (~ a l ~ ~ ~ Cb ~, DosingC6ambtr ~pU ~ ~ VII. Responsibility Statement- I, the untie ed, assume r nsibility for installation of the POWTS shown on the attached plans. Plu~er's Name (Print) Plum s Signature ~1MPRS Number Busi~ss Phou Number Plumber's Address (Strut, Ciry, State, Z' e) L ~ ~ '`y~2 ~ (~ / G ' ~ ~ . ~ y . e 1 S UG ~ ov ~ ~~ l ~ VIII. Cotmt /De artment Use Onl d A roved ^ Disa ~~Y Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) pprove , pp ^ Owner Given Initial Adverse Surcharge Fee) ~ ~~ 3~- ~ ~I .. Detetmtination • IX. Conditions of Approval/Reasons for Disa prov ~~ ~ ' S ~~ -~'p b.LQ.a.YZ. s~ s~ -{r- ~-- ~~ ~ r -~*4, 'iE M~~- a.~o~ ` ~ u~--a- ~ t~~. DI~ l ~ s+. erg ?~'Q.~ ~' (~.er- ` -~~ `w ~ . t ~ f at ~tT' is .~-s~b.Qe ~ ~~ t, ""J /wt.a.t ~ "'t'" `~ Attach tompttxe ptana (to the ~ouhry on~y) nor me system uu prpu uv..csa .,..,. o.,., ......,...~ ... a...c SBD-6398 (R. OS/O1) PLOT PLAN Scale 1 "= 44 •Page 3 of 1 ~ $~~, . --.._ v i~~ 0 ~' o~ .o s~s~~ w~L ~ ~10~t x 3 ~D~2..w1 -.,or 1b _~ ------ ~b'oF _ D~I,V~tivt~~_ tikcv~ G f~ ~~~Q et . qz.o BOl'SU~'1 0~ ~.l.l tt, ~8 •'25 ~~\ Go to Pv~M ~~ ~ ~\ ~~9 9s g,3 ~ ~ \~~ ~ ~ \ ~ o~\ qq~ do ~ y_ ~~ '~ ~D 'NUT L°OwIP'h-e.1' Oiz D ~Slv~,Zg TtfiLS p~ .~ NOTES 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( Z required). 3. Septic tank to be 1000 1600 gallon capacity manufactured by Covh,~-y C-Oh~ c~~ w ~ f? ! 80 0 Z~ ~z. ~i ~`r~~'R 4. $ench mark~F-1-~°'t..,100.p'ON `r,p oF) 3J~~ Woo~~1 ~T'Ps-k.~ w /Lf}-~.~ ~5. Divert surface water around system to prevent ponding at the uphill side. s ~ ~scons~n Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD lA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www. corn merce. state.wi. us/sb www.wisconsin.gov Scott McCallum, Governor Brenda J. Blanchard, Secretary August 03, 2001 A777V: POWTS Inspector w~ CUST ID No.691727 ARTHUR L WEGERER WEGERER SOIL TESTING & DESIGN SERVICE PO BOX 74 RIVER FALLS WI 54022 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/03/2003 RE~~~ ZONING OFFICE 1~~`~ ~ ~ ~~~~ ST CROIX COUNTY SPIA ~, X HUDSONWI 5 016E RD ~ ~~ S AGE ~~ \ Z~(3 Identification Num Transaction ID No. 664262 SITE: Site ID No. 633764 JEFF & ALLISON MENTINK Please refer to both identification numbers, 260TH ST above, in all cones ondence with the a enc TOWN OF BALDWIN ST CROIX COUNTY NWl/4, SWt/4, S13, T29N, R16W FOR: DESCRIPTION: THREE BEDROOM MOUND SYSTEM OBJECT TYPE: POWT SYSTEM REGULATED OBJEC"f [D NO.: 804950 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD-10572-P (8.6199) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD-10573-P (8.6/99). 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 manual, and section VI of the pressure distribution component manual are complied with. A copy of this letter including instructions and information relating to proper use and maintenance of the system must be given to the owner and each subsequent owner upon completion of the project. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. • Access to the filter for cleaning must be provided per Comm 84 product approval conditions. Maintenance information must be given to the o+vner of the tank explaining' that periodic cleaning of the filter is required • Limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • Comm 83.52(3) The activities relating to evaluation and monitoring mechanical POWTS components after the initial installation of the POWTS in accordance with an approved management plan shall be conducted by a person who holds a registration issued by the department as a registered POWTS maintainer. ARTHUR L WEGERER Page 2 8/3/Ol • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). In addition, 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. • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145. l9, Wis. Slats. • 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. Slats. 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 instal lation/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 slats 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. Sincerely, ~~~ ~ ~~~~ Charles L Bratz POWTS Plan reviewer II- Integrated Services (608) 789-7893, Mon.-Fri. 7:45 AM to 4:30 PM cbratz@commerce.state.wi. us FEE REQUIRED $ 175.00 FEE RECEIVED $ 175.00 BALANCE DUE $ 0.00 WiSMART code: 7633 cc: JEFF MENTINK ~ ~ ~scons~n Department of Commerce August 03, 2001 CUST ID No.691727 A7TN: POWTS Inspector Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www. commerce. state.wi. us/sb www.wisconsin.gov Scott McCallum, Governor Brenda J. Blanchard, Secretary ARTHUR L WEGERER ZONING OFFICE < WEGERER SOIL TESTING & DESIGN SERVICE ST CROIX COUNTY SPIA PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/03/2003 Identifi ~ rs Transaction ID No. SITE: Site ID No. 633764 JEFF & ALLISON MENTINK Please refer to both identification numbers, 260TH ST above, in all comes ondence with the a enc . TOWN OF BALDWIN ST CROIX COUNTY NW1/4, SW1/4, S13, T29N, R16W FOR: DESCRIPTION: THREE BEDROOM MOUND SYSTEM OBJECT TYPE: POWT SYSTEM REGULATED OBJECT ID NO.: 804950 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD-10572-P (8.6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD-10573-P (8.6/99). 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 VI[[ of the Mound manual, and section V [ of the pressure distribution component manual are complied with. A copy of this letter including instructions and information relating to proper use and maintenance of the system must be given to the owner and each subsequent owner upon completion of the project. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. • Access to the filter for cleaning must be provided per Comm 84 product approval conditions. Maintenance information must be given to the owner of the tank exp]aining that periodic cleaning of the filter is required • Limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • Comm 83.52(3) The activities relating to evaluation and monitoring mechanical POWTS components after the initial installation of the POWTS in accordance with an approved management plan shall be conducted by a person who holds a registration issued by the department as a registered POWTS maintainer. ARTHUR L WEGERER Page 2 8/3/01 • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). In addition, 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. • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. , • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Slats. • 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. Slats. 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. [n 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 slats 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. Sincerely, ~~~~ ~ ~~~ Charles L Bratz POWTS Plan reviewer II- Integrated Services (608) 789-7893, Mon.-Fri. 7:45 AM to 4:30 PM cbratz@commerce.state.wi. us FEE REQUIRED $ 175.00 FEE RECEIVED $ 175.00 BALANCE DUE $ 0.00 WiSMART code: 7633 cc: JEFF MENTINK TITLE SHEET FOUND SYSTEM FQR A 3 BEDROOM RESIDENCE Page ~ of This plan has been prepared in accordance ~~ith the Mound Component Manual SBD-1057 P and the Pressure Distribution Manual SBD-10573=P CCz. blq~1~ Ctz. 6144 LOCATED iN THE -vw 1 /4 OF THE Sw 1 /4 OF SECTION 1 3 , T ~ N, R 1 6 cd, TOWid OF '~3 PsL,~I~JLN S'T'. ~'_2U1X COUNTY, WISCONSIN. INDEX PAGE 1 of 7 TITLE SHEET PAGE 2 Of 7 SYSTEri MAi~TAGEMENT PLAN PAGE 3 of 7 PLOT PLAN PAGE 4 of 7 PLAN VIEW-CROSS SECTION PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT PAGE 6 of 7 PUI.IPING CHAZIBER CROSS SECTION PAGE 7 of 7 PUriP PERFORi4ANCE CURVE RECEfIFED PREPARED FOR _ ~~~~ 2 r~ 2001 _;_._-__;-_ ~~-~ . ~~SON ~~,~,,-~,FETY & BLDGS DIU. __ ~~~Dwt~,; wt shoo-Z--_ PREPARED BY WEGEF~ER SOIL . TEST S NG AND . . . DES 2 GN SERVICE P.0. Box' 74 421 Id.Pfain St. River Falls, WI 54022 *~°~~ Phone 715-425-0165 ~ ®~~~^ Fax 715-425-6864 ~~,••*'"""`••..ti~ . ,:~ ARTM/q ~ = WEi,ERER } D~75 h E.LSWORTh. ° ~1 W5. CO~ll~ltlOilQl~ . APPRC}VED ~ ~~ ~ ~~~•~"~~ °$r~ ~SIGIr~' DEPMRi11ElIT OF ©01 ~i~ ~_Z3-41 JOB NO . ~ 1 ~ l`1~ Mound System Management Plan Page Z of ~ Pursuant to Comm 88.54, Wis. Adm. Code • Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. 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 fitter 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 filter 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 perforred 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, Safety and Buildings Division. Pum° 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 snail 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 for frost protection. Influent quality into the mound system may not exceed 220 mg/L BOD5, 150 mg/L TSS, and 30 mg/L FOG. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing paint at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at (east once every 18 months. When a pressure test is performed it should be compared to the initial testwhen the system was installed to determine if orfice 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 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General This system shalt be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manual [SBD-10572-P (R. 6199)] arid 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. Continaencv 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 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 location by increasing basal area if toe leakage occurs or by n:moving biologically clogged adsorption and d'~spersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. Questions about the operation or maintenance of this system should be directed to: The County Zoniag office at ~ 1,S - 3$'6 . f168D ST. C-~O ~(' The system installer at -1 LS-(~~' $.. ZZ~ 6 ST`Pt-~16 The tank manufacturer at 1. 1 S _'Zl~q _~~LZ.7 (~j~~-.1 (~yVLo The effluent filter manufacturer at $'~- -Z-Z.I ~ S~u2. Z~'$~ _. _ The pump manufacturer at ply- ~,Z = ' ~ PLOT PLAN Scale 1"= 40 ' i p v I- ~ i o~ i D ~~ Page ~ of ~1 f N I~ROI~ elZ. L lAJ E ~ ,ay„1~,.I , --..._ S~6C,~s~~ W ~L LO ~'•Pc~IOJ -~ x 3 ~WR.w1 ,---_ I.~oT lb _~ ------ ~o'oF GPI ~0'~TO~R. 2l . c~'~.p ~ ~\ Gl 0 ill ~ ~C ~•M_ ~ ~ z" P~ ~~ $. q9 s 9~ ~~\ ~~ ~ ~ ~ a~~ ~ ~q' No .v, . ~~ '~ by NoT ~~prr~T oR D ~s~-rz8 'rms ~~ NOTES• 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( Z required). 3. Septic tank to be ~o~o Iboo gallon capacity manufactured by Covrv'~-Y Cpl ct~'~- ~, f R- t~ao z~~'c. Fz ~ ~ 4 . $ench mark it-I - ~-.100.0 ~ ON `Cop o~ ? 31g `` woo~~l ~1^Pck~ w /LF}ii-I. ` •~. Divert surface water around system to prevent ponding at the uphill side. .. Page ~Of' -j Approved Synthetic Covering ASTi`i C33 Medium. Sand Topsoil '6 % Slope Distribution Cell of ' 2" to 2 Z" Aggregate 3 J i ~ ~- istributian Fipe _ T F ~D e Force Main From Pump CROSS SECTION OF A MOUND SYSTEa A ~' Ft . Linear Loading. Rate=6,0_ GpD/LN FT Design Loading Rate=O~-3.GpD/SQ FT ~' L B ~5 Ft. I 1 ~ Ft. J 8 Ft. K `Z- Ft. L ~.9 Ft. W Z8' Ft. ~a Elev . °18 .~1S Plowed Layer D 1.75= Ft. E 2• tl Ft. " F D- 8 Ft. G 0.5 Ft. H 1.O Ft. . ~ ~~ -Observation Pipe B --=- K ~ -- -------- ----- ---- -----7 ~ goc-ss Q - 1~ I~6 $ _ ~ _ - VY -~-r-----~------ -----= ---------------------- ~ Force ain l_---~ - - ~--------- J ~iL"~S PST" _ opvoS ~D Distribution `-Cell of '~" to 2'~" ~ . ' Pipe aggregate ~ . Observation Pipe U~achbr securely) PLAN VIETd OF A MOUND SYSTE~4 Distribution Pipe Layout Page S of ~ Place the holes at the bottom of the distribution pipes . at equal spacing. Remove all burrs from the pipe and holes. Extend the end of each lateral up with the use of long turn or 4f ° fitting to a point withinsix -- inches of the final grade. Te-rr,;natP ~e ends of the laterals with a valve, threaded cap or • threaded plug. Provide access from final grade for the vaIye; threaded cap or threaded plug. " pV C - F~1L PV C Latera(~ ~ Manifold r- Laterl x x x x x2 :Lateral Leneth ~~.t~-N V \~ -_ ~ _ P h t~f.11 Fc~ ~: a ___ P 3 ~ Ft. S 3 Ft. X ~_ Inchps C- r~C.c ys sfl~ - -o ---0 Nole Diameter 3/~~ Incfi~ ~-~ Lateral " ~ 1 ~ t~. InchEes) Manifold Z• Inches ____r- Force Main " Z Inches - ~: , # of holes/pipe Lq - Invert Elevation of.lateraTs ~4-~ Ft. .. .~ _ , ~ Combination Septic~:Tank and PI~~MP CHAMBER CRO55 SECTION AAId SPECIFICATIOAIS ' PAGE ,C~ OF 'L~LO~~~pp dr F~ N>.S~ G~DE I la'nlrJ. - UJLET Approved joint w/ PVC pipe t Ftl~~~ ..A X800 6 C EYF~•~3ZFx D CO-JCRETE ,$4-0n~ ! ~ DLOCK~ Approved joint w/ PVC pipe RISER EXIT PERMITTED OIJLy IF TAI.JK MAIJUFACTURER Hq5 SUCH APPROVAL~3NAF~~D B>:Dt~ t N4 SEPTIC F SPECIFiCATfOt`1S DOSE TnNK MA-IUFI-CTUiZCR: C~UI`-~~y ~NC ~ IJUMBEA OF DOSES: U •~ TAAJK SIZC: 1000 ~ X00 GAI.LOIJS PER DAB DOSE VOLUME r • ALAR1h MAUUFACTURCR: S•S-C~~°-T~ZL~ S~~s IIJCLL1011J6 6ACKPLDW: ~ ~~`•~ GALLONS MODEL 1.1UM8ER: }O ~ ~~ CAPACITIES: A. .Z Z--iuCHCS OR 30 • q GALLOI~s SWITCH TyPC:-- M~ZCUti~ g. z I-JCHES'OR Z~'Q G~LL01J5 PUMP MAIJUFACTURCR: _. z-o~L- Z CO C=~_IULHES OR 1l~' ~ MODEL 1JUM8ER: 1 ~ O WILLOUS ~ D= 1 ~IAiCHES OR 1S3• SWITCH TYPE: - ~~-~1~y .- GAt~o~ls WOTE: PUMP AUO ALARMA~ R TO 6C~ 8 MI-JIMUM DISCHARGE RATE Ste- L~ GpM INSTALLED OA1 SEPARATC CIRCUITS VERTICAL DIFFEREIJCE DETWCCI,1 PUMP Off AIJO..OISTRIBUTIOIJ PIPE.- 1y.33FEET 1.lI ~- M I M'lUM AIETWORK SUPPLY PRESSURE , ~ , ~ 3. ZS~FLET ~Z-Sx l 3~ - ~ ~ ~ + l O ~ FEET OF FORCE MAttJ X 5' ~~- F~o FtFRICTIOU FACTOR.. S • ~~ FEET TOTAL Oy1JAMlC HEAD ~-?•~OFEET f, W1=ATN£R PROOF . -VEUT CAP Ju1JCTi0U eox . ti C.Z. VEAI7 PIPC ~ APPROVED LOCKIIJG ~ lO' FROM ODOR. ~ ~wAAR~.NIUG VLF E~ ~ilAlDOW OR FRCSH ALR IAIT~IKE t ~ ~.~1J ~ S ~ ~ ~ ~ co+~Du~r I ~-- ~' MIEI. ~. 18' MIiJ. t l I 1f ~~ ---------- c ~, ~~ I~ - LL ~`\; ~~~ PROVIDE I AIRTIGHT SEAL I ~ I I I i~~ II~ ~ I~ ALARM .I II ~ t i Ou •I I I PUMP -~ ~• ~ !'i` ~ OFF As per manufacturer 13 -qS gal/in. Liquid depth ~ 3-tI '~ ~ W ~ W ~ 14 45 12 40 35 10 ~~.~ = 6 2 v a r 1 0 4 a a 2 0 ~-- U.S. GALLONS ~~~ ~?~R~D~Z~~r~ ~ Cv~zv~. HEAD CAPACITY CURVE TOTALDVNAMICHEADlCAPACITY MODELS "140/4140° EFFLUENT ANDDEWATERING Ft. .Deters Ccl. Ltrs. 5 I 1.52 91 314 I I 70 I 3.05 fia 318 i 15 I a.67 ( 76 266 ~ 1 40,4 i 40 2° 6.10 68 267 i ` 25 I 7.62 59 I 223 30 i 9.ta t9 165 JS 10.67 36 I taa 40 I 72.19 27 79 a5 13.72 5 I 19 ~6 I ~ i i r i ~ i i 11 7I 30 40I 50 60 I 70 60 I 90 100 ~ 110 1 I 60 160 240 320 400 FLOW PER MINUTE 010940 1 1/2 NVT CONSULT FACTORY FOR SPECIAL APPLICATIONS • Electrical alternators, for duplex systems, are available and supplied with an alarm. • Mechanicalaltemators,forduplexsystems,are available withorwithout alarms. • Control alarm systems are available for 1 phase pumps used in simplex system. See FM0732. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long cycle controls. • Sealed Qwik-Box available for outdoor installations. See FM1420. • Over 130°F. (54°C.) special quotation required. • Refer to FM0806 for 200° F. applications. 140 Series - 53 lbs. 4140 Series - 73 lbs. 14014140"' MODELS Control Selection Model Model Volts-Ph Mode Amps Simplex Du lex N140 N4140 115 1 Nan 15.0 1 or i $ 5 2 or 3 $ 4 E140 E4740 2~ 1 Nan 7.5 1 or 1$ 5 2 or 3 $ 4 BN140 BN4140 115 1 Non 15.0 1 or 1$ 5 2 or 3 $ 4 BE140 BE4140 230 1 Nan 7.5 1 or 1 $ 5 2 or 3 $ 4 •'• DoublasealPtenpsareavalabNwitlopti6rlalmasNreset~aa.SealFaiin~rator6~tavair~leinNEhUIIOrNEMA4X cantml panels. I6 SELECTION GUIDE SK1624A B SK7524B 1. Single piggyback variable level float switch or double piggyback variable level float switch. Refer to FM0447. 2. Mechanical alternator M-Pak 10-0072 or 10-0075. 3. See FM0712 for cortect model of Electrical Alternator E-Pak. 4. Variable level control switch 10-0225 used as a control activator, speafy duplex (3) or (4) float system. 5. Four (4) hole J-Pak, junction box, for water tight connection orwired-in simplex or 2 pump operation,10-0002. caunoN All installation of controls, protection devices and wiring should be done by a qualified licensed electrician. All electrical and safety codes should be followed including the most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. +n-~ MAIL TO: P.O. BOX 16347 Q Louisville.KY 40256-0347 Manufacturersof.. O ~ *~ ~, ~ SHIP T0: 3649 Cane Run Road s ~~ ~ ' Louisville, KY 40211-1961 QuaurrPuriv9 SNC6 /4y4~49~ PUMP !O. (502) 778-2731.1(800)928-PUMP __ FAX(502)774.3624 ~~ -- or -~ S 1 t/2 NVT - - ~ Wlsoonsin Deparbnent of Commerce Oivlslon at Safety and Buildings SOIL EVALUATION REPORT ~~ ~ ~ ..p l Page _~_ of m acwraence wrm turnm a~, rns, hum...uun ~°~"ry ST. C,~~ Plan muss r not less titan B 1@ x 11 Inches M size i t . an on pape te p Attach complete s Include, but not limned to: vertical end horizontal rsferonee point (BMA, dfrsdton and pevnel IA. percent atope, state or dimenskxts, north arrow, end tocatbn end distance to nearest road. QO Z-1 aZ"7_ ?~ - QQ Please print all inlormatlon. R owed by Date - Persond inromtexon Y~ provWa may De used fw sseondery pu.posss (PrivsCy Lsw, s. 15.M (t) (m)). O~ p property owner g~„v t.=,e : ~'t= F /`ICEIJT t 1JK Property location ~J~~ ~~ASSON NW 7/45t-~ 114 S 13 T 2 N R Property Owner's MalArtg Address Lot a Block A Subd. Name ar CSMrt E '' : 5 G1 H. 25$ ~Y State TJp Code Phone Number ^ City ^ Village $J Town Nearest Road ll1~t)t)T~~ It_t~ { WT l .S40L$ (7tS 98 - 2-173 SA~DW l "~`-.ST. New Construction Use: ~ Residential / Number of bedrooms __._~ Code derived design Aow rate _ t _ • ~,~ I ; f.~ . GPD i ^ Replacement ^ Public or commeraai • Describe: -_ .___._._ -~,L. i ~,, . Parent material ~ C6A L '-C I l-L.- Flood Ptaln elevation if eppNcabl ~ ~'' R. General corrnnerrb ~ ~4~ and reoommendatbns: /`^ O t~W 0 ~ y JT>E M { , 75 t s~w'D F It_~ ~~~~ ~ ,- ~ ` ~ ~~~~ ~ , d5 t~ptlJCt, t2>P."~E ~~~~ C'., X ~. ' ~IST'trM EtTcVATtorJ tDrJ CDvt-.r'ttJut~ °)Ip,ZS ~'' ~~ v~.S,f ,F--' .~%~ .. LJ 13onng -~,,~ - ,,~~'' Boring q { 5 ~' , ,.:.. pit Ground surface elev. _ 7, ~l 2 K. Depth to limiting (actor ~_ ~ ~ ~ ~..... _ it i Rata Horizon Depth Dominant Color Redoz Description Texture Swcture Consistence Bounds PO fn. Munsell Ou. Sz. Cont. Color Gr. Sz, Sh. 'Effa1 'Eff112 1 D-5 10 le~/z 1 2ms M sF= o. Z, 5_ J z - t 4 z' Q-b , M o. S I -1 ylt 2 m - ~~ , 2 -~j a ro v~~ f CS X 1 2 .S 1 ti `+ o y SI 1 rn 1 v -m 0.1 Z- Z U Boling '°"-.- -, Boring ~ pp Ground surface elev, ~_ it. Depth to Ilmidng, fads _ ~ In. Soil iceGon Rate l tltxt dox Desai R Texture Structure Consistence Boundary Rools GP D/ff Horizon Depth in. or Dominant Co Munseli p e Qu. Sz, Cont. Color Gr. Sz. Sh. 'Eft#t 'Etfk2 ~ - JOvQ~Z ~" 5~1 Zw~ Fr 4••~ a Z. 3 10-1L i - 20 `~ 0~ -- y ' roti 4• 't 2~ab -Fab ~ nn~r a ..-~ o, o. S o. ' EmUent p1 a F3UU ~ ;X3 ~ Liu mprt. ono ~~~ +.w_ ~w n~W4 ......._....._ ___ - __ ., _ _ _ CST Name {Phase Print) Igneture ~T ~~ /Yt~R ~0 L S t 2z y k 3Z ~~~ ~ Date Evaluation Conducted Telephone Number 875 6 p-~~,gtle. RtvE A S .S~10ZZ -OI "1 ~ 42b-! Property Owner ~~ _ Parcel ID q OC~Z-~ 1 t.7 Z~ ~ 20 ~p(7~ Page Z-_ of _~_ (_,~ Boring Boring p ~' Pti Ground surfeoe elev. -~Jr~17 fl. Depth to Ilml!!ng factor ,~,~_ In. Solt Ikation Rye i H De th Dominant Color Redox Oascriptlon Texture Structure Consistence Boundary Roofs GPD/fP zon or p in. Munsep 0u. Sz. Cont. Color Gr. Sz. 5h. 'Effp1 'Eti#2 3 - y 3 N .~ (rnab 1~f-m .Z- 0~'S c{ ~ y t2 3 ~ 5~.1 2.m sbt rn-~r - y 0 , (o ~~ ar,Ann a ^ Boring U a ^ Pit Ground surface elev. __~, R. Depth to limiting tatttor ,_ . rn• th Dominant COior Redox Descripton Texture Structure Consistence Boundary Roots D i goq ication Rate GPD/ff zon Hor ep in. Manses Qu. Sz. Cont. Color Gr. Sz. 5h. 'ERfft •Effls2 ~~ # [~] Borng ____ ^ PN Ground surface elev. _ ft. Depth to Ilmiting factor in. Sdi lion Rata l i R D ti d Texture Stn7dure Consistance Boundary Roots GPDIR Horizon Depth in. or Dominant Co Mansell escr p on ox e Qu. Sz. Cont. Color Gr. Sz. Sh, 'Ettttl 'Eff#2 'Effluent ft1 = BODr > 30 < 220 mglL and TSS >30 < 150 mgll ' Ertluent if2 = BOOS ^ 30 mglL and TS5 < 30 mgR 7'he Department of Commerce is an equal opportunity service provider and employer. 1f you need assistance to access services or need material in an alternate format, please contact the depaRment at 6U8-266-3151 or TTY 608-264-8777, SBDdI)0 tR.NOUJ P~Of pI.AN ~~~ 3 ,, ~ , ~~~ rj PRoP~r1 ~ aE -sou, ~ox~~ w~ aACKHO~ NO COMM 83 5E1I3ACK f'~ODl.EMS 2Q ~CQ~S ~pL,oµlED~ X -PITS Di0 NoT Plebs ® SM # t - Do ,vvr DisT~-Rii x \S'~ i J `~ C.T. rt , F T~ ~ ~ $[~,I~ 4 + X t ~: u qn -t+a av~ ~. ~,o~ 5lGiJECJ C51 ZZ4832 nA~: 04 - moo- o~ x c:S a "." E l s.r x..°'s.t. ~ s;z. x<as ua . +. ~.~5.....•.. , ,...._ iy Y~f 2Y~I\s.Si2SX ~9.:i.L4TAL'~k,~~d'~. 3, 3.~..*1. `6 ~~ ~erli3ftyer _._S1_e ~~ a- ~ ~ ,4sva1_ _ ~°~< ~ n t ta~i£fi i~r~ .~.d~rti.~s ~ 3 U L ~ ~ ~* U~- -_______-~--~~, ~ ' rt Address l ~~e y -- "__ . {t~eri i~itiutt regeaiseci from Plarutitx~ I7cparfia~ent far rsecv ccaastructieni °~-~..~- f ,~~ ! d w ~ ~~+ ~~ Paxcet iderttificat~on un7~er ~ U ~ _ j v 2 ? ~ ~ U :ifi~', Sate ..~.-----^--- / C~ GcJ i ~ 4G21Z1'~IY ~ ,~'~': ~( !c/ i"d, ~'f~. ~ ~ P d ~ C ~^~_,,~ ~ '"~v , ~ Q~VIl CSS .~ r ~'r't7~Gr~ ~- :~tYl~tVlSid}i'+ ._, i~f' d ~+~r~~ trap I.,Ot, s~ ,o,,.......,.._ ~~~~~:• ~,~usc C=I fires ~"~:~~ Lot tines sd.e~.t~~t~fbi~ ~s ~.' n:7 SYSTEM 1Y~+li]PI`~Et~IA~~~~ Improper use and maini~~ ~~ c ter} +~ ~ Y ars~o saoiner, iflu ecied~y a li e~sscci pe~~: kc~d~t h t ynu ou~in3~~e~s u~t*;`a ?::t~IP.szSd,S tai ~~a?Y1Y~iTt~ [3Ut t~`~ ,. ~+ affect day faaa~ctiuu: ~f ti24 septic f::r~: ;IS a trea.izaiecaf sra~c at #lac watite ~'isa~s~=? ~yatccr. The property awncr agrees ics submit fa Si. ~rc~ixx T..aanis ; Dcuar~=rrt a ecriificati~€: form, si~cted try the owner and by ~t acz lumber, zestricterlp(umber' or a liccsised ~sumger veri€;~ing °~t t = 9 u`t= ~~-sitc: t~tastewaferdis}xtsal sysccrn esaasttr~turabeg jouErncytn P ,~ ec ~' ~' ~' z is in lsrolacr cperatang cauditirtn andlflr {.,} after insp tiort and pumring (~ u..~e.."E' 1, the set ~:;c faze: i; less ihra 11~ full of sludgy:;. "~~ ~ ~zndersied wend the a3~~,w r cuts sxt egret; to Diu€auz the prtva€e sc~'3~e c.~sp~511 .s;~stem ~a~fh the stan~n~ ~.r .J4.;, t~.~ y;ct f~ar~, hercisa, as sc®by tlir, DepurtuYCUt of must be ccoznpl~ ed ~d rcturs~~d ~c St.~<_~rtai~~C~stant~~i,~~f ~SO~cc ~'ithiu 3~ :;Lsiax~g tla.~t }your s;:ptic syrvstent has begin ritazntaaaed of tl~e tllri.c y r gig' riots dates. ~ r ~ • ~ . DATL~ ~.. T"it~-E I~ ,~PPI1ic~~. I (wej ccrtir"y t22^t staterneritr car. this for:' are t-ue ice t~tc hest taf si~y' {:a~~.r) iw.:-,~~ic:~3c. l itt.° ~ <_~'`, {argil the o~vucrEsi ~t tai proge dcscri cl c ~;rtic cif a iva°~nty deed recorded in Register c~i I}eeti~ f}:~sar.. , ~ ~~ ~ 8 ~~_.~._ /,' LyATE ~~~«~~ r'iuy ir~ioamaticaa that is mis-represcndreay* ~esuff ;~ tae s<.nifar' ncrbx:st beiaa~ rc~'olti:d lay the ~oraing L)cnartmeat. ~~ Izttiutie ttiitla this apglscafiots: ~ 4 ~f tixc ~ertificc£ survey z*sap fcrcf~c~ eie ma;#f izsc tllc ~vsc:aLt}-~ dccA .1,~ pY xu ~~ ,,,,. i724i?~~f 573 ' STATE BAR OF WISCONSIN FORM 2 - 1999 Document Number WARRANTY DEED This Deed, made between Lavern Johnson and Nola Johnson, husband and wife, as joint tenants Grantor, and Jeffrey J. Mentink and Allison K Mentink, husband and wife Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Northwest Quarter of Southwest Quarter (NW 1/4 of SW 1/4) of Section Thirteen l13), Township Twenty-nine (29) Nortll, Range Sixteen (16) West EXCEPT South 47 rods of West 37.5 rods thereof. Exceptions to warranties: Easements and restrictions of record. Dated this ~orN day of ~e~r~~~ 2001 * * Signature(s) AiTTHENTICATiON authenticated this _day of * TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED B~'i" `'~i~'.j~- `- ,~!`~ , Thomas A. McCormack ~~ Baldwin, WI54002 ; •. t ~;:, (Signatures may be authenticated or acknowledged. Both aet necessaga) ~• ~ - * Names of persons signing in any capacity must be typed or WARRANTY DEED Recording Area 65?389 h'EGISTER OF DEEDS RECEIVED FOR RECORD ,,-~:,-2~70i 3:34 AM idARRA4~TY DEED cXEt9PT 0 CERT COPY FEE: COPY FEE: TRA!~iSFER FEE: 174.40 SE~ORDI4ti FEE: 11.00 PAGES: 1 Name and Return Address Thomas A. McCormack PO Boa 2120 ~`~ Baldwin, WI54002 24~ 002-1027-20 Paroel Identification Number (PIN) This is not homestead property. (is not) ,P.cs1 * Lavern Joh son * ola Jo son ACKNOWLEDGMENT STATE OF WISCONSIN St. Croix ss. County ) Personally came before me this ~' ~ day of SC,dTL'~.s~YT~cxi 2001 the above named Lavern Johnson and Nola Johnson to me known to be the person(s) who executed the foregoing .ins ie and acknow]edged,~esem~. r--, ~"~atary Public, State of Wisconsin -M}. Commission is permanent. notte exprration te: r:. Notsrv Put>ftc-State o W isc s 7.2002 • ) - 1999 Information Professionals Corrpany, Fond du Lx, WI 800-855.2021 28' OWNER BEDROOM 15'-3" x 13'-1 " ~I/ , UTILITY/ OWNER BATH /I\ 0 BATH #1 KITCHEN/DINING 21'-1" x 13'-1" t ~+ ~. ' p ~ l" r f r r ' ~ CvJt ,. - v 56' --_