HomeMy WebLinkAbout018-1038-10-050
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
538878 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:
Lindquist Family Limited Partnership,, do Roe Hammond, Town of 018-1038-10-050
CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No:
/pp (jN1 ► C-OT 17.29.17.268A10
TANK INFORMATION ELEVATION DATA 90 TYPE MANUFACTURER ~M5 CAPACITY STATION BS HI FS ELEV.
I
Septic 3 Benchmark oz.? /66
l~u~~~, ~a o Zq
Dosing 2 . 5 5.Oa Alt. BM
O M✓ '
Aeration ID Bldg. Sewer LIrN
Holding F f St/Ht Inlet 75 s~ 15
TANK SETBACK INFORMATION St/Ht Outlet
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic AZ 2Q l Z. Dt Bottom u -F L s
I Header/Man. Z-
g$
Dosing ' 140 20, 7,7 Z7 a
/
Aeration Dist. Pipe Z
Holding Bot. System 0
2. ~ 7
GG.
PUMP/SIPHON INFORMATION Final Grade J '
Manufacturer Demand St Cover r-'` Lo 3. <SJ 9~. g
Oc.jL S GPM
Model Number A a Al Z1-112 e~ '5 j
9 S SZ
TDH Lift Friction OLos~3 System/Hefadd TDH t 7~
J
Forcemain Length Dia. I r Dist. to Well
Z
SOIL ABSORPTION SYSTEM
/h / NPIT DIM NSIONS No. Of Pits Inside Dia. Liquid Depth
BEDITRENCH Width Length
DIMENSIONS
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
INFORMATION CHAMBER OR
TA)4
UNIT Model Number:
J -,X DISTRIBUTION SYSTEM
Header/Manifold Distribution ' Ix Hole Size Ix Hole SpacingA/ Vent Air In
/ 4:5/K
Length Z ' a5 Dia Pipe(s h ) OV-Dia /I G.6 Spacing Z' S
t
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over xx Depth of xx Seeded/ dded ^A.# + xx Mulched
Bed/Trench Center / / Bed/Trench Edges Topsoil s y No Yes Q No
r4
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2:
Location: 1652 Hwy 12 Hammond, WI 54015 ((SSE 1/4 SW 1/4 17 T29N R17W) metes & bounds Lot Parcel No: 17.29.17.268A10
1.) Alt BM Description = ` 1 I h' vd J 4A-
,.6IL,1~ t'j Zl, tp<
2.) Bldg sewer length = CIO
- amount of cover = Plan revision Required? ins Yes No 6
Use other side for additional informat on. V ( ~~~~!!lIJJJJ _J
Date ISigna re Cert. No.
SBD-6710 (8.3197)
J
afety and Buildings is County
commerce.
201 Washington Ave., x' i St. Croix
CO s' adison, WI 53707-7 62 ` t an itary Permit Number (to be filled in by Co.)
"1e~ 7
lt~ Department of me
F State Transaction Number
San arySP~a ication Q/P WE
In accordance with s. Comm. 83.21( , wt.. submission of this form to the appropriate governmental than mailing address)
unit is required prior to obtaining s ' ermit. Note: Application forms for state-owned POWTS are Project Address (if different I
submitted to the Department of Co erce. Personal information you provide may be used for secondary Same
purposes in accordance with the Privac Law, s. 15.04 1 m , Slats. ✓
1. A lication Information - Please Pri 11 Information Parcel # 018-1038-10-050
Property Owner's Name
Lind y Limited Parnershi Property Location 'r g M
Property Owner's s Mailing Address L1P
1652 US Hwy 12 Govt. Lot
City, State Zip Code Phone Number SE %,SW'b, Section 17 Hammond, WI 54015 715-796-5696 (circle one)
T29N; R17 W
11. Type of Building (check all that apply) Lot #
Subdivision Name
1 or 2 Family Dwelling -Number of Bedrooms Na Na
Block #
® Public/Commercial - Describe Use Employee restroom in Ag building City of
Na
I / CSM Number ❑ Village of
State Owned -Describe Use VN Town of Hammond
S X ~ Na
111. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A New System ❑ Replacement ❑ Treatment/Holding Tank Replacement Only Other Modification to Existing System (explain)
System
❑ Permit Transfer to List Previous Permit Number and Date Issued
B. ❑ permit ❑ Permit Revision ❑ Change of
Renewal Before Plumber New Owner
Ex iration r
`IV. Type of POWTS S stem/Com onent/Device: Check all that a I
Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade Mound 24 in. of suitable soil El Mound < 24 in. of suitable soil
❑ Holding Tank ❑ Other bispersal Component (explain) ❑ Pretreatment Device (explain)
V. Dis ersal/Treatment Area Information: tion
Design Flow (gpd) / Design Soil Applic n Rate(gpdsf) Dispersal Area Require (sf) Dispersal Area Pro s sf) S 9$,0 levati above
100 1.00 100.00 sq. ft. 100.00 sq. ft. ~G) @
D, l Q j (p(P • 5 97.50' contour
Capacity in Total # of Manufacturer H z w
VI. Tank Info Gallons Gallons Units o
L w U W W
New Tanks Existing Tanks
® ❑ ❑ ❑
Septic or Holding Tank 1000 1000 1 leser Cyoncrete
Dosing Chamber 500 500 1 Combination ST/PC ® ❑ ❑
VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
MP/MP RS Number Business Phone Number
Plumber's Name (Print) P Signature 220853 (715) 684-3378
Dale Hudson
Plumber's Address (Street, City, State, Zip Code)
820 Main Street, Baldwin, WI 54002
V Conn /De artment Use -n.
V
Approved isal>g Permit Fee Date sue Issui Agent Sign e
Owner Give . so for Denial I
IX. Condit' ~ [teasons for Disapproval
1. Septic tank, effluent filter and
'r-t
ire n e }C - (~tJI t~j ~~rdN r
dispersal cell must all be services / maintained 't
as per management plan provided by plumber.
2, All setback requirements must be maintained
code / ordinances.
Attach to complete plans for the system and submit to the County only on paper not less than 8 in x 11 inches in size
SBD-6398 (R. 01/07) Valid thru 01/09
• EI eda.~•oh
120, to Wct/
O ..~/Fys~sw/%y See./7, T. ~9~1., ~F'•/%~7~,
/0 -xi~0/8-/U.9-/O-0SUi
~jE,'~ 312- ~4creS•
I
> so`~rom sysF~-m.a~a~
I our+-/lead
1,'OpOStd Loft x-dMCi Q/'Jf(JF7 Q .S.LG? (~i nG~"Cii
u~~ c~D-SCGrt1Q Co•~b~i 7o» btci laC;ny ~{ssccrrec'eleq: ~edct~
"Sc,{ . S!o P. J. e ~ ,Q,/ !mac'✓/-sus JJ
Ey b e r~ s a-fead ` J (c) ash' m~t•PZ•
99.25' 4
- - 975
97 '
PrOpcS~ ndaf 9 47.0 of
97' 5' eon i6Q',l ' 7r-r1 d,-s ~,'6 w~b+, ' ~ wroc~ec+
o Q
/'%~;'eeu 5~oaceda E /.SSA` f , 96.0'
h
i
v
Safety and Buildings
2y~otiPT~-~Nj_~ 3824 N CREEKSIDE LA
HOLMEN WI 54636
D 9 Contact Through Relay
3 S P 1 www.commerce.wi.gov/sb/
J www.wisconsin.gov
9~d S /`Lw
Scott Walker, Governor
A~O~'SSfON P~ Sti
Dave Ross, Secretary
October 27, 2011
CUST ID No. 220853 ATTN: POWTS Inspector
DALE E HUDSON
BOLDT'S PLUMBING & HEATING, INC. ZONING OFFICE
820 MAIN ST ST CROIX COUNTY SPIA
PO BOX 78 1101 CARMICHAEL RD
BALDWIN WI 54002 HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 10/27/2013
SITE: Identification Numbers
Lindquist Family Limited Partnership Transaction ID No. 2010708
1652 US Hwy 12 Site ID No. 773325
Town of Hammond Please refer to both identification numbers,
St Croix County above, in all correspondence with the agency.
SE1/4, SW1/4, S17, T29N, R17W
FOR:
Description: Commercial Mound System / 9% slope
Object Type: POWTS Component Manual Regulated Object ID No.: 1342314
Maintenance required; 150 GPD Flow rate; 36 in Soil minimum depth to limiting factor from original grade; System(s):
Mound Component Manual - Version 2.0, SBD-10691-P (N.01101), Pressure Distribution Component Manual - Version
2.0, SBD-10706-P (N.01101); Commercial System, Effluent Filter
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed
and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. PRIVATE EV
The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code ~ •
requirements.
No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06,
stats. tl F
The following conditions shall be met during construction or installation and prior to occupancy or use: CI'VISION Of SAFI
Reminders
• A sanitary permit must be obtained from the county where this project is located in accordance with they
requirements of Sec. 145.135 and 145.19, Wis. Stats.
• Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with
the designated county official in accordance with the provisions of See. 145.20(2)(d), Wis. Stats.
• A state approved effluent filter is required. Maintenance information must be given to the owner of the tank
explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided
per Comm 84 product approval conditions.
• The area within 15' downslope of the dispersal cell shall remain undisturbed. Vehicular traffic, excavation or
soil compaction is prohibited in this area.
• A copy of the_pproved 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.
DALE E HUDSON Page 2 10/27/2011
Owner Responsibilities:
• The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating
to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and
maintenance manual and/or owner's manual for the POWTS described in this approval.
• 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).
• 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. In the event this soil absorption system or any of its
component parts malfunctions so as to create a health hazard, the property owner must follow the contingency
plan as described in the approved plans.
• The owner is responsible for submitting a maintenance verification report acceptable to the county for
maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized
in the POWTS.
In granting this approval the Division of 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
6~" 4YZ
Balance Due $ 0.00
Gerard M Swim
POWTS Plan Reviewer, Integrated Services
(608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633
jerry.swim@wisconsin.gov
DALE E HUDSON Page 2 10/2712011
Owner Responsibilities:
• The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating
to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and
maintenance manual and/or owner's manual for the POWTS described in this approval.
• 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).
• A POWTS that is not maintained in accordance witli the approved management plan or as required under s.
Comm 83.54(4) shall be considered a human health hazard. In the event this soil absorption system or any of its
component parts malfunctions so as to create a health hazard, the property owner must follow the contingency
plan as described in the approved plans.
• The owner is responsible for submitting a maintenance verification report acceptable to the county for
maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized
in the POWTS.
In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should
conditions arise making them necessary for code compliance. t~s 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
Gerard M Swim
POWTS Plan Reviewer, Integrated Services
(608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633
j eny.swim@wisconsin.gov
MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN
Commercial Application F-CEIVED
INDEX AND TITLE PAGE
OCT 13 2011
Project Name: Lindquist Family Limited Partnership Mound & BUILDING,`
Owner's Name: Lindquist Family Limited Partnership
Owner's Address: 1652 US Hwy 12
Hammond, WI 54015
Site Address: Same
Legal Description: SW1/4 SE/4, Sec.17, T.29N., R.17W.
Township: Hammond
County: St. Croix
Subdivision Name: Na fkGE SYSTEM
'Or? t7l
Lot Number: Na Block Number: Na,
Parcel I.D. Number: 018-1038-10-050
Plan Transaction No.: y AND BUILDINGS
Page 1 Index and title •
Page 2 Data entry Page 3 Mound drawings 'F OIDI=NCE
Page 4 Lateral and dose tank
Page 5 System maintenance specifications
Page 6 Management and contingency plan
Page 7 Pump curve and specifications
Page 8 Site Plan
Page 9 Daily Flow Calculations
Page 10 Attached Soil Evaluation Report
Designer: Dale Hudson License Number: 220853
Date: 10/03/11 Phone Number: (715) 684-3378
Signs ure: .
Designed Pursuant to the
Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and both
SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01181) and
Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01)
Version 5.1 (R. 06/06) Pagel of 10
Mound and Pressure Distribution Component Design
Design Worksheet
Site Information
(R or C) 4(_- C Residential or Commercial Design Note: Sand fill (D) calculations assume a
100.00 Estimated Wastewater Flow (gpd) Table 83-44-3 in-situ soil treatment for
r
l 1.50 Peaking Factor (e.g. 1.5 = 150%) fecal coliform of 36 inches.
150.00 Design Flow (gpd)
9.00 Site Slope
97.50 Contour Line Elevation (ft)
36.00 Depth to Limiting Factor (in)
0.601 In-situ Soil Application Rate (gpd/ft2)
Distribution Cell Information
V 40.00 Dispersal Cell Length Along Contour (ft) = 5.00 Cell Width (ft)
0.75; Dispersal Cell Design Loading Rate (gpd/ft2)
Influent Wastewater (duality (1 or 2) Are the laterals thehighest point
in the distribution ! Y
Pressure Disribution Information network? Enter Y or N
(C or E) - E I Center or End Manifold
2.50 Lateral Spacing (ft) If N above, enter the elevation (ft)
2 Number of Laterals of the highest point.
_ 0.125 Orifice Diameter
_ 1.50 Estimated Orifice 1" pacing (ft) = 3.85 ft2/orifice
1.50; Forcemain Dian c«er (in)
40.001 Forcemain Length (ft) Does the forcemain drain back? - J
91.001 Pump Tank Elevation (ft) Enter Y or N
6.50 System Head (ft) x .3 3.67 Forcemain Drainback (gal)
6.50 Vertical Lift (ft) 24.53 5x Void Volume (gal)
1.69 Friction Loss (ft) 28.20 Minimum Dose Volume (gal)
0.00; In-line Filter Loss ii t) 21.42 System Demand (gpm)
14.69 Total Dynamic HE, 1 (ft)
Lateral Diameter Selectio Manifold Diameter Selection
in. dia. options choice in. dia. options choice
0.75 1.25 x x
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 501.84 Total Tank Capacity (gal)
1000.00; Septic Tank Capa,4 (gal) - 51.001 Total Working Liquid Depth (in)
'Wieser Concrete %Manuf<, t"rer 9.84 gal/in (enter result in cell B49)
_ _
Dose Tank Information Effluent Filter Information
501.841 Dose Tank Capaci'.; (gal) Poly Lok !Filter Manufacturer
9.84' Dose Tank Volun; (c,al/in) PL-525 Filter Model Number
Wieser Concrete Manufc,curer
Project: Lindquist Family Limited Partn ;iship Mound Page 2 of 10
Mound Plan and Cross Section Views
t
J
1/10 B Observation Pipe
:r T
K
A
i
5
I
:.Q:::...:.:.:
L
Mound Component Dimensions
ft
A 5.00 ft E 11.40 in H [Aft ft K Aft
B 40.00 ft F 9.25 in 1 ft L ft
D 6.00 in G 0.50 ft J W 200.00 (ftz) Dispersal Cell Area 565.07 (ftz) Basal Area Available
3.75 (gpd/ft) Linear Loading Rate 4.00 (ft) 1/10 B Obs. Pipe Placement
Mound Cross Section View
Aggregate Dispersal Area
Finished Grade 99.77 (ft) -
♦ H
G j
(ft) Lateral
I F Dispersal Cell 98 50
98.00 (ft) - Invert
Dispersal Cell
E :D . Q:
Elevation • .
<4{ '
.t
~.s
G
J A 4_
VC t.l AI ❑
97.50 (ft) Contour Elevation
9.0 % Site Slope
-fir- Geotextile Fabric Cover
Shading Key a I Dispersal Cell See lateral details on
1❑ ®Topsoil Cap o a 1.5 ft Page 4 for number, size,
and spacing of laterals.
Subsoil Ca o
❑ ® p :
ASTM C33 Sand Laterals are equally
m f0 ~ F
spaced from the
Tilled Layer N 0.5 ft Typical Lateral distribution cell's
Aggregate v o . centerline in the
A.--~ distribution cell (Ax6).
Project: Lindquist Family Limited Partnership Mound Page 3 of 10
End Connection Lateral Layout Diagram
Laterals center" Ovtr the A& B dimension Turn-up r`i ball valvvor oloancutplug t
P
All laterals are identical Ir X I Holes dial+d on the bottom of the lateral S
equally spaced
Fotco man eomoctton via too a cross to maniloW at any point.
Latet aIS & loroe main of {7YC Sch 40
(per COMM Table 84.30-51
Number of Laterals 2 Orifice Diameter 0.125 in
Lateral Diameter 1.25 in Orifice Spacing (X) 1.54 ft
Lateral Length (P) 38.50 ft Orifices per Lateral 26
Lateral Spacing (S) 2.50 ft Orifice Density 3.85 ftz/orifice
ft
Lateral Flow Rate 10.71 gpm Manifold Length LAft/sec
System Flow Rate 21.42 gpm Manifold Diameter in
Total Dynamic Head 14.69 ft Forcemain Velocity Dose Tank Information Locking cover with warning
label and locking device and
sealed watertight
Electrical as per NEC 300 and
Comm 16.28 WAC 4 in. min.
Disconnect
Tank component is properly vented \ F- Alternate outlet
location
Forcemain diameter
Wieser Concrete Manufacturer 1.5 in.
Capacityl 501.84 Gallons T
Volume 9.84 gal/inch A
Weep hole or anti-
Dimension Inches Gallons B siphon device
A 34.13 335.88 C
B 2.00 19.68 ~ P♦ ump off elevation (ft)
C 2.87 28.20 92.00
D 12.00 118.08 D
Total 51.00 501.84
Dom se tank elevation (ft)
Bedding un er tank. 91.00
Alarm Manuafacturer SJE Rhombus
Alarm Model Number Tank Alert SJE1011421
Pump Manufacturer Goulds
Pump Model Number EP04
Pump Must Deliver 21.42 gpm at 14.69 ft TDH
Project: Lindquist Family Limited Partnership Mound Page 4 of 10
Mound System Mains nance and Operation Specifications
Service Provider's Name )ale Hudson Phone (715) 684-3378
POWTS Regulator's Name St. Croix County Zoning Dep't. Phone (715) 386-4680'
Systen I low and Load Parameters
Design Flow - Peak 150 3;,d Maximum Influent Particle Size 1/8 in
Estimated Flow - Average 100 -',)I J Maximum BOD5 220 mg/L
Septic Tank Capacity 1000 -11 Maximum TSS 150 mg/L
Soil Absorption Component Size 200 I t" Maximum FOG 30 mg/L
Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL
ervice Frequency
Septic and Pump Tank is ect and/or service once eve 3 ears
Effluent Filter Sh i inspect and clean at least once eve 3 ears
Pump and Controls Test once eve 3 ears
Alarm Should test month)
Pressure System Laterals Ad be flushed and pre sure tested eve 1.5 ears
Mound InE t for ponding and seepage once every 3 years
Miscellaneous truction and Materials Standards
1. Observation pipes are slotted and mats conform to Table Comm 84.30-1, have a watertight cap,
and are secured in as shown in the me,. : omponent manual.
2. Dispersal cell aggregate conforms to C 84.30 (6)(i), Wis. Adm. Code.
3. All gravity and pressure piping materia' iform to the requirements in Comm 84, Wis. Adm. Code.
4. Tillage of the basal area is accomplish, !h a mold board or chisel plow.
5. The mound structure and other disturbs eas will be seeded and mulched to prevent soil erosion
and help reduce frost penetration.
eral Turn-up Detail
Finished
Grade
6-8" Diameter Lawn Threaded Cleanout
Sprinkler Valve Box Plug or Ball Valve
Distribution
Long Sweep 90 or Two
45 Degree Bends Same
Diameter as Lateral
Project: Lindquist Family Limited Partner Mound Page 5 of 10
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), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N.
01/01)] 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, 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 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
fiter 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
Sank. 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 BOD5, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30
mg/L BOD5, 30 mg/L TSS, 10 mg/L FOG, and 104 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.
Continsiencv 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 location by increasing basal area if toe leakage occurs or by removing biologically clogged 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.
Pretreatment Units
The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection
units are attached as separate documents and are considered part of the overall management plan for this system.
Project: Page 6 of 10
GOULDS PUMPS Submersible
Effluent Pump
a EP04
3871 EP05
it
APPLICATIONS • Fully submerged in high ■ EP05 Impeller: Thermoplas- ■ Bearings: Upper and lower
grade turbine oil for tic enclosed design for heavy duty ball bearing
Specifically designed for the lubrication and efficient improved performance. construction.
following uses:
• Effluent systems heat transfer. ■ Casing and Base: Rugged
• Homes Available for automatic and thermoplastic design provides AGENCY LISTING
• Farms manual operation. Auto- superior strength and corrosion $P Canadian Standards Association
• Heavy duty sump matic models include resistance.
• Water transfer Mechanical Float Switch ■ Motor Housing: Cast iron
• Dewatering assembled and preset at the for efficient heat transfer, Goulds Pumps is ISO 9001 Registered.
factory. strength, and durability.
SPECIFICATIONS ■ Motor Cover: Thermoplastic
FEATURES cover with integral handle and
• Solids handling capability: float switch artachrnent points.
i maximum. ■ EP04 Impeller: Thermoplas- N Power Cable: Severe duty
• Capacities: up to 60 GPM. tic Semi-open design with rated oil and water resistant.
• Total heads: up to 31 feet. pump out vanes for mechanical
• Discharge size: 1'/.-" NPT. sea! protection.
• Mechanical seal: carbon-
rota ryrcera uric-stationary,
BUNA-N e!astomers.
• Temperature:
10'-F (40`C) continuous
140=F i,60 C) intermittent. METERS FEET
to-
• Fasteners: 300 series
stainless steel.
9 30 ►j I 1 S GPM
• Capable of running ~J
dry without damage to $ t-_2_s1Fr
components. 25
Q 7
Motor =
• EP04 Single phase: 0.4 HP, 6 20
1 or 230 V, 60 Hz, 1550
RPM, built in overload with Z 5
automatic reset. ~Q 4 EPOS
• EP05 Sing!e phase: 0.5 HP, a
115 V or 230V, 60 Hz, 1550
3 10
RPM, built in overload with EP04
automatic reset. 2
• Power cord: 10 foot 5 37p.m. t Qcu.4-P,5 y e
standard length, 16/3 1
SJTOkA! with three prong L.
grounding plug. Optional 20 0 00 e 20, 30 40 50 GPM
foot length; 16/3 SJTW with ~~~y°~'1•~~ s,,Iy -e-W
three prong grounding plug o 4 6 10 L I/ 12 miih
standard on EP05).
CAPACITY
Goulds Pumps
20c2GouluSPumps ITT Industries
Effectve September, 2002
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Daily Design Flow Calculations
JOB DESCRIPTION: Existing Agricultural production operation adding restroom facilities within existing
building for daily employee use, three (3) employees maximum per owner. Dispersal cell area to be increased to
maximize efficient use of available system area.
Design Flow Calculations
Total Daily Design flow: (64.00 Gpd daily flow)(1.5 conversion factor) = 96.00 Gpd
(3 employees) (13gal. per apartment) = 39.00 Gpd
(1 floor drain)(25 gal./drain) = 25.00 Gpd
Daily wastewater flow = 64.00 Gpd
Pg. 9 ofl 0
Jul-29-2011 11:25 AM 5t. Croix County Plan/Zoning 715-386-4686 1/21
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer
Mailing Address / G~ ~Z l/✓. J ~f.~ Y - /
Property Address
(Verification required from Planning & Zoning Department for new construction.)
City/State Iv/n o Parcel Identification Number 018 LEGAL DESCRIPTION
Property Location Tar- V. , V. , Sec. T ~N R~W, Town of
Subdivision Plat; ,Lot #
Certified Survey Map Volume , Page
Warranty)) eed (before 2007)Volume , Page
Spec house 17 yes)(no Lot lines identifiable)(yes ❑ no
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Praper
maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put 1111+
the system can affect the fltnction of the septic tank as a treatment stage in the waste disposal system. Owner maintenance
responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance.
The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed liy tlik
owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site
wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is
less than 113 full of sludge.
I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with thu
standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin.
Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning iL
Zoning Department within 30 days of the three year expiration date.
Ywe certify that all statements on this form are true to the best of my/our knowledge. I/we am/are the owner(s) ul'the
property described above, by virtue of a warranty deed recorded in Register of Deeds Office.
Number of bedrooms
mvu
SZ T F A PLICANT(S) DATE
***Any information that Is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department,
Include with this application a recorded warranty deed kom the Register of Deeds Office and a copy of the certified survec map it'
reference is made in the warranty deed,
(REV. 09/07)
vo.1734PA(;E 283
STATE BAR OF WISCONSIN FORM 3 - 1999 6S$5$ 1
QUIT CLAIM DEED KATHLEEN H. WALSH
REGISTER OF DEEDS
Document Number ::1I CROIX CO. , WI
This Deed, made between Roger E. Lindquist and June L. RECEIVED FOR RECORD
Lindquist, husband and wife
10-03-2001 9:30 AM
QUIT CLAIM DEED
Grantor, and Roger & June Lindquist Family Limited Partnership EXEMPT M 15M
CERT COPY FEE:
COPY FEE:
TRANSFER FEE:
RECORDING FEE: 13.00
PAGES: 2
Grantee.
Grantor, quit claims to Grantee the following described real estate in
St. Croix County, State of Wisconsin:
Recordin Area
Name Bud Return Address
Roger and June Lindquist
See legal description attached Rural Route /4--s- s~cc~ t~ i v
Hammond, WI 54015
018-1037-70-000
n1 A-1 017-Rf)-()()t7
Parcel Identification Number (PIN)
Thisis not homestead property.
*j*) (is not)
018-1038-10-000
018-1037-90-000
Together with all appurtenant rights, title and interests.
Dated this V4 day of ~t_~4L1 2001
Z
. Roge . Lindquist
a ,
s J e L. Lindquist
V
AUTHENTICATION yf ACKNOWLEDGMENT
STATE OF ftweso t.
Signature(s) ) as.
('.j Ask ita~~- County. )
Per ally came before me this day of
authenticated this day of , 2001 the above named
Roger 7l. Lin uist and June L. Lindquist, husband
and wife
TITLE: MEMBER STATE BAR OF WISCONSIN
([f not, to me known to be the person(s) who executed the foregoing
instrument a ttr6wledge the same.
authorized by § 706.06, Wis. Slats.)
THIS INSTRUMENT WAS DRAFTED BY
Dwight P. Cummins ' I~G✓. f' Cv . s . t+ i ar
363 Sth Avenue North, Bayport, MIN 55003 Notary Public, State of
(Signatures may be authenticated or acknowledged. Both are not My Com of state ex if8tlon ate:
necessary.) )
NNE80?A
'Names of persons signing in any capacity should be typed or printed below their Signatures MpCosr0*610EaII JNL31.2005
WISCONSIN
QUIT CLAIM DEED STATE BAR OP
FORM N..3 - Is*$
INFORMATION PROFESSIONALS COMPANY POND DU LAC. Wt $00-655-2021
voi. 1734 PAGE 284
The Southwest Quarter (SW 1/4) of Section 17, Township 29 North, Range 17 West
EXCEPT part to State of Wisconsin in Volume "584" page 104, and
EXCEPT : Beginning at a point on the South line of said Section 17, 77 rods East of the
Southwest corner of the Southwest Quarter of the Southwest Quarter (SW 1/4 SW 1/4) of said
Section 17; thence along the south line of said Section 17 a distance of 24 rods; thence North
parallel to the East section line of said Section 17, 28 rods; thence West parallel to the South line
of said Section 17, 24 rods; thence South to the point of beginning, containing 4.50 acres, more
or less, and
EXCEPT : Part of Southwest Quarter of Section 17, Township 29 North, Range 17 West,
described as follows: Commencing at southeast corner of said Southwest Quarter; thence north
on quarter section line 460 feet; thence west parallel to south section line 323 feet to POINT OF
BEGINNING; thence west parallel with south section line 150 feet; thence south parallel to east
section line 460 feet to south section line; thence east on south section line 150 feet; thence north
parallel to east section line 460 feet to point of beginning. Containing 1.6 acres, more or less,
and
EXCEPT: Part of the Southwest 1/4 of Southwest 1/4 of Section 17, Township 29, Range 17
described as follows: Lot 1 of Certified Survey Map filed February 19, 1985 in Volume "6",
page 1506, and
EXCEPT: Lot 2 of Certified Survey Map filed July 26, 2000, in Volume 14 of Certified Survey
Map, page 3919, as Document No. 627235, being located in part of the Southwest 1/4 of the
Southwest 1/4 of Section 17, Township 29 north, Range 17 West, Town of Hammond, St. Croix
County, Wisconsin, and
EXCEPT: Lot 3 of Certified Survey Map filed January 31, 2001 in Vol. 14 of Certified Survey
Maps, Page 4025, as Document No. 637762, located in part of the Southwest I/4 of the
Southwest 1/4 of Section 17, Township 29 North, Range 17 West, Town of Hammond, St. Croix
County, Wisconsin.
- I
2266
Wisconsin Dep ment mmerce SOIL EVALUATION REPORT Page 1 of 3
Division of Safe and Buildings Q 41 acco ance with Comm 85, Wis. A Code A.C.E. Soil & Site Evaluations
~f 4 n nb
Attach com to site 116a paper no inches in size. Plan m St. Croix
include, but t limited to:n point (BM), direction an
percent slope, tale or tfrile ufy1~ and location and distance to nearest arcel I.D.
18-1038-10-050
P print all information. viewed Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).
Property Owner Property Location
Lindquist Family Limited Partnership Govt Lot SE 1/4 SW 1/4 S 17 T 29 N R 17 W
Property Owner's Mailing Address Lot # Block # S ame or CSM#
1652 Hwy. 12 Na Na
City State Zip Code Phone Number _J City _J Village y Town Nearest Road
Hammond WI 54015 715-796-5696 Hammond US Hwy 12
9*01 New Construction Use: J Residential / Number of bedrooms Code derived design flow rate 39 GPD
_f Replacement i001 Public or commercial - Describe:Em to ee restroom - farm facility Paie~eF . l
Parent material loess over weathered sandstone Flood plain elevation, if applicable Na
General comments
and recommendations: Site suitable for Mound or At-grade POWTS placed on 97.50' contour.
Boring # I Boring
II Pit Ground Surface elev. 98.16 ft. Depth to limiting factor 38" in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft'
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-5 1Oyr3/2 none sil 2fgr ds cs 2vf,f 0.6 0.8
2 5-24 1Oyr3/4 none sit 2fsbk dsh gs 2vf,fm 0.6 0.8
3 24-34 1Oyr4/4 none sit 2msbk dsh cw 1vf 0.6 1.0
4 34-38 1Oyr5/8 none ifs Osg dl cw - 0.7 1.6
5 38-51 1Oyr6/8 m2p 7.5yr5/8 fs Osg dl - - 0.7 1.6
Boring # J Boring
0 Pit Ground Surface elev. 96.53 ft. Depth to limiting factor 44" in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft'
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-5 1Oyr3/2 none sit 2fgr ds cs 2fm1c 0.6 0.8
2 5-12 1Oyr3/4 none sit 2fsbk dsh gs 2fm1c 0.6 0.8
3 12-38 1 Oyr4/4 none sit 2msbk dsh cw 2fl me 0.6 1.0
4 38-44 1Oyr5/8 none ifs Osg dl cw 1vf,f 0.7 1.6
5 44-64 1Oyr6/8 m2p 7.5yr5/8 fs Osg dl - - 0.7 1.6
* Effluent #1 = BOD5> 30 < 220 mg/L an TSS >30 < 1 mg/L ffluent #2 = BOD5 <_30 mg/L and TSS <.30 mg/L
CST Name (Please Print) Signature CST Number
James K. Thompson 3602
Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number
340 Paulson Lake Lane, Osceola, W154020 9/30/2011 715-248-7767
r
Property Owner Lindquist Family Limited Parcel ID # 018-1038-10-050 Page 2 of 3
3 ]Boring # J Boring
96.42 ft. Depth to limiting factor 36" in.
liel Pit Ground Surface elev. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots D
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-9 10yr3/2 none sil 2fgr ds cs 2fm1c 0.6 0.8
2 9-18 10yr4/6 none sl 2fsbk dsh gs 2fmc 0.6 1.0
3 18-26 10yr4/4 none Ifs Osg dl gw, 3f1 me 0.5 1.0
4 26-36 10yr7/6 none fs Osg dl cw 1fm 0.7 1.6
r 5 36-54 10yr7/6 m3p 7.5yr5/8 fs Osg dl - - 0.7 1.6
F-1 Boring # J Boring
J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fe
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
❑ Boring # I Boring
J Pit Ground Surface elev. ft. Depth to limiting factor in. Sod Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
* Effluent #1 = BOD5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS <_30 mg/L and TSS <30 mg/L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
SBD-8330 (R.07100) A.C.E. Soil & Site Evaluations
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1 1 OF 1
Parcel 018-1038-10-050 10/31/2011 PAGE E 01:00 PM
F 1
Alt. Parcel 17.29.17.268A-10 018 - TOWN OF HAMMOND
ST. CROIX COUNTY, WISCONSIN
Current ❑
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
O- LINDQUIST FAMILY LIMITED PARTNERSHIP, ROGER & JL
ROGER & JUNE LINDQUIST FAMILY LIMITED PARTNERSHIP
1652 HWY 12
HAMMOND WI 54015
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description * 1652 HWY 12
SC 2422 SCH D ST CROIX CENTRAL
SP 1700 WITC
Legal Description: Acres: 34.218 Plat: N/A-NOT AVAILABLE
SEC 17 T29N R1 7W 34.54 AC SE SW EXC W 21 Block/Condo Bldg:
RDS OF S 28 RDS & EXC W 150 FT OF E 473
FT OF THE S 460 FT FKA(238A) 018-1038-10 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
EXC PT DESC IN WD-1626/542 17-29N-17W SE SW
Notes: Parcel History:
Date Doc # Vol/Page Type
10/09/2001 658581 1734/283 QC
04/27/2001 643884 1626/542 WD
2011 SUMMARY Bill Fair Market Value: Assessed with:
Use Value Assessment
Valuations: Last Changed: 07/01/2011
Description Class Acres Land Improve Total State Reason
AGRICULTURAL G4 28.718 7,500 0 7,500 NO 05
UNDEVELOPED G5 0.500 50 0 50 NO
AGRICULTURAL FOREST G5M 2.000 4,000 0 4,000 NO
OTHER G7 3.000 21,000 122,700 143,700 NO
Totals for 2011:
General Property 34.218 32,550 122,700 155,250
Woodland 0.000 0 0
Totals for 2010:
General Property 34.218 31,350 122,700 154,050
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00