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Home My WebLink About002-1082-10-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Saf,' and BuiilSing 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)]. 'ermit Holder's Name: City Village X Township Delon ,Steve & Maxine Baldwin, Town of :ST BM Elev: Insp. [~M Elev: BM Descripti n: TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~ ~ O Dosing ~ V ~itl ~" "' ~-} ~ ~ v v Aeration ~ ' a ~ '/ Y Holdin TANK SETBACK INFORMATION TANK TO P/ ~. ~4 WELL BLDG. Vent tc Air Intake ROAD Septic Dosing ~ > (r_~/ 0 Aeration Holding i~I1t1BP/SIPHON INFORMATION Manufacturer ~ Demand GPM Model Number ~ G ~ ~~ 0 TDH Lift (P' / iS Friction Loss t System~Heard / 5 TDH •~ Ft Forcemain Len ~ Dia. 2 " Dist. to Well ~ 2 UD' ELEVATION DATA county: St. Croix Sanitary Permit No 506205 0 State Plan ID No: Parcel Tax No: 002-1082-10-000 Section/Town/Range/Map No: 33.29.16.481 A STATION L T BS HI ,~ ~ FS a, o ELEV. oo. o Benrhmark~~ / . ~~ Y ~7a / 7 /OQ --CJ Alt. BM ~--" Bldg. Sewer U~, ~ ~ ~ Q`. r St/Ht Inlet I~, ~~ ~.o ya9 St/Ht Outlet ~, _-^ Y Dt Inlet p ~. ~.~-- Dt BotB~„ ~ ? ~ $ 3 Header an. y. yS.y~ Dist. Pipe . ~ ys Bot. System ~ 75 ~ s: s 9 Final Grade ~' St Cover r/ ~~ 7t ~ Z q / ~• ~. ~ 93. f ~~ ~ .. ~. w r.ealn nTlll\1 QVCTC1111 ~ A w / .dl l~ _ / /~ .. ~ _i BED/TRENCH DIMENSIONS Width ~ , Length No,10f Trenc es ..~~ PI DIMENSIONS / No. Of Pits Inside Dia. Liquid Depth SETBACK SYSTEM TG P/L BLDG WELL LAKE/STREAM L C G CHA R OR Manufacturer: i R INFORMATION Typ O System: ~~ / , I ~~1 ~ ~/ ~ Model Number: ~ n1~TRIRI1TIfl1U SVCTFM .I/. /I/,»_ I ~ 7 Header/ anifol N Distribution / ~ x Hole Size x Hole Spacing Ven~A~lnta e~~ ~ ~ Pipe(s) /' acin ~' / ~ ~ "~ S th ~ ~'~ Di L C ~ J - Lenyth Dia g p a eng / _ t~ CP\11 /^fl\/CO __ r.____..__ c•.._a_..._.. ~_i.. / ..., ee...... r1 Ylr A4_Rr~rln Svc4amc Only Depth Over t /T h C Depth Over Bed/Trench Ed es xx Depth of , `/ Topsoil ~l/w' xx Seeded/Sodded ~ ' xx Mulched Y er renc en Bed g ~ ; Yes ~ NO es ~„ / ~ COMMENTS: (Include code discrepencies, persons present, etc.) Inspectio~i ~~~^~/ ~ `'~//r~~~ Inspection #2:~If~/~_/ Location: 2393 Highway 12 Baldwi ,~ 154002 (NE 1/4 NE 1/4 33 T29N R16W) NA~Lpot~ ~~C Parcel No: 33.29.16.481~q 1.) Alt BM Description = ~~ ~~ L ~ ~" "" ~'•~ ~~ ~~"' ~ ~~4,~ 2.) Bldg sewer length = I ~ ~ / W/ ~ _ , y ~ y~ / ' ~ ~~ /~ b ~,~~ /~~ IH 0 ~, 33 amount of cover = 0~1 / ` 6~~~~(C„ ~Q,,,~~0 ~ ~ ~/~~.dc+~ - --- ----------- __ _ ----r- Plan revision Required? Yes No I ~ [~j~ ~ I ~ C ! ~ (i (~ ~~,~ ~ ' Use other side for additional information. ~ ~ ~ I v ~ ~ ~1' ~~~ ~~" - J L__~___1~:~ Date Insepctor's Si ature Cert. No. / SBD-6710 (R.3/97) cotnn't~rce.NtigoY Safety and Bu[7diags Division Co[mty ~~ C ~° t \ Y .201 W. Washington Ave., P.O. Box 7162 Madison, WI 5370 1to~ is by Co.) Sanrmry ~~ oc Sanitary Permit Application S'~ ~ [n accordance with s. Comm. 83.2 t{2), Wis. Adm. Code, wbmissiort of this form to the go (~ 2 ~ ~ G~J unit is required prior to obtaining a sanitary permit. Note: Application for[r~s for state-o PO aax A Tess tfdi oma[lingaddress) submi[ted to the Deparurrent of Commerce. Personal information you provide may be used ses in aowrdanoe with the Pri Law s. I5. 1 m Slats. %~ ~~ 93 " L A ticstion Information -Please Print All Information ~ Property Owner's Name - Ste ~ ~ f ~ ~ d? ' lit -/d L~J ~~ ~ %U ~~ v ~ . ` .~„ ! ,4 , ~ r, - - Property Owner's Mailing Address ' ~ ° ~ Location ~~~~_~ ~ r ~ ~~ 3 ~ ~- ~rs . ~ City , Stage Zip Code Number ~ '„ ~ y. Sectim ~~ ] , i,/`'T 1 j;1 (~ ~,~' j' ~f G~ 0 ~` - ~ , T ~ N R lG cc ~a W IL T f B , ype o uilding (check aH that :PPIy) ~ # ~ 1 Family [~..~dling - Nu.ntrr of __ _ - Subdivision Name -- -- - ~ ~' S ~~s{ / Block # ^ PubliclCommercial -Describe Use r ~_ ^ City of ^ State Owned -Describe Use CSM Number ^ Village of ~__ ~" ®Town of / 3 ; t ! C1 ~/ c //j III. T ype of Permlt: ( A. Complete line 8 if app6cabte) `+" ^ New System ~ltephacettrent System TreatmendHolding Tank Replt Only ~ Other Modification to Et[isting Sysmn (explain) B. ^ Permit Iteaewal ^ C6aage of Ph[mber ^ Permit Tratuferto New List Ptevioua Permit Ntmtber and Date Itsued . Before Expiration I t tV. T of POW1S S m/Com aeat/DevleG Check aH that 0 Non-Ptessvrized In-C,mu[d 0 Pressurised In-Ground ~ At-Grade ^ Mound > 24 ia. ofsuitabk ~~Mound < 24 is ofsuitabte soil f ^ Holding Tank 0 Other Dispersal Comporuxtt (expl ') [~ Pretreatrnent ex n / V. D' reatmentArealnformation: Design Fbw jgpd) Design Soil Appli ~ ~ ~ ~ 1 Dispersal trod fst1. KG Z - Dispersal Area fsfl Lis-cam S ~ Cl , ! ` ~ S . . s ~/ o~ r Y .Tank fo Caparaty in T 1 # of / Galhws Gallons Units ,$ g v New r>a~ FYw;aa rada E 3 ~ ~ ~ w O a c SeptrcorHaldioaraak ~~ c2' ~ ~~` CSC __ ._ YII. attsibt'tity Statement I, tht aadersigned, respons for installation of the POVIrI'S shows oa the attached plans. Plumber's Name (Print) PI Signature P1LS Number Busit-ess Pbone Number Plumber's Address (Sweet, City, Zip Code) ~', ~ ~ /~~ ~~' ~~ ~ ~u ~ `I ~~ 4.i,~ spa-~-~ VIII. ` an t Use O ~~ O ~ Permit Fee ~ Dau ISSUmB Alters ~ - ^ Owner Given Reason for Denial Approval/Reasons for Disappro 7 ,s !~ ~C~~~ ~~~~_ ~~ 9 ! c n ~e ~ / ~ ) ent filter and k, eff tic ta S p dispersal cell must all be serviced / maintaine ~~----~~j ~~~-~ ~(~.ST ~~~ / ~~~/ as per management plan provided by plumber. ,~ ~~ ~ / ~~6~ . ~~ All setback requirements must be maintained (~.~tiu'~ 2U~/i'' ~ "~G ~~ ,'[iKG ~. plans for [re system subart [re coaaty oely a. paper not [!aa•~'t/2 = t t ~~ `~~~-""` G,L. ~~~ ,~%~ ssn-639a (~. olro7y vaa~ta olro9 S~'1i~~ ~'1,~,~,c~ Gt~~ C~' ~ ~D ~t ~~ 1~- -~-~' ~ ~--~~ . '~ 3 '3 ~~ ~Q ~~~ /~-a~- ~ Cyr ~ ~~ D~ S~PV~? h ~ ~Q~r~-e ~e~'o~~ a3~ 3 U. s. H~ ~ 1-.~ ~ ~ ~ l 6J 1~~ N~`/y~ jV yy S 3 "~ T'N l b w ~ ~ ZowY, a-P 3 ~aw~~. -~baL-lo~~ - o - oa o ~'!3 /~ ~ rt CS ~~ ~~ -~- -~~ J3~c~ ~ ~,~ ,,., ~, , ~~~, ~ ~ ~~ a ~.~ a.: '3 '= ~ ~~ t ~ . ~~ ~" ~- d f ~.~ '~ S° T~ ~' 9 `~ 4? • !'Y1 ~n N r ~ ` ~. ~' `` X3-3 ~3tto `: t ,~V~ ~ ~~~ ~~~ ~ a~ ~ - ~~~~ ~ ~~ ~~o ~~pp ..nay ~eS ~ n3~ 'M ' 3 /1' ~p ,/~~ ® v11 f` I ' ~~ ' c11`~' . ~ ~ ~ ~ ~~ ~ ~~7y ~ Q3 ~` ,,.~ ~ J •~ '~' ..ate. ,v "~ ~ t k ~ ! SV fi `~ ~ ~ 4 ... ~ ~ ~ 1 5 V I ~ ~~~ n ._ _. _ _..~,._ . _~ ,. r -. _.._.___ _ _._ __-----_-___~_ ~ .~ ~ _. ~~__ _~ . _ __ ~.. ____ _.._--Y~.~ _ _._.. commerce.wi.gov isconsin Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LACROSSE WI 54601-1831 TDD #: (608) 264-8777 www. commerce.wi.g ov/sb/ www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary May 17, 2007 CUST ID No. 223475 JOE STANG STANG PLUMBING & ELECTRIC PO BOX 263 WOODVILLE WI 54028 ATTN.• POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/17/2009 Identification Numbers Transaction ID No. 1394983 SITE: Site ID No. 725265 Steven & Maxine Delong .Please refer to both identification numbers, United States Highway 12 above, in all corres ondehcewith the'a encv, Town of Baldwin St Croix County NE1/4, NE1/4, S33, T29N, R16W FOR: Description: Three Bedroom Mound System /Replacement construction Object Type: POWTS Component Manual Regulated Object ID No.: 1130881 Maintenance required; 450 GPD Flow rate; 15 in Soil minimum depth to limiting factor from original grade; System(s): " Mound Component Manual -Version 2:0, SBD-10691-P (N.O1/O1), Pressure Distribution Component Manual -Version 2.0, sBD=lo7o6-P (rl.ol/ol) The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the component manual(s) referenced above. • 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. Stats. • .Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • The area within 15 feet horizontally down slope of the dispersal cell shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • The existing POWTS shall be properly abandoned per Comm 83.33, Wis. Adm. Code. • 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. • Comm 83.22(7) - A copy of the approved plans, specifications and this letter shall be on-site during construction and oven to inspection by authorized representatives of the Department which may include local inspectors. p,Q .T.S. Coir ~ Ily e P1 JOE STANG Owner Responsibilities: Page 2 5/17/2007 • 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. • Comm 83.52(1)(a) -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). • 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. 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 maybe 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 to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, ~/ ti erard M Swim POWTS Plan Reviewer, Integrated Services (608)789-7892, Mon -Fri, 7:15 am - 4:00 pm j erry. swim@wisconsin.gov Fee Required $ 175..00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code:-7633' cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544 ,Friday, 7:00 A.M. To 3:30 P.M. ~~ MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN c~ ~ Residential Application ~ ~ INDEX AND TRLE PAGE Q' Q ~ Project Name: Delong Replacement Mound Ls. C~ Owners Name: Steven ~ Maxine DeLong Owners Address: 2392 U S HHry 12 Baldwin, YNisc. 54002 Legal Description: Township: County: . Subdivision Name: Lot Number. Parcel I.D. Number: Plan Transaction No.: NE 1/4, NE 1/4, S 33, T 29 N, R16W Baldwin St. Croix Block Number: 002-1082-10-000 Page 1 Index and title Page 2 Data entry Page 3 Mound drawings 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 Plot Plan Page 9 Soii Evaluation Report Designer. Jae Stang License Number. 223475 Date: 05/0 /07 Phone Number. 5715) 6$45166 Signature: ~ pesigned Pur3vArrt to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 011), and SSWMP Pubiicafion 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) Version 4.01 (R. 09/04) _, _ Page 1 of 9 ` IrQ~t M t~l ttr CiJNiWiLRCE a~{4 I '~ . a~l~~n A~tL1$t~l. tt~IGs 0{1i '~ hi +r ~ 1 ..~~. , SEE .; ; ~ ; ~`L ESPONU~NCf_ Mound and Pressure Distribution Component Design Design Worksheet Site Inform ation (r or c) R Residential or Commercial Design 400.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 =150°~) 600.00 Design Flow (gpd) 6.00 Site Slope (°h) 93.50 Contour Line Elevation (ft) 21.00 Depth to Limfing Factor (in) 0.40 In-situ Soil Application Rate (9Pd/ftz) Note: Sand fill (D) calculations assume a Table 83-44-3 in-situ soil trealme-~t for fecal oolifoim of ~= 36 inches. Distribution Cell Information 80.00 Dispersal Cetl Length Along Contour (ft) _ 1.00 Dispersal Cell Design Loading Rate (gpd/ft~) 1 influent Wastewater Quality (1 or 2) Pressure D~ribution ir>fonmation (c ore) a Center or End Manifold 3.7 Lateral Spacing (ft) Number of Laterals 0.156 Orifice Diameter (in) (e.g. 0.25) 3.00 Estimated Orifice Spacing (ft) _ 2.00 Fon~main Diameter (in) y'D 50.00 Fon~main Length (ft) 82.00 Pump Tank Elevation (ft) 4.55 System Head (ft) x 1.3 ~ , t ~ 12.67 Vertical Lift (ft) 0.91 Friction Loss (ft) 18.13 Total Dynamic Head (ft) Lateral Diameter Selection in. dia. o ~tions choice 0.75 ~~ 1.00 1.25 1.50 x x 2.00 x 3.00 x Treatment Tank Information 1000.00 Se tic Tank Capacity (gal) Wieser ~ Manufacturer 7.50 Cell Width (ft) Are the laterals the highest point in the distribution Y network? Enter Y or N If N above, enter the e~vation (ft) of the highest point. 11.11 ftzlorifice Does the forcemain drain back? Y Enter Y or N 8.16 Fon;emain Drainback (gat) 72.04 5x Void Volume (gal) 80.20 Minimum Dose Volume (gal) 29.08 System Demand (gpm) Manifold Diameter Selection in. dia. o lions choice 1.25 x 1.50 x x 2.00 3.00 Gallons/lnch Calculator (optional) 650.00 Total Tank Capacity (gal) 38.00 Total Working Liquid Depth (in) 17.11 gaUn (enter result in cell 649) Dose Tank Information Effluent Filter Information 650.00 Dose Tank Capacity (gal) Zabel Filter Manufacturer 17.11 Dose Tank Yolume (gauin) A100 Filter Model Number Wieser Manufacturer Project; DeLong Replacement Mound Page 2 of 9 Mound Plan View i- 1 J~ 10 B Observation Pipe Q ' . ~: t -+ _fi -1 L Mound Component Dimensions Down slo a toe extension made. A 7.50 ft E 20.40 in H 1.00 ft K 9.80 ft B 80.00 ft F 9.50 in z 11.25 ft L 99.60 ft D 15.00 in G 0.50 ft J 6.46 ft W 25.21 ft ~ C2 600.00 (ft2) Dispersal Cell Area 1500.00 (ftZ) Basal Area Available s~~' 7.50 {gpd/ft) Linear Loading Rate 8.00 (ft)1/10 B Obs. Pipe Placement rs~ (;tee .(~` Mound Cross Section View Aggregate Dispersal Area Finished Grade 96.54 (ft) . f»~~, F 94.75 (ft}--- - ~ : = Dispersal Cell ;~ Elevation ..f~,+ ii.... G ~ 1 H ffrJ~~}f 2 ~1~1~~~i:. iii{r. Diispeeisai Ceu 95.25 (ft) Lateral Invert D :~ ~ ... .- .- ..- ...... .. .. .. .~ ... .........:1 .. .. . .... . .....~ 6.0 °~ Site Slope Shading Key 10 . Topsoil Cap Q !~~{~ Subsoil Cap • ASTM C33 Sand Tilled Layer []5 =r::~~ Aggregate $. ~- Dispersal Cell °- 1.5 ft o ~ ~° Z 0.5 ft Typical Lateral ~~ ~ - ~ 0 5 I ~--- q *+ Project: DeLong Replacement Mound 50 (ft) Contour Elevation Geotextile Fabric Cover See lateral details on Page 4 for number, size, and sparing of laterals. Laterals are equally spaced from the distritwtion cell's centerline in the distribution cell (Ax6). Page 3 of 9 End Connection Lateral Layout Diagram center overtheAEc •=Turn-uprdl~Ii value oralsanoutplug J P Ag laterals arerdettticai (F X-~~ Floles ariled on d,e t-oteam of tle lateral ~ ~~spaced Farce main cor-rle~iolt via tee or rxo55 to mar>i<okl at .xrg paint. t.aterats of force main of PVC Sch 40 (per COMPA Ta61e B#.30-5j Number of Laterals Lateral Diameter 1. Lateral Length (P) 78. Lateral Spacing (S) 3. Lateral Flow Rate 14. System Fkwv Rate 29. Total Dynamic Head 18.1 2 Orifice Diameter 0 in Orifice Spacing (X) 2 ft Orfices per Lateral 5 ft Orifice Density 4 gpm Manifold Length 8 gpm Manifold Diameter 3 5 5 7 5 0 ft Forcemain Velocity Dose Tank Information Electrical as per NEC 300 and -~ Comm 16.28 WAC _~_ Disconnect Tank componern is properly verned Wieser Ca ac' 650.00 Volume 17.11 Manufacturer Gallons gaUnch Dimension Inches_ Gallons A 24.30 415.81 B 2.00 34.22 C 4.69 80.20 D 7.00 119.77 Total 37.99 650.40 _fi A B C D .1 3. 11.11 3.75 in Locking cover with warning label and lx~cing device and sealed watertight 4 in_ min. E-- A~emate outlet location Forcemain diameter ~ 2 in. weep hole or arlti- siphon device elevation (ft) 82.58 tank elevation (ft) 82.00 Alarm Manuafacturer SJE-Rhombus Controts _ Alarm Model Number Tank Alert 1 Pump Manufacturer Goulds Pump Model Number 03871 EP05 Pump Must Deliver 29.08 gpm at 18.13 ft TDH Project: DeLong Replacement Mound Page 4 of 9 Mound S~rsfiem Maini~enance and Operation Specifications Service Providers Name Joe Stan Phone 1-715-684-5166 POWTS Regulator's Name St. Croix Coun Zonin Phone 1-715-386-4680 Sv~+ Fbw and load Parameters Design Flow -Peak 600 gpd Maximum lrriiuent Pattide Size 1/8 in Estimated Fk~r -Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 flz Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Freauencv Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Other In andlor service once ev 3 rs Should ins and Dean at least once eve 3 rs Test once eve 3 ears Should test month Laterals should be flushed and ure tested a 1.5 ears Ins for nd'rn and once e 3 rs Mieceilaneous Construction and Mater3a~ Standards 1. Observation pipes are skrtted and materials conform th Table Comm 84.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggn~ate conforms th Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel pkrw. 5. The mound structure and other disturbed areas wHl be seeded and muk~ed do prevent soil erosion and help reduce frost penetration. Lateral Tunwp Detail Finished •..~~,......•. •~~~~~~~~~~~~~• Grade ~~ 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: DeLong Replacement Mound Page 5 of 9 Mound System Management Plan Purst,lartt ~ Comm 83.54, Wis. Adm. Cow Beepers! Th~ system shall be operated in aocordanoe with Comm 82-84 UVIs. Adm. Code, and shall mainlined in accordance with its' component manuals [BBD-10691-P (N.01l01) and SSVYMP Publication 9.6 (01/81)) and local or state rules pertaining to system mairrtenanoe and maintenance reporting. No one should ever enter a septic or pump tank Since dangerous gases may be Present that ccuk! cause death. Septic and pump tank abandonment shah be in accordance wNh Comm 83.33, Wyss. Adm. Code when ttte tanks are no longer used as POWts components. Septic or pump tank manhole risers, access r~s and covers should be inspected for water tightness and soundness. Access openings used for service and assmerrt shah be sealed watertight upon the completion ~ service. Arty openurg deemed uuound, defective, ~ subject to faNure must be replaced. Exposed access openings greater than 8-inctres in diameter shag be secured by an ef~tive kx~cmg device !n prevent acddentai a unauthorised entry into a tardc ~ corrrporrerrt. Septic TaMc The septic tank shad be maintained by our individual certified to servkoe septic tanks under s. 281.48, S'tats. The oonteMs of the septic tank snail be dkposed of kr aaoordance wNh NR 113, Wis. Adm. Code. The operating oorrditiwr of the septic tardc and outlet filer shah be assessed at I~st once every 3 years by inspection. The outict filter str~ be dearred as necessary to errstrre Pry operation. The fifer cartridge should Trot be rerrroved urtiess provisions are made to retain soils kr the tank that may skwgh off the 7iPoer when removed from Ns encbsure. tf the filter ~ equipped with an alarm, the fiNer shah be serviced if the alarm is adnrated aorrtdruoirsy. IriterrriNterit filter airems may itrdkute surge flows ~ an imperiling raontinuous alarm. The septic tank shah barns its corltetlfs removed when the voksrie of skrdge and scxuri in the tank exceeds 1/3 tiie liquid vohmie of the tardc. ff the c•Antents of the tank are not removed ~ the tirrie of a triennial assessment, n~iteriarioe persoririel shah advise the owner of when the next service needs to be pertonried to maintain lei than maximum scrap and skrdge accumuNitiori kt the tank. The addNion of biological or diemk;ai adder to erihar~e septic tank performatioe is gerieraNy not regtwed. Fkreever, if such products are used they stiaiN be approved f~ septic tayc use by the Deparbrient of Commerce. Pump TaMc The Pump (dosing) tank shah be inspected at least once every 3 years. M . alums, and pumps strati be tested to verify proper operation. tf an eifiuent fiNer is ~aNed within the tank fi shag be inspected and serviced as necwssary. mid and Pre~ure Distribution Svstam No trees or shrubs should be planted on the mound. PlariMigs maybe made around the mound's peririetar, and the mound shah be seeded arM muk~ied as necessary to prevent erosion and to Provide some protection from frost paietratiai. Traffic (other than far vegetative niairrterianoe) on the mound is not recorrttriended since soN Cori may hinder aeretiori of the kifNtrative surface witiiut the mound and snow t~tripadiort ~ the winker w~ Promote frost penetration. Cold Mr~ttier ir>:tioris (October-Febnrary) a timt the rrwund be heavNy nurkdied ~ protection frortt fireazing. IMluerit qualfiy Gtto the mound system may not exceed 220 mglL BODs, 150 mgA. TSS, and 30 nglL FOG for septic tank effiueM or 30 mglL BODs, 30 mg/L TSS,10 rrgA_ FOG, and 104 du/100 mL for highly tr+eaitecl effluent. Influent flow may not exceed maxirriimi design flow speccdfised in the permN for this ~mN~iori. The Pressure distritiirtiori systun is provided wr~li a t>ush®ig P'~t at the end ~ each hderal, acid k is reoorrsrieridedlhat each Feral be flushed of arxxuriul~ed solids at iimst orx~e every 18 months. VVtieri a pressue test is performed fi should be to thesiitiaii fiest wtu<r the system was to detemtine fi orifice dogging has ooqured and if orifice leaning is required to maintain equct d~tribution within the dispersal oeN. Obsennatiort pipes within the dispersal ceM shah be checked for effitierit porrrfing, Poriding levels shah be reported to the owner, and any levels above B inches considered as an impending hydraulic faNure requairg additional, more frequent Wig. Project DeLong Replacement Mound Page & of 9 GOULDS PUMPS Wastewater PERFORMANCE RATINGS COMPONENTS Tatal Head of water) (ft Gatb~ Per Minuxe . EP04 EP05 5 53 - to a6 6z 15 36 55 20 21 46 25 0 33 30 - 11 METERS FEET 10 9 30 ~~.13 1 `~' 0 7 ~*~-•~ - - ~ ~ 6 20~ __-- - - ~ "_ --- ~ z 5 G 15 ~_._.. _. _.. ~ 4 O 3 -__ 10 ~ -- ---- 2 = - 5r°'~ _ ___ i 1 0 S 00.. __ __.._...~...__. _.__ 0 ~ Desaipibn 1 Impeller 2 Base 3 Pump Casing 4 Mechanical Seal 5 Bail Bearings 6 0-Rings 7 Power Cord 8 Oil Filled Motor 9 Motor Housing( Stator Assembly 10 Motor Cover ~ ~ 6' P~~ 3 to s 6 9 5 a 3 t 2 lJ -e l-- o~~ ._ ~/ r °` e v ~ ~ ~ ~ Q. X / r1 e ~ ~ ~. O~'1~ ._, ~~.~ a3~ 3 u. s, Hwy ,2 (.~~ Id wt~, I,v; s~_ S'~ Buz ~ ~ lbw T w r. a"~' (J~t1d w~~. -~U4L-l0?~~ -/~ - O a o h'~'f~ /} 6 2 CS ~3_~G~ o ~v4 k r~ ~t f r' r`o ~ , ~ ~~ ~,~ Q-mom C j3-3 ~~,~ ~~ t~~~,~ ~ '~; ~ ~~ r ~~~~ ~~ G ~ ~~ . ~~ ~ ~ _~ ~ + , r ~, v. ' ~~ _. /~ ` ~ ~,' ~• ~ _ _ a~~ o ~ ~ S i ... V ~ _ v ~~ 1C3'_'_ ~s ~ ~' f ~ ' ~~ Wisconsin Department of Commerce OIL EVALUATION REPORT Division of Safety and Buildings Code derived design flow rate ui awvroancz wiu~ ~.omrn oa, vvis. rwrn. ~.wC ~+nb St. Croix Attach cromplete site plan on paper not less than 81/2 x 11 inches in size Plan must . inGude, but not limited to: vertical and horizontal reference point (BM), direction and .parcel I.D. 002-1082-10-000 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all infon»ation. Re 'wed Date Personal information you provide may be used for Law s. '15.04 (1) (m)). ~ ~s ~ ~ f ~ Q~ Property Owner ope Location ^ ^ Steven & Maxine Delon Govt. L ~ 1/4 NE 1/4 S 33 T 29 N R 16 E (or) W Property Owner's Mailing Address of # Block # Subd. Name or CSMI~ / _ ' '~ 2393 U.S. Hwy 12 ~/Yi.l~ (a8 City State Zip Code Ph ne N ~Vllage own Nearest Road Baldwin Wisc. 54002 ( - U. S. Hwy 12 New Construction Use Residential / Number of bedrooms,_ Replacement ~ Public or commeraal -Describe: _ Parent material Glacial Till Generalcomments /J and re~~~lg~enda 'on ~~~~ i~ _; ,`SL~c--~ ~~.J -- ;%j/ Page 1 ~ 4 GPD _ Flood Plain elevationrf applicable Mound System _;.~/ ~~ ~C~~~"~G~ Contou ~~~`~ ~ ~/~~~~- ~~~~~t~~ ,. ~~N ~ 2~~" ~~~~ ~ !~-I'f `~~~~ ~~~ a-~f~c~ Boring # ~ Boring J Q pit Ground surface elev. 93. ~ ft. Depth to limiting factor 2b in. Soil icatron Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/I~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eft#1 "Eff#2 1 0-6 10YR3/3 --- sil 1 fsbk mfr as 2f 0.4c 0.6 2 6-13 10YR4/4 --- sil 2m mvfr ~,, if 0.6 , 3 13_2 10YR3/6 ---- sil 2msbk mfr cw lvf 0.6 0.8 4 26-38 10YR4/6 t2f5~x4/4 ~°~ sl 2msbk mfr' cw --- 0.6 0.8 2 Boring # --~ Bonng 30 pit Ground surface elev. ~~• 2e ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/f~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. 5h. *Eff#1 *Eff#2 1 0-9 10YR3/3 --- sil lfsbk mfr as 2f 0.4c 0.6 2 9-19 ~ 10YR4/4 -- sil 2mp1 mvfr cw if 3 19-30 10YR3/6 ---- sil 2msbk mfr cw lvf 0.6 0.8 4 30-42 10YR4/b ~~~4/a~~ sl 2msbk mfr cw --- O.b 0.8 tmuent ~1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature /' , CST Number Thomas W. Gedatus (~(/i ~'9b2178 Address Date Evaluation Conducted Telephone Number Stang Plumbing & Electric P.O. Box 263 Woodville, Wisc. 54028 4/30/2007 1-715-684-Slbb Property Owner ~ Steven & Maxine DeLong parcel ID # 002-1082-10-000 Page 2 of 4 3 Boring # i Boring ~ 0 Pit Ground surface elev. '~' r° ft. Depth to limiting factor 21 in. Soil liption Rate Horizon Depth Dominant Color Redox Description Texture Structure Consist nce undary Roots GP D/ft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-9 10YR3/3 ---- sil lfsbk mfr as 2f 0.4c 0.6 2 1t1~9C414 -- ~ m~ cw if 3 14-21 10Y123/6 ---- sil 2msbk mfr cw lvf 0.6 0.8 4 21-46 10YR4l6 f2f5YR414 spots sl 2msbk mfr cw --- 0.6 0.8 ^ Boring # ~ Boring a pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/it= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ^ Boring # Boring pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DIfP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *EfF#1 *Eff#2 * Effluent #1 =GODS > 30 < 220 mg1L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mglL 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. .~G~/ ssn-assoro~ ~x o~ioo~ j'~"ev~~ ~ ~QXr~e ~~Lan a3~ 3 u. s. Hwy :2. ~ 1 d. w; .~ ~ t~1 i S c, S'~/ v a Z N~`/y, N yy/^jy 5 3 3~ T Z t 1~J} ~ /~.W w ~ O -C' ~g1 c~ w;,.1 -~(Ob2.-IDQ~ -t0 - o a o ..' ~~, ~s ~----v- ~ d .~ ~+~. ~ s~ ~ ~~~~ ~` ~ ~. I,3-~ j t~~ ~ _~a' ~ ~~~~ .~ ~~ tom ~ ~-~ ~~ ~~ ~•z ~z. ~. ~~,5 ~oaR G" , 1*: ,~ ~ , 3 ~ E V r J ,> ~ i ~~, ,,~~~ ,, _ ~ , . ` u • .. ,~ ,~ ~ ,~ ~ ~ ~ ~ ~ j ~~~ ~~ r S ~ V ~ ~ ~/ ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer ~Z'e v e_ a- /~ i ~ ~ ~ ~~Co.- ~G s-i Mailing Address ~ C ~ S ~w~ / Property Address ~ 14% ~,~,' y1 ~r ~ ~ ~! GG '~ (Verification required from Planning & Zoning Department for new construction.) CitylState ~~ /~ sv ,' ~ ~ ~ } Parcel Identification Number ~ ~ G l ~ ~' ~ - /U ~ ~ v a LEGAL DESCRIPTION Q ~~~ _A 1 J Property Location (~ ~ '/4 , t~ ~ '/a ,Sec. ~~ , T ~ R~W/, Town of ~~/-~- ! ~ w i ~'L Subdivision Certified Survey Map # Warranty Deed # ~~~ ~ ~~ ~~ Spec house yes no Lot # Volume / ,Page # Volume ~-~~ ~ 1 ,Page # ~~~ 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. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What. you put into the system can affect the function 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 by the 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 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my/our knowledge. Uwe am/are the owners} of the property described above, by vi ., e of a warranty deed recorded in Register of Deeds Office. Number of bedrooms SIGNATURE OF APPLICANT(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 from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) Parcel #: UUZ-1082-~ 0~~0~ 05118/2007 11:37 AM PAGE 1 OF 1 Alt. Parcel #: 33.29.16.481A 002 -TOWN OF BALDWIN Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O =Current Owner, C =Current Co-Owner O - DELONG, STEVEN &MAXINE STEVEN &MAXINE DELONG 2393 HWY 12 BALDWIN WI 54002 Districts: SC =School SP =Special Property Address(es): ' =Primary Type Dist # Description "2393 HWY 12 SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 49.000 Plat: N/A-NOT AVAILABLE SEC 33 T29N R16W E 1/2 NE N OF RR R/W Block/Condo Bldg: EXC P481 B ~/ 2 _ ~d~~~ Tract(s): (Sec-Twn-Rng 401/4 1601/4) 33-29N-16W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1055/295 QC 07/23/1997 664/47 07/23/1997 442/562 ~nn~ ci innneeQV Bill #: Fair Market Value: Assessed with: ---- Use Value Assessment Valuations: Last Changed: 04/16/2007 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 44.000 8,700 Q` ~ 8,700 NO 05 UNDEVELOPED G5 2.000 200 / 0 200 ' NO OTHER G7 3.000 12,000 13,600 ~ 25,600 NO 08 Totals for 2007: Gen eral Property 49.000 20,900 13,600 34,500 Woodland 0.000 0 0 Totals for 2006: Gen eral Property 49.000 20,200 133,900 154,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch #: 510 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 F~arcel #: 008-1073-30-000 05/25/2007 12:00 PM PAGE10F1 Alt. Parcel #: 25.28.16.384A 008 -TOWN OF EAU GALLE Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O =Current Owner, C =Current Co-Owner O - DELONG, STEVEN C &MAXINE R STEVEN C & MAXINE R DELONG C -TIMM LARRY TIMM LARRY 2393 HWY 12 BALDWIN WI 54002 Districts: SC =School SP =Special Property Address(es): * =Primary Type Dist # Description SC 5586 SPRING VALLEY SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 10.000 Plat: N/A-NOT AVAILABL E SEC 25 T28N R16W 10A IN SE SE BEG NE COR Block/Condo Bldg: ' ' TH SELY TO A PT 95 W SE SE; TH W 565 OF SE COR; TH E TO SE COR TH N TO POB Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 25-28N-16W Notes: Parcel History: Date Doc # Vol/Page Type 12/10/2003 748705 2471/273 WD 12/15/1993 510556 1055/295 QC 716/520 362/566 2007 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/11/2000 Description Class Acres Land Improve Total State Reason PRODUCTIVE FORST LANDS G6 10.000 8,200 0 8,200 NO Totals for 2007: General Property 10.000 8,200 0 8,200 Woodland 0.000 0 0 Totals for 2006: General Property 10.000 8,200 0 8,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: 04/17/2001 Batch #: PRGRM Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 U 2'471P 273 I STATF. RAR OF W ISCONSIN FORM 2 - 2000 Document Number WARRANTY DEED This Deed, made between Deborah Timm Biron, Steven C. DeLong and Maxine R. DeLong, husband and wife Grantor, and Steven C. DeLong and Maxine 12. DeLong, husband and wife, holding as survivorship marital property 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:) Commencing at the Northeast corner of the Southeast Quarter of the Southeast Quarter (SE 1/4 of SE 1/4) of Section Twenty-five (25), Town Twenty-eight (28) North, Mange Sixteen (lti) West. thence West 565 feet, thence in a southeasteriy direction to a Noint y5 iect iYesi it ti;c Southeast corner of the Southeast Quarter of the Southeast Quarter (SE 114 of SE 1/4); thence East to the Southeast corner of the Southeast Quarter of the Southeast Quarter (SE i/4 of SE 114); thence North to place of beginning. Steven C. DeLong and Maxine R. DeLong are joining in this deed solely for the purpose of creating survivorship marital property in the above described premises. ~~+8~tz,~ ~t tiATHLEEIi H. NALSH REGISTER OF DEEDS ST. CROLX CO., WI RECEIVED FOR RECORD 12!10/2003 10:30A1i MARRANTY DEED EXEMF'7 kEC FEE: 11.00 TRANS FEE: 12.60 COPY FEE: CG FEE: PAGES : 1 G~ r,/ -' _ C~~~ k-`~--' ~~~{ ~y' Q ~- Area Name and Retum Address Thomas A. McCormack 102010th Avenue Baldwin, WI 54002 008-1073-30 Parcel identification Number (PIN) phis is not homestead property. fxsd (is not) Exceptions to warranties: easements and restrictions of record. Dated this _ / '7 day of __%~ , 2003 . 4~ * Steven C. DeLong k . f ~r~ * lNaxine R. eLong U AUTHENTICATION Signaiure(s j cf Stese.: ~.1)eLong and M? ane R. P_e_L_ong, __ husband and wife _ __ authenticated this ~ y of ,~~v.+eP,P,i~ , -~i~:- * G~YL~ j ~ ~ . I'4'~CF.~~1~ cY'' ~.~.~-~~.~.lU~~-c~ltl~v >~j t~t,A~ -- *Deborah Timm Biron ACKNOWLEDGMENT STATE OF WISCONSIN_ ____ ) ----- ~„uuran~~~ ,.. __~Y~h County) '~p.~'.:.. .,f~'% '~••. Person/c~ before me this ~ t;~ _~ ~? ~~eo NQye ~ Zpo3~~` the above liatatE Deborah Timm Biron ~ .,; •_ ~ ~`~~' t s ; TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats.) TH[S INSTRUMENT WAS DRAFTED BY Thomas A. McCormack Baldwin, W154002 _ _ __ _ _ _ ___ __ (Signatures may be authenticated or acknowledged. Both are not necessary.) tome known to be the person(s) who ex~`c"tYted,l~i ;fare~oing ins ment and know ie ed the me. Not blic, State of WISCONSIN _ __ _ __ _ __ My Commission is tm neut. (If not, state expiration c)ate: * Names of persons signing in any capacity must be typed or printed below their signature. WARRANTY DEED STATE BAR OF WISCONSIN INFO-PRO (800)655-2021 www.infoproforms.com FORM No. 2 - 2000