HomeMy WebLinkAbout004-1003-60-300nmentotCommerce PRIVATE SEWAGE SYSTEM
eng Division
~ INSPECTION REPORT
~ (ATTACH TO PERMIT)
cAL INFORMATION
el information you provide maybe used for secondary purposes [Privacy Law, s.15.04 (1 }(m)].
pit Holder's Name: City Village X Township
;' Feiss, Larry Cadv Township
ICST BM Elev:
TANK INFORMATION
~~
G`~ l ~
ELEVATION DATA ~. ec, /63. b5
~ 1Sa
TYPE MANUFACTURER CAPACITY
Septic ,
rye ~,~~
l~~c
Dosing f
C-cv~~ ~
b SSG
Aeration
Zu i~
Holding
TANK S ETBACK IN FORMATI ON
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD
Septic `j~O~S "72~ C~ ~
o `f f ~b~
Dosing ~ ~~ ~ (
`U~, 7 ~ ~~ ~ .~
Aeration
Holding
PUMP/SIPHON INFORMATION ~
Manufacturer (~
1~ c~{0;t~a,c;.s~-r L Deman
GPM
Model Number #
s ~ ~ 3 ~7
l~
TDH Lif~ , ~ Friction Loss` System He ~ .~ TDH, , , `~ Ft
~ ~ `I
Forcemain Len t~~ Dia. 1 ~ Dist. to Well ~ ~ ,
Z
SOIL ABSORPTION SYSTEM
STATION
~ BS
9• Y HI
z'`',`r"1 FS ELEV.
>~
Benchmark 3 3 J~.3.3 ~da
Alt. 8M
~, ` C,J Q.,~
~ .~ 3
yc, , 3
Bldg, ewer ~ ! •3 4~ 9 (~ • `~5
SUHt Inlet
ri~~
y~.3s
SUHt Outlet ~
Dt Inlet ~
Dt Bottom 1 `7 •LS ~ `7 • ~
Header/Man. ~ ,' Q ~ ,
/
Dist. Pipe q
~
Bot. System
.gS
`~~ ~ Z
Final Grade
~p `
Cover ~. ~~ (~ .7 ~(~ ~ 3Z
t ,~c: J ~ ~ . ~ .l"~ ~j
BEDITRENCH
DIMENSIONS Width ~ Length ~ No. Of Trench
/~ PI7 DIMENSIONS No. Of its Inside LiquSc~Depth
~~
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
\
INFORMATION CHA
OR
Type f ~tem: + ~ ~t ~ ~ r ~r ~ UN 7 Model Number:
~~
DISTRIBUTION SYSTEM
Header/Manifold ~ ~ Distribution r ~ I x Hole Size x Hole Spacing ~ Vent to Air Intake
~
~ Pi e s ~2 [1 L
J~ 4
~
~
~ ~ r i
3 ,~/ ~. 's ~-
'_- T
Length~_
__ Dia Length
Dia
Spacing 7
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Onlv
Depth Over
BedlTrench Center ~
'~ Depth Over
BedlTrench Ed es
g xx Depth of
To soil
p xx SeededlSodded
c xx Mulched
~ , ~, Yes li] No Yes ~ No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~ I ~ /~ Inspection #2: / /_
Location: 577 310th St. Wilson, WI 54027 (NW 114 NE 1l4 2 T28N R15W) NA Lot 3 ~~~~` ~~~ Parcel No: 02.28.15.220
__`` ~~0~
- S~~t~ GOJ2.ti•- ~ .
1.) Alt BM Description - , ~ ~~\ w~S
2.) Bldg sewer length = 3p0 ~ '~- ~ G ~`~ "`'~ ~ d u S a'~
- amount of cover = ~ ~
r T--- -, r---
Plan revision Re uired?
' q [~ Yes No ~ 1 ~ ~ _ _
Use other side for additional information. L`__L___ ~ ___.J _
Date
SBD-6710 (R.3/97)
County:
St. Croix
Sanitary Permit No:
453399 0
State Plan ID No:
Parcel Tax No:
004-1003-60-300
Section/Town/Range/Map No:
02.28.15.220
1
~K
~u .~±'
Cert. No.
Safety and Buildings Division County O j"
7`
.. ~.
201 W. Washington Ave., P.O. Box 7162
a
~
~~~O~~ Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.)
J
.
Department of Commerce (~$) 266-3151
Sanitary Permit Application pq~p State Plan I.D. Number
`
In accord with Comm $3.21, Wis. Adm. Code, personal information you provi lg~
~s ~d L
may be used for secondary purposes Privacy Law, s15.04(1)(m) Project Address (if different than mailing address)
I. Application Information -Please Print All Informati - - -------x-~r ~ ~ ~ ~ ( 5--~'-"
Prope Owner's Na m~ Parcel ~ Lot !f 3 Block I
ailing Address
M
Prope O r' Property Location , vZ
~
r~ ' ~ !4, ~/,,Section~
Ciry, te` f~/1~ ~S ~.J.-
V Z C V C Z 1 ~5~ 1lGL/'-~' D. ~ O i ~cle
T N
R 1 E o~
(I(I
~ctic~"~i
(check all that apply)
~
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e of Buildin
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a
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g
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yp
.
~ mbe
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sion Name CSM N
Subdi
vi
~d
or 2 Family Dwelling -Number of Bedrooms ~'ta ~
L~
-
\
~
~ • , ~ ~`~ ~ 7
^ Public/Commercial -Describe Use `-
.~, " ~ ~ ~
^ State Owned -Describe Use D~.~ r ~L(~ (o' ~ ~~' ~ Oyt L'~~ a ~/~ ~ ~ a- ~ ^City_^Village ~ownship of
III. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A' ew System ^ Replacement System ^ Treatment7Holding Tank Replacement Only ^ Other Modification to Existing System
B. ^ Permit Renewal ^ PerrnitRevision ^ (range of ~ Permit Transfer to New List Previous Permit Number and Date Issued
Before Expiration Plumber Owner
rv. of POWTS S stem: (Check all that a 1 )
Q Non -Pressurized Irr-Ground out > 24 in. of suitable soil ound < 24 in. of suiffible soil ^ Ai-Grade ^ Single Pass Sand Filter
^ Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter
^ Recirwlating Synthetic Media Filter ^ Leaching Chamber ^ Drip Line ^ Gravel-less Pipe ^ Other (explain)
V. reatment Area Information: ~
Design Flow (gpd) Design Soil A `cation Rate(gpdsf) Dispers Area Required st) Dispers ea Pr posed (sf) System Elevation
VI. Tank Info i in ,Total Number Mamtfacturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Units Concrete Constructed Glass
New Existing .
Tanks Tanks
Septic or Holding Tank
1
Aerobic Treatment Unit _ / Jl j1
(•CJ
Dosing Chamber ~ ` ~~~!
VII. Responsibility Statement- T, the'itli' ed, asscime respo~'liility for tion of the rovvTS shown on the attached plans.
Plu ber's a )
~
I~ I Plumber's
~ ~,~ MP r
~ 3~I ~ Z Business Phone Number
IS-l~^1Z
_
_
PI V t(/~ ~ ss (SUeet,~'ty, State, tP Code) C\
VIII. Cotmt /De artment Use Onl
pproved ^ Disapproved Sanitary Permit Fee (includes Groundwater
Surcharge Fee) ~ ~ ~ !/D Date Issued
~ 2 g Agen Si o tamps
^ Owtter Given Reason for Denial
1X. Conditions of Approv al /'".~. Q~, f% N,~~~-`.~~s~~
effluent filter and d 3 • ,(i4~ ~^-
tic tank
1 Se
~
,
p
dispersal cell must all be serviced /maintained ~ A~~~ C'~~ ~ /"~~~'''r.~t h'1Gv~ ~~ld
as per management plan provided by plumber. ~"
2. All setback requirements must be maintained "~ - n ~ ~
as per applicable code/ordinances. „~ ~,„"yy,Ww~4 /~' /'YU~' • !yt-
~~f"
I~~DLuT ~ .~6 m e ° ~l~~i~~r t~stem ~~~s~~~" Si~J
SBD-6398 (R. 0 3)
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- commerce.wi.gov
i ^
iscons~n
Department of Commerce
Safety and Buildings
4003 N KINNEY COULEE RD
LA CROSSE WI 54601-1831
TDD #: (608) 264-8777
www. commerce. state.wi. us/s b
www.wisconsin.gov
Jim Doyle, Governor
Cory L. Nettles, Secretary
July 09, 2004
CUST ID No.3412
HERB J PELKE
PELKE PLUMBING
N6298 STATE HWY 25
DURAND WI 54736
ATTN: POWTS Inspector
ZONING OFFICE
ST CROIX COUNTY SPIA
1101 CARMICHAEL RD
HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 07/09/2006
Identification Numbers
Transaction ID No. 1017867
SITE: Site 1D No. 686176
Larry Deiss Please refer to both identification numbers,
310th Street above, in all corres ondence with the a enc .
Town of Cady
St Croix County
NW1/4, NW1/4, S2, T28N, R15W
FOR: ,
Description: Three Bedroom Mound System
Object Type: POWTS Component Manual Regulated Object ID No.: 968042
Maintenance required; 450 GPD Flow rate; 26 in Soil minimum depth to limiting factor from original grade;
System: Mound Component Manual -Version 2.0, SBD-10691-P (N.O1/O1),
Pressure Distribution Component Manual -Version 2.0, SBD-10706-P (N.O1/O1); Biofilter
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, C0J7dltL'!
slats. ~1 ~R~
The following conditions shall be met during construction or installation and prior to occupancy or use: DERARTMENT OF
OF EY
General Approval Requirements: J
• This system is to be constructed and located in accordance with the enclosed approved plans and with the SEE CORRESF
"Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD-10691-P (N.O1/O1)
and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION
2.0" SBD-10706-P (N.01 /01).
• The manifold diameter must be reduced to 1.5 inches so that the velocity of the effluent is 2.0 ft/sec or more
• Per manual cited above, 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.
• The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption
area. chs. NR 811 & 812c
• A Sanitary Permit must be obtained from the county where this project is located in accordance with the
requirements of Sec. 1.45.135 and 145.19, Wis. Slats.
HERB J PELKE
Page 2 7/4/04
• 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. Stat
• Comm 83 22(7) 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 injectors.
Owner Responsibilities:
• 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).
• 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.
• Comm 83.55 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.
All permits required by the state or the local municipality shall be obtained prior to commencement of
construction installation/operation.
In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should
conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review
shall relieve the designer of the responsibility for designing a safe building, structure, or component.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
The above left addressee shall provide a copy of this letter to the owner and any others who are responsible
for the installation, operation or maintenance of the POWTS.
Sincerely,
~ f~
Charles L Bratz
POWTS Reviewer II ,Integrated Services
(608)789-7893 , 7:45 am - 4:30 pm Monday -Friday
cbratz@commerce. state. w i. us
Fee Required $ 175.00
Fee Received $ 175.00
Balance Due $ 0.00
WiSMART code: 7633
cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544
.•
RECEIVED
~ U l_ - 7 2004
SAFETY & BLDGS DIV.
~~ . ~ e~ p
~.
Private On-Site Wastewater Treatment System (POWYS)
Index and Title Sheet
Owner: ~i9it~l y ~DE-iss
Project Name and System Type: L.vear ~~-i.rs - .~ ~'~ ~du~o ~a ~ rs
Location: ~/o ~ Sr.
Street Address
Legal Descripti~o-n. / /
!/ O lJ./ D f ~ADY .3 y"' Gi10/X ~o
,Township/County
Contents: Page 1: ~,v~~x ,v.ro t: r~ ~ .S~.~r r
Page 2: G~4 o r G~i s~
Page 3: ~/Ioss - .~~~ ri..,i ,o„io ~/.-./ ~/~~ of ~...~o -
Page 4: ~.oe~ do rair,~~ L,~yo„ r
Page 5: ~~PTic ~.~.~ ~D~.,-~ G IN.ON,Otst G /1011- .~~~ r,..~
~ r,
Page 6: Duyo Da-ii~'o~r.~,..r~~ CuA~r ~~~'/~~
CO1~fAlFRCE
Page 7: Do ~/ rs o .v./r•~ .`s ~s./a,~a ~,o.~,v~ ~irr.~r oi.,/ ANB~BING.
i~ n n ~ ~ --rum
Page 8: ~~ (JNp~N
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.Page 9: ,~
Attachments;.. .~a i a ~"drtN.v rior ~~si.- rr
~~~
?lumtierlor: Jets ~~•~~'' Signed:
Credential Number: ~~ ~yia Date: ~-/- D s'
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D ~,[,Ft. • PAGE .3 OE,~_
E-~Ft.t CROSS SECTION~OF MOUND
F- . 9 Ft.
G- .6 Ft. yiru.ir~e ~..ir~sso .
SYNTHETIC COVERING DISTRIBUTION• LATERAL '/~ ~~~°~~
• ,trry_ c-ss •
s/ MEDIUM •SAND H G
TOP SOLI, ~ ~I.EV • 9s; Z
. . 3 g D 9t! Z c..,ire~<
GEU of ~-2~" aggregat -FORCE MAIN PLOWED LAYER
Sl
y oPe G z 78 ~ o? "Pvc
~~ . L
n- G Ft.
8: ~Ft.
I-~/d Ft. ~ ~ ~ $ FORCE MAIti -.9~~/dG
't
K- /O Ft. ~X..
X
U- ~a Ft. ~ %s ~ yea'
N-,73 Ft . A MA2IIFOLp - ? "i°ac
N ~ X ~ ~• Observation
.__. X Pipe
Dist ibuCiou Pippes = /% ~ ` 'J
Observation Pipe GE« of '~-2~S" aggregate
G X T8
Y
p ,t(r C/~'j'NANlO L s T!i[ ft S
PLAti VIEW OF MOUtiU
. - ~ PIPE ~I;ATERAL LAYOUT ~~ .
HOLE DIAMETER- ~6In.
LATERAL " ~In.
MANIFOLD " - ,? In .
FORCE MAIN " ~In.
,-
P- 38 FG. ,
S- 3 Ft.
x- y Ft.
Y- y Ft.
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~~ rrt.~~
~rf C'N•~o7iero
l~~~vG
.cl/ /!~~dt .sLEtvs'
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~rce Ma
n
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~ "/dc
4'' ~ . s_
y' SEE CORRESPONpF .
P ,
38
PAGE• y OF. 9
.38
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. Page S Of 9
• SEPTIC TANK E'PUMP CHAMBER CROSS SECTION~AND SPECIFICATIONS
..c ~Scr• yo.
4" CI VENT. FYPE 12" MIN. ABOVE GRADE >y
>_' /p~ FROM DOOR, WINDOW OR
FRESH AYR INTAKE
Fiaisv da _ .~
18" MIN. •. ~
INLET ..
:WATER TYGHT SEALS - '
• 2 A~6s'G
' fic T'E.t
APPROYEO ~ ~ ~°0
PIPE 3`
orrYO soL I a
SOIL'. PUMP OFF ELEV . 8X a FT .
,~
A
B
C
D
WEATHERPROOF
JUNCTYON BOX
WITH CONDUIT
~. ~ ~.„
~~
~~
I'
GAS- ~ 1'
TIGHTi
SEAL ~. ~
i
~ AL.
~ ON
~.
I ~
OFF
APPROVED
MANHOLE COVERS
W/ PADLOCK E
WARNING LABEL
~-- 4" MIN.
~ ~t
PPROVED
JOINTS WITH
APPROVED PIPE
3' ONTO
SOLID SOIL
~~~ RISER EXIT
PERMITTED ONLY
IF TANK
MANUFACTURER
HAS APPROVAL
3" APPROVED BEDDING UNDER TANIC
CONCRETE .PAD
SPECIFICATIONS
SEPTIC./ DOSE
TANK MANUFACTURER: ~/J~sE-,~ ~,~~,~~.r~ NUMBER DOSES PER DAY: .s; / C/P.G ~,~
~'8 3 y / -
TANK SIZES: .SEPTIC /ooo GAL. ~ ~ DOSE VOLUME INCLUDING * '
DOSE 6 oa GAL.. ~ ~ • FLOWBACK: fa, y/ .GAL.
ALARM MANUFACTURER: , ~' f~yn~y,Cwt ~
'-'
• CAPACITIES: A = ~ YNCHES = .331' GAL.
T
MODEL NUMBER:
NK E*r .~ - `~
SWYTCH TYPE: _ r1,;~~4~ r ~ /` ~ G.~cs . B = 2 INCHES = - 33 G GAL .
PUMP . MANUFACTURER: ~yp,~o,,,,~ric. %~c~ C = 5
,'S INCHES = 9.T y GAL.
MODEL NUMBER: ~~/ ~ ,~
.
SWYTCH TYPE: iut r D . = g ,S' YNCHES = /Y.~ 8 GAL .
REQUIRED DISCHARGE RATE ~ GPM PUMP E ALARM WIRING AS PER ILHR 26:23 WAC
~VERTICA L~DIFFERENCE $ETWEEN PUMP OFF AND DISTRIBUTION PIPE 8.g FEET
+ MINIMUM NETWORK SUPPLY PRESSURE 3 3 FEET
+~ FEET FORCEMAIN `X /. s' FT/100 FT. FRICTION FACTOR _ '. yT FEET
TOTAL DYNAMIC HEAD ~ ' ,/,~ s FEET
INTERNAL DIMENSIONS OF PUMP TANK: LENGTH ,s3 " ; WIDTH J'8 ~~ ; DIAMETER -
. LIQUID 15~T~ 3C "
~. ~ ~F 9
s
Typicol Application' Sump/Effluent ump
Ca dties SW/SD/V525 - to 44 GPM (2.8 Vs)
Heads SW/SD/VS25 • to 24 ft (1.3 m)
Electrical SW/SD/V525 - 115V,1 e, B.OFLA, 60Hz
Moror SW/SD/VS25. 1/4 HP shaded pale w/thermal overload
1550 RPM
Minimum Recommended
Sump Diameter SD/VS25 =12" (304.Smm)
SW25 =18" (451 mm)
Automatic Operation
(manual available) SW =Wide angle float
SD =Diaphragm pressure svritches
VS =Vertical float switch
Materiah of (onstructian (ast iron and engineered thermoplastic
Impeller Thermo (astir vortex
Dischar a Size 1-1/2" NPT(38.1mm)
Solids Handlin 1/2" (12.8 mm)
Power (ord 10' , S11W,120' optional)
Superior Features • Carbon/(emmic mechanical seal
• Oil filled motor w/automatic reset thermal overload
• Uses single row ball bearing construction
• Piggy-back plug available for easy maintenance and
replacement
9 3C
b ~ 2C
1Wi.
~ ~
J
S Q
3 °1(
OL 0
Capacity-U.S. G.P.M. 10
Liters/Second p 1
~~
Ty ical A plication' Sump/Effluent um
(apai~ies SW/SD/VS33 - to 48 GPM (3.0 Vs)
Heads SW/SD/Y533 - io 26 h (1.9 m)
.Electrical 5W/SD/VS33 - 115V, le, IO.OFLA, 60Hz
Motor SW/SD/V533 - 1/3 HP shaded pole w/thermal
overload 1550 RPM
Minimum Recommended SD/VS33 =12" (304.8mm)
Sump Diameter SW33 =18"(457 mm)
Automatic Operation SW =Wide angle float swHch
(manual available) SD = Diaphragm preswre switch
VS =Vertical Hoot svritch
Materiah of Construction Cost iron and ' eared thermoplasfic
Impeller Thermoplastic vortex
Dischar a Size 1-1/2" NPl(38.1mm)
Solids Handling 1/2" (12.8 mm)
Power (ord 10' , SJIW, (20' optional)
Superior Features • (arbon/Ceramic mechanical seal
• Oil filled motor w/automatic reset
thermal overload
• Uses single row ball bearing construction
• Piggy-back plug avalabk: for easy
maintenance and replacement
S D3 ,SW3 3 S33
SD2 , 25, VS25
0 20 30 4 0 5
2 3
Q~~~~~ack SwitchA~G
:~ 9
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3.91f6'
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~_=_
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. f ~
.^.--1f x,318' DIR. ---- _.
Maoectal Spedflcatiozu
Cases, Lids, Reducers ~ Rigid Vinyl PVC 87371
Discs High Impact Polystytsne
Rod, Nuts High Dcnsiry Polyechylenc
U.S. Patent No. 4,710,295
Ca111-800-ZZI -5742 or Fax (SOZ) Z67-8801 for further information.
tenance
The interval for servicing septic tanks is set byy state and local code Throughout the United States there is a
wide difference of op.1'nion on what this, intenralshould be, but m~sx regulatory atgencu3s suggest two to five years.
The Zabel'" filter, which does. not increase the frequency of servicing fOr the tank, should be cleaned when the
septic tank is nom~t~lly inspected and pum p: ed. However, our filter is virtually self-cleaning. The continued action
of the anaerobic organisms on theme e~lte~ra se~u ~9be pnot iffcl~e. ~ a l ala-en rwattien the fifte nheeds servicing.
the tank. If your fitter contains a S Y it
TQ service the filter:
~Sen~ng any zabel filter should only be done by a certified septic tank pumper or Installer.
Lot;atQ, the:
dutlst of 'the
sefank.
and siide~t) e
Remove the
and pumF
neces
e ~~
'Nola: A tee ~~
to be used X drs b
below. ~ -evd ro
Conn zabe- % h-Io
t~dres
MIfDE M U571
The product(s) shown are covered by one or more of the following patents:
U.S. 5,762,793, 5,580,453, 5,591,331, 5,759,393, 5,683,577, 5,582,716, 5,779,896, 5,593,584,5,795,472,5,736,035,4,710,295, 5,382,357, 5,482,621
U.S. Des. 386,241, 349067, 4605501,5098568, Des. 309007, Australta:134440; Canada: 2,135,937; Israel: 111574; New Zealand: 264824,
Other Patents Pending
Call for a free ZABEL ZONE An Onsite Wasfewater Magazine 1-800-22.1-5742 • Website http://www.~abe~l~ 6om
'~
wsconsinDepartmentofCommerce SOIL EVALUATION REPORT Page ! of 3
" I]ivision of Safety and Buildinos -
in accordance with Gomm s5, wis. aam. t;oae
t •
County ~j. /
G Ao i
~
Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan mus
indude, but not limited to: vertical and horizontal reference point (BM), direction and Parcel LD.
^ ~~
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.. - 3 - d
.Please print all information. Review Date
Personal (nfonnatlon you provide maybe used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ~ Z
Property Owner Property Location
/G R ar'/s'S Govt. Lot ~/ 1/4N~ 1/4 S a T ,~~ N R /S ~(or
Property Owner's Mailing Address Block # Subd. Name or CSM{~
16 ~Y
Via. ~dx Boa 3 0~ 9 ~ 7 ~
State Zip Code Phone Number
City ~ lege ®Town Ne est Road
//
/v ~L /AL [ S L/.T ,S O.?.2 (~ S )1L0 - /~..~ -~ O r~ fir.
New Construction Use: ~ Residential / Number of bedrooms 3 Code derived design flow rate 'y-sa GPD
^ Replacement ^ Public or commercial -Describe:
Parent material LDltl ou~~- LL,IG/Ay f"it~. Flood Plain elevatio nffapplicable ~~9 ~
General comments ~ea
/a l/G tJ YS / r ~A~O tiff oB~./ 6 /r A S j f/E[ ~
„
and recommendations: > >, ~
llECOe,,~.~.o Srs. ~'i. of 9s z o-/ 9y 2
Ge.~re~..c
Boring # ^ Boring ,
/i
® pit Ground surface elev. 9'Y. D ft. Depth to limiting factor .~.? in.
Soli lication Rate
i
on
H th
De Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fP
or
z p
in. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'EtT#2
~ O /2 a YiC .~~.~ - ! n ~ G /. O
a? /,~-/ ~ /o rt .r .3 - / 6k /~ G 8
~ z a rr _ r.6k ^ -'
s ~ s/8f - /C
~~ f a Y~C 8 ~ ~e rrz o / r ~ ri/iir ,o SS a o uc
°? Boring # ~ Boring „
®Pit Ground surface elev. 9~ `! ft. Depth to limiting factor _~_ ln. Soil ication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fl?
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
.ohs r a sk ~~~ s ~~ .~ .g
`Effluent #1 = BOD > 30 < 220 mg/L and TSS 0 < 150 mg/L "Effluent #2 = BOD a 30 n'IgIL and T55 _< 30 mglL
CST Name (Please Print) " n CST Number
~,v EL .T ssarj' .7,1y9J3~
Address ~ / ~Q-/ Date Evaluation Conducted Telephone Number
~.S`O,~ /.t>/.~a/.e Y ~~: , ~.~u 4 LAlitar GI..Z~ .S 517/ ` ~3/-t1 `~ ~/S 8~' S/ - ~`/D
~ ! a
~i~/ditY ~df`ls`S- ~. ~ ~ Parcel ID # Page ~ of -~
Property Owner
t
Boring # ^ Boring ~
'~ ®Plt Ground surface elev. 9~ S ft. Depth to limiting factor ~_ in. Soil A ligtion Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
in. - Munsei( Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 _ -. •Eff#2
/ o-~ a r~ .~ s -- s / ,~ ,~ -
~ -/ o r~ s ~ / .~ f' s6/~ ~ c s /~ ~ ~' G 8
-3 /B- o fSt ~ .? .~ ~ t ~ G / o
l -.~8 5 /1 S~ G c~ ,J'YR a -SG ~ 6.6~ N ~ ~ G.tJ .2
f' /L L E T//t~lA o f TL D SS Ao~/~
Boring # ^ Boring
^ Pit Ground surface elev. ft. Depth to limiting factor ~ in. Soil A Iication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DIff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
^ Boring # ^ Boring
^ Pit Ground surface elev. ft. Depth tp limiting factor in.
Soil lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
"Effluent #1 = BODa > 30 < 220 mglL and TSS >30 < 150 mg/L ' Effluent #2 = BODa < 30 mgll 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.
SBD-8330 (&07!00)
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commerce.wi.gov
~sconsin
Department of Commerce
INSPECTION REPORT
SAFETY AND BUILDINGS DIVISION
Integrated Services Bureau
13 East Spruce Street
Chippewa Falls, WI 54729
www. commerce.state.wi. us/sb
{715) 726-2544
Date of Inspection: June 15, 2004
Project Name: Deiss
Use: Resdiential
Legal Description: NW, NW, 2, 28, 15W
Site Number:
Subdivision:
Municiipality: Town of Cady
County: St. Croix
Plan Transaction Number:
Sanitary Permit Number:
Wastewater Flow: 450 gpd
Persons Present: No One
Mike Hassett, CST 2497 NING OFFICE_
1503 Fairway St ~~
Eau Claire, WI 54701
Larry Deiss
PO Box 202
River Falls WI 54022
...n,e~ J .,~ ~ A%LI.I.CS~PicTicc~ v
Onsite soils verification at the request of the CST. Three soil borings were reviewed in the tested area
with the following results:
CST B-1
00-03" 10YR 3/3 sil, 2mgr; mfr, cw.
03-09" 10UR 3/3 sil, 2msbk, mfr, as, w/f2f 7.5YR 3/3 & 10YR 5/2 rmfs.
09-12" 2.5Y 5/3 sicl, 2msbk, mfr, cw, w/c3f-d 10YR 5/6 & 5/3 rmfs.
12-16" 10YR 4/4 cl, 2msbk, mfr, cw, w/continuous 7.5YR 6/2 depletions 1-2 mm
thick on ped surfaces and c1d 7.5YR 5/8 Fe concentrations in ped interiors (rmfs).
16-19" 10YR 4/4 cl, 2msbk, mfi, w/m2-3d 10YR 5/6 & 5/2 rmfs (no seepage noted).
Adjacent backhoe pit (2 ft away) had standing water at 13 inches.
.....CST B-2
00-03" 10YR 3/3 sil, 2mgr, mfr, cw.
03-13" 10YR 3/3 sil, 2msbk, mfr, as.
13-15" 10YR 4/4 sil, 2msbk, mfr, w/fad 10YR 4/6 & 5/2 rmfs
Backhoe pit had standing water at 22 inches.
CST B-3
Noted rmfs in lower part of A-horizon similar to B-1.
It is my opinion that this site is not suitable for a mound system based on morphological soil features.
Options include monitoring the site in accordance with Comm 85.60(3) during a normal spring season to
negate shallow redoximorphic features. Depending on the land area available, additional soil borings
elsewhere on the property may reveal soil of adequate suitability for mound system approval.
If thQ,re are any questions regarding this report, please contact me.
Croy G. Jaky, Wast~ater Sp¢cJalist
Ljansky@c merce.st te.wi.us `~~ mail
715/726-2544 Voice
715/726-2549 Fax
Plumber Name and Addre~s: ~~C~~~EQ
NA
cc: ®County ^ Plumber 0 CST ^ Owner ^ Other
4' ~
..
Wisconsin Department of Commerce
Division of Safety and Buildings
"~RIG~6~AL
SOIL EVALUATION REPORT
in acrordanre with Comm 85 Wis. Adm. Code
1661
Page 1 of 3
Certified Soii Testing
County
Attach complete site plan on paper not less than 8'/~ x 11 inches in size. Plan must St. Crolx
include, but not limited to: vertical and horizontal reference point (BM), direction and
north arrow
and location and distance to nearest road.
percent slope
scale or dimemsions ..,
Parcel I.D. 3 ~ p 3(,s ~
'
,
,
, 20 A CSM Pending
Please print all information. evlew ~ ; Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 ( 1) (m)). ~ ) ~y L~ • -7 Z (i G~
G
Property Owner , ::' ~. -1_
~Pi v.'
s ~.~ ~ L~ ro rty Location
French, Bruce , Govt. of NW 1/4 NW 1/4 S 2 ~~T28-gN R 15 W_
Property Owner's Mailing Addre$ ~ Lot # Block # Subd. Name or CSM# - ' T
~ ~
3026 60th Ave. ~`~~C1'~ ~ ~ 2~~2 ~ '~/G'U `l ~ ~
~~U' ~~~
City State Zip de Phone Number I City _, }Village ~i Town Nearest Road ~~-
Wilson ~ WI 54 7 S' 'f~~`- ~~~ ` ~~}'~~~i~' CadY ,577 310Th St.
/ New Construction Use: y) Residential /Number of bedrooms 3 Code derived design flow rate 450 GPD
Replacement Public or commercial -Describe:
Parent material loess over till Flood plain elevation, if applicable NA
General comments
and recommendations: install 4' x 112.5' rock cell mound on 99.0 cont our as upslope edge of rock w/ 1.1' sand fill for 3 br
(assumed-not staked)
^ Boring # ~_ Boring
98
23
/? Pit Ground Surface elev.
.5 ft. Depth to limiting factor ~
in. Soil Application Rate
Horizon I Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIft'
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh, "Eff#1 `Eff#2
1 'T 0-4 ~ 10YR 3/3 - sil 2 f sbk mvfr ~ cs , 1 f/m ', .5 8
~ _
2 ~ 4-15 ~ 10YR 3/3 - sil 2 m sbk mvfr ~I cs ~ 1f I
.5
8
~
~
3 115-23 10YR 4/4 - sl 1 m sbk mvfr cs 1f .4 6
4 `23-43 10YR 4/4 f2d 7.5YR 5/8,5/3 sl 1 m sbk mvfr - 1f ~ .4 ! 6
-t
I
--
;
-, i -- -- -
---
I i
Boring # _:' Boring
Pi
44
99
t Ground Surface elev.
.0 ft. Depth to limiting factor
in. Soil Application Rate
Horizon ! Depth Dominant Color Redox Description Textwe Structure Consistence Boundary Roots GPD/ft'
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ~ `Eff#1 *Eff#2
1 i 0-6
--+- 10YR 3/3 - sil 2 f sbk mvfr cs 1f/m ~ 5 8
2 ~ 6-12 ~
10YR 3/3
-
sil
2 m sbk ~
mvfr
cs _
~ 1f ~ 5 8
__ _ __--
-
-- -- -
3 12-20 ~
~ 10YR 4/4 - sl 1 m sbk ! mvfr ! gs I 1f ' 4 6
_ __ _~ _
t __ _
-
~
_~
~ - I i
~__ _ _ -
4 ' 20-34 ~, 7.5YR 4/4 - sl 1 f-m sbk mvfr cs ~ 1 m ! 4 6
5 134-44
- 10YR 6/4 - fs 0 sg ml cs - 5 9
6 ; 44-50
10YR 6/4
fad 7.5YR 4/6
fs
0 sg
ml _ _.--
- i; - '~ .5 9
--- -
---
~
- -
'Effluent #1 = BODS> 30 < 220 mg/L and TSS >3 < 150 mglL 'Effluent #2 = BODS < 30 mglL and TSS < 30 mgr
CST Name (Please Print) Signa r ~ CST Number
Henry F. Grote ~ 222774
Address Certified Soil Testing Date Evaluation Conducted Telephone Number
E. 4366 353rd Ave., Menomonie, Wt 54751 10/14/2002 715-233-0398
~e
•,~
,.
Property Owner French, Bruce Parcel iD # 20 A CSM Pending Page 2 _of _ 3-- _
Boring # ~~ Boring
Pit Ground Surface elev. 100.2 ft. Depth to limiting factor 40 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots PD
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-6 10YR 313 - sit 2 f sbk mvfr cs 1f/m .5 .8
2 ~ 6-14 10YR 313 - sit 2 m sbk mvfr ~ cs 1f .5 j 8
__._
3 ~
14-25
10YR 414
-
sl
1 m sbk
mvfr
cs
1f
.4 .6
4 25-40 7.5YR 414 - sl 1 m sbk mvfr cs 1 m .4 6
5 ~, 40-44 7.5YR 4/4
I f2d 7.5YR 5!8,513 s1 1 m sbk mvfr - ~ - .4 6
---
-------, -- - I
----.-
-_ --~ --
i
^ Boring # .Boring -
Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth I
in. Dominant Color
Munsell Redox Description
Qu. Sz. Cont. Color Texture Structure ,
Gr. Sz. Sh. ' Consistence i Boundary Roots P /
~ ~ i *Efi#1 'Eff#2
I
I ~
-----i-
I
~
'
---- ~
I
j
~
i
I
I
--• -- _.. _
- __ _ ---
---
-
II f ~
--
^ Boring # _ 'Boring
Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color
in. Munsell Redox Description
Qu. Sz. Cont. Color Texture Structure
Gr. Sz. Sh. Consistence ;
I Boundary Roots !_,zCPQ/ff _
*Eff#1 'Eff#2
j
I
- --- _ -
- - -_ i T
I
-__ ~
----- -
------ _ - - --
_ _ _ -T----
i r-- i
j i
* Effluent #1 = BODS> 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 608-266-31 ~ I or TTY 608-264-8777.
seo-s; ;o tk ovoo~ Certified Soii Testing
s
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07!06/44 Tt~E 09:94 FAX 715 986 4686 ST CRX CO ZONING
ST CROIX COUNTY
SEPTIC TANK MAII3'TBNANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
OwnorlBuyer _ L.''~rr~ ~ 5 S
Mailing Address ~ 8 ~ ~ a"D ~ ~ ~ ~u ~ ~ ~ S i,tJ.Z ~{ p ~ ~
Pc+oporty Address ~ .~ ~ ~~ 5~
(Verification rcquirod from Planning Dopartmeat for tuav
CitylState __ _ _ Parcel Identification Number tro~- l~3 - ~"
.~AL,~ESCRIPTION ~ ~~ G
Property Location N~ t/s, N ~ ~1., Soc. ~ . T ag N R_ ~~own of
Subdivision Lot # ,~,,,_.
Cerdiied Survey MaP ~ ~ ~ ~ Volume ,Page #
~ _ -.
wuTanty Deed # Volume ~ ~ Page # 3
Spec house ^ yes l~, no
Lot lines identifiable ~! yss ^ no
1
X001
SYSTEM MAINTENANCE , Q ~°
lmpsgperase aadtuaintenauceo yseptic~systo~ieOUtd~in; .failuroto l~aandIewastes. Propermaintenance
eaaeisls of pumpit{g out ttu septic tank Query three years or sooner, if needed by a licortsed pumper. what yow put into the system
can affect the $aiictioa 4f tea septic fault as a treatment ste8e in the waste disposal system. `.
The properly owner. agrees to submit to St. Croix Zoning Dtpattment a certification form, sigaod brave owner and by a
mastCrplumber,lourncynuu;Plumber, restrictedplumbvr or a licensedpttanper verifying that (1) the on-site wastea-atedisposal system
is in prap~er operating condition and/or {Z) after inspoction sad pumping (if neeessaiy), the septic tank is less than 113 full of sludgo.
Vwc, the uadetsigned Gave dead the above requi~meots astd ague to maintain the private sewage disposal aystetn arith the standards
set forth, herein, as set by the Depattmeut of Commerce sad the Depattffient of Natttra3 Re3ot~tC4S, State of wfscoasin. Certification
t'dumg ~~~~~ptic system has been maintained must be completed and returned to the St. Croix County Zoning Qf~ice within 30
days o y expi:atioa date.
I /d
A OF LICANT Dg7'E
that a1! statements an this form are true to the best of my {our). knowledge. I (we} am (arc) the owaes(s) of
by ultras of a warranty deed recorded in Registor of Doeds Ot~ce.
/ v/~
DATE. , .
•••••• Any iafonaut4on that is mis-re=presented may result is the sanitary petrnit being revoked by t>1e Zoning Depactmcat. """•~'~
,; .
sa' Include wlm ,thle appllcatIon: astasRpod wstt~aty deed f:t-m the. R~istcr of Doeds o8~itce
a copy of the certified etirvey map if tafereoce is made is the waisaaty decd
j ~ POWTS OWNER'S MANUAL AND MANAGEMENT PLAN
FILE INFORMATION
Owner ~ ,~,~ y ,his s
Permit # 3
DESIGN P METERS
SYSTEM SPECIFICATIONS
Number of Bedrooms 100 d/bedroom 3 ^ NA
Number of Commercial Units NA
Estimated flow (average)* ~aa aUda
Design flow (peak), estimated x 1.5* ~,so aUda
Soil Application Rate , ~ aUda
Influent/Effluent Quality (NA^) Monthly Average**
Fats. Oil & Grease (FOG) < 30 mg/L
Biochemical Oxygen Demand (HODS) ~ 220 mg/L
Total Suspended Solids (TSS)
5 150 m
Pretre ted~~^.± 1 ^ Monthly Average***
Biochemical Oxygen Demand (HODS) < 30 mg/L
Total Suspended Solids (TSS) ~ 30
Fecal Coliform (geometric mean) cfu/100m1
Maximum Effluent Particle Size 1/8 inch diameter
*Wastewater Flow Verification and Calc ations:
(Other than bedroom based)
** Values typical for domestic (non-commercial wastewater
and septic tank effluent.
***Values ical for retreated wastewater.
Se tic Tank Ca aci Goo al ^ NA
Se tic Tank Manufacturer sd,t ^ NA
Eilluent Filter Manufacturer Z,¢~EL ^ NA
Effluent Filter Model /ao ^ NA
Pum Tank Ca aci GOO al ^ NA
Pum Tank Manufacturer /,/i~-s~.c. ^ NA
Pum Manufacturer yoiro ~i~ ^ NA
Pum Model ~~ 3~ ^ NA
Pretreatment Unit ~'NA
^ Sand/Gravel Filter ^ Peat Filter
^ Mechanical Aeration ^ Wetland
^ Disinfection ^ Other:
Manufacturer: Model:
Dispersal Cell(s)
^ In-ground (gravity) ^ In-ground (pressurized)
^ At-grade ~j'Mound
^ Dri -line ^ Other:
^ Leaching Chamber Manufacturer
Model Laying Length/Chamber_
~
Soil Application Rate~gpd/ft Area Req.
Infiltrative Surface/Chamber-ESIA Rating ft2
Minimum Number of Chambers
^ A e ate Desi Flow/Loadin Rate= min
Materials: all materials must comply with WI Adm. Code
COMM84 and be installed per manufacturers specifications
and a royal letters.
~xri~~xiA
^ "Wisconsin At-grade Soil Absorption System, Siting, Design & Construction Manual" (Converse et.a1.1990)
^ "Wisconsin Mound Soil Absorption System: Siting, Design & Construction Manual" Converse, J.C. and E.J. Tyler.
Publication 15.22
^ "Design of Pressure Distribution Networks for Septic Tank-Soil Absorption Systems" Publications 9.6
^ "Design of Conventional Soil Absorption Trenches and Beds". R.J. Otis - ASAE Publications 5-77 and "Design Manual -
Onsite Wastewater Treatment and Disposal Systems". EPA 625/1-80-012 October 1980
^ SBD - 10570-P (8.6/99) "At-Grade Component Manual Using Pressure Distribution"
^SBD -10567-P (8.6/99) "In Ground Absorption Component Manual"
^SBD -10705 P (N.O1/O1) "In Ground Soil Absorption Component Manual" Version 2.0
^ SBD -10628 P (N.6/99) "Recirculating Sand Filter System Component Manual"
^ SBD -10656-P (N.6/99) "Split Bed Recirculating Sand Filter System Component Manual"
^ SBD - 10572 P (IZ.6/99) "Mound Component Manual"
,j~ SBD - 10691 P (N.O1/O1) "Mound Component Manual" Version 2.0
^ SBD - 10595 P (8.6/99) "Single Pass Sand Filter Component Manual"
^ SBD -10657-P (8.6/99) "Drip-line Effluent Disposal Component Manual"
^ SBD - 10573 P (R 6/99) "Pressure Distribution Component Manual"
jS~SBD - 10706-P (N.O1/O1) "Pressure Distribution Component Manual" Version 2.0
p Drip-line Effluent Dispersal Component Manual for Multi-flo Onsite Wastewater Treatment Units
MAINTENANCE AND MANAGEMEIV'1'
MATNTRNAN(`F. M(1NTT(1RTN(, Sf'HF.TITTT.F.
Service Event Service Fre uenc
Ins ect condition of tank s At least once eve ^ months 3 e s Maximum 3 s.
Pum out contents of tank s When combined slud a and scum a uals one-third 1/3 of tank volume
Ins ect dis ersal cells At least once eve ^ months 3 ears aximum 3 s.
Clean effluent filter At least once eve y months ^ ear s
Ins ect um , um controls & alarm At least once eve ^ months .3 ears ^ NA
Flush laterals and ressure test At least once eve ^ months 3 ears ^ NA
Valves At least once eve ^ months ^ ears ^ NA
Other: At least once eve ^ months ^ ears ^ NA
rage_Lot~_
START UP
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemical's that
may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the
tank(s) removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
OPERATION
The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity
and quality of the wastewater stream will affect the performance and longevity of your POWTS. The installation ofwater-saving
appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water
softeners, iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground surface
whenever possible. Note: this does not include laundry waste, showers, dishwater, etc.
This system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable/fruit
peels and seeds, bones, and food solids such as those produced by a gazbage disposal should be minimized. Toilet tissue is the only
paper that should be discharged into the system. Other non-biodegradable items such as baby wipes, tampons, sanitary napkins
condoms, cigarette butts, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, paint,
disinfectants, pesticides, antibiotics, solvents, etc., should not be flushed into the system as they can seriously damage your POWTS
and contaminate your drinking water supply.
Maintain a regular steady flow by spreading laundry washing throughout the week. Avoid vehicle traffic over all system components.
Compaction of snow over the dispersal unit may cause it to freeze up.
^ Valves
Valves shall be operated in the following manner:
Alarms
Alarms should be tested on a regular basis by the home owner. If an alarm sounds, contact an individual licensed to service
POWTS, There is normally a 1 day reserve under regulaz operating conditions, however water should be conserved until any
problems with the system are corrected to prevent back-up of sewage into the dwelling or surfacing.
INSPECTIONS
Inspection shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master
Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule):
Q~ Septic Tanks Component
Tank inspections must include a visual inspection of the tank to identify any missing or broken hazdwaze, identify any cracks
or leaks, measure the volume of combined sludge and scum and to check for any backup or ponding of effluent to the ground
surface. Access openings used for service or assessment shall be sealed and/or locked upon completion of service. Any
defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective
locking device to prevent accidental or unauthorized entry into the tank.
When the combination of sludge and scum in any tank exceeds one-third (1/3) or more of the tank volume, the entire contents
of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with Chapter NR113, Wisconsin
Administrative Code.
The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's
specifications. Provisions are to be made to retain solids in the tank. Filter cleaning maybe necessary at more
frequent intervals than stated in the maintenance schedule to keep the system operating.
Pump Chamber/Treatment Tanks Component
The inspection must include,a test of all electrical equipment such as pumps, alarms and floats. A visual check must be
made for leaks, backups, surfacing, missing or broken security devices and other hardware and the condition of any filters.
Any service needs or repairs shall be promptly taken caze of.
^ In-Ground Gravity Component Dispersal Cells
The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any
evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory
authority. Ponding at depths greater than 75% of the height of the component may indicate overloading or impending
hydraulic failure necessitating more frequent monitoring.
Page$of 4
`~~1Vlound, A Grade, In-Ground Pressure
inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any
evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory
authority. Ponding greater than 75% of the height of the component may indicate overloading or impending hydraulic failure
necessitating more frequent monitoring.
The pressure distribution system is provided with an opening at the end of each lateral to be used for flushing. The laterals
should be flushed at least once every three (3) years. Pressure checks of systems with multiple laterals should be done to
ensure that equal distribution of effluent is occurring to promote the longevity of the system.
REPORTS
Reports for maintenance, inspection, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin Administrative
Code.
ABANDONMENT
When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is
properly and safely abandoned in compliance with Ch. COMM 83.33, Wisconsin Administrative Code.
All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
- The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator.
- After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with
soil, gravel or other inert solid material.
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant
replacement system:
^ A suitable replacement area has been evaluated and maybe utilized for the location of a replacement soil absorption system.
The replacement azea should be protected from disturbance and compaction and should not be infringed upon by required
setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the
need for a new soil from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will
result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must
comply with the rules in effect at that time.
^ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a
holding tank maybe installed as a last resort to re a the failed PO S.
Th site of been evaluat to ' entify a s ' le re ce azea. on failu • POWTS a soil and site evaluation
m t perfo ed to loc a suitab ement area. I no replacemen a is available c may be installed
as ast resort to ce the failed POWTS.
Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative
surface. Reconstructions of such systems must comply with the rules in effect at that time.
«WARNING»
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTIAN LETHAL GASSES AND/OR INSUFFICIENT
OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIItCUMSTANCES.
DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR
IMPOSSIBLE.
ADDITIONAL COMMENTS
POWTS INSTALLER
Name ~~.t6 ~Ft~E' /1P-3yia
Phone 7jS G7.? - s.?~G
SEPTAGE SERVICING OPERATOR um er - ,/ir.Jad,/
Name
Phone
K:\WPDATA\EH\POWTS OWNER'S MANUAL.doc
POWTS MAINTAINER
Name E',ca 6~E'~.~c~ t ! GLairci./6
Phone 7/s G7.?- S.?G6
LOCAL REGULATORY AUTHORITY
A enc ~F.' q of Zo•v..~c Dff~c ~
Phone 7/S .?8c - y~ ~
Page 9 of 9
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LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02
REAL ESTATE TOWN OF CADY
COMPUTER NUMBER 004-1003-60-300 Parcel Number 2.28.15.22C
OWNER NAME: First LARRY J Last DEISS
PROPERTY ADDRESS: Hse # 1/2 PD --Street Name-- Type SD Apartment
SECTION 2 TOWN 28N RANGE 15W'/4160 NW'/<40 NW
Line Description Line Description
TOTAL ACREAGE 20.000 PLAT CSM 16/4419 LOT3 BLK
01 SEC 2 T28N R15W NW NW 15
02 LOT 3 CSM 16/4419 16
03 17
04 18
05 19
06 20
07 21
08 22
09 23
10 24
11 25
12 26
13 27
14 28
F1-General, F4-Prev. Parcel, F5-Next Parcel, F7-Valuations, F8-History, F10-Exit
l (. y~.
[! 2''S9P X73
STATE BAR Ot~ .. tSCONSIN FORM 2 - 1999
Document Number WARRANTY DEED
This Deed, made between Bruce A. French and Ruth A. French,
husband and wife Grantor,
and Larry J. Deiss.
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):
Part of Fractional NW 1/vf NW 1/~of Section 2, Township 28 North, Range
15 West, St. Croix County, Wisconsin described as follows: Lot 3 of
Certified Survey Map filed December 5, 2002 in Vol. 16, Page 4419, Doc.
No. 700977. '"--
* Bruce A. French
•`~~ll `~~h, ~LO~-~
* Ruth A. French
004-1003-60-200
Parcel Identification Number (PIN)
This is not homestead property
(is) (is not)
Exceptions to warranties: Easements, restrictions and rights-of-way of record, if any.
Dated this ~ o~ day of November , 2003
AUTHENTICATION
Signature(s)
authenticated this day of
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not,
authorized by § 706.06, Wis. Stats.)
STATE OF
~~~~~ ~
REGi~TEl7 11F DEEDS
ST. CFts3ilt C13. ~ Mi
RECEiVrD FOR RECORQ
il/20/20fd3 O'3.50A1i
WARRAKTY DEED
REC FEE: 11.00
TkANS FEEc 175.50
COPY FEE:
CC FEE:
PAVES. 1
Recording Area
Name and Remrn Address
WESTCONSIN CREDIT UNION
PO BOX 308
RIVER FALLS WI 54022
ACKNOWLEDGMENT
c~ L~-~ t X County
ss.
Personally came before me this I a day of
November , 2003 the above rtamed
Bruce A. French and Ruth A. French, husband and wife
to me known to be the person(s) who executed the foregoing
instrument and acknowledged the same.
THIS INSTRUMENT WAS DRAFTED BY ``,```~~~t"""'f I jh
PFt.21Ee
Attorney Kristina Ogland `~ 'S . ' '
~~ ~A .r~ ~-~U~--~ .r• '4 k-
Hudson, WI 54016 • ~ : lTl bh ,'State of ~~ ~ _
` Commis on is permanent. (If not, state expiration date:
(Signatures may be authenticated or acknowledged. Both are not necBSsaryj ~ `~ - ~~.~ , ~ .)
~/ \
* Names of persons signing in any capacity must be typed or printed beloNGJhei~ sigpatuie` ~ ~ ~~ Information Professionals Co., Fond du Lac, WI
cTe~ tARit~>LvVrcrnNCnv~~..` 800-655-2021
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