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HomeMy WebLinkAbout004-1063-30-000/* Wisc~msin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provice may be used for secondary purposes [Privacy Law,~.15.04 (1)(m)l. Permit Holder's Name: ^ City ^ la ~a~Y ~~4 egory, Richard & Marcia CST BM Elev.:. Insp. BM Elev.: BM Description: .~ a0-ate s =- csi B~ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic avt~ 6 Dosing Aeration Holding ~ ELEVATION DATA TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. vent to Airlntake ROAD Septic 7 t~so ~ f ' ~ ~ -~' NA Dosing ~ !,~' ~ ~ ~t NA Aeration NA Holding PUMP / SIPHON INFORMATION Manufacturer Demand Model Number ~ ~j GPM TDH Lift Lriction SystemZ TDH Ft HH Forcemain Length 317 r Dia. 2 u Dist. To Well '~-5 f All ARGAQDTIA~AI ~V~TC11A ~~•~ ~~7-S RR Tf I- ~ ~ ~••• count~t, Croix . Sanita3~P~~t No.: ate Plan ID No.: ~ III off =Tro+~ts. In.~ Pa rcel~®~N~63-30-000 STATION BS HI FS ELEV. Benchmark p . Sa / '~ ~ /~ ! Bldg. Sewer ~~ ~ St/ Ht Inlet ~. ~ q3. gyp' St/Ht Outlet ~- ~---- Dt Inlet ---- Dt Bottom ~f - 2S 9p • Z$ ~ Header /Man. Dist. Pipe 3'gs l ,b~ / Bot. System ~ (o D ~~¢ , ~ ~ Final Grades ~ ~ tZrl{- ~/ I'~ cover 3.6.0 , 0 RENC Wi th i Length ~ f T PIT No. is Inside Dia. Depth DIM N , S ~ ~9~XS DIMEN I N SYSTEM TO P / L BLDG WELL LAKE /STREAM LEACHI nu acturer: SETBACK T C BER l N M INFORMATION ypeO r SD f- ~ 7 , OS '~ -'"~ R UNIT u r: o e System: (p / DISTRIBUTION SYSTEM ~" ~~DjrO~'IO``~' ~ `"~'~~"'1pe 5 "~ Header /Manifold ~~ Distribution Pipe(s), ~ ~ x Hole Size x Hole Spacing Vent To Air Intake Length ~ Dia. 2 Length ~ Dia. I ~L Spacing °7'~ ~ g ~~ ~. p SOIL COVER x Pressure Systems Onty xx Mound Or At-Grade Systems Only (`IS.G S ~"`'~"'~ Depth Over Depth Over xx Depth Of xx Seeded /Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ^ Yes ~^ No ^ Yes ^ No COMMENTS: (Include code discre ancies, persons resent, etc.) v ~ rum =~3~p~ Ins ection #2: -t'~ p p Inspection #1: 06 p LocaHon• 182 310th Street, Wilson, WI 54027 (NE 1/4 NE 1/4 27 T28N R15W) - 272815419 - _ 1.) Alt BM Description = r r, n ,~D ~'~~T" ~ ~ 2.) Bldg sewer length = nC ~O k'~,°"'< n <'~ -amount of cover = ~ } ~' ~°~` ~'°`~! ~) 3.) contour = .~- 9 s . S-S~~ S 5.95-at" tf.~ % I d (. S-a/ Plan revision required? ^ Yes ~ No Use~~o er si a for additional information. ~ 0 1~ ' oo ~( SBD=6710 R.3/97~ _ r~ • l~ D~1~~ ~~~ S Inspector's Signature Cert. No. C ~ Ir Sanitary Permit Application sarery ~ tsuumngs liwtswn In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 iS~onsin personal information you provide may be used for secondary purposes Madison, WI 53707-7302 Department of Commerce [Privacy Law, s. 15.04(1)(m)] (Submit completed form to county if not ~-~~ data nwna~l 1 Attach com fete tans (to the coun co onl )for the s ~s >a er I g't 8-1/2 x 11 inches in size. Count~- L State Sanitary Permit Number ^ Check i re ~ i to previous app ' ti State Plan 1. D. Number 1. A lication Information -Please Print all Information cation: Property O r Name • e ~ ~ r~ t1 1 ~~ [ ~; ~ GQvO J P perty Locartion N,R ~or 1/4 Cl/4, SoZ7 T~ Property Owner's Mailing Address t Number Block Number J, oZ ~ ~ ~7 • ~ ZC2NNG0~'FtG~ City, State Zip Code Phon u Subdivision Name or CSM Number l.J ~ D (? 1 '' c s~1 va . ~ 4 _ ~'~ ~ ~ 1[. Type of Buil ing: (check one) a f d ^ Cary ^ Village rooms : J Be ~Q 1 or 2 Family Dwelling - No. o ~ Town of ^ Public/Commercial (describe use):_ ~~ ^ State-Owned Nearest Road Pazcel Tax Number(s) U D y (0(03 - p - dop Ill. T e of Permit: (Check onl one box on line A. Check box on line B if a licable) Z~• Z6'. S. `~l ~ A) l . ^ New 2. ~ Replacement 3. ^ Replacement of 4. 5. 6. ^ Addition to System System Tank Only Existin System B) Permit Number Date Issued i ^ A Sanitary Permit was reviously issued IV. Type of POWT System: (Check all that apply) ~ ^ Non-pressurized In-ground Jet Mound ^ Sand Filter ^ Constructed Wetland ^ Pressurized In-ground ^ Holding Tank ^ Single Pass ^ Drip Line ~ ~ ^ At- rade ^ Aerobic Treatm nt Unit ^ ecirculating ^ Other: Dis ersal/Treatment Area Information: . ~ d ~ ~ 1.13 ~ r S~"M S S V . 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Elevation Required Proposed Rate (Gals./day/sq. ft.) (Min./inch) , ~ ~ , -- 9~ 7 48 ~ ~~ / y ~o ~, o o ,~ ~ ~ ~o 0 .9 Tank VII Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic . Information Gallons Gallons Tanks Con- Con- glass New Existing Crete structed Tanks Tanks l~ ^ ^ ^ ^ G D DDD ~ ~ rvv~ ~e - ~ D ~sv / ,, ,. u ^ ^ ^ ^ V[II. Responsibility Statement I, the undersi ned, assume res onsibilit for installation of the POWTS shown on the attached tans. Plumber's Name (print) PI b Signature ( t ps): MP/MPRS No. Business Phone Number Plumber's Address (Street, City, State, Z Cod y9 5 ~S`/8~'~ IX. County/Departure t Use Only ^ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) Approved ^ Owner Given Initial Adverse Surcharge Fee r---~--- Determination ~ 3 Z ~ ~~ ~ ~ ~ ~ ~"- X. Conditions of Approval /Reaso/ns for Disapproval: ~ du /o,~~~ ~ fie,. ~ C W(ok) '!'~ lC~,c: 4 ~rt~ S ~ S~uw /~ O0 a d~~o-~ eon ~ /~ .- GeO~o ,/ ;Mt' t'~~><er ~ ~c /-~~cra.I't~N.M Pty M'l4.ft6~~tC/-[~,rC.i /l Ca u,w~~-ry~Ct.(~~~5 t ~ ~ iscons~n Department of Commerce Safety and Buildings 10541 N RANCH ROAD HAYWARD WI 54843 TDD #: (608) 264-8777 www.commerce.state.wi.us Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary July 31, 2000 CUST ID No.220728 CLARENCE L GLOTFELTY N4955 SUNNY HILL RD WEYERHAEUSER WI 54895 ATTN.• POWTS INSPECTOR ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 1tE: CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/31/2002 Identification Numbers Transaction ID No. 411071 Site ID No. 193829 SITE: Please refer to both identificationnumbers, Site ID: 193829, RICHARD GREGORY ' above,;, in all carres ondence with the; en ST CROIX County, Town of CADY; 182 310TH ST, WILSON 54027 FOR: MOUND, 450 gpd Object Type: POWT System Regulated Object ID No.: 667660 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. The following conditions shall be met during construction or installation and prior to occupancy or use: 1. This plan action is subject to designer comments on the plan. 2. The maintenance plan for this system must be given to the owner of the POWTS. 3. The orientation of the mound system must be such that the mound's longest dimension is oriented along P.~.w.T ~ the surface contour per COMM 83.44(6)(a)2. C'p]ZdltlOlZ~ 4. Activities that may cause soil compaction are prohibited in the area 15' beyond the down slope edge of the mound. ~ ~~a Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the Zabel filter oEPARTMENT of C will be required. 0' A copy of the approved plans, specifications and this letter shall be on-site during construction and open to SFE t/pRRESPC inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/instal lation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. ,--~ . Sinter , !~ . ~. PATRICIA L DORF , PO PLAN REVIEWER Integrated Services (715) 634-?810, FAX: (715) 634-5150 , M-F 7:45 AM - 4:30 PM PSHANDORF@COMMERCE. STATE. WLUS DATE RECEIVED 07/24/2000 FEE REQUIRED $ 120.00 FEE RECEIVED $ 120.00 BALANCE DUE $ 0.00 WiSMART code: 763 cc: RICHARD GREGORY MOUND SYSTEM DESIGN Residential Application INDEX AND TITLE SHEET Project Gregory Mound Owner Richard Gregory Address 182 310th Street Wilson, WI 54027 (715) 772-3468 Legal Description NE, NE, 27, 28, 15W Township Cady County St. Croix Subdivision Name NA Lot No. NA ~~ i Parcel ID Number 00410633000 ~ !, ~. Plan Transaction Number 33~ ~jf Q~j~ rally Index and title sheet ', Mound calculations Mound drawings Pres. dist. calcs. and laterals TDH and pump tank drawing Pump specifications ', Site plan ', Turn-up detail Management plan ~~ Page 1 MME Page 2 Page 3 ~`~ Page 4 ~NOENCE Page 5 Page 6 ', Page 7 ~ ~ ~ (;'~ Page 8 Page 9 Designer Claren a Glotfelt License Number I I Signature Phone No. Date J 27, 2000 i ~r~~ «.~ _ . ~. .. 220728 (715) 868-5831 Page 1 of 9 MOUND SYSTEM DESIGN red boxes as necessary. 750 gpd maximum design flow. Residential or commercial? ~~(r or c) ~ elope ~ '~ 5 070 Design flow rate 450 gpd Depth to limiting factor 22 in Iri situ soil infiltration rate 0.2 gpd/ftl Contour line elevation 95.6 < ft Use standard fill depths? x OR Design depth? ~in Place X in box to use standard depths (24 and A+4 inclusive} OR specify design fill depth. Orifice density 4.50 Orifices per ft` Center or end manifold c (c or e~ Orifice diameter 0.125 in o.i2s, o.isa, o.,aa, o.2~e, o.2s, Lateral spacing 2.00 ft Use 0 lateral spacing for trenches. 0.281, or 0.313 inch only. Estimated orifice space 2.00 ft Not a final calculation. Number of laterals 4 Pump tank elevation 88.5 ft Outside bottom of tank. Forcemairi length ~ ~' ft Forcemain diameter 2.0 in 1.5, 2, 3 or 4 inch only. ' 2.067 in Actual LD. DIAMETER CONVERSIONS 1/8 = 0.125 1/4 = 0.250 SYSTEM SOLUTIONS 5/32 = 0.156 s/32 = 0.281 Design flow rate ' 450 gpd 3/16 = 0.188 5/16 = 0.313 7/32 = 0.219 Absorption cell Application rate & area 1.0 9Pd/~ 450.0 ft1 i Linear loading rate'(LLR) ', 4.50 gpd/ft ', Design width (A) 4.50 ft C~II length (B) 100.0 ft Depth of cell (F) 9.5 in Sand filter Upslope fill depth (D) 14.0 in Downslope fill depth (E) 16.7 in Basal area required (gpd/infiltration rate) 2250.0 ft2 Supporting components ' Topsoil depth 3.0 in Subsoil depth at center 9.0 in Subsoil depth at cell wall ' 3.0 in End slope toe length (K) 9.21 ft ', Up slope toe length (J) 7.10 ft ,Down slope toe length (I) 18.00 ft Basal adjustment made. Total mound length (L) 118.42 ft Total mound width (W) 29.60 ft Project: Gregory Mound Transaction Number: - Page 2 of 9 ~~~~~~ ~ (E-->~ _ A = 4.50 ft 29.6 ft ~::{~:::::;:::~ :.::::::::::::::::::~~~~~~~~~:;:;:;:;:'~ q~ B = 100.0 ft I ~ ,'''''''''•' ' '.''''''''' ''' J = 7.10 ft W ~E~---- B I = 18.00 ft I ' K K = 9.21 ft y 1/66 = 16.67 ft ~_,__ L _ 118.42 ft r typ. obs. pipe (anchored securely) I =down slope dimension L =absorption cell (AxB) J = up slope dimension ~ =plowed area (LxW) K =end slope dimension s^ MOUND CROSS SECTION subsoil cap D ., ~F'` lateral topsoil G H E = 16.7 in invert 97.27 ft_ F 9.5 in elev. ---- - - ------ : :,:::.:.`:: ~F G = 6.0 in T ASTM C33 H = 12.0 in ~ Sand Fill E sys. 96.77 ft y ~' --~ elev. 95.60 ft contour 5 % --~ slope D = upslope fill depth plowed layer E = downslope fill depth Note: Absorption cell media will consist ', F =absorption Cell depth of aggregate and pipe with laterals G =subsoil + topsoil depth at cell wall centered across Ax6 media. The cell H =subsoil + #opsoil depth at cell center media is covered with geotextile fabric. Designer notes: Project: Gregory Mound Transaction Number: - Page 3 of 9 ~/lam/ ', MOUND PLAN VIEW . i ~~ ~ I PRESSURE DI STRIBUTION CALCULATIONS Dispersal cell Width (A) 4.5 ft Length (B) 100.0 ft Lateral specifications Number laterals 4 Orifice/lateral 25 holes Lateral length (P) 49.00 ft Orifice diameter 0.125 in Lai, dis. rate 10.30 gpm Sys. dis. rate gpm Orifice spacing (X) 24 in Lateral diameter Pipe diameter Design options Design choice j. .-,~.• , ., ~ .. , _ __ Designer,must _ "X" one choice ', from the options provided. 11n x 1 1/41n x 1 1/2 In x x 2 in x 3 in X Place X in red box of chosen diameter. Manifold diameter Pipe diameter Design options Design choice arab "X" one choice from the options provided. 1 in x 1 1/4 in x 1 1/2 in x X 2 in x 3 in x 41n x Place X in red box of chosen diameter Distribution system contains: 4 Lateral(s) LATERAL DIAGRAM -CENTER CONNECTION Place correct lateral diagram by clicking in one of the drawings at right and dragging the diagram into this area. Foro~ main oonn~otion via t~~ or Dross to manifold at any point. le P ~ -Turn-upnn'ball valve or IEX-3IExi2 I xf2->I ol.anoutplup Holes drtlted on the bottom of the lateral. laterals are identioal Laterals & foroe main of PVC Sch 40 per COMM Table 84.30.5 ', Lateral length (P) Lateral spacing (S) Orifice spacing (X) Manifold length Orifice diameter Lateral diameter Forcemain diameter Project: Gregory Mound Transaction Number: 3~~• ~/l~l a~D ft x, ft ~R in ft , 0~1~6 ~ in :-x::50. ~ in in Page 4 of 9 TDH and Pump Tank Drawing Total Dynamic Head f Operational head 6.50 ft ~ Vertical lift 7.57 ft ~~'t,0 Are laterals the highest point in the Friction TOSS 1.39 ft Z' system? Yes "X" here. ~.J Total dynamic head 15.46 ft If no, what is the highest elevation ', d03@ VOIumA downstream of pump? C~ Dose is > 5 times lateral volume Forcemain drain Lateral void volume 20.7 gal back to tank? ("x" one) Minimum dose 103.5 gal x Yes Drain back 8.7 ~ gal No Dose volume 112.2 gal j Typical Pump Chamber Layout In combination with state approved treatment tank. 0 approved manhole coverer W ~ • weather proof warning label and locking device 1 - ~ ~~ junction box -~ grade Levels ;~ f; n disconnect ~y r electric as per NEC 300 and ~ ~•~ t alterna e ~ outlet Comm 16.28 WAC ', ~, location 18" min. U ' wall of pump 2~r ~ chamber or "^•><"!"""'~ '~' combination tank ~-- A alarm on pump on B pump 89.7 ft C ` off elev. t D 3 " of bedding under tank Tank manufacturer Midwestern Preca Pump tank capacity 17 gal/in Pump tank volume 650 gal Pump manufacturer Zoeller Pump model number 98 o A '~ B Alarm manufacturer SJ Electro ~ C • Alarm model number 101 HW 'p D M d ~~ approved ~ outlet joint Provide 1/4" weep hole or anti- siphon device as necessary Grade levela - pump tank manhole = 4" minimum above finished grade -vent = 12" minimum above finished grade 88.5 ft Pump tank elevation at bottom of tank Inches Gallons 18.6 316.8 2 34.0 6.6 112.2 11 187.0 Project. Gregory oun Transaction Number: O s ~ ~ ~~~'~+e 5 of 9 • ~~; ~ X ~. ,t ~~ = fi 15 4 O 1.•• 10 2 5 0--'-- U.S. GALLONS LITERS 10 HEAD CAPACITY CURVE MODEL "98" 30 401 80 1fi0 FLOW PER MINUTE 240 70 TOTAL OVNAMIC HEAO/FIOW PER MINUTE EFFLUENTANOOEWATERINO CAPACITY HEAD UNITSfMIN FEET METERS GALS LTFt3 5 1.52 72 273 t0 3.05 61 231 15 4.57 45 170 20 8.10 25 95 Lode Valve ~ 23' CONSULT FACTORY FOR SPECIAL APPLICATIONS • Electrical alternators, for duplex systems, are available and supplied with an alarm. • Mechanical altemators, for duplex systems, are available with or without alarm switches. Standard all models -Weight 39 Ihs. -'/: N_P 98 Series ConVoi Selection Model Volts•Ph Mode Amps Slm lex Du lex M98 115 1 Auto 9,4 tar 1 b 7 - N98 115 1 Non 9.4 2or288 3or485 D98 230 1 Auto 4.7 1 or 1 8 7 - E98 230 1 Non 4.7 2 or 2 8 8 3 or 4& 5 FarhlbmtelbnonaddNbnalZoallerplodueblaferbeabbgonCombhxiflonSlener, FM0514; Piggyback Vartabk LevelSwitches, FM0477; EkctrkalAllemabr, FM0488; MechanicalAitemator, FM0495;Sump/ Sewage Basiru, FM04B7; and Single Phase Simplex Pump ConUoUAkrm Systems, FM0732. 4 3f 16 i eK1102 • Variable level float switches are available for controlling single and three phase systems. • Double piggyback variable level float switches are available for variable level long cycle controls. SELECTION GUIDE 1. integral Moat operated 2 pole mechanical. switch, no external control required. 2. Single piggyback variable level float switch or double piggyback variable level, float switch. Refer to FM0477. 3. Mechanical alternator 10-0072 or 10-0075. 4. See FM0712, for correct model of Electrical Alternator, E•Pak, 5. Control switch 10-0225 used as a conUol activator, specify duplex (3) or (4) float system. 8. Four (4) hole J-Pak, )unction box, for watertight connection or wired-in simplex or duplex operation, 10-0002. 7. Two (2) hole J-Pak, for watertight connection or splice. CAUTION All Installation of controls, prolecNon devices and wiring should be done by a qualified licensed electrtelan. All electrical and sa[ety codes should he toilowed including the most recant National Electric Code (NEC) and the Occupational Safety and Health Act (OSHAI• . ~F~ESERVE POWERED DESIGN ~ ` For unusual conditions a reserve safety factor is engineered into the design of every Moeller pump. '~ _ _ ~ ~- ArA2 T0: P.O.80X 18347 --- ~ oE~~E~ Lodsl~8e, rcr 40158-0317 Alanlahciue,s or.. O SH/P717: 3649CaneRunRaad ~ lol~afe, r<y 1o11ta96t l~~P S~~ l9.99~ .~ ~~ PUMP !O. (50?) 778.1731 • i (800) 91B-PUMP FAX(502)771.3614 ,~~~~a~9 6 1/4 ~/8 _~ I 3 5/8 1+ d 3j16 1 1/2-11 1/2 NPT d A L ~ I . . u~ ~., .~ . .... ..... ..... f ~........ 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Y > Y Y > > Y >~J < < t < < < < < < < i < < < < < t { { t t < t < < < < { < { < { < ) > Y ) > > <Y<><>f,<YfY<Y<Yt>`YtY<,tYtYf> )<)t>t)<)t Yt) > > Y Y ) > > > > > > > Y > > < t < t < Soil Material t t<<t<<t<<<t<<< )>>>. )> > Y > > Y Y Y Y ) Y > > > Y < t < < < <~ <~ <~ <• <~ <~ <~ <~ <• < < < < < < t i < i < < < < i < < > > > > > f > > > ) ) Y > > > Y > Y > > > Y > > > Y > > Y i < < < < < < < < < < < < < < < ' i Y > > Y > > > Y > Y > Y > < t < < < < < < < < < < < < < t t < < < < < < t < t '. < < < i < < t <<t<< Long Sweep 90 ' ' ' ' ' > > > Y or Two 45 ` ` Bends to Vertical Distribution Lateral II i .. Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The 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 filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be 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, Safety and Buildings Division. Puma 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 Svstem No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched for frost protection. Influent quality into the mound system may not exceed 220 mg/L BODS, 150 mg/L TSS, and 30 mg/L FOG, Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing 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 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manual [SBD-10572-P (R. 6/99)] 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. Continaency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged adsorption and dispersal media, and related piping, and replacing said components as deeme necessary to bring the system into proper operating condition. OG ~~ ~ v 1 ~~n ~~ Questions on the operation o aintenance of this system should be di~ecte to your county zoning r health inspector. S`~-, ~ ~X ~ ~.~.~ Z Imo- 38~- y~8~~ '~ t 9 ~ • f ~, ~ 1 f p., . ~ FORM N0. 985-A ~~ M.C.Mi11.rCdprry~ 36~~1,~ -~`. CERTIFIED SURVEY MAP ,; ~~ ,: .~ ~~ _ .. ~,~ `L+ ~`Ep~ F 1979 0 CT. 9CON-tEll S4 (lolx ~^~ ~ W~~,•M • ~ r m ~~ ~~ rn Z - ~ v ~ = m O w -I z ~ -_ ~ W ~ cn ~ ~ N m m ~ ~ ~ - .•~ O r O c Z Z Z v m ~ D ~ r m ~~ ~rn 0 ~ c, Z O C ~O C ~AFO rn y -1 a a ~o ,p o ~ o N 0 0 -~ --- `' Z 0 z ~'p ~ I x W r S I °21° 15~~W 783.25 ~ I°~ I Z N W~ N N °, 750.24 rnl ~ ^~ p p ~ O N~ ~ - °o+ a r ~ O1- 450.24'^ of N I °21'15"E 483 25 w m I 1 ~ n ~ y nl p ~,, n ~ ~ ~ . \6 I b° 0 m 0 o •. o o ,~ ~ W ~ y y\• I 1 2 ~ m ~ 300.00' i',o •~'•• O I,, ~ O ~ ° N I 2! I S E ND I •_.• .• 1 y I Z I I~ ~ _ _ I ~ W N I 'P ~ I I ~ O 4 C O ~ Z~ ~ ao o ~ n~ ~- O ~I I O - . ~ y~ ~ m m V ~ f O m o o ~ w ~~ o o N 'I I O ~ ~ ~ roZ ~~ I ~ o l o 0 ~ o w O tic ~ ~ I F o ° I ~ ~i O i - w - I I -~ 0 I Iz v°~6 m m~,~. Iw I , ~`` ' v,,~0 750.24 I ~ N 1°21 1 5 E 783.25 I I " _ ~~ ~o "~ Z-_ ~- ~ ~~~ .p I ? ~ I n Z APPROVED I ~ ~ ~, z m 133 ~ ITt 3~ ~ 19 1979 I 1 ~ ~ ~ rn N 0° 2440 " W 855. 34 1 ~ 9 COMPRENENSIV_ p•~KiC:; .A' '"+~ I V 4.° AND tONINa GOMM11 Ott 1 ~ ~'~ I to ~ ~~ p m ~ ~ ZI n °c y ~ ~ O ~ APPROVAL OF THIS MI rn i m m --I ~ NOR $U D DOES NOT MEAN ~ LION ~ "' "' `O VA BUILDING APPRO SIT FOR _ _ _ o o _ °o L c OR SEPTIC SYSY ~ REFER TO H62 2 . p, I ~ o ~ ~,,, ~ rn = - -- - - - - - 855.34' - - - ~ --~ I--z C1 ~ TOWN ROAD ~W" w 455.81' _ -~ ~ ~ S 0°24 40 E- _ _ _ _ 1311.15 W - - _ _ _- Z EAST LINE OF SECTION 27 ~ volume 3 Page 875 - -- - --- I I I c»,~~ ~ RI I ~ rn>"/ ~ c- 'I 79-75 THIS INSTRUMENT DRAFTED 8Y ~'''""'~ ~ i Wisconsin Department of commerce SOIL AND SITE EVALUATION Qivisio/1 o(Safety and Buildings in accordance with Comm 83.09, Wis. Adm. Code Page ~ of~. Bureau of Integrated Services Attach. complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not {invited to: vertical and horizontal reference point (BM), direction and ~"~ ~ O 1 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. parcel I.D. # ~(- /D ~ 3 - °30 - DC~00 APPLICANT INFORMATION -Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy law, s. 15.04 (1) (m)). ~~ ti- ~ O Pro rty Owner /~ f ~ 1/ (~Gl Ol. C~ Property Location ~~t ~L, 1/4 /l~~i/4,S a ! T ~ C~'N,R ` ~ ~ W Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# 3 ~~^ Ste, ~` A C S ~ S Ciity~ State Zip Code Phone Number LC ~ 1 ~~©1~ I t~1~ I ~4b~71(-71~)77a-~~ ^ ~. ^Jy~~ ®Town Nearest Road ~v ~ 3~~ S l a ^ New Construction Use: ~ Residential / Number of bedrooms ~.- Addition to existing buildirig /Y Replacement ^ Public or commercial -Describe: x/ , , Code derived daily flow ~ 5D gpd f C~~~~ecommended design loading rate bed, gpd/ft2 0 ~ trench, gpd/ft2 Absorption area required ~~bed, ft2 3'~? ~ trench, f/t2 (fMaximum design loading rate c 3 bed, gpd/fl~~~trench, gpd/fl2 Recommended infiltration surface elevation(s) 9 ~' 9 A (~~,~Glhoye 9'Jr• GS~~ ft (as referred to site plan benchmark) Additional design/site considerations ++ ~1 Parent material a ~ 1 ~ Flood plain elevation, if applicable ~=T ft S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U = Unsuitable for system ^ s ~ u ®s ^ u ^ s ®u ^ s ®u ^ s l~l u ^ s ® u Boring # __~ . Ground I v. ~~ft. Depth to limiting factor ~~n. Boring # ~' . Ground 9 Ift. Depth to limiting factor Z3 in. CSZ Name Address SOIL DESCRIPTION REPORT Horizon Depth Dominant Color Mottles Structure i C t nd B Ro t GPD/fi2 in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. ons ence s ou ary o s B r A9" ++ ff~~ • IV ~3 C 31 ~ ~ ~S ~ (~ t' Q. s o~~ ~ ( y • ~C7 4 L -----~ ~~ ~,~ i 5 r y ' L ~r- aw , 5 .L . ~- .0 Remarks: U C C11 ~c~J S°~~ w~ , ~ ~~ ~c s,~ o_~ r, n kc-{ 1 a y ~~ L ~ c ;o "-7~ '1 5 ~ 1 r I o~~o" •v Remarks: (Please Print) (~ ~- Telephone No. 15 - 8 ~8 - ~~33 s~B~is Dat~las/oo cS~D7~•~ PROPERTYOWNER~4~e.Q 0 ~_ SOIL DESCRIPTION REPORT PARCEL I.D.# Wy ~-~©(p3 _ 3~ _ f~C•~-~lJ Boring # Ground `~~ V eft. Depth to limiting fa or , ~in. Boring # Page ~ of~ ' Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounda Roots 2 in. Munsell Qu. Sz, Cont. Color Gr. Sz. Sh. ry Bed ranch r ~ ~~ ~ ~ ~ - c c~ t ~ f' 1~ ~'Js `~ ' a L_ 1=1 ~ -- 5) L ~ ~ i ~u l~- ~~ ~ ~ ~; L blc r o~ ; v ,o Remarks: q~~ ,~j _ , Ground elev. ft. Depth to limiting factor in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Boring # Ground elev. tt. Depth to limiting factor Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounda Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ry Bed ,Trench Remarks: m. Remarks: SBD-8330 (R.9/98) i i-i: { C'tarence Glotfelty U ~~/~t~ Pnviro-Tech Systems & Services N49SS Suiuiy Hill Road _ Weyerhaeuser, WI 54895 ,(~ i 1 . Wis~nsin Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code /JEl's~rl~jy Sec, z7,Tz~~t, ~ E/eda>"ca'-i ScaCe~ ~ „ ~o Attach canplete site plan on paper not less than 8'/z x 11 inches in size. Plan must Coun ty inGude, but not limited to: vertical and hor¢ontal reference point (BM), direction and ~, percertt slope, scale or dimerrtsions, north arrow, and location and distance to nearest road. Parcel I.D.# ~-~'"' ;, 004-1063-30-000 APPLICANT INFORAAATION - sie ptmt~a~l i-tformation. Reviewed By Date Personal information you provide may be o~sectindary puryoses (Piivacy Law, s. 15.04 (1) (m)). , Property Owner ~.`. ° ~ " ; ,« ~ '• `'~ Richard & Marcia Gre o _' Property location GovL Lot NE 1/4 NE 114 S 27 T 28 N,R 15 W _ Property Owner's Mailing Address ~ Lot # Block # Subd. Name or CSM# 182 310th Street ~ " ' ` E 1 CSM Vol. 3, Pg. 875 City State Zip Cody F~P-~it~Number ~ ~ City ~ Village Town Nearest Road ' 3468:; Wilson WI 54027,. -'~ =.7~ ,_ - Cady ~ 310Th street ~ Residential / Numbeer of bedrooms 3 ^Addition to existing building New Construction Use: ^ Replacement [~ Public or comn~ceCal describe r . Recommended design loading rate 0 bed, gpolft2 .3 trench, gpolftz Code Derived daily flow 450 gpd ,_ Basal area required bed, ftz 1500 trench, ft~ Maximum design loading rate 0 bed, gpdi'ft~ .3 trench, gpd/ft2 Recommended infiltration surface elevation(s) 97.57' at 23" above 95.65 contour. ft (as referred to site plan benchmark) Additional design I site Considerations Mound to be kept as close to house as possible per owners desire. Parent material Glacial till Flood lain elevation, if a icable NA ft S=Suitable for System Conventional Mound In-Ground Pressure AT-Grade System in Fill Hording Tank U=Unsuitable for system ^ S ®U ®S ^ u ^ S ^ U ^ S ®U ^ S ®U ®S ^ U C(lll f1FCCRIPTIUN KCI+UK 1 Boring# 1 Ground elev 94.80' it Depth to limiting factor 22' 2 Depth Dominant Color Mottles Structure i d B ots R ~~~ Horizon in Munsell Qu. Sz. Cont. Color Texture Gr. 5z. Sh. Cons stence oun ary o B~ ~, Trench 1 0-9 10yr3/2 None sil 2fsbk mfr as 2f,lm 0.5 0.6 2 9-15 10yr4/4 None sil 1 thin pl dsh as if NP 0.3 3 15-22 10yr4/6 None sil 2msbk ds aw if 0.5 0.6 4 22-37 7.Syr5/8 f2f7.5yr4!6 & f2d10yr6/2 scl Om dsh - - NP ~ 0.2 Remarks: 1 0-6 10yr3/2 None sil 2fsbk mfr as 2f,lm 0.5 0.6 2 6-10 10yr4/2 None sil 1 thin pl dsh as if NP 0.3 3 10-13 10yr5/4 None sil 1 thin pl ds aw if NP 0.3 4 13-24 10yr5/4 f2p7.5yr4/6 sil 2msbk dsh aw - 0.5 0.6 5 24-44 7.Syr5/8 ~ t2,dj~j'y~f2 scl Om dsh - - NP 0.2 Ground elev OZ dR' H Depth to limiting factor 1 R" Remarks: CST Name (Please Print) Signatu Telephone No. James K. Thompson °' 715-248-7767 Address A.C.E. Soil & Site Evaluations Date CST Number Ref # 340 Paulson Lake Lane, Osceola, WI 54020 4/12/00 3602 1198 MAY 15 0 Owner': ~•Gliarci~ i'~a-i'C..'a ~rel~ory ~ tl.2 3 /OO ~` //fit . cv.-l~s a>7, ~i syoz ~ ~¢ncil+ ii'ti(ai~~ ~'~v~ off' P 5id~'n9. /fs5umed elatf = iOD.cp," eX~'s~''J 3 bedreo~*, ~ jFEXiS~inq 5y.5~fe.n (y~r,~oone.~~s f`GS,~e~Ce /lob ei/ido~~. ~rc~cZ~ /oca_-C'~i ~~oo~r' cc6a..r donm~o-t. ~5. ~_ _. ~r ~, ^ ~1'VrCG .SGt!'.~'QCQ p/,S[r~ics~C -irrar» 6<XiS~d`r~_q jlr.'~'""i Page 1 of 3 A.C.E. Soil & Site Evaluations driUe~y ~e ~{;rnc~~e~ei' Qle~ o~ •{vo of buy [al„~q 5ec,~er' =~8. ~ 0 ~ 956Sr" ^j~--1r! ~r` S~1 S/oac ~3io~' 5~'~ c~ ST CROIX COUNTY SEPTIC `TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/B 1i ~YI~c-c'° Mailing Address ~B ~ 3 ~ ~~ ~_ property Address (Verification required Planning Department for new construction) City/State ~ ~ ~ SO ~ ~ ~ ~ ~ Pazcel Identification Number (~`{ ' x(7(03 `3c~ ° UGbD LEGAL DESCRIPTION Properly Location i v G--'/., N E '/<, Sec. a--~ . T ~3N-R~_w, Town of ~ L~~~ Subdivision (Y~ d ~-~ Lot # Certified Survey Map # ~ ~ lOV 3 ~ 1 ,Volume ~ .Page # S7 S Warranty Deed # ~ y9 ~ ~ g _, Volume Page # 3 Spec house ^ yes ~ no Lot lines identifiable j~ yes ^ no SYSTEM MAINTENANCE 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. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a mastCrplumber, journeymanplumber, restrictedplumber or a licensedpumper verifying that (1) the on-site wastewaterdisposal 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. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards szt ;arth, 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 Zoning Office anthm ~~ days of the three year expiration date. / / D SIGNATURE OF APPLI DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) lmowledge. I (we) am (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE OF APPL DATE ****** ****** Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed yol. ~'S'98 P~cE~$'~ ~ ~/ 5[~9~~8 STATE BAR OF WISCONSIN FORM 2 - 1982 ~ WARRANTY DEED DOCUMENT NO. Sidney C. Anderson and Rose M. Anderson, husband and wife, conveys and warrants to Richard B. Gregory and Marcia A. GreQOry, husband and wife, as survivorship IBarital property, the following described real estate in St. CroiX County, State of Wisconsin: ~ p ~ -- REGISTER'S OFFICE ST. CROU(CO., WI RtrotlbrRmd SEP 4 1996 at 1:00 P M '~.*tle..,. `F~ ~,J.h. Register of Deeds THIS SPACE RESERVED FOR RECORDING DATA NAME AND RETURN ADDRESS EQu.t~f Tiff-e;- X73 ~ l ~.5~7 400 ot,t~G\ ate- ~~lS 004-1063-30 PARCEL IDENTIFICATION NUMBER Lot 1 of Certified Survey Map filed October 9, 1979, in Vol. 3, page 875, Document No. 360317, being a part of the NE1/4 of the NE1/4 of Section 27, T28N, R15W, St. Croix County, Wisconsin. TRANSFER $330 -- _I - This _ is homestead progeny. (is) Exception to warranties: Easements, restrictions and rights-of-way of record, if any. Dated is ~~ day of _ AU ust , A.D., 19 96 ~ C ~ (SEAL) (SEAL) Sidney C. :4nderson R se M. Anderson AUTHENTICATION Signature(s) (SEAL) authenticated this day of , 19_ TITLE: MEMBER STATE BAR OF WISCONSIN (I(not, authorized by §706.06, VJis. Stats.) Diane NI. Marron Notary Public THIS INSTRUMENT WAS DRAFTED BY State of Wisconsin P.ttorney Kristina Oland Hudson WI 54016 (Signatures may be authenticated or acknowledged. Both are not necessary.) ACKNOWLEDGMENT (SEAL) State of Wisconsin, ss. St. Croix cou Personally name before me this V ~ day of n„,.,,~r 19~._, the above named ~- Sirinay (:_ Anrlarcnn and Rnca M_ Antlarcnn, hltahanrt and o~i Ya r to me kno\vlr to be the person S-_ who executed the foregoing instrttmen[ and acknowledge the same. Notary ublic, County, Wis. My commission is permanent. (If not, state expiretio te: • Namcs of persons signing in any capazity should by typed or printtd below their signatures. N',11t RA NTY b F F U 5'rATE IM R OP \V I SCON S IN Wgcorsin I °tpy Plv,k Cn .Inc. I~nrm No. 2 - 1982 M1wa,ktrr. Wb Contingency Plan: In the event that this POWTS or a wmponent of this POWTS fails and cannot be repaired the following is proposed. Replacement area for absorption cell (per Soil evaluation ), or add an ATU to recover a failing drain field, or other repair or replacement to code. If dosing tank is used -dosing tank, pump, pump controls, alarms or related wiring becomes defective the defective component shall be immediately repaired or replaced with a component that is betty or equal too performance. Questions on the operation or maintenance of this POWTS should directed to County Zoning or Health Inspector. ~ty Zoning 7 ~f ~ra~ x Cf~ ~~ ors- ~~-y~ao