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HomeMy WebLinkAbout044-1039-95-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 552354 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Heath, Robert D. Cady, Town of 044-1039-95-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: l 65 I 17.28.15.268A TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. 77 -1 row Septic Benchmark Dosing Alt. BM l 6 -t~K- A"= el Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WEt'vj BLDG. V t to Air Intake ROAD Dt Inlet , 56 44- C" Septic Dt Bottom .h 7 ®t)6 9 -Y di n 'W ~5 , Dosing o 9 " U Header/Man. /60 Z -1 Aeration Dist. Pipe ~r Holding Bot. System - d J1 Final Grade PUMP/SIPHON INFORMATION Manufacturer 6 j /tom GP and St Cover d Model Number ~ I TDH ILk,56 Friction L System Head TDH®~o Ft Forcemain Lengt a Dia. ,r Dist. to Well SOIL ABSORPTION SYSTEM__„ BEDITRENCH Width r Length No. O Tren ies PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Ma st~ 4r1 Ajt ~ UNIT Model Number: DISTRIBUTION SYS EM 5 Header/Manifold 's Distribution x Hole Size x Hole Spacing Vent t Air Intake Length ?04ZDia Length 31-71 Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Over Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center r/ JBedrrrench Edges Topsoil I Yes Fq] No Yes No Y COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: l6/ Z-31 12 Inspection #2: Location: 2820 Cty Rd N Wilson, WI 54027 (NW 1/4 SW 114 17 T28N R1 5W) NA Lot Parcel No: 17.28.15.268A 1.) Alt BM Description =(~~~1 LJ 2.) Bldg sewer length - amount of cover 3.) Contour = Plan revision Required? E Yes >rNo Use other side for additional information. Date Inse ctor's nature Cert. No. SBD-6710 (R.3/97) ~'ty County / r Safety and Buildings Division ez~ ' 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit tNNumber tobebe fill in by Co.) SIP fit! Madison, Wl 53707-7162 55 Z J Sanitary Permit Appli o State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this fo a appropria emmental unit .2 0'3 C7,3 (o is required prior to obtaining a sanitary permit. Note: Application forms for state-ow S are submitted to Project Address (if different than mailing address) _ . 1 the Department of Safety and Professional Servies. Personal information you a may be u ferondary I`D_~1()1 N purposes in accordance with the Privacy Law, s. 15.04(1 m , Slats. ~kk// z$Zb I. A lication Information - Please Print All tion t` ms Owner's Name / Parcel # Pro Property Owner's Mailing Address 53. v U„• NjNG ofr ivy Property Location 14, r4 pv,NNING 8` Zd Govt. Lot o / I City, State Zip Code Phone Number iC4 Section Lt"I` / f t./ le one r S. r T ~a N; R e0 H. Type of Building (check all that apply) Lot # * or 2 Family Dwelling - Number of Bedroom Subdivision Name Block # ❑ Public/Commercial -Describe Use ❑ City of ❑ State owned - Describe Use / CSM Number El Village of g Town of ( y L-,73 e J6 III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ❑ New system i Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued B. ❑ Permit Renewal ❑ Permit Revision Before Expiration Owner IV. Type of POWTS S stem/Com onent/Device: Check all that a 1 ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade 0 Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis ersal/Trea ent Area Information: Design Flow (gpd) Design Soil Application (gpdsf) Dispersal Area Dispersal Area Propo s System Elevation 11s~ I. L3 d, Z( r0 7~~ a s~ Q? ,/a VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units a 21 U, New Tanks Existing Tanks w ° d ` m le.J B d~ F Uc 0-20 m w 0 a Septic or Holding Tank ~d G U , t? X 2 Dosing Chamber i~r VII. Responsibility Statement- I, the undersigned, ass a responsib' ' or installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumbe Signature /MFRS Number Business Phone Number J-e e GEC 2 3 7 ~s~ G - s7C Plumber's Address (Street, City, tate, Zip Code) VIII our /De artment Use Only Approved Permit /_~fFee~j Date Is ued Issuing t Signatur ~~~..J t IX. Condit{kM"eWeasons for Disapproval 4eA- 1. $eptlc tank, aftluartt filter and [.s I dispersal cell must an be services / maintain A()!- #'A- ~ t.wl as per Management plan provided by plumber. 2. A# stack requ 0rW1tts must be mainWridd as Par 411110110010 Wft / ad mica : Attach to complete plans for the system and submit to the County only on paper not less than Te i'~4 SBD-6398 (R. 11/11) i _ I t flip ~2gct )Sr- ~%f ^ 2 7 7 0 C/C a, ux v 5 rm ~t i 97., C--1 z . 2 i t v. ~ ~ ~ . Jae r r r J t i i t 4 0 0: 14,11 1 T-F 1 tf AR21ipN~ Safety and Buildings 3824 N CREEKSIDE LA e \ ; HOLMEN WI 54636 3 0 S Contact Through Relay P $ www.dsps.wi.gov/sb/ 9 `Gw www.wisconsin.gov ~O sS101,4 Scott Walker, Governor Dave Ross, Secretary May 11, 2012 CUST ID No. 223475 ATTN: POWTS Inspector JOE STANG ZONING OFFICE STANG PLUMBING & ELECTRIC ST CROIX COUNTY SPIA PO BOX 263 1101 CARMICHAEL RD WOODVILLE WI 54028 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/11/2014 Identification Numbers ' Transaction ID No. 2081836 SITE: Site ID No. 779056 Robert Heath Please refer to both identification numbers, 2820 County Road N above, in all correspondence with the agency, Town of Cady St Croix County NWIA, SW1/4, S17, T28N, R15W FOR: Description: Three Bedroom Mound System / 6% slope Object Type: POWTS Component Manual Regulated Object H) No.: 1370364 Maintenance required; Replacement system; 450 GPD Flow rate; 18 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD-10691-P (N.01101), Pressure Distribution Component Manual -Version 2.0, SBD-10706-P (N.01/01); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructe(PRI A E Z"i i' and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. le-T The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code Condit 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 PRI stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Bill !ON OF SAF 00-1 Reminders • A sanitary permit must be obtained from the county where this project is located in accordance with the SEE CORRES 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. • 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 SPS 384 product approval conditions. • The area within 15' downslope of the dispersal cell shall remain undisturbed. Vehicular traffic, excavation or soil compaction is prohibited in this area. • The existing shall be properly abandoned per SPS 383.33, WAC. • A copy of the approved plans specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department which may include local inspectors. JOE STANG Page 2 5/11/2012 Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. SPS 383.54(1). • In the event this soil absorption system or an y of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 Gerard M Swim POWTS Plan Reviewer, Integrated Services WSMART code: 7633 (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm jeny.swim@wisconsin.gov cc: Charles L Bratz, POWTS Reviewer II, (608) 789-7893 , 7:45 am - 4:30 pm Monday - Friday Joe Stang, Stangs Plumbing and Electric Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Safety & Buildings will be modified. Code references with prefixes starting with "Comm" will be replaced with "SPS" to recognize the relocation of the Division of Safety & Buildings from the former Dept. of Commerce to the Dept. of Safety & Professional Services. Additionally, all S&B codes will be renumbered and addressed in a "300" series. For future reference, the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. JOE STANG Page 2 5/11/2012 Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The. owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a. copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 ~ Balance Due $ 0.00 Gerard M Swim POWTS Plan Reviewer, Integrated Services WiSMART code: 7633 (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm jerry.swim@wisconsin.gov cc: Charles L Bratz, POWTS Reviewer H, (608)789-7893 , 7:45 am - 4:30 pm Monday - Friday Joe Stang, Stangs Plumbing and Electric Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Safety & Buildings will be modified. Code references with prefixes starting with "Comm" will be replaced with "SPS" to recognize the relocation of the Division of Safety & Buildings from the former Dept. of Commerce to the Dept. of Safety & Professional Services. Additionally, all S&B codes will be renumbered and addressed in a "300" series. For future reference, the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. -4ECEIVED APR 3 0 2012 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Heath Mound Owner's Name: Robert Heath Owner's Address: 2820 Cty Rd. N Wilson, Wisc. 54027 Legal Description: NW1/4 SW1/4 S17 T28N R15W Township: Cady County: St. Croix - Subdivision Name: Lot Number: Block Number: Parcel I.D. Number: 044-1039-95-000 f Plan Transaction No.: ovrz Page 1 Index and title ! Page 2 Data entry AND Page 3 Mound drawings Page 4 Lateral and dose tank, Page 5 System maintenance specifications 3O'N E-NC6 Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Soil Evaluation Report Page 9 Plot Plan Designer: Joe Stan License Number: 223475 Date: 04125V12 Phone Number: 1-715-684-5166 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) Version 4.01 (R. 09/04) Page 1 of 9 Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 300.00 Estimated Wastewater Flow (gpd) Table 83-44-3 in-situ soil treatment for 1.50 Peaking Factor (e.g. 1.5 = 150%) fecal coliform of - 36 inches. 450.00 Design Flow (gpd) 6.00 Site Slope 91.60 Contour Line Elevation (ft) 18.00 Depth to Limiting Factor (in) 0.60 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 65.00 Dispersal Cell Length Along Contour (ft) = 6.93 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ft) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (c or e) c Center or End Manifold 3.47 Lateral Spacing (ft) If N above, enter the elevation (ft) 4 Number of Laterals of the highest point. 0.156 Orifice Diameter (in) (e.g. 0.25) 3.00 Estimated Orifice Spacing (ft) = 10.24 ft2/orifice 200 Forcemain Diameter (in) LE~40'0o Forcemain Length (ft) Does the forcemain drain back? 6.00 Pump Tank Elevation (ft) Enter Y or N 4.55 System Head (ft) x 1.3 6.52 Forcemain Drainback (gal) 6.77 Vertical Lift (ft) 25.86 5x Void Volume (gal) 0.50 Friction Loss (ft) 32.39 Minimum Dose Volume (gal) 11.82 Total Dynamic Head (ft) 23.69 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection im dia. options choice in. dia. options choice 0.75 1.25 x 1.00 x x 1.50 x x 1.25 x 2.00 1.50 x 3.00 2.00 x 3.00 x Gallons/inch Calculator (optional) Treatment Tank Information 650.00 Total Tank Capacity (gal) 1000.00 Septic Tank Capacity (gal) 38.00 Total Working Liquid Depth (in) Wieser Manufacturer 17.11 gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 650.00 Dose Tank Capacity (gal) Best Filter Manufacturer 17.00 Dose Tank Volume (gal/in) GF10-8 10x18 Filter Model Number Wieser Manufacturer Project: Heath Mound Page 2 of 9 Mound Plan View T J Observation Pipe FK. 77, A I L Mound Component Dimensions ft A 6.93 ft E F----2-2-9-9 in H 1.00 ft K Uft B 65.00 ft F 9.00 in I 11.58 ft L ft D 18.00 in G 0ft J 6.99 ft W 450.45 (ft) Dispersal Cell Area 1203.29 (ft) Basal Area Available 6.92 (gpd/ft) Linear Loading Rate 6.50 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 94.85 (ft) ► 2 }r}}rrrrf.. }}}}}tom. F 11 - 93.60 (ft) Lateral Dispersal Ce 93.10 (ft) - ► - Invert Dispersal Cell . t Elevation E, D : ~3 -tik„ R,. y f$ ~?.{a + a a y 1 ti 3 a A a,~%{a {ti ? { a... 91.60 (ft) Contour Elevation 6.0 % Site Slope Geotextile Fabric Cover Shading Key a E Dispersal Cell See lateral details on 10 Topsoil Cap o = 1.5 ft ell" % Page 4 for number, © g Subsoil Cap o size, and spacing of ASTM C33 Sand ~ F laterals. Laterals are 0.5 ft Typical Lateral equally spaced from the Tilled Layer a c m v 5° distribution cell s Aggregate o ye centerline in the A distribution cell (AxB). Project: Heath Mound Page 3 of 9 Center Connection Lateral Layout Daigram Force mai n connection Mia tee or cross to manifold at any point. Laterals are identical P Turn-up wrbalI valve or I<-X~I{012 I x12-> Laterals & force main of PVC Sch 40 clesnoutplug per COMM Table 84.30-5 Holes drilled on the bottom of the lateral. Number of Laterals 4 Orifice Diameter 0.156 in Lateral Diameter 1760 in Orifice Spacing (X) 3.02 ft Lateral Length (P) 31.71 ft Orifices per Lateral 11 Lateral Spacing (S) 3.47 ft Orifice Density 10.24 ftz/orifice Lateral Flow Rate 5.92 gpm Manifold Length 3.47 ft System Flow Rate 23.69 gpm Manifold Diameter 1.50 in Total Dynamic Head 11.82 ft Forcemain Velocity 2.42 ft/sec Dose Tank Information Locking cover with waming label and locking device and sealed watertight Electrical as per NEC 300 and Comm 16.28 WAC4 in. min. Disconnect Tank component is properly vented E- Alternate outlet location Forcemain diameter Wieser Manufacturer 2 in. Capacityl 650.00 Gallons Volume 17.00 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 24.33 413.61 B 2.00 34.00 Pump off elevation (ft) C C 1.91 32.39 86.83 D 10.00 170.00 D Total 38.24 650.00 Do~tank elevation (ft) 3" Bedding un er tank. 86.00 Alarm Manuaaacturer SJE-Rhombus Controls Alarm Model Number Tank Alert ! Pump Manufacturer Goulds Pump Model Number 3887 EP05 Pump Must Deliver 23.69 gpm at 11.82 ftTDH Project: Heath Mound Page 4 of 9 Mound System Maintenance and Operation Specifications Service Provider's Name Joe Stan Phone 715-684-5166 POWTS Regulator's Name St. Croix County Zonin Phone 715-386-4680 System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450.45 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once eve 3 ears Effluent Filter Should inspect and clean at least once eve 3 ears Pump and Controls Test once eve 3 ears Alarm Should test month) Pressure System Laterals should be flushed and pressure tested eve 1.5 ears Mound Inspect for ponding and seepage once every 3 ears Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to 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 plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up 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: Heath Mound Page 5 of 9 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01101) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the 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. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD5, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5, 30 mg/L TSS, 10 mg/L FOG, and 10° cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Heath Mound Page 6 of 9 ITT GOULDS PUMPS Wastewater PERFORMANCE RATINGS COMPONENTS Total Head Gallons Item Mi a No. Description (ft. of water) EP04 EP05 1 Impeller 5 53 - 2 Base /6 10 46 62 3 Pump Casing 8 15 36 55 4 Mechanical Seal 20 0 21 46 7 5 Ball Bearings 6 25 0 33 6 0-Rings 9 30 - 11 7 Power Cord 5 8 Oil Filled Motor 4 Motor Housing/ 3 9 Stator Assembly 10 Motor Cover 2 METERS FEET 10 8 2.5 Fr 25 7 q V Q - z 5 _ 15 ~~~rJ2 rJQ- 4 EP05 3 10~. 2 - - - - - - EP04 5'_-. 1 0 00 10 20 30 40 50 GPM 0 2 4 6 8 10 12 m3/h C %PACITY a3.6~ C, P 3 -47 VV, ~Mtiwr~rFisya~'rulMeiMssavlfYc f~reay~tas~t~s.7S~4#tj~:. Oft wo#e iWyrra# taK iF sii~--W' Nam tw cm A, c_ _ _ ro Wit rx <.-ts j + moo" / If IN-,,aae AM ~ 0^ cowf " 91.1. INp- eutt cwwr ;J4; IM2 fc- `10 loll - 4 141 w ft ~.~w► aftooftw" PAR" y c . 44 54 4 .44 7AJ .o vwmuruv O w lay Ua_ 1t~►-a~t e7 lg,j~ -Ii Daub* It cwsftImftmb*ww it w T416" II sobs 0 kwk= 006 IIL fht *L +r~. ems, . e tom: *k ANN" QWU C44*or 'M2 The D of Commexce is an equal oppo r aeevioe poa w araM ob 9 8 ~s amrdaa +e aoce sdeuiaas+er need material m an alternate format, p1me ce ct the &"bi d 6MYj6.31Sf eat TfY GW264-Vr*. ~o:uop~wo} ~~ta2_~]._,e r _~.5.~ ~er~nrc~ sr~ ~oa9a 1-7,gcR~s S7" CRotk Cou~fr s 0' mt y 7'o~.v~s / A) LO ~ SW 5u i7 T~gaJ R isrv I S i y► A t ~ r V 'I, lp 1L ~ ~ f 6Q----___~ 5 ~ ~ ~•j~PF+i. TnN~C Mot 1 :A Dpi 1 1F-- 2a Rou s e ~ sro p - Top 0 ~DhcKir Slap d Top of Cornty- Pouf k ---M !e 4---- _ L Prey t`~NZ AA-q7. el 4 -roF► e C Qhon<- Q . ~dyL c~ 1~c6c c~ ell mr ~as4~~sp vl, T 0 Aclco,, c4.*vsrrz is.. fv 1 ~ pp.Ov 97, 2 4O. 2 i k i' 97.6 sl' ~ ~ ~ az.~ ~ ~6Pf tt Q ] ~ tJ~~' IVic, t. . r^1 T o, ID Wisconsin De rtment fe of ComrgeroP7"0~ SOIL EV~LUATIUN RT Page of Division of Sa and B~s e with Comm 85, Wis. 7nm-eede, -bounty Attach comple site plaoiYs than 81/2 x 11 inches in size. Plan must include, but no irn ited~ Q~ d horizontal reference point (BM), direction and Parcel I.D. percent slope, s a1~1pYt]' sions, north arrow, and location and distance to nearest road. LSOS/ - %Q~? fs- D O c~ Please print all information. Revie'we Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Gw rI+ 5//" Property Owner Property Location R0 `eri Leo- l k Govt. Lot /V W 1 /4 $ UJ 1 /4 S/ 7 T 8 N R 15 E (o W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 82 0 Cl Rai. N - - / 04 . ' A"Z1 12?1 J city l) State Zip Code Phone Number ❑ City ❑ Village W Town Nearest Road W 0n WE ( S ).2 7/ - NY0 CAA Y Ct , 4/. ❑ New Construction Use: Cff Residential / Number of bedroomsCode derived design flow rate '?o0 GPD Replacement ❑ Public or commercial - Describe: Parent material L6~- SS OUer Flood Plain elevation if applicable IVA ft. General comments - and recommendations: l.G S << 3 C ~ ~$cLn c~ c.~ rt c..+..tp IOe ~O~g c a ~ < ( I ©►1 eo"~f-our- Mdu d sy5~~~, gIej. y3: (f~~ ~.y A-L, 6` caw / Boring # Boring Boring # I~ Pit Ground surface elev. ft. Depth to limiting factor c~ O in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 / 0-7 10 YR L f sk P, VK : fi a2 7-20 0 4 a nt sbir 4r --q j 3 ~b°3q Ia 4~D 7•6-'`IR 'r- L .2 c sb rVnu~t I Ids' 41 9-4/0 t o -E~ o -7, S-YR c L oc -5W M-iE i UL , ® Boring # ❑ Boring ® Pit Ground surface elev. q0 / ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 o I L k MG C LA-) I l" U-) l l ~o O 3 .-3 o VA sl~ 1.57` i u f . zl 33 C Ib y ~ -Ga D 7, 9-- 9 t ut s tM~ ~I y * Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Tint) f Signa CST Number erl e ,H-e1 ,esovk a:2 0Q 9--~ Address Date E aluation Conducted Telephone Number /U76Y9 f-~w 1D9 UtJ-r. (7/ S)7;~-.3--> 7S Property Owner 'RD 6rf Parcel ID # ©d "9~-00 d Page of 3 FT Boring #❑q Boring Pit Ground surface elev. 0, 3 ft. Depth to limiting factor 4i~) Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence 666ndary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 J 10V 3 -Gr L-L) t t _3 18-5 l o~ aD . s e- L s ► t y ❑ Boring # Boring pit Ground surface elev. ft. Depth to limiting factor in. Soil Ap lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ❑ Boring ❑ Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BODE > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (R.07/00) Property Owner D ParcelID# ©D - "/r.S- oc Page d of 3 13-1 Boring # ❑ Boring Pit Ground surface elev. L76, 3 ft. Depth to limiting factor t Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence 66ndary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ! ~ ~ ~d t~ 3 ~r its ` , ~ t ~ ~ -3 rai . S'Y 1Z ST ~L o -s~k of y F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Boring F-1 Boring # 11 Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (R.07/00) ~l~f fi~I Q~ 5 , 6. 5.T ~ev~n►c t~e~gesa~oa9, (9 WELL l-7 ~-}CRTs 57" CROIV Coin y C C, 't y j'oc vk,-< A /11 /~Itv~f ~W Sc~.i7 ! I ~s ? -c r qt. p ~ I ~ MCLL~ t ~~tP~,t ►~~k I ~1 A~ D F--_La_ ~7a 51~(p~ ~Sto~~- ~ ~1 M j~r,nec~ Q©cs~►n f kou -c= r Slop Top - COh~re~ ~~a~ d L I I ' B, M, t oo, o ea T©p of 6„Y g, Corr►{~ Pmt j i Prolae' A~a.l✓1. 97. qS ago -rot n~ Pho~,~ pA. ~ Edye of lack op ST. CROIX COUNTY SEPTIC TANK 11MR?MANCE AGMEMENT AND OWNERSHIP CERTIFICATION FORM OwnerlBuyer ~v c ~A e7- i Mailing Address %Z P2 C Y Property Address (V on required from Planning dt zoning Deparmront for new couatuctyorr.) City/State `fo w ti Pared Ideafification Number LEGAL DESCRIPTION Property Location 0_ %4 /4 , Sec.. , T N R l 5- W, Town of CA 4 Subdivision Lot # C rifled Survey Map # , Volume , Page # Warranty Deed # 7 3 9! S' , Volume 3Lrt Pap # Spec houao yes 6;) Lot lines idenditble yea no SYST$M MAIIVTRNANCE AND OWNER C9~RTIPTCATION lnrprop-use and matotenam of your septic system could result in its premature failure to hardy wastes. Props nmusenance consists of puffing out the septic tank every three yeses or soonm if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage m the waste disposal system. Ownernamtonance dies are spwi5od in §Coasn. 8352(1) acrd m Chapter 12 -SL Croix County Sanitazy Ordinanc o. The property owner agrees to submit to St: Crone Canty Planning & Zoning Department a boa form, signed by the owner and by a meet- plum1mjourneytow phnmb-, restricted plumber or a Hcensed pumper vai4ring drat (1) the on4e wastewater disposal system am proper operating condition and/or (2) after inq)ecdon and pumping (if r), the septa tank is less bran 1/3 M of sludge. Uwe, the undersigned have read the above requirements and agroe to momom the pravnta sewage disposal system with the standards set fords, hecein,.as set by the Department of Conamem and the Department of Natural Resources, State of Wroensin. Cacti n stating that your septic system has been mod mast be completed and z+atrned to the St. Cram County Planning Zoning Department wig 30 days of the three year expiration date. Uwe certify dw all on this form era am to the beat of my/our kwwledge. Uwe am/are the owner(s) ofthe propedy described -by virtue of a deed recorded in Register of Deeds Office. abom N of bedtnonmk' SIGMA OF APPLICANIMS) DATE **"Aay inf08natmn that is misrepresented may reauh in the sanitary permit being revolmd by the Ping dt Zo~g Dap.rfinent Include with this application a recordod warranty deed from the Rogow of Deeds Office and a copy of the cemfied noway map if raft=eo is made in the waranty deed. (MV. ft" 2 3 6 0 6 7337.1 STATE BAR OF WISCONSIN FORM 1 - 2000 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS Document Number ST. CROI Co., r x r This Deed, made between Stephen S. Beckman and RECEIVED FOR RECORD Lynette M Beckman, husband and wife 08104/2003 12:45PK Grantor, WARRANTY DEED and Robert D. Heath EXOPT # REC FEE: 11.00 TRANS FEE: 675.00 Grantee. COPY FEE: Grantor, for a valuable consideration, conveys to Grantee the following PAGES: 1 described real estate in St. Croix County, State of Wisconsin (the "Property") (if more space is needed, please attach addendum): The East Half of the Northwest Quarter of the Southwest Quarter (E't of NW'a of SW14), Section 17, Township 28 North, Range 15 West, lying North of Recording Area Highway, Town of Cady Name and Return Address Title One Premier Group, Inc. 706 19th Street South Hudson, Wisconsin 54016 004-1039-95-000 Parcel Identification Number (PIN) Together with all appurtenant rights, title and interests. This is homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except Roadways, Easements, and Restrictions of Record. Dated this 31st day of July 2003 * *S hen S. Beckman * *L ette M. Beckman AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN ) Signature(s) ) ss. St. Croix County. ) authenticated this day of Personally came before me this 31st day of July , 2003 the above named SteEhen S. Beckman and * h~....._.R Lynette M. Beckman TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person s who executed authorized by §706.06, Wis. Stats.) the fore ing i st a knowledged the same. THIS INSTRUMENT WAS DRAFTED BY * . Palm Michael H. Forecki, Attorney N tary Public, State of Wisconsin Eau Claire, Wisconsin My Commission is permanent. (If not, state expiration date: (Signatures maybe authenticated or acknowledged. Both are not necessary.) December 12 2004 . 'Names of persons signing in any capacity must be typed or printed below their signature. WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 1-2000 ttorney Michael H Forecki 1830 Brackett Ave, Eau Claire WI 54701-4627 Phone: (715) 835-3029 Fax: (715) 835-4112 Kay Palm T6753357.ZFX Produced with ZipForm- by RE FormsNet, LLC 18025 Fifteen Mile Road, Clinton Township, Michigan 48035, (900) 38398M ~ 11 i I _ ~ ~ T j I a ~ ~ t C~ G~ / 1 ~ S~ y~~ E SP ~ ~ ~ 1i~y s rb 1 1 10 G i~2/ a ~3 ay ;27' ,26 ~lj 3/ 3i 33 / 35 36 -47 -f LIZ' y3 '7rL G, vJ ~ . V t v l-Ie 16 t~ Is'-6 IV J3~,7, if 16 ~ `b_ -1 b IDX .