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HomeMy WebLinkAbout018-2011-87-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 552353 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: Peissi , Justin & Sarah Hammond, Town of 018-2011-87-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: C-5) 30.29.17.1101A TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. ' A.5 /m/.4 /60 Septic 4 GA. Benchmark Z - 96 ld2 .07 164~' Dosing Alt. BM Wal 10 a f 240'6 /o /.71 Bld .Sewer ` (v5 S 79 Holding St/Ht Inlet Q I ?-7 75.(-7 St/Ht Outlet y,77, TANK SETBACK INFORMATION TANK TO P/L / WELL BLDG. Vent td a ROAD Dt Inlet ` . QA A Septic AA C' I Dt Bottom ~Z55 C1 v Dosing U A 51" 194 ~ Header/Man. 15 / O oa . Z9 Aeration Dist. Pipe ~Ar$ Sao. ~ Holding Bot. System Q cr7. t.~ PUMP/SIPHON INFORMATION Final Grade 3.15 /d li . L-7 Manufacturer /I Demand St Cover r GPM 4,31 AZ' /3 Model Number A5; 4 3~A s v TDH 11-ifta, FrictioryLos System Head TD )J,. _25 /Ft Forcemain Length / Dia. 1 Dist. to well 7-4 z SOIL ABSORPTION SYSTEM BED/TRENCH Width Len th No. Of enche PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth -7 DIMENSIONS 16 SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type f ystem: j " I N /A_ UNIT .4Vi Model Number: ~ Q J DISTRIBUTION SYSTEM Spacing / Ve to Air Intake Header/Manifold / d Distribution Ix Hole SYI-11 / x Hole 2• O3 /47Dia x Length- Pipe(s) 7_7v Spacing 333 p~ Length4 AZ ✓ Dia SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth ver I ~ 75 Bed/Tre ch Edges` Topsoilh of xx Seeded/Sodded xx Mulched Bed/Trench Center lls~ Yes N No Yes ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~f Inspection #2: / / Location: 793 157th Street Roberts, ,WI 54023 (NW 1/4 SE 1/4 30 T29N R17W) Emerald Acres Lot 87~ Parcel No: 30.2~9.117.1101A 9. 1.) Alt BM Description Cp~~ / AAO 2.) Bldg sewer length - amount of cover = Plan revision Required? ❑ Yes No Use other side for additional information. Cert SBD-6710 (R.3/97) Date Inse is S' ture . No. co 1°t~ler Safety and Buildings Division o ' 201 W. Washington Ave., P.O. Box 7162 C F_ i s a Fla Madison, WI 53707-7162 Sanitary Permit Number (to be filled in by Co.) a~ 5 53 Sanitary Permit Application State, Transaction Number - -Z D ~ ~ In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application fortes for state-owned POWTS are Project Address (if different than mailing~ s) submitted to the Department of Commerce. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. 15.04 I m Scats. 773 /~71. Application Information - Please Print All Information AMA Property Owner's Name Parcel # Property Owner's Mailing AddresProperty Location / a 0 I (J C Govt. Lot C ~J City, State Zip Code Phone Number At (J L _ y., Section 3 0 Q le one r` ~M P,46 w l ~ ~1 T N. R lrcE o II: Type of Building (check all that apply) Lot # ~or 2 family Dwelling- Number of Bedrooms Block # ❑ Public/Commercial - Describe Use I b1 ❑ City of k o 4 CSM Number ❑ Village of if El State Owned - Describe Use ~ d Nd X 75 Dv s 111. Type of Permit: (Check only one box online A. Complete line B if applicable) A. ANew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner /11" 1 9Q l IV. Type of POWTS System/Component/Device: Check all that apply) ❑ Non-Pressurized in-Ground ❑ Pressurized In-Ground ❑ At-Grade &Mound> 24 in, ofsuitable soil ❑ Mound < 24 in of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis ersalfrreatm t Area Information: Design (gpd) Design Soil Application Rate(gpdst) Dispersal Area Required Dispersal Area Propo (s System Elevation -0XI 176 '0 Y i .5 - V1. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units u New Tanks Existing Tanks Q 625 ~ p in rn 'w C7 a. Septic or Holding Tank ~~S r '-A Dosing Chamber Sd Vi" t c VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plum s Name (Print) Plumber' Signature MP/Ni~ItS Number Business Phone Number Plumber' Address (Street, City, State. Zip Code) Lw( _61 '7 VIII ount /De artment Use Only [Xpproved 70v sapprov Permit Fee Date suueed Issuin gent Signat erg 5 n, ' en Reason enial $ IX. Condi TF.%* NMeasons for Disapproval .3 Gs t~p~ I ee 1. 'Septic tank, effluent filter and _ dispersal cell must all be services I maintained t tJ I~snw~ o J as per management plan provided by plun)*., 2 A44e6111ck requirements must.bemaintairtt 1 th t e N t Attach to complete plans for the system and submit to the County only on paper not less t an 8 1/2.X 11 Inches In size SBD-6398 (R. 01/07) Valid thru 01/09 Plot Plan Page V of Z Property Owner J~ERIVOAI ':~T, 1"=4Dft. Legal Description tn a '(except where noted) ~ NWOF THE Nom' s 30 -r17+4J TotL/A) O At Backhoe pit 67.E s - \ North z Af-PW, 4 t r ro WEST I r- hQ y ~ L t", ~ M3 ` v J y~' a~ % -77 Site L c-ri~. -rz- ITT ^ "f ~p +H 1411E +l► ~4~T ~fE4T Safety and Buildings 3824 N CREEKSIDE LA o`er HOLMEN WI 54636 0 Contact Through Relay 3 $ e P www.dsps.wi.gov/sb/ 9~o S www.wisconsin.gov ADO 'sSIOW, we Scott Walker, Governor Dave Ross, Secretary May 10, 2012 CUST ID No. 224832 ATTN: POWTS Inspector MARY JO HUPPERT ZONING OFFICE HOLLISTERS SOIL TESTING & DESIGN ST CROIX COUNTY SPIA W9875 690TH AVE 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/10/2014 Identification Numbers SITE: Transaction ID No. 2081592 Kernon Bast Site ID No. 779012 793 157TH St Please refer to both identification numbers, Town of Hammond above, in all correspondence with the agency. St Croix County NW1/4, NE1/4, S30, T29N, R17W FOR: Description: Five Bedroom Mound System / 7% slope Object Type: POWTS Component Manual Regulated Object ID No.: 1370116 Maintenance required; 750 GPD Flow rate; 39 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD-10691-P (N.01/01), 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 constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. PRIVATE SEW 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, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: DIVISION OF SAFET Reminders • A sanitary permit must be obtained from the county where this project is located in accordance with th requirements of Sec. 145.135 and 145.19, Wis. Stats. SEE CORRE • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of See. 145.20(2)(d), Wis. Stats. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per 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. • 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. MARY JO HUPPERT Page 2 5/10/2012 + 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 This Amount Will Be Invoiced. Gerard M Swim When You Receive That Invoice, POWTS Plan Reviewer, Integrated Services Please Include a Copy With Your (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm Payment Submittal. jeny.swim@wisconsin.gov WiSMART code: 7633 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. I I MARY JO HUPPERT Page 2 5/10/2012 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 This Amount Will Be Invoiced. Gerard M Swim When You Receive That Invoice, POWTS Plan Reviewer, Integrated Services Please Include a Copy With Your (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm Payment Submittal. jerry.swim@wisconsin.gov WiSMART code: 7633 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. l: MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE ccjv Project Name:' KERNON J. BAST 2412 Owner's Name: (same) ~0//VG8 Owner's Address: 948 LaBarge Rd. Hudson, WI 54016 Legal Description: NW 1/4 of the NE1/4, S 30, T29N, R17W Township: Hammond County: St. Croix Subdivision Name: Emerald Acres 1 st Addition Lot Number: 87 Block Number. NA AGE SYSTEM Parcel I.D. Number: 018 - 2011 - 87 - 000 ®nt7lly Plan Transaction No.: Oak Page 1 Index and title OVEU Page 2 Data entry Page 3 Mound drawings r AND BUILDINGS Page 4 Lateral and dose tank Page Page 5 System maintenance specifications R• A 6 Management and contingency plan PONDENCE a Page 7 Pump curve and specifications ~ r+ye s ar: Page 8 Plot Plan ew ~ ^AAS sew r'4 n,~ p•,. Designer Mary Jo Huppert License Number. 1859-007 Date: 04/25/12 Phone Number. (715) 426-1775 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01) Version 5.1 (R. 06/06) Page 1 of 8 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 500.00 Estimated Wastewater Flow (gpd) Table 83-44-3 in-situ sal treatment for 1.50 Peaking Factor (e.g. 1.5 = 150%) fecal coliform of - 36 inches. 750.00 Design Flow (gpd) 7.00 Site Slope 99.00 Contour Line Elevation (ft) 39.00 Depth to Limiting Factor (in) 0.40 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 75.00 Dispersal Cell Length Along Contour (ft) = 10.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) 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) E Center or End Manifold 3.33 Lateral Spacing (ft) If N above, enter the elevation ft 3 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) 2.67 Estimated Orifice Spacing (ft) = 8.93 ft2/orifice 2.00 Forcemain Diameter (in) _ 24.00 Forcemain Length (ft) Does the forcemain drain back? Y 92.00 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 3.91 Forcemain Drainback (gal) 7.33 Vertical Lift (ft) 70.19 5x Void Volume (gal) 0.61 Friction Loss (ft) 74.11 Minimum Dose Volume (gal) 0.00 In-line Filter Loss (ft) 34.60 System Demand (gpm) 14.44 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia options choice in. dia. options choice 0.75 1.25 x x 1.00 1.50 x 1.25 x x 2.00 x 1.50 x 3.00 2.00 x 3.00 x Gallons/inch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1595.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Wieser Manufacturer gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 950.00 Dose Tank Capacity (gal) Pol lok Fitter Manufacturer 25.00 Dose Tank Volume (gal/in) 525 Filter Model Number Wieser Manufacturer Project KERNON J. BAST Page 2 of 8 j Mound Plan and Cross Section Views a t 1/10 B 'Observation pipe J rK T O Q A W B I L Mound Component Dimensions Down slop a toe extension made. A 10.00 ft E 14.40 in H Elft ft K A29-39 ft B 75.00 ft F 9.25 in z ft L ft D 6.00 in G 0.50 ft J W ft 750.00 (ft) Dispersal Cell Area 1875700 (fe) Basal Area Available 10.00 (gpd/ft) Linear Loading Rate 7.50 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 101.27 (ft) ------No rrrrrrr....r rrrrrrri,. 1 I F oispersa~ cell 100100 (ft) Lateral 99.50 (ft)-♦ ' Invert Dispersal Cell Elevation D ~Q c:... - a 99.00 (ft) Contour Elevation 7.0 96 Site Slope Geotextile Fabric Cover Shading Key T Dispersal Cell See lateral details on Q Topsoil Cap = 1.5 ft Page 4 for number, size, ••••••r Subsoil Cap 3 0 Q and spacing of laterals. ASTM C33 Sand .o Laterals are equally ® Timed Layer : 0. ft Twicai lateral F spaced, from the the © Aggregate .r c ® distribution ceirs centerline in the in A distribution cell (AxB). Project: KERNON J. BAST Page 3 of 8 I End Connection Lateral Layout Diagram .rrHCret.r?ateeatovrstF.et. :Ba!mrrr,.yn 7urr.-uF+atbvisvah.es.~rctaseauut~"uy P All ree-01S are =dent;,; al X ->I HC-- !a Cw1*4 Q'n tha Dottcm ar It+ Umecai EyU,'a~~J S,:IatfC Late. arz Y. t,.rce -air. as r-vc Sct. a.) ~ NFrei-. L,tiiM[ Ta -]r $4.5O•5l F-wee maven e-annex; tran v=a tfe.>r c. a ss tc. mar,4old a: ang Taint. Number of Laterals 3 Orifice Diameter 0.125 in Lateral Diameter 1.25 in Orifice Spacing (X) 2.72 It Lateral Length (P) 73.44 ft Orifices per Lateral 28 Lateral Spacing (S) 3.33 ft Orifice Density 8.93 fe/orfice Lateral Flow Rate 11.53 gpm Manifold Length 6.67 ft System Flow Rate 34.60 gpm Manifold Diameter 1.25 in Total Dynamic Head 14.44 ft Forcemain Velocity 3.53 ft/sec Dose Tank infonnation Locking cover with wamkg label and lodtft device and sealed watertight Electrical as per NEC 300 and ~ Comm 16.28 WAC Disconnect 4 in. rain. Tank component is pnopedy vented Albemate outlet kx~on Forcemain diameter Wieser Manufacturer 2 in. Capacdyl n25. .00 Gallons Volume 00 gaVinch A Weep hole or anti- Dimension Inches Gallons B siphon device A 25.04 625.89 B 2.00 50.00 C (g) C 2.96 74.11 ~ 92.67 D 800 200.00 D Total 38.00 950.00 I I Dose tank elevation 3" Bedding uncTer tank. 92.00 Alarm Manuafacturer :Tank Alert Alarm Model Number ' HW101 Pump Manufacturer Gould Pump Model Number PE41 Pump Must Deliver 34.60 gpm at 14.44 ft TDH Project: KERNON J. BAST Page 4 of 8 s Mound System Maintenance and Operation Specifications Service Provider's Name Ron's Septic Service Phone 715 749 -0153 POWTS Regulator's Name St. Croix County Zoning Phone (715 386-4680 System Flow and Load Parameters Design Flow - Peak 750 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 500 gpd Maximum BODE 220 mg/L Septic Tank Capacity 1595 gal Maximum TSS 150 mg/L Soil Absorption Component Size 750 fe 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 years Alarm Should test month) ear s Pressure System Laterals should be flushed and pressure tested eve k11.5 Mound Inspect for pondin and seeps a once eve 3 s 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 Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: KERNON J. BAST Page 5 of 8 Mound System Management Plan Pursuant to Comm 83.54, Una. Adm. Code This system shag be operated in accordance with Comm 82-84. Code, and shall maintained in accordance with its' component manuals (SM10691-P (N.01101), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SOD-10706-P (N. 01101)] and local or state riles pertaining to system maintenance and maintenance reporting. No one should ewer enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tarn 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 cowers should be inspected for water tightness and soundness. Access openings used for service and assessment shag 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 84iches in diameter shag be secured by an ofk dive lnddng device to prevent accidental or unauthorized entry into a tank or component. Saclic Tank The septic tank shag be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shag be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shag be assessed at least once every 3 years by inspection. The outlet finer 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 fnter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intern nt filter alarms may indicate surge tows or an impending continuous alarm. The septic tank shag have its contents removed when the volume of sludge and scrum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the tine of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain Was than maximum scour and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, 9 such products are used they shall be approved for septic tank use by the Department of Commerce. Puma Tank The pump (dosing) tank shag be inspected at least ounce every 3 years. AN switdres, alamts, and pumps shag be tasted to verify proper operation. If an effluent filter is installed within the tank it shag be inspected and serviced as necessary. Mound and Pressure Distribution Sustain No trees or shrubs should be planted on the mound. Plantings may be made around the mounds 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 i dNfttive surface within the mound and snow compaction in the winter will promote float penetration. Cold weather installations (Odaber-February) diddle that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mglL. BOD5,150 mg/L TSS, and 30 mg1L FOG for septic tank effluent or 30 mg& SOD$, 30 mgA. TSS, 10 mg/L FOG, and 104cW100 mL for highly treated effluent. Influent flow may not exceed macdmum 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 shag be checked for effluent ponding. Ponding levels shag be reported to the owner, and any levels above 6 inches considered as an appending hydraulic failure requiring additional, more frequent monitoring. Continaerw.w Plant If the septic tank or any of its components become defective the tank or component shag 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) shag be Immediately repaired or replaced with a component of the same or equal performance. If the mound component fags 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 dogged 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. Pr rto t Units The information and schedule of mananagement and maintenance for pretreatrment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. i ' L% QUULDS PUMPS Submersible Effluent Pump PE _ is - Dis ge: , - owe Onstruc km Tempera cure; I cWv 0000 ' 60 Herb ■ W iron body, nw*nm, wmWus when • 115 and 230 voks 0 theaaal M e Wd pro- ~ impeller and • Sodas thandCug: 'h" tecdai vtth a bnatic nset ■ upper skw* and lower maxhhwn sphere. ' Class 0 irmliatm. AFFUCATM - Ad matic model badude a 'tamed design. bowing aNSMKOWL no WAtch. ' High length carbon Sted a =Wfo arl~ty *d* f ar die • Manual models available. shaft. r foiiawhhg uses: ' Pumping range: see PE31 Manor: service ife. • Mound Systems perhu mice chart or am. - 33 HP, 3000 RPM to PoweFed forcanti ulous • Eftluer*ulsl g Systems PE31 PohnrOhc • 115 "its operation. Low Pressure Pipe Systems • Mah6mhnn apadty: 53 GPM • Shaded pole design ■ AN ratings are within the • Basernent Draining • Mmdmum head: 25' TDH PE41 Moto: vror*q limits of the mW". • Heavy Duty SMPl K41 Plane: - .40 HP, 3400 RPM ■ Qukk disconnect pow Dowaterhhg • inn 61 GPM - 115 and 230 volts • Ma*mun head: 2W TDH • PSC design h"dUIyIWSJTWwkh PE51 t+raeathc PES1 Nhmr. 115 or230 volrgnw cWq 04 • Ma>dm m capaW. 70 GPM • 50 HP, 3400 RPM M CampleEe unit is heavy duty, • MaAnwn head: 37T DH • 115 and 230 vo f; portable and cet qma METERS FEl r • PSC design ■ Mechanical semi is earbort 40 coank ► r , . -4 . _ PE3h. +~hh, ~+l .ate J DUNA and SS • .11L0 35 .1-4-44 hlP •~4 so • Stass steel fasbener5. 10, 2 GPFA AGE CtROM 30 1 FT i ~t 2S . • Y f.'.~ 1 1 TGQedmU.nsad f.4 ` SAW 10pSMtldatds t W. Sbod"AmOdWbe t-i *I 10 Go" ►sk rsowm Neon d~nd. T-1 L 0 O Q 10 , 20 30 a 40``----k- o 60 76-&FA so +SE eT 1\~21~1f1A1 I- ~ g 0 5 is 10 15 mail. Plot Plan Page T of Property Owner atwa bv+sa ]"=40 • t where noted) Legal Description tcT r e Aw 1A or- rhtf Nc' s 30 - ZIA) i 7ic1 rV-V OF = Backkoe pit H4 tvt ctx; 5f 0 re01 s \ North on wEST pil- II I 1 ~ c ~ 1 v J yFp F- 1D' 0 o s~ fi Ql~ Site L 'on: cr+a. -i-r ITT 0 I lillll lull lIIIIlIII! l~II illlll 11111111 902246 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI CERTn Fl En SURVEY MAP RECEIVED FOR RECORD LOCATED IN PART OF THE NW1/4 OF THE NE1/4 08/18/2009 09:30AM CERTIFIED SURVEY MAP OF SECTION 30, T29N, RI 7W, TOWN OF VOL: 24 PAGE: 5649 HAMMOND, ST. CROIX COUNTY, WISCONSIN; REC FEE: 13.00 BEING LOTS 65 AND 66 OF THE PLAT OF EMERALD PAGES: 2 ACRES 1 ST ADDITION. _ 13 NOTE: OWNER SURVEYOR THE PURPOSE OF THIS MAP IS TO KERNON BAST EDWIN C FLANUM COMBINE LOTS 65 AND 66 OF THE ' 946 LABARGE ROAD NORTHLAND SURVEYING, INC. PLAT OF EMERALD ACRES 1ST HUDSON, WI 54016 P.O_ BOX 14 ADDITION. NO NEW LOTS ARE I Cu~G~Jpt CAD ROBERTS, WI 54023 CREATED BY THIS.MAP_ ~~D C_T-_H_'91--rs - m ------------m N8901 1'33"E 340.02' c NOTE: ; NO OWNER OR RESIDENT SHALL I Q DO ANYTHING WHICH WOULD NIGH WATER $ ~r INTERFERE WITH OR CHANGE LINE I = 1055.30 a o rr O THE OPERATION OF THE z x r in APPROVED COMPREHENSIVE r O WATER DRAINAGE AND SOIL F; E EROSION PLAN FOR THIS PLAT. I dI w ¢ 0 THIS INCLUDES BUT IS NOT _ LIMITED TO BUILDING UPON. I W w O OBSTRUCTING, ALTERING, LOT 87 ! el ~r w 0 cr- EP FILLING, OR EXCAVATING OR p 3.67 ACRES 30 j LL o C PLANTING IN ANY DRAINAGE N 159.904 SQ.FT. W¢ UU O AREAS OR EASEMENTS, WATER O _&_O_ _4_ _66_ O w fJ DRAINAGE DITCHES, WATER I1 I I r - - - RUNWAYS, WATER CULVERTS. loo w I I cQ Ov BERMS OR GRASS SEEDINGS. I I Z O LOU LOWEST BUILDING OPENING I m C V r ELEVATION = 1057.30 30' WIDE r DRAINAGE _ EASEMENT BENCHMARK f1\ ! 30' TOP OF 314" REBAR ~s Z , I ELEVATION =1065.36 EDWIN C. FLANUM J I I =_,t s2x87 C~►VED o i AMERY -1 R I I DEB 1 S 2r) Q 1 g1 .p2 ; I ~ , Or ~T. CROICOUNTY d ! d ~ ~ j ~o~ yy~ 6 d~4 6~7 ` S~JRVEYOR'S RECORD NOTE: } C I THIS LOT IS PROHIBITED FROM M r DIRECT ACCESS TO COUNTY TRUNK HIGHWAY TT" I ~i I O LEGEND CURVE DATA TABLE 1. O.D. IRON PIPE FOUND NUMBER Cl RADIUS 80.00' 3/4" IRON REBAR FOUND CENTRAL ANGLE 48'43'27' / 50' ROADWAY SETBACK LINE (UNLESS CHORD BEARING N31'13'57.5'W t OTHERWISE SHOWN) CHORD LENGTH 66.00' ~ ARC LENGTH 68.03' , 12' UTIUTY EASEMENT TANGENT IN N06'52'14'W / TANGENT OUT N55.35'41'W 1 SCALE IN FEET 11" = 100' THIS INSTRUMENT DRAFTED BY KEVIN REED JOB NO. 07-24 DATE 03-07-07 SHEET 1 OF 2 SHEETS 100 0 100 DRAWWG;C~ Vol. 24 'Page 5649 MAY-14-2012 MON 07.34 AM FAX NO. P. 01/01 ~oo~ra4t r...... HE1.S ti Pt u~iBlNa o5/1112012 06:12 FAX Tit 273 0444 ST. 0 k.( IS COUNTY Swnc ANi Y TEATANCE AGRBM 0T AND G 1 CATMN FORM Q,i SSi OWMAwer Mttilitn$ i.J I S~talS- A s~ (MM O ZoNjO6 ~ for aew cft.*0 ) ~ {Veri~stioas t~l+►'~ ~ ~ paroei aldon Number -0 '1-211 - - b d x7 City/Stata Mail~Scan= gropcrty Location _AJ,,W- IA +1i".L '/4 , ac. T 21LV_N R 1,_1 W) Town Ff 0.m OA L . Lot 0 S 7 Subdivision cSVolwale` pap # Ce,rafeat Snrvgry YQ Warrtmty Deed # Speo hotwe yea Xe¢liasa idbk~„ ua a AN- e or r" =w Masnit bL #5 pw"We biho- to lam WadcL Prow Y Iffi pa,aae and yogir aM soom, if naiad, by a licensed p • Y peal ay+; xm Dwns< ~ canoieti of p 8 out dm sapllc ov"m atagd fha wasEe d tfia sysWit "►t the [unction ofthe septic as a s. tesponemuties we specified in #C= M 63.524(1) in ter 12 - St. Croix Gea+ttY SAniury ate!: ~t r retdil~tioa &M ft Tin p qww owner agrees to in mat to Pb>~8 & zowq pap f t1 m & tmp • d plwa►bsz or a lioeused, pwnP°C ~ceasat~, ft sephc owner end by a mu* piuv*at 1~e p A." ~ ~ ~andpt~m : a►8 ~ ift.0 k ~vastewates' dispdsat iyra~u is u: yopff °operift lass than 1t3 M drWp. the w6nigned bsve todDdo ab re and ago to e~aCUn the ii'ing aewags disposal a wnt w►ilah ad Ate ARpattmsat af•'.i Resota:eos. State of staadsrds set berehy. u act by tba ashes b~ must be cosapiated aad r~» 1 to tlta St. 4six CQU* p 094 006 Vchn aaon.vitl0 days Ptlte roc ye dete. I thebbst of =uY/oux knowledge. t!we erMVt►[e elvo owna~r(s) c~t'tfb vwe certify that all statements on wo to *d in R"kw of Daeba t • pMOparty desaxiioad aAeva• by virtue of at Number of bedrooms 5 DA SIGNA OF APP IC ) aitary p beft re voW by tea Piamiog do 7wft D "WARY Mm,stiaa that is auuiareptea+e►ted may It I aa ii the Register of Dee& 4fttes ad it OWY of the m0fied tur My U0 P IwAud,y wiAttLic application a recorded wsrrsntY wmx wd is made in an wa mq dad- (RLV. OS/45! 05/14/2012 7:43AM (GMT-05:00) 954122 BETH PABST State Bar of Wisconsin Form 1-2003 REGISTER OF DEEDS WARRANTY DEED ST. CROIX CO., WI RECEIVED FOR RECORD Document Number Document Name 04/10/2012 11:54 AM EXEMPT # NA REC FEE: 30.00 THIS DEED, made between Richard O. Stout, a married person and Kernon J. TRANS FEE: 114.00 Bast, a married person ("Grantor," whether one or more), PAGES: 1 and Justin D. Peissig and Sarah J. Peissig, husband and wife, as survivorship **The above recording information marital property verifies that this document has ("Grantee," whether one or more). been electronically recorded & returned to the submitter Grantor, for a valuable consideration, conveys to Grantee the following described real Recording Area estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ("Property") (if more space is Name and Return Address needed, please attach addendum): Edina Realty Title, Inc. 400 So. 2id St, #115 Lot ,87 of Certified Survey Map filed August 18, 2009 in Volume 24 of Certified Hudson, wI 54016 Survey Maps, page ~ 9as Document No. 902246, located in part of the NW '/4 of File No.: Ina` 5 Soo the NE 1/4 of Section 30, T29N, R17W, Town of Hammond, St. CroixCounty, Wisconsin; being Lots 65 and 66 of the Plat of Emerald Acres 1st Addition 018-2011-87-000 Parcel Identification Number (PIN) This is not 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: Dated (SEAL) I (SEAL) (SE(SEAL) * ?STATE O. Stout . Bast AUTHENTICATION ACKNOWLEDGMENT Signature(s) WISCONSIN ) authenticated on ) ss. 5-~ - Ce di X COUNTY ) * Personally came before me on P'`u,.e1n t f- o l Z TITLE: MEMBER STATE BAR OF WISCONSIN the above-named Richard O. Stout, a married person and Kernon J. Bast, a married person (If not, to me wn to be the person(s) who executed the foregoing authorized by Wis. Stat. § 706.06) instr nt and acknowledged the same. THIS INSTRUMENT DRAFTED BY: ~Y a •r.c (w 4- W i 1 1 w.a Richard O. Stout Notary Public, State of Wisconsin II 1353 Awatulcee Trail, Hudson, WI 54016 My Commission (is permanent) (expires: 1 "Zl ' I `l ) (Signatures may be authenticated or acknowledged. Both are nPodiceecsr~' 1 man NOTE: THUS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHqft / ft IDENTIFIED. WARRANTY DEED C 2003 STATE BAR OF WISCONSIN FORM NO. 1-2003 WQ name below signatures. State of Wisconsin M1 t ~ wi^cp►sinDepaitmer►totC Pi can SOIL EVALUATION REPORT Page _ I of _3 Division of Safety and BuHJrE+ni ~l~rc a with Comm 05, Wis. AJrn. Cute County Allah complete sfle plant on paper not less then 0 1/2 x 11 inches irr size. Plan n►uat. Include, Iv it not limited to, vertical and horizontal referer Paitrl I.D. percent rlops, scale or dhnensions, north arrow, and to lion t r t roaJ Date Please print all Inrofm Ion. R (awed M Personal Informtrilon you provide may be used for secondary rposes (Viva y wls. 'C~~~) (nr)).. %Property Owner V rv AAPiopeityLocati 1 ST. CROI T~ 1l4 Pio/4 S 3L )'r ect N 11 E (ote Properly Owners Mailing Address # Solid. Name or GSM1f 1(4 4 b- City ~ S~~pCode Plivne Number City illage ~ town Nearest ad ~W won (u 7 i SO/10 i 4nvl ( 7~~`L-12 2/_ _ cr "w Construction Use:ftesidential / Number of bedrooms_ CuJo derived design flow rate 44~U 0 ---GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material _ Flood Plain elevation it apple able R. General comments '5Sj 2ew\ eft , l q, 5~--- fitow d and recommendations: ` U Boring # l❑~ Bainy 2~ l~l tLr-Pit Ground surface elev.`? I =It. Depth to lindting (actor Soil l A licalion Rate Horizon Depth Dorninant Colo Redox Description Texture Structure Consistence Boundary Roofs GPD/It' In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. C 'Eff#1 'Eff#2 1Ti L to C J- I V - 3 31-i s m Z Boring # ❑ Boling Pit Ground surface elev. l~ ft. Depth lulimiting factor--q(6- in. Sol Application Rate Horizon Depff► Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft= in. Munsell Qu. Sz. ConL Color Gr. Sz. Sir. _ 'Eff#1 'Eff#2 ~-1 (O Z SI! 2 rn S I v.C . ~j I CZP -r,5 1 Lo s; cl r Effluent #1 = 800> 30 < 220 erg/L ar►d TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 nig/L and TSS < 30 n►g/L CS Name (P q - nature CST Number f"VI 1 ~ . _ 2 s3T Ad iess Dale (:valuation_Co_nducted Telephone Number L _ f Page Lot - parcel ID It properly Owner _V---- ❑ Boring F-151 Bororg # ~ , It. Depict to limiting factor Soil A nG it Ground swfac a elov. _ Dominant Color Redox Description Texture Slrudure Consistence Bowldary Roots Horizon Deptlt Donor Gr. Sz. Sit. Mtnnsell Qu. 5zCtrtL Color I 4-1 r 3 39 I c s 7s Lt ❑ Boring l_ J Boring # E] pit Ground swtace elev. It. Depih to limiting factor U . Soil A lication Rate IloriLOrr Deptit Dominant Cok r Redox Description Texture Structure Consistence Boundary Roots 'Elf#Gt'DIIFEtfN2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sit. _ f Boring # 8orirg Ground surface elev. Il• Depth to limiting factor in• - (__J ❑ Pit Sort Application Rate Horizon DepUr Dominant Color Redox Description lexture Structure Consistence Boundary Roots GpDIfF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sit. '01111 'Eft#2 Effluent #1 = BODS> 30 < 220 rnglL and TSS >30 < 150 mglL ' Effluent 112 = BUDS < 30 mglL and TSS < 30 mgti- The Department of Commerce is an equal opportunity service ptovider and employer. If you [iced assistance to access services or need material in an alternate fort-tat, please contact lite department at 609-266-3151 or 'ITY 608-2(v1-8777. sao-uso ra.oaorq Parcel ID 11 ~t2 Page of Properly Owner f Boring # 0 goring Cy _QL ✓ I I -Prt Ground surface elev. t- r it. Depth to linriting tactor 31-111. Soil A , Iication Rate Horizon Depot Dominant Color RedoxDesc,-ription Texlure Strurlme Consistence Boundary Roots GPDffF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - 'Ell1f 1 'EIIg2 l2 (Q IZ st f Z ' S I VX ~ S Z f2- v y/4 5(,L C--1 2ir\Sbk ,mfr cS s1~~1 2rn 1~ 3 1 c 5 7- Y,C [-I Boring F] Boring # - - ~_J ❑ pit Ground surface elev. It. Depth to limiting factor Soil 4pplication Rate I lotizorr Deptli Dominant Color Redox Description Texlure Structure Consistence Boundary Roots GPDIfF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - TIM TIM a Boring # Boring Ground surface elev. ft. Depth to limiting factor in. - ❑ Pit _ Sol Application Rate Horizon Depth Dominant Color Redox Description Texture. Structure Consistence Boundary Roots GPD11F in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'EfNf1 'Eff#2 Effluent #1 = BOD5> 30 < 220 rnglL and TSS >30 < 150 mg1L ' Effluent 112 = BOD, < 30 mgfL and TSS < 30 mgfL The Department of Cotntnerce is an equal opportunity service pr'OVidur and employer. If you aced assistance to access services or need material in an alternate format, please contact the departineut at 608-266-3151 or 'ITY 608-264-8777. snD-ru 3o rrt.ovmp r I'A(;L 3 Ol: 3 NAN1L:~~ ~Y4- I.c )1'tl ~1 ~_I.►:c;~~.l. I Itll''I'I~ SCALE: 1"---_0 - - - - - CLEVATIOW_-_ 6U $,~n L U DM I DGSCItII' I'IOI I: 1 BM 2 ELLVNI 1O1,1: - _ , Q - ` 3a-- - - Btvl 2 Dl'CRIP FPA l: 0 _Q_- ---I PUc. ~J ~e SYSTI.NI 1A.FVI\ I I1 it 1. 'SYS"1'1~f~1"1'ti'I'I~.:__~`!~,C9~_v'\~_ ~o,l~ovr-I;tie.._~~(•vtl g~Z ~ g 0 e ~ D Z w 6,3 oa 1 140 qq.60 Sa G C`~ Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County r Attach complete si!.- P r not less than 8 1/2 t..=:... include, but not limit ran I refer ice po Parcel I.D. percent slope, scat Pin and I tion = t roakkkk . Re 'ew Date Please pr J inform Won. Personal information you provide may be used for secondary urpos414i-Jacy2aN-..210 Wp(1) (m) ~~v / ~~(JS Property Owner P arty Lo ion ST. CROIX Ol r~ ZONING W ti 1/4,,(/1% 1/4 S T N R f 3- E (or)& Property Owner's Mailing Address o # r . Name or C M# State Zip Code Phone Number ❑ City ❑ Village f~] Town Nearest Road iLd d-4-q 7- T- //s o'O GPD ( New Construction Use: R Residential / Number of bedrooms _ Code derived design flow rate ❑ Replacement ❑ Public or commercial - Describe: - Parent material , I ` ( Flood Plain elevation if applicable ft. General comments SYS / y~ e ` jO S and recommendations: #WZ' 00V\-fo J r e1~~~ J~` ~j fj3 1 (/yrn (~~dd / a Boring # Boring Pit Ground surface elev. ft. Depth to limiting factor- in. Soil Application Rate zon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Fg in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 l Zt'nsbk ~ 5 • 5 • $ e- 44 F'M2' F2-]Boring # Boring Pit Ground surface elev. 6 d ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ffF 'Eff#1 'Eff#2 In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. I I (DIr3l 2 S/ I 2r- r c5 I v~ 16 )5bk ,~r c5 44 I1`22 I - 3 Zz :3fl - - SL 2 1Z 5 (0 ID sly 0 In • Effluent #1 = BOD > 30 1220 mg/L and TSS >30:S 150 mg& ' Effluent #2 = BOD < 30 mg/- and TSS 30 mg/L (Pleasf Signatu CST N c7mm hk Wrn Date Evaluation Conducted Telephone Number Ad dress _ y - / 1 7 2A b KP- ~a~4 rmz,