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Home My WebLink About008-1012-10-100i' 4C e ~ , ~ w ~1~~r, ~cansin Department of Commerce PRIVATE~SEWA ~E SYSTEM Safetyan!~tuilding Division INSPECTION REPORT GENERAL INFORMATiflA (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 'ermit Holders Name: City Village X Township Peterson, Jake & Lindsa Eau Galle Townshi ;ST BM Elev: Insp. BM Elev: BM Description: !bd ( ~;~ l TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~ ~ /~ Dosing Aeration ~~ Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ~~ ~ ~~ / ~ r ~ ~ -~ Dosing ~ i ~ ~ ~ • ' ~~ ,_ Aeration Holding PUMP/SIPHON INFORMATION Manufacturer ~, Z nd o ~~'`. GPM Model Number ~~~ / ~ TDH Lift Friction Loss System Head TD Ft ,~JS ~ ~ ` lD• I ~~~ Forcemain Leng th ~ Dia. ~ N Dist. to well r~ Z ~~ SOIL ABSORPTION SYSTEM ELEVATION DATA county: St. Croix Sanitary Permit No: 453306 0 State Plan ID No: Parcel Tax No: 008-1012-10-100 SectionfrowniRangeiMap No: 04.28.16.63A10 STATION BS HI FS ELEV. Benchmark /~ ~z_ la/.s~ ~I'~ Alt. BM o ~ ~u , ~' C-o Q--°~ ` ~~ c J~ ~ 17 Bldg. Sewer ~ ~, ~5. x ~ St/Ht Inlet 1~• ~ GC 0 J ~~0 SUHt Outlet 1~ .3 ~ -~, Z'Z~ Dt Inlet l~` ~ ~~ ~ Dt Bottom Zb% ~~,1~7 Header/Man. 1.~ `~.7 Dist. Pipe ~~ >. `; .8 t .'7'{ , 7Z. ~~ ,'~' Bot. System 1.~5 1``~~~7 Final Grade 1 ~, /~ ' -~ St Cover ,2~ Z ~r10 I~r3 ~«P•Z. r BED/TRENCH DIMENSIONS Width f Length ~ No. Of//~~nches /J PIT DIMENSIONS No. Of Pit si a ia. Liqu' epth ~ ~ ~ ~ ' SETBACK SYSTEM TO P/L BLDG WELL LAKE/BYRE M LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of S stem: ~j ~ T ~ ~ ~ ~ ~ ~ UNIT Model Nu er: U DISTRIBUTION SYSTEM A Header/Manifold J r r ~ /~ ' Distribution f Pipe(s) ~ ~~ ~ ' f l L f x Hole Size / ~ l ~ f, x Hole Spacing ~' Vent ko it Intake ~ Length~_ Dia Spacing Length Dia ` Z ' 8 ~ ~' SOIL COVER x Pressure Systems Onlv xx Mound Or At-Grade Svstems Onlv Depth Over 1 Bed/Trench Center ~ / Depth Over Bed/Trench Edges xx Depth of ~ ~ Topsoil xx Seeded/So ded xx Mulched ~ lD \ - L J Yes I ~~ No es L] No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~/ 30 /~'\"'_ ,~,,~ Inspection #2: / / Location: 2352 50th Avenue Woodville WI 54028 (SW 1/4 SE 1/4 4 T28N R16W) NA Lot 1 y Parcel No: 04.28.16.63A10 amount of cover '7 ~ ~~ 3.) Contour = rb ~ , 3~7 . ~ L ,- --- -~- ~- - -- _ -- - - ---- ---~ __ _ Plan revision Required? L~ Yes ~ No ~ ~ ~~ 7 f Use other side for additional Information. ~_. _ _ L~__~ ___"_(_ _-____ __. ...___ ____ ______- _ ______.._-._ __~ Date Insepc is Sign e SBD-6710 (R.3/97) 1.) Alt BM Description = ~P "~ ~/n,~' ~~ ~,~.~"'~ 2.) Bldg sewer length = ~ ~ ~ ~ ~ Lo~~ _ ~ I~~., ~ i Cert. No. Safety and Buildings Division ~ 201 W. Washington Ave., P.U. Box 7162 ~S~~n~I it ^ Madison, WI 53707 - 7162 rtment of Commerce (fig) 266-3151 Sanitary Permit Application In accord with Comm g3.21, Wis. Adm. Code, personal information you provide may be used for secondary purposes Privacy Law, s15.04(1 (m I. Aaolication Information -Please Pritit All Property Owner's Na me Property Owner's M ailing City, State ~~ 9 II. Type ~f Building (check all that apply) 1 or 2 Family Dwelling -Number of Bedrooms ^ Public/Commercial -Describe Us ~.~" " ^ State Owned -Describe Use (e 1(/(7O o~ Jl.li GONINGOFFICE Zip Code I Phone Number _'1 r..~ ~ ~,~ •- 103.2 Sanitafy permit Numlwr !tn hn fug in by Co.) L.+ ~ ;r,. State Plan I.D. Number /oo33oc~ Project Address (if different than mailing address) Parcel X of ~ Block v , ~. i(~ , b3~ ~ v tea- , - Property Location ~(.~ ~~,y~,~~,b,SeCttOn qp (circle e) T ~r~ N; R ~~ E ot~ Subdivision Name CSM Number ^City ^Village ~'fownship of III. Type of Permit: (Check only one box on line A. Comp ete line if applicable) A' ~ New S stem ^ Re lacement S stem y p y ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System B• ^ Permit Renewal Permit Revision Change of ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration umber Owner O.` O IV. T of POWTS S stem: (Check all that a 1 ) ^ Non -Pressurized In-Ground .Mound > 24 in. of suitable soil O Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank U Peat Filter U Aerobic Treatment Unit ^ Recirculating Sand Filter ^ Recirculating Synthetic Media Filter ^ Leaching Chamber ^ Drip Line ^ Gravel-less Pipe ^ Other (explain) V. Dis rsaUTreatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) U .D $at~ Dispersal Area Requir 1 ~37s ~°~ ~~ Dispersal Area Propo 8 - loon System Elevation i VI. Tank Info Capacity in Gallons Total Gallons Number of Units Manufactu er 7j ~~ ~_ ~~ ~ t Prefa Concrete Site Constructed Steel New Tanks Existing Tanks ~ ~ Septic or Holding Tank / ~ t`o 0 / i , few (~lJ ~S / Aerobic Treatment Unit Glass Dosing Chamber / 80 l~tJCt° /'f `,5 VII. Responsibility Sta/cement- I, the tmdersigned, asslLne rhsponsibility for installation of the POWTS shown on the attached plans. Plumber's Na me (Print) Plumber's Si gn re MP/MPRS Number Business Phone Number ~~m ou ~~a ~ ~i~ 386- Q~ Plumber's Addre ss (Street, City, State, Zip Cod /a1'D ~J .;~5~ u~ s a~ lies _ ~a ~b VIII. Count /De ent Use Onl Approved ^ bt roved Sanitary Permit Fee (includes Groundwater Date Issued Is wing ent Signatur (No Stamps) Surcharge Fee) ~ ~ _,__ J ^ ner Given ' I llX. Condl of Approval/Reasons for Disapproval 3\ ~ _ - S,~ ~ ~ ~~ SYSTEM OWNER; ) .~ 1 Septic tank, effluent filter and ~~ ~ ~~~ dispersal cell must all be served /maintained as per management plan provided by plumber. .. ~ t3+~ 2. All setback requirements must be maintained as per applicable code/ordinances. \ wtwch rnmptete plena (to the County only) for the system on paper nol less than 81/2 x l l inches in size ~ D-6398 (R. 01/03) ~/ 50~ l 2 /a/ua~ior~ .:~. .~ ~ ~ .~?n ~~ ~Y~ /oaf !, ~~~ ~• y~~ /off 56Q-rC'e. C/u!` =/~ 1~' SCSca Sec.y T.oF P/'opos~d ~e a pro posed ~ S ~+` `~ .~ o ~/'oP p$ed driVCu.7ay ~ ~,Lbt~ol roam ~ ~ ~^~ ~ 8 8 a~a~.~ o 0 0 . R.oposed l„z~~a.o ~ ~ I ~ o werks G„cre,~e _~ y'suC.dop.~.c. ^ ~ ~T~/~a.b.el.4-lam ~{~Yew~~l~~+e~ ~-- o ~ Q~/kc.,~~ %~r i~s ~ ~ i /o~.Z3' iD~o~eosCcl BGID .~ I cJGtXSCDnCrL~G I cc~/~ "~'erce r~~+ e_X;~- ~-t roue i Forcerla,'•~. To be 6 3 1 ~ I i~..5a./att!cdaS u P I, II begeaz7~otriv .~~, ~ ~oPL ~~ I b~` `~ ~ 1 .~ ' ~ c -d r j. z g, 1 0. O` 1 l Q ~'O~td Mau., pl ct ~ f3~ 2`•~9k~L2.P'3'w/!~'x ice' d,sPc~a/CeI/, F~r(y, /ai6C~a-(S at lr~'X yf 3f~'w/ %y"c~~ F'ccJ S,oaccda-~ x•53,' e c,4, Y-'lant~ ~ To o{ /o E S~.,e~_ ,4ssu,~.ed t I• =IcXJ eD" ~Q ~ /~rde- p~. s °~ 9 . commerce.wi.gov <_ i ^ ~scons~n Department of Commerce .~ r Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www.commerce.state.wi. us/sb www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary May 24, 2004 CUST ID No. 222904 JAMES W BOUMEESTER BOUMEESTER & SONS EXCAVATING INC 1070 HWY 35 N HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/24/2006 SITE: Jake & Linsay Peterson Town of Eau Galle, St Croix County SW 1/4, SE 1/4, S4, T28N, R16W Lot: 1, Subdivision: Csm Vol 15, Pg 4180 ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 Identification Numbers Transaction ID No. 1003300 Site ID No. 671538 Please refer to both identification numbers, above, in all corres ondence withthe a enc . FOR: Object Type: POWTS Component Manual Regulated Object ID No.: 959556 Maintenance required; 600 GPD Flow rate System(s): Mound Component Manual -Version 2.0, SBD-10691-P (N.O1/O1) The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the septic tank outlet filter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. • This system is to be constructed and located in accordance with the approved plans, the "Mound Component Manual for Private Onsite Wastewater Systems Version 2" SBD-10691-P(N.O1/O1). • The pressure network is to be constructed in accordance with publications SBD-10706-P(NO1/O1) "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems -Version 2.0" and/or the sizing methods of publication "SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS 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. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. ~ JAMES W BOUMEESTER ~` T Page 2 5/24/04 l Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, d- Leroy G. sky, Wastewater cialist Integrated Services Bureau (715)726-2544 lj ansky@commerce. state.wi.us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 . { L . MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Jake & Lindsay Peterson 4 bedroom residential mound Owner's Name: Jake & Lindsay Peterson Owner's Address: 8335 Manning Ave. North Stillwater, MN 55082 Legal Description: SW1/4 SE1/4, Sec. 4, T.28N., R.16W. Township: Eau Galle County: St. Croix Subdivision Name: CSM Vo1.15 Pg. 4180 Lot Number: 1 Block Number: na P.O.V6I.T.S. Parcel I.D. Number: 008-1012-10-100 on Tonally Plan Transaction No.: ~ ® ~~ ~ ~ ~ ~ ® ~ ~ ~~~ Page 1 d x and title ~ pARTMENT OF COMMERCE In e Page 2 Data entry DIVIS N OF SAFETY AND BUILDINGS Page 3 Mound drawings RECEIVED Page 4 Lateral and dose tank C RESPON NCE ifi t~ ~ Page 5 ca n System maintenance spec [V1AY 2 Q ~~<<'~"~ Page 6 Management and contingency plan Page 7 Pump curve and specifications SAFETY & BLDGS DIV.. Page 8 Site Plan Page 9 Soil Evaluation Report Designer: Jim Boumeester License Number: Date: 05/17/04 Phone Number: Signature: 222904 715-386-1794 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 3.0 (03/01 /01) Page 1 of 9 . ~ 1 Mound and Pressure Distribution Component Design Design Worksheet Site Inform ation (r or c) R Residential or Commercial Design 400.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 = 150%) 600.00 Design Flow (gpd) i 6.00 Site Slope (%) 103.23 Contour Line Elevation (ft) 14.00 Depth to Limiting Factor (in) 0.50 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 100.00 Dispersal Cell Length Along Contour (ft) _ 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) 1 Influent Wastewater Quality (1 or 2) Pressure Disribution Information (c or e) ~ c Center or End Manifold 3.00 Lateral Spacing (ft) 4 Number of Laterals 0.125 Orifice Diameter (in) (e.g. 0.25) 2.50 Estimated Orifice Spacing (ft) _ 2.00 Forcemain Diameter (in) 200.00 Forcemain Length (ft) 86.00 Pump Tank Elevation (ft) 6.50 System Head (ft) x 1.3 18.69 Vertical Lift (ft) 4.61 Friction Loss (ft) 29.80 Total Dynamic Head (ft) Lateral Diameter Selection in. dia. o tions choice 0.75 1.00 x 1.25 x 1.50 x x 2.00 x 3.00 x Treatment Tank Information 120 00 Se tic Tank Capacity (gal) Weeks concrete Manufacturer Note: Sand fill (D) calculations assume a Table 83-44-3 in-situ soil treatment for fecal coliform of <= 38 inches. 6.00 Cell Width (ft) Are the laterals the highest point __ __ in the distribution ~__ Y network? Enter Y or N If N above, enter the elevation (ft) of the highest point. [~ _ _ _ 7.50 ft2/orifice Does the forcemain drain back? Y ' C=- ~__~___; Enter Y or N 32.62 Forcemain Drainback (gal) 90.53 5x Void Volume (gal) 123.16 Minimum Dose Volume (gal) ~~~ ~~ 32.95 System Demand (gpm) Manifold Diameter Selection in. dia. o tions choice 1.25 x ___ 1.50 x x 2.00 3.00 Gallons/Inch Calculator (optional) 805.12 Total Tank Capacity (gal) 37.00 Total Working Liquid Depth (in) 21.76 gal/in (enter result in cell 649) Dose Tank Information Effluent Filter Information 805.12 Dose Tank Capacity (gal) 'Zabel __ _ Filter Manufacturer 21.76 Dose Tank Volume (gal/in) A100 _~ Filter Model Number Weeks Concrete Manufacturer Project: Jake & Lindsay Peterson 4 bedroom residential mound Page 2 of 9 . ~ . . Mound Plan View 1 /10 B • Observation Pipe ' ~ ' . ~~~' if: . B _ _ _ _ - . .Lf -t J - T A I ~_ L Mound Component Dimensions A 6.00 ft E 26.32 in H 1.00 ft K 11.42 ft B 100.00 ft F 9.50 in z 12.75 ft L 122.83 ft D 22.00 in G 0.50 ft J 7.94 ft W 26.69 ft 600.00 (ftZ) Dispersal Cell Area 1875.00 (ft2) Basal Area Available 6.00 (gpd/ft) Linear Loading Rate 10.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 106.86 (ft) % H .,,~, .,,.. G • .ll/lt!/ !1!1l.., ft) Lateral I F ..:: ; : ~ Dispersal~Cell 105.56 105.06 (ft)--- - Invert Dispersal Cell :~ : ~ ~ ~ ' ~ Elevation . E ~ ~ D ~ : ~: _ _ ._ ~ .._ ti ti ~t 4~•h-=.~ti.l..M1^'ti~'{~"~~':.~.~~{..~~~1~'r'•, ~~.`?,u~~•~4h~~'IA 1-~ 'S -~ 7 1- 1 6.0 % Site Slope Shading Key 0 ®Topsoil Cap 0 ~~~~~ Subsoil Cap ASTM C33 Sand ~,~ ~:`~~ Tilled Layer Aggregate ~ a o ~ 1.5 ft c N O A ~ ~° ~ 0.5 ft ~ o *--- A Project: Jake & Lindsay Peterson 4 bedroom residential mound 103.23 (ft) Contour Elevation Geotextile Fabric Cover See lateral details on Page 4 for number, size, and spacing of laterals. Laterals are equally spaced from the distribution cell's centerline in the distribution cell (Ax6). Page 3 of 9 { , a 1 Center Connection Lateral Layout Daigram Project: Force main connection via tee or cross to manifold at any point. I P •=Turn-upwf ball valve or IEX--~IFK+2 I ><f2-~I cleanoutplug Holes drilled on the bottom of the lateral. Laterals are identical S _~ Laterals & Force main of PVC Sch 40 per COMM Table 84.30.5 Number of Laterals 4 Lateral Diameter 1.50 in Lateral Length (P) 49.34 ft Lateral Spacing (S) 3.00 ft Lateral Flow Rate 8.24 gpm System Flow Rate 32.95 gpm Total Dynamic Head ~ 29.801ft Orifice Diameter 0.125 in Orifice Spacing (~ 2.53 ft Orifices per Lateral 20 Orifice Density 7.50 ft2/orifice Manifold Length 3.00 ft Manifold Diameter 1.50 in Forcemain Velocity 3.37 ft/sec Dose Tank Information Electrical as per NEC 300 and -- Comm 16.28 WAC _. Tank component is properly vented Weeks concrete Ca acit 805.12 Volume 21.76 Manufacturer Gallons gal/inch A Dimension Inches Gallons A 18.69 406.60 B 2.00 43.52 C 5.81 126.52 D 10.50 228.48 Total 37.00 805.12 3 Disconnect tank. Alarm Manuafacturer LevelArm _ _J Alarm Model Number DLV ~__, Pump Manufacturer ~Z_o_ell_e_r__ _ _ ~, Pump Model Number 141 0 ~Y __ „ _ r~~ Pump Must Deliver 32.95 gpm at 29.80 ft TDH Jake & Lindsay Peterson 4 bedroom residential mound B C D Locking cover with warning label and locking device and sealed watertight 4 in. min. ~- Alternate outlet location Forcemain diameter ~ 2 in. Weep hole or anti- siphon device Pum off elevation (ft) 86.88 Do• se tank elevation (ft) 86.00 Page 4 of 9 '` ~ Mound System Maintenance and Operation Specifications Service Provider's Name J. Thompson, POWTS Maint'r #30021 ~ Phone X715-248-7767 _ POWTS Regulator's Name St. Croix County Zonin~Dep,t. __ I Phone) _715-386;4680_' System Flow and Load Parameters Design Flow -Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow -Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 12 0 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Freauency Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Other Ins ect and/or service once eve 3 ears Should ins ect and clean at least once eve 3 ears Test once eve 3 ears Should test month) Laterals should be flushed and ressure tested eve 1.5 years __ _ Insect for ponding and, seepage, once every 3_years 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: Jake & Lindsay Peterson 4 bedroom residential mound Page 5 of 9 Mound System Management Plan . 4 , 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.Ot/01) 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 wfth 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. Facposed 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 wfth NR 113, Wls. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at 1 st once eve ears by inspection. Th outlet f e 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 fitter when removed from its enclosure. If the fitter Is equipped wfth an alarm, the filter s~~II be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. (~Jrhe 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 ~e contents of the tank are not removed at the time of a trlenn}a! assessment, maintenance personnel shall advise the owner of when the next service needs to be.pertormed 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. 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 arreffluent fitter 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 as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODS, 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 tt is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed tt should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and it orifice cleaning Is required to maintain equal distribution within the dispersal cell. Observation pipes wtthin 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. Continaencv 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 wfth a component of the same or equal performance. If the mound component falls to axept 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 tce 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 B,of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Jake & Lindsay Peterson 4 bedroom residential mound Page 6 of 9 ~ 9. S~ T. ~~ HEAD CAPACITY CURVE EFFLUENT MODELS ~ Ia0 I ! 02 I35 ,o ~ 3o I I ~ t25 36 20 36 I15 191 - 3a Ito 105 }2 t00 I 30 ~ 95 I 16~ 26 ~ 190 g5 186. 0186 I 60 2•-{ l 75 al6 ~ J 22~ 70 I ~ I 1 20 ~ 65 60 163 i 18 . a163 169. I 0189 i6 55 50 - --t __ Ia a5 12 °0 IaO. 188. / J5 ala0 oleo IQ g 25 137 165. a185 6 ~ 20 - __ t5 a~ t0 1 1 161 2 1 5 i 1 a161 I 0 53,57 99 ~ u.9. WLLON9 IO 20 30 a0 50 60 70 60 90 10 0 Ito 120 130 Ia0 t50 160 LIiE RS 60 160 2a0 320 a00 a60 560 6aC D CAUTION Model 1851a 185 shown I not be subjected to less !han 30 1ee~ T'Jr, 0 FLOW PER uINUiE 3.Z .9Sg~.r~. /17~~J.'mc~ir~ ~u~v i"a~°P~9 10lAL OYNAIAIC HEAD/CAPACITY ' PER MINUTE ErfwEN1 AND DEwATERING uocel ', 53/57 98 I}7 140/at40 161 /a16t 163/1163 165/4165 185/a185 ~ t86/a186 ~ 188/a18b i 'd9 /a194~ y ~ %I Mele lS Gal. LII S. G01. LIlS. GOI, LflS. GOI. Lfl S. GOI, Lt/5 C01. LII S. G01. LI/5. GOI. ll/5. ~ COI :I/S T_~_ -l G01 Lli s. l's .1'- 1 i ''. c5 'I 163 71 27} 93 351 91 }1a 100 }79 6t 1}I 6t 1}I 58 220 lay 5a9 I 1.5 Sag 17 S.t 3a 129 i 6t 231 79 299 81 318 93 352 61 231 61 231 SB I 220 1a0 510 ~ 1<0 -r s__r.__ 550 ', +. IS a.6 ~ 19 72 a5 170 64 2a2 76 288 85 S22 60 227 61 231 56 220 13a 507 I 135 _ Sn ~ :g i ~r 2? '. 6t ~, 25 95 36 I}6 68 257 79 299 59 223 60 227 58 220 128 a8a 1}I a96 a°T~---~ 15 ~ 75 8 30 59 211 70 265 57 216 59 223 58 210 122 a62 125 a7} ! ~~ 17C SO it 19 185 62 235 55 206 58 220 85 321 58 I 220 116 a39 I 120 -~ _ _ a a ~ +~ 12 2 21 79 45 t)0 46 172 55 206 70 265 58 210 104 }ga I 109 , a } r - ~- 7~ SG 152 ~, 20 76 31 I 125 50 189 51 19J 58 220 90 Sal .7 _ - 7 60 Id.3 ! ~ 15 5] 39 148 31 111 58 210 71 _. ~ r 169 a5 ___.. _ __..~ 322 I 7., 7G I 2t 3 23 87 9 31 52 197 51 193 ^9 761 ~ ~~ ~ 30 I 211 I 10 }g a5 170 I 18 106 _I 193 '~ 5 1 7; ri i7a } 1 I V 2 8 =a -T___-.-_ 129 s ~. iC ~. p': ~, JO S 16 60 I '. 7 6 a c C '.I ,, 5 . - 1' 52.7 ~ I I < 15 ~ ~ T-' 3C T ~ ~~ '. i5 365 ! 3C I 39.5 I ~ -.0 , I _-t-:-__ __~_3-_ ~. oc. lone ff93 n (i9m) 2311. (7m) 26 IL (7.9m) 16 IL (lam) 56 fl. (171m) 66 11. (20.1 m) 86.5 11. (26.1 m) 7} q. (223m) 114 II (3aJm)~9t q (2 L7m) 110 113}~ )',,'.};- ~- ..,cs ! MEMBER w w ~ ~ / ~ ~ °i\ ~~ li COyi `J1H ~® •RO SEwaOE ~ ~_~1 vUMV MGRS a55h © Copyright 1998 Zoeller Co. All rights reserved. ~ ~ _ /lp . +. .~ 1 p;~ ~~ ~ ~Cf~~al~ a~ l~.e>L•f./~n ~O~oj~'by ,4 CE. B r;1_ : Tai of lob /, ~~/5~~y/~ /a~ s~-rf'.e. Clu!`',~c~17' 5C Sc.~ ~~. 5; T , of Ca.oc,~a-fie, ~~.Croi,rCo.~cv~. proPosecl ta~2 ~( ProPoSed V- Stich '~ 0 Qroposed d,riy2~.Jay ~Lbeolr~ri d ~Da.riG^~ ~ 8 8 ara~•2 0 0 0 . d i ~ ~, ~T, cJ/~ab,e//f!-/LO CFF/wco.~~E~cd/,~,e'Gu "I Q~/kcnf •~i %~er ~~sse_d ~ o ~C ~Q6 ou~~~E ~ ~ M $rdc I to .23' y/'o/ppSC.C~ BGb ggsQ kJcc~S (~On Cr'G't~ P~..roGf~,.s 4cr - cv/,2 Nice ~%~ ¢,X;~- ~ roue /~u~~'~. F'or~elr(4~r1. To bt iikStc/ct.¢ c d a S ~u ecM.n gz..3a(~) Gary eat`1«F;ve,,aa .,~ b`~ i m`0. I I ~ s opE 1 ~ I `~ 1 I~ I ~ /o c 6 3~ ~ ~ 1 I~ ~l yk~ I Q L E I' Ib lopt ~1 l~~ .~ ,d s ~ ~ 1 23' I~'a~c,drKcu.,,d at as ~~.~9;r~L2.P.i'W/G x ice' d~S14trS~t/ce/% Fow'(S/,~ /a~~.CS 4t lyZ, X ~9 3y'w/ %y„ar~',~'ccs 1c~k~ ~ To,~ a~F /a ~ ss u,ned e L =IcYJ.cD,~ p~. S o~ 9 .~ h"iscensin Department of Commerce D vision of Safety and Buildings SOIL EVALUATION REPORT in arrnrdanca with Comm 85. Wis. Adm. Code 1445 Page I of 3 AG.E. Sal & Site Evaluations County Attach complete site plan on paper not less than 8'/z z 1 t inches in sae. Plan must St. Croix indude, but not limited to: vertical and horizontal reference point (BM), direction and - ------ -- - - -- - -- ---_ -- D Parcel I percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. . . 008-1012-i0-000, ID#4.28.16.63A Please print all lnformaUon. --- ------- -_ -- - - ----- - - - - __ Reviewed By Date Parsonal inlorrnaUon you provide may be used for secondary purposes (Privacy Law, s 15.04 (1) (m)). Property Owner Property Location Robert & Richard Torgerson _ Govt. Lot SW 1/4 SE 1/4 S 4 T ?8 N R 16 W Property Owners Mailing Address Lot # Block # ' Subd. Name or CSM# 508 Co Hwy. 8B 1 _ _ _ - __ _--Proposed CSM - _. City State Zip Code Phone Number J City J Vltage /~ Town Nearest Road ~~ti'oodville WI ~ 54028 ~ 715-684-3927 Eau Galle 50Th Ave. New Construction Use: y~ Residential /Number of bedrooms 3 Code derivad design flaw ra3e 450 GPD _; Replacement '_J Public or commercial -Describe: Parent material Glacial Till __.___ ___ . _ Flood plain elevation, 'rf applicable _ _ . na General comments and recommendations: Mound system elev. = 105.07' at 22" above 103.23' contour. a Boring # _J Boring 3 2 14" i ft - ' .4 __ /i Pit Ground Surface elev. _ _1_0 _.____ n. Soil A.pplicati on Raie ~ . Depth to limiting factor _ _-__ p Horizon Depth Dominant Color Redox Descri lion Texture Boundary I Roots I____, GPDift' I Structure Consistence % _ _ •Effi#2 •Effttl Y ~ ~ as 2fm 0.5 0.8 ~ t __ _ .... ~74- - - --- - - f--- _ _ - --- { -- ;_ _._- - - ._ __ - ~ _ ' 10yr5/4 none 2 ~9-i~l` sit _ 2msbk ds ._ _ cw , 2fm 0.5 0.8 -. -- _ - -- - __--- I -- __- _ y f2f75 r5/6 3 id-22 ~ 10yr5/4 t ~ sl ~ mfr ~ 1fm 0.5 0.9 2msbk cw ~' -----_ ,_ + _ .-- _ ____ ._ - t__ ;____.-----------1----------- m2f 7.5yr5/6 & 4 22-30 7.Syr4/6 ~ fZd t0 /2 sl I ~ 'i 2msbk mfi cw 1fm 0.5 0.9 5 30-43 ': 7.5yr4/6 I m2d IOyr6/2 _, t scl _ _ _ icsbk dsh i - 0.2 0.3 -' - -- - - 1- __ a ___ ~_ _. _ -_ I ~ ~~ ' a Boring # / Boring 1 0 7 1 8'~ i ft ' - _ _ _ Pit Ground Surface elev. __ 3,1 - _ ____ n. Sal Application Rate . pepth to limiting factor _ __ Horizon Depth Dominant Color Redox Description Texture Structure I Consistence ~ Boundary ~ Roots _._ GPO!ft' ~ i i, ; 'Eff#1 'Eff#2 1 0 9 10 r3/3 ~ none ~ sl y_ - - __ f - ---- ~ - -- __._. 2fsbk ~I - - -;-_-_-__.._ ___ -._ ds as 2fm 0.5 0.9 -I- __ ~ - ,._ _ ._ __ ._ .._ _ 2 9-18 10yr4/4 none ~ s! 2msbk dsh i cw ~ 2f,1m ~ 0 5 0.9 3 18-22 '~, 10yr4/4 ' m2d 7.5yr5/8 ~, sl 2msbk mfr ' cw '~, 1 f 0.5 0.9 ; ~ _ 1 _ - -- m2f 7.5)TS/6 & 4 22-3a 7.5yr416 ' t2d 10 /2 ~ scl - _ , 0.4 0.6 2msbk I mfi i cw j 1 f . ~ 5 34-45 j 7.5yr416 _ ~ m2d 10y5i-68/2 1 scl r j 1csbk ~~; dsh ! 0.2 0.3 _ -r -- _ -- - _ _ ._ i , 'Effluent #1 = BOD ~> 30 <_ 220 mg/L and TSS < 150 mg/L lue = BODS < 30 mgiL arxi TSS <30 mg/L ~~ST Name (Please Print) Sign re: CST Number James K, Thompson ~-,~OS--- 3602 Address AC.E. Sal & Site Evaluations ~ Date~luation Conducted Telephone Number 340 Paulson Lake Lane Osceola, WI 20 _ _ 8/2/01) 715-248-7767 ~ Property Gwner Robert & Richard 7or~er5on Parcel ID # 008-1012-10 =000, ID#4_28.16.63A _ Page _ 2 . of _ _3 _ ~ Boring _ ,(~ . ~' / ~/yS Boring # . Pit Ground Surface elev. .__. _102.11_ __ _ ft. Depth to IimRing factor _ .19°___ in. Soil Application Rate i Horizon Depth Dominant Color Redox Description I Texture i Structure ,Consistence I~ ~ Boundary ' Roots I_ ~ _ GPD(ft' 'Eff#1 'Eff#2 1 0-10 10yr3/3 none sl I 2fsbk ds as ~, 2fm .-, 0.5 0.9 _ _ 2 _. _ . 10-19 10yr414 none __--- - - ___- sl ~, -~_.. _ _ _ 2msbk i dsh - --- ---._ - __-- . t cw ~, 2f,1m , ,_ --_ __ - - --- 0.5 ' 0.9 -- 3 __ - 19-28 -- --- ___ 10yr414 ___-- -- m2d 7.5yr5/8 j '~ sl 2msbk mfr cw i 1 f 0.5 0.9 4 28-33 _ ___ 7.5yr416 _ _ -- . _ . _._- -- m2f 7 SyrS/6 & f2d 10 /2 - - - _- scl 2msbk mfi ~ ----f -- I cw ~ 1 f --- ----- 0.4 0.6 - 5 _ 336 y 7.5 r4/6 m2d7.5 5/8 & m2d 1 yr6/2 scl dsh 1 csbk i - ~ - 0.2 0.3 _ ;_ - _ - -- - ---. a I l~J Boring # _J Boring f Pit Ground Surface elev. _.__ _____ - __ _ n• Depth to limiting factor ____ __ _ in. Soil Application Rate p p ~ ~ Bounda Roots GP_D/ft__.. Horizon De th Dominant Cola Redox Descri tion Texture Swcture Consistence ry r _~__ . I i ~ Eff#1 `Eff#2 !, i ~ i ' , 1 _ _ __ _ ~_. __ i -_ _.. .___ - ___._ __ i ' ~, . a- - - - -- -- ~ __ _ -- ~' ~ __--- _ ... _ r I~ T _ - - .- ..._ - ._ _------- ----r-- -.. _ .__ . _.___a.. . I, .. J i I ----- - --_-- - ~ - ~- ---- I_____ ;-... --..-----1- _.. ~ ~_ ~- - - _ __ ; -- - --- i ~ I ,. _ . _ _ _ - _.__ .___ _~- --- -.._..-- F------ ' ~ I_ _ ', ~ ' ~~ Boring # J Boring ---- -- - ----^-_ J Pit Ground Surface elev. ._ ft• Depth to limiting factor in. Soil Application Rate I p p '- ~~ Boundary i Roots '~=.-Eff#1~Dtf ~ _ Horizon De th Dominant Color Redox Descn Uon Texture Structure Consrstence i • Effluent #1 = BOD 5> 30 < 220 mg/t. and TSS >30 < 150 mgJL 'Effluent #2 = BODs < 30 mg/L and TSS < 30 mgiL The [3ep<utment of Commerce is an dual opportunity service; provider grid employer. If you need assistance to access services or need matc:ruil lei an alternate formal, please contact flee devartnient alt 608-266 3151 or TTY 608-264-8777. .~ /.~,'~ 8 ~ le/a ~ic~~ Sca/e .~ / ~. ~o , ti so. -- - ~o hared ` ;•c~a~d 7o.~~r3vn ~rc'7~~~j' /o ~ ~ o F~o~~. Csn~ 5r ScJ ~~. y T,of Ca.~c, ~a~2e ~E.. Cro; .r ~. c,) ~ lE. B o~ /off SfuKe. C/u!` = b I ~ '~ i ~~ II ~ ~ 0 63 .~ I \ i ~'~ 8 I ® ~. ~C 1 o i I \ IY1 ~I S NI ~I'! 5/~ of ~I ~I ~ I i,~ I! ~~03,2~ I I ~ l -~ I ~~ ~l y o1~1 t Slopc ~I ~ ~ ~ll ~~ro3.z3' It l 1 1, 1 1 ~ a~ 5~a.~C'e. ,QsS~.,~~.d~ I' =lc~.c.b.' ~,~. ~*iyys-' ,~ ,~ x Management Plan fvr a Septic Tank and Soil Absorption Component 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 scum and sludge 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 an 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. R ' 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 uppn 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 the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank maybe difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance,: and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shah include recording the levels of ponding. if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may Lead to more intense, and earlier, organic clogging of the soil. ?_. Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In-Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment , System (POWYS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the cvtinty zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In-Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- Table 1: System Design Spe~cifications~ Sanitary Permit Number D Number of Bedrooms Desi n Flow -Peak (gpd) p t7 Estimated Flow -Average (gpd) y Uu Se tic Tank Capacity ( al) (a ~b Soil Absorption Component Size (ft2) CQo~ Type of Wastewater Domestic Table 2: Soil Absorption Component -Limits of Reliable Operation Septic Tank Component Soil Absorption Component Desi n Flow -Peak ( pd) ~ '~lo O (e Ob Maximum Influent Particle Size (in) ~ ~ 1/8 Maximum BODE (m /L) ~~ 0 220 Maximum TSS (m /L) ) S G 150 Table 3: Maintenance Schedule Septic Tank Inspect and/or service once every 3 years Outlet Filter Inspect once a year and clean at least once eve 3 ears Soil Absorption Component Inspect once every 3 years 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 (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the se and outlet filter shall be assessed at least once every 3 years by inspection. a outlet fi shall be cleaned as nece to proper oper n. The filter cartridg not be removed un ess provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the / Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division ~ INSPECTION REPORT ` ' (ATTACH TO PERMIT) GENERAL INFORMATION ' 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 Peterson, Jake & Lindsa Eau Galle Townshi CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATIO ELEVATION DATA 'TYPE MAN CTURER CAPACITY Septic Dosing Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG Septic Dosing PUMP/SIPHON INFORMATION Model Number TDH Lift Friction Loss System Head Forcemain Length Dia. Dist. to well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. C DIMENSIONS SETBACK SYSTEM TO P/L INFORMATION Type Of System: DISTRIBUTION SYSTEM Air Intake Demand GPM TDH / Ft I BLDG IWELL county: St. Croix Sanitary Permit No: 0 State Plan ID No: Parcel Tax No: 008-1012-10-100 Section/Town/Range/Map No: 04.28.16.63A10 STATION BS HI FS ELEV. Benchmark Alt. BM Bldg. Sewer t/ nlet Outlet Dt Dt Header an. Dist. Pip Bot. System Final de Cover ~~ ~~~~r- PIT DIMENSI S No. f Pits Ins a a. uid Depth Header/Manifold Distribution x Hole Size x Hole Spac Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER / x Pressure Svstems Onlv xx Mound Or At-Grade Svstems Onlv ~ Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center BedlTrench Edges Topsoil i Yes ! No Yes ' No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 2352 50th Avenue Woodville, WI 54028 (SW 1/4 SE 1/4 4 T28N R16W) NA Lot 1 Parcel No: 04.28.16.63A10 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = i - ~-- - __ Plan revision Required? ! Yes ~ ,; No Use other side for additional information. __ --- __ Date Insepctor's Signature Cert- No. SBD-6710 (R.3/97) ST CROIX COUNTY SEPTI~,ANK MAINTEI~IANC>? AGREEMEI~ AND OWNERSHIP CERTIFICATION FORM OWller~UYCr ~JAttt 1 L~"'!~(4 7 Pc TE1u ~ ~y Mailing Address ~s3 ~ /~ ~,P i~~,•l l~ifTS. Gz ~~ M nJ ssD r ~ Property Address e?.3 S~Z ,`DS'O ~/~~ ~jovav~-tte~' (Verification rcquircd from Planning Department for new coastructioa) ~,_„__ City/State ~~~_ S~d~ ~ Parcel Identification Numbt:rGt~B' /o,~,,~ /d -~9 .5l,~8. i~ . G ~.9 --- /0 LEGAL DESCRIPTION Property Loeatiots~~ %.,~,~,_ %,, Sec. ~, T~,,~N R /~ W, Town of ~'Av LT~I~~, ,_ Subdivision _ .Lot # `- . ~" ~ ~ g ~- ~~~~/ CertiCed Survey Map # ~" .Volume Page # warranty need # .~~ y~?o5~ . Volutne/~'l~~ .Page # ~ Spec tuouse ^ yes ~' no Lot lines identifiable ~ yes ^ no SYSTEM MAINI~NANCE Improper aae and maint~enaneeof yourseptic systemoould rrsutt in its cfa~ime to handle wastes. Ptnpermautoau~oc doavsts of pampiag oat flue optic tank every throe years or sooner; if neededby a ticxased pumper. What you put into the system can affect the function of the septic tank as a treatimeat sCrge is the waste disposal system. 't'he property owner agrties to submit to St. Qrouc Zaniag Dot a oeiti5uxtion fa<m, signed by the ownx and by a z~P~l~y~P restriceo~dpiumberor a li~censedpumpervrxifying Qzat (1) the on~rtc Rrastewaterdisposal system is in proper operating condition and/or (2) aEeroa and pampitig (if neoessary~ the septic tank is less Phan t/3 fall of sludge. Uwe, the aadetaignod have read the about requiresarts and a~ to aoaiatain the private sewage disposal system with the standards set forfli, herein, as td by hue Departmeunt of Cannaenoe and floc Departaueat of Natural Resoarccx, State of Wisconsin.. Certification stating that your septic system has been maintained ~ be wmpleted and rchuned to flue St. Croix County Zoning OScx within 30 days of flue year expintioa date. ,,-~ SI TURE OF G~" Il /~ y DATE QWNER CERTIFICATION I (we) certify that all stataments oa this form are true to the best of my (our) Imowledge. I (wc) am (are) the owner(s) of tine property above. by virtue of a warranty deed recorded in ~Registcr of Deeds Office. SI ATURE OF I:I DATE ssssss ~y iaformatioa that is mis-npresartod may result in the sanitary peanit being revoked by the Zoning Department «sss.• ss Iadude with this application: a stamped warranty deed fmra the ltegistec of Deeds office a copy of the certified survey map if reference is made in the warranty deed , P0~5 OWNER'S Mt4NUAt & MANAG~NT PLAN Page 1 of 2 ` FILE INFORMATION Owner JAKE & LINDSAY PETERSON Permit ~ S3 0 3 DESIt3N PARAMETERS Number of Bedrooms 4 ^ NA Number of Public Facility Units ^ NA Estimated flow {average) O ~- al/da Design flow (peak), {Estimated x 1.51 ~~~_ gal/da Soil Application Rate .5 allda /ft~ Statt~td Influe /Effluent Quality Monthly average• Fat ,Oil & Grease (FOG) 530 mg/L Biochemical Oxyge Demand (GODS) 5220 mg/L ^ NA Total Suspends Solids ITSS) 5150 mg/L Pretreated Effluent Quality `,~ Monthly average Biochemical Oxygen Demand ,{BODE) <_30 mg/L Total Suspended Solids {TSS) 530 mg/L ^ NA Fecal Coliform (geometric mean) 510° cfu/t00m1 Maximum Effluent Particle Size Ys in die. ^ NA Other: jl!!~NA "Vak,es typical for domestic wastewater and septic tank effk~srK. C SCHEDULE SYSTEM SPECIFICATIONS Septic Tank Capacity 1250 ai ^ NA Septic Tank Manufacturer WIESER ^ NA Effluent Filter Manufacture~A EL ^ NA Effluent Filter Model ^ NA Pump Tank Capacity 10 al ^ NA Pump Tank Manufacturer ^ NA Pump Manufacturer ZOELLER A Pump Model 98 ^ NA Pretreatment Unit O Sand/Gravel Fiher ^ Peat Filter ^ Mechanical Aeration O Wetlan ^ Disinfection ^ Oth ~~1A Dispersal Cell(s) ^ NA ^ In-Ground {gravity) In-Ground (pressurized) ^ At-Grade C~Mound ^ Drip-Line ^ Other: Other: '~A Other: .Q NA Other: ~ NA MAINTENAN E Service Event Service Frequency Inspect condition of tank{sl At least once every: 3 ^ monthls) 1~ year{s) ^ NA Pump out contents of tank(s) When combined sl ge and scum equals one-third IY91 of tank volume ^ NA Inspect dispersal cellls) At least once a ery: 3 ^ Yea~~g~{s) ^ NA Clean effluent filter At least once every: 1 _ 2 ^monthlsl f5~year{sl ^ NA Ins ect pum um controls & alarm P P. P P At leas once every: ~ ^ monthls- ^ year(s) ^ NA Flush laterals and pressure test At ast once every: ~ ~~~S,1s1 Y ^ NA Other: t least once every: ^monthlsl ^ ear{s) NA ~' Other: ~(.NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal lis shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber estricted Sewer; POWTS Inspector; POWTS Maintainer; ~Septage Servicing Operator. Tank inspections must include a visu inspecYwn of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of comb' ed sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cellls) shall b visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground urface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification the local regulatory authority. When the combin accumulation of sludge and scum in any tank equals one-third (Y31 or more of the tank volume, the entire contents of the nk shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (4/01) _ >p~~ • • Page 2 of 2 START Up AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s- for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersdl cell(s-. If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks antl dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that tbd system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: ~` • All piping to tanks nd pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all to sand pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks d pits shall be excavated and removed or their covers removed ,and the void space filled with soil, gravel or another inert olid material i~ /" CONTINGENCY PLAN ~' If the POWTS fails and cannot be repel the following measures have been, or must ita taken, to provide a code compliant replacement system: A suitable replacement area has bee evaluated and may be utilized for tb6 location of a replacement soil absorption system. The replacement area should b rotected from disturbance and Ctimpaction and should not be infringed upon by required setbacks from existing and propo ed structure, tot tines and y~fls. Failure to protect the replacement area will result in the need for a new soil and site eve ation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. %` ^ A suitable replacement area is not available du to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last ri3~ort ta~'eplace the failed POWTS. ^ The site has not been evaluated to identify a suitable~;l~placement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replace t area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ^ Mound and at-grade soil absorption systems -pay be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in affect at that time. < <WARNING> > ~ ~` SEPTIC, PUMP AND OTHER TREATMENT TANK$'MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATM~T TANK UNDER ANY CIRCUMSTANCIrS. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK;LAY BE DIFFICULT OR IMPOSSIBLE. \~ ADDITIONAL PAINTS INSTALLER ( POWTS MAINTAINER Name ~~ Phone ~' ~- , 7©r C~/ Name FEATH RST Phone 715-3 1-1704 SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name PINKY'S Name ST. CROIX COUNTY Phone 651-436-5788 Phone 715-386-4680 This document was drafted in compliance with chapter Comm 83.221211b1(111d)&If) and 83.54(11, 121 & 131, Wisconsin Administrative Code. ~~ ~~ ...~• .. «, ~...v.v8 ~. a v rr v.~o, ivrvre of Luu V(.[NG, .J! i ~ ~ GwlvER•'SADDRESS B~TO~TtIS~NOR,-~i~uTM;: .LEGEND 508 C.T.H. BB SECTION LINE OF SECTION 4, ~ O INDICATES 1 " x 24"IRON PIPE SET WOODVILLE, W154O28 T 23 N, R 16 W, ASSUMED AS (MIN. VvT - 1. i3 LB.A.lN. FI'.) N OZ° Z4' 03" W. ~ INDICATES 1 "IRON PIPE FOUND NORTH f/4 CORNER SCALE fN FEET 1 "=300' SECTION 4, T 28 N. R 16 W p SOIL BORINGS (PROPOSED SEPTIC SYSTEM) (FOUND 2` IRON PIPE) 1 1 0 3 Ga SECTION CORNER MONUMENT (AS NOTED) "--- --~__`_ 1` ~~' ~-~.__ ~NP x INDICATES FENCELINE ''- ~ ~_7_`ED _[,qN~ (R=) RECORDEDAS A - - -- ~ -- NTH ~~ ti ~OT_ 1, ~ -max ''-•=._ _ _ _9°¢. x _ ~r/r~ fS_ M, t3-%-__ ~ 56736 S 8107'48" E "121" 2~ 3 x i ~Ql..._ 14, ~ STgTEgNO00UN7Yl/j jr - _ _t a ~~ TAI y ~ `. y `~; . ~. ~ P~_ _3920 ~" _ SOUTH UNE NWi/a-SEf/4 -~~_ 64_q_ ~~'~." ~4" ~ x "'-~ ~ ^ ` -- ----- _ _ _ - .94' o ~. 8' x NORTH UNE SW1/4-SEf/4 "~~~ - - " - - '-- I I SE~~LINE- ~~ '~--_ ~ """"- N CAUTION- m ~.~ .A~ 3Wi/a-SEf/4 HIGFIVIIAYSciI~AGK ~ y z ~ RESTRICTIONS PROHIB/T '` ~ N lMPROYEMENTS (SEE SHEET 2J ~ m ~~' A N s LOT 3 ~ ~ .a ;; : ~ o g ~ p CONTAINS 871,200 SQ. FT. +~ +- Z i ~ _ w OR 20.000 AC. (850,486 SQ. N I to FT. OR 19.524 AC. EXCLUDING N TOWN ROAD RIGHT OF WAIF o ..~- UNPLATTED i r :.+ r ~. ~ I _ i ~ r ~t ~ ~ W p Vii 1 LO 1 ~ ~_ m LANDS ~~ ;~ ~~ a NOTE: cWn ~0 ~' CONTAINS 703, Q. FT. l LOT 2 CONTAINS 117,161 SQ. FT. 'w OR 16.144 AC.(695,005 SQ. OR 2.690 AC. (107,031 SQ. FT. OR ~ O ~ ~ 1111 FT. OR 15,955 AC. EXCLUDING 2.457 AC. EXCLUDING TOWN ROAD ~ i ~~-~~~ .~.... y ; m ;~ ~ ROAD RIGHT OF WAIF RIGHT OF WAIF I ~ iJ ~ I rn I~ ~ ~ BY P_LA_ TT~RS) %0 ~'i' '~ ~ ~p A N 89 46'55" W p C rtyi w nN°~ ~ SHEDSILOj~ p ' ' ~ ~m ~ ~ ~ ~ cN~af1 o LOT~LL o N ~ PROPOSED i U1 i j 3 ! m nGAR. o w ,DRIVEWAY I rji Q" ~ ;n __ ~~ ~~__ ~__ p~IC~DWELUNG ! ___ 100_000NTV 8U1L~ING _SEfBACK _UNE _ ~ ~ f ~' g j'- N 89°46'55" W 1184.81' - ~ i NORTH RAN UNE ,~ :'_ ;250.00'1 $ 30700' id- 3f0' _ .:627.81' $ '~. f'" 50THAVE. - ~- ` "' w SOUTH RAN LINE: 0 i~, Z °;o _~ o ~ ~`' '~ ~~~ iO ;• ~~ W ~ ~cp'~ ,rn ,~, ~~ -IY OAMO J:7 YY ~"~ SOUTH 1/4-~ CORNER cMi - N 89°46'55~WE 7.04' - SECTION 4, ~ 71 728N,R16W (P.K.NAILSETFROMTIES) LOT '~ _~~RTIFIED I UNPLATTED ._____ SURVEY MAP ______ ~A.ND$ I yQL(~ME_ 8, PAGE 220 .L O~ 4.0f '- _~_ 50~h AVENUE _ ~ N89°46'55"W 1482~3T p, _ OUTH UN/ E SEi/4 ~ SOUTHEAST CORNER SECT/ON4, 7 c^8 Pl, R 16 W (FOUND 9ERNTSEN ALUMINUM MONUMENT) (QWIVED ' _ BY THIS INSTRUMENT DRAFTED BY JERALD L. LARSON l~1VPLATTED LANDS _QTHERS) DATED: ' AUGUST 10, 2001 °' SG~NS/ ~`~'0 ~~ ti ~v~ <, .° , ° ° '~~; <~°LAUREI)IG ' W.~ UR Y ~S 1713 j RIVER '~ ,! FALLS, o aO W I. !V 2 ~ ° -~ o , ° ` JQ.oQa° ;~< °LAND 9 ~o SHEET 1 OF 2 :1ia -~ / / •.7 "1l"w1 •••,•.1.t•.• •~~• J s~ IY! Y! """"CI `lf'`a~IK t`fG a.~a1~aurw~ ri [ v[1/n~ fv ~~ ~sva~l;nOS a~f~~~ sir 1sa, oST aye puv ~:, ~sna~f~noS a~f1.~~ p/r 1sa ~ ay~~o 1~tnd ut pa~n~o7 ~.~a~xo,I, 'O ~a9~2I' Puy 'Z P~~q ' d`~L~I A~A?Ir1S . Q~I,~I,L2I~~ State of Wisconsin) County of Pierce) I, Laurence W. Murphy, Registered Land Surveyor, do hereby certify that by directiyon of the Owners, A.'..^.ltn..r.7 a.1 L? ~l.nrt T r r n a q..r~.oa~)o~ ..n-~~' deg lded Q la..rl., shn ?l .. h._. ~__ (a ,. L. .a..d .,~.. O. c. ge.so., I h.,~e .aa.+. J a P th n C \ m PrP 11 111 a^~Ar ~±1(.P with official records, Chapter 236.34 of Wisconsin Statutes and the Ordinances of St. Croix County and that this map and description are a true and correct representation thereof. Dated: August i0, 2001 NOTE: Each parcel shown on this map is subject to State, County, and Township laws, rules and regulations (i.e. wetlands, minimum lot size, access to parcel, etc.). Before purchasing or developing any parcel, contact the St. Croix County Zoning Office and appropriate Town Board for advice. HIGHWAY SETBACK RESTRICTIQNS (Applies to areas adjacent to I.S.H. "94") "No improvements or structures are allowed between the right-of--way line and the highway setback line. improvements and structures include, but are not limited to, signs, parking areas, driveways, wells, septic systems, drainage facilities, buildings and retaining walls. It is expressly intended that this restriction is for the benefit of the public as provided in section 236,293, Wisconsin Statutes, and shall be enforceable by the Department of Transportation or its assigns. Contact the Wisconsin Department of Transportation for more information. The phone number may be obtained by contacting the County Highway Department." NUTE REGARDING NOISE LEVELS "The lots of this land division may experience noise at levels exceeding the levels in S. Trans. 405.04, Table 1. These levels are based on federal standards. The department of transportation is not responsible for abating noise from existing state trunk highways or connecting highways, in the absence of any increase by the department to the highway's through-lane capacity." THJS JNSTRUMENT DRAFTED BY JERALD L. CARSON SHEET 2 OF 2 ~ ~«~ 173?PA7E269~ ~ < I STATE BAR OF WISCONSIN FORM 2 - 1949 Document Number WARRANTY DEED . This Deed, made between Robert Torgerson and Richard Torgerson, a/k/a Richard Louis Torgerson Grantor, and Jake B. Peterson and Lindsay E. Peterson, husband and wife Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Part of the Northwest Quarter of the Southeast Quarter (NW 1/4 of SE 1/4) and the Southwest Quarter of the Southeast Quarter (SW 1/4 of SE 1/4) of Section Fcur (4), Township Twenty-eight (28) North, Range Sixteen (16) West, Town of Eau Galle, St. Croix County, Wisconsin, more particularly described as follows: Lot One (1) of Certified Survey Maps filed September 26, 2001, in Volume 15 of Certified Survey aps, at a e 4180 as ocument No. 6 , o fice of the Register o eeds for St. Croix County, Wisconsin. Exceptions to warranties: all easements and restrictions of record. ~-- Dated this ~~ day of ,~,~~t~~'yt~~l:~ Recording Area -~-r~ y.~ - - :~ - - _ -- ;; _ ; ~_A35 ., Name and Return Address Thomas A. McCormack 1020 10th Ave. Baldwin, WI 54002 ~~~-y ~Ul3~,J~-/dd Parcel Identification Number (P[N) This is not homestead property. ~~ (is not) COPY AUTHENTICATION Signature(s) authenticated this day of , * TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Thomas A. McCormack Baldwin, WI 54002 (Signatures may be authenticated or acknowledged. Both are not necessary.) * Ro rt Torgerson ~ ~"''~ U~ -x ~3-vT/" * Richard Louis Torgerson ACKNOVO'LEDGMENT STATE OF WISCONSIN St. Croix ~~4~a4 :tie ' ~ ; "..: i`i !,r rr,:; 4 .., ~~ ss. County ) t~ Personally came before me this ~ day of .L~~~~~~E'~4~, ~L`;~ 2001 ~ atlto,~'er named Robert Torgerson and Richard Torgers a Rich~r'N,Louis Torgerson "d~-. ~ r,-f' ~- to me known to be the pers (s) w e~e~u`te~'th~'Tbregeing instrument a acknowle ed the bane. ... ~ `--._..... -`mss" !' Notary Public, State of Wisconsin My Commission is permanent. (If not, state expiration date: - •) * Names of persons signing in any capacity must be typed or printed below their signature. i~ro~mauo~ P~ores5~o~ai5 comPa~y, Ford a~ ray, wi STATE BAR OF WISCONSIN 800-655-2021 WARRANTY DEED FORi~INo.2-1999 ~.. . >~ ir' - Wtaoorrein Department ~ Comrheroe Division of Safety and Buildings SOfL EVACUATION REPORT in arrmlanrQ with ('.mvn R5 Wis_ Adm. Ctrle 1445 page 1 of 3 AC.E. Sal 8 Site Evauatkxrs ~~ Attach complete site plan on paper na less than 8'F~ x 1 t indres in sae. Plan must ti d drc St. Croce include, but not limited to: vertical ~ horizon ec ai at , Parcef percent slope, scale or dimemsrons, noM I di ce to nesest road. 00$-1012-10-~00 I 28 16 63A - ~ ~ J . . , . Please grin nnatloQ. 4 ,~ Daie Persons iMormafbn You Drovide may second .} .04 (1) (ro))• 2 ZZ j~ J OWrler v P LOCatlon ~ 3 ~ ert 8~ Richard To arson R ob ' 28 R 16 W • ~ SW 1/4 SE 1/4 S 4 T Property Owners Mailing Address ST C~iOiX i= Biack # Subd. Name or CSM# CJ 7 7 ~ / 508 Co. Hwy. BB 1 Proposed CSM City State 4NMi~9iIM1®E ,~ City ~ Village 7wvn Nearest Road Woodville ~ WI 715-6 Eau Gape 50Th Ave. New ~ Use: ~! ~ moms 3 Code derived design flow rate Replacement ~ Pub6c or commercial - Descn'be: Parent maCerial Glacial Till _ Fkxxi plain elevation, if appdicabie General conenerrts ,/ and re~aarrrrerbatians: Mound system elev. = 105.07' at 22" above 103.23' contour. 450 na GPD ~~ # ~ Boring ~J Pit Ground Surtace elev. 103.42 ft. pepth to timing factor 14" m• Soli Application Rata Horizon Depth Dominant Color Redox Description Texture SUucture Consistence Boundayy Roots P DIft2 'Eff#1 1 0-9 10yi3/3 none sil 2fsbk ds as 2fm 0.5 0.8 2 9-14 10yr5/4 none sil 2msbk ds Cw 2fm 0.5 0.8 3 14-22 10yr5/4 f2f 7.5yr5/6 sl 2msbk mfr cw 1 fm 0.5 0.9 4 22-30 7.5yr4/6 °'~a j~~ sl 2msbk mfi cw 1fm 0.5 0.9 5 30-43 7.5yr4/6 m2d l~yr6%L~ scl lcsbk dsh - - 0.2 0.3 Boring # ~ Borirg Pd Ground Surface elev. 103.17 ft. Depth to limiting favor 18° in. Soil Ap~igtion Rate Homan Depth Dominant Cabr Redox Descriptxm Texture Structure Consistence Boundary Roots GP DIft' ~~ 1 0-9 10yr3/3 none sf 2fsbk ds as 2fm 0.5 0.9 2 9-18 10yr4/4 none sl 2msbk dsh cw 2f,1m 0.5 0.9 3 18-22 10yr4/4 m2d 7.5yr5i8 sl 2msbk mfr cw 1 f 0.5 0.9 4 22-34 7.5yr4/6 pfd j/~~ scl 2msbk mfi - cw - ---- 1f -- 0.4 - -- 0.6 - ---- 5 345 7.5yr4/6 m2dd i~yr6Y2& scl 1csbk dsh - - - 0.2 0.3 Effluent #1 = BOD ~ 30 <_ 220 mglL ar-d TSS < 150 mglL = BOD < 30 rrgN. arrd TSS <~30 mgrt. CST Name (Please Print) Sig re: CST Number James K. Thompson =---- 3602 Address AC.E. Sal ~ Site Ev~uations Date Evaluation Conducth?cl Teleptrone Number 340 Paulson Lake Mane, Osceola, WI 0 812101 715-248-7767 3 ` ~ Property Owner Robert ~ Richard .T_!!_____._.__ Paroei ID # 008.1012-10-000, ID#4.2$.16.63A Pape 2 of 3 P8 Ground Surface elev. 102.11 ft. Depth to limiting facto' 19" in. ~ Applict Rate Horizon Depth Dominant Color Redox Desaiptia- Texture SWcture Consistence Boundary Roots 'Eff#1 "Eff#2 1 0-10 10yr3/3 none sl 2fsbk ds as 2tm 0.5 0.9 2 10-19 10yt4/4 none sl 2msbk dsh cw 2f,1m 0.5 0.9 3 19-28 10yr4/4 m2d 7.5yr5/8 sl 2msbk mfr cw 1 f 0.5 0.9 4 28-33 7.5 r4/6 Y m2f 7.5yr5/6 & f2d 1 /2 scl 2msbk mfi cw 1 f 0.4 0.6 5 33-46 7.5yr4/6 m2d7.5yrS/8 & m2d 10yr6/2 scl 1 csbk dsh - - 0.2 0.3 ^ ~~ # ,J Boring Pit Ground Surface elev. ft. Depth to Irrniting factor in. Sal Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots "Eff#1 *Eff#2 ^ ~~ # ~ P~~ Ground Surface elev. ft Depth to timfiri9 factor in. SalApptication Rate Hor¢on Depth Dominant Color Redox ' tion Texture Structure Consistence Boundary Rants ' *Eft#'I *Eff#2 • Effluent #1= BOD ~ 3D < 220 mglL 8rnd TSS >30 < 150 mgll. ' Etfluer~ #2 = BODS <_30 mglL and TSS <30 mgll. The t of Commerce is am equal opportunity servkxr provider and employer. ff you need assistance to scows services or need material et am ahem~e format, please t the deperErment at608-266-3151 ~ TTY 608-2b4-877?. * . ~' ~ S of l Z /Q lcca~'or~ ' ~ ~ p;~ • Ele/a ~~ ~0 6a-~~ ~c~a:d T~~ars~n ~p~oyJ. A L6. B.rr1_ : To~o~ / /off l o F~o~~. ~1 /off She. C/u!` SC Su? Sec. S; T,oF Ea~.c,~~e, ~E_Cro;XCo;~I, b `i. -o g O ` ~~ ~ M ^ ~ ~ N M 1 ~1 s NI 4_~y° «' u~ ~I ~I ~=1o3.2i 63 T ~~ 6,£~ SIOPL ~i~ ~~ ro3.Z3' 1 1 1 as ~ehc.l~ Wlar,~ ~ To,~ a{ /o t~ ~O~ f~de- ~~ ~~ ~ P5. 3 a~' 3 r~ ----- Safety and F3nildings Division 201 W. Washington Ave., Y.O. Ilvx 7(182 ST. CROIX `' ~~~~~~ M;idissm, Vlf l 5375.?7. 7082 8at,i~,ry Penni! Number (to be filled'!n by Ca.} ~~~~> 261 ~5~ y s o Depar ment of Commerce "'~ Sanattnry Permit Applicat>lon i SEa>Y Plan T.D. Number ~ Tn a,xord with camas 83.21. Wis. Aam code, v~souat i,rfern,ati~n yax, provide 9 7 ~ a ~ i _ may fw usad fix sea,ntlary purposes Privacy l~ew, s15.U4(l }(m) Projact Address (ifdiffererti than mailing address) ~~~' ~V~ ~ oZ Z 3 L Application Information - Ficase PNnt Aft lnfi E ~ ~ ~~ ~ ~ , - Pnxxrtg~ ()weer x Nance Parcel # I.At # --- I3fock ~ JAKE 8, LINDSAY PETERSON R '~. `~ 104 008-1012-10 ~ /Ob _ _ . Properly owncs's Mailing nddinss '~~ ~{ Property ~~ 0 6 3~ -/D 7434 INSKIP TRAIL sT ~'~`~~~" c°`~~~ Fic~ SE ~,~ icar 4 SW =~. city, States 7..ip C . COTTAGE GROVE MN 55016 651-4303713 T 28 N. tiV~ raw ~ Type of Boildiag (c al! that apply) Q II . XI lor2FamuyTAvelting-N 'Hethooa~s 4 PER SUBMITTED HOUSE PLAN ~i Name t:S'tittitrml~er C ~~- bY, ~'~D W ~/ / ZS / ~S U Publi~Comrocrcial - I)<vcrilxc [:lsc _ / , ^ ~~ p~,,,,,t r~~ rr~ __.. .._.____._._._ /d 3 . Z 3 ccitvv_Llvitla~a i~1 own.~l,ip of U GALLE III. Type of Permit: (Check Doty urre box !ll)e A. ComplMe line B if applicable) -_ _ ___ A. t~Q New System ~-.-- U Replaarnem Syslern ^ Trrrahnat,tlTluldir,l; Tank Replacement ( L~ ()dtalr Mu<iification ra )rxi~ting 5_ ~. ^ Permit Renewal U Permit Revisiart ge of (~ Permit Tr to New list Prrviws Fermit 14umber and Date fklixc E~q~iratiun P ow,xx IV. T of POWTS S feet: Cheek all that a t ^ Ncm -Pr~svutized Tn-Grottad U idlaund > 24 is o!'utiratdn scxif - outtd < 2~ - of 5ti ~ Single .' •r I~ ConsnttcYed Werlaat U Pteeelur[eA In-c;ramd LI Holding •r'smk U P Er;rt 14 nerotri rt,~cr~ar~ ~ t• ~r LI Reciec7,latirtg Syttthdic 14lectia Filter ^ Leachingchamber U Drip I,it>e val-lass Pip: explain} V. Dis i/'I'reatment Area Informatlmr P VIEW -- - - _ _ _. Desigp Flow (gpd) Di.~ign Soil ~catian Rete(~Ct) ~~~ `B ! `xl" (ctg "- .ra P., ~ x sleet Elevation 600 .5 /.o d 207 jp 05.6 'VI. Tapte l'nfo ~ Y ~ ' Tara! Numk,cr t~fanuf Prefab i Si Y Gatiot~ f;alk,r~s nfiirritc /.2~ QQ Concede ed Nsw F.x,riaay ~/~ r Tanks T~ks '~'~°~~'°'~T~ YES 1250E 1 WIESER YES Aerobsc Tngl,nl~,N SJnil r)nsi,~ t'.tstintxr YES 1000 1 WIESER ES VII. Responsibility Statennrot- 1, flee aae®ae iea for ~ of the fowl's ev t6c Plumber's Nmre (Print) .Plum 1'fMl'!LS NumdcT H,rsincav IN+nrse Nr TODD FEATHERSTON ---- - 715-381-17 rllar,ner~s Aaare~ (swnel, oily, state, ~ cep a P.O. BOX 467 HUDSO , WI 54016 ~ , Vet. Dun /De artmest Use _ __- - Appmved U))isavotuved `Mary Permit Fee (includes Grounthuater Date Issued Tsui Si mare tN S rtps) ^ o~nnr Gi for Denial -- - --- - tX. Conditions of App easons far lJisappravat - 5~- OUm~~ Q (/ SYSTEM O WNER: ~p~'YI Y> 1~ ~ _ i -.. . . 1 Septic tank, effluent filter and ~ ~lvt~~t/1~,a ~5..~~_ di spersal cell must all be serviced /maintained ~~GUt~ ~ - i as per management plan provided by plumber ~~ . 2. All setback requirements must be maintained as per applicable code/ordinances. ~~-,,t„~,~ ~3 C`3 - ~ _ ~ ~ / ~o ~~~~~,~~ l` 1 -~~../~ Z(~6(il~ .ittac9 pum 11a tM [:sear) wry) wr uur systcta as paper twa rwa r~u dui z ri rages ®s®e U r r W N ~~'r • y~ ~,y • ~ m/ 4 ~ ~~ ~'' _- .-_" ~~~. ,fit f~' .~ _ _. -- . fs ~ .~ ~.,~•. ` ~~ .,.rte 4 ~ ~ . a~ . ~(~~ ~ ~ v . 3 ~ 1 ` `\ ~ ~ ~b ~ ~ ~ s~ ~~ ~~ { ~~ ~ . ~ .~ ~ ~ ~~ ~„ _ ~ ~y ,l ~ %, ~~ 1 - -------~-- ~ ~ s • `~ - ~ J '7 r --' .~ 1_~ ~A.rE ~D~ r ~ J{ a ~ /~, per' , .4oT -~/i°~.~a~ /~ ~,i ia3_s~~~/~3./~~/off ~/ . ,E~- FfTla~s 1 ~~ ~D ~. -'~ ~ ~~ • ~, ~ ~ ~scons~n Department of Commerce Safety and Buildings PO BOX 7162 MADISON WI 53707-7162 TDD #: (608) 264-8777 www. com merce.state.wi. us/sb www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary March 15, 2004 CUST ID No.242514 TODD C FEATHERSTONE FEATHERSTONE EXCAVATING INC PO BOX 467 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 03/15/2006 SITE: Jake & Linsay Peterson -Dwelling 50TH Ave Town of Eau Galle, St Croix County SW1/4, SE1/4, S4, T28N, R16W, Lot: 1 ATTN.• POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 Identification Numbers Transaction ID No. 976271 Site ID No. 671538 Please refer to both identification numbers, above, in all corres ondence with the a enc . FOR: Description: Mound System / 600 gpd Object Type: P TS Component Manual Regulated Object ID No.: 945917 Maintenance requir 600 GPD Flow rate; 14 in Soil minimum depth to limiting facto om original grade; System(s): Mound Component ual -Version 2.0, SBD-10691-P (N.O1/O1), Pressure Distrib n Component Manual -Version 2.0, SBD-10706-P (N.0 1); Biofilter The submittal described above has en reviewed for conformance with applica Wisconsin Administrative Codes and Wisconsin Statutes. The submitt as been CONDITIONALLY APPR D. The~wner~as defined in chapter 101.01(10), Wisconsin Statutes, responsible for compliance wi 11 code requirements. ` . No person may engage in or work at plumbin the state unless li sed to do so by the Department per s.145.06, stats. The following conditions shall be met during construct installation and prior to occupancy or use: • This system is to be constructed and locate accor ce with the approved plans and with the component manuals listed above. A copy of the approved plans, specificat' and this letter shall be o ite during construction and open to inspection by authorized representati of the Department, which may i ude local inspectors. All permits required by the state or the local icipality shall be obtained prior to co encement of In granting this appro the Division of Safety & Buildings reserves the right to req ' e changes or additions should conditions arise ng them necessary for code compliance. As per state stats 101.12 nothing in this review shall relieve esigner of the responsibility for designing a safe building, structure, or co onent. Inquiries concerning this correspondence maybe made to me at the telephone number listed belo or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsibl~or the installation, operation or maintenance of the POWTS. Ca, DIV/S Fp r SF~ C O/~RE C FEATHERSTONE Sincerely G eter ag 1' ~-- Private Sewage Pl Reviewer ,Integrated Services (608)266-2889 , M - F, 0630 - 1500 Hrs pepagel@commerce. state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 2 3/15/04 Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 ~ound System Management Plalrl~ Pursuant to Comm 83.54, Wis. Adm. Code Gen ral This system shall be operated in acxordance with Comm 82-84 Wis. Adm. Code, and shall maintained in arxordance with its' component manuals [SBD-10691-P (N.01/01) 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 subj to failure must be replaced. Exposed access openings greater than 8-inches in diameter shalt 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 oft ptic tan shall be disposed of in accordance wkh NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filters be assesse least once every 3 years by inspection. The outlet finer shall be aped as necessary to ensure proper operation. The fitter cartridge should not be remov less provisions a made to retain solids in the to that may slough off the fitter when removed from its enclosure. If the filter is equip h an alarm, the filter shall be serviced if the alarm is ivated continuously. Intermittent finer alarms may indicate surge flows or an im ing continuous alarm. The septic tank shall have its tents removed when the volume of sludge and scum in the tank exceeds 1 e liquid volume of the tan the contents of the tank are not remo at the time of a triennial assessment, maintenance personnel shall a the owner of when the nee service needs to be performed to maint less than maximum scum and sludge akxumulation in the tank. The addition of biological or chemical hives to enhance septic tank performance is generally not wired. However, "rf such products used they shall be approved for septic tank u y the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least ce every 3 years. All switches, alarm nd pumps shall be tested to verrfy proper operation. -f an effluent filter is installed within the tank it all be inspected and serviced as ssary. No trees or shrubs should be planted on the mound. Planting a and mulched as necessary to prevent erosion and to provide some maintenance) on the mound is not recommended since soil compacti~ compaction in the winter will promote frost penetration. Cold weather as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L B BODS, 30 mgll TSS, 10 mg/L FOG, and 1d cfu/100 mL for highly trea in the permit for this installation. ro the mound's perimeter, and the mound shall be seed i penetration. Traffic (other than for vegetative .r aeration of the infiltrative surface within the mound and sr (October-February) dikxate that the mound be heavily mule TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L fluent flow may not exceed maximum design flow specifie The pressure distribution system is provided with a flushing poi t the end of each ral, and it is recommended that each lateral be flus of accumulated solids at least once every 18 months. When a pr sure test is performed ould be compared to the initial test when the system was installed to determine if orifice clogging has occurr and if orifice cleaning is to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be ch for effluent ponding. Ponding levels all be reported to the owner, and any le~ above 6 inches considered as an impending hydraulic fa' requiring additional, more frequent moni g. Continoencv Plan If the septic tank or any of its components beco defective the tank or component shall be repaired or rep to keep the system in pro operating condition. If the dosing tank, pump, pump controls, ala or related wiring becomes defective the defective component(s) sh be immediately repair or replaced with a component of the same or ual performance. If the mound component fails to accept tewater or begins to discharge wastewater to the ground surface, ft will be fired or replaced its' present location by increasing basal a ff tce leakage occurs or by removing biologicaly cogged absorption and dispe media, and re piping, and replacng said components a eemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name nd telephone number of your local POWTS regulator and service provider. Project: PAUL NORD CONSTRUCTION Page 6 of 12 Y Y i MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: PAUL NORD CONSTRUCTION Owner's Name: JAKE B. AND LINDSAY E. PETERSON Owner's Address: 8335 MANNING AVE. NO. Legal Description Subdivis Name: Lot Number: Parcel I.D. Numbe Plan Transaction No. STILLWATER, MN 55082 SW1/4 SE1/4 S4 T28 R16W EAU GALLE ST. CROIX 1 Block Number: 008-1012-10-000 16.63A • ~` ~~ +~~c~w~o l~AR 1 1 ~0~4 ATV ~ ~~AG6• DIV. Page 4 ter nd dose tank Page 5 S maintenance specifications Page 6 ement and contingency plan Page 7 ump rve and specifications Page 8 Soil Test Page Soil Test .. .,. ,r.,_~ ~,-- Pag Index and Page Data entry Page 3 Mound d Designer: TODD ATHERSTONE License N Date: 03/ 04 _ Phone Nu 242514 p 715-381-1704 j!Q ~ T jP! Si - j ohg~y Desi ned Pursuant to the NT ~ ~~ ~- 9 and Component Manual for POWTS Version 2.0 SD8-10691-P (N. 01/01), SWMP Publication 9.6 Design of Pressure Distribution Netwo rks for ST-SAS (01/ Version 3.11 (05/01) Page 1 of ,~ • Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R Residential or Commercial Design 400.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 = 150%) 600.00 Design Flow (gpd) 5.00 Site Slope (%) 103.23 Contour Line Elevation (ft) 14.00 Depth to Limiting Factor (in) 0.50 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 125.00 Dispersal Cell Length Along Contour (ft) _ 1.00 Dispersal Cell Design Loading Rate (gpd/f~) 1 Influent Wastewater Quality (1 or 2) Pressure f7ilsribution Information (c ore) C C ter or End Manifold 2.40 Late Spacing (ft) 4 Num f Laterals 0.156 Orifice DI eter (in) (e.g. 0.25) 4.50 Estimated ' ce Spacing (ft) _ 2.00 Forcemain Dia ter (in) 215.00 Forcemain Lengt ) 86.00 Pump Tank Elevatio ft) 4.55 System Head (ft) x 1.3 18.56 Vertical Lift (ft) 4.21 Friction Loss (ft) 27.32 Total Dynamic Head (ft) ~ Lateral Diameter Selection in. dia. o tions choice 0.75 1.00 1.25 x 1.50 x 2.00 x 3.00 x Treatment Ta nformation 1250.00 tic Tank Capacity (gal) WIESER Manufacturer Dos ank Information 1 00.00 Dose Tank Capacity (gal) 27.83 Dose Tank Volume (gal/in) WIESER I Manufacturer Note: Sand fill (D) calculations assume a Table 83-44-3 in-situ soil treatment for fecal coliform of <= 3g inches. 4.80 Cell Width (ft) Are the laterals the hig st point in the distribution Y network? Enter Y or N If N above, e r the elevation (ft) of the high t point. 10.71 ft2. Does the fol~.emain drain back? Y Enter Y or N .07 Forcemain Drainback (gal) 78.62 5x Void Volume (gal) 13.69 Minimum Dose Volume (gal) 30.16 System Demand (gpm) M ifold Diameter Selection in. o tions choice 1.25 x 1.50 x 2.00 x 3.00 Gallons/Inch Calcula (optional) Total Tank acity (gal) Total Working uid Depth (in) gal/in (enter resu cell B49) Effluent Filter Information Zabel Filter Manufac r A100 Filter Model Num Project: PAUL NORD CONSTRUCTION Page 2 of 12 • • Mound Plan View L Mound Component Dimensions E 24.88 in H 1.00 ft K ft F 9.25 in z 11.80 ft L in G 0.50ft J 8.10ft W 600.00 (ft2) Dig 4.80 (gpd/ft) Cell Area 2075.37 (ft2) B< Loading Rate 12.50 (ft) 111 Cross Section View egate Dispersal Area Finished Grade 106.83 (ft) F -} _~ -~ -I ~Crea Available Obs. Pipe Placement his .a~.... 105.56 (ft) Lateral Invert 1 (ft) Contour Elevation 5.0 % Site Slope Geotextile Fabric Cover See lateral details on 'age 4 for number, size, spacing of laterals. L rals are equally sp d from the distri tion cell's centerli in the distribution (Ax6). Page 3 of 12 `~ Center Connection Lateral Layout Daigram Force ma n cwmection tria tee or cross to manifold at ang point- I P i=Turn-upv~dballvalve or IEX~IE olesnoutplug Holes drilled on the bottom of the lateral. Laterals are identical ~k Laterals & force main of PVC Sch 40 per COMM Table 84.30-5 Number of Laterals 4 Orifice Diameter 0.156 in Lateral Diameter 1.25 in Orifice Spacing (X) 4.57 ft Lateral Length (P) 61.70 ft Orifices per Lateral 14 Lateral Spacing (S) 2.40 ft Orifice Density 10.71 ft2/orifice Lateral Flow Rate 7.54 gpm Manifold Length 2.40 ft System Flow Rate 30.16 gpm Manifold Diameter 2.00 in Total Dynamic Head 27.32 ft Forcemain Velocity 3.08 ft/ c Dose Tank Information Locking cov ith warning label and ing device and sealed ertight Electri s per NEC 300 and ---- Corn 6.28 WAC Disconnect 4 in. min. - --~-~_ Tank component is properly v ed ~: ~ Alternate outlet location WIESER - Ca aci 1000.00 Volume 27.83 Manufa~ Gallons gaUinch Dimensio Inches Gallons A 17.85 496.69 B 2.00 55.66 C 4.09 113.69 D 12.00 333. Total 35.93 100 0 ~- \A /C D Forcemain diameter ~ 2 in. Weep hole or anti- siphon device P~elevation (ft) 87.00 D~ ose tank elevation (ft) 86.00 Alarm Manuafacture EVEL Alarm Model Num r LVL1 Pump Manufa rer ZOELLER Pump Mode umber SIB Pump M Deliver 30.16 gpm at 27.32 ft TDH Project: PAUL NORD CONSTRUCTION Page 4 of 12 ~~ • s ~ ~ ! . Mound System Maintenance and Operation Specifications Service Provider's Name FEATHERSTONE EXC. INC. Phone 715-381-1704 POWTS Regulator's Name ST. CROIX CO. Phone 715-386-4680 System Flow and Load Parameters Design Flow -Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow -Average 400 gpd Maximum BODS 220 mg/L Septic Tank Capacity 1250 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Freauencv Septic and Pump Tank Effluent Filter Pump Controls )arm Pressure S em Mou Other Ins ct and/or service once eve 3 ears Should ins ct and clean at least once eve 3 ears Test once eve 3 ears Should test month) Laterals should be flushed and ressure tested eve 1.5 ars Ins ct for pondin and see a e once every 3 ye 1. Observation pipes are slotted and mat 'als conform to Table Comm 84. -1, have a watertight cap, and are secured in as shown in the mou component manual. 2. Dispersal cell aggregate conforms to Com .30 (6)(i), Wis. Adm. e. 3. All gravity and pressure piping materials con to the requirem sin Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with old board or sel plow. 5. The mound structure and other disturbed areas be seed and mulched to prevent soil erosion and help reduce frost penetration. Lateral Tur p tail Finished .... ~ • ........ • ....... ............ .............. Grade v/ 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box ug or Ball Valve Distribution Lateral Long Sweep 90 or T 45 Degree Bends Sam Diameter as Lateral Project: PAUL NOD CONSTRUCTION Page 5 of 12 ^ v I . s' D , . • ~iDTAL DYNAh~IC 'ICACfCA°ACITY I-IEAD GAP~CIT'~ CURVE Fri It Mifaurr EFr~UE;dT ANC ~E`~:A?ER!NC ~ MODf~~ 152/153 ~._ __-T_ _. -- w ~ ti~acE~ ~ t.h~ -~~ ~~ ........... __T ...... __r____ 50 Fret Ur F ~; l,r~i. ~~ I filer ~ gal ~ I_iiers i53 ~0 F? 2f31 7^ ~ 29; ' _ .._ ~ 5 i 1 6.. ~,~T07 _ ~3 t 40 ~_ 5L 1J 4 l 5 152'`, ~ G., ~ 3 201 i S1 2;1 T :. + .~ ~ 30 .. - -- + +_ i . ~ "~' '' 25 !E i .4 ~_ 1[y ~ 42 759 8 ~i y.i t3 ', 87 -~3 __._.125 `<; ~ 20 ~~ .. _ ~ ~`..~ 1 U.7 i~~ 22 R5 _ .. --~ i 4 tQ ''~:~•~~. ~'ar.k 'dare _+3Rn Fr,.ft1.6"i) 4a.rJ ~l. (7~ .. _ _ _ --- 0 2f) ~t0 60 80 100 GAL~ON3 C17ERS 0 80 l b 240 320 mow I'eR Ure . '~~tw ~ ;s .+"-~ _ ~ ._.-.fr,. '..r,~'S is rrfS14.'s"-. • Tinned dosing pancds available- • Electrscai altemalors, f~ duplex systems, are available and su ~ with an alarm. • Variable level control switches are available for controlling single pit systems. • Double piggyback vari~le level float switches are available for variable level long and short cycle controls. • Sealed Qw~c-Box avaikable for outdoor installations. See FN11420. • Over 130°F. (54°C.}special quotation required. 1421153 MODELS Control 5electwn _~ Model YeNs•P~ Mode i Arr~g ;Simplex f7upler Ni52 115_ 1 ~ Non ~ 8.5 ! 9 2or3 BN152 115 1 I Auto 8S included 2ar3 f E152 230 1 T Non __ 4~3 7 2or3 ------- -----a------ --------- - BE152 230 1 € Auto 4.3 indxl2d 2or3 __ -- l N153 115_ ,1 ,j Non 1 5 1 2or3 € ~ 2i/ -1 _ _ ... i ,? ~r/9 ~_ BK2o°n + 9Ni53 115 1 ~ Aida 10.5 lnduded + Por € ,, i,,'i: _ .. i. E7xi 1~ 1 ; raon ! s.3 ? 1 _ _ s 1. Sin91e Pi89yli~k Variable ~vel float -tch or double pi~ybadc variable level float BE153 23f} 1 i Auro I - 5.3 Irlduded ' or3 ~ ~- ~ swiich_ Refer to FM047T. d CAUr1oN 2 See F11A0712 fnr correct model of Etectr~al nator E-Pak .. } ;' :'' 3. VatlatAle level C0r4[rol swttcn 10-(i225 used as a ral a~tivalor, spei~ify clop€ax (3) _~ - ~ ,, A , r- N~; O[ (4f tio2t system. ~~5ER1FE POt~iERE ~=~.~t"~~i For usual conditions a reserve safety factor is engineered into the design of every Zoeller pump. llUll r~D: P.O. @OJr 1674E ` ~ Louisville, KY 4025tiD34T ~~ ~, . SfRP ro: 3649 ~ Run Road \`~Ly// - ~ ~ouswr~: KY ~o2f1.1s6} ~/rr Prr SarcE I~9~9 htrvan~w+.:j~n~~» _,, PU/G1P lll, r~z "~~~SA'2~ ~~b~a ~"' ~ Copyright 2001 Zoeller Co. All rights reserved. ~~/s S 21/52 ~..... r .~ ~ I Wisconsin Department of Commerce Division of Safety and Buildings • ~ 1445 SOIL EVALUATION REPORT ~ ~ ~ 1 of 3 ,,.,..,,.~,.,,b,.,;,r, r~,,.w., ~ w~ AAim cnr~ AC.E. Sail 8 3rteEvaluatiorts Attach complete sde plan a1 paper not less tfrarr 8f4 x-11 indres in size. Plan must ~~ - St. CrCIUC inchrde, but nd timiled to: vertical and fwrizont , drcection and pen~rtt slope, scale or dimemsions, oath ~n¢' ', , to nearest road. ~/ __ Parcel I.D. --- 008-1012-10-000, ID#4.28.16.63A Please prln rnratlo0. \/ ~ gy p~ l~xrrs• , .04(11 (ml?~ Petsa+al information you provide may woad J 1 Property Owr>~ ~~ P Location Robert 8~ Richard To arson ~ c' ~ilu ' --~ ~ --- ~. Lot -_ SW 1/4_ SE 1l4 S _4 T 28 N R 16 W _ Property Owner's Maitirg Address _~ ST ~ 1 ~ tb~ # _ BlOdc # Subd_ Name or CSM11 Pro o d CSM ~ 508 Co. Hwy86_` ~ - ~ C4~'1r___--~` ~ ~-?---_ ------- p se _ ------- ~1'IaiF /.^, Cdy State ' . _J City _J vtlage ~ Town Nearest Road `~ , ~ Woodr711e i WI 1544 \~-X715-0_~4~39'~ ~ Eau Gape 50Th Ave. NE~ir Construction Use: e/ Resiai~'1Vtirnbe~oF•Tiedroans 3 Code derived desi~r flow rate 450 _IGPD J Replaicerrrerrt J PubhC a cOmmerctal -Describe: ___ _ --- Parent material Glacial Till __~ ___ Flood plarn eir~atrori, rf applx:able na General carrrnents and rEx:arttrrieridatlons: Mound system elev. = 105.07' at 22" above 103.23' contour. 141 m a~# ~~ • Sad App6ratiar Rate Ground Surface elev. 103.42 ft. ~ to timi6rg fatxOr Har¢on Depth Dom t Cobr Redox Description Texture SUudure Consistence ' ary Roots GPDIft~ `Eff#1 'Eff#2 1 0-9 ~ 10yt3J3 none si- ( 2isbk ds as ; 2fm 0.5 I 0.8 2 9-f 4 ~ 10yr5J4 none ' siI 2msbk Cw 2fm 0.5 ~ 0.8 3 14-22 10yr5/4 - _ f 7.5yr5/6 _-- ~ 2msbk _ mfr ~ cw 1 im 0.5 _ 0.9 4 22-30 II 7.5yr4J6 m2 S J6 ~ ~ /2 sl 2msbk mfi cw ' 1 fm 0.5 0.9 ___ 5 30-43 ~ 7.Syr4J6 m2d7.5 /8 & m2d I ~scl _--lcsbk dsh _ - - 0.2 _ 0.3 -_ l0_3_ s~ _ i rL i-~ i .S" i ~ . i ----- i - ~ - t I -- ^ e~~ # ~.1 Boring liption Rate S P A 17 18~~ in l 103 t f o pp ev. or . . ac 1/ Pd Gror~d Surface e Depth to Ong Horizon Deptr ~ Dominant Color I Redox Description Texture Sbuctixe Consistence Boundary ' Roots GP `[ff#1 D1ft= `E 1 0-9 10yr313 none ~ 2 k ds I as '; 2fm 0.5 0.9 2 9-18 - 10yr4l4 ~ - -_ _ _ none -- sl t - 2msbk --I _dsh_ ------- ---- _cw ! 2f,1m -- 0.5 I +-- - 0.9 3 18-22 10yr4J4 i m2d 7.5yr5/t3 sl 2msbk mfr cvir 1f 0.5 0.9 4 22-34 - -_ 7.5yr4J6 m2 7f S /6 t2d t scl 2msbk fi cw 1 f 0.4 0.6 5 3445 ~ 7.5yr4J8 m2d7.5 &. m2d ~ scl --- ~ lcsbk ---- ~ dsh - - 0.2 0.3 r ----- - - E --- a -- - ----- --- -- ` Effluenk #1 = BOD ~> 30 < 220 and TSS ~0 < 150 mglL J ~%`~r~2 = ~D5 <_30 -rrxyL~ TSS <.~0 mglt_ - ~~ ~ ,~ ~, ~Perb p~~ Robert. & Rlchard_Tor~gerison per{ tp ~ 008.1012-10-000, ID#4. , . 6.63A Pape 2 d 3 rJ Pk Grand Surface elev. 102.11_ - ft Depth ~ I~9 factor _ 19° in. Sod Appl~ion Rate HoROn I ~ Damarant Color Redox Desaripton Texture Structure Consistence 8ounaa<y Roots ~ GPDIft° r'Ett#t 'EffJr!2 1 0-10 ~ 10yr'3/3 none sl 2fsbk ds as 2fm 0.5 ~ 0.9 2 j 10-49 j 10yr4/4 -- none --- sl ~ 2msbk I -- dsh ~ cw 2f,1m 0.5 0.9 3 19-2t3 ~ 10yr414 m2d 7.5yr518 sl ~ 2msbk ~ mfr cw 1f 0.5 ~ 0.9 --- { -'_` - + ----___- t-------- - - 4 ` 28-33 7.5yr4/6 ~fzd i ~~n& scl 2msbk ~ ~_mfi ~ cw 1 1f 0.4 0.6 5 336 7.5yr4/6 o n2da io~yrb/ rz ; - -- s~i ---- I 1 csbk i ---------- dsh j --1 -'---..-_ I, 0.2 ~ 0.3 ~ .. ,.---------...- -- ---__ - + - I r I i - i ~ - ----~-------- - -- ---------- + - - ------- - - --- 1 i-------- - --_- --- ~ T---- I _] Pd Ground Surfaoe elev. _ -. __-__ ~- ~ to limiting factor _ _-- in. Soi Appix~bon Rate ~~ # ~ ~~ Horizon Depth Dominant Color Redox Description Texture ~ I Stnxture Consistence I Boundary Rook ~_- 'EtT#1 'EffJF2 i , ~ ~ --- - ~, -- ~ I----- - -- - - - ~ i -- ~ -- - - - j ~ __--- -- - - ~- --- _-_- --- -- __ + - _ ~_ i - ~----- _. - i i ^ Borirg * -"~ caring ft. Depth to limiting in. J Pit Ground S~xface elev. _ Sal ApplicaUoe Rate Horgan Depth Dominant Color Redox Description . Texture Sttutiure once Boundary Rools I>L._ __ 'Eff#1 'Eff~ ,, -- l -..._- - ____ -- ~ ~ r--- - ~ --r------ --- ( - i -~ ~ ---- i --.-. -t_ -- J _ _- -----r .- f - _ 7 ---- 1 ~ - i ~- -- ---~--- -- _ _. I i i --- - ----- ---- ----~---- - --_. -- - - _. ~ ----f ; r ---- ~i ~- ~ -----t----- ---._._...--- I --~ I --~---1~---- • Ettiuent *1 = t30D ~ 30 < 220 mglL and T5S >30 < 150 mglt. ' Etlluenl #t2 = f30D3 <30 ngA. and TSS <~0 mg/L The DepaRment ofCommenoe is an equal opportunity service provider and empbyer. Ify~ou need assistance to access serviocs or aced mxderial b err altem8se format. Dlease oartatx the deper'hnent at 608-2fi6-3151 or TIY 608164-8777. ~~- 9 PG 36'3 /~ r r• .~ ~ • ~ • • • ~ ~`` I ~ ~ 4~~ ~ ~ . ._ _ _. _.- -~ fs ~ ,~ ~«,,,~. a ,~, 0,4 0 0~ ,~ +~d ~ . ~ ~ 3 ,,., __ .._.._. ~ ~ - V y ~ ~~ ~ ~ `~ , s~ ~ ~ ~ y ~ ;~° ~~ ~ - @C 3 i ~ , ~. % c Z ~~~ ~ " ~ ~ ... - ~ _._.--~-- ~~ a3 ~ `e U ~ ~ _... ac ~~ ~- ,, _, ., ~v#h ~ vG ., Sa~~ ~' ~/s~i'io~/ ~~ ~l ia3.5~.~~/~'3./~~/off i/ ~~~i nepanmeataf ek>nvnaree Safety 8 Buildings Division Bureau of Integrated Services • « J ~- • APPLICATION FOR REVIEIIV -Complete all pages- NOTE: Personal information you provide may be used for secondary purposes [Privacy Law s. 15.04(1)(m), Stats.j POWTS For plan status, check our websde at http:/lwww.commerce.state.wi.us/SB/SB-DivReviewStatusSearch.html Several counties have been delegated certain authority to review plans in lieu of Commerce. For a current Ilst of those counties and their delegation check our website at http://www.commert~.state.wi.us/SB/SB-PowtsProgram.html. 1. Project Information -Fill in all known infomtation. Confirmation of assignment to a roviewer. Project/sae Name NORD CONSTRUCTION-JAKE PETERSON Transaction ID: Location, Number 8~ Street of project (If unknown, indicated nearest road) Previous Related Trans. tD: 233RD ST & 50TH AVE. Estimates completion Date: Legal Description: SW1/4, SE1/4, SEC.4, T28N, R16W Assigned Reviewer: County ST. CROIX ()City () Vllage (~7own ofEAU GALLS Assigned Office: Mall to your office of choice below: 2. After plans aro reviewed, e: (check alt that apply) Green say, Hayward, uCrossa, Madison, Sh no, Waukesha ~ -Ceti customer t, 2 (circle nu -_ ,Requesting party will pick up NOTE: We reserve the right to re-di ute plans to Mail plans to customer 1 2 (circle n bar)" another office if needed to naaso y balance , _ 'Refers to customer number from below turnaround Umes. 3. CompNte the fogowing dealgneNowner/ ng infom>;atton. Utilize the check boxes when designer, owner or nesting party Is the same to avoid ropeating InfonnaUOn. Designer Irrfonmtion (Customer 1) Commerce Other Please Spseffy (Cue Commerce First Name Last Name Customer Nkxnber First Name Last Name Customer Number TODD FEATHERSTONE 242 4 Com an Name F~AYfHERSTONE EXCAVATING, IN Company Name Address Address P:O. BOX 467 7535 IN TRAIL City State Zip+ 9digits) Ci State Zip+4 (9digits) A HUDSON, WI 54016 G O GE GROVE, MN 55016 Phone Numt-er (area code) Fax or Internet cab phone P umber (area code) Fax or fntemet cell phone 715-381-1704 715-386-6885 -430-3713 Check others iF applicable others ff applicable ( )Owner )Owner 4. Information and Plan Submittal Checklisffi. POWTS uling is of available. Plans will be assigned to a reviewer after receipt of plans. If you select a specific office your estimated co don date m be t~rtsiderably greater than what would be possible in arwther office. Submittals received without a specific o Indicated on the rrn may be assigned to offices other than the receiving office depending on reviewer availability. To obtain a ittal checklist call t material order unit at 608-266-1818 or one of the full _service offices fisted below. You ma email_te,sftni code uestions to tee commerce.state.wi.us. Madison SRBD Hayward S&BD rosse S&BD. 5hawano 5>!iB Groan Bay S86D Waukesha S3BD 201 W Washington Ave 10541N Ranch Rd 4003 N Kinney 1340 E Green Ba 2331 San Luis Place 141 NW Barstow St 53703 Hayward WI 5484 Coulee Rd Shawano WI 541 Green Bay,1NI 54304 4'" Floor PO Box 7162 715-634-4870 LaCrosse WI 54601- 715-5243626 920~t92-5601 Waukesha WI 53188- Madison WI 53707-7182 Fax: 715-834- 0 1831 Fax:715-524-3833 AX: 920-492-5604 3789 608-266-3151 Email: 608-785-9334 Email: ail: PlanSchedule~ 262-548-8600 Fax:60B-267-9566 Plan lei Fax: 608-785-9330 PlanSchedule~ merce.state,wi.us Fax:262-548-8614 TDD 608-264-8777 Comm state.wi.us Email: cmr-merce.state.wi.us Emait: Plan$chedule~ Email: PlanSchedule~ PlanSchedulel@ commercestate.wi.us commerce.state.wi.us cammerce.state.wi.us MAKE CHECKS ABLE TO DEPT OF COMMERCE I TOTAL AMOUNT DU~ 175.00 Attach check Review Code 7833 SBD-10577 (R. 1?/03) THIS FORM IS VAUO ONLY FROM 012/01/2003 to 01107!2005 FOR THE MOST CURRENT APPLICATION, CHECK OUR VVEBSRE ATwww.commerce.state.wl.uslSB/SB-DivForms/POYVTS ~~ /~ w 5. POWTS SUBMITTAL (check all that apply) ,, (~ New Construgion ()Aerobic Treatment Unit(s) ()Anchoring of System Components Required (}Chlorinator - (- Replacement of System O Commerctal System OMetering and/or Monitoring Required (} UV Disinfection Unit SYSTEM TYPE(S) NOTE: Submit separate sheets for each system if submitting mukipie systems on the same site. Enter Fee () Revision to previously approved plan $60.00 ` ^ Com M Manual All atment componeMS are previously approved under s. Comm 84.10 (2) or O At-G omponent Manual, SBD-10570-P (R.6/99) (3 - () Conventio OWTS Component Manual, SBD-10587-P (R.6199) O Drip-Line Ois I Component Manual, SBD-10657-P (N.6199) esign wastewater flow of the proposed system: () Ezflow Mound eM Manual, (N.6/03) $175.00 In-ground POWTS onent Manual, SBD-10705-P (N.01/01) Design 1,000 gpd or less 5175.00 6/99) Mound Component Man SBD-10572-P (R Wastewater Flow 000 gpd $225.00 1 001 - 2 . ()Mound Component Manua rsion 2.0, SBD-10691-P (N.01101) in Gallons Per D ~ , , 2,001 - 5,0~ gpd 5275.00 OMoving Bed Biofllm Reactor, ( R) Component Manual (04N2) F in(7 greater than 5,000 gpd 5300.00 ()Multi-Flo ATU wfth Drip-Line Dispe Component Manual (10/01) GPD plus 30.05 for each gallon over 50D0 gpd. ()Pressure Distribution Component Ma SBD-10573-P (R.6/99) ()Pressure Distribution Component Manua ersion 2.0, SBD-10706-P (N,01/Ot) ()Recirculating Sand Filter Component Manua , D-10628-P (R.6/99) ()Single Pass Sand Fiter Component Manual, S 0595-P (R.6/99) OSplit Bed Recirculating Sand Filter Component Man SBD-10656-P (N.6/99) ^ Individual Site Oesign• One or more treatment components are not previously approved under s. () At Grade Comm 84.10 (2) or (3): (individual site design/deviation from component ()Non-Pressurized In-ground manuals and use of components without product approval): (~ Pressurized In-ground Design wastewater flow of the proposed system: ~ ( Mound Design () Oriplne Wastewater Flow 00 1 000 d or less $300 ()Constructed Wetlands in,C~ll-gns Per Day , . gp 1,001 - 2,000 gpd $400.00 ~,~_ • Documentation must be provided to support treatment and dispersal claims. a t~UU 2,001 - 5,000 gpd 5500.00 separate statement, provide rationale for the project and attach supporting d meMs D greater than 5,000 gpd $600.00 plus 30.05 (code sections, test reports, technical papers, research articles, etc.) each gallon over SOOD gpd ^ Holding Tank Individual Site Design Design Holding tanks NOT previousy approved under s. Comm 84.10 (2) or (3) and ()Site Constructed Holding Tank Wastewater site constructed tanks. Design wastewater flow of the proposed system: in Gallons Per Da ,000 gpd ar less 5120.00 GPD 1 -10,000 gpd 5200.00 gre r than 10,000 gpd $300.00 ()Holding Tank Component Manual, SBD-1057 (R.8/99) Design Holding ks previously approved under s. Comm 84.10 (2)(3). Design Wastewater Flow wastev+ate w of the proposed system: in Gallons Per Day 5,000 gpd or le 560.00 GPD 5,001 -10„000 gp 3100.00 greater than 10,000 3150.D0 (- Soii Saturation Determination Repo $100 00 . OInterpretive Determination $100.00 (- Experimental System (O sne additional fee. Submit fee for individual system as per appropriate above system type) Experiment Number $300.00 subtotal $175.00 Priority Review: Add same amount as subtotal Prior apprval from a section chief is required for a priority review. If approval is granted, the priority will be reviewed within 6 days of receipt. Priority review fees are double the normal review fee. Enter Total (rounded to the nearest dollar) here $175.00