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HomeMy WebLinkAbout032-1084-95-025 'sin Department of Commerce PRIVATE SEWAGE SYSTEM County' St. Croix .dty and Building Division INSPECTION REPORT Sanitary Permit No: 552363 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Stricker, Karen Somerset, Town of 032-1084-95-025 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: / C<-1$ ism c! s1 29.31.19.411C10 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic j C-9,j N 11- Z Benchmark 161,1 8 ~ l,.► Dosing Alt. ,PM oM cocv '7• p/ t (L 95 AefeN" Bldg. Sewer 6e.(- j St/Ht Inlet M-3 r CI,~ UL Holding St/Ht Outlet ~ TANK SETBACK INFORMATION TANK TO ^ P WELL BLDG. Vent to Air Intake ROAD Dt Inlet K a. Septic / 1&6 'F? Dt Bottom C~ 75 Dosing / It 4 y Header/Man. lD~,, ~ / S 7 9 Y Aeration Dist. Pipe 1 P' S Holding Bot. System o. ro 93 , 3Z5 9 PUMP/SIPHON INFORMATION Final Grade Manufacturer Demand St 9over / ~o J GPM 1 C.~J a-~-- J Model Number 53 `/1}~✓ TDH Lift ~ iction~ Loss System He d TDH ~ Ft 1 7 Forcemain Length / Dia. Dist. to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width ~ / Length ~ No. 0~f Trenche ~ ~ IT DIMS NSIONS No. Of Pits Inside Di` Liquid Depth DIMENSIONS /lO , SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacture INFORMATION / CHAMBER OR Type f System: UNIT Moil Number. 4 DISTRIBUTION SYSTEM Rom Qjb~ /64-1 LP ' 3 e) Header/Manifold / Distribution x Hole ize x Hole acing Ve to Air Intake 4 1 Pipe(s) Length_ Dia Length \ Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only e... Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center 3 - Bed/Trench Edges Topsoil \ es 0 No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 1905 37th Street' SOMERSET, WI 54025 (SE 1/4 SE 1/4 29 T31N RI 9W) NA Lot 4 Parcel No: 29.31.19.411C10 1.) Alt BM Description= oe.., CLC- 2.) Bldg sewer length = G>~ Gt - amount of cover l.4 4s^ Plan revision Required? Yes No Use other side for additional informati n. Date Insepcto Signat Cert. No. SBD-6710 (R.3/97) x,,t4 Comm B. Safety and Buildings Div Coun 201 Washington Ave., P.Okaox 2 t ' SCC~ S i ft1? Madison, WI 53707-7162 _ ary Permit Number (to be filled in by Co.) oepartmeM U C. .SSZ 3C~ S nit lication Transaction Number In accordance with s. Comm. 8 .2ft* e, submission of this form to the appropriate governmental !JA unit is required prior to obtair i a sanitary permit. Note: Application forms for state-owned POWTS are Project Addre (if different than mailing address) submitted to the Department of Commerce. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. 15.04(1 m), Stats. 1. Application Information - Please Print All Information / V S 5 Property Owner's Name Parcel # trot 4 6,-" ~Y i C~{ - d y s Property Owner's Mailing Address Property Locatrfa 9~ g v S Govt. Lot City, State Zip Code Phone Number s~- Y< SC/. Section ~ 6u c~ircleon II. Type of Building (check all that apply) Lot # T N; R - or 2 Family Dwelling -Number of Bedrooms / Subdivision Namet ey ( S~Block# ...A JA ❑ Public/Commercial - Describe Use ❑ City of El State Owned -Describe Use ' "T` /CSM Nur 11 Village of own of /S III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ❑ New System eplacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV. Type of POWTS S stem/Com onent/Device: Check all that apply) n-Pressurized ht-Ground ❑ Pressurized In-Ground At- rade ❑,Wund > 4 in. 7pttreati3ept itable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (expla 6h ' Device (explain) V. Dispersal/Treat ent Area Information: V/ V De~ignn Flo (gpd) / Design Soil Application Rate(gpdsf) Dispersal Dispersal Area Proposed (sf) System Elevati VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units New Tanks Existing Tanks w v _ aU in~ ri wC7 fi, Sept ic or Holding Tank Dosing Chamber VII. Responsibility Statement- 1, the undersigned, assn esponsibility for installation of the POWTS shown on the attached plans. Plumb s Name (Print) Plumber' afore MP/MPRS Number Business Phone Number Plumber's Address (Street, City, State, Zip Code) 141 S Z 1ZD VIII OUR epartment Use Only Approved ❑ Disapproved Pe/rm(it Fee Date Issued suing Agen Sign ` El Owner Given Reason for Denial $ / 7 ✓ / zd UC. Conditions of Approval/Reasons for Disapproval SYSTEM OWNER: 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained D Sf J&tL/ as per management plan provided by plumber. 0 2. All setback re uirements must be maintained S?J .3JV3 .33 as per applicablEM"d#avdiplfllne" for the system an ubmit to the County only on paper not less than 8 14x 11 inches in size SBD-6398 (R 02/09) PLOT PLAN PROJECT Karin Stricker ADDRESS 92 206th St. New Richmond Wi 54017 SE 1/4 SE 1/4S 28 /T 31 N/R W TOWN Somerset COUNTY ST. CROIX 5/30/12 BEDROOM 3 MPRS Shaun Bird 226900 DATE CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT XXX HOLDING TANK SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE630 DOSE TANK SIZE MOUND HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambe 3BENCHMARK V.R.P. Bottom of siding ASSUME ELEVATION 100' Filter BEST Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 93.493.2 4' below qrade All piping shall be SDR 30/34, within 10' of tank, piping shall be Schedule 40. Scale is 1" = 40' Property Line unless otherwise Well noted 10' Plans Designed Using 30' Conventional Powts Manual Version 2.0 Existing 3 Bedroom 5 1 Well is to meet all House B.M.* setbacks required by WDNR 15' B-2 35' 30' 0% Slope 35' Old system location not exact 85' 70' 80' B-3 Huffcutt 2-3' X 66' cells Combo Tank with >3' spacing a, 40' Vents O Overflow B-1 170' Vent y I I >6" Quick4 Standard ' of Cover Leaching Chamber with 20.0 ft2 of Area 10.2ft^2/pair of end caps 4' Long 12„ Grade at System Elevation 3 4" 37th St. VON-" _ ZrnOr- O vn C Z a ~ m O Z ~ n1 (A. LN~ El Cl) --;~A -n ~ O rn • z > ?It) ~ 'T1 ~ --I --I G V co) --1 0 s m m Z ~ o X 4 Q% C/) Z ~ rn O C D z p c N Cl) X -n C3 x > r- G O ,Z _ z rn O Z r r" 0 c v CO) Z Z ~r ca _ CO) m m < N X r- z O CO) ) S m O m ~ - Z -I m m O C O 0 v X Z Q ~C tV o ~o Z• kx p O C C~ 7 7 Y~ m o Z o a Qmrgsic0 O G) M w " ~ j a i F TO m m ps g Q3 m~ doi 11 tes M m S M n = 3 .3 = o~ om N C Z gm 1'Z my»» O o w--~ M arm v ~r'~ vow 3 N»-$n~ ` c N CO) --I CL. cr i no ° ego > Z J m' w -a = A. m o 0 • O g a a o Z w PLOT PLAN PROJECT Karin Stricker ADDRESS 92 206th St. New Richmond Wi 54017 S'E 1/4 SE 1/4S 28 /T 31 N/R W TOWN Somerset COUNTY ST. CROIX 5/30/12 BEDROOM 3 MPRS Shaun Bird 226900 DATE CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT XXX HOLDING TANK SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE630 DOSE TANK SIZE MOUND HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32 BENCHMARK V.R.P. Bottom of siding ASSUME ELEVATION 1001 Filter BEST Filter ❑ BOREHOLE SWELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 93.493.2 4' below qrade All piping shall be SDR 30/34, within 10' of tank, piping shall be Schedule 40. Scale is 1" = 40' Property Line unless otherwise Well noted 10' Plans Designed Using 30' Conventional Powts Manual Version 2.0 Existing 3 Bedroom 5' Well is to meet all House B.M.* setbacks required by WDNR 15' B-2 35' 30' 0% Slope 35' Old system location not exact 85' 70' 80' B-3 Huffcutt 2-3' X 66' cells Combo Tank with >3' spacing 40' Vents Overflow B-1 170' ent ji Quick4 Standard Leaching Chamber with 20.0 ft2 of Area 10.2ft^2/pair of end caps „ Grade at Sys tem Elevation 34" 37th St. Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715-246-4516 Date: 5/29/12 Owner: Karen Stricker Location: SE1/4 SE1/4 S28 T31 N,R19W 1905 37th St. Somerset System type: In-ground absorbtion system(conventional) Manuals Used: In-ground absorbtion system (version 2.0) Pressure Distribution Manual (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross Section 4-6. Maintanance and Contingency Plan 7. Filter Specifications Sheet 8. Dose Tank Cross Section 9. Pump Curve 10.-11. Soil Test Signature License numbe 26900 Cross Section of Infiltrator Quick 4 Leaching Chamber Typical cross section for 2 of 2 cells Quick 4 Standard Leaching Chamber with 20.0 ft2 of Area per Chamber To be >1' above grade 10.2ft^2 pair of end plates Finish grade elevation Typical Installation 97.5' Vent Grade Vent 3' 4" 3' X30/34 Septic Tank 5' Long 1 5' S' Long 1 Grade at System Elevation 3611 Grade at System Elevation Spacing 5' 2-3' X 66' Cells Same on other end Observation tubeNent At end of cell A B 16 chambers per cell System elevations: A__93.4 B__93.2 ILU _._..,_..._-.4 _ la: ic~Ytions Septic-I:)ose Wank Cross Section And Pump Performance Specifications rank Ma_nufac.turerr~ PUMP Manufacturer ^ eV Tank Model Number (j 6 TM Pump Model Number yu S 3 Total Tank Capacity 3 Alarm Manufacturer Ve c _ Max. Bury DE,rpth Alarm Model Number c _ Switch Type ~ ru•_G~ Filter Manufacturer Total Dynamic Head (TDH) Feet Filter Model;N'umber 77- Elevation Head g Distal Pressure - - - Network Loss Minimum Pump performance Required Force Main Loss -7 GPM:."4 'Y Ft H Tote! Outlet Manhole Min. V Above Grade With Locking l)e lice. Inlet Manhole Manhole Min. 4" Above Grade < 6" Below Grade Sealed Watertight securely Mounted With Looking Device t Weather-proof Junction Box - - Fnni' fished Grade Now I ow ~w w <r. ras Y..i Vent Min. 12" Disconnect Above Grade Means With Vent Cap > r; Y Y r Y a l Y Y Y i,a 1 Y i a l a Y; t 1 a,i<r,1; 1 r1 Y; f; Y M; l,Y, !,1 •1`a `I a rY `Y ✓r`Y•I•!•>`r~a`! r`rrl~a 1>.,1~ a • 1 • • r; a a T` Y ` ~ a, a s r Y 1 1 r a Y a 1 a Outlet Filter Inlet „i.. blot Baffle -74 s and Reserve Ca Switch S pacify A Y4aa Tank Volume = -5- GPI weep r r ;;a Dimension Inches Volume Gal. B Hole µ(reserve) A aY s 6 7, S : .;a (alp) B . 2 3 Off Ele anon C (dose) C Ft (dead) D Bottom Total D Elevation y~ ~3 Ft < arrs~-s-rr ,rc-cr c-r-ss-r i i•'-r~'r Yr!`4 a•aar<a t a`Yas Y<Y i<Y+a{aaaf lrl<r<I<Yal >jata*Y~rf•arr.i r>r>~r;Y'> /'a'Yaari`I`a<Y a+!`a;!•rtr•t Y` `tat /`a`Y`I•rYY •i` • • ` a • Ir •Y`!•a •i`r• ~ ,r,., a,r/rt' • 1,< r• r r r l a < a r a a r r a r a < a r< a a< a< r< 1 oat a s •<< r< r a a a< a 1 a< I r 1<< t /tar 1</ 1`t ra1•<rtal•1' a oar a l i a': JVA C v~ GENERAL INSTALLATION: The septic/dose tank is bedded and batik filled in accordance with the manufacturer's product approval specifications. Maximum depth of bury arc speoi~ied by the manufacturer may not be exceeded without prior approval. Manhole covers exposed to grade have an effootive lookibg device (padlock) installed. Piping at the inlet and outlet is of approved material, connected to the tank with watertight fittings, and laid on stable soil to prevent nt settling or sagging. The force main is sleeved with 4" Sch. 40 PVC to bridge the tank excavation and the sleeve is sealed watertight. Electrical service complies with NEC 300 and Comm 16.2$, 02/05 LJ Page of Of TOTAL DYNAMIC' HEAD/CAPACfTY HEAD CAPACITY CURVE PER P.RIr,IUTE MODELS 53/55/57/59 EFFLUENT AND DWATERING 25 _ Model 53/55/57/59 6 20 Ft. Meters Gal. _trs. _ 5 i 1.5 4a ' 63 U 15 - - - - 4 1 U 3.1 34 '.29 15 ~ 4.6 19 72 10 Shut-off Head - 19.2' ft --(5.9rr) i 2 -►j3 5/16 -6 5/32-► 4 5/3 0--1 - 1 /2 rIPT U.S. GALLONS 10 2 30 40 50 f e - LITERS (-11 3 15/16 0 80 160 FLOW PER MINUTE 009697 4 1/15 _ ~~A APe Variable level float switches available. _ Variable level long cycle systems available. ' r Available with special cord lengths of 15', 25', 35' and 50'. Alarm systems available. I I i 10 1/iS Duplex systems available. , -1, j4" _ I 3 3,32 SK856 ~I Single 5aaI Control Selection Listings L L',- i,_ 1 Model Volta Phase Mode Amps Simplex Duplex CSA UL 1. Integral float operated mechanical switch, no external control roquired. M53/55 & M57159 115 1 Auto 9.7 1 - Y Y Z Single piggyback variable level float switch or double piggyback variable level N53155 && N57/59 115 1 Non 9.7 2 3 or 4 & 5 Y Y float switch. Refer to FMO477. BN53 115 1 Auto 9.7 Y Y_ Auto 9.7 N Y 3. Mechanical alternator "M PaK' 10-0072 or 10.0075. BN57 115 1 t _ BE53157 230 1 Auto 4.8 Y Y 4. See FM0712 for correct model of Electrical Alternator. D53155 & D57/59 230 1 Auto 4.8 1 Y Y 5. Variables level control switch 10-0225 used as a control activator, with Electrical E53155 & E57159 230 1 No 4.8 2 3 or4 & 5 Y Y Alternator (3) or (4) float system. ` Single piggyback switch included. O CA TION For information on additional Zoeller products refer to catalog on Piggyback Variable Level RoatSwitches, FM0477; , Electrical Altemator, FM0486; Mechanical Alternator, FM0495; Sump/Sewage Basins, FM0487; and Single Phase ~ s... Simplex Pump ControVAlarrn systems, FMO732. E S Q V P RE b DES, For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL To, P.O. BOX -R12,> Louisvila, KY 4025o•r~. - SNIP TO. 3649 Cane Run Road Manufacturers of.. ® ® Louisville, KY 40211-1961 QaW,rrpa"1as S CT 1939 Mtp.1Avww.zoe11er.c0m PUMP !O. (502) 778. FAX (5 X (5 • 02) f 774-3624 928-PUMP 624 0 Copyright 2002 Zoeller Co. All rights reserved. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Kc4 2,~,✓ cJ Mailing Address 41 s4- _ 21tC ,tiu~5l L lJ l~~ Property Address _Z&0,!: (Verification required from Planning & Zoning Department for new construction.) City/State t4 ~ Parcel Identification Number (j 3n~ - ~D ~Y~~-~ da LEGAL DESCRIPTION Property LocationL _ Se . Z , T N R/-W, Town of s 2?1 wy La~ _ Subdivision Lot _ # S~ Certified Survey Map # _ gc> g ~d 0 , Volume , Page # Warranty Deed # Volume , Page # Spec house yes no Lot lines identifiable es no SYSTEM MAINTENANCE AND OWNER CERTIFICATION improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. 1/we certify that all statements on this form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Numb of bedrooms SIGNATURE OF APPLICANT(S) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) r POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page / of FILE INFORMATION SYSTEM SPECIFICATIONS Owner `C Septic Tank Capacity 1OZ70 gal ❑ NA 1 Permit # 5 ~Z Septic Tank Manufacturer K ❑ NA L3 DESIGN PARAMETERS Effluent Filter Manufacturer S ❑ NA Number of Bedrooms _3 ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units NA Pump Tank Capacity gal ❑ NA ❑ NA Estimated flow (average) SZ70 gal/day Pump Tank Manufacturer Z4 Design flow (peak), (Estimated x 1.5) S -0 gal/day Pump Manufacturer 0 NA Y Soil Application Rate gal/day/ftz Pump Model ❑~NA Standard Influent/Effluent Quality Monthly averagePretreatment Unit NA Fats, Oil & Grease (FOG) <_30 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD5) 5220 mg/L ❑~NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) <_150 mg/L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BODS) 530 mg/L )26n-Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) <_30 mg/L 21!~Q1A ❑ At-Grade ❑ Mound Fecal Coliform (geometric mean) 5104 cfu/100ml ❑ Drip-Line ❑ Other: Maximum Effluent Particle Size %a in dia. ❑ NA Other: NA Other: ANA Other: NA *Values typical for domestic wastewater and septic tank effluent. Other: NA MAINTENANCE SCHEDULE Service Event I Service Frequency Insect condition of tank(s) At least once ever Q ❑ month(s) (Maximum 3 ears) ❑ NA p y' v year(s) y Pump out contents of tank(s) When combined sludge and scum equals one-third (%3) of tank volume ❑ NA Inspect dispersal cell(s) At least once every: ❑ month(s) year(s) (Maximum 3 years) ❑ NA Clean effluent filter At least once every: month(s) ❑ NA year(s) Inspect pump, pump controls & alarm At least once every: ❑ month(s) year(s)- ❑ NA Flush laterals and pressure test At least once every: ❑ month(s) of,,A ❑ year(s) J~-'~ Other: ❑ month(s) ❑ NA At least once every: ❑ year(s) Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (%3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter 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) Page 2 w 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 dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. 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 and 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 the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant repl;ut system: suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement 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 may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name S Name A,- Phone Phone 1'7'~ SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name pLl c) i,- Y77 J&1_7 Phone 7~J-- - 5/4j 49 et/7 <7 Phone J--- ~jV This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. I' il'I~Illll!~I~Ililllii~ Ili{ 805,17 46 Tx.403 6'"33 SPECIAL 954035 WARRANTY Document Number DEED DFTH PASS-S ' REtil&-t'ER OF DEEDS Return to: S1 CROIX Co., W1 Karin Stricker 0IZQ9/2012 -A-so PM ~LY z~[Xtir fit `~t^ U i 'RE`a~ FMS:: 30,00 Drafted by: PAGES« 2 Robert M. Piette 032-1084-95-025 Parcel Identification Number Fannie Mae a/k/a Federal National Mortgage Association, hereinafter GRANTOR and Karin Stricker, hereinafter GRANTEE: WITNESSETH, that GRANTOR for a valuable consideration conveys to Grantee and to her successors and assigns, but without recourse, representation or warranty, except as expressed herein, all of its right, title and interest in and to that certain tract or parcel of land described as follows, to wit: Lot 4 of Certified Survey Map, recorded in the St. Croix County Registry on September 30, 2005 in Volume 20 of Certified Survey Maps on Pages 5080, as Document No. 808108, and being a part of the Southeast 1/4 of the Southeast 1/4 and Government Lot 1 of Section 29 and the Southwest 1/4 of the Southwest 1/4 of Section 28, all in Township 31 North, Range 19 West, Town of Somerset, St. Croix County, Wisconsin. GRANTEE HEREIN SHALL BE PROHIBITED FROM CONVEYING CAPTION PROPERTY TO A BONAFIDE PURCHASTER FOR VALUE FOR A SALES PRICE GREATER THAN $48,000.00 FOR A PERIOD OF THREE MONTH(S) FROM THE DATE OF THIS DEED. GRANTEE SHALL ALSO BE PROHIBITED FROM ENCUMBERING SUBJECT PROPERTY WITH A SECURITY INTEREST IN THE PRINCIPAL AMOUNT OF GREATER THAN $48,000.00 FOR A PERIOD OF THREE MONTH(S) FROM THE DATE OF THIS DEED. THESE RESTRICTIONS SHALL RUN WITH THE LAND AND ARE NOT PERSONAL TO GRANTEE. THIS RESTRICTION SHALL TERMINATE IMMEDIATELY UPON CONVEYANCE AT ANY FORECLOSURE SALE RELATED TO A MORTGAGE OR DEED OF TRUST. EXEMPT FROM TRANSFER FEE AND FORM 77.25(2). RE: 190537th Avenue, Somerset, WI 54025 TOGETHER with all and singular the hereditaments and appurtenances thereunto belonging, or in anywise appertaining; and the reversion or reversions, remainder or remainders, rents, issues and profits thereof, and all the estate, right, title, interest, claim or demands whatsoever, of the said GRANTOR, either in law or equity, or, in and to the above-bargained premises, with the said hereditaments and appurtenances: TO HAVE AND TO HOLD the premises as before described, with the appurtenances, unto the said Grantee, her successors and assigns. Property Owner _ Parcel ID # Page of Boring # ❑ Boring 1 © Pit Ground surface elev~ ft. Depth to limiting factor in. Soil -Appricabon Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Z 2 -3 rs r 3 - G S s ❑ Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. 11 Soil Application Rate Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ~I I Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (R.W00) Soil Test Plot Plan Project Name KarinStricker Shaun Address 92 206th St. New Richmond Wi 54017 CS #226900 Lot 4 Subdivision Date 5/29/12 SE 1/4 SE 1/4S 28 T 31 N/R W Township Somerset Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Bottom of siding System Elevation 93.4/93.2 *HRPSameasBenchmark Scale is 1" = 40' unless otherwise Well Property Line noted 1 30' Existing 3 Bedroom 5 House B.M.* 15' B-2 35' 30' 0% Slope 35' Old system location not exact 70, 80' B-3 Overflow / B-1 170' 1 I 37th St. ~.z alea8 1 4063 VOL~q PAGE 5080 KATALEEA H. MBA`-""- WX MAP ST. CR~OIXOC.O DEEDS, CERTIFIED SURVEY 09%30%2005 ei -3ePM LOCATED IN THE SE 1/4 OF THE SE 1/4 AND GOVT LOT ONE OF RECTIFIED SURVEY MAP SEC. 29,(AND THE SW 1/4 OF THE SW 1/4 OF SEC. 28,`,,~ALL IN COPY FREt TWP. 31 N.. RGE. 19 W., TOWN OF SOMERSET. ST. CROIX' CO., W. PAGES¢ 2 ST. CROlX RIVER NOUN (b 0 .`'~-u4m -t m H- m V 1 N ~T P Qs 4, r U ,`V~ z m A JA fA g P cOV'r Lor f ssc. 29 `?rrrn rn N cn. 'O C w p Z Fn C-) 1" . CA cR HIM I- z m 10, o ~ S iLO v Cy+ 2 m co o ~..N O if? " m Z I ~ 1< y CNn O ;i Z 'D Z-~C Iq ~ ~ cV.~ ~ I Fn ~ ~ CJy ~ o r+•f tJ,, m z ~ o 0 t A ttoo N IA N # N} Ory f O ; Ln f n. N N SE i/I OF SE fl-f Sb1C. 29 ~ Iyn SS t__ _N A i FR CZ72 _ ♦ N~O L., I 14plkitl4Wpp lI - •L~.~ a 7 a ic_- v m 7tz s'GN01 z IiN t° IN c: tn. IIN4 1 t ~ N4 R~ e3 N N 1 a to g N-N ♦$mW~ r+. (D N N i :9 39 44 ;4 rq :9 Un\ eL~ 26 p67.52 , ~r 3 c- tw N00.20'02..E x'r~ NPtJ"T ,SANDS- $?S J\ r` ---OF SW 114 SsC. 28 ~ °fuAgat c~n~ 28-31-19 l lit v o i rn" JOHNSON & SCOFIELD INC. LAND YORS 1203 MAIN ST. RED WING MN 55066 651-388-1558 . PAGE 1. 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