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HomeMy WebLinkAbout008-1013-10-050Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECT~N32EPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law; s,15.04 (1)(m)]. Permit Holder's Name: City Village X Tdwnship Eno, Ken & Ellen Ea Galle Townshi CST BM Elev: Insp. BM Elev: BM Description: /o~,~U C`~r ~r~t~-~ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~ ~t S.Q~ Ca.r.l~ t, l 1 „~.CJ~/ / ~ tacJ Dosing .__.-------'~___ .,.... .. Aeration `~ _J Holding ~ ~..b~.S~. '4~-- I v - TANK SETBACK INFORMATION TANK TO P/L WELL ._---~. BLDG. Vent to Air Intake ROAD Septic ],1~ , ~~~ ~,7 Dosing ; ~CCX~ ~ / ,>~7S ~- C~~ ^- y5 ~ "_ Aeration Bolding PUMP/SIPHON INFORMATION Manufacturer " ~ ~ C Demand Cyv.~Lc~VS GPM Model Number ~. ~?G~ 5 y~. ~? ~ TDH Lift Friction Loss System Head TDH Ft 13 c~ti'a a .~5 Lo .~ ~3. Forcemain Length .. ' Dia. Z , Dist. to well ~ ~~ . ~ c:v .. SOIL ABSORPTION SYSTEM >75 ~ BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~/ ' 7'J C SETBACK SYSTEM TO P/L BLDG W ~ LAKE/STREAM LEACHING anufacturer: INFORMATION CHAMBE Type Of System: ~ ~ ~ > J~+ ` ~) (P J /~ ~ ~ j ~ ~ Model Numbe . ~ 14 DISTRIBUTION SYSTEM ~~ Header/Manifold Distribution (((), i '~ ~ x Hole Size ~i ~ x Hole Spacing r ~ ) Vent to Air Intake + n th ~ Di L ~~ Pipe(s) ). 5 , L h Di f• / ~ ~ ~~ / - eng a_ engt a_ Spacing SOIL COYER x Pressure Systems Only xx Mound Or At-Grade Systems Only D°pth O er D th O D th f S d d/S dd d xx Mulched v , +~alc ep ver 7 ~~ xx ep o xx ee e o e s Bed/Trench Center ~ Bed/Trench Edges I ' Topsoil 1 - Yes No Yes No ~ v 4-~ "rc l~ mac, -cyl- 1 t~/ S ~ COMMENTS: (Include code discrepencies, p~crsons pr ent, etc.) Inspection #1: C! / ~~ / U' Inspection #2: (' /~/ `7' Location: 2299 60th Ave Unknown (NE 1/4 NE 1/4 5 T28N R16W) NA Lot Parcel No: 05.28.16. ~y ~ 1.) Alt BM Description = ~~ c-r. `+.>:v.~ ~ d~~ `~ ~~ '~ 2.) Bldg sewer length = ~'~ ` ~) ~`Y~y~~ 4~ ^'`~'~ ~/uryy~.,~ ~ • 6 ~~ J~'~ -amount of cover= ~r_ G~ b~~l`~ ~~~,tpc~ CrC ~~JS' ~~'G~ ~~"L- `<, rte- -- ---- - --- -_.._. - _..--- f --- i '--- ......_ Plan revision Required? Yes ~~ No ~ ~ i~~~w7 ; ~ ~~~ - ~~ /~ ~~ (~ ' use other side for additional information. ~~ i J ~~___ __ __ Date Insepctor's Signature Cert. No. •6710 (R.3/97) _ ELEVATION DATA County: St. Croix Sanitary Permit No: 453190 0 State Plan ID No: Parcel Tax No: ar)3 - fyr~-' is-~;5~ Section/TownlRange/Map No: 05.28.16. STATION BS HI FS ELEV. Benchmark ~.9s /c~o• t'C7 Alt. BM 3_~s ,va- (v Bld .Sewer v~l•.fl..~-~- ~3.~i~ gv:c7j SUHt Inlet l~..~v 89.35" SbHt Outlet ~ Dt Inlet Dt Bottom 17.E SC, .ZS Header/Man. 3 32- ioa.e:3 Dist. Pipe 3 . 3 3 . 'sY~ /~•S~ Bot. System 3,yS !cam coo Final Grade ~. St Cover q (D(y(.~ ~ w~ +v~-- ti 17. v $~. g 5 >~ -~~ c ~%c. ~. Safety ar+'.t E3ui~ldutib{s Division Count)' , s ~ 201 W. Washington Avc., P.O. Box 7162 /1 O r ~ ` iseonsin Madison, WI 53707 - 7162 Sanitary Permit Number (to he tilled in by Co ) (608) 2GG-315 I I)'-3 ~ ~ Department of Commerce Sanitary Permit Application State Plan LD. Number personal information you provide Wis Adm Code ccord with Comm 83 21 I ~~ ~ ~ S • ~•~ . . , . , n a may be used for secondary purposes Privacy Law, s 15.04(1 xm) ject dress (if d ffere than mailing address ~a~~ ~ 0 ~ due. . I. Application Information -Please Print All Informati . - ' -- - ~-y Property Owner's Name ~ ~a~ ~ ~ l~~oa (?ztrcetJ( Lot !I Block t< ..._ r! . k • ~ Property Owner's Mailing Address Property Location r L - d ~ ,~ ~ ~ 'ONING OFFICE ~'/., ~~' '/., Section City, State Zip Code Phone Number y~/~ / ~ ~ /, S (/ (circle one) ~d (L ~ J /Il l! J rW N; R T I l ll h k m ~ S ~"^ y) a at app t II. vpe of Building (chec ~ MS •6tt~+v+siea•htatne CS{at~dnrrrber' • 1 or 2 Family Dwelling - Number o edrooms ~ ~9.0~ r ~ 35.E ~C3s~l~ ^ Public/Commercial - Describe U ~~ tt ^ State O+vned -Describe Use S , X ~S 1~ ` 9 ~ • ~ ~2 ^City_^Village ownship of L-~ (y A lll. Type of ermit: (Check only one box on line A. Complete line B if applicable) A' e+v System ^ Replacement System ^ TreatmenVHoldin Tank Re lacement Onl g P y ^ Other Modification [o F_xisting System B. ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer [o New List Previous Permit Number and Date Issued Before Gspiration Plumber Owner IY. T e of P04VTS S stem: Check all that a l ^ Non -Pressurized In-Ground l~. Mound ? 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ ment Unit ^ Recirculating Sand Filter ^ ea t Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Tr ~ ~ t Recirculating Synthetic Media Filter ^ Leaching Chamber ^ Drip Line ^ Gravel-less Pipe LJ Other (explain) V. Dis ersal/Treatment Area Information: Design Flow (epd) Design Soil Application Rate(gpdsf) Dispersal Area Required (st) Dispersal Area Proposed (st) System Elevation ' ~JU ~~ ~ (eG ° CvG vD• ~ VI. Tank Info Capacity in Gallons Total Gallons Number of Units Manufacturer Prefab Concrete Site Constructed Steel Fiber Grass Plastic ~~~~/~ t10 E New Foisting ~ lJ/ Z °"X'~ ~ ^ I Tanks Tanks Septic or Holding Tank /,~i~ ~ r ~ 5,~. Aerobic Treatment Unit Dosing Chamber ~~ `'1S~ t t d/ VII. Responsibility Statement- I, the un ersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Natne (Print) PI bet's Signature _•P.f~PfARPRS Number Business Phone Number Plumber's Address (Street, City, Hate, Zi Code) ` / / f , t /! ~~ l VIII. County/De artment Use Onl ~4pproved ^ Disapproved Sanitary Permit Fe includes Groundwater Date Issued 1 uin gent Signat re (No Stamps) Surcharge Fee) ~ ~~ ~ !/ ^ Owner Given Reason for Denial ~--n (~ ~, 1~. Conditions ppt-oval Reasuus.Se+-Bise{~rroval 3~ ~ ~Cn{ `~ ~9.dt t?•+~ L-sO-af d~4.QbL SYSTEM OWNER: C~asZ c~u~-~r ~,~4"^^S ~,-t`~'~ ~~.~ 1 Septic tank, effluent ~Iter and ~~~~, ~ ~ (o~~~ ~ ~~~ dispersal cell must all be serviced /maintained ~ k ~ ~ -Lo-~ o~ t K ir as per management plan provided by plumber. -• 2. All setback requirements must be maintained S~ ~ ~;+~ nttacn comprere pism iro me eounry onryt roe me sysmm u.. pap.. •••..•• --•- - -- ••--•--- ••• •••-- G~~ a M~2.. SF3D-6398 (R. 01/03) - _J ~ ~ O ~ ~ I C~ ~~ - - I o 4- t i ~" j f3. M (a a. cP o I'' Pv~ P~ro~ 11,~~k~ -~o ~~+~ k ~ ~~ ~ g„ o ~ ~ G ~ \o ~ t~ I ~ ~ -~~ ~~'~ ~ ~ i S /oP 1 ~ ~ r m ~q ~~ ~ '~ ~~ ~ ;~~ r ~ '~ j ~ ~-~ ~~' _~_. ,, ti ~~ ~ . .- ~„ ~~ P~~ ~ 1, ~~ ~: ~ ~r°P°s~~' 1 ~ 3. M. {oo.oo I2So~7SoCrr~l, s~ 7a~o of I"~ipu~ P,,o.Q ;~4 ~ s SeP ~-~ c ~~os e. rcih.~( ~ Iv' ~,~ f -f"o ~ c~-~-~t ~` ~'. ~r It's,- _ _ _ __ <,'~ ~St ~:Q 4 ~ V -~~ ------ _J ~ / / A ~scr45~' e ~C ~tic~. -.--- r~ i (~ .~--~ COPY ' commerce.wi.gov ^ ^ ~scons~n Department of Commerce Safety and Buildings } r 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 Apri126, 2004 CUST ID No.223475 JOE STANG STANG PLUMBING & ELECTRIC PO BOX 263 WOODVILLE WI 54028 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04/26/2006 SITE: Ken & Ellen Eno 230`" Street Town of Eau Galle St Croix County NE1/4, NE1/4, S5, T28N, R16W Identification Numbers Transaction ID No. 992284 Site ID No. 682224 Please refer to both identification numbers, above, in all corres ondence with the a enc . FOR: Description: Proposed Four Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 954213 Maintenance required; 600 GPD Flow rate; 26 in Soil minimum depth to limiting factor from original grade System(s): Mound Component Manual, SBD-10572-P (R.6/99), Pressure Distribution Component Manual, SBD-10573-P (R.6/99); Biofilter. 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: • This system is to be constructed and located in accordance with the enclosed approved plans and with publication SBD-10572-P(R.6/99) "Mound Component Manual for Private Onsite Wastewater Systems". The pressure network is to be installed in accordance with publication SBD-10573-P(R.6/99) "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems". • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • The area within 15 feet horizontally below the system shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • Comm 83 22(7) - A copy of the approved plans specifications and this letter shall be on-site during construction and open to inspection y authorized representatives of the Department, which may include local inspectors. ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 F? C3. ~~J.7:a. Cc~~za~i~`go~~rr~~,y ~. >l~ n A ~...- i~ JOE STANG Owner Responsibilities: Page 2 4/26/04 • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • Comm 83.52(1)(a) -The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Gerard M. Swim POWTS Plan Reviewer -Integrated Services (608)-789-7892, Mon. -Fri. 7:30 am to 4:15 pm j swim@commerce.state.wi.us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 IND~~ SHEET PROPERTY OWNER: KEN & ELLEN ENO 1816 SLATER LANE BURNSVILLE, MN 55337 PROJECT NAME: KEN & ELLEN ENO PROJECT LOCATION: NE 1/4, NE 1/4 , S 5, T 28 N, R 16 W MUNICIl'ALITY: TOWN OF EAU GALLE COUNTY: ST CROIX DESIGN: PRESSURE DISTRIBUTION MANUAL SBD-10573-P(R/99) MOUND COMPONENT MANUAL SBD-10572-P (R 6/99) CONTENTS: Page 1: Plot Plan R~CEIV E D APR 3 9 2004 SA,FEfY & BLDGS D~~~ Page 2: Cross Section and Plan View of Mound Page 3: Distribution Pipe Layout Page 4: Septic Tank & Pump Chamber Cross Section & Specifications Page 5: W 1250/750-MR Tank Specifications Page 6: Pump Specifications Page 7: POWTS Owner's Manual & Management Plan - Pg. 1 Page 8: POWTS Owner's Manual & Management Plan - Pg. 2 Name: Joe Stang Address: PO Box 263 Woodville, WI 54028 Credential Number: 223475 Signed Date: April 15, 2004 ~~Q ~AR MEN~Q~M~ E~ p 1SION OF SAFETY AND BUIkD1NGS SEE CORRE ONDENCE ~10~ ~I Q~1 a J • C7 u~ ~ ~ r ', ~eh ~- ~ ~ ~ e -1 .~ h ~ ~3.M I ~~ t~o P o I " P v ~ P. ~o ~. 11,~e k~- -~-~ L- ~-~- ~ i _ 1 ~F T G-~ti ~c~ ~ ~~ \ ~G ~ ~ ~° ~, \ ~ ~ g/ 1 ~ ` 1 ~ 1 1 ~ ~,, 1 1 -3 ~° 1 ~ ~ 1 r ~ ~ I q ` ~ ~ '' ~' \ ~ \ 1 Ir,~; ~" n ~ ~ `'~ ~ P~` ; ~' ~ro~ ~S~~C 1 ~ 3. M. 100.00 f 2 So / 7 so ~~t , 7 ~° o f~,y 1 " `~~'u c P,,o.Q i ~- ~ SePf-~C~.~ose rank ~~~f 10 hC~~~'1 r~ ~J G :o ` p; c~~ ~ f-t~ ~~b~ l A- ioo y„Pv~ ~~ li-~e,- __ - ~t; Prc',FoSe cQ / , ~--- -- - _ '~ ,,~\\q ~~ ~Ii'c c~ W~~~ 1-pLc~~toh - --~-/ II ~ ~ ~- ~ i = y Page .~ Df ~. 3 % slope Aggregate ` Cross Section Of A Mound Signed: License Number: Date: istribution Pipe ~G - F o / ~ Gr~~ ~I.~~, g9 Force Main From Pump q $_ Ft. g ~_ Ft. K y Ft. L ~ Ft. J (. `L Ft. t g s Ft. W ~~.~ Ft. Plowed Layer D / Ft. E /.~y Ft. F ~3 Ft . ~ , s" Ft .. H % Ft. L -_______._"_ Observation Pipe J g ------ ' ~ K _ q la--------------~-----~------~ 2„- 2 ~2~ . Distribution E~i_~ Of Pipe Aggregate I _ Observation Pipe ~~Sa-) A`' e ~- ~ X3.7' ~ ~ Synthetic Covering AsrM ~ 33 Medium Sand -~ _ Topsoil _ J - I E 3 Plan View Of Mound ~~ C jea~.o~ 'r A-~~Cs` ' ~Env~O~~ Pu~roio~~d r~~. o~~on J End Vl~w P~rforolcd _. ~ ` l Holes Located on Bottom are Equally Spaced J II /,yA/ 1 ~ I~~, Distribution Pipe Layout Pte' Io~„ ... R 2.. S S' S X ~ / ~~ Y ~~ i~ Signed: License Number: Daee: np.s Hole Diameter ~ Inch Lateral ~ Inch (es) Manifold ~ Inches Force Main ~ Inches ~.,VVER(~~" I~ILe~. I ~~~. S Nobs I f t- 4-cx~[~rW = ~ T~~«/ N~if~ - is t+rn.r•T!~ •reUK E PUMP CHAMBER , Page~Of~_ SECTION AND SPECIFICATIONS 4" .~~( VENT PIPE 12" MIN. ABOVE GRADE E WEATHERPROOF JUNCTION BOX •, > 25' FROM DOOR, WINDOW OR WITH CONDUIT FRESH AIR INTAKE G,~ou..,, ~. .~1~~. ~ ~ 2y" s, d. • 18" IN • _ . ~~ ~~ INLET ~ ~. . i GAS- ~ ~ WATER TIGHT SEALS ~` ~ TIGHT ~ A SEAL APPROVED ' (a"xl(o" ~'- ~ PIPE 3 C ~ ; ONTO SOLID SOIL PUMP OFF ELEV . gB.UFT . OFF D APPROVED MANHOLE COVER W/ PAD LOCK E WARNING LABEL 4" MIN. • ~~ ~$ M111. . APPROVED JOINTS WITH APPROVED PIPE 3' ONTO SOLID SOIL 3" APPROVED BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS _ 1 n i d. ~ ~ ~1 . T 1 ~, l •e rs~~ SEPTIC / DOSE .~~ 15 X ~.. ~~ /__ ' 7s ~`;~• TANK MANUFACTURER: ~j~.S~~---- TANK SIZES: SEPTIC ~ SG GAL. DOSE VOLUME INCLUDING '~'-- GAL ~•(S C`~-f,--~FLOWBACK: /~~ GAL. DOSE ~- o _ c>~~SCAPACITIES: A = ~ ~~~ INCHES GAL. = y___~.~_ ALARM MANUFACTURER: MODEL NUMBER: ~ S B = ~ 2 INCHES = GAL. SWITCH TYPE: oc~ ~ INCHES = /J~• ~y GAL. C = PUMP MANUFACTURER : MODEL NUMBER : ~~~ • ~ s ~04~ WE43M D ~ = ~ INCHES = a O ~ ~~AL. SWITCH TYPE: ^^r~~• • ~^- FIo~ •--1 ~"- 16.23 WAC GPM PUMP E ALARM WIRING AS PER ILHR REQUIRED DISCHARGE RATE ~~•g /~ ,5 FEET VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE• • ~-=- FEET + MINIMUM NETWORK SUPPLY PRESSURE ~~_ FEET + O FEET FORCEMAIN X `3~FT/100 FT.•FRICTION FACTOR •_ FEET ~_ TOTAL DYNAMIC HEAD • WIDTH DIAMETER INTERNAL DIMENSIONS OF PUMP TANK: LIQUID ~`~~ ~~ ~(o. l~ ~o-~• Ptr~l~nc~~ f 12as~ .~e~ ~c},,.~. S~o«. 5~i~~~ LICENSE NUMBER: DATE: SIGNED: • 1/88 155" Tnp ~n~'w SCALE: 1 /4" = 1 SIDE VIEW SCALE: 1/4" = 1' ~~ 5 GF8 W1250/750-MR TANK SPECIFICATIONS DIMENSIONS: WALL: 2 -1 /2" BOTTOM: 3" COVER: 6" MANHOLE: 24" I.D. HEIGHT 66' O.D. LENGTH: 155" O.D. WIDTH: 86" O.D. BELOW INLET: 53" O.D. LIQUID LEVEL: 47" WEIGHT: 14,795 LBS INLET AND OUTLET: 4" BORE WITH STOP FOR QUIK-TITE, FERNCO GASKET, CAST-A-SEAL BOOT OR EQUAL INLET AND OUTLET BAFFLES: WISCONSIN, SEE DETAIL #10 (OTHER STATES SEE CHART) LIQUID CAPACITY: 25.96 GAL/IN (SEPTIC) 16.12 GAL/IN (PUMP) LOADING DESIGN: 7' 0" UNSATURATED SOIL ~OC~~C~Q ~oaC~p~~~ W3716 US HWY 10, MAIDEN ROgC, WI 54750 800-325-8456 MODEL W1250/750-MR SEPTIC/SEPTIC, SEPTIC/PUMP OR SEPTIC/SIPHON JANUARY, 2000 FlLE: W1250 750-MR Performance Curves METERS FE"~ 25 O F- 15 10 5 0 METERS FE 35 30 = 20 O t- GPM 30 m'/h ~~GOULDS. PUMPS, INC. SB~EfJ1 Fi41.15 I~IN YLYdC 13148 15 I ~- 10 20 0 CAPACITY 10 5 0 P lc of B_.. ~Wb111~~1~b~~ ~f~lU~~_ IpUi'~'1pS 30 m'/h Effective July,1985 .., -- 10 20 0 CAPACITY ' `~ OWNERS : KEN & ELLEN ENO Pafle 8. of ~-_ .. START UP AND OPERATION. For new construction, prior to use of the POWTS check treatment tank(s) for the presence of panting 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 r8 t~ ~ ey ax~s ~ ~8 wastewater will be discharged to the dispersal cell(s) in one.large dose, overloading the oaf)( ) 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 Malntalner 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 oust, or otherwise dlsttub or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or ellminatlon of the following from the wastewater stream may improve the performan~ anted p,~,~o~~ of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; ~, hI disinfectants; fak foundation drain (sump pump) water, fruit and vegetable peelings; gasopne; g scraps; medications; oil; painting products; pegticldes; sanitary napkins; tampons; and water softener Ixine. ABANDONKlVIENT 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 ch. Comm 83:33, Wisconstn`Adminlstrathre 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 e compliant replacement system: O A suitable replacement area has been evaluated and may be utilized for the location of a replacement soU absorption system. The replacement area should be protected from disturbance and compactlon,and Should nOt be infringed upon by required setbacks from existing and proposed structure, lot Imes and welts. 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. Barrittg advances In POVYTS technology a holding tank maybe Installed as a last resort to replace the failed POWTS. ^ The site has not been evaluated to identify a suitable replacement area Upon lettuce of the POWTS a soA 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 POVYTS. ~ Mound and at-grade soil absorption systems may be reconsWcted In place following removal of the blomat at the infiltrative surfs ~ . Rns~~ons~o-f such systems lrtust~comply etjl th ~ , In aff~ e~ctrat t~tat tlma~s.(Y.u~~ go. ~G dLr d1 -h ~nn~+~ / <WARNING» SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES ANDlOR INSUFFICIENT OXYG . DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY ClRC,UMS7ANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFfICUL7 OR IMPOSSIBLE ADDITIONAL COMMENTS ~OWTS INSTALLER POWTS MAINTAINER ' Name STANG PLUPiBING & HEATING Name ABC SEPTIC SERVICE -I~1ENOMONIE n~__.. ~t S/~QS_lAhF, POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page 7 of 8 cn c uuCARMATIAN Owner KEN & ELLEN ENO Permit # ~3 ~ ~ O nccinN DnRAMFTFRS Number of Bedrooms 4 ^ NA Number of Public Facility Units ~ NA Estimated flow (average) 400 al/da Design flow (peak), (Estimated x 1.5) 600 al/da Soil Application Rate 0.5 al/da /ft2 Standard Influent/Effluent Quality Monthly average ' Fats, Oil & Grease (FOG) 530 mg/L Biochemical Oxygen Demand (BODE) 5220 mg/L ®NA Total Suspended Solids (TSS) 5150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BODE) 530 mg/L Total Suspended Solids (TSS) 530 mg/L ®NA Fecal Coliform (geometric mean) 510' cfu/100m1 Maximum Effluent Particle Size Ys in die. ®NA Other: ^ NA "Values typical for domestic wastewater and septic tank effluent. SYSTEM SPECIFICATIONS Septic Tank Capacity 1250 al ^ NA Septic Tank Manufacturer WIESER CONCRETE O NA Effluent Filter Manufacturer ZABLE ^ NA Effluent Filter Model A-100 12" x 20" ^ NA Pump Tank Capacity 750 al ^ NA Pump Tank Manufacturer WIESER CONCRETE ^ NA Pump Manufacturer GOULDS PUMPS INC ^ NA Pump Model 3885 WE03M ^ NA Pretreatment Unit ^ Sand/Gravel Filter ^ Peat Filter ^ Mechanical Aeration ^ Wetland ^ Disinfection ^ Other: ®NA Dispersal Celllsl ^ NA ^ In-Ground (gravity) ^ In-Ground (pressurized) ^ At-Grade ®Mound ^ Drip-Line ^ Other: Other: ^ NA Other: ^ NA Other: ^ NA MAINTENANCE SCNEDULt: Service Event Service Frequency Inspect condition of tankls) At least once every: 2 ^ month(s) Maximum 3 years) earls) ( ^ NA When combined sludge and sc um equals one-third IY,1 of tank volume ^ NA Pump out contents of tankls) Inspect dispersal cellls) At least once every: 2 ^ month(s) (Maximum 3 years) ® earls) ^ NA [~ month(s) ^ NA Clean effluent filter At least once every: 13 C] year(s1 ® month(s) ^ NA Inspect pump, pump controls & alarm At least once every: 13 ^ year(s) r : 3 ^ month(s) ^ NA Flush laterals and pressure test y At least once eve year(s) ^ month(s) ^ NA other: At least once every: ^ earls) 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 cellls) 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 (Y3) 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) .+ .. Wisconsin Department of C mmerce S~JIL EVALUATION REPORT Page ~ of 3 ~~.. Division of Safety and Build gs f; i ~; ~ ~~co~~l>~e withi'Comrt185, Wis. Adm. Code County S ~~ o [ ~ Attach complete site pia on par h6tJ~as;.than 81/2 x 11)nches in size. Plan must include, but not limited 'caF~i'dihod~~C@ference nt (BM), direction and Parcel I.D. ocati nand distance to nearest road. percent slope, scale or dimensions, n"QRh'amew.-endl_,_,., Date viewed by Please print all Informat/on. ~~ •~ Personal Information you provide mey bs used for secondary purposes (Privacy Lew. ~• 18.04 (1) (m)). Property Owner A Property Location ~d~ / "I C'xa-~ I ~V~ Govt Lot NE 1/4NE 1/4 S S T .~ g N R ~ Fo E( W Property Owner's Mailing Address Lot # Block # Sutx1. Name or CSM# ~~90 ~'Sfli /fvQ • ~-- ------- ~, State Zip Code Pt>one Number ^ Ciry ^ village own Neares~oa~ SLr-P-er Code derived design tlcw rate ? GPD [~A"ew Conswdion Use: esidential / Number of bedrooms ^ Replacement ^ Pubiic or commercial -Describe: 1L /L .•.. + ~ . ?". I ~ Flood Piain elevatlon ff applicable Parent material sl..(~ ~ ~ ~ 1 General comments G(s~ . ` ~ °~ ~~ `~ ~ ~ ~ ~ T C l ~ ©t.. C O ~ ~t~ir' q ~, C 0 and recommendations: u~P-e r ~ 5 .~ o ~ ~~ ~u.~ ~~ s y s~~ ~, ale U. ~dc~ ~ d v / ~ Boring q-7 ~ Boring # pit Ground surface elev. _.(.:= ft• Depth to limiting factor ~In. ~ ~~ Red Horizon Depth Dominant Color Redox Description Texture SWdure Consistence Boundary ~~ •Eff#1 'EtT#Z Gr. Sz. Sh. ln. Munsetl Qu. Sz. Cont. Color / D - ~ a_ !~ Y ~ ~~ ~ 3 7s R ~ 3 ~o ' _y 7, ~~`/ s ~ ~ ~.-~ bk w~~ ~ ~v ~ r L S ~ c s~~ iM u-~~- I M F SC L 3 b~ Baring G a Boring # Plt Ground surface elev. 9/~ g~ ft• Texture Horizon Depth in. Dominant Color Munsell Redox DesaipUon Qu. Sz. Cont. Color -l3 toy 3~ `--. ~ 3 a o ~" 3 aS-3~ ,S ~ • Effluent Si a ',Tame (Please P t) Q~~~~ ~ ldress S3~.L- ~S > 30 < 220 mg/l. and TSS >30 _< 150 mg/L ~ ~~ a 9 77o t~ ,~1~~ r,h U~~I ~~/167 Depth to limiting factor ~~~ in• Swctpra Consistence Boundary Roots Gr. Sz. Sh. wr s k ~" ~ , , ,~ . • Effluent #2 = BOD, _< 30 jtion Conducted 3-31-bY (~ ~ ~~ ~. i `-l .~ b _~' T" ~ . , 6 ~ ,° ,~ yl and TSS _< 30 mglL CST Number ~2aa 9~ Telephone Number (7/s~7>~~-3a~~ ~ ~! t ti Paga ~ ~ 3 Property Owner ~~ ~ ~`{-~ ~~ ~ Parcel lD # ^ Boring . Boring # Plt Ground surface elev. g~ a ff• Depth to limiting factor ~~ ~-• Soil (~}~ Ra GPD/fE Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color l D- l o ~ 33 ~ 3 10- --~ ~ .5-~" _ i2 ~ o Texture Structure C,onslstenca Boundary Roots Gr. Sz. Sh. •E~1 •i a S e s ~~ [~ Boring Boring # Ground surface elev. ff• ^ Pit Horizon Depth in, Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture ('~ ~] Boring I Boring # Ground surface elev. n• ^ Pit Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture ' Effluent #1 =BODE > 30 ~ 220 mg/L and TSS >30 _< 150 mglL Depth to limiting factor in. ~ Structure Consistence Boundary Roots Gr. Sz. Sh. •~~ Depth to limiting factor ~• Structure Consistence Boundary Roots Gr. Sz. Sh. • Effluent #2 = BODE _< 30 mgll. and TSS <_ 30 trglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance Co access services oC need material in an alternate format, please contact the department at 608-266-3151 or T"fY 608-264-8777. . (o .~ SBD•t330 (R.6I00) l ~~ h ~e ~- , oh ~s.T , 1~~~.,~,. e~,., ~ f ~ P ~ p La~, ,~. M~~~~-~-_1---------_ __ ---- ~ ~~ s~~ ~~oa~~ K~ 3. M. ioa ~ rop ~ ~~~ u~ ~~~.~ ti,-~u f f~ ~Q~ (~ ro Pv ~Qri.~ ~ ar n -r ~ a3o +4, ~~re~f ~\ ~r~ ~ ~ ~ ~ \ \ / n lci' ~l ~ ,~ l e ~ ~' ~ k33 ~ ~- 1 \ ', 1 ~` X 1 ~ 1 ~ , ~' 3 ~6 ~/d~L S l ~ 1 a 1 l ~ p 1 ` s ` ~ 1 1 ~ Q~ ~~ ~ ~Eleu. icx~ oo s ~ ~ Elev ~1~,,. E~cu, 9q,oo i ~i~'o a~ (~~, ~U C ~~ ~ -2 ~ c-~/orb . ~ ~ b b o ~ Nei -~ -1-o I~a-F(,~ . Jv ~~~I.~ ~'' _ << u' ST CROIX COUNTY SEPTIC TANK hBNANCE AGRBEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer Mailing Address Property Address City/State (Verification required from Planning Department for new LEGAL DESCRIPTION Pazcel Identification N ber U ~ ~ ' ~ ~ [ 3 r !U - GG~ f ?~ N-R W, Town of l _.t (~(~ .~~F ~~ ~s~' property Location ~ '/., ~ '/•, Sec. ~~ . T_~ ~.~ ~ ` - '~,~,:, Subdivision _ Lot # Certified Survey Map # ~- ,Volume ~- ..Page # Warranty Deed # V]`"~G~~~?~ ,Volume ~ „_, Page # ,~~. Spec house ^ yes ^ no Lot lines identifiable ^ yes ^ no SYSTEM MAINTENANCE Innproper 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 caa affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification fom~, signed by the owner and by a masterphrmber, journeymanplumber, restrictedplumbcr or a licensedpumper verifying that (1) the on situ wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. 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 W isconsin, Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. ~,(/i~ ~, l1,Gr SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (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 descn'bed above, by virtue of a warranty deed recorded in Register of Deeds Office. ~~~ ~~ 3~i Y~ a SIGNATURE OF APPLICANT DATE «««««+~ «««««« Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. «« Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty dud ~~ .. U~:25~6P 133 DOCUMENT NO. WARRANTY DEED This Deed, made between Jon Moulton, a single person Grantor, and Kenneth Eno and Ellen Eno, husband and wife as survivorshi marital property ,Grantee, WITNESSETH, That the said Grantor, for a valuable consideration conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin:: The North 35.01 acres of the Northeast Quarter of the Northeast Quarter (NE'/./NE'/.) of Section Five (5), Township Twenty Eight (28) North, Range Sixteen (16) West. 7S'93~3 KATHLEEN H. MALSH REGISTER OF DEEDS ST. CROIJ{ CO. , >dI RECEIVED FOR RECORD 04/12/2004 11:30At1 iiARRANTY DEED EXEMPT # REC FEE: 11.00 TRANS FEE: 360.00 COPY FEE: CC FEE: PAGES: 1 RETURN TO: Loberg Law Office 359 West Main Street Ellsworth, W 154011 PID #: 008-1013-10-000 1~ U' a = v=-Q-a^~ ~ P ([ l ~~c U Together with all and singular the hereditaments and appurtenances thereunto belonging; And Grantor warrant that the title is good; indefeasible in fee simple and free and clear of encumbrances except easements, conditions and covenants and will warrant and defend the same. This is not homestead property. Dated this ~-'F"day of April , 201 (SEAL) (SEAL) AUTHENTICATION Signature(s) authenticated this day of , * e TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by §706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY LOBERG LAW OFFICE (Signatures may be authenticated or "`~''`~~'''' ". ~: acknowledged. Both are not. necessary)sjt1:~•'" .~ fl. ' o., y~~~~ ~~. v'~i .~ p ;'j + ' g^. ACKNOWLEDGMENT EAL) (SEAL) STATE OF WISCONSIN } } ss. COUNTY OF PIERCE } Personally came before me this ~ day of April 2004 -the above named Jon Moulton t0 me known to be the person who executed the foregoing instrument and acknowledge the sa /. otary Public Pierce County, Wis. My ~''"'~>~Commission is ermanent. If not, state ~,. ;, ' P ( "=`~~r, expiration date: 9-19-04 .) ,~~~,,4 \ ` ~1 ~k ~~f I i ~~ ~~ f `^* ':' .1 ,~ .. l` ~~I 1~ iV _~ll alei,Sian.`.M.'~w~:'iL1e..vaarL}Zi\ia .. GOULDS PUMPS Submersible Effluent Pump 3871 E~ APPLIrAT1ON5 • fvgy submerged in high ^ EPOS NnptNer:1'hermopias- ^ tteath+gs: Uigter and lower h ' ~ ~ grade turbhle aR for tlc enclosed desiOt fa aavY 9 ! SPAY ~ ~ hdlritatwn and efficiem Improved perfomwna. omsauctioa 9 ~~ Heat iTansier. ^ G anti Base; Rugged • Elfhrem systems therrtasdcdesign provides AGENCY LISTING • tiretles • Farms AvaBnble fa suomnatic and manual operation. Auto ~~ s ~ carTOSbn resistar~e ~~ hnediansaalsrdtArodeMat • Heary duly sung • Water transfer rastlc atodds bKbrde Metitankel boat Sladtdt ^ Motor : Cast ~ (aA R~ rlxtdel rNSmbers end ° " " • Devvatedng auembled aad preset at the for efRdem heat transfer, and dttrabRRy. a F .) in Y SPECIHGti0N5 , ^ Moon Ctwer: Thennoplastk FEATURES ~,,,~ gttegml handle recd • Solids hardRng TapabNRy: fbat swhth atmchrttetd P~ 'i.' maxNatm. ^ EP04 bapeNer: Thttrmoplas- ^ Power Cable: Severe dory _ ~ M rated otl and waMr resistant. 31 feel. • T s: igt pump varcesout medwnkal • Olsdtrege she: t'/:° Nf'T. seal protection. • fdedtanical seal: ®rborr retrey/reramk-stationary, BONA-N elastomers. ~ va corttkNlous t~ 14O°F (tr0°q itroemthtem. AAETERS FEET -~--- _ ,.______ -- _ _^..~.n....._.._.._~ ------~ • Fasttxrers: 3~ series ; 5•B~ItIl55 StCel. 9 3a~ ~ ~ ' '--- - SGPM "~~ • Capable of runrtiltg ~ i _ _ .. t _ _. ~,. _ ~~~~ components. ~ a zs` ~_, ~ ~._-_.~~ f zsFr ~ i NP ' .._..~ _ _. j _ ,__ _~ ~j s , atgk phase: 0.4 • EP04 S5 1S50 60N 11 2~V 3 ; __ -_.. i_ z, 5or , 5 z , j ~ i ' RPM, bunk in overload wink autemaUcreset hase: Os NP • EPOS Si~ k 8 ~ a 1s' __ .~ f ~ _. _ ~ .... _ { f -.. ~ ~ _i_ , i Ea05 ~ , pp g 601h,1550 115 V or 230V ~ 3 ; f for _- -;_ _ ~ { __ r ._.._____ ._ ._. _ _. .-~ t f , RPM,buikinovedoadwRh ~ i _ _ ~..__ ~ . __- ;._ePOa __'.. _- BIROmdUt rests. •Paweraord:TOfont 1 a sj~.-'` ~- - ! ' ~"'~~ ___.j,_. -_ f ~ ~ ! stantkrdlength,iW3 t __, ~ _. i.__ .-.._ ;-}- ;-. _ j f ~ rou~ f~4• ~ o o oQ - _~~._.... u ~_-_~.___.~~~ ~~____ia 3o J _ '_ ao so aPM ~_.-.l_~. - -- fwt kng ,14i3 SJTw with f tluee P-~9 9r~J pW9 o z a a a to a rMm (standard on EPOS}. ~~m, Goulds Pumps ITT ladt3stries i6 ~GQULDS PUMPS ,a 9 6 9 ' S 4 3 t I Submersible Effluent Pump V 7 1 EPOS COMPONENTS DNl1ENS1ON5 PERFORMANC Ua dimensbnt are M 6rdrs. Do not use hr masutrctioa ' 8 OX flaed maa 8 assemby~~ 10 thernpp4stk moron mver ~ • Taal Naad (h. a wausf s to is i0 1 !~ _ ~ 17 NPT 2a 1a 31.5 i a MnnMUMwATfa lE4El. wFFU~ w1TN aoAr swrtcx P ~ , MODEL INfORMATiON Order NO. NP VoNa Aatps ~01Hm tMadt Naater Phue ltoatStratdl ~ Cord -~9N Discbpya ~~ ~""'a ~ term) aNaimmtt tNT larval aflMmuM axb Diuaater Madf Sot SE EPM11 Nu No Switch id i" Mamml taannal 15" EPONIA ~ edtJtMh~M In Id 1'h' 12' 6" 15' EPOtitF A t14 17 15 ~ JNoSwhdi 1d t'6" Manual Marawl 15' fewttAC Jwwe•A as th• tr e• ts• fPo111 1 ItbSaradt td 1%" hknual Memd 15' Y. EP0112F 130 6 t0 /aoAytMt Id t'b' Manual Manmi IS' fPOSiiF Plu /aoSwach id t'/," Mamtal Aamnrel 75' EP0517AC ,5 115 13 15 J p' iK` 11` 6' 15• fP0511F 130 6S t8 N /No Swadr 1d ih" Mamraf Mwmal iS" (CTA baed model mmfbers end in "C' a `f'.1 Goulds Pur ITT tr 19