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032-2124-40-000
PP_ PRIVATE SEWAGE SYSTEM County: St. Croix Wisconsin Department of Commerce Safety and Building Division INSPECTION REPORT Sanitary Permit No: 552375 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: Stout, Richard O. & Janet Somerset, Town of 032-2124-40-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 100-0 0 05.30.19.1112 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark 10061 ©s /00 . ~00. D Dosing (jtJ 1 / O Alt. BM U (Y Aeration Bldg. Sewer -f s r -}TiV I if 0 3 - 2 tIn Y~ Holding - t outlet TANK SETBACK INFORMATION S RWflW TANK TO P/L WE BLDG. Vent to Air Intake ROAD Septic 00 ~ OD 0 2 Dt Both /D (O Heade Man. 3~3 S Dosing (m > We" Aeration Dist. Pipe Sja(A_)96-k~ o" Holding Bot. System Final Grade PUMP/SIPHON INFORMATION -3,1 ~cf • I Manufacturer ~~1Lef u-~ Demand St Cover V~ I ~O D~ GPM Model Number rt, U~ cNia j~- ° .Lj (ft Fricfon s System Ad TV3 ji( TDH If 4 -7) If 1 - Forcers Len 1 Dia. I/ Dist. to Well 6 r / SOIL ABSORPTION SYSTEM I C1. '77 5 BEDITRENCH Width ) Length / No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ti Oln SETBACK SYSTEM TO IXwJ P/L BLDG WE LAKE/STREAM EACHING Man er: INFORMATION CHAMBER 4 Irv Typ7,9 f System: t 5 2# / f , ,n / UNIT Model Number: O1v P 15,T IBUT N SYSTEM 1 IuLrk ~Header/ nifold s nbution x Hole Size x Hole Spacing Intake r1 r~ Pipe(s) -7 Ar ngth hl 'Z Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over 1 Depth Over xx Depth of Ixx Seeded/Sodded xx Mulched Bed/Trench Center n/ `,Z Bedrrrench Edges Topsoil ® Yes No ® Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 426 172nd Ave Somerset, WI 54025 (S 1/4 W 1/4 5 T30N R1 9W) Chabre Lot Parcel No: 05.30.19.1112 a , Z j p~ Fc ps tu.>hc~,wl co ~ ~ u/w/~ 1.) Alt BM Description /~l((fCUCJC.o 2.) Bldg sewer length - amount of cover / S Q Plan revision Required? E Yes No [CKFT_~ Use other side for additional information. Date Insepctoes Signature Cert. No. SBD-6710 (R.3/97) PLOT PLAN PROJECT Richard Stout ADDRESS 1353 Awatukee Trail Hudson Wi 54016 SW 1/4 SW 1/4S 5 /T 30 N/R 19 W TOWN Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 6/6/12 BEDROOM 3 CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT XXX HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE630 DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .4 ABSORPTION AREA 1 170 # of chambers 57 BENCHMARK V.R.P. Top of power box ASSUME ELEVATION 100' Filter 'EkIp'OST Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 94.0/93.9/93.8 3' below qrade Property Line All piping shall be SDR 30/34, within 10' Scale is 1" = 40' of tank, piping shall be Schedule 40. unless otherwise Plans Designed Using Vent noted Conventional Powts 15% SLope >6" Quick4 Standard Manual Version 2.0 Leaching Chamber 5 of Cover with 20.0 ft2 of Area 1 Vents 10.2ft^2/pair of end caps Long 12 3- 3' X 78' cells B-2 3 4„ Grade at System Elevation with >3'spacig Well is to meet all Hillside 0 S setbacks required by WDNR Tested area has been cut, old golf course 50' B M * 40' 12% Lope 35' 40' S , -~0 Y, um4c,~ - 4wt,~ da16h) T c~ eg. B-1 N Huffcutt Combo Tank 10% Pro 3 303 5 sc N c~ k4n Bedroom House Property ~AV cgp~i 17 d Ave commeree.W1.90v Safety and Buildings Division county - - ~~~0~~' ~ 201 W. Washington Ave., P.O. Box ?I62 't r- I t~ Madison, WI 53707-7162 Sanitary of Cwnmerc® Lary Permit Number (to be filled in fry Co.) - DO INWhimmit 7.5 Sanitary Permit Application State Transactio umber In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this PRidim the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Applica or state-owned POWYS are oject Address (if different than mailing address) submitted to the Department of Commerce. Personal intorma yo be used for secondary oses in accordance with the Privac Law, s. 15.04 1 luts, L Application Information - Please Print All Info n ~i Property Owner's Name Parcel # r C~l J JUN 1 ?_012 o3,21 -,-;21,,; Property Owner's Mailing Address / > ST Criv~n Property Location r PLANNING & ZONING OFFICE Govt. C _ / City, State Zip Code Phone Number ~ . J Section Cam/ /r Cie on (UW . Type of Building (check all that apply) L #U N; R l - E r2Family Dwelling- Number ofBedrooms Subdivisio Name 3 LA 6 a Block ❑ Public/Commercial - Describe Use 11 ° City or - ❑ State Owned - Describe Use CSM Number ❑ Village of _ 'town of_5e l /..5 45 ice rt5 M. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Pemtit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner r W. Type of POWTS S stem/Con onent/D vice: Check all that apply) on-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil 10 ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis ersal/Treat ent Area Information: - Design Flow (gpd) Design Soil Application rpdsf) Dispersal Area Required (so Dispersal Area Proposed (st) System Elevation VI. Tank Info Capacity in Total # of Manufacturer - Gallons Gallons Units o New Tanks Existing Tanks c gn / ` a U in A is C7 ii leeA4- Septic or Holding Tank Dos.g Chamber X 163c) ~ x _ VIL Responsibility Statement- 1, the undersigned, assume 00onsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print} Plumber's re MP/MPRS Number Business Phone Number AAU Plumber's Address (Street, City, State, Zip Code) 2- 1.2-o, A./ek J &~a L Z VIII. onn tpartment Use Only pproved ❑ Permit Fee Date sued Issuing Age gntlture $ I'D ' L CNbElim lven Reason Denial IX. Condi#VjWE Reasons for Disapproval 3 U• 1. "$eptic tank, tyif bnt filter eini dispersal cell must all be se es IesI Maitd lruxl. t 4 A4 21--~ as per management plan provided by plutpbtlr.. 2. AI s4(back requWtments mLmt be maintak as per 410*664 code / A/0 - Attach to complete plans for the system as submit to the C re 1.X_ 49 ounty o 1 oa paper not Tess than 8 lrt x 11 inches so sire 1.X_ 49 ven :5v ~We, o✓l ~a l s SBD-6398 (R 02/09) Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715-246-4516 Date: 6/7/12 Owner: Richard Stout Location: SW1/4 SW1/4 S5 T30 N,R19W 426 172nd Ave 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.-12. Soil Test Signature License number 26900 PLOT PLAN PROJECT Richard Stout ADDRESS 1353 Awatukee Trail Hudson Wi 54016 SW 1/4 SW 1/4S 5 /T 30 N/R 19 W TOWN Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 6/6/12 BEDROOM 3 CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT XXX HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE630 DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .4 ABSORPTION AREA 1 170 # of chambers 57 BENCHMARK V.R.P. Top of power box ASSUME ELEVATION 100' Filter NEST Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 94.0/93.9/93.8 3' below qrade Property Line 49 All piping shall be SDR 30/34, within 10' Scale is 1" = 40' of tank, piping shall be Schedule 40. Unless otherwise Plans Designed Using Vent noted Conventional Powts 15% SLope >6" Quick4 Standard Manual Version 2.0 of Cover Leaching Chamber 5 with 20.0 ft2 of Area Vents 10.2ft^2/pair of end caps 4' Long 12 " 3- 3' X 78' cells B-2 34„ Grade at System Elevation with >3'spacig Well is to meet all Hillside 0 S setbacks required by WDNR 80' Tested area has been cut, old golf course 50' B M * 40' 35' 40' 12% SLope -1 [ I t 5' 40' B-1 30' Huffcutt Combo Tank 10% SLope Pro 3 Bedroom House Property Line 4 172nd Ave Cross Section of Quick 4 Standard Leaching Chamber Typical cross section for 2 of 3 cells Quick 4 Standard Leaching Chamber with 20.0 ft2 of Area per Chamber 10.1ft^2 pair of end plates To be >1' above grade - / Finish grade elevation Typical Installation 97.0 Len Grade Vent 4' Septic Tank L5' 4' Long 1 Grade at System Elevation 34Grade at System Elevation 34" Spacing 5' 3-3' X 78' Cells Observation tubeNent Same on other end To be located on end of Cells A B System elevations: C A__94.0 B 93.9 19 chambers per cell C___93.8 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner Septic Tank Capacity ❑ NA gal Permit # Septic Tank Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer] A f~ Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units ANA Pump Tank Capacity gal ❑ NA Estimated flow (average) 20V gal/day Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.5) ~J gal/day Pump Manufacturer l NA Soil Application Rate , 71 galfday/ftz Pump Model ❑~NA Standard Influent/Effluent Quality Monthly average*! Pretreatment 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) 5150 mg/L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BODS) <_30 mg/L In-Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L ><N A ❑ At-Grade ❑ Mound Fecal Coliform (geometric mean) <_10' cfu/100ml ❑ Drip-Line ❑ Other: Maximum Effluent Particle Size Ya in dia. ❑ NA Other: ❑ NA Other: NA Other: ❑ NA *Values typical for.domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event I Service Frequency Inspect condition of tank(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA year(s) Pump out contents of tank(s) When combined sludge and scum equals one-third (Y3) of tank volume ❑ NA El. Inspect dispersal cell(s) At least once every: -3 month(s) LiNyear(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: - earth(s) ❑ NA Flush laterals and pressure test At least once every: ❑ month(s) NA ❑ year(s) Other: At least once every: ❑ month(s) NA ❑ 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 (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. GMVV (4101) I Page of F'' 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. I • 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 replace nt system: R I~M` A, ry+o~n© 5tr~h U~.~Cnd~. WOr~- ►5 Ora+►~Q„ A suitable replacement area has been evaluated and may be utili d elocation 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 Name S a-41j11 Q Phone Phone ~J J SEPTAGE SERVICING OPERATOR (PUMP R) LOCAL REGULATORY AUTHORITY Name _D Name ~ -0 7 a hone , - L Phone E P 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. Page of 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 replace ont system: R 1wAaA&4 wo-a L a ~Yto AL sp4e vxke'`~ c-Sk. w-&rL t.5 Sork, A suitable replacement area has been evaluated and may be utili d 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 / a Name l ~•~1/~`~' Phone Phone SEPTAGE SERVICING OPERATOR (PUMP R) LOCAL REGULATORY AUTHORITY 17 Name -A ,y` !'yj Name _ ✓t9 Phone J , aloCi Phone 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. .4 t ! R ( E INSTRUCTIONS Installation' Dry fit the filter case onto the end of the outlet pipe to ensure it is centered under the access opening. If not, then either insert more pipe into the tank through the outlet or solvent weld (glue) additional pipe onto the outlet pipe. S`EP 2 While the case is still dry fitted on the outlet pipe, measure the length of %-inch pipe needed to brace the filter to the tank and wall if utilizing the optional supplemental side support. If side support method is not utilized, proceed to step four. For installations utilizing the optional supplemental side support: solvent weld the V4-inch pipe onto the filter case. If side support method is not y wp 4 utilized, proceed to step four. Solvent weld the filter case onto the outlet pipe. Insert the filter cartridge into the case, pressing down until the filter locks into the bottom of i the case. If a VRS switch is utilized: insert into the filter and lock by turning clockwise 90°.~ Maintenance 1. The effluent filter should be cleaned every time the septic tank is serviced. j 2. Open the outlet access opening to inspect the tank and filter. 3. Pump the septic tank completely, making sure to remove the sludge layer on the bottom of the tank and not just the scum and effluent. 4. Once the effluent level has been lowered below the invert of the outlet pipe, firmly pull up on the filter handle to dislodge the cartridge from the case. S. Slide the cartridge up and out of the case for cleaning. 6. If a VRS switch connected to an alarm is present, the switch should be removed by turning counterclockwise 90° and cleaned N• with water only. i+ 7. While holding the cartridge on its side (large flat surface facing down) over the access opening, rinse off the cartridge with water only, making sure all septage material is rinsed back into the tank. :M S. If VRS switch is utilized, replace by inserting into filter and 3 turning clockwise 900. r q 9. Insert the filter cartridge back into the case, pressing down until' ' - the filter locks into the bottom of the case. 10. Replace and secure the access opening on the tank. www bearonsitexom 877-MLFILTERS (6534583) l2- --<Z- Septic-Dose Flank Cross Section And Pump Performance Specifications Tank Manufacturer Pump Manufacturer 7:o P Il Tank Model Number p Pump Model Number 3 Total Tank Capacity 3 d Alarm Manufacturer Max. Bury Depth c - Alarm Model Number L ✓ Switch Type 'Liz e- Filter Manufacturer ; Total Dynamic Head (TDH) - Feet Filter Model Number F )o - Elevation Head Distal Pressure Network Loss Minimum Pump Performance Required Force Main Loss -7 Z 4D GPM Ft TDH Total 1 L . Outlet Manhole Min. 4" Above Grade With Locking Decrice. Inlet Manhole Manhole Min. 4" Above Grade < 6" Below Gride Sealed Watertight Securely Mounted With Locking Device Weather-proof Junction Box Now Finished Grade r• " r Nis Vent Min. 12" Disconnect Above Grade Means With Vent Cap Ell" Outlet Filter Wet Baffle " - Inlet • • A • Capacity 1/a)f Switch Setqu and Reserve Tank Volume = 15 GPI Weep •:a: Hole Dimension Inches Volume Gal. B Milk, : • (reserve) A S` 6 7 -1- : Off Elevation C ' (alarm) B : 2 Ft (dose) C 7~ - Bottom :•1 {dead) D D Elevation Ft + a V V . :•<•t 1 < a a i 1 t< a a a 1 1 1 1 a<! t i< t 1<<< 1't < I t a< 1: 4 a a I I t< t 1 a: : i:<: a 1 1 t 1 t a > > i > . Y Y~,'Y , Y > Y . r : Y v I f Y Y Y; r ; :j 1 i s>:: : a:•<•: a 1:•::a•i a>••a t< a< t I 1: a 1 r 1 a a l t t 1 a t a tat { t GENERAL INSTALLATION: The septic/dose tank is bedded and back filled in accordance with the manufacturer's product approval specifications. Maximum depth of buryas specified by the manufacturer may not be exceeded without pjrior approval. Manhole covers exposed to grade have an. effective looking 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 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 16.23. Page of 02105I,J Wastewate'n . SEN-40 Series 4/10 hp Submersible Effluent Pump, 3/4" Solids Construction Flow - Liters/Minute 0 50 100 150 200 250 300 Cover Epoxy coated cast iron 35 11 Motor Housing Epoxy coated cast iron 10 30 9 Impeller Material Thermoplastic Elastomer 25 $ Impeller Type Non-clog 7 l! oee 20 6 0 Volute l Epoxy-coated cast iron 15 5 Power Cord SJTN = 4 to Mechanical Shaft Nitrile with carbon and 10 3 Seal ceramic faces 5 Fasteners Stainless steel 0 0 Shaft Steel 0 20 60 80 Flow - Gallons/Minute Bearings Upper sintered sleeve and lower ball bearing OW -a6s- { s.1s 6.60' 6.60' t-99.6(r- SEN-40-AF SEN-40 Specifications SEN 40 „ 509211 4/10 115 1-1/2" FNPT 9/920 80 l 70 J 60, { 45 1, 25,1 32 14 l 20 l 26.5 1750 4 1 Q: SEN-40 - 509212 4/10 115 1-1/2" FNPT 9/920 80 70 60 45 25 32 14 , 30 27.5 1750 SEN-40-AF 509213 i 4/10 115 1-1/2" FNPT 9/920 50 70 60 4E 25 I 14 20 1 27.5 1750 SEN-40-AF 509214 14/10 1 115 1-112" FNPT 9/920 80, 70 60 j 45 25 32 14 30 28.5 ,1750 Franklin Electric 400 East Spring Street, Bluffton, IN 46714 Tel: 260.824.2900 • Fax: 260.824.2909 Form: 996199 7-11 www.franklin-electric.com Walaewate-'---t'r"~~ SEN-40 Series 4/10 hp Submersible Effluent Pump, 3/4" Solids Features ■ 4/10 hp PSC motor with thermal overload protection ■ Energy saving low amp draw ■ Cooler running motor which extends the life of the pump ■ Cast iron pump housing with protective epoxy coating for corrosion and rust resistance, polypropylene base ■ Stainless steel screws, bolts and handle ■ Mechanical seals (stainless steel spring, nitrile parts, carbon and ceramic faces) ■ Upper sintered sleeve bearing and lower ball bearing ■ 1-1/2" FNPT discharge ■ Handles liquid and solid waste materials up to 3/4" diameter ■ Available in manual or automatic operation with piggyback mechanical float switch ■ On level 9" - 14" ■ Off level 2" - 6" ■ Two year warranty Franklin Electric STATE BAR OF WISCONSIN FORM 2 - 1998 I I'I'I IIII~ I~~II (III ~I'f il~~l I~,I I,~IlI II~k I~~I 1 WARRANTY DEED 8 8 9 4 4 2 1 Document Number I 889442 BETH PABST This Deed, made between REGISTER OF DEEDS GRAND PROPERTIES LP ST. CROIX CO., WI RECEIVED FOR RECORD 02/24/2009 11:55AM Grantor, OARRANTY DEED j and RICHARD Q- STOUT and JAN .m srp0 Im, EXEl1PT s 14 husband and wife, REC FEE: 11.00 PAGES: 1 Grantee. j Grantor, for a valuable consideration, conveys and warrants to Grantee the following j~ described real estate in St. Croix County. State of Wisconsin: _ I Recc ding Area Plat of Chabre, Town of Somerset, ame and Return Address LotCroix County, Wisconsin. ti Richard O. Stout 1353 Awatukee Trail Hudson, WI 54016 1L 032-2124-40-000 Parcel Identification Number (PIN) This homestead property. (is) (is not) I~ This deed is given in lieu of foreclosure. Exceptions to warranties: easements, restrictions, rights of way and covenants Ij of record. Dated this 'PtN day of February 2009 .LR~C~~1 J~L1~1C~iCJU.~ (SEAL) (SEAL) Grand Properties, LP r I I (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT i i Signature(s) j State of Wisconsin, ss. St. Croix count authenticated this day of =+~'GO,yrf February before me this 009 ` day of y 2 the above named TITLE: MEMBER STATE BAR OF WISCONSIN ? - to I. (If not, me known to be the person who executed the foregoing authorized by §706.06, Wis. Slats.) siniln instru nd ac dgertt same. U THIS INSTRUMENT WAS DRAFTED BY Janet P. Stout 1 3 5 3 Awa. tukI=%o !r=;aiI - Hudson, WI 54016 Notary Public, State of Wisconsin My commission is ermanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not y C) ) necessary.) • Names olp Opri signing In any capacity must be typed or printed below their signature. - WARRANTY DEED STATE BAR OF WISCONSIN Wisconsin Legal Blank Co., Inc. FORM No. 2 - 1998 Milwaukee. Wis. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer CA r, Mailing Address r 5 Property Address 14a e.- (Verification required from Planning & Zoning Department for new construction.) City/State Parcel Identification Number LEGAL DESCRIPTION Property LocationSc.4__2 1/4, .5LO %4 , Sec. :S , T 3D NR/9 W, Town of J©~r_e Subdivision 4.~ r Lot # Certified Survey Map # Volume , Page Warranty Deed # , Volume Page # Spec house (9 no Lot lines identifiable yes 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 fo owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri, signed by the wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping O (if ng that necessary), the onssite less than 1/3 full of sludge. the septic tank is Vwe, 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. I/we certify that all statements on tl~s 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 7wanty deed recorded in Register of Deeds Office. Number of bedroom's 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) Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code V County rc9 ,~C Attach complete site plan on paper not less than 8 1/2 x 11 in n size. Piq J f, ' include, but not limited to: vertical and horizontal refere i M), di'" Parcel I.D. percent slope, scale or dimensions, north arrow>aloca and dis nce to nearest road. 3d2- - Please print n atio ~uN 11 2012 Review y Date Personal information you provide may be used to econda poses (Privacy Law, s. 15.04 (1) (my v tC Property Owner NN~~ ion A T TON R E( W rk~ Q r aT1~ Govt. Lot [ J 1/4.S4 Property Owner's Mailing Address Lot # Block # Subd. Name CSM# ,4U IL (4 city State Zip Code Phone Number ❑ City ❑ Village Town Nearest Road IA-J' )I ew Construction Us . Residential / Number of bedrooms Code derived design flow rate ' Z-17-2 GPD ❑ Replacement Public or commercial - Describe: Parent material Flood z~ca`; .S rn IfCPlainn levationn if pplicable General comments d4; 1t/ / l4 ft. / LJ /~~c~ pco O~rc r.✓ and recommendations: System Type 11 System Elevation ✓ O P1 Boring # ❑ Boring A Pit Ground surface elev. ft. Depth to limiting factor / in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 ® Boring # E] Boring -01 Pit Ground surface elev. &I, 0~7 ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 r L,4 jta Effluent #1 = BOO > 30 < 220 mg/L and T >30 < 150 mg/L • Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signatur CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address I Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 Z 715-246-4516 P Property Owner _ Parcel ID # Page of Boring 1-31 # ❑ Boring IvZ ll Pit Ground surface elev. Y I. Z_ 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 o -/0 7- o-9© ~d1 Iv w/ 1 a 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 a Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil Application Rate Horizon Iepth Dominant Color Redox Description- Texture Structure Consistence Boundary Roots GPDIff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BODS > 30 < 220 rrg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L I 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. 580.8330 (8.6/00) Property Owner _ Parcel ID # Page of Boring a Boring # pit Ground surface elev. ~ -7 ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Colo Redox Description Texture Structure Consistence Boundary Roots GPD/k in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 l q0 I a 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 GPDAf in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2 F-1 Boring # 11 E] Pit Boring Ground surface elev. ft. Depth to limiting factor in. Soil ication Rate . Horizon ")epth Dominant Color Redox Description. Texture Stricture Consistence . Boundary Roots GPDAf in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD5 > 30 < 220 mg/L and TSS >30 < 150 mg/l_ ' Effluent #2 = BODS 130 mg/_ 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. SBD4330 (8.6/00) * A i Soil Test Plot Plan Project Name Richard Stout Shaun d Address 1353 Awatukee Trail Hudson Wi 54016 (6* #226900 Lot 4 Subdivision Chabre Date 6/7/12 S W 1/4 S W 1/4S 5 T 30 N/1319 W Township Somerset Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of power box System Elevation 94.0/93.9/93.8 -HRpSameas Benchmark Property Line Scale is 1" = 40' unless otherwise noted B-2 5' 15% SLope Tested area has been cut, old golf course Hillside 0% SLope B-3 80' 2 250' B M * 40' 35' 40' 12% SLope 4 04 hy-d 20' 59 B-1 10% SLope Property Line 4 172nd Ave me elm OF IM MNI M age scrw-2 r s , ! : ' - . ' .J..........._.... 9544,00 4VtG BLF 1 4 44.1 T 2B&7W TOWN READ ~ o ap'"V W T s Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page of Bureau of Integrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must"' County include, but not limited to: vertical and horizontal reference point (BM), direction and , Crbt percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # 71 (9 3 _0 OD APPLICANT INFORMATION - Please falY1 formation.". Re ed b Date Personal information you provide may be used for se d 3yp"purposes (vacy Law, F. 15.04 (1) (m)). Z D Property Owner Property Location n. Govt. LOt J 1/4S _f 1/4,S T E (01 Property Owner's Mailing Address Lot,# Block# Subd. Name or CSM# 1 E TY City State Zip Code Rhone"'I (*tnlbr E, City ❑ Village ~ Town Nearest Road d W1 CI16a" (7/5 7 7~> -7-- 7 2rt New Construction Use: Residential /Number of bedrooms '~_Z _ y Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow (9 0'_ gpd IOC>6 Recommended design loading rate _3_4 bed, gpd/fit' - Q trench, gpd/ft2 Absorption area required l 6~O bed, ft2__ -trench, ft2 Maximum design loading rate bed, gpd/ft? . G trench, gpd/ft2 Recommended infiltration surface elevation(s) C4 Z • S~ ^ ft (as referred to site plan benchmark) Additional design/site considerations s C e. y • I • S U Parent material 40 k Flood plain elevation, if applicable 24Z ft S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U = Unsuitable for system ❑ S [a U Q S ❑ U ❑ S [;i U ❑ S C~ U ❑ S W U ❑ S [ U SOIL DESCRIPTION REPORT eide co 4w Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft2 Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 11sA,h I 1 o"Z, c 5 14 Z Z -9g L'S Ground elev. U-10-ft. Depth to limiting facjgr , Remarks: Boring # -Z l 2 S; Zrlla -fir- CS s Z 2 Zy- (p - 5d 2- ineJUK rY) ~ r S Ground elev. 94.t7~ ft, Depth to limiting f or in. Remarks: CST Name (Please Print) Signature Telephone No. Address Date CST Number Z.~ 13 ~O 5 >e-T SYv 5 S !S -mac, Z S33o t 40 SOIL DESCRIPTION REPORT PROPERTY OWNER Page Z of PARCEL I.D.# 61d ntd Zb a Coc{t Borin # Horizon Depth Dominant Color Mottles Structure 2 I 9 Texture Consistence [Boundary Roots ~Y in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Ground 3 F~ S i 2 rY ~r L S elev. `ll.5o ft. Depth to limiting factor , J~L-in. Remarks: Boring # ✓ 1 6-6 - 6 r 3/.3 5 I z >m r' 41 7810 L. zwtb k m r, eleY ft. Depth to limiting Ia l~j ?f GL S Z factor QctSI V~ -O -in. r 1 /0 Remarks P1O COnUe~rAI S~Sj-e vv\ b4ACck 1'5 7! On 1! Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ,Trench Boring # Ground elev. ft. Depth to limiting factor in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD-8330 (R. 07/96) J SOIL DESCRIPTION REPORT PROPERTY OWNER Page Z of PARCEL I.D.# 614 nt V cent c Me Boring # Horizon Depth Dominant Color Mottles Structure 2 I Texture Consistence Boundary Roots JI in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench ► 6_ l0 r 3/2 ~ I 2 mab A- !f V s Ground 3 I F-r `t S I 2 rY b nr) -F~ 5 Zo elev. qI•5o ff. Depth to limiting factor , .3'4 in. Remarks: Boring # 0-~6 -16w-3/3 SCI z m ✓ 41 ro 78~ _ ele ft. Depth to limiting q-S C-rl Z - a 07 t~ ~U, factor min. Remarks: PQSS, ~(k_ ('o~U~✓t-4~~r~) e v WlG<<l ->C1 S- an 10~ Horizon Depth Dominant Color Mottles Structure GPD/ft2 Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Boring # Ground elev. ft. Depth to limiting. factor in. Remarks: Boring # Ground elev. Depth to limiting factor in. Remarks: SBD-8330 (R. 07/96) PAGE 3 OF_ NAME LOT# t LEGAL DESCRIPTIONSw `/,SwV4 S S T3a N,R I S E (or) ~ SCALE: F'= ('00 , BM I ELEVATION 100- C) BM I DESCRIPTION4a, (i n (2 uw~ t.~/ F/aT BM 2 ELEVATION ~00 ' y BM 2 DESCRIPTION 1Aa -1 , n 12, I&t w` e„J / F SYSTEM ELEVATION `I Z . Sd I ALTERNATE ELEVATION t(~- CONTOUR ELEVATION ~d 33 .t z ~o L b Oi (y23 2` I SIGNATURE DATE S~~-5