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HomeMy WebLinkAbout038-1078-95-005 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 552394 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: Soden, Doris Lee Star Prairie, Town of 038-1078-95-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: M ) 61EA- 18.31.18.324 TANK INFORMATION 19, ELEVATION DATA TYPE MANUFACTURER ► CAPACITY STATION BS HI FS ELEV. Septic Benchmark J Z / ,Z lh4.Z Dosing Alt. BM~o 4--,, 6.3 o ~v~ '1 Cow Aeration Bldg. Sewer Q , fie.. a ~XI (0.3 7 Holding St/Ht Inlet 7.4 er- 2, TANK SETBACK INFORMATION St/Ht Outlet 111~ 1_~ TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet ` Septic "7 510 ' ka _ Dt Bottom Z 257,1 Dosing 7 56 / 7/ ~ .l Header/Man. A 5 g M -ye, J Aeration O0 Dist. Pipe _7• X_ 4772, a Holding Bot. System $ `f (p T L-0 '75 - 6, / PUMP/SIPHON INFORMATION Final Grade 3 • 16I Manufacturer f-/1 110 DPn and St Cover~~l `e 2A /ix ~3 Model Number { / ► cy , V(' G ~V b I Loss System H~/gad„ TDFJ /t TDH Lift Friction Lo c! ~ / Forcemain Length / Dia.Z Dist. to Well / Z~ SOIL ABSORPTION SYSTEM BEDITRENCH Width I Length / No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liqui Depth DIMENSIONS ;5 b Z SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: r 1 INFORMATION Type Of System: j CHAMBER OR y/~~►' ~?"fara~ UNIT Model Number: u DISTRIBUTION SYSTEM ZZ 4-ZZ Header/Manifo14 it Distribution x Hole Size x Hole Spacing Verlt to Air Intake Length Dia Length Dia Spacing` SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only e C Depth Over Depth Over xx Depth of xx Seeded/ gp\dded xx Mul hed Bed/Trench Center Bed/Trench Edges Topsoil Yes 0 No Yes No 45 1 COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: 0 Location: 2110 90th Sr.- et SOMERSET, WI 54025 (SE 1/4 SE 1/4 18 T31N R18W) 40 acres Lot :5 Parcel No: 18.31.18.324 l ~ 1 1.) Alt BM Description = t Cap l.l_ J jr of- / T ` 2.) Bldg sewer length = r A A.,d- 01P / G~ / -amount of cover = G -bow Plan revision Required? g Yes kNc -7 it, a Use other side for additional information. SBD-6710 (R.3/97) Date Insepctor's Si ature Cert. No. commerce.wl.gov Safety and Buildings Division county V,01 W. Washington Ave., Y.O. Box 7162 ~fp l ' a'~Q~,~' ,G Madison, WI 53707-7162 Sanitary Permit Number to be filled T. by (o.) Deparbnwd of Comme !F ' -r~ i. Sanita~ \\~IYI! A ~jCatjAjj State Transaction Number In accordance with s. Comm. 83.21(2), Wis!`Adm. Cogc, s (~p691 a of this form to the appropriate governmental 3 9 unit is required prior to obtaining a sanitaip -iO~ot : Application tomes for state-owned POWTS are Project Address (if different Van mailing address) submitted to the Department of Commerpt sonal information you provide may be used for secondary purposes in accordance with the Privacy lP s. 15.04 1 m , Slats. L Application Information - Please Print All Information Property Owner's Name parcel # p f Property Owner's Mailing Address Property Location 4& 3 2~) I L7 9 c4• Govt. Lot City, State Zip Code Phone Number y,, Section ~ i-met 1,4J 41012 (ycrc.le one ,So . Type of Building (check all that apply) Lot # TN; R l/O E )&or 2 Family Dwelling- Number of Bedrooms Subdivision Name Block # 2 ❑ Public/Commercial - Describe Use ❑ City of ❑ State Owned - Describe Use CSM Number 1-1 Village of j f` ~<wn of1~/-- III. Type of Permit: (Check only one box-a line A. Complete line B if applicable) A. ❑ New System 14-eplacement System El Treatment/Holding Tank Replacement Only [I 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 1 W. Type of POWTS S stem/Cam onent/Device: Check all that al 0 Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ t Grade ❑ Mound ? 24 in, of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ~za/treatment Device (explaut), V. Dispersal/Treatment Area Information: t!~ ~^c Design Flow (gpd) Design Soil Application Ratg(gpdsf) Dis rsal Area Required (s0 Dispersal Area Proposed (st) Fystem Elevat n pt` VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units Y New Tanks Existing- Tanks L o a a. U in rn U a Septic or Holding Tank 4L ~P~- 4- C Dosing Chamber VIL Responsibility statement- I, the undersigned, sssu pon"ility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumb t ature MP/MPRS Number Business Phone Number ~C Plumber's Address (Street, city, state, Zip Code) _ V1I oun /De artment use Onl Permit Fee Date Issued Issuing Agen Sign re Approved ❑ Disapproved ❑ Owner Given Reason for Denial G~i-- LX, S4pg s ~val/Reasons for Disapproval 3 J~ 1 Septic tank, effluent filter and 4 Slo5 3,Y3 .3 3 dispersal cell must all be serviced / maintained 7 as per management plan provided by plumber. 2. All setback requirements must be maintained c 9... mp e p ns for the system and submit to the County only on paper not less than a ltz 1L "'aches io size SBD-6399 (R 02/09) PLOT PLAN PROJECT Doris Soden ADDRESS 2110 90th St. Somerset Wi 54025 SE 114 SE 1/4S 18 /T 31 N/R 18 W TOWN Star Prairie COUNTY ST. CROIX 7/12/12 BEDROOM 3 MPRS Shaun Bird 226900 DATE CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT XXX HOLDING TANK SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE630 gallons DOSE TANK SIZE MOUND HOLDING TANK SIZE LOAD RATE • 5 ABSORPTION AREA 930 # of chambers 45 BENCHMARK V.R.P. top of 1.5" pipe ASSUME ELEVATION 100' Filter BEST Filter ❑ BOREHOLE 0 WELL * H. R. P. Same as Benchmark SYSTEM ELEVATION 95.8/95.4/95.0 T below qrade All piping shall be SDR 30/34, within 10' of tank, piping shall be Schedule 40. Vent 90th St. Scale is 1" = 40' >6" Quick4 Standard of Cover Leaching Chamber unless otherwise with 20.0 ft2 of Area noted 4' Long 12" 10.2ft^2/pair of end caps Grade at System Elevation B-2 3411 Vents Plans Designed Using B M * Conventional Powts Manual Version 2.0 7 Well is to meet all 20 B-3 setbacks required by 3-3' x 62' cells WDNR Old System is to be 10' with >3' spacing pumped and b rried 3 3 Driveway ailed SQS 7% Slo Huffcutt Combo Tank D W 140' 150' ST B-1 10' Line is to be insulated under 90' driveway as per really good idea! Well 00' xisting 3 edroom 30' House 100' 1, 1 IF 30' 100 210th Ave Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715-246-4516 Date: 7/12/12 Owner: Doris Soden Location: SE1/4 SE1/4 S18 T31 N,R18W 2110 90th St. Star Prairie 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 # 90900 PLOT PLAN PROJECT Doris Soden ADDRESS 2110 90th St. Somerset Wi 54025 SE 1/,4 SE 1/4S 18 /T 31 N/R 18 W TOWN Star Prairie COUNTY ST. CROIX 7/12/12 BEDROOM 3 MPRS Shaun Bird 226900 DATE CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT XXX HOLDING TANK SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE630 gallons DOSE TANK SIZE MOUND HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 930 # of chambers 45 BENCHMARK V.R.P. top of 1.5" pipe ASSUME ELEVATION 1001 Filter BEST Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 95.8/95.4/95.0 5' below qrade All piping shall be SDR 30/34, within 10' of tank, piping shall be Schedule 40. Vent 90th St. Scale is 1" = 40' >6" Quick4 Standard of Cover Leaching Chamber unless otherwise with 20.0 ft2 of Area noted 10.2ft^2/pair of end caps 4' Long 12" Grade at System Elevation B-2 34 Vents Plans Designed Using B.M.* Conventional Powts Manual Version 2.0 Well is to meet all 20' B_3 setbacks required by 3-3' x 62' cells WDNR Old System is to be 10' pumped and b cried 33 with >3 spacing r Driveway 7% Slo Huffcutt Combo Tank 140' 150' B-1 10Line is to be insulated under 90' driveway as per really good idea! Well 100' Existing 3 Bedroom 30' House 100' 30' 100 210th 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 100.0 Vent Grade Vent 4' 4„ j4p X30/34 Septic Tank 4' Long 1 19 5' 4' Long 1,9 Grade at System Elevation 34" Grade at System Elevation 3 Spacing 5' 3-3' X 62' Cells Observation tubeNent Same on other end To be located on end of Cells A B System elevations: C A__95.8 B 95.4 15 chambers per cell C__95.0 I •c_Dose Wank Cross Section And Pump Performance Specifications Septi Pump Manufacturer .4Tank Manufacturer Pump Model Number Tank Model Number 0 Alm ufacturer GGh~ S Total Tank Capacity 3 Alarm Model Number v Max. Bury Depth Switch Type !n~ Total Dynamic Head (TIM) -Feet Filter 09E Elevation Head Filter i '-7 Distal Pressure t Network Loss Minimum Pump ~'erformatrce Required Force Main Loss ji GPM' Ft TDH Total Outlet Manhole Min. 4" Above Grade With Manhole Min. 4" Above Grade Locking Deice. Inlet Manhole With Locking Device Securely Mounted < 6" Below Grade Sealed Watertight Weather-proof 1 Junction Box OW '00 + Finished Grade Vent Min. 12" Disconnect Above Grade Means With Vent Cap outlet Filter Inlet Baffle Inlet A '/a" Switch Settings and Reserve Capacity Weep 'l'ank Volume GPI B Hole Dimension Inches Volume Gal. (reserve) A 3 3 Z pg levation C 2. 0 (alarm) B ~ Ft Bottom ` (dose) C > S" / 2 ' S Elevation l 3 S" g~ (dew) D : D J Ft Total Z • > ; _ septic/dose tank is bedded and back filled in accordance with the th of bury as specified. by the manufacturer may not GENERAL INSTALLATION. The manufacturer's product approval specifications. Maximum dep (padlock) be exceeded without prior approval. Manhole covers exposed to grade have an effective locking device fittings, and in at the. inlet and outlet is of approved material, connected to the tank with watertight mare is sleeved with 4" Sch. 40 PVC to bridge the tank installed. pip in settling et is of approved laid on stable sort to prevent or sagging., The force is sealed watertight. Electrical service complies with NEC 300 and Comm 16.2:1. excavation and the sleeve Page of 02/05 L7 Sent 9y: HP LaserJet 3100; 1 715 5b? t1deI wu y•a-ury tr~7W`Nfl~ a may.. 0 LP _:~.j 9EH SERIES SUMP/EFFLUENT PUMP O m m u. 0 eras mom am s ~ .1tss m a O Lb) t K M it W ! Ou ow Nstrsd 1 S M WOR 4N 115 $4 W In 70 64 65 41 62 111 26' ft I'll 111614 W&W SEI2806 ma V-D W0 a1! 85 1006 70 64 55 A 82 138 W 24 111 s 11.$ AS eet4WWG WOO WA 404 11S so lie in 70 W 55 a 88 418 26' V 8.11 I11mit81 a.+..K m442-0 8r1 85 i~ 70 51 SB 14 42 118 1U a all If il- N G~biisuui0tlgrp~Y1-"tislrt~IpM1~FpYINM7N1»dcow~IM~AIlIm Nlllcby~(b11MINb_I~II~Id~~RMAIIMDYII~i." FLOW- LITVWU k7tft lfA1C~1an 0 loco am 3000 Motor Houabig EVM Coated C st iron --I -fill 11 _fs1EeEler SldafeciaE Po C*bonm Cload Wm to vWutre A M Power SJTW-A 'au Mcchmical Shaft Sod Nitrile with carbon SM ceramic faces - s Fasten" _ Stsbeless :4t+eeE i to Shaft gS.inidra Steel Upper Sleeve and Lower S3earingr PAdl Seariaga 0 20 W 60 80 rLOV- GALLON4S/SOWTE PUW PERPORKWE CURVE Wim LKtte (fit nURP Ca 11su bOHZ VO im tlrt# • a*"" 4fy1, 73157 rtoo n4amim•n,=Meanssss r.+.« www.umeoiamtftmp.com 43 Farn 9ersa--07M POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page iI of FILE INFORMATION SYSTEM SPECIFICATIONS Owner Septic Tank Capacity j Ocro al ❑ NA Permit # 39 Y Septic Tank Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer - EA fz_ ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA al El NA Number of Public Facility Units ,NA Pump Tank Capacity 3e> g Estimated flow (average) al/day Pump Tank Manufacturer NA Design flow (peak), (Estimated x 1.5) J al/da Pump Manufacturer ❑ NA Soil Application Rate ' -5- al/da /ft2 Pump Model ❑ NA Standard Influent/Effluent Quality Monthly average* Pretreatment Unit NA Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BODs) <_220 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 (BOD5) 530 mg/L n-Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L ANA ❑ At-Grade ❑ Mound Fecal Coliform (geometric mean) 5104 cfu/100m1 ❑ Drip-Line ❑ Other: Maximum Effluent Particle Size X in dia. ❑ NA Other: ❑ NA Other: NA Other: ❑ NA *Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: ❑ m a~ts(s) (Maximum 3 years) ❑ NA Pump out contents of tank(s) When combined sludge and scum equals one-third of tank volume ❑ NA [I month(s) (Maximum 3 years) [3 NA Inspect dispersal cell(s) At least once every: rear(s) ❑ month(s) ❑ NA Clean effluent filter At least once every: t/ ear(s) Inspect pump, pump controls & alarm At least once every: ❑ onth(s) ❑ NA ear(s) ❑ month(s) NA Flush laterals and pressure test At least once every: ❑ year(s) Other: Omonth(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 (f6) 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. Z START UP AND OPERATION Page of?/ 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 replacement system: ❑ A 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 olding 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 ust 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 cS V' f l Phone L F Phone - 71 j._,c, V&- -_Z, 64 SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORITY Name ` Name Phone JJ Phone This document was drafted in compliance with chapter SPS 383.22(2)(b)(1)(d)&(f) and 383.54(1), (2) & (3), Wisconsin Administrative Code. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer j- ® ~ Mailing Address Property Address 5--~-- - (Verification required from Planning & Zoning Department for new construction.) City/State - .Parcel. Identification Number ©c~ ?3 - /D r LEGAL DESCRIPTION Property Location 5t~ 1/.,:5,F '/a Sec.) , T N R, W, Town of Subdivision - Lot Certified Survey Map # , Volume - Page # Warranty Deed # Volume Page # _ - Spec house yes 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 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 fidl of sludge. I/wee, 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 this form are true to the best of my/om 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. Number of bedrooms - z-SIGNATURE OYAPPLICANT(S) 7 /l - - DA TTE ***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. 108/05) FILTER CARTRIDGE INSTRUCTIONS Installation aTEroY b I ~Ir ry 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. STEP While the case is still dry fitted on the outlet pipe, measure the length of 3A-inch pipe needed to brace the filter to the tank end wall if utilizing the optional supplemental side support. If side support method is not utilized, proceed to step four. , 7 FP = For installations utilizing the optional supplemental side support: solvent weld the V.-inch pipe onto the filter case. If side support etho utilized, proceed to step four. method is not Solvent weld the filter case onto the outlet pipe. Insert cartridge into the case, pressing down until the filter locks into he bottom of ~1 "j `t the filter the case. j I If a VRS switch is utilized- insert into the filter and lock by turning clockwise 900, Maintenance 1. The effluent filter should be cleaned every time the septic tank is serviced. 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. 5. Slide the cartridge up and out of the case for cleaning, 6. If a VAS switch connected to an alarm is present, the switch should be removed by turning counterclockwise 900 and cleaned with water only, 7. While holding the cartridge on its side (large flat surf-ace facing i" down) over the access opening, rinse off the cartridge with water only, making sure all septage material Is rinsed back into the tank. l U, • 8. If VRS switch is utilized, replace by inserting into filter and turning clockwise g0 9. Insert the filter cartridge back into the cast t}^ the filter locks into the bottom of the case. Pressing down until Y• v 0. 10. Replace and secure the access opening on the tank. www.beammmte.corn 877-MLFILTIERS (653-4583) 12 . . 55 US w 'mac r ' -:JA - _ J ~ - VM~ ~ ~SC1D~F1M1lY'}~M7^P•` - - 1~83 1406 ~2*$> 77 1f4 Ciflafltit~~te®ieLndarmas and~or~its{~t tom-- . - _ _ - - t } _ =s ntr Lss sspa ~o►Y~ivti~3f a~° lt [ i=stlaf _ 5-Mamm ca-p-= - 9 z,' =cam _ - - * ? ; M, , 51 - z i`' 6>~`~K Fite '~'-yi"- - - _ - _ __I:'.•~ l-~ _ Scj h df tih~asti ` ( ? of je ttiQn 18, snap 1;~ ~c Ramie. 1$I~P~ , JSSSbusd tu~tbn - Equal Value Re~rdi 'f7ste z ` ' 06.003 .~i9 Fig ~34 : - s~K P.acondi f?at7e~ on' ~4uplisltf`Vatu® _ Mt' , : ~ dtion Equalized V*lU* Date u. - . 'trie c ~4 nth ha abo+rs ►arrred decedent•and tli gr~S$ t~Fiaistt tee. sst bfe tai&n Jvor r sw ~s1 Yet filsoppyc tiWt ?ttno beiiaf a true od,t ct and cbmplete andIs in conformity whit, the prc*l ' ns and lira. itsion'S~bf itra w-s-C-f B1111T, 6vs9 ~t# ~J t rife Tenan* fiams►ir~derman-' awres all mutt sign M,~ F 4~`~ 3>fna 16, 1486 LL , f ` rtifyt6t I, Ws * ml*d or deiiwr`d c6 Ne of this. iCation-ai Provi in i.-887.0"W. WWStBts. on Y 044.0 JamQf~ri tiell - s n - - - iiRef of t}abdt ` - R ryes drafted by (pd"i or"type name) - ORIGINAL Wisconsin Department of Commerce SOIL EVALUATION REPORT Page/ of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County /1~ Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must ll include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 3 8~ A ?9 Py -pfjv Please print all information. R viewed b Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 711 P Owner Property location 0 t Govt. Lot -fC 1/4,5,6 1 /4 S Ig T 3 N R/9 E (or -15- Sp 1bFj Property Owners Mailing Address Lot # Block # Subd. Name or CSM# 9 - I City State Zip Code Phone Number ❑ City ❑ Village :W Town Nearest Road So r~efsP i 6VDC4 -1( ) os4 , ❑ New Construction Use;2esidential /Number of bedrooms 3 Code derived design flow rate ydu GPD Replacement ❑ Public or mmeraal - Describe: Parent material 40 Flood Plain elevation if applicable /V 1r5~ ft. General comments an re,omimendations: /9 ~o . /X22 5 13el~c J 9 ~GiS~Jn / erwrs System Type System Elevation S Boring # Boring 1 Pit Ground surface elev. ft. Depth to limiting factor //L7) in. r*Eff#l 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#2 V, 2 Y94 4 Boring # Boring / 4 ® a Pit Ground surface elev. / ty , 8 ft. Depth to limiting factor ~ in. Soil Appli 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 ~S Q~ t &2 Ova tylA Effluent #1 = BOD > 30 < 220 mg/L and TSS > mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Si Lure CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, 54017 7-,12-12- 715-246-4516 Property Owner _ Parcel ID # Page of Boring # ❑ Boring pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 1&-~ 3 z S ~s 1 ~t7 2 4-419 13 4!2 I -A -T E Boring # ❑ Boring ❑ 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 F-1 Boring # ❑ pit Boring ❑ Ground surface elev. ft. Depth to limiting factor in. Soil lication 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 Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mgA- ' Effluent #2 = BOD, 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. SOD-8330 (8.6=) Soil Test Plot Plan Project Name Doris Soden Shau Ird Address 2110 90th St. _ Somerset Wi 54025 CST #226900 Lot Subdivision Date 7/ 2/12 SE 1/4 SE 1/4S 18 T 31 N/1318 W Township StarPrairie ❑ Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of 1.5" pipe System Elevation 95.8/95.4/95.0 *HRpSame as Benchmark Scale is 1" = 40' 90th St. unless otherwise noted 99' 101' B-2 B.M.* 30 20' B-3 20' 10' e Failed , 7% Slop 5' DW 150' 15' S B-1 90' Well 100' Existing 3 Bedroom 30' House 14 100' 30' 100 2 10th Ave c r 3 rn z= o m Cl) W- o 'T 0 O D) to N O OD w 1 • :7 a w o CDa a _ C m a m A? O O p,1 CD CO O o d. O 9D N a 9 N CA q 00 €7 7 (6D 0 N p 0071 ~ O 0) C 6 ~ . O .r C f 00 C7 a1 m N O N v^ Z n o M C o aj a c c o 3 o o (D W O Cn a 0 0 0 " N O e 0 0 cn cr_ 3 N o v m°^.' • z OOO @ tv 0 p ID ~E3cD Cr D O 0 N d _ N lr d CJ7 N ~ T ~ m CL y m 0 0 O -ma ' 0. m h • x m y C -U CD C (D w @ a a 3 7 z CD to '.i -1 y N r .0 N A z 3 W m j 6; z CL , 0 3 0 cn 3 m 00 00 y z fD A I w D a 'I CD a a a - w '1 CD - -o. o a N 0 0 O a N CD w a ~ i I ~ ' N O I C V O b O (D ~ a H fA 0 O ~ a CD Q Wisoonstn Department of Health and Social Services Pib. #67 3r0 Division of Health SEPTIC TANK PERMIT APPLICATION TYPE or USE BLACK INK n j STS D 3f- lo- d f s • `~•Z1 V v C A. OWNER OF PROPERTY Name Address (Street, City, Zip Code) I B. LOCATION OF PROPERTY WHF..RE SYSTEM WILL BE CONSTRUCTED ALTERED oR EXTENDED COUNTY Check Ones CITY VILLAGE LEGAL DESCRIPTION TSH C. IS LOCAL PERMIT 'REQUIRED FOR THIS WORK? YES _ NO PERMIT NUMBER D. SEPTIC TANK CAPACITY Gallons NEW INSTALLATION REPLACEMENT ADDITION MATERIALS: Prefab Concrete Poured in Place Steel Other NUMBER OF TANKS TO BE INSTALLED: / E. TYPE OF OCCUPANCY Check Ones One or Two Family Recid nce Commercial. Industrial Other Specify Number of Persona to,be Accommodated : Number of-Bedrooms 5 F. APPLIANCES, ETC: Food Waste Grinder YES_ NO Automatic Clothes Washer YES NO Dishwasher YES NO Automatic Potato Peeler YES_ I NO Other (Specify) G. MASTER PLUMBER MAKING NSTAI j ATION Name: Address: License Numbers MP _ i Signature of Applicants 2 5 = 4 -.z. MP RSW _ i Address: H. (To be Completed by Issuisl; Agent) Date of Application / o17 Fee Paid Permit Issued (dat7 Permit Number l Agent (Name) "-(~f'(~ YC- Y_~)'-l Fors k/ - Town, Village, City, County, etc._ (Specify) Notts The application oannot be considered for filing until all of the above questions are answered and the fee paid. Agents will forward application, the fee of 41.00 for each septic tanx and the third copy of the permit (canary) to the Division of Health. Checks and money orders should be made parable to the Division of Health. Do not write in space below FOR DEPARTMENT USE ONLY I. DATE RECEIVED ACCEPTED BY RETURNED (Initials) (Date) See Cores FEE RECEIVED VALID. No. ~OZ 9 3 PERMIT NO. _ _V, es or No REVIEWED BY APPROVED DATE (Initials) Yes or .No COMPLETE OTHER SIDE ' SEPTIC TANK PERMIT NO. 9, r' R Z P 0 R T ON SOIL Pt R C 0 L A I 1 0 N T t S T A N D S O I L B O R I N G S ?0 DIVISION OF HEALTH - PLUMBING SZCT16N P.O.Box 309, Madison, Wis. 53701 Pursuant to H 62.20, Wis. Administrative Code P E R C O L A T I O N T E S T Test Depth Character of Soil Hours Hater Test Time Drop in Water Level Inches Minutes Number Inches Thickness in Inches Since Hole in Hole Interval Second to Next to Last To Fall Example 1st Wetted Overni in Minutes Last Period Last Period Period One, Inch P - 0 3610 ?o Soil 10N Cla 26" 25 Yes or No 30 J2 112 1/2 60 RECORD DATA FROM MINIMUM OF 3 TEST HOLES Compute size of absorption area in accord with H 62.20 Wis. Administrative Code. S O I L B 0 R I N G S- Minimum 36N Below Pro osed Abso tion S stem Boring Total Dspth Depth to Ground Water De th to Bedrock Number Inches Observed Estimated Observed Estimated Character of Soil with Thickness in 2noh83 Example B - 0 7]210 72#' Black -To Soil 12" C1 18l' Sand lE". Gravel 2411 • ~ /-fit RECORD DATA FROM MINIMUM OF 3 BORE BOLES PE OF OCCUPANCYs RESIDENCE- Number of Bedrooms ~ i OTHERS (Specify) Number of Persons .a' FOOD WASTE GRINDERS Yes No Dishwashers Yes No A- Automatic Clothes Washers Yes No t EFFLUENT DISPOSAL SYSTEM- NEW EXTENSION ADDITION REPLACEMENT Tile Size 4~' No.Lin.Feet % Trench Width Depth / Number of Lines Seepage Beds Length Width Depth Tile Size No. Lines Seepage Pit: Inside Diameter ? Liquid Depth Is the undersigrsed, hereby certify that the percolation tests reported on this fors were made by me or under my super- vision in accord with the. procedurss and method specified in Chapter H 62.20 (13), Wisconsin Administrative Code, and that the data recorded di location of test holes are correct to the best of my knowledge and belief. NAME s / /I~ f'• t_ F r: TITLt~ Type or Print REGISTRATION NO. , or MASTER PLUMBER LICENSE NO. ADDRESS c / DAB J C SIGNATURE Parcel 038-1078-95-000 06/18/2007 10:23 AM PAGE 1 OF 1 Alt. Parcel 18.31.18.324 038 - TOWN OF STAR PRAIRIE Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner DORIS P SODEN O - SODEN, DORIS P 2110 90TH ST SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 2110 90TH ST SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE SEC 18 T31 N R1 8W SE SE Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 18-31N-18W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 743/472 2007 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 10/05/2005 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 9.000 1,400 0 1,400 NO UNDEVELOPED G5 16.000 37,600 0 37,600 NO OTHER G7 3.000 30,000 92,700 122,700 NO MFL BEFORE 2005 OPEN W7 12.000 30,000 0 30,000 NO Totals for 2007: General Property 28.000 69,000 92,700 161,700 Woodland 12.000 30,000 30,000 Totals for 2006: General Property 28.000 69,000 92,700 161,700 Woodland 12.000 30,000 30,000 Lottery Credit: Claim Count: 1 Certification Date: Batch 212 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 STAR PRAIRIE T 3 1 -J i POLK COUNTYI I R. 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