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HomeMy WebLinkAbout006-1074-95-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 552397 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: TPOH LLC C ton, Town of 006-1074-95-000 CST BM Elev: Insp. BM Elev: BM Descri~~' n Se : ction/Town/Range/Map No: pp LL O 33.31.16.509 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark J~~C b Dosing O Alt. BM Aeration / ll Bldg. Sewer - S l V (L- 30 W G •~6 S(a W Holding S t nlet TANK SETBACK INFO RMATIO cje- St/Ht outlet / TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic ~5 / / ~ I I ► 7 Dt/otto-m Z / 2.Jg 46'F' H- 3 ~ 2' 7 I Dosing t, , Head Aeration Dist. Pipe ~►~C 2. 6% Holding Bot. System Cs' 41-4 Final Grade PUMP/SIPHON INFORMATION Manufacturer De GPM f mand St Cover 2'311 IN. V? Model Number 3.5 13.3 TDH Lift I Friction Loss Syste H ead T~Fy' t Irv'-) Q IL- lForcemaih Len th q- Dia. Z r Dist. to Well SOIL ABSORPTIO SYSTEM BED/TRENCH Width , Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS /0 7 5 SETBACK SYSTEM TO / P/L B DG WELL LAK T EAM AC Manufacturer: INFORMATION Typ f System: ( CHA R OR • ~~f~ too UNIT Model Number: DIST ION SYS EM i ,J~•~ ,QJ~. M& Heade anifol Distribution x Hole ize x Hole Spacing Pipe(s) 5&. 241 f 1 Length Length ~ 9 Dia S Spacing / / Ff 7 SOIL COVER x Pressure Systems Only Mound Or At- ade Sy s my V-5 ~ Depth Over Depth Over xx Depth of ee odded Mulche Bed/Trench Center Bed/Trench Edges es No ❑ Yes ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / I Inspection #2: -7 2- rvN Location: 1850 CtY Rd O New 'chmond, WI 54017 SE 1/4 N 1/4 33 T5iN R1 6W) 40 acres Lot ' • _J Parcel No: 3.6.50 T T- a 1!~ q/- 1. Alt BM Description =1 U 1 J ~ " "4 1 ° `Sd 3 9 - " 2.) Bldg sewer length S1 bJ - t/Yt L - amount of cover f ~ Cep Sbc~ Plan revision Required? Fr-1 Yes X/No / e r -7 -7 Use other side for additional information. C (P SBD-6710 (R.3/97) Date Insepctor's Signa ure Cert. No. HARDINA SEPTIC SYSTEMS MPRSICST 824825 ~a?Te w< o ~ s 1e~4 ~ ~ Cv ~~2 - V rh yl-e Pp ~rG ~c utw y~'1 Q' Os /oaolGOb CAL t f4'65'r 44 i Safety and Buildings Division County lVisoDonsin 201 W. Washington Ave., P.O. Box 7162 ' j7, t) Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) De ar nt of Commerce (608)266-3151 55 Z 39 7 Sanitary Permit Applicat;'' n State PlanLD.,yNumber J (Oct In acrd with Comm 83.21, Wis. Adm. Code, personal infon~~ y vide c2 cS `,m4y~p ised for secondary purposes Privacy Law, sl5. roject?Address (if different than mailing; address) O (15~b d 1. AppQc on Inf ation - Please Print All Information ` . 70 Property Qwpei. ame Parcel # Lot # Block # Property wner's Mailing Address Property Location P~ . g© 56 dLo Section S'.5' City, State Zip Code Phone Number . ~o~ (circle one) ~cJ T51 N; RE or W U. Type of Building (check all that apply) Subdivision Name CSM Number or 2 Family Dwelling - Number of Bedrooms ❑ Public/Commercial -Describe Use / 7o s~ ❑City_❑Village Township ofCy lAJ El State Owned - Describe Use III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ❑ New System kMeplacement system ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. T of POWTS System: Check all that apply) ❑ Non -Pressurized In-Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil 14"At-Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In-Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel-less Pipe ❑ Other (explain) V. Dis rsallTreat ut Area Information: Design Flow (gpd) Design Soil Application Rate( pdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation d► a a `75 y'3: 3a C~ -rc VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing / Tanks Tanks Septic or Holding Tank O df 7 Aerobic Treatment Unit Dosing Chamber 4nv- Lice VII. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signatu MP/MPRS Number Business Phone Number ZY 4r Plumber's Address (Street, City, State, Zip Code)- 5/77. / -707* 9 . t t. LAU 5 VIII. Coun /De artment Use Only Approved tsa Sanitary Permit Fee (includes Groundwater Date ssued Issuing nt Sign to Surcharge Fee) ~5 /2 ~ al ❑ msonf_-,-berti 60 IX. Conditions of Approval/Reasons for Disapproval r t , 51~.~e. d SYOT ul owl s: 3) 'I; `'3 ptic' tank- effluent filter and j1e_1A%0& dispersail cell must all be services I maintained tt*90 management plan provided by plumber. 2. fl`aexbackre4uirements must be maintained ss per appkable code, ordinances: L~ J U~ Attach complete plans (to the County only) for system on paper not less than 81/2 x 11 inches in I. SBD-6398 (R. 01/03) „ ~~1~o~rTNT Safety and Buildings ° 10541 N RANCH ROAD ,10 7~ HAYWARD WI 54843 3 j S Contact Through Relay -e P S www.dsps.wi.gov/sb/ www.wisconsin.gov A ~ L ~ ~O sSIO14 Scott Walker, Governor Dave Ross, Secretary June 12, 2012 CUST ID No. 824825 ATTN.• POWTS Inspector BOB J HARDINA ZONING OFFICE HARDINA SEPTIC SYSTEMS ST CROIX COUNTY SPIA 477 170TH AVE 1101 CARMICHAEL RD TURTLE LAKE WI 54889-9187 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 06/12/2014 Identification Numbers Transaction ED No. 2086925 SITE: Site ED No. 779747 Mike Weiskey Please refer to both identification numbers, 1850 Cth O above, in all correspondence with the agency. Town of Cylon St Croix County SE1/4, NWl/4, S33, T3 IN, RI 6W FOR: Description: At grade, 3 br res Object Type: POWTS Component Manual Regulated Object ID No.: 1373544 Maintenance required; Replacement system; 450 GPD Flow rate; 40 in Soil minimum depth to limiting factor from original grade; System(s): At-grade Component Manual, Version 2.0, SBD-10854 (N.03%07), Pressure Distribution Component Manual - Version 2.0, SBD-10706-P (N.01/01), SSWMP Pub. 9.6; Effluent Filter Condit The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes APP and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed SAFE and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. p The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. SEE CORK No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s. 45.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Key Item(s) • In the event this soil absorption system malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described the At Grade Component Manual are complied with. A copy of this information must be given to the owner upon completion of the project. • The float switch shall be a type that does not contain mercury. 2009 Wisconsin Act 44 prohibits the installation of float switches or relays that contain mercury. • The designer proposes to install an effluent filter to achieve the requirement of wastewater particle size. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the septic tank outlet filter will be required. The outlet filter shall be installed per product approval stipulations. Reminder • The orientation of the at grade system must be such that the longest dimension is oriented along the surface contour per SPS 383.44(6)(a)2. BOB J HARDINA Page 2 6/12/2012' • Limit activities in the area 15' beyond the down slope edge of the at grade per At grade Component Manual. • Surface water drainage shall be diverted away from the system area. • Materials shall conform to the requirements of SPS 384. SPS 384.10. No fixture, appliance, appurtenance, material, device or product may be sold for use in a plumbing system or may be installed in a plumbing system, unless it is of a type conforming to the standards or specifications of chs. SPS 382 and 383 and this chapter and ch. 145, Stats. • The existing POWTS must be properly abandoned per s. SPS 383.33 Wis. Adm. Code. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. 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 and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, j ' Fee Required $ 250.00 This Amount Will Be Invoiced. When You Receive That Invoice, Patricia Shando Please Include a Copy With Your POWTS Plan Re iewd Services P ayment Submittal. (715) 634-7810, ax: ) -5150 , M - F 8:00 a.m. - 4:45 p.m. WiSMART code: 7633 pat.shandorf@wisconsin.gov cc: Charles L Bratz, POWTS Reviewer II, (608) 789-7893, 7:45 am - 4:30 pm Monday - Friday Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Safety & Buildings will be modified. Code references with prefixes starting with "Comm" will be replaced with "SPS" to recognize the relocation of the Division of Safety & Buildings from the former Dept. of Commerce to the Dept. of Safety & Professional Services. Additionally, all S&B codes will be renumbered and addressed in a "300" series. For future reference, the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. BOB J HARDINA Page 2 6/12/2012 • Limit activities in the area 15' beyond the down slope edge of the at grade per At grade Component Manual. • Surface water drainage shall be diverted away from the system area. • Materials shall conform to the requirements of SPS 384. SPS 384.10. No fixture, appliance, appurtenance, material, device or product may be sold for use in a plumbing system or may be installed in a plumbing system, unless it is of a type conforming to the standards or specifications of chs. SPS 382 and 383 and this chapter and ch. 145, Stats. • The existing POWTS must be properly abandoned per s. SPS 383.33 Wis. Adm. Code. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. 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 and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 This Amount Will Be Invoiced. When You Receive That Invoice, Patricia Shando Please Include a Copy With Your POWTS Plan Re iewe , Integrated Services Payment Submittal. (715) 634-7810, ax: (715) 634-5150, M - F 8:00 a.m. - 4:45 p.m. WiSMART code: 7633 pat.shandorf@wisconsin.gov cc: Charles L Bratz, POWTS Reviewer H, (608) 789-7893 , 7:45 am - 4:30 pm Monday - Friday Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Safety & Buildings will be modified. Code references with prefixes starting with "Comm" will be replaced with "SPS" to recognize the relocation of the Division of Safety & Buildings from the former Dept. of Commerce to the Dept. of Safety & Professional Services. Additionally, all S&B codes will be renumbered and addressed in a "300" series. For future reference, the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. I I AT-GRADE AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application Level Site INDEX AND TITLE PAGE Project Name: WEISKEY Owner's Name: MIKE WEISKEY Owner's Address: P.O. BOX 142 WOODVILLE, WI 54028 Legal Description: SE,NW,S.33,T.31 N-R16W Township: CYLON County: POLK Subdivision Name: Lot Number: Block Number: Parcel t.D. Number: 006-1074-95-000 Plan Transaction No.: GOnal Zy Page 1 Index and title r Page 2 Data entry v Page 3 At-grade drawings Page 4 Lateral and dose tank tY p DU1LD1 Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications ~PONDE Page 8 Piot Plan Page 9 Filter Maintenance / Page 10 Soil Data (a b,c) 0 Designer: Robert Hardina _ License Number: 824825 Date: 05/14/12 Phone Number: 715-986-2508 Signature: Designed Wursuant to the At-grade Component Manual for POW T S4, 10570-P (R. 06/99), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST - SAS (01/81) Version 4.0 (R.04/03) Page 1 of 10 At-grade and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R Residential or Commercial Design 300.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 = 150%) 450.00 Design Flow (gpd) 0.00 Site Slope 93.32 Contour Line Elevation (ft) 40.00 Depth to Limiting Factor (in) 0.60 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 75.00 Dispersal Cell Length Along Contour (ft) 10.00 Cell Width (ft) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (c or e) c Center or End Manifold 0.00 Lateral Spacing (ft) If N above, enter the elevation (ft) 2 Number of Laterals of the highest point. 0.188 Orifice Diameter (in) (e.g. 0.25) 2.00 Estimated Orifice Spacing (ft)= 1.99 Actual (ft) 2.00 Forcemain Diameter (in) 5010 Forcemain Length (ft) Does the forcemain drain back? E Y 8310 Pump Tank Elevation (ft) Enter Y or N 3.25 System Head (ft) x 1.3 8.16 Forcemain Drainback (gal) 9.99 Vertical Lift (ft) 33.38 5x Void Volume (gal) 0.67 Friction Loss (ft) 41.53 Minimum Dose Volume (gal) 13.91 Total Dynamic Head (ft) 24.58 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. r!ions choice in. dia. o t ons choice 0.75 1.25 1.00 1.50 1.25 2.00 1.50 x x 3.00 2.00 x 3.00 x E._. Gallons/inch Calculator (optional) Treatment Tank Information 627.00 Total Tank Capacity (gal) 1000.00 Septic Tank capacity (gal) 4200 Total Working Liquid Depth (in) huffcutt Manufacturer 14.93 gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 60000 Dose Tank Capacity (gal) Best Filter Manufacturer 14.93 Dose Tank Volume (gal/in) Gf 10-i -]Filter Model Number huffcutt _Manufacturer Project: WEISKEY Page 2 of 9 At-grade Plan View 1 116 B Observation Pipes (2 typical) D W A B D L At-grade Component Dimensions A 10.00 ft D 5.00 ft (ft2) Dispersal Cell Area A x B B 75.00 ft W 20.00 ft PM(gpd/ft) (fe) Total area (L x W) 116 B 12.50 ft L 85.00 ft Linear Loading Rate At-grade Cross Section View Aggregate Dispersal Area p(-' Observation Pipe Finished Grade 95.12 (ft) Typical Lateral See Details Invert (ft) Lateral 93.82 Geotextile Fabric A ~D~ 0.0 % Site Slope 93.32 (ft) Contour Elevation Shading Key See lateral details on Page 4 for the number of U Topsoil Cap laterals, size, and spacing. Laterals are equally Tilled Layer Aggregate spaced from the centerline of the distribution cell. Project: WEISKEY Page 3 of 9 Center Connection Lateral Layout Daigram l P x )I x12 ff Laterals & force Per COMM Tab1e~84 30-5jG Sch 40 Holes drilled on the bottom of the lateral, Turn-up wtballvalve or cleanoutplug equally spaced Number of Laterals 2 Orifice Diameter 0.188 in Lateral Diameter 1.50 in Orifice Spacing (X) 1.99 ft Lateral Length (P) 36.38 ft Orifices per Lateral 18.75 Lateral Spacing (S) 0.00 ft Orifice Density 20.00 ft2/orifice Lateral Flow Rate 12.29 gpm Manifold Length 0.00 ft System Flow Rate 24.58 gpm Manifold Diameter 0.00 in Total Dynamic Head 13.91 ft Forcemain Velocity 2.51 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and to Comm 16.28 WAC 4 in. min. Disconnect F-- Alternate outlet Tank component is properly vented location Forcemain diameter huffcutt Manufacturer 2 In. Capaci 600.00 Gallons T Volume 14.93 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 25.41 379.31 C B 2.00 29,86 pf ump off elevation (ft) C 2.78 A>=33"" 83.83 D 10E140.19 00 D Total Dose tank elevation (ft) Bedding under tank. 83.00 Alarm Manuafacturer s e rhombus Alarm Model Number L 101 Pump Manufacturer zaeuer _ Pump Model Number 152 Pump Must Deliver 24.58 gpm at 13.91 ft TDH Project: WEISKEY Page 4 of 9 At grade System Maintenance and Operation Specifications Service Provider's Name Robert Harding Phone 715-986-2508 _ St Croix Phone POWTS Regulator's Name E System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 750 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 MU/100 ML Service Frequency Septic and Pump Tank Inspect and/or service once eve 3 ears Effluent Filter Should inspect once a ear and clean once eve 3 ears Pump and Controls Test once eve 3 ears Alarm Should test month) Pressure System Lr terals should be flushed and pressure tested eve 1.5 ears At-grade Inspect for pondin and seeps a once eve 3 ears Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The at-grade structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished , • • • • • . Grade Threaded Cleanout 6-8" Diameter Plug or Ball Valve Lawn Sprinkler Valve Box Distribution Lateral Long Sweep 90 or Two 93.82 ft 45 Degree Bends Same Diameter as Lateral Page 5 of 9 Project: WEISKEY At-grade System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SDB-10570-P (R. 06/99) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1 /3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. At-grade and Pressure Distribution System No trees or shrubs should be planted on the at-grade. Plantings may be made around the at-grade's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the at-grade is not recommended since soil compaction may hinder aeration of the infiltrative surface within the at-grade and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD5, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5, 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the at-grade component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: WEISKEY Page 6 of 10 w PUMP PERFORMANCE CURVE MODEL 151/152/153 50 14 45 153 ...u._ fi 35 ..e M e 152 w 10 30 151 2256 20 15 ~....~.a~._~. 10 2 ry. w 0...„M, 1 E 2 30 40 50 6 70 80 90 100 GALLONS LITERS 0 40 80 120 60 200 240 280 320 360 FLOW PER MINUTE 014508A HARDINA SEPTIC SYSTEMS MFRS/CST 824825 707-Ta 04 ©s 5 1r04 Af c CL) a 1 1 tono~ob QAlt°nr -7-4 d IL Lt~TC_ "-M a N ul v W y u i O C Q C m « N 4- Z 4.E > 7 Q m c O N = \ in o o a fd -4- Z m w W vmmmmm~ 00 V O y Y OO MJ #Zr, Y Q, w 3« N w o 3 c° 41 C W m «c m v m C x o m E em V m m c rn.a ~ iJ ~ v w a u v y ~ LL q° o>° orn rn w 1~ O J tv„ ° v m v i v rn c o m rl a c _ /y i6 fO c' a - c y Q v w~ ~C 6~ w rn= 4J W O A m n 41 3: - a Ssi 0 d 4, d t Y LL T~ V O C _0 Y m 4 Y v w e ms' - O N C VI ~C N E w ` V Y c N QJ W > o v = Y`~ -r m MUM=., mr4wvm V v l'J c E Z d H O v-gin l7 C 0 ~c EE ~w w° O Q L ° k w u d C 'O z L r d Y f ~C y ry 3 a E Z y~j a c- •ry ° o. a V ' a c ` °E a c E m Y i4 Z rn 3 a 0 ^ E 1, r a v o v~ ci O c 3 W e w t o E ro a-0 0 E o o ° -0 o w IE N d v v O :D C .O. a C r rs m -0 0~~ O N u N- - m v ° ,c 'O Y Y :~5~xt!C~3=on.'„ B»,rv.+~~: = ~ 3 C rr .r w =O A~NV O AO , v y i My p 'd N y N v 'N, L a0. Y V LL O V° ~vn L N _Ol • I o u o s v v 3 A a • A' a Q c o y Y t C La, ° ,CO, d I « o Y/'y ,A 6 7 O N C O C > pp,, ~N to C O O O p I M .Q . I i-I ° v v> c o 1 0 0 ? a a m O C LL C 1 75 -01 1 %4-4 O YO O y ..,0+ u w m 1 d 0 ■ N L N . CL U CL Cc: w -u >0 d C c m 2> V1 .6 t E 1 3 a I 0 v o d y n. o C, CL a IL 1 U M 1 a a4) oEv a= 1 d m=0-wcoc ~ GE r~.► N a c . I O 1 ate`. ~Yv yo 1 1 1 v 'o r v y N v = `V ° ~c v e a o 4-6 o JLI 4-0 a'Oyr 1 DC 1 0 fl. ° v~'', Ca7 0 W IA i 7E 7E Flec~wet) Wisconsin Department of Commerce 09.761 SOIL EVALUATION RE j j, Page 1 of 2 Division of Safe and Buildings j/ n acxor with Comm 85, Wis. Adm. Code NCNG O County ST CROIX Attach complete site plan on "dt s than 8 1/2 x 11 inches in size. Plan must include, but not limited to: B~I and horizontal reference point (BM), direction and Parcel 1. -1074-95-000 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all infonnation. Revi d by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 7 ~ Property Owner Property Location 9 In TPOH LLC (MIKE WEISKEY) Govt. Lot SE 1/4 1/4 /33 T 31 N R 16 E (or))WW Property Owners Mailing Address Lot # Block # Subd. Name or CSM# P.O. BOX 142. N/A N/A City State Zip Code Phone Number ity [:]vllage Town Nearest Road WOODVILLE WI 54028 ( 7I5-781-1138 CTH "O" New Construction UseE] Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD E] Replacement Public or commercial - Describe: Parent material GLACIAL TILL Flood Plain elevation if applicable General comments AT-GRADE and recommendations: Boring # 11 Boring / Q Pit Ground surface elev. 93.32 ft. Depth to limiting factor 40 J in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-10 10YR3/2 -a- SIL 2MSBK MVFR GW 2M .6 .8 2 10-30 10YR4/4 -o- SIL 2MSBK MFR CW 2F ..6 .8 3 30-40 7.5YR4/6 -o- SL 2MSBK MFR CW IF ...6 .8 4 40-55 7.5YR4/6 C2D5YR4/4 SL 2MSBK MFR N/A N/A 2 Boring # ❑ Boring F El 93.32 60 Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDKF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *EfF#1 *Eff#2 1 0-10 10YR3/2 -o- SIL 2MSBK MVFR GW 2M .6 .8 2 10-35 10YR4/4 -0- SIL 2MSBK MFR CW 2F .6 .8 3 35-60 7.5YR4/6 -o- SL 2MSBK MFR CW IF .6 .8 4 60-80 7.5YR4/6 C2D5YR4/4SL SL 2MSBK MFR N/A N/A * Effluent #1 = BOD > 30:5 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = B0135:5 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signa CST Number ROBERT J HARDINA 7/ ..v 824825 5~~ Address Evaluation Conducted Telephone Number 477 170th AVE. TURTLE LAKE WI. 54889 11-15-11 715-986-2508 Property Owner TPOH LLC Parcel ID # 006-1074-95-000 Page 2 of 2 Boring ❑ Boring # ❑ pit Ground surface elev. 93.41 45 ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-9 10YR3/2 -0- SIL 2MSBK MVFR GW 2M .6 .8 2 9-30 10YR4/4 -0- SIL 2MSBK MFR CW 2F .6 .8 3 3045 7.5YR4/6 -0- SL 2MSBK MFR CW IF .6 .8 4 45-60 7.5YR4/6 F2D5YR4/4SL SL 2MSBK MFR N/A N/A ❑4 Boring # O Boring 93.32 41 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 1 0-10 10YR3/2 -0- SIL 2MSBK MVFR GW 2M .6 .8 2 10-30 10YR4/4 SIL 2MSBK MFR CW 2F .6 .8 3 30-44 7.5YR4/6 -0- SL 2MSBK MFR CW 1F .6 .8 4 44-60 7.5YR4/6 C2D5YR4/4SL SL 2MSBK MFR N/A N/A H Boring F-1 Boring # Ground surface elev. ft. Depth to limiting factor in. Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ F in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg& The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330T.I (K07/00) !j HARDINA SEPTIC SYSTEMS MPRS/CST 824825 e "1 . b , aa ~ ` - o 60 1 , T ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CER'T'IFICATION FORM Owner/Buyer Mailing Address Property Address t'D ..6 ©;r ~E~ R,L saur~ t~ t (Verification required liom Planning & Zoning De a nrr _n-t for new construction.) City/State ~Il~w ~tl.ll t Parcel Identification Number ~ jq_ 9r' ~Ck~ LEGAL DESCRIPTION Property location ,!!rC-_'/4 . AIV %4 , Sec. _N R_ JJZ_W, Town of etr 4yAj - SUbdlVlsion Lot # Certified Survey Map # _ Volume _ Page # Warranty Deed # (before 2007)Volume , Page # Spec house yes no Lot lines identifiable yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance ofyour 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 IJ3 full of sludge. 11we, 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 myfour knowledge. I/we am/are the owner(s) of the property described above, by virtue of a wa ranty deed recorded in Register of Deeds Office. Nurrij)gr of bedrooms S _ l=DATE DATE env 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. 09/07) i RECEIVED M~dcorn! a 9 State ®Forge 3-2003 8 0 3 7 9 3 5 ~nl~ ~tJW&ED Tx:4027397 i ST ( CR FANNING &vr~ I ZONING OFF 942275 Document Number Document Name BETH PABST I REGISTER OF DEEDS THIS DEED, made between Michael W. Weiske and Lisa M. Weiske, husband ST. CROIX CO., WI ! and wife 09/30/2011 12:56 PM l: EXEMPT#: 15S I ("Grantor," whether one or more), and TPOH, LLC, a Wisconsin Limited Liability REC FEE: 30.00 1 Company PAGES:1 3 ("Grantee," whether one or more). Grantor quit claims to Grantee the following described real estate, together with the I rents, profits, fixtures and other appurtenant interests, in St. Croix Recording Area County, State of Wisconsin ("Property") (if more space is needed, please attach addendum): Name and Return Address s 1. Southeast Quarter of Northeast Quarter (SE 1/4 of NE 1/4), Northeast Quarter of Southeast Thomas A. McCormack i Quarter (NE IN of SE 1/4), and East 1 rod of North I rod of Northwest Quarter of Southeast Quarter 1020 10th Avenue (NW 114 of SE 114), all in Section Thirty-two (32), and South Half of Northwest Quarter (S 1/2 of NW PO Box 2120 114), and North Half of North Half of Southwest Quarter (N 1/2 of N 1/2 of SW 1/4) of Section Baldwin, WI 54002 Thirty-three (33). 3 2. South One-half of Northeast Quarter of Southwest Quarter (S 1/2 of NE 1/4 of SW 1/4) North of 006-1074-95-000, 006-1075-60-000, railroad tracks, Section Thirty-three (33). 006-1071-40-000, 006-1074-90-000* j 3. Northeast Quarter of the Northwest Quarter (NE 1/4 of NW 1/4) of Section Thirty-three (33). Parcel Identification Number (PIN) l This is not homestead property. F All in Township Thirty-one (31) North, Range Sixteen (16) West (i8) (is not) t * 006-1075-20-000,006-1075-10-000,006-1074-70-000,006-1073-10-000 z t Dated ~ g t pot 1 1 (SEAL) (SEAL) * * Michael W. Weiske 6 (SEAL) 4r, mt kt-,,~ (SEAL) Lisa M. Weiske g AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF Wisconsin ) ? ) ss. authenticated on St. Croix COUNTY) S Personally came before me on R'2 g 1~. * the above-named Michael W.< . iske-and Lisa M. Weiske 4 TITLE: MEMBER STATE BAR OF WISCONSIN K' (If not, to a known to be th l;(s) Who executed the foregoing authorized by Wis. Stat. § 706.06) in ent an ac#~te same. THIS INSTRUMENT DRAFTED BY: F Thomas A. McCormack Notary Public, State of ' gin _ Baldwin, WI 54002 ~(za l 13 ) ! My commission (-isle t~~ - (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATION TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. ' QUIT CLAIM DEED 02003 STATE BAR OF WISCONSIN FORM NO. 3-2003 t 'Type name below signatures. INFO-PRO' Legal Forms • laool65e-2021 • Wwrotorms.com 1 of 1