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HomeMy WebLinkAbout008-1037-80-000~ Department of Commerce PRIVATE SEWAGE SYSTEM ~' ~Suilding Division INSPECTION REPORT ERAL INFORMATION (ATTACH TO PERMIT) ial information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. it Holder's Name: City Village X Township esselman, James Eau Galle, Town of - BM Elev: Insp. BM Elev: BM Description: ANK INFORMATION ~e. I Ib~ ~ ~ c~ I ELEVATION DATA TYPE MANUFACTURER ;~ CAPACITY Septic y, o~- C~J • sc..~, a.Q.Q, /Z S U Dosing Go~,~~ 75 ~ ~o I Ic Pl. 5 z5 Holding TANK SETBACK INFORMATION TANK TO P/L WE LL BLDG. Vent to Air Intake ROAD Septic 7 ibv, n Y~ ~ / 30 / ~c3o ~ -- Dosing 7 /O!l) / 11 ' Nt~" /c3d / / 3b Aeration Holding PUMP/SIPHON INFORMATION r I~ Manufacturer G~ v L ~ Demand GPM Model Number ~~ ~ ,,,~I, g Z TDH LiftG 6 Fricti ~ Loris System Head TDH Ft Forcemain Length ~ 3b Dia. ~ ~ 2 Dist. to well . f /v C(lll ~RS(1RPTInN SYSTEM County: St. Croix Sanitary Permit No: ~ 488295 0 State Plan ID No: Parcel Tax No: 008-1037-80-000 Section/Town/Range/Map No: 13.28.16.190B _ a.,l sr /RCS, y g Si4-. r STATION BS HI /D .r11 FS ELEV. Benchmark 5 . ~ 7 ~' ~S Alt. BM F, ~ Cam, 3. b 5 /x L. ~3 Bldg. Sewer Z• e /°3•~~ SUHt Inlet $ 55 4 7. / 3 SUHt Outlet ~ ~ Dt Inlet Dt Bottom IZ.Y9 4Z. 79 Header/Man. 3.z~ /oz•yz Dist. Pipe ~ Z ~ / 6 z ~ ~ Bot. System 3.9 /b/ • 78 Final Grade 2.Z~ /a3• yz St Cover~,~~ CoJ 3, b 5 /02 ' d3 ~.~.~v~' 3.5~ /ate BED/TRENCH DIMENSIONS Width ~ ~ Length ~ 75 No. Of Trench ~ 2 PIT DIMENSIONS ~ No. Of Pits ~ Inside Dia. Liquid Depth SETBACK INFORMATION SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING CHAMBER OR Manufacturer: ~ Type ~ f System: O J ~ l~ s , Z3 i ~ ~ ~~ UNIT Model Number: ~ IIICTRIRI ITICIN SYSTEM Header/Manifo~d/ ' ~f Distribution ~ ~ 1/ ~/ ~ / x Hole Size ~ r x Hole Spacing i~ Vent t-~ir I tak Length W~ Dia i ~ Length Dia Spacing ~ Z6' OcJ'~~ C/lll /`~1VfrR .. o..,........,. c....F.....~ n..~.. ..., nn.,.....~ nr a+_r.~arla Rvefams only Depth Over 1 Depth Over xx Depth of xx Seeded/Sod ded/ xx Mulched ~ / Bed/Trench Center / ~ ~ G~ Bed/Trench Edges o Topsoil 1 ~ • _ ~( Ye5 I No ~~\ Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ib // O ~ `,~ Inspection #2:_ '_'_ Location: 395 County Road B Unknown (NW 1/4 NW 1/4 13 T28N R16W) NA Lot rI o~ 6~ FBI! tt Parcel o: 13.28.16.190B 1.)AItBM Description= ` ` ~~ GoOe~. C1/~a~ n• C..r~,'s~~ ~Iv'"" V ~ S 2.) Bldg sewer length = f / ~ ~-- Lp vltc.,S o~ - amount of cover = ~ / __ Use otherlside for additional in Yes ~l .. formation. ~- ~-0 !--- _ _ _ Date I Insepctor Signat e SBD-6710 (R.3/97) 1, ~3Lf 7S Cen. No. z l•fir at Safety and Buildings Division only ® 201 W. Washington Ave., P.O. Bo 71 T. CROIX ,~~~~~,~ Madison, WI 537 716 (608) 266-31 anitary Permit Num~to be fil~ by Co.) Department of Commerce ~ Sanitary Permit Application State Plan I.D. Number TRANS. ID # 1276606 in accord with Comm 83.21, Wis. Adm. Code, personal information you provide may be used for secondary purposes Privacy Law, s15.0 m ~~ C E i V E ® G Y Proj ct Address (if different than mailing address) 39~ I. Application Information -Please Print All Information ,# ~~ C'~-} Property Owner's Name Para 1 # Lot # Block # JAMES RIESSELMAN ST. CROIX COUNT 008 1037-80-000 (~ /90g Property Owner's Mailing Address Lo~c ron Prop y~ 851 POLEN DRIVE ~ .~j ~~ lO . O~(o ~ (!" NW , Section 13 /s /< City, State ip Code Phone Number , , HUDSON, WI 54016 715/38x9067 28 16(ciroleone) T N; R r II. Type of Building (check all that apply) -ti+ b S / a t+- a! b 4 Q 1 or 2 Family Dwelling -Number of Bedrooms ,~ Subdivision Name CSM Num er __ Public/Commercial -Describe Use N/A N/A ^StateOwned-Describe Use ~~..,, ^City_^Village I_Irownshipof EAU GALLS III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A' 0 New Svstem ^ Replacement System ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System B• ^ Permit Renewal ^ Pemtit Revision ^ Change of ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner tf ~ / ~~ / M IV. T e of POWTS S stem: Check all that 1 ^ Non -Pressurized In-Ground ^~ Mou 'n. of suitable soil Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized -Ground ~ Holding Tank ^ Peat Filter Aerobic Treatment Unit ^ Rec' lating Sand Filter ^ ~ Recirculating Synthetic Media Filter ^ Leaching Chamber d Drip Line ^ Gravel-less Pipe ^ Other (explain) = ~ Q1D •~ V. Dis ersaUTreatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) ystem Elevation ~ 600 1 600 600 '~t63-9'~~ p VI. Tank Info Capacity in Total Number Manufacturer Prefab Sit Gallons Gallons of Units +D~~~ D ~( ~ ` oncrete Constructed Glass New Existing j 1 r v7r w ~" ` L+ ~ + Tanks Tanks V Septic or Holding Tank 1250 1250 1 WIESER CONCRETE X Aerobic Treatment Unit Dosing Chamber 750 750 1 WIESER CONCRETE X VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWYS shown on the attached plans. Plumber's Name (Print) Plu 's Signature MP/MPRS Number Business Phone Number BENNIE HELGESON 92 715/772-3278 Plumber's Address (Street, City, State, Zip Code) W1229 770TH AVENUE, SPRING VALLEY, WI 54767 VIIL Coun /De artment Use Onl Approved ^ Disa ro Sanitary Permit Fee (' cludes Groundwater h Date Issued Issuin gent Signs re o Stamps) w ' Surc arge Fee) ~ ~~~~ OZ ~1~/ C.Gi~l7 ven Reason for ial ^ ' t IX. Conditions Apr 3> S ~ ~ ~ Z s '~"~ SYSTEM OWNER: ~~Q _ ~ - ~ ,~,- effluent filter and t k ti S ~ `n an , c ep 1 ~ dispersal cell must all be serviced /maintained ~~q,, ~ ~~~ Sss~ ~~ Q - ~T lumber rovided b l n t . y p I ; ~i p p a as per managemen uirements must be maintained 1~,.9.m~ t~ ~ .~~ tback re All 2 q se . as per applicable code/ordinances. ~y~ ~ ~~.~ ~,,~ . Attach complete plans (to the County only) for the system on paper not less than 81/Yx 11 inches in size ~ ~ ~ ~~°~" -~~~ sue. -~~- ~~ -p~! -~ Su. r~1A.i SBD-6398 (R. 01/0~3,)"~.I n_ a~eSS ~ ~ S ~ ~` 1 0° ~i ~+ ~ __5~<< ~ ____~ Ay ~~---------- Ex~~+P E /~s SGT oil n CZr~ ~ f v s~"c~ ~{ re cL ~o~ PI~~.. ~ ~ "~ I ^ ~K ~s~. ~ .t-v ~.`-, f h . ~v-e- -~i aNA NEu.vts A.~ev~~ ~~v~-C i :.zt~2~~4'~ - i iQro~S ~'y-(p~poSe c(Q ~r~ C i ~~ ~~.~ • ~ ~ -~ (off a ~P4~ / yM~~ ~}~ CORRECTION NEEDED -' SEE CORRESPONDENCE -~. j~ ~.c GS<<~ SAP ~, ~/' ~s~ ~-~ ~ Po y o '~~-M, lcC.er n rte. \. \- ~` Pic.. ~ ~, ~~L ~ ~~, A ~,~c.~ ',,- `_ v ~` - , ~` ~~ AfO~.Or~ ~. \ , \ \ `` ~` ~ `~ ~ O ~. ~- - -i - -~ ~(~ . 111 L `t; ~ c ~"" r' r- o{~ L v- ~~y ~ t+~ -E t t -y~- . ~-t , 9 ~ . ~ r G` ^`~ rOPY +~ • commerce.wi.gov ~ ^ isconsin Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LACROSSE WI 54601-1831 TDD #: (608) 264-8777 www.com merce.wi.gov/sb/ www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary June 07, 2006 CUST ID No. 220292 BENNIE W HELGESON HELGESON EXCAVATING W 1229 770TH AVE SPRING VALLEY WI 54767 ATTN.• POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPII2ES: 06/07/2008 Identification Numbers Transaction ID No. 1276606 SITE• Site ID No. 713610 James Riessehnan Please refer to both identification numbers, '' 40~` Avenue above, ur all corres ondence with the a enc . Town of Eau Galle, St Croix County NE1/4, NW1/4, S13, T28N, R16W FOR: Description: Four Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 1078414 Maintenance required; 600 GPD Flow rate; 15 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual, SBD-10572-P (R.6/99), Pressure Distribution Component Manual, SBD-10573-P (R.6/99) The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, StatS. The following conditions shall be met during construction or installation and prior to occupancy or use: Reminders • This system is to be constructed and located in accordance with the enclosed approved plans and with the component manuals listed above. • The mound area must. be deep chisel plowed to help break up the platy soil structure that was reported at the site. The county may, at their discretion, request verification of the plowing prior to continuation of system construction. • Comm 83.54(1)(e) The management plan shall specifically address the servicing mechanics of a POWTS tank ~~~ where either the bottom of the tank is located more than 15 feet below the. elevation and or more than 150 feet horizontally from where the servicing pad is located. Rte,,,, oT„~ • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. ( ,~~ Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and SEE dispersal are prohibited. ' BENNIE W HELGESON Page 2 6/7/2006 ~- ~ ~ . • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. 5tats. • Inspection of the POWTS installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat • Comm 83.22(`n A copv 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. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All pernuts 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 to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Charles L Bratz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday charlie.bratz@wisconsin. gov Fee Required $ .175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 ~' ~ , INDEX SHEET PROPERTY OWNER: JAMES RIESSELMAN 851 POLEN DRIVE HUDSON, WI 54016 PROJECT NAME: JAMES RIESSELMAN PROJECT LOCATION: NE 1/4, NW 1/4, S 13, T 28 N, R 16 W MUNICIPALITY: TOWN OF EAU GALLE COUNTY: PIERCE DESIGN: PRESSURE DISTRIBUTION MANUAL SBD-10573-P(R/99) MOUND COMPONENT MANUAL SBD-10572-P (R 6/99) CONTENTS: Page 1: Plot Plan Page 2: Cross Section and Plan View of Mound RECEIVED Page 3: Distribution Pipe Layout MAY 2 5 2006 Page 4: Septic Tank & Pump Chamber Cross Section and Specifications Page 5: W 1250/750-MR Tank Specifications SAFETY & BUILDINGS Page 6: Pump Specifications Page 7: POWTS Owner's Manual & Management Plan - Pg. 1 Page 8: POWTS Owner's Manual & Management Plan - Pg. 2 Name: Bennie Helgeson Address: W 1229 770th Avenue Spring Valley, WI 54767 Credential Number: 220292 Signed Date: May 24, 2006 ~'l:1,??Ef i ~ l ~~,~ ~~~ COUf~',t~~C~ ~~ =SpONDENCE {~l o~ P l~~ ;, ~~her'~ ~~u,~ncs ~i~s~r~~~L~~~ (~ .-- ~~ ~ C.Lw~ u ~ f' ~ ~ ~ [' Lt In - `e Q QS e c- ~ .-1 c~ Z'~ ~ ~f ~ ~~ i t i ,~ / ~xc~t~ F ~ s 5G~ ~~~ -1 l~p-Y ~ • f~/l ~jo~o ~ ~ ,~l n .-~ 5 Qr'~ ~ b ~C7 -~~ SfC w~ ~ r e cL ~~ 't~.M. ICC.ec• (~ Tc~ ~{`" ~~~ Qt1L 1"~~` e. ~' r ~~~ ~~x ~ s`' fio y~-t fh . h~-e- 1~ aN ~ N ea,r{s ~- f}-~ev- {~, ~ i h -Q r t ~ ~ / ~ I lea.. a-,..~" ~'r p~oS e cQ \`` ~~ C~arw~- i~~rc~5 pry C ~-~ ~~~ • ~~/ i -~ ~~ M it pQ~1,. y~,`' CORRECTION NEEDED SEE CORRESPONDENCE ~~~ ~. ~ ,, p~ ~ ~. ~ ~.- \~`~, ~ ,~ ~ ~\~...p S(o ,. ;~ ~ _~ ,. ~,. .. ~. v ~~. _ ~. ~. ~_ .__y~_ . -..ti- ----; I-CIr1L'f .I~AC~ 47r-cf~~?~'- ~" ~l+~fr. Y--- ~ 6 L.. ~ly~~k Sir \. ~ ~pi,~~ ~,_ ~._ ~~O 1SC.Oc> , ---- Synthetic Covering /-ISTM L 3:3 Medium Sand -~ Topsoil • ~% Slope 3 -~ i _ ~ J~_ ~ E~-o f z'_ ~ 'z Aggregate "" Cross Section Of A Mound Signed: License Number: Date: - L D /, 75' Ft . E ~ Ft. F .X~ Ft. ~ , S Ft. y /, Q Ft. Observation Pipe ~ K ~, - --~---- -- -'_-- 1 Ir_ _~---------~--------- _ _ _- ----- -- ~ - - t J ~.-- -- ~ ^-------- --------------------------- j W - C~LL Of 2~- 2'~ Distribution Pipe Aggregate Plowed Layer Observation Pipe (3a5a~ ~r~o.. •Distribution Pipe FJ~.-1 ~'3-_'~ -~G F /b. D / ~ on t-a.~ ~ . /or' ~o Force Moin From Pump q ~ Ft. a ~ Ft. K // Ft . ~ ~~ ~ Ft. d ~,/ Ft. I /~~3Ft. W ~~, y Ft. 0 r" Plan View Of Mound %f4•r5c `.~ ~~ Perlurulnn hIp• Unlull ~ , ~ / % EoU VI~w 1 I'0(IUi U~(J ~~ C Holes Located on Bolcom are Equally Spaced ~ ICI vID~ Signed: License Number: Dace Discc•ibu~ion 1'1PC_ L___ d-Y°LC ~ I- P 7~ ~ ~~ 5 ~~ r R ~; `~ ~~ x ~~..~ Y ~~ 1{ole Diameter ~ Inch ~~ / ~ Incn (es) Lateral htanifold " ~„ Ynches I~orce Main " ~ Inches ~,rl.~L~E~`~ tl~e~. 1G~p ,~~ Not~> ~~-~- 1~+~r~.l = ~ Y ~j«~~t ~ ~~,- ~ r ~~+-~~~5 ~- x -~ ._--- TD~c~/ ._ ~~'S'- /'~%c~ ~~~Y + ~m P 5 l j ie 55~1ma r~ Page~Of~ _ •. - SEPTIC TANK E PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS u" •~UC_VENT PIPE 12" MIN. ABOVE GRADE E 25' FROM DOOR, WINDOW OR FRESH AIR INTAKE i .~, ~~~nG~ ~~~v; /mil • ~~ 18" MI INLET ~ WATER TIGHT SEALS FILTER A 1'0l ~ /~ S~ S~ _f- APPROYEO Y B PIPE 3' ~ ONTO SOLID C SOIL PUMP OFF ELEV . ~FT. --~--' D uEATI~ERPR00F JUNCTION BOX WITH CONDUIT 2yu S. D. ~~ ~ ~~ ~ ~, GAS- ~ ~~ TIGHTS SEAL ; i ' APPROVED MANHOLE COVER W / PADLOCK E WARNING LABEL ____.. 4 " MIN . • u 18 rn-~+• ~1APPROVEO JOINTS WITH A LM APPROYED PIPE ON 3' ONTO SOLID SOIL OFF 3" APPROVED BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS SEPTIC / DOSE tt' ^ S V1 ~ ~ 'C~- .a ~'_ c=-~ X Lam! -._- GCS ~ . TANK MANUFACTURER. S - TANK SIZES: SEPTIC I_= DOSE GAL. `~_ ALARM MANUFACTURER: ~ ~~. ~ Inc ~-~-U MODEL NUMBER : i~ 1 w rr SWITCH TYPE: /~1n~-~~ .c-~-,~.1oc:t~ PUMP MANUFACTURER: F~c..i~c~ _ MODEL NUMBER : ~`~ L SWITCH TYPE: M~~-r'~-~- ~~aa.r REQUI RED DISCHARGE RATE ~//.~~ GPM DOSE VOLUME INCLUDING ~C~. 7 GAL. S. 7 C~~- ~ ~ F LOWBAC K CAPACITIES: A = ~ S INCHES = GAL. B = 2 INCHES = ~~~e ~ GAL., C = ~ INCHES = ~.~ GAL. p = ~ ~~ INCHES = b~c(S~GAL. PUMP 6 ALARM WIRING AS PER ILHR 16.23 WAC VERTICA L DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE . + MINIMUM NETWORK SUPPLY PRESSURE . .~ FEET FORCEMAIN X ~~FT/100 FTOTALIDYNAMICAHEAD •_• INTERNAL DIMENSIONS OF PUMP TANK i~.I~ C,P.Z g, ~S' FEET •S FEET ,~ FEET _1,~1•E ET LENGTH WIDTH DIAMETER _ LIQUID 1I6~.`l~')~N-~_ • / !"ifi:c S-e Sic CZac ,~" S~~~c.. S~t~~ SIGNED: LICENSE NUMBER: DA; E: 1/88 S o Z ~ J W Q l~ ~ ~ Z ~' o 0 io ~a ~ Yr a~ W ° Q 00 ~~ Ni~ . Q ~ U ~m ~Q ~ WO 4V JJ Q ~ w , wwW ; N U o ~, a~ O Ul ~ Z O W O O == m ~-- Q N ~ ~ O ~ ~ o ~~ _ p O ~ , =F- l+-W(n QWW ~ ~ o ~~//~~ N `r O~ O~ J l~ N ~ Q ~ Q ' N '- 1~ Y J N \: to = W ~ st > ~ M ~ f- r U Z M- ~ v 3 .. J N I J(O OOZ IJ-~/- W FJ-Z4' ~ ~ C_~ Z o ~ ~W== = ~ S o Op~N O~ ~, W Q (nJ (7 F -O ( j ZO O oaooQww°w °a~ F 3° ° a ° a~ ~ ' z ~ ~ mJ S n7U~2J N Q Q z Z ~ O ~ p J Z J Z Q J J ~~ yki 3 ~~ w- S~ aw J N t f 6 s a Q' ~ o ~ ~ ~ ° ~-7 n 'r \ r ~ U c u; ~~~ 1- ~1 ~ (Q ~ d ~' 3 ~ N O w ~ ~ ~ ~ = F ~ v: a,n v~ I U G ~ ~ ~ N (~ ~_J~Q OUW o Q N d ~ N nom., ~-7_~ ' u u ~ N 3cWno ~' ~ L_..J ~ o ,~ J W Q O L n 3 O ~ Q ~ 3 ~~ w= 5~ Q I J Q (n U N ~i ,. Pttmp Specifications ,~~ H P Up fo 40 GPM Discharge size 1'/."NPT Solids:'/e" maximum Motor Single phase: 115V Materials of Construction Brass/thermoplastic Features and Benefits • Top suction eliminates impeller clogging. • Corrosion resistant construction. •Floal actuated switch. MC!tRS CECI '~ •~ ---.~ MOOEL DUP03 i o z~ a" I ws 1 V 1$ I Z o , ,~ ~2 O 5 ~ ! o, o ~_ .... i_ _ ! 0 5 10 IS 20 2S 00 75 40 U.S.GPM 0 $ ~ 8 8 101IaAM CAPACITY ~,4 ~ v F __~. MtIEIIS CEEI to I ~ ~/ \~ e ' Jo . ~ I '~~Jl ~ ~~. a I~ , . _.. . o '' 6 20 ____ .___._ ~.L_._ ~ ~. _ ,. _... _. U 5 < t5 ____ _ __ _ ___~.~ I z a ~ '~" 1 o _ a J lo~-• ~....__.. 2l --~ ~ ..... ~. _.._I. 1 ' I ~ -~ 0. Ot_.. .__~.. _...i__.-_!.. .. o l0 20 MOOEL:3871 ~. v . I _i_ ._ I EPOC I j -- _ ' i ~ _ - ~ ~ 70 40I SO-~-~~ U.S.Q7A a `6 B CA• AC1LY~ Pump Specifications Features and 8eneiits '/IU and'/: HP • EP04 impeller- semi-open design Up to 60 GPM with pump out vanes to protect Maximum head to 32' mechanical seal. Discharge size 1'/:" NPT • EP05 impeller -enclosed design Solids:'/~" maximum for improved performance. Motor • Rugged glass-tilled thermoplastic All motors feature ball casing and base design provides superior strength and corrosion bearing construction. Single phase: 115V resistance. Materials of Construction 'Cast iron motor housing for efficient heat transfer, strength, Cast iron Thermoplastic and durability. Stainless steel • Corrosion resistant threaded stainless steel shaft. •Available (or automatic and manual operation. . • CSA listed models available. All Models are designed for continuous operation and feature stainless steel hardware. ,' , , ` POWTS OWNER'S MANUAL & MANAGEMENT PLAN FILE INFORMATION Owner Ja~aes I::ies~elc~an Permit ~ („E ?.~ Page % of ~_ MAINTENANCE SCHEDULE Service Frequency Service Event ^ monthisl (Maximum 3 years) ^ N Inspect condition of tank(s) At least once every: 2 ® ear(s) 1 of tank volume -third (Y ^ NA When combined sludg e and s , cum equals one Pump out contents of tank(s) " ^monthis) (Maximum 3 years) ^ NA Inspect dispersal celllsl At least once every: Z p yearls) ~ monthis) ^ NA At least once every: 13 ^yearls) Clean effluent filter Q monthis) ^ NA Inspect pump, pump controls & alarm At least once every: 13 [] year(s) ^ monthis) ^ NA Flush laterals and pressure test At least once every: 3 yearls) ^ monthis) ^ NA Other: At least once every: ^yearls) ^ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the Sept ge Serv'cing OperatorcatTank Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer, inspections must include a visual inspection of the tannd toocheck' fo r any backgupr or pond ngdof aeffluentton the ground surface. measure the volume of combined sludge and scum a The dispersal celllsl shall be visually inspected to c ffluent onfthe ground surface ay indicate a failing cond t on and requires the of effluent on the ground surface. The ponding of e immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in aCi t Okefatorl and disposed-ofrin a co dance with chaptertNRe11'3, contents of the tank shall be removed by a Septage Servi g P Wisconsin Administrative Code. All other services, including but not limited to t the shallnbe perfol medfby a certifiednPOWTS Ma ntainercomponents, pretreatment units, and any servicing at intervals of 512 mon , A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. ___ _ ~~~w.~,w wT~A\IC "Values typical for domestic wastewater and septic tanK tl~~~~~,~,• `~o Page b of ~_ '.'ART~UP AN.D OPERATION For new construction, prior to use of the POWTS check treatment tankls) 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 tankls) 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 shalt 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 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. POWTS INSTALLER Name A:1LGL'SGi~i 1;XCAVA['ION INC Phone 715/772-32713 SEPTAGE SERVICING OPERATOR (PUMPER) Name JGIitiSON SANITATION Phone 715/'173-Still n~.wrrc RA AIHITAl1U~R rv.v , v ..... Name ... . Phone 715/273-5311 OCAL REGULATORY AUTHORITY Name ST. CkUIX COUNTY ZONING Phone 715/3136-46t3U This document was drafted in compliance with chapter Comm 83.221211b1(111d)&If- and 83.54(1), 121 & 13-, Wisconsin Administrative Code. ve~~ ~e e~ ~~ t T P.O. Box 155: Hammond, WI 54015 ~~1~ ~ r `~ June 5, 2006 RECEIVED ,s1~N o 7 zoos St. Croix County Zoning Dept. sT. cROix couNTY Attn: Ryan Yarrington 1101 Carmichael Road Hudson, WI 54016-7710 RE: James Riesselman Soil Test; Parcel ID# 008-1037-80-000/ Replaces the May 12, 20061etter Dear Mr. Yarrington; On October 14, 2005 I completed a soil test for Mr. James Riesselman. It has been brought to my attention that there was an error on the soil test. The loading rate in boring #2, horizon #2 is not correct. It should be 0.0 for Eff# 1 and 0.2 for Eff#2. I recommended a loading rate for boring #2, horizon #2 of 0.4 GPD/sq. ft. following chisel plowing to 15 inches and installation of a 21" sand lift. If the installer is not able to chisel plow to 15" the sand lift must be adjusted accordingly. If you have any questions please feel free to contact me at 1-715-796-5664. Sincerely, Evergreen Irrigation Inc. I~~., ^ ~- Mark (Iverson Professional Soil Scientist Enc. ~~t c. Phone: ~,~-~-~ ~: ~~-~~~ Cc: James Riesselman Ben Helgeson ~ P.O. Box 155: Hammond, W154015 May 12, 2006 St. Croix County Zoning Dept. Attn: Ryan Yarrington 1101 Carmichael Road Hudson, WI 54016-7710 ~ve~~~eea _ ~o~r~atro~t RE: James Riesselman Soil Test; Parcel ID# 008-1037-80-000 Dear Mr. Yarrington; RECEIVET MAY 1 5 2006 ST. CROIX COUNTY' On October 14, 2005 I completed a soil test for Mr. James Riesselman. It has been brought to my attention that there was an error on the soil test. The loading rate in boring #2, horizon #2 is not correct. It should be 0.0 for Eff# 1 and 0.2 for Eff#2. The recommended loading rate for the system of 0.4 GPD/sq. ft. will be acceptable following chisel plowing to 15 inches and installation of a 21" sand lift. Ifthe installer is not able to chisel plow to 15" the sand lift must be adjusted accordingly. If you have any questions please feel free to contact me at 1-715-796-5664. Sincerely, Evergreen Irrigation Inc. g~~~ Mark Iverson Professional Soil Scientist Enc. ~~ C' . Phone: 715-796-5664 Fax: 715-796-5246 Cc: James Riesselman Ben Helgeson `if/is~sin trepan Ptivjsi~ of Safet! ~ Attad Incht< Peresw Personal inforr ~P~Y Owner James Riesselman Property Owner's Meiling A~ 851 Palen Drive GiRy Hudson n S L EVALUATION REPORT tie 1 of 4 P~4~ x with Comm 85, Wis. Adm. Code ~ ~ / v County St. Cra1X /T~ 'o ~4 in size. Plan must e (B ;rection and >~ I.1). 008-1037-80-000 ~~ ~ ~ .a BM D by Date s. 15.04 (1) (m)) TI'~~1 ~ ~ ~ ~ Location Govt Lot NE ~~. NW ~~. s 13 T 28 N R 16 w ess - u Lot # Block # Subd. Name or CSivl# State Zip N I NG U ^ City ^ Village ®Town Nearest Road WI - 7 Eau Galle 40th Ave. ~ New Constriction Use: 0Residential /Number of Bedrooms 4 Code derived design flow rate 600 GPD ^ Replacement ^ Public or Commercial -Describe: Parent IVtaterial Glacial tt7l FIood Plain elevation if applicable NA ft. General comments and recommeadatioas: . Recommended loading rate 0.4 GPD/sq. ft. installed on the 100' contour. ^Boring 1 Boring # ®Pit Ground Surface Elevation 100.6 ft. Depth to Limiting factor 1 S in. C~° Horizon Depot in. [bminard Color MunseB Redox Descxiptiort u. Sz. Cant Cobr Texhtn: Structure Gr. Sz. Sh. Corrsistenoe Bourt~ry Roots 'EffaR'1 • 1 0-9 10YR2/2 None SIL Z-fir Mfr As 3f 0.6 ~ 2 9-15 10YR4/3 None L 2 f-sbk Mvfr Gs 2f 0.6 3 15-23 10YR4/3 10YR52 8 7. 4/4 f- - GL 2-m-sbk Mfi gs 1f 0.4 0. 4 23-40+ 7.5YR5/8 None SCL 0-m mfr - 1f 0.0 0.0 ~~g # ^ Boring HPit Ground Surface Elevation 99.3 ft. Depth to Limiting factor 15 in. S ' n Rate Horizon Depth Dorninartt Cobr Redox Descr~tion Texture Structure Consistence Boundary Roots GP D/ft in. MunseU . Sz. Cont. Gr. Sz. S . *E1F#k1 *Etf#2 1 0-9 10YR2/2 None SiL 2-f r Mfr Gs 3f 0.6 0.8 2 9-15 10YR4I3 None L 2 Mfr Gs 2f ~ 3 15-23 10YR4J3 10YR4/2 84/4 f-1 f 1-m-sbk Mfr Gs 1# 0.2 0.3 4 23-34 10YR4/6 None S 0-sg ml As 1# 0.7 1.6 5 34+ imeston Effluent #i = BODs> 30 <_ 220 mg/L aml TSS > 30 <_ 150 mgtl. • EtHu~tt #2 = BODs <_ 30 mgjL a~ TSS <30 mpJi. CST Name (Please Print) Sure CST Number Mark Iverson .~,:,,....~~.---~''~ 46672 Address Date Evahtation Condueted Telephone Number P.O. Box 155 Hammond, WI 54015 October 14, 2005 715-796-5664 ~i Property Owner 3ames IZiesselman Parcel >D# 008-1037-80-000 Page 2 of 3 ~o ~\ Boring # ~ Boring b~1Pit Ground Surface Elevation 99.0 & Depth to Limiting factor 20 in. Soil ication Rate Horznon Depth Dominant Cobr Redox Qescr~tion Texture Structure Consistence Boundary Roots Dlftz in. MunseU u: Sz. Cont. Cobr Gr. Sz Sh. "Etf~1 'Eif#2 1 0-10 10YR2/2 None SIL 2-f-gr Mfr As 3f 0.6 0.8 2 10-20 10YR4/3 None Sll 2 f-sbk Mfr As 1 f 0.6 0.8 3 20-33 7.5YR4/4 '~ ~~0" su~ GL 0-m Mfi As 1f 0.0 0.0 4 33-36+ 7.5YR4/6 None LS 0-sg ml - - 0.7 1.6 ~~g # ^ Boring PJPit Ground Surface Elevation ft. Depth to Limiting factor in. Soif Horizon Depth Dominant Cobr Redox Descriptibn Texture Structure Consistence Boundary Rocts GP DlR~ in. Munselt u. Coat Cobr Gr. Sz Sh. 'E~ `E~ aBor~g~ °~g ®1'it Ground Surface Elevation ft. Depth to Limiting factor in. Horizon Depth Dominant Cobr Redox Description Texhue Structure Corrsintence Boundary Roots in. Mu U Qu. Cobr Gr. Sz. Sh. ~~ ~11•#Z • EtHuent #1= BODs> 30 <_ 220 mgJi. and "PSS > 30 <_ 150 mg/L ' Effluent #2 = BOD, <_ 30 mg/L and T5S <_ 30 mp,~L The Department of Commerce is an equal o~-ordmity 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. ..~_ Page 3 of 3 Site Location 0 ft. 24 ft. 40 ft. ~ ft. r= ~ N Proposed House Location 1' .-~- The property lines are greater than 100 feet from the boring locations ~` ~~°~ =Bench Mark B-~ _ elevation ~~, -Boring Location 8 Elevation O=Well Owner. James Riesselman Site Information: Completed By: Mark Iverson, PSS #197 851 Polen Drive NW 1/4, S13, T28N, R16W 680 Larcom Street Hudson, W154016 Town of Eau Galte Hammond, WI 54015 St. Croix County 715-796-5664 Phone: 715-389-9067 CST# 46672 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer ~ cx vti~ S ~ t ~ ~s e.-~ rt~a a Mailing Address ~ ~ ~' °~ Property Address (Veri tcatton required from Planning Department for new construction) v©S -/035-30 ooS -!a3 --~o~ City/State ~` 7 r-r~ Sz- Parcel Identification Number ao R - ~~~~-~~~- 008 /os ~'-8° . . LEGAL DESCRIPTION Property Location IUL~ '/<, ~'~ `/4, Sec. ~, T~_N-R._/G~ W, Town of „~~.. ~ /~ Subdivision ~V /~ ,Lot # // ~ - 1 Certified Survey Map # ~~' ,Volume .~- ,Page # Warranty Deed # ~_ °~'~ ~ ~~ LJ ,Volume ~~~~ _, Page # Spec house O yes ~ no Lot lines identifiable ['~ yes ~ no SYSTEM MAINTENANCE 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. The property owner agrees to submit to St. Croix 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 wastewaterdisposalsyctem is in proper operating condition and/or (2) afrer inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, 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 Zoning Office within 30 d of the three ar xpiration date. ~,....., cam/ ~r / ~ G SI ~ ATURE ~ OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the prpperty described bov , by virtue of a warranty deed recorded in Register of Deeds Office. ATURE OF APPLICANT t^ l iA~G DATE '***** Any inforrnation that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. ****** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed • U 268SP 2~i9 STATE BAR OF WISCONSIN FORM 2 - 2000 Document Number WARRANTY DEED This Deed, made between Timothy Sandvig, a/Wa Timothy C. Sandvig and Syliva Sandvig, a/k/a Sylvia J Sandvig, husband and wife Grantor, and James W. Riesselman and Sandra A. Riesselman, husband and wife Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach adds 1) NW'/, of NW'/. of Section 13-28-16 EXCEPT Lot 1 of Certified Survey Map in Vol. 6, Page 1619 and EXCEPT Lot 1 of Certified Survey Map in Voi. 11, Page 3156. ~j 3 ~ S 2) NE'/, of NW'/, of Section 13-28-16. - t~~ , 3) SW %, of SW '/. of Section 12-28-16 EXCEPT Lot 1 of Certified Survey Map in Vol. 2, Page 472 and EXCEPT Lot 1 of Certified Survey Map in Vol. 4, Page 1065. L~ 2 ~ p Exceptions to warranties: Easements and restrictions of record. Dated this ~s'~ day of ~To43E(L , 2004 AUTHENTICATION Signature(s) authenticated this day of r TITLE: MEMBER STATE BAR OF WISCONSIN (If not, _ -- - - authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Thomas A. McCormack Baldwin, WI54002 (Signatures may be authenticated or acknowledged. Both are not necessary) • Names of persons signing in any capacity must WARRANTY DEED Area '778390 I{ATHLEfiH H. 111ALSH REGISTER OF DEEDS ST. CROIX CO. , liI RECfiIYED FOR RECORD 10/29/2004 10:88A1i YARRAIiTY DEED EXEIPT ~ REC PEE: 'TRANS PEE: COPY PEE: CC FEE: PAGES: 1 Name and Return Address Thomas A. McCormaC PO Box 2120 Baldwin WI 11.80 1275.80 \~ ~~ 1~ .- ~ ~L~..l~ t~~ ~~ ~ o~ '~~ rr / / l - 008- 035-30,008-1037-60,008-1037-7.0,008-1037-SO Parcel Identification Number (PM) This is homestead property. (is) STATE OF WISCONS St. Croix IN ) ss. County ) Personally came before me this ~S•l'~- _ day of 2004 the above named Timothy Sandvig, a!k/a Timothy C. Saadvig and Sylvia Sandvig, a/k/a Sylvia J. Sandvig to me known to be the person(s) who exe~i~e2~•tlgifitt~ nt and a knowledged the sam~.1 ~~0,*- ,_, No lic, State of WISCONSIN ~'•••••••• My Commissi n is permanent. (If not, state ~ date: or printed below their signature. STATE BAR OF WISCONSIN FORM No. 2 - 2000 INFO-PRO (B00)855-2021 www.inioprotomis.oom ACKNOWLEDGMENT HELGES N EXCAVATI N, Inc. SEWER AND WATER SPECIALISTS Plumber/CST Cert. #220292 BEN HELGESON Office (715) 772-3278 W. 1229 770th Ave. Home (715) 772-3127 Spring Valley, WI 54767 Fax (715) 772-3387 August 21, 2006 RECEIVED St. Croix County Zoning Kevin Graber AUG 2 3 2006 1011 Carmichael Road Hudson, WI 54016 ST. CROIX COUNTY RE: SANITARY PERMIT # 488295 JAMES RIESSELMAN Dear Mr. Graber: The septic tank pump chamber will be assessable for servicing by means of a field drive from the proposed driveway. Sincerely, Bennie Helgeson President BH:cb / °d ~ -~ Gat~t/ ~ 3~ ~ ~o~ g ~- 103- ~o_o~ 13. 2$• ~~, t 4a B