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040-1051-30-050
. Croix Wisconsin Department of Commerce. PRIVATE SEWAGE SYSTEM County: St Safety and Building Division INSPECTION REPORT Sanitary Permit No: 556314 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: Purfeerst, Patricia Troy, Town of 040-1051-30-050 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 12.28.19.189A05 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURE t CAPACITY STATION BS HI FS ELEV. s ^IS- 'V- 102-4z- / Septic Benchmark ! - 1 b Dosing IQ, yS 2 S Alt . 1 CA 1,06 . -1Z ex -L i Aeration ff JJ s ,7 Bldg. Sewer 1 /Z- 7 St/Ht St/Ht Inlet 33 ~Q.7L r' 1 St/Ht Outlet 2 TANK SETBACK INFORMATION 66 + . TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet cm -3 Septic -766' Dt Bottom ' r q Dosing 7 Ab Header/Man. . 1% 166 1641 Aeration Dist. Pipe 'a O Holding Bot. System Final Grade I+ a ~k PUMP/SIPHON INFORMATION t 0q / fah 1116 Manufacturer L_1 GDemand St Cover 6 JQ.^.-. r • I lJ~~+7 Model Number (q .Z~ TDH Lift' C1 Frictior} Lo System H ZS TDZ I' Z ~ ~O r '3 . v e)- Forcemain Length Dia.,st Dist. to Well I SOIL ABSORPTION SYSTEM S.` S is Z7 BEDITRENCH Width Length No. Of nch PIT DIMENSIONS No. Of Pits Inside Dia. Liquid' Depth DIMENSIONS to I _7q I N., SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: ` INFORMATION CHAMBER OR Type Of S s J /J+-- UNIT Model Number: d►► DISTRIBUTION SYSTEM IHeader/Manifol ID istribution j/ / x Hole Size x Hole Spacing j Ven Air Intake Pipe(s) 3 Dia Length Dia Spacing ✓ f 117 ° Length_ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded Mulched No Bed/Trench Cent%y/ Bed/Trench Edges Topsoil es Rfl No es '64, 11 -74 I COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / Z Inspection #2: / / Location: 864 Coulee Trail Hudson, WI 54016 (NW 1/4 SE 1/4 12 T29N R19W) metesl~4& bounds Lotrcel No: 12.28.19.189A05 1.) Alt BM Description of chdj r r/ 2.) Bldg sewer length - - amount of cover Plan revision Required? Fv~ Yes N J-475 Use other side for additional information. =71 - - - Date Inse tor's S to Cert. No. SBD-6710 (R.3/97) A ~tJv A Obef"Pull~ Specifications A 290 Series 3/4 hp Submersible Effluent Pump LITERS PER MINUTE 0 50 100 150 200 250 300 50 14 45 40 12 35 10 30 w Z z a 8 g _ 25 4 a w t- _ O 20 6 0 F 15 4 10 2 5 p I 0 . - 0 10 20 30 40 50 60 70 80 90 GALLONS PER MINUTE 290 PI 807/11/2011 CCopyright 2011 Liberty Pumps Inc. All rights reserved. Specifications subject to change without notice. Pu~nps° 290-Series Dimensional Data 9.5" [240mm] 6.5n [166mm] CORDS 230V, OR 120V PIGGY BACK - AUTOMATIC SHOWN 13" [332 m] .6" [90MM] 8.9" [226mm] PLYG. NC. FROYMIETARY AND CONFIDIDVAL 290 SERIES DIMENSIONAL THE. INP MMARONCONTAINED IN THIS DRAWING IS THE SOLE PROPERTY OF INSERT COMPANY NAME HERE-. ANY 2ffRGDOCTION IN PART OR AS A WHOLE WOMOI,CTTHE WRITTEN PERMISS?DN OF A JULY 2011 INS'E'RT CC)WAM! NAME HERE, B PROHIMM AP%.ICAYgN t70 NOT SCALE DRAWING scAiEn:a st,w, of i 290_P2 807/1112011 ®Copyright 2011 Liberty Pumps Inc. All rights reserved. Specifications subject to change without notice. Pumps 290-Series Electrical Data FULL LOCKED THERMAL STATOR CORD MODEL HP VOLTAGE PHASE LOAD ROTOR OVERLOAD WINDING LENGTH DISCHARGE AUTOMATIC AMPS AMPS TEMP CLASS FT 290 3/4 115 1 10.4 24 120°C/ 248'F B 10 11/2 NO MANUAL YES 291 3/4 115 1 10.4 24 120°C/ 248°F B 10 1112 INTEGRAL FLOAT YES 293 3/4 115 1 10.4 24 120°C/ 248°F B 10 11/2 PIGGY BACK FLOAT YES 297 3/4 115 1 10.4 24 120'C/ 248°F B 10 11/2 INTEGRAL VERTICLE FLOAT 290HV 3/4 208-230 1 5.3 13 105°C/ 221 °F B 10 11/2 NO MANUAL YES 291HV 3/4 208-230 1 5.3 13 105°C/221'F B 10 11/2 INTEGRAL FLOAT YES 293HV 3/4 208-230 1 5.3 13 105°C/ 221 °F B 10 11/2 PIGGY BACK FLOAT YES 297HV 3/4 208-230 1 5.3 13 105°C/ 221'F B 10 11/2 INTEGRAL VERTICLE FLOAT 290-Series Cord Length Options* Model 10' 25'(-2) 35'(-3) 50'(-5) 290 Standard Optional Optional Optional 291 Standard Optional Optional Optional 293 Standard Optional Optional N/A 297 Standard Optional N/A N/A 10' cord length standard on all models. For optional lengths, add "-2, -3 or -5" suffix to model number. Example: for model 290 with 35' cord. Order 290-3 WARNING: *Always use a replacement power cord assembly of the same length and type as originally installed on the Liberty product. Using a cord of improper gauge or length may lead to exceeding the electrical rating of the cord and could result in death, injury, fire or other significant failure. 290-P3 R07/11/2011 ®Copyright 2011 Liberty Pumps Inc. All rights reserved. Specifications subject to change without notice. Pumps 290-Series Technical Data IMPELLER VORTEX ENGINEERED POLYMER SOLIDS HANDLING SIZE g/4n PAINT POWDER COAT MAX LIQUID TEMP 60°C/ 140°F MAX STATOR TEMP CLASS B 130°C/ 266°F THERMAL OVERLOAD 120°C/ 248°F (115V Models) 105°C/ 221°F HVModels) POWER CORD TYPE SJTW (1 Oft & 25ft models) SJTOOW 35ft & 50ft models MOTOR HOUSING/ VOLUTE CLASS 25 CAST IRON SHAFT STAINLESS HARDWARE STAINLESS ORINGS BUNA N ENGINEERED DOUBLE LIP SHAFT SEAL SEAL WITH STAINLESS STEEL SPRINGS WEIGHT 31 LBS 290-Series Specifications 1.01 GENERAL: The contractor shall provide labor, material, equipment, and incidentals required to provide_ (QTY) centrifugal pumps as specified herein. The pump models covered in this specification are Series 290 single phase pumps. The pump furnished for this application shall be model as manufactured by Liberty pumps. 2.01 OPERATING CONDITIONS: Each submersible pump shall be rated at 3/4 hp volts, single phase, 60 Hz., 3450 RPM. The unit shall produce G.P.M. at feet of total dynamic head. The submersible pump shall be capable of handling effluent with 3/4" solid handling capability. The submersible pump shall have a shut- off head of 48 feet and a maximum flow of 78 GPM @ 5 feet of total dynamic head. The pump shall be controlled with: A piggy back style on/off float switch. An integrally wired on/off float switch. A Vertical Mechanical Float (VMF) type on/off switch. A NEMA 4X outdoor simplex control panel with three float switches and a high water alarm. A NEMA 1 indoor simplex control panel with three float switches and a high water alarm. A NEMA 4X outdoor simplex control panel with four float switches and a high water alarm. A NEMA 1 indoor simplex control panel with four float switches and a high water alarm. A NEMA 4X outdoor duplex control panel with three float switches and a high water alarm. A NEMA 1 indoor duplex control panel with three float switches and a high water alarm. A NEMA 4X outdoor duplex control panel with four float switches and a high water alarm. A NEMA 1 indoor duplex control panel with four float switches and a high water alarm. 290-P4 R07/11/2011 ®Copyright 2011 Liberty Pumps Inc. All rights reserved. Specifications subject to change without notice. Pumps 3.01 CONSTRUCTION: Each submersible pump shall be equal to the ®R.'s certified Series 290 SERIES pumps as manufactured by Liberty Pumps, Bergen NY. The castings shall be constructed of class 25 cast iron. The motor housing shall be oil filled to dissipate heat. Air filled motors shall not be considered equal since they do not properly dissipate heat from the motor. All mating parts shall be machined and sealed with a Buna-N o-ring. All fasteners exposed to the liquid shall be stainless steel. The motor shall be protected on the top side with sealed cord entry plate with molded pins to conduct electricity eliminating the ability of water to enter internally through the cord. The motor shall be protected on the lower side with an engineered double lip seal with stainless steel springs. The pump shall be furnished with stainless steel handle. 4.01 ELECTRICAL POWER CORD The submersible pump shall be supplied with 10, 25, 35, or 50 feet of multiconductor power cord. It shall be cord type SJTW, or SJTOOW capable of continued exposure to the pumped liquid. The power cord shall be sized for the rated full load amps of the pump in accordance with the National Electric Code. The power cable shall not enter the motor housing directly but will conduct electricity to the motor by means of a water tight compression fitting cord plate assembly, with molded pins to conduct electricity. This will eliminate the ability of water to enter internally through the cord, by means of a damaged or wicking cord. 5.01 MOTORS Single phase motors shall be oil filled, permanent split capacitor, class B insulated NEMA B design, rated for continuous duty. At maximum load the winding temperature shall not exceed 130 degrees C unsubmerged. Since air filled motors are not capable of dissipating heat they shall not be considered equal. The pump motor shall have an integral thermal overload switch in the windings for protecting the motor. The capacitor circuit shall be mounted internally in the pump. 6.01 BEARINGS AND SHAFT An upper and lower ball bearing shall be required. The ball bearing shall be a single ball / race type bearing. Both bearings shall be permanently lubricated by the oil, which fills the motor housing. The motor shaft shall be made of 300 or 400 series stainless steel and have a minimum diameter of .311 7.01 SEALS The pump shall have an engineered double lip seal with stainless steel springs. The motor plate / housing interface shall be sealed with a Buna-N 0-ring. 8.01 IMPELLER The impeller shall be vortex style made of an engineered polymer, with pump out vanes on the back shroud to keep debris away from the seal area. It shall be threaded to the motor shaft. 9.01 CONTROLS All pumps can be supplied with a CSA and UL approved VMF type switch, an integrally wired wide angle tilt float switch, or piggy back type wide angle tilt float switches. The piggy back style switches are equipped with a plug that allows the pump to be operated manually without the removal of the pump in the event that a switch becomes inoperable. Manual pumps are operable by means of a pump control panel. 10.01 PAINT 290-P5 R07/11/2011 ®Copyright 2011 Liberty Pumps Inc. All rights reserved. Specifications subject to change without notice. naps The exterior of the casting shall be protected with powder coat paint. 11.01 SUPPORT The pump shall have cast iron support legs, enabling it to be a free standing unit. The legs will be high enough to allow 3/4" solids to enter the volute. 12.01 SERVICEABILTY Components required for the repair of the pump shall be shipped within a period of 24 hours. 13.01 FACTORY ASSEMBLED TANK SYSTEMS WITH GUIDE RAIL AND QUICK DISCONNECT DISCHARGE Guide factory mounted rail system with pump suspended by means of bolt on quick disconnect which is sealed by means of nitrile grommets or o-rings. The Discharge piping shall be schedule 80 PVC and furnished with a PVC check valve and shut-off ball valve. The Tank shall be wound fiberglass or roto-molded plastic. A cast iron inlet hub shall be provided with the fiberglass systems. Stainless steel Guide Rail Zinc plated steel Guide Rail "diameter of basin size "height of basin size "distance from top of tank to discharge pipe outlet Fiberglass cover Structural foam polymer cover Steel cover Simplex System with Outdoor panel and alarm Duplex System with Outdoor panel and alarm Separate Outdoor Alarm Remote Outdoor Alarm 14.01 TESTING The pump shall have a ground continuity check and the motor chamber shall be Hi-potted to test for electrical integrity, moisture content and insulation defects. The motor and volute housing shall be pressurized, and an air leak decay test is performed to ensure integrity of the motor housing. The pump shall be run, voltage current monitored, and the tester checks for noise or other malfunction. 15.01 QUALITY CONTROL The pump shall be manufactured in an ISO 9001 certified Facility. 16.01 WARRANTY Standard limited warranty shall be 2 years. Pm 290-P6 R07/11/2011 ®Copyright 2011 Liberty Pumps Inc. All rights reserved. Specifications subject to change without notice. =R Air ps 'fCounty Safety and Buildings is St. Croix e ID 201 W. Washington Ave., t`.U. l~Ux 2 anitary Permit Number (to be filled in by Co.) P Madison, WI 53707-7162 - VGeimit Application State Transaction Number in accordance with SPA 3830 is. Adm. Code, submission of this form to the appropriate governmental unit 212446 is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary 1 / purposes in accordance with the Privacy Law, s. 15.04 1 m , Slats. Q l 6oJ'e4, 1. Application Information - Please Print All Information SAME Property Owner's N Parcel # 040-1051-30-050 Patricia Purfeerst 5 Property Owner's Mailing Address Property Location 864 Coulee Trail Govt. Lot City, State Zip Code Phone Number l2_ _NW_ y4 _SE_ Section _ Hudson, WI 54016 (circle one) U. Type of Building (check all that apply) Lot 1 T 28 N; R _t9_ E or w 1 or 2 Family Dwelling - Number of Bedroom G-7 Subdivision Name Block # ❑ Public/Commercial -Describe Use (GCtZY1~! ❑ City of ❑ State Owned - Describe Use CSM Number ❑ village of 11 Town of ~O J l..-C~l~ ~ ~ 7 5 Troy III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ❑ New System Replacement System ❑ Treatment/Holding Tank Replacement Only clol- odificati on g S'n) Z~i ❑ Permit Transfer to New List Previous Permit Number and D ate ];sued B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ~ n / ~xw C/2 Before Expiration Owner / V G' IV. Type of POWTS System/Component/Device: (Check all that apply) ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil It Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dispersal/Treatment Area Information: Design Flow ( ) Design Soil Application te(gpdsf) Dispersal Area Requite sf) Dispersal Area Proposed (s System Elevation 450 0.40 1125 1224 5 99.96' VI. Tank Info Capacity in Total # of Manufacturer w c Y Gallons Gallons Units U C7 New Tanks Existing Tanks lam, 5z5 ° 2 w Septic or Holding Tank 1000 0 1000 ieser oncrete X Dosing cl'aa`ber 750 0 750 Wieser Concrete X VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print)John Schmitt Plumber' r MP/MPRS Number Business Phone Number 223760 715-760-0486 Plumber's Address (Street, City, State, Zip Code) 616 150'th Ave. Somerset, WI 54025 VIII County/Department Use Only 17 AKApproved lsapproved Permit Fee Date Issued Issuin ent Signature tea$ ko~~ IX. Conditj*.jl*aVg9q*R.easons for Disapproval n t r i. $eptic tank, of kWt 8fter and 3, ~~dl -~s ,ems y , ti- fG PatJ e. A- dispersal call must all be services / maintained alspermanagement plan provided by plumber, 2. lase per q*1o meats must g maintained ' [ • tide /ordinances: Attach to complete plans for the system and submit to the County oafty on paper not less than 8 1/2 x 11 inches in size SBD-6398 (R. 11/11) ~~vAxZ PIV Safety and Buildings ~0 3824 N CREEKSIDE LA Q HOLMEN WI 54636 3 S Contact Through Relay S www.dsps.wi.gov/sb/ F w www.wisconsin.gov 9?O o 5~ ssiorsPt, Scott Walker, Governor Dave Ross, Secretary July 25, 2012 CUST ID No. 223760 ATTN: POWTS Inspector JOHN F SCHMITT ZONING OFFICE SCHMITT & SONS EXCAVATING ST CROIX COUNTY SPIA 615 150TH AVE 1101 CARMICHAEL RD SOMERSET WI 54025 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/25/2014 SITE: Identification Numbers Patrica Purfeest Transaction ID No. 2124476 864 Coulee Trail Site ID No. 781770 Town of Troy Please refer to both identification numbers, St Croix County above, in all correspondence with the agency. NW1/4, SE1/4, S12, T28N, R19W FOR: Description: Three Bedroom Mound System / 2% slope Object Type: POWTS Component Manual Regulated Object ID No.: 1382599 Maintenance required; Replacement system; 450 GPD Flow rate; 16 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual -Version 2.0, SBD-10691-P (N.01/01), Pressure Distribution Component Manual - Version 2.0, SBD-10706-P (N.01/01); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. RO. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code Condit 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, APPR stats. The following conditions shall be met during construction or installation and prior to occupancy or use: DIVISION OF SAFE Reminders EE CORRE • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per SPS 384 product approval conditions. • All POWTS component piping material shall be SPS 384, Wis. Adm. Code compliant. • The area within 15' downslope of the dispersal cell shall remain undisturbed. Vehicular traffic, excavation or soil compaction is prohibited in this area. • The existing POWTS shall be properly abandoned per 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. JOHN F SCHMITT Page 2 7/25/2012 Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • 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. SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter 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. Gerard M Swim z~~, When You Receive That Invoice, POWTS Plan Reviewer, Integrated Services Please Include a Copy With Your (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm Payment Submittal. jerry.swim@wisconsin.gov WiSMART code: 7633 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. JOHN F SCE= Page 2 7/25/2012 Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • 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. SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter 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. Gerard M Swim When You Receive That Invoice, POWTS Plan Reviewer, Integrated Services Please Include a Copy With Your (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm Payment Submittal. jerry.swim@wisconsin.gov WiSMART code: 7633 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. MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Purfeest 3 Bedroom Mound J(f ! ® ~l7~2 Owners Name: Patricia Purfeest Owner's Address 864 Coulee Trail Hudson, WI 54017 Legal Description: NW1/4, SE1/4, S12, T28N, R19W Township Troy County: St. Croix Subdivision Name: 19.28 Acre parcel Lot Number: 1 Block Number Parcel I.D. Number 040-1051-30-050 Plan Transaction No. J.T.S. 'ovally Page 1 Index and title OVED Page 2 Data entry Page 3 Mound drawings Y AND BUILDINGS Page 4 Lateral and dose tank , Page 5 System maintenance specifications Page 6 Management and contingency plan NDENCE Page 7 Septic tank specifications Page 8 Effluent filter information Page 9 Dose Tank Specifications Page 10 & 11 Pump specifications and curve Page 12 Plot plan Page 13 Septic tank maintenance agreement Page 14 Warranty deed Page 15 Aerial Photo Page 16 - 20 Soil evaluation report Designer: John Schmitt License Number: 223760 Date: 7/9/2012 Phone Number: 715-760-0486 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SBD-10691-P (N. 01/01) and both SSWMP Publication 9.6 Design of pressure Distribution Networks for ST-SAS (10/81) and Pressure Distribution Component Manual Ver. 2.0 SBD- 10706-P (N. 01/01) Version 7.0 (R. 03/2012) Page 1 of 20 Mound and Pressure Distribution Component Design Design Worksheet Site Information (R or C) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 300.00 Estimated Wastewater Flow (gpd) Table 383-44-3 in-situ soil treatment for 1.50 Peaking Factor (e.g. 1.5 = 150%) fecal coliform of - 36 inches. 450.00 Design Flow (gpd) 2.00 Site Slope 98.29 Contour Line Elevation (ft) 16.00 Depth to Limiting Factor (in) 0.40 In-situ Soil Application Rate (gpd/ftz) Distribution Cell Information 79.00 Dispersal Cell Length Along Contour (ft) = 5.70 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/fe) 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 2.85 Lateral Spacing (ft) If N above, enter the elevation (ft) 4 Number of Laterals of the highest point. 0.188 Orifice Diameter (in) 2.50 Estimated Orifice Spacing (ft) = 7.04 fe/orifice 2.00 Forcemain Diameter (in) 175.00 Forcemain Length (ft) Does the forcemain drain back? Y 88.00 Pump Tank Elevation (ft) Enter Y or N 3.25 System Head (ft) x 1.3 28.55 Forcemain Drainback (gal) 11.55 Vertical Lift (ft) 71.11 5x Void Volume (gal) 6.31 Friction Loss (ft) 99.65 Minimum Dose Volume (gal) 0.00 In-line Filter Loss (ft) 41.94 System Demand (gpm) 21.10 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. diia, options _ choice in. dia. options choice 0.75 1.25 1.00 1.50 x 1.25 x 2.00 x x 1.50 x x 3.00 2.00 x 3.00 x Gallons/Inch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1000.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Wieser Manufacturer gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 750.00 Dose Tank Capacity (gal) PolyLok Commercial Filter Manufacturer 20.28 Dose Tank Volume (galljn) 525 Filter Model Number Weiser Manufacturpr Project: Purfeerst Mound Page 2 . Mound Plan and Cross Section Views ~ t J ::1/106 . Observation Pipe ; ; ; • : - K A W :.I........... - :::.:.1: y . B I 3: Mound Component Dimensions A 5.70 ft E 21.37 in H 1.00 ft K 10.55 ft B 79.00 ft F 9.50 in z 9.81 ft L 100.09 ft D 20.00 in G 0.50 ft J 8.37 ft W 23.88 ft 450.30 (ft j Dispersal Cell Area 1224.92 (ft2) Basal Area Available 5.70 (gpd/ft) Linear Loading Rate 7.90 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 101.75 (ft) ♦ H G1 F Dispersal Cell 100.46 ( a era T I 99.96 (ft)-► - Invert 1 Dispersal Cell Elevation E D..•........•.•.::•. 98.29 (ft) Contour Elevation 2.0 % Site Slope Geotextile Fabric Cover Shading Key T Dispersal Cell See lateral details on 10 _ Topsoil Cap 1.5 ft . Page 4 for number, size, Subsoil Cap 5 ' ' and spacing of laterals. ASTM C33 Sand Z F Laterals are equally Tilled Layer c d 0.5 ft Typical Lateral spaced from the ❑5 ::r r rr Aggregate;; distribution cell's `?`a`s''s'sy'.`I'`'....s: centerline in the - A distribution cell (AxB). Project: Purfeerst Mound Page 3 . s Center Connection Lateral Layout Diagram Force main connection via tee or cross to manifold at any point. Laterals are identical I P S Al- IE-~I sl2•a Turn-upvm'bsllvseor XEK12 +l Laterals MorcemainSch40PVC clesnoutplug per SPS Table 384.30-6 Holes drilled on the bottom of the lateral. Number of Laterals 4 Orifice Diameter 0.188 in Lateral Diameter 1.50 in Orifice Spacing (X) 2.50 ft Lateral Length (P) 38.75 ft Orifices per Lateral 16 Lateral Spacing (S) 2.85 ft Orifice Density 7.04 ft2/orifice Lateral Flow Rate 10.49 gpm Manifold Length 2.85 ft System Flow Rate 41.94 gpm Manifold Diameter 2.00 in Total Dynamic Head 21.10 ft Forcemain Velocity 4.28 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and SPS 316.300 WAC Disconnect 4 in. min. Tank component is properly vented E- Alternate outlet location Forcemain diameter Weiser Manufacturer 2 in. Capacityl 750.00 Gallons Volume 20.28 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 19.17 388.73 B 2.00 40.56 C P~ ump off elevation (ft) C 4.91 99.65 88.91 D 10.90 221.05 D I F~ Total 36.98 750.00 Dose tank elevation (ft) 3' Bedding un er tank. 88.00 Alarm Manuafacturer Septronics Note: Switches Alarm Model Number TM-1 containing mercury may not be used in Pump Manufacturer Zoeller this system. Pump Model Number 140 1 Pump Must Deliver 41.94 gpm at 21.10 ftTDH Project: Purfeerst Mound Page 4 f Mound System Maintenance and Operation Specifications Service Provider's Name John Schmitt Phone 715-760-0486 POWTS Regulator's Name St. Croix County Zoning Phone 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 450.3 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once eve 3 ears Effluent Filter Should inspect and clean at least once eve 3 ears Pump and Controls Test once eve 3 ears Alarm Should test month) Pressure System Laterals should be flushed and pressure tested eve 1.5 ears Mound Inspect for ponding and seepage once every 3 years Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound 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 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Purfeerst Mound Page 5 Mound System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01)] 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 SPS 383.33, 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. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound'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 mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound 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 BODS, 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 mound 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. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. Project: Page 6 D z X Vf z m s 61" 86" z c a 42" ~ z 8 0 UP 4 t-3 a ~ s 4" CAS / 0 N 8 3" 36" ( 4" a o D 5 V) y~ I a;u a UP 38 r 0 n F~ ~ 4" CAS I I ~ v I z ~ g 0 ° a c ;o a:::I m ° " z 0 N <o 39 ° -I ODZ N -1 ma~ CO D OmD In 1.10 > :U;u O r m~ x n x D Z O m N g0 z z o x Cp z z s -1 x c g c ~ ~ Q D ° D D D v P a C v x c0 CO z z 31 K~ z O r. cn ~V mz Z~X G7 nC0 n O~ZD D c) - Z ~ rm-°~ r!IZO OD Z T cAamm xx v Fv~ ° - i! 8v woo bEg o ix~ Fn Cv v BCD m D X v*„ il - of C ND ~rn \m y SLt R m 1°znO g N 1- Z o~ c F~ ox• In- , -,04' FizFri v'~ 7C Zs~ x xp D° ~Z na s0~ N~ D -1 , g el`: m c) Dv v ~S? )'Z oo Dm N ~y"i Vl > I --l co ~~~♦s M 0 a z oho -D ~m 0-0 ~4 Nmmv ~m CA-06P 000- -c~ ~ O p c 1""1 N W. c ~C w Nv mD Dr FD C °OV G7W m O 0 0 m Q cn s (n z my m W N n 560 -4 Z 0 1+1 Q ~.j f~ CD v X o v pp C N D D p m a H nm Vs (7 I $ CA D oo m m Z oil c o D mrz Ov fr a r - 1 W m< v m s ^D ° Z n zv z z z~ v CO O Nn I ul ;d ;D TI r Z D a°~ 0;u ~0-1 ° Z 0,m .vn M F o W m W T n O ° 17c p Z o W x o In N D D A 2 z 4 mr 0 p " H g z z m DRAWN BY. SME SCALE: 1/4"-l'-O" PRE-POUR: \O WLP1000-MISER TE REV. -n -1 SEPTIC MANUAL mllE z W3716 US HWY 10 MAIDEN ROCK. WI 54750 DATE: JANUARY 2010 DATE:. POST-POUR: \ ° REVISED JAN. 2010 800-325-8456 FILE: WMWO Ml Page 7 pDL Inc, ~KINSTALLATION INSTRUCTIONS Innovations in Precast Drainage Zabel* Wastewater Products ~ A Division of Poiyhk Inc. & PL-525/PL-625 FILTER INSTALLATION INSTRUCTIONS Center filter with opening yy~~ Z J~ mo x Additional pipe or Polylok Extend & Lok, Glue for centering. Step 1: Step 2: Step 3: (A) Locate the outlet of the septic tank. (A) Before installation, place the (A) Glue the filter housing on the (B) Remove tank cover and pump tank filter housing on to the outlet pipe. outlet pipe, if necessary. (B) Make sure that the housing (B) Insert the filter cartridge in the is positioned so the filter can be housing, making sure the filter removed from the tank for cartridge is properly aligned and maintenance and service. completely inserted in the housing. MAINTENANCE INSTRUCTIONS Step 1: Step 2: Step 3: Locate the outlet of the septic tank. (A) Remove tank cover and pump (A) Insert the filter cartridge back if necessary. into the the housing making sure • NOT USE PLUMBING (B) Pull the filter out of the housing. the filter is properly alighed WHEN FILTER IS • ' and completely inserted. (C) Hose off the filter over the septic tank. USE RIBER GLOVES Make sure all solids fall back into the (B) Replace septic tank cover WHEN CLEANING FILTER septic tank. Page 8 D Z X N m X 61" 84" n 42" 9 Z r O ^N -4 s i m UP 41" 4 CAS \ 8 3" 37" 4" 'o ( D I W~ N UP 39" m 1 Po a 4" CAS \ m m / n g M U O ONE ~s m Dv 40" o < o a m W r 0~;' . D A - N r*i ?aM0C X t+ 1 o ;u S D Z m y 0 --q mO gi D v g C Z Z Z~Z O Co 0 p~D ODD CIWC ,E3DnOfSC► v~ XX vFc"n v ~~ZV cDn0 v 250 y =W2 D V) °mm n ~D c1 r m f''iDZ n mz° 42 ~Ng zm ..f M ` 0 - --I Fn s ZD Q so 0** cn I N 22 x 4 =m z O>~ DZ 0D FD~ N~WN (n r- > ~ v D OD Fn D N > M o In r~*i ~ r-n v D Z OOD D m co ~o v -I x Z N O r N V1f*l y I D ~ w N l~* 00- t- m y a < m w tvi+ W n (nOZ C GOB O T -I ~~*1 Dr N~ s~v v m C m WWp O a cc m m n23 O D 0 y co r 0r D >O ~r'scrOfm -Ti 51 m v m z 0 ~M Q-u M D Z~ 10 ,a) p~O(A J> -n .a+ D F C r ~ v 3 m m = O cn cn Fp O g o O ~D 0 Z 0 g r N n " ;D H 0 z F 4 \ cn RP750-MR rn DRAWN BY: SME SCALE: 1/4"=l'-O" PRE-POUR: ° mi SEPTIC MANUAL MHER mCRETE REV. \ Z W3716 US HWY 10 MAIDEN ROCK, WI 54750 DATE: JANUARY 2010 DATE:. POST-POUR: ° REVISED JAN. 2010 800-325-8456 FlLE: NF7" Page 9 r SECTION: 2.20.045 QLG4L/TV PL/MP8 glNCE 1,9,7.q FM1502 1211 oduct information presented Supersedes Pr here reflects conditions time PUMP 0710 P9. of publication. Consult factory regarding discrepancies or inconsistencies. MAIL TO: PO, BOX 16347 • Louisville, KY 40256-0347 visit our web site: SHIP T0: 3649 Cane Run Road • Louisville, KY 40211-1961 www.zoeller com (502) 778-2731.1(800) 928-PUMP • FAX (502) 774-3624 COMPARE THESE FEATURES 14014140 & 14514145 Cast Iron Series • Durable Cast Iron construction • Model 140 features a Non-Clogging engineered (For Pump Prefix Identiff'cation see News & Views 0052) thermoplastic vortex impeller design and passes %2" spherical solids "FLOW=MATE" • Model 145 features an engineered thermoplastic single vane impeller design and passes 3/4" spherical solids FOR SEPTIC TANK - LOW PRESSURE PIPE (LPP) • Motor - 60 Hz, 3450 RPM, oil-filled, hermetically AND ENHANCED FLOW STEP SYSTEMS sealed, automatic reset, thermal overload protected • Available in both single or double shaft seal designs EFFLUENT • Carbon/Ceramic mechanical shaft seals OR DEWATERING PUMPS• • Assembled with Stainless Steel bolts SUBMERSIBLE ti v • Stainless Steel lifting handle 1'/2" NPT DISCHARGE • Upper sleeve and lower ball bearing running in bath of oil • 20 ft. UL Listed Neoprene cord with molded plug cap and ground wire Model BN140 Model 140 • 1'/2" NPT vertical discharge and BN145 and 145 • BN and BE models include a variable level float Single Seal Single Seal switch and 1'/2" X 2" PVC adapter fitting Pumps Pumps • Operates at temperatures to 130OF (54°C) in effluent or dewatering applications • Corrosion resistant powder coated epoxy finish Note: The sizing of effluent systems normally requires variable level float(s) controls and properly sized basins to achieve required pumping cycles ordosing timers with nonautomatic pumps. C CHOUS Model 4140 Tested to UL Standard UL778 and 4145 and Certified to CSA Double Seal Standard C22.2 No. 108 Pumps k/FeMP l0. POWDER COATED MAIL TO, PQ' BOX 16347 TOUGH- Louisville KY 40256-0347 SSPM9 ` SHIP TO: 3649 Cane Run Road Louisville, KY 40211-1961 (502) 778-2731 • f (800) 928-PUMP MODELS AVAILABLE FAX (502) 774-3624 • Automatic (Models BN & BE) • Nonautomatic Manufacturers of... • 1 HP, 1 Ph 115V or 230V (140/4140) HP,1Ph115V(145/4145) `O `QL/.4L/TY /-lwvw ~/iNCE 19Mo 0 Copyright 2011 Zoeller Co. All rights reserved. Page 10 PUMP PERFORMANCE CURVE TOTAL DYNAMIC HEAD/FLOW • MODEL 140/41401104146 PER MINUTE 7b EFFLUENT AND DEWATERING 3713 65115 77 4P ~ MODEL 140/4140 145/4145 >o ~ Feel Meters Gal. Liters Gal. Ulm eb 5 1.5 88 328 81 232 326132 16 10 3.0 80 303 80 228 + 15 4.8 73 278 58 213 +e bo 20 8.1 88 250 53 201 25 7.8 59 223 49 188 1 W A1112 1 14 46 2 30 9.1 49 185 45 171 x 40 12.2 28 108 35 133 Y 13 50 15.2 - - 28 99 36 80 18.3 - - 18 81 10 Shut-off Heed: 50 ft. 15.2m 74 ft 22.8m f? d0 b $ I e ID 121332 ib t500a0 4 10 4 6132 2 SK152AA 6 1461 14N N/6 /1/0 ° 10 70 JO M W 70 b BO fiM1DtN 1f6~0 0 p 100 2[0 370 • • a - FLOW PER MINUTE CONSULT FACTORY FOR SPECIAL APPLICATIONS 37M 461+6 • Electrical alternators, for duplex systems, are available and supplied with an alarm. --I 46re • Mechanical alternators, for duplex systems, are available with or without alarms. I • Control alarm systems are available for 1 phase pumps used in simplex system. See FM0732. 320132 • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long cycle controls. + • Sealed Qwik-Box available for outdoor installations. See FM1420. • Refer to FMO806 for applications above 1307 (54°C). 14014140 & 14514145 MODELS • SINGLE PHASE Control Selection Model Model Volts Mode Amps Simplex Duplex N140 N4140 115 Non 12 1 or 2 3 E140 E4140 230 Non 6 1 or2 3 BN140 BN4140 115 Auto 12 BE140 BE4140 230 Auto 6 N145 N4145 115 Non 13 1 or2 3 4 U32 E145 E4145 230 Non 6 1 or2 3 ~L SK1524B BN145 SN4145 115 Auto 13 - BE145 BE4145 230 Auto 6 - SELECTION GUIDE *Single piggyback switch included. 1. For automatic use single piggyback variable level float switch or double OPTIONAL PUMP STAND P/N 10.2421 piggyback variable level float switch. Refer • Reduces potential clogging by debris. to FM0477. • Replaces rocks or bricks under the pump. 2. See FM 1228 for correct model of simplex • Made of durable, noncorrosive ABS. "Easy assembly" control panel, e (Puny & "Charge Pipe • Raises pump 2 off bottom of basin. not ind Wed.) 3. See FM0712 for correct model of duplex • Provides the ability to raise intake by adding control panel. sections of 1 V2° or 2• PVC piping. • Attaches securely to pump. o cnunoN • Accommodates sump, dewatering and All installation ofcontrols,protectiondevicesandwidngshould effluent applications. be done by a qualified licensed electrician. All electrical and NOTE: Make sure Host is free from obetrucdon. safety codes should be followed including the most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. 0 Copyright 2011 Zoeller Co. All rights reserved. Page 11 PLOT PLAN N Project Name: PURFEEST 3 BEDROOM MOUND Legal Description: NW1/4 SE1/4 S12 T28N R19W P.I.D: 040-1051-30-050 Subdivision Name: NA Lot NA Township: TROY Parcel Size: 19.28 Acres County: ST. CROIX SCALE: 1" a Contour Line Elevation: 98.29' System Elevation: 99.96' 4 inch Sch 40 -ASTM D2665 Slope: 2% 2 inch Sch 40 -ASTM D1785 • BM1 Elevation: 100.00' TO Of 2" PVC pipe 11/2 Sch 40 -ASTM D1785 BM2 Elevation: 99.27' To of 2" PVC pipe 4" 3034-ASTM3034 ■ Backhoe Pits: NO R , o GQT U N e z 3ZS ~ to ! r q ~i 1 ® R `b Z®1o 5LOPE Zy'x ioo' rvloarJ ~ gM t CON 1 vU P, 1 L►Nc 83 © gMZ i ~qo 175' i=oRco MAIN eNc,c LINE -150 GALLOtJ QDy~p SAN pld 3"0' 3031 !0' L4.':;(14 1000 GA Lw Q L4.':;(14 4 SeArIC TAIU Sc:µ y 0 \Ol r `.L )N -Z0 \NELL flR Page 12 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGRE£*vIENT AND ONN'NERSHIP CERTIFICATION FORM ONvnerBu} er ~ Tip ~C /ia c~ ~FE/ZS7 _ Mailing Address ~'0u L ft T,e/git , l/C/D.SvN, (~.,1 5 yO Property Address t - COO L CF TiP~'1 /1111JS0!! ; (Verification required from Planning & Zoning Department for new construction.) City/State I l Parcel ldcntification Lumber CJV0 `lag-1 _30 - a(zi LEGAL DESCRIPTION Property Location /VGI/'/., . S ` , Sec. /a . T r,29 _N' R 9 ~V. ToNN n of ~iQ 0 S~ Subdivision Plat: Lot r Certified Survey Map # Volume . Page y Warranty Deed # 70 y6S- (before 2007)Volume 17 . Page y ev 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. b-, 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 .3(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The propem owner agrees to submit to St. Croix Count} Planning & Zoning- Department a certification form. signed b} the owner and b% 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 i. the septic tank is less than I full of sludge. I'we. the undersigned have read the above requirements and agree to maintain the private sewage disposal s} stem with the standards set forth. herein. as set by the Department of Commerce and the Department of \atural Resources. State of Wisconsin. Certification stating that %our 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 m% our knowledge. i we am: are the ownerfs) of the property described above. by virtue of a w antv deed recorded in Register of Deeds Office. Number of bedrooms .3" SIGNATt E OF AP ICANT(S) DATE ***Any information that is misrepresented may result in the sanitan permit being revoked by the Planning & Zoning Department. Include with this application a recorded ~yarranh' deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warrano deed. (RED`. 09/07) VOL 1 02PA!::. 5 47 TERMINATION OF DECEDENT'S 6~i424S PROPERTY INTEREST KATHLEEN H. WALSH REGISTER OF DEEDS DECEDENT'S NAME 5T. CROIX CO.! WI GERALD B. PURFEERST RECEIVED FOR RECORD ADDRESS OF DECEDENT AT DATE OF DEATH CITY STATE ZIP oe-zo-zoos io:oo An 864 COULEE TRAIL HUDSON WI 54016 DATE OF DEATH' TERN OF DECEDENT PRO SOCIAL SECURITY NUMBER EXEMPT # OCTOBER 29, 2000 468-48-2088 CERT COPY FEE: COPY FEE: PRESENTATION OF DEATH CERTIFICATE TRANSFER FEE: RECORDING FEE: 25.00 I certify that I have viewed a certified copy of the decadent's death certificate. PAGES: REGISTER OF DEED'S SIGNATURE DAT Interest in property Is terminated under (please check appropriate statute): Recording area Name and return address: s. 867.045 which pertains to property in which the decedent was a joint tenant,' Leo A. Beskar had a vendors or mortgagee's interest, or had a life estate. '(You must provide a copy RODLI, BESKAR, BOLES & of the document establishing joint tenancy or life estate.) KRUEGER. S.C. s. 867.046 which pertains to (1) PO BOX 138 property of a decedent specified in a marital 219 N MAIN STREET property agreement, and also to (2) survivorship marital property. (You must provide RIVER FALLS, WI 54022 a copy of the document establishing survivorship marital property.) Presentation of recorded document establishing joint tenancy, life estate, 040-1049-30-000 survivorship marital property, vendor Interest, or mortgages Interest in real estate. PARCEL IDENTIFICATION NUMBER This document number is 284998 volume 424 page 547 & 54a of (check one) Records Deeds Description of the real estate. Include only the extent of ownershio (or vendor or mortgagee's interest) in land at the time of the decedent's death If the extent of land is exactly the same as on the document a copy of that document may be attached to describe the real estate. The legal description of the property and the persons receiving the property are as follows: (if more space is needed, attach pages.) Southwest Quarter of Northeast Quarter (SW 1/4 NE 114) and Northwest Quarter of Southeast Quarter (NW 1/4 SE 1/4), all In Section Twelve (12), Township 28 North, Range 19 West. Description of personal property (if any) being transferred. You may list savings accounts, checking accounts and securities on attached pages. Indicate person(s) receiving property. DECLARATION: 1, we declare that this document is, to the best of my (our) knowledge and belief, true, correct and complete and is in confor- mity with the provisions and limitations of the Wisconsin Statutes. (If more space is needed, attach pages.) Name and Address of Person Receiving Property Relationship to Decedent Signature (Notarized) O Patricia J. Purfeerst 864 Coulee Trail Hudson, WI 54016 .lie IG This document was drafted by: STATE OF WISCONSIN, County of Pierce c, (print or type name below) Signed and sworn to before me on - V ~ by the above named person(s). Leo A. Beaker Signature of notary or other person authorized to administer an oath ( NOTE: SEE DIRECTIONS ON REVERSE SIDE. as per s. 706.06, 706.07) Print or type name Leo A. Beskar Wisconsin Register of Deeds Association Form HT-110 (11196) 215-16 (11196) information Professional Company' Fond du Lac WI 500-655-2021 Title Attorney Date commission expires Is permanent. .J . .G r ~ 1J r' y~ ti 9 a t f Y ry. S- i l~ 1 b! yY 1 •:S`;~^ 6 Y ~ t ice. r; ~ r a 1- r ~l' viz < ~ r r. c Page 15 k"WrWst a S DSa rtment ofofSOIL EVALUATION REPO9 a Page 1 of#1489 p = 5e in accordance with Comm 85, Wis. Adm. Professi rvices Schmitt Soil Testing, Inc. gnat J~N7 County Attach complete site plan orppl I ss than 8% x 11 inches in size. Plan must St. Croix include, but not limited to: vaeFFth~ IldWence point (BM), direction and percent slope, scale or dimen3i and location and distance to nearest road. Parcel I.D. aA0-1051-30-050 jprint aH information. view Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). tlz_ Property Owner Property Location Purfeest, Patricia J. Govt. Lot NW1/4, SE1/4, S12, T28N, R19W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 864 Coulee Trail NA 19.28 Acre Parcel City State Zip Code Phone Number ❑ City Village ❑ Town Nearest Road Hudson WI 54016 715-222-9533 Troy Coulee Trail uction Use: Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD TEI Replacement ❑ Public or commercial - Describe: Parent material Shale Residuum (Derinda Series) Flood plain elevation, if applicable NA ft. General comments Area is suitable for a mound system. System elevation is 99.96' based off a contour line established at 98.29'. Slope of area is 2% and recommendations: and depth to limiting factor is 16". F-1 ❑ Boring 1 Boring # Pit Ground surface elev. 98.55 ft. Depth to limiting factor 16 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 0-9 10yr3/2 none A lfsbk mfr as lm,2vf 0.4c 0.6 2 9-16 7.5yr5/4 none A ifsbk mfr gw ivf 0.4c 0.6 'Y 1 t 3 16-19 10yr5/8 c2d 7 57.56/6/1 Sid lfsbk mf cs lvf 0.2 0.3 4 19-45 5yr6/3 c2d 7.5yr6/1 sic imsbk mfi 0.0 0.0 7.5yr6/8 ❑ Boring F2 Boring # Pit Ground surface elev. 98.42 ft. Depth to limiting factor 18 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistent Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Efr#1 *Eff#2 1 0-11 10yr3/3 none sit ifsbk mfr as 1m,lvf 0.4c 0.6 r~ 2 11-18 7.5yr5/4 none sit ifsbk mfr gw 1vf 0.4c 0.6 56/6/8 .56/6/1 3 Sid imsbk mf cs ivf 0.2 0.3 18-21 1~r5/6 7c2d. 7 4 21-45 5yr6/3 c2d 7.5yr6/2 sic imsbk mfi 0.0 0.0 7.5yr6/6 " Effluent #1 = BOD? 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 <_30 mg/L and TSS <_30 mg/L CST Name (Please Print) Signature: CST Number 227429 Thomas J. Schmitt Address Schmitt Soil Testing, Inc. 10, Date Evaluation Conducted Telephone Number 1595 72nd Street New Richmond, WI 54017 6/1/2012 715-760-1978 M-8330(11,07100) Property Owner Purfeest, Patricia I Parcel ID # 040-1051-30-050 Page 2 of 4 ❑ Boring 3 Boring # Pit Ground surface elev. 98.55 ft. Depth to limiting factor 16 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *Eff#2 1 0-14 10yr3/2 none SO lfsbk mfr as lm,lvf 0.4c 0.6 2 14-21 7.5yr5/4 none SO lfsbk mfr gw lvf 0.4c 0.6 3 21-24 10yr5/6 c2d 7.5yr6/1 Sid imsbk mfi cs 1vf 0.2 0.3 7.5Yr6/6 4 24-47 5yr6/3 m2d 7.5yr6/1 sic lmsbk mfi 0.0 0.0 7.5yr6/8 ❑ Boring F4 Boring # pit Ground surface elev. 98.55 ft. Depth to limiting factor 16 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-10 10yr3/3 none sil lfsbk mfr cs lm,2vf 0.4c 0.6 1 ~r 2 10-16 10yr5/4 none SO lfsbk mfr gw 1vf 0.4c 0.6 c2d 7.5yr6/2 3 16-19 10yr5/8 7 5yr6/6 sicl imsbk mfi cs ivf 0.2 0.3 4 19-44 5yr6/4 c2d 7.5yr6/1 sic imsbk mfi 0.0 0.0 7.5yr6/8 ❑ 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/ft2 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 = BODS < 30 mg/L and TSS -,1-30 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. SBD•8330 (R.07/00) Schmitt Soil Testlng, Inc. Page 3 of 4 Conducted by: Conducted For: Schmitt Soil Testing, Inc. Name: Patricia J. Purfeest Thomas J. Schmitt, CST 227429 Address: 864 Coulee Trail 1595 72nd St. City, State, Zip: Hudson, WI 54016 New Richmond, WI 54017 Phone: 715-760-1978 PID: 040-1051-30-050 signature Lot No. NA Date Legal Description: NW1/4 SE1/4 S12 T28N R19W Backhoe Pit Township, County: Troy, St. Croix County Bench Mark 1 El. 100.00' Top of 2" pvc pipe. Bench Mark 2 El. 99.27' Top of 2" pvc pipe Slope= 2% Contour Line El. 98.29' Contour Line Length 90' 1" = 40' MIAMI 109402 t~ / V t~ Ot v qj C©rv7a.~a ya, 4 OMA y~g' 36' aa~ bllS TW 6 , DyW~~ F~rISr,NG SrpIX r k 30 LveL~- uL~ Pa P o~ • od t' o 11 1~ t • S a n ?n IY Aid '4. F ; a, Y'A 0 4 wo 1i p (D L$,5 ¢ Cn x V x- CD ,