HomeMy WebLinkAbout004-1044-20-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
556316 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:
Kielme er, Kristine M. Cady, Town of 004-1044-20-000
CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No:
i 6.5-k 19.28.15.300A
TANK INFORMATION ELEVATION DATA 3, ZS 165.z
~j
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
_Z 35 97. (5
Septic Benchmark
elc;-.- F 6co 1.75 161.7
J' i ` / GA Alt. BMF %M
a ~ 5 (o aJC.) ~ T~ 9~ • 5
l 2 Idg. Sewer 0 ` . 7a 94 . 5
/1.55 C? /r 7
Holding SUHt Inlet 764
TANK SETBACK INFORMATION St/Ht Outlet
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
IN%
Septic 7 L~ ~a$ f 6 Dt Bottom A.5
Dosing '_7 5a 54 Header/Man. Z.57 -66
Aeration Dist. Pipe
IZ -57 95-a,z
Holding Bot. System
.3 A 'I J/- zS
PUMP/SIPHON INFORMATION Final Grade
/,S7 96. a$
Manufacturer Demand St Cover C
`J -151 GPM r: O Ir S
Model Number
ZZ . Z 9L, r.
TDH Lim ,331 Friction Lp;s System HeadCb T H 3(ft
$ + b ,J
Forcemain
I at Lent SO JDZ ,Dist. to well Ia$ /
SOIL ABSORPTION SYSTEM t2. e,
BEDITRENCH Width ~j Length / No. C Tre es PIT DIMENSIONS No. Of Pits Inside Dia._ Liquid Depth
DIMENSIONS I. (v 3 OC /J] a
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
INFORMATION CHAMBER OR
Type O System:
O J y~JO 166 w fk UNIT Model Number:
DISTRIBUTION SYSTEM A-4 k /v I
Header/Manifold I Distribution /
yy L ( Z / x Hole Size x Hole Spacing / t to Air Intake
G.SSL I S Pipe(s) 5Z / 7,5 2, Z / ZJ
Length Dia Length Dia Spacing v2
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only A
Depth Over I Depth Over xx Depth of xx Seeded/ odded Mulc !kYes Bed/Trench Center Bed/Trench Edges Topsoil s 0 No 0 No
COMMENTS: (include code discrepencies, persons present,•etc.) Inspection #1: / ZY/tz- Inspection #2:__/ /
Location: 2731 27th Ave Wilson, WI 544027 (SE 1/4 NW 1/4 19 T 8N R1 5W) metes & bounds Lot Gt~ + Parcel No: 19.28.15.300A
1 %j
1.) Alt BM Description = ` , tL (-bi t.L - P"-
2.) Bldg sewer length = / Q1r,
- amount of cover S•-
Plan revision Required? ❑ Yes No
Use other side for additional information.
Date Insepctor ignatur Cert. No.
SBD-6710 (R.3/97)
~V,~r
~q~~
1
Safety and County
Buildings Division
® *Gx 201 W. Washington Ave., P.O. BOX 7162 Sanitary Permit Number (to be fdled in by CO.)
v Madison, WI 53707-7162 31
Sp$`
%
° 7
L ~ ; S ransantion Number
4 ,qai~ art Application 3 7 2 3 - ? 3 2
In accordance with SPS 383.21 ly8&.1Wdm. Code, submission of this form to the appropriate govemm`Cnke!-unit.
is required prior to obtainirfg~tary permit. Note: Application forms for state-owned POWTS are submitted to Pr~oJ dct Address (if different /m; mailing SO
the Department of Safety and Professional Servies. Personal information you provide may be used for secondary yL 2 I 04k
u ses in accordance with the Privacy Law, s. 15.04(1)(m), Stats. '"ii ff 1~
1. Application Information - Please Print All Information
Property Owner's Name / Parcel # l d
h 1~r'e l e
Property Owner's Mailing Address Property Location w~
CA U Govt. Lot
City, State Zip Code Phone Number S -/4, y4 Section
one)
(circl/orW
~ 3 s"_ - /23 7 T Y N, R EJ
h ~ G
H. Type of Building (check all that apply) Lot #
L1 or 2 Family Dwelling - Number of Bedroo Subdivision Name
Block#
❑ Public/Commercial - Describe Use ❑ City of
CSM Number El Village of
❑ State Owned - Describe/Use / ~t~C q Town of ~ y
5. 80
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 ❑ Other Modification to Existing System (explain)
r
B. ❑ Permit Renewal ❑ Permit Revision 11 Change of Plumber List Previous Permit Number and Date Issued
❑ Permit Transfer to New
Before Expiration Owner
IV. Type of POWTS S stem/Com onent/Device: Check all that a 1 O •
❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade u 24 t ❑ Mound < 24 in. of suitable soil
❑ Holding Tank ❑ Other Dispersal Component (explain) Pretreatment Device (explain) I~
V. Dis ersaVIrreatment Area Information: •
Design Flow (gpd) Design Soil Application gpds Dispersal Area R ired ( ) Dispersal Area Pro sed s System Elevation
Voz 0-111 Ilsd )12-
VI. Tank Info Capacity in Total # of Manufacturer c r
Gallons Gallons Units
U m
New Tanks Existing Tanks
in y A w c7 a
Septic or Holding Tank C S'C' /Z
Dosing Chamber L S'U 1 t i
VII. Responsibility Statement- I, the undersigned, me responsibilityfal installation of the POWTS shown on the attached plans.
P(.00
Plumber's Name (Print) Plum s Signature MPIMPRS Number Business Phone Number
Tc)~ 234?5 -•51 t
Plumber's Address (Street, City, S te, Zip Code)
P 0, 13V Vic 3 L-c~riL~ Q,, , 1I e G Z
VIII. County /De artment Use On
Approved Permit Fee Dapte I ued Issuing nt Signatur
iven Reason ial $ ' o 7~ !
IX. Condi ' ~teasons for Disapproval 3) ~ r•,.y O
A. Z'S , }yl,~, p('0 cl,lE:
•
~ep* ~6lu*nt fker end J
dispersal cell must all be services I maintained J
as per management plan provided by plumber. L Q
2 i`N sett a mq [f must be makltauled .4
Attach to complete plans or the system and submit to the County o on paper not less than 8 1/2 x I l inches in size 4
SBD-6398 (R. 11/11)
Safety and Buildings
'1 N 3824 N CREEKSIDE LA
,P HOLMEN WI 54636
C 0 Contact Through Relay
3 S < www.dsps.wi.gov/sb/
www.wisconsin.gov
A~OssrorPtiS~~ Scott Walker, Governor
Dave Ross, Secretary
August 20, 2012
CUST ID No. 223475 AM. POWTS Inspector
JOE STANG ZONING OFFICE
STANG PLUMBING & ELECTRIC ST CROIX COUNTY SPIA
PO BOX 263 1101 CARMICHAEL RD
WOODVILLE WI 54028 HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 08/20/2014
SITE: Identification Numbers
Kristine M Kielmeyer Transaction ID No. 2137234
2713 27TH Ave Site ID No. 783021
Town of Cady Please refer to both identification numbers,
St Croix County above, in all correspondence with the agency.
SE1/4,X1/ , S19, T28N, R15W
FOR:
Description: Three Bedroom Mound System / 14% slope
Object Type: POWTS Component Manual Regulated Object ID No.: 1387645
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.01101); 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. P.O.W.
The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code P
.O.
P l•
requirements. Condit!
No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, A~ PR
stats.
The following conditions shall be met during construction or installation and prior to occupancy or use: DIVISION OF SAFETY
Reminders
• A sanitary permit must be obtained from the county where this project is located in accordance with the EE CO RES
requirements of Sec. 145.135 and 145.19, Wis. Stats.
• A POWTS Maintainer shall be identified in the Management Plan before the sanitary permit can be issued.
• 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.
• 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.
JOE STANG Page 2 8/20/2012 0
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
Fee Received $ 250.00
Balance Due $ 0.00
rard M Swim
POWTS Plan Reviewer, Integrated Services
(608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633
jeny.swim@wisconsin.gov
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.
JOE STANG Page 2 8/20/2012
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
Fee Received $ 250.00
Balance Due $ 0.00
rard M Swim
POWTS Plan Reviewer, Integrated Services
(608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633
jerry.swiin@wisconsin.gov
Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Safety & Buildings will be
modified. Code references with prefixes starting with "Comm" will be replaced with "SPS" to recognize the
relocation of the Division of Safety & Buildings from the former Dept. of Commerce to the Dept. of Safety &
Professional Services. Additionally, all S&B codes will be renumbered and addressed in a "300" series. For future
reference, the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366.
I
MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN
INDEX AND TITLE PAGE
Project Name: Kielmeyer Replacement Mound
Owner's Name: Kristine M Kielmeyer AUG 13 2011
Owner's Address: 2M 27th Ave.
-2131
Wilson, Wisc. 54027
N
IYV-
Legal Description: SE1/4~!&l /4 S19 T28N R1 6W
Township: Cady
County: St. Croix
Subdivision Name:
Lot Number: Block Number:
Parcel I.D. Number: 4104420000 Es.
dally
Plan Transaction No.: IVED
Page 1 Index and title
Page 2 Data entry 4ND BUILDINGS
Page 3 Mound drawings J
Page 4 Lateral and dose tank ad 4
Page 5 System maintenance specifications NDENCE
Page 6 Management and contingency plan
Page 7 Pump curve and specifications
Page 8 Plot Plan
Page 9 Soil Evaluation Report
Designer. Joe Stang License Number: 223475
Date: 08/2911:2 Phone Number: 1-715-684-5166
Signature:
Des gned Pursuant to the
Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and both
SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and
Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01101)
Version 7.0 (R. 03/2012) Page 1 of 9
Mound and Pressure Distribution Component Design
Site Information
R Residential or Commercial Design Note: Sand fill (D) calculations assume a
300.00 Estimated Wastewater Flow (gpd) Table 38344-3 in-situ soil treatment for
1.50 Peaking Factor (e.g. 1.5 = 150%) fecal coliform of 36 inches.
450.00 Design Flow (gpd)
14.00 Site Slope
92.60 Contour Line Elevation (ft)
16.00 Depth to Limiting Factor (in)
0.40 In-situ Soil Application Rate (gpd/ft2)
Distribution Cell Information
80.00 Dispersal Cell Length Along Contour (ft) = 5.63 Cell Width (ft)
1.00 Dispersal Cell Design Loading Rate (gpd/ft2)
1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point
in the distribution Y
Pressure Disribution Information network?
e Center or End Manifold
2.82 Lateral Spacing (ft) If N above, enter the elevation (ft)
2 Number of Laterals of the highest point.
0.125 Orifice Diameter (in)
3.00 Orifice Spacing (ft) = 8.34 ft2/orifice
2.00 Forcemain Diameter (in)
50.00 Forcemain Length (ft) Does the forcemain drain back? Y
82.60 Pump Tank Elevation (ft)
6.50 System Head (ft) x 1.3 8.16 Forcemain Drainback (gal)
11.26 Vertical Lift (ft) 50.03 5x Void Volume (gal)
0.56 Friction Loss (ft) 58.19 Minimum Dose Volume (gal)
0.00 In-line Filter Loss (ft) 22.24 System Demand (gpm)
18.32 Total Dynamic Head (ft)
Lateral Diameter Selection Manifold Diameter Selection
in. dia. options choice in. dia. options choice
0.75 1.25 x
1.00 1.50 x x
1.25 x x 2.00
1.50 x 3.00
2.00 x
3.00 x
Gallons/Inch Calculator
Treatment Tank Information 650.00 Total Tank Capacity (gal)
1000.00 Septic Tank Capacity (gal) 38.00 Total Working Liquid Depth (in)
Wieser Manufacturer 17.11 gal/in (enter result in cell B49)
Dose Tank Information Effluent Filter Information
650.00 Dose Tank Capacity (gal) Best Filter Manufacturer
17.00 Dose Tank Volume (gal/in) GF10-8 10x18 Filter Model Number
Weiser Manufacturer
Project: Kielmeyer Replacement Mound Page 2 of 9
Mound Plan and Cross Section Views
-t
1/10 B : 3 J
Observation Pipe
.
FK
-+p - A
I
L
Mound Component Dimensions
in H .49 ft
A 5.63 ft E Elft
B 80.00 ft F in 1 19.27 ft L 102.99 ft
D 20.00 in G ft J Ni 6.21 ft W 31.11 450.40 (ftz) Dispersal Cell Area 1992.07 (ft) Basal Area Available
5.63 (gpd/ft) Linear Loading Rate 8.00 (ft) 1/10 B Obs. Pipe Placement
Mound Cross Section View
Aggregate Dispersal Area
Finished Grade 96.04 (ft)
`.rrr... H
t ,ifr 2 «r{ff: G
T F
Dispersal Cell 94.77 (ft) Lateral
94.27 (ft)-
Invert
Dispersal Cell t
Elevation E D : .
4
fl
92.60 (ft) Contour Elevation
14.0 % Site Slope
Geotextile Fabric Cover
Shading Key s Dispersal Cell See lateral details on
1❑ Topsoil Cap = 1.5 ft Page 4 for number,
Subsoil Cap a c 0 size, and spacing of
ASTM C33 Sand 16 ' T laterals. Laterals are
0.5 ft Typical Lateral equally spaced from the
Tilled Layer c a F
cell's
Aggregate v c 0 I distribution
centerline in the
in the
- A distribution cell (AxB).
Project: Kielmeyer Replacement Mound Page 3 of 9
End Connection Lateral Layout Diagram
Laterals centered o%w the A & B dimension 0= Turn-up ball valve or cleanoutplug
p .I
AN laterals are identical k- X--> I Holes drilled on the bottom of the lateral
equally spaced S
Force main connection via tee or cross to manifold at ava point.
Laterals Morcemain Sch 40 PVC per SPS Table 384.30-6
Number of Laterals 2 Orifice Diameter 0.125 in .
Lateral Diameter 1.25 in Orifice Spacing (X) 3
Lateral Length (P) 78.52 ft Orifices per Lateral 27
Lateral Spacing (S) 2.82 ft Orifice Density 8.34 ft2/orifice
Lateral Flow Rate LAft gpm Manifold Length 2.82 ft
System Flow Rate gpm Manifold Diameter 1.50 in
Total Dynamic Head Forcemain Velocity 2.27 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 4 in. min.
Disconnect ---'!ll---
Tank component is properly vented qForcemain Alternate outlet
location
diameter
Weiser Manufacturer 2 in.
Capacityl 650.00 Gallons
Volume 17.00 gal/inch A
p hole or anti-
Dimension Inches Gallons B siphon device
A 21.91 372.51 C
B 2.00 34.00 Pump off elevation (ft)
C 3.42 58.19 -t 83.51
D 10.90 185.30 D
Total 38.24 650.00
Dom se tank elevation (ft)
3" Bedding un er tank. 82.60
Alarm Manuafacturer SJE-Rhombus Controls
Alarm Model Number Tank Alert 1 c illi-m nq rnercurv
Pump Manufacturer Goulds
Pump Model Number 3887 EP05
Pump Must Deliver 22.24 gpm at 18.32 ft TDH
Project: Kielmeyer Replacement Mound Page 4 of 9
Mound System Maintenance and Operation Specifications
Service Provider's Name Joe Stang Phone 715-684-5166
POWTS Regulator's Name St. Croix County Zonimg Phone 715-386-4680
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 450.4 ftz 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 ondin and seepage once eve 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: Kielmeyer Replacement Mound Page 5 of 9
r
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 BOD5, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or
30 mg/L BODE, 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 dogging 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 dogged 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 of 9
ITT GOULDS PUMPS
Wastewater
PERFORMANCE RATINGS COMPONENTS
Total Head Gallons Per Item Description
(ft. of water) Mm No.
EP04 EP05 1 Impeller
5 53 - 2 Base 10 /6
10 46 62 3 Pump Casing 8
15 36 55 4 Mechanical Seal
20 21 46 5 Ball Bearings 6 7
25 0 33 6 0-Rings 9
30 - 11 7 Power Cord
5 -
8 Oil Filled Motor 4
Motor Housing/ 3
9 Stator Assembly Z~
10 Motor Cover
METERS FEET
10
9 30 -10.~5GPM
8 Iuu~J2.5 FT
25
W
4 7
DT
= 6 20
►8.32 z 5
15
4
EP05
O
~ 3 10
EP04
2
5
1
0 00 10 20 30 40 50 GPM
0 2 4 6 8 10 12 m3/h
CAPACITY
~2,2y
3 Poc~e -7 vP 9
K(~ S~ •he M K;ct nnG~~We r
+h
07--1 ? ~3 ~`x ALA
►AJ11 soh, tv"►~c,- S'y1) 2.-7
5~ yy, sw~1y, 519, TZgNJ Rlbw
0044104" 2-0oo
Soo to 4Zo~d-
N CT
~ 450 ' +o PcoQ ec'~ e
IVd-r }o ScS#
`s., : I~wse a M ~
VV E-LL
A 5Trn-.F q91-10
A 5T rA D- -2.
Soo gy. o
► f 1 "it, PVC.
It A T ► 1~$S'
9a. b ~ 1
B Z q H
r
q2. b 189-11 Cokht~cc cj 2" L
8d Ac F,6s
S ~
RECEIVED
06
ht~
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 4
Division of Safety and Building4UG 10
I rdance with Comm 1i5, Wis. Adm. Code
St. Croix
~f 4.,..... . .
Attach complete site plakb ag""#i~J~ 1/2 z 11 inches in size. Plan must
include, but not limited to: vertical and horizon _tall ree`rence point (BM), direction and Parcel I.D. 00410442000
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. lou,jAvcl - A60
Please print all infonnation. Reviewed Da / r
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m
Y aY %Property Owner Property Location
Kristine M Kiehneyer Govt Lot SE 1/4 SW 1/4 S 19 T 28 N R 15 E (or) W
Property Owner's Mailing Address 27 3 J cc~ n'V Lot # Block # Subd. Name or CSM#
27th Ave. d. 7 / 3
City State Zip Code ne Number Elcity M. Village E]Town Nearest Road
Wilson Wisc. 54027 ( 7} 5-928-0489 C a4 7-Y 27th Ave.
i New Construction Use ; ■ Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD
- -rte----.
Replakrrrerrt Public or commercial - Describe:
Glacitalft Flood Plain elevation if applicable hr .6 ti•
General
recommendations. j J ~ I1~J Mound System
Contour El. 92.6
a Boring # D Boring
El Pit Ground surface elev. 92.6 ft. Depth to limiting factor 16 in. Soil Appfication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/f?
in. Munsell Qu. Sz. Cord. Color Gr. Sz. Sh. `Eff#1 -Eff#2
1 0-8 10YR3/2 sl 2mbk dsl as 3 0.6 1.0
2 8-12 10YR4/3 sl lmpl dh cs 2 0.4 0.6
3 12-16 10YR5/3 sl 1mP1 dh cs 1 0.4 0.6
4 16-24 7.5YR4/4 c2d7.5YR6/8 SO 2mbk dh cW - 0.4 0.6
2 Boring # 0 Boring 89 20
Q 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 *
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Ef{#1 "Eff#2
1 0-7 10YR3/2 sl 2mbk dsl as 3 0.6 1.0
2 7-14 10YR4/3 - sl 1mPI dh cs 2 0.4 0.6
3 14-20 10YR5/3 sl 1mP1 dh cs 1 0.4 0.6
4 20-30 7.5YR4/4 c2d7.5YR6/8 SO 2mbk dh cw - 0.4 0.6
' Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ` Effluent #2 = B < 30 rng/L and TSS < 30 mg&
CST Name (Please Print) Signatu CST Number
Thomas W. Gedatus QY)r0'a- {~(1' r 962178
Address Date Evaluation Conducted Telephone Number
Stang Plumbing & Electric P.O. Box 263 Woodville, Wisc. 54028 8/07/2012 715-684-5166
Property Owner Kristine M Kielmeyer Parcel ID # 0 U y/ 0 9" f 2 0 0 0 0 Page 2 of 4
Boring
3 Boring # ® Pit Ground surface elev. 92.6 ft. Depth to limiting factor 18 in. Soft Application Rate
Horizon Depth Dominard Color Redox Description Texture Structure Consistence Boundary Roots GPDOW
in. Munsell Qu. Sz. Conk. Color Gr. Sz. Sh. 'EW 'EfF#2
1 0-8 10YR3/2 - sl 2mbk dsl as 3 0.6 1.0
2 8-14 10YR4/3 - sl lmpl dh cs 2 0.4 0.6
3 14-18 10YR5/3 sl lmpl dh cs 1 0.4 0.6
4 18-26 7.5YR4/4 c2d7.5YR6/8 scl 2mbk dh cw - 0.4 0.6
F-1 Boring # Boring
Ground surface elev. ft. Depth to limiting factor in.
Elpit Sod Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Rawls GPM
in. Munsell Qu. Sz. Conk Color Gr. Sz. Sh. 'EW1 `002
S Boring
Boring # Ground surface elev. ft. Depth to limiting factor in.
F-1
Pit Sal Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDAF
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'SM 'Eff#2
Effluent #1 = BODS > 30:5 220 mg/L and TSS >30:5 150 mgA. ' Effluent #2 = BODS < 30 mgll. and TSS < 30 mg/L
I
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-2648777.
SBD-8330Test (8.07/00)
NT CA W.,
kj'~\gp,nj Lu~S~. ~'yA2'7
c Jt L~ s `/fir S W ~da4 7 l ri -r z. N~ F
e~ a ya>
~gre~4 T Q - 004 0 494 2.0000
xt~
500
To toad, L
t0 S~~k
NOT
, C' wd~ } 458 Prof ~►e
-'~o Sc~,1
3 IV( -r
BSc aw ~-t (
40
IV
1 1 - 3
~ 300 8_
%9.
9~6 t
g-- 3 j ~ -
90.E {
,
M j ct*
T V4
w ~ '~M Z cv ~ ,
!
I
0 06 i
Er4~ _
w
t ~
C
0
m8
°o m 0
E~v
W m
~y m C
. . ' ' C3
-77
I
CRMtXPuw17f
S~'P TANx:uAINTi mAmmA I o or
AM
t~flNB~tSD Pt CAT +fMAW
Q /IdZ~SC In 1~~ ~t
A,Wm
_ tYer~ias~ieiio■tZi■ri~AYo~i~sD~l~wtsrae~.aiMw~i~
Nn~er „ Z~ ~u 2~ o y
Ckyohft PMOBI
LIGiAL
PMPOO Lo026=5
Nil s 3rioR
PMIP#
8pee~ona 3os ~ Lac1i■lsiieo~is peo ae .
b~oper~aada■1~a~~sd7~v~raq~iasl~Ie~ca~isewltit~ls~es~aSomiehoiswadm PAPW
mileommuoe dprping -atom aside mokerstys eoyosawair ~oeiea,Llalioareiprpe` WLR7smipetimb
~asyelrataaaAleet~~d~aseiNictletass~aeNneeta4~aessw~led~padsptle■d.Owatraei■re~oe .
eapq■iiiN,i~essas~edai fClwsa ~(QadiiCil~llr i2-8ttlelivctloe■g►t~lhit]►Orli~oe~ .
'lie~wrera~oeeate a■turlitt.lt Cyas6cClv.l!ll..ds,t7~Dep~~el~essas~6c~iaa~ a~sdb!►~
a~c~tilrstr~lerje~lapi~i~eyser~bedp~Le~ac:lioew~pe■~er.mjQ~sti.t(i}~aa~~Is -
inlpeadoaaNdpr~ilis~~aa~l~tie _
w~la+retar+li pant:p le~s~TsiEpeaperapa~oetie~eammm a~itd, (*now
Y~atis~ila~sserd~~wm~s■e~11ai~~tWalirlirtispli~lsssw~sii~allislrea~d~tia
~Irrll~rita~tf~,I~e~ad~.ss~tirlr~■~tat~lueoe~tieieat~llil~atTte~e~err,8111s~t~iaai. -
t~aliaasMi■6lait}aaraaplips~y■stieaaairiireiartt~eaa~lda~sa~edtr~r8t l~ic4~rkYir~is#
zolft ~11ir1rE~1~ia3i~sdAs~s300 aa0 &&AOL
tliwa~rti.ia~lrll.l■~r+~itsf~tis~~►frirlc~lti■~fl.clo~l~r I~r.ar.~.sfr.~...[~.t~iv
poopaq~►dw~dling,7r1r1u~sMae /lldsoewieiia filler#laooio~ea.
~1 12-
DAM
eie+'111~►iwiarl~t/nitianil~epmpealeds■0►s~ltit/lra0le7- m - M ii~i~ir!►i~11■a
LrdWb%MMapIYalSma mom Ill ■na■g►ieatir•~r~neilllretDorilQAosaliisa~dfrral~~risrriw~alllil
eeieeeaeisanieia~ewa~■Ipiaed.
1490PAGE 475 i v
DOCUMENT NO. WARRANTY DEED Y 61 4M45AL H ATHLEEN REGISTER OF DEEDS
ST. CROIX CO., WI
RECEIVED FOR RECORD
02-17-2000 9:45 AM
WARRANTY DEED
Scott Kielmever, a/k/a Scott T. Kielmever, a single person EXEMPT N 8M
CERT COPY FEE:
COPY FEE:
TRANSFER FEE:
conveys and warrants to RECORDING FEE: 12.00
Kristine Kielmever, a/Wa Kristine M. Kielmever, a single PAGES: 2
person
_the
f06OY1ii/IC3 deg^!.°3flC •~2i/ e.,.e.~ iI:
State of Wisconsin:
RETURN TO.* sK/NNER LAW F/RM v
406 Technology Or. E
MENOMON/E, W/ 54751
Parcel Identification Number (PIN) Part of.
004-1043-95-000. 004-1044-10-000: 004-
1044-60-000, 004-1044-20-000: and 004-
104440-000
SEEATTACHED LEGAL DESCRIPTION
This Deed is given pursuant to the terms of the divorce judgment entered in Case No. 98 FA 170,
SL Croix County, Wisconsin.
This is homestead property.
(Is)
Exception to warranties. highways, easements and restrictions of record.
i 2000
Gated this 7 _ dayof
(SEAL) (SEAL)
* * Cott T. ffie/me r
(SEAL) (SEAL)
*
AUTHENT1CATION ACKNOWLEDGMENT
Signature(s) u-Q Sc6,7T STATE OF WISCONSIN )ss.
County. )
authenticated this aa- day of Personally came before me this
day of , 1999, the above named
to me known to be the person who
* executed the instrument and acknowledge the
same.
TITLE.• MEMBERS E BAR OF WISCONSIN
(If not, authorized by §706.06, Wls. Stets
THIS INSTRUMENT DRAFTED BY "
Brent O. Skinner Notary Public County, Wisconsin.
406 Technology Dr. E Menomonie. WI 547.51 My commission is permanent (If not, state
19 )
expiration date.,- '19
(Signatures may be authenticated or acknowledged.
Both are not necessary.)
'Names of persons signing In any capacity should be typed or printed below their signatures.
1490PAGE476
A PART OF THE SE1/4 OF THE SW1/4, AND THE NE1/4 OF THE SW1/4,
AND THE SE1/4 OF THE NW1/4, AND THE SW1/4 OF THE SW1/4, AND
THE NW1/4 OF THE SW1/4, SECTION 19, T28N, R15W, TOWN OF CADY,
ST. CROIX COUNTY, WISCONSIN, AND DESCRIBED AS FOLLOWS; THENCE
BEGINNING AT THE SOUTHWEST CORNER SAID SECTION 19,
NOO°27'22"W ALONG THE WEST LINE SECTION 19 376.90 FEET TO AN
IRON PIN ON THE LEFT BANK OF THE EAU GALLE RIVER;
THENCE N23°19'19"E ALONG SAID LEFT'BANK 1599.06 FEET TO AN
IRON PIN; THENCE S63°07'35"E ALONG SAID LEFT BANK 262.51 FEET
TO AN IRON PIN; THENCE N37°18'58"E ALONG SAID LEFT BANK 490.60
FEET TO AN IRON PIN; THENCE N13°32'32"E ALONG SAID LEFT BANK
390.75 FEET TO AN IRON PIN ON THE NORTH LINE NW1/4 OF THE
SW1/4; THENCE N89°09'08"E ON SAID NORTH LINE 26.49 FEET TO AN
IRON PIN; THENCE N00°05'54"W 1317.35 FEET ALONG THE WEST LINE
SE1/4 OF THE NW1/4; THENCE N89°08'13"E ALONG THE NORTH LINE
SAID SE1/4 OF THE NW1/4 929.27 FEET; THENCE S00°03'33"E 981.15
FEET TO AN IRON PIN; THENCE S89°09'08"W 758.76 FEET TO AN IRON
PIN; THENCE SO1°48'25"W 1203.63 FEET TO AN IRON PIN; THENCE
S0003^8'09"W 1720.17 FEET TO AN IRON PIN ON THE SOUTH LINE SAID
SECTION 19; THENCE S90°00'00"W ALONG SAID SOUTH LINE 1456.42
FEET TO THE POINT OF BEGINNING, SAID PARCEL CONTAINS 80.00
ACRES MORE OR LESS, INCLUDING ALL LAND FROM THE LINE
ESTABLISHED ALONG THE LEFT BANK OF THE EAU GALLE RIVER AND THE
WATERS EDGE. AND SUBJECT TO ANY EASEMENTS OR RESTRICITONS OF
RECORD.
Parcel Vs - Part of 004-1044-10-000
004-1044-60-000
004-1044-20-000
004-1044-40-000
t '
Parcel 004-1044-35-000 08/20/2012 08:39 AM
PAGE 1 OF 1
Alt. Parcel M 19.28.15.3000 004 - TOWN OF CADY
Current ❑X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units
01/30/2006 00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
0 - KIELMEYER, KRISTINE M
KRISTINE M KIELMEYER
2731 27TH AVE
WILSON WI 54027
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 2731 27TH AVE
SC 0231 SCH D BALDWIN-WDVILLE
SP 1700 WITC
Legal Description: Acres: 21.980 Plat: N/A-NOT AVAILABLE
SEC 19 T28N R15W PTS SE NW DESC IN THIS Block/Condo Bldg:
DESC NE SW, NW SW, SW SW, SE SW; COMM SW
COR SEC 19; TH N 00'W 376.90FT;TH N Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
23'E 1599.06 FT; TH S 83' E 262.51 FT; TH 19-28N-15W SW
N 3T E 490.60FT; TH N 13'E 390.75FT; TH
N 89'E 26.49FT TH N 00'W 1317.35FT; TH
more...
Notes: Parcel History:
Date Doc # Vol/Page Type
02/17/2000 618455 1490/475 WD
12/23/1997 570307 1284/325 WD
07/23/1997 792/143
2012 SUMMARY Bill Fair Market Value: Assessed with:
Use Value Assessment
Valuations: Last Changed: 04/23/2012
Description Class Acres Land Improve Total State Reason
AGRICULTURAL G4 16.480 3,100 0 3,100 NO 05
UNDEVELOPED G5 4.000 6,000 0 6,000 NO
OTHER G7 1.500 23,800 97,500 121,300 NO
Totals for 2012:
General Property 21.980 32,900 97,500 130,400
Woodland 0.000 0 0
Totals for 2011:
General Property 21.980 32,800 97,500 130,300
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00