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HomeMy WebLinkAbout040-1303-00-039 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 552340 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)]. 207 6 3 SZ Permit Holder's Name: City Village X Township Parcel Tax No: Westview Construction, Inc., c/o Aaron Clay Troy, Town of 040-1303-00-039 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: /1 D v 6h,P 22.28.19.1774 TANK INFORMATION ELEVATION DATA iCZ;7` TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. L - 37- /6(.. 3 /60 Septic J ^ Benchmark 1+1 'DO -o Dosing /~-Wl • i/~ a SZ S Alt. j . /D r d3 Aeration Bldg. Sewer Am. , Q Holding SLfi7 7 7./o S t Inlet - _1 F o k 'If 9, 2,0 TANK SETBACK INFORMATION St/Ht Outlet TANK TO nn rr P/L WELD BLDG. Ve it Intake OA Dt Inlet Septic N i I 1 f lac; h f ~b S YI Dt Bottom _ / 7 d yS G ~J Dosing Header/Man. h '521 Aeration Dist. Pipe Holding Bot. System 1.52 /a~ g Z21 /D y % "C vl Ay. 6Z Final Grade ,kicip-j- - - A PUMP/SIPHON INFORMATION . S /O S , $ Manufacturer Demand St Cover 4, //h~ Zd~( 6-11 GPM ~ oil )f 696 l7 T' D 3 T.? Model Number / ✓ CJ i TDH Lift Friction Loss System Head 7__FTDH t - 3 9,95 6 r 50 G , 50 /S 95F - 25 Z.'f 3 Forcemain 1 Length r Dia. j7 Dist. to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width / Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~6 \ SETBACK SYSTEM TO P/L ' BLDG WE LAKE/STREAM L NG Manufacturer: INFORMATION CHA OR Typ f stem: f c-~ f ZD ~fDt1 1 tSoT Ny~- UNIT Model Number: L_ I DISTRI T N SYSTEM Heade Manifold Distribution Ix Hole Size '07 Pipe(s) / x Hole Spacing r~ Vent to Air Intak Length ia _ Length (p Dia z5 Spacing 3 l 2 tp C ~U l SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/ odded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil I ( , Yes ❑ No Yes ® No COMMENTS: (Include code discrepencies, persons present, etc.) Inspec ion #1: //J Inspection #2: Location: 228 Walnut Hill Way River Falls, WI 54922 (SE 1/4 SE 1/4,2Q22 T28N RI 9W) Walnut Hill Farm aka The Tribute Parcel No: 22.28.19.1774 1.) Alt BM Description 2.) Bldg sewer length = lb ' -`y~~vU rt0 NYC D~ rL'~ L' - amount of cover = / r Plan revision Required? FO-1 Yes No Use other side for additional information. 1 In SBD-6710 (R.3/97) Date Insepctor' ignature Cert. No. NEEM f:-:,4 m _ i County A r? Safety and Buildings Division t I r~ 201 W. Washington Ave., P.O. Box 7162 Sari tr a a F1 tary Permit Number (to be filled in by Co.) Madison, WI 53707-7162 Sanitary Permit Application State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit / 9 6 . U is required prior to obtaining a sanitary permit. Note: Application too rtes Ishoewiled gd to Project Address (if different than mailing address) the Department of Safety and Professional Servies. Personal informatio you pr~jli~tA& seco u oses in accordance with the Privacy Law, s. 15.04 1 m , Stats. 1. Application Information - Please Print All Information 1 4 5 Property Owner's Name 7 - Parcel # vlwa re (.k7 /tvc. I - 0 ,T 30 3- 00 Property Owner's Mailing Address ST. l COUNTY Property Location S"' CR PLANNING & ZONING OFFICE C I / 74) r 0, T Govt. Lost City, State Zip Code Phone Number , f, ~t 4~J Section ~r p1 t Y W Z `715- 740 Q 0 circle one Tfy-A N; REo H. Type of Building (check all that apply) Lot # LN I or 2 Family Dwelling - Number of Bedrooms a 3 Subdivision Name Block # Q ❑ Public/Commercial -Describe Use ❑ City of ❑ State Owned - Describe Use CSM Number ❑ Village of ITownof III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. X New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner 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 Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretr ent Device (explain) 102-0 V. Dis ersal/Creatment Area Information: W 22 Design Flow (gpd) Design Soil Applicati Rate(gpds Dispersal Area R fired (sf) Dispersal Area 773 osed (sf) System Elevation Z, 06 ~ 1 Ov Q/I ~ o GAP 0 /4'~ i~ VI. Tank Info Capacity in To # of Manufactur Gallons Gallons Units 4 0 New Tanks Existing Tanks c Y u fly/% 52,51,4 a U in w a Septic or Holding Tank n v ~q ~t V,,7 I r &e- c Dosing Chamber g V VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plum s Si MP/MPRS Number Business Phone Number a.r 9Y/~ yr 4 Plumber's Address (Street, City, State, Zip Code) R 4'o -5 1t1' g tv id /4 (.40 40Z, Z_ VIII. oun epartment Use Only Approved El Disapproved Permit Fee 0 Date Issued Issuing At S ❑ Owner Given Reason for Denial IX. Conditions of Approval/Reasons for Disapproval t yw ~`fG" s &Y,- 6(Jt C SYSTEM OWNER: U V,,,4 268 ~ 1 Septic tank, effluent filter and V dispersal cell must all be serviced / maintained as per management plan provided by plumber. 2. All se aC regwre tl W@ p" pJ:tem and submit to the County only on paper not less than 8 in a 11 inches in size as per applicable code/ordinances. SBD-6398 (R. 11/11) Plot Plan for Site and Soil Evaluation Page 8 of B Property owner I"=40ft. Legal Description Lp-r 3g W AuN~T (except where noted) oF: THE :5r-- 11(41 f>-2Z -rzg,~j 0 F, kg W; Backhoe pit TpWkl DF 791DY ! ST. C1Zotx tk-NZXa WjSCMSjA), 1.05-AckF5 North 39. 2q 7b L-L c Of qR, PIS °o_ .a 1S c c ~F&NCE LiNE~y EL IWO ° oo ga ~ ~ Q ifs as 44:P )Z9..79 roP©~~~ Site Location: C* R P SECS ZZ g~ s X 4 ` ityl~ OARTSafety and Buildings a 3824 N CREEKSIDE LA o 9 HOLMEN WI 54636 / Contact Through Relay 31 S ~c www.commerce.wi.gov/sb/ 9 P www.wisconsin.gov A~OSSfors~~'~y Scott Walker, Governor Dave Ross, Secretary April 03, 2012 CUST ID No. 224832 ATTN: POWTS Inspector MARY JO HUPPERT ZONING OFFICE HOLLISTERS SOIL TESTING & DESIGN ST CROIX COUNTY SP1A W9875 690TH AVE 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04/03/2014 SITE: Raiml Re Shell, /Westview Construction Identification Numbers 228 Walnut Hill Way Transaction ID No. 2070350 Town of Troy Site ID No. 733082 St Croix County Please refer to both identification numbers, SETA, SETA, S22, T28N, R19W above, in all correspondence with the agency. (Lot:-39, ubdivision: Walnut Hill Farm FO1T----~ Description: Four Bedroom Mound System / 4% slope Object Type: POWTS Component Manual Regulated Object ID No.: 1365292 Maintenance required; 600 GPD Flow rate; 14 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 abo'PRIV TF SEWA The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code • requirements. coned No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: APP Reminders: 1xvISION Of !SAR" • A sanitary permit must be obtained from the county where this project is located in accordance with the _ 5 E C;,C~ requirements of Sec. 145.135 and 145.19, Wis. Stats. 4(~F_ • 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. • 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. 1 Y MARY JO HUPPERT Page 2 4/3/2012 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 Gerard 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. r MOUND AND PRESSURE DISTRIBUTION COMPONENT' DESIGN Residential Application INDEX AND TITLE PAGE CElVED MAR 2 2 2012 Project Name: WEST VIEW CONSTRUCTION ry Owner's Name: same BUILDINGS Owner's Address: 20 Serenity Ct River Falls, WI 54022 Legal Description: SE 1/4 of the SE 1/4, S22 T28N., R19W Township: Troy County: St Croix Subdivision Name: Walnut Hill Farm (Tribute) Lot Number 39 Block Number. NA Parcel I.D. Number. 040 -1303 - 00 - 039 SYSTEM Plan Transaction No.: val Page 1 index and title Page 2 Data entry ~ err Vi,~ Page 3 Mound drawings )VEr Page 4 Lateral and dose tank AM 101MUrn Page 5 System maintenance specftation plan - Page 6 Management and contingency : Page 7 Pump curve and sperfic ns Page 8 Plot Plan s t* 4l~l. aar tis Designer. Mar y Jo Huppert License Number. 1859-007 Date: 03!27/12 Phone Number (715) 426-1775 Signature: FIT- Designed 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 Displbution Networks for ST-SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01) Version 5.1 (R. 06/06) Page 1 of 8 Plot Plan for Site and Soil Evaluation Page 8 of B Property Owner I"=40fi. Legal Description Lp-r 39 w i\Lm i (kept where noted 50q of THE Se '/q ~ 52Z 1 TLg\) I g kct w Backhoe pit North ~7o pJN+t n3uT LL WA BM~ghR o Of M zf F"t; NCE U S EL ras,60 ~D I ~I Qw i I s a lyl ;a q ~ Ire ZA, ~ o p 15CN 'LN ~H, ya o V/ "F l_ ro's.bD .C~ '~-29, 39 ~oPoFR~~K ~s V.M E'17 l uR OQ Site Location: a ~ SF.CZZ P~ w Mound and Pressure Distribution Component Design Design Worksheet Site Infom-moron (R or C) Residential or Commercial Design Note: Sand 0 (D) cahdaftm assume a 400.00 Estimated Wastewater Flow (gpd) T e3-44-3 in-situ soa treaarnent for Irictm . 1.50: Peaking Factor (e.g. 1.5 = 15096) fecal corkrrn of 36 600.001 Design Flow (gpd) 4.00 Site Slope 102.00 Contour Line Elevation (ft) 14.006 Depth to Limiting Factor (in) ✓ 0.60 In-situ Soil Application Rate (gpdhY) Distribution Cell Infon"ation 60.00 Dispersal Cell Length Along Contour (ft) _ 0.00 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 Dieribution Infomnation network? Enter Y or N (C or E) E Center or End Manifold 3.33 Lateral Spacing (ft) if N above, enter the elevation (ft) 3? Number of Laterals of the highest point. 0.125_` Orifice Diameter (in) 2.09 Estimated Orifice Spacing (ft) = 7.14 fly/orifice 2.00Forcemain Diameter (in) 20.00 Forcemain Length (ft) Does the forcemain drain back? Y_ 96.00 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 3.26 Forcemain Drainback (gal) 7.67 Vertical Lift (ft) 56.00 5x Void Volume (gal) 0.50 Friction Loss (ft) 59.26 Minimum Dose Volume (gal) 0.00; In-line Filter Loss (ft) 34.60 System Demand (gpm) 14.67 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. o tionsTchoice in. dia. options -choice 0.75 - 1.25 x X 1.00 1.50 x 1.25 x x 2.00 x 1.50 x 300 2.00 x 3.00 x GaliorWnch Calculator (optional) T reatrnent Tank n fixtnation Total Tank Ca PAY (gal) -1200-00 Septic Tank Capacity (gal) Thal Working Liquid - ng Depth (in) Wieser Manufacturer gaUin (enter result in cell B49) Dose Tank ktfomnation Effluent Filter information 800.00 Dose Tank Ca i P ICY (gal) olylok j Fitter Manufacturer 22.24 Dose Tank Volume _ (gain) 525 Tiller Model Number Wieser Manufacturer Project: WEST VIEW CONSTRUCTION Page 2 of 8 I Mound Plan and Cross Section Views K O ❑ A W B L Mound Component Dimensions A 10.00 ft E 26.80 in H 1.00 ft K 11.41 ft B 60.00 ft F 9.25 in I 11.95 ft L 82.83 ft D 22.00 in G 0.50 ft J 8.31 ft W 30:26 ft 600.00 (fe) Dispersal Cell Area 1316.76 (fe) Bash Area Available 10.00 (gpd/ft) Linear Loading Rate 6.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 105.60 (ft) H G ♦ 1 I F Dal 104.33 (ft) Lateral 103.83 (ft)--10- Invert Dispersal Cell Elevation D.. 102.00 (ft) Contour Elevation 4.0 % Site Slope Geotexxtile Fabric Cover Shading Key Dispersal Cell See lateral details on Q Topsoil Cap 1.5 ft Page 4 for number, size, Subsoil Cap © 0 T and spacing of laterals. e ASTM C33 Sand F Laterals are equally ®Q Tilled Layer = 0. ft Typical Lateral spaced from the © Aggregate © distribution cell's centerline in the 01, A distributom cell (AxB). Project. WEST VIEW CONSTRUCTION Page 3 of 8 End Connection Lateral Layout Diagram '.-mwthrvatelsf,avrrthrf.:.Bem~-r.>,n Taar~wpwtb$t¢+ralvaarelaanaut ug 1 r P 1 Ae A~31 X-3,ned v:1 t: "C"'.. Of lip! law Al t xe+als L~ farce rn am V-VC 5ca s0 1 o~nr.tctiotl wa t4t ar alo ss tc. mar.,+ald a+ arln C-Din1- Number of Laterals 3 Orifice Diameter 0.125 in Lateral Diameter 1.25 in Orifice Spacing (X) 2A7 ft Lateral Length (P) 58.59 ft Orifices per Lateral .28 Lateral Spacing (S) 3.33 ft Orifice Density 7.14 fe/orificce Lateral Flaw Rabe 11.53 gpm Manifold Length 6.67 ft System Flow Rate 34.60 gpm Manifold Diameter 1:25 in Total Dynamic Head 14.67 ft Forcemain Velocity 3:53 ft/sec Dose Tank Information Locking cww vAM waming WW WW bV ht sealed waterggdevlce old Electrical as per NEC 300 and - 10 Comm 16.28 WAC Disconnect 4 in. min. Tank component is properly vented E-- Alternate outlet kxmrwn Foroemain diameter Wieser Manufacturer 2 in. Ca 800.00 Gallons Volume 22.24 galifinch A Weep hole or anti- Dimension Inches Gallons B siphon device A 23.31 518.34 C B 2.00 44.48 pum off ekn2 on ft) C 2.66 59.26 96.67 D 8.001 177.92 D Total 35.97 800.00 -Dose tank ek°n R 3" Bedding under tank. ~ 96,00 Alarm Manuafacturer Tank Alert Alarm Model Number HW101 Pump Manufacturer ;Zoeller _ Pump Model Number .~8._ Pump Must Deliver 34.60 gpm at 14.67 ft TDH Project WEST VIEW CONSTRUCTION Page 4 of 8 Mound System Maintenance and Operation Specifications Service Provider's Name Ron's Sewer Service Inc. Phone! (715) 749-0153 POWTS Regulators Name St Crobc County Zoning Phone' (715) 38fi-4680: System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1200 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 fe 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 every 3 years Effluent Filter Should inspect and clean at least once eve 3 years Pump and Controls Test once every 3 years Alarm Should test month Pressure System Laterals should be flushed and pressure tested every 1.5 years mound Inspect fcF ponding and seepage once every 3 years Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. Al gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Tum-up Detail Finished Grade 6-8" Diameter Lavin Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: WEST VIEW CONSTRUCTION Page 5 Of 8 J 1/O O 1/4 W HEAD CAPACITY CURVE 30MODEL "9fr 4 5/8 e - 25- 3 5/8 s 20 ~ m I'f-rr i- + o t DIt O o 10- 4 3/16 8 2 5 0 1 1/2-11 1/2 NPT W& GALLONS 10 20 M 40 50 60 7o to LITERS 0 so FLOW L ISO 240 MODEL 96 0o CYCLE Feet Gollons Meters Liters 5 72 1S 273 10 51 3.1 231 1s 45 4 6 170 12 20 25 &1 es anew vm.c a aatr9rt 4 3/16 SK1102 CONSULT FACTORY FOR SPECIAL APPLICATIONS • Electrical altemators, for duplex systems, are available and • Variable level float switches are available for =910 supplied with an alarm. and three phase systems.. • Mechanical aitemators, for duplex systems, are available - Double piggyback variable level float switches are available with or vvMxxA alarm switches. for variable level long cycle controls. SELECTION GUIDE Standard all models - Weight 39 lbs. - % H.P. 1. M too open W 2 Pole nieclu 1°Oal awtktr, no exssmal cm*W required- 2. S6p)le pkwbatdt vrriebie lmd float swiYis ardatble p%ebaclt variable level, ss series control Selea Wn Goat swildt raefert0 f9M10477. Model Voim-Pe Mode 3 Medw kal iiamnatm 10-0072 or 10.0075. M96 115 1 Auld 9.4 1 or 1 & 7 - 4. See F1r1D712. for correct nwdd al t3ecI M ANwinew. tow 115 1 Non 9.4 2 or 2 & 6 3 or 4 & 5 S. 10.0225 used as a coral activow, speta'fy duplex (3) or (4) DI18 230 1 Auto 4.7 1 or 1 & 7 & Fsmsystem aor (4) tote J-Pak Aooc1Ion boor, forwv" 0g1lt connecffon orafiad-in ESS 230 1 Non 4.7 2 or2 & 6 3 or 4 & 5 sirnpim ordupbex operallar,10-0002, 7. Two (2) tole J-ftK for walerW connection or splice. i For 6dornreiort on addBaral Zae9er praduds referb CAUTION WIMB * rallmt an addilim cafalop onFigWbadt Variable Level 9wkh6q All installation of controls, protection devices and airing should be done by a qualified Fr h 11edimiwlAMtrebr. SkmWM&+ WBesfnL licensed electrician. All electrical and safety codes should be followed including the most Single Phrase Smrpiert PunpCmrYOi, FMiS t Alarm &js emv, RADM recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA), RESERVE POWERED DESIGN For unusual conditions a reserve safety favor is engineered into the design of every Zoeller pump. YAR i0: P.Q 8011 f034T ~ - LOWSWAlk KY. ~O f17 hlrrRribdhrmsad.. e Lor601a, KY 4MI-19Br e~a~►.t:~,b PUMP !O_ ~Zc = t±rar Mound System Management Plan Pursuant to Comm 83.54, Vft. Adm. Code This system shall be operated in accordance with Comm 82-84. Code, and shall maintained in accordance with Its' component manuals [SBO-10891-P (N.01101), 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 Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or Pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Amu openings used for service and amant shag 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 84ndm in diameter shall be secured an effective locking device to prevent accidental or unauthorized entry Into a tank or component. Beeft Tank The septic tank shag be maintained by an individual certified to service septic tanks under s. 281.48, State. The contents of the septic tank shag be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shag be assessed at least once every 3 years by inspection. The outlet filter shag be cleaned as necessary to ensure proper operation. The foot cartridge should not be removed unless provisions are made to retain solids in the tank that tray slough off the filter when removed from Its enclosure. If the fir is equipped with an alarm, the filter shag be serviced if the alarm is activated continuously. interrrrittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shag have its contents removed when the volume of sludge and scum in the tank exceeds 113 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 nerd 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 shag be approved for septic tank use by the Department of Commerce. Pump The pump (dosing) tank shag be inspected Tank and servicealarms, and pumps shag be tested to verify proper operation. Nan eftleent Star is irk within the tank 4 shall be 3 inspected years. AN inspected and serviced as necessary. Mound WW ftwoutre 019bi"m Senn trees or shrubs should be planted on the mound. Plantings be m seeded and mulched as may b be made around the mound's perirrmeter, and the mound shall be 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 wince frost penetration. Cold weather, installations (Oetober.February) dictate that the mound be heavily mulched as protection from influent quality into the mound system may not exceed 220 mglL 60135,150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mglL BOD5, 30 mg/t. TSS,10 nVt FOG, and 104du/100 mL for highly treated eft Influent flow may not exceed maximum design flew 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 fldo accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the Mittel last system when installed to determine if orifice dogging has occurred and if orifice cle rting is required to maintain equal distribution within the dispersal Observation pipes within the dispersal cog shag be checked for efiluennt pondirng. Ponding levels shag be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring.' If the septic tank or any of ft components became defective the to* or component shag be repaired or replaced to proper operating condition. keep the system in If the dosing tank, pump. pump controls. alarm or related wrong becomes defective the defective component(s) shag be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wactewater or begins to discharge wastewater, to the ground surface, it swig be repaired or replaced In its' present location by wing basal area if toe leakage occurs or by mmovag biologically clogged absorption and and related piping, and morlSao Page 5 Of this plan for the saw components as deemed necessary to bAV the system into proper operating grad dispersal name and telephone number of your local POWTS regulator and service provider. ition. The information and schedule of man Prom Unrdts units are attached as anagernent and maintenance for prebeetrment devices such as aerobic treatment units or disinfection separate documents and are considered part of the overall management plan for this system. rs~-r• Ula=sVl~wi eansT. [ t..a-~ 39~ Oct-19-2010 01:59 PM St. Crcix County Plan/Zon ng 715-386-4686 1;1 ST. CROIX COUNTY SEPTIC' TANK MAINTENANCE AGRI:FM>~NT AND,, OWNERSHIP CERTIFICATION FORM 2Z8 (~a~2'Vwt~ owner/Buyer _ 'V A`I% 0;11 Mailing Address se- 6VI Property Address r (Varifcation acquired froth Planning & oning Departmcl or stew construetiun,) City/State 41vx_ 1(iAl Parcel Identification Number 04 6 3_Q3 - - 00 - D 9 LEGAL DE PTION Property Locatioll _5E T LaN R~W, Town of Subdivision Plat:-ZJ'ILu_i ' ( rk;-, ,Lot # . l Certified Survey Map Volume, Page # r Warranty Teed # (before 2007)Volume Page # Spec house es Ito Lot lines identi{iablo es : no SYSTEM MAINTENANCE AND OWNER CERT FICATI N Improper use and mainter a of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumpin septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the @tnction tic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities arc specified in §Co (l) and in Chapter 12 - St, Croix County Sanitary Ordinance. The property owner agrees it to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, jou n plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in prole crating condition and/or (2) after inspcction and pumping (if necetmsury), the septic tank is less than 1!3 11111 of sludge. 1/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards sot forth, herein, us set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin, Certification stating that your septic system has been maintained must be completed and returned to the St, Croix County Planning & Zoning Department within 30 days of the three year expiration date. i/we certify that all statements on this form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Offloe, Number of a rooms I-- I fATUREOFAPPLICANT(S) Dl ***Any inforn ation that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department, Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed, (REV. Q8/D5) Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I of 3 Division of Safety and Buildings in a ce with Comm 85, Wis. Adm. Code County ST. CROIX Attach complete site plan on no than x 1 indf aE OENED include, but not limited to: verb odzo farm point (BM), direction and Parcel I.D. 040 - 1303 - 00 - 039 percent slope, scale or dimensions, no w, and to tion and distance to nearest road Please rant all Inform on. L L .3 2007 Revie by Date p~ Personal information you provide may be used for secondary rposes (Privacy Law, s. 15.04(l) (m)). ~ 1 p ZZZ-6 ZONING ®®@I n ®i ty E 1/4 SP 1/4 S T 29 N R 19 7Govt. Lot (or) W Property Owner's Mai ' g Address # Block # Subd. Name or CSM# 839S . Park Drive 9 Tribute (Walnut Hill Farm) City State Zip Code Phone Number []City []Village • Town Nearest Road Hastings, NW 55033 ( ) NK Walnut Hill Way E] New Construction UseE] Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement Public or commercial - Describe: fl. Parent material loess over glacial till Flood Plain elevation if applicable :WA General comments Mound System 1.84 ft. sand fill 0.6 loading rate and recommendations: Plow depth 10". PE'MT 00&8 !s ZZ~ 'W U u 1 LL WM FT] Boring # ❑ Boring Pit Ground surface elev. 103.60 ft. Depth to limiting factor 14 in. Soil Application Rate H@04on D@pfh D@fnin@nf Q@l@f R@d@it D@o@Flpfi@n T@itfuf@ @Vu@tuf@ G@nllifltow kund@fy R@ft GREW - in: Mufull Qu: t. conf: cdof Of. f ; Oh: '€ffm 'Effigy C/ h 1 0-6 10YR2/2 1 3fabk mvfr aw 3vf-co 0.6 0.8 D 2 6-14 7.5YR3/3 - A 3fabk mfr cs 2vf-co 0.6 0.8 3 14-20 7.5YR3/3 m1f7.4YR4/4 sicl lfabk mfi as 2vf-m 0.2 0.3 4 20-24 7.5YR4/4 m2d 7.5Y&/6 c Om mfi lvf-m 0.0 0.0 Horizons 2 & 3 have some gr/cobs. F 2 Boring # ❑ Boring 100.90 14 / E] pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *EN#2 h~ 1 0-7 10YR2/2 1 3fgr&abk mvfr aw 3vf-co 0.6 0.8 2 7=14 3/ gil 2&bk tfift Aw 3v€ ®o 0:6 0:6 3 14-17 7.5YR4/4 m2f 10YR4/4 sicl Ifsbk mfi as 2vf-co 0.2 0.3 4 17-33 7.5YR4/4 m2d7.5YR5/6 cl lfabk mf 2vf-co 0.2 0.3 Horizons 2,3 & 4 have some gr/cobs/stones. * Effluent #1 = BOP > 30 < 220 mg/- and TSS >30 < 150 m9/L * Effluent #2 = @_ OD < 30 mg/l- _ and TSS < 30 _ _ mg/- CST Name (Please Print) sit re _ CST Number ~Yj ~ S 224832 Ma Jo Hollister ollister's Soil Testing & Desi ~ Address Date Evaluation Conducted Telephone Number W9875 690th Avenue, River Falls, WI 54022 12 - 04 - 07 (715) 426 - 1775 Property Owner HUGHES, Brian & Shelly Parcel ID # 040-1303-00-039 Page 2 of 3 F3 Boring I Boring # a Pit Ground surface elev. 103.60 ft. Depth to limiting factor 19 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff *Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. FE 1 0-4 10YR2/2 1 3fa&sbk mvfr aw 3vf-co 0.8 2 4-10 10YR4/3 1 2f-mabk mvfr cs 2vf-co 0.8 3 10-19 10YR3/4 sil 2f-msbk mfr as 2vf-co 0.8 4 19-24 10YR3/4 Of7,5YR4/4 $if If--msbk mfr 2vf--m O.b fpefiin 2 has some ji o pti l A4 have 66M grkoh: F-1 Boring # Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil "Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 ❑ Boring # ja 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 PD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 ' Effluent #1 = BODS > 30:5 220 mg/L and TSS >30:5 150 mgA. * Effluent #2 = BOD, < 30 mg/l. and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264.8777. SBD-8330TM (R.07/00) Plot Plan for Site and Soil Evaluation Page 3 of Property Owner $P-IAX) 4,5fiE" +WC-HES 1"=40ft Legal Description LZT !~4 ► WAwuT r-tiU-r-*RW\ (except where noted) ~,TRIPitTE 1 SE /I OF Tt4E SE~~4. 5 22, Tzw, R 191ii = Backhoe pit 'Tbwm Or-MIDy_ ST. CPO%X C'_Ok#ju W15cOwi'sim. North a~ r _ 24~ae1.R1~i 37. o -o ~$N C Q~3 D3.1n0 ~ Je' o `3` W S~ q p `o .QO Qy ~ lil $ T 'al t-) lty 3Z4. 39' gM # 1= 10P ofr ~d4R AS9uMen 100•~0C Site Location: zZ o~ I II ~I~I~II~ If~~l~lll! 11111 ~II 8054859 Tx:4040841 STATE BAR OF WISCONSIN FORM 3 - 2000 954891 QUIT CLAIM DEED BETH PABST Document Number REGISTER OF DEEDS THIS DEED, made between Citizens State Bank, Grantor, ST. CROIX CO., WI and Westview Construction, Inc., a Wisconsin Corporation Grantee. 04/23/2012 11:31 AM EXEMPT#: NA Grantor.quit claims to Grantee the following described real estate in St. REC FEE: 30.00 Croix County, State of Wisconsin (the "Property"): TRANS FEE: 204.00 PAGES: 1 Lots 38 an 39 of Walnut Hill Farm, Town of Troy, St. Croix County, Wisconsin. I Recording Area Name and Return Address: SOLD AS IS WITHOUT FAULTS Title One Premier Group File # 17851 Together with all appurtenant rights, title and interests. 040-1303-00-038 & 040-1303-00-039 Parcel Identification Number (PIN) This is not homestead property. Dated this 17th day of April, 2012. Citizen S to Bank Zk-.X- ",A,~~ * Gene Haberman, its Vice Chairman * AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN ) Signature(s) COUNTY ST. CROIX ) ss. authenticated this Personally came before me this 17th day of April, 2012 the above named Citizens State Banks by Gene Haberman, its * Vice Chairman to me known to be the person(s) who executed TITLE: MEMBER STATE BAR OF WISCONSIN th ego no i trume t an o dged the same. (If not, authorized by § 706.06, ~1Ar'ep?.~5~,~) * Jm Palett THIS INSTRUN_eSR1UA'91WAF`FBD Bf., Notary Public, Oat of Wisconsin Mich 1,Po~ y ? My commission is permanent. (if not, state expiration date: Q tn - 10/27/2013 ) (Signatures may be authenticatCsl or dcknoA Boni of necessary.) 'Names of persons signing in any~&pacitylnu$t be typed ~y3ted below their signature 1 Of 1 QUIT CLAIM DFED STATE BAR OF WISCONSIN FORM No. 3-2000