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HomeMy WebLinkAbout002-1048-20-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and f3'_Iding Division ,, INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) 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 Ran ,Curtis & Deanna Baldwin, Town of CST BM Elev: Insp. BM Elev: BM Description: ~~ ~ ~~ ~~ TANK INFORMATION /~ _ TYPE MANUFACTURER ~ CAPACITY Septic Dosing d ~.... ~ o ~ 3 ~o DO Aeration 5~ ~~ / x (~ Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic 7 ~ Z22. / /Z9 J Z9 Dosing ~~ ZLZ ~ Z~j ~ /Z5• ~ --- Aeration Holding PUMP/SIPHON INFORMATION ~,I,. Manufacturer Demand by ~dls GPM ~ Model Number ~ D ~„ 3b• TDH Lift Friction Loss System Head TDy t ~ 2.0 3•ZS /3-a Forcemain Leng h d5 Dia. / / z Dist. to well ZZZ . SOIL ABSORPTION SYSTEM ELEVATION DATA County: St. CfDiX Sanitary Permit No: 515072 0 State Plan ID No: Parcel Tax No: 002-1048-20-000 Section/Town/Range/Map No: a 20.29.16. 0 STATION BS I FS ELEV. Benchmark 6 /~ /DZ~ Alt. :~ o~ Z. 5 9G -5~ Bldg. Sewer ~~ ,,y_ ,7 /0 ~ ` SUHt Inlet (,, 55 ~'Z. 53 SUHt Outlet ~' ~, 92. 2~ Dt Inlet Dt Bottom ~' • Q 7, ~$ Header/Man. 3 . 97 - ~~ 7 Dist. Pipe 3. ~J 95. ~v a Bot. System ~~ ~, ~7y - 3$ Final Grade ~ /~. ~~ StC,,oyer // F : ~ fit,, c~o~, ~~ ~ ~ • Jb$i~ ~ 'T Z . S 9~p - Sg O 'd ~ ~ 4~I~ ~ ~~ BEDITRENCH Width / Length ~ enc No. O PIT DIMENSIONS No. Of Pits ~ Inside Dia. Liquid Depth DIMENSIONS 1 Z ~ ~ ~.~,~ " SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHA OR S[y /~ Type~Tstemy 1 GL ~~~ / '7 G 3 ~ ~( ~V ~ ,/ ~ /~~ UN T Model Number: ^~ \ nISTRIBUTION SYSTEM , ~ Header/Manifold \ ~ ` Distribution I/ Pipe(s) ,13 ~ lUl~ ~ S "T Di i ~~ x Hole Size /~ J /~ x Hoie Spaac~ing / ~ ~ %~ Ve Air In e ~ Dia Length ac n Length a p g SOIL COVER Y Pracsnre Svstamw Anly YY Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center ~ ~~ • Bed/Trench Edge Topsoil ~ (~~ i~-- 9i Yes ~ No = Yes ~ No ~ '~ COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~/ Z ~ / d~ Inspection #2: / / Location: 823 225th Street B Idwin, WI 54002 (SW 1/4 SE 1/4 20 T R16W) metes & bound~Lot~ ~( Parcel No: 20.29.16.000 1.) Alt BM Description = ~ `~ Go ~.~._ !~ ~ao~0 ~ ~O'"~rJS~-°~ (~ [Z-. 2.) Bldg sewer length = ~ SO ~~~"' t a` - amount of cover = f ~ ifNlQ r, ~„~ ~ ~ ~~i Plan revision Required ~ Yes ~ No ~~I II i I Use other side for additional information. - ___ L__ ~J ~__ _ -~ ~--- - -- Date ~ Insep or's Signature Cert. No. SBD-6710 (R.3/97) ~ ` i1 f commerce.wi.gov Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 St. Croix i sco n s i n Madison, WI 5 3 7 07-7 1 62 Sanitary Permit N umber (to be filled in by Co ) Department of Commerce ~ x ~ J V Sanitary Permit Application State Transaction Number 663074 In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the ariat mental unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are Project Address (if different than mailing address) submitted to the Department of Commerce. Personal information you provide may 1?e used for secondary ur oses in accordance with the Privac Law, s. 15.04 1)(m), Stats. ~ 11 225th St I. A lication Information -Please Print All Information . Property Owner's Name Parcel # Curtis Rang 002-1048-20-000 pZB Property Owner's Mailing Address J Property Location 811 225th St . Govt. Lot City, State Zip Code Phone Nu®'f6eiE LANNIt'K'~ZONING SW y, SE /<, Section) 0 Baldwin WI 54002 P (circle one T 29 N; R ~ 6 E or W II. Ty a of Building (check all that apply) Lot # ~ 3 10 Subdivi a me si on N or 2 Family Dwelli~/ - Number of Bedroo s acres ~ ) p ' ^ Public/Commercial -Describe Use ~ ~ ^ City of ^ State Owned -Describe Use CSM Number ^ Vi Jage of / 1 2/449 own of Baldwin I,l..d''T III. Type of Permit: (Check o one box on line A. Complete line B if applicable) '4' ^ New S stem y Re lacement S stem p y ^ 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. T e of POWTS S stem/Com onent/Device: Check al at a 1 ^ Non-Pressurized In-Ground ^ Pressurized In-Ground t-Grade ^ Mound > 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ~~ - ~ ^ Holding Tank ^ Other Dispersal Component (explain) ~ Pretreatment Device (explain) V. Dis ersal/TreatmentRrea Information: Design Flow (gpd) 450 Design Soil Application Rate(gpdsf) 6 Dispersal Area Required (sf) /~ ~ Dispersal Area Proposed (sf) / System Elevation . 900 75 D 900 95.2 VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units ~ o ~ U =' N ks T E i i T k c R ew an x st ng an s ~ 0 ~ ~ Y ~ a U iin y rn r . C7 G. Septic or Holding Tank ~ 00~ ~~ 1 Wieser X Dosing Chamber 600 / b ~ fv ~ /d VI[. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signa r MP/MPRS Number Business Phone Number Rick Brown ~2~--, 231251 715-419-0739 Plumber's Address (Street, City, State, Zip Code) 319 Badger Rd. Rice Lake WI 54868 VII oun /De artment Use Onl Approved ^ Disapproved $ermit Fee ~ Da t e Issued I ing Agent ignatu ~ ~ri.S~~ ^ Owner Given Reason for Denial (1' D~ ~' / i `r S Q ~~j~ n pions oft,~~~nnro 1/Reasons for Disapproval SYSTEM OWNt`K: 3 T~f~ ~CCUP IT ~SSV~D Td 1c an ,effluent filter and ~ t all be serviced I mai ~ ~ d E ~~/( f ~ ~ ~ dispersal cell mus r. fjl ~~ lumbe as per management plan provided by p II setback requirements must be maintained ~ ~ ~u/~' !77 ~ dN a$ per appllCdUlCAltittwo-cbmptete'pl~7us'ior the system anrt submit to the County only on paper not Tess than 8 llz x 11 inches in size p~ ,~l~w r~~~~~- SBD-6398 (R. 02/09) Valid thrub2/1 I ~ ~ ~ ~ G~-vl'~-~ ' N ~~b~ e p ' l ~ ~V) ~ ~ i ~;,:, ~~. ~~~.~ f ~ ~~~ L ~ ~ k, ~ .~ -___ ~-, ;~ wt. .~ ~ ~ ~~. i~~.~ ~~~ 1,~ j ~ ~ 3 y' `'s v ,x' 1 5~~ ~ I ~' '` J~ e ~~l LEGEND 1 " = 40' ~c BM Bench Mark ~ Boring B1= 9~.~ B2= ~ ~. ~ ` B3= q;.~' ~~ ~ ~ SITE PLAN S W - ~~ ~~ -~~ - fC i3~,1U'.,.1,`~ ~~`~s~,, y~ Rick Brown 231251 r II ~J~ r vV ~~~~:J y w,L' ;5.~ iy.5 `3. ~ ~: ~J ~ ~,~' June 5, 2009 urtis & Deanna Rang 11 225'h Street ~aldwin, WI 54002 CodeAdministrati Temporary Occupancy Land Use Permit LU0123 715-386-4680 ~;•. Town of Baldwin Parcel # 20.29.16.302B Land Information &ear Mr. & Mrs. Rang: Planning > ° 715-386-4674. This letter confirms zoning approval according to the plans you have submitted to temporarily Real P live in an existing dwelling on your property in the Town of Baldwin pursuant to Section n~ 17.70(3)(c)3 of the St. Croix County Zoning Ordinance until a modular home and replacement 715~~ -4677 ~` Private On-site Wastewater Treatment System (POWYS) can be constructed. Staff finds that the proposed temporary occupancy request meets the spirit and intent of the St. Croix County Zoning Ordinance with the following fmdings: 1. The dwelling currently occupied is connected to an existing septic system, which must be replaced due to lack of compliance with current Dept. of Commerce code. 2. The existing dwelling and its septic system will be abandoned upon completion of the new house and code-compliant POWYS. 3. The approval of this project meets the intent and purpose of the Ordinance and will not affect the public health, safety and welfare of County residents. Approval of the land use permit is subject to the following conditions: 1. The applicant shall secure a sanitary permit from St. Croix County to connect the new house to a replacement Private On-site Wastewater Treatment system (POWYS). 2. The applicant shall obtain a building permit from the Town of Baldwin's Building Inspector, Todd Dolan, for the remodeling/construction of the new house. 3. The applicant shall contact the Planning and Zoning Department when all construction has been completed. Within 30 days from completion of the construction activities, the existing dwelling shall be abandoned and either demolished or removed from the site. r 4. The applicant shall submit to the Planning and Zoning Department an as-built drawing and photos of the completed project to document removal of the mobile home. 5. The applicant shall have one year from the issuance of this land use permit to complete this project. The applicant may request an extension of up to six months from the Zoning Administrator prior to this deadline. If the land use permit expires, the applicant will be required to secure a new land use permit. `~~ This approval does not allow for any construction beyond the limits of this request. Your information will remain on file in the St. Croix County Planning and Zoning Department. .. «.:.~ ;::.;: ;< Please contact the St. Croix Coun Plannin and Zonin De artment to obtain..the_.,necessa .>~ :. ..... ,. ,... ~~.::,:,.,x::. ST. CRO/X COUNTY GOVERNMENT CENTER 1 101 CARM/CHAFE ROAD, HUDSON, ty 54016 715386-4686 FAX PZC~CO. SA/lVT-CROIX. WI. US W WtiV. C O. SAI NT-C ROIX. WI . U S sanitary permit for the proposed construction. It is your responsibility to ensure compliance with any other local, State, or federal rules or regulations. If you have any questions, please do not hesitate to call. Sinc , l Pamela Quinn, PO TS Inspector Zoning Specialist/Zoning Administrator Cc: Ken Klanderman, Clerk, Town of Baldwin Todd Dolan, All-Croix Inspections file m a m 3 0 m n C -~ ~ a m _. ~s~ i ~A 3 m !~ Z v S y 3 C fl. O m n O C! O ~H = ~ y ~ ~ ~ ~ n _• ~ y ~ --1 ~ z ~ ~ 'D 3, y y y C o~ O C1 O O O z y ~. ~. y a a s .` commerce.wi.gov ^ ^ ~scons~n Department of Commerce Safety and Buildings PO BOX 7162 MADISON WI 53707-7162 Contact Through Relay www. co m m e rc e. w i. g o v/s b/ www.wisconsin.gov Jim Doyle, Governor Richard J. Leinenkugel, Secretary May 21, 2009 CUST ID No. 231251 RICK BROWN RICK BROWN SOIL TESTING 319 BADGER RD RICE LAKE WI 54868 ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/21/2011 Identification Numbers Transaction ID No. 1663074 Site ID No. 747509 SITE: Please refer to both identification numbers, above, Curtis & Deanna Rang -Dwelling in all comes ondence with the a enc . 811 225TH St Town of Baldwin, 54002 St Croix County SW1/4, SEl/4, S20, T29N, R16W FOR: Description: At-Grade Object Type: POWTS Component Manual Regulated Object ID No.: 1224590 Maintenance required; Replacement system; 450 GPD Flow rate; 36 in Soil minimum depth to limiting factor from original grade; System(s): At-grade Component Manual, SBD-10570-P (R.6/99), Pressure Distribution Component Manual, SBD-10573-P (R.6/99) The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This_system is to be constructed and located in accordance with the enclosed approved plans and with the component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements.. ~-+ No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. ~" ~j~t A copy of the approved plans, specifications and this. letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. ~: It ~'. ~-- C1EP (~ DiVIS~Q 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 Sic CORR the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincere Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 eter Pa el Private Sewage Plan Revi er ,Integrated Services WSMART code: 7633 (608)266-2889 , M - F, 0600 - 1430 Hrs pete.pagel @wisconsin.gov cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544 ,Friday, 7:00 A.M. To 3:30 P.M. t y~ ~ , RESIDENTIAL AT-GRADE DESIGN Pressurized -Sloping Site INDEX AND TITLE SHEET Project Rang Owner Curtis & Deanna Rang Address 811 225th St. Baldwin WI 54002 Legal Description SW 1/4 SE 1/4 Sec 20 Town 29 Range 16W Township Baldwin County St. Croix Subdivision Name CSM Vol 2!449 Parcel ID Number 002-1048-20-000 Plan Transaction Number Index sheet Calculations At-grade drawings Laterals and dose tank Specifications Management & contingency plan Site Plan Pump cure Designer Rick Brown License Number Signature ~ /J~ Phone Number Date 05/14/09 Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 231251 '~` ~- ~. ti 1~ o~ ~ 419-0739 Designed pursuant to: At-grade Component Manual for POWTS SBD-10570-P (R.6/99), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) Lot No. 10acres Version 3.11 (05/01) Page 1 of 8 PRESSURIZED AT-GRADE DESIGN At-grade Design Worksheet -Sloping Site Flows and Site Data Entry. (r or c) r Residential or commercial? 300.0 Estimated wastewater flow (gpd) 450.0 Design wastewater flow (gpd) 4.00 % Site slope 95.20 Contour elev. below lateral (ft) 36.00 Depth to limiting factor (in) 0.50 In-situ soil application rate (gpd/ft^2) Distribution Cell Information (1 or 2) 1 Influent wastewater quality 10.00 Linear loading rate gpd/ft 10.00 Effective absorption width (ft) 10.00 Max. effective width permitted (ft) 90.00 Aggregate length (ft) Pressure Distribution Data Entry {c or e) c Center or end lateral connection 2 Number of laterals 0.188 Orifice diameter (in) e.g. 0.188 Not a final 2.00 Estimated orifice spacing (ft) calculation 2.00 Forcemain diameter (in) 3.10 Forcemain flow velocity (ft/sec) 150.00 Forcemain length (ft) 90.50 Pump tank elevation (ft) 3.25 System head (ft) x 1.3 4.37 Vertical lift (ft) 2.98 Friction loss (ft) 10.60 Total dynamic head (ft) Lateral Diameter Selection Designer must select cane lateral dia~~neter Pipe diameter Design options Design choice 1 in 1.25 in X 1.5 in X 2 in X X 3 in X Gallons/Inch Calculator (optional) Total Tank Capacity (gal) Total Working Liquid Depth (in) Gal/in (enter result in cell G46) Treatment Tank Information 1000 Septic tank capacity (gal) Wieser Manufacturer Effluent Filter Inform_a_tion Dose Tank Information Best Filter manufacturer 600.0 Dose tank capacity (gal) GH10-8 Filter model number 15.9 Dose tank volume (gal/in) Wieser Manufacturer Project: Rang Transaction Number: y or n Does forcemain drain back? y or n Are laterals at highest point? NA 24.5 Forcemain drainback (gal) 71.5 5x Lateral void volume (gal) 96.0 Minimum dose volume (gal) 30.4 System demand (gpm) Page 2 of 8 AT-GRADE PLAN VIEW ~D-f 1/6 B Observation pipes (2 typical) A 10.00 ft v ~ B 90.00 ft ~~~ 1/6 B 15.00 ft C 12.00 ft W ~ D 5.00 ft ~~~ E 2.OOft . L 100.00 ft D B W 22.00 ft A x B 900.00 ft^2 L ~ Cap Typical obs. pipe. = Total aggregate cell A x B Slotted in the lower =Plowed area L x W s", and anchored securely. 6" AT-GRADE CROSS SECTION Lateral invert elev Synthetic fabric cover 97.03 ft Finished grade elevation 95.70 ft ~'~:~:::::::. ~.E. ... f- Observation pipe at aggregate toe Surface contour g5.20 ft C =A and system elevation ® = 12 in. topsoil and subsoil over aggregate and tapered to toes. = 6 in. aggregate below pipe(s), and 2 in. above pipe. Project: Rang Transaction Number: 4 % Slope D -# Plowed layer below L x W Page 3 of 8 PRESSURE DISTRIBUTION AND DOSE TANK Lateral Diagram -Center Connection P IE ~~If~xl2 ~ x~2~1 Last hale drilled next to end cap Hales drilled an t he bottom of the lateral, equally spaced Laterals ix foroe main ~f f"VC Soh 40 [per COMM Table 84.30-5) # =Turn-upm'ballualaeorcleanoutplug Lateral Specifications Center Lateral connection point 2 Number laterals P 43.88 Lateral length (ft) 2.00 Lateral diameter (in) 2.00 Forcemain diameter (in) 150.00 Forcemain Length (ft) Typical Pump Chamber Layout Weather-proof junction box 0.188 Orifice diameter (in) X 1.95 Orifice spacing (ft) 23 Orifices/lateral 15.2 Lat. discharge rate (gpm) 30.4 Sys. discharge rate (gpm) 10.6 TDH (ft) Final grade -~ Tank component is properly vented C o q C B ~ C E G D Totals Electrical as per NEC 300 and Comm 16.28 WAC Inches Gallons 19.7 313.2 2.0 31.8 6.0 96.0 10.0 159.0 37.7 600.0 Tank full A Alarm on Pump on B 91.33 ft C -~ Pump off D Approved manhole cover with warning label and locking device disconnect 4" Alternate ~~ outlet location 18" min. /~ Approved outlet ~ joint Provide 1/4" weep hole or antisiphon device. ~ 90.50 ft Goulds Pump manufacturer EP05 Pump model number SJE Alarm manufacturer HW 101 Alarm model number Project: Rang Transaction Number: Page 4 of 8 At-grade System Maintenance and Operation Specifications Service Provider's Name Rick Brown ~ Phone 419-0739 POWTS Regulator's Name St. Croix County Zoning Phone 386-4674 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 900.0 ftZ Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Other Ins ect and/or service once eve 3 ears Ins ect and clean at least once eve 3 ears Test once eve 3 ears Should test month) Laterals should be flushed and pressure tested eve 1.5 ears Inspect for pondin and seepa a once eve 3 ears 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 at-grade component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping. materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The at-grade structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. 6. Areas within 15 feet of the downslope toe will be protected from compaction. 7. All other construction details are as per the at-grade component manual SBD-10570-P (R. 6/99). Lateral Turn-ug 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: Rang Transaction Number: Page 5 of 8 At-grade System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals jSBD-10570-P (R. 06199) and SSWMP Pub. 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1 /3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. At-grade d Pressure Distribution System No trees or shrubs should be planted on th lantings may be made around the at-grade's perimeter, and the at-grade shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the at-grade is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the at- grade be heavily mulched as protection from freezing. Influent quality into the at-grade system may not exceed 220 mg/L BOD5, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5, 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the at-grade component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by renovating the biologically clogged absorption and dispersal media, installing new piping, and replacing other components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Rang Transaction Number: Page 6 of 8 ' ~~ GOULDS PUMPS Submersible Effluent Pump 3871 EP05 APPLICATIONS Specifically designed for the following uses: • Effluent systems • Homes • Farms • Heavy duty sump • Water transfer • Dewatering Motor: • EP04 Single phase: 0.4 HP, 115 or 230 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • EP05 Single phase: 0.5 HP, 115 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • Power cord: l0 foot standard length,16/3 SJTOW with three prong grounding plug. Optional 20 foot length,16/3 SJTW with three prong grounding plug (standard on EP05). • Fully submerged in high grade turbine oil for lubrication and efficient heat transfer. Available for automatic and manual operation. Automatic models include Mechanical Float Switch assembled and preset at the factory. FEATURES ^ EP04 Impeller: Thermo- plastic Semi-open design with pump out vanes for mechanical seal protection. ^EP05 Impeller: Thermo- plasticenclosed design for improved performance. ^ Casing and Base: Rugged thermoplastic design provides superior strength and corrosion resistance. ^ Motor Housing: Cast iron for efficient heat transfer, strength, and durability. ^ Motor Cover: Thermoplas- ticcover with integral handle and float switch attachment points. ^ Power Cable: Severe duty rated oil and water resistant. ^ Bearings: Upper and lower heavy duty ball bearing construction. SPECIFICATIONS Pump: EP04 • Solids handling capability: 3/a"maximum. • Capacities: up to 55 GPM. • Total heads: up to 24 feet. • Discharge size: l1/z"NPT. • Mechanical seal: carbon- - rotary/ceramic-stationary, BUNA-N elastomers. • Temperature: 104°F (40°C) continuous 140°F (60°C) intermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Pump: EP05 • Solids handling capability: 3/a" maximum. • Capacities: up to 60 GPM. • Total heads: up to 31 feet. • Discharge size:lY2" NPT. • Mechanical seal: carbon- rotary/ceram ic-stationary, BUNA-N elastomers. • Temperature: 104°F (40°C) continuous 140°F (60°C) intermittent. • Fasteners: 300 series stainless steel. ,-~. • Capable of running dry without damage to components. METERS FEET,. .r.._.____ 10 9 301-^-` _ ____. $ E 25".....___- ,._,..._ o ~ a w U 6 a } 5 0 J 4 0 ~ 3 2 1 0 40 50 GPM 0 2 4 6 8 10 12 m3/h CAPACITY Goulds Pumps ©1999 Goulds Pumps C~ ITT Industries Effective January, 1999 ~/ AGENCY LISTING $~° Canadian Standards Association (CSA listed model numbers end in "F" or "C".) Goulds Pumps is ISO 9001 Registered. .m__ , _ --~~--5 GPM ~ _ _... --- - _ __ ~ - 2.5 Fr _. ~__._.__ _~ ._... ,_ ,._ __ ~ , .. -- - - -- a__.~.___ ______ i r \~ t -.- ~- L ~ . , . . ~" ~;,;; r, ~V C ~~ .~ Y' 1J, \y 0 ~;3 '~. .,, '~~ k, ~ .~ -..._. ,~ ~t.~ ~© t ~' ! ~ ,\~ i \ i ; i f ~'~1 _ { ¢ in y 3~~~5 SITE PLAN S P. Cri: x ~.0~_ +^J~ /~ ~ ~ ~ ~ ti~ i, ~' ~y <` 3. ~ LEGEND 1"=40' ~c BM Bench Mark L~ Boring B1= ~~.~ " B2= 93.i` B3= ~ ~ . 7 Ricgk Brown 231251 ~~ (~ ~~ ~(-1~-~9 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address 0 ~ ( ~v2 .~~` .~ 1~• ~ a,~~, ~ ,• r~- (~/~ S L1 y D 2, Property Address ~ ~ ~ ~ ~ S ~- .S ~• ,~,r-~ o' L-' ° ~^- w~ S Lf O D Z. (Verification required from Planning & Zoning Department for new construction.) City/State l ).,... ~ ~ ~.-~ , ~- L~.~ Parcel Identification Number ~4~. ' ~D `~ g ~D -OD O LEGAL DESCRIPTION Property Location ~ t/a , S ~ t/a ,Sec. ~~ , T ~ 9 N R 1 ~ W, Town of ~~~ ~~-~' ~ -~ Subdivision Certified Survey Map # Warranty Deed # 5~/~d ~ Spec house yes no V Lot # Page # ~ 9 Volume ~ ~ ~0 ,Page # d Lot lines identifiable ye 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, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms _~ ~ SIG ATUR F APPLICANT(S) DATE ***Any information that is misrepresented. may result in the sanitary permit being revoked by the Planning & Zoning Department. *** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. 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'~ -= ~-'~-, ° dam- ~ b- ~ A , !N ~ ~i/ P ~ii/V ~~ a ~~ ~~~ i i~ ~~ ~~ ~~ 1 ,,.' ~~ ~ _ ..a~ ~ ~ #L. ~_ '.,,--,,,,,..'.r- ,` ~-~- _f ~~ ~ r i y - - ~. .a r ` ~ _--Y^~~~ ~!, ._., ~ j S .+:"' _ ~ E 1 ~"*' --1--..~...V . y F ~'~ ~ _ _.d-° ~ ~~ ~} ~-~_ . ' ~,, ~';--a ~- y ~ 1_ 3' ~~ -~ ~ ~ ~~ Wisconsin Department ofCommerce SOIL EVALUATION REPORT Division of Safety and Buildings Page 1 of 3 ui accuwancx wiui t.ornrn ao, vws. rum. i.uue County St. Croix Attach complete site plan on paper not less than 8 1/2 x 11 inches in size Plan must . include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 002-1048-20-000 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. R iewe Date Personal information you provide may be used for second~Es~~a'~,~L?w, s. 15.04 (1) (m)). ~~ Property Owner Property Location Curtis & Deanna Rang JUN 0 4 2009 Govt. Lot SW 1/4 SE 1/4 S 20 T 29 N R 16 E (or)® Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 811 225th St. ST.CROIX000PITY l0acres CSM VOL 2/449 City State Zip Code ity ~ Village Town Nearest Road Baldwin WI 54002 ( ) 225th St. New Construction Use Residential /Number of bedrooms Replacement ~ Public or commercial -Describe: Parent material General comments and recommendations: 3 Code derived design flow rate Flood Plain elevation if icabl t-Grade contour elevation 95.2' B1 H4 2" to 4" bands of scl Syr /4 B2 HS 2" to 4" bands of scl 5yr 5/4 B3 H4 2" to 4" bands of scl 5yr 5/4 GPD ft. goring # ~ Boring pit Ground surface elev. 95.2 ft. Depth to limiting factor 36 in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-8 l0yr 4/1 - sl 2msL-k m1 cw 3fm .6 1.0 2 8-24 10 r6/4 - sil 2msbk ml cw lfm .6 .8 3 24-36 l0yr 5/4 - fs osg dl cw if .5 1.0 4 36-74 2.Sy 7/4 - fs osg dvh _ - .5 1.0 2 Boring # Boring 93.6 60 Pit Ground surtace elev. ft. Depth to limiting factor in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-6 l0yr 4/1 - sl 2msbk ml cw 3fm .6 1.0 2 6-18 10 r 5/4 - sl 2msbk ml cam' lfm 1.0 3 18-30 Syr 5/4 - sl 2msbk dh cw _ .6 1.0 4 30-60 2.Syr 6/4 - fs osg ds cw - .5 1.0 5 60-84 2.Syr 7/4 - fs osg dh - - .5 1.0 * Effluent #1 = BODS > 30 < 220 mglL and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Sig CST Number Rick Brown ~ ~ 231251 Address Date Evaluation Conducted Telephone Number 319 Badger Rd. Rice Lake WI 54868 4/13/09 419-0739 Property Owner Rang Parcel ID # 002-1048-20-000 Page 2 of 3 3 Boring Boring # ~ Pit Ground surface elev. 95.7 ft. Depth to limiting factor 48 in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-12 l0yr 4/1 - sl 2msbk ml cw 3fm .6 1.0 2 2- 10 r 6/4 - sil 2msbk ml cw 2fm .6 .8 3 28-48 l0yr 5/4 - fs osg dl cam' lfm .5 1.0 4 48-75 2.Syr 7/4 - fs osg dh - - .5 1.0 ^ Boring # Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fg in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Boring Boring # Ground surface elev. ft. Depth to limiting factor in. Pit Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/f~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 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-8330Test (R.07/UO) k"~ ~, 5° ~k ~.~ ~~ e r`> S" .---~ ~~-~' ~ ~~s r -,~~t n 1~ `(r i ~ ~k •~ J~ . ,~'y 7 ~fi ~ \~ \) ~ ~~ ) ~/ ~~~ LEGEND " = 40' B ench Mark EL 100.0 ^ Boring B1= 9~,1 B2= g3. ~' B3= 9~.-~, ~~~~ SITE PLAN o~ ~~ _. k- ~~~ ~ ~~. C~-~ ~- ~ ~~~y ,3a..1~~,~~ ~~~ S~ ,~ ~~ ~~ -r-~~°~ 96-a g? ~ .~ \ ~ r '~ n~o ,- p . ~- 9 S.1 9N~~ ~3. ~ _--. Rick Brown 231251 ~'~~ ~7i.~1- ~-~3-0~ St;,t~~ Nar :a! \\'i:a:a,nsin h.xm 2 _._ Iv82 ~`~'-~-~-r~~ ~VA~CjtRANT1` DEF_D (JOCUMEN? rdp V1:~;. ~~„tJg'-'t~sE' ~[`~.y M'AR 2 2 1~~6 -~* 9:45 :~a.~ t , jia'aitd' 13~` ~ :Ct2: i t'Iy15 SP.nCE RE SERVED FOR RECQRDIrlC DATA NAFAF nND R~tUn~! ADDnE SS 6~'dESdC•sFJStd %17~'t3{T l{til{Oi11 ~`(:st ~flice ~cfx 1F?t1 lttanomynie, IrVisconsln 5~?i 022-1048-`l0 (T'c,rrz4 Idcentiflcntian {Vumberl The West Half of the Southwest Quarter of the Sc,utheast Qua=-ter- (Wlg a_ SinT;~ of SE4) of Section Twenty ti 'Powrt Yiip Twenty-nine ( 29) i'fart.-r, P>nge Sixt~esrt (16) Wes EXCEPT Lot Ctne 1 of the Survey Ma ii. Certified Survey Maps, Paye.449, as Document No. 342551, St. Cro.tx County, Wisconsin. ~~ `o~'~ ,•- 'this _.......__3'S _ ........._. _._._..__.. hc,mcsta:ad prapcrty. Gxw(~tirln to avasranticsc Easements and- restrictions of rer.ord . t~at,,rtth;s _. ___ _ _._ .~9tii._:_._...__,- _....____ day or ..:____:_ Fet~ruar_Y .. ._.__---___.,_ _._______._.. I~96 AU-i'1-IF.NTICATION Signn urc(c)____ __ .. _____._ ___.__. I,uthunucalc.d this _. <;lay of _ __. 6v .... Tt"f't.L ~li'~1R~R 4't':\TE l3.AR Ot~ t\'ISC'O.t'Sfty (I(noi. _ _ __ ___ :nuhaxizrd F.c §~Of.flc:, ti"ic. Stag., t ~+• :. INS r~._; h-!EM ~ ~vA () .Ja !' e F ~i L, ~. Thomas A. McCormack Baldwin, 6~2 541702 ! ~1>_n snrc~ :,,a} hr• ,un hrnei: ;rtr:.. rar .,:knnr lal}~ed. Rr.U, am net( nt: !•..i:a 1 #\ ~- `~i ..r--..~ (S I~ A 1 1 ~ _._ _ . James G. Niemann -- `I-l ,.. ~ Bonnie A. Niemann ACKNOWI.EDGMCN"f Sl'r\T I' t7F \V lSCCSNCI l~ St Croix C:oun,y. f `"` ____ _. Pu.:onally tame bef!,rc nu this __ 19 ~ ~ __. ilay n!' _ _ F_E~7T.U2I~! -,-._ _.__ _. ..:. 1v.~6 the.tb<,ve nantc,: James G. Niemann and Bonnie A. Niemann (rr mr kno•.vlru.+ he (hc f~a•rson ~ . as hD i ~ =C utrcl tar ia,:cR.aing Inc("rTl'tn}nt n~J :r.:IS:H, ~}ts.:br•he ~:,~r~l•. . y - t_cROy'. ~Larl~y ..sir , .=a,:~f;~ ~` . ~rcix _. c'...rnr> . h:a cc?mmi.u nn i. fu•: manrn; f If ~ ntl .; lar~ .mar ~,ftl; Ju ty r 7 ,.~,~,,r , as \1: It a\1, 1~1 11! ~! \Tr. I,\It f)1 \a lam.( 11\~1\ i / I CERTIFIED SURVEY N0. 1~(~9 - Part of the S~d4 of the SEq of Section 20, T29N, R16W, Town of Baldwin, County of St. Croix, State of Wisconsin, described in Volume 2 of Certified daps, Page lili9 as Certified Survey li~9 ~ g 9 ~~:?a~v~. ~' FILFD ~ ~S rsn ~ f I ~ i ~°~ ~ s, G h I , w1,~ ~ s 6' I ST. CROIX COUNTY ~ 2 s 67° 32' 19" E SURVEYOR'S RECORD ~~ 0 657.17 y SCALE I OA ° ~ c> 9~' A t"~ 200' m T I O ~ ~ I z m LEGEND I ~' LOT ~ p n ~ 3/4"z 30" ROUND IRON ROD I m p ~ N 9.86 ACRES v o WEIGHING 1.502 LBS./L. F. I I v, ` o y r_ - w 0 Z o v m o RAILROAD SPIKE I ~. ~ ~ I VVV . 0 m , ~~`~un~~t~~,,~ d ~~~ ~SGONS~ '~i~,~ o ° \~ ~ a~\ ° ° ', o~ i~ ~ o °j~ 2 5 0.13' ~ 26 ~ ~ • ~, ~ ~ ~ • i ~ I ~ N87°5'32"W N 00° 07' 46" E ~ = p ~, .„ W3,;c5n ~ ~ I ~ ~ 143.41' o ~ ~ '1 ,~ • ~ , I m l '~ N 87A 35' 32" W ,~0 S ~~~,'~ I~ ~m ~ I, Thomas G. Kuester, Registered Land Surveyor, hereby certify: N ~m That I have surveyed, divided, and mapped a part of the SWq of the SE4 ~' of Section 20, T29N, R16W, Town of Baldwin, County of S t. Croix, State of I Wisconsin more particularly described as follows: A P PROVE® _ SOUTH 1/4 COR_ TOWN m ------ 8EC. 20,T29N, R16W o! -----------R99.Q--- AUG 17 1977 Commencing at the South ;corner of said Thence N00° 07' 46" E 744.39 feet to the Thence continuing N 00° 07' 46" E 567.57 Thence S 87° 32' 18" E 657.17 feet; Thence S 00° 14' 07" W 710.30 feet; Thence N 87° 35' 32" W 405.71 feet; Thence N 00° 07' 46" E 143.41 feet Thence N 87° 35' 32" W 250.13 feet to thl Section 20; St. CROtX COUNTY COMP:tEHEN5IVE PARKS PUINNING point of begi nni n~g~w zoNING coMtiurr~ feet; APPROVAL Ur (Fi;S MiN~::a? SD~~;V;SiGN DOES NOT MrAN ~4PPROVAL FOB BUJLDJNO SITE OR SEPTIC SY;Tty1A. REFEi2 TO H62.20. point of beginning. Said parcel contains 9.88 acres more or less. That I have made such survey, land division, and plat by the direction of ~lamPS and Rnnnia Niemann_