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HomeMy WebLinkAbout012-1040-00-000/* Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Buildi~lgs Division , INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provice may be used for secondary purposes [Privacy Law, X.15.04 (1)(m)]. Ij9~I~~P~6frf,~~iald ~ ^ city ^ vl~irl ~JrTi~'II~~Towns~ip LS I BM tlev.: Insp. BM Elev.: /~ d /OcJ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~ ~~ ~' O ~ Dosing Qn ~~~ Ing TANK SETBACK INFORMATION TANK TO P/ L WELL BLDG. vent to Air Intake ROAD Septic >~b / 7 }S~ 3 ~ ~ NA Dosing y3'1j ' 7 ~Sr ~ ~ r NA NA Holdin rvw~r i ~irnv~~ i~~ruRw~~-~ iv~~ ~ Manufacturer Demand Model Number ~ 3 ~ c-(GPM TDH Lift ~~ Lriction Syete TDH ,Z Ft Forcemain Length~~~i Dia. HH Dist. To welt SOIL ABSORPTION SYSTEM ~ ~s e ELEVAtION DATA county rolx Sanitar$ o.: 3~3 S State Plan ID No.: Parcel ZD'#L~'#040-0 - STATION BS HI FS ELEV. Benchmark ~` 0, ~~~ Bldg. Sewer ` t$~ Ht Inlet " (~/ Ht Outlet ~ ~~, ( 9~ Dt Inlet ~ /Q,~Q ~Q. Dt Bottom ~ ~ ~ ~` Header /Man. ~ ~ J lag • ~(~ Dist. Pipe ~ fy 02. Z(y a at.:~ Bot. System ~ p,~Q f 8~q,~p f°o-9~ Q~ F~~~f~la ~` °~ y. / 0~ .3 X ~.lo~ 9 , 11 z lo% L loa BED /TRENCH width / Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMEN I N 3 2• ~ 3 DIMEN I N SYSTEM TO P/ L BLDG WELL LAKE /STREAM LE H Manuf turer: SETBACK r INFORMATION Type O , ~~ ~ ~ ~ ~/ HA E OR T Model Num er: r System: ~ (JD K ~ ~x DISTRIBUTION SYSTEM I",Q''~~ 9arrtfc~s4~e~ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Header /Manifold // // y Distribution Pipe(s) i/ ,~, ~ ~~ x Hole Size x Hole Spacing Vent To Air Intake Length ~ Dia. ~ Length „ c•S Dia. ~ Spacing -.-r ~l ~ ~ Depth Over Depth Over xx Depth Of xx Seeded /Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil InS eCtlO :Yes / Flo In l'l~dn Iu / !L~MMENTS: (Include co Y discrep nci~s, per~Qn~present, e~t~.)54017 (NW 1/4 NW 1/47 T30N R17W) - Location: 1587 Count Road t;G, ew Ic mond, 173017258D ' 1.) Alt BM Description = 2.) Bldg sewer length = / ~~~ -amount of cover = ~/ ~~ ~~J ~ ~~ ~~ ~ y~ ~~,~.~ Plan r vision requ~? ~es No Use other side for additional information. ~p SBD-6710 (R.3/97) Dat Inspector's Si n ture Cert. No. Sanitary Permit Appiicati n i Sat & Buildings Division ~~ n accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. ~`+~ ~~S~n Sex revexsc side for instrtrctiona for eotnpleting this application PO Box 7302 OeparCrtient:of•~~tnrne:re:s Personal information you provide may be used for secondary purpos es Madison, WI 53702-73,02. - [Privary Law, s. 15.04(ixm)) (Submit completed form to county if:,not . Attach ext tetc tans to the coon on for thG oti a nat. leis than ~" St t start owned, 8-1R X 1 l inches in size. ~-~, . '. ` _ a e Permit Number Check if revision to previents appiiextiem 3 State Plan L D. Numtser I- A )icatlan Info ; anon -P lease Print art Information Owtsix Nsrrte Location: 1 Propcrry rotation ~T PropcrtyOwner's hngA ~~ Q SO 1^- IUWI/4 ~kJt/4 St T N R) W s ~ ~` ~ \C. J `~ i.ot Numbix Block:Nym City, State ~ Cexfe p~ ~„ba Subdivision Name or CSM Number to t~ ~S ~' o~ 'Il to l II. Type of Buliding:'(check one) I or 2 Family DavelIing _ Ido. of Bedrooms.,,,~_ PubGcJCommctcial (describe usc) p City O VlOage 1 1 L ~ Town of n © State-Owned ~ P c ~ ii'~ r ~tr~ '~~2 ~ ~ /a ~ ~ ~ Nearest ~ yy .Ears Parcei ax be a _ .. o ~' _ III. T e o[ Permit: Chet aal oar box on line A. Check box on tine B if a liable O ~ S A) i• New 2. Replaocma-t 3. Rep ent of 4. S. 6. Addition to S tern B) Tank Ott1 Pamtt N F.xistin S cm ^ A Sanity Permit was 'oust issued Date sued IV. Type of P©VYT' System: (Che:ck all that apply) ` ,~l No+i-Pressurittd Ir! gnqund ^ Mound ^ Sand Filter O Pressurized ~-St'am-d ^ Constructed Wetland ^ Holding Tank t7 Single Pass O At- de O Drip Line O Aembfc Treatment Unit ~ Rccirculatin O Other: ~E V. Dis crsal/Tr~rttment Area Information: t. Desigst w tt~ 2. Disperse Area p~,„,=W 3. Ater ~ ~ 4. ~ 18tlOn Rate 6, yat Crr1 7 p M ~~ (~ J ~ ~~ ~ ~ F ~ VII; ')'ank Infortnatton Caps ity in Oaliona Total Galiorts # of Tanks Matwfacturer Prefab Site Steel Fiber- Plastic ~: • Near Existing Coa_ crctc ~ ~- sttuctexi 8~ Tattles Tanks a ~ v c~~ 7~ ~ ~ l~ r ,eS ~_S ^ 24 /4-1 YII RcsponslbIiity S Eatemcnt i the understi assume bt7i for in 'oa of the POWTS shown oa the attached lens. l~(~`~ C$S~`'` ~~e ~~~ 1C~tc~~or ~ L~ ~tlol7 IX. CaantylDepartment Usc Only A D Disapprovtxl Sanitery Pes-mit Fats (Includes Oroemdvvadx Date lssned Agar Signature (-'b aters>psj PPm~ O Owner Givr~t Initial Adverse PZZS. qp Dcmmtirtation X. ~ gaditio s ai pproval iR asons for ~Isapp vat: ~ C~lt s~~ ~+ ~ +nn~u`tn~l~1 CcS ~e~, ~/Q^t~$ , ~ ~s~{-: cl~a,t`~.~~ ~~ ~• ~at,,~Qm,,,~ as ~;,,~~Q,e,,- - ~`sJ~ ~~,.1~ ~o~--wY~ ~ u.~.~..Q -~- ~t6~2retxs~a/ n~.t,~~{- ~.s ~~ a.S A.o,`, 2.f-z a~tetit,S . Z I I I ~ ! • j i i I i ~ 4 j I A ~ t i I I , _ _ f i ii L.-_- ! t i f I ._ _ - ~ _- , ~ ~ ~ ~ ~ ~ 1 I ~~ + ! 1 • ~ 9 __.._~. I ~ ~ ~.. JJ111111pp (1AA1~~ 7{~lnJ~}{r- ~~//' ~ ~ , ~~•~y /~~f . ~ /Vl _-_ _.._._.. • ,p 1 I , ~ i c .__~___. ~-_.. _...- ~-__._~_..~.. ~. _. ,.__..y ~~t~ __. L. -! L ~~ ~_! i ~ - } -- "( ~ ~ i i ! ~ ~ ! I I t I ~ E I I ~ ~ ~" i -- - ! ~ ~' i I I ~~ ~ 1 I ~ ~ ~ t ,~ I ~ - ~- ^ _ - ~ - -- - ~ _ --- ~ _ ~ , ; ~ ! ~ i ~ i .;~~s • V i i i ~ ` ! 1 r i ~ f ! f I ~ ~ ~ ! i ~ E k ' I ! I 1 1 ~ I I ~ - ~ _~--~ ' I 4 , ~ I I_ I It I I i 4 ~ ~ I V ~ f ~ i l r ~ ~. _ _ t _ _ ~ I~ 1 -__ ~ i ! I 1 ~ i ! 1 E ..~ E 1 I IL - ~ _ ~, i t ~ ~ i i I I ~ ~ I E i t i I~ ~~ r E!~ z I __a_ 1 __ ~_ , ---~ -- -- ----~-- ~_-._, --- ~--_ . - - k - - - -- --- f 1 I I i f ~~ ~ 4 ~~ i ~~~~ i ~.._ ~ - - `~ - ~~ ~ i ~ ~ ! 1 1 1 f I i I ~ ! 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T I 1 g - - - ---+ ---- --- ~ ci -- ---- -- --- - ~ i i I I i I i 1 ~ I S ~ ~ ~ I k ! ~ I I ~ - - - - - - ~- _- r, .. -~_ (- ~ -t -. ~ _.T_ _ k- -_.~ -- --- ~ i I ! ! ~ ! ~ ~ ~ ~ ~ i + } + $ I ~.. . k ~ ! i _., ~ E ~ f R i ! ~ i ~ ~ i f k r ~ . ~ ~ t F ~ ~ I ~ ~ ~ ~ r i t ~ ~ f ! i ~ ! f P I ~ ~ ~ ~ ! ~ ~ ' s i ~ ~ ~ ~ ---- -- --- ' ~ _ _ __ _ -.-_ ~ _ I i I I k ~ ! E I { I f I ~___.._.i_. j I I ~ I i j e ~ ~ ~ I c ~ i ~ f r ~ ~ ! w ~ _ ! ~ 1 ~ , ~ i ! ~ ~ ~ l ~ ~ ~__ i e 9 i ~ ~_ ~ti~ _ C _ _ - _ . - ~ !t ~ - __. ..t... !._. _.~ ~ ~ I E ' _ _ ~ _ ~ __ 1 _ k - - ~ I~ i _ _, _ - . , - ~ ~ -- ---- I- k ~ - -- + ~ -- - - - , 1 + ~ ~-_ ~ ! _ - - ~ - - ~ , ,.. ~ i f ! I i ~ j f 1 f I t ` i { i I ~r ~ E ~ 1 - i--- --- ~ I I ! ~ ~ - .. --._l-- -,- -- --.a-- -- f- ~ - 7-- I ! ~ ~ 1 ! ! Y ~ ! 1 ~ ! I ~ 1 , ~ ~ k a ~ ~ ~ ~ f 1 ~ _ --- - - - ~ - - °- E I i ! ~--- ~ ~ ' 4 y ` ~ € f j i ~ 1 ~ ~ S I > ~ - ~ ~ _ 1 ! ! , -T I _ ! ! t i .__r-. .. k ~ - 1 - I 1 ~ I 4 ~. 1ti ' ST CROIX COUNTY ~ ~ ' , ' ~. "' °` { SEPTIC TANK MAINTENANCE AGREEMENT ~~\~, ~' AND ~ ~.% "~' ~ ~~ ~ ~" ' _ : OWNERSHIP CERTIFICATION FORM ,. ~ ~i~'F~f ,, 't. OwnerBuyer ~ ~ ~ ~QQ1 ;~ . ~_ Mailing Address ~ Al,e~ ,.; ~ ~x ~~. ~ .. ~-,.: '~ . ~ ' ~~~ ~ Property Address (Verification required from Planning Department for new construction) City/State Parcel Identification Number D/oZ~~O /~ -~+ ~ LEGAL DESCRIPTION Property Location ~~ '/a, ~~,'/4, Sec. Lam, T~~N-R~W, Town of fir` Subdivision _, Lot # Certified Survey Map # ,Volume ,Page # Warranty Deed # ~ X0710 ~' Jo ,Volume ~o~L`~ ,Page # ~a~~ Spec house ^ yes l~i no Lot lines identifiable C~C yes ^ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewaterdisposal 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. I/wc, the undersigned have read the about requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 s o e three year expiration date. /°~~/~~ SIGN OP APPLICANT DATE OWNER CERTIFICATION I (we) certify that ail statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of th ro rty described above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE OF APPLICANT DATE ****** Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. ****** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed ~: ~~ SOIL EVALUATION REPORT Division of Safety and Bungs in accordarxer w><h Comm 85.111~s. Adm. Code County nttecn compete site Plan on Peer not lass tl,ax- 8 U3 x „ in sloe. Pleat rswst ktclude. but not ~rrrited b: vattical end lwr~orttsl refetertce Point (BM), dtreWart and F. . PemeM slope. srxrle or drnte~nsions, rtortlt arrow. and location and distance to clearest road. ... Please print alt lnformatian. R by P~atsonM Mdormr+llon ra+ P-avids m*t+ ee awed fa seoondaY purposes (P-ivicX i.aw, s. 15.04 (1) (m)). ljC, trot ~ I.t,)1k ~~l4 S ~~ Cry U ~l ~ e ~ ~hi ' r~~ ~~~~ ~~x -00--0 ©a Date Zb ~h N R 17 t;f~ W n fbw rate L d desi i d f 5 U GPD Q New Consftttc~ort l?se~ Resider tt~l / Number of bedrooms g ve er Cale Public or oorrwaerdsf - Describe: tL narer-t rrastetial Flood Plata elevation tf app~ca6le C~ertere and reo ~ conxrterMs ~ , „~g~~ otttrrrartdations: ~"_-.- L' ~ / O s~ R o ~ ---- _--- ~-- ~ s ~ s b _ P~ a, ~ 85 S Wit? O ~ ~. sic Groraxi ~rfar~e elev. /6 ~°~ ". oeP~t a sat. gate d r t3 Fi n ooh R~ooc 7exhae sauctt.e Consistence Baxt arl ' ' in. car,. Sz cent. color Cr. s~z. sh. r ~ ~ ~ ' ~ p - /0 f0 ~ a a a ~ ~- SIrF Sr m ~ 5 ' S ~ /p-aft k s o ~. S, a r~ sb ~~ ~r C s ~'~ - ~ ~ m ~ r G cJ - , 5 , ~ ~ .p .Z q~.2 ^ eorirtg Borl~ ~ ~ ~' / ~ ~ ~ timitirtg ~a> S T ~' ~ n. Prt c3round surface elev. So1 Horizo n - h DorrrUtaryt Mtx>seA Redwc pespip4on flu. Sz. Cont. Caor Texture StrttcUtx~e Gar>sistence Bou~Y c7. Sz. Sh, Roots GPDiIPP "df#1 'Ef(#2 . ~. 03~ ~ s,! a~.s~~ ~f~ c~ ,s ,$ S ~ S p ¢t~ Ovl lr s ~ O r~ 2 'f' t J r s a 6 34 ~~~ • Ef thaeM aft= BOD, > 30 < 22D rrtgft. and TSS >30 ~ 150 • Effluent #2 30 rrtslL and TSS <_ 30 w ~ I t-owa~r.~o~a.l~ ~41u.~~sA~ P~m~ 01,E-10y0 __~ -cx~~ Page I^ ~a 8or(r~ # ,raf Pit Ground surface elev. I~ ~ ~ R$ Depth to Nmiting factor ~~ in. Sab fioriaon Oep>h Dorr~ar-t Redox Oesaiptlon Texture ShtrcU~te Ccxu~sterx.e l3c~d~Y Roots t3F' DAt' in. Munseb tau. Sz. Cont. Cobr Gr. Sz Sh 'EIt#1 'Efr#2 l O -/n ~D ~ /v c71t~ ~ f Sbk I'n l) ~r C w a . i ~ ~ ~ .a ,n, 5, m . aK rn ~ r ~ ~ 5 ~ f~ L3 -~-~ 7S -~. ~~ m ~'~~ C S - ~ ~ ~ ~ 46 ~s ~ a ~, e s t m -~ -~~ ~ _ 3 ~ s ~~, z~ y Z ~~ ^ ~ ^ Pit Cxound surface elev. ft Deptl, b r factor in. Sob .Rage Hori>9Or, Depth Redcot 0esaiption texture struca,re Corraistenoe l h Murrsep Qu. Sz Cant. t:olor Gr. Sz Sh. 'EfE~1 'E1f#2 ^ ^ Pit Qrourrdsiafaos slay R Depth to timdin~ factor h ~ Sob Rate la n Ft D th- er po ~ t Q4rt Redox Desai Texture Structure Ccr>s~enoe Bw»~dary Raots GP DI# or a ep trr. rr n r Mur-s~ p . flra. Sz Cont. Cola tr. Sz Sh. `Eiff11 'Eff#2 ' Etltuent #1 = BODE > 30 <_ 220 mgll. and TSS >30 <_ 150 mgfL ' Etf~ent #2 = 80D6 530 mglL and TSS 530 The Department of Commerce is an equal opportunity service provider aad 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 608-264-877?:. otru~oot ! ` f ~ { 1 i E E I ~ I f f 1 I F ~ ` f i ~' ~ ( ~ r I I ; I ~ i '~ Get i ~l~r~y~ '~`~ Oi~ ~ f i C - _ . ~ ~ ' I ' ~ f_ i f ( 1 ~ i~~ ~ ~(\ ~f ! I ~ I ' I ~X/ ~ ,, {/ ~~ ~ i f ~i I ! f ~ ~ ~ , i ~ i t ~ N _ _ __ ~- _~ ~ ~ i s ; - k ~ i ! 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I `{ ~ ! !! ~ ~~ f ~ ~~~~ ~ E ~ ~ f ! f ~ i ~ f ~ f ~ ` i i f I i - --- I ,; ~ I _ ,. ~ ~ , i ~ E I ~ ~o I ~ i _ - _ ~ ~ 1p < < ~ f 1 ~ ~~ / ~ __ - tt rt f ~ ~ f i 4 ~ ~ t ~ Y i , f ~ V i , i t ! i E ~ ~ i " i ~ I I t E ~ ( ( ~ I 3 i ~ I - R f k ~ I i ~ ~ ` ~ ~ -- - ~~ - ~ -- I _ - -~ ~ ~ _ ~ - __. a `-~ ~ ~ ~ L 1 E --- i- - - - ~- ~ ~ -__ 1-- ± ~ i E , i - ~'_ _ ~ 4 - , ~ ~ I s , s , ~ , ~ i f ,~, I f ~ i ~ ~ i ~ ~ ~ . _° {{ ! _ -i - f ;_ i ~__ _ -1---- -- --- I ~ ~ -- - - ~ - ~-- `_ -_ _ i ~ - ~ ~ ~ 1 t 1-- ,, ___ - . _.~f-- -~ i ) ~ ! -- ---- -_-~ --- .---- -- ~ - --- -- - ~ -- ._- ~. _ ~ ~ f - ~ -1----'-f--~- ~ f y _- -_' _ ~ - ~ __ _ ~ _ - 1' -- ~ -- -- - - - j ! (4 4 t t f 4 ' 1 ~ ~ t t ~ f f i _ ~- _ -__..- ~ E ~ I f - E y ~ ~ f ! f -- t- t ~ { t ~ i ~ ~ f ! _ ~_ f ~ f -- -- ~- i t I P f E r _ ~ ~ _ _ ~ ~ _ - 4 f - I -- --- ! r` --- ----~ _ . _ ~ k 1 , ( i f i I f f ~ ~ ~ ~ ~ t ~ - --- - - f ! i f I f C f ~ ~ ( ~ i ~ j _ _ e k._ _«.__ - E __ -_- _-- - - f 1 ~ __ - _-_- _- ~ ~ ~ i ~ ' _ f _ _ ._ _- _ k _ ~ f _ ..- - _ -__' __ - ~ t ~ i f 1 ~ [[ I E 1 f II S I ~ f I i ~ '- i I 1 I 1 i __ ._.. i ~ ~ i - -_ _- -__ _ ~ Ef i k I ~ ! --- I t ,-__ ~ _ ,_ r ! i I ~ i } - --._ - --.. k.- ~ _.-~.____ f-_ t I 1 r.__-. _. _- _ __ --------- -- __ ----- - - ! - ~ ~ ~ ~ f o' i ` r , _-~' - - ~.""~' ^ `I'C.Z. VCNT PIP[ ~ L3' fROlri OOOR. wtrvoow oR FRCSr+ AIR INTAKC le•nlu. INJLET APPROVED JOIAIT w~C.=. -IP[ ~ [XTfNDI1JG 3' 0-JTO iOLID iolL .• ,• VCIJY CAP WCATNCR PROOF JuUCT101J poX • 1=•Mlu. GRAOC I • cououlT ~-- ~ i. yMlu. ~ l e• Jr111J. -- ------ --__------ -' YftOVIDE ( AIRTIGHT SEAL, I III ( I I A I ICI I ALARM d I I • I I oN APPROVED JO1tvTS W/G.I. PtPE EXTCIJOIIJ6 3' ONTO SOLID i01L . ~~r~~f C , i I CLEV.._.L~ F?. ~ , . . PUMP -1 "- on • .. ._. o _ . ,; , ... CONCRCTC DtOCK , RIS[R EXIT PCRMI'TrCD OLILy IF TAWK MANUfACTURCR HAS SUCH APPROVAL j 3~~APPRoV[0 BIEDO•~ N~ SEPTIC E SPEGIFICATIOAJS OOSC - TANK MAIJUFACTURCR: I~~~~'"'" ~ IJLIMBER OF OOSES:~_.._..-P6R OAR TAIJK SIZC: __Z:SC> GAtl.GWS DOSC VOIUMC / v~ ALARM MAIJUFACTUR[R: ~~~~, /' I1JCLlJOW6 OACKPLOW: Oho GALLONS A1000L LIUMbCR J-Q!_•N- ~ CAPACITIES: A= a~~IUCNCS OR ~~~~~°~,, CALLOUS SWITCH, TyPC: •~'©~ aa~11JC1lES OR.~ GALLOIJS___ PUMP MAIJUFACTURCR: ~ d`a-•,~~ 2 ''rr C s d~ IIJCNES OR ~~ 7 _ GALLOAJS MODEL IJUMDCR: ~ ~ +1 I 7T" ~ 0 • ~ INCHES OR j' GALLO1~l5 SWITC}{ TJPE. r f D~-- IJOTE: PUMP AL10 ALARM ARC TO OC MIIJIMUM OISCHAR~£ RATE~GPM INSTALLED ON SEPARAT[ CIRCUITS VCRTILAL DIFfCRCNCC DETWCCU PUMP.OFF AWO pI5TR1pUT101J PIP[.. __L_ FECT ~- MIlJIMUM IJfTWORK SUPP~.y PRESSURE , . , , ~ .. ~~ ;-; -~-'SET • / DID F T,~ _+ • ~ FEET OF FORCC MAItJ X ~/oo~LFRICT1o1J FACTOR.. ~'b FEET ~ D ~ ~4 f ~. 1 TOTAL .Oy1JAMiC .HEAD = ~~ FECT IIJTERIJAL OIME.IJSIOfJZ Of TA1.1K: LEA1CaTH'~'fa~ -T~L.IQU10 DEPTH PAGC _~ OP'..~ ~d Cfi~-~V~Qr''S~ APrROY[D LOCKIAIG MAldHOLC COVER Goulds Sub~~~~ible ~n~td ~ a.~~ arse >^ Eff iuent Pump ~~ ~ ~ 3885 APPLICATIONS Specifically designed for the following uses: • Homes Farms • Trailer courts • Motels • Schools • Hospitals •~ Industry • Effluent systems SPECIFICATIONS Pump • Solids handling capabilities: '/,"maximum. • Discharge size: 2" NPT. • Capacities: up to 128 GPM. • Total heads: up to 123 feet TDH. • Mechanical seal: silicon carbide-rotary seat/silicon carbide-stationary seat, 300 series stainless steel metal parts, 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. Motor Single phase: • '/ HP,115 V, 200 V, 230 V, 60 Hz, 1750 RPM;''/z HP, 115 V, 60 Fiz, 3500 RPM; '/z HP -1'/: HP, 230 V, 60 Hz, 3500 RPM. '. • Built-in overload with. automatic reset. • Ciass B insulation. Three phase: • '/z H P -1'/z H P 200/230/ 460 V, 60 Hz, 3500 RPM. • Ciass B insulation. • Overload protection mtast be provided in starter unit: • Shaft: threaded, 400 series stainless steel. • Bearings: ball bearings upper and lower.. - • Power cord: 20 foot standard length (optional lengths available). Single phase: •''/a and'/: HP -16/3 SJTO with 115 V or 230 V three prong plug. •'/,-1'/z HP -14/3 STO with bare leads. Three phase: •'/z-1'/: HP -14/4 STO with bare leads. On CSA listed models - 20 foot length SJTW and STW are standard. FEATURES ^ Impeller: Cast iron, semi- open, non-clog with pump- outvanes for mechanical seal protection. Balanced for METERS FEET' r so 80 70 20 ° so ~. s ~ 50 ~ 1s z c 40 p 10 30 • • 20 5 '10 00 10 20 30 40 50 60 70 80 90 100 110 120 130GPM 0 10 20 30 m~/h smooth-operation: Silicon bronze impeller available as an option. ~~-~»i-~ ,.:: ~ Casing: Cast iron volute type for maximum efficiency. 2" NPT~discharge adaptable for slide rail systems. <- ~ Mechanical Seal: SILICON CARBIDE VS. SILICON CARBIDE sealing faces. Stainless steel metal parts, BUNA-N elastomers. ^ Shaft: Corrosion-resistant stainless steel. Threaded design. Lockout on three phase models to guard against component damage on accidental reverse rotation. ^ Motor: Fully submerged in high-grade turbine oil for lubrication and efficient heat transfer. ^ Designed for Continuous Operation: Pump ratings are within the motor manufacturer's recommended working limits, can be operated continuously without damage. ~ Bearings: Upper and lower heavy duty ball bearing construction. ^ Power Cable: Severe duly rated, oii and water resistant. Epoxy seal on motor end provides secondary moisture barrier in case of outer jacket damage and to prevent oil .wicking. ^ 0-ring: Assures positive sealing against contaminants and oil leakage. AGENCY LISTINGS S P Canadian Standards Association UL Underwriters laboratories ___. SERIES: 3885 - SIZE:'/~ SOLIDS WEt RPM: VARIOUS - --- ~ S GPM -- - - W,Et H 5 Ff . EO - - - -- - - - i -• i - - - WEO -W1F~ H - _ - _ VI~E03 L CAPACITY ~ i995 Goulds Pumps Etlective May, 1995 83885 r ~~ r ~ z ~ a S :~ 'y . :~ ~~~ ~ ~. tti 4l _ ^'+ .~ ~ O A '[I %in n ,~ ^ ~ E~ ~r t _ {: ~ , r ~ 4t A ~ 7 _ ~ h M ~ 7~ M,. e 7 t R n s '~' e r _ ~` .. ~:! ~ ~ . ;:: 1• ~ N ' ..~ e~ a r ~ 3 n ' F, i i k .s ., t': ,! i '•~ f t ~cQ'{ :L1 ~ x ~~ r ' x ~ Z ~~ ... C7 ~ ~~ N .-. N O i~~3 ~ l ~ w ~ Xi ~. ~~ 1 .'f4 • 4• • • ~ • -~ ~;Or~ a a~~~~ M tt1 ~ sr-. ~ ro ro, ~ ~~ t4 ro ~ ~~ 4 c (~D ti~ ~ G O ~' tom'"' cri o a ~-ag ~ ~ ; ~ ~~~ ~`° ~ ~'- ~° .~ O ~ ~ t11 ~ D . to ~ 4~ iu a ~~'_~ = ~ ca . ~ ~sao~ ~~<~ ~ ~ ~ Q. G ,': N i O r' ~ , ~ ~ 3 ~ O ~ ~ 3 ~ - u, ~,= 0 ~ ~ r~ _ ~ ~ -t ~ ~ ~ ~, ^ ~ T }~ .t ~' °n ~W~'` ~ a O~ G~ - -_ l~ ~-- Invert i i'--?~ A ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify tY serving the ~ ~ ~~ v~ PCcc n c ~ tank and baffles to gat I have inspected the septic tank presently 1~g.1.~~a:~So~~ residence located at: Sec . ~, T~N, R_~,W, Town of Upon inspection, I certify that I have found the be in good condition, and it appears to be functioning properly. Last time serviced ~ ~ ~~ - ~ j Did flow back occur from absorption system? Yes~No (if no, skip next line) Approximate volume or length of time: / a~ ~ gallons minutes Capacity: Construction: Prefab Concrete~_Steel Other Manufacurer (if known):--, Age of Tafrrk~(if known) : aD~r~ (Signature) ~ m~~~'~S~ (Title) q I U 1 v~ tom? 'e'rg (Name) Please Print a ~ ~~~`~ (License Number) (Date) Farm to be completed by licensed plumber (s.195.06, Wisconsin Statutes) or Licensed Disposer (NR 113 Wisconsin Administrative Code) Plumber (applying for sanitary permit) Certification: In accepting the above statement regarding existing septic tank condition, I certify that the tank to the best of my knowledge will conform to the requirements of ILHR-83, Wis. Adm. Code (except for inspe/c~ti11on o Wing over outlet baffle). Name l~'Qll! l-'1 ea1~Q~'S S ignature ~/MFRS aat>S3 7 5/88 j Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In-Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWYS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In-Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- Table 1: System Design Specifications Sanitary Permit Number 3 S Number of Bedrooms 3 Design Flow -Peak (gpd) Estimated Flow -Average (gpd) 6'~ Septic Tank Capacity (gal) - ~ Soil Absorption Component Size (ftz) cro 2 - ~ ~ Type of Wastewater D estic ~nnc~ Gt~S Tahla 9~ Snil Ahcerptinn Component -Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow -Peak (gpd) ts~D 2-5- 2' Maximum Influent Particle Size (in) 1/8 Maximum BODS (mg/L) 220 Maximum TSS (mg/L) 150 Tab le 3: Maintenance 5cneauie .Septic Tank Inspect and/or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years 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 (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. Th outlet fil r shall be cleaned as necessary to ensure ~r~~P.r o en ration. The filter cartridge shou be removed un ess provisions are ma a to retain solids in the tank that may slough off the filter when removed from its enclosure. If the Management Plan for a Septic Tank and Soil Absorption Component 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 scum and sludge 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 an 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. 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 the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the sepfic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank maybe difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at feast once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 Management Plan for a Septic Tank and Soil Absorption Component Plantings ofdeep-rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. 3 ~' ;~ # ~. r OO~uMlEPIT tVO. .. f~ ~ ~' rr~kTi HA>w r aDafO ro~~+ : e, ~t~~ ~. TNIe NAG[ R[f[RY[il /OR R[COIIDINO DATA i~ ~~ Cect2i~ K. Halverson Lieffring formerly Ceceli# REGISTERS C~HCE pk ,_._~..,~_~~ .........................«.................................._.........._.«: ST. CROtX ~., WIS. ~' ~.....,..,~~~.....«..... ---« ........:. .....«...........................«........... .. Recd. frx Reaord Ai 1Zth }" ~a~t~.~rr~ts.te~.......~t'AIR~S~_ Jx_.~~.~.Ye~~4ti...~t~S~«G~?~~~ a doy of lio___~ 19 ~ € a~~t~llat....aa..~enanLa_.ia...cpnoomran_._.....:. ...................... at 2: 0 P .. j .«.......«..«.« ..........................«.«._......._... _. .. _. ......................._...... 1b deeettbed :sal estate in ........~'t.__7:rOi.x........-•.----•--~n~~ __--- ---- "~.:E sS Wieemisin: Ts: Xey Nu ........:.............................. South 520 feet of the North 948 feet of the West 300 feet of the Northwest quarter of the Northwest quarter (NWT-NWT) of Section 17, ownship 30 North, Range 17 West, St. Cxoix County, Wisconsin. ~4~~ TRA~IL~S s.~[-'--.'... is not This .•-•-.-._----•°.°•--.-•.-. hamatead property. ?~oeeption !:, ..arrantiee; Subject to municipal and zoning ordinances and recorded easements and restrictio~is of record, if any. D,tsd ~~ ------------------------------4th------ ~y ~f ----•--------November ----------• 19.80 _. •--••----°-----...._(SEAL) ..`'Q~!~~!/.:.~~~Y-ks~?:`•(>~~ ...(S AL) ________ _ _ __ .Cecelia_ M,___Halverson__Lieffring --••------ (SEAL) ---------------------•---....---•--..._.._..... (SEAL) AOHNOWLBDGiSrISNT _________________ ~~ STATE OF WISCONSIN ---Polk.------ - -County. ---~ °....----•---•----•• ...............•---........---•----•--------- •----- Personall a before me, this ..__.4th..----da " at November, yl~ a above ~ Cecelia.~!i__ °•------- Ha~versor~ Li erin ~ormer~ .._Cecelia ----------------------------5.----• -- -•----X M. ~~Ha~verson TNIf INfTRUM[NT WAf DRA1rTCC eY to me know the person -..__....... who e7tlCntei the Bert D. Petersen, Attorney at Law fore a r same. ..... ---•~leas'--Lake, •-~Tiacons~~n---54003-- --• . Evert ~ Per~p .:--~-•-----•--..r.... .. .. . ~i tc ............. :..•----................County, W!s. (Siznatarte may be anthentieated or acknowledged. Both. a 0~1~ .....-....--•--...--••-•- - - are not neeessszyJ 'd~~ , ion ~ pertp~ient. ~lbmr d Oerfofs flenk~{ in fn7 enOfelts [hogld ~ trpe3 ur Drlnted bebw their s4t~Wr[[. ~ASAtif!! DaA !1'ATi 1.k8 OI WI9CON6>>I Riecoffiz I.e[al Honk Ce. ins. so~is~ a.. a-ssTT Yliwuke.. ~~. tlfetaee- I