HomeMy WebLinkAbout012-1056-40-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
*
430344 0
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No:
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)).
Permit Holder's Name: City Village X Township Parcel Tax No:
Korn, Paul I Erin Prairie Township 012 - 1056 -40 -000
CST BM Elev: Insp. BM Elev: BM Description: / Section/Town /Range /Map No
/ 0 0 pv % Z E -� p VC-1 13 YY) 25.30.17.396
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septio Benchmark
ao 0 D 1 ae..ta 1 00.
Dosing Alt. BM T,,�) F nd4,
(A a' Id 104. Srt: ;1 3,(v� �(` U3
Aeration Bldg. Sewer
Holding St/Ht Inlet
TANK SETBACK INFORMATION St/Ht Outlet
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet j
Septic _ � S n 04 i 5! � Dt Bottom
!G 5
Dosing Header /Man. n 'V, o b o
Aeration Dist. Pipe 4.; 66 2. -
L �
A i0 �az.25'
Holding Bot. System
� 4�7
Final Grade
PUMP /SIPHON INFORMATION
Manufacturer ! ^ Demand St Cover
t 1 -
WJ GPM 3. 3D M I 6 . 5
Model Number P b 5 , Can '7t a o 5 —
TDH Lift Friction Loss System Head TDH Ft
DHAN / 4r 5 S 1 01,
Forcemain Length Dia. Dist. to Well
a,o 6� " i�t z
SOIL ABSORPTION SYSTEM �� tic 1 tmGtvt2 �� � q1. 1 O n C)
BEDITRENCH Width Length No. Of TrencMs PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS � /
SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Man ufacturec
INFORMATION Type Of System: ON MBER OR
('lCf ii1 -�f. UNIT edeHV
7b D 60 ��
DISTRIBUTION SYSTEM
Head , Distribution (e -t o {� �t x Hole Size I t( x Hole Spacing Vent to Air Intake
�0 `/r �� Pipe($) i� / //
Length Dia Il Length J Dia ) Spacin 3 l 3 J'0'� l / le
SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only
Depth Over
Bed/Trench Ce Bed/Trench Edges Topsoil
E] Yes No , 1 Yes No
COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: 1 G / � Inspection �: / 0 /� 2 / U 3
� 2 � C `! u3 TmL
Location: 2090 130th Avenue New Richmond, WI 54017 (SE 1/4 SE 1/4 25 T30N R1 7W) 40 acres Lot Parcel No: 25.30.17.396 K 16W
1.) Alt BM Description = I Uf f- 00hORT �� 2.) Bldg sewer length = 51 / O,, l l oo t W
- amount of cover = 5� .I Cow" -+ -�u* (�o , ) / bo r) t ft �w 1
3 b' h1AVAuQ Yl5ey e,o�n /
Plan revision Required? _ ] Yes No l �(I
Use other side for additional information. ��� _ ,�
Date , Insepctor's Suture Cert. No.
SBD -6710 (R.3/97)
Safety and Buildings Division County
201 W. Washington Ave., P.O. Box 7082
N sevnsin Madison, WI 53707 — 7082 Sanitary Permit Number (to be filled in by Co.)
Department Of Commerce (608) 261 -6546 I L A^ 3IL
Sanitary Permit Application late Plan I.D. Number
In accord with Comm 83.21, Wis. Adm. Code, person m o 11 0 7 =Trb+% . 10
may be used for secondary purposes Privacy -, s 1 E� Pro ject Address (if different than mailing address)
I. Application Information - Please Print All Informatio 0 �Q
Pro er's N Parcel # Lot # Block #
ST. CROIX COUNTY O�2— KM - • X00 9b /
Property Owner's Mailing Address E Property Location •�
I r �/ E '/., .5_E Section
City, State Zip Code Phone Number
b = - (circle one)
Typ of Building T ICJ N; 1� or W
Typ g (check all that apply) s Nnti
I or 2 Family Dwelling - Number of ms S Subdivision Name M Number
—�
❑ PubliclCornmeroial- Dnscribe Use r � ' .t"�
El State Owned - Describe Use , ro� l G!{XJL = 1 _ ❑Village iA of ` rA
III. Type of Permit: (Check only one box on line A. Complete line B if applicable) -
A. New System yst ❑Replacement System ❑ Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System
B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued
Before Expiration Plumber Owner
IV. Type of POWTS System: Check all that ap I
❑ Non - Pressurized In -Ground A Mound > in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑
Constructed Welland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter Cl Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑
Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain)
V. Dispersal/Treat ent Area Information:
Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersa Pr ( tent Elevation
5 � /0 /,
VI. Tank Info Capacity in Total Number Manufacturer a Site Steel Fiber Plastic
Gallons Gallons of Units Concrete Constructed Glass
New Existing
Tanks Tanks
Septic or Hokling Tank 2
Aerobic Treatment Unit GY _
Dosing Chamber �..�
VII. Responsibility Statement- I, the undersigned, assume respgnsibiHty forjap4liation of the POWTS shown on the attached plans.
Plumber's Name (Print) Plumber ature M ' PRS Number Business Phone Number
lumber's Address (Street, City, State, Zip ode x cl_z Yt�d
S
VIII. county/Department Use Onl
Approved ❑ Disapproved Sanitary Permit Fee eludes Groundwater Date Issued Issuin Agent Signature o Stamps)
Surcharge Fee) . `
❑Owner Given Reason for Denial I
IX. Conditions of Approval/Reasons for Disapproval
SYSTEM OWNER:
1 Septic tank, effluent filter and
dispersal cel! roust all pe st;rviced / maintained
as per management plan provided by plumber.
2. All setback requirements must be maintained
as per applicable code /ordinances.
Attack complete plans (to the County only) for the system on paper not [as than $1/2 x it inches is size
SBD -6398 (R. 08/02)
PLOT PLAN
Scale 1 "= yp' Page o f
r o
� rs 3 3
I I
I
ED g.
D AN
L
CDR-
10 1.6'
U J
�-, g O`Ow ' /z `' P�1C PL
MWM) --
�z t 'J Nw" -
�sr� 63
NOTES:
1.- Elevations shown are existing ground elevations unless otherwise noted.
2. Install 4" observation ppipes with approved caps. ( Z required).
3. Septic tank to be I ZU� ho (kallon capacity manufactured by w1t'5�1Z CD\JO - ��'7
W Up k B oo - Mil w q — L3 DO - Z,-g t=� L-�cz, ' ,
4. Bench mark : SEl�: fl$
Divert surface water around system to prevent ponding at the uphill side.
-- -- Safety and Buildings
RECEIVED 4003 N KINNEY COULEE RD
F ` LA CROSSE WI 54601 -1831
TDD #: (608) 264 -8777
Nvisconsin p U 4 2003 www.commerce.statemi.us /sb
www.wisconsin.gov
Department of Commerce OIX COUNT NG OFFICE Jim Doyle, Governor
- -- Cory L. Nettles, Secretary
August 20, 2003
CUST ID No.267341 ATTIC• POWTS Inspector
ARTHUR L WEGERER ZONING OFFICE
WEGERER SOIL TESTING & DESIGN SERVICE ST CROIX COUNTY SPIA
PO BOX 74 1101 CARMICHAEL RD
RIVER FALLS WI 54022 HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 08/20/2005 Id entification Numbers
Transaction ID No. 898044
SITE• Site ID No. 663563
Paul & Billie Jo Kom Please refer to both identification numbers,
130TH Ave above, in all correspondence with the agency.
Town of Erin Prairie
St Croix County
SETA, SETA, S25, T30N, R17W
FOR:
Description: Four Bedroom Mound System
Object Type: POWT System Regulated Object ID No.: 916219
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes COttd7d
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in ��
chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements.
The following conditions shall be met during construction or installation and prior to occupancy or use: DE ARTMENT O
N OF FT
General Approval Requirements:
SEE CORRES
• This system is to be constructed and located in accordance with the enclosed approved plans and with the
"Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD- 10572 -P
(R.6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems"
SBD- 10573 -P (R.6/99).
• Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area.
Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal
are prohibited.
• The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption
area. chs. NR 811 & 812c
• A Sanitary Permit must be obtained from the county where this project is located in accordance with the
requirements of Sec. 145.135 and 145.19, Wis. Stats.
• Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the
designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat
• Comm 83.22(7) 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.
` T'ITLE SHEET Page of
MOUND SYSTEM
FOR
A BEDROOM RESIDENCE
This plan has been prepared in accordance with the Mound Component
Manual SBD- 10691 -P and the Pressure Distribution Manual SBD- 10706 -P
(N.01 101) (N.01 101)
LOCATED IN THE SE 1/4 OF THE �� 1/4 OF SECTION ZS , T 3y N, g 17 W
TOWN OF��� COUNTY, WISCONSIN. '
INDEX
PAGE 1 of 7 TITLE SHEET
PAGE 2 Of 7 SYSTEM MANAGEMENT PLAN
PAGE 3 of 7 PLOT PLAN
PAGE 4 of 7 PLAN VIEW -CROSS SECTION
PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT
PAGE 6 of 7 PUMPING CHAMBER CROSS SECTION
PAGE 7 of 7 PUMP PERFORMANCE CURVE
PREPARED FOR
RECEIVED `� � k �N�
ein G t�-S S ST, 'Hall
AUG - q 2003 t-v) S4ol� y
SAFETY & BLDGS D1V. C O MMERCE
p 4 " D DING$
PREPARED BY ONDEN
Wa SC3 2 L . TEST 11 (3
AND.
Z7ES = Gt'V SEFcW 3: SCE
P.O. Box 74 421 N.Main St.
River Falls, WI 54022
Phone 715- 425 -0165
Fax 715 - 425 -6864 5CCNS
i AHTIUR
= WEGERM
D675 �
RLSWORTN
I G� ti4
3 3
JOB NO.
Mound System Management Plan Z of
Pursuant to Comm 83.54, Wis. Adm. Code Page
The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. 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 th
the tank. The addition of biological or chemical additives to enhance septic tank p ormance is ge erally of required. in
However, if such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and
Buildings Division.
Pump Tank
The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to
verify proper operation. If an effluent filter is installed within the tank it shall be. inspected and serviced as necessary.
Mound and Pressure Distribution S tem
No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound
shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic
(other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the
infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather
installations (October - February) dictate that the mound be heavily mulched for frost protection.
Influent quality into the mound system may not exceed 220 mg/L 8005, 150 mg/L TSS, and 30 mg /L FOG. 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.
General
This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its'
component manual
reporting. L36 — 10 l t� °I and local or state rules pertaining to system maintenance and maintenance
1 �— t�
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 shail 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.
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 shall be
immediately repaired or replaced with a component of the same or equal performance.
If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired
or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged adsorption
and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper
operating condition.
Questions about the operation or maintenance of this system should be directed to:
The County Zoning-Office at 1 S —}
The- system installer at b- 6 0 1915 VTG P�' b
The tank manufacturer at �S w IER
Th
�oO =ZS=
The effluent filter manufacturer at �� Z.�� — S � Z �
. 1 t p
e pump manufacturer at x,30 — gj `-L �4 Gott \ — D S
PLOT PLAN
Scale 1 "_ 4 0 ,
Page of
r o
ao I
er �
1�10 Yvo7 CU1�p�� _.-
fz- 1 ?1STUlzz
T S
v`wl CAF
p 1, 6'
61-1 1oD,0'ON //Z PlPIZ-
ZS� N 6 we-- - 10 �3E > S C ' r iz /jj M JK4)
Z S' F-1 - Myjk
�sN- 63
�T LII� OF
1.3 0 `T AN f�-t1 E _ LA k3 �e , F' � 2C�L
NOTES: -
1.- Elevations shown are existing ground elevations unless otherwise noted.
2. Install 4" observation pipes with approved caps. ( Z required).
Z ! 0
3. Septic tank to be Y o Ckallon capacity manufactured by w\eSt�Z CL*JOIQ�
W LP t`zUU /£� v0 - M11 kJ q - L8 0 0 Zug C� �71- L -[t'KZ,
4. Bench mark
_ S � Pry pV
5. Divert surface water around system to prevent ponding at the uphill side.
Gr - 7
Apprcce_ S;rn t�e�ic Cove_inc
C33 Distribution Pipe
Medium Sand
Tcpsail --� �" !G 6
0
Slope
Distribution Cell of Force Main Flowed
Z to 2- Aggregate From Pump Laker
0 ' �' Fr.
E 2.1 Ft.
CROSS SECTION Or A MOUND SYSTEM F D Ft.
G O -S Ft.
A Q 1 Ft.
Linear Lcadir_c P.a =°► C) C?D/L.ty FT B Ft. `
Desicn Loadinc Rat ==D -3 1GPD/SQ FT
I 'G Ft.
J Ft.
K 11 Ft.
t L_ Ft.
�nrc� Mein W 3 3 Ft,
} - Observation Pipe
E —!.— K
0-- ------------- - - - - -- ---------- - - = - -- - - --
A 6 8 - - -- --- - - - - -- -------- - - - - -- --- - --
W o- - --- - -- - -- - - -- ---------------- - - - - -- �--o Force Main
Distribution
Pipe Cell of �" to 2
aggregate
Observation. Pipe
(.1^ehor secsrelyl -
-
PLAN VIEW Or A MOUND SYSTEM
Distribution Pipe Layout pag S of
Place the holes at the bottom of the distribution pipes
at equal spacing. Remove all burrs from the pipe and holes.
,q
Extend the end of each lateral up with the use of long turn or 45 fitting
inches of the final grade. Terminate the ends of the laterals with a valve,: t to a point breaded p six
. threaded plug. Provide access from final grade for the valve, threaded can or threaded . I g
P�
-
T`-t F'_ 1 L
C
Lat rat Mangold t'\) C
Lateral
X x x x x2 1,0
x 1 x x x
'Lateral Length — Lateral Lenqth _ P
Distribution Line
P
h t°s1J 1 Ffl u� __0
S
PvC► =vec, �r� - -�i
° --
_ � q
P_ Ft. Hole Diameter $ Inch
S 3 Ft. Lateral 1 Inches)
X = Inches Manifold Z, Inches
Force Main " Z Inches
Of holes /pipe '
Invert Elevation of- Laterals 1 O2 J Ft.
= 4.SIV 6 Z_),o t GPI^ -j
- Combination septic:Tank and
PIJAP CHAMBER CROSS SECTIOM AMD SP ' PAGE OF �
VEWT CAP �• WEATHER PROOF
JUUCTiOiJ BOX .
Y C.I. VENT_ PIPC APPROVED LOCKING
110' FROM DOOR, AAAHOLE COVER koM
,- JS?tMQQ P►pE %✓ uDow OR FRESH LN EL.
w /r}tcLr6q�- AzP wTAKE car�pu�T
s ,
` ti i
Fl to ls"ij> -L i r
GZE
xlu.
�__ � IB•MIU.
IIULET PROVIDE
• `•;� C �AiRTIGHT SEAL
� 1= I I
8 "rL I I
Approved Z>'z8�t u� °A I ICI Approved
joint w/ R — \`d DO I II I joint w/
PVC pipe ALARM
a - II PVC pipe
-
C I I ON
I
ELEk FL
Pump--- OFF
D
1 COUCKETE
0 O 5LOCK
Y
• RISER EXIT PERMITTED OIJLy IF TAWK MAUUFACTURZR !iA$ SUCH APPROVAL 3 "APPQo - t
- . SEDD I N r
SEPTIC f SPECIFICATIOIJS
OOSE
TA M KJ MAW U FACT URCR: w`rZSJE�R CC0QQ Z1;tTP_ S
J 1ZUp R DA4
TA)►IK .,IZC: 1A WM BER OF DOSES PE
��� `�RGALLOAIS DOSE VOLUME r
ALARM �'SA 5 � , ��T1ZU S'-JS'Tk�-13 BACKFLDW: 133
• GALLON:
MODEL I.JUMBER: hl-.l u
• CAPACITIES: A= 1 V IAICHCS OR LI _
M � �`
SWITCH T U P E : 1 1 ZJAZ
C1-Y
HUMP ANUFACTURCR: Gc)U Lp2 8 ' I►JCHES'OR LI _&G LLONS
MODEL 1 AlUMHER:
�� cN S C = 6 JUCH OR E i 3 ._ I CLLOUS
D = --E— INCHES OR zzz Y GALLOWS
SWITCH TYPE: -� MOTE: PU MP AND 1 0 RM AR l0 6E
MIAIIMUM DISCHARGE RATE - ' (3 GPM INSTALLED C1A1 SEPARATE CIRCUITS
VERTICAL DIFFEKEME CETWCEIJ PUMP OFF AIJO..DISTRIBUTION PIPE., 1S'-Z:7 16
+ MIIJIMUM METWORK SUPPLY PRESSURE , .. 6 - �(�
i - bZ FT• FEET (S -Ok .
f 1S � FEET OF FORCE MAIM }( �OfC FRICTl01l FACTOR_. Z'g3 FEET
TOTAL OyWAMIC HEAD � ZO .FEET C
.As per manufacturer L gal /in. Liquid depth 3 �I
GouldsE
Submersible _
Effluent Pump
3871 EPO4
EP05
APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron
Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer,
following uses: • Capable of running lubrication and efficient strength, and durability.
• Effluent systems dry without damage to heat transfer. ■ Motor Cover. Thermoplas-
• Homes components. Available for automatic and tic cover with integral handle
• Farms Motor: and float switch attachment
• Heavy duty sump • EPO4 Single phase: 0.4 HP, manual operation. Automatic points.
• Water transfer 115 or 230 V, 60 Hz, 1550 models include Mechanical
RPM, built in overload with Float Switch assembled and ■ Power Cable: Severe duty
• Dewatering
automatic reset. preset at the factory. rated oil and water resistant.
SPECIFICATIONS • EP05 Single phase: 0.5 HP, ■ Bearings: Upper and lower
115 V, 60 Hz, 1550 RPM, FEATURES heavy duty ball bearing
Pump: EPO4 built in overload with ■ EPO4 Impeller Thermo- construction.
• Solids handling capability: automatic reset.
3 14' maximum. • Power cord: 10 foot Plastic Semi -open design AGENCY LISTING
• Capacities: up to 55 GPM. standard length, 16/3 SJTO with pump out vanes for
• Total heads: up to 24 feet. with three prong grounding mechanical seal protection. $p• Canadian standards Association
• Discharge size: 1 NPT. plug. Optional 20 foot ■ EP05 Impeller. Thermo -
Mechanical seal: carbon- length, 16/3 SJTW with plastic enclosed design for (CSA listed model numbers
rotary/ceramic - stationary, three prong grounding plug Improved performance. end in °F° or "AC".)
BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged
• Temperature: thermoplastic design provides
104 °F (40 °C) continuous superior strength and
140 °F (60°C) intermittent. corrosion resistance.
• Fasteners: 300 series METERS FEET
stainless steel.
• Capable of running 10 ! !
dry without damage to s 30
components.
Pump: EP05 a
• Solids handling capability: 25
^ �.Eq
° 7 - 1 1 4
maximum. a
• Capacities: up to 60 GPM.
• Total heads: up to 31 feet. S2 6 20
• Discharge size: 1'h' NPT. z 5 —
• Mechanical seal: carbon- >_ 15 !
rotary/ceramic- stationary, _j 4 I
BUNA -N elastomers. -- -- —EPOS
• Temperature.- 3 10 Z't • Q b -
104 °F (40 °C) continuous
140 °F (60°C) intermittent. 2
5
1 !
0 00 10 20 ! 30 40 50 GPM
0 2 4 6 8 10 12 ms/h
CAPACITY
®1995 Goulds Pumps, Inc.
Effec!ive May. 1995
_.
Wisconsin Department of Commerce • SOIL EVALUATION REPORT 1333
Page 1 of 3
Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Steel Soil Service
Attach complete site Ian on County
pl p paper not less than 8'/: x 11 inches in size. Plan must St. Croix
include, but not limited to: vertical and horizontal reference point (BM), direction and
percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parcel I.D.
Please print all inf_onnation iewed By ate
Personal information you provide may be for spsa �dfpoBeS tf11r1C Law, s15.04 (1) (m)). I
Property Owner property Location
Kom, Paul ;Govt. Lot na SE 1/4 SE 1/4 S 25 T 30 N R 17 W
Property Owner's Mailing Address r of # Block # Subd. Name or CSM#
1544 Hwy. 65 na na 40 Acers
City State tip Code Phone Mumbler City I Village 16 Town Nearest Road
New Richmond WI 54017 715 - 246 - 7535 Erin Prairie 130th Ave
!d New Construction Use: ld Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD
Replacement J I Public or commercial - Describe.
Parent material ground moraines Flood plain elevation, if applicable na
General comments
and recommendations: Mound design, system elevation 102.08ft based on contour line 100.50ft.
Boring # Boring
sm Pit Ground Surface elev. 98.30 ft. Depth to limiting factor 1 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
1 0 -6 10yr3/2 none sil 2msbk mfr cs 1 c .5 .8
2 6 -17 10yr6 /4 none sicl 2msbk mfr gw 2f .4 .6
3 17-48 7.5yr4/4 f2f 7.5yr5/ scl 2msbk mfr gw 1C .4 .6
4 48 -60 7.5yr4/4 c2d 7.5yr5/6 scl om mfr na na .0 .0
Boring # I Boring
sm Pit Ground Surface elev. 98.30 ft. Depth to limiting factor 17 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fe
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Etf#1 I *Eff#2
1 0 -6 10yr3/2 none sil 2msbk mfr cs 1 c .5 .8
2 6 -17 10yr6/4 none sicl 2msbk mfr gw 1f .4 .6
3 17 -32 10yr6/4 f1 — 5A5, sicl 2msbk mfr gw 1c .4 .6
4 32 -50 7.5yr4/4 c2d 7.5yr5/6 scl om mfr na na .0 .0
* Effluent #1 = BOD? 30 < 220 mg/L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L
CST Name (Please Print) Signature: CST Number
David J. Steel 248956
Address Steel Soil Service Date Evaluation Conducted Telephone Number
1564 CR GG, New Richmond, WI 54017 6/30/2003 715- 246 -5085
Property Owner Korn, Paul Parcgl ID # Page 2 of 3
3] Boring # Boring
01 Pit Ground Surface elev. 101.50 ft. Depth to limiting factor 30 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 -6 10yr3/2 none sil 2msbk mfr cs 1 c .5 .8
2 6 -18 10yr6/4 none Sid 2msbk mfr gw 1f .4 .6
3 18 -30 7.5yr4/4 none scl 2msbk mfr gw 1 c .4 .6
4 30 -50 7.5yr4/4 c2d 7.5yr5/6 scl om mfr na na .0 .0
F I Pit Boring # - Boring
J Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
F I Boring # -� Boring
y Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
* Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L * 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.
Page 3 of 3
STEEL'S SOIL SERVICE INC.
David J. Steel 1564 Cty Rd GG
CST - POWTSM Paul Korn New Richmond,WI 54017
Lic. #248956 SE1 /4,SE1 /4,S25,T30N,R17W Bus .(715) 246 -6200
Town of Erin Prairie, St.Croix Co. Fax (715) 246 -9372
40 Acres Legend
✓1" = 40'
Benchmark Ele. 100 t
To of 1/2" PVC pipe
• Alt Benchmark Ele. 100. ft
Z op of 1/2" PVC pipe
❑ = Borings
7 j , 7of`s j6/, Boring Elevations
B 1 = 98.30Ft
B2 = 98.30Ft
B3 = 101.50ft
B4 = 00.00ft
s/ 3'
o
V
OA 6
L � z5 i
/s0'L
4�- 36 -d j
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer Cl t,C ( i l JG�,��''
Mailing Address
Property Address D �I +111 l�-
(Verification required from Planning Department for new construction)
City /State Parcel Identification Number `' )05 —V0 -0 00
LEGAL DESCRIPTION , 3gt0)
Property Location S� % s y Sec. T ? O N -R )2W, Town of Atli
Subdivision # 0 Lot #
Certified Survey a # —�
Y P Volume . Page #
Warranty ed # o V !1
�' Volume ! Page #
Spec house ❑ yes ❑ no Lot lines identifiable ❑ 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
masterplumber, journeyman plumber, restrictedplumber 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.
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 Zoning Office within 30
days of )three year expiration date.
"'t / 6 y 3
SIGNATURE OF APPLICANT DATE
OWNER CERTIFICATION
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 operty described above, by virtue of a warranty deed recorded in Register of Deeds Office.
I
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
i
I
V01..15`i0PAGE 533
DOCUMENT NUMBER WARRANTY DE D _� 629434
KATHLEEN H. WALSH
Thomas E. Close and Tamara R Twedt -Close husband and wife individually REGISTER OF DEEDS
and each in their own right ST. CROIX CO., WI
RECEIVED FOR RECORD
conveys and warrants to Paul E. Korn and Billie Jo Korn, husband and wife as 09 -06 -2000 2:45 PM
marital survivorship property WARRANTY DEED
EXEMPT M
the following described real estate in St. Croix County; State of CERT COPY FEE:
Wisconsin: COPY FEE:
TRANSFER FEE: 300.00
RECORDING FEE: 10.00
PAGES: I
The SE ''A of the SE '/4 of Section 25, Township 30 North, Range 17 West, Town
of Erin Prairie, St. Croix County, Wisconsin.
THIS SPACE RESERVED FOR RECORDING DATA
NAME AND RETURN ADDRESS;
GWIN LAW FIRM, S.C.
430 Second Street
(rb Hudson, WI, 54016 -1510
This is not homestead property. 012 - 1056 -40 -000
(is) (is not) PARCEL I.D. NUMBER OR G.I.S.
Exception to warranties: TOGETHER WITH AND SUBJECT TO any other easements, covenants, reservations or
restrictions of record, if any, but this shall not be deemed to extend any such other recorded encumbrances beyond
the term established by law therefor.
i4
Dated this �!' day of September, A.D., 2000
(Seal) /1Z:-c— t. 'n ' l-L (Seal)
Thomas A Clo e Tamara R. Twedt -Close
AUTHENTICATION ACKNOWLEDGMENT
}
Signature(s)of Thomas E. Close and Ramara R. STATE OF WISCONSIN }
Twedt -Close
authenticat /di ' d of September, COUNTY }
2000 Personally came before me this
� day of 20 , the above-
" Hu¢h H. 49win named
TITLE MEMBER STATE BAR OF WISCONSIN
(If not,
authorized by §706.06, Wis. Stats.) to me known to be the person _ who executed
the foregoing instrument and acknowledge the
THIS INSTRUMENT WAS DRAFTED BY: same.
Atty. Hueh H. Gwin, GWIN LAW FIRM S.C.
430 Second Street, Hudson, WI. 54016 Notary Public, County, WI.
(Signatures may be authenticated or
acknowledged. Both are not necessary.) My commission is permanent (if not, state,
NOTE Names of persons signing in any
expiration date: 20
capacity should be typed or printed below their
signatures.