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HomeMy WebLinkAbout012-1065-22-000U/isconsin Department of Commerce Safety and Building Division GENERAL INFORMATION Personal information you provide may be used for econdary Permit Holder's N ~~~,, ~ Ho ,Martin R. ~' ~ ~ ~~, S CST BM Elev Insp. BM Elev: BM D TANK INFORMATION TYPE MANUFACTURER hq Septic ~" d~c w. ~ .u :~ Dosing ~ as~tior, 2 ~- r ~ ' ~ folding PRIVATE SEWAGE SYSTEM INSPECTION REPORT (ATTACH TO PERMIT) [Privacy Law, s.15.04 (1)(m))- City Village X Township Erin Prairie, Town of ELEVATION DATA ~QOO C.Oo TANK SETBACYQINFORMATION TAfJK TO P/L 0 WELL BLDG. Vent to Air Intake ROAD Septic ~ 7D ~ 2S / J I ~~~ ~S I ~ Dosing ~ 7 ~a ~ ~9 /o' i 5 ' --, Aeration Holding PUMP/SIPHON INFORMATION Manufacturer t ZoG``~• vlodel Number 9~ - ~ -°•Z , ~ ~~~~ oysrem Hess l /,~Z 2.5 Forcemain Length ~ Dia. , ~ Dist. to Well i~o z 3. SOIL ABSORPTION SYSTEM BED/TRENCH Width ~ Length I No. Of~nch DIMENSIONS ~ .y g SETBACK SYSTEM TO / P/ BLDG INFORMATION Type O ° ~stern_ DISTRIBUTION SYSTEM ~ 8 Header/Manifold ~~ Distribution ~ ,~ ~ Pipe(s) Length Dia /t v Length ~~ ~ `~ Dia ~ ~ 5 Spa SOIL COVER „ oro~~„~„ ~,,,.,,,__ „ FPM Z(o. Z ~ ~• 1 STATION BS HI FS ELEV. Benchmark 1. 9a /oz ~ ~6~ Alt. BB1y1 •~ „~ VS 9t,2g Bldg. Sewer /0 •'f 9Z.5 St/Ht Inlet io .55 sz. ss St/Ht Outlet ~ ~ Dt Inlet ~ ~ Dt Bottom `, i~ YS ~ y Header/Man. /. ~5 /o~. 15 Dist. ipe 1.71P gal . i Bot. System / ~ Final Grade o~75/az.~S St Cove. l ~ Co +.` 1 ' 3.(05 e~'`~l. L $ ~., r' ~.~ 3, ~ 99. 5 -- ~ PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth ~_ WELL LAKE/STREAM LEACHING Manufacturer:~~ ~ ~ CHAMBER OR ~ ~.~.~' 5~' ~ UNIT Model Nw~iber~ ~ L!t ,- . - i~ro.~ ~, x Hole Size ~~ x Hole Spacing Ve~o Air I ` Depth Over - - -~- -- ....., Depth Over ~~ irwu~~u yr wr-vraa e systems only / ~ ~ Bed/Trench Center ~ Bed/Trench Edges xx Depth of To oil pJ ~ xx Seeded/Sodded °~ 1 -, Yes No xx Mulche`d' Ies !VO COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~ / Z4/ O~ Inspection #2: __ / Location: 1528 130th Ave. N w Richm nd, WI 54017 (SE 1/4 SW 1/4 30 T30N R17W) NA Lot 1 Fr®~ ~' ~~ ~ arcel o: 30.30.17.4596 1.) Alt BM Description = ~' ~ ~J`~'~- C ~~; w,S ~,., / _ _ L ~ - OG+-k 2.) Bldg sewer length = ~ ~'°~ Ja Prow ~ - amount of cover = ~ 6 ,.~ ~ s ~-:~.. d--Q.,,.~ u Plan revision Required Yes ~!', No '~J ~ ~` ~~ ~ Use other side for additional information: ~ ` ~ Z~ ~~~~3~ SBD-6"r 10 (R.3/97) Date Insepc o ignatu Cert ~~i ~~ ^ Ct)111f11@YCe.wi.gOV Safety and Buildings Division County ~ 201 W. Washington Ave., P.O. Box 7162 St. Croix ' ~~~ n ~, ~ Madison, WI 53707-7162 Sanitary Permit Number (to be filled in by Co.) ~egarttrtetlt of Cvtfanerce 5. Q r ` Sanitary Permit Application State Transaction Number In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the a propriate governmental ~ J~J 3 ~~ unit is required prior to obtaining a sanitary permit, Note: Application forms for -owned POWTS are submined to the Department of Commerce. Personal infomration ou ~.lect Address (if different than mailing address) u ses in accordance with the Ptiva Law, s. 15.04 1 m , Stars. y provide us for secondary I. A lieation Information -Please Print All Inforlllati ~ / 5 ZB l 3Q ~ ~ ~` Property Owner's Name REC Panel # ' d 5~-w ` 1 GJ ('' 01 a-1 os5-zs-0oo Property Owner's Mailittg A ess c~ c~ Property Location / 1528130th Ave. MAY ~ 2 2007 C ~ ~f cj ~ City, State Govt. Lot New Richmond, WI Z p 1~ ST. CROI ~~ ~r SE '/., SW %, Section 30 (Check Orta) II. Type of Building (check all that apply) t # T 30 N; R 17 ~ E Q W 1 or 2 Family Dweiling - Number of Bedrooms 3 Bedrooms 1 Subdivision Name ------~ ^ Public/Commercial -Describe Use E~r~ ~'`'; ,n Block # 5 ^ City of ^ State Owned -Describe Use CSM Number ^ Village of J? c f ~) ~' ^/ Town of Etin Prairie --~~_ III. Type of Permit: (Check onty one box on line A. Complete line B if applicable) A' New S stem / Re lacement y System- Treatment/Holding Tank Replacement Only Other Modification to Existing System (explain) B. Permit Permit Revision List Previous Permit Number and Date Issued Change of ~ Permit Transfer to Renewal Before Plumber New Owner ~ E iration 1V. T of POWTS S stem/Com onent/Device: Check atl that a ~ Non-Pressurized In-Ground Pressurized In-Ground At-Grade Mound _> 24 in. of suitable soil / Mound < 24 in. of suitable soil ^ Holding Tank ^ Other Dispersal Component (explain) Pretreatment Device (explain) V. Dis ersaUTreatment Area Information: Desi nFlow a~'t-' ' / 7 g (gPd) Design Spil Application Rate(gpdsf) Dispersal Are~Required (sfj Dispersal Area Proposed (st) System Elevation 450 / .6 ~ 750 / 783.2 ~Z .~ 7 100.92 VI. Tank Info Capacity in Total # of Manufacturer Material Gallons Gallons Units New Tanks E~dsting Taaks /ns Septic or Holding Tank ~ ^' GS ~ G F ~~ 1000 1000 1 HUFFCUTT INC. Prefab Concrete Dosing Chamber ~~ 600 VII. Responsibility Statement- 1, the undersigned, assume responsibitity fo testa tion of the POWTS shown on the attached phta4. Plumber's Name (Print) Plumber's S' MP/MPRS Number Business Phone Number Mark Weis ~ MP 657274 71558-0740 Plumber's Address (Street, City, State, Zip Code) 1879131/2 Ave. Cameron, WI 54822 VIII. Coun /De artment Use Onl Approved _ Di ved Permit Fee Date I ued Issuing A Signature _ er Given for Denial $ / oO , ~~ ~~ZZ ~7 IX. Conditi~~asoes for Disapprovahd /~ 1. Septic tank, effluent after and 3 ~ b ~ ct~v (~ s tf e,,,~ ~ ~ g, ~ja „` dispersal ceH must all be services / malntaL~ed ic.~ /1(~ c. o as per management plan provided by plumber. I 2 AN k fequireriterits must be maintained ~ 1~-q4 ~_ - ---'- '-- Attach to complete plans for the system and aubmrt to the County only on paper not ksa than 8 to a 11 inches in size SBD-6398 (R. 01/07) Valid rhea 01109 3 -' °~ a ~ ~ a ~ ~ ~_ L ~-' ~ h _ `t~ ~ p ~ V'~ `~ 4 ! ~ ~ ~ 3 `-~ ~ * ~ ~ ~ ~ c Y = c ~ ~ ,~ ~ ~ ~= d a k o ~v r 4 ~ cn Q ~ ~ ~ a tt ~.r.~r ~-r.~.r. w ~~ r~- aaa.~ way ~~ ~~ aa~ ~ 3 -' . R ~ o° ~ ~ ~_ ~ ~ ~ ~- ( i • t~ h ~ ~; e~ V • o c~. 1 ~ ~ .,,T ~ ~ d L V r c =' 3 Y la - ~ ~ o ~~ ~ ~ o ,v 3 r -~ 4 ~ ` ~ ~ G? u ~ ~ 3 a c~ ~~'~ ~~~ ., . J commerce.wi.gov i isconsin Department of Commerce May 10, 2007 CUST ID No. 657274 MARK WEIS 187913 1/2 AVE CAMERON WI 54822 CONDITIONAL APPROVAL PLAN APPRO Safety and Buildings 4003 N KINNEY COULEE RD LACROSSE WI 54601-1831 TDD #: (608) 264-8777 vwwv.commerce.vvi,gov/sb/ www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary ATTN.• POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 ~'AL EXPIRES: 05/10/2009 ' Identification Numbers SITE: Transaction ID No. 1393757 Martin & Sonia Hoglund Site ID No. 725029 1528 130th Avenue Pleasexefer to both identification numbers, Town of Erin Prairie above, in all cones ondence with thew enc . St Croix County SE1/4, SWl/4, 530, T30N, R17W FOR: Description: Three Bedroom Mound System /Replacement construction Object Type: POWTS Component Manual Regulated Object ID No.: 1129600 Maintenance required; 450 GPD Flow rate; 19 in Soil minimum depth to limiting factor from original grade; S stem s Infiltrator Chamber Mound Manual (8/04), Pressure Distribution Component Manual -Version 2.0, SBD-10706 P ( ) (N.01/O1) The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes 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. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06 stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the component manual(s) referenced above. • A sanitary permit must be obtained from the county where this projecf 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 wi the designated county official in accordance with the provisions of Sec.145.20 2 d Wis. Stats. ~ • The area within 15 feet horizontally down slope of the dispersal cell shall remairi)undisturbed. Vehicular traflic or soil compaction in this area is prohibited. • The 1 S` and last. orifice in each lateral shall be located no less than 6" and no greater than 2' from the ends of both chamber rows. • The existing POWTS shall be properly abandoned per Comm 83.33, Wis. Adm. Code. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • ~'nmm 4Z ~f ~f i.n _ mS1J- ectOrS Conditiana(!y APPROVED MARK WEIS Page 2 5/10/2007 Owner Responsibilities: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • Comm 83.52(1)(a) -The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for . maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence maybe 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. Sincerely, `~ ~ Gerard M Swim POWTS Plan Reviewer, Integrated Services (608)789-7892, Mon -Fri, 7:15 am - 4:00 pm j erry.swim@wisconsin.gov Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSvIART code: 7633 Wisconsin Sand Mound Desi n Pro ram for Infiltrator Chambers Infiltrator Mound and Pressure Distribution Component Desi ~' 9~ ~~ - ~~~, 9~ ~~G Index and Title Page ~ f ~O Project Name: ~~~ ~~~~ Ho hind Mound ~Q Owner's Name: Martin & Sonia Hoglund I`~ Owner's Address: 1528 130th Ave. New Richmond, WI 54017 715-497-8964 Legal Description: SE1/4, SW1/4, S30, T30N, R17W Township: ~ ~'~~ ~ n~~+ f ` ~ j' County: St.Croix Subdivision Name: CSM V 21495 5 acre parcel Lot Number: 1 Block Number: ~ Parcel I.D. Number: 012-1~5-22_000 Plan Transaction No.: ~ Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System and maintenance specifications Page 6 Management plan Page 7 Plot Plan Page 8 Pump Curve Page 9 x Page 10 Designer: Mark Weis License Number: MP 657274 Date: Aril 26, 2007 Phone Number: 715-458-0740 Signature: ,Y~ Page 1 of 6 Mound system design criteria based on: The (nftflrafor Chamber Mound Component Manual, Ver. 3.0 (August 11, 2004), Pressure Distribution Component Manual Ver. 2.0 SBQ107U6-P (N. 0}i01J, and Design of Pressure Distribution Networks SSWMP Publication 9.6 (01/$ }J Current version as of June 9, 2005 DIVISION OF AFETY AND Bt1iLDINGS t SEE CGRF~ES ~~GEIJCE Wisconsin Sand Mound Design Program for Infiltrator Chambers Mound and Pressure Distribution Component Design ~_-~L .~-~. hug, Site Information R Residential or Commercial Design (R or C) 300.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 = 150°i6) 450.00 Design Flow (gpd) 3.30 Site Slope (%) 99.50 Installation Contour Elevation (ft) 19.00 Depth to Limiting Factor {in) 0.60 In-situ Soil Application Rate (gpd/ftZ} Distribution Cell Information 78.00 Distribution Cell Length Along Contour (ft) 1.00 Distribution Cell Loading Rate (gpd/ftz) 1 Influent Wastewater Quality (1 or 2) Q Enter Q or S Q = Quick4 Standard; S = H-10 Standard Pressure Di stribution Information E Center or End Manifold (C or E) 3 Lateral Spacing (ft) 2 Number of Laterals 0.188 Orifice Diameter (in) (e.g. 0.25) 3.83 ~_~= _~ N~~~ Orifice Spacing (ft) 2.00 Forcemain Diameter (in) 100.00 Forcemain Length (ft) 88.00 Pump Tank Elevation (ft) 2.50 Distai,Head (ft) 0.75 Net9vork Losses (ftj 1 .92 Vertical Lift (ft) 1.51 Force Main Friction Loss {ft) 16.68 Total Dynamic Head (ft) Lateral Diameter Selection in. dia. o tions choice 1.00 1.25 1.50 x x 2.00 x 3.00 x Treatment Tank Information 1000.00 Se tic Tank Capacity {gal) Huffcutt Inc Manufacturer Dose Tank Information 627.00 Dose Tank Capacity (gal) 14.93 Dose Tank Volume (gal/in) u cuff nc Manufacturer Note: Sand fill (D) calculations assume a Table 83-44-3 in-situ soil treatment for fecal coliform of <= 36 inches. 6.00 Cell Width (ft) Are the laterals the highest oint in the distribution network? Enter Y or N If N above, enter the elevation ft of the highest point. Lateral placement Enter S or G 11.70 ftz/orifice Does the forcemain drain back? 0 Enter Y or N 16.31 Forcemain Drainback (gal) 70.19 5x Void Volume (gal} 86.50 Minimum Dose Volume (gal) 2621 System Demand (gpm) Manifold Diameter Selection in. dia. o tions choice 1.25 x 1.50 x x 2.00 3.00 Dose Tank Gallons/Inch Calculatorv~' or-,;~' 627.00 Total Tank Capacity {gal) 14.93 Total Working Liquid Depth (in) 42.00 gal/in (enter result in cell 651) Effluent Filter Information Best Filter Manufacturer - Filter Model Number Project: Hoglund Mound Page 2 of 6 Current version as of June 9, 2W5 wsconsin Sand Mound Design Program for Infiltrator Chambers Mound Plan View trio-vs6 lion Pipes -';`"---:-'.--"'=:::::::':':::':.:.:':: L Mound Component Dimensions T Jl T A I z 1 A 6.00 ft E 19.38 in H 12.00 in K 10.55 ft B 78.00 ft F 12.00 in I 10.37 ft L 99.09 ft D 17.00 in G 6.00 in J 7.96 ft W 24.33 ft 468.00 {ftz} Dispersal Cell Area 1276.91 (ftz} Basal Area Available 6.00 (gpdfFt} Linear Loading Rate 750.00 (ftz} Basal Area Required Observation Pipe Placement is Between 1110 B ~ 1/5 B 7.8 ft {vto s} ana 15.6 ft (1/5 i3> Infiltrator chambers (typ.) Not to scale -Distribution lateral at trench bottom {typ.) Project: Hoglund Mound Current version as of June 9, 2005 Page 3 of 6 Lateral Layout Diagram Laterals centered over the A & B dimension '`----- P Q =Turn-up+r{bell valve orcleanoutplug 1411 laterals are identical IE X-3~ Hales drifted on the top of the laterals, erpurlty spaced 5 Fvree main aonrmativn via tee or cross to m antfDlii at any pvxtt_ Laterals ix farce main of PVC Sch 40 [per t..dtvtllrt Table 84.30.5) Pressure Distribution System Detail Number of Laterals Sit v` Lateral Diameter 2 1 50 in Orifice Diameter 0.188 in Lateral Length (P) . 76 50 ft Orifice Spacing (X) 3.83 ft Lateral Spacing (Sj . 3 00 ft Orifices per Lateral 20 Lateral Flow Rate S t . 13.11 gpm Orifice Density Manifold Len th 11.70 ftZloriftce ys em Flow Rate Total Dynamic Head 26.21 gpm g Manifold Diameter 3.00 ft 1 50 in 16.68 ft Forcemain Velocity . 2.68 ft/sec Number of Chambers 19 per lateral Dose Tank Information Locking cover with warning label and working device and Electrical as per NEC 300 and ~ ~~ sealed watertight Comm 16.28 WAC -• Tank component is properly vented Manufacturer Gallons gal/inch A Alarm Manufacturer SJ Electro Alarm Model Number 101 HW Pump Manufacturer Zoeller --~ Pump Model Number N98 Pump Must Deliver 26.21 gpm at 16.68 ft TDH Project: Hoglund Mound Forcemain diameter ~ 2.00 in. ~ Pump off elevation (ft) 89.00 Dose tank elevation (ft) 88.00 Page 4 of 6 Curcent version as of June 9, 2005 wscansin Sand Mound Design Program for Infiltrator Chambers Mound System Maintenance and Operation Specifications Service Provider's Name Weis Se tic S stems & Soil Testin LLC Phone 715-458-0740 POWTS Regulator's Name St. Croix Co Zanin Phone 715-386-4680 System Flow and Load Parameters Design Flow -Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow -Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L 3oii Absorption Component Size 468 ft~ Maximum FOG 30 mglL Type of Wastewater Domestic Maximum Fecal Coliform >10E4 ctu/100 mL Service Frequency Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Other Ins ect andlor service once eve 3 ears Should ins ect once a ear and clean once eve 3 ears Test once eve 3 ears Should test month) Laterals flushed and ressure tested once eve 1.5 ears Ins ectonce eve 3 ears 1. Observation pipe materials conform to Table Comm 84.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 3. Tillage of the basal area is accomplished with a mold board or chisel plow. 4. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion. Finished Lateral Turn-up Detail grade ............... .........,...... ................. ............... 6' diameter lawn sprinkler Threaded cleanout plug ar valve box -~ `' ' ball valve Distribution Long sweep 90 or two 45 degree lateral bends same diameter as lateral Last orifice ~~~ Lateral cleanout extends beyond end of chamber AntiSiphon Detai{ Pressurized PIPin9 Current version as of June 9, 2W5 1 /8' hole in the e pipe iegree ~ (TYPO pe sizing K design 2 J-hooks for stabilzing Wisconsin Sand Mound Desi n Pro ram for Infiltrator Chambers Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm .Code C~Tanlr The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stets. The contents of the septic tank shall be disposed of in a~ordance wtth NR 113, Wis. Adm. Code. The operating conditon of the septic tank and outlet fitter shall be assessed at least once every 3 years by inspection. The outlet fitter shall be cleaned as necessary to ensure proper operation The finer cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the fitter when removed from tts enclosure. If the filter is equipped wtth an alarm, the fitter shall be serviced ff the alarm is activated continuously. Intermittent finer alarms may indicate surge flours or an impending continuous alarm. The septic tank shaft have its contents removed when the voume of sludge and scum in the tank exceeds 113 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be pertonned to maintain less than maximum scum arxkludge accumulatiwt in the tank The addition of biological or chemical additives to enhance septic tank performance is generally n~ required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. The pump (dosing] tank shall ~ ins Pump Tank an effluent fitter 5 installed within the tank it shah be i ~ ~ry 3 ~m All svdches' alamrs, and pumps shall be tested to ve petted and serviced as necessary. MY Proper operation. If Mound and Pressure Distribution ~"trm 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 cwnpaction may hinder aeration ~ 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 mgJL BODS, 150 mg/LTSS, and 3D mg/L FOG for septic tank effluent or 30 mg/L BOD 5, 30mgJL TSS, 10mgJL FOG, and 10r cfu1100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specfied in the permit for this installation. The pressure distribution system is provided wdh a flushing point at the end of each lateral, and ft is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is pertormed tt should be compared to the initial test when the system was installed to determine tt orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes wthin the dispersal cell shay be checked for eflluent 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. This system shall be operated in accordance with Comm 824 Wis. Adm. Code, and shall maintained in accordance with its' component manuals Pressure Distribution SBD-10706-P (N.01/01) and Infiltrator Mound Ver 5.D and local or state rules pertaining to maintenance and maintenance reporting. No one should ever enter a septa or pump tank since dangera~ 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. If the septic tank or any of its componenrts 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 detective the defective component shall be immediately repaired or replaced with a component of the same or equal pertormance If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, tt shall be repaired or replaced in its' present location by increasing Nasal area rf toe leakage occurs or b)/ removing biologically clogged absorption and dispersal media, and related piping, and replacing sad components as deemed necessary to bring the system into proper operating condition. Questions on the operation or maintenance of this system should be directed to your designer, installer, service provider, county zoning office or focal health inspector. See Page 5 far the name and telephone number of your local POWTS regulator. Project: Haglund Mound Current version as of June 9, 2005 Page 6 of 6 • ? . ~ ~ w W ~ LL 25 6 ~ 20 z v ~ 15 > 4 0 J ta.- 10 2 5 0 GALLONS LITERS 0 TOTAL DYNAMIC HEAD/FLOW PUMP PERFORMANCE CURVE PER MINUTE MODEL 98 EFFLUENT AND DEWATERING MODEL 98 Feet Meters Gal. Liters 5 1.5 72 273 10 3.0 61 231 15 4.6 45 170 20 7.1 25 95 Shut-off Head: 23 ff.(7.Om) 009971 ~~ 10 20 30 40 50 60 70 80 80 160 240 FLOW PER MINUTE 1: r mro L sK„a~ CONSULT FACTORY FOR SPECIAL APPLICATIONS • Electrical alternators, for duplex systems, are available and Variable level float switches are available for controlling single supplied with an alarm. and three phase systems. • Mechanical alternators, for duplex systems, are available Double piggyback variable level float switches are available for with or without alarm switches. variable level long cycle controls, • Refer to FM1922 and FM0806 for temperatures above 130°F. SELECTION GUIDE 98 Series Conirot Selection Model Volts-Ph Mode Amps Simplex Duplex M98 115 1 Auto 9.4 1 4 N98 115 1 Non 9.4 2 or 3 4 D98 230 1 Auto 4.7 1 4 E98 230 1 Non 4.7 2 or 3 4 1. Integral float operated mechanical switch, no external control required. 2. For automatic use single piggyback variable level float switch or double piggyback variable level float switch. Refer to FM0477. 3. See FM1228 for correct model of simplex control panel. 4. See FM0712 for correct model of duplex control panel or FM1663 for a residential alternator system. CAUTION For information on additbnal Zoeller products refer to catalog on Piggyback Variable Level Switches, All installation of controls, protection devices and wiring should be done by a qualified FM0477;EIeciricalAftemator,FM0486;MechanicalAlemator,FM0495;SumplSewageBasins,FM0487; licensed electrician, All electrical and safety codes should be followed including the Singk: Phase Slmpk:x Pump Control, FMt596; Alarm Systems, FM0732. most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. avarr.rv: rv.nvxTS;i4r ~ 0 • Louismdlle, KY 40256.0347 Manufacturers of.. SHIP 70: 3649 Cane Run Road ® Lou15Nlle, KY 40?11-1981 Qauirv PUMPS SNCE /999 ~~ PUMP !O. (502) 718-2731 ~ 1(800) 928-PUMP http:!/www.mel-ercom FAX (502) 714-3824 ©Copyright 2004 Zoeller Co. All rights reserved. Wisconsin Department of Com SOIL EVALUATION REPORT Division of Safety and Buildings Page. 1 of? ~°- ni nwv~uan ~ wnmr oa, vvis. rwnr. ~.uue Cour>H St. Croix Attach complete site plan on paperffH ess than 8112 x 11 inches in size Plan must . inGude, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 012-1065-22-000 lJ /, percent slope, scale or dimensions, north arrow, and location and distance to nearest road. ~ 7 S 7 Please print all information. Reviewed by , _ D to Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (f) (m)). (`_... u ~ Property Owner R Pr erty Location ^ ~ Martin & Sonia Ho and Go Lot SE 1!4 SW 1/4 S 30 T 30 N R 17 E (or Property Owners Mailing Address MAY ~ ~ Zip 1 Lot Block # Subd. Name or CSM# 1528 130th Ave CSM V 2/495 5 acre parcel City State Zip Code Phor~e.INt~ ~~~ flY Village Town Nearest Road New Richmond WI 54017 7 5-497-8964 ~ ~ ~ 130th Ave. New Construction Use Residential /Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement Publ' or com eraal - Describ Parent material ~~ ~`- ~ Flood Plain elevation if applicable ft. and recommendations: Mound System along the 99.5 contour w~. ~ 1^ Boring # ~ Boring Q pit Ground surtace elev. 99.75 ft. Depth to limiting factor 20 in. Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DlfP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Effi112 1 0-10 10yr2/2 sil 2mabk mfr gw 2f .6 .8 2 10-20 1 4/3 sil 2mabk mfr cw 1 f .6 .8 3 20-39 7.Syr4/4 flf7.5yr5/8 scl 2mabk mfi cw - .4 -6 4 39-62 7.Syr4/4 flf7.5yr6/2,7.Syri/s sicl 2mabk ~' - - .4 .6 2 Boring # U Boring 99.75 20 pit Ground surface elev. ft. Depth to limiting factor in. Soil 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 0-10 10yr2/2 sil 2mabk mfi' gw 2f .6 .8 2 10-20 1 4/3 sil 2mabk mfr cw l f .6 .8 3 20-33 7.Syr4/4 flf7.syrs/s scl 2mabk mfi cw _ .4 .6 4 33-6D 7.Syr4/4 f1f7.5yr6/2,7.Syr5/s sicl 2mabk mS - - .4 .6 * Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 30 mgll and TSS < 30 mg/L CST Name (Please Print) Signature '' -- II CST Number Mark Weis (~(,/„ I!,cp~ b57274 Address Date Evaluation Conducted Telephone Number 1879 13 1/2 Ave. Cameron, WI 54822 7/24/07 71S/458-0740 Property Owner Parcel ID # 012-1065-22-000 Paoe 2 of 2 3 Boring # V Boring Ground surface elev. 98'75 ft. Depth to limiting factor 19 in. Pit Soil icatfon Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fl? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#t1 "EtT#2 1 0-11 10yr2/2 sil 2mabk ~- gw 2f .6 .8 2 11-19 10 4/3 sil 2mabk mfr cw if .6 .8 3 19-33 7.Syr414 flf 10yr5/8 scl 2mabk mfi cw _ ,4 .6 4 33-60 7.Syr4/4 flf 7.Syr6/2,7.Syr5/8 sicl 2mabk mfi - - .4 .6 Boring # Boring Pit Ground surface elev. ft. Depth to limiting factor 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. 'Etf#1 "Eft#2 Boring # Boring Pit Ground surface elev. ft. Depth to limiting factor in. Sofl ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P DIfF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 "Efi#2 'Effluent #1 = BODS > 30 < 220 mg1L and TSS >30 < 150 mg1L 'Effluent #2 = BODg < 30 mg/L and TSS < 30 mglL The Department of Commerce is an equal opportunity service provider and employer. Ifyou 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 (R07/00) V - ~ ~ l3~ i4v~ a~~r ~~~ fry ~~ `~~ bl~~ ~~ fllr~~ ~YY ~~w~ wwa~s ~~ ~~ f - P .I ~' c~ (~ w ~~~ ~ ~ 3 F""'w a w b A i ~ 0 a ~ n~ ~~ o ~ J R! } `~ `v -t ~v m ro v O #` ` N ~` ~ A ~ ~. ~ ~ ~ ~ ~ t 1~ ~ ~ O N v ~, ~~ ~ ~ ~ ~ o ~ ~' z r-. o o ~D ~, ..~ ~ ~- n ~ n ~ ~ ~ 1 P 3 M © ~ ~ ~ n d -h !~ ~ r f ,~ ~ z 0 a Q n' old NoAr~ ~~ 3441:1 Arthur L. Wage er Wis. R.L.S. No.S-963 Dittloff Engineering Co. River Falls, Wi. 54022 EAST 391.G3~ ~~,••~"~~~~~~"•,,• 0 00 ~~ •.• ••. '. O' .•` ~ ARTHUR L~ C WEGERER • = ~ ~ S-963 ELLSWORTH WIS. .• LOT I 5.00 ACRES ,~~'•.~ ~N''••....••y~~ ~~.•'~~ ~''~.,,~~ ~SUR~E ~,.~`~~ CERTIFIED SURVEY MAP CERTIFIED SURVEY I, Arthur L. Wagerer, registered land surveyor, hereby certify: That in full compliance .with the provisions of Chapter 236.34 of the Wisconsin Statutes and the provisions of the St. Cr t Subdivision Ordinance and under the _:~_ ..., ~_..__ ction u Cihla owner of said land, I have surveyed, divided, and mappe said parcel of land, that such plat correctly represents all exterior boundaries and the subdivision of the land surveyed; and that this land is located in the SE ~ of -the SW ~ of Section 30, T 30 N, R 17 W, Town of Erin Prairie, St. Croix County, Wisconsin,To--w3.t: Commencing at the Southwest corner~of Section 30; thence East along the South line of Section 30 A .distance of 1174.701 to the point of beginning; thence North 556.141; thence East 391.631; thence South 556.141 to the section line; thence West 391.63.1 to the point of beginning. Contains 5.00 acres of land subject to Town Road Right-of-way over 'the Southerly 331 Thereof. Dated this 7th day of September, 1977 •~~~~~ ~'/~ NORTH 0-1"x24"IRON PIPE WEIGHING 1.13 LBS./LINEAL FOOT... SCALE ~, ~_.__~ N 00 75 50 0 100 I.f) ~' l(') APPROVED OCT 19 19~Ir ST. C~tOIX COU:•~iY COMPREHENSIVE PARKS PLANyItiG AND ZONING COMMITTEE O APPROVAL OF TH-S MINGR SUBDIVl; z DOES NOT McAN APP120VAL ;- BUILDING S~Tc OR SEPTIC SY,.TEPv1~ REFER TO H62.i0. ~~ SOUTHWEST CORNER SEC. 30,T30N,R 17W. (FOUND NAIL8ICAP) EAST 1174.70 ~~a d' N ~ d' ~, `~ ~ g ti RHO _ ~ ~~~ ~191~~~ t- 0~~ o. W~o,.a. o ~, d "' ,-~` ~ ~_ * ~~~ ~1STING FUSE o ~' ~O 2~~ IRON PIPE .... .. .. r 3JI:G3~. ; ~; M • ~ • '~ ......:TO,W N . WEST 391.G3~ Volume 2 Pale X95• ~~ ~~. M M .ROAD; '~ 'W a 0 SOUTH LI N_E OF ~ SECTION 30 RF 77-Rt ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer Mailing Address ~ ~L~' f ~ l~ ~ ~tf~ . / Vii ~c ,K~~ ~h~/1 , (,(~ ~0/ 7 Property Address (Verification required from Planning & Zoning Department for new construction.) City/State ~(',~.. ~ ~,ic. ~ ~t~ ~vd . W r Parcel Identification Number d /a - ~ 0(o S - a a - Opa LEGAL DESCRIPTION Property Location 5 ~ t/a , 5 ~ '/a ,Sec. ~~, T 3 'O N R ~ 7 W, Town of C r% ~ 7"i ~ i i' ~ e Subdivision Certified Survey Map # Warranty Deed # Spec house yes no RECEIVED MAY 2 1 2007 ST. CRO1X COUNTY Lot # Volume ,Page # Volume ,Page # Lot lines identifiable yes 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 aze true to the best of my/our knowledge. Uwe amaze the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. f Number.4~b rooms f' %~ ~~ .... ,_. ~.°L~ ,i~ti, I L- ~v~ l ~' ~ SIG F PLIC(S) DATE ~ ,.~ ~: . *~`*Any info 'o th s ~r pre~ented ay result in the sanitary permit being revoked by the rlanning dz Zoning Department. *'~ Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) STATE BAR OF WISCONSIN FORM 2 - 1998 This Deed, made between Martin R. Iioglund and Sonia L. Hoglund, f/k/a Sonia L. Tingblad, husband and wife, Grantor, and Stacy L. Wright, Grantee. Grantor, for a valuable consideration, conveys and warrants to Gran[ee the following described real estate in St. Croix County, State of Wisconsin (The "Property"): Lot 1 of Certified Survey Map recorded in Vol. 2, page 495, Doc. No. 344111 located in the SE 1/4 of SW I/4 of Section 30, Township 30 North, Range 17 West, St. Croix County, Wisconsin. 111111111111 IIIII Illil Ilill il111111111111111111111 * 8 5 0 6 5 8 1 850658 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., WI • RECEIVED FOR RECDRD 05/16/2007 10:40AM WARRANTY DEED EXEMPT p REC FEE: 11.00 TRANS FEE: 495.00 PAGES: 1 Ntune and Return Address Ronald L. Siler VAN DYK, O'BOYLE &SILER, S.C. 201 South Knowles Avenue New Richmond, WI 54017 012-1(165-22-000 Parcel IdentiFication Number iPIN) "Skis is fiomestead property. Exceptions to warranties: Subject to all easements, restrictions and covenants of record. _-~ Dated this ~~ day of May, 2007. K *Martin R. Hoglund A UTHF,NTICATION Signature(s)_ ~a~'~t.. ~ h1-celw-ci ~+~ sue„ ~~r~ a ` Wit'-'~-' authemic• ed this /S day of May, 2007. ~-' - 4. ~ ~ TITLE: MEMBER S'I'A'I'E BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats.) THIS tNSTRUMENT WAS DRAFTED BY Ronald L. Slier VAN DYK, O'BOYLE &SILER, S.C. 201 South Knowles Avenue, New Richmond, WI 54017 iSignatures may be authenticated or acknowledged. Both are not necessary.) * o a L. Hoglund ACKNOWLEDGMENT' STATE OF WISCONSIN ) ) SS. County ) Personally came before me this day of Mav, 2007 the above named _ _ _ _ _ to me known to be the person(s) who executed the foregoing instrument and acknowledge the same. Notary Public, State of Wisconsin My Commission is permanent. (It' not, stale expiration date: j 'Names of persons signing in any capaciry should be typed or printed below their signawres 1 011 µ•A RK AN7'Y nEH;n STATG aAR OF WISCONSIN k'ORM Nn. 2 - 19YA INFORMATION PROFESSIONALS COMPA nIV cn..~n..••~-~~~~~ --