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HomeMy WebLinkAbout032-1066-60-000 FORM - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER/ r_.L~sES TOWNSHIP SECTION 1 T N-R_2y W ADDRESS 'e ST. CROIX COUNTY, WISCONSIN SUBDIVISION o LOT_44&/LOT SIZE PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM M Z t/mus.~ o?.~ ` I ~ II o~ INDICATE NORTH ARROW BENCHMARK:Elevation and description: Af, ~e,- ,/~a_ Alternate benchmark SEPTIC TANK: Manufacturera iquid Cap. Rings used:z-Manhole cover elev: Final grade elev: Tank inlet elev.: Tank outlet elev.: No. of feet from nearest road:Front , Side, Rear Ft. From nearest prop. line:Front , Side , Rear 3S~ No. of feet from: Well 2D Building: (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE rt ~LL ~ S PUMP CHAMBER Manufacturer: ,,a~;~c Liquid CapacitT 2/00.4 Pump Model: A2e4 /Pump/Saphon Manufact. : s Pump Sizej Elevation of inlet: Bottom of tank elevation Pump on elev.: Pump off elev.: Gallons/cycle:~Z z / Alarm: Man.:S /,Switch Type: Location Distance from nearest prop. line: Front-, Side_, Rear,,&t.,27 Distance from: Well .fh Building SOIL ABSORPTION SYSTEM 1,' GIe WIO Bed: Trench:Seepage Pit: Width: _y Length Number of Lines:__~_Area Built ?ZL- Exist. Grade Elev. Proposed Final Grade Elev. Fill depth to top of pipe: ool No. feet from nearest prop. line:Front , Side , Rear-2(-Ft.1rL No. feet from well: XS- No. feet from building_,,,4C HOLDING TANK Manufacturer: Capacity: No. of rings used: Elevation of bottom tank: i Elevation of inlet: No. feet from nearest prop. line:Front , Side , Rear Ft. No. feet from: Well , building , nearest road Alarm Manufacturer: INSPECTOR: DATE : - PLUMBER ON JOB: LICENSE NUMBER: 6/90:cj [JEPAR7MLNT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING LABOR & HUMAN RELATIONS DIVISION P.O. hOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION QQE~AISOAI,1(1(I 507 State Plan I.D. Number: Y o i ec . 24 . T31-R19 (If assigned) 4" Town of Somerset ❑ CONVENTIONAL ❑ ALTERATIVE ❑ Holding Tank ❑ In-Ground Pressure Mound Hwv. 35 NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: / Steve Forest RSomerset WI 54025 - BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: F. PJ V.: CST REF. PT. V.: Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: Cal Powers Jr. 1563 St. 128766 fiF = S, 5~S l SEPTIC TANK/HOLDING TANK MANUFACTURER: LIQUID CAPACITY: TANK IN E V. TANK O L EV.: WARNING LABEL LOCKING COVER / PROVIDED: PROVIDED: d p-~ ~r< C OY C . IDrl~ YES ❑ NO ❑ YES NO BEDDING: V DIA.: VENT MATL.: HIGH WATE NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT T FRESH f ALARM: FEET FROM LINE: AIR I T:, ❑ YES O S ❑ YES NEAREST ( DOSING C I E 1,~' - -4 'S ~ MANUFACTURER BED ING: PUM: MANUFACTURER: WARNING LABLOCKING COVER GCd~ PROM ES ❑ NO PROYES ❑ NO I CYES O G,I GALLONS PER CYCLE: PUMP AND CQNTROS OPERATIONAL: NUMBER OF (DIFFERENCE BETWEEN FEET FROM LINE: IR INLET? PUMP ON AND OFF YEF-1 NO NEAREST Z q - - - 3 j& SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: DIAMETER: MATERIAL AND MARKING: or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN / 3 the soil is dry enough to continue.) CONVENTIONAL SYSTEM: WIDTH: LENGTH: NO.OF ..COVER BED/TRENCH INSIDE DIA.: # PITS' DEPTH: DIMENSIONS / PIT - EL DEPTH FILL E DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. I TR. NUMBER O PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES: COVE C IFEEF NEAREST ~ AIR INLET: MOUND SYSTEM: Mound site plowed perpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM slope and furrows thrown unslope: mound systems to make certain that it ON REVERSE SIDE. SHOW YES ❑ NO meets the criteria for medium sand ELEVATIONS MEASURED. SOIL COVER TEXTURE: PERM ANE T ARKERS: OBSERVATION WELLS; ✓ ~K G=>rt S ❑',(ES ❑ NO ElYiEg- [__1 NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPT S OF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: it EDGES: „ u _ 3 f/ - /Q ❑ YES O L•~'YES ❑ NO Ei- S ❑ NO PRESSURIZED DISTRIBUTION SYSTEM: L+, , ' Lc = 81 BED/TRENCH WIDTH: LENGTH: NO. OF LA ERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: TRENCHES: DIMENSIONS MANIFOLD PUMP MANI OLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: ELEVATION AND ELEV.: ELEV.: DIA.: i, ELEV.: PIPES: DIA.: i, 9 DISTRIBUTION q. & / 3 op HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO ; INFORMATION APPROVED PLANS 0 - LjI'PES ❑ NO ❑ YES ❑ NO )c' PERMANENT MARKERS: OBSERVATION WELL : NUMBER OF PROPWY WELL: BUILDING: COMMENTS: FEET FROM LINE:q(/f~ YES ❑ NO YES ❑ NO NEAREST 3 _'0 cc (geo2 03 1J, ~ A9.3 -C,le,CY 'Sb C >'~.~.d 62 Sketch System on etain in county file for audit. Reverse Side. SIGNATU : TITLE: SBD-6710 (R. 06/88) T DILHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code COUN STATE SANITARY IT # -Attach complete plans (to the county copy only) for the system, on paper not less than ? Ile 8'r4 x 11 inches in size. ❑ CFfeck if revision to pr vious application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. I PROPERTY OWNER PROPERTY LOCATION szwer '/a '/a, Sc2 T2 1 , N, R E (ordv PRO TY OWNER'S MAILING ADDRESS LOT # BLOCK # 46 el I Azlw~: CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION N E OR CSM NUMBER 11. TYPE OF BUILDING: (Check one) El State Owned VILLLLAGE : NEAREST Of ❑ Public ❑ 1 or 2 Fam. Dwelling~# of bedrooms `3 R L AX . NUMBER(S) III. BUILDING USE: (If building type is public, check all that apply) 3 Dg 0_ 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. ❑ New 2. ® Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit - Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 ® Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION 14Q -e710 Feet Feet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New Existing Gallons Tanks Manufacturer's Name concrete Con- Steel glass Plastic App Tanks Tanks structed Se tic Tank or Holdin Tank Lift Pump Tank/Si hon Chamber Vill. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's me (Print): Plumber's Signatur • o tamps) MP/MPRSW No.: Business Phone Number: Plum is Addre (Street, City, tate, Zip Co e): l IX. COUNTY/DEPARTMENT USE ONLY Disapproved Sanitary Permit Fee (Includes Groundwater Le ue Issuing Agent Signature (No Stamps) -Fd Approved OwnerGivenlnitial Surcharge Fee) Adverse D termin i n Q~ X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete of bedrooms if 1 or 2 Family Dwelling. Ill. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in ##1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8% x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by tbe.co4nty; E) soil test data on a 115 form; and F) all sizing information. - - - - - - - - - - - - - GAOIADWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The.monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD-6398 (8.11/88) L APPLICATION FOR SANITARY PERMIT 8TC-100 This application form is to be completed In full and signed by the owner(s) of the property being developed. Any Inadequacies will only result In delays of the permit Issuance. -Should this development be Intended tot tesels by thtst should awlth the completed ttwhen ge e property Is sold and submitted to this office appropriate deed recording. - - - - - - - Ovnet of pcopetty Location of property /4 s~~ ..1/4, Sactlon TIL-P-M.L.LY Tevnehtp Malling address Address of site •ubdtvlslon new* /U~~ • Let number Al A Previous ovnet of property Total also of parcel Date parcel was created Acs all cornets and lot lines Identifiable? Is this property being developed foe sesale tgpgc house)? as Yalu" 4~ and Page Numbet-5 as tecotded with the Reglstet of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWINCt A WARRANTY DBBD which Includes a DOCUMENT NUMBBR, VOLVMS AND pAOt NUMaER, and the SEAL OF THE REGISTER OF DEEDS. In addition, a eattltled survey, if available, would be helpful so as to avoid delays of the reviewing process. it the deed description tolerances to a Castifled Survey Nap, the Cettlfled survey Map shall also be requited. PROPERTY OWNER CERTIFICATION IVO) cettify that all statements on this Eotw ats true to the best of my (out) knowledge; that I (we) am (ate) the owner(s) of the pcopetty described In this Intotmstlon form, by vlttue of a warranty deed recorded In the office of the county Register of Deeds as Document No. t and that I (vol presently 'own the proposed alto for the sewage disposal system (or I (we) have obtained an casement, to tun with the above described property, tog the consttuctlon of sold aysta and the same has been duly recorded in the ollice of the County aeglst c of d as Document No. ~;7 dV, S'S). slgnat a of ov ec" Signature of Co-owner III Applicable) ate of Signature Date of signature 1 _ KGMiiler Conparry~ VSF DOCUMENT NO. V01. 6A`}Ppuf 509 STATE BAR OF WISCONSIN - FORM 2 WARRANTY DEED QQ THIS SPACE RESERVED FOR RECORDING DATA 78855 Douglas Beauvais and Mary Beauvias, REGISTERS OFFICE his wife ST. CROIX CO., WIS. Rec'd. for Record thrs 29th conveys and warrants to Steven A. Forrest and day of_ J_ lv -A.D. 19&2 Lauri P Forrest, formerly known as at 1:45 P M. Lauri. auyi s, husband and wife as joint tenants, Rp4tw of Deeds I RETURN TO the following described real estate in St. Croix County, State of Wisconsin: Tax Key No. Commencing 462 feet North of the Southwest corner of the Southwest Quarter of the Southwest Quarter (SW4 of SW4) of Section Twenty-four, Township Thirty-one (31) North, Range Nineteen (19) West; thence North 132 feet; thence East 20 rods; thence South 132 feet; thence West 20 rods to the place of beginning. TRANSFER This is not homestead property. (is) (is not) , Exception to warranties: Subject to easements, reservations and restrictions of record. , Dated this A_ day of July '19 82 (SEAL) ~/[.tte~.r h/• /J-~.t-~i-zu~ (SEAL) DO GLAS BE VAIS (SEAL) (SEAL) * MA BEAUVAIS AUTHENTICATION ACKNOWLEDGEMENT Signatures authenticated this 26tki day of STATE OF WISCONSIN July e 1 tg 92 } as. County. JJJ Personally came before me, this day of Stephen A. Seifert is TITLE: MEMBER STATE BAR OF WISCONSIN the above named (If not, authorized by § 706.06, Wis. Stats.) This Instrument was drafted by STEPHEN J. DUNLAP Hudson, Wisconsin to me known to be the person _ who executed the foregoing in- strument and acknowledged the same. (Signatures may be authenticated or acknowledged. Both are not necessary.) Notary Public County, Wis. i ' Names of persons signing in any capacity must be typed or printed below their signatures. i! My Commission is permanent. (If not, state expiration date: fl WARRAN-•.•-TY DEED - STATE BAR(SCO1J$11T,-FAb1T7M3 --fg77'- _ it 11 r SEPTIC TANK MAINTENANCE AGREEMENT Ct St. Croix County ~ OWNER/ BUYER ROUTE/ BOX NUMBER )i Fire Number 0 N CITY/ STATE So • ~ r ski` L) \ ZIP sy O.D Ct PROPERTY LOCATION:' Section TN, R4 W, Town of St3-y-n e rc,~ St. Croix County, Subdivision Lot number. Improper use and maintenance of your septic system could result in its premature failure to handle wastes.- Prover maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licen's•ed 'septic tank pumper. What you put into the system can acct t e .unct on of the septic tank as a treat- ment-stage in the waste disposal system. St. Croix County residents maw be eligible to recieve a grant for a maximum of 60% of the cost-of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new s'ys'tems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site.wastewater disposal system is in proper operating condition and •(2)•after inspection and pumping (if nec- essary), the septic tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year-expiration. H I/WE, the undersigned have read the above requirements and agree 0 to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin Depart- w ment of Natural Resources. Certification form must be completed •d and returned to the St. Croix County Zoning Office with 30 days of the three year expiration date. SIGNED DATE Z 190 _ St. Croix County Zoning Office 911 4th St. Hudson, WI 54016 386-4680 Sign, date and return to the above address. LDINGS NDUSTRYENTOF REPORT ON SOIL BORINGS AND SAFETY *B DI VISION LABOR AND PERCOLATION TESTS (115) MADISON W 7969 HUMAN'RELATIONS (ILHR 83.09(1) & Chapter 145) LOCATION: SECTION: TOWNS. HIe/1 "fdf2tP}lb4-Flf: LOT O.:BLK. O.: SUBDIVIS NNAME: t,~'/ I 2 /T3 N/R I? I(.,) W (Uo °1l, td//, COUNTY: OWNER'S/BUYER'S NAME: MAILING ADDRESS: o _gr s r1L s USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DES RIPTION: PROFILE A TESTS: Residence ❑New Replace I ~.~.Z~ 90 72-740 RATING: S= Site suitable for system U= Site unsuitable for system ONVE~+NTIONAL: MIN_ -GROUND-PRESSURE: SYSTEM-IN- ILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) ❑S U S ❑U ❑S U ❑S U ❑S U If Percolation Tests are NOT required DESIGN RATE- If any portion of the tested area is in the under s. ILHR 83.09(5)(b), indicate: N Floodplain, indicate Floodplain elevation: A PROFILE DESCRIPTIONS Q BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) A B- J S, 5 0 0 r 0 We ro 0-'~dlmh B- B- .3 S, a R 7. O C - 2, 6 fin o fin .S B- w )IJ (_a ere. PERCOLATION TESTS TEST DEPTH ATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD I PEW? 2 PER PER INCH P- I v b P_ 2_o O /!o P_ 2-u v E L7 I P- P- P PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface ele~&R 0b"n,3njh jre~ic&d percent of land slope. 11 V SYSTEM ELEVATION e_a2 ~Cn~ !>-~a~K~fla~~' in Tf ems. ~I loan ~ ~ L.C-20" _ . _ . ~ it n i ~ r. b r r Li 1D I, thl undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): TESTS WERE COMPLETED ON: C P, r 07 - Z'-7 - 17 0 ADDREE CERTIFICENUMBER: PHONE NUMBER (optional): a U t -2-SI 1 CST S DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 10/83) - OVER - s State of Wisconsin ` Department of Industry, Labor and Human Relations PRIVATE _SEWAGE _PLAN APPROVAL SAFETY & BUILDINGS DIVISION Northeast Regional Office 1053A East Green Bay Street P.O. Box 434 Shawano, Wisconsin 54166 CALVIN W. POWERS JUNIOR Owner: STEVE FOREST RR 3 BOX 249 R R "1 NEW RICHMOND, WI 54017 SOMERSET', WI 54025 RE: Plan Number: S90-31115 Date Approved: August 28, 1990 Gallons Per Day. 450 Date Received: August 27, "1990 Project Name: FOREST, STEVE - RESIDENCE Location: SW,SW,24,31,19W l-own of SOMERSET County: ST CROIX The plumbing plans and specifications for this project have been reviewed for compliance with applicable code requirements. This approval is based on Chapter '145, Wisconsin Statutes and the Wisconsin Administrative Code. The plans are stamped 'conditionally approved'. 'This approval is contingent upon compliance with any stipulations shown on the plans. All items that are noted must be corrected. All permits required by the city, village, township or county shall be obtained prior to construction. The licensed plumber responsible for this installation shall keep one set of plans with the department's approval stamp at the construction site. The installer shall notify the appropriate inspector when inspections can be made. ..this approval will expire two years from the date approved or if a sanitary permit is obtained, it will expire the day the initial sanitary permit expires. The Section of Private Sewage has reviewed these plans for private sewage system code requirements only. These plans have not been reviewed for the code requirements set forth in Section ILHR 82 for general plumbing or in Chapters 50-64 of the Wisconsin Administrative code. -This approval is for the following components only: - REPLACEMENT MOUND Inquiries concerning this approval may be made by calling (715) 524-3630. Sincerely, KARL J NRICH Section of Private Sewage Division of Safety and Buildings 3PP044/0009n/3'1 cc- STEVE FOREST _X_ Private Sewage Consultant SBD-6423 (R. 08/88) r1t~ R. 14ROAET MOUND SYSTEM DESIGN PROBLEM: Dgsfgn a mound system for a The site characteristics are.: Depth to groundwater or bedrock y7.~n, Landslope min din. r Pero,lation rate ft. a 5. ;Distance from dgse'chamber to distribution system: jt,fz. f+y~ Elevation difference betwe0n sump and distribution system 4~ ~ { 1 1V Step I NASTIATER,; LOAD ~ X ~ Ste 2: SIZE=`THE q SORPTJO.N AREA ~A Area required ' ~~57~~~~ /g~~~r1 sq R f t` y It' G: e S i rt a! ~c 6,, n r B 8e'd or;. trench 1en9th (B) • 1 M a ;C) Bed ors trench width (A) ft, { r Trgnch spacing asteNaCer load .24 coal/ft /day - 6 f't,J~'h .trenc . Step 3. MQUN© HEI7 `A) F11 epth (0) f't ~~s` y• X ~y ft. . B) Fill depth (E) ' 'D + ~ slope (AA) C) Bed or trench ldepth (F) _ • ft ! f D) Cap and topsoil depth (G) - i ' ' ' s E) Cap and topsoil depth (H') S90" ' x 1~ Ikh iN~ J. 1C0111fiG k~ • 4 v r?Y T✓~~,e t'gyp, i r A Step 4. MOUND LENGTH A) End slope (K) + F + H x 3 ft. B) Total mound length (L) = B + 2(K) ft. Step 5. MOUND WIDTH Al) Upslope correction factor F A2) Upslope width (J) (D + F + G)(3)(factor) ft• B1) Downslope correction factor = ~-3 B2) Downslope width (I) _ (E + F + G)(3)(factor) Cl) Total mound width (W) for bed = J + A + I ft. C2) Total mound width (W) for trenches J + + (no. trenches -1)(c) + A + I_ ft. / -/)0)-71 /a 9 Step 6. BASAL AREA A) Infiltrative capacity of natural soil = ~9al./ft2/ B) Basal area required = wastewater flow natural soil infil rdti e c •acity sq. ft. Cl) Basal area available for bed for sloping sites = sq. ft. Bx (A+I) _ C2) Bas are avail le for trench for sloping sites = B W ~J + A 1 ,-.?Ssq. ft. C3) Basal area available for trench or bed for level s tes = B x W = zla- sq. ft. Liconse u _ 7- LL S90-31115 Data : _..,s=9 6---. Era Step DISTRIBUTION SYSTEM 7A) SIZE DISTRIBUTION SYSTEM n„~~sE~ ~✓~'.5~.-?S Hole size = _G... in. 2) Hole spacing in. 3) Distribution pipe length = ice. fir' 4) 'Distribution pipe diameter • , in. V 5) Spacing between distribution pipes in. b) Distance from sidewall to distribution pipe in. 7B) DISTRIBUTION PIPE DISCHARGE RATE ft., Number of holes per' pipe 2) Flow per pipe * GPM 7C) SIZE MANIFOLD 1) Manifold is _ central/ end 2) Manifold length_ ft s 3) Number of distribution lines <ti 4) Manifold diameter in. f 7D) SIZE FORCE MAIN 1) Minimum dosing rate • GPM 2) Force main diameter in. CP12 3) Friction loss ~ / /,o ft. 7E) TOTAL DYNAMIC HEAD 1) Vertical lift ■ / ft. 2) Friction loss S90-31 1 ft. 3) System head 2.5 ft. ft, 7 4 Total dynamic head ft. : Si n LiCC';" ac; C.. L C. . Pr f lJ- -y s me sX Stl s 7F) PUMP SLLECTION 1) Pump selected will discharge, GPM atc'. ft, . total dynamic head. 2) Pump model and manufacturer 7G) DOSE VOLUME 1) 10 times void volume f distribution lines ■ 1./c ~e 2) Daily wastewater vol 4 doses/24 hrs. /9a1./cycle a l./C 3) Minimum dose volume 9, yc l e 7H) DOSE CHAMBER 1) Minimum capacity required gal.- ri• i✓ la/Qj.r/ bictn:utii Pate: S 90 - 3111`5 ^J~r~~ lsf' 1 /vi vraoi?C~s.JC ONSITE SEWAGE SYSTEM RuVED pir r R R u HUMAN RELATIONS ABOI DEPARTMENT VS'NN OF SAFE Y AND BUILDINGS ,~F r~ti~x Irr_ ~~dS,C Q /at5~ Fromm 1 0 AID AX7 i S90-31115 I '~r L ~ t \r i w , Straw, Marsh Hay " Synthetic Cover So M rr q a istribution Pipe Medium Sand, mr } Topsoil • w „ d.. , - ( Bed 0f 2 2 Force Main F allowed; 9yer s. r. Agregote y tt QNSITE SEWAGE SYSTEM D~ Ft`°C Z Y 3; r1 A Cri Section~,0 Mound Sys a Ung ss q ; 1y ~Ar, t.t a y,~ i r • k,,~Pr!S"a B@~Y "Zo yl k AP P r' A J HUtit RELA IOrN', •3,> +1~, x~ EPAiIT.MENT'Or INDUSTRY r~ti - H r ! . ~r Wry, C ~,:it y! lAE P IDiNt-~' aye r~ nf; q 1i!$aOWN SA j r ned • r t r r X13 r ' ; 4~ , t1~r3s }i' t t } l.~~ii.i.a •i5 1 f ,S r4ti +1 ense NWm`er:,~ ;SEE C~JR E I §fytr'a L R, R F f~ ~r I ! • J\ J I t • RY .ap R 1r' r(/ i } Al rnate Position z Ft N Ir l wrX r. e.' t,* vac v' ar 4 yt. NTO W~7a Fore Ma r l~ , ?fir SJbservatipn :Pipe-- 4✓ ,fir rti~; *,,t'w r' , r \ t ♦ , Y Z s - ! Nr ,y/✓ Ya f~ tla' ~ „ ~ t.. ~ 1 ~ a kti L1~ 'pX c~~✓ri~`,y~ •1 rt --tl r • 7ir+b ;i` t i., 4'jJ,.~TM• ~kL ' E~~. 1 , ~y ..ist•.._ j ,r ~(n tv Cl~' ,>~•i rxF+'~'~rb;J ' 4 v r yT ~ k~'F , ~ For~~e; Ntair~ ~t : Y .v Dist4ribution Bed O:f 2• 2 %2 tripe Ag'grega 0 bserv44 1 on Pipe Per.'manerit M' ers, x r. 71 y ~1'{rS• S4~ii , , oy flan View Of.. Mound Ustng A Eied For The absorptions Are. x \ i kwv ityi~ {`f r k ji , t s a ' . ~ ~ - _ ri to , ~ a +rx' ~ 4i y k;; FZ,,. ::i , Pago Z QPerforated Pipe Detail . End _V11- /'4- End Cop PVC Pipe End HOtee Located On Bottom, Are Equally Spaced s loe Q \L" nos rtwibv ONSITE SEWAGE SYSTEM S g ti - Lott Hole Should Be Neat To End Cop AmPROWcu DEPARTM V fp'I,ABOWAAND HUMAN RELATIOaIS ,r Ft. DIVISION OF SAFETY AND UILDINGS R SEE CORRESPONDENCE X Inches y Inches Z- Hole Diameter _L/e; Inch Signed: 124 Lateral_ Inch( s) License Uumber: Manifold Inches Date 2L2 Force Main Inches # of holes/pipe.2-, Invert Elevation of Laterals Ft. N A G ra C~~s o y N (D A N 0 0 n M ~a N by 1 ~ N 1•r fD % - a rt n 0. (D 9044 ~ 3 x a 0 5 M :3 , f'r b' Z A ~ t~ rt p y W a • as „R PAGE OF PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS VENT CAP 40 C. I. VENT PIPC WEATHER PROOF APPROVED LOCKING f r-T I 25' FROM DOOR, JUIJCTION BOX MANHOLE COVER WINDOW OR FRESH I2"MIU. AIR INTAKE GRADE I I 40 MIN. L_- !B"MI coNOUIT Ia"MIIJ. fAJI_.F:l' PROVIDE I ONStTW-SYSTEMI I I A W/ C. PPROVED . P I P F. JOINT A I I i I APPROVED JOINTS EXTEN PDIhJPf• 3' I II W/C.I. PIPE XT II ONTO 601.10 SG.;. B I 1 1 ALARM EXTENDING 3' ONTO SOLID SOIL APPROVE 1> C DEPARTMENT OF INDUSTRY, LABOR AND HUMA) Twns DIVISION OF SAFETY AND BUILDIN I 1 PUMP --j I OFF D SEE CORRESPOND0 - CONCRETE BLOCK 115 RISER EXIT PERMITTED ONLY IF TANK MANUFACTURER HAS SUCH APPROVAL SEPTIC AND 5PECIFICAT10kiS 1 DOSE TANKS MANUFACTURER: ~S NUMBER OF POSES: PER pAy TANK :AZE: GALLNS DOSE VOLUME g~j.1 ALARM MAIJUFAGTURCR' --rY s nle INCLUD!!::. Z.;C„FLOW: _ 1&2 'GALLONS MODEL NUMBER: CAPACITIES: A- 3IJCHES OR .A GALILONS SWITCH TYPE: 41-6 " ~.~~i I tq." , PUMP MANUFACTURER: 4 B C = = ~,INC INCHES . OROR~ GGALLONS MODEL NUMBER ZTT,, : D.-INCHES OR -d GAAMIOS SWITCH TYPE: MOTE: PUMP AND ALARM ARE TO BE PUMP DISCHART.E RATE 7 _GPtA INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE Dj°? WGEN PUMP OFF AND DISTRIBUTION PIPE.. FEET + MINIMUM NETWORK SUPPLY PRESSURE , . , 2.5 FEET + ca~ FEET OF FORCE MAIN X , Fy ' ' IooiLFRICT101J FAGTOR..44~~ FEET _ TOTAL DYNAMIC HEAD = FEET INTERNAL. QIMENSIG d NC F TANK: LEAIGTH ;WIDTH ...;LIQUID DEPTH SIGNED: LICENSE NUMBER: Zr -117 DAT E: 42Z-14Q - ~ k Eta Ypp a GOt1LDS SUBMERSIBLE SEIWAGE''AHD EFFLUEH r . EP0311 ODIREP0311 142 EP0311 1/3 HP 115 V EfflUWt Rnp t,.', F a~ ~`+r Submersible - Effluent Pump . MODEL EPol» ,rt.. SIZE /e SOLIDS ; METERS FEET P, 25 20 Y. 10 } 21 24 28 32 36 40 d. 0 00 4 e 12 ?d GPM t 2 S _5 0 7.5 m1/h 0 t.: CAPACITY 0 ~s Performance 3885 Curve 4, •.cMRS rccs t MODEL 3885 •~-~N- n SIZE 3/4" Solid ' to 20 10 ss ".x WE0?H-- 4 S0 IS - WEOSH 1 1 . - ■ ti, µS.~ d VV P~~ 40 WE 10 1(. 30 y _ WE03L 4 - so 90 100 Ito 130 orm ° °0 to 20 W 10 w •o _J -~J 10 _ 30 WAt CAPACITY LIST DISC. 3/4' solids 491.55 329.3S DOLT 'E03111, 142 WE0311L 1/3 HP 115 V taw H 3/4" solids 491.5S 329.35 (XxSR.E0311t1 142 WE0311M 1/3 HP 115 v Mod H 3/4" solids 704.25 47.1.85 Iz. . GpUFS.c 0 1111 142 WE0511H .1/2 i'P 115 V High H ti . r Hi: 3/q'• solids (44].65 565.25 L. a GOUNco?12H 142 1.'E071'1i 3/4 tip 230 V High ~s ~t•~~SEE'FC4,LOWIHG PPGE Ftii PIRFCRi4ANCE AA>D SPOCIFICATICRS. PAGE 07u =7T 30 DA= IO/88 State of Wisconsin \ Department of Industry, Labor and Human Relations SAFETY & BUILDINGS DIVISION 1053A East Green Bay Street P.O. Box 434 Shawano, WI 54166 October 16, 1990 Calvin W. Powers, JR. RR3, Box 249 New Richmond, WI 54017 RE: Plan Number: 590-31115 Dear Mr. Powers: The mound dimensions that were originally submitted for Steve Forest, Plan INS90-31115, are correct. The Revisions that I have placed on the Plan are for a slowly permeable mound and do not pertain to this mound. I apologize for any misunderstanding. If you have any questions, please feel free to call me at 715-524-3626. r Sincerely, Karl Jennrich Plan Examiner Private Sewage Section , SBD-8020 (N. 08/88) ST. CROIX COUNTY rY r. WISCONSIN n Y A3' ZONING OFFICE -r' ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 Aug. 24, 1990 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 Dear Sir: An on site investigation for the Steve Forest property, located at the SW 1/4 of the SW 1/4 of Sec. 24, T31N-R19W, Town of N. Somerset, St. Croix County, revealed suitable soils at a depth of 30 inches below which seasonable high ground water was noted. This site should be suitable for a mound. Should you have any questions, please feel free to contact this office. ("Since ely, es K. Thompson Assistant Zoning Administrator cj COMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 jot& kt~ 715-962-3121 800 - 962 - 5227 i ST. CROIX ZONING REPORT NO.S 17433/01 PAGE 1 ST. CROIX COUNTY REPORT DATE: 1/30/92 COURTHOUSE DATE RECEIVEDS 1/29/92 HUDSON, WI 54016 ATTNS THOMAS C. NELSON Iq p-,, OWNER: Steve 6 Laurel Forrest i a LOCATION: 2015 Hwy 35., Somerset COLLECTORS St. Croix County Zoning DATE COLLECTERS 1-28-92 TIME COLL.ECTEDS 2:30pm SOURCE OF SAMPLES Kitchen faucet DATE ANALYZED:1-29-92 TIME ANALYZED:2:00pm COLIFORM: 0 /100mI INTERPRETATIONS BacteriologicalLy SAFE NITRATE-NS 3 ppm Above 10 ppm exceeds the recommended PubLic Drinking Water Standard. Coliform Bacteria/100 ml,- Nitrate-Nitrogen, mg/L LAB TECHNICIANS Pam Gane NpEP04 WI Approved Lab No. 19 E < Means "LESS THAN" Detectable Level, Approved by: 0 PROFESSIONAL LABORATORY SERVICES SINCE 1952 ST. CROIX COUNTY ZONING OFFICE St. Croix County Courthouse 911 4th Street Hudson, WI 54016 Telephone - (715)386-4680 The St. Croix County Zoning Office offers the service of septic and water inspections to Lending Institutions, Realty Firms, and private individuals. Completion of this form is essential so that the property can be located. Please provide the following information, enclose appropriate fee made payable to St. Croix County Zoning Office, and mail, along with form to the above address. Testing will be done as soon as possible after fee and form are received. WATER TESTING----------------------------FEE: $ 25.00 XXXX (For nitrates and coliform bacteria) WATER TESTING FEE: $127.00 (For VOC'S) SEPTIC SYSTEM INSPECTION-----------------FEE: $25.00 (Determines if system is properly functioning at time of inspection) Property owner's name Steven A. and Laurel J. Forrest Property owner's address _ 2015 Highway 35, Somerset,-WI 54025 Legal Description SW 1/4 of the sw 1/4 of Section 24 , T 31 N-R 19 Town of Lot Number _____,Subdivision Name G~ FIRE NUMBER 2015 LOCK BOX NUMBER ~ ~ -10~P • 7~ 1 Color of house Realty sign by house? If so, list firm: PLEASE CALL LAUREL AT HOME FOR AN APPOINTMENT - TELEPHONE #247-3290 PLEASE INCLUDE, IF AT ALL POSSIBLE, A MAP,i.e,COPY OF PLAT BOOK, WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET. Testing of residential water requires a sample that is fresh. If the home is vacant, and has been so for some time, the water line must be purged by running the water for several hours before the test can be conducted. WINTER TESTING: Many times water lines are turned off, or sill cocks are turned off, making access to the home necessary. If this is the case, please make proper arrangements with' this office to ensure time when entry may be gained. Firm or individual requesting services: Bank of Somerset Telephone Number (715) 247-3348 REPORT TO BE SENT TO: Bank of Somerset, ATTN: Kristen Dixon, P.O. Box 220, Somerset, WI _ 54025 Closing date ASAP Signature