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HomeMy WebLinkAbout004-1086-80-001Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)J. 'ermit Holder's Name: City Village X Township Tull ,Michael & Bonnie Cad ,Town of :ST BM Elev: Insp. BM Elev: BM Description: ~3 ~~ ~ TANK INFORMATION n TYPE MANUFACTURER ~ CAPACITY i Septic / I~~~ ~ W F.~1 ~..~.._ ~ /~ Dosing ~ S v ~ ~ DQ ~J a ld/z. 5ZS Holding TANK SETBACK INFORMATION TANK TO ~ P/~ ^ dw K WELL BLDG. Vent to Air Intake ROAD Septic ~~ ~ /~ 7 ~ 78 ~ FS'7 Dosing /6Q ~ ~~~ ~/ / g7 Aeration Holding ;PUMP/SIPHON INFORMATION ~V Manufacturer / Demand v]~~ GPM Model Number ' I G ~~ G W ~ c, 23, (01 TDH Lift 2~ • Friction L oss 3.13 System Head ~, 5 TDH Ft 3 i. zc.v Forcemain Length ~ ~Z Dia. Z Dist. to well 38' ~ C[lll ~RS(]RPTION SYSTEM County: St. CroiX Sanitary Permit No: 515144 0 State Plan ID No: Parcel Tax No: 004-1086-80-000 SectionlTown/Range/Map No: 35.28.15.557 ELEVATION DATA Sc 7.4 !hR'.~~, /D1S STATION BS 3 . ~ (~ HI /03. Jlo FS ELEV. l1~ Benchmark y. ~~ ion, v rt~G AI . BM ~~n,(no1.e~ /~ ~ ~.~ 33 Bldg. S wer ~' ~. 5s~ ~5. 37 SUHt Inlet * e~~G J $Z .75 St/Ht Outlet * 9,7[ ~ Z .sy Dt Inlet ,~ ~~ ~$ $Z • 37 Dt Bottom .~ ~. O ~ ~~ /~ Header/Man. 5 5 /~z • 75 Dist. Pipe ~j, ~j(p Jvz• 33 Bot. System ~O, ~3 /a 1. ~~ Final Grade St Cover ~~ ~~ 9Z 92•~ ~5 • ~~ 33 / _ iA /~~ /1~R ~ VY~ /~ /5. 8~i BED/TRENCH IMENSIONS Width ~ ~ Length / No. Of Tren es PIT DIMENSIONS No. Of Pits ~ Inside Dia. ~ Liquid Depth D ~ ~ ~3 ~ ~ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING MBER OR Manufacturer: ~ INFORMATION ~ / CHA Type O System: ~ 7~~ y /C~ ,f J i1 UNIT Model Number: ~ rIICTRIRI ITIf1N CYCTFM W /G6l ~ Header/Manifold / /I l s ~ Distribution / ~t~ v i~ ~. S ~ ~ ~ ~ x Hole SizLe / ~ r/ x Hole Spacing ~ ~ ~ VenJit9 Air Intake J•~~~ • Dia ' Length Z' z Dia Spacing z ' ' length ~ ~ 3Z ~ .~. Cnll ('_fl\/FR ., o...~~...e e..~re.,,~ n..i.. vv Mni~nrl nr D+_r~rarlP SvstPms Only ~Jl .. _ I_. _ .~-~~-~~7~ - - Depth Over - Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Z tj~'~ BedlTrench Edges ` Topsoil I ~ `~I vas 0 No ~ Yes ~ No Z •, 0 Dom, COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~ / Z~ / C • ~ n Inspection #2: / / Location: 3138 Pierce St. Croix Rd. Spring Valley, WI 54767 (SE 1/4 SW 1/4 35 T28N R15W) 40 acres Lot ~`'`0y Par~l No: 35.28.15.557 ~ 1.) Alt BM Description = ~~~ sue`"`" P~ ~ ~ ~ ~ ~ ~ 4 2.) Bldg sewer length = ~~ ~ ~ ~~ - amount of cover = 5 ~o,,.~„ Plan revision Required? ~Y~ Yes ~No ~ ~~ ~~ Use other side for additional information. _ __ Date Insepctor' Signat SBD-671 p (R.3/97) 6 3 75, Cert. No. ~ ,~_A _ R~p~ac,~m~~ Safety and Buildings Divisio t ` ~ ~ 201 W. Washington Ave., P.O. Box Sd~, f~Coi ~ iscons~n Madison, WI 53707 - 7162 Sant Permit Number (to be filled in by Co ) Department of Commerce (608) 266-3151 5~5~ Sanitary Permit Application State Plan I.D Numbcr . In accord with Comm 83.21, Wis. Adm. Code, personal information you provide > C j ~ ~ • 5.5 / 5 may be used for secondary purposes Privacy Law, s 15.04(I)(m) Project Address (if diffc nt than mailing address) cc Sd- ~; 1. Ap lication Inf rmation - Ple Print All Information • 1' +Y~:v . c,r~.. ^~' ~3~3b ~J Property Owner's Namc ~~~ ~, ~ ~oo~ T' SEP Parc~# Lot # Block # ~~~f - - j~ aaio Property Owner's Mailing Addr s S~ LHUIx~V~"" < / ~ •~-~N ~~ pLpNN1NG S, ZONING OFFICE ° ~ S Property Location /~C ` .7 ~ ~~ 1~ ,r . U~ lilt t-~' t"t ' S ~ ' ' Ciry State Zi d C Ph N b w /., Section ~, , f n ~~ ~ ~ -~ p o e one um er (circle ) T ~ ~ W T of Buildin ( k ll th t l N; R ~ot . yp g c c a a app y) I or 2 Family Dwelling -Number of Bedrooms lG Subdivis' me CSM Number ^ PublidCommercial -Describe Use ~f D ~ /U ~I~ I'G~~ ^ State Owned -Describe Use _ ~~ ~,,~ ~ ~aiA ~ D T` ^City_^Villagc~Township of 1[I. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ^ New System ~.Replacemcnt System ^ Trcatment/Holding Tank Replacement Only ^ Other Modification to Existing System B• ^ Permit Rrnewal ^ Permit Revision ^ Change of ^ Permit Transfer to New List Previous Permit Numbcr and Datc Issued Before Expiration Plumber Owner IV. T e of POWTS S stem: Check all that a 1 D/ ^ Non -Prtxsurized In-Ground ^ Mound > 24 in. of suitable soil ~ Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constrtxted Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter Aerobic Treatment Unit ^ Rccircul it Sand Filter ^ f ~ Recirculating Synthetic Media Filter ^ Leaching Chamber ^ Drip Linc ^ Gravel-less Pipe ^ Other (explain) V. Dis enallTreatment Area Information: Design Flow (gpd) Design Soil Application Rat dsf) Dispersal Arca Required ( Disper s a l Arca Prop osed ( System EIev ation ~ / ZZ/ ~ ~IZS / (~ JJJ l / ~-f /T' ~ v ,/ ~ ~ D~, //~~ V w VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Stec l Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing ~ ~~~ ~ Tanks Tanks ~ ~ a Septic or Holding Tsnk ~~~ _ ~O f Aerobic Treatrrxnt Unit Doringcwmber --, 80~ I C, VI1. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plum 's Name (Print) Plumb 's Signature MP/MPRS Number Business Phone Number ce r ~ ~ 2Z-,oSZ 7/~-772 - 3Z/ . Plum s Address (Strut, Ciry , State, Zip Codc) j ~ 2 /// ~sI G ~'/ `i(~ w VIII. Coun /De artment Use Onl .~A roved PP tsa Sanitary Permit Fcc (includes Groundwater Datc Issued lssuin cot Signature o Surcharge Fee) ~ r _ ~ e ~ ~6 `O J I$ ~ iven Reason nial y f ' IX. Conditions of ApprovaVReasons for Disapproval 3' O 1 e ~~ ~ ~ ~ 6~ ( 7 ~ r SYSTEM OWNER: ~ 1. Septic tank, effluent filter and [~,~„ G ~ ' r dispersal cell must all be s~~%~in~~ / ' as per management plan provided by pkarltier. t ~/~ 2. AU setback requirements mutt bs ~ ~~ Lowe f"~onS + ~ /~~~j'C, ~~t,1e.A. Y~ ate. as per applicable code ~ ~. 1 . _.,...r.... ~._.., t.., .,,~ ..,.,,u,y unryt tur the sysrem on piper no[ tear roan a u1 x I t tncttes in riu SBD-6398 (R. 01/03) __ Sr~s~ S.3S Tz8,~1~~ Y / c~V b~ I` J ~ ~~ ~, r 11 ~ ... ~ is pb$ 0 v '~~ a ~, 'w Q, \\ ~/ ~~ v,, mil'`` gba e~sa ~ T .. ~ ~ "~ c.v.e~ks C , ~ `ate ~.~ s...pf~c. ~-nk- `~' Fr r PL52S __ ~' ., c.J~ ~ ~ ie ~>~ ~~ ~< ~ -~ to ~. , - - - ~ ~~~~ ~o~e 1~~ g ,S ~p~tb~ Of ~Ldl,~/ JW (~/ILEV f{~~COPY Srfs~ 5.35. T26 ,~~5~ ~~ ,,,;,~ ~'t' _~, rtie~ I -}- s L loop v b~ ~~ i` ~ ; i/ '` ~ '~~~ I '~ _; ' 2' S '~~ j i _ ~b-1~ _. __ ~~7 ~rce . ~~ `~ . '~ b _~ w ~ ~; q \ ~ ~~ \ ~`~i/ _ ~/ . _ _ ~. 0./ i ~ ~~ A^/ i V ~ee~.S C. ~` gao ~~ a~ ~i ~+ i fly ~sf ~ ~ r ~~~~ (~o~~ ~C $,S_ .. ~vt~a?Y~ a~S~d~eL S!~Cs,/ne~ , /v ? ,t~' --^`_._- commerce.wi.gov isconsin Department of Commerce Jim Doyle, Governor Richard J. Leinenkugel, Secretary August 20, 2009 CUST ID No. 226524 ROGER L TIMM TIMM EXCAVATING 3128 20TH AVE WILSON WI 54027 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/20/2011 SITE: Mike Tully 3130 Pierce St Croix Rd Town of Cady, 54767 St Croix County SE1/4, SW1/4, 535, T28N, R15W Safety and Buildings 3824 N CREEKSIDE LA HOLMEN WI 54636 Contact Through Relay www.commerce.wi. gov/sb/ www.wisconsin.gov ATTN.• POWTS Inspector ZONING OFFICE ST CROD~ COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 Identification Numbers Transaction ID No. 1695575 Site ID No. 750547 Please refer to both identification numbers, above, in all comes ondence with the a enc FOR: Description: Mound /Three Bedroom /Sloping Site Object Type: POWTS Component Manual Regulated Object ID No.: 1237033 Maintenance required; Replacement system; 450 GPD Flow rate; 16 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual -Version 2.0, SBD-10691-P (N.O1/O1), Pressure Distribution Component Manual -Version 2.0, SBD-10706-P (N.O1/O1); Effluent Filter 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. Cnra~ 1 The following conditions shall be met during construction or installation and prior to occupancy or use: i ~a Reminders 0~~r.~z~~E ~ t• of • This system is to be constructed and located in accordance with the enclosed approved plans and with the `~~ component manuals listed above. SEE t.Of • The changes made in red to this plan on 8/20/2009 by this reviewer were acknowledged and approved by the system designer. • 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. ROGER L TIMM Page 2 8/20/2009 • Inspection of the POWTS 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 ap rp Dyed 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 ins ecn tors. Owner Responsibilities: • Comm 83.52 Responsibilities. 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. • Comm 83.55 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, ~~~~~ ~~~ Charles L Bratz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday charles.bratz@wisconsin.gov Fee Required $ 250.00 Fee Received $ 175.00 Invoiced Amt $ 75.00 This Amount Will Be Invoiced. When You Receive That Invoice, Please Include a Copy With Your Payment Submittal. WSMART code: 7633 cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544 ,Friday, 7:00 A.M. To 3:30 P.M. Notice: Starting July 1, 2009, no person or entity may engage or offer to engage in construction business in Wisconsin unless they hold a Building Contractor Registration, or equivalent, issued by the Safety and Buildings Division of the Wisconsin Department of Commerce. "Construction business" means a trade that installs, alters or repairs arty building element, component, material or device that is regulated under the commercial building code, chs. Comm 60 to 66, the uniform dwelling code, chs. Comm 20 to 25, the electrical code, ch. Comm 16, the plumbing code, chs. Comm 81 to 87, or the public swimmingpools and water attractions code, ch. Comm 90. The term does not include the delivery of building supplies or materials, or the manufacture of a building product not on the building site. For further information, go to our website: www.commerce.wi.gov/SB/SB-Buildin~ContractorProPram.html ~ , a + MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name Owner's Name: Mike Tully Owner's Address: 3130 Pierce St. Croix Rd. Spring Valley Wi. 54767 Legal Description: SE / SW S 35 T28 R15 W Township: Cady County: St. Croix Subdivision Name: NA Lot Number: NA Block Number: Parcel I.D. Number: 004-1086-80-000 Plan Transaction No.: RECEIVED AUG ~~ 5 2009 SAFETY ~ ~3UILDINGS Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications ~®i 1 ~ ~/~. u.~~ ~--t.~n Designer: Roger Timm License Number: Date: 08/04/09 Phone Number: Signature: ~f/tt. ` VED 7OFCOMMERCE rTEY 8 GS ~~ DESPONDENCE 226524 715-772-3214 Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01101), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01) Version 5.1 (R. 06/06) Page 1 of 7 Mound and Pressure Distribution Component Design Design Worksheet Site Inform ation (R or C) ~__~ Residential or Commercial Design j ____300.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 = 150%) 450.00 Design Flow (gpd) 10.00 Site Slope (%) 100.00 Contour Line Elevation (ft) 16.00 Depth to Limiting Factor (in) 0.40 In-situ Soil Application Rate (gpd/ft2) D__is_ t_ribu_tion Cell Information 93.001 Dispersal Cell Length Along Contour (ft) _ _ _ ___ 1.00' Dispersal Cell Design Loading Rate (gpd/ft2) ____ _ _ 1' Influent Wastewater Quality (1 or 2) 3j Z5~ Pressure Disribution Information (C or E) ! C! Center or End Manifold 2.42 Lateral Spacing (ft) 4I Number of Laterals 0_156; Orifice Diameter (in) _ _ _ _4.00_ Estimated Orifice Spacing (ft) _ L _ 2.00 Forcemain Diameter (in) 257.00 Forcemain Length (ft) 80.00 Pump Tank Elevation (ft) 4.55 System Head (ft) x 1.3 X~ 21.33 Vertical Lift (ft) 3.22 Friction Loss (ft) nLJtj 0.00! In-line Filter Loss (ft) ~j 29.10 Total Dynamic Head (ft) Lateral Diameter Selection in. dia. o tions choice 0.75 1.00 x _ _ _ ; 1.25 __ . x 1.50 _ x ; x ~ 2.00 _ _ _ x 3.00 x i_ _~ Treatment Tank Information ~ 1000.00 Septic Tank Capacity (gal) Weeks Concrete Prod Manufacturer Note: Sand fill (D) calculations assume a Table 83-44-3 in-situ soil treatment for fecal colfform of <= 36 inches. 4.84 Cell Width (ft) Are the laterals the highest point in the distribution Y network? Enter Y or N If N above, enter the elevation (ft) of the highest point. 10.23 ftz/orifice Does the forcemain drain back? ___Y__ Enter Y or N 41.92 Forcemain Drainback (gal) 84.01 5x Void Volume (gal) 125.93 Minimum Dose Volume (gal) 23.69 System Demand (gpm) Manifold Diameter Selection in. dia. o tions choice 1.25 x 1.50 x x 2.00 3.00 G___a_Ilo_n_s_/Inch Calculator (optional) ___ I Total Tank Capacity (gal) Total Working Liquid Depth (in) ~~ gal/in (enter result in cell 649) Dose Tank Information Effluent Filter Information . __. _ I ___ 800.00 Dose Tank Capacity (gal) Poly Lock 'Filter Manufacturer i 21.74; Dose Tank Volume (gal/in) PL 525 'Filter Model Number Weeks Concrete Prods Manufacturer __ _ ._. Project: Page 2 of 7 Mound Plan and Cross Section Views 1- 1 -r -f _f -1 Mound Component Dimensions A 4.84ft E 25.81 in H 1.OOft K 11.10ft B 93.00 ft F 9.50 in z 14.75 ft L 115.20 ft D 20.00 in G 0.50 ft J 6.83 ft W 26.42 ft 450.12 (ft2) Dispersal Cell Area 1822.14 (ft2) Basal Area Available 4.84 (gpd/ft) Linear Loading Rate 9.30 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 103.46 (ft) F 101.67 (ft) --- • - . Dispersal Cell ~~~~~~~~~ Elevation { ; ~ ., .. '' ` ` `' " ' "'"'" " 100.00 (ft) Contour Elevation 10.0 % Site Slope Geotextile Fabric Cover Shading Key m o. ~- Dispersal Cell See lateral details on 1^ -Topsoil Cap c °~ 1.5 ft • • • • • • • • • • • • • • • Page 4 for number, size, ~~~~~~~ Subsoil Cap ~ o ~:~•'•'•'~"•"•"•'•"•""•"•';•"•' I and spacing of laterals. B ASTM C33 Sand `6 ° ~~~•:•';.:~'•• "~;_ , • • • Laterals are equally ® Tilled Layer ~ ~ 0.5 ft ~ ~`~:~; Typical Lateral • `~ spaced from the _~ distribution cell's © Aggregate ~ o .~ ~ centerline in the ~'~: distribution cell (AxB). ~' A Project: Page 3 of 7 Center Connection Lateral Layout Diagram Force main connection via tee or cross to manifof0 at any point. I P •=Turn-upwi'tsell valve or IFX~IE~o12' xT2->I cleanoutplug Holes drilled on the Dottorn of the lateral. S .~L Numberof Laterals 4 Lateral Diameter 1.50 in Lateral Length (P) 45.78 ft Lateral Spacing (S) 2.42 ft Lateral Flow Rate 5.92 gl System Flow Rate 23.69 gl Total Dynamic Head 29.10 ft Laterals & force main of PVC Seh 40 per CONINI Table 84.30-5 Orifice Diameter Orifice Spacing (X) Orifices per Lateral Orifice Density Manifold Length Manifold Diameter Forcemain Velocity Laterals are identical 0.156 in S-_:~ ~, .< - 11 10.23 ftz/orifice 2.42 ft 1.50 in 2.42 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and -- 1~ Comm 16.28 WAC ~ 4 in. min. Disconnect ~_ y - Tank component is properly vented Weeks Concrete Prod Ca aci 800.00 Volume 21.74 Manufacturer Gallons gal/inch ~- A B C D Dimension Inches Gallons A 19.01 413.19 B 2.00 43.48 C 5.79 125.93 D 10.00! 217.40 Total -- -- --- _ 36.80 800.00 E- Alternate outlet location Forcemain diameter ~ 2 in. Weep hole or anti- siphon device P= ump off elevation (ft) 80.83 Do• se tank elevation (ft) 80.00 Alarm Manuafacturer Septronics Alarm Model Number 2501 _- __ __ Pump Manufacturer Gould __-__ Pump Model Number !WEOSH Pump Must Deliver 23.69 gpm at 29.10 ft TDH Project: Page 4 of 7 Mound System Maintenance and Operation Specifications -- - - _ --- Service Provider's Name Roger Timm _ _ _ Phone: 715 772 321_4 POWTS Regulator's Name __ St. Croix ' Phone! 715 _386-4680_ System Flow and Load Parameters Design Flow -Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Ffow -Average 300 gpd Maximum BODS 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450.12 ftz Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frecwency Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound `,it~F;~ Ins ect and/or service once eve 3 ears Should ins ect and clean at least once eve 3 ears Test once eve 3 ears Should test month) Laterals should be flushed and ressure tested eve 1.5 ears _ _ __ Inspect for pondin~_and seepage_once every 3 years _ __ Miscellaneous Construction and Materials Standards Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight cap, and are secured in as shown in the mound component manual. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. Tillage of the basal area is accomplished with a mold board or chisel plow. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished .•.••••......•• ............... Grade 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Bail Valve Distribution Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Page 5 of 7 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code eneral This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals (SBD-10691-P (N.01/01), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01)) and k~cat or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance wlth 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 leaned 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 shalt be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addltion of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent faker is installed within the tank it shall be inspected and serviced as necessary. _Mound and Pressure Distribution System 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 as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L GODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODS, 30 mgJL TSS, 10 mg/L FOG, and 10' cfu/100 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 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 pertormed it should be compared to the initial test when the system was installed to determine ff orifice dogging has occurred and 'rf 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 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Continsrencv Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in lts' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. Project: Page 6 of 7 ~GOULDS PUMPS ^ Shaft: Corrosion-resistant, stainless steel. Threaded design. Locknut on three phase models to guard against component damage on accidental reverse rotation ^ Fasteners: 300 series stainless steel. ^ Capable of running dry without damage to components. ^ Designed for continuous operation when fully submerged. 3885 PROSURANCE AVAILABLE FOR RESIDENTIAL APPLICATIONS. APPLICATIONS Specifically designed for the following uses: • Homes • Farms • Trailer courts • Motels • Schools • Hospitals • Industry • Effluent systems SPECIFICATIONS Pump _ • Solids handling capabilities: 3/4" maximum. ,~_. '• Discharge size: 2"NPT. • Capacities: up to 140 GPM. • Total heads: up to 128 feet TDH. • Temperature: 104°F (40°C) continuous 140°F (60°C) intermittent. • See order numbers on reverse side for specific HP, voltage, phase and RPM's available. FEATURES ^ Impeller: Cast iron, semi- open, non-clog with pump- out vanes for mechanical seal protection. Balanced for smooth operation. Silicon bronze impeller available as an option. ^ Casing: Cast iron volute type for maximum efficiency. 2"NPT discharge. ^ Mechanical Seal: SILICON CARBIDE US. SILICON CARBIDE sealing faces. ,.,stainless steel metal parts, ~~-- BUNA-N elastomers. MOTORS ^ Fully submerged in high- gradeturbine oil for lubrica- tion and efficient heat transfer. ^ Class B insulation. METERS FEET 40 130 120 35 110 30 100 a° 90 = 25 80 U z 20 70 o so F 15 50 ° ao 10 30 5 20 0 Submersible ~=~~~~ Effluent Pump ~~ Single phase: • Built-in overload with automatic reset. • All single phase models feature capacitor start motors for maximum starting torque. •'/3 and''/z HP -16/3 SJTOW with 115 V or 230 V three prong plug. • 3/<-2 HP -14/3 STOW with bare leads. Three phase: • Overload protection must be provided in starter unit. • '/z-2 HP -14/4 STOW with bare leads. ^ Designed for Continuous Operation: Pump ratings are within the motor manufacturer's recommended working limits, can be operated continuously without damage. ^ Bearings: Upper and lower heavy duty ball bearing construction. ^ Power Cable: Severe duty rated, oil and water resistant. Epoxy seal on motor end provides secondary moisture barrier in case of outer jacket damage and to prevent oil wicking. 20 foot standard with optional lengths available. ^ 0-ring: Assures positive sealing against contaminants and oil leakage. ^ Consult factory for infor- mation on CSA listed models. AGENCY LISTINGS _ Canadian Standards Association $P FileMLR38549 ~~ File rf83318 Laboratories Goulds Pumps is ISO 9001 Registered. i H - ..... - _ ,. . . -~- -- -~-- -- _._ ! - _ -` - i... --- --.-- _ ., ._r- _ ~ - ~~-_~ SERIES: 3885 L --- '--- SIZE 3/I SOLIDS . •.. I . -- .. r F .. ~ . --.-~ ~. + I-- : RPM: 3500 & 1750 WE2 H f . _+ .~ 1 -- --.. r ~ •-i-- +- ~~SG Pfy1 _ ~ --+ ~ _ r- - ~ i ---i- --- - ,, r S FT - ~E1 ~ H ~_ ,-- --+-- --r ~ ~ .. ~ F ~._ ~, --- + -t- - . - ---, ~ ~ _EO tt.r-- .__ ~ . . ._ 1 , i_ _. _ w~a i , - ~Q -- , - -1 ._ i ,_ - + ~ I ~ ..~_ 10 00 10 20 30 40 50 60 70 80 90 100 110 120 130 140 150 160GPM 0 5 10 15 20 25 30 35 m3/h CAPACITY Goulds Pumps ©1999 Goulds Pumps ~ ITT Industries Effective January, 1999 83885 Wisconsin Departrnent of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings In accordance with Comm 85, Wis. Adm. Code i~ ~~ Attach complete site plan on paper not less than 8 %a x 11 inches in size. Plan ~'~ ~ County St. Cro1X Include but not limited to: vertical and horizontal reference point (BM), dire arcet LD. 004-1086-80-000 ~ Percent slope, scale or dimensions, north arrow, and BM referenced tQ neares d. Please p ' r ion Revie y Date ~ ~ ~ Personal information you provide may be (Privacy Law, s. 15.04 (1) (m)) 6 Q Property Owner Property Location Mlke Tull JUN ~ 5 009 ~~- Lot SE '/. SW % s 35 T 28 N R 15 w Property Owner's Mailing Address ROlx counlTV ~ i 3130 Pi S C Rd Lot,# 1 Block # Subd Name or CS~ ! ` ! c . s t. ro x erce ~ /_~ - J ~/~ J ~R/ City State Zip Code Phone ^ City ^ Village 0 Town Neatest Road S rin Valle WI 54767 715-772-4578 Cad Pierce St. Croix Rd. ^ New Construction Use: DResidential / Number of Bedrooms^~ Code derived design flow rate 450 GPD 0 Replacement ^ Public or Commercial -Describe: Parent Material Loess over Till Flood Plain elevation if applicable N/A ft. General comments and recommendations: ~ r y C~D~ ~ ~~Z<, ~ ~~ ~ZZd~ytpr/ l /~ C~'yL7~'?~t/t/ ~' Za (~Gd~ ('~'Yj~a.~~t.~~~ `std 2~' ~Q ~- ~ i~ ~~ 1 ~ Boring # 0 pit y a Ground Surface Elevation 100.0 ft. Depth to Limiting factor 17 in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP O/fl~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Efi#1 'Eff#2 1 0.9 10YR3/2 - SIL 2-f-gr mfr cs 3f 0.6 0.8 2 9-17 10YR4/3 - SIL 2-f-bk mfr gs 2f 0.6 0.8 3 17-27+ 10YR4/4 7.5YR5/6&10YR5/2f-2-d SIL 2-f-bk mfr - 1f 0.6 0.8 Boring # ^ Boring OPIt Ground Surface Elevation 100.0 ft. Depth to Limiting factor 21 in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP Dlft~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#t `Eff#2 1 0-8 10YR3/2 - SIL 2-f to m-bk mfr cs 3f 0.6 0.8 2 8-21 10YR4/4 - SICL 2-m-bk mfl gs 2f to co 0.4 0.6 3 21-31+ 10YR4/4 10YR5/6 & 4/2 f-3-d SIL 2-m-bk mfr - 1f 0.6 0.8 • redox is present at the top nd bottom inch of the horizon ~` r;rtluent ~ - = tsuu5> su 51GU mgiL ano 1 Js > su 5 i ~u mg/L '~ ~muent ~L = tsVUS ~ ~v mgrL ana i as s 3u mgiL CST Name (Please Print) Sign CST Number Mark Iverson a~ 46672 Address Date Evaluation Conducted Telephone Number P.O. Box 155 Hammond, WI 54015 June 11.2009 715-796-5664 • Parcel #: 004-1086-80-000 06/16/2009 04:20 PM PAGE 1 OF 1 Alt. Parcel #: 35.28.15.557 004 -TOWN OF CADY Current U ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): O =Current Owner, C =Current Co-Owner O -TULLY, MICHAEL F & BONNIE K MICHAEL F & BONNIE K TULLY 3130 PIERCE/ST CROIX RD SPRING VALLEY WI 54767 Districts: SC =School SP =Special Type Dist # Description SC 5586 SPRING VALLEY SP 0100 CHIP VALLEY VOTECH Property Address(es): " =Primary * 3130 PIERCE/ST CROIX RD Legal Description: Acres: SEC 35 T28N R15W 40A SE SW EZ-UT-1503/354 40.000 I Plat: N/A-NOT AVAILABLE Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 35-28N-15W SE SW Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1060/197 WD 07/23/1997 437/387 2009 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 03/31/2008 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 37.000 3,400 0 3,400 NO UNDEVELOPED G5 1.000 100 0 100 NO OTHER G7 2.000 24,000 72,500 96,500 NO Totals for 2009: General Property Woodland Totals for 2008: General Property Woodland 40.000 27,500 72,500 100,000 0.000 0 0 40.000 27,500 72,500 100,000 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch #: 511 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer ~C~ Mailing Address ~) ~CC~ ~l~e ~Cs~ S J', Y ~-c u 1`.~ Property Address (Verification required from Planning & Zoning Department for new construction.) City/State ~ Parcel Identification Number U6 y- j~~- ~0 --alXj LEGAL DESCRIPTION Property Location s ~ `/4 , ~ I-J '/a ,Sec. ~, T ~N R (~J W, Town of Subdivision ~/I/ /~ 'J~~ ~Gj'~° ,~C ~/LPi~ ,Lot # Certified Survey Map # ,Volume ,Page # Warranty Deed # ~(~ ~I~ ~ ,Volume ,Page # ' '7 Spec house ~s 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 are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms -~ ~~ SIGNAT OF APPLICANT(S) . `~ /~/~ ' DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. *** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) DOCU(v1El`xT NO. STATE I;AR OL WISCONSIN I''OIt 1T ~^IIID2 ~1 THIS SPACE RESEFVED FOR REGOROl.aG DATA ~,,~ ,Q ,•,y ~ WARRANTY E7EED '„ , .. ~~~ n t .. -.. ,_. - - __. _ • ~L~:v : L.: ~ __.. This Deed, n:~d~ het..•eel, -Laird reeves and ~~ ST. GR~OIX CO., VV! Myrt.~.ce Reeves-, YIU~T~~nd. an3- wife., _ ~; ~ ^:-' f~rR°^^-'d ... . .......... ._.... --_--- -- - !! ~. JAN 3 1994 ~ ;, AA 10.5 A.- Snci -.i`~1GLtd.~l- F ...T l.1. J..y 4i~~.. 13O~1I1-1 c- K. T1l ~y-,-- .. !~ • M husba,id..anr1.tyife, Zs. mcaacital st,~rvivorshi~- - .- - l ~ ~~~,t~Q.Q. j property, 1! ~Sl~roft7ee~s ~~ --• . . .. ...... .............. .. .. _ ..- --- --'---...-, Grantee •_. ~.Tl$I79SS6(;~I, n^hat the said Grantor, for a valuable cousiderat~on._._.. I' ~' conveys ;o Grantee the iollovnng descrihed real estate in - 5t ,. CT:o15f-_-- _ ~4 - iUC ~ gox 199 '' - County, State of ~Viacongin: ~f River falls, WI 54022 i! >~ of SW 4 of Section 35-28-15 . Tu_e Yrrccl No_ ___________________________________ __ n _~~ 'Phis ~ 5 .__..._. homestead property. •--- (iS) (13 RJt) - Together with ali and singular the hereditamenea and appurtenan^es thereunto belonging; Arc?.------'-~r311 ~Or ....-'-----------'---------• --~----=. warrants that the titic is good, indrfeasible in tee simple and tree and clear of encumbrances except muriYC3j7a1. and zoning orda_nasices ~ eesema_nt.s for public utilities, and building restrictions, if any, and wlil warrant and defend the same. Dated this ...:..........---~$~-'-------- - .-...._..:. day of ...---- ......_.Ae.aembe.r ----....:. .:............ IcJ.... -- -- -------- ---- ------- ----- ---'--- •--------.-..........(SEAL) n .....................................• --•----------------- --------(SEAL) ,. - ,ft...,y' ---1.~>~ ~ -_. .. _...._. .......... ...(SEAL! Laird R;=eves ,_ i 7.,~~ `~ i .._(SEAL) -Myzt-ice, itee_yes......_ -- - - --------- AiTTH]uN'TYCATION AG i3NO W LEDGMENT '~ Sigrstare(=; •-•------------•--------'--•-----•-------•-•-•--•----------- STATE-0F S:~SCd1rSIIQ ~ ii ss. ~' authertticatel this _______da,• o£___________________________ 19...._. P~r~ona'ly came before may this .. -----•-------.--daY of u LfCtto}t~-IH~'-~Ty2~~Y_-•--•---_--, 19--3__ L'he abote named ±i --- •---------------------------•---•-•-------._...--•---•--------._._•. ---....._ Tf -11 . * ! TITLE: MEMBER STATE BAR OF LlISCONSIN ---_-_---------------___..._.____.._--......_...._..-__........_. ....... ~~ . .rp not. --•--------~ -- ._.. , ~ --------•----• ..............................................•---......_.. i;horized by § 705.t~1i, Wiv. Sta.ts.) ' to me known to 6e the person . S____..__. tcho exticuted tht, {! ioregoinc~iact;-Lmcnt_anrl nak nn~vla.l trra kha . amn. !' THlS INSTRUMENT Wq5 DaZnFTF_t7 BY _ i L ( InJ l.•11 C pq„rF L~a~ ~~ i3 F 1 J 1 V! U fl ~ii ( Attor ne KrUeCT r J t ~ t - -- _ - - - -.--_ e ua ~. ,.• -- . River..Falls ,.. Wa. sconsin .._- .- Not•t `PlEY,T c f PL~?^.^. ~ ~+ ,J37- Coun•~~-, `6i-, IX 77'` L.~-f -~' xp; QIi~ !Si!;niku rt•s may he anthem-icated or acl: no«Ic.itre•1. Bnth , 93c C'W ~ r •te expiration '~. .~- ... :Ire not necesea rc.) t,.r ria:cr ~ •...CCn7,fJr.-.. ..> 19.3...1 .... ...-. -_....F_.._... •l~inm... of n^rsnne ai~n;- :?i. •: cn, n. - •h...r S•! he x.....•.I ..- rr nt•: •! !...1. . .. :.fi•-.r n.n~.n,... !+tn R[t A:V TY nrr•_n Yi:\if: l1Att IrY Wt>~.'IS\,~i ~i I•: i,:rnn -in [.~v :l Ulnnk !~... In:. - F-GIt11 Nn. 1.-!'J 4. •Iii..w•rkea. ~Y is. ~ _.. ` \