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HomeMy WebLinkAbout028-1022-70-050 Wisconsin Department d Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 561091 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Walton, Richard D. Famil Trust Rush River, Town of 028-1022-70-050 CST BM Elev: Insp. BM Elev: BM Description: Sectionlrown/Range/Map No: /ap k7 W / GS 14.28.17.127A TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. . vv Septic ; es" 6/ , 4640 Benchmark -LS /641.Z44 /64. Dosing r J i Alt. BM o ,w ~n (o 6,6 Z u, 3.5 160.775 Aeration Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. nt to Air I ke Dt Inlet u Septic '2166 I , rA' -7 Dt Bottom 7:r / Dosing ~7 /66' AA /Z Header/Man. 5, a 25 Aeration Dist. Pipe IZ at O Holding d'j Bot. S stem S.qZ y$. 33 97 2145 PUMP/SIPHON INFORMATION Fin Grade Z 0y 9-1`. 17 Manufacturer Demand St Cover W.. 49 a,~l GPMt 3. S Mu. 7 Model Number 45r P 64+ 01 TDH Lift Frictio, OSS System H;04_ ITDHI/ / jt Forcemain Length Dia. i i Dist. to Well Z N SOIL ABSORPTION SYSTEM BED/TRENCH Width Length I No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 2 5 C" . A SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR j~ Type Of System: UNIT Model Nyfn` % tL~ 4 DISTRIBUTION SYSTEM (y~A-yt-3 / CA'a . Header/Manifold ~I IDistribution x Hole Size x Hole Spacing Ve to Air Intake , e~ Pipe(s) e" Length tJ Dia T Length `Dia Swing U SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only s Depth Over / Depth Over xx Depth of =~~ded xx M Iched Bedrrrench Center 1 Bed/Trench Edges ` Topsoil ~ Yes ❑ No Yes ® No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1 - / Inspection #2: Location: 1962 30th Ave Baldw', WI 54002 (SW 1/4 SE 1/4 14 T28N R17W)` NAJLot~ Parcel No: 14.28.17.127A 1.) Alt BM Description = Z~' 66 4-b 2.) Bldg sewer length = 1 ~P ~a r - amount of cover= ° , g h Pmt Gb IDOJ~, Na r- t~ a ~cstj Plan revision Required? ❑ Yes No to Use other side for additional information. [4-4, t SBD-6710 (R.3/97) Date Insepctor's ignature Cert. No. B3 98.82 B5 98 36 B2 99.68 B1 98,96 B4 93,12 ■ ■ Install 3 Quick 4 trenches 11' deep 5 a Gound Level o g Exi\1ng SheGround Level ".02 w tye,,J Install 3 Wieser 1000/650 Combo tank Plot Plan 1'-40' Z 0 0 20 40 Scale in Feet County e Safety and Buildings Division O~ ~vo \ 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to b filled in by Co.) a Z S P Madison, ®I 53707-7162 o t ~ C °r~` State Transaction Number i ' rmit Anp~lical ion f tthis form to the aa," overnmental unit W' Co ubmiss In accordance with S*81 is required prior to ob ttpe ote: Application forms for stge-owned P are submitted to Project Address (if differen mailing ad the Department of Saro nal Servies. Personal information you ir6W6W,ay be used for secondary purposes in accordancPrivacy Law, s. 15.04 1 (m , Slats. 1. Application Information - Please Print A formation Property Owner's Name l Parcel # R i f 'o c.1 ©2l, t o x-'`1( 05 A tr 4w Property Owner's Mailing Address Property Location 1/ Govt. Lot City, State Zip Code Phone Number 1/,, Sech (circle one 13C VW ~t t/ l W d s ~ 4 3 J T N; R E or W H. Type of Building (check all that apply) Lot # Subdivision Name 1 or Family Dwelling - N b of Bedrooms AT- (C5sdri f 3lj~~_ S ttJ Block# ❑ Public/Commercial - Describe Use A ~ ) _ ~I ❑ City of S l Z f hY 0.s ' J CSM Number ❑ Village of ❑ State Owned - Describe Use - it V CO own of P, LC 1 y i th 3 ,Q• K III. Type of Permit: (Chec only one box on line A. Complete line B if applicable) A. ew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) List Previous Permit Number and Date Issued B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New Before Expiration Owner A - II'`e►. QcJ~°~Z r IV a of POWTS S stem/Com onentlDevice: Check all that apply) 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) 1 V. Dis ersal/Treat nt Area Information: Design F low (gpd) Design Soil Application Rate(gpds Disp al a Required ( Dispersal Area Proposed (sf) S e on it 15 D b , ~ 375 3`7 ~7 7~ z, VI. Tank Info Capacity in Total # o Manufacturer B Gallons Gallons Units U New Tanks Existing Tanks 0010. U co w 72 C7 A, J U 2 Septic or Holding Tank 10M e 5eA^ Dosing Chamber c 5D VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number -7-7-2- A06 4CjQf 2 Br0c?.", khevl V+, 4qev Plumber's Address (Street, City, State, Zip Code) ZL~ / VIII. oun /De artment t$e Only Permit Fee Date sued Issuing A Signature Approved isapprove $ #75- 13 Aw iven Reason for al IX. Cond*S;~RHReasons for Disapproval 1. Septic tank, effluentf9W a.r 3) j4w-, /~atJ~ f - A4,✓C- Q Gd Lied'. :dispersal cell must all be -A.-'1 as per management plan provkfed by plus( , 2. Al setttack requirements mustbR,ltnfd is per epl"ble code 1 ordinal ` Attach to complete plans for the system and submit to the County only on paper not less than 8 121 11 inches in size SBD-6398 (R. 11/11) CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: P/c~ay) W d~ t t Owner's Name: 1 W1>~ W d~ Owner's Address: w'-/ G 0w u>>s S ~f o® 7 Legal Description: J s"C/V,S Ot- W F Township: "l ( d v ~v County: r~ cini y Subdivision Name: Lot Number. Parcel ID Number. Page 1 Index and title Page 2 Plot Plan Page 3 System Sizing & Cross-Section Page 4 Filter Specs Page 5 Maintenance Information Page 6 Management Plan Page 7 St. Croix Cty Septic Tank Maintenance Form Page 8 Warranty Deed Page 9 CSM or Plat Attachments: Soil Test & House Plans Designer/Plumber. Ryv~4-,. w"S - License Number. Date: (3 Phone Number i Aso z y 77 Signature Designed pursuant to the In-Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P (N.01101). Page 1 M I• j I•, 8 7 Z' fV f Ij ti ZLOZ• II 6 S90Z I ~90Z 1~SOZ• ISOZ •Tt7OZ Q! 'I •£ZOZ pOZ ,l 90 M V f 600 Ln N ~t00 ~ ~'f`~' i_ fn \ • N j •S86T 96T• i i -L96T l N £6T• M 'IS Pu 6 ; f 'i I ~ N N N Is M! OLST. B3 98.82 B5 98.36 B2 99.68 B1 98.96 B4 93,12 . Install 3 Quick 4 trenches 11' deep 5 4 ~ Gound Level o W EXIS IYIg ~o4eN, Ground Level 919~02 Shed (f Install 3 Wieser 1000/650 Combo tank Plot Plan 1"=40' Z O o 20 40 Scale in Feet B3 98,82 B5 98.36 B2 99.68 B1 98,96 B4 9312 = ■ Install 3 Quick 4 trenches 11' deep 5 "',~-"-Gound Levet o Exis ing Shed Ground Level 95-0-2 Install 3 Wieser 1000/650 Combo tank Plot Plan 1'-40' Z 0 0 20 40 Scate in Feet Management Plan Page 3 of 4 Owner Richard D Walton Permit # Parcel # 028-102270056 System Specs Tax ID # Septic Capacity 1000 gallon Des!gn Parameters Manufacturer Welsers sized for 3 employees Pump Tank Cap 650 Gal or 1 bedroom Manufacturer Weiser Combo Effluent Filter Symtex Estimated Flow 100 gal Model 100 Peak Flow 150 gat/day Pump Manufacturer Gould Soil Application Rate Model # EP04 0,4 gal/day/sq ft Efluent Quality BOD>30<220mg/L Max Particle Size 1/8' Start Up System will be ready upon installatin Maintenance Monitoring Schedule Inspect Tanks Every 3 Years Pump Tanks when sludge = 1/3 tank Inspect dispercement cells every 3 years Clean Symtex Filter every 13 months Inspect pumps controls & alarm every 3 years Flush laterals every 3 years I Management Plan Page 4 of 4 Operations The property owner is responsible for the operations and maintenenceof the POWTS and submissions of required reports,The quantity and quality of the wastewater stream affect the performance and longevity of your POWTS. The installation of water-saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volumn, The brine or waste from water softenners and other water treatment devicesshould discharge to ground surface whenever possible. This system is designed to handle domestic strength wastewater, food grease and oil discharging into this system should be kept to a minimum or avoided. Non biodegradable product such as tampons, cigareete butts dental ftoss, sanitary napkins should not be disposed of into the POWTS, Toilet paper is the only paper that should be disposed into any POWTS, Inspections Should be conducted by a licensed plumber, POWTS maintaner, or Septic system service operater, Tank inspections include visual inspection of tank and system for leaks or surface discharge. When sludge fills 1/3 of the septic it shall be removed by a licensed pumper, The effluent filter should be cleaned twice yearty, Contingency plan. Suitable room for alternate East of system POWTS INSTALLER Bruce Webster phone 594-3080 Septic Pumper Johnson Sanitation or Marko Sanitation P❑WTS Maintaner Johnson Sanitation or Marko sanitation Regulating Authority St,Croix County Zoning Office E Soll Absorptlon System Cross Section 4" Schedule 40 Final Grade PVC Vent Pipe With Vent Cap ft Leaching -0, Chamber ft / System Elevation N W.I ft 9-6 ft ft Soil Absorption System Plan View I ft 4h I ft ' ft Leaching Trench 1 Chambers 4" Dia. Trench 2 Header Vent Or Observation Pipe Trench 3 Leaching Chamber Specifications Manufacturer And Model Q0 I C,,,~, 4 EISA Rating ~y sq ft per chamber Soil Application Rate ?pd/sq ft gpd Design Flow - 0 '`f Soil Application Rate : 37 s EISA = I ~ Chambers 3 rows of chambers each. 1 Page of PAGE GF PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS VEUT CAP 4"C.I. VEAIT PIPE WEATHERPROOF APPROVED LOCKIAIG JUNCTIOM BOX MANHOLE COVER 25' FROM DOOR, WINDOW OR FRESH 12"MIU. AIR INTAKE I GRADE I I y" MIN. ~ 18" mild. COQDUIT 18"MIN. \ \ 11, INLET PROVIDE I AIRTIGHT SEAL / T I III / A I III I I I I ALARM a I ~I. I *APPROVED I I ON C JOINTS WITH i ELEV. FT. APPROVED PIPE 3 ' ONTO PUMP OFF r D SOLID SOIL CONCRETE BLOCK RISER EXIT PERMITTED ONLY IF TANK MANUFACTURER HAS SUCH APPROVAL SEPTIC E SPEGIFIGATIOt\.IS DOSE I TANKS MANUFACTURER: V` ~I }'Y. V IJUMBER OF DOSES: PER DAy TANK SIZE:~~~o , LED GALLONS DOSE VOLUME ALARM MANUFACTURER: h y E-I 4:f vv) INCLUDING BACKFLOW: ~7-GALLONS MODEL NUMBER: ( CAPACITIES: A= WCHES OR GALLOWS j SWITCH TYPE: l II g c INCHES OR GALLONS I PUMP MANUFACTURER: l36 A C = INCHES OR GALLONS I MODEL NUMBER: F-P (2 D- INCHES OR GALLONS i SWITCH TYPE: Sfr- 'e-G` I 4~II NOTE: PUMP AMD ALARM ARE TO BE MINIMUM DISCHARGE RATE D GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.. FEET I + MINIMUM NETWORK SUPPLY PRESSURE . . . . . - 5 FEET I + 4 FEET OF FORCE MAIN X .U.=F/jooyt.FRICTION FACTOR. `]-FEET TOTAL DYNAMIC HEAD = Jro -7 FEET IIJTERNAL DIMENSIONS OF TANK: LENGTH la'' 1 ;WIDTH ` -;LIQUID DEPTH 5 IGI`1E0: LICENSE NUMBER: DATE: - - _•~aaK t:KOSS SECTION AND SPECIFICATIONS 4" Cl VENT PIPE 12"'MrN. ABOVE GRADE E WEATHER PROOF 25' FROM DOOR. WINDOW OR JUNCTION BOX FRESH AIR INTAKE WITH CONDUIT APPROVED MANHOLE ~ FINISHED GRADE 4" Cl RISER W/ PADLOC 7 6" MIN. WARNING l ABOVE G ADE ~i --}sz_v" MI1 Is" 'IN. 6" MAX. INLET ~WATER TIGHT SEALS GAS- • 4^ T TIGHTS ; CI PIPE BAFFLE A SEAL APPROVED LM JOINTS W/ 3' ONTO ' SOLID -,r- ' ON PIPE 3' 0 SOIL C ' SOLID SO! PUMP OFF ELL'V. FT. "I OFF RISER D PERMITTM IF TANK MANUFACTU) 3" APPROVED BEDDING UNDER TANK HAS APPRO. CONCRETE PAD SPECIFICATIONS +EPTIC / DOSE TANK MANUFACTURER: NUMBER DOSES PER DAY: 'DANK Sins: SEPTIC GAL. DOSE VOLUME INCLUDING DOSE GAL. FLOWBACK: GAL. A[ARM MANUFACTURER: CAPACITIES: A z MODEL NUMBER: INCHES = SWITCH TYPE: B = INCHES PUMP MANUFACTURER MODEL NUMBER: C = INCHES = SWITCH TYPE: D INCHES = REOUIRED DISCHARGE RATE GPM PUMP F. ALARM WIRING AS PER ILHR 16. VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DZSTRIBUTION PIPE 33 • MINIMUM NETWORK SUPPLY PRESSURE FEET ♦ FEET FORCEHAIN X FEET _,__FT/ 100 FT. FRICTION FACTOR . TOTAL DYNAMIC HEAD FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH FEET WIDTH DIAMETER LIQUID DEPTH IGNED LICENSE .NUMBER: POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner 2 ; WC., tv IN Septic Tank Capacity 0"gal ❑ NA S~I'Zx V) Permit # Septic Tank Manufacturer ~C Sam// ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer yN ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model 1(3)0 0 NA Number of Public Facility Units ❑ NA Pump Tank Capacity b gal ❑ NA Estimated flow (average) gal/day Pump Tank Manufacturer W rCicv- Co k4-,? ❑ NA Design flow (peak), (Estimated x 1.5) f 50 gal/day Pump Manufacturer Go ❑ NA Soil Application Rate gal/day/ftz Pump Model fw -f ❑ NA Standard Influent/Effluent Quality Monthly average* Pretreatment Unit ❑ NA Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BODS) <_220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) :0 50 mg/L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BODS) <30 mg/L ❑ In-Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) <_30 mg/L ❑ NA ❑ At-Grade ❑ Mound Fecal Coliform (geometric mean) 510° cfu/100ml ❑ Drip-Line „90ther: P v~4' • 4W4 Maximum Effluent Particle Size Y. in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA *Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA ❑ ear(s) Pump out contents of tank(s) When combined sludge and scum equals one-third (Y3) of tank volume ❑ NA Inspect dispersal cell(s) At least once ever ❑ month(s) (Maximum 3 years) ❑ NA y' V year(s) At least once every: ` Fa month(s) ❑ NA Clean effluent filte ❑ year(s) 1 I 19 Inspect pump, pump controls & alarm At least once every: 2 ❑ year( )(s) ❑ NA Flush laterals and pressure test At least once every:-❑ month(s) ❑ NA T9 year(s) Other: At least once every: ❑ month(s) ❑ NA ❑ year(s) Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Y3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of <12 months, shall be performed by a certified POWTS Maintainer. A service report shall lie provided to the local regulatory authority within 10 days of completion of any service event. GMW (4/01) Page of • START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name ~ruwc'6-w Name TAIA500 gAii F Phone '11 T 600 e 1 7 15 J ly 0 Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name S Name Sr CVY) Z eq►l Phone Phone 1 -7 I This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. 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Housing: Cast Iron Sp~ifically designed for the stainless steel. grade turbine od for for efficient had transfer, • Capable of running lubrication and efficient strength, and durability. following uses: dry without damage to heat transfer. ■ Motor Cover. Thermoplas- • Effluent systems Homes components. tic cover with Integral handle operation. automatic and Automatic and W switch attachment . Farms ms • Motor manual Available for at • Heavy duty sump • EP04 Single yhase. 0.4 HP, models include Mechanical points • Water transfer 115 or 230 V, 601.10550 Float Switch assembled and ■ Power Cable: Severe duty • Dewatering RPM, built in overload with preset at the factory. rated oil and water resistant. automatic reset. ■ Bearings: Upper and lower SPECIFICATIONS ' EP05 Single phase: 0.5 HP, FEATURES heavy duty ball bearing 115 V, 60 Hz,1550 RPM, construction. Pump: EP04 built in overload with a EP04 Impeller. Thermo- Solids handling capability: automatic reset. plastic Semi-open design AGENCY LISTING 8/40 maximum. • Power cord: 10 foot with pump out vanes for • Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal protection. DOWN sanda* AtsKNOn • Total heads: up to 24 feet. with three prong grounding m EP05 Impeller Thermo- Discharge size:1 NPT. plug. Optional 20 foot (CSA listed model numbers plastic enclosed design for end in "F' or "AC".) • Mechanical seal: carbon- length, 16/3 SJTW with improved performance. rotary/ceramic-stationary, three prong grounding plug BUNA-N elastomers. (standard on EP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 104°F (400C) continuous superior strength and 140OF (6010C) intermittent. corrosion. resistance. • Fasteners: 300 series MEMRS FEET stainless steel. 10 • Capable of running dry without damage to 9 30 components. Pump: EP05 e • Solids handling capability. a 25 Yimadmum. 7 w ► • Capacities: up to 60 GPM. 6- 20 • Total heads: up to 31 feet ra ~ • Discharge size: IIN NPT. • Mechanical seal: carbon- 5 rotary/ceramic-stationary, j 4 15 BUNA N elastomers. • Temperature: 3 10 104'F (400C) continuous 140°F (600C) intermittent. 2- s , 0. . 00 10 20 30 40 so QPM 0 2 4 e a. 10 12 M-1h CAPAWY 0 1095 C*Kft Pumps, hr. r e3875 i I I I I I I I I I I I I 111 ~ I I L 111 H 1 I I I 8005253 State Bar of Wisconsin Form 3-2003 Tx: 4004131 QUIT CLAIM DEED 921234 Document Number Document Name BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI THIS DEED, made between RICHARD D. WALTON, RECEIVED FOR RECORD ("Grantor," whether one or more), 08/23/2010 4:39 PM EXEMPT 16 and THE RICHARD D. WALTON FAMILY TRUST REC FEE: 30.00 ("Grantee," whether one or more). PAGES: 1 Grantor quit claims to Grantee the following described real estate, together with the Recording Area rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ("Property") (if more space is needed, please attach Name and Return Address addendum): Richard D. Walton 18226 Hartley Lake Rd f~ The SW of the NE of Sec 23 T28N R17W (40.00 Acres) Brainerd, MN 56401 Sec 23 T28N R17W NE NE EXC IA SE COR (39.00 Acres) Sec 14 T28N R17W SE SE EXC CSM 13/3599 (38.65 Acres) Sec 14 T28N R17W PT SW SE FKA 028-1022-70 (127) EXC PT TO CSM 15/4118 The NW of the SE of Sec 14 T28N RI 7W (40.00 Acres) 028-1027-40-000; 028-1027-10-000; The NE of the SE of Sec 14 728N R17W (40.00 Acres) 028-1022-80-000; 028-1022-70-050; The SE of the NE of Sec 14 T2 8N R17W (40.00 Acres) 028-1022-60-000; 028-1022-50-000; %2 Interest in the NW of the NE of Sec 23 T28N RI 7W (20 Acres) 028-1021-40-000; 028-1027-30-000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Dated & "2- 3 " ` O W6&1~ (SEAL) - (SEAL) * Richard D. Walton (SEAL) (SEAL) * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) authenticated on ) ss. ST. CROIX COUNTY ) * Personally came before me on Z41 0 TITLE: MEMBER STATE BAR OF WISCONSIN the above-named Richard D. Walt n P (If not, O authorized by Wis. Stat. § 706.06) to me known to be the person(s) who executed t IbNt oing instrument and acknowledged the same. JESSICA L. THIS INSTRUMENT DRAFTED BY: , ARCO Richard D. Walton No ary ublic, State of Wisconsin f~j ,''9l p~ f G nF 1s M Commission is 1~5 2~ W Y ( permanent) (expires: ~174 1t Z~1iu .1 _ --ni~ii- (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. QUIT CLAIM DEED © 2003 STATE BAR OF WISCONSIN FORM NO. 3-2003 * Type name below signatures. 1 of 1 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND ~~F OWNERSHIP CERTIFICATION FORM '114' / 19 40 Owner/Buyer V~ VU Ali sr 71 Mailing Address 60 Property Address LV'C.?'' (Verification required from Planning & Zoning Department for new construction.) 5 HUD^-- City/State ~~I Parcel Identification NumberA'K_ (4 LEGAL DESCRIPTION Property Location Sec. T~VN RL W, Town of , Subdivision Plat: , Lot # Certified Survey Map # 77 , Volume , Page # Warranty Deed # ~21 ZJ (before 2007)Volume , Page # Spec house ❑ yes Rio Lot lines identifiable O es ❑ 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 §SPS. 383.52(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. I/we, 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 Safety And Professional Services 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. I/we certify that all statements on this form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtuee/ of a warranty deed recorded in Register o eeds Office. Number of bedrooms ITGGC~✓So~ ' ~Z~J' L'la'&f E~ .1 SI NATURE 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. 04/12) Soil and Site Evaluation Page 1 of 4 County St. Croix Parcett ID # Applicant Inf orMation 02e- 1 7 6 Revie d by Date Property Owner Property Locntbn outLf 10 A o Richard D Walton Govt. Lot SWu4 SE 1/4 s14 28m. 17 v Prap.r►y ..n.r. MOM ..M ee Lot or CV1 1985 30th Ave not site address aty state zp code Phone 777 CKy ❑ YKaw Town Nearest Rood Baldwin Wisconsin 54002 W Rush River 30th Ave ®New Construction Use ❑ Residential Code derived dally flow 150 ❑ Replacement ® Public or comerclal -office area being added to shed estimated flow Parent material Address site to be determined 3 employees 39 gallons Installing system for 150 GPD bottom tin on shed 100' verticle bench 150 gat / 0.4 = 375 sq ft 6 ends = 30 leaves 345 sq ft 245 sq ft/ 20 sq Ft per blfittretor = 13 infiltrators requried wilt Install 3 rows ofi6Infiltrators each bottom Infiltrators 11' below grade 1' cover required above Inflttrators F Boring a Boring ® Pet Ground Surface Elevation 98.96Depth to twtmg Factor 53' Sol appucatlon Rate Horizon Depth munsell Redox De9o^Iptbn Texture Structure Candstonae swnd" Raotc GPD/ ft inches Color as a cone mbr 0% am Ob EfFei Eff/P 2 10-39 7.5YR 4/6 cl 2 m abk mfr cs 1f 0.4 0.6 3 9-53 10 YR 5/4 st 1 m abk m fl cs if 0.4 0.7 4 3-62 10 YR 5/4 see remarks st 1 m abk m fl cs if 0.4 0.7 L_ u Remarksl ground water at 53' May 23, 2013 R ❑ Boring ® pit Ground Surface Elevation 99.68 Depth to Uniting Factor 48" sal nppucatlon Rate Horizon Depth 7YR Redox Description Texture Structure oo oe y Roats GPD/ ft fiches r s< a.w Cd- a, sL sl. Effrl EPf~'d 1 0-1 sit 2 f a k mfr c 1 0. 0.8 2 10-18 4/3 sit 2 f ab mfr cs if 0.6 0.8 3 18-48 4/3 sit 2 m ab mfr cs if 0.6 0.8 3 8-58 10 YR 5/3 f1f 5YR5/8 St. 2 m abk m fr cs 0.6 1.0 4 8-62 10 YR 4/3 f2d 5YR 5/8 is 1 m abk m fir 0.7 1.6 Remarks, horizon 3 is closer to loam than horizon 2 CST Name telephone ~ 4 /SI nptu~e ;2017 4d~C address a I" 3L°~/ C,- ,il li&t cA1 ;s v,,~4 CSTM # 22 C~ ~I C/ / r property owner Richard D Walton Page 2 of 4 Boring a Boring " 98.82 >49 ❑ pit Ground Surface Elevation Depth to lhltIng Factor Sall Application Rote Horizon Depth Munsell Redox Description Texture Structure consist,,* enia.d"Y R GPD/s ft Inches Color a U cans aa: e„ sz SA Effe1 Effie 0-11 YR / i mfr 2f 0,6 0.8 2 11-40 7.5YR 4/6 d In abk mfr cs if 0.4 .6 3 0-49 10 YR 5/4 st 1 m abk In fl cs if 0.4 0.7 Remarks: © Boring a Bong 93.12 ® Pit Ground Surface Elevation Depth to Uniting Factor 36• Sell Application Rate h Munsell Redox Description Texture Structure Cm tsnoe Bouidory Roots GIRD ft Horizon Indies Color IN sa C..* a.- t. a. SA Effil Eff#2 1 0-11 SOYR 4/2 sit 2 f abk mfr cs 2f 0.6 0.8 2 11-30 7.5YR 4/6 cl m abk mfr cs if 0.4 .6 3 0-36 10 YR 5/4 sl 1 In abk m fl cs if 0.4 0.7 4 6-61 10 YR 5/4 see remarks st 1 m abk In fl cs if 0.4 0.7 Remarks: around water at 36' May 23, 2013 this hole outside of area ® Boring a Baring a 98.36 ❑ Pit Ground Surface Elevation Depth to Unithg Factor >49 say AppUk,ti,,, Rate Horizon Depth Munsell Redox Description Texture Structure Consistence S Roots GPD/ ft Inches Color a, s. cwA caws Is, SZ. SA Effi1 Effie 1 0-12 IOYR 4/2 sit 2 f abk mfr cs 2f 0.6 0.8 2 12-38 7.5YR 4/6 d 2 m abk mfr cs if 0.4 0.6 3 8-49 10 YR 5/4 sl 1 m abk m fl cs if 0.4 0.7 Remarks property owner Richard D Walton Page Z of 4 ® Boring p Boring 3 ❑ Pit Ground Surface Elevation 98'82 Depth to limiting Factor >49 Soft APPlication Rate Horizon Depth Munsell Redox Description Texture Structure corswton= q..d Y Roots GPD/s ft inches Color a, to cons Dow or. V. Sh Effill Effie 1 0-11 IQYR 4/ it 2 f abk mfr 2f 0.6 0. 2 11-40 7.5YR 4/6 Cl. m abk mfr cs if 0.4 .6 3 0-49 10 YR 5/4 st 1 m abk m fl cs if 0.4 0.7 Reriarksi ❑ Boring Boring M 93.12 r ® pit Ground Surface Elevation Depth to limiting Factor 36 Soft Application Rate Horizon Depth Mu-11 Redox De rrlptln Texture Structure Cortonce GPD/s ft Inches Color a, a Caa ~ 6n SL SA Boundory Roots EffMl Effie 1 0-11 10YR 4/2 sit 2 f abk mfr cs 2f 116 018 2 11-30 7.5YR 4/6 Cl m abk mfr cs if 0.4 .6 3 0-36 10 YR 5/4 st 1 m abk m fl cs if 0.4 0.7 4 6-61 10 YR 5/4 see remarks st 1 m abk m fl cs if 0.4 0.7 Remarks: around water at 36' May 23, 2013 this hole outside of area ® a Baring i Boring ❑ pit Ground Surface Elevation 98,36 Depth to Uniting Factor >49 Soft Applicntlon Rate Horizon Depth Munsell Redox Description Texture Structure y Roots GPD/s ft inches Color a S. Can Cd- 6r. S. Sn Effill Eff/2 1 0-12 10YR 4/2 sit 2 f abk mfr cs 2f 0.6 0.8 2 12-38 7.5YR 4/6 Cl. 2 m abk mfr cs if 0.4 0.6 3 8-49 10 YR 5/4 sl 1 m abk m fl cs if 0.4 0.7 Remarks: Page 3 of 4 Parcels Id 028- 102270056 35 acres In the SW SE 14 28 17 GPS appr coordinate here N 44 degrees 54,431 minutes W 92 degrees 24.191 minutes ~ „yes 5 Acre Parcel A Page 3 of 4 Parcett Id 028- 102270056 35 acres In the SW SE 14 29 17 GPS appr coordinate here N 44 degrees 54,431 Minutes W 92 degrees 24,191 Minutes rrr , YlRM ll~f! llof Yn 1'f0Y ILWiLrI~ h PM\ 5 Acre Parcel B3 98.82 B5 98,36 B2 99.68 B1 98.96 B4 93.12 0 Install 3 Quick 4 trenches 1"Z' deep o Gound Level 94A-8 Rj-D 2, o Exis ing Ground Level 9- .8 Shed Install -*-Wieser 1000/650 Combo tank Plot Plan 1"=40' Z 0 20 40 Scale in Feet