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HomeMy WebLinkAbout020-1108-00-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 563871 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 Holde(s Name: City Village X Township Parcel Tax No: Garbe, R. Charles & Barbara Hudson, Town of 020-1108-00-000 CST BM Elev: Insp. BM Elev: BM Description: Sectionfrown/Range/Map No: Q /1/l e-,,-5 ~ 35.29.19.431 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic 'Z.S / LSU Benchmark Dosing / 1 y 7So Alt. Bfvy" !.7 c7ti - Z 01 JP t L_4^, ALFat#en Bldg. Sewer r Holding St/Ht Inlet q TANK SETBACK INFORMATION St/Ht Outlet TANK TO n PLL . WELL BLDG. Vent to Air Intake ROAD Dt Inlet a Septic /19 / 7 /66" Dt Bottom Dosing Header/Man. y/p0/ ✓.75 f,~ 1 ~~o g 77 / Aeration Dist. Pipe tp 9 - 7 Holding Bot. System l 7 . Z 4 7 1 7'3 . g5 Final Grade PUMP/SIPHON INFORMATION L-ac.J S% 7• Manufacturer Demand St Cover .751 Zo GPM Model Number TDH Lif~ Friction Loss System Held/ TD9 s /U 151637 ~ Forcemain Length / Dia.Z it Dist. to Well 7 /Z) 6 / SOIL ABSORPTION SYSTEM B DIMENSIONS Width Length No. Of Trenches PIT DIME SIONS No. Of Pits Inside Dia. Liquid Depth ED/TRENCH 1- 1 DIMENSIONS SETBACK SYSTEM TO ll// P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION L CHAMBER OR Type Of System: 7$ Z / UNIT Model Numb )'17 A49- 'q 67V. Jj DISTRIBUTION SYSTEM /c)5 L ).,ze v Header/Manifold~ 1 Distnbut*q_ Ix Hole Size Ix Hole Spacing Vt Air Intake Pipe(s) Length Dia Length Dia Spacing Ar SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges N~ Topsoil Yes Efl No Yes No ti ~J COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / S. 1107-- Location: 772 Cty Rd N Hudson, WI 540116 (NW 1/4 SE 1/4 35 T29N R19W) >35 acres Lot Parcel No: 35.29.19.431 1.) Alt BM Description 6604-1- to1,~ C,' 2.) Bldg sewer length = 5to ~'o G~ec•w o J ~'G~. f Ta„~,~'S ~vb~ diG " - amount of cover Plan revision Required? in Yes No ~co Use other side for additional informatio SBD-6710 (R.3/97) Date Insepctor's Si ature Cert. No. PLOT PLAN PROJECT Charles Garbe ADDRESS 772 Ctv Rd N Hudson Wi 54016 SE 1/4 NW 1/4S 35 /T 29 N/R 19 W TOWN Hudson COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 8/6/13 BEDROOM 4 CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT XXX HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE765 DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 891 # of chambers 44 BENCHMARK V.R.P. Top of corner post ASSUME ELEVATION 1001 Filter BEAR Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark Scale is 1" = 40' SYSTEM ELEVATION 96.7/95.5 4'below qrade unless otherwise noted County Road N B.M.* _ 150' 40 120 B-2 Huffcutt Comb T 30' WEll 90' 110' ~ 100' 14% Slope EP B-3 Existing 4 Bedroom Hous 40' to 1 Ol ank is to be mped and B-1 urie 2-3' X 88' cells 10, with >3'spacing ents 97' ' All piping shall be SDR 30/34, within 10' 101' 99, of tank, piping shall be Schedule 40. Vent 1 Overflow >6„ Quick4 Standard ?4' ver Leaching Chamber with 20.0 ft2 of Area 5.6ft^2/pair of end caps 12" ong Line Grade at System Elevation Property 3411 F nty - - r .>t Industry Services Division ~ 1400 E Washington Ave tary permit NumbeQ(to be filled in by Co.) ?,Q. Box 7162 J Madison. WI 53707-7162 State Transaction Number SanX,,edj)m1- e it Application r` A r LDe with SYS :ft33.2t(2 , su bmission of this form to hhe appropriate gb ®ntal trait __A 11 z to obtain mg a sa er Note: Appircauon forms for st ~te P wTS are submitted to Proj ct Address (if different Chan rnailin ' dd Ss} lanceA and Proral , s. 15Personal information you provide 9 d,fo secondary dance with the Prionvacy Laww s. 15 04(I)(m)5tats~iJJ Information - P. ase Print All Inform 0 Jvt Property Owner's Name L a - 1111 11, C ~lI - Parcel N Property Owner's Mailing Address Property Location / u --1- L/ Co o - Govt. f,ot. - - c/~ 7~ City, State Zip Code Phone Nurnber C / I - Y" -lsLcl1 ~a section ~ 11. ype of Buildin on - g (check all that apply Lot # N' 1< W - r 2 Family Dwelling— Number of Be o ns - - T= Subdivision Name ' G4C Q G_ Block N ❑ Public/Coimnercial - Describe Use ' ❑ City of•_- _ ❑ State Owned - Describe Use _ CSM Nurnber ❑ Village of ^ 2. U b~" Cl5 cnJ~ZZ~-Z_Z C Town of - ill. Type o1' Permit: (C beck only one ox on line A. Complete line B if applicable) A. - ❑ New System a lacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Pftl nber ❑ Permit' Transfer o New List Previous Permit Number and Date Issued-- - Before Expiration Owner IV. e of POWTS S ,;tern/Comuonent/Device• (Cite <k all that annly) on-Pressurized In-Groli7d ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound % 24 in. of suit.lble soil Mound < 24 it le soli ❑ Holding Tank ❑ Othe- Dispersal Component (explain)^ ❑ Pretr;atrnent Device (explain) V. Dis ersaU"1'reat cut Area Information: Design Flow (gpd) Desi n oil Application Rate(gpdsf) Dispersal Area 2equsred (sf) / Dispersal Al Pro os - --ht / v tt J p (st) QSystem ^uttevat n V1. Tanlc Info Capacity in al 4 o- Gallons Manufacturer - Gallons Units New Tarrks Existing Tanks U N~ eGt^, a, U a! 2 -2 !2 t4 W3 Septic ur Holding Tank w y Dosing Chamber ! -S - - - - Vill Responsibility statement- 1, the undersigned, assum sl nsibility for installation of the PO W'1'S shown on the attached plans. Plumb is Name (Print) ~ Plumber's rre MP/MPRS Number Business Phone Number Plumber's Address (Street, Ciy ,State, Zip Cod Vlll, Count /De artment Use Only Approved o;e Permit- Fee -r Date lissued ]ssui g nt Signature Ow ven Reason for Denial $ IY 75 $ /Z f.3 IX. Condit ~Fasons for Disapproval t. iG tank eft' Ubi filter and' dispersal cell•musf all be se-*as / maintaifred I ✓ ft per Management plan provided by plumber. G p~ I A II selbseit reguilrements must, 6eNwiinteinid -_as oer aeoNct~fe code / ordirtsrlgs A reach to complete plans for the system and submit to the County only on paper not Itss dean 8 uz ;--Ii inches fn size SBD-6398 (R0313) Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715-246-4516 Date: 8/6/13 Owner: Charles Garbe Location: SE1/4 NW1/4 S35 T29 N,R19W 772 Cty Rd N Hudson System type: In-ground absorbtion system(conventional) Manuals Used: In-ground absorbtion system (version 2.0) Pressure Distribution Manual (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross Section 4-6. Maintanance and Contingency Plan 7. Filter Specifications Sheet 8. Dose Tank Cross Section 9. Pump Curve 10.-12. Soil Test Signature rLicense number 4426900 PLOT PLAN PROJECT Charles Garbe ADDRESS 772 Ctv Rd N Hudson Wi 54016 SE 174 NW 1/4S 35 /T 29 N/R 19 W TOWN Hudson COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 8/6/13 BEDROOM 4 CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT XXX HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE765 DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 891 # of chambers 44 BENCHMARK V.R.P. Top of corner post ASSUME ELEVATION 1001 Filter BEAR Filter ❑ BOREHOLE O WELL * H. R. P. Same as Benchmark Scale is 1" = 40' SYSTEM ELEVATION 96.7/95.5 4'below qrade unless otherwise noted County Road N B.M.* 150' 40' 120' 45 B-2 40' Huffcutt Comb Tank 30' WEll 90' 110' 100' 14% Slope B-3 5' Existing 4 Bedroom Hous 40' Old tank is to be pumped and T buried 2-3' X 88' cells 10' B-1 with >3'spacing ents 97' All piping shall be SDR 30/34, within 10' 101' 99' of tank, piping shall be Schedule 40. Vent Overflow >6" Quick4 Standard of Cover Leaching Chamber with 20.0 ft2 of Area 5.6ft^2/pair of end caps Long 12" 34" Grade at System Elevation Property Line Cross Section of Infiltrator Quick 4 Leaching Chamber Typical cross section for 2 of 2 cells Quick 4 Standard Leaching Chamber with 20.0 ft2 of Area per Chamber To be >1' above grade 5.6ft 2 pair of end plates Finish grade elevation Typical Installation 100' Vent ACI Grade Vent 3' 4" 3' x/30/34 Septic Tank 5' Long 1 l~ 5' S' Long 1 Grade at System Elevation 36" Grade at System Elevation Spacing 5' 2-3' X 88' Cells Same on other end Observation tubeNent At end of cell A B 22 chambers per cell System elevations: A-96.7' B 95.5' POWTS OWNER'S MANUAL & MANAGEMENT' PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner Septic Tank Capacity ❑ NA Permit # ILL 1 Septic Tank Manufactul er !LL❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer-U NA - 3 Number of Bedrooms O NA Effluent Filter Model ❑ NA Number of Public Facility -74A Pump Tani, Capacity ~~p S~ dal ❑ NA Estimated flow (average) - gal/day Pump Tani, Manufacturer - - NA Design flow (peak), (Estimated x 1_5) gal/day Pump Manufacturer ❑ NA Soil Application Rate - Pump Model ❑ NA _yal/da /ftz Standard Influent/Effluent C!uality Monthly average' Pretreatment Unit Fats, Oil & Grease (FOG) s30 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD5) 5220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg/L ❑ Disinfection 11 Other: Pretreated Effluent Quality Monthly average Dispersal Gell(s) ❑ NA Biochemical Oxygen Demand (BOD5) <30 mg/L -Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) s30 mg/L 7<~A ❑ At-Gradra ❑ Mound Fecal Coliform (geometric mean) x104 cfu/100m1 ❑ Drip-Linn ❑ Other: Maximum Effluent Particle Size in dia. p NA Other: ❑ NA Other: NA Other: ❑ NA "Vaiues 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: marts s) (Maximum 3 years) ❑ NA Pump out contents of tank(s) When combined sludge and scum equals one-third of tank volume D NA Inspect dispersal cell(s) At least once every: ❑ month- s) ~ (Maximum 3 years) ❑ NA Clean effluent filter At least once every: , ❑ month(s) ❑ NA Inspect pump, pump controls & alarm At least once every: _J - Qmonth(s) - JE1 Flush laterals and pressure test At least once every: ❑ month(s) other At least once every: ❑ month(s) ❑ year(s) Other: MAINTENA NCE 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 Rlestricted Sewer; POWTS Inspector; POWTS Maintainer; :;eptage 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 scurn and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shalt 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 th•~ immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordanc~i with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechan[.,al or pressurized components, pretreatment units, and any servicing at intervals of s12 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of cornpletion of an!, service event Page of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the pr;sence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high co-icentrations 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. Wher power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may -esult 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 i (sump pump) water; fruit: and vegetable peelings-, gasoline; grease; herbicides; meat scrap: ; 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 step: shall be taken to insure that the system is properly and safely abandoned in compliance with chapter COMM 83.33, Wisconsin Administrstive Code: • All piping to tanks. and pits shall be disconnected and the abandoned pipe openings seale 1. • The contents of all tanks and pits shall be removed and properly disposed of by a Septag(! Servicing Operator. ® After pumping, all tanks and pits shall be excavated and removed or their rovers 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: 0 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 tic 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. O 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. El 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 effe,t at that time, <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES ANDIOR 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 IMPOSSIBLI=. ADDITIONAL COMMENTS POWTS INSTALLER _ POWTS MAIN'rA)NE - -Name ~~--1. - - - - NameJ~ Phone ot Phone SEPTAGE SERVICING OPERATOR MPER LOCAL REGU:_ATORY AUTHORITY e - -Name -Name LC2~ti✓~ _ Phone `J-- Phone/'J This document was drafted in compliance with chapter SPS 383.22(2)(b)(1)(d)&(f) and 383.54(1), (2) & (3), Wisconsin Administrative Code. per. ai CARTMUr WE INSTRUCTIONS 'ILTER ~tlu11tts~W~{if~ltrrr irrew Y De Ht the t ~ y rtrair cusll+ .retie Chm olttl at I:tiri uu1{ltt oipt oalAurud under tier 4W%;4 W4 opwnipV g. If hurt, than wither Insert move touro nrrsmo fit i# took h, ate flew vuurnh the uutlMt for aeioent wa.Yd (glue) additleNlaF mlpe emo Urtttl Clio le u Utla1 Ii{pe. 1at5w a Whole the cleat Is StN1 dry wed 5111 thsi uUtidt IuhYes, mullsurv tiro leavyth ut 46•-6ch peon receded I,* braru the filter to the tides: mil lull it utIftI g tine uptiuninl Supplemental Mille supp rt. If side. snppurt ernuthud. Is Ilut Utlihtd, promed to step lour s•~'tr.N' Fvat• inatallatturuc UtIiziltll the UptMirerl Istlpgidnlrlntel side surrpewt_ soluexvi weld tlve W••ihe it i Ipa ovoku thtl I•1W C.' ON. If Slide support h%thdd le; loot udiiudd, proCead'tu step foul'. 5dlvent wild ale filter c,rrrre Onto the !nutlet pima, itmort tilt, inter rrartridiia into the ruse, ifruasirirl dom Until thoo filter' lottku Ititu the butt7lre ur fire vas". 1'+c5! If a UN5 switr:li is ut•Nrred: irre:gii: into flue iillxxr rind lock by turnurlf} riockwire sr Maintenance t. '111re effluolet tiltet should be ciarrrred every tiomi tier tAllptic tulll( tr; serviced. I 2. Opel, the outlet ramema apehfo4u to inspect titer tank rind Our, ` H. puatp ti.u septic tank a mvepletr:rV, fnaikhU .Veal to rainuvw rho sludge hover "a the hutfuvve of thca talrw awl not guYat the sptlin and r t%tillt. u o. Once tfle vn7luunt 16vei lies buu n (uvwered buldrei tht: invert let the outlet pipe, firmly pull up eel. the riltrdr faundke to d1wodfle this rurttldoo haul till, ces0- 5. Slide the r®rtridw up and enIr of tile ailwm flw loaning. yr ee vets switch wirimmlod ho art Flhlrrei is 0111Mnt, tiler saaitl:fa ` sti'uuld he eawnuveti by ttervihmiy c auntorduckwisu 911 lend citltltir!d ; s J t with writer tinny. While holding tine cnirb'idga rely its hide (Ime Hat sutf it- Foci!:,f down) avirr the 44WU56 uperdng„ 01166 00 tim r1111:rldNe With Winne qi. urily, making sure all sivl„taiger material is ringed buck, Into the tank. i~Nd. t tt. If VHkj WWRch is utilized!, rep1m:* by Insnrtlieg W u I111:61 ~nrrfl e' . turn&7p e3nekwh:u lax!°. r .x•„ 9. nizign tar, imer a mdridgle back irate the 41l4i8, preoi Ajq down iilWI tine filter kicks Into the 110tt4an of We ctrstj. ice. Kep{ace end guru the i W&M %W6111nli Oil 11111 WhIL Y., 1r• •-K It "Y e: ~ 4i1 :•$:i7/,}~ , 1..t,, y t:.7 z tit' iA::.U:,Slde.Y •7'•' '{MK1iN"W G SEPTIC TANK € PUMP CHAMBER CROSS SECTION AND SP£CIFICATIt3N5 w» C~ SCENT PIPE 12" MIN. ABOVE GRADE it wEAtH£JUNCTIORPRROOf BOX APPROVED > Q` `RflM D4flR. 41I NI?f3SJ OR WITH CONDUIT MANHOLE COVER FR£ .ii AIR INTAKE W/ PADLOCK .....WARNING LABEL 110 FItif D GRADE I L 4++ MIN. i 2Y" Wig. a + s INLET GAS- , WATER TIGHT SEALS TIGHT ~ VpQPRD1fED A SEAL ! JOINTS VITH ~i 1.T E.fZ_ ALM APPROTED PIPE • ON 3 ONTO APPROVED SOLID SOIL. PIPE 3` I OM SOLID 8 Z, 7r OFF SOIL PUMP OFF ELEV - G!' =T. c D 3" APPROVED BEDDING UNDER TANK / CONCRETE PAD SPECIFICATIONS NUMBER DOSES PER DAY: SEPTIC f DOSE I&Ny, MANUFACTURER: -5 S~ GAL. DOSE v4WME FL~i BpCKNG. ~ GAL DOSE SIZES: SEPTIC ~AL- DOSE GAL. S INCHES = CAPACITIES: A 3 c f GAL- AIARM MANL1FACIVRER,. iiP.C ✓ 8 = 2 INCHES = MODEL t!1UMBER, C j SWITCH TYPE: '2 C INCHES c GAL- PUMP HANEJFACTURER: 'f ' INCHES = /GAL. - MODEL NUt#t3ER : D _ SWITCH TYPE PER IL~iR 15.23 WAC ~ - puMP ~ ALARM y~tlRltsG AS GPM FEET REQUIRED DISCHARGE BATE.~FEET ICAL. DIFFERENCE BETWEEN PUMP OFF ,ANB-I3ISTRIBUTION PIPE FEET ;MINIMUM NETWORK SUPPLY PRESSURE 100 FT. FRICTION FACTOR , _ ~~iFEET + F££T FORCEMA;N TOTAL DYNAMIC t'iEAD Z WiDTHT DIAMETER or DIMENSIONS OF PUMP TANK: LENGTH LIGTH pA;£= LICENSE NUMBER: S IGNED: =I68 :fl I i _ LY r-IFAD PA'IIY CURVE 7: rA.L D t;/ali~iG lit_AG/C7~rAC;IiY V0:0EL 53 55/57/59 i-EH k'IN';T 25 LFFLUENI AW MAT; l~!.hG 6 1 2'~ - - - - - I 1 I-r t l1' e e f 5 .`I o z 15 - + - 1.; 4, 19 t- off f!e ct I Ift. ( Grr1 V gh .6 x/32--I j I I r r . i , 0A( LC`rV 10 L 0 30 40 1 - - U 60 01'd FtR P,FIh,'UTE ocsaw - t Variable level float switches available. Variable level long cycle systems available. - Available with special corCI lengths of 15', 25', 35' and 50'. ..`L c -i- --'I - Alarm systems available. Duplex systems available. t - ; I ~ 3 2 SKSH IT -Sin le Seal T - 9 Control Selection _ Listings Model volts Phase J Mode Amps Sim F~,, u l ex CSA UL M53/55 & M57l59 fo~ 9.7 P Y Y _a 1. Integral float operated mechanical switch, no external control roquired. N53/55 8 N57/59 115 1 M,^n g7 ~ - 2. Single piggyback variable level float switch or double piggyback variable level 5---- 2 3 or 4 8 5 Y Y~ M53 115 1i~Auto 9.7 - Y Y that switch. Refer 1 FM0477. 1 - _ BN57 11 - 1-1-Auto 97 fV Y- 3. Mechanical aternator W-Pak" 10-0072 or 10-0075. ' BE53l57 230 ! t Aut 4.e o - - Y -y 4. See FM0712 for co rect model of Electrical Alternator. f D53l55 & D57/59 230 1 Auto 4.6 t r - { _ v v 5. Variable level control switch 10-0225 used as a control activator, with Electrical L-E53/55 8 E57/59 230 1 I Non 4.8 2 - L or 4 5 -Y Y Alternator (3) or (4) float system. Single piggyback switch included. 1 For information on additional Zoeller products referto catalog on Piggyback Variable Level Float Switches, FMO477; o CAUTION 1 Electrical Alternator, FM0486; Mechanical Alternator, FM0495; Sump/Sewage Basins, FM0487; and Single Phase Simplex Pump Control/Alarm Systems, FM0732. For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO. P.O. BOX F. - Z y Louisville, KY 40250 Road Manu(acturersof.. O Z A 2" A SHIP o r.' Lom4ille, KY C 40211-19 (502) 7782731 i (800) 928 PUMP , y~urvYurc>~6 SycE /9v7~/ http://www.zooller.com ,/~11"P IM. FAX (5W) 774-3624 © Copyright 2002 Zoeller Co. All rights reserved. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer a Mailing Address Property Address (Verification required from Planning & Zoning Departrucut for new construction.) _ City/State Parcel Identification Nunther _ Ae"C20 go -Oro LEGAL DESCRIP110N Property Location '/4, Sec. T Z~ N It W, Town of _ //Z.4',_e _ Subdivision u _ _ Lot # Certified Survey Map Vohme Page # Warranty Deed # Volume -,,Page # _ Spec house yes no Lot lines dentifiable yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its pre:uature 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 your put into the system can affect the f ancti.on 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 & Zord;ig Department a certification form, signed by the owner and by a toaster plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal systvin 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 Cornmerce 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 exp ration date. I/we certify that all statements on this form a true to the best of my/our k lowledge. Uwe am/are the owner(s) of the property described above, by virtue of a warranty d ed recorded in Register of Deeds Office. Numb of be y°oonns SIGNATURE OF APPLICANT(S) DATE ***Any information that is misrepresented may result in the sanitary permit being rsvoked 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. 0$105) , ,5 S Robert 8. Garbs and Boris L. Ga.rb@. husrw.-d ifad wife as scrvivrarshaip /fir- -p. marital pr-ty. Grantcr, conveys and warrraW s to R. Charles Gerbe a:sd i r -jfR Y/r FICr 8srb►ra J. Carte, an and:✓:dr cafe-half intere-st to each. s ar"t's ere a 'E ~rJf -cc,T,-n. Grantee, the following descrabed real --state :re S--. Croix / i 19. cp(",;;,A, f 0,Y Wi 1 C=n, y. =tote of +siscrcfsinY 'he Gc Lileail'L Q.,3Lr..er 6f the gc; hwesc ZSarter (S~: ~1-( G! i"2!' '1141. MAY 4 8 1998 yang Stmth of the 9 -j'h way: ! the scratm1_-s' Y~Sr r as ti.~ titt~u5t QCZirter (S32 114 of NE 1/4), n-en the W--s; 10 feet -e~ES _te 1!i ) 9:30 A Nort_`w-est ~TM~arte* off the SCUT t,--2-ST- CWZZL :S+a :14 of 1r ecticn Thirty-five (1,!, 'e :aslstp `u3ceT¢y ::i.ar= (291 North. Rai:,; !71ceteen (19) rieit. ?H fA .this Warranty D "-,-d as q!veen in full fees final 53ii3f3Ctica of th:;t vD iginal Laud ccnLray: dated %r.ve.^i>--r 26, MO. recorded V"..~ a' 4 -r S. ~ at 8*3L a.m. in 6-22, Pales 20P-VG, Z-5 ^DCCU:Pvet 868159, as svu!:v~u nt:y assigned by the V*sndcr nr+ Pay 19, 1995 recorded may 10. 091. ar plume 902. Pale 544, s Docu-n.-T.t NU;her 469460. l"ff:l%m A!0 P-M-Ua.^i il ADMESS iEO A BESKAR, ATTORNEY AT LAW 4DLI,BESMR,SOLES & KWEGER 19 N MAIN ST, PO BOX 138 IL715)425-7281 WER FALLS WI 5 022 TRANSFER 020-1110-L--20; 020-1106-30 40-1108-00 parcel F arecefecat< CY^~1sr fPf1+R) FEE .hio to not hvu°Lat$- proputy. °"lcep son tc. warranuesi All easepentes. restrictaons acid rights-of-way of record. if any. Dated this - day of May, 1998. SEAL 1 Robert S. Gar6e rL { SET` ) (SEAL I Doris Z. Garbv AUTHENTICATION Ar-MIO1NEDGMIT Signature m _ of Robert B. Garbe and _ SA'j E OF WISCONSIN ) ) ss. Dorn- Z. C.3rbe COUNTT ) authenticated ls~ day ~f May. 1998. Personally cane before fre this day' of , 19 the above naffed to me kncwn to be the Person(s) who executed the Leo A. Beskar for=going instrument and acknowledge the sate. TITLE: HEK: ER STATE 8.%R OF WISCONSIN (If not, authorized by §'106.06, Wis. Stats.) ' THIS IYSTMIENT WAS DRAFTED BYt t+otary aublic County, Wis. Lao A. Boskar, Attornaq my corwa ss=on is permanent. )I1 not. expiration date: RODLI, BESRAR, BOLES 6 KRUEGER, S.C. 2:0 North main street, P. O. Box 130 River Falls,Wl 54022 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance oComm Wis. Adm. Cod pp c my I~c~ 1 X- Attach complete site plan on paper not less than 8 1/2 x ze. Plan must include, but not limited to: vertical and horizontal r direction and Pa -WAE~p pe rcent slope, scale or dimensions, north arrow, n nce to nearer 'do d0-110,7-42o-ovip Please print all rm sT / by Date cp Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (q)q/,1 $ /Z 13 Property Owner / Property Location hey t`1, / ( G C,,/' 1,Le Govt. Lot 1 /4/I f(-.31/4 S T 2 N R E (or Property Owners Mailing Address Lot # Block # Subd. Name or CSM# "7 5, , PL city State p Code Phone Number ❑ City ❑ Village Town Nearest Road h (7147) 07-//, ❑ New Construction Use: Residential / Number of bedrooms Code derived design flow rate (~Q GPD eplacement .rte ❑--P_ublirpr commercial - Describe: Parent material Flood Plain levation if applicable /d/ / A- ft. General cormtents so$. 14Y e fug Ldt / and recommendations: 113p5' System Type V System ElevationQ ! i ~n9 # ~ Boring .r- J Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. -Eff#1 •Eff#2 lB 3/L S ex- 2- . n .~P-t / Boring # Boring ® Zj-pit Ground surface elev9 -11 ft. Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Eu ry Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 c o -30 0ILL- Effluent #1 = BOD > 30 < 220 mg1L and TSS >30 < 150 ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) - - - CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54 7 r 6 715-246-4516 I Property Owner _ Parcel ID # Page of Boring # Boring a F21 . Z-) it Ground surface elev. Q ft. Depth to limiting factor in. Soil Application Rate P Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 _9 14-1 3 -7 lo, 5 E Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Boring Boring # Ground surface elev. ft. Depth to limiting factor in. F-1 ❑ Pit Soil Application Rate Horizon 'lepth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mg/L ` Effluent #2 = BOD5 130 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-9330 (8.6/00) Property Owner Parcel ID # Page of } ❑ Boring # Boring Pit Ground surface elev. V~ ft. Depth to limiting .factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ~l ~ 31L le l ►i 72 ~J ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil iigtion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ❑ Boring E Bong # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil Application Rate Horizon 'lepth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPDlff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BODS > 30 < 220 rng/L and TSS >30 < 150 mg/_ ' Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (R.6A0) Soil Test Plot Plan Project Name Charles Garbe Shaun Bi Address 772 Cty Rd N Hudson Wi 54016 CS #226900 Lot Subdivision Date 8/6/13 SE 1/4 N W 1/4S 35 T 29 N/R19 W Township Hudson Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of corner post System Elevation 96.7/95.5 *HRpSameasBenchmark County Road N B.M.* 150' Scale is 1" = 40' unless otherwise 45 B-2 noted 120° 4 0 30' WEII 90' 110' B-3 14% Slope s' Existing 4 Bedroom Hous 40' T 20 10' B-1 97' 101' 99' Overflow Property Line