HomeMy WebLinkAbout040-1053-40-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
(ATTACH TO PERMIT) 563875 0
GENERAL INFORMATION 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:
Campbell, William & Susan Troy, Town of 040-1053-40-000
CST BM Elev: Insp. BM Elev: BM Description Section/Town/Range/Map No:
rj d'`f (03 13.28.1911-1
. M98
TANK INFORMATION ELEVATION DATA 2-3 /Oz -5 466
TYPE MANUFACTURER i CAPACITY STATION r a p OHIS FS ELEV.
)f. a
Septic Benchmark
Dewing- / Alt. BM
jera,tion L 'L, lip, I- Bldg. Sewer
Z St/Ht Inlet
~
TANK SETBACK INFORMATION St/Ht Outlet SG~ ,2/ T F, 3
TANK TO P(L WELL BLDG. ent to A Intake ROAD Bt Inlet - ~p~ ~yc,•_ Jas z
o f ~.3`~
Septic U" 11-7 + Dt Bottom I3 . Z `t'
Header/Man.
135 102- 164
AValian / Dist. Pipe
00 ~ol
Holding Bot. System 07 4
PUMP/SIPHON INFORMATION Final Grade z,46 dR. I(o
Manufacturer e J~ k GPM Demand St Cove p
c,y - `D
Model Number E P !73 z 66 V..,
*7, 7
TDH Lift Friction Loss LSystem Head TDH t
1;x.73 t3, 6 S , 5S
Forcemain Lenh Di:a: t. to We ll / -
SOIL ABSORPTION SYSTEM
BEDITRENCH Width Length / No. Of ench PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS 5 /Do
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
INFORMATION CHAMBER OR
Type Ofgtem: UNIT Model Number:
DISTRIBUTION SYSTEM ec.
Header/Manifold 5 Distribution g C ~ / Ix Hole Size of Ix Hole Spacing ! Vent to Air Intak
L-5 Pipe(s) J
Length Z. Dia Length Dia Spacing Z
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only d e,4-'
Depth Over I Depth Over xx Depth of xx Seeded/Sodded xx ulched
Bed/Trench Center Bed/Trench Edges Topsoil
ZYes No Yes
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:ZZ/ / TJ Inspection #2:~~~/
Location: 816 Glover Rd fiver alts, 154022 (SW 1/-4-NW1/4 13 T28N R19W) NA Lo 6L,~~ Parcel No: 13.28.19.198D 1.) Alt BM Description = J r a fin L)
2.) Bldg sewer length ~e/~~
- amount of cover = I L S a G ~a <<,,~ 5 d-- L o c~,~
Plan revision Required? ❑ Yes No
Use other side for additional information.
Date Insepctor s i Cert. No.
SBD-6710 (R.3/97)
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Coun,
C
A~ Safety and Buildings Division •
201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by o.
S Madison, WI 5371,E
5~3 9 75
~4p~'"` State Transaction Number
Sanitary Permit Application ~~q oc7
ovemmental unit
In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to th
is required prior to obtaining a sanitary permit Note: Application forms fors e POWTS are submitted to Project Address (if different than mailing address)
the Department of Safety and Professional Servies. Personal information you provide ma p~ 1t9"r secondary ' purposes
in accordance with the Privac Law, s. 15.04(1 (m , Stats. ✓ ClU
1. Application Information - Please Print AI formation parcel #
Property Owner's Name / ye;
(%_Pr n P 8 1653- D . trod
Property Owner's Mailing A / 5 Z irk SY ; Properly Location / 19
p,,& s s C
alb GL o 1!E' 12 /'£d Govt. Lot
City, State ACV, EA 0rRA.1_S W,r Zip Code Phone Number SGa 1/4, At GJ '/4, Section
(circle one
~V
T 28 N; R ~_E0
,y
II. Type of Building (check all that apply) Lot #
~ Subdivision Name
2- or 2 Family Dwelling - Number of Bedroo
Block #
❑ Public/Commercial - Describe Use ❑ City of
CSM Number El Village of
11 State Owned -Describe Use.3 y 9 g r f g Town of -
_PM V
o~
III. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A. ❑ New System Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain)
• List Previous Permit Number and Date Issued
B. ❑ Permit Renewal El Permit Revision El Change of Plumber ❑ Permit Transfer to New
Before Expiration Owner
-1 J.
IV. T e of POWTS S stem/Com onent/Device: Check all that apply)
❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil K Mound < 24 in. of suitable soil
❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) f~
V. Dis ersal/Treat ent Area Information:
Design Flow (gpd) Design Soil Applicati ate(gpdst) Dispersal Area Require sf) Dispersal Area Propo d (sf) System Elevation /
Also 6-7i Y5° y5b 5,0 460 4?_5 ✓
VI. Tank Info Capacity in Total # of Manufacturer
U
Gallons Gallons Units o
New Tanks Existing Tanks 4 c 2
w U vs y ca ice. C7 a
Septic or Holding Tank 6 O o / d o O a c► Ls~ °
Dosing Chamber b o 0o W
VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the P S shown n t e attached plans.
Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number
0.44T E A Al ~'e✓ ~ V1'Lt-~ C,~ ~ Z-i'? 1 t> s - 7YY - ~7-
Plumber's Address (Street, City, State, Zip Code)
q&-7 t4 6s RAe[Z : ~qaa,
VIII oun /De _epart4ent Use Only
Permit Fee Date Is ued Issuing t Signatur
f~
)Approved ❑ Own en Reason for D $ '115
enial 12.5
DL Condit"! pNsilWeasons for Disapproval 3)
Septic'tank, efiltlerlt filter i+nd
dispersal cell must all be services / mairrtaW
as per management plan provided by plumber. l
2: Ail se'Cl( repuirerr "ts must belmOnti A" I
or d(nat S S{z l0-~
as per applilee*0do Qa.
Attach to complete plans for the system and submit to the County oi#y on paper not less than 8 In x 11 inches in size Ga n _
SBD-6398 (RR 11/11)
DIVISION OF INDUSTRY SERVICES
~~~;Axr.3rE 10541N RANCH ROAD
o 9 HAYWARD WI 54843
Contact Through Relay
www.dsps.wi.gov/sb/
3 S
P
S w www.wisconsin.gov
\\oa~sSJo_N Scott Walker, Governor
Dave Ross, Secretary
August 06, 2013
CUST ID No. 224059 ATTN: POWTS Inspector
ZONING OFFICE
KEITH E STONER ST CROIX COUNTY SPIA
23220 WOOD CREEK RD 1101 CARMICHAEL RD
SIREN WI 54872 HUDSON WI 54016
CONDITIONAL APPROVAL Identification Numbers
PLAN APPROVAL EXPIRES: 08/06/2015 Transaction ID No. 2294007
Site ID No. 794181
SITE: Please refer to both identification numbers,
Bill Campbell
816 Glover Rd above, in all correspondence with the agency.
Town of Troy
St Croix County
SWIA, NW1/4, S13, T28N, R19W
FOR: CONDI
Description: Mound, 3 bedroom residence APP
Object Type: POWTS Component Manual Regulated Object ID No.: 1443312
Maintenance required; Replacement system; 450 GPD Flow rate; 7 in Soil minimum depth to limiting factor froDEPT OF
original grade; System(s): Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01101, R. 10/12), PressurPROFESSIO
Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01101, R. 10/12); Effluent Filter DIVISION OF IN
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED.
This system is to be constructed
and located in accordance with the enclosed approved plans and with any component manual(s) referenced aboy~
The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code SEE lCQ
requirements.
No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06,
stats.
The following conditions shall be met during construction or installation and prior to occupancy or use:
Key Item(s)
• In the event this soil absorption system or any of its component parts malfunctions so as to create a health
hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the
owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the
mound component manual are complied with. A copy of this information must be given to the owner upon
completion of the project.
Reminder
• The orientation of the mound system must be such that the longest dimension is oriented along the surface
contour per SPS 383.44(6)(a)2.
• Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual.
• Surface water drainage shall be diverted away from the system area per Mound Component Manual.
• Materials shall conform to the requirements of SPS 384.10. No fixture, appliance, appurtenance, material,
device or product may be sold for use in a plumbing system or may be installed in a plumbing system, unless it
KEITH E STONER Page 2 8/6/2013
is of a type conforming to the standards or specifications of chs. SPS 382 and 383 and this chapter and ch. 145,
Stats.
• The existing POWTS must be properly abandoned per s. SPS 383.33 Wis. Adm. Code.
A copy of the approved 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 inspectors. All permits
required by the state or the local municipality shall be obtained prior to commencement of
construction/installation/operation.
In granting this approval the Division of Industry Services 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 may be 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 and the POWTS management plan to the owner and any
others who are responsible for the installation, operation or maintenance of the POWTS.
Sincerely, Fee Required $ 250.00
This Amount Will Be Invoiced.
When You Receive That Invoice,
Patricia L Shandorf Please Include a Copy With Your
POWTS Plan R'eview6r, Integrated Services Payment Submittal.
(715) 634-7810, izax: (715) 634-5150 , M - F 8:00 a.m. - 4:45 p.m. WiSMART code:' 7633
pat.shandorf@wisconsin.gov
cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm
Walter F Nechville , Nechville Excavating Inc
. a rill Campbell (Plans Mailed To)
Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Industry Services (formerly
Safety & Buildings) will be modified. Code references with prefixes starting with "Comm" have been replaced with
" to recognize the relocation of the Division of Industry Services from the former Department of Commerce to
the Department of Safety & Professional Services. Additionally, all IS (formerly S&B) codes have been renumbered
and addressed in a "300" series. For future reference, the Wisconsin Commercial Building Code will be addressed
by SPS Chapters 360-366.
KEITH E STONER Pa.-e 2 8/6/2013
is of a type conforming to the standards or specifications of chs. SPS 382 and 383 and this chapter and ch. 145,
Stats.
• The existing POWTS must be properly abandoned per s. SPS 383.33 Wis. Adm. Code.
A copy of the approved 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 inspectors. All permits
required by the state or the local municipality shall be obtained prior to commencement of
construction/installation/operation.
In granting this approval the Division of Industry Services 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 may be 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 and the POWTS management plan to the owner and any
others who are responsible for the installation, operation or maintenance of the POWTS.
Sincerely, Fee Required $ 250.00
This Amount Will Be Invoiced.
When You Receive That Invoice,
Patricia L Shand' f Please Include a Copy With Your
POWTS Plan Review6r, Integrated Services Payment Submittal.
(715) 634-7810,'F-ax: (715) 634-5150, M - F 8:00 a.m. - 4:45 p.m. W SMART code: 7633.
pat.shandorf@wisconsin.gov
cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm
Walter F Nechville , Nechville Excavating Inc
Campbell (Plans Mailed To)
Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Industry Services (formerly
Safety & Buildings) will be modified. Code references with prefixes starting with "Comm" have been replaced with
3 " to recognize the relocation of the Division of Industry Services from the former Department of Commerce to
the Department of Safety & Professional Services. Additionally, all IS (formerly S&B) codes have been renumbered
and addressed in a "300" series. For future reference, the Wisconsin Commercial Building Code will be addressed
by SPS Chapters 360-366.
2
Page 1 of 7
Index and Title Sheet
Project Name: Bill Campbell
Property Owner: Same
Address: 816 Glover Rd.
H"lsen WI 5403A
R.rv Cll. ro" s
Legal Description: Part of the SW1/4-NW1A
Sec. 13 T28N-R19W
Township: Troy County: St. Croix
Subdivision Name: Csm Vol. 3 Pg. 608 Lot: 2
Comp.#/Parcel ID: 040-105340-000
CONTENTS OVALLY
,OVED
Page: 1 Index and Title Sheet AFETY AND
IAL SERVICE Page: 2 Plot Plan and Sizing Calculation J Page: 3 Mound Plan View and Cross Section
Page: 4 Lateral Layout _$pONDE
Page: 5 Pump Chamber Cross Section
Page: 6 Pump Curve Data 3q, (-',()'7
Page: 7 Management and Contingency Plan
Attached: Soil and Site Evaluation with County Onsite Report
Mound Component Manual Used = Version 2.0 SBD-10691-P (N.01/01)
Pressure Distrib ' 9Pf1Pp ,ent Manual Used = Version 2.0 SBD-10706-P (N 01/01)
Designer: ith F.~tor , ~fi License # Designer 157-007
.N
Signature. _ Phone # (715) 653-2324
a
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Date 8-1-13
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Page 3 of 7
Mound Plan View
Observation.
A
W • . din:B, f
L -
Mound component Dimensions
A 4.5' E 36.48" H 12" K 13.69'
B 100' F I 20-301 L 127.37'
D 30" G 6" J 8.36' W 33.17'
450 (ft. sq.) Dispersal Cell Area 480.4 (ft.2) Basal Area Available
4.5 (gpd/ft) Linear Loading Rate 10.0 (ft) 1/10 B Obs. Pipe Placement
Mound Cross Section View
Aggregate Dispersal Area
Finished Grade 99.30'
34 G H
G
9. 0 ft) I F Dis ersal C II 98.00' (ft)
Lateral
Dispersal Invert
Cell
Elevation
95.00'(ft) Contour Elevation
12.0 % Site Slope
Detail of
Typical Dispersal Cell Geotextile Fabric
Shading Key Cover
® Topsoil Cap
Subsoil Cap U= BMW=
ASTM C33 Sand KNM Typical Lateral F
Tilled Layer
Aggregate
o- A ~
Page 4 of 7
Center Connection Lateral Layout
Diagram
Force main location.
1.25' p P 1.25'
4.5 ' S Laterals and Force Main of PVC Sch. 40
per Comm Table 84.30-5
X X Holes equally spaced on
Tum-up w/ball valve or clean + bottom of lateral
out plug X/2 X/2
100'
Number of Laterals 4 Orfice Diameter .156 or 5/32 in.
Lateral Diameter 1.5 in. Orifice Spacing (X) 2'50 ft.
Lateral Length (P) 48'75 ft. Orifices per Lateral 20
ft2/
Lateral Spacing (S) 2.25 ft. Orifice Density 5'62 orifice
Lateral Flow Rate 10.80 gpm Manifold Length 2.25
ft.
Cell Flow Rate 43.20 gpm Manifold Diameter 1.5 in.
System Flow Rate 43.20 ft Forcemain Diameter 2"/ 70'
and Length
Total Dynamic Head 14.70
Lateral Turn-up Detail
I
Finished Grade Threaded Cleanout Plug or Ball
6" to 8" diameter Lawn Sprinkler Box Valve
_ Long Sweep 90 or Two 45° Bends Same
Distribution Lateral Diameter as Lateral
Page 5 of 7
Combination Tank Component Cross Section
Approved Manhole Covers With Warning Labels
and Locking Device / 4" Min. Above Final Grade
Weather Proof Junction Box
Electric per NEC 300 & SPS.
4" Sch. 40 > Vent 316.012 WAC
> or r = = to 12"
Above Final Grade
Disco t
Alternate Outlet Location
W/Approved 4" Sleeve
Inlet 94.00 Approved Force Main Diam.
Effluent Filter
Baffles! < or = to 1/8" Weep Hole or Anti Siphon Device
Particle Size A
B Pump Off Elev. 90.73'
W1000/600-MR
Wieser C
Tank Mfr. Concrete
D
Dose Tank Elev. 89'~
Vertical Difference Between Pump Off and Distribution Pipe = 7.27'
Minimum Required Supply Pressure = 4.55
70 FT. of Force Main x 4.11 Friction Factor/100FT.... = 2.88
Note: 5X Void Total Dynamic Head = 14.70'
Volume = 89.70 gals.
Number of Doses _ -5 Per Day Gal. Per Day/ #of Doses = 89.70 Gal.
Volume of Backflow = 11.41 Gal.
Total Dose Volume = 101.11 Gal.
Pump Tank Capacity 602.82 Gallons Dimensions Inches Gallons
Pump Tank Volune 11.82 GaUInch A 18.00 301.68
B 2 33.52
Pump Mfr. Goulds C 6.033 101.11
Pump Model EP05 D 9.97 167.09
Minimum Discharge Rate = 43.20 GPM
Alarm Mfr. SJE Rhombus Total= 36 603.36
Alarm Model Tank Alert
Bed Tank per SPS. 383.45(5)
Anchor Tank as necessary to negate buoyant forces per SPS. 383.43(8)(g).
Note: Pump Controls and Alarm Switch require separate circuits.
US 12 _`IW
Pane 6 of 7
ITT GOULDS PUMPS
Wastewater
PERFORMANCE RATINGS COMPONENTS
Total Head Gallons Per Item
(ft. of water) Minute No Description
EP04 EPOS 1 Impeller
5 53 - 2 Base to " + 6
10 46 62 3 Pump Casing a
15 36 55 4 Mechanical Seal
20 21 46 5 Ball Bearings
6
11
25 0 33 6 0-Rings.
30 - 11 7 Power Cord 5
8 Oil Filled Motor 4
Motor Housing/ 3
9 Stator Assembly 2
10 Motor Cover
METERS FEET
10
j
9 30. - - - - - S GPM
8 II~~J~JJ2.5 Fi
25
2
= 6 20:
gvg
Z 5
0 15
4 EP05
0
~ 3 10
EP04
2-
. - - -
5
1
0 00 10 20 30 40 5...
0 ...GPM
0 2 4 6 8 10 12 m3/h
CAPACITY
3
r
Page 7of 7 -1 of 3
Private Onsite Wastewater Treatment System Mound
Management Plan
Pursuant to SPS 383.54 Wis. Adm. Code each Private Onsite Wastewater Treatment
System (POWTS) Shall Include information and procedures for maintaining the system
within the parameters of SPS 383 and 384, and the conditions of approval by the
department, agent, or governmental unit. The approved plans and permits for the system
will be filed with the county zoning or health department.
This management plan complies with SPS 383.54, Wis Adm. Code, and the Mound
Component Manual for Private Onsite Wastewater Treatment Systems SBD-10691-P
(N.01 /01) And the Pressure Distribution Manual SBD -10706-P (N 01 /01)
Table 1: System Design Specifications
Sani Permit Number
Number of Bedrooms 3
Design Flow (GPD) 450
Soil Absorption Component Size ( . ft. 450
Septic Tank Capacity Gal. 2 tanks 1000 gallons a piece
Dose Chamber Capacity Gal. 600
Lift Chamber Capacity Gal.
Type of Wastewater Domestic
Table 2: Soil Absorption Component - Limits of Reliable Operation
Septic Tank Component Soil Absorption Component
Design Flow-Peak (GPD) -950 450
Max. Influent Particle size NA 1 /8 Inch
Maximum BOD 5 (m g/1) NA 220
Maximum TSS (mg/1) NA 150
Maximum FOG NA 30
Table 3: Maintenance Schedule
Septic Tank Inspect and/or service once eve 3 years
Outlet Filter Should inspect once a year and clean eve 3 ears
Dose +Lift Chambers Inspect once eve 3 ears
Soil absorption Component Inspect once eve 3 ears
Page 7of 7 -2 of 3
Septic Tank
An individual certified to service septic tanks under sec. 281.48, Stats, shall maintain the septic
tank. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm.
Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage
Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms).
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 cleaned 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 shall 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 scum and sludge 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 an 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.
Pump Chamber
The pump chamber also requires monitoring once every three years or the time of problem,
complaint or failure. Inspection should include checking the dose rate, volume and frequency.
Warning: The dose chamber may fill due to flow continuing during pump malfunction or power
outages. One large dose when the power comes on or when the pump is repaired may cause the
dispersal system to have problems. In this situation, a licensed pumper should pump the pump
chamber before pump cycling begins or other measures shall be used to dose the component with
only the proper amount of influent. This may include manual operation of the pump controls
until such time the pump chamber has reached its normal level.
Septic tank and Pump chamber 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. An effective locking device to prevent accidental or unauthorized entry
to the tank shall secure exposed access openings greater than 8-inches in diameter
Warning: No one should enter a septic or other treatment or holding tank for any reason without
being in full compliance with OSHA standards for entering a confined space. The atmosphere
within the septic or other treatment or holding tank may contain lethal gases, and rescue of a
person from the interior of the tank may be difficult or impossible.
Tank abandonment shall be accordance with SPS 383.33, Wis Adm. Code when the tank is no
longer used as a POWTS component.
Page 7of 7 -3 of 3
Soil Absorption Component
The soil absorption component serving this structure is designed to accept domestic wastewater
from a residential facility. The limits of operation of this component are shown in Table 2.
The longevity of a soil absorption component depends greatly on proper and timely maintenance,
and system use within or below the limits of reliable operation. Good water conservation
practices by all occupants and the installation of water conserving plumbing fixtures are key
factors in extending the useful life of this component.
The soil absorption component's operation must be assessed by inspection at least once every 3
years. The inspection shall include recording levels of ponding, if any, in the observation pipes,
and visual inspection for any evidence of surface discharge from the component. On steeply
sloping sites, areas of erosion should be identified and reported to the owner for repair. The
surface discharge of domestic wastewater or sewage from the system is prohibited and considered
a human health hazard.
Traffic around or over the soil absorption component should be avoided particularly during
winter months. The compaction or removal of snow cover over the component may lead to
hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or
impossible to repair until weather conditions improve. In general, soil compaction over this
component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to
more intense, and earlier, clogging of the soil.
Planting of deep rooted trees and shrubs directly over or within 10 feet of the component should
be avoided since root intrusion into the component may obstruct wastewater flow.
Contingency Plan
In case of septic or dose tank component damage, measures shall be taken to repair or replace the
tanks to they're original operating condition. Upon failure of the distribution cell component, the
system shall be inspected to determine the cause of failure. Steps taken to repair or replace the
dispersal cell may involve the removal of a bio-mat, which requires cleaning, or replacement of
the distribution network as well as replacing the aggregate system and clogged portions of sand
fill.
Component Owners Contact List
Walter Nechville Plumber #227710 (715 749-3322
St. Croix Co. Zoning 715) 386-4680
Weeks Concrete Products New Richmond WI (715 246-5285
.Wieser Concrete Products Maiden Rock WI (800 325-8456
Septic Pumper Ron's Septic Service 715 749-0153
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tiETTIC I'ANK_'_` L`ill"TTENNA NTCJEEI AGREEN1E~T
AND
(TWNERSHIP CEPTIFICA i'TON FORM
An _M'r1. , r-ra b
' eriftcci>?:'n reauired ti-om Planning & Zoning Department for new construction.)
Rlv45rl - rt~11.S w ` Parce' Identification Number _o''~o -l 0 3 -q6 0
T1 a I 1, T'A;I SCRIPTSON
7a . Sec. 10 T A8 N R / q vJ Tovvn of
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"cd before 2~1~)7)Volurae 8 g Page 7r
- y 3---
Spe( 1-,ouse yes no Lot lines identifiableXyes no
1 t''s_ 'Ai NT EN ONCE AND ONVI ER f_E•r.TIFIC,ATIO`v
r ]E'.U "Cl.,, rua.x. mlance ofvo ! Septic systerr_ could result in its premature failure to handle wastes. Prope:
Is S . _ E zrlp o t ll . septic t, r e vsry three ears or sooner; if needed, by a licensed pug lper. What you put into
~CIL U11 X41 C; 1101) of the septic tank as a aeatrnen tage ii the waste disposal system. OWN oer rnawtenance
e ]ecl in §SPS 3' =.52(I) and rr Crab.:er 12 - St. Croix Countv Sai ita-, Ord-dance.
C 2~'S~es to s bni o St, Cool:, .oun y F anrnirg & Zoning Derart7lent a ce] -tificatior, form, sgmedby the
:r I ;C1L Pei J? ar pl z lnel ?Stiz ,ted L7~U libel . I a lice S -0 "U1 i =r VeI ty1ng that (l }the on-site
ancilor after inspection and pumping (]S necessary), the septic tatt-, is
" 1 . tem is pr pt-1 op .1aill ~ cop
}'i ; t1I.+ Iy;leC: t]ave read r_ e. ,above reau.-- einents and agTee to maintali; the private sewage disposal system with the
ii_,n; as set by the Department of Safety Anu Professional Services and the Department of Natural Resources,
it u«or; s 't na that your septic. system has been maintained must be completed and returned to the St. Croix
~ .'_.~g Dcparnleilt within 3-0, day of the th"e:: Year expiration. date.
i « :li seat"n,_nis oi. this foie-l are true to the best of my%our knowled e. liwe am are the o«mer"s) of the
a. , a ~t . l 'irCae o_' a wal-ra v due' cord(l d i Rea ;,ster of Deeds Office.
DATE
.,ser 3w' reslu. Th.:, •-i .:11?y per-nit bl ~ revoked by the PiantiLn & Zoning Department.
t L$ z.A..i '_~)i
art uc uiion a _:.c•cvdei `xarra.nv, eed '''oin the, i< e.;Stei of Deed a-ld a copy" of the certified survey m.ap tf
1.i c,~ 7z Yz" SN£}i'T Lr!;V ddeU_
,
O.FILED
QQ ~T
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CERTIFIED SURVEY MAP
DESCRIPTION
A parcel of land located in the S2 of the NWl & the NWI' of the SW of Section 13, T 28 N, R 19 W,
Town of Troy, St. Croix County, Wisconsin, described as follows: Commencing at the W 1/4 corner
of said Section 13; thence N 890 30' E (assumed bearing referenced to the West line of said NW 1/4
bearing N 00 01' 50" W) 449.65' along the East - West 1/4 Section line of said Section 13; thence
N 00 01' 50" W 13.73' to the point of beginning; thence continuing N 00 01' 50" W 502,71'; thence
s 890 52' 30" E 369.24'; thence North 427.80'; thence S 890 52' 30" E 1,035.10' to the Westerly
right-of-way line of present County Trunk Highway "U"; thence Southerly 133.34' along the Westerly
right-of-way lire of resent County Trunk Highway "U" on an 879.93' radius curve concave Westerly
whose chord bears S 69 14' 49" w 133,211; thence S 790 24' 43" E 25.00' along said right-of-way
line; thence Southerly 213.20' along said right-of-way line on a 904.93' radius curve concave
Westerly whose chord bears S 170 20' 15" W 212.71'; thence S 240 05' 13" W 272.59' along said
right-of-way line; thence Southerly 356.61' along said right-o£-way line on a 1195,92' radius
curve concave Easterly whose chord bears S 150 32' 40" w 357.P9' to said East - West 1/4 Section
line; thence S 890 30' w 664.14' along said 'A n.e; thence S 250 03' 29" W 45.28' to the Northerly
right-of-way line of Glover Road; thence Westerly 145.63' along a 238.00' radius curve concave
Southerly whose chord bears N 710 33' 17" W 143.361; thence N 890 05' W 325.04' along said
right-of-way line to the point of beginning. Subject to 1/2 of the mineral rights in the name of
Federal Land Bank and also subject to an easement to St. Croix County Electric Cooperative.
I, James E. Rusch, registered Wisconsin land surveyor, do hereby certify that I have surveyed and
mapped the above described property; that such plat is a true and correct representation of the
exterior boundaries of the land surveyed; and that I have fully complied with the provisions of
Chapter 236.34 of the Wisconsin Statutes and the Subdivision Ordinance of St. Croix County to the
best of my professional knowledge, understanding and belief. ~~NNftfpN,
~gG~NS~~~'i
James E. Rusch NOTE: R denotes pr r y rec %-ta
Wisconsin Land S eyor S-137 JAMES E. >
Stevens Engineers, Inc. RUSCH
1407 Coulee Road
Hudson, Wisconsin 54016 ' S-1376
River Falls,
N \ SCALE IN FEET Wis. f -
wz O' 100' 200' 300 UNPLATTED _LAQy'0~NO SURJ~,~,``~ I S
z w (L" = 200') EAST R
o #*;1 _
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w = - - S 89, 52, 30" E 103 5.1 O' ~~.10 - _ I
zM ~ U_ EXISTING tC919e 511.00 524. 10 T A~ 75
Oz DRAIN
0
U W WWCO q, Z n FI ELD _ sue, 'DOES OF HtSLt~p h Q
3°, OES NOT - ~V! I
v LE-moo
3 wJ z BUllTO a cfiN pp•OV S!9 9 4360
5E 3932" I
a Cn M b ~~REFER SIT, SEPTIC EAL F °2d 507/11
wz ti NG2,r TCM 25.00' to 3:2,m gyp/ O °wwv_ v
M=w
U) < N = 5.869 ACRES
aOOm W C>
C° S~ Z / 12.703 ACRES
EAST 368.0'
N V i R / 0V, h-
J~Q 369.24' M "100 159.94' / / 273.31 . ti. /
e.9° S 89° 52' 30" E N 89° 52' 30" W n~ ti
539. is. X 666 3 J/
h h
3 ° Z °R SW - N w APPROVED
NUN 0 5 1978 y / r
C. W ~8°32'3'.1'' Sp S
o Z ST. CROIX C~.51.•
Z Cr O - p s _ -k-
COMPREHENSIVE PAKKS f .a:- .:NG 19
C, 3 r AND ZONNG COMMITTEE Q~
vz op 5.541 ACRES ° N25°0379"E 45.tS'
- 00 o
-3: a- 0 0
'oO N 44°51' 19" E 88.07' / N 25-03' 29"E 31.1
aj a 0 (I
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3 e A !
13.73 N 189* 05'W
25.04' ~ S 89 30' W 664.14' 1
j - - %y EAST-WEST 1/4 SECTION LINE 50
-----TOWN
CORNER
N89°3O'E NUNPLATTED LAND
_ a I
450.05RM \S'A WESTERLY RIGHT-OF-WAY LINE
NORTHERLY RIGHT-OF-WAY LINE Volume 3 Page 608
N,`~~~~ GON~~'~~
~~r ti s=
May 8, 1978 Revised May 14, 197e JAMES E.
RUSCH
S-1376
Surveyed For: Arthur Neuman Owner Q RiverFaiis,
Harold Von Kuster Owner ' yy~ s°
Route 5, Box 72 Route 2 • _ f0
River Falls, Wisconsin 54022 River Falls, Wis. 54022<"9No SUR ~4~
This map is hereby approved by the Town Board. ,,f~lfllffiN•~,
~'D te Lawrence Handlos, Chm., Town of Troy
This instrument drafted by Scott B. Lohman
Conaent of Corporate Mortgagee
Federal taid Bank of St. Paul, a corporation duly organized and existing under and by virtue
of the laws'of the State of Wisconsin, mortgagee of the above described land, does hereby
consent to the' urveying, dividing, :napping and dedication of the land described on thi's plat,
and does hereby e sent to the above certificate of Arthur Neuman, owner.
In Witness Whereof, th aid Federal Land Bank of St. Paul has caused these yr6s nts to be
signed by its Assistant T asurer , and countersIgned by its
Secretary (cashier) , at St. Paul, Mi~ota, and its corporate
sea:. to be hereunto affixed thia,day of 19
In the presence of:
,(e rporate Seal)
Corporate Nam Countersigned
Assistant Treasurer' Secretary or Cashier
STATE OF WISCONSIN) SS
County)
Personally came before me this day of l
Assistant Treasurer, and ' 9 '
Secretary cashier o he above named
corporation, to me known to be the persons who executed the foregoing in strum t, and to me
known to be such Assistant Treasurer and Secretary (cashier) of said corporation, and acknowledged
that they executed the foregoing instrument as such officers as the deed of said co oration, by
its authority.
(Notary Seal)
Notary Public, , Minnesota
My commission expires
CURVE DATA TABLE
Lot No. Curve No. Radius Length Chord Bearing Chord Length Central Angle Tangent Bearing
1 4 238.00' N 830 28' 13" w 46.56' 110 13' 34"
4 238...00' N 650 561 29„ W 98.28' 230 49' 541,
1L 238.00' N 710 33' 16" w 143.36' 350 03' 28" N 890 05' W
3 1 879.93' S 60 14' 49" w 133.21' 80 4o' 56" S 100 35' 17" W
3 2 904.93' S 170 20' 15" W 212.71' 130 29' 56" S 240 05' 13" W
3 3 1195.92' S 150 32' 4o" w 355.2.9' 170 05' o6" S 70 00' 07" w
-Legend-
I" Iron Pipe Found
T Tee Fence Post Found
0 1" x 24" Iron Pipe Weighing 1.68 lbs./lineal ft. set
Fence
- -Centerline of Road
Section or 1/4 Section Line
_ _ _ _ = Existing Improvements
DOEUMGNT r',IO. WARRANTY DEED rz THIS SPACE RE6ERV GO.FOR. RECORDING DATA
STATE fi:°_n OF WISCONSIN FORM 1952
i;
,rct PAGE-410 - REGIS` ER OFFICE
- ST. CROM CO., W1
L?R y Ts ieS.__and- _L _1741Sj1f7e M... I- artze l I1 ! nr.¢ . . .cee'v wr +s7recrrQ
irie_.M . Hartze 1_I, a/Kla S, t_,3UQ_iI1C riq!- 4s i > t~(i~_ V 7
C1 aud > O tW
hi-s 4vife - - . ~t 11 :55 aM1
- I -
convey~ - and w rrunts to .W711 -Lam E_,,.Campbeli and Susan Stor1 , - - I~
--husband--and --wife -as--marital--property- with. r-iglats_-af - Replsterofaeeds
sur_ui-uorsh .p_..--- . . _ - I f
-
- - _
-
. Ry~o-=l6tl rp _
. - - 0. _.G~ rC 5~~2~'~
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-
the follotiwing°described real estate In t• rOiX --County,
State of Wisconsin: - I
„ Tax Parcel No:-
Part-of-the ' S~ of the' NW'd of Section 13,--Township-28 -=North, Range 19 West-,--desct°ibed_ 1__
as follows: Lot 2 of Certified Survey Map filed in the Office of the Register of
Deeds'for'St, Croix County, Wisconsin on June 5, 1978 in Vol. "3" of C_S.M., Page
608 -Document Number 349181_
- i; -
f~
This Is - homestead .property..
(is) (is.T1ot)
-
..Exception to warranties:
Easernents and restrictions of record, if any.
990
- t,
this 15Lh - day of - - November - J
TJated .
(SEAL) (STEAL) $
- LeRoy T. Kies -
(SEAL) Claudine (SEAL)
M. Hartze -Kies, f/k/aClaudine
~!:Harex7fia/k/a 1 audine "Hart`zi31 1 -Kies ;
.
AUTHID NTICA, TI ON AC NN0WLEDGM2,.NT:
Signature(s) STATE OF WISCONSIN
_
- _
- St Cr01 X - Counts s
authenticated this day of....... 13------ eerlsonally came before me s 15th.- ....day o£
NOVE'mD 19- V the above named
- 1 okTtiy.?. K,Pii and Clau:djne M. Hartzell Kies'-
i - - -
fi%kTc C7 aud) ne in Hartzel vkfa Claudine
- - Hartze---- -1Zi es
TITLE: 1SIEMBER STATE BAR OF WISCONSIN
-
authorized by § 706.06, Wis. Stats.) to me knovn to be the person SAha L~stlted H~
for 6~Ing ilfstru,~euh and acknowl E}lee.
C3 0
THIS INSTRUMENT WAS DRAFTED BY <i~
William J. Radosevich, Attorney at"-Law
c3o
502 Second St., Hudson, Wi 54016 Notary Public ._St Croix ~ 5.,.
a
, ~Sta$eT>~ i 10+
(S gnatures may be authenticated or acknowl_d> ed. Both My Commi ssion is nrrmanent. (If noYT, it.
.
arc nuo Pdarrh 17 1J__l...)
..c<<oo....ov uuoc.
+.Namu" O. --_:i9 signin5 :a cap^_i!y _ I-i i,~ tynm[ - m.cd bc:om c`uir aim _.n.
T..-¢al Itln e, i, 1..•, fn.
- WAnRANTY DEED - STATe. BAR OF W:a ON .N
ST'1RIK. No. 2- 1_cg~fii,~urw r~• S4ir.
SOIL EVALUATION REPORT #1159
$ p 14 i Department of Safety and Professional Services page 1 of 3 I Division of Safety and Buildings Keith E. Stoner
in accordance with Comm 85, Wis. Adm. Code
Attach complete site plan on paper not less than 8'/ x 11 inches in size. st County St. Croix include, but not limited to: vertical and horizontal reference point (BM),
di
percent slope, scale or dimensions, north arrow, and location and distance to ne Parcel I.D. 1053-40-000
ilase print all informadon. 4U('i 7 ,C)Rev' By Date
P may be used for secondary purposes (Privacy Law, s. 15.Og~ ql))- / 3
Pr oS Location
Bill Campbell Govt~40/vb , SWIM, NW1/4, S13, T28N, R19W
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 816 Glover Rd. 2 CSM Vol. 3 Pg. 608
City . State Zip Code Phone Number City ❑ Village ® Town Nearest Road
River Falls WI 54022 715-388-2634 Troy Same
❑ New Construction use: ® Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD ® Replacement ❑ Public or commercial - Describe:
Parent material Loess over loamy till weathered from limestone bedrock Flood plain elevation, if applicable Na ft.
General comments Propose a 4.5'x 100' mound cell located along the 95.Woaltour applying 30 inches of sand and a .20 basal loading rate as a safety and recomme ations: factor
to insure that effluent is treated and a sufficient downslope toe to prevent toe leakage.
F-1-1 Boring # Boring ® Pit Ground surface elev. 95 ft. Depth to limiting factor 12 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fts in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh.
*Eff#1 *EffQ
1 0-5 10YR2/1 15% co fragmnts sil 2msbk-gr mvfr cs 3f-co .06 .08
2 5-8 10YR3/4 30% co fragments sil 2msbk mvfr gs 3f-co 0.6 0.8
3 8-12 10YR3/4 50% co fragments sil 2msbk mvfr gs 3f-co 0.6 0.8
4 12-24 10YR3/4 75% co fragments sil 2msbk mvfr 2f-m 0.6 0.8
5 24 Fractured Limestone Bedrock WB
From 8 to 12 inches fragmented bedrock with plenty of avenues for surface wager or effluent to re-assimilate into soil and fractured bedrock.
L] Boring
F218oring # Pit Ground surface elev. 95.30 ft. h to limiting factor 7 in. ® ~ Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft'
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-4 10YR2/1 10% co fragmnts sil 2msbk-gr mvfr c5 3f-co .06 .08
2 4-7 10YR3/4 30% W fragments sil 2msbk mvfr gs 3f-co 0.6 0.8
3 7-12 10YR3/4 70% co fragments sil 2msbk mvfr gs 3f-co 0.6 0.8
4 12-16 10YR3/4 80% co fragments sil 2msbk mvfr 2f-m 0.6 0.8
5 16- Fractured Limestone Bedrock WO >80%
From 7 to 12 inches fragmented bedrock with soil filling the voids between the pieces of bedrock.
* Effluent #1 = BOD? 30 < 220 mg/L and TSS >30 < 150 mg/L uent #2:m BODs <_30 mg/L and TSS <_30 mg/L
CST Name (Please Print) Signature: CST Number
Keith E. Stoner 224059 Address Keith E. Stoner ate Evaluation Conducted Telephone Number
23220 Wood Creek rd. Siren, WI 54872 8/112013 715-653-2324
SM-5330 (Rl1111)
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Cc: Swim, Jerry M - DSPS Swim Wisconsin.9ov (Jerry. G )
Subject: RE: Bill Campbell Soil Test
Thanks for sending the report - the profile descriptions are accurate and reflect my observations in the 3 test pits that
were open for inspection on 7/30/13. 1 think your recommendations for a long, narrow mound with 30 inches of sand
and a low loading rate are appropriate for the conditions on this site. This will be an improvement over the existing
system and provide good, long-term wastewater treatment.
Pam Quinn, Land Use Specialist (POUTS)
St. Croix County Community Development Dept.
iioi Carmichael Road
Hudson, 'IVI 54o16
715-386-4680
pam. quinnAco. saint-croix. wi. us
From: Keith Stoner (mailto:adventurers(~Ocenturytel.net]
Sent: Thursday, August 01, 2013 11:18 PM
To: Pam Quinn Subject: Bill Campbell Soil Test
Pam,
I tried twice to send soil test w/photos and it was returned so I will just send the soil report now and a photo separately.
Thanks for your help, Keith