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HomeMy WebLinkAbout016-1030-80-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division t ~ INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) 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 Dale, Steve Glenwood Townshi CST BM Elev: ~ Insp. BM Elev:~ BM Description: ' e~ TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic t't'K. ~ ~~ i) ~ ~~ Dosing + L~j << Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. ~. 1 Vent to Air Intake ROAD Septic ~ ~ ~~ t ~ i ~--- Dosing l~ « ~ , /~ >< `'Cb Aeration Holding ~~ n~oicrnunu urrne~~ wT~nu Manufacturer Demand ~,_„ ~ GPM Model Number ~~ ~3o ZS• TDH Lift Friction Loss System Head TDH Ft ~~'~ o•3S 3~ZS lobo Forcemain Length , { Dia. ~ li Dist. to Well 2S SOIL ABSORPTION SYSTEM BED/TRENCH Width / Length I DIMENSIONS s SETBACK SYSTEM TO ~t INFORMATION - DISTRIBUTION SYSTEM 2 S P/L BLDG WELL ~ ~ S,~ t (y~ `~'~Uf rz~ 1~i~G r County: $t. CroiX sanitary Permit No: 430243 0 tate Plan ID No: ~'. ~a Parcel Tax No: 016-1030-80-000 Section/Town/Range/Map No: ~ 14.30.15.2278 S ~! ~• ?e STATION BS HI FS ELEV. Benchmark 2 ~~ n '~~ ~ ~ ~ ~ 3~ Alt. BM Bldg. Sewer '0.20 ~ iD .10 SUHt Inlet • l SUHt Outlet Dt Inlet Dt Bottom ~ .~ ~ :- )~. 3 a ~ ,/ p Header ~•~~~ Or,1S Dist. Pipe ~ .! ~. ol•~S Bot. System Q ~~_~ ,~ •~i! Fi I Grade ~ ~ w•l~ ~+ ^•- St Cover g,,µ i ~~.a ~~• ~ ~. 1`F, ~o ~ ~~-• 30 ~-- ate. ~ PIT DIMENSIONS Of Pits Ins' a. Liquid Depth `~ LAKE/STREAM I LE/jpl~ilPl~ (Manufacturer: ~-_ ~/ UNIT Header/Manifold D / ~ U ~ Distribution ~ r pipe(s) , / ~~ ( ~ 1 x Hole Size ~~ 3 ~ x Hole Spacing ~~ ~ Vent to Air Intake ~ Length Dia . Length~~4a•,Dia ?- Spacing ~~ ~ SOIL COVER x Pressure Svstems Onlv xx Mound Or At-Grade Svstems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil i ~ ~ - Yes ~ ~ No , Yes _ No C(~IV[111[EN ~; (I~ ud r encies, persons present, etc.) Inspecton' P` AA 1'Cs'*.+L.~~3 Inspection #2: •~.~-~ Location: 1561 310th Stree Glenwddl7 ~ty,~Wl 54013 (SW 1/4 NW 1/4 14 T30N R15W) NA Lot Parcel No: 14.30.15.227B 1.) Alt BM Description = N//~ 2.) Bldg sewer length = .r. dJ`a - amount of cover = ~ K~ Plan revision Re wired? Yes "No ~ • tp-.~~_~ _ . _ _ - --- ~ _ ~L~~~-.~ ~r , q { 1 ~ 'rf" CA (~(O ~ Use other side for additional information. 1 i _; SBD-6710 (R.3/97) ~ ~te ~ ~ Insepctor's Signature Cert. No. 0 ~ Safety and Buildings Division 201 W. Washington Ave., P.O. Box 7162 C~tY ~ t ` ~ Madison, W L 53707 - 7162 Sanitary Permit Numbs (to be filled in by Co.) (608)266-3151 i,~~O~~~ ~ 3 Department of Commerce Sanitary Permit Application r State Plan L Number ~. rovide ou tion l i f s p y orma n In accord with Comm 83.21, Wis. Adm Code, persona s15 04(ixm) be used for secondary purposes Privacy Law ma Prgect Addnsc (if 'S t than mailing address) ._ .. _ .~ .,~ _ y a va ~ .. ~* ~~ti..~ ~ k ... _. i 1. Application lnformatlon -Please Print All ln[ormation D ~ ~D ~ ~ ~D ~ ObO Property Uwner's Name i 4 ~ i ~ Parcel # Lot # Block # Property Owner's Mailing Address ~ ~ , : y ~ ' ~ pZa ~ _ B dy Mr. ._... .._~ . ...W_..,__. S r . • ~,., NW ',., Section L~ ~ . City, State a ~~ Zip Code Phone Number ~~~ ~ //~~ "~~ ~- ~~~r rele e) ll. Type of wilding (check all that ap y) j ~ ~ ~ ~ S ~ ~ Subdivision Naute CSM Number I ~1 or 2 Family Dwelling -Number of Bedrooms ~ ~ (,~ CJi TL' 4 ~G} i /t^ ^ PublidCommercial -Describe Use _ ~-I-1 / ~ ~ ^VHlage Township of e ^Ctty ~v O S X ^ State Owned -Describe Use J ~ _ 111. Type of Permit: (Check only one boz on line A. Complete line B if applicable) A' ^ New System ~ Replacement System ^ TreatmenUHolding Tank Replacement Only ^ Other Modification to Existing System B. ^ Permit Renewal ^ Permit Revision - ^ Change of ^ Permit Transter to New list Previous Permit Number and Date Issued Before Expiration Plumber O"'°~ 1V. T e of POWTS S stem: Check all that a l ^ Non -Pressurized ln-Ground Mound > 24 in. of suitable soil ^ Motmd < 24 m. of suitable soil ^ At-Crrade ^ Single Pass Sand Filter ^ Constnrcted Wetland ^ Pressurized ln-Ground ^ Holding Tank ^ Peat FIIter ^ Aerobic Treatment Unit ^ Reciroulating Sand Fiher ^ Recirculatin S thetic Media Filter ^ Leas ' Chamber ^ Dd line ^ Gravel-less P' ^ Other ( lain) ~' V. Dis rstil/1'reatmentAre~ Information: Design Flow (gpd) Design Soil Appl~icrat''i Ra Dispersal Area R aired/~(sf) Dispersal Area Proposed (s~ System Elevation / ~ a/ ~ ~a7~~ ~~ ~~ , d0 ~Ir7 a ~J . Vl. Tank Info CaP~ih' ~ Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units ~/~ ~~ A ~ ~ Concrete Constructed Glass Ncw Existing v Tanks Tanks Septicoe,~Siat~T+nk p19D DDo ~ ~~ Aerobic Ttca[mctu Unit Dining Chamber V Vll. Res nsibill Statement- 1, the under d, assume nslbWty for lnstaBatlon of the POWTS shown on the attached lens. MP RS Number Business Phone Number Plu Name (Print) PI s Si t z 3 ~ z ~s z~s`-- u ~~ Plumber's Address (Street, City, State, Zip ~~7 tT "/ ~ 6 D 9 ~p ~ ~ .C ,5 Vlll nun /De artment Use Onl Sanitary Permit Fee (includes Groundwater Da Issued lsswng t Signahrre tamps) Approved ^ Disapproved Surcharge Fee) ~ ~~ W g 'ZO 6 3 ^ Owner Given Reason for Denial IX. Conditions of ApprovaUReasona for Disap{rroval ~,~.~f,, ~~ 'n~ ,~J/~ ~ a ~. s ~~ ~~/s/o3' ~ c>y. ~~- 1~`' Pt3u/TJ /'1'1 `.nom- lp,ryt~t. ~3 Tz 1~1 ineha in aixc ~`l ~~`~rn..~3.~3--~ lGTii'(i/~ ~UAttaeh , mpk ptfF" "v "' ~:a my only) for toe ryatem oo paps uua r.[y~ fn SBD-6398 (R. 01/03) ~~.y~ IJw,`ct, -~~o~ I~~a-~- $w.Mw.l~"3tp-lSw ..._, 1 0,..,,.; ~sla...~•eo O\1o-lozo -gSo-ooc7 ~ Sbl 3 l'o'g'`'' S ~ , , 3~ SG,.I~. \" 1 J~~ O lS b0 C~ V '^`~+~t Llt~'74 `.^ p s ~ c ~ aec.., ~ ~O ~ (o w.~ ~ .r0.O c-s.,. ~O.w "~w ~~y~~ ~S~ ~">o lo" s..lso~ 1 r 6' ~oa.,~.; J~ [~1 -+- rn ~....,..s:11- .ems w ~~ t~, t e~ 1-o w,~t a~ , o ~ d~+~. LILi ? \.?~ SU'^7.a. S~ ii ~~,t~~ C~~~,~ ~-'-~_. ~ S. Q.~e~w L4y~y.~\ SC.r V.~Q -.~-_ ~ LK ~ o z~ + (.~ '- \~ ~ ~' ~~ \ W~~~ - Sp ~s' i'~ T ~ t(QC ..~w~.n~ O dfT J1 0.r n.: r ~ Pat, v K :tlJ..~; 8e~.lr. \ . Sw.:..e , \ +~ ~~ -.( I \ ~a acs) L ~ ,,,, . ~,-r-- - _ ~,~, ~ L..~ ~ ~ Q ac ~~ oo. o~ ~~t. ~ ~ n e ~2. A i- u V. i.: t.Jl. S • dc-: V ~ ~ +~ ~ ~_~ > >-- ~;~~"-- ~sc: . FF?psr TT.:'v~ ^~~cc ~_-_~ »;> =m=T= f a ~ ~scons~n Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www. commerce.state.wi.us/sb www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary August O5, 2003 CUST ID No.139462 TODD L SINZ T L SINZ PLUMBING INC E5609 708TH AVE MENOMONIE WI 54751-5520 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/05/2005 SITE: Steve Dale 1561 310TH St Town of Glenwood, 54013 St Croix County SW1/4, NW1/4, S14, T30N, R15W FOR: ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 ~~3~~-~3 .Identification Nurribers Transaction ID No. 894939 Site ID No. 662903 Please referto both dentficationnumbers,. above, in all correspondence with the agency.. Description: Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 914391 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Requirements: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD-10691-P (N.O1/O1) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD-10706-P (N.O1/O1). • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal L'or are prohibited. ~~~ • The existing POWTS must be properly abandoned per Comm 83.33 Wisc.Adm. Code. pE RTM ,6J91 N OF • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Slats. SEE COF • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Slat • Comm 83.22(7) 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. TODD L SINZ Page 2 8/5/03 Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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 Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence 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 to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Charles L Bratz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday cbratz a~commerce.state.wi.us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 Henry F Grote ,Certified Soil Testing a ~F s ~~ cFi t ale -Mound 9~ C ~ ~~ S eve D ~~`!' 3~0 O ~~ Q,~ Transaction # ~O~ Construction Materials and Techniques soi All materials must comply with Comm 84 and be installed in accordance with manufacturer's specifications. Construction methods must comply with the following Component Manuals: Mound, SBD-10691-P (O1/O1) Pressure Distribution, SBD-10706-P (O1/Ol) Location: SW 1/4, NW 1/4, Sec. 14, T 30 N, R 15 W Town: Glenwood County: St. Croix Date: August 6, 2003 Owner: Steve Dale Address: 1561 310th St. Gler~wood City, WI 54013 Plumber: T Signature: License # MP 13 Attachments: 6748-Plan Approval Application SBD-8330 page 1: cover 2: design criteria & calculations 3 : plot plan ~i~nal y 4: system cross section ~O V 5: plan view, lateral detail . Ep COMMERC 6: pump tank exit detail E LI3fNG 7: pump curve 8: system management =SPONDEN page 1 of 8 ';r ~ ~ ;~ , Design Criteria ~~ Residential Wastewater Contaminant Load: 30 mg/L < BODS < 220 mg/L Anticipated septic tank effluent 30 mglL < TSS < 150mgiL Fecal Coliform > 10,000 cfu/100 mL Fats, oils, grease < 30 mg/L 3 Bedrooms x 100 gal/bedroom/day x 1.5 ~~ gallons/day hydraulic load In situ designed loading rate Depth to estimated high ground water Depth to bedrock Cross slope at system ~ ~ Force main length ~ ~~ Manifold/header length 4" Drain-back 3. ~ Lateral length z @ s4 • ~ Lateral elevation ~ ~~• o Lateral hole size ~~~ b in. @ 3 I~• o ~ `~ holes/lateral 3 ~ Lateral volume 9.9 3 b Total lateral discharge rate 25 • © 8 Network pressure compensation losses ° •~-S Elevation difference S' ~ Friction loss d•21 Total dynamic head ~ .4 b Pump/sip~aon ~ Ql gpm @ ~ Z Manufacturer }~ ~ o w... ~,~ Dose volume ~ ~•~ Lift/sipP~on tank ~~ w~~ awl ~ ~-b~ ~~~ ~, Septic tank ~' '' Effluent filter ~ r a•.do ~ T o ~ z-Z - ~~+ ~3 ~ Measurement pump on and off S' ~ Height alarm from tank bottom ~~'' ° Reserve capacity ~ ~~~ specs.calcs.res Desi n Calculations ~ • 3 a~ gallons/sq. ft. per day ~, 3 8 in. ~ ~ o in. 0/a w ~. x ft. of Z in. ft. of Z in. gallons ft. of ~ ~2 in. ft. @ bottom of lateral in. ( 3 • ~° ft.) Spacing holes total gallons gallons/minute @ ~' s~ ft. head ft. ft. ft. @ z~~ gallons/minute ft. ft. of head Model # g ~'= ~ gallons ~ ~'° gallons t ~-vti gallons in. in. gallons So Page ~" of ~ +Q ve. 1.~ •~,`2. -'~~o~ 1-~ q,.~, Sw . h~.., _~~t-3 c~ -lSw "~' ~r1a...M.eo~ 1 Owv-L Olle-lo 3o -~So-ooo ~Sbl 3~'0~`'' S1, . 3~ w t~ SG1.l~. ~,~ _. ~Q~ t7 IS ~~ Y ~~ 1 l u p T ` ° yw"t' a'tlC.~ ~ b'C ~ ~ O wy l ~}'O. 0 ~~6~w ~'O r.Y ~~g~~ -~'- r ~awL~ ~ •tX <w 1~3 c~, ~ ~.a,,, ~` o w,~t .~ . o `~ b~ tlis ~ \~ s ~~.a, s%~ ~+.-ic~,~O ~( Q C~~~,~ t~ ~A~ i -" ~' ~ Cis: ~,~~ ~ ~ ~`~~` ~z~ > lo" s..ls~~ 1 1~. Z„ 1--~ dLt1a.:... ~ac\t ~o tarl- ~, `(\ Q .O ~ w L K ~- ~ .Q..~~ (S\ GAS V. ~~ Q///~ 'r~~~a m w~ ~{ ^ w- MV ~.~ ~~ w~c~ ~~ z~~. ~~ ~~ ~~ ;~. r ^~ \ ~ . S o.~.,.:.. o ' ~ w f' L . ~. ~,,.~. -~ ~ 6 ac ~~ o-o , o~ -~.c.. ~ ~ M e e~- s(~a~Q S~~ s~~~ ~ z~ ~K c-~l.~s .Q.c~ ~_, m ~.,~~~ ~~Y:=x ~~,T~T ~~ ~~TmT~, =='>ss= mmN,N~,s ~~~~- ~~__=~_ D>D>-D ~,i~,m ~, T,T ~ ~ ~~s ~~ ~:.~~ ~ ~ :~ a.i , i S ~-s.~, . C. pro s s . S ~ ~. ~-; o,~ ,~ '~ i ,r l 6. M! °~L~t ~~r ~Ji 1 Ow rr I~~' ~ Ct9'$3r eAn.o~, •`'y p av `~a•r .+~..tv.' aiv, 1.~t.o Ql 1 / m m' 1 wc~ ~ 1 t3tr.~ 1 r C. r Z ~- I ,;,'g 13 ~~ ~lc1 bco:, b«a~ ~1 ~.,.. 41~- M.4Y ~~~~~, ~~~i~ e.w~c~..~a~t,~ z ~9,~-C~` ,-.-^ O -~ ~z~ ~,~ r---~ S• 3' _ T .~ o, ~~,}' ~--9' T I ~ ~ ~ . 4-' .,i' 3 , $~ ~6•b~ 1 1 ~.~' N o'Y Q. ; ~ 4 7 Qr. ~ i ~ QJ.r w.'..n. a. ~ ._--~ ~ w w ~^~'s O ~ `r ~ G~4 lw „: O'. 4C~ ~- ea ~ ~ ~ ~ v C o b S ~r v ~'i-~ o .~ ~.. a l1 t i-O b e •4 ~ o ... O •~ r o c. K b N P l` ~]1 ¢. ~-O~ ~n p 1 1 1 O \ t? ~..r ~\ S ~v'1 1 C •• ( ~ t PVC S c~ dro ~~..~..~~ 1 4• d' 3.0' I 'S.d~ I I 3.a' I 'S.a' l S ~ ~' { (( CC l ~. 3%.~ '~ 01 ~ o r, 1.~ ~. ~ ~...~ ~ ~ o-~ a ~ 1, ~ ~, ~ ~b•~ a e..-~ ~ z.~~ i a ~~~ S ~~ 'a 4M Ptic,~~,~ X17; 4m GIP6 3' (lU NC>ISTuR~ED S01 t_ i~ r ~ G W it OvLO. L P t P'G ,rur E C.T I O N.S ;C~e.,. Q V•O 4C l.i~r v. i ~ Q ~~ O C. L~ R oR~~ I"~Air ~ WEATNERPRCIJF n ,TL N trT I O N I~ 6cac I.' /7/i~i~I P.*c ki. 4" 4 0 VENT J ,,'z~ ~, ~,. ~ w C::. P ,~~ 4c 3' ono 1.++cLl1''lx~ 4z° P~1~1P Co~vt~~-r-c bcoGK 14•~ ~ SEPTIC E SPECIFI~GATIOIJ$ ~ "~" . 0o s E ~ 1 . ~, -~- ~w~ T~~.'. S MA-JUFAGTURCR: IJUMB ~, 3 CR OF TA-.IK SIZE : 1 ~WV` - V~ GAl L01J5 pOSCS: PEK C~~ - • .DOSC VODUME S d ~} ~ ALAR11 r~A,.,UFACruRca: 'K-~YS IAJCLUDIAJG 6AGKFl.OW: ~•~'S /'~ODCL 1,1UKDER: . 1 e 1 1-}.~ . CAPAC G~~~O~: 3$x'4 ITIES, A= ~b'~ SWITCH TyPC; ~"'Q'~'`"" `"~~o IuCHCS OK C'f'-`~~= Nur,P '~ ~ /'1AIJUFACTUR B = Z' IucHCS oa 2~'g ;,.,..~,,. ~ y.~.vw~. ~ CR; '~"" ;)u MODEL 1JUMDCR; ,~'1-11eF '~O ~,O ~~•~ C a WCMES OH `'~`_~`~- `'1 ~ JWITCH TyPC: V"~2~w,v w D . . 13 4,1 INCHES GR ~a~_.~..,_ IJOTE: 1"111JIMUM DISCH1IR(,F RATE ?'S'~ E,PK PUMP A1J0 ALARM ARC TO 8C INSrALLEO 01.1 SCP~RATC VCKTICAI_ DIFFCRCIJCf OCTWCCU PUMP OF- /-UO OISTRI~UTIO/J PIPE CiK._ ~~~ ` ,. + MiuIMUM -~eTWORF( SUPPI.y PRELiURE ~ ~ ~ ~ ~ 1 ` FELT Z.S FDET ~' ~~~-J' + ' FEET OF PORCC !'MIIJ X 1~ ~~ ~ ~ ~ -oo rCFRICTI01u FACT , l9.'t„~ Z ~ pR. FEET ~ S _ ~~ TOTAL. Dy1JAMIC HEAP c ~ ~ Q~b FEEr IIJTERAIA~. DIME).,.lb101JG '0/ TAIJK: LEIJG7H \ ~_`„ WI 2.11 4 11 2 ; DTH ~Iqul~ oe PT H ~' 1'au~ 6 a ~ ,,. h ~, -~ 24u I.D~ r~a„uo~ -WCKING GOVfiR ---~ lt/A/t~N ~,uc .( ABED . avlcK Cia~o.I~~cT--~ > '4',~~ ~~ ~ ,_.. ; ~ ~ rc~ . ~ A Zb• c N. __~__-- BAFFLE 1 ~ a~ a ~^ ~- ~ro.K t.o F'r' m tit-143 ~1 ~ ON - ~O ~ ~ ~ ,9„ ~. 7e ~ n 1 "'. Puma Charactaristica /MNa lhlt Svb.+wsril+ AedoeeoNt A~odads SBEF30A) µon+prrwK .30 MI Load Anp t.0 liMla T Sboled ~eM {4 } R.PJd. 1350 Phone @ 1 VeM 11S N eri: 60 ien,pM.tao 140'F A~nf NENU Dos13e A ~s>datfoa Gams A Dieshot Sh. 1-) /1' N-T (Std Sollds Hearj'inq 3J4~ (19RIA) U>t!r Welgitl JO bs. Pewer Cad 16/~, S1iW, 20' sd. Performance Data Dimensional Data i. AEAwendweb'vders Ira ~ ~~« ~. z. ~t s ~, wy: Vl nc! 3. Na br t«struaan pure v~ ~ +. pMnsan onl eeip-t+.~ me ,~pn,b,,,,, S. On/OH brel aA~e b, Ye rtrrve tM r~ht A ae~te rt~ a a- pr•Fuct ad tM~ tp~dimsao eMotA netxe ~,~, ..,•,~ t ~I. `. ~ ,,.7,~ c~o~t q~l~ z• ~~ ~„a~ 1 ~~/~s~•y~y (94) i,Ad br ~~~j° HYDRdMATIC W e e ~ X810 Barty Rwd A~Nand,,~to 44EOS Te1;119•IB9.90~1 Fix; 419.9Y1•4011 Web Slie: wew.peetdrpunp.rom SALES OFEKES IN Ail NWOR CRIES ANQ COUNTRIES nem u: Wci2.83S0 12G8 5M 1909 H drarKii<' Purnpf, Ath~oroi, Chao. N! R' n Reeved. - Ywi Authonied lord CauribWo~ - `~~~~. a ~ o~ ~ ~~ hE` . Materials of Construction S System Management Management of this system is critical. As a condition of approval of these plans this system management section must be reviewed with the owner, and the owner must be provided with a complete set of plans including this management section. If problems develop with the adsorption system or any other system components, the installing plumber, T.L. Sinz Plumbing, 715-235-2644, or the St. Croix County Zoning Office, 715-386-4680, should be contacted for assistance. General Proper functioning of an on-site disposal system, "septic system," is significantly dependent on the volume of water which flows into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the better and longer the system will function. Typical system components include a septic tank or compartment to settle out solids and contain greases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a pump tank or compartment to allow a dose to be accumulated, a pump and controls, and finally some type of soil adsorption cell to recycle the water in a manner to protect ground water quality and public health. I . If the septic tank is installed prior to sheet-rock and/or painting, pump the septic tank before normal use begins to ensure adherence to contaminant load design criteria. 2 Install water-saving appliances whenever and wherever possible. 3. Repair even small water leaks as soon as possible. 4. Never pour grease or oil down any drain or stool. 5. Garbage disposals are not recommended; if you must have one, use it sparingly. 6. No paper products other than tissue should go into the system. 7. No chemicals should go into the system. 8. Avoid surge flows of water; try to spread laundry throughout the week. 9. Septic tank effluent must be less than or equal to the design criteria specified in page 2 of these plans. 10. If septic or pump tanks are no longer used, they must be properly abandoned. 11. If construction timing and weather could create a frozen infiltration system, weather-proofing with plastic sheeting and heavy mulching may be required to maintain a functional system at start-up. Maintenance 1. The septic tank must be inspected every three years by a properly licensed person. 2. If necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids volume equals one third of the tank volume. 3. When the septic tank is pumped, any solids in the bottom of the pump tank must be pumped, and the filter must be back-washed into the septic tank to remove accumulated material. 4. Periodic observation pipe inspections should be made by the homeowner to examine the state of the in-situ soil adsorption cell. Quarterly inspections are recommended; a licensed plumber should be notified if effluent is consistently ponded in the adsorption cell. 5. If this system contains specific treatment components other than those mentioned here, maintenance requirements will accompany their specifications. 6. The pumping components for this system include an alarm which must be installed and remain on a separate circuit from the pump. If the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allows reserve capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or two days should pass before any necessary repairs can be made. 7. Avoid compaction such as vehicle traffic within 15' down-slope of the adsorption system. 8. Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system. 9. Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth. 10. Surface drainage must be diverted around the system; avoid landscape changes which might send surface run-off into the system area. 1 1. Warning: Do not enter septic, pump or other treatment tanks; death may result because they may contain lethal gases or insufficient oxygen. Contingency Plan Wastewater monitoring of volume and quality is not a normal requirement for low effluent strength systems; such monitoring may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83.4 (2). Pumping and hauling of wastewater may be necessary while analysis and repairs are implemented. Additional testing, designing, and/or installation of additional treatment components or conversion to a holding tank may be necessary. y Page 8 of 8 ~....,... ,. y f ~. , Wisconsin Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT in accordance with Cnmm R5 Wis. Adm Code 1799 P~ Page 1 of 3 Certified Soil Testing County Attach complete site plan on paper not less than 8'/: x 11 inches in size. Plan must i l d b t li i h l d ri f roix nc u e, u not m zonta re te to: vertical and o erence point (BM), direction and percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. parcel I.D. 016-1030-80-000 Please nt_all info_rm_a_tion. Per n l inf m ti id b ~g i L 1 04 1 eviewed y Dat or so a a on you prov e m y e use c~y~~r vacy , s. ( ) (m)). 5. Property Owner ! Property Location Dale, Steve i i ~; ~ ~ Govt. Lot SW 1/4 NW 1/4 S 14 T 30 N R 15 W Property Owner's Mailing Address; Lot # Block # Subd. Na ~ r CSM# 1561 310th St. ,; ~,~J /'J City St i Z8 ID`~0~' Pk~orie`i~Cutnber _ City Village Town Nearest Road Glenwood City ~ WI 54013 715-265-4582 Glenwood 310Th St. -- _:W New Construction Use: ~ Residential /Number of bedrooms 3 Code derived design flow rate Replacement „_ Public or commercial -Describe: Parent material loess over tit! Fiood plain elevation, if applicable General comments and recommendations: install 8' x 57' rock cell mound on 100.0 contour as upslope edge of rock w/ 0.5' sand fill 450 GPD NA Boring # -_-', Boring Pit Ground Surface elev. 100.0 ft. Depth to limiting factor 40 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DIft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-11 7.5YR 3/2 - sit 2 f sbk mvfr cs 1f/m .5 .8 2 11-33 7.5YR 4/4 - sit 3 m sbk mvfr gs 1m .5 .8 3 33-40 7.5YR 4/4 - sit 1 m abk mvfr cs 1f .2 .3 4 40-50 7.5YR 4/4 f3f 7.5YR 5/3 sit 1 m abk mvfr - - .2 .3 - horizon 2 has occasional gy si coats on peds; soils suitable for at-grade, available area requires mound Boring # __J Boring Pit Ground Surface elev. 98.3 ft. Depth to limiting factor 38 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-10 7.5YR 3/2 - sit 2 f sbk mvfr cs 1f/m .5 ~ .8 2 10-19 10YR 4/3 - sit 2 m sbk mvfr gw 1f .5 .8 3 19-38 7.5YR 4/4 - sit 2 m sbk mvfr gs 1 m .5 .8 4 38-54 7.5YR 4/4 f2d 10YR 6/2 sit 0 m mvfr - - 0 .2 1 I worm channels & decayed roots to 54" w/ classic, vertical 7.5YR 5/8,5/3 redoximorphic feature w/ dark root center @ 16-24" * Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 1 mg/L 'Effluent #2 = BODS < 30 mg/L and TSS _< 30 mgr CST Name (Please Print) Signature: , CST Number Henry F. Grote ~ ~ /~~~~ . 222774 Address Certified Soil Testing Date Evaluation Conducted Telephone Number E. 4366 353rd Ave., Menomonie, WI 54751 7/2/2003 715-233-0398 f ,..~ ~, Page 2 of 3 ^ Boring # ~ ~~~~~ iN p f Ground Surface elev. 100,0 ft. Depth to limiting factor 48 in. Soil Application Rate e Horizon Depth olor Redox Description Texture Structure Consistence Boundary Roots ' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-9 7.5YR 3/2 - sil 2 f sbk mvfr cs 1f/m .5 .8 2 9-16 7.5YR 4/4 - sil 3 m sbk mvfr gs 1m .5 .8 3 16-48 7.5 - sil 1 m abk mvfr cs 1f .2 .3 4 48-60 7.5YR 4/4 f1f 10YR 6/2 sl 0 m mvfr - - .3 .5 I horizon 4 near field capacity Property Owner Ddle St ,; Parcel ID # 016-1030-80-000 ^ 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 P I in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 I 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/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ~ *Eff#1 *Eff#2 I ~ -- i i * Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L * 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_07/00) Certified Soil Tes[ing d ~ ' / 3~ a S r~QrV~ 1/ ~~Qr ~ J 1 O~ ~ 1 ~rM O1ln-le3o -qso-ood Orel 3~0'`~' s1. S61~Q~ ~~~ = 10~ ~ ~S ~~ ~. se• ~4`B~ ~lUt~q~ t ~----- K l~ dL.~,~,;t~ ~' ...y` ~ ~ ~ ~~` L kbY ~,y~ Sa~'V•kQ l~~ \ ~ -3 \ ~ ~~ ~ ~ ~ ~ ~~,.~ 1\~Zb ~ n~~ K / \ `' ~ . ~, $w .1~~+-14 -3w -~Sw ~I o..,ti; ~r1a...~.eo~ a (~ ~.. two 8 ~~~10_o1~~p„o~.\ o...r( ~~ ~IC.i ? 1J~~ S '^~.o., S~~t I~ i 1~~f, -~ ~ ~ \~ ~ L . ~. ~.,:~ -~- ~a G~ ac C~ uo , o~ ~,~.. ~ ~'+ e ~Q. 8 i- v ems. ~+~a~(. S~ ~ 3o~s ~=1 a >.:~ ~r ~~~~~ti '~s"~~~u ~~TT~,~ ~~y~, OJIT TYF+ ff~~Dr mm ~N lryS ox5u'c`o'o ccc-c D>DDDD TT~.Tm;• (1~~.bS u6. OZ. Oc.i FRI 10:31 FAT i1S •7S6 d686 ST c;R1 C'0 ZONING [1001 sx cRO~c covrrrx SEPTIC TANK MpII.I'T'BNANCB AC3R.BBMSNT' AND OWNERSHIP CERTIFICATION >~ORM QwnerBuyer /~ Mailing Address ,_!~l ~/c7~S S ~ ~ ~/ ~ ~~ /~ C~s.SCo ~d! 3 Property Address _~~ ( ~~~-~ /~` (Vcrificatioo required from Plattnittg Department for new construction) (~-(P,~~u~ ~•t ,/~l~ Parcel Identification Number ~~~0 f030- ~0-'~~ City/State Z.,EGAL DESCRIP'Z'~ON ' ~~7~ Property Location ~~ `/4, `~'~ `/., Sec. l~ . T c ~ N-R~_W, Town of L~ ~0~ Subdivision -.--------_-. ~, Lot # .~.. ~_• Certified Survey Ma/p # ,Volume Page # `'r ~~Deed # _(~ J~ ~ ~~ , 'Volume ~ ~ ~ Page # Spec house ^ yes ®no Lot lines identifiable ^ yes O no SYSTEM MA.IN7.'ENANCE Improper use and maintenanceof your septic system could result in its pret»~ failura to handle wastes. Proper maintenance consistx of pumping out the septic tank every three years or sooner, if needed by a licensed pumps. What yon put {nta the system can affect the function of the scprie tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signal by the awaer and by a masoerplumbor, journcym~'tnplumbcr, tesdrictedplumbtr or a licensedpttmpcr verifying that (1) the on-site wastewater disposal sYstcm ~ in proper Operating condition and/or (2) aRcr inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/wc, the undersigned have read the above requirements and agree to maintain the Private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Dcputtimc>it of Natural Resources, State of Wisconsin. Certification stating that your septic system has txen maintained must be eompteted sad rcttuned to the St Croix County Zoning Office within 30 Sys three year cxp' rion date. J lb _ DAT'1~ SiGA ::~.1 :JIt~. t~F A~'YLII.Y.i`~I' OWNER CERTTFICATI N I we arJ ;arc) the owner(s) of I (we) certify that all statements on this form are true to the beat of my (o~) l~°wledgc. ( ) the p petty described hove by virtue of a warranry decd recorded in Register of Deeds 4l'Iice. /~~ DAT'B SIGNA'IYJRE OF APPLICANT •••R•• •••••• Any information that is mis•rcpresented may result in the saaitary permit being revoked by the Zoning Department. ++ Include with this appticatioa: a stamped wart~anty decd from the Register of Deeds office a copy of the certified survey trap if ccference is made to the wnuanty deed (~ STATE BARQOF WISCONSIN FORM 3 - 1998 Document Number ~ Y `~~~~P~f DE~1~ ' This Deed, made between Rita J. Dale paletaicz f/k/a.-B.ita-,.T_--Date.,- a s~,ngle-~sen '- _. _ _ Crantor, i and Steven J. Dale _ _ - T _ _, Grantee. Crantor .quit claims ro Cramee the following described real estate in ut . Croix County State of Wisconsin: Beginning at the. Southwest corner of the Northwest Quarter (NW 1/4) of the Northwest Quarter (N?4 1/4i of Section 1R, Township 30 North, Range 15 West, Thence South 613 feet to point of beginning; Thence East 400 feet; Thence South 300 feet; Thence West 400 feet 6.381.07 Y.RTHLEch H. WALSH kEGIST~h OF DEEDS ST. CF'OIX CO., WI RECEIVED FOR RECORD n2_rJ6-?O01 2:45 Ph DUIT CLAIM DEED EY.E!!PT 9 8M CERT COPY FEE: COPY FEE: TRANSFER FEE: RECORDING FEE: 10.00 GAGES: 1 •. ,.....,:1 • ,.~ , .er.,....... ,.~,., Name antl Return Adtlress~ WESTCONSIN CREDIT UNION post Office Box i 60 Menomonie, Wisconsin 54751 to center of road; Thence North to point of beginning. ` -- _. ,. -- ._. -._ _ 016-1030-80-000 Parcel Identi(tcalitxt Number (PIN) -~-- This 1S ~~ homestead property. (Is) (is not) This conveyance is given to also release the $62,500.00 lien in favor of the Grantor, as cited in the Marital Settlement Agreement in St. Croix County Case No. 99 FA 244. Together with all appurtenant rights. title and interests. Dated this 1 $th day of Signature(s) _ authenticated this day of TITLE: MEMBER STATE BAR OF WISCONSIN (lfnot. _._.__--_-_- authorlud by §7O&.O6,Wis. Stats.) - Tr+IS INSTRUMENT WqS DRAFTED ev Doar, Drill & Skow, S.C. Baldwin, WI 54002-0460 (Signatures ntay be authenticated or acknowledged. Both are not necessary.) AUTHENTICATION 2001 (SEAL) _~]^~~'~- ' (SEAL) Rita J. Dalep~Q,,,;~z f/kfa Rita J. Dale (SEAL) '.yQL Js ACKNOWLEDGMENT :i State of Wisconsin, ss. S ~ • CCO t_~ County Personally came before me [his _ I~~'I' day of ' t. , ..~t~0 \ ,the above named Rita .T '~ me known to be the person ~.. w instrument and acknowledge the san..e~~ y~GWCCv~e~-- )1r~, ~,.~~~~, Notary Public, State of Wisco ~'•.~~ My commission is permanent. (It"'noY•x a _ t -+ (SEAL) _ to foregoing iratlon date: ~t~..) 'Names of persorsc signing Yn any capacity nast 6e typed or printed Oelow ehe4 signature. STATE BAR OF WISCONSIN Wisconsin legal Stank Co.. Inc. QUIT CLAIM DEED FORM No. 9 - 1998 Mswaukw, was.