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HomeMy WebLinkAbout008-1063-70-000 in Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Permit No: id Building Division INSPECTION REPORT 567233 0 (ATTACH TO PERMIT) State Plan ID No: GENERAL INFORMATION Personal information you provide may be used for secondary purposes[Privacy Law,s.15.04(1)(m)]. Parcel Tax No: City Village X Township 008-1063-70-000 Permit HnJar Name: Eau Galle, Town of CST Jared &Jenna Section/Town/Range/Map No: CST BM Elev: IInsp.BM IBM Description:6 m I C 57- 22.28.16.325 �C/ ELEVATION DATA TANK INFORMATION CAPACITY STATION En HI TYPE MANUFACTURER 0/, 9111111M • Benchmark $� f Septic t ,i• � -- "" If i ZDC) j b W - gM tram,— , Dosing ✓ �� Alt.f • -- 'l, j,1 6 / Bldg.Sewer -- �a�� Aaetatrerr" j--r 1. '� St/Ht Inlet i� . q7 Holding - St/Ht Outlet �"�+ ..........:‘,1 TANK SETBACK INFORMATION -- . .. TANK TO , /L1 WELL BLDG. ent to ''r Intake ROAD Dt Inlet Septic 7 /6o 7 4/11f— •Sy --- '°'- Dt Bottom .00 EU= Header/Man. /. 75 / Z Dosing /d v -•� A 11-f �O4 7 Dist.Pipe Eart it Z Aeration -�\ /�Z, q Bot.System 2.1 oils •Holding ''`/ (::T71--------- 31>) �� Final Grade j�3, �r-01 PUMPISIPHON INFORMATION Demand St Co r T 113.`h $ .6 jbil" Manufacturer / D 1 [�L GPM .. (e./..,!...4 e`� !, �� V cJ`ac�/. 2 , / IIIIIre /� Model Number � C.b •✓� TDH 1Lift7 Friction Los System He d 97 'System 1TDH/ 3 Forcemain• Length / Dia. 1 Dist.to Well _M�. . 6 z N'� SOIL ABSORPTION SYSTEM PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth BED/TRENCH Width Length ' No.Of Tr ches �� DIMENSIONS '7 Z e LAKE/STREAM LEACHING Manufacturer: -. SETBACK SYSTEM TO P/L BLDG WELL CHAMBER OR INFORMATION UNIT Model Number: Type Of Syst= • l 75D. pit, DISTRIBUTION SYSTEM x Hole Size 1 x Hole Spacing jT' Length a3,7 , ` Distribution A /3 Z 3. 2'1 f f` 3 ! J Pipe(s) '�'D /. Length Dia Length Dia Spacing �� SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only O t,+w , Depth Over )xx Topsoil xx Mulched Depth Over 1 �L ` xx Depth of Topsoil 1 Yes No Yes No Bed/Trench Center ` �J Bed/Trench Edges Inspection#1: �� / 2Q/ /3 Inspection#2: / / COMMENTS: (Include code discrepencies,persons present,etc.) /�a�'106 _ arcel No: 22.28.16.325 Location: 2433 30th AvQ� ille,WI 54028(NE 1/4 NW 1/4 22 T28N R16W) 40 acres Lot 1 ,, � 1.)Alt BM Description ��S � 2.)Bldg sewer length= O 6 / 23 rc ill 0 amount of cover= $ iq Dt l 4- I_ Plan revision Required? Yes No It 3 Use other side for additional information. I Insepctor Signat''- Cert.No. Date SBD-6710(R.3/97) I Ito ke,Re CkZ(° 136r11611e' 6--44.12. N C kg N 41* S2Q k 16 4./ ect 1-cl i 1 t' i..4,4,n c,c 47146( 1,4114, Li 5R 4..„, St‘ dietoY &a , _________ • .? . . r • 5— \ ...._ mt, --., r ..... r . ' ! , cl 4,p \ ,0 10 \ ,,, 1-Z03 f(t300 L41eS5Z-Z ' • CO I .. TAIJK oi a 't Af , . . \ .... ___ c , ffi \ \ ,.,. - 111 ■-• ...... iarr. , k i's-o'o el ,i . , "-- \ P ,, i . _ t ... ° 41 t"- ,Fia .1 _ --. ,--- i -. -- _ f 5555 - - ... _ . .... __ ig = ioci , ■ i o4 - _ _ - I •-•■ 1 ---____ 13 _2 I 5/opt ._ ..... , -.1 sit,ty, Plo it il 0/ 1vo , 4 3 y 31,s-0 8 e d 7. r/ g°0 I ' I (AYes-e,e C fi-4 't N 0& -i',P0C) itt i 0 s Sat-e-4-01 &4 n 4 90 ' I . -1- 3 .st - . f , _ jc 1 cOA 5 it.„4.: it;to f ( ) 1021=====11 I I ; k [ , --4 c) cs S C'444 ar 'n" C County Industry Services Division ~t r 1400 E Washington Ave Sanitary Permit Number (to be filled in by Co.) pr P.O. Box 7162 L''-;r . Madison, WI 53707-7162 5(v 7z3-5 State Transaction Number it ermit Application In accordance with S1~.21 is. Adm. Code, submission of his form to the appropriate governmental unit l ~lf (S / y 1 is required prior to ob g a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address) 1 I a the Department of Safety and Professional Servies. Personal information you prof ay be used for secondary purposes in accordance with the Privacy Law, s. 15.04(1)(m), Stats. Ia ti / G J, )Iv ~ ~OV 1. Application Information - Plea Print All Information ~C '1 Property Owner's Name Parcel # •hJ s d ~ 1/4 rr75 ® lUG3. 06 Property Owner's Mailing Address 7' U Property Location (J t?' ffl L 1,0011. Govt. Lot City, State Zip Code Phone Num V%, Section 2/2, ) C( ~tcucle one) (9 A e ~G 6/ W -T Z S 0 Y3 T N, R/ C~ E or W 11. Type of Building (check all that apply) L J Lot # Cffj 1 or 2 Family Dwelling - Number of Bedrooms ( Subdivision Name 11A Block# ❑ Public/Commercial - Describe Use C/1~- Owl O J~' ❑ City of ❑ CSM Num ❑ State Owned - Describe Use G b ~ Village of 5 U i,, Ur Town of [It. Type of Permit: (Check only one box on line A. Complete line B if applicable) ZAAA, ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) A. X 'New System List Previous Permit Number and Date Issued B• ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New Before Expiration Owner IV. Type of POWTS S stem/Corn onent/Device: Check all that apply) ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade V Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) ` Non 3 V. Dis ersal/Trea ent Area Information: .11, 110' Design Flow (gpd) Design Soil Application 7,00,4 dDispersal Area Requi sf) Dispersal Area Propo d (sf) System Elevation 460 ) b 3U CO G3~ fi2~ ~61 VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units ^ a o New Tanks Existing Tanks / t o Y R A a. U v~ ~ v~ is. C7 a. Septic or Holding Tank i Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsi ' for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plum is Signature IC~PRS Number Business Phone Number S7` d~L 2 ~y~s' {715 ~y Plumber's Address (Street, City, S , Zip Code) 00i~ ~3' WUGprcr I `lam 4JIt ~GjD L?T VIII. Con /De artment Use Only pproved Disapprove Permit Fee Date Is ed Issuing Agent nature ~b i~ rven Rea~Z5 • IX. Condit easons for Disapproval 1. Septic lank, effluent filter and 3 dispersal cell must all be services I maintained as per management plan provided by plumber. Cie, asdpiiick 3.. AN ! lre Gs Must ,be.maint as PV 006 / o►dimnbN Attach to complete plans for the system and submit to the County only on paper not less than g 112x 11 inches in size SBD-6398 (R0313) ti,PAR DIVISION OF INDUSTRY SERVICES T 3824 N CREEKSIDE LA o~ ' o~ I 9 HOLMEN WI 54636 3 Q Contact Through Relay www.dsps.wi.gov/sb/ P $ www.wisconsin.gov ~o~ssfoIN Scott Walker, Governor Dave Ross, Secretary October 09, 2013 CUST ID No. 223475 ATTN: POWTS Inspector JOE STANG ZONING OFFICE STANG PLUMBING & ELECTRIC ST CROIX COUNTY SPIA PO BOX 263 1101 CARMICHAEL RD WOODVILLE WI 54028 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/09/2015 SITE: Identification Numbers Jared Evans Transaction ID No. 2315986 30TH Ave Site ID No. 796192 Town of Eau Galle Please refer to both identification numbers, St Croix County above, in all correspondence with the agency. NEIA, NWl/4, S22, T28N, R16W FOR: Description: Four Bedroom Mound System / 15% slope Object Type: POWTS Component Manual Regulated Object ID No.: 1451940 Maintenance required; 600 GPD Flow rate; 23 in Soil minimum depth to limiting factor from original grade System(s): Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01101, R. 10/12), Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01101, R. 10/12); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. CONS The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code AP requirements. DEPT OF No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, PROFESSIO DIVISION OF IN stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Reminders: • A sanitary permit must be obtained from the county where this project is located in accordance with the SEE CORK requirements of Sec. 145.135 and 145.19, Wis. Stats. • 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. Stats. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per SPS 384 product approval conditions. • The area within 15' downslope of the dispersal component shall remain undisturbed. Vehicular traffic, excavation or soil compaction is prohibited in this area. • 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. JOE STANG Page 2 10/9/2013 r Owner Responsibilities: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive. a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • 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. SPS 383.54(1). • 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. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of 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 . Fee Received $ 250.00 Balance Due $ 0.00 gS1 erard M Swim POWTS Plan Reviewer, Integrated Services (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633 jerry.swirn@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Industry Services (formerly 41 Safety & Buildings) will be modified. Code references with prefixes starting with "Comm" have been replaced with RSPS" to recognize the relocation of the Division of Industry Services from the former Department of Commerce to 1-1 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. JOE STANG Page 2 10/9/2013 Owner Responsibilities: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive. a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • 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. SPS 383.54(1). • 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. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of 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 eceived $ 250.00 Fee R Balance Due $ 0.00 ~Ee4~VV~ erard M POWTS Plan Reviewer, Integrated Services (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633 jerry.swim@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm 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 'SPS" 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 "°a~fdressed in a "300" series. For future reference, the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE '~`'I ' Project Name: Evans Mound )EP 2 3 2010 DUS-rr ~KYc'._ Owner's Name: Jared Evans Owner's Address: 2986 130th Ave. Glenwood City, Wisc. 54012 Legal Description: NE114, NW1/4, S22, T28N, R16W Township: Eau Galle 'VNALLY County: St. Croix ROVED Subdivision Name: 3AFENAND VAL sERViCEs Lot Number: Block Number: VSTRY SipaV1CEs Parcel I.D. Number: 008-1063-70-000 Plan Transaction No.: Pagel Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Plot Plan Page 9 Soil Ealuation Report Designer: Joe Stan License Number: 223475 Date: 09/19 3 Phone Number: 715-684-5166 Signature: Designed P uant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01) Version 7.0 (R. 03/2012) Page 1 of 9 Mound and Pressure Distribution Component Design Design Worksheet Site Information (R or C) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 400.00 Estimated Wastewater Flow (gpd) Table 383-44-3 in-situ soil treatment for 1.50 Peaking Factor (e.g. 1.5 = 150%) fecal coliform of - 36 inches. 600.00 Design Flow (gpd) 15.00 Site Slope 100.00 Contour Line Elevation (ft) 23.00 Depth to Limiting Factor (in) 0.40 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 80.00 Dispersal Cell Length Along Contour (ft) = 7.50 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) 1 influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution C Y Pressure Disribution Information network? Enter Y or N (C or E) a Center or End Manifold 3.75 Lateral Spacing (ft) If N above, enter the elevation (ft) 2 Number of Laterals of the highest point. 0.156 Orifice Diameter (in) 3.19 Estimated Orifice Spacing (ft) = 12.00 fe/orifice 2.00 Forcemain Diameter (in) 50.00 Forcemain Length (ft) Does the forcemain drain back? Y 90.00 Pump Tank Elevation (ft) Enter Y or N 4.55 System Head (ft) x 1.3 8.16 Forcemain Drainback (gal) 10.68 Vertical Lift (ft) 72.01 5x Void Volume (gal) 0.79 Friction Loss (ft) 80.16 Minimum Dose Volume (gal) 0.00 In-line Filter Loss (ft) 26.93 System Demand (gpm) 16.02 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75. 1.25 x 1.00 1.50 x x 1.25 2.00 1.50 x x 3.00 2.00 x 3.00 x Gallons/inch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1200.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Wieser Manufacturer gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 800.00 Dose Tank Capacity (gal) Best Filter Manufacturer 22.24 Dose Tank Volume (gal/in) GF10-8 10x18 Filter Model Number Weiser Manufacturer Project: Evans Mound Page 2 of 9 Mound Plan and Cross Section Views -t ipe . 33 J 1/10 B . • Observation ion Pipe .T~... T'.'.'. . . . . . . . . . - - r,~~;'r~r"",~:,"r.,r.r;r;r.rR`,"r,r "~:;r ~".r.,r:"r,",~,~.~;'~,.,~;r;'~;,~.a~, r• ":r:,'rx, ~~•~~•~,s,~,~".r~ ~q;,r;r,,r,~r,rr; r~",~r; ~;t,r,r,r.r.r,,r.~,~, ~;Y~ ~.,r. . ' ,.:r.`"1,~1,~•~`%`~S,¢•a"~•r,~.",J,.,~,~J°„~,~J`~,.7,~.•J,bpd,:J,~.'d`~s•.rs~,de•d.,s.,s'r~.~~~,~~r~xvw x•'.~•~,•F`l~,•f W B ' .4 . . . . . I L Mound Component Dimensions ft A 7.50 ft E 26.50 in H [Aft ft K Eaft B 80.00 ft F 9.50 in 1 ft L ft D 13.00 in G 0.50 ft J W 600.00 (ft2) Dispersal Cell Area 2127.27 (ft2) Basal Area Available 7.50 (gpd/ft) Linear Loading Rate 8.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 102.88 (ft) ► ,ff ! G H 1 ,{{{ff!llffff!!fllff.. F Lateral Dispersal Cell 101.08 (ft)-~ - 101.58 (ft) Invert Dispersal Cell Elevation E D r - r - 4 a 4, - - - 100.00 (ft) Contour Elevation 15.0 % Site Slope Geotextile Fabric Cover Shading Key a c_. I Dispersal Cell See lateral details on Topsoil Cap 0 a 1.5 ft Page 4 for number, © fffff Subsoil Cap H c _ L' size, and spacing of 0 ASTM C33 Sand `6 1° t s'1.;:~:;ti F laterals. Laterals are Tilled Layer = 0.5 ft ;__:_'Typical Lateral c;.~.°= equally spaced from the ® ti,,~,ti • distribution cell's 05 .r•r•,r• Aggregate p ._•~::=~~~r•i>r::•::•:r`':; 5 T centerline in the A * distribution cell (AxB). of 9 Project: Evans Mound Page 3 End Connection Lateral Layout Diagram Laterals centered over the A & B dimension • = Turn-up Yd ball valve or of eanoutplug P All laterals are identical I<- X--3) Hol es drilled on the bottom of the lateral S equally spaced Force main connection via tee or cross to manifold at anV point. Laterals Morcemain Sch 40 PVC per SPS Table 384.30-5 Number of Laterals 2 Orifice Diameter 0.156 in Lateral Diameter 1.50 in Orifice Spacing (X) 3.27 ft Lateral Length (P) 78.48 ft Orifices per Lateral 25 Lateral Spacing (S) 3.75 ft Orifice Density 12.00 ftz/orifice Lateral Flow Rate 13.46 gpm Manifold Length 3.75 ft System Flow Rate 26.93 gpm Manifold Diameter 1.50 in Total Dynamic Head 16.02 ft Forcemain Velocity 2.75 fUsec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and SPS 316.300 WAC 4 in. min. Disconnect _ Tank component is properly vented MForceemain Alternate outlet location diameter Weiser Manufacturer 2 in. Capacity 800.00 Gallons Volume 22.24 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 19.47 432.94 B 2.00 44.48 C Pump off elevation (ft) C 3.60 80.16 90.91 D 10.90 242.42 D Total 35.97 800.00 1 11 Do~tank elevation (ft) 3" Bedding un er tank. 90.00 Alarm Manuafacturer SJE-Rhombus Note: Switches Alarm Model Number Tank Alert 1 J containing mercury may not be used in Pump Manufacturer Goulds this system. Pump Model Number 3887 EP05 Pump Must Deliver 26.93 gpm at 16.02 ft TDH Project: Evans Mound Page 4 of 9 Mound System Maintenance and Operation Specifications Service Provider's Name [ Joe Stang Phone 715-684-5166 POWTS Regulator's Name St. Croix County Zoning Phone 715-386-4680 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1200 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once every 3 ears Effluent Filter Should inspect and clean at least once eve 3 years Pump and Controls Test once every 3 years Alarm Should test month) Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound Inspect for ponding and seepage once eve 3 ears Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished Grade 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Evans Mound Page 5 of 9 Mound System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with SPS 383.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be 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 sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD5, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5, 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. Project: Page 6 of 9 Goulds Water Technolog Wa METERS FEET 10- } 9- I 30 5 GPM ! f l i S 2.5 FT 8- i 25 7 W If u 6- 20 Q i 15 I ' ' EP05 T 4 'I'S 0 t ~ I 3 10 ' i -i- - ~ EP04 ; 2 5 I 0 00 10 20 30 40 50 GPM 0 2 4 6 8 10 12 m3/h CAPACITY a6 Q3 Gi P M MODEL INFORMATION Minimum Minimum Minimum Minimum Maximum Shipping Order No. HP Volts Am Circuit Phase Float Switch Cord Discharge On Off Basin Solids Weight Breaker Style Length Connection Level Level Diameter size lbs/k EP0411 Plug / 10' 1'h" Man No Switch ual Manual 15" 20/9.1 EP0411A Piggyback / 115 12 10' 1%" 12" 6" 15" 21 / 9.5 Wide-Angle 20 / EP0411 F Plug itch 20' 1Manual !6' nual 15" 20 / 9.1 .4 EP0411 AC Piggyback / 20' 1 12" 15" 21 / 9.5 Wide-Angle EP0412 1 - Plug / 10' 1'h" Manual Manual 15" Y4. 20 / 9.1 r230 6 10 No Switch EP0412F Plug / No Switch 20' 1'h° Manual Manual 15" 20 / 9.1 EP0511 F Plug / 20' 1336" Manual Manual 15" 22 / 10 115 13 20 No Switch EP0511AC .5 Piggyback / Wide-Angle 20' 114" 12° 6" 15" 23 / 10.4 EP0512F 230 6.5 10 Plug / 20' 1'h" Manual Manual 15" [22 / 10 No Switch PAGE 3 J wed 1 2„ ~ ni 4J~ s 2 2 ~ t G w ; la, .,g 14 )!®0 cO Iz~ ~g~ u?l Q~ y 1 t tl -(AA)K p (A% o del 4$. p L = V ` !v ,~loE+G ~ )37, S pPG f d4 1vG.4 1. !4 ~ r 13 9 n~ r l a p t^ ~c~g 13 ~ w 2304 Wisconsin Department of Co x. ~ SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings A.C.E. Soil & Site Evaluations ccordance with Comm 85, WiOl~dm;lde Attach complete site Planes PeYnof lees th an 8'% x 11 inches in size. Plan must ounty St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale d t Nglglltfo~4lf hftcation and distance to nearest road I.D. 8 °n - 6 3-70-000 .3 Please print all information. Re i ed B Da e Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). C L Property Owner Property Location Jared & Jenna Evan Govt. Lot NE 1/4 NW 1/4 S 22 T 28 N R 16 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 2986 130th Ave. na na Na City State Zip Code Phone Number City _J Village vj Town Nearest Road Glenwood City WI 54013 (507) 993-9880 Eau Galle 30Th Ave. ✓1 New Construction Use: J Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement Public or commercial - Describe: ~e Z U t't' r 11 ~ Parent material Glacial Till Flood plain elevation, if applicable Na General comments and recommendations: Site suitable for mound system with 13" of ASTM-C33 sand placed on 100.00' contour. Infiltrative surface elevation to be 101.10'. Boring # J Boring ✓f Pit Ground Surface elev. 99.93 ft. Depth to limiting factor 24" 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 0-8 10yr3/3 none sit 2fgr ds as 2fmc 0.6 0.8 2 8-17 10yr5/4 none sit 2fsbk ds cw 2fm,1 c 0.6 0.8 3 17-24 10yr4/6 none Ivfs 0 sg dl cw 1vf,fm 0.4 0.6 4 24-34 7.5yr4/6 m2d 7.5yr5/8 fscl 1msbk dsh - 1vf 0.2 0.3 Boring # J Boring Zvi Pit Ground Surface elev. 97.45 ft. Depth to limiting factor 23" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftZ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-5 10yr3/3 none sit 2fgr ds as 2fmc 0.6 0.8 2 5-17 10yr5/4 none sit 2fsbk ds cw 2fm,1 c 0.6 0.8 3 17-23 10yr4/6 none sicl 2msbk dsh cw 2vf,fm 0.4 0.6 4 23-26 10yr4/6 f2d 7.5yr5/8 sicl 2msbk dsh cw 1 vf,fm 0.4 .06 5 26-37 7.5yr4/6 m2d 7.5yr5/8 fscl 1 msbk dsh - - 0.2 0.3 * Effluent #1 = BOD? 30 < 220 mg/L and SS >30 < 1 0 mg/L * Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signatur : CST Number James K. Thompson 3602 Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, WI 54020 10/12/2012 715-248-7767 Property'Owner Jared & Jenna Evan Parcel ID # 008-1063-70-000 Page 2 of 3 3] Boring # Boring 100.00 ft. Depth to limiting factor 39" in. ✓f Pit Ground Surface elev. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots PD in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-6 10yr3/3 none sil 2fgr ds as 2fm,1c 0.6 0.8 2 6-18 10yr5/4 none sil 2fsbk ds Cw 2f,1 m 0.6 0.8 3 18-27 10yr4/6 none fsl 2msbk dsh Cw 2f,1m 0.4 0.8 4 27-39 7.5yr4/6 none fsl 1csbk dsh Cw 1v 0.4 .06 5 39-52 10yr4/6 f2f 7.5yr5/8 Ifs 0 sg dl cw 1vf 0.5 1.0 6 52-60 7.5yr4/6 f2d 7.5yr5/8 fscl 1 csbk dsh - - 0.2 0.3 F-1 Boring # I 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 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F-1 Boring # I 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 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 I * Effluent #1 = BOD 5> 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) A.C.E. Sal & Site Evaluations - - - • -So l e ✓ah<A-6~ Ave . ♦ ex1367 rade e14 ✓a-6'0,? .2 40 ,Pt'°FZSo~ .~"ar•ea(~nrra Edon 0 r1~Ys~/1~'/y, Sec ZZ, T. 2M., %ocf bc~~ sta 60 a cres 2~ ~r A 9a, 3 T beg" YYI ag re .40P .J.e. p/a-j' 3 Z✓ / ,Y gssu,ncd ~1 , two- i 99.0' ,4 pp ~aX%n4a~e poi o'er„ bK;/d;n~ S~~• FDA 9z, 30{.3 !i 05/27/08 TUE 09:32 FAA 715 386 4686 t~001 ST. cam COUNTY SEP M TANK k(ADUENANCE A AND OWNERSEDMT `AMNFORM Ownasuye r cc t do d v a YX I Property Adds cP y 3 3 4L (V onwedfftmmr iagAZmdagDgwzMatdorumcoa a.) CitWS= t4/6 d o, l If ~,J r Paroe1 ideatific Nm b, 001- aq 6 3- 70 o o o LAG& Property LOMiOn IV A . N W ! . sec. 22- , T 29 NR l6 W, Tows of 6g y <G i Subdivision Piet Lot # Cttrti&d Survey Map # _ Valt~re . Page # Watnmty Deed # C l s' (befm 2W)vaMne PaV # . h i i ~Ly~M Lot fines e C yes 413 no lrnpr+OperIISI:aa1 ofyoro~raeptrC Coeidtesalt itsp[+CBI~e ID wastes. nag= ofpt txtduosepticttt*cmytimrmortnnlipr,ifBeetled,bya>icmodpaalper. VWymputinto &t sysom cast affxm the fmtcdm ofd m septic u*n a aiealmaststrgm is the vaaaediq+osd ayaead Ownd'4amltumm respoWies aye specified m §Caaam. 83.SZ(1)m distamer i2-St: Cmk(Xwmty rOrSom m. Jim property owner agrees to suit to St. Cnix Coigy Phasing & Zaagg Dot a cutificafm form, sued by die owner and by a mastar pkwdw ,jowneymm pkmtbm rued phnubw or a Nceond pampa vadfying that (1) the aa4ite waaewaa disposal sysl m is impauper opustiagcowfitien wAfor (2) Aw and pvil8 (ifrteceaa'Y). the septic teak is lessdtaa 113 fu3ofsWdm awe, the tended lsmae read die above retttmemama and ag~aem to wAblm dw pdvasm seams Aspwd syslaa4 w1* die set ttatb, berain m set by the Depaeament oaf Can and the Depwbou t of Wdeut Resotstaes, SHIS Qf Wieooradn. Ce acefiuastaftaxtyoarsepdcsymnahmsbeearadmakedrombeeoaipktmdsniitmtaaaed1bdeft CvobcCandy Ptesaing 3t. Zo imgUq-pmm- idi-30dasofdotmyesc upi S da*e. Uwe reify than ail SOMOSIS on this form are to die best of mylow kwwJedgL Ywe uW%re the owna(s) of the "overw des m ibed by virtue of a warrsay deed in Regaw dMemb Off ce. N m- of bedrooms y = IC)4f SIGNATURE OF APPLICAMS) DATE U'*-*Any iafomu doa dubs muqx=mbdarea ms&is &essaslary> beleg wPdmd by *e Fdiasie9 "60'8 s Dep~. h w%& wi lb this appocauna a recorded v uTamty dmd frOnai ie Raft er of Daub Office and a COW Of the *wtd" SmvreY map if -unx= ri :Wade in rice wa nwty deed (REV_ 01M ,25-27-08 11:40 TO: FROM:715 386 4656 Pei 8 0 7 5 5 6 3 Tx:4056586 STATE BAR OF WISCONSIN FORM 3 - 2000 961395 QUIT CLAIM DEED BETH PABST Document Number REGISTER OF DEEDS THIS DEED, made between Citizens State Bank, Grantor, and Jenna ST. CROIX I PM Evan and Jarod Evan, husband and wife as survivorship marital property, 08/08/2012 C OIX CO., O., EXEMPT#• 39 Grantee. REC FEE: 30.00 Grantor quit claims to Grantee the following described real estate in St. TRANS FEE: 240.00 Croix County, State of Wisconsin (the "Property"): PAGES: 1 The Northeast Quarter of the Northwest Quarter (NE 1 /4 of N W 1/4), Section 22, Township 28 North, Range 16 West, Town of Eau Galle, St. Croix County, Wisconsin. Property is sold "as is" and with all faults. Recording Area Name and Return Address: Together with all appurtenant rights, title and interests. 008-1063-70-000 Parcel Identification Number (PIN) This is not homestead property. Dated this 22nd day of June, 2012. Citizen S e Bank * Gerfe berman, Vice Chairman * * AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN ) Signature(s) ST.CROIX COUNTY. ) ss. authenticated this 22nd day of June, 2012 Personally came before me this 22nd day of June, 2012 the above named Citizens State Bank by Gene Haberman, * Vice Chairman to me known to be the person(s) who executed TITLE: MEMBER STATE BAR OF WISCONSIN the foregoing inst ument and acknowledged the same. (If not, authorized by § 706.06, Wis. Stats.) *Ja P. Pen eld THIS INSTRUMENT WAS DRAFTED BY Notary Public, isconsin {\~►&atk u - Poack My commission is permanent. (If not, state expiration date: 1 { 8/26/2012 ) (Signatures may be authenticated or acknowledged. Both are not necessary.) *Names of persons signing in any capacity must be typed or printed below their signature ciao 1 of 1 QUIT CLAIM DEED STATE BAR OF WISCONSIN FORM No. 3-2000 Parcel 008-1063-70-000 07/2212005 05:04 PM j PAGE 1 OF 1 Alt. Parcel 22.28.16.325 008 - TOWN OF EAU GALLE Current X' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): Current Owner * NISEN, PETER PETER NISEN 3944 WESLEY WAY EL SOBRANTE CA 94803 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 1J\ SC 0231 BALDWIN-WOODVILLE AREA S SP 1700 WITC Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE SEC 22 T28N R16W 40A NE NW (ADD'L Block/Condo Bldg: HISTORY 480/460) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 22-28N-16W Notes: Parcel History: Date Doc # Vol/Page Type 02/11/2005 787307 2748/245 WD 08/24/2001 654679 1705/429 TD 07/23/1997 1162/596 LC 07/23/1997 1037/481 moW D 2005 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 07/19/2004 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 17.000 2,000 0 2,000 NO PRODUCTIVE FORST LANC G6 22.000 27,100 0 27,100 NO OTHER G7 1.000 2,700 500 3,200 NO Totals for 2005: General Property 40.000 31,800 500 32,300 Woodland 0.000 0 0 Totals for 2004: General Property 40.000 31,800 500 32,300 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: 04/1712001 Batch PRGRM Specials: User Special Code Category Amount I I Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00