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HomeMy WebLinkAbout036-1065-60-000 oito — /(5(05. - (-16 — 6160 Z . 3 I , (7 . 5 I ‘" -R'. 6,,'■.,J-,,.\U S /i.ko ''''.' \si% G S.0• \''CI ,j003\A FIELD INSPECTION & SERVICE REPORT INSTALLATION AUTHORIZED SERVICE PROVIDER Address: (,)4/ Name: / ( r1ct,e.)t0_t.4.14..4)4 6,1 g xve i vciStreet: 34/0 PrtX•S 411-,9r,e.e)PP.2.--'— cress: /,f/ t01 -' Mail Address: State L.1/4) . zip 5$40/7 City 05ceo(a State 1-4)4Zip 5—VOX ''"- ],-' (ii. .424-stfo a 6644,4 -.24os- Phone(.715)214-7rGr F.a., - e-mail ACG-.60/7(5? F7-04 tiC/4eZ./1C6 INSTALLATION INFORMATION I No. I Blower Brand and ' Serial Nu. Date of Installation ' Date of last pump-out Size (4)/(1-a eAMite 4# 4 riAti.3,.zo/3 FQ LIPMENT f DETAILED COMMENTS OF SITE CONDITIONS - OPERATION YE NO MAINTENANCE PERFORMED OR REQUIRED Electrical Panel(s) p '..:5t:al Alarm Operating T--' i , -,.:.,d io Alarm Operating i -- present) 13(u ers : •.17 Inlet Filter Clean V Hood Vents Clear \ot.ssive Noise . F,..: sive Vibration V Tis:IrTeritt_I r lit s): _____ , / — fi"'- '_ :sual Odor •....0.5.1_ ../dA_ .•_444/=.1.41,M. 0 • _ _t_-111- _ %stem Vent 'O -,:, I .. 1111 IP :a.. cr-. yunTout Required: _. =nrnary Settlin2 Zone s/- r • Treatment Zone 1 -- — EFFLUENT: LIMIT RES1211.v4..,T4_ _ _ Estimated Daily Flow bt•-• _ pH (Standard Units) 6-9 S.U. Color Clear Temperature _Dissolved Oxygen (effluent) 2 ing/L. Odor Slightly AO Musty odor (not se tic 45,. .-4.P.,W -' /41-7/3164 • OWNER SIGNATURE TEC fNICIAN SIG■ • - ' SERVICE DATE ..."--, 7"-,t,, ' . 72 .5-----• -K.R.,6• -2, 2.0/5- - - a 3(0 - /CGS- Go -aon RE���VE® Z S� 3/ • r 7. 925 SUN 2�Z014 c�a S1 CROm co 'T"' S COMMUNITY FIELD INSPECTION & SERVICE REPORT INSTALLATION AUTHORIZED SERVICE PROVIDER Installation Address: Cb fie. �� Name�.�,ame4 Owner Name: ( p ��; Street: 4/0 C-71 t Vail Address: /4,f/ ACO A,09�' Mail Address: /' 1 Cit p,�J i etc) Stated . Zip �4�0/7 City OSCGOc 0 State e�/,Zi S,(OX Phone AZO-vfo *W040-1400, :Phonc(7/ )zV9'1TGTFax-mail ail AC4.r;;50;/ Fro,7 4-V LL.IteL� INSTALLATION INFORMATION Model No, Blower Brand and Serial No. Date of Installation Date of last pump-out Size W a1 EQUIPMENT DETAILED COMMENTS OF SITE CONDITIONS- OPERATION YES NO MAINTENANCE PERFORMED OR REQUIRED Electrical Panel(s) Visual Alarm Operating _ ,Audio Alarm Operating >� _ f resent Air Inlet Filter Clean —1 Blower Hood Vents Clear Excessive Noise Excessive Vibration Treatment Unit (s): L'nusual Odor i Svstem Vent Pum_pout Required: Primary Settling Zone _ Aerobic Treatment Zone EFFLUENT: LIMIT RESULT Estimated Dail • Flow PH (Standard Units) 6-9 S.U. Color Clear Temperature Dissolved Oxygen effluent 2 m /L Odor Slightly Musty odor not se ti __— 0«'NER SIGNATURE TEC NICI N SIG TURF SERVICE DATE VCounty: Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 567241 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes[Privacy Law,s.15.04(1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Richter, Deland &Andrea Stanton, Town of 036-1065-60-000 CST BM Elev: Insp.BM Elev: BM Descriptio Section/Town/Range/Map No: AO U /Up� v o�/�. S S� 1� 28.31.17.425 TANK INFORIV�AT,� d oA/l CS- ELEVATION DATA g t (e l G0 4, /DO U TY D Z FACTURER CAP ITY , STATION BS HI FS ELEV. t /S1—/ ' —c1P.�r-:��/Sj�" l c� C-2•//c,, ^'AD ,s--, C vs: ti' ,-ra3 Septic Benchmark Z�v �.5. T. /p Tao. a Dosing W I/U i- Li' �� / Alt. BM / / O v lo& 3' t p 66-Le-vi i / ,� 6 .ft... . B ete t` __ 14 i 0 5 ayS 9,z�x.•. Holding ( Q- i....--e. OI-It Inlet Ceeer4incr eYt -_n 0`/ 64& o-> < y-1-1-e) y r 7�2 M a e [gHt Outlet TANK SETBACK INFORMATION ,J 11 14-k" k11 1-114- ,037 9y 43 TANK TO � WELL POLE. Vent to Air Intake ROAD I Inlet -„. if ci- ,44 1 i Septic t Dt Bottom WU /61,(.7 " 22- t4- / . , -.-.---- .. eft '- ,�� . ,ii ff— q/, re Dosing i Obt ,/COI 30 I ,> . f Header an. /G/'1,■_ If ) •7 ie i Dist.Pipe , jj,,, ■■��� at 7a /(25 41 Holding — J '• �-W. Bot. S mist / Final Grade 6 � // "/ / C�(7',{- PUMP HON INFORMATION �v �_ i anu acturer - D and t(�ove I `%V. � � GPM '" �r+r' �' d% Model Number �f ����� El 'G ( I Z�° �� 3// y o k.a !ors ? TDH Friction Los Sy�jtem 15:9-1 ad TDH Ft b_ 'Lift �� (jr r 2f. a �'.01 t i-t ,,14/lic2 �, Farcem8irl Lent �t Dist.to Well ! ry�V SOIL SORPTION SYSTEM BED/TRENCH Length No.011_ PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth DIMENSIONS /12-, S SETBACK SYSTEM TO P/L pG WELL LAKE/STREAM LEA Manufacturer: INFORMATION C E R Type f ystem: -- / `/C / \ I A i UNIT Model Number: ja DISTRIBUTI ON SYSTE _mK i a Header/ tanifold Distribution / /�(� � � x Hole Size�f x Hole S�pa7cing eerft t2Air nta �// Pipes) fW� /` U / //� 3(77 Lengt Dia Z Length Dia � Spacing / I• SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only /' D ((��� Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched" Bed/Trench Center Bed/Trench Edges Topsoil Yes D No 0 Yes E No COMMENTS: (Include code discrepencies, persons present,etc.) Inspection#1: (( / �L,I J (2 )nsPection#2: 1 I Location: 1641 200th AAve.New Richmond,_WI 54017(NE 1/4 NW 1/4 28 T31 N -/7W) /NNA Lot 1 Parcel No: 28.31.17.425 1.)Alt BM Description= j"/L%✓•l�'/ah hp le aw-�' /- r n1:� - it4 - A a_ 2.)Bldg sewer length=3(p' JQp,f y/ A �,4Q , -amount of cover= oaf `/`i'""t t 31 a 4 1/0 3. # '4'2''cr'ivyi. �d- ■ I. ' ./1J.e!o ,> '., ' C . , 0 i e i A ,+ Plan revision Required? Yes ' r ` i I No I 2 Use other side for additional information. 1 L_ ,!3 L13_I J i , L 44- SBD-6710(R.3/97) Date /� — epctof's Signature Cert.No. 7 , .50/./Qd4/A4 d.-,// 6X/:5 ✓ f'2nce/lle//Lc,e4-le ^0 t A-L/-e. , _ ,Sca/Q:/= ap(- .z.3 s !)e/arz,l d r9ifc/re4 1)I-Ze r- 9 Lzizf/C 5ni r/0'4 7e.2.0.----/, t � Q \ t /E`r 'sc .a� 3/,(. ■ � � T Il iii _y ' a3 Ptopos�ntou�d4 � ;6.c�.x6;W� I /7.71X,24.97'w/(, /a.s' � /-c I. c3G^-/cc,f -Gc-�x:�. ''F d,�` S4iee./% Two(.) t '1 \ �10Lr I ,1 i S')CI /.6c c&cres \ vecra/s a-6 //s%x 5..s. / rJ ! )�� ; i d w/%8'oc1/'Ces 4a0ca6A ,f ''' \ , k. \\ /76: �- a i ` t 94.5 3 ice.S.7 /00.1)1!GrXi5 4‘.-well �'1 o-Ee: t��;uetoc y erty.`�e� I = 1 £ b L,tL('r76.et eaoPoerrsIt :1)11. >I g-2- 1 I-0 I i I i - 1 )i- 1 1 11,/\ i : j.` AS/der/et E)crs E+' i,�¢¢,E�t '�cy,crc c I,(jd0c�e-F. ,l 1S / ! Dteg CS‘ 'SCi0�'C-+ J -iZ• U <° �i------ EXiSii), t.WeL4<S jmcrL- Bag a. �! I ( I � S.rja�f , j-6*//4tio-, ocbu�f/P 5/ 1 I kJ of fw4-.... /e e Cam.,O/ i u::• s Y 1 1 ' C J� accee6e Gee Si n s-(a,..,daL.-d s, v r-a7 / C 1 1 I ' t t ttis6:z J .� j 1 I r �', / 9 1 r - �W� \ 4' f{srm 303 e (/ue►,f I;.+c 417i45ri t D/78S .r' sa.yo►�J.e. \ 7/`AST'fL/Zi' .5c-4-VoP.d,CtoGmlP,u.Y S38-2.3C,M4. r 'Ad oca ef --' es. 9'�9L/ Fxis 1 CORRESPONDENCE A.L. i I o l2/JC Y-/cc o,� a ��-�j�pr t�QSe a. I aban na:Yt, T, tl Sit, .A unt.d e(tv -/ct.:.V. ! ' I o•�andur,cd 0.s - �'�,�' \' 1�°r_' Y 5 P5 38 3.33. C ?.o I JC. P°pos4-01(1.7ic5 ``-',.• LOicstr '&lc:rd..<c..)2,6 0-bri.R Sc1,.5/� C�cru{c + = 5. �, ..y. ., lC..)(cu.S�Omi44/Cccx/. Tom X f rrercew+a;� pa-nip lK. us 4.c1as .4•rktrec„-Em1-nE-ty..4/. tv ii;t1) to '` ;r1) GO Y-78( .t )mss) fx,,a/a c eel 16'61-4.4-415 eCCflL 1( /E.g-- {�Rio/aced of tsw,�� �0 61) 6a.�ct'aneo��sN`� //'1 1/1 ego Ctgv S{°S3�z•35- SP.s �ss,33' �" i i' . o4/.L °g~aT County Safety and Buildings Division St. Croix S a 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) P= Madison, WI 53707-7162 Sani . Permit Application State Transaction Number In accordance with SPS 383.21(2) W1 Code, submission of this form to the appropriat ental unites r7 !r1 is required prior to obtaining it ate: Application forts for state-awned POWT miffed to Project Address (if different f 17 than mailing address) the Department of Safety f on ices. Personal information you provide rm/be used e ndary s in accordance v w, s. 15.04 1 m , Stats. Same I. A lication Infor a lease Print All Information Property Owner's Name Parcel # 1,~ ly~t7i Deland Richter 036-1065-60-000 Property Owner's Mailing Address J} Property Location 1641 200` Ave. Govt Lot City, State Zip Code Phone Number NE -/4, section 28 New Richmond, WI 54017 612) 616-2605 T 1 (circle one) II. Type of Building (check all that apply) Lot # - I N; R 17 W I or 2 Family Dwelling - Number of Bedrooms 1 Subdivision Name ('1n r ~iJ4 Block # CSM i Public/Commercial - Describe Use Catering Kitcl}g~1 300 Na ❑ City of ❑ State Owned - Describe Use CSM Number ❑ Village of Vol. 7, Pg. 2021 Town of Stanton III. Type of Permit: (Chec_k_onlyon0m on-line A. Complete line B if applicable) A. New System XReplacxment System Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) 2 FIB S. a ],I rvit ~Fbt c-,-S g• ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previ0fis Permit Number and Date Issued Before Expiration Owner 74792 issued 10/23/85 IV. Type of POWTS System/Component/Device: (Check all that apply) ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade Mound > 24 in. o suitable soil ❑ Mound < 24 in f ramiu bl .s_ ❑ Holding Tank ❑ Other Dispersal Component (explain) ent ice (expla' ~V¢ite Knig,-t WK-78 A1~I V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) is al a Required (sf) Dispersal a Proposed (st) S n E c Gutd-,+ 5o'( 6,W 7s"'04 Bu l 04.75' at " ove 900.OOG 2.0 G d/S . Ft. ©A/ 450.00 s q. ft. 450.00 s q. ft. 104.25' contour VI. Tank Info capacity in Total # of Manufacturer k Gallons Gallons Units 3 (51 v New Tanks Existing Tanks U _f~ y Qn Wz 0 r1,a3 Septic or Holding Tank 2,000 1,000 & 800 3,000 3 Weeks & Wieser Conc. X Dosing cha'nbe` 1,250 Na 1,250 1 VII. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS sbown on the attached plans. Plumber's Name (Print Plumber's Signature MP/MPRS Number Business Phone Number Dale Hudson MP 220853 715 684-3378 Plumber's Address (Street, City, State, Zip Code) 820 air Street, Baldwin, WI 54002 . County/Department Use Only Approved 11 Disapproved $eniltt "G S Issugd Iss ' g Agent S' e ❑ Owner Given Reason for Denial f b f~' 1(2-031.3 IX. Conditions of Approval/Reasons for Disapproval 3 l 1 S S aAe ~v 1 hLS SYSTEM OWNER: 1. Septic tank, effluent filter and ~r,UR ~n - eK U p+-D r rKak,n VAZr G~~ccce_ gym' dispersal cell must be serviced / maintained s-P.S 3 9 2 , 3 S Y~Q l~ D~i/12 as per management plan provided by plumber. 2. All setback requirements must be maintained vv- SPS 3 8 2, 30 C 29 A N A--f ! c),+vi T /ic/ST gE mc--e ~ as per applicable CO a plans for the system and submit to the County only on paper not leas then S 1/7 a 11 inches in t~ sBD-6398 (R 11/11) -0 DlseL6sL Od s. oh a S,K Vv7 F /~lls~L,~..s~-Tsd~ ~'rJS~~ZTlo~f - DIVISION OF INDUSTRY SERVICES o~~~~~EraxTTO 3824 N CREEKSIDE LA HOLMEN WI 54636 Q Contact Through Relay S K www.dsps.wi.gov/sb/ P S www.wisconsin.gov ~O0SSIONA~ Scott Walker, Governor Dave Ross, Secretary October 17, 2013 CUST ID No. 220853 ATTN. POWTS Inspector DALE E HUDSON ZONING OFFICE BOLDTS PLUMBING & HEATING INC ST CROIX COUNTY SPIA 820 MAIN STREET 1101 CARMICHAEL RD BALDWIN WI 54002 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/17/2015 SITE: Identification Numbers Deland Richter Transaction ID No. 2317689 1641 200TH Ave Site ID No. 792755 Town of Stanton, 54017 Please refer to both identification numbers, St Croix County above, in all correspondence with the agency. NE1/4, NWl/4, S28, T3 IN, R19W FOR: Description: Commercial-Residential Mound System / 7% slope / Pre-treatment Object Type: POWTS Component Manual Regulated Object ID No.: 1452780 Maintenance required; Replacement system; 900 GPD Flow rate; 24 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 for POWTS - Ver. 2.0, SBD-10706-P(N.01/01, R. 10/12); White Knight WK-78 Aerobic Treatment Unit, 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. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code 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, CONDI aP stats. DEPT OF The following conditions shall be met during construction or installation and prior to occupancy or use: PROF T OF Reminders DIVISION OF IND • 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. Stats. • The application for a sanitary permit shall be accompanied with documentation that the master plumber o SEE CORRE master plumber-restricted service who is to be responsible for the installation or modification of the POWT has completed approved training on the proposed. POWTS technology or method or has documentation that approved training will be provided during the installation of the POWTS. • The application for sanitary permit shall be accompanied with legal documentation of all the components requiring servicing at an interval of 12 months or less shall be recorded on the deed for the property. If this is not present, a sanitary permit can not be issued. • 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. DALE E HUDSON Page 2 10/17/2013 • The activities relating to evaluation and monitoring POWTS components after the initial installation of the POWTS in accordance with an approved management plan shall be conducted by a person who holds a registration issued by the department as a registered POWTS maintainer. • 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. • 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. • This plan has not been reviewed for any SPS 382, Wis. Adm. Code requirements that may necessary before the system can be put into full operation. Note: Per plumber, the Rhombus float configuration in main pump chamber shall have settings for "redundant pump off', "timer on/timer off', "surge condition visual light alert" and "high water audio/visual alarm" built in to the control panel. The controls shall be field calibrated per design page 2 of the plans. 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 the POWTS shall be responsible for ensuring that the operation and maintenance occurs in accordance with this chapter and the approved management plan under 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 Gerard M Swim ' PO'W'YS Plan Reviewer, Integrated Services (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633 jeny.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 and addressed in a "300" series. For future reference, the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. Mound POWTS Index & Title Sheet Mixed Residential & Commercial High Strength Waste Project Name: Richter mixed Residential & High Strength Waste Contact Name: Deland Richter RECEIVED Owner's address: 1641 200th Ave., New Richmond, WI 54017 SEP 2 2013 Site address: Same INDUSTRY Project Location: Subdivision: Na Legal Description: NEl/4NWI/4, Sec. 28, T.3 IN., R. 17W., Town of Hudson, St. Croix Co., WI. Parcel ID 036-1065-60-000 Page 1 Index and Title Sheet Page 2 Daily Flow, ATU, Treatment Tank & Dispersal Cell Sizing Calculations Page 3 Mound & Dispersal Cell Cross Section Page 4 Pump chamber Cross Section & Lateral Detail Page 5 Site Plan Page 6 Management Plan Page 7 Filter Specifications Page 8 Aeration Treatment Tank cross section ROVED Page 9 Pump Curve 7OVEp Page 10 White Knight ATU Certification Letter CAF T AND Page I I Aeration Treatment Unit Agreement IAL Page 12 Aeration Treatment Unit Service Contract RVICES uSrRY SERVICES NDENCE Attachments: Soil Evaluation Report Mater Plumber Restricted Service: Dale Hudson, Dept. of Safety & Professional Services Credential #220853 y F `'-a y..rr~".~=tt'`Z-•- Date: Signature: /~i Page I Of 12 Design pursuant to In-Ground Soil Absorption Component Manual for POWTS, version 2.0 SBD-10705-P (N.01101; R. 10/12) Richter Mixed Waste Residential/Commercial Mound POWTS Calculations In accordance with Mound POWTS Component Manual, Version 2.0, SBD-10691-P (N.01/01, R. 11/12) JOB DESCRIPTION: Proposed mound POWTS will serve existing 4 bedroom residence and proposed family operated commercial kitchen that will be used to prepare baked and smoked foods, i.e. pulled pork, baked beans, spare ribs, ham, fish, etc. for offsite sale. The facility will not be open to the public. All meat products arrive at the site pre-processed and ready for cooking/smoking. interior grease interceptor will be installed in the commercial kitchen as per general plumbing requirements. The facility is antict~o generate 76 gpd estimated flow that will be high strength waste. Design flow will be based on 200 gpd estimated flow to provide additional safety factor for system calculations and design. Waste water strengths assumed as 392 BOD residential waste and 1,200 BOD commercial waste. PROPOSAL: Reuse existing Weeks 1,000 gallon concrete septic tank and convert existing 800 gallon pump tank to septic tank capacity by removal of pump and electrical and installing baffle at outlet. Effluent will flow downstream by gravity to a 2,000 gallon septic tank were it will be combined with the commercial waste to create a mixed residential/commercial waste. A White Knight WK 78 ATU (two towers) will be placed at the center of the tank. The treated effluent will be discharge by gravity to a 1,250 gallon pump tank and then time dosed to equalize effluent distribution to a newly constructed mound POWTS. Design Wastewater Flow: 900.00 gallons per day 1. Residential Estimated Daily Flow: 600.00 gpd (4 bedroom residence) (100 gal./bedroom) = 400.00 gpd Estimated wastewater flow = 400.00 gpd Design Wastewater Flow: (400.00 go)(] 50% design safety factor) 600.00 go 2. Commercial facility Estimated Daily Flow as per facility operator: 300.00 ad (Calculated design flow increased to provide additional safety factor) (2 family employees all shifts)(13 gal./employee) = 26.00 gpd (2floor drain)(25 gallons) = 50.00 gpd (3 compartment sink)(2 dish washings/day) = 42.00 gpd (Kitchen cleanup)(twice daily) = 30.00 gpd Estimated wastewater flow = 148.00 gpd Design Wastewater Flow: (14800 gpsi)(150% design safety factor) 222.00 go 3. Total Design Flow: 2QUO 90Treatment Tank Capacitv Calculations: Residence: Existing Weeks Concrete 1,000 gallon septic tank + 800 gallon septic tank to serve existing residence Minimum required Residential septic tank capacity = (600 gpd) + (2.008 "magic = 1,204.80 gallons Commercial kitchen: Wieser 2,000 g llon septic tank/aeration treatment tank to serve proposed commercial facility Minimum required Commercial septic tank capacity = (300 gpd) + (2.008 "magic = 602.40 gallons Proposed Grease Interceptor Interior Grease Interceptor as per general plumbing requirements Proposed ATU Treatment Tank Qapacity Wieser Concrete W2000- 1. Required effluent retention time per White Knight design specifications = 48 hour minimum retention time. 2. Proposed retention time = 2,017.24 capacity/900 gpd = 2.24 days or 53 hrs, 46 minutes tank retention time. Aeration Treatment Apparatus Calculations: 4.97 lbs BOD Removal/Day Required Wastewater Strength Target: B.O.D. 30Mg/L, T.S.S. < 30 Mg/L, F.O.G. <_50 Mg/L, Ph = 7.2 White Knight WK-78 is designed and approved to remove 8.001bs. BOD/day. 600 gpd residential wastewater strength assumed at 330 mg/L BOD = 1.97 lbs. BOD to be removed/day. (392 Mg1)(600 gpd)(8.34) = 1.961568 Lbs, BOD/Day removal capability required 1,000,000 300 gpd commercial wastewater strength assumed at 1,200 mg/L BOD = 3.00 lbs. BOD to be removed/day. 1( ,200 M &)(300 gpd)(8.34) = 3.0024 Lbs. BOD/Day removal capability required 1,000,000 Pg. 2 of 12 d . DOSE CHAMBER CAPACITY & TIMED DOSE CALCULATIONS: SEE CORRESPONDENCE Timed dosing is proposed to allow retention & mitigation of surge flows. Dose timer to activate pump at 2 hr., 24 minute intervals resulting in 10 doses per 24 hrs. Pumping duration to be set at 3 minutes, 00 seconds per dose. Pump discharge rate to be calculated as installed and timer duration to be recalibrated to provide required dose volume. Control Panel: SJE Rhombus IFS 11 W 114H8AC w/ evgnt counter, redundant off float current sensor & electrical disconnect Dose tank Manufacturer & capacity: Wieser Concrete )MI .250-MR, 36 00" a, 34-81 galdinch (1253.16 gal. actual) Sizing calculations and float settings: A) One day holding capacity: 19.40" = 675.31 gal. B) Alarm setting: 2.00" = 69.62gaal. C) Dose volume + flow back: 2.61Y'= 90.51 gal. Dose volume = (600 gpd)/(12 doses/day) + (.163 gal. flow backX 175') = 78.53 gal. Min. dose = (5X55.44)(2X.064) + (.163 gal. flow backX175') = 64.01 gal. D) Reserve storage: 12.00" = 417.72 gal, TOTAL: 86.00" = 1,253.16 gal. Pump selection: Manufacturer: Goulds ' Model number: 3871 EP05 Minimum discharge rate required: 26.24 gpm Pump will discharge ,30.00± gpm Q 24.15' TDH Mound Calculations: ABSORPTION AREA SIZING 1. Design wastewater load: 900.00 GPD 2 Depth to limiting factor: 40" 3. Land slope: 7% 4. Infiltrative capacity of soil at system elev.:2.0g~sq.ft. ASTM C33 med. Sand 5. Dispersal cell area required: 450.00 N. ft. Dispersal cell area proposed: 450.00 sq. ft. (Bed width (A) 4.0, Bed length (B) 112.5') MOUND DESIGN 1. Mound Height: Fill depth (D) 0.50' or 6" Downslope fill depth (E) , ,0.78' or 9.36" [0.50' + (70/oX4.0')] Depth of aggregate (F) 0.75' or 9" Cap depth (G) 0.50' or 6" Topsoil depth (H) 0.50' or 6" 2. Mound dimensions Downslope width (I) 9.75' Upslope width (J)_4.50' (.78' +.75' + 1)(3X1.27) = 9.6393' (.50' 75' + .50')(3X0.83) = 4.3575' End slope (K) 7.25' (.50' + 0.78')/2 +.75 + 1.013= 7.17 Total length (L)127.00' Total width (W) 1$.25' (112.5')+ (2 X 7.17') = 126.84' 4.5' + 4.0' + 9.75' = 18.25' SYSTEM ELEVATIONS BASAL AREA Installation Contour elevation: 104.25' Basal area required: 6,000.00 sq; ft. Dispersal Cell elevation: 104.75' 9.00 gpd./0.6 gal./sq.ft./day = 1,500 sq.ft. Highest Dist. Network elev.: 105.25' Basal area provided: 1,546 87 sq. ft. Pump off elevation: 91.00' (112.5'X4' + 9.75') =1,546.875 sq. ft. 2 Y Pressure Distribution Network Calculations 1. Distribution pipe sizing: Laterals per cell: Lateral length: 55.44' Sidewall separation: 2.00' Lateral size: 1'A" Lateral spacing (s): NSA Orifice size: /8"" Orifices per lateral: 32 Orifice spacing (x): 1.76' Orifice density: 7.03 (1 st hole at 0.88' from manifold) 2. Distribution network discharge rate: 26.24 ag 1. Anjoute (2 lateralsx32 orifices/latera1x0.41 gal/orifice) = 26.24 gpm 3. Manifold sizing: Location enter Length Diameter 2" 4. Force Main: Diameter 2" Length 175' Flow rate 30 ±gal./min. Friction loss 3.395, (175'x1.941/100ft.) 5. Total dynamic head: 2 . ' Min. distal supply pressure 6.50, Vertical lift 14.25' Friction loss (Forcemain) 3.40' Total dynamic head = 24.15' 3 Mound Plan and Cross Section Views ~t 1/10 B ation Pipe J1 _Observ :ti.. . W B I L Mound Component Dimensions Down slop a toe extension made. A 4.00 ft E AO.50 in H 1.00ft K A17.72 ft B 112.50 ft F in z 9.33 ft L ft D 6.00 in G ft J 4.39 ft W ft 450.00 (ft2) Dispersal Cell Area 1500.00 (ft) Basal Area Available 8.00 (gpd/ft) Linear Loading Rate 11.25 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 106.52 (ft) G I I F Dispersal Cell 105.25 (ft) Lateral 104.75 (ft)--► - Invert Dispersal Cell D ( ' Elevation x •k . < t .1 1,i. r : il• " ' Y ?ti+ ' 1 , , < t ? 1 !'C`c4 ,l. Y z . , 104.25 (ft) Contour Elevation 7.0 % Site Slope Geotextile Fabric Cover Shading Key Dispersal Cell See lateral details on T Page 4 for number, size, 1[] Topsoil Cap 1.5 ft Subsoil Cap a c and spacing of laterals. ASTM C33 Sand Laterals are equally F spaced from the ;.TypicalLateral. c ; :r; I distribution cell's Tilled Layer Hrl": v centerline in the © Aggregate " ' _ .A distribution cell (AxB). Project: Richter Mixed Residential & Commercial Waste W/ ATU Page 3 of 11 Center Connection Lateral Layout Diagram ►E P ;zip IE X --X1+.12 I w2+1 Laterals &forcemain Sch 40 PVC per SPS Table 38430-6 Holvsdtdtdon MNbottc4nof the latwal, 40 - Turn-up vdballvalvooraleanoutplug squally spaced Number of Laterals 2 Orifice Diameter 0.125 in Lateral Diameter 1.50 in Orifice Spacing (X) 1.76 ft Lateral Length (P) 55.44 ft Orifices per Lateral 32 Lateral Spacing (S) 0.00 ft Orifice Density 7.03 fe/orifice Lateral Flow Rate 13.18 gpm Manifold Length 0.00 ft System Flow Rate 26.36 gpm Manifold Diameter 0.00 in Total Dynamic Head 25.26 ft Forcemain Velocity 2.69 ft/sec 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 E--- Alternate outlet location Forcemain diameter Weiser Concrete Manufacturer 2 in. Capacityl 1253.16 Gallons Volume 34.81 gal/inch A Weep hole or anti- Dimension Inches Gallons B) siphon device A 19.00 661.45 °J B 2.00 69.62 C -Pump off elevation (ft) C 3.00 104.37 91.00 D 12.00 417.72 Total 36.00 1253.16 D I F- Dose tank elevation 3" Bedding un er tank. 90.00 Alarm Manuafacturer SJE Rhombus Note: Switches Alarm Model Number Tank Alert SJE1011421 containing mercury may not be used in Pump Manufacturer Goulds this system. Pump Model Number 3871 EP05 Pump Must Deliver 26.36 gpm at 25.26 ft TDH Project: Richter 4 bedroom Residentail + Commercial facility Page 4 of 12 EX~ s6;13, ya _40 ¢ ltd. Scale: s / Lit/ ~'Sw( d 7~y, zo7J, II i 0 //Ef'!//JW'/~l SPC' ,18T 3 / 5e Tt Ci u)/. L,3 St'd /q, 17 71-r12(.97rwl V' ~c -,63&-icc>1 ~c-~w- i 1 99. s'8 ieoz7 iao.oy Xis, ooe1C 10{e: tk; «~ye.rea-les 1 I ; ® , A6¢nm iotTu.9ean po~,JTs e ~ I y ~ I I~ I ~ 3 Pak A i ~ ~ ~1.J ! /PeSrcl¢~1CC a E~ ~ ~EG4~~ ~1 ~'o»ereiL /r G'oo~a.~. ° ` i 'i Deese-J EXi3.4-+ e.detXS Gmerd-e 84CVAJ- ~ a ~.n64-- •E~ 5e convtrf~d I I i 5 -f by ,v7644 //a -6!P" o e bavK/P i % ' W of •Ea..rt'v~le z! CvsKP/y.%sg r..> ."'tC. ~ r RcCe~led Gle sir, S-Er.„ <-✓a-Is s so3 eglk t ° 5CA.yo►,d.e. y"Asr~►t~/yJ'ss~ac.s~o~✓.e ~cNnpy ~s38.2.3c~r:~e. I 1 0. in4 o"'E o e Exist CORR. SPyO,~N,D~CNCE I I !I - ve a e i I i f irClM4:,'f To be ~d Sr1. ~sune~d elW. -i~.cC. } ° i a bandut,CC~ as r 5 FS 38 3.33. n C I~s'oPosL~l~rrSri- Aropostd c4e Ser cuntut cw24uw-wtR j 1 .Zr/V?J.e. cr,,,cr {c +vtZ,so +K~1 Sspb•c fo..(C~.71cus~o*t; ed cs~. To be i ll~'olYe rblia rs pump t-,tl K. u std as r4TK tr4G~ two 'Oh, '&f L° We- 78 CA N' `rs) ' br ;a c eL✓ r3~ 6,¢~,ea tr? ea-rrE~.-^~ar,/id/e. F~~ylo~ Ced 4,Z S_ le AQU 417& r`"X.S'L~in99 diS~lr.SQ~CI/~ Q'f. fiw~C 0 64e cY 6a,, a'dr1 e d as 5PS 385. 33' POWTS Mound Dispersal Cell Management Plan for High Strength Waste Pursuant to Wisconsin Dep't. of Safety & Professional Services 383.54, Wis. Adm. Code General The POWTS shall be operated in accordance with Dep't. of Safety & Professional Services 382-384 Wis. Adm. Code, and shall be maintained in accordance with component manual SBD-10706-11 (N.01/01). All local and/or state rules pertaining to system maintenance and reporting shall be complied with. Questions on the operation or maintenance of the system should be directed to the System Maintainer, Jim Thompson at (715) 248-7767 or the St. Croix County POWTS Inspector at (715) 386-4680. Effluent Quality The sewage effluent concentration levels generated at this site will be high strength effluent as defined by the Wisconsin Dep't. of Safety & Professional Services. Influent quality entering the dispersal component of the POWTS may not exceed 30mgf L BOD5, 30 MG/L TSS, and 30 mg/L FOG. Testing of effluent concentration will begin 30 - 60 days after the system is placed in service and will continue at 3 - 6 day intervals for a period of 30 days with 6 samples being collected within that period. If concentration levels exceed DSPS standards, additional ATU treatment components will be installed in the existing treatment tanks. Effluent quality will again be assessed as described above. All test results will be submitted to the County Zoning Department. Influent now may not exceed maximum design flow specified in the system design and sanitary permit. The ATU will be inspected and maintained as per Agreements on file with system design and approvals. Septic Tank fhe operating condition of the septic tanks and outlet filters shall be assessed at least once annually by inspection. The outlet biters shall be cleaned as necessary to ensure proper operation. The septic tank contents shall be removed when the sludge and scum in the tank exceed 1/3 the liquid volume of the tank. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code, by an individual certified to service septic tanks under s. 281.48, Stats. If the contents of the tank are not removed at the time of the annual assessment, maintenance personnel shall advise the owner of when service will be needed to maintain less than 1/3 scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. If such products are used they shall be approved for septic tank use by the Dep't. of Safety & Professional Services, Safety and Buildings Division. Any treatment tank opening deemed unsound, defective, or subject to failure shall be replaced. Exposed access openings shall be secured by an effective locking device to prevent accidental or unauthorized entry into tanks or other components. No individual should ever enter a septic tank or pump tank as dangerous gases may be present that could cause death. Dispersal Cell Observation and vent pipes within the dispersal cell shall be monitored for effluent ponding. Ponding levels shall be reported to the owner. Any ponding will be deemed an indication of an impending hydraulic failure requiring more frequent monitoring. Persistent ponding of 3" or more within the system will be addressed by either installation of additional aeration treatment units or removal and replacement of existing dispersal cell. Coutim!eacy Plan If the septic system or any of its components become defective, the component shall be repaired or replaced to keep the system in proper operating condition. Aeration Treatment Units shall be immediately repaired or replaced with approved components of the same or equal performance. Persistently ponding within the dispersal cell shall be monitored and dispersal cell shall be replaced when deemed necessary to relieve ponded condition. Monitoring and Inspection Schedule All system components shall be monitored and inspected semiannually for 24 months after installation is completed. Monitoring, and inspection shall be conducted annually thereafter. Start-Up Procedure: I . Inspect aerator operation weekly to verify air flow, turbulence, monitor water flow, etc. for 30 days. 1 Test effluent samples for 30 day period, beginning within 30 - 60 days of installation. Samples to be collected from sampling chamber at 3 6 day intervals for 30 days, 7 total. Tests to include BOD, fSS, Ph. Two FOG tests will be completed at beginning and end of sample period. 3. Monitor water flow weekly for 6 months, monthly afterward. Pg. 6 of 12 Semi-Annual/Annual Monitoring and Inspection Procedures Treatment tanks & ATU" 1. Visually inspect all system components. 2. Evaluate grease trap condition and pump contents quarterly or as needed. Inspect & clean outlet filter as needed. 3. Evaluate sludge levels in septic tanks and pump contents annually or as required by inspection. 4. Inspect all treatment tank outlet filters & clean as needed. 5 Determine dissolved oxygen levels. Collect and submit BOD, TSS & FOG samples as needed. 6. ATU Inspections shall include the following: Blower Unit Inspect blower unit and air intake, clean or replace filter as needed. Check for excessive heat, noise or vibration. Alarm &/or Control Panel Test electrical connections, current draw, alarm, pressure switch and high water alarm. Adjust or repair as needed. Treatment U it Inspect manhole rings, covers, locks, vents, etc. determine operating condition of the units by visual observation & measuring sludge volume in each treatment tank. Measure dissolved oxygen level, temperature and pH of effluent within each unit. Collect effluent samples for B.O.D. & T.S.S analysis as needed. Replace Bacterial Inoculators annually or as needed. Semi-Annual/Annual Pdonitoring & Inspection Procedures - Dispersal Cell: 1. Monitor water flow from building by use of existing water meter. 2. Monitor existing trenches quarterly to determine condition of bio-mat and remediation of hydraulic failure. 2~__. -u -0 D DOm r r r , ;10 Z r -TI o ;K a. C O Cn` rh~f11 it Ij ~1r a~l~klg/~ I AVM . IAN/ 111 D O VNi -0 m ~ rn r n J X ✓?r a°,r1 r/a 1 ~ / ! 6t1 cn cD Iv m D ~~,~•%!1/~1~~~~jr,lJ~,l.;,~ r!f o z " ~7// 00 -i U) -1 C/) N IT) ~r(rfGrwl>li:'! /1rrliL !(rl~r ~Ltll1 li;~ r i m - Z n m T O O r c can o °n rn C„ rte-- ~ _~\a~\\ Co Ali z CTS o ! 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' 'llll(~ S . I'I~1 ' l l 111 I ~t. '•i1,4' 1 jtl', L 'if I I~ ~ - sl • 5 66" AS 86 53" READ m z :c n Z N CC nsu D n UP 5j" 4" CAS s ? D m~ 4" 56" 6" X D > 'n m D a A I D ~ D N UP 8j" ( m N A 4" CAS \ \ g l 50" F, m N -n r-CD* Xxo W* ~ ~~•o goo~o~o z alp ~g~ zo > sZ~N 0 xX D n m ~.pp "p gg D -1 Uj -1 s ? • m O sxh D Q O G t/1 Q 0 OO D a• O W a ~v v N NZ \ C Nm ' Cp o • n D o c N vZ° m D~ Z o 8 O H z ~'tg ®Ro ~ Na =i m w Z 0 D Som 8~ C1 -1 Z m{ D to m r 0 D 2 (n ZI i- v c A H ~ m v to ACE SOILS DRAWN BY: SWT SCALE: t 4"-t'-O" RE-POUR: REV. m MIEBERIBRINETE 7 13 DATE: • POST-POUR: *i PROJECT' RICHTER W3716 US HWY 10 MAIDEN ROCK, WI 54750 PA7.91 0 800-325-8456 FILE: WMD-W Pq . o,~/Z lull ll Loll 1J: b1 11bb64J144 BUI-015 F'LBU H I to F'AUE 02 ut 1, /tll~ 1'4yfM First supply LLC NO. 9113 P. 2 Single phase, simplex demand do00 or timed dose, float or C-Level" cortrollad system for pump oontmt and system monitoring. The IFS s'hrnplex control panel is designed to control one 120, 208, 240 VAC single phase pump in water end sewage installations. The panel features an eaay-to-use touch pad with display on the inner door for programming and system monitoring. The panel configuration can be easily convertod in the teid to either a timed dose O or demand dose. 1V The optional C-Level° sensor is a pressuretransduoerthat senses thin liquid level in 0 the tMnk and sands a signal to the IFS panel. Pump activation levels can be adjusted O byusingthepanel touch ee d,C-Level'CL40sepsor eratingrangele3-39.9Indres (7.6-101.3 cm), C-Level CL100 operating range is 3-99.6 inches (7.6,252.7 cm), TOLICIII AD FEATURES A. Level Status Indicators illuminate when floats or set points are activated. AIArm will Activate If a float operates out of sequence. B. HOA (Nand-(W-Automatic) Buttons control pump mode with Indication. Hand mode defaults to Automatic when stop level or redundant off level is Maoliad. C. Pump Run Indicator illuminates when pump is called to run. D. LED DleplayshowssystaMinformationIncluding: level ininch" orcentlrnetera (C-Level" only), mode, pump elapsed time (hh:mm), events (cycles), alarm counter, float error count, timed dose override counter (timed dose only), and ON/OFF times (tinted dom only), E. NEXT Push Sutton toggles display. F. UP and SET Push Button set pump ON/OFF times (timed doge only) or activation levela (C-Level" only). PANEL COMPONENTS Model Shmm IPSII WI14XBAC 1. Enclosure base measures 10 X 8 X 4 inches (25.4 X,20.32 X 10.16 cm). Rea. can Pa[ A TM 4R NEMA 4X (ultraviolet stabilized tnerrnopleatic with removable mounting feet c-ravel-sensorus wnlamesae,=& oCh 101A endrta. for outdoor or indoor use). Note: Options, voltage, and amp range selected may change enclosum size and eomponwt layout, 2. Red Alarm Beacon provides 960° visual check of alarm condition. 3. F~riorAlarmTestlNormal/SllenceSwitch allowshomandf, httohetested 6 meet dustrfsfety and hoe to be silenced In an alarm condition. Alarm automatically resets once mend and/or exceed industry safety alarm condition is cleared. standards d. Alarm Horn provides audio warning of alarm condftlon (83 to 85 decibel / Dual safety certification forihe United rating), States and Canada 6. Circuit Breaker (optional) provides pump disconnect and branch Circuit protection. N Standard package includes: 6, Polder Reidy controls pump by switching electrical lines, Definite purpose Demand Doge - throe 20' SJE MilliAmplulaster'm contactor used when pump full load amps are above 15. Ti med Dome ome - t hcontrol switches SJE 7. Float Connection Tlrtminall Block Timeero 20' MilliAmpMaste"contof switches It. Incoming Control/Alarm Power & Pump Terminal Block 9. Control Power Indleator/Fuoe indicator fight illuminates If control power is hnstruotl Oompteoe with step-by-step InRta(latlon present in panel. Alarm will ric9vato if control fuse is blown. ns 10, Alarm Power IndicatodFuse Indicator light illuminates if alarm power Is AF Three-year limited warranty c@ as present In panel. LWED 11, Ground Lug NOTE: Sohemat a Wiring Diagram and Pump Specification Label are locnied inslda the panel on enclosure oover IPO Box 1708, Detroit Lakes, MN 56502 1-888-D)AL-WE • 1-218-647-1317 1-218-847 BEE BACKSIDE FOR COMPLETE LISTING OF AVAILABLE OPTIONS. email : ajc@9prh .sjor 17omb Fax SEE PRICE BOOK FOR LIST PRIG, ue,com www.stferhAmbus^com 7 10/17/2013 13:51 7156843144 BOLDTS PLBG HTG PAGE 03 uci• 1/.'1013 2 50PM First Supply LLC NU, 9113 N 3 ~J wU IFS W 8AD I J G MODEL IFS MODEL TYPE 1 = SPLX TIMED DOSE (Includes option 8A standard) 2 m SPLX DEMAND DOSM (includes option SAO stands ) ALARM PACKAGE-- - • 1 = alarm package (lnoludes test/nommal/silence Switch, fuao, red light $ hum) ENCLOSURE RATING - W = NEMA4X STARIING MMOR B 1 =1201208/240 VAC 9 m 120 VAC PUMP FULL LOAD AMPS 1 =0-7" 1 ~ 7-15 FLA 2 =15-20 FLA PUMP DISCONNECTS 0 -no pump disconnect 4 = Circuit breaker 120 %1AC (must select starting device option 8) 120/208/240 VAC (must select starting device option 1) ® 8VATCHAPPLICATIONS H r- floats (Tamed dose = timer enable and alarm / Demand dose = stop, start, and alarm) (select 17 opflon) X = no floats timed dose demand dose C C-Leval* sensor (must select 24 or 29 option) (select option 3E and/or 4A & kD 16r high wattir alarm and/or redundant off floats) timed doae demand doso Note; Purnp down applications only. Industry practices suggest that a secondary device such oR afloat aWitch, ba used for reo!undant acBvation of the high love) alarm arnd pump shut of OPTION'S Lleisdharow CODE 13WcAPTION 006E DESCA"ON 1J Duo alarm inputs 15A Control / Almmi circuit breaker 3A Alarm tlastmr 16A 10' cord in lieu of 20' (perHoat) 3B Manual alarm reset H1138 19' cord in lieu of 20' (per IlovV aE High water alarm float (must Wed 17 op6bn) 16C 30' cord In lieu of 20' (per Rent) (Avalrab/e only when Swfth Appiccations = C) 16D 40' cord In flau of 20' (par float) 0 4A Redundant oft (select option 40 If 27opits are required) 170 sensor F1000 ! IntornAlly welghtgd A (per Boat) Demand Dose 17D Sensor Float*/ externally weighted A (porlloao Timed Dose 4D 70 MllkAmpMoator V pipe clamp • (poe doeo (must seRedundantect 4off A 4A qp opttical) (must sele 17H MinlAmpMasler'/ e*-tnally weighted 9 (per Roar) 17 option) 6A Auklliary alarm contacts, fan C H 17J Sensor Floate / pipe clamp A (per lost) BAC Display board indudox: ETM counter, events (cycles) 16A Timer override float counter, alarm counter, and override counter (timed dose (timed dote float panel only) on 1,Y). (Inoludad as stonoa/d.) 24E C-Level" CL40 sensor with 4' vent NbA & 20' cord 106 Lockable latch - NEMA 4X 24F C-Leval" OL 40 sensor with 4' vent tube & 40' cord 16F Lightning Annstor (mud select pump c)rcuk breaker, 24G 0-Level' CIAO sensor with B' vent tub* & 20' cord control and alarm power complned) 241-1 CrLevar" CL40 sensor with 9' vont tube & 40' cord. Q 10K Antrcondansa6on heater 24X No C-Level' CLAD sensor q 110 NEMA I Henn panel 29A C-Level' CL100 sensor w/10' vent tube & 20' cord (must Woof option 6A) 298 C-Leval" 01.100 eenmor w/10' vatt tube & 40' coati J 11D NEMA 4X alarm panel 2BX No O-Level" CL100 sensor (must sole-at option QA) • MechanicalVactivtltad A Mercury-sotwated : 41 ft lift i NOR SAMPLE „ MODEL IF g ] 4 M BAC IOE176 Model Typo Alarm Package Enclosure Rating9 1 1 W Staging Device Pump Pull Load Amps Pump Disconnects Switch Appllcntlon Options: Display, Lockable Latch, SJE M11 HAMPMegter"'/pips clamp w aefthcm~uc owls 8 GOULDS PUMPS Submersible Effluent Pump EP04 EP05 3871 APPLICATIONS • Fully submerged in high v EP05 Impeller: Thermoplas- r Bearings: Upper and loti,,er Specifically designed for the grade turbine oil for tic enclosed design for heavy duty ball bearing lubrication and efficient improved performance, construction. following uses: heat transfer. ■ Casing and Base: Rugged • Effluent systems • Homes Available for automatic and thermoplastic design provides AGENCY LISTING • Farms manual operation. Auto- superior strength and corrosion SP Canadian Standards Association • Heavy duty sump matic models include resistance. • !"dater transfer Mechanical Float Switch u Motor Housing: Cast iron • De,.vatering assembled and preset at the for efficient heat transfer, Goulds Pumps is ISO 9001 Registered. factory. strength, and durability. SPECIFICATIONS a Motor Cover: Thermoplastic FEATURES cover with integral handle and • Solids handling capability: float switch attachment points. maximum. ■ EP04 Impeller: Thermoplas- a Power Cable: Severe duty • Capacities: up to 60 GPM. tic Semi-open design with rated oil and water resistant. • Total heads: up to 31 feet. pump out vanes for mechanical • Discharge size: 1'12" NPT. seal protection. • Mechanical seal: carbon- rotaryiceramic-stationary, BUNA-N elastomers. • Temperature: 104 F (40 C) continuous 140`F (60-C) intermittent. METERS FEET • Fasteners: 300 series 10 sta able steel 9 30 .~f5GPM • Capable of running dry without damage to $ L-__ L2.5P components. ,2f~/S TD.f/ o 7 a Motor: _ • EP04 Single phase: 0.4 HP, U 6 20 115 or 230 V, 60 Hz, 1550 c RPM, built in overload with o 5 15 . . 11 1 automatic reset. J 4 • EP05 Single phase: 0.5 HP, <P 5 115 V or 230V, 60 Hz, 1550 3 10 RKA built in overload with EP04 automatic reset. 2 • Power cord: 10 foot 5 - standard length, 16/3 1 S1TOW with three prong grounding plug. Optional 20 0 00 10 20 30 40 so GPM foot length, 16/3 S1TW with .ZG•.tf~9✓~~rl. M,~:rnu.n ~u ~✓D/sues ~t~a!• three prong grounding plug (standard on EP05). 0 2 4 6 s 10 12 ml/n CAPACITY Goulds Pumps 2uu2 Goulds Pumps ITT Industries f _ ..vc So;n~,inbor, 2002 01, Mound POWTS Index & Title Sheet Mixed Residential & Commercial High Strength Waste Project Name: Richter mixed Residential & High Strength Waste Contact Name: Deland Richter Owner's address: 1641 200th Ave., New Richmond, WI 54017 Site address: Same Project Location: Subdivision: Na Legal Description: NEl/4NW1/4, Sec. 28, T.3 IN., R. 17W., Town of Hudson, St. Croix Co., WI. Parcel ID 036-1065-60-000 Page I Index and Title Sheet Page 2 White Knight Specification Sheet Page 3 Certification Statement for Utilization of Existing Septic tank Page 4 Septic Tank Maintenance Agreement Page 5 Waranty Deed Attachments: State Approved Design & Installation Plans Mater Plumber Restricted Service: Dale Hudson, Dept. of Safety & Professional Services Credential #220853 Signature Date: 13 Page i Of 5 Design pursuant to In-Ground Soil Absorption Component Manual for POWTS, version 2.0 SBD-10705-P (N.01/01; R. 10/12) 1'a~77~ i of i KNIGHT TREATMENT SYSTEMS ttention: MARK C NOGA, PRES. 291 COUNTY ROUTE 51A ,:)S'WEGO, NY 13126 e:ie{hone; 900-560-2454 -ax: 315-343-2941 Product Name: WHITE KNIGHT MICROBIAL INOCULATOR/GENERATORS„¢ Model Number(s): WK-1.50 AND WK-200 ENHANCED BIOLOGICAL INNOCULATOR GENERATOR; THIS APPROVAL AND ITS CONDITIONS ARE LIMITED TO USE & INSTALLATION IN NEW POWTS SYSTEM DESIGNS; SEE SPECIFIC CONDITIONS FOR RESIDENTIAL. WASTEWATER AND HIGH STRENGTH WASTE/COMMERCIAL [WK-150: MAX. 2000 GALS.; DA,(; RESIDENTIAL STRENGTH WASTEWATER; MIN. TANK CAPACITY = 3000 GAL. or 1.5-DAY RESIDENCE TIME WITH 2-DAY RESIDENCE TIME PREFERRED; NOTE: THE WK-150 IS ONE WK-40 AND ONE WK-78 INSTALLED IN A SERIES; SEE ATTACHMENT FOR INSTALLATION SKETCH] [WK-200: MAX. DWF 2400 GALS./DAY; RESIDENTIAL STRENGTH WASTEWATER; FOR HIGH STRENGTH WASTEWATER/COMMERCIAL USE; MIN. TANK CAPACITY = 4000 GALS. or 1.5-DAY RESIDENCE TIME WITH 2-DAY RESIDENCE TIME PREFERRED; NOTE: THE WK-200 IS TWO WK-78 INSTALLED IN A SERIES; SEE ATTACHMENT FOR INSTALLATION SKETCH] MAX. BOD5 1500 MG/L/DAY; FOR AVG. F.O.G. SEE STIPULATIONS REGARDING TREATMENT TRAIN. Product File No: 0: i-? 73 Attachments: t)1 ? C 3A, DO 'v r kuad a {)pr_c v a~ letter and attac hn)ents for. 201,10173 as azip file archive. _ Product Name: WHITE KNIGHT MICROBIAL INOCULATOR/ GENERATORS„¢ Model Number(s): WK-40 AND WK-78 THIS APPROVAL AND ITS CONDITIONS ARE LIMITED TO USE & INSTALLATION IN NEW POWTS SYSTEM DESIGNS [WK-40: MAX. DWF 750 GALS./DAY; RESIDENTIAL STRENGTH WASTEWATER; MIN. TANK CAPACITY = 1000 GAL. or 1.5-DAY RESIDENCE TIME WITH 2-DAY RESIDENCE TIME PREFERRED] [WK-78: MAX. DWF 1200 GALS./DAY; RESIDENTIAL STRENGTH WASTEWATER; FOR HIGH STRENGTH WASTEWATER/COMMERCIAL UP TO 1500 MG/L BOD5; MIN. TANK CAPACITY - 2000 GALS. or 1.5-DAY RESIDENCE TIME WITH 2-DAY RESIDENCE TIME PREFERRED; FOR MAX. AVG. F.O.G. SEE STIPULATIONS REGARDING TREATMENT TRAIN] Product File No: 2011001' , 2 ohs 5 TRI"'ATIL9}.'.`T A1111-ARAi ('S Douglas J. Nelson, PE N23W25025 Valleyview Lane, Pewaukee, WI 53072 (920) 342-2467 email: Dnelsonl28@wi.rr.com September 20, 2013 Mark Noga, President, Knight Treatment Systems, Inc. 281 County Route 51 A Oswego, NY 13126 RE: Richter POWTS plan Dear Mark, I have reviewed the above referenced plans that were sent to me on September 15'', 2013 at your request. My review specifically relates to the design of the White KnightTM MIG unit to be installed as a component of the new system as designed by Jim Thompson. The system information contained in the plan is as follows: Wastewater Quality and Flow Assumed Influent BODS value 1200 mg/L Assumed Influent TSS value 550 mg/L FOG level measured N/A Avera a Desi Flowr plan) 900 GPD N/A is not available The system serves both a residential and commercial establishment. The estimated organic load is approximately 3 pounds per day. Tank Volumes Grease Intercepter Internal Total Treatment Tank (2@2500) 2000 allons Pump tank 1250 gallons Given the above data, the total volume of tanks and detention time should be sufficient to result in an effluent quality of BOD5 of <30 mg/L and TSS of <30 mg/L. A grease trap is planned to treat the wastewater generated by the commercial kitchen. If you have any questions please contact me. Sincerely, Douglas J Nelson, P.E. / D o/,Z POWTS SERVICE CONTRACT The proper operation and maintenance of the components listed below will significantly influence the performance and life expectancy of the POWTS (Private Onsite Wastewater Treatment System). This agreement authorizes A.C.E. Soil & Site Evaluations, L.L.C. personnel (Service Provider) or their representative access to the POWTS components during regular business hours to perform regular inspections and routine maintenance of those components. It is herby agreed by and between Owner and Service Provider that in consideration of the payments provided for herein, Service Provider will provide a manufacturer trained and State licensed inspector to perform periodic inspections of the POWTS components as set forth below. Service Provider will prepare a written inspection report after each inspection containing any recommendations for the operation, maintenance, and or repair of the POWTS deemed appropriate by the Service Provider. A copy of the report will be provided to Owner and the appropriate Governmental Unit. Service Provider will supply additional services, parts, or labor only after authorization by purchaser. This agreement does not assume any responsibilities or obligations that are normally the responsibilities and obligations of the Owner and does not cover any costs associated with operation, maintenance and or repair of the POWTS. In no event shall Service Provider be responsible for any special or consequential damages, including but not limited to, loss of time, injury to person or property, or incidental economic loss due to equipment failure for any reason whatsoever. This agreement shall remain in effect for a period of two (2) years from the date of POWTS installation, and will be automatically renewed each year thereafter unless amended or cancelled by either party with 30 days written notice. This agreement may be cancelled by Owner only if replaced by a service contract with another service provider authorized to inspect and maintain the specific POWTS components in question. Purchaser agrees to pay Service Provider the sum Of 125.00 per inspection. Pour (4) inspections will be provided over the first two-year period at six-month intervals. Payment for the fast four inspections will be included in the cost of the POWTS design. One (1) inspection per year will be conducted thereafter with inspection fees billed at the time of inspection. Additional fees associated with effluent testing, when required, will be billed at time and material cost. POWTS DESCRIPTION: One (1) White Knight WK-78 containing two (2) aeration pre-treatment units, pre-treated effluent discharged to Mound dispersal component constructed in accordance with Mound Component Manual, version 2.0, SBD-10691-P (N.01/01, R. 11/12). POWTS Location: 1641200'h Ave, located in: NE '/4 NW of Sec. 28, T., 31 N., R. 17 W., Tn. of Stanton, St. Croix Co., WI, Parcel # 036-1065-60-000 Owner name and address: Deland Richter 1641200' Ave. New Richmond, WI 54017 be~~_J~ //7 (Deland Richter) (Date) Service Pro C.E. it & Site Evaluations, L.L.C. 340 Pauls n Lake Road sceola, 54 J es K. Thompson) (Date) Instrument Drafted By:_ James K. Thompson Pg. 12 of 12 c~ 2330 eio SOIL EVALUATI N REPORT page 1 of 4 Wisconsin Department of Commerce . Al A.C.E. Soil & Site Evacuations Division of Safety and buildingsin accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper $ 11 inches in *a. Plan must St. Croix include, but not limited to: ve ' riCal reference point (8M), direction and arcel I.D. percent slope, sc~e or d arrow, and NQion and distance to M~ 036-1065-60-000 Please p>nlprmation. ev' 71/1 Personal mformebw you provide may be used for secondary purposes (Privacy Law, F-j Property Owner Property Location Govt. Lot NE 1/4 NW 1/4 S 28 T 31 NR 17 W Deland & Andrea Richter Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1641 200th Ave. 1 na CSM Vol. 7, Pg. 2021 City State Zip Code Phon7eNumb er Ci ty J Vitiage 01 Town Nearest Road New Richmond WI 11 54017 (6616-2605 Stanton 200Th Ave. Residential / Number of bedrooms 4 Code derived design flow rate 900 GPD ew Cons ruction Use: J Replacement ✓6 Public or commercial - Describe:Combined Residential & Commercial Flood plain elevation, if applicable na arent material acial Till Gene mments and recommendations: Site suitable for mound system with 6" of ASTM-C33 sand placed on 104.25' contour. infiltrative surface elevation to be 104.76. Boring # J Boring 41" in. Sal Application Rate rI Pit Ground Surface elev. 103.07 ft. Depth to limiting factor Dominant Color Redox Description Texture Stnxture Cornsistenrx3 Boundary Roots PD Horizon Depth Gr, Sz. Sh. *Eff#1 *E In. Murnsell Qu. Sz. Cont Color 1 0-10 1Oyr3/3 none SO 2fgr mfr MVfO.2 2 10-19 10yr4/3 none sil 2fsbk mefi 3 19-28 1 Oyr4/4 none sic] 1 msbk mfr l fm 4 28-36 1 Oyr4/4 none sl 1 qesbk mvfr 5 36-41 1Oyr3/6 none Is Emi 6 41-60 7.5yr4/4 f2d 7.5yr5/8 fsl mfr I 2 ' Boring # J Boring 40" in. Sail Application Rate ce elev. 106.39 ft. Depth to limiting factor lm Pit Ground Surfa Dominant Color Redox DescdR&i Texture 7Structure Consistence Boundary Roots GPD/ft' Horizon Depth Gr. Sz. SK * ff#1 ff#2 Cdor in. Munsell Qu. Sz. Cont. 1 0-4 1Oyr3/2 none sit 2fgr mvfr cs 2fmc 0.6 0.8 2 4-16 1Oyr3/4 none sil 2fsbk mvfr gw 2fmc 0.6 0.8 3 16-40 1Oyr3/4 none sil 1msbk mvfr cw 2fm1c 0.4 0.6 4 40-50 1 Oyr4/4 f2f 7.5yr518 sicl 1 msbk mvfr cw 1 fm 0.2 0.3 1fm 0.2 .3 5 50-58 7.5yr4/4 f2d 7.5yr4/6 Sol 1csbk mfr * Effluent #1 = BOO S> 30 < 220 mg/L d TSS >30 < 50 mg/L " Effluent #2 * BOD <30 mg/L and TSS <30 mg/L CST Number CST Name (Please Print) Signatu 3602 James K. Thompson Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted 71 Telephone Number 340 Paulson Lake Lane Os'a WI 54020 5124/2013 Property Owner Deland & Andrea Richter parcel ID # 036-1065-60-000 Page 2 of 4 Boring # --j Boring " in. Sol Application Rate _yj Pit Ground Surface elev. 101.74 ft. Depth to limiting factor >(>2 . GP Iff Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 in, Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0-14 1Oyr313 none SO 2fgr mvfr cs 2fmc 0.6 0.8 2 14-28 1Oyr4/4 none sicl 2fsbk mvfr gs 2fm,1c 0.6 0.8 3 28-40 7.5yr4/4 none sl 1 csbk mvfr cw 1 fine 0.4 0.7 4 40-62 1Oyr4/6 fad 7.5yr5/8 strat. s Osg ml - 1vf 0.7 1.6 E 1.~...l Boring # J Boring 1 1 Pit Ground Surface elev. 104.75 ft. Depth to limiting factor 36" in. Boll Application Rate GPDM 7ftizon Depth Dominant or Redox Description Texture Structure Consistence Boundary ---Roots *Eff#1 *Eff#2 in. Munsel Qu. Sz. Cont. Color Gr. Sz. Sh. 0-15 1Oyr3/2 none SO 2fgr mvfr cs 2fmc 0.6 0.8 2 15-20 1Oyr4/4 none sil 2fsbk mvfr gw 2fmc 0.6 0.8 3 20-36 7.5yr4/6 none sl 2msbk mvfr cw lfmc 0.6 1.0 4 36-46 7.5yr4/6 f2d 7.5yr5/8 sl 1msbk mvfr cw 1vf,fm 0.4 0.7 5 46-72 7.5yr4/4 c2d 7.5yr4/6 scl 1 csbk mfi - - 0.2 0.3 Saturated flow observed at 547. Boring # J Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Sol Application Rate GPD& Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in MunSeli Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 g 30 mg/L and TSS a 30 mg/L * Effluent #1 = SOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 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 608-266-3131 or TTY 608-264-8777. A.C.E. SON & Site Evaluations SBD-8330 (R.07I00) 2330 Page 3 of 4 ' PROPERTY OWNER: Deland 8t Andrea Richter SOIL AND SITE EVALUATION PARCEL I.D.# 03(-1065-60-000 A.C.E. Soil & Site Evaluations REPORT MEMO Proposed POWTS will serve existing 4I)edroom residence and proposed family operated commercial facility that will be used as a smoke house to prepare baked and smoked foods i.e. pulled pork, baked beans, spare ribs, ham, fish, etc. for off site sale. All meat products arrive at the site pre-processed and ready for cooking/smoking. Facility is anticipated to generate 100 gpd estimated flow that will be residential strength waste. Design flow will be based on 200 gpd estimated flow. o E c o eD > > n 3 ••r I ~ ~ ' ~ co c '~I. (D \ 1 3 # O o$ O m ai o O a u w W q • m CL ro Z a fA N 7 p O v A W C O O 0 W 7 U) N N N z O y fD O N O O g D O Q O (~D O N U1 O O N O O C O n 7 7 p O '•1 7 VI O C) O• C Us D a N m co' N y a C \ m m O N N 3 0 O O O r W ; ~1 O O a ~ co CO V a0. o f n o C y Un 0 O (q O c D 3 !r ~ N O O O m l~l• co :9 * * * m Z a 3 to to In o D Oro v v 0 S' O :3 (D 0 fm L N C N (D C N D 0 o (OZyu, 0 a N :3 O Q N a C N fD ~1 • CA (D (A CD 0 'a (A tam CD v c v y 63 n. n y C N N ID 767 3 cr 0 0 63 CD B y r_ ID M m' o A z CD - y 0 Q A 7 n N p N Z N N(D3m p ca M m CO p N(D a Z d a a o z m 3 9 HOC y CL : A CL C.) I ~ m o CL 3 ao o m *co o' I w c n oZ a w N CD O co y O ag O CA W N y O d fi N 5 N ~ N 7c O 42~ N VO X N O W A .v o CD oa ?a f p 0 `t O i ti f 4 ♦ Ek,3~ grade eJ«: 12 004A✓e. -if-FV36',~, fencl~rte/lot4ite \ O i l L cc~.~'~Ch /~70Y7C~ C.t~ ~ S~J Lot/, c.5m Pao 7, .2o;z/ 1 v t 11 1 ~Ey,~hw Sec --A .3ar, 1( I I ♦ Zf z7' O` / o3G. ions- 6v-cao al -Vtro • ktaa/:S~-4 /Co.olePE r I I ~r y 1 1 ro 1W ew i2df1 Val / V r i ~ E,~iS~in q bZ'Clve4~ ~7cJTS ~ 64, "10-11 `~/:tee r_ ~j / l I l1 .I uX- ~ C'a w-✓.' E/¢ v, = /o%B9, r ~ 1 Ek~~6• w~ I`--•- ( fi' ! t ~Cancr~clc~,~oP b r ~ ~ ~c~b•c ~JC: o ar , I ~xis~r- cvt:~ ll 1 1 i fs'be I I 1 / ~ I'~~ g4~'apG 1 lot o/ '01 1 iSL A".Sa.4o I )cve rrut;i►.7- ! be 't ba.+ d/ "Zd as I t Pa' S ~s 38j. 33, 1 1 1 I t I EX~ S~ po% L~ -1 to be ctSedas .5mo CXi3Ei~ oi;spc~sa/ Cell, a~ : L°bL~Edm a7eS.oli~y. Tobea dc" ed a 14SSun12al.C /lo.= O47 i! ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF EXISTING SEPTIC TANK(S) This is to certify that I have inspected the existing septic and/or dose tank presently serving the following residence: (Street address) 1641 200th Ave. New Richmond, WI 54017 located at: NE 1/4, NW 1/4, Section 28 , Town 31 N, Range 17 W Town of Stanton , St. Croix County Wisconsin. J Upon inspection, I certify that I have found the tank(s), to the best of my knowledge, will conform to the requirements of SPS. 384.25, and it (they) appear(s) to be functioning properly. Most recent date of inspection or service Did flow back occur from absorption system? Yes No~ (if no, skip next line.) Approximate volume or length of time: A14 gallons AM minutes Tank Capacity: 1,000 & 800 gal. Construction: Prefab Concrete x Steel Other Manufacturer (if known): weeks concrete Age of Tank (if known): 28 Years Permit number (if known) 74792, Issued 10/23/85 /'0 /a4' 0. l' D t z- (Licensed Plumber Signature) (Print Name) (Title) (License Number) MP/MPRS 9- l3 (Date) Form to be completed by licensed plumber (Dept of Safety and Professional Services Chapter 305 and s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) Rev. 2/2012 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Deland & Andrea Richter Mailing Address 1641 200th Ave., New Richmond, WI 54017 Property Address Same (Verification required from Planning & Zoning Department for new construction.) City/State Parcel Identification Number 036-1065-60-000 LEGAL DESCRIPTION Property Location NE 1/4, NW '/4 , Sec. 28_, T 31 N R 17 W, Town of Stanton Subdivision Plat. ~'SM Lot # 1 Certified Survey Map # Volume 7 'Page # 2021 Warranty Deed # 646957 (before 2007)Volume 1650 , Page # 32 Spec house 0yes0w Lot lines identifiable Qyes[]no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §SPS. 383.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Safety And Professional Services and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms 4+ IMI r-3 SIG ATURE OF APPLICANT(S) _DAT _ ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 04/12) VOL 1650PAGE - 32 /D STATE BAR OF WISCONSIN FORM 2 - 1999 6.46957 Document Number WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., WI This Deed, made between Gerald W. Germain and Susan L. RECEIVED FOR RECORD Germain, husband and wife, 05-31-2041 10:30 AM WARRANTY DEED Grantor, and Deland J. Richter and Andrea J. Richter, husband and EXEMPT N wife, - CERT COPY FEE: COPY FEE: TRANSFER FEE: 471.00 RECORDING FEE: 10.00 PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix _ County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area Part ofNEI/4 of NW 1/4 of Section 28, Township 31 North, Range 17 West, Name and Return Address St. Croix County, Wisconsin, described as follows: Lot 1 of Certified Survey Map filed September 14, 1988, in Vol. 7, page 2021, Doc. No. ~i 441406. 036-1065-60 _ Parcel Identification Number (PIN) This is homestead property. (is) iatOQ Exceptions to warranties: Easements, restrictions and rights-of-way of record, if any. Dated this day of May 2001 + er Id W. ermai% • + usan L. Germain AUTHENTICATION ACKNOWLEDGMENT Signature(s) (tee j tn7 STATE OF WISCONSIN ) y,r S Dkiti. - E'"~. •t. t,.re..+ ) ss. ) 01Yk St. Croix _ County authenticated this y Personally came before me this day of May 2001 the above named Gerald W. Germain and Susan L. Germain, husband and wife, TITLE: MEMBER STATE BAR OF WISCONSIN - (If not, to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED 13Y • _ Attorney Kristine Ogiand Notary Public, State of Wisconsin Hudson, W 16 _ My Commission is permanent. (If not, state expiration date: (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. ant-nektlon Prwem n*Is C=Peny. Fond du Lae. VN STATE BAR OF WISCONSIN 800-65e-2021 WARRANTY DEED FORM No.2- 1999 4'14 OF FH ERTIFIED SURVEY MAP NO.. 2027 in part of the Northeast Quarter of the Northwest Quarter of Section 28, 31 North, Range 17 West, Town of Stanton, St. Croix County, Wisconsin. are referenced to the north line of the Quarter of Section 28-31-17 which is as S89° 19' 33"E y TEp ,ANDS CORNER 389 19'33" [ 2601.36-'--- - - SEC SEC. ORNER 20-31-17 Roc, - S89°19'33"E 759.19'- NW CORNER NORTH TOWN ROAD 3LE I"s3~ SEC.2631-1LINE X - _ OF N89 19'33"W 79SEC.26. N p X~ORIVE WAY OVER' IOd 200' 30 40POWER 8 lN1DER GROUND LEGEND I TEGLEPHO OF-WNE AI.OIVt'1 c RI-Y. , PUSUC LAND CORNER OF RECORD OR S NED T TO 8E RECORDED. 11.60 ACRES MORE OR l° BY 24" LESS, INCLUDING TOWN t0 IRON PIPE SET, WEIGHING ¢ 1.13 LOS. PER LINEAL FOOT. 40 I ROAD. • FENCE LINE (WIRE). m --Y--X N{ J~ p; 11.02 ACRES EXCLUDING ~ p OI TOWN ROAD RIGHT-OF-WAY. tV Owner: Harold 1:. Jones W1 N _ J Rt. 3 Box 290 Now Richmond, WI 54017 A. N69°23'3{"W 759.tW ' '111is being that property described in a Z1 l Warranty Deed recorded in the Register 3m 4. of Deeds Office in Vol.. 757 - 90- 1u 41 pg. 176 in _ 46RODS m nI St. Croix County, WT. (Also shown as a M (799FEET) , - owneir thereon is Kathryn A. .Johnson). o° ~ ~ ,1n Z " O SURVEYOR'S C ER'1 I F KATE L O T 2 w Ronal F.'JoFin-son, a Registered Wisconsin ' Land Surveyor, do hereby certify that I have 71-D+ ACRES MOREOR LESS- surveyed and mapped a parcel of land being I OPEN FIELD the Bast 46 rods of the Northeast. Chtarter ; T T. NW IN4 of TSEC h-16 N /4O of the Northwest Quarter of Section 8, Y- TOWnship 31 North, Range 17 West, Town of X --N89°23'29"W 759.18'- S MCE Stanton, St. Croix County, Wisconsin, being that UNPLATTER _LANOS_ `1 property described in Volume 757 page 176 of deeds recorded Nis 1/4 LINE m in said County, described by metes and 130culds as follows : s 1/4 CORNER Beginning at the North.Quarter Corner of said Section 28; LINEOF-31-1 7. . CENTER LINE A thence, on an assumed bearing along the north/south quarter STATE NWY. NO. 6t of said Section, South 00 degrees 37 minutes 18 seconds Bast a distance of 1296.96 feet to the south line of said NE of the Nl: thence, along; last said south line, North 89 degrees 23 minutes 29 seconds West a distance of 759.18 feet; thence, North 00 degrees 37 minutes 18 seconds West, on a line parallel with and 46 rods easterly of, as measured at t right angsle to the east line of said NE 4 of the M1 '4 of said Section 28, distance of 1297.84 feet to the north line of said section; thence, along list said north line, South 89 degrees 19 minutes 33 seconds East a distance of 759.1.9 feet to the point of beginning;. Containing 22.61 acres more or less. Subject to the Town Road along the north 33.00 feet of the above described parcel. Also subject to all easements, restrictions and covenants of record. I further certify that I have complied with the provisions of Chapter 236.34 of the Wisconsin State Statutes and the subdivision regulations of the Town of Stanton and St. Croix County in surveving and mapping the same. F'' TZ. L. nald F. if son RS. No. 1.186 Da.tc Ron Johnson Land Surveying 11. O. Box 194 N07']?: THIS MXP IS CRFATED IN ACCORDANCE WIT}{ ST. CROIX Amery, WI 54001 COUNTY ORDINANCE 1.8.02(4)(b)(3)--.-the sale or exchange of parcels between adioining owners; with the land owner to Tele. (715) 208-2601 the south,LaVon Krurim,obta.ining s Lot 2. aapNS~ ~ r .ry`a' ~yG °Ns by . ~ylE+R 98 ~il~,l,'€1 ~RONAL+D F. COMM --N SEP A WfS Y. JA49S 1t . c flea,,* 44. s tnstrui f uzAqt.&as drafted by R. F. J. tClo>a1Cq Wi ~~~~N~9ss►ssaaaa VOLUME T PAGE 2021 Form - S T C - 104 b+w AS BUILT SANITARY SYSTEM REPORT P c? r' e e i2 TOWNSHIP J_SEC. T :N-Rl~f W ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of I1HR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM u l l Y j Pf C ► L L / C f Q~ 11 T ~cJ-e'a~H I3~ INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used Elevation of vertical reference point: Proposed slope at site: el Liquid Capacity: /b 0z) SEPTIC TANK: Manufacturer: Number of rings used: ---f-~~--- Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: i Number of feet from nearest Road: Front 10 Side 0 Rear, W --.---T U feet From nearest-property line Front 10 Side,0 Rear, O feet Number of feet from: well 11~Dl, building: ~/i l (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER , Manufacturer: Liquid Capacity: Pump Model: 4'5 Pump/Siphon Manufacturer: Pump Size Elevation of inlet: Bottom of tank elevation: Pump off switch elevation: Gallons per cycle: Alarm Manufacturer: ~y Alarm Switch Type: ih y~~ J17PGCri^y Number of feet from nearest property line: Front, O Side, aRear, 0 Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: 2 Trench: Width:1 /-'Z Length: L Number of Lines:-,A_ Area Built: "2 y,5 Fill depth to top of pipe: Number of feet from nearest property line: Front, O Side, Rear,0 P't•,L p , Number of feet from well: -2c,~,o Number of feet from building: ~a Q (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: Capacity: Number of rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Front, O Side, O Rear, O Ft. Number of feet from well: Number of feet from building: Number'of feet from nearest road: Alarm Manufacturer: Inspector: Dated: Plumber on job: - License Number: 3/84:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O: BOX 7969 BUREAU OF PLUMBING MADISON, WI 53707 ~1 XRCONVENTIONAL ❑ALTERNATIVE State Plan l.D.Number: (lf El Holding Tank El In-Ground Pressure El Mound assigned) NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER INSPECTION DATE. Steve Green R.R. 3, Box 290, New Richmond, WI 5401 ;,30 BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV. CST REF. PT. ELEV.: NE NW, Section 28, T31N-R17W, Town of Stanton Name of Plumber IMP/MPRSW No. Cnumy IS,,,,,,, Permit Number: Byron Bird, Jr. 3318 St. Croix 74972 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLE7„~4EV._ TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER p (XJ LJ P O IDED. PROVIDE t ABM / v V O Oa r L YES ❑NO ❑Y NO BEDDING: VENT DIA.. VENT MATT HIGH WATER NUMBER OF ROAD. PROPERTY WELL: BIUILDIN13IVENTTOIRESH ALARM FEET FROM LINE. I AIR INLET: ❑YES NO ❑YES ❑NO NEAREST 7 S DOSING CHAMBER: MANUFACTURER BEDDING. LIQUID CAPACITY PUMP MODE L PUM PISIPHON MANDE AC T I IH E H WARNING LABEL LOCKING COVER 11 1 'J J PR DED P80 IDED: mob' ❑YES O V``' Zoe-l I YES ❑NO YES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF PROPERTY WELL BUILDING VENTTO FRESH (DIFFERENCE BETWEEN FEET FROM Ne R INLET PUMP ON AND OFF) z/ 1 tYES ❑NO _ NEAREST 0. SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing JDIAMI TEH 111ATEHIAL AND MARKING, or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE MAIN the soil is dry enough to continua.) CONVENTIONAL SYSTEM: WIDTH LEN H NO. OF DISTH PIPE SPACING COVEH INSIDE DIA -PITS LIQUID BED/TRENCH TRENCHES n*r*e++lA PIT DEPTH DIMENSIONS &Ar/ 1 GRAVELDEPTH FILL DEPTH I(EIS TI PIPE ISTH PIPE DISTR. PIPE MA RIAL NO DI TH NUMBER OF ►PROPERTY WELL. BUILDING: VENT TO FRESH BELOW PIPE ABOVE COVER E IN LE i ELEV. END PIPES LINE AIR INLETET FROM Z-7 7i' NEAREST EST Z FE Q 0 /.Z O/L - MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- YES NO meets the criteria for medium sand. TIONS MEASURED. ❑ ❑ SOIL COVER TEXTURE PERMANENT MAHKEHS OBSEHVATION WELLS ❑YES NO ❑YES ❑NO CH RENCH BED DEPTH OVFH TRENCH BEU DEPTH OF TOPSOIL SDI)Df I) SEF UfO MULCHED EDGES ❑YES. ❑NO ❑YES ❑NO ❑YES ❑NO ED DISTRIBUTION SYSTEM: ENCH WIDTH LENGTH TRENCHES: LATEHAL SPACING IGHAVIL DEPTH BE LOW PIPE FILL DEPTH ABOVE COVER DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL NO DISTH DISTR. PIPE DISTHIBUTION PIPE MATERIAL & MARKING ELEV.. ELEV. CIA. ELEV. PIPES DIA ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORHECI LY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS ❑YES ❑NO _ ❑YES ❑NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS. NUMBER OF PROPERTY WELL. BUILDING: FEET FROM LINE: ❑YES ❑NO ❑YES ❑NO NEAREST , d r) Sketch System on ,Retain in county file for audit. ` 1 > Reverse Side. S . TITLE DILHR SBD , ~R. 01/82) ` ~0 wlsconsln APPLICATION FOR SANITARY PERMIT 'IDILHR Lr~~X COUNTY (PLB 67) - DEPfiRTTEnT OF UNIFORM SANITARY PERMIT # InOUSTRV,LRQOR 6 HUMRn RELRTIOnS / -Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8'hx 11 inches in size. -See reverse side for instructions for completing this application. PLEASE PRINT PROPERTY OWNER / MAILING ADDRESS eve (Tr-cep 099 o? O ~ ,012 6',2 c Sao/ PROPERTY LOCATION CITY: yVb vl AGE: L Rh / O 1/4 /4, S T, N, R /;7E (or LOT NUMBER BLOCK NUMBER SUBDIVISION NAME NEAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER TYPE OF BUILDING OR USE SERVED 1 or 2 Family Number of Bedrooms: ❑ Public (Specify): THIS PERMIT IS FOR A: ❑ New System ❑ Tank Replacement ❑ Repair Replacement Soil Absorption System ❑ Revision ❑ Privy In. Alternate System ❑ Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. Seepage Bed ❑ Seepage Trench ❑ Seepage Pit ❑ Holding Tank System-In-Fill ❑ In-Ground Pressure ❑ Vault Privy ❑ Pit Privy ❑ Existing, For Which A Previous Permit Is On File, Permit # issued - E An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions. Total #of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump Tank/Siphon Chamber Holding Tank capacity Manufacturer: IF THIS IS AN ALTERNATIVE SYSTEM CCjMPLETE THIS BLOCK: ❑ Mound ❑ In-Ground Pressure Total #of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump/Siphon Chamber Manufacturer: PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumber (Print): Signatur MP/MPRSW No.: Phone Number: goz ( /sfi Plum is Address: Name of Designer: ,COUNTY/DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: ❑ Disapproved 8 ❑ Owner Given Initial s Approved Adverse Determination eason for Disapproval: Alternate course(s) of Action Available: DILHR-SBO-6398 (R. 5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing, Owner, Plumber INSTRUCTIONS FOR COMPLETING THIS PERMIT APPLICATION, PLB 67 - SBD 6398 To be complete and accurate the permit application must include: 1. Property owner's name and complete legal description, please circle the appropriate municipal government unit, (whether this is in a city, village or town); 2. Indicate specifically what type of use is served, if public is checked indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.); 3. Complete the block for conventional or alternate system depending on system type, check all appropriate boxes or blanks. 4. Indicate the design percolation rate listed on the 115 soil test report, the number of square feet required by code and the number of square feet to be installed; 5. Complete the section on water supply; 6. PRINT the name of the master plumber or master plumber restricted who will install the system, circle the appropriate license classi- fication, place your license number in the space provided and sign the permit in the signature block; 7. Please place the plumbers business phone number in the blank provided, if there is a problem or question this will speed review of the permit; 8. Change of ownership or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to installation. Failure to comply will void the sanitary permit. 9. This permit may be renewed, and at the time of renewal any new criteria in the Wis. Adm. Code will be applicable, 10. A new permit will be needed if there is a change in, estimated wastewater flow, (number of bedrooms„ etc.), location of the system, depth of the system, type of system. 11. All, revisions to this permit must be approved by the permit issuing authority. 12. A complete plan including a plot plan, drawn to scale or with complete dimensions. 13. Horizontal and vertical elevation reference points that are permanent and clearly shown. 14. Piping detail including pipe size, separating distances, distances between beds if appropriate, tank locations, effluent line from tank(s) to system, building sewer and vent observation pipe(s). 15. The permit issuing agent may require a cross section drawing of the effluent disposal system. I TO THE OWNER: This is valid for two years. Changes in your building plans or locations may require you to obtain a new permit. Private sewage systems must be properly maintained. Have a licensed pumper clean your septic tank whenever necessary usually every 2 to 3 years. If you have questions concerning your system, contact your local code administrator or the Bureau of Plumbing, DILHR, State of Wisconsin. 4=-1 i. ` r x P, EAU' ii« Y.~ .dpi gwlF ~9 ,+i^ot_. v -d•~ • was 7 ii C . n 2 . r tE fir. . 1k= 1 701ALdMMA14C t~ EFFLUENT=AND DEWATERiNG Fr. a& au 42 i SEWAGE AND DEWATERING t° a• s7 7f k'#s 20 ` s ,~q.~+ k+.-: y v *y . 15 719 bt =~~p Us w . hi as • ':ref 30 40' r fb I ~ i ~ cep 9! 43 2 fo 163 `i 14 r wo~wno- ~r Ks d ~r sr 140D 1DlALOYNAMCHKAWCArMp1`9rPWWO 1 fEWWA/iDOEMff 1 s: % ff1Mi >a lff: !Ia 2N 16 1 filll tiAL' GAIi►k 6AC t0 sQ 72 ff say 2D 4403 14 i ! of s`+► ss, % 12 - 36 ec MODEL wr. ~r r ar ' sus s3' 10 • ± ' Lom • i4m MODELS 6-1 M OEL, . OD 4 `15 MODEL I~iO: 268 ; 2 y MODELS r t 1; 53 MODE M&40bEL S9 97 tU.& ~`'t c :gyp 8 UTESr 0 A 1 Y} k 6a 240 320 400 p Ow PER RNNUj1ii. D WyssfeI R . .f.,~ r p W ~ i6nJ7 t 't { _ toulsvula KarttucAjr {502) 778-2731 ~~/17J? ' ! !i" ~ ~ ,~~.~r5` .nab`--, • ~ ~ s ~ . ~T afy`v 7 il + y ' . APPLICATION FOR SANITARY PERMIT S T C - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor, ("spec house"), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Owner of Property 5i- tie A ;R n j~u, Location of Property _ ) E:k A) U) 3%. Section T 91 N-R / -7 W Township ~4.n1-0 h, Mailing Address x c:? h Cy ~ ~ ,,gyp % A)-e uj c vyl 0,4, Address of Site C S Lek o P• Subdivision Name Lot Number n Previous Owner of Property T Total Size of Parcel ` p Date Parcel was. Created Are all corners and lot lines identifiable?~ Yes No Is this property being developed for resale (spec house) ? Yes No Volume] and Page Number ~03 as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A Warranty Deed which includes a Document number, volume and page number, and the Seal of the Register of Deeds. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description refer- ences to a Certified Survey Map, the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTY OWNER CERTIFICATION I (We) centi.by that att .6tatement6 on this bonm au true to the best ob my (oun) knowledge; that I (we) am (ahe) the ownen(s) ob the pnopeAty de6eA bed in thivs inbonmatLon bonm, by vi tue ob a wa &anty de d neconded in the Obbice ob the County Register ob Deed6a3 Document No. .50 and that I (We) pnesentey own the proposed 6 te, bon the sewage d ins poz .S yes em (on I (we) have obtained an easement, to nun with the above desn,ibed pnopehty, bon the construction o6 said .6ybtem, and the same hays been duty neconded in the Obbice ob the County Regizten o6 Deed6, at Document No. SA NATURE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) 0C1 a~5 1 18q DATE SIGNED DATE SIGNED ~t DOCUMENT NO. STATE BAR OF WISCONSIN-FORM I « A j. WARRANTY DEED VOL 5 P VC ".,70~ ii THIS SPACE RESERVED FOR RECOROINO DATA 345019 Th Larry T. Simpson and _ - - - REGISTERS OFFICE ` li~~ eed, made between Polly d. impson., husband and wi~'e ST. CROIX CO., WIS. - Recd. for Record this 28th -----.....----------------.................--------.........Grantor da of N A.D.19~7 and-John R._ Green, _ Steven_P. Greent_ and Janice K. Green Y oy as tenants in common and not as point tenants at 9! - -----------------------------------------------------------------------------------------------------Grantee, S •pb • Witnesseth, That the said Grantor for a valuable consideration------ of One Dollar and Other Valuable donsideration - - - conveys to Grantee the following described real estate in St. Croix JRETUoRNAlolest Federal S. & L Assn. County, State of Wisconsin: Box 160 New-Richmond, Wi. 54017 Tax Key No- I I ' East Forty-six (46) rods of the Northeast Quarter of the Northwest Quarter' (N* NWI) of Section # 28, T 31 N, R 17 W. i TRM $ FEE This As not homestead property. (i1q (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; Andrry T. and PO1],y J. Simpson, husband and wife • warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except and will warrant and defend the same. it Dated this 22nd = day of November 19.. 7 ----------------------------(SEAL) - el= EAL) =T. Simpson ~ (SEAL) = _..U-P-7 t`11-2 ---------------(SEAL) Polly J. Simpson " AUTHENTICATION ACKNOWLEDGMENT Signatures authenticated this day of STATE OF WISCONSIN ss. St. Croix County. P rsonal c e before me, this . day of Novem~er, _9~ the above named _Larry _--~a TITLE: MEMBER STATE BAR OF WISCONSIN PQ J• S3mP$on (If not- authorized by § 706.06, Wis. State.) 1 v 1 - THIS INSTRUMENT WAS DRAFTED BY 0~GO 0 to me known to b-i the person who executed the A4 t foregoing ins ment aid a, owled he same. .-----------J.R. Haasch by c t . - YY~{ ~o'4;'' * J n R. Haasch Notary Public - ~rO~x - County, Wis. ' I (Signatures may be authenticated or acknowledged. Both are not necessary.) My Commission is permanent. (If not, state expiration date: 9-&80 , 19 .Names of persons signing in any capacity should be typed or printed below their signatures. WARRANTY DEED STATE BAR OF WISCONSIK Wisconsin Legal Blank Co. Inc. FORK No.1-1977 milwankee, Wie (Job 82704) H Z • H a STC-105 r - r ' a H SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County z d a OWNER/BUYER 1j&nC(_e, Gre"F,ji- ROUTE/BOX NUMBER Z 60Y A6 Fire Number .CITY/STATE iveIA) ~I C hyYldyl~ ~~~5 ZIP 5510/7 PROPERTY LOCATION:.A(t -14, Section, T 51 N, R,L2 W, Town of St. Croix County, Subdivision Lot number Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper. What you pit into the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St. Croix.County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. H 0 • E I/WE, the undersigned, have read the above requirements and agree vi to maintain the private sewage disposal system in accordance with x the standards set forth, herein, as set by the Wisconsin Depart- ro ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. SIGNED I'1 ✓ DATE_6~ ` I9~ 7 St. Croix County Zoning Office P.0 Box 9$. Hammond, WI 54015 715-796-2239 or 715-425-8363 Signs date and return to above address. c LO) n s ~ ~ w sU vc, ro~ 3 O v Nw~(D ~wc v r O (D N 0 0 (D 7Z 03 v`°www w a ~ O c O y~ Z ?0 O 3 c(O(G O c (D (a (D N qaos 7 :E (D - 7C (D w w W fD (D -M .a o30. oQDw O°~ X0,0) > ) ?13C 3 ° °c '0 c c a:c n ra- Z~ - v'Z a- R 0 ` W m O ~ w M 0 wo n. -O~DZ•v~ D 'tea, cr Fa O' Ica, '00 a W c1 0 am yto t?D~ w 0 C CA o cD C a `°*a v =r m Ch Z s° aCDm w (A (D wm~7 ~wa (D 0 3 ; CA CD d ~p~?c _ Q N a (D (a CL (a w y a c CD 0 to et S. m o ~w a w cOD O N w _ 0 4,00 as o wow ((a~cc~~ m CL a° Q m a? y O 0 (p 7 o< y O (sO no o(o a 0) -1 CD c ~(D 0 --63 (p 7 p 91 .c..«. i (D V t o DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION UAN`D PERCOLATION TESTS (115) MADISOP.O. BOX 76 N WI 53707 HUMAN RELATIONS (ILHR 83.09(1) & Chapter 146) LOCATION: 'SECTION: !07 S /MUNICIPALITY: LOT NO.: BLK. NO.: SUBDIVISION NAME: 1/ V4 /T./ N/R/ E co Ar5 - UNT OW ER'S/BUYER'S NAME: MA LING ADDRESS: USE DATES OBSERVATIONS MADE J~* NO. BEDRMS.: COMMERCIAL DESCRIPTION: (PROFILE DESCRIPTIONS : PERCOLATION TESTS: esidence 3 ❑New Replace /O _ RATING: S= Site suitable for system U= Site unsuitable for system 0.J CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) ❑U NS ❑U ®S a ❑S NU U 36e,/ :f ASS If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the under s. ILHR 83.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER O SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN. ELEVATION OBSERVED EST. HIGHEST- TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.( 30 4~y.rt~ S.' F - ~ 9 67 areJ~ o B- B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 P RIOD 2 PERIOD PER INCH P- 05 P C S o flnez/4',5 se-6 P- P- P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION ~L3 _ _ _ E f r ~ ~ E i 0, A . is y5 X 3 d 5co JA6 f ; ro L Jh c 1, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): TESTS WERE COMPLETED ON: i 1^C cT~. /O v2 < - ADDRE : CERTIFICATION NUMBER: PHONE NUMBER (optional): o •Cr ljt^ - v oo JAS a647G1 CST SIGNA UR~ J 4 i DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 10/83) - OVER - ,U TIONS I COMPLETING O 115 - SBD - C ..F Tc~ '1 H' z y 2, o" _ _ ct r I I~ Ski i L ,.-_C%' axes &5 do( ~ x, 12, tr'_.zY ALL . vST sL ,,s v,TH SHE I T I FOR C TI , IL, TES., pawes and Textures Othei y s;.. ; r o E 10- SS c r r3 -"1 LS Lin HGW !-Iigdh -ater Bldg r; L nlrn r1i Muck d p 4 £ I-i~A- L ! F-il^ s€.€ ' n, TO THE OWNER: This soil test report is the st step in securing a sanitary pe:rrnit. The co£€rity or the Department may request verification of this in the field pr t nit issual' A complete set of plans for the private ~ _ _ ap,1r date local authority in order to .t?{ t7C'131",' application of-ai per,l, , The sari::- y permit mu_r 1. I and , d prier tO the start of any construction. r MMM" EH 115 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH P.O. BOX 309 MADISON, WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION TESTS T LOCATIOyV: a /4, '/4, Section TVN, R tE (or township or Municipality ~ Lot No. , Block No. County r _3T,a ve C-. •eeeA1z . Subdivision Name Owner's Name: Mailing Address: eS «h~ f.~T 1 se- TYPE OF OCCUPANCY: Residence ~ No. of Bedrooms Other a EFFLUENT DISPOSAL SYSTEM: NEW ~ADDITION REPLACEMENT .x~ DATES OBSERVATIONS MADE: SOIL BORINGS Nddj d l M PERCOLATIO TESTS A~ l f~7~ SOIL MAP SHEET SOIL TYPE PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL MIN/IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P-1 21~r 7-.s-- /2. ""1 3, 3 K71J 3~) Y/ - Y'-P ~ z 13 J' SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) B 731/_ s ~l 130 S4 k F ID 11 _ 7 ~sr B C T 4`0 SJ 1 „ st ~ ~f PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable are s. number of square feet of absorption area needed for building type and occupancy. f .Z vs- Indicate scale or distances. Give.horizontal and vertical reference points. Indicate slope. em •J :y v .d V Iwg~ ~f tlNl A J S s ~ S q' aver, I, the undersigd 3d, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best of my knowledge and belief. Name (print) ! AV/ ~a~.~ • l Certification No. Address L Name of installer if known CST Signature COPY A - LOCAL AUTHORITY PAGE OF - ~ CrOSS SecTton o~ ~.~ei~ SyS~ePt', ~ Fresh Air Inlets And Observation Pipe Approved Vent Cap Minimum 12" Above Final Grade f i 20- 42" Above Pipe _ 4" Cast Iron To Final Grade Vent Pipe Marsh May Or Synthetic Covering Min. 2" Aggregate Over Pipe Distribution - Tee Pipe -1 0 0 0 0 i Aggregate Beneath Pipe o Perforated Pipe Below Be o Coupling Terminating At Bottom 01 System j Proposet~ ``9rAd< SOIL FILL DISTRIBUTI01'.1 PIPE APPROVED $4N'rNETIC COVER ° "MATERIAL OR 9'. OF STRAW rOFAG6RE6AlE OR MARSH Hk`i to OF 12-21/2 AGGREGATE V-LEV.OFFEET-~ 1 DIS'1"1115UTIOU PIPE TO BE AT LEAST ~3o INCHES BELOW ORIGIUAL GRADE AUU AT LEAST 20 INCHES BUT 1.10 MORE THAM 42 INCHES BELOW FINAL GRADE M01MUM WN OF EXCAVATIOW ROM ORI&VVA.. 69AoR WILL BE HP- INCHES P0141MUM AEPnt OF EXCAVATION FRoM 00,14INgL GRAPE WILL BE -4&zl-- INCHES I SIGLfED: ~ r LICEMSE DUMBER: DATE: -L © ~ PAGE OF PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS VENT CAP '4"C.I, VENT PIPE WEATHER PROOF APPROVED LOCKING > 25' FROM ODOR JUNCTION BOX MANHOLE COVER , WINDOW OR FRESH 12"MIU. AIR INTAKE I GRADE I ti" MIN. 18" Mlu. CONDUIT le"MIN. \ lAl l_.E l' PROVIDE AIRTIGHT SEAL I III APPROVED JOINT A I i I APPROVED JOINTS W/C.I. PIPF-. III W/C.I. PIPE EXTENDfhJ& 3' I II ALARM EXTENDIWG 3' ONTO SOLID SC;;. B I I ONTO SOLID SOIL I I ON C I I I jjj PUMP OFF D CONCRETE BLOCK RISER EXIT PERMITTED ONLY IF TANK MANUFACTURER HAS SUCH APPROVAL SPECIFICATIONS SEPTIC AND D4S TAKIKS MANUFACTURER: - ~f -5- NUMBER OF DOSES: . PER DAy TANK SIZE: *)C2 GALLONS DOSE VOLUME ALARM MANUFACTURER: Z~ INCLLIV!~!C, :AC7;FLOW: - 11a • 2- GALLONS MODEL ►JUMBER: CAPACITIES: A=-INCHES OR - GALLOWS SWITCH TYPE: B 112 INCHES OR - GALLONS PUMP MANUFACTURER: C=-.INCHES OR GALLOWS MODEL NUMBER: ` D - _j INCHES OR ~ GALLONS SWITCH TYPE: '-1/Y NOTE: PUMP AND ALARM ARE TO BE - PUMP DISCHAR&rE RATE v ~n GP/A INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE Bi5 WCEAI PUMP OFF AND DISTRIBUTION PIPE.. -__.Z / FEET + MINIMUM NETWORK SUPPLY PRESSURE . . . . 2.5 FEET +A.._ FEET OF FORCE MAIN X i0oFT.FRICTION FACTOR..-LS=L FEET TOTAL D`JWAMIC HEAD = / ✓ ,v FEET INTERNAL QIMEIJSIONG OF TANK: LENGTH ;WIDTH ;LIQUID DEPTH c S0 SIGAlED: LICEMSE WUMBER: :i DATE: -117- Cv . Spa n fog 417 w 5t ~r 41 ;,k, li a If ,J 2 C', 0 tie ~h Uy n~ S0 ~c /~tllG ®h c~v ~ W a zf YAW ®G /vatos~ ~`j~~5 v l r~s"' fs a`/ ~ ~o C or~~r ~~S f j to ~ rill 44 14 0G CERTIFIED SURVEY MAP N0. 2021 p Located in part of the Northeast Quarter of the Northwest Quarter of Section 28, Township 31 North, Range 17 West, Town of Stanton, St. Croix County, Wisconsin. Bearings are referenced to the north line of the Northwest Quarter of Section 28-31-17 which is assumed as S89019' 33"E SIN1?LATTE0 LANDS NV4CORNER S89119'33"E 2601.36'--- SEC.28-31-17 GI 1?60-fb Ar, - S890I9'33"E - - 759,19'- Rae. NORTH NW CORNER NORTH _TOWNR_OAD_33 31.01 . SEC.28-31`17 SCALE= I =300 ap E N8-99 '33"W 739.19'- 1 SEC. 28. 1 ' HSE. RIVEWAY [P I I OVERH AD 0 50' 1001 200' 300' 400' , POWER 6 UNDER GROUND TEL E PHONE ALONG LEGEND iARACE RIGHT-OF-WAY. =PUBLIC LAND CORNER OF RECORD OR C I 0 T ! TO BE RECORDED. 1 M SHED a I ip I 11.60 ACRES MORE OR m O z I" BY 24"IRON PIPE SET, WEIGHING yl d i ROAp~ INCLUDING TOWN p t0 1.13 LBS. PER LINEAL FOOT. = CO -x-Tx x =FENCE LINE (WIRE). zI 11.02 ACRES EXCLUDING oI tl1 TOWN ROAD RIGHT-OF-WAY. CV 1 N CI Owner: Harold R. Jones F1 _ 1 - J Rt. 3 Box 290 lx New Richmond, WI 54017 UJI This being that property described in a z1 Nes°23'3a w 759.18' r _ x _I 1 Warranty Deed recorded in the Register 90° W zI of Deeds Office in Vol. 757 pg. 176 in h 46 RODS m ::'1 St. Croix County, WI. (Also shown as a M i (759 FEET) - r h owner thereon is Kathryn A. Johnson). o° 1`~ 1 ` a M ~ o z SURVEYOR'S CERTIFICATE : i 0 T 2 1P I, Ronal F. Johnson, a Registered Wisconsin Land Surveyor, do hereby certify that I have 01 ACRES MORE OR LESS. surveyed and mapped a parcel of land being I OPEN FIELD the East 46 rods of the Northeast Quarter. ' l / SOUTH LINE OF THE NE I/4 OF of the Northwest Quarter of Section 28, X THE NW I/4 OF 31-1711 Township 31 North, Range 17 West, Town of x ---N89°23'29"W 759,18'--- suarACE Stanton, St. Croix County, Wisconsin, being that UNPLATTED LANDS property described in Volume 757 page 176 of deeds recorded N/S 1/4 LINE 1/4 C. CORNER ? in said County, described by metes and bounds as follows : 5 Beginning at the North Quarter Corner of said Section 28; CENTER LINE O O-31-IZ M F i thence, on an assumed bearing along the north/south quarter STATE HWY. NO. •64 - of said Section, South 00 degrees 37 minutes 18 seconds East a distance of 1296.96 feet to the south line of said NE 'o of the NW thence, along last said south line, North 89 degrees 23 minutes 29 seconds West a distance of 759.18 feet; thence, North 00 degrees 37 minutes 18 seconds West, on a line parallel with and 46 rods easterly of, as measured at a right angle to the east line of said NE of the N1^' a of Said'.Seclion;28, distance of 1297.84 feet to the north line of said section; thence, along last said north line, South 89 degrees 19 minutes 33 seconds East a distance of 759.19 feet to the point of beginning. Containing 22.61 acres more or less. Subject to the Town Road along the north 33.00 feet of the above described parcel. Also subject to all easements, restrictions and covenants of record. I further certify that I have complied with the provisions of Chapter 236.34 of the Wisconsin State Statutes and the subdivision regulations of the Town of Stanton and St. Croix County in surveying and mapping the same. 1Tir f ,-ri :r ~,6 p" xonald F. Jamison R.L.S. No. 1186 Date Ron Johnson Land Surveying 0. Box n L NOTE: THIS MAP IS CREATED IN ACCORDANCE WITH ST. CROIY Amery, o 194 54001 COUNTY ORDINANCE 18.02(4)(b)(3)- -the sale or exchange of parcels between adjoining owners; with the land owner to Tele. (715) 268-2601 the south,LaVon Krumm,obtaining s r Lot.2. ~yc oEMI q "RONALD F. So W1 s 186 J '0 sr. CRl~O( ccv _ b • JOHNSON SE , M AMERY, 1 J~N+ s. t s instr Q t was drafted by R.F.J. ~3t'luic Ggri ••r O ,00.4- VOLUME 7 PAGE 2021