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032-2019-40-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 567277 0 GENERAL INFORMATION State Plan ID No Personal information you provide may be used for secondary purposes[Privacy Law,s.15.04(1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Riedesel, Gregg Somerset, Town of 032-2019-40-000 CST BM Elev: Insp.BM Elev: BM Description: Section/Town/Range/Map No: /6b 6 An 1 GS T _ 05.30.19.541 A&541 C TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER �Jr CAPACITY STATION BS HI FS ELEV. �" I. 75 /0I r 75 /od Septic Benchmark k W■ _, T 6.5 /z5O J. , /61.9 / Dosing F Alt. BM n w`./o iad um- 5 7 V Z i 2 `r l . 63 'k egirL, Ve )a V Bldg.Sewer Q•1,7 "73,4 Holding St/Ht Inlet 1.y$ /, 77 TANK SETBACK INFORMATION St/Ht Outlet TANK TO WELL BLDG. 6•Air Intake ROAD Dt Inlet Septic •;. 56 j 75 �,.. Dt Bottom 15• 5 Dosing ,56 ...,,/ '5 7a t Header/Man. Aeration Dist. Pipe 1 q • /7• 4 V Holding Bot.System PUMP/SIPHON INFORMATION Final Grade Manufacturer 6 Demand St CoverO / ca �� 0(........ GPM 1 vwf 6.4)4; sv -z .`7 "Mat�j 44 Model Number 1 APE 5 I z3•4 C6„,.,4-b L,1- 4; .4 9-5. s TDH (Lift AN 4 Friction Loss System H a L� TDH Z Ft Forcemain Length Dia. ' ( Dist.to Well "76 /Z Z \_._ SOIL ABSORPTION SYSTEM f, BED/TRENCH Width �� / Length/ No.Of�ench PIT DIMENSIONS No.Of Pits Inside ia. Liquid Depth DIMENSIONS due SETBACK SYSTEM TO /� P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Typ stem: / t /3z CHAMBER OR �� J / 7 /e$ / UNIT Model Number: �` DISTRIBUTION SYSTEM Ai V /gyp Header/Manifold I i/ Distribution /rs) /1 / x Hole Size x Hole Spacing Vent Air Intake 7 i Pipe(s) 's Length b Dia / Length Dia /• 5 Spacing �� + /�� 3• ' ✓f�("�� SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only /1/,, �,,,�,"'"—" Depth Over I Depth Over xx Depth of xx Seeded/Sodded xx Mulched 13.4 Bed/Trench Center /, 13.4 Bed/Trench Edges ‘..„,,.....1 Topsoil % es D No Yes Li No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: II / 11 / 13 Inspection#2: / `/ Location: 450 CTY RD V V SOMERSET,WI 54025(SE 1/4 NW 1/4 5 T3ON R19W) metes&bounds Lot Parcel No: 05.30.19.541A&54 1.)Alt BM Description= 6■Q J G,..;- .4 (6,J J 2.)Bldg sewer length= 56 j„ Q ij —"' �T PI Otc_amount of cover= Go 7(pi Ow et I 44-"444•A Plan revision Required? Yes No r 1 1 t.3+3 ,. `1 �7 ?� I I D li Use other side for additional information. I v ✓ -. t.:SBD-6710(R.3/97) Date Insepctor's Sig lure ,' C, >9/49T )1914,-A) . /4goJ 8 4.4•• -©e6 7 P . if .,,.m? r . \--------.."----....,,...\-:-__. /re al . 1 `4 \ , , : pbidooa -0rd G - 7 /a5-o/76-6-> d reheat' :a- d)iis el 7a' r / --- 4 6 i/% /- /&75‘,, o�..4.�/ a 7 '-,, �9 oo-ro.) ..5-.,,a-i/G=n,,E - .tiiec:e ._i eko A ,.}G.� /.4,e,_ - 4 a t'/>G>[JQ�.7x?,�) 6 4us,c /6371 ./ 1.T5 /co L ,-,::,-.7.:74 I oetv County , `� °� Safety and Buildings Division -7-5--/ , 1 -, 201 W.Washington Ave., P.O. Box 7162 Sanitary Permit Number(to be filled in by Co.) '''' i};"si -,,,, A °fit. Madison,WI 53707-7162 5C 7 eti State Transaction Number Sanitary Permit Application Nov ?. p 2013 2315 0 In accordance with SPS 383.21(2),Wis.Adm.Code,submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note:Application forms for state-owne4 rO V e submitted to Project Address(if different than mailing address) , the Department of Safety and Professional Servies. Personal information you provide may baiitY14ndary purposes in accordance with the Privacy Law,s.15.04(1)(m),Stats. i / 4/1// [�b I. Application Information-Please Pri nformation �f ,1 Prope Owner's Name / Parcel# 4a�s l D 3 2 Zo/9• �o- c� Property Owner's Mailing Address / Property Location (, 5 /A-,-c-. )s g. L)/4L 4 ,�/ Govt.Lot City,State /� Zip Code Phone Number SE y,, /VW V4, Section S circle one �• `II " 's T -../, N; R /X Eo V II.Type of Building(check all that apply) Lot# Subdivision Name ixf 1 or 2 Family Dwelling-Number of Bedrooms '- Block# 4- el ❑Public/Commercial-Describe Use — ❑City of CSM Number ❑Village of ❑State Owned-Describe Use /� Town of ir/ES /0 /)r- 4 n O,/J ce,32, III.Type of Permit: (Check only one ox on line A. Complete line B if applicable) A. ❑New System X Replacement System ❑Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System(explain) List Previous Permit Number and Date Issued, B. El Permit Renewal ❑Permit Revision ❑Change of Plumber ❑Permit Transfer to New Before Expiration Owner 9 C IV.Type of POWTS System/Component/Device: (Check all that apply) (.6 t/�A0 v C' /J • 3 ❑Non-Pressurized In-Ground ❑Pressurized In-Ground ❑At-Grade ❑Mound>24 in.of suitable soil Igi Mound<24 in.of suitable soil i A ❑Holding Tank ❑Other Dispersal Component(explain) ❑P eatment Device(explain) /1 , V.Dispersal/Treat nt Area Information: 6.t. - vt. Design Flow(gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required(sf) Dispersal Area Proposed(s i System Elevation /6G /5236 (-)12,s 7,.sue OD* ‘, 83 VI.Tank Info Capacity in Total #of Manufacturer �� o a ° Gallons Gallons Units / '//t ,1 6 /_ 3 New Tanks Existing Tanks (� o °�' r° - `� r( g. a) =n ti rn w3 a, d., Septic or Holding Tank .6126,2:-) .51) / 10 i • Dosing Chamber x�0 7i-e) VII.Resp•nsibility Statement- I,the undersigned,assume respo sibility for installation of the POWTS shown on the attached plans. 76,...L_ Plumb: 's i ame 'rint Plumber's ign2.4e e7 MP/MPRS Number Business Phone Number Plu .er's Address(Stre- ,City,S ate, ip Cod VIII.County/Department Use Only / / Permit Fee Date Is ed Issuing%Signature Approved ❑ : sapprov . $ (m Z5• ob �/ l/3 ❑ ts..• ..'en Reason for Denial / �' IX.Condi ' easons for Disapproval 3) �!!! / _/ � w - 1. Septic tank,effluar*filter and 3) L `!n e v dispersal cell.must all be servtces I maintained cQ as per management plan provided by plumber. // 2. setback code I orrdin rt;attl8d ,/ /_ Lnoye btiet.J� �-D Jl't are.. i\t . Attach to complete plans for the system and submit to the o ty only o essitht n 8 In x 11 inches in size i I e.. tA.) .444,t.. p e'f\AA'. r— • SBD-6398(R. 11/11) I ro ITT DIVISION OF INDUSTRY SERVICES 10541 N RANCH ROAD (e' HAYWARD WI 54843 - Contact Through Relay p� $ K www.dsps.wi.gov/sb/ www.wisconsin.gov Scott Walker,Governor �0 'SSIONA�5� Dave Ross,Secretary October 04,2013 CUST ID No. 224263 ATTN:POWTS Inspector KIM A OCONNELL ZONING OFFICE KO CONSTRUCTION ST CROIX COUNTY SPIA 504 3RD AVE 1101 CARMICHAEL RD OSCEOLA WI 54020 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 10/04/2015 Transaction ID No.2315104 Site ID No. 796090 SITE: Please refer to both identification numbers, Gregg Riedesel above,in all correspondence with the agency. 450 CO RD VV Town of Somerset St Croix County SE1/4,NW1/4,S5,T3ON,R19W FOR: Description:Mound,4 bedroom residence Object Type:POWTS Component Manual Regulated Object ID No.: 1451622 Maintenance required; Replacement system; 600 GPD Flow rate; 20 in Soil minimum depth to limiting factor from original grade; System(s):Mound Component Manual-Ver.2.0,SBD-10691-P(N.01/01,R. 10/12),Pressure OFy� Distribution Component Manual-Ver.2.0, SBD-10706-P(N.01/01,R. 10/12), SSWMP Pub.9.6; Effluent FitO ApPRO�'E The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Code��.` OF SAFE and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constr SS10141%L and located in accordance with the enclosed approved plans and with any component manual(s)referenced abcs441,OF � s The owner,as defined in chapter 101.01(10),Wisconsin Statutes,is responsible for compliance with all cocIpnc,1014 OF Div requirements. 4-< No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.0. stats. CpRRES The following conditions shall be met during construction or installation and prior to occupancy or use: SEE Key Item(s) • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard,the property owner must follow the contingency plan as described in the approved plans.In addition,the owner must insure that the operation,maintenance and monitoring duties as described in section VIII of the mound component manual are complied with.A copy of this information must be given to the owner upon completion of the project. • This system is not designed for and may not be sited on a concave slope. A mound located on a concave slope requires lengthening of the cell per the formulas in the component manuals,while a mound with any portion of the cell crossing a slope of 1%or less,will require adjustments to the sand fill heights and perimeter dimensions. Since contours shown where the mound is situated indicate that neither of these situations apply,a revision would be required if it is found that the slope in the mound area is not as depicted. Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per SPS 383.44(6)(a)2. • Limit activities in the area 15'beyond the down slope edge of the mound per Mound Component Manual. KIM A OCONNELL Page 2 10/4/2013 • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of SPS 384.10.No fixture,appliance,appurtenance,material, device or product may be sold for use in a plumbing system or may be installed in a plumbing system,unless it is of a type conforming to the standards or specifications of chs. SPS 382 and 383 and this chapter and ch. 145, Stats. • The existing POWTS must be properly abandoned per s. SPS 383.33 Wis.Adm.Code. • Insulate building sewer per SPS 382.30(11)(c). A copy of the approved plans,specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department,which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance.As per state stats 101.12(2),nothing in this review shall relieve the designer of the responsibility for designing a safe building,structure,or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below,or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation,operation or maintenance of the POWTS. Sincerel Fee Required$ 250.00 Fee Received$ 250.00 Balance Due $ 0.00 Patric . - :,ando POWTS Plan Revi r,Integrated Services WiSMART code:7633 (715)634-7810, Fax: (715)634-5150,M-F 8:00 a.m. -4:45 pat.shandorf @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. KIM A OCONNELL Page 2 10/4/2013 • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of SPS 384.10.No fixture,appliance,appurtenance,material, device or product may be sold for use in a plumbing system or may be installed in a plumbing system,unless it is of a type conforming to the standards or specifications of chs. SPS 382 and 383 and this chapter and ch. 145, Stats. • The existing POWTS must be properly abandoned per s. SPS 383.33 Wis.Adm.Code. • Insulate building sewer per SPS 382.30(11)(c). A copy of the approved plans,specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department,which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance.As per state stats 101.12(2),nothing in this review shall relieve the designer of the responsibility for designing a safe building,structure,or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below,or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation,operation or maintenance of the POWTS. Sincere Fee Required$ 250.00 _,� Fee Received$ 250.00 Balance Due $ 0.00 Patric . - :,ando POWTS Plan Revi r,Integrated Services WiSMART code.7633 (715)634-7810, Fax:(715)634-5150,M-F 8:00 a.m.-4:45 p.m. pat.shandorf@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. ? 1 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Gregg Riedesel Owner's Name: Gregg Riedesel Owner's Address: 12868 Deliwood RD N Stillwater MN 55082 Legal Description: SE-NW-secs T3ON-R19W Township: Somerset County: St Croix Subdivision Name: Lot Number: Block Number: Parcel I.D. Number: �Y Plan Transaction No.: )r AND ES Page 1 Index and title Y SERVICES Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan ON Page 7 Pump curve and specifications Page 8 Plot Plan i Li- Designer: Kim Oconnel License Number: 224263 Date: 09116113 Phone Number 715-381-7917 Si nature - / �` f g de Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SW-10691-P(N.01101,R. 11/12),and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS(01/81)and Pressure Distribution Component Manual Ver.2.0 SBD-10706-P(N.01101,R. 10112) Version 7.0(R. 11/12) Page 1 of 8 Mound and Pressure Distribution Component Design Design Worksheet Site Information (R or C) R Residential or Commercial Design Note: Sand fill(D)calculations assume a 400.00 i Estimated Wastewater Flow(gpd) Table 383-44-3 in-situ soil treatment for ro 1.60 i Peaking Factor(e.g. 1.5= 150%) l cofifom►of<=36 inches. 600.001 Design Flow(gpd) i 7.00i Site Slope(%) 96.501 Contour Line Elevation(ft) 20001 Depth to Limiting Factor(in) ()AO! In-situ Soil Application Rate(gpd/ft) Distribution Cell Information 60.00i Dispersal Cell Length Along Contour(ft) = 10.00 Cell Width(ft) 1.00l Dispersal Cell Design Loading Rate(gpd/ft2) 13 Influent Wastewater Quality(1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (C or E) E; Center or End Manifold I 3.331 Lateral Spacing(ft) If N above,enter the elevation(ft) 3€ Number of Laterals of the highest point. 0.125 Orifice Diameter(in) t 319; Estimated Orifice Spacing(ft)= 10.53 ft2/orifice 2.00i Forcemain Diameter(in) __ 72.001 Forcemain Length(ft) Does the forcemain drain back? Y i 89.00; Pump Tank Elevation(ft) Enter Y or N Head(ft)x 1.3 11.74 Forcemain Drainback al 6.50 System He d (gal) ys ( ) 7.83 Vertical Lift(ft) 80.51 5x Void Volume(gal) _0.89 Friction Loss(ft) 92.26 Minimum Dose Volume(gal) 0.001 In-line Filter Loss(ft) 23.48 System Demand(gpm) ( ..,._.,.x..15.221 Total Dynamic Head(ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. options 1 choice i in.dia. options L choice 0.75 1.25 x � 1.00 x 1.50 x mx 1.25 x ; ZOO 1.50 x x 3.00 2.00 x 3.00 x Gallons/Inch Calculator(optional) Treatment Tank Information _r 1250 00 Total Tank Capacity(gal) 1250.06i Septic Tank Capacity(gal) 53 00;' Total Working Liquid Depth(in) Wieser i Manufacturer (.�. ' 23.581 gal/in(enter result in cell 549) Dose Tank Information Effluent Filter Information 750.00l Dose Tank Capacity(gal) PolyLok Commercial 'Filter Manufacturer 1612 Dose Tank Volume(gaVin) 525 Filter Model Number Weiser Manufacturer Project: Gregg Riedesel Page 2 of 8 L . Mound Plan and Cross Section Views T 1/110 obseniabbon Pipe —1 •--K A W I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • L • ` Mound Component Dimensions Down slope toe extension made. A 10.00 ft E 24.40 in H 1.00 ft K 10.43 ft B 60.00 ft F 9.50 in I 15.00 ft L 80.85 It D 16.00 in G 0.50 ft J 6.51 ft W 31.51 ft 600.00 (ft2) Dispersal Cell Area 1500.00 (ft2) Basal Area Available 10.00 (gpd/ft)Linear Loading Rate 6.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 98.63 (ft) ---► .;ruirriir.. H riiuirrir ...rruiirrn: G' I I F Dispersal Cell 97.33 (ft)Lateral 96.83 (ft)---* : :: l..- .-.•.- .-. Invert Dispersal Cell : : _Q: : : :- : :::::::::::: i:: :: i:ii : ;= Elevation D , t a t , 95.50 (ft)Contour Elevation 7.0 %Site Slope f Geotextile Fabric Cover Shading Key 'V a n - Dispersal Cell t See lateral details on ® Topsoil Cap c 1.5 ft T Page 4 for number,size, © Subsoil Cap �►c and spacing of laterals. ASTM C33 Sand 4 is T d: • Laterals are equally 0 f E Tilled Layer = 4 0. ft .�' Typical Lateral F spaced from the distribution cell's Q Aggregate d'o centerline in the A distribution cell AxB . Project: Gregg Riedesel Page 3 of 8 f End Connection Lateral Layout Diagram ...... ......._.......... Center the laterals over the A&8 dimension •=Turn-up*Obeli valve or cleanout plug < p >1 All laterals are identical if X—>) Holes drilled on the bottom of the lateral S equally spaced T s • Laterals&forcemain Sch 40 PVC per SPS Table 384.30-6 1 • Force main connection via tee or cross to manifold at any point. Number of Laterals 3 Orifice Diameter 0.125 in Lateral Diameter 1.50 in Orifice Spacing(X) 3.25 ft Lateral Length(P) 58.50 ft Orifices per Lateral 19 Lateral Spacing(S) 3.33 ft Orifice Density 10.53 ft2/orifice Lateral Flow Rate 7.83 gpm Manifold Length 6.67 ft System Flow Rate 23.48 gpm Manifold Diameter 1.50 in Total Dynamic Head 15.22 ft Forcemain Velocity , 2.40 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and —* t SPS 316.300 WAC Disconnect 4 in.min. __--- DE -`_ Tank component is properly vented D--1] u E �— Alternate outlet location 1 b Forcemain diameter Weiser Manufacturer _� 6 2 in. Capacity 750.00 Gallons Volume 16.12 gal/inch A Weep hole or anti- Dimension Inches Gallons i B 1111 siphon device A 32.80 528.78 B 2.00 32.24 C ® i Pump off elevation(ft) C 5.72 92.26 n 1 89.501 D i 6.001 96.72 D c± :_ __I . Total 1---46-.0 750.00 Dose e tank elevation(ft) 3"Bedding under tank. 89.001 Alarm Manuafacturer SJ Electro Note: Switches Alarm Model Number HW 101 containing mercury,.._______.,,___ __ may not be used in Pump Manufacturer Goulds this system. Pump Model Number f PE 51 Pump Must Deliver I 23.481gpm at 1 15.221ft TDH I Project: Gregg Riedesel Page 4 of 8 Mound System Maintenance and Operation Specifications Service Provider's Name Kim Oconnell Phone` 715-381-7917 POWTS Regulator's Name St Croix County Zoning Phone 715-386-4680 System Flow and Load Parameters Design Flow-Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow-Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1250 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test monthly Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound Inspect for ponding and seepage once every 3 years Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SPS 384.30(6)(i),Wis.Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis.Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished Grade 6-8"Diameter Lawn • •::::::::•:•:•: . . . . . . . Th�Ball Clean Valve Sprinkler Valve Box Distribution . . • • . Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Gregg Riedesel Page 5 of 8 Mound System Management Plan Pursuant to SPS 383.54,Wis.Adm.Code General This system shall be operated in accordance with SPS 382-84 Wis.Adm.Code,and shall maintained in accordance with its'component manuals[SBD-10691-P(N.01/01,R.11/12),SSWMP Publication 9.6(01/81),and Pressure Distribution Component Manual Ver.2.0 SBD- 10706-P(N.01/01,R.10/12)]and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with SPS 383.33,Ws.Adm.Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers,access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound,defective,or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s.281.48,Stets. The contents of the septic tank shall be disposed of in accordance with NR 113,Wis.Adm.Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be leaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm,the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment,maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However,if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump(dosing)tank shall be inspected at least once every 3 years. All switches,alarms,and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted-on the mound. Plantings may be made around the mound's perimeter,and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic(other than for vegetative maintenance)on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations(October-February)dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD5,150 mg/L TSS,and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5,30 mg/L TSS,10 mg/L FOG,and 10*cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral,and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner,and any levels above 6 inches considered as an impending hydraulic failure requiring additional,more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank,pump,pump controls,alarm or related wiring becomes defective the defective component(s)shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface,it will be repaired or replaced in its'present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media,and related piping,and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. Project: Page 6 of 8 f , , 73 7 cc g • [GOULDS PUMPS Submersible -I Effluent Pump MODEL , PE _ „.....,,, , _ - rfiouLos pumps , °RllENT PUMP SPECIFICATIONS MOTOR FEATURES ' Pump—General: General: ■Corrosion resistant • Discharge:1W NPT • Single phase construction. • Temperature:104°F(40°C) • 60 Hertz •Cast iron body. z • maximum,continuous when • 115 volts •Thermoplastic impeller and fully submerged. • Built-in thermal overload pro- cover. • Solids handling:'A" tection with automatic reset •Upper sleeve and lower m aximum sphere. • Class B insulation. heavy vY duty ty ba ll bea rin 9 • " n• Oil filled design.n. conswcdo Automatic models include a 9 APPLCAT IO NS floa t switch High h strength carbon steel •Motor is permanently • Manual models available. shaft. lubricated for extended Specially designed for the • Pumping range:see PE31 Motor service life. following uses: performance chart or curve. • .33 HP,3000 RPM •Powered for continuous • Mound Systems PE31 Pum • 12.0 Maximum amps operation. • Effluent/Dosing Systems p' Shaded n • Low Pressure Pipe Systems • Maximum capacity:50 GPM • pole design •All ratings are within the limits of the motor. • Basement Draining • Maximum head:25'TDH PE41 Motor: •Quick disconnect power '--- • Heavy Duty Sump/ PE41 Pump: • .40 HP,3400 RPM cord,20'standard length, • capacity:60 GPM • 7.5 Maximum amps SITW with Dewaterin Maximum ca heavy duty 16/3 Pa�Y �Y 9 vY n • Maximum head:29'TDH • PSC design NEMA 5-15P,three prong, PE51 Pump: PE51 Motor: 115 volt grounding plug. • Maximum capacity:70 GPM • .50 HP,3400 RPM •Complete unit is heavy duty, • Maximum head:37'TDH • 9.5 Maximum amps portable and compact. • PSC design •Mechanical seal is carbon, METERS FEET ceramic,BUNA and stainless 40 µTM j MODELS:PE31,PE41,PE511 steel. _ i , l HP: 33,.40 SO ; •Stainless steel fasteners. 35' ''' ----------. 10- ( i # -► 2GPM S - _r AGENCY LISTINGS 30 F-P[41 ` ' 1 F O t I 1 t 1 w 25 E3 t . ;._. . - ._-j = i .. ! E I CR US v r i g ... _ � T Tested to UL 778 and 1 z 20= _ _. —Y... . i_ CSA 22.2108 Standards } - _ I .. BY Canadian andards Association Q ° ;- t 1 O A Goulds Pumps is ISO 9001 Registered. 10 - .v -, ` e � 1 5L--- c-- , S I ; f I r- 1 ... i 0- 0 0_---- 1'0 - 20 30 40 50 60 70 GPM 80 0 5 1�0 1i5 m3/h Goulds Pumps CAPACITY "-mrn r-..,,l, o.•mnc .-- • 1 >e/97- 194a) �gafg. e __,—,E*.Ah,.' `/- .eke "-7 O /iy v /, h,t2.5 :T 7 i'/ <.74t:s.. 7 i-5r---5 .s4. 's- 6.1i 7 1/✓f ict r --s---',.. \ Ye 151 e ..5.,. :� „..„, 1 Rb,„:,,,..,„ 0. ,,,Ledoii 7 1.26-6/75-6-i* 7....________,,..„.„9 •..,7' A 1 �a "1 PS ,9.716/ 1 L2c.d e.,4 c i) - /95,',5--- $ ,60A. ., "i..; /- Jr l+ Oc..rte GG.4/ - 7 '■ 4-res.,) :5--114 -/l/.27-0-4:� - . 2/eC-C ' .�4 0 / A S`.J v i//4 - 4 a( /?4.; _ / a �irc5. /6. T '/ .-5;/ 7°75 f/G. '4 J ■ e it Wis.Dept.of Sa '?‘ d Professional Services SOIL EVALUATION REPORT Page / of J Division of Sa Bu'dings in accordance with SPS 385,Wis. Adm. Code County ,��ace�X Attac /Plan on paper not less than 8 1/2 x 11 in siQlpp.ry�st inclu d to:vertical and horizontal reference poiii d((cc ��aadd Parcel I.D.per nP lo or dimensions,north arrow,and location and distance to nearest road. Q �2 ,,� �� C D Please print all information.SEP 13 2013 Rev' ed Date Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). 1 ?(-7 13 Property Owner ' t'K,urx 41? r Location -61t°2�(- 41 _5'G1 Govt.Lots. 1/4AU 1/4 S T_3/) N R /9 E(ore Property Owner's Mailing Address Lot# Bck# Subd.Name or CSM#,/ c- -/(,.() (3,e.2_ ,,, ...-s-J tul /di -v4 City State Zip Code Phone Number El City El Village Town Nearest Road //�/,���c 10A/ L<5-2 2 I ( ) . ;,.e",-4-r;e-7/ '9,50 ��L/ V ❑ New Construction Use:® Residential/Number of bedrooms 1 Code derived design flow rate '0,(*) GPD ®Replacement ❑ Public or commercial-Describe: Parent material 7,// Flood Plain elevation if applicable A/ ft. General comments ,�y;, /J � I �,-� and recommendations: ,sr--",-, J " ,) a„, (.26.,6 Jo u.0 __, ,nJC- ' Boring# ❑ Boring / , ® Pit Ground surface elev. 9g, / ft. Depth to limiting factor - 7 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure consistence Boundary Roots GPD/ft 2 in. Munsell _ Qu.Sz. C nt.Color Gr.Sz.Sh. *Eff#1 *Eff#2 0 f 9 is se-//2 i &in�„- ,,, c 1.3 .3 . 7/ // 9 c_ 2 9"a-97 W-5-- ,d' 1-/ 4,04/ .��-(^ s 1 - 7 , --Z5`�Y1 ��, 1�'.S 5e7Z .S'/ 01/1 �-0 -- -- , r� , ei / Boring# OI Boring ILL Pit Ground surface elev. 9/ / ft. Depth to limiting factor c D in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence :oundary Roots GPD/ft 2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. " ff#1 *:ff#2 9 - 9 WAL'! M M AIMII — — J -' 1 1 "Effluent ' =BOD 5>30<220 mg/L and TSS>30 <150 mg/L `E?i ent#2=Be It <30 mg/L and TSS <30 mg/L CST Name J,-- e Print) 0 Signature / s CST Number Address •ate Evaluation Conducted Telephone Number .-5 -/ . -7)Ej9 (9 LP -V'cei 11,)," .5-:/:(,--2r, .*/1--/3 A5----.__K -79/7 SBD-8330(R11/11) Property Owner r19 C% cii c.E/ Parcel ID# Page � of Boring# ❑ Boring Pit Ground surface elev. N' ft. Depth to limiting factor ,—,i923 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure consistence Boundary Roots GPD/ft 2 in. Munsell Qu.Sz. C nt.Color Gr.Sz.Sh. *=ff#1 *`_ff#2 / /9)-- /4"6/Z l 3 /4 5es- ti/ _-�/ /, 44- �,)--, O.5 -7e, . 1 . 7 3 -z5` .:j--)'1, qo_-,--xe1 -3 .s% ;, ,it- — /,, , Z Boring# ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *1E01 * ff#2 ❑ Boring Boring# ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure consistence Boundary Roots GPD/ft 2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *�ff#1 *Eff#2 *Effluent#1 =BOD 5>30<220 mg/L and TSS>30 <150 mg/L *Effluent#2=BOD 5<30 mg/L and TSS <30 mg/L The Dept.of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format,contact the department at 608-266-3151 or TTY through Relay. SBD-8330 11/11 ■ Property Owner l-,rr? C/ ��.*i-) S2"/ F arcel ID# Page o! of Boring# ❑ Boring Pit Ground surface elev. ft. Depth to limiting factor ,-,? in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft 2 in. Munsell Qu.Sz. C nt.Color Gr.Sz.Sh. *Eff#1 *Eff#2 (>? l-..>9.3 in 5(),5-4 A/4 -51 4,--AZ ..ri I:4-, ,P-5 -,? -3 ,F723-- ,f- ' _ xx1- )‹. 7 s/ &P ,-,74 - /,,,,-( , , r • Boring# ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft 2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 r Boring# ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure consistence Boundary Roots GPDfft 2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 • r r ■ *Effluent#1=BOD 5>30<220 mg/L and TSS>30 150 mg/L *Effluent#2=BOD 5<30 mg/L and TSS <30 mg/L The Dept.of Safety and Professional Services is an ec zal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format,contact the department at 608-266-3151 or TTY through Relay. SBD-8330(RI 1/11) IL • gr7---66 2ee..0R.sh l .-.,-,eg/-slit; .s e.J---71.30A/x"/y6✓ _1-.1n, -/.5-0e67ifiv V /7 ILbZ ioo 14),(11 Z116f- \ T,2—\\: a - -. /vT1'/ \ LJ r+ \ "a,. C a 1, ,bA: tI -Il \ 1 1 / % gin 11 ay 91 28 -, eo.v,4.4 .E "5' f J, ,y 4 ,&/ /- ,.&4,, of.. L/ 4)6a -"5-Za-i/%0.0.- - .nL/ao,o ./,D A >er,,k,vgJ/ sc' 7- jo a(,.. -/,,J Ai s / /5 ____ l� ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer � Mailing ddress jf Qre/A5tii S � tis,/lL /�/ g � Property Address 13 ,0 i/IJ (Verification requiEtd from Planning&Zoning Department for new construction.) City/State m��°�Sr Parcel Identification Number 0 32 4-011 -Lla-o0D LEGAL DESCRIPTION Property Location,,°/3.' 1/4 , Ex) 1/4 , Sec. T �/� N R ) W, Town of Subdivision Plat: � , Lot# Certified Survey Map # , Volume , Page # Z (before 2007 Volume �0 2 , Page# 2 0 0 Warranty Deed# .36g 7 � ) ' Spec house D ye9i(no Lot lines identifiableyes D 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 or // /3 Alb. �_. / f.IGNATURE OF APPLICANT(S) DATE ***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) • / I I 368529 _ - - i _ �. . _Julian Victoria A Cooley.y. }mid - ST. OrOattltki, •i _ t: 011:„,- -.ms's. _+ ' 1 `- .tea - _ tie kalariae diTOOtailla Mad+fir St. Cenral/. __ State of stiareolowila Tax ICeY - The Meat 440 feet of the Southeast one-fourth t or the one—fourth (S€ ) of 5 r To ehip 30 North, 19 West, together t )th the rat to maintain a driveway ac the fit sea foot or said Southeast ono-fourth of Northwest one-fourth SEAdatti ) for purposes of providing and ogress to State Trunk Highsay •35ra'. SEER T 8:0--M FES _ 4 I (la) (is sea) _ ExottAttoo to : Easements of record, if arty. coshed tbLs 23rd ,—day of December_ „ 19.811.... i Victoria A. Cooley AUTKENT!CATi0$ - ACKNOWLEDGMENT Si i alates esaistatticatted this day of STATE OF WISCONSIN , 19 ss. St. Croix County. Personally came before me, this 23rrt day of December, 1980 the above named Julian $. P TITLE 111E1143EN STATE BAR OF WISCONSIN .Cooley and Victoris A_ Cooiey - , tit'io°asst by 3 TDfr.11fi, Wis. Slats.) "" K- �-. This iaatcamea'I was drafted bg r'" t•� 1 _ W3 i i 3.. Racko eVjOh _ 1_ -gym rn kas�QeJ lo-be the persaa who executed the fore-A at Z ggiag itisCri� Pa d ack owledge.d the same. Hudson Wisconsin t®is54015 _ '" i en .1 r - ..�i (Signarame may be authenticated or acknowledged Elk ,..„1%-......* MMa 7Or gSt. Croix Coast Wis. u cc-- +ace.not s ��., ,rtx, gmefc�ssiag is permanent. (U trot, state expiration ate Oct. 33 _, 1983. .) d . _ _ mod': ,A .IMIZRAIOW D Eti-10'.44T2 /AX Or enaCOSED7. DORY NO. 2-1211 - it500.64.66 Owe. L ' Parcel #: 032-2019-40-000 09/17/2013 08:08 AM PAGE 1 OF 1 Alt. Parcel#: 05.30.19.541A&541C 032-TOWN OF SOMERSET Current X ST. CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type #of Units 00 0 Tax Address: Owner(s): 0=Current Owner, C=Current Co-Owner O-RIEDESEL, GREGG GREGG RIEDESEL 12868 DELLWOOD RD N STILLWATER MN 55082 Districts: SC=School SP= Special Property Address(es): '= Primary Type Dist# Description *450 CTY RD V V SC 5432 SCH DIST OF SOMERSET 1 SP 1700 WITC Legal Description: Acres: 12.000 Plat: N/A-NOT AVAILABLE SEC 5 T3ON R19W 13.3A W440FT OF SE NW Block/Condo Bldg: THIS DESCRIPTION INCLUDES P541C Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 05-30N-19W SE NW Notes: Parcel History: Date Doc# Vol/Page Type 12/23/1980 368529 623/200 WD 2013 SUMMARY Bill#: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/12/2010 Description Class Acres Land i - Total State Reason RESIDENTIAL G1 3.000 25,000 123,100 148,100 NO PRODUCTIVEFORSTLANDS G6 9.000 36,000 0 36,000 NO Totals for 2013: General Property 12.000 61,000 123,100 184,100 Woodland 0.000 0 0 Totals for 2012: General Property 12.000 61,000 123,100 184,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: 03/24/2011 Batch#: 11-01 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00