HomeMy WebLinkAbout040-1303-00-009 County: St. Croix
Wisconsin Department ofi Commerce PRIVATE SEWAGE SYSTEM
Safety and Building Division INSPECTION REPORT Sanitary Permit No:
567266 0
(ATTACH TO PERMIT) State Plan ID No.
GENERAL INFORMATION
Personal information you provide may be used for secondary purposes[Privacy Law,s.15.04(1)(m)]. Parcel Tax No:
Permit Holder's Name: City Village X Township
Town of 040-1303-00-009
Oevering Homes LLC, aka Oevering Propertie Troy, Section/Town/Range/Map No:
CST BM Elev: Ilnsp.BM %' IBM Description: 5 ��1 22.28.19.1744
97 A/ �
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER h''' r CAPACITY STATION BS HI FS ELEV.
Septic -,r 2i Benchmark-
)4 G51 �� I�/�� 97• ��
+J FFw 0' Pk IA,- 4 /zoo - 3
Alt.BM Fif L G x" 2. 5 11.3(e
EtrISITTI Aeration Bldg.Sewer G,1 95 - 41(
Holding C �•.---__________ St/Ht Inlet 7 iJ 74/- l'/
St/Ht Outlet �,7 49g4/49 TANK SETBACK INFORMATION
TANK TO P/L WELL i BLDG. ent t Air Inta a ROAD Dt Inlet
Septic l r f o / � Dt Bottom
p /5 �0 Lln I
Dosing �i ce/ Header/Man. V. 3 yy s(
�dt3 y Dist. Pipe Ir..35 93'5(0 Ts.S
Aeration g•� q'3'
Holding Bot.System 97.31 9Z • 5
Final Grade 7.9/_,
PUMP/SIPHON INFORMATION 3 x'1 (
Manufacturer Demand St Cover r'6 6,,A.... L 5 9 7 3�i
GPM Ir
Model er�
TDH IL. . Friction Loss System Head ---"..T.QH Ft
c _ 1.-.--. ..........___......._
Forcemain Length 'Dia. 'Dist.to Well
SOIL ABSORPTION SYSTE
BED/TRENCH Width L.pn th No.Of Trenches PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth
DIMENSIONS 3 1 ' 4 0Z '6 3 .,J.44 �— �-
SETBACK SYSTEM TO P/L BLDG / WELL LAKE/STREAM LEACHING Manufacturer:
INFORMATION / CHAMBER OR "P".4,cr L 1--(4,4,-....
Type Of System: ,,/ UNIT Model Number:
Co v�tJ e v� e l°l HIL 'Fitt !V t?u 'c,k 44 54...__./....,,,i/ /vs
DISTRIBUTION SYSTEM tclt�l"-- ^e '16 I gr 2D 4- ZZ = (.a 4-a4-..Q .
w6
Header M nif ., 1 to' a Distribution x Hole Size (Vent take Pps) • � \ \ 1xl-iolepacng
G
(Length Dia 4 (Length Dia Spacing
SOIL COVER / x Pressure Systems Only xx Mound Or At-Grade Systems Only
IDepth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched I
p y Bed/Trench rench Ed es Topsoil Yes No Yes E No
Bed/Trench Center � ,�✓ I g � I � � 0
COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: / / Inspection#2: / /
Location: 660 Traditions Trail River Falls,WI 54022(SE 1/4 SE 1/4 22 T28N R19W) Walnut Hill Farm aka The Tribute L Parcel No: 22.28.19.1744_1
6.11.,...„ Go f/Q,�, C _ 4- G e�l� 61/ �.1
1.)Alt BM Description= f v""^" ,�/� r 1 I b
2.)Bldg sewer length= I v Ad W n A� ��r"�D
-amount of cover= /
5 0A. a _._ ______ I
, co-tk,,s
)4
, , • r I
Plan revision Required? Yes )(No r 20 13 i - .
Use other side for additional information. - 1 L — ———
Date Insep •r's Si•7 r ure Cert.No.
SBD-6710(R.3/97)
VIIIIIM
PLOT PLAN
PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017
SE 1/4 SE 1/4S 22 /T 28 N/R 19 W TOWN Troy COUNTY ST.CROIX
MPRS Shaun Bird 226900 DATE 11/6/13 BEDROOM 4
CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 1212 # of chambers 60
■ BENCHMARK V.R.P. top of 1/2" steel conduit ASSUME ELEVATION 100' Filter BEAR Filter
❑ BOREHOLE O WELL *H.R.P. Same as Benchmark
SYSTEM ELEVATION 93.8/93.7/93.6 4.4' below grade
319' Property Line All piping shall be SDR 30/34,within 10'
of tank,piping shall be Schedule 40.
3-3' X 82' cells with>3' spacing and
4.4.' below grade max depth
Scale is 1" = 40'
Vents 40--
unless otherwise
98' ^ noted
A
99' 4
B.M.* 20' I D Q,
10' I\ A 5' 48' !J
10'B-
44,
Pro 4 �D�
Bedroom
House 20
119'
ap Vent
>6" Quick4 Standard
of Cover Leaching Chamber
- .y with 20.0 ft2 of Area
u ° 5.6ft^2/pair of end caps
4' Long
Town Road
34" Grade at System Elevation
•
+irt*16. County S 1-■ ('f In )
t, ;, � 1400 E Washington Ave Sanitary Permit Number(to be filled in by Co.)
le P.O. B. 162
'%' 7f 5�`7 2 C0
,` `;r Madison„�(IK �7-7162
Sanitary Permit Ap• . .o 1 tate Transaction Number
ff,/ A-
In accordance with SPS 383.21(2),Wis.Adm.Code,submission.,ai.' orm , i e appropriate govemment
is required prior to obtaining a sanitary permit. Note:Applicationy` fa state-owned POWTS are submitted to( Project AddreSSif different than mailing address)
the Department of Safety and Professional Servies. Personal info a ion you provide may be used for secondary ,/1) -f
+u ++ses in accordance with the Privac Law,s. 15.04 1)m),Stats. r,F //7� '
I. Application Information-Please Print All fit” .` (0(�(J I ra,.4 fk" & (ral 1
r
Property Owner's Name � ' '
�/ederi tlt 06 - /363 - oo - 009 ,q-:119
,�V
Proppeerty Owner'sMailinngAdc ss` , Property Location �' /7� h�
/-1 -s ee f,/Lt7 Uj 9(� ' i Govt.Lot �\
City,State \ Zip Code Phone Number s� y Sg /,, Section
A' 2 \ P p ( circle o•
vim' , C q2O N; R1 / E,
II.Type of Building(check all that apply) L+ •
`
1 or 2 Family Dwelling-Number of Bedroom, I
Subdivision N me /
Q�C cry In of 2- %ock: tx.,C y'),t;(. M�l fCe.111.t..'
❑Public/Commercial-Describe Use ❑City of
O0.
❑State Owned-Describe Use r 1 I CSM Number ❑ Village of - -
3 4,,,.- Gea s w Zb GIA&,...6e.r5 en- Town of
III.Type of Permit: (Check oniy one box on line A. Complete line B if applicable) (///
A. lew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System(explain)
B. ❑ Permit Renewal ❑ Permit Revision .' ' '❑Change of Plumber ❑Permit Transfer to New
List Previous Permit Number and Date Issued if ,
Before Expiration Owner i J 1 1-7" 4� (?)...,%(.,k_
IV.Type of POWTS System/Component/Device: (Check all that apply) J6 5i-Q,.�ufaQ pIuJ a.-.1.e.(.
Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑At-Grade ❑ Mound>24 in.of suitable soil ❑ Mound<24 in.of suitable soil
❑ Holding Tank ❑Other Dispersal ComponenA' ) ❑ reatment Device(explain)
V. //
V.Dispersal/Trea entArea Information: V-°tr C(...9-.""/6 (rev y/r°(�l�'jlf('.,ci3,ign Flow(gpd) Design Soil Application R Dispersal Area Required(sf) Dispersal Area Proposed(sf) "temElev do / z 7
VI.Tank Info Capacity in Total #of Manufacturer
N G
Gallons ' Gallons Units U z y ;
New Tanks Existing Tanks Q / as c 2 j; o
G✓ V --, D PO r ifs a) U in a, yr w c7 a
Septic or Holding Tank tom/ ' 42,5-.5- / ALL ri i 1-- 7`-- —
Dosing Chamber •
VII.Responsibility Statement-I,the undersigned,ass , ponsibility for installation of the POWTS shown on the attached plans.
Plumber's Name(Print) Plum D- : _ ature MP/MPRS Number Business Phone
Nu r
SAS z; 2z� 7) =��
-41.-r :,
Pill is Address(Street,City,State,Zip Code pAdi,k,
•
VIII, unty/Department Use Only
Permit Fee Date ssue Issuing A t Signature / /
Approved ❑ Dis:-i : = $ L( /l
/75 .a� ///r1��3
❑ 0 n Reaso +r Denial (!(
IX.ConditIINSTEMONNENteasons for Disapproval' 3 r� _` �+ I I'o :d/a , e,,.• ) •,,,,��t..... .
. 1.: Septic tank,effluent'filter and
dispersal cell:must all be services I maintain! +. cO, ,^�/ ^'`L#
as per management plan provided by plumber. i'�" � 1 n�1
2. All ietback requirements must be.tnaintained g) j- A-r 4--, Ina. P fesecuaQ
as per applicable cede I Waimea:es.
Attach to complete plans.for the system and submit to the dounty only on paper not less than 8 1/2 x 11 inches in size
•
SBD-6398(R0313)
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 11/6/13
Owner:Oevering Homes
Location: SE1/4 SE1/4 S22 T28 N,R19W Lot 9 Walnut Hill Farm Troy
System type: In-ground absorbtion system(conventional)
Manuals Used: In-ground absorbtion system (version 2.0)
Page#
1. Cover Page
2. Plot Plan
3. Chamber Cross Section
4-6. Maintanance and Contingency Plan
7. Filter Specifications Sheet
8.-10. Soil Test
Signature
License number#1•900
PLOT PLAN
PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017
SE 1/4 SE 1/4S 22 /T 28 N/R 19 W TOWN Troy COUNTY ST.CROIX
11/6/13 BEDROOM 4
MPRS Shaun Bird 226900 DATE
CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 1212 # of chambers 60
BENCHMARK V.R.P. top of 1/2" steel conduit ASSUME ELEVATION 100' Filter BEAR Filter
❑ BOREHOLE O WELL *H.R.P. Same as Benchmark
A SYSTEM ELEVATION 93.8/93.7/93.6 4.4' below grade
319' Property Line All piping shall be SDR 30/34,within 10'
of tank,piping shall be Schedule 40.
3-3' X 82' cells with>3' spacing and
4.4.' below grade max depth
Scale is 1" = 40'
Vents B-3 unless otherwise
98' —� noted
99' 0-
B.M.* 20' 43'
0 45' , 48' �❑ B-2
10"'B-1
10'
Pro 4
Bedroom
House
119'
apVent
>6" Quick4 Standard
of Cover Leaching Chamber
with 20.0 ft2 of Area
5.6ft^2/pair of end caps
4' Long
Grade at System Elevation
34"
V Town Road
Cross Section of Quick 4 Standard Leaching Chamber
Typical cross section for 2 of 3 cells
Quick 4 Standard
Leaching Chamber with
20.0 ft2 of Area per
Chamber 5.8ft^2 pair of end plates To be >1' above grade
Finish grade elevation
Typical installation 98.0'
Vent Grade ;Vent
4' 4„ 4'
x/30/34 Septic Tank
4' Long II& 5' 4' Long Ilikk
Grade at System Elevation
3 4" Grade at System Elevation n 3 4"
Spacing 5'
3-3' X 82' Cells
Observation tubeNent
Same on other end To be located on end of Cells
System elevations:
A__93.8
B 93.7 20 chambers per cell
C__93.6
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer 0'e u e r► r► /4„.r,,,e ,
Mailing Address �0 e dj
1�/
Property Address 66 D ' _ _ _ --.-----_._
t .1
(Verification required from Planning&Zoning Department for new construction.)
City/State
Parcel Identification Number
LEGAL DESCRIPTION
Property Location$E Y4 5E' %4, Sec. 2-2- T 23 N R l?' W,Town of Tfoy .
Subdivision L.c�-1 u, c
• , Lot#?
Certified Survey Map#
Volume ,Page#
Warranty Deed# ° ta
Volume Page#
Spec hoes 0 o Lot lines identifya.
no
SYSTEM MAINTENANCE OWNER CERTIFICATION
Improper use and maintenance of your septic system could result in its premature failure to
maintenance consists of pumping out the septic tank every handle wastes. Proper or the system can affect the function of the septic tank as a treatment stage in the waste needed,by y tem. O pumper. What you put into
responsibilities are specified in§Conmu.83.52(1)and in Chapter 12-St.Croix County Sanitary Ordinance.
Owner maintenance
ty tary Ordinance.
The property owner agrees to submit to St.Croix County p
owner and by a master lumbar,journeyman ty lanning&Zoning Department a certification form,signed by the
y p ° urneyman plumber,restricted plumber or a licensed
wastewater disposal system is in proper operating condition and/or(2)after inspection pumper pumping(if tcets r the on-site
less than 1/3 full of sludge. nspechon and pumping(if necessary),the septic tank is
1/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 Commerce
Certification stating that your septic system has been maintamemustbee completed and returned to the St. State of my Planning
Zoning Department within 30 days of the three year returned to the St.Croix County cleaning&
Ys Y expiration date.
Uwe certify that all statements on this 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 warr deed recorded in Register of Deeds Office.
Number of bedrooms
0
� TGNA 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 front the Register of Deeds Office and a copy of the certified survey map if
reference is made in the warranty deed.
(REV.08/05)
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of _
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner ` Septic Tank Capacity fads— gal DNA
Permit* � � Septic Tank Manufacturer _M-;.-ii ❑ NA
DESIGN PARAMETERS Effluent Filter Manufacturer DNA
Number of Bedrooms 9 ❑ NA Effluent Filter Model — ❑ NA
Number of Public Facility Units >41 NA Pump Tank Capacity / •al it NA
Estimated flow(average) -- al_ gal/day Pump Tank Manufacturer s■ NA
Design flow(peak),(Estimated x 1.5) 0 0 gal/day Pump Manufacturer - ■ NA–
Soil Application Rare- ., .. gal/day/ft2 Pump Model —�_ — ■ NA
Standard Influent/Effluent Quality Monthly average* Pretreatment Unit s, NA
Fats,Oil&Grease (FOG) _530 mg/L ❑Sand/Gavel Filter ❑ Peat Filter
Biochemical Oxygen Demand (BODs) 5220 mg/L ❑NA ❑ Mecharical Aeration ❑Wetland
Total Suspended Solids (TSS) .5150"mg/L ❑Disinfection ❑Other:
Pretreated Effluent Quality Monthly average Dispersal Cell(s) w — ❑ NA
Biochemical Oxygen Demand (BOD5) 530 mg/L Ai-Ground(gravity) ❑ In-Ground(pressurized)
Total Suspended Solids (TSS) 530 mg/L A At-Grace ❑ Mound
Fecal Coliform(geometric mean) 5104 cfu/100ml ❑ Drip-Line ❑Other:
Maximum Effluent Particle Size in dia. ❑NA Other: ❑ NA
Other: , ,,A Other. ---- ❑ NA
*Values typical for domestic wastewater and septic tank effluent. �` Other: ❑ NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
Inspect condition of tank(s) At least once every: ❑month(s) (Maximum 3 years) ❑ NA
71Slyear s i
Pump out contents of tank(s) When combined sludge and scum equals one-third O of tank volume 0 NA
Inspect dispersal cell(s) — — At least once every: El month,s) (Maximum 3 years) ❑ NA
----------- _— /.. ( , j months s) _---- NA
Clean effluent filter At least once every: years;__ ❑ NA
Inspect pump, pump controls&alarm At least once every: ❑months) II NA
Flush laterals and pressure test At least once every: ❑year(s) II NA
_ _ _ __— ❑year{s,_— —__ —_ ___
Otter. At least once every: ❑month{s) n NA
ID years)
Other: _ _—__--
— — --
• NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master
Plumber;Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must
include a visual inspection of the tank(s)to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of
combined sludge and scum and to check for any back up or ponding of effluent or the ground surface. The dispersal cell(s) shall be
visually inspected to check the effluent levels in the observation pipes and to chest:for any pending of effluent on the ground surface.
The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local
regulatory authority.
When the combined accumulation of sludge and scum in any tank equals one-third(6)or more of tile tank volume,the entire contents of
the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin
Administrative Code.
All other services, including but not limited to the servicing of effluent filters, mechar ical or pressurized components, pretreatment units,
and any servicing at intervals of 512 months,shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority within 10 days of completion of an!,service event.
Page of
START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that
may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the
tank(s)removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be
discharged to the dispersal cell(s)in one large dose, overloading the cell(s)and may result in the backup or surface discharge of effluent.
To avoid this situation have the contents of the. pump tank removed by a Septage Servicing Operator prior to restoring power to the
effluent pump or contact a Plumber or POWTE; Maintainer to assist in manually operating the rump controls to restore normal levels
within the pump tank.
Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact,the area within
15 feet down slope of any mound or at-grade soil absorption area.
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS:
antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain
(sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scrap:; medications; oil; painting products;
pesticides;sanitary napkins;tampons;and water softener brine.
ABANDONMENT
When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly
and safely abandoned in compliance with chapter Comm 183,33,Wisconsin Administrative Code:
• All piping to tanks and pits shall be disconnected and the abandoned pipe openings seale'i.
• The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator.
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil,
gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant
replacement system:
A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system.
The replacement area should be protected from disturbance and compaction and should not be infringed upon by required
setbacks from existing and proposed structure,lot lines and wells. Failure to protect the replacement area will result in the need
for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in
effect at that time.
❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a
holding tank may be installed as a last resort to replace the failed POWTS.
❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation
must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as
a last resort to replace the failed POWTS.
El Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative
surface. Reconstructions of such systems must comply with the rules in effect at that time.
«WARNING»
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC,PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINER
Name e � Name Ir
Phone 7AU ,`5-1 Phone —at yJ
SEPTAGE SERVICING OPERATO (PUMPER) LOCAL REGULATORY AUTHORITY
Name -L � Name Cy 6-c9
Phone 7A) �U��/U— J j� Phone 7 3
This document was drafted In compliance with chapter.BPS 383.72(2)(b)(1)(d)&(f)and 383.54(1),(2)&(3),Wisc oi}sin Administrative Cod e.
:tim l► S
i TION
m T
t .
Installation „,_
nstallation , - _ �
STEP 1 Dry fit the filter case onto the end of the outlet pipe to ensure it is 11
centered under the access opening. If not, then either insert more pipe into the
tank through the outlet or solvent weld (glue) additional pipe onto the outlet
pipe.
STEP 2 While the case is still dry fitted on the outlet pipe, measure the length
of 3/4-inch pipe needed to brace the filter to the tank end wall if utilizing the
optional supplemental side support. If side support method is not utilized,
proceed to step four.
STEP 3 For installations utilizing the optional supplemental side support:
solvent weld the 3/4-inch pipe onto the filter case. If side support method is not
utilized, proceed to step four.
STEP 4 Solvent weld the filter case onto the outlet pipe. Insert the filter
cartridge into the case, pressing down until the filter locks into the bottom of _
the case.
STEP 5 If a VRS switch is utilized: insert into the filter and lock by turning
clockwise 90°.
Maintenance
1. The effluent filter should be cleaned every time the septic tank is ' '_ ,-kt '1 «
serviced. . '
2. Open the outlet access opening to inspect the tank and filter. _.
3. Pump the septic tank completely, making sure to remove the sludge _ , i .
.i._, ,4,..;=-0*- `k
layer on the bottom of the tank and not just the scum and effluent.
4. Once the effluent level has been lowered below the invert of the
outlet pipe, firmly pull up on the filter handle to dislodge the
cartridge from the case. 4,:,
5. Slide the cartridge up and out of the case for cleaning. ' - '-- -------77 �. _ _,
6. If a VRS switch connected to an alarm is present,the switch "# 112*,>4,.
should be removed by turning counterclockwise 90° and cleaned
with water only. s M r
7. While holding the cartridge on its side (large flat surface facing ''LL
down) over the access opening, rinse off the cartridge with water y
only, making sure all septage material is rinsed back into the tank. - ''
t
8. If VRS switch is utilized, replace by inserting into filter and *I� .
turning clockwise 90°. . -_
9. Insert the filter cartridge back into the case, pressing down until �'` k --- . �
the filter locks into the bottom of the case. "`m'4"tom.= 4 4
10.Replace and secure the access opening on the tank.
BEAR ONSITET"FILTER CARTRIDGE-FIVE-YEAR LIMITED WARRANTY
Bear Onsite filter cartridges are warranted to be free of defects in material and workmanship for five(5)years from the date of 1
consumer purchase.
BEAR ONSITET”Filter Case-Lifetime Limited Warranty
Bear Onsite warrants the filter case will be free of defects in material and workmanship during normal use for the period of time
the original purchaser owns the product.
If a defect is found in normal use,Bear Onsite will,at its election,repair,provide a replacement part ort product,or make
appropriate adjustment.Damage to a product caused by accident,misuse,or abuse is not covered by this warranty.Improper
care or malfunctions resulting from units not installed,operated,or maintained in accordance with instructions provided will
void the warranty.Proof of purchase(original sales receipt)must be provided to Bear Onsite with all warranty claims.Bear
Onsite is not responsible for labor charges,removal charges,installation,or other incidental or consequential costs.
In no event shall the liability of Bear Onsite exceed
the purchase price of the product.
' I
I I IV I`I1(I III I)II
8140849
Tx:4113918
STATE BAR OF WISCONSIN FORM 3-2000 975248
QUIT CLAIM DEED BETH PABST
Document Number REGISTER OF DEEDS
THIS DEED, made between Citizens State Bank, Grantor, and Oevering ST. CROIX CO., WI
Homes LLC,Grantee. 03/20/2013 09:08 AM
Grantor quit claims to Grantee the following described real estate in St. EXEMPT#: NA
Croix County,State of Wisconsin(the"Property"): REC FEE: 30.00
TRANS FEE: 449.70
PAGES: 2
Lots being sold`as is'.
SEE ATTACHED EXHIBIT A
Recording Area
Name and Return Address:
Title One
File 19240 •
Together with all appurtenant rights,title and interests. see attached
Parcel Identification Number(PIN)
This is not homestead property.
Dated this 15th day of March,2013.
Citizens State Bank
l/'"f0/2;cf4111Q-
1* anD erBroeke, ce Presn
AUTHENTICATION ACKNOWLEDGMENT
STATE OF WISCONSIN )
Signature(s) ST CROIX COUNTY. )ss.
authenticated this 15th day of March,2013 Personally came before me this 15th day of March, 2013
the above named Citizens State Bank,Alan H VanDerBroeke,
* Vice President to me known to be the person(s)who executed
TITLE:MEMBER STATE BAR OF WISCONSIN the foregoing ins ent and acknowledged the same.
(If not, � ,r
authorized by§706.06,Wis.Stats.) `e el'`Jae
Evelyn IVI Jaeger �r —
THIS INSTRUMENT WAS DRAFTED BY Notary Public,State of Wisconsin
My commission is permanent. (If not,state expiration date:
Michael H Forecki,Attorney 12/16/2016 )
(Signatures may be authenticated or acknowledged. Both are not necessary.) -�A
*Names of persons signing in any capacity must be typed or printed be• �� (Ito—P lc
Sate of
1 of 2 QUIT CLAIM DEED STATE BAR OF WISCONSIN FORM No.3-2000
File No.: 19240
EXHIBIT A
Lots 8, PIN 040-1303-00-0081of 9 PIN 040-1303-00-009; Lot 23, PIN 040-1303-00-023;Lot
28, PIN 040-1303-00-028 and Lot 40 IN 040-1303-00-040 of Walnut Hill Farm, All in the
Town of Troy, St. Croix County, Wisconsin.
2 of 2
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- .. 'Wise �sinn Department of Commerce SOIL EVALUATION REPORT Page of '3
Division of Safety and Buildings
in accordance with Comm 85.Wis. Adm. Code Comity Sr G�D/)L-- .V
Attach complete site plan on paper not less than 81/2 x 11 inches in size.Plan must L or AWNS C
indude,but not limited to:vertical and horizontal reference point(BM),direction and Parcel 1.0. iP/A-1�
percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Pe b
Please print all information. R by Date
Personal Information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m))- tiArvl/7 • I / 3,Ji3
Properly Owner
CTOP.? ll PropetyLca or
To PD 83 ERS Tee 7_. /v 4/0"/ b
Govt.tot it!' yq 5S 1/4 S IL- T24 N R /9 E(or)w
Property Owner's Maling Address Lot# I Block# Subd.Name or CSM#
&D 15 CA ft-LL At)-e- - 9 i cvAL/vv r tki t i PA-R'-t
City SA!(ve2 State , Tip Code Phone Number ❑City ❑Village (Town Nearest Road
6-IDVE HT5 i Mtv i SSo7(e ( (DSR) 1, g.. toy% ?-Roy so. (riooe;
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50-New Conatrudion Use:IZI Residential/Number of bedrooms 3 Y Code derived design flow rate_f " - 6� GPO
❑Replacement ❑ Public or commercial-Describe: - -- t
Parent material /6E-55 Oat(. 5441D du Tce/il- Flood Plain elevation if applicable Alfr ft. .
.
General comments
and recommendations: , 7*Pe,4 T rap -5.a/r, le- {.e •W /.vfeo v.ol7
Rt
�p.(,D •�S . , or /o /u - ssue, � �,
— G p -dam �� ,,,,o .�1
! Boring# ❑ Ground surface env. f 1.79 R Deptrr tD li /rrtuUng factor
7o in. GZ e `t
® Pit Sod Apprrcation Rabe
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPO/ff:
in Mu used Qu.Sz. Cont.Color Gr.Sz.Sh. 'Efl#1 'Eff#2 b
•
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2 g ® pit Ground surface elev. �" ' ft. Depth to htlting factor} "1 in. j sod Application Rate (r‘
Horizon Depth Dominant Redox Description Texture Structure Consistence Boundary Roots GPD/ff ('
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2 (\
a•/3 to R 7 L- EW IQs MigfilliaM N
'2- iliMFANTAMEMINAMIMICAPIENMISIIMMI 14
"RIME Sz- E? cs — • 5 MI
MZM l6 I 1,M1=PAI S 4 n 11MI
IIIIIIIIIIIIIIIIIM 1111L1111
'Effluent#1=130135>30<220 mg&L and TSS>30<150 mglL •Etfluerd#2=BODD<30 mg!L and TSS<30 rtg/L
CST-Mbar
CST Name(Please Print).R -u LB R i<✓i r` 2. .G 3 7 5
Address Ulbricht &Assgciates Date Evaluation Conducted Telephone Z
Private wage Gor�s�l anti 4• 3 a2oo 3 715- 77A "H
2812 10th Ave.
Spring Valley, WI 54767
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TODD ale e s TED7—
Property Owner Parcel ID# 2'6 I Page z d 3
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3 :t t Ground surface etev. R- } in.
Horizon Depth Dominant ... Redox Description Structure Consistence So�i �� `"•,-� Rate
i3ourr�ary Roots GPtXRf
in. Munsefl Qu.Sz. Cont.Color Gr.Sz.Sh. •E11#1 'E}
O JO & ' 31 12111 2-F s4& dlsA Fra • S
MOM zo '. EM ,, r#3 . .
darn
11111111111111111 MB 11111111111111111111111111 ,
riBoring ailing# 0 Pit Ground surface elev. ft. Depth to limiting factor in.
Soft Applicalkin Rate 1
Horizon Depth Dominant Color Redox Desaiption Texture Structure re Consistence Boundary Roots GPD/ff
In- Monett Qu.Sr. Cont.Color Cr.Sr.Sh. 'Eff#1 'Pfff#2
=MIN 11.111WAIIIMEIMINIMI II 1
Boring# 0 Boring
• ❑ Pit Ground surface elev. ft. Depth to • '4. 4 factor In
I Horizon Depth Dominant Color Redaoc Soft Rate
Description- Texture � , - Consistence Boundary Roots Gl
In. Munsell Qu.Sz. Cont.Color GF• Sh. 'Eff#1 'Eff#2
1
, 1 # [fir--
Bori
Jy�r �
FlL_iF Pit Ground surface elev. ft. Depth to fang factor in.
Soft Appleafron Rate
Horizon 1 Depth Dominant . . Redox Descrtption Texture Structure Consistence Boundary Roots GPM
in. Monett Qu.Sz. Cont. Gr.Sz.Sh. 'EMI1 •Eff#2
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'Effluent#1=BOD5>30<220 mgt!and IBS>3Q<150 mgll 'Effluent#2=BOD5<30 mgA.and TSS<30 rngfL
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format,please contact the department at 608-266-3151 or TTY 608-264-8777.
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a = Contour elevation lines.
• = Backhoe Soil pits.
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DAjQ,t" lathes. 1/2" steel conduit pipes.
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