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016-1065-90-050
Wisconsin Departmento~ommerce ~ PRIVATE SEWAGE SYSTEM Safety and Building Division ~ INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) rersonai intormanon you provitle may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)] Permit Holder's Name: City Village X Township Meineke, Patricia ~ Glenwood, Town of CST BM Elev: Insp. BM Elev: BM Description: /~ , ~ ~-I ~ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic g ~. ~ sew ~ l~ Dosing } ~Ow~-~D (DJ ltcraTl~ F~ a l Holding TANK SETBACK INFORMATION TANK TO P/L p~ C~ WELL BLDG. Vent to Air Intake ROAD Septic ~~ ~ ~ 3a~ c~/ 1 Dosing ~ 3 , ~ ~, 3 ~ r ._, Aeration Holding nri~norcinunai uirnonen-rrnnt Manufacturer Demand 1 Q,( GPM Model Number ~ ~ 53 ~~ ~ I TDH Lift,$r /g Frictio~o~Z System HealJd ~ T Z/ ~~t JJ ~ ~ ~,~, Forcemain Len tg h Dia.2~i Dist. to well ~ /J SOIL ABSORPTION SYSTEM County St. Croix Sanitary Permit No: 463313 0 State Plan ID No. Parcel Tax No: .9a-c~v Section/Town/Range/Map No 30.30.15. ELEVATION DATA STATION BS HI FS ELEV. Benchmark •3~ Ib`1.57 ioo zo (~ AI~B bl~ ~ .n, c~_ d 5'~D Q~~Z~'~ Bld .Sewer X5.58 8$ ,9~ St/Ht Inlet ,~ I I S / ~ I I Z SUHt Outlet ~ Dt Inlet ~ ~ Dt Bottom ,a3 8`~S Header/Man. ~'~ ~aZ ,~ Dist. Pipe ~ • $5 /tj z •7Z Bot. System ~. ~bz -b~ Final Grade St Cover g ~!a 95• e BED/TRENCH Width ~ Length ~ No. Of Tren es PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~ I ~ '~ ~ 5 ~ ~, ~ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: MATION CHAMBER OR INFOR Type ystem: ~ ~~ i j /~ J ~J p"~ ~ /~ Y•~•^- UNIT Modet Number. Ov O 78 DISTRIBUTION SYSTEM Header/Manifold Length ~ Dia Distribution f ~ Pipe(s) ec•• h Length 5J' Dia Spacing d x Hole Size ~ ~ !j I ~ ~ x Hole Spacing ~ ~ • U Z Vent to Air Intake SOIL COVER Y Praccnra Svefamc only YY Mnnnd nr At-Grade $VStemS Only Depth Over Bed/Trench Center ~ Depth Over Bed/Trench Edges ` xx Depth of Topsoil 1 ~ xx Seeded/Sodded No xx Mulched No ~fes ~ • ~ ~ • es ~ COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:J~1 /U i d.5 Inspection #2: / /_ Location: 2770 130th Avenue Gle(n~wood City, WI 54013 (SW 1/4 SE 1/4 30 T30N R15W) NA Lot 1 ~I~ ~ I Parcel No: 30.30.15. 1.) Alt BM Description = °~ dY ~dJ~a~~O.~._ F0 Tc.L. -'~^^p~- ~ 1,~, /~ _ 2.) Bldg sewer length = L{3 , I 7 r rc72~p ~ PIG ~ `~ I ~ -amount of cover = ~ / Gln.c-~ ~.S o w- cD v(~-_ Q Sr- Q('; J+2c,.)~ /. v Plan revision Required? ~ ''~ Yes o ~ uJ~~~ Use other side for additional information.' / D_ ,/~ Date Insepctor' ignatu Cert. No SBD-6710 (R.3/97) w I PUMP PERFORMANCE CURVE I t1~ODEl 151/152/153 14 45 153 12 40 JS - 1e 152 30 - ° s zo 15 4 10 2 C' i G?LLONS f~OW PER MINUTE 014508A "`rUr~Y FUF • Timed dosing panels available. • Electrical alternators, for duplex systems, are av~l~le and supplied with an alarm. • Variable level control switches are av~lable for controlling single phase systems. • Double piggyback variable level float switches are avalable for variable level long and short cycle contrds. • Sealed Ovvik-Box available for outdoor installations. See FM1420. • Over 130°F. (54°C.) special quotation required. `'!,`1~2!i.`+'', Series _ 151!1521153 YODELS Contrd SNection Yodall Volts-Ph Mods Amps Simplex Duplex N151~ 115 1 9N151 115 1 Non Aura 6.0 6.0 1 Included 2 a 3 2 a 3 E151 230 1 Non 3.2 1 2 a 3 - -t -- - BE151 230 1 ~ Auto 3.2 Included _ 2 a 3 N152 115 1 Non 8.5 1 2 a 3 BN75-2t 115 1 E152 ~ 230 1 Auto Non 8.5 4.3 Inducted 1 2 a 3 2 a 3 BF152 230 1 Auto 4.3 Inducted 2 a 3 N153 _ 115 1 Non 10.5 1 2 a 3 BN153 115 1 Aulo 10.5 Included 2 a 3 -------- E753 230 1 BE153 30 1 Non Auto 5.3 5.3 1 Inducted --- 2 a 3 2 a 3 TOTAL DYNAMIC HEAD/FLOW PER MINUTE EFFLUENT AND DEWATERING MODEL 151 152 153 Feel Meters Gal. Liters Gal. Liters Gel. Liters 5 1.5 50 189 69 261 77 291 10 3.0 45 110 61 231 70 265 15 4.6 38 144 53 201 61 231 20 6.1 29 110 44 187 52 197 25 7.6 18 61 34 129 42 159 30 9.1 - - 23 87 33 125 35 10.7 -- -- -- -- 22 85 40 12.2 -- -- ~~ -- 11 42 Shut-off Head: 30 K. (9.tm) 38 H. (1 t llm) 04 fl. (13.4m) 0145088 Model 151 Models 1521153 h-~- 6 7/32 37/8 ~ 4L6 T 3 ne 3 7/8 I~I - ---C".. -----_1 I I ~~ ~ I 11 77/76 _-- 4 3ie sx2a44 3 27/32 z z - I I tz 1re i ~ s i~a ~- ~ I r- sx2oBa O CAUTION -., ~ /~: ~i 3~':' .. ] a!1^_ 1~1 vIj! ~ !f 11 'ti K) il!li 1. Single pggyback variable level float switch a double piggyback variable level float switch. Reter to FM0477 2. See FM0712 for correct model of Electrical Alternator E-Pak. 3 Variable level control switch 10-0225 used as a control activator, speedy duplex (3) or (4) float system. ~~ ~ER1r~: P~v'JEREt~ C~~5it~ly For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. _ _ _ _ _ MAIL T0: P.0 SOX 18347 ` Lousville, KY 4 02 58-034 7 IAanufacturers of 0 SHIP T0: 3849 Cane Run Road /p p ® o Louisville, KY 40211-1981 QVifUTYPI/MP6 SNCE /j~r-/ httpllwww.zoeller.com PUMP !O_ (502) 778-2731.1 (800) 928-PUMP FAX (502) 7743824 © Copyright 2004 Zoeller Co. All rights reserved. 1 i Safety and Buildings Division 201 W. Washington Ave., P.O. Box 7162 Cotmty ~ ~~ ,SCO~S~~ Madison, W I 707 - 7162 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608) 6-3 .~ -> ~~, _~ ~ /3 Sanitary P ~ ~ tl ]] ~~/~ I ~~JJ u State Plan LD. Number ~1 I In accord with Comm 83.21, s~ Code; pers orm [on you provide / ~~ ~ _ ~Q.I~ S• I ~ may be used for secon p vaey Law, s15 4(l)(m)j t ,; ~ Proj •t Address (ifdiflerent than mailing address) ~ J. L .Application Information -Please Print All Information ` i _ (i;' ,~;;x Z~~ <oN ;,,, ~ , X30 '- !/~e• ~~C~ Prop rty Owner's N• me areel # Lot # I Block # /tic. ~. lvl .,~. D (o- ~- I Property Owner's Mailing Address Property Location ~y~ ~ ~ ~ ~(~~ ter- Section ~a S~ '/e ~/a i City. State Zip Code Phone Number , , ~_ I S ,. S Z~(O ` .s~(o trele one) T ' O N; R ~~•Te~W . 11. 'T'ype of Building (check al! that apply) ; ~ ~ „~, ,/ ~v ~S l Yl 2 F il D lli N b f B d r CSM Number t or am y we ng - um er o e rooms __~-____ _ v. l9 ~~'S( 6 `(~~S ~' ^ Public/Commercial -Describe Use . 7 o __ ____ _ _ ^State Owned -- Describe Use ^City_^ V illage L7l ownship of ~e%n }(,~i , Ill. 'T'ype of Permit: (Check only one box on line A. Complete line B if applicable) ~ I A. I ~~ew System ^ Replacement System ^ TreatmenUHolding Tank Replacement y ^ Other Modi ion to Existing System I B• ^ Permit Renewal ^ Permit Revision ^ Change of ^ Yermit Transfer to New List Previous Percrtit Number and Date Issued Before Expiration Plumber Owner / I 1V.'I' e of POWTS S stem: Check all that a 1 - j U Non -Pressurized In-Ground ^ Mound > 24 in. of suitable soil bound < 24 in. of suitable soil ^ At-Grade Single Pass Sand Filter ^ ~ - ~ ^ ~ Constncrted Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recireulating Sand Filter I i ' Recirculating Synthetic Media Filter ^ Leaching Chamber ^ Ihip Line ^ Gravel-less P' e Other (explain) ' V. Dis rsal/'I'reatmentRrea Information: x / 2. S ~~ = I (sf) System Elevation Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed ~~11 I DSO d _ D. ~ ~ _ T 0 DSO D~ ~ i -- te Steel F[ber I` pl P S ti 1 C i T l N b f ~~ ' re t as c a ac acturer m ota um er u I VL T k l an nfo W ~b~ _ 1 Gallons Gallons of Umts ~ UO oncrete Constructed Glass I I I I Ncw Existing ~'1 ('N ' Tanks Tanks Scpuc ur HolJing Tank ~gL~ (/~J ~ ~~p~ GK/ / es~• ~(:~,~Q ~ I'~ ~ Acrubie Tmatmcn[ Uni[ - - - e.p•- bri~a.~: ~n j Da.~in~ C:kurnbcr - / ~..y~ !.T ~ ~~ VII. Responsibility Statement- b the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. ~ ~ Plumber's Name (Print) P her' Signature / -M'P/MPItS Number Business Phone Number ~ i P t~r's Address (Street, City, State, Gi Code) ! oyD h~~~ ; ol~ ~~~/~~~, ~ /. s~o/~ Vlll. Coun /De artment Use Onl ~ ~ Approved I APP ~ Sanitary Permit Fee ('ncludes Groundwater Surcharge Fee) . Date Issued Is uin Agent Signal (No Stamp,) _ ^ Owner Given Reason ar Detual ~ ~~ ' DZ ~~ ; lX. Conditions of p rava SYSTEM 1 Septic tank, effluent filter and dispersal cell must all be serviced /maintained as per management plan provided by plumber. I n nn ,.,.ati,,..l.. rnmcn4c mutt he maintainari .G. r,rr va wuv.. ,vy.... ........ .......-._. __ .. as per applicable code/ordinances. A[tach complete plans (to the County only) for [he system on paper not Icss than 81/2 x I 1 inches in size SBD-6398 (R. 01/03) w i.~u - ~r~ • - --'~~. P9.80~'9 commerce.wi.gov i ^ ~sconsin Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www. comme rce.wi. gov/sb/ www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary January 20, 2005 CUST ID No.225036 MICHAEL P MC DONELL A.C.E. SOIL & SITE EVALUATIONS LLC 1070 HUNTER RIDGE RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 01/20/2007 ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 SITE: Brian Pawlak 130' Avenue Town of Glenwood St Croix County SW1/4, SE1/4, S30, T30N, R15W FOR: Identification Numbers Transaction ID No. 1102916 Site ID No. 694201 Please refer to both identification numbers, above, in all corres ondence with the a enc . Description: Proposed Three Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 1001112 Maintenance required; 450 GPD Flow rate; 7 in Soil minimum depth to limiting factor from original grade System(s): Mound Component Manual, SBD-10572-P (R.6/99), Pressure Distribution Component Manual -Version 2.0, SBD-10706-P (N.O1101); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with publication SBD-10572-P(R.6/99) "Mound Component Manual for Private Onsite Wastewater Systems". • The pressure network is to be constructed in accordance with publications SBD-10573-P(R.6/99) "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" and/or the sizing methods of publication "SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81)". • 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. • 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. The area within 15 feet horizontally below the system shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • 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 Comm 84 product approval conditions. p.p.~,+V.7.i. Cc~nditio~nally ~~ P R01J'~D MICHAEL P MC DONELL Page 2 1/20/2005 • Comm 83.22(7) - A copy of the approved plans, specifications and this letter shall be on-site durine construction and open to inspection by authorized representatives of the Department which may include local inspectors. 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. • Comm 83.52(1)(a) -The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. 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 Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, ~~~ Gerard M. Swim POWTS Plan Reviewer -Integrated Services (608)-789-7892, Mon. -Fri. 7:30 am to 4:15 pm j swim@commerce. state.wi.us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 T code: 7633 cc: James K Thompson , A.C.E. Soil and Site Evaluations (Plans Mailed To) Leroy G Jansky, Wastewater Specialist, (715) 726-2544 . 9Fc~ ~q /~ O sq,~ "l8 F MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN' ~~ ~~O,f Residential Application ~~// INDEX AND TITLE PAGE `~//'j~ s Project Name: Brian Pawlak 3 bedroom residential mound Owner's Name: Brian Pawlak Owner`s Address: 20466 county Rd. C Somerset, WI. 54025 Site Address: XXX 130th Ave. Legal Description: SW1/4 SE1/4, Sec. 30, T.30N., R15W. Township: Glenwood County: St. Croix Subdivision Name: na Lot Number: na Block Number: na Parcel I.D. Number: 016-1065-90-000 Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Site Plan Page 9 Soil Evaluation Report Designer: Mike McDonell License Number: 225036 Date: 12/29/04 Phone Number: 612-865-1927 Signature Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) Version 3.0 (03/01/01) pEPARTMfNT OF AND~gU~lD1iGS Page 1 of 9 p-vts~aN SEE CORRE ONDENCE Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) 'T_ R Residential or Commercial Design ~- 300.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 = 150%) 450.00 Design Flow (gpd) _ 2.00 Site Slope (%) ___100.20 Contour Line Elevation (ft) r 16.00 Depth to Limiting Factor (in) 0.40 In-situ Soil Application Rate (gpd/ftz) Distribution Cell Information ___112.50 Dispersal Cell Length Along Contour (ft) _ 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) C 1 Influent Wastewater Quality (1 or 2) Pressure Disribution Information (c or e) ! - c~ Center or End Manifold 0.00 Lateral Spacing (ft) 2 Number of Laterals _ 0.156 Orifice Diameter (in) (e.g. 0.25) ~____ 2.00 Estimated Orifice Spacing (ft) _ 2.00 Forcemain Diameter (in) C 195.00 Forcemain Length (ft) ----- 86.00 Pump Tank Elevation (ft) 3 $ZX Z~ ~h 4.55 System Head (ft) x 1.3 15.37 Vertical Lift (ft) 3.82 Friction Loss (ft) 23.73 Total Dynamic Head (ft) Note: Sand fill (D) calculations assume a Table 83-44-3 in-situ soil treatment for fecal coliform of <= 36 inches. 4.00 Cell Width (ft) Are the laterals the highest point _ in the distribution Y network? Enter Y or N If N above, enter the elevation (ft) r--,. of the highest point. ; _: 8.04 ft2/orifice Does the Forcemain drain back? ~-_ Enter Y or N 31.81 Forcemain Drainback (gal) 50.97 5x Void Volume (gal) 82.78 Minimum Dose Volume (gal) 30.16 System Demand (gpm) Manifold Diameter Selection in. dia. o tions choice -- 1.25 1.50 __ _ ----.. ---- 2.00 ____~_-- 3.00 Gallons/Inch Calculator (optional) Treatment Tank Information 646.00 Total Tank Capacity (gal) 1000.00 Septic Tank Capacity (gal) ~_ `_ 38.00 Total Working Liquid Depth (in) Wieser WLP1000\650 Manufacturer 17.00 gal/in (enter result in cell 649) Lateral Diameter Selection in. dia. o tions choice 0.75 i 1.00 ~ ~__,~_~ 1.25 I ~ i~-- 1.50 _~ jj x i x 1 2.00 x ~ ~ ~ 3.00 I ~~ x Dose Tank Information Effluent Filter Information 646 00 Dose Tank Capacity (gal) Zabel Filter Manufacturer 17.00 Dose Tank Volume (gaVin) ~A100 _ ;Fitter Model Number Wieser____ _ _ _~Manufacturer Project: Brian Pawlak 3 bedroom residential mound Page 2 of 9 Mound Plan View 1_ 1 /10 B • Observation Pipe .~'~"'~' K .,,. .,, :~:... ,s~ ....I• ~ 'F. . B ......................................... • L -r -1 _I -1 Mound Component Dimensions A 4.00 ft E 20.96 in B 112.50 ft F 9.50 in D 20.00 in G 0.50 ft 450.00 (ft2) Dispersal Cell Area 4.00 (gpd/ft) Linear Loading Rate H 1.00 ft K 10.50 ft z 9.70 ft L 133.49 ft J 8.37 ft W 22.07 ft 1540.89 (ft2} Basal Area Available 11.25 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 103.66 (ft) F ,,,,, 101.87 (ft)~• - . Dispersal Cell :: ~[~ :::::::: Elevation ~I H Dispersal Ce11 ~ 102.37 :~ ~ ~ ....... ~l~. , , , ,y-.. ,-,-, , . 2.0 % Site Slope Shading Key 10 ®Topsoil Cap ~~~~~ Subsoil Cap Q ~ : ~ : ~ : ASTM C33 Sand ~~-~`-?`--:` Tilled Layer ^5 0 Aggregate c 1.5 ft ~ o ~~ 0 ~ ~ 0.5 ft (ft) Lateral Invert 100.20 (ft) Contour Elevation Geotextile Fabric Cover Dispersal Cell 'Typical Lateral .:'tt.: A See lateral details on Page 4 for number, size, and spacing of laterals. Laterals are equally spaced from the distribution cell's centerline in the distribution cell (Ax6). Project: Brian Pawlak 3 bedroom residential mound Page 3 of 9 Center Connection Lateral Layout Daigram I P ~I IE X~IIExf2 I xf2~l Laterals & foroe main of PVC Soh 40 [per COMM Table 84.30.5) Hofer drilled on t he bottom of the lateral, • =Turn-u p v~' ba I Iva Iv®or of as n out pl u g equally spaced Number of Laterals 2 Orifice Diameter 0.156 in Lateral Diameter 1.50 in Orifice Spacing (~ 2.02 ft Lateral Length (P) 55.55 ft Orifices per Lateral 28 Lateral Spacing (S) 0.00 ft Orifice Density 8.04 ft2/orifice Lateral Flow Rate 15.08 gpm Manifold Length 0.00 ft System Flow Rate 30.16 gpm Manifold Diameter 0.00 in Total Dynamic Head 23.73 ft Forcemain Velocity 3.08 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and --- Comm 16.28 WAC ~_ Disconnect ~ 4 in. min. ~"!- _~~ Tank component is properly vented Wieser WLP1000\65 Ca acit 646.00 Volume 17.00 Manufacturer Gallons gal/inch Dimension Inches Gallons A 18.33 311.64 B 2.00 34.00 C D . _ _ 5.67 _.. 12.00 ~~ 96.36 204.00 Total ~ 38.00 646.00 3" Bedding er tank. _ ---_ _ Alarm Manuafacturer LevelArm __ Alarm Model Number ! DLV Pump Manufacturer !.,Zoeller Pump Modei Number',140 Pump Must Deliver 30.16 gpm at 23.73 ft TDH A B C D E- Alternate outlet location Forcemain diameter ~ 2 in. Weep hole or anti- siphon device P_ ump off elevation (ft) ~~ 87.00 Dose tank elevation (ft) 86.00 Project: Brian Pawlak 3 bedroom residential mound Page 4 of 9 Mound System Maintenance and Operation Specifications Service Provider's Name __ J. Thompson, Credential #30.021 Phone,715-248 7767 POWTS Regulator's Name ~ St. Croix County Zoning Phone ~ 715 386-4680 { System Flow and Load Parameters Design Flow -Peak Estimated Flow -Average Septic Tank Capacity Soil Absorption Component Size Type of Wastewater 450 gpd Maximum Influent Particle Size 300 gpd Maximum GODS 1000 gal Maximum TSS 450 ft2 Maximum FOG Domestic Maximum Fecal Coliform 1/8 in 220 mg/L 150 mg/L 30 mg/L >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Ins ect and/or service once eve 3 ears Should ins ect and clean at least once eve 3 ears Test once eve 3 ears Should test month) Laterals should be flushed and ressure tested eve 1.5 ears Inspect for ponding and seepage once every 3 years_ _ Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished .~~~~~........ ............... Grade \ , " " . 6-8" Diameter Lawn ~/- ~ ~ ~ ~ ~ ~ ~ ~ Threaded Cleanout Sprinkler Valve Box ~ Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Brian Pawlak 3 bedroom residential mound Page 5 of 9 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals (SBD-10691-P (N.01/01) and SSWMP Publication 9.6 (01/81)] 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 Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet fitter shall be cleaned as necessary to ensure proper operation. The finer cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the finer when removed from its enclosure. If the fitter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent fitter 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 addttion of biological or chemical additives to enhance septic tank performance is generalty not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Purr p 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 Svstem 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 BODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODS, 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 tt 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. Continaencv 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 tce 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 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Brian Pawlak 3 bedroom residential mound Page 6 of 9 HEAD/CAPACITY CURVE EFFLUENT & DEW ATER ING TOTA L DYNA MIC HE AD/CA PACIT Y PER M INUTE - . i - sl~ss 4i_ l a_T 3 ~ _ i 14>-, _~_ . FT. M. Gal. Ltn. Gal. Ltn. G21. Ltr5 Gal. Ltt Gal. LYS Gal. Ltt Gal. Utf Gal. LUa. Gal. Litt, GaL Lin. Gal. Ltrs. Gal. Lua. GIL Lln. I Gal lIIS _. 5 1.52 16,5 61 Id 106 A 167 7I 271 97 Jd2 9/ 351 106 d01 61 IN 61 231 Sd 720 155 SIJ 155 Sdi IS 170 ~- ~ ~ ~ ~ I f0 3.05 17.2 SB 37 17 N 179 6i 271 79 300 90 K1 100 na 61 731 61 IJ•1 Sd 210 t/d Sfd 151 571 i 15 179 - 10_6,10 1s 9 7 11 -- IS 9b ]6 1J6 J] T16 d2 310 59 22J 60 221 Sd 270 t)6 Sif 110 fJ9 i 15 170 -~ ~ _ 1 Is L62 --_~~~ a 30 6] 27d 7/ 260 57 211 59 223 58 220 121 161 177 50] i t5 170 ' __ ]0 9.1{ ~ 5] 101 65 7A6 f5 206 50 210 90 3{0 58 220 111 {71 117 W1 ~ a5 t/0 ' - ~ ~ ~ {0 11.19 ]0 111 ~16 114 16 173 55 206 75 26] 58 2I0 105 797 111 tJt , IS 179 ~- ~ ~ r- ~~~; -i - 50 162{ ~~ ~ -_- 11 10 7] IIS 51 191 Sd 219 58 120 90 3{1 100 ]79 ~I /9 110 ~- 60 1d3! _~~~~~ 15 S7 /] 161 ]6 136 Sa 720 I1 761 aJ 37 a5 170 ._ _ ,. I r ~ ~ 70 71.N ~ _- eo Lae 90 T7.{7 _ ~ I i ~ l ~ I -- T i1 r - --_- - ~ _ -- ]0 111 t1 SJ _ I r 10 3/ ~ s2 1s7 l /5 110 ]2 121 i s1 117 20 106 2 8 /0 gas 15 170 _ 5/ I0/T15_ COJ -~ J7 110 15 170 -. 100 30A6 - __ -. I - - - - ----1 1e 6d i i - -- 1t 19 ', /0 151 ~ ~I ~ i _ tt0 71A0 - -___ 7 26 d 30 JO to ' 110 .5 -------. 110 76 '- I ` LxY Vaire1 11_1_1__11' ~ 19.I5' _1_._._ D _ _ - -_76~_ _ _-~___L- '~ ~ eT 1J' I 115' 91' , nI' U' ' l ! WARNING: Model 185/4185 should not be subjected to ~, _ . - j I ~ , less than 30 feet TDH. ,. ~, t ~ ny ~i69 NOTE: For Head Capacity on Model 112, Industrial column-explosion proof pump, see FM0219. •~ 1 - i I r i j ) ... 00991- 1 i 1 11 I inn. I , I < , nitln / I.. i. iF1I'. ~ I I ) 23.73 i ~, ,~ ,, f , I ` 9H ~ { I - i ~. aip1l ' )'.) t+Vl /0 HU ~ VU tUV I'~'V '/U ~ f 1 V i'~C '~li:) ' '~ ~~, JnU S1U aUU n'Sl '~OJ b~V ~IIJw )'tH uirvulf 3©. /~ 9.,0. h?. /I'I~ ~~'mu r~ Sci.O,o~Y /12 ~c /'C9 c% WARNING: Model 293/4293 should not be subjected to less than 15 feet TDH. M 160 210 J20 100 1E0 560 610 720 E00 !60 900 1040 1120 1200 12D0 1360 1140 1520 009v01 ROW PER NINUiF P5 7o~G A' Sole: ~'= s/©' B~,a.n J°a.uJ/a~~ivP~w.f~ 5e.e. 30 T. o~'6/enu.Ynd s6. ~i,r Cv., c.J/. a '~ v O~ M ~ `~ ~ ~ ,~~o ~~ ~~~d ~~~~ d \ (~ 3~3~, o~ ~~ o~ ~~ 3 h C' ~ e Z ~ Z ~~ ~~ p~oPose ~ ~~i ~- /o ca.f,•on v ~'sc.{~. 5~d P. d, e . bu;,rol:.~ Sewn: 9S~ e~.,• hut~~ly u~coJe.al s,'.~ .z s~,(. ~o Pd.~. ~~~e.~;,, . T'o be iiJsu/a~cd 4s ~- Ctaefe b~nee+- `'C~ aG~i/eeJaV. . ~ p0. Z S'co.~Evu i i 3 ssu.ne.d ele~r. _ ~~•~' .' __ ~~ , a ------- _, - ,,fSoPR' ~~ e/ W i r ~ ~/~~~/ .~ ~ ~=. Prak;brt _~~ c, + IE . ' rl4 ~ I ~ n 3 Stc..r+Med n1n,P/t t!'e e. Elea: - ~i ~ loo. ~ Pro~sc~d ~'loc..nd at ~z.o7 X /33. y9'w/ i/X //Z.S isoe~a./ ee //. Tub (,~ /Q ,6e~./s a.~ /y ;r SS.SS' ~ %b' on F'ee,5 5~ e e.d a.-E z .oz' /3o~fl~ . v 4 L a d ,z w ,d P~.~o~9 JAN-19-2005 04:19 PM A.C.E. Soil & Site E~al 715 248 7764 P. 02 1a23 ` Witx~nsinAepei-tmerttdComma'ce SOIL EVALUATION REPORT papa (- of ,; Division of Safety and 13uildlttps In taooardanoe with Comm 85, Wis. Adm. Code A.C.E. 5dl 8 51te Evaluations At18Ch opmpfate ails on r not less then 8~i x f t irrctree in arze. Plan must County P~ Pape St. Cloix indude, but not IIIrI1lOd to: WdlCal and hor¢antal relbrenCO point (BM), dlrecuon and - - - -- - - - --• - -- .._ _ ... _ . _ percanl slops, scab a ditnemaions, north snow, and bcatlon end distance to nearest road, Parcel I.D. - __ 01CS-1065-90-U00 Please print alllnformat/on. Reviewed By - --- _._~. _...- ---Date - ---... _ pcru>nel IMormelian you prwido may bo used br r+eoondey purposes (Pnvecy t,ew, a. 15 f)4 !1) (m)) Property Owr'ier Property Location RandYThompson Govt. Lot SW 1/4 SE 114 S 30 T 30 N R 15 W Property Owner'si Mailing Address l.ot # Blook # 5upd, Name or CS1v1# 27135 130th Ave. _ _____ __ _ _ Gity State Zip Code Phone Number ~~ City J Village t/ Town Nearest Road Glenwood City i WI 54013 715-285-7107 Glenwood 130Th Ave. /J New Construction Use: t~ Resldentlal /Number of bedrooms 3 Code derived design flow rate 450 GPD J Replacement i:, PubIIC or commsrctal - Describe' Parent material OleCial Ttll _ - , ___ Flood plain elevation, if af?plicable na cen.ret comments and reovmmendatbna: install mound system et elev. 101.87 at 20" above 100.20' contour, I 1 I eor+np N :J Borino I L 4 9 ~ ~~~ - - ~ d Pk Ground Sutlaee elev. 9.7 tt. Depth to limiting factor ___in, _ _ SGiI AppIM,E;Wn RHt2 ~aot¢on j Depth Dominant Color Redox Desoripton Texture I Structure Coreistern;e [lound~ry Roots GP Oht' _ +n. Mtmsell Qu. Sz. Cont. Color Gr. 5z. Sh. '~ff#1 'Erl#2 1 ~ 0-4 10yr32 none sit ~ 2fsbk mvfr cs 2fmc 0.8 0.6 2 4-12 -~--.._. ~ 10yr4/4 none sit lthinpl mvfr cs -- w•. 2fm,1c 0.4 .__ - C.E _.. . 3 ~ 12-17 10yr5l4 none sit 2fsbk mvir . cw 1fm ~ 0.6 C.8 i 4 i t 7.26 7.5yr41!B f2f 7.5yrS18 sl 1 msbk dsh - 1 Vf 0.4 G.8 . -i---. _ .. -. - .._._. __ . _ ... _..._- -- - - - -........ _ i ~ , _ _ _. ... ~ ~~--.--~ arse eununa + uun pr euucwre mran e><pnsca u+ p+acC a+ru craun mrmr ms+urveu anu ,cunweu +r~+u+ rn~ wau L Z ~ t3onng ~ J e~^e ---t ~/J Pk 1 i D•5 ._--i`- --2 ~ 5-13 3 i 13-23 4 '. 23-313 5 ~ 36-51 .4_ ,, ....,,. AqurrsoN 10yr32 10yr4/4 10yr5/4 7.5yr4/6 7.5yr4/4 Ground Surface elev. 100.23 ft. pepth to limiting factor _2~ __ _ _in, -, Sorl Aq?IF;a!ron Ftetz Redox Description t]u.3z, Cent Color exture btruciure Gr. Sz. 5h. Consistence fiourdr~r/ Hoots _ GP 'Eff#t Of°t' _ 'Eifirn2 none sll 2f6bk mutt cs - 2fmc 0,6 C.6 none sit lthinpl mvlr cs 2fm,1c 0.4 O.E none sll ~ 2fsbk mutt cw 1im 0.8 QB m2d 7.5yr5/B 51 1 msbk mfr gw _ .. - - 1f --- , 0.4 Ct 6 m Qf 1 Oyr6IB2 ~ scl 1 csbk _.__ ~,fr _ - 0,2 0.3 - li#2 exhibits 1 t n p structure e m place and when I~sturbed and removed from pA well. ails"g,aG~s ob'serve3on pad laces in H'sM 3,4, &t5. ~~ ' Effluent #1 = 80D ~ 30 t 220 mg/L d TSS >30 < 150 g/L ant #2 = ®OD x_30 mg/L and T3S •~_~0 mgrL CST Name (Please Print) ipnalure' GST Nu+nWr James K. Thompson S ---_-- 3602 -- Address A.C.E. Soil & SNe Evaluations Date Evaluation Conducted Telephp~te Nwntar 340 Paulson Lake Lane. C•sceela. WI 54020 711420D4 ~~s-2aa-778r JAN-19-2005 Q4 :20 PM A.C.E. Soil & Site E~o.l 715 248 7764 P. 03 1 F roperty owner Ran tfy Thompson ~ Percrl ID # 016-1065A0~000 ~,,,,____~_. _ _ _ Ptaga ._ 2._,ot .. 3 _ ~ 3 ~ eotlnp M ~ ~r"a 99 76 16~~ D~rtt, to Ilmnlnq factor ft In. ! 5oif A~a,t,on Ra!e l J l~ p~ Oround 3urtt~a •kv. . . _. ~ -~ _ ~ . ._. Horizon Depth Daninent Cola edox De6piption Texture $truCtush I Ct3r1SislenCe Boundary Flc+ots _T~~~f'U.` E fftt2 in. Murrell Qu. Sz. Cont. Color ~ 1 0-5 10yr3I2 none _ tail 2febk ~ mvfr cs ~ 3fmc 0_8 _^ 0_ti _ 2 ~ Y5.16 10yr414 none ail ~ 1thlnpl mvfr ~ c9 2ftn,1 c - 0_4 ..~ 0.6 3 i 18.26 7.5yr4lB f2f 7.5yrSJe st 2msbk mvfr cw ~ 2fm 0 t~ 0.8 4 126-34 7,5yr418 m2d 7.5yr5/8 sl ~ 1 mabk mfr i gw ~f 0•d ~ E3 •-- - T 5~ ~_ 3450 7.5yr4/4 ~ m2d7.5yr5/8& f2f 10yr6/2 . scl_ ...-. lcabk __ rnfr ~__ . 1f • -~-r- • ---- U.2 D.3 --- - --- .. _ __ - ~--- H+t2 exhibits 1 thin pt structure when exposed in place and 2fsbk when disturbed and removed from pit wall. Sena grains observaG on pad facie in H':# 3,4, &S. .. _ j ~ Boring # ~.,~ Bering II,,... ^^ii j„~ p~ GrOUnd Sut'faCe elev. f Horizon Depth DOnliiTBrd Color Redox Descripib i in. Murrsell Qu. Sz. Cont. CC rt. Depth to ilmilinq factor _- __ __ in. Sal App+roatiari kale exture I Structure GonsiStenCe , l3o~naay~Rools- '21'C/.fl' _ Gr Sz Sh. 'Bfllit 'Ertrt i i.. I•~ ~- ..- ~.J Boring # J 9oring ,_.J J pk Ground Suridoeelev. _ Nor¢on ~ Depth Dominont Cola fleriox Desorption in. Munseil tau. Sz. Cortl. Caor 1 _ I _.. .- I__~....-..~.. i i .___..... -- i a-_ - .. -_.... _._._. _ ; _ • - ! - - i - f-- ---- .. _._ ~ --r..~__. - .. _, . _T. _.._ - -~- -. _... .__. ~._..._ . _._ ~ ___-~- i ~ ft. pepih to Ilmiting factor _ -- _ in. F;oii Applicaiirn Nat re Structure Cortsislence Ftol:n~q Roots ~~ft#1~~Eflii2~ ' Gr. Sz. Sh, i .._~_......._..--- -i------~-•-•-- ...---• ~i l ._..,. ..... -. - ---- I-_-- _._._ __. -.__ ' €ftluent sit = BOQ,T ~ ~ 220 mg/L and TSS >30 < 150 mgJL 'Effluent #2 ^ BODsc 30 mg/i_ and TSS ~ :i0 mg~L 7?IC ]:kpdrttIletlt of Commcn:C ie: 811 equal opportunity service provider and employer. If you Heal tissisu~,r~CC: to aCCf3:~ 1C1 JIC:C~ Ur need material in an altematt format, please Contact the dcpartmtnt at G08-26G-3151 nr f fY bJ i-2f4-R7"7. JAN-19-2005 04:20 PM A.C.E. Soil & Site E~al. .. 715 248 7764 P. 04 ^ So.% ublua~fii»~Q.E Scat r ~ ~s ~i ~~ '~ /~~3 0 V htAV~tr wooded s;~ ~`o. ~ s'c••~ ~ ,~~ e' ti v~ ~ ~•• RyF d) ~ r - V A t .: 11a:1 .n 3 S{~.~+,~ne.d n~.plc ti-tt. E1e~ • 4 c .~.... P~. 30'3. Wisconsin Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT in accordance with Comm 85. Wis. Adm. Code 1823 Page 1 of 3 A.C.E. Sal & Site Evaluations Attach complete site plan on paper not less than 8'/ x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I D percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. . . 016-1065-90-000 Please pr7nt a/l icat~tatian.o ., • R awed By Date Personal information You. ovide ~ ~ ~~p~is:(~fivvcrcY Lawi s. 15.04 (1} (m)). _ ~ used ~ 02 2~ ~ __ . Property Owner ~. 1 ' Property Location ~ i " ~ ~, Randy Thompson ~`- Govt. Lot SW 1/4 SE 1/4 S 30 T 30 N R 15 W Property Owner's Mailing Address ! Lot # Block # Subd. Name or CSM# 2785130th Ave. j ~ ,, ,~ : ,; City State~ZrQ Cod(~i1~iAtkie l5ttmb~er,,._,,, _._ ~ City J Vllage t~' Town Nearest Road Glenwood City ~ WI 54013 715-265-7107 Glenwood 130Th Ave. New Construction Use: Residential !Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement _,f Public or commercial -Describe: Parent material Glacial Till Flood plain elevation, if applicable na General comments and recommendations: Install mound system at elev. 101.87' at 20" above 100.20' contour. ~ U ~,-,1ar-r ~ ,~- Boring # ~ Boring Pit Ground Surtace elev. 99.74 ft. 17" in. Soil lication Rate t~ Depth to limiting factor -~~ App Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *Eff#2 1 0-4 10yr3/2 none sit 2fsbk mvfr cs 2fmc 0.6 0.8 2 4-12 10yr4/4 none sit 1thinpl •---> mvfr cs 2fm,1c .4 0.6 3 12-17 10yr5/4 none sit 2fsbk mvfr cw 1fm 0.6 0.8 4 17-28 7.5yr4/6 f2f 7.5yr5/8 sl 1 msbk dsh - 1 of 0.4 0.6 H#2 exhibits 1 thin pl structure when exposed in place and 2fsbk when disturbed and removed from pit wall. Boring # ~ Boring N..~ Pit Ground Surtace elev. 100.23 ft. Depth to limiting factor 23~in• Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ffz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eft#2 1 0-5 10yr3/2 none sit 2fsbk mvfr cs 2fmc 0.6 0.8 2 5-13 10yr4/4 none sit 1thi~~l mvfr a 2fm,1c .4 0.6 3 13-23 10yr5/4 none sit 2fsbk mvfr cw 1fm 0.6 0.8 4 23- 6 7.5yr4/6 m2d 7.5yr5/8 sl 1 msbk mfr gw 1 f 0.4 0.6 5 36-51 7.5yr4/4 ~Qf 10yr56/2 ~ scl 1 csbk mfr - - 0.2 0.3 H#2 exhibits 1 thin pl structure when a in place and bk when disturbed and removed from pit wall. Sand grains observed on pad faces in H's# 3,4, &5. * Effluent #1 = BOD ~ 30 < 220 mg/L an TSS >30 < 150 g/L ant #2 = BOD < 30 mg/L and TSS <30 mg/L CST Name {Please Print) ignature~ CST Number James K. Thompson ~ 3602 Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane. Osceola. WI 54020 7/14/2004 715-248-7767 Property Owner Randy Thompson Parcel ID # 016-1065-90-000 Page 2 of 3 Boring # --~ Boring /~ Pit Ground Surtace elev. 99.7fi ft. Depth to limiting factor 16" i . Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 1 0-5 10yr312 none sil 2fsbk mvfr cs 3fmc 0.6 0.8 2 5-16 10yr4/4 none sil 1thi~ I,L, mvfr cs 2fm,1c 0.4 0.6 3 i-26 7.5yr4/6 f2f7.5yr5/g sl 2msbk mvfr cw Zfm 0.6 0.8 4 26-34 7.5yr4/6 m2d 7.5yr5/8 sl 1msbk mfr gw 1f 0.4 0.6 5 34-50 7.5yr4/4 m2d 7.Syr5/8 & flf 10yr6/2 scl 1 csbk mfr - 1 f 0.2 0.3 H#2 exhibits 1 thin pl structure when exposed in place and 2fsbk when disturbed and removed from pit wall. Sand grains observed on ped faces in H's# 3,4, &5. ^ Boring # ~ Boring J Pit Ground Surtace elev. ft. Depth to limting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Descripiion Texture Structure Consistence Boundary Roots P in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *Eff#2 ^ Boring # ~i Boring J Pit Ground Surtace elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots / in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 Effluent #1 = BOD y> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS<30 mg/L and TSS <30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. d~ J o~ 0 • Ex~s~.~ ~~Q e~ea!. ~e~~ a 1~~3 h eft ~; t y ~v cfl~led s,'~ ~p0.15 ~con~ /" i i ~ yo 3Q.,~cl, wlv.r~t!' To,o off' ~ "!? d. ~ . , '' A ~° ~ 9 9. ~s ~% sr~Pc~ ,, ,, ^-____ - ----- -' fl If . 8• . ~ 11a~ I `.n 3 5~,c~„r2cJ ~-~" i :.,,., 1 /30~/4~ . ~. > .: .; ~~ v ~7 b v C ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer Mailing Address ~S/ ZS' Property Address ~7~ ~ /30~',4v~e . (Verification required from Planning Department for new construction.) City/State Parcel Identification Number D /~ _/OCo.S-9d L~ LEGAL DESCRIPTION Property Location SW '/4 , 5 L' %4 ,Sec. 30 , T 3o N R /S W, Town of ~ /e n u~~ Subdivision ,Lot # _~. Certified Survey Map # ? 7.~((p ~ ,Volume /q ,Page # 5/~4Cs` Warranty Deed # ~ 7 ~7~3 ,Volume aG ~/ ,Page #, /S'3 Spec house yes no Lot lines identifiable ~ no SYSTEM MAINTENANCE 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 § Comm 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County 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. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the 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 Zoning Depalrtment within 30 days oMf the thre-elyear expiration date. SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION Uwe certify that all statements on this form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the ~° descri above y e of a warranty deed recorded in Register of Deeds Office SIGNATURE OF APPLICANT DATE ****** Any information that is misrepresented may result in the sanitary permit being revoked by the Zoning Department. ****** Include with this application a stamped warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in. the warranty deed. I .U, 2681 P 153 STATE BAR OF WISCONSIN FORM 2 - 2000 Document Number WARRANTY DEED This Deed, made between Randy R. Thompson and Doris M. Thompson, husband and wife Grantor, atricia L. Meineke, a single person Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum: Part of the iSouthwest Quarter of the Southeast Quarter (SW 114 of SE I/4) of ~ection Thirty (30), Township Thirty (30) North, Range Fifteen (15) West, Town of Glenwood, St. Croix County, Wisconsin, more particularly described as follows: of One (1) of Certified Survey Map filed September 29, 2004, in me 19 of Certified Survey Maps, at Page 4845, as Document No. ?~, office of the Register of Deeds for St. Croix County, tsconsin. ~-.,~_ Exceptions to warranties: Easements and restrictions of record. ?7 :T 783 ~l KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO. , MI RECEIVED FOR RECORD 10/22/2004 10:00Ali MARRANTY DEED EXEMI~T ik REC FEE: 11.00 TRARS FEE: 254.70 COPY FEE: CC FEE: PAGES: 1 Recording Area Thomas A. McCormack Attorney at Law PO Box 2120 Baldwin, WI 54002 O1(r1065-90 Parcel Identification Number (PIN) This is not homestead property. (~ (is net) t- Dated this 13 day of (Jt~r,~ , 2004 - - ----- ~ _ I~~~~--''~- - -- * * Randy Thompson _` _ -_---- ---- 1l~IAa- Yh . ~m~- ---- * * Doris M. Thompson _`~ Signature(s) authenticated this * AUTHENTICATION day of , TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stets.) THIS INSTRUMENT WAS DRAFTED BY Thomas_A. McCormack _ _ _ _ _ ___ Baldwin. WI 54002 _ _ _ ___ (Signatures may be authenticated or aclaww{edgcd Both are not necessary.) ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. St. Croix County ) 3 ~~~ da of Personally came before me this _ y (7,L!~„ !` 2004 the above named Randy R. Thompson and Doris M. Thompson to me known to be the pers) who execu ~~tl~fRrggoing in a and acknowledg the same. .. ~ ~ '~; Notary Public, State of WISCONSIN *,'~ ~ ' • •- _ My Commission is permanent. (If not, ~sXate e:tcpua~e * Names of persons signing in any capacity must be typed or printed below their signature. l ''rb'(A ~ WARRANTY DEED STATE BAR OF WISCONSIN iMFO-PRO (a00~55-2021• • www.irNoprofom~s.cwm FORM No. 2 - 2000 FORM NO. 985-A ~er P.,., ~..,.......;.. 7 7 S Es 6 ~+ Stock No. 26273 VOL 19 PwGE 4845 40 corner ~ I Set 1' Iron Pipe !33' NW of fence corner ' NI / sw z 0 0 N N m CERTIFIED SURVEY MAP NO.RSCEivsn-r~loR-~tBCORD 04:00PM VOLUME 19 PAGE 4845 CERTIFIED suRVS1r MAP REC FEfi • 13.00 COPY FEfi: 3.00 PART OF THE SOUTHWEST QUARTER PACES: z OF THE SOUTHEAST QUARTER SECTION 30, TOWNSHIP 30 NORTH, RANGE 15 WEST, TOWN OF GLENWOOD, ST.CROIX COUNTY,WISCONSIN 9.00' U_NPLATTE_D LANDS Set 1' Iron Pipe f30' NW / SE 1073.90' N89'31'S2"E north of fenceline ~ 5W / SE 1054.84' ~ N89'42'36"E 27.70' OUTLOT 2 QOUTL~O Deed Quit Clain Deed Vol. 2659 Pg. 210 Vol. 2659 Pg. 2tl 30,959 sq.ft. 19,121 sq.ft. 0.71 acres 0.44 acres incl. r-o-w 18,873 sq. ft. 0.43 acres excl. r-o-w v 31.00' N o c,a rn w O ( u7 ~ ~ t zv ~~ ~~ `° l~ I~ v' ley 256.36' O0- S84'51' 51 "W OWNER/PREPARED FOR: Randy and Doris Thompson 2785 130th Avenue Glenwood City, WI 54013 z 0 0 w UNPLATTED _ c n LANDS N tD N N ~ l0 Cn V N o _._ ~ w w oD Cn cD 0 O LOT 1 1,137,860 sq.ft. 26.12 acres incl. r-o-w 1,116,511 sq. ft. 25.63 acres not incl. r-o-w 71.89' S28'35'14 10.17' 24.65 South )/4 Section 30-30-15 Found I' Iron Pipe Cn I o rn N j c.1 ~'! S it HIV 1'T7 GRAFTED BY: JB SURVEYING LLC 966 Rustic Rd 3 Glenwood City, WI 54013 / ''+' \ JOf1 A° * for w saeos atEwwppp om, soli tests builG~ng setbcci< lire p-~ ~ ...----- --..... ___ -------------..---- - ----N N 4 71' ' j °o_ 29.67' v S89'13'S3"W 788.29, _ _ 130th Ave _ 786.14' _ S89'35'01"W ,. _ _ 796.14' V ~_v. O'~ ~(o 211.94' ~( S04'33'09"W ~ _ fl _ 1853.68' f. . ~ '~S89'35'01 "W ~ lo.oo' ~ ~~~ ~2649.82'~ 589'35'01"W"" " SE corner Section 30-30-15 UNPLATTED LANDS Found 3/4' Rebnr Note: Each parcel on this map is subject to State and County laws, rules and regulations (i.e. wetlands, minimum lot size, access to parcel, etc.). Before purchasing or developing any parcel, contact the St. Croix County Zoning Office for advice. N Note: Outlot 1 and Outlot 2 are to be used for agricultural and recreational use only. No building development is allowed unless resubmitted for approval as a "lot". LEGEND SCALE: 1" = 200' North is referenced to the ~•~---•-••Government Corner (as noted) South line of the Southeast p..-.......Set 1.25" O.D. Iron Pipe weighing 0' 200' 400' Quarter of Section 30-30-15, 1.68 lbs./lineal ft. which bears 569°35'01"W 1St. Croix County Grid System) a,•....•••~.Set "PK" nail w/washer Page 1 of 2 Vol 19 Page 4845 Wisconsin Departrnent of Commerce IL E ALUATION REPORT Division of Safety and Buildings '~,~~1 ~ ,",;rh r v~u< A~tm ~~P 1870 Page 1 of 3 A.C.E. Soil & Site Evaluations - ~ ~ CouMy Attach complete site plan on not less t ~(1~n~ ~ ~ St. Croix ~ include, but not limited to: vertical nd hori of n mt {B dir percent slope, scale or dimemsion north nd location ~r~~tance nearest road. parcel I.D. 016 1065-90 O - Please p t a//~~f~ak~~M~Ft~E ' t G Re By _ e Da Personal information you provide may used for (Privacy Law, s. 15.04 (1) (m)). L,/ 6 ~~ Property Owner Property Location Brain Pawlak Govt. Lot SW 1/4 SE 1/4 30 T 30 N R 15 W Property Owner's Mailing Address Lot # Block # Subd. Name CS 20468 Co. Hwy. C Q ~~ (~ V ~ City State Zip Code Phone Number ~ City ~ Village ~ Town Nearest Road Somerset ~ WI 54025 715-246-5168 Glenwood 130Th Ave. ~X. Y 1r d' New Construction use: tJ Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD ~~ Replacement J Public or commercial -Describe: Parent material Glacial till Flood plain elevation, if applicable nor General comments ~~I and recommendations: No soils were fiound throughout area of proposed building site that meet A+4" code requirement. ~n /Y `. Boring # ~ Boring 9~~ in. Pit Ground Surface elev. Na ft. /.~ Depth to limiting factor Application Rate Soil Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ftT in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 *Eff#2 ' 1 0_. 10yr3/2 none sil 2fsbk mvfr a 2fmc 0.6 0.8 2 6-9 10yr4/4 none sil 1thinpl mvfr cw 2fmc 0.4 0.6 3 9-13 10yr5/4 f2d 7.5yr5/8 sil 1fsbk mvfr cw 1fm 0.6 0.8 4 13-21 10yr5/4 m2d7.5yr5/8 sil 1msbk dsh cw 1vf 0.4 0.6 5 21-37 7.5yr4/6 '"Zf?.SyrS/g & f2d 1 /2 sl 1csbk dsh - - Sand grains observed on pad faces in H#5. Boring # ~ Boring 1~' Pit Ground Surface elev. Na ft. Depth to limiting factor 7~~ in• Soif Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fts in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-5 10yr3/2 none sil 2fsbk mvfr cs 2fmc 0.6 0.8 2 5-7 10yr4/4 none sil 1thinpl mvfr cvv 2fmc 0.4 0.6 3 7-12 10yr5/4 f2d 7.5yr5/8 sil 1fsbk mvfr cw 1fm 0.4 0.6 4 12-20 10yr5/4 m2d 7.5yr5/8 sil Om mvfr cvv - 0.0 0.2 5 20-31 7.Syr4/6 Qd 1~ 2~ sl 1csbk dsh - - 0.4 0.7 * Effluent #1 = BOD ~ 30 <_ 220 mg/L a TSS X30 < 150 L Effluent #2 = BOD <30 mg/L and TSS <30 mg/L CST Name {Please Print) Signature: CST Number James K. Thompson ~--- 3602 Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, O 154020 11/30/2004 715-248-7767 / ° ,, Property Owner Brain Pawlak Parcel ID # 016-1065-90-000 Page 2 of 3 Boring # ~:~ Boring 1/ Pit Ground Surtace elev. Na ft. Depth to limiting factor 12" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 'Eff#2 1 0-5 10yr3/2 none sil 2fsbk mvfr cs 2fmc 0.6 0.8 2 5-12 10yr4/4 none sil 2fsbk mvfr cw 2fmc 0.6 0.8 3 9 10yr5/4 f2d 7.5yr5i8 sil 1 msbk mvfr cw 1fm 0.6 0.8 4 19-26 10yr5/4 m2d 7.5yr5/8 sl 1csbk dh - 1vf 0.4 0.7 ^ Boring # ~ Boring e) Pit Ground Surtace elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 *Eff#2 Boring # ~ Boring Pit Ground Surtace elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 'Eff#2 * Effluent #1 = BOD ~ 30 < 720 mg/L and TSS >30 < 150 mg/L ' Effuent #2 = BODS< 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. .• Parcel #: 016-1065-90-050 oa/os/2oo7 12:48 PM PAGE 1 OF 1 Alt. Parcel #: 30.30.15.4566 016 -TOWN OF GLENWOOD Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 09/29/2004 00 0 Tax Address: Owner(s): O =Current Owner, C =Current Co-Owner O -PAWLAK, PATRICIA L & BRIAN S PATRICIA L & BRIAN S PAWLAK 2770 130TH AVE GLENWOOD CITY WI 54013 Districts: SC =School SP =Special Property Address(es): " =Primary Type Dist # Description ' 2770 130TH AVE SC 2198 GLENWOOD CITY SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 26.120 Plat: 4845-CSM 19-4845 016-04 SEC 30 T30N R15W PT SW SE CSM 19-4845 Block/Condo Bldg: LOT 1 LOT 1 (26.12 AC) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 30-30N-15W Notes: Parcel History: Date Doc # Vol/Page Type 11/16/2006 838974 QC 09/05/2006 833797 OC 08/29/2005 804765 2876/442 EZ-U 10/22/2004 777783 2681/153 WD more... 2007 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: ~ast Changed: 07/26/2006 Description Class Acres Land ~ Improve \ Total State Reason RESIDENTIAL G1 1.000 7,500 '~ 204,900 212,400 NO PRODUCTIVE FORST LANDS G6 25.120 52,400 ~ 0 52,400 NO ~~ '~ ~ ~ Totals for 2007: General Property 26.120 59,900 204,900 264,800 Woodland 0.000 0 0 Totals for 2006: General Property 26.120 59,900 204,900 264,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: o Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 O.bO