Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
018-2009-38-000
Wisconsin Department of Commerce F PRIVATE SEWAGE SYSTEM Safety and Building Division - • INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)j. Permit Holder's Name: City Village X Township Ber ,Chris Hammond, Town of CS7 BM Elev: Insp. Elev: B M BM Description: ~ 9 p ( {~ V v' ~/~ / ' 1, ' `_ 'L ~ ~'l TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~.arr~. I Z6~ Dosing Aeration Holding TANK SETBACK I ORMATION TANK TO P/L f WELL / BLDG. Vent to Air Intake ~- ROAD Septi / ~ 2 ~ ~/ Z ( Dosing 2 ~ /til ~ Aeratio Holding s PUMP/SIPHON INFORMATION „ Manufacturer Demand GPM Model Number ff y / ~ / TDH Lift / Fric`i o~ ~ Systerp ale ~ TDH Ft • FW emam Len th ~ Dia. ~ ~, D' . to well County: St. Croix Sanitary Permit No: 463472 0 State Plan ID No: Parcel Tax No: 018-2009-38-000 Section/Town/Range/Map No: 04.29.17.1022 ELEVATION DATA STATION BS HI FS ELEV. Benchm~~ ~~ //$$~~)) t,/V6 Alt. BM Bldg. Sewer ~ V yZ• ~~ St/Ht Inlet ~. SbHt Outlet ~. /~.. Dt Inlet ~ /- Dt B~ ottom 6•~' S7 Header/ n. , l S- 3 Dist. Pipe ~~ ~ ~~ ~ ~, ~~ 9s .Y Bot. System ~ /,' / ~ /'~ / 0 ~ ~3 . Final Grade t~ ~ `~ / ~s f t /may (, St Cover i ~ ! ,, ~ ' ' I (. ~ /~ ~- 7~ ~c ~~• •a -R .~ SdIL ABSORPTION SYSTEM / Q S ~ ~ ~.fllfit2 ~ BED/TRENCH DIMENSIONS Width ` Length _ ~ / /VCVT No. Of Trench ~ PIT DI NS No. Of Pits Inside Dia. Liquid Depth SETBACK INFORMATION SYSTEM TO P/L BLDG WE L LAKE/STREAM ACHING CHA ,,, `~ ,. J /V~:I Typ Of System: ~ ~ ~ / ~ _ ~ 1 / UNIT Mod ~efs DJS'T~JBUTION SYSTEM ~ e f~r~.r r3 `Q, ~ dllJlt/~ /~.~-,off Header/ nifold 8 L h Dia Z ~ pistribution Pies ~ ~~ ~' ~ Length Dia_ Spacing~_ x Hole Size // x Hole Spacing __ Ve r_S Aul kes ,/ 7~- Gf1~a ~ RCII! C(~VFR „ o.-e~~~~re c„~re.,,~ nni.. ,.v Mnnnri nr Af_(:rada Svcfems t7nly / V u~~ ~'U Depth Over ~ Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center ~ Bed/Trench Edges Topsoil i Yes , ~ No Yes i No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 7 / t ~ / is ~n #2: I Location: .1787 119th AvenuefHammond, WI 54015 (SE 1/4 NE 1/4 4 T29N R1'7JW) Hillsid Heights. Lyo~t,3,,8 ~ Parcel No: 04.29.17.1/022 1.) Alt BM Description = ~ ~'~t" ~1Ni'I-~ ~~3 i~Oru'~-fa~~/0," ~~~ 6~ V3~,rr~~QMl~~~ 2.) Bldg sewer length = ~~ ~ ~ \~,', ~~,.v ? ; ~° ~ ~.,~~ ~ ~G~G ~ ~~ -amount of cover = I ~~~yVh L~ ~~ .~ ~1,~}~- ,5~~ G~~ 7 ~ ~ ~~S'_ _ -- ---- ---- Plan revision Required? ', es tirtio i ~ ~~ (J Use other side for additional information. _ _, ~ / - _~ - _ --.i ___ - - - r Date „- 1 ~ J In~p tor's Si a ~~ ~r~- ert. No. SBD-6710 (R.3/97) ~ ( ~~ j~_ ~ ~j~-. ~ J1~2~~ ~0 Safety and Buildings Division County ~ ~ t ' ' '~' 201 W. Washington Ave., P.O. Box 7162 i~~~ ~~ ~ri Madison, WI 5370 7 - 7162 it Number (to be filled in by Co.) Department of Commerce 266-3 1 ~E Sanitary Permit Appli n State Plan .D. Number In accord with Comm 83.21, Wis. Adm. Code, personal i a on you ovide ~.8 / ~ ~ ~~ may be used for secondary purposes Privacy 5. 4(1)(m) Protect Ad ress (if differe nt than m a ili ng a ddress) v Y T. Application Information -Please Print All Informatio ZONING OF ICS 44 g { r ,- f ~ ~ ~0~ I V ` " "~ ~J Property O ner's Name Parcel # Lot # Block # r t ~ ts~J .? ~d Z Z Property Owner's Mailing Addre s Property Location G ,- 5- ~.$~ (ice ~~~ ~ L-r/ y City State Zi C d P h %.> ., Section _ , ~ p o e one Number /~ t~ t~~ t dD ~ h (~~~ - / ~ ~ ~rcle o T ~ N R ~E II. Type of Building (check all that apply) ; _, or j~ 1 (1 2 Family Dwelling -Number of Bedrooms '7 Dk• ~„~e,(+ Su~O,i„~,; ~eGC Subdivision Name CSM Number ^ Public/Commercial -Describe Use _ ~ n\~,~ ^ State Owned -Describe Use ~,~, ~'n ,~ (.~ i 1 ~ /~~~ ~'i ~S_~w~ o - ~ - t ' ^City_^Village~£owrtship of III. Type of Permit: (Check only one box on line A. Complete line B if l i a p cable) ~ 9 _ _ d p A. ew System ^ Replacement System ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System B• ^ Petrrtit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. a of POWTS S s tem: Check all that a 1 -Pressurized ln-Ground ^ Mound > 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized In-Gro nd ^ Holding Tank ^ Peat Fi ter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^ Recirculating Synthetic Media Filter caching Chamber ^ Drip Line Gravel-less Pipe ^ Other (explain) V. Dis ersaUTreatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area roposed (sf) Sys VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Plastic Gallons Gallons of Units A- ~ ~ St Z Concrete Constructed Glass New Tanks Existing Tanks -- a, loe ~~~ Septic or Holding Tank ~ / o~ G.i ~ s ~ D` Aerobic Treatment Unit Dosing Chamber ~ D~ w~ ~~~ VII.. Responsibility Statement- 1, the undersigned, assume respons' ility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber' igna e MP/MPRS Number Business Phone Number ~ e ~ - a-s- ©~ ~ 7 s 3~', ~i3 ~ Plumber's Address (S t, City, State, Zip Code) ~~ /I ~ ~~• ~ s.~~~ / r ~~ tJGX.~ J ~ C VIII. C n /De artment Onl pproved ^ sapprove Sanitary Permit Fee (includes Groundwater Dat Issued Issuin ent Signa a tamp ^ ytt en Reason o ia] Surcharge Fee) ~l 3~ ~ vii IX. Conditions of ApprovaUReasons for Disapproval ~1(STEM OWNER: 1. Septic tank, effluent filter and dispersal cell must all be services /maintained as per management plan provided by plumber. 2. AA setback requirements must be maintained as Per applicable code /ordinances. wwp,cw p~aus tto me i.ounry onry~ for the system on paper uo[ less tpan 81/Z x II incees in size SBD-6398 (R. 01/03) !L ' ~. • '~Isconsfn Department of Commerce f11. :-:~~ -f G.~f~L. ..J o..:~.a...... Q SOIL EVALUATIO Oy~RT in accordance with Comm 85, _~~CF ode w #1664 Page 1 of 3 Steel's Soil Service, Inc. ~ Attach complete site plan on paper not less than 8'/: x 1 inches in size. Plan must St. Croix include, but not limited to: vertical and horizontal refer nce point (BM), direction and arcel I D percent slope, scale or dimensions, north arrow, and I catior~r~dis~r~e torfree,+rest r L~ ~U U~ JJ ad. . . Pending Please print all informa n. Reviewed By Date ~~~n1 ~I Personal information you provide may be used for secondary` urpos~ ~Y~~T~ (1) ( )). .S ~ d Property Owner n Cutting Edge Four, LLC Govt. Lot na SE1l4, N /4, S4, T29N, R17W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# E976 170 TH Street ~ ~^ na Hillside Heights City State Zip Code Phone Number ^ City ^ Village ^ Town Nearest Road Hammond WI 54015 715-796-2793 Hammond C Rd T ^ New Construction Use: ^ Residential /Number of bedrooms 4 Code derived design flow rate 600 GPD ^ Replacement ^ Public orcommercial -Describe: na Parent material Ground and end moraines, pitted glaical drift Flood plain elevation, if applicable na ft. General comments Conventional system, system elevation 94.90ft. Trenches spwced and depth to code 4.OOft below grade. and recommendations: ci`•, ~ I ~ ~ ~~i''0_-u~U'G~ N~EL/i~~ ~ ~ S 1 !' 1.(A//~'{/~~'~ w~,~ 7 ~ ~ '~ f0 "T~ /' - • yr/ </_ . - ~v ~"I~.." Boring # ~ ~ Ground surface elev. 98.90 ft. Depth to limiting factor 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consisten Boundary Roots GP D/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-6 10yr3/1 none sil 2msbk mfr cs ivf .6 .8 2 6-16 10yr4/4 none sicl 2msbk mfr gw n/a .4 .6 3 16-37 10yr4/4 none scl 2msbk mfr gw n/a .4 .6 4 37-$0 7.5yr4/4 none sl 2msbk mfr cs n/a .6 1.0 5 80-120 7.5yr4/4 none cos osg ml na na .7 1.6 1~ n // `b Boring # ~ ^ Ground surface elev. 97.70 ft. Depth to limiting factor 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consisten Boundary Roots GP Dffts in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#'I 'Eff#2 1 0-10 10yr3/1 none sil 2msbk mfr cs lvf .6 .8 2 10-22 10yr4/4 none sicl 2msbk mfr gw na .4 .6 3 22-75 10yr4/4 none sl 2msbk mfr a n/a .6 1.0 4 75-120 7.5yr4/4 none Is osg mfr n/a n/a .7 1.0 d w ' Effluent #1 = BODS> 30 <220 mg/Land TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) i nature: CST Number David J. Steel - 248956 Address Steel's Soil Service, Inc. ~ Date Evaluation Conducted Telephone Number 994 200th St. Baldwin, WI 54002 4/26/2005 715-760-0347 i Jtlll-833U IKU/!UU I Pr6perty Owner Cutting Edge Four, LLC Parcel ID # Pending Page 2 of 3 Boring # ^ Ground surface elev. 97.40 ft. Depth to limiting factor 120 in. ^ Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fts in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Etf#t *Eff#2 1 0-li 10yr3/1 none sil 2msbk mfr cs if .6 .8 2 11-26 10yr4/4 none sicl 2msbk mfr gw n/a .4 .6 3 26-56 10yr4/4 none sl 2msbk mfr cs n/a .6 1.0 4 56-120 10yr6/4 none cos/Is osg ml n/a n/a .7 1.0 d 3~ ^ Boring # ^ Ground surface elev. ft. Depth to limiting factor ^ ~n• Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'E~t `Eft ^ Boring # ^ Ground surface elev. ft. Depth to limiting factor in. ^ Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eft#t *Eff#2 * Effluent #1 = BODS> 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 deparhnent at 608-266-3151 or TTY 608-264-8777. SBD-8330 (R.07/001 StE21'S Soil Servke. Inc. STEEL'S SOIL SERVICE INC. 3of3 David J. Steel Cutting Edge Four, LLC 994 200' St. CST-POWTSM SE1/4,NE1/4,S4,T29N,R1&W Baldwin, WI 54002 Lic. #248956 Town of Hammond, St. Croix Co. Cell (715) 760-0347 Hillside Heights, Lot 38 Fax.(715) 684-3449 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. ' Legend N 100.00 ft 100.00 ft Boring Elevations B 1 = 99.90 ft B2 = 97.70 ft B3 = 97.40 ft ~~3 >' .~ 3 r '~3' ~o~ ;;~ ~~/ r G t~ ,!/' / ~ i ~~ ~ ~ ~ 1" = 40' • =Benchmark Ele. Top of 3/4" pvc pipe • =Alt Benchmark Ele. Tnn of 3/4" nvc nine _~ S > ~~ ~. ,33 ~ ~ ZS J J/ ~ I ~-~~ i ~ l ~ ~I _ ~ ~ \ ~ , ~ ~ ~ ~ 89°3~7 51 W 625.185 \ ~ ~~ \ ~ / \ ~ ~. 1 ~ ~ ~ ~ ~ 65499 S.F. \ ~ 1 ` rn 1 1\ \ F ~~ \~ ~ o ~~ 1.50tiAc._ 1 ~ ~ ~ 1 \ W ~ \ N.B. 6541J9-SfF. / ~ / ~ ~ 1 ~1 ~7 1~ ~ \\ ~~ \ ~ J ~ /l i I l ~ \ - ~ ~ N.B. 1.50 Ac. / ~ ~ / 1 ,T 7 0 657 6 S.F. ~ ~ 6516 S~ \ ~.~-8`}'20 ~~ / 1.~1 Ac. ~ o ~ ~.50 Act ----~~O:fis7 / i 1 •~ 1 / / / / 0 N~B. 60789 F. ~ N.B. 655~~6 S.F. / ~ I Z ' . ~. 1 6539 S.~'. / I ~ N`.B. ,.4d a~. ~ / N.B. ~~o Ac. w / 1.50` A~ / t d'• Z ~ / ~ / V ~''~ N.B. 6 93'~S.F. / / 1 I~ ~ ~ ~ ~ f / ~ N.B. 1 ~50(Ac. ~ / ! ~ ~ , ~ 4.5-g' - / =-~ :"~16~~'~ ~ ~ ___~f-_-86'~~„ ~ x_5.9-8/- ~ ~_ ~ 16/7.401 N ~ 9.28, „ W ~ 218.58' l____-~-, I / j c,~ 0 ~ X330 1' -~ ~~ / ' ! ~ /~ ~ q~__ \ , ~ ~ , ~ ~ ~ ~ ~ (10744 S.F. /I ~; ~ ~ / I ~ ~ ~~ \ 9~ ,,, 1.62 Ac. I 7792 /S.F. / ~,, _ 6k40~ S.F! ~~~ '~,, I : / 1.56 /Ac. / Io . f" ~ 1 ~ ~ ~~ / ~ N.B. 7m744 S.F. I / / ~1 .50 AC. ~ 79894 ~~S.F~ N.B. X1.62 Ac. / / I j ~ I / I~.B, 6779 S.F. / I ' ~ 1.83 ABC. / N.B. 1 6 Ac. N.B.~ 65409 .F. C / / ~ ' // / N.~. 1.501 A ~ r N.B. 79894 S.F.\ ~ / ~-'-~ I /~ ~ ~ ~ / ~ ~ N.B. 1.83 Ac. / ~ ~ ,L 1 p/ ~~ / ~ ~ ~ y-~l--fig- ,~ ~ ``~ S-Q-~`-1 ~-- I ~~~ ~: S ~~ ,c. ~~~~ Legend 1" = 40' ~ = Benchmark EIe. IOO;OOF`C Top of 314" pvc pipe • =Alt Benchmark Ele. 100:1 SFt Tap of 314" 1~ pipe n = B Boring Elevations B 1 = 47.65Ft B2 = 97.65Ft B3 = 95.85Ft B4 = OO.OOFt ~~r~,(t~ (0 3 o (~ 7r i'b~ r'~ ~~ '~ 3~, - ~a~ ~ o+ $rr-. ~ ~~ , ~ ~p ~~f ~-~ ~y 1 ~j(.~~r ~ o~ J ,r S' 4s~ t' %~n . . ~..; ~- Q ~9 ~'~~ ~~r~ 1 -~vcs~,. a6~os' .., ~ 1• /.cal <0 2 j ?~.~s- Legend ' 1" = 40' ~ =Benchmark EIe. I OO;OOFC Top of 3/4" pvc pipe • =Alt Benchmark Ele. 100.15Ft Tqp of ~4" 1~ 1~Pe D =Borings Boring Elevations BI = 97.65Ft B2 = 97.65Ft B3 = 95.85Ft B4 = OO.OOFt ~O ~a t ~, /~. a~ ~ } r . ~4s `~K ~'~- _. .b~s' 9~;k- l'7.6s- TDH Calculations TOTAL DYNAMIC HEAD CALCULATIONS Gravity or Pressure Dosed Systems lot 38 Owner's Name 5/12/05 Review Date X g X YorN y Gravity Dosed, or Pressure Dosed Forcemain Drainback gpd ft in Design Wastewater Flow Total Combined Lateral Length Lateral Diameter ~v ft 2 in 20 gpm ft 1 ft ~ 0.55 ft Forcemain Length Forcemain Diameter System Flow Rate Minimum Design Head Vertical i Forcemain Friction Loss , 12.55 ft Total Dynamic Head 2.04 ft/sec Forcemain Effluent Velocity Choose Pump That Discharges At Least: 20.00 gpm at 12.55 feet TDH Maximum dose volume is >20% of design wastewater flaw gal Maximum Dose 0.0 gal 9.79 gal Forcemain Drainback 9.79 gal #VALUE! gal Maximum Dose Volume 9.8 gal 5x Lateral Void Volume Forcemain Drainback Minimum Dose Volume Version 4.1 (07/03) Chamber SAS SYSTEM ELEVATION AND SIZING CALCULATIONS Below Grade Soil Absorption Systems lot 38 Owner's Name 5/12/05 Review Date ~~n ~',Y or N Highly Pretreated Effluent 3 ft Suitable Soil Below System ~ 12 in Chamber/Unit Height2 8 ft Maximum Bury Depth s 600 gpd Estimated Daily Peak Flow 0.60 gpd/ft` In-situ Wastewater Infiltration Rate 91.65 ft Proposed SAS Elevation Soil Boring Number Surface Grade Elevation ( 1 97.65 2 97.65 3 95.85 Ezflow EZ1203HP & EZ102H ~ 1000.00 ft` Chamber/Unit Area 50.00 EISA ft2 /Unit 20 # of Chambers/Units 26.50 Bottom Area ftL /Unit Limitation SAS Elevation (ft) Acceptable System Depth (in) Lowest Highest Elevation? 120 90.65 96.65 Yes 120 90.65 96.65 Yes 110 89.68 94.85 Yes 1. Depth of suitable soil required below the infiltrative surface for treatment. 2. Total height of chamber in inches. 3. Maximum bury depth as per manufacturer's recommendations. 4. Based on chosen system elevation, and chamber height. Top of chamber is finished grade may be required to meet minimum or maximum code standards. Finished Grade EL 4 (ft) mum Minimum Maxi 93.65 100.65 ersion 4.0 • TOTAL DYNAMIC HEADIFLOW ~ ~ PUMP PERFORMANCE CURVE PER MINUTE MODELS 53/55/57/59 EFFLUENT AND DEWATERING g 20 a Q w v 15 z 4 r 0 10 i-- 0 ~ 2 5 MODEL 53/55/57/59 Feet Meters Gal. Liters 5 1.5 43 163 10 3.0 34 129 15 4.6 19 72 Shut-off Head: 19.25 ft.(5.9m) oosas7 10 20 30 40 50 GALLONS LITERS 0 80 160 FLOW PER MINUTE CCNS~LT i=i~CTGRY 1=CSR PE+CIAL ~APPLiCATIDN VariableJevel float switches available. Variable level long cycle systems available. • Available with special cord lengths of 15', 25', 35' and 50' Alarm systems available. • Duplex systems available. Sin le Seal Co ntrol Selection Listin s Modet Volts Phase Mode Amps Simplex Duplex CSA UL M53/55 & M57/59 115 1 Autc 9.7 1 ----- Y Y N53155 & N57/59 115 1 Non 9.7 2 3 or 4& 5 Y Y * BN53 115 1 Auto 9.7 Y Y BN57 115 1 Auto 9.7 * ----- N Y * BE53/57 230 1 Auto 4.8 * Y Y 053/55 & 057159 230 1 Auto 4.8 1 Y Y E53/55 & E57159 230 1 Non 4.8 2 3 or 4& 5 Y Y `Single piggyback switch includetl. A CAUTION ForinformationdnadditionalZoellerproductsrefertocatalogonPiggybackVariableLevelFloatSwitches, FM0477; All installation of controls, protection devices and wiring should be done by a yualir'ied EI13ctricalAlternator, FM0486; MechanicalAlternator, FM0495; SumplSewage Basins, FM0487; and Single Phase licensed electrician. All electrical and safety codes should be followed including 'the Simplex Pump Control/Alarm Systems, FM0732. most recent National Electric Code (NEC) and the Occupational Safety and Health yct (OSHAI. RESERV'c P~~~ERE1~ DEIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MA1L T0: P.O. BOX 16347 ~ ~~7j ~7 .~/~'~``~_ Louisville, KY 40256-0347 Manufacturersof.. ~ ~~V ~iJ~ SHIP T0: 3649 Cane Run Road ® ~ ® Louisville, KY 40211-1961 Vi1L/TY~UA~PS,./iNCE ~~iJ,'9~~ (502J 778-2731. 1(800) 928-PUMP http:Jlwww.zoellercom ~ PVMP CO. FAX {502) 774-3624 3 7/8 ~{~- 6 3116 IFS-- 4 518 - i i i i I touts ~ I i i i I SELECTION GUIDE - 1 1/2 -tt 112 NPT 3 7/8 i a 3 3132 SK858 1. Integral float operated mechanical switch, no exlemal control required. 2. Single piggyback variable level float switch or double piggyback variable level float•switch. Refer to FM0477. 3. Mechanical alternator "M-Pak" 10-0072 or 10-0075. 4. See FM0712 for correct model of Electrical Alternator. 5. Variable level control switch 10-0225 used as a control activator, with Electrical Alternator (3) or (4) float system. © Copyright 2004 Zoeller Co. All rights reserved. r ?~ r . 4..- ,x `/ ' >' SOIL EVALUATION REPORT Wisconsin Department of Commerce ~' >/~C~L; Division of Safety ~1nd Buildings in accordance with Comm 85, Wis. Adm. Code 1516 Page 1 of 3 Steel's Soil Service, Inc. 1."`A ` tY Coun Attach complete site ptan®a~~perri~t~ than 8% X 11 inches in size. Plan must '" St. Croix include, but not limited to: verticel ~ndntal ref ence point (BM), direction and percent slope, scale or dimemsions, north a location and distance to nearest road. Parcel I.D. Pending Please print all information. Revie d By Date Personal irdomurtion you provide may be used for secondary purposes (Privacy taw, s. 15.04 (1) (m)). 5 ~ ds Property Owner Property Location Cutting Edge Four, LLC Govt. Lot n/a SE 1/4 NE 1/4 S 4 T 29 N R 17 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# E976 170 TH Street 38 N/A Hillside Heights City State Zip Code Phone Number J City ~ Village ~I Town Nearest Road Hammond ~ WI 54015 715-796-2793 Hammond Cty Rd T 1~ New Construction Use: YJ Residential / Number of bedrooms 4 Code derived design flow rate 600 _f Replacement J Public orcommercial - Describe:n/a Parent material Ground and end moraines, pitted glaical drift Flood plain elevation, if applicable n/a General comments and recommendations: Conventional system, system elevation 92.65 ft. Trenches spaced and depth to code 5.00 ft below grade. - ~- GPD Boring # J Boring ~J Pit Ground Surface elev. 97.65 ff. Depth to limiting factor 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 *Eff#2 1 0-11 10yr3/1 none sil 2msbk mfr cs 1f .6 .8 2 11-26 10yr4/4 none sicl 2msbk mfr gw n/a .4 .6 3 26-56 10yr4/4 none sl 2msbk mfr cs n/a .6 1.0 4 56-120 10yr6/4 none cos/Is osg ml n/a n/a .7 1.0 u a `,Q (.e Boring # Boring ~/ Pit Ground Surface elev. 97.65 ft. Depth to limiting factor 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft= in. Murrsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-15 10yr3/1 none sil 2msbk mfr cs 1f .6 .8 2 15-37 10yr4/4 none scl 2msbk mfr gw 1vf .4 .6 3 37-66 10yr4/4 none sl 2msbk mfr gw n/a .6 1.0 4 66-120 7.5yr4/4 none Is osg mfr n/a n/a .7 1.0 lv ~~ ~ ~~ "Effluent #1 = BODS> 30 <_ 220 mg/L and TSS >30 < 150 mg/L "Effluent #2 = BODS < 30 mg/Land TSS < 30 mg/L CST Name (Please Print) 'gnature: _. CST Number David J. Steel 248956 Address Steel's Soil Service, Inc. Date Evaluation Conducted Telephone Number 994 200th St., Baldwin, WI 54002 9/7/2004 715-684-5680 r ' Property Owner Cutting Edge Four, LLC Parcel ID # Pending Page 2 of 3 Boring # ~ Boring 1~ Pit Ground Surface elev. 95.85 ft. Depth to limiting factor 100 in• Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots PD in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-10 10yr3/1 none sil 2msbk mfr cs 1f .6 .8 2 10-28 10yr4/4 none sicl 2msbk mfr gw 1vf .4 .6 3 28-50 10yr4/4 none scl 2msbk mfr gw n/a .4 .6 4 50-110 7.5yr4/4 none sl/Is 2msbk mfr n/a n/a .6 1.0 1~ ~0 t` (~ l!/ ^ Boring # ~( Boring ~ Pit Ground Surface elev. ft. Depth to limiting factor in. Sol Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ^ Boring # -J Boring J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Applicaton 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 = BODS> 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. r Page 3 of 3 STEEL'S SOIL SERVICE INC. David J. Steel 994 200' St. CST-POWTSM Cutting Edge Four, LLC Baldwin, WI 54002 LiC. #248956 SE1/4,NE1/4,S4,T29N,R17W Bus.(715) 684-5680 Town of Hammond, St. Croix Co. Fax.(715) 684-3449 Hillside Heights, Lot 38 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. Legend 1" = 40' • =Benchmark Ele. I OO.OOFt Top of 3/4" pvc pipe • =Alt Benchmark Ele. 100.15Ft Top of 3/4" pvc pipe ^ =Borings Boring Elevations B 1 = 97.65Ft B2 = 97.65Ft B3 = 95.85Ft /~`I.~z B4 = OO.OOFt c? l~ ~~~~ ~~.- ~~ ~ `~ `~~~~1~ ~~y~ obi % ~~ ~- ~-n ~ ~~ab Co 3 ~ a~ 7 q3 ,~ ~zr ~.y ~~ !~ / ~D r - ~~~ ~~ 33 ~'4s~ ~~ ~ ~~ ~ ~~ ~ N 89'37'51' W \ ~ ~~ ~~ • \ II 1 N ~ \ ~ ~~ ~ 89°37 51 W 625.185 \ ~ ~~ \ ~ ~ \ \ \ \ ~ J 1 \, ~ ~ rn \ 65499 S.F. \ ~ I I ~~ ~ ~~ `\ ~ o ~\ 1.50 Ac._ I C I I • s \ ~~ \1 W ~ 3~ ~ ~ ~ \ N.B. 654~J9-SfF. ~ / / ~~ /~ I t ~ \I } \, ~ - \ \ N.B. 1.50 Ac. ~~f ~ / ; \ / 1 0 657a 6 S.F. ~ ~ 6516 S~~. \~____- X20 _,~ / ~ / ~~ ~ /l ~ ~- l ~ l ~~ I I •, fd~B. 60789F. / N.B. 6551E S.F. I 4~/ / / / I Z ' l 6539 S.~. / I ~2 N~,B. 1 /4d Ac. ~ ~ N.B. 1~0 Ac. W ~ f 1.5q( A~ ~ / cp, 2 O // /~ ~/ W N.B. 65}393S.F.~ // 1 ~ ~I / / ~ i / ~ N.B. 1 501 Ac. / / , / ~ ~ 4.5~' / '-~ 16~'i / ~ ---I~--86 ~ f ~-•t-~8i5.9-g!- ~ I 1~ / 16/7.401 N ,~9~ W ~! 218._ //---I--, I o / ~ / 330.,81 ~ i t / ~ ~ \ t I I rh 4'3- '~ ~ ,~ \ZI ' 1 ' , ~ ~ \ '10744 S.F. I ~ ~ / } I ~1o r 9 1.62 Ac. LL ~ Oo i \ 1 / f~7792 / .F. / ~,, .. 6 40~ S.F I ~ '~-, ~~ 1 : / 1.56 lAc. / I o ~ I 7 • / / ~~ / ~ ~ N.B. 7t~744 S.F. ~ / 11 .50 AC. ' ~ 79894 ~S.F~ ~ N.B. /1.62 Ac. / / / I ~ I >6 / ~ / 1 I.B. 6779 S.F. / 1 1 ~ 1.83 ABC. / / 1 N.B. 1 6 Ac. / / N.B.1 654091 .F. Q / 1 N.~. 1.50 A \ f N.B. 79894 S.F. / ~ / ~ ~/ // ' ~ / C ~ } N.B. 1.83 Ac. / / / `Z ~ / ~~ ~ ~ _ ' I ~~79' ~ .~ i 5-0-11 ~-- I ~- - - ~--~__ U / ~ i/ l ~ J ----_ ~¢- ~, ~- ~ } CQ ~ a s' , 1 ~ I ~' Z \ o ~ ~ ao ~ ti, s~~.-~ ` 9 ~~ ~~ tied ,~ 6.20 /, b i ~ 6 ~ - _ ~ ~ _ _~ , _ ~ `-- C54 ~3~ ~„ ~ 3%306.16 , , ~s~ _ _ _ _ C 5 3_ / 18 1 ~ ~ - _- -`~ S ~ p3'4 ,~ 5 2 _ ~=96'L~b l M ~,OZ, lS.ZO S M C~ _ ~' _ N , , ~ g~, / , i ~~ 50 ____ ~-- __ C4 ~ _ _ _ _ ~ ~ ~ ,96'L~ L ~ s ~ C42 ~ ~ ~ ~ ~I ~~I I,-' ~, ° 40 ~n I ~ I ~ I ~ ~ ,~ I N~ 5,13 W v NI O v I I o~ I ~ I tri n- I ~ Q ~I ~ I~ ~ ~ w~ Q ~V ~''~~ I z to a, ~° ~ I ~~~' Q ~~ I ~ ~ ~ O ~p w c0 ~ I 0 cp ~ cv w 00 ~ °°I ---I E-i ~~ I m Z N c~ I ~ I / ~ ~,8Z~L0.00 N ~ I C I ~- z1 ~ ~' ~N ~ I •= I cNO ~ I 226.00' 176.33 /' 0$ ~ " °'I I --- ~Zp~O ~ ~ ~ I ~'-' '~ i ~ N 00'51'10" W 402.33' ~ IN ~ ~~~ I I ~ I n I C I ~ v I-~ rn d- Q ~°~ I n'~ ~Q co of ~h~ - _ _ I I ~ ;~ i ~~ 00 ~ I co ~ I~ I rn I ~-- ~~ o ~ ~„~ I o ~- _ _ _ ~ ~ ~ 3 „Z~b,8 1. LO N~ N I cn ' z ~ - - - `D - - - -I ~I ol~ ------ ~ ~'~/ ~ ~ I\ ~ ,08' 10~b ~ „0,90.00 N I ~I , ~~~ I N ~~o/ ~ I°~I ~~ I~~~~~i I~ ~ I cNO~ ~ ~ Q ~ ~ zh ~i I I ~i ~~ I ~ ,LL • LLB I I ~ I ~ ~ L~' l0~ I / ------J ,00'9 ~I~--!' -._.-- --- ~ ~ ~ z ~b/ ~~N ~H1 ~0 Z/ ~~ ~H1 ~0 ~NI~ 1S~M r ~ .~-w a U F- p p ~a°w `` ~, ~w W ~Z6'99 ~Z ~«60~ZZoDON dNZp Jpr l°.(~ U (n wow ~Z3 r` Q Q - o ~ ~ Q ~ F- ~-' ~a~l~ Q~~C7~t]~IG~lC~1 bmawal~xo ~ ~ aoUwmm w~ O ._~ ~:_..~ ~ ~~'`~ SOIL EVALUATION REPORT Wisconsin Depa nt of Commerce% ~ zOQ~ Division of Safety.. d Bui~ijn~s~ in actor ante with Comm 85, Wis. Adm. Code Zp O~XCOU J y t L'' Y i it W cy S K l.,t-t/r. 1516 Page 1 of 3 Steel's Soil Service, Inc. NT~ N - County ~ Attach complete site n 8'/: 11 inches in s¢e. Plan must St Croix include but not limited to: verb ntal ref nce oint (BM} direction and . , p , percent slope, scale or dimemsions, north arro location and distance to nearest road. Parcel I.D. P Pending lease print al/ information. Reviewed By Date Personal information you provide maybe used for secondary purposes (Privacy l.aw, s. 15.04 (1) (m)). Property Owner Property Location Cuttin Ed a Four, LLC Govt. Lot n/a SE 1/4 NE 1I4 S 4 T 29 N R 17 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# E976170 TH Street 38 N/A Hillside Heights City State Zip Code Phone Number ~ City Village Town Nearest Road Hammond ~ WI 54015 715-79fi-2793 Hammond Cty Rd T New Construction use: ~ Residential / Number of bedrooms 4 Code derived design flow rate 600 Replacement _j Public or commercial - Describe:n/a Parent material Ground and end moraines, pitted alaical drift Flood plain elevation, if applicable n/a General comments and recommendations: Conventional system, system elevation 92.65 ft. Trenches spaced and depth to code 5.00 ft below grade. GPD ^ Boring # J Boring 4~1 Pit Ground Surface elev. 97.65 ft. Depth to limiting factor 120 in. Soil Application Rate 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 0-1.1 10yr3/1 none sil 2msbk mfr cs 1f .6 .8 2 11-26 10yr4/4 none sicl 2msbk mfr gw Na ~ .4 .6 3 26-56 10yr4/4 none sl 2msbk mfr cs n/a .6 1.0 4 56-120 10yr6/4 none cos/Is osg ml n/a n/a .7 1.0 Boring # --1 Boring Pit Ground Surface elev. 97.65 ft. Depth to limiting factor 120 in- Soil Application Rate 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 0-15 10yr3/1 none sil 2msbk mfr cs 1f .6 .8 2 15-37 10yr4/4 none scl 2msbk mfr gw 1vf .4 .6 3 37-66 10yr4/4 none sl 2msbk mfr gw n/a .6 1.0 4 6fi-420 7.§yr4f4 rjone fs -osg mfr tt/a nfa .7 1.0 ~muenr ~ r = rsvus> su < zzu mgrs and t 5s >su < 450 mg/L `Effluent #2 = BODS <30 mg/Land TSS < 30 mg/L CST Name (Please Print} 'gnature: CST Number David J. Steel 248956 Address Steel's Soil Service, Inc. Date Evaluation Conducted Telephone Number 994 200th St., Baldwin, WI 54002 9/7/2004 715-684-5680 v~ 1~ ~d ~ ~ ST CRO1X COUN`1'Y ANCE AGREEMEI~IT Jwner/Euyer SEPTIC TANK btiAII~T D OWNERSHIP CERTIFICATION FO1tM r.,~-z ltiailing Address - ~' ` Pro arty Address I ? ~ 7 / ~ ~ ~ ~ L`~ p (Verification required from Planning Department for new construction) 1 ~ - Zo6~ - ~S J ~d City/State Parcel Identification Number b LEGAL pESCRIPTION 7 ~~~~ n~ ~-. ~ Z' o~ 9 N-R. l W, 'town of .1 Location g ~ .'/+, ~ /+~ Sec. ,~ Property ` ~ /~t' t `i Lot # ~_. Subdivision ~~ ~/ ~ -- , Volume _~ ..Page #~ Certified Survey Map # _ ~ 3`' -~ ~ ~..{ Z ~ ~ ~ Volume Z 7 ~ Page # T Warranty Deed # Lot lines identifiableci~yes ^ no Spec house ^ yes o I ~~ ,~„ ,7 ~ 5 ~ ~ ~ Va L ~ o ~. 31 NANCE ~ remature failure to handle wastes. Proper ma; atenance SYSTEM ou ut into tt ~ system 1pQproper use and maintenance of yo~ir septic system could result in its r a licensed g~pef• What y p ~~~ of pumping out the septic tank every three years or sooner, if needed b sal systeiu. can affect the function of the septic tank as a treatment siege is the waste dispo the owner and by a owner agrees to submit to St. Croix ZOiillig Department 8 certification form, signed by ~ al s em The property um verifying that (1) the on-site wastewaterdispo.: Yst masterplumber, journeymaiiplumbcr, restrictedplumber or a lice~iscdmp tf~necessary), the septic tank is less thaw 1/3 full c f sledge. is in proper operatingconditionand/or (2) a fter inspection and p p g (~ ee to maintain the private sewage disposal system with the standards rtification Uwe, the undersigned have read the above requirements and agr 7.o~g Ofl'co ~~ 30 fo herein, as set by the Department of Commerce and the Dep~ a d returned to tlRieeSt. Crosix County ~~~ set rth. Stating that your septic system has been maintained must be coruplet Sys a year expiration date. ~ b // /~ ~ DATE ~5It3N OF A13T O~rR CERTITICATION our knowledge. I (we) am (are) the ~ :wuei{s) of I (we) certify that all statements on ibis form are true to Qta best ° s er of Deeds Office. the propert cn'bed a e, by virtue of a warranty deed recorded in Reg + ~ ~ / O DATE SIGNA O LICANT «««««« «s«««• qn information that is mis-represcutcd may result in the sanitary permit being revoked Uy the ZoriinS Departm =nt• Y «« Include with tuts application: a atarnped warranty deed frotn the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed POWTS OWNER'S MANUAL MANAGEMENT PLAN FILE INFORMATION C}wner Permit # n~ eT(,N P AR A METERS Number of Bedrooms 100gpd/bedmom ^ NA Number of Commercial Units NA Estimated flow (average)* gaUday Design flow (peak), estimated x 1.5* gaUday Soil Application Rate gaUday Influent/Effluent Quality (NA^) Monthly Average** Fats. Oil & Grease (FOG) < 30 mg/L Biochemical Oxygen Demand (BODs) ~ 220 mg/L Total Suspended Solids (TSS) _< 250 mg/L Pretreated Effluent Qualify ^ Monthly Average*** Biochemical Oxygen Demand (BODs) < 30 mg/L Total Suspended Solids {TSS) 5 30 mg/L Fecal Colifonn (geometric mean) <10+cfu/100m1 Maximum Effluent Particle Size 1/8 inch diameter *Wastewater Flow Verification on and calculations: (Other than bedroom based) ** Values typical for domestic (non-commercial wastewater and septic tank effluent. ***Values typical for pretreated wastewater. cvSTF.M SPECIFICATIONS Septic Tank Capacity d gal ^ NA Septic Tank Manufacturer ^ NA Effluent Filter Manufacturer ^ NA Effluent Filter Model ^ NA Pump Tank Capacity ~c~ gal ^ NA Pump Tank Manufacturer `~ S~ ^ NA Pump Manufacturer ^ NA Pump Model ^ NA Pretreatment Unit ^ NA ^ Sand/Gravel Filter ^ Peat Filter ^ Mechanical Aeration ^ Wetland ^ Disinfection ^ Other: Manufacturer: Model: Dispersal Cell(s) -ground (gravity) ^ In-ground (pressurized) ^ At-grade ^ Mound ^ Drip-line ^ Other: eaching Chamber Manufacturer ~,z -~ ~~ ~i Modeler o ~ t -~/~.vApproval Stipulation Soil Application Rate~gpd/fl Area Req. /es~ tuft Absorption Area Credit per unit rc~ ftz Minimum Number of Chambers A-~ ^ Aggregate Design Flow/Loading Rate= min Materials: all materials must comply with WI Adm. Code COMM84 and be installed per manufacturers specifications and approval letters. nFCTr_N C'RiTERIA "VVisconsm At-grade ~ol! ADSOIpuon ~1y5[em, flung, LGSI~u oc. ~.vaa~uua.uvia aa.......+. ~....~.•.-•-..- --•--•--- -i ^ "Wisconsin Mound Soil Absorption System: Siting, Design & Construction Manual" Converse, J.C. and E.J. Tyler. Publication 15.22 "Design of Pressure Distribution Networks for Septic Tank-Soil Absorption Systems" Publications 9.6 ^ "Design of Conventional. Soil Absorption Trenches and Beds". R.J. Otis - ASAE Publications 5-77 .and "Design Manual - Onsite Wastewater Treatment and Disposal Systems". EPA 625/1-80-012 October 1980 ^ SBD -10570--P (8.6/99) "At-Grade Component Manual Using Pressure Distribution" ^SBD -10567 P (8.6/99) "ln Ground Absorption Component Manual" ^SBD -10705-P (N.Ol/O1) "In Ground Soil Absorption Component Manual" Version 2.0 ^ SBD -1062&.-P (N.6/99) "Recirculating Sand Filter System Component Manual" ^ SBD -10656-P (N.6/99) "Split Bed Recirculating Sand Filter System Component Manual" ^ SBD -10572: P (8.6/99} "Mound Component Manual" SBD -10691-P (N.O1/Ol) "Mound Component Manual" Version 2.U ^ SBD - IOSyS-P (8.6/99) "Single Pass Saud Filter Component Manual" ^ SBD -10657-P (8.6/99) "Drip-line Effluent Disposal Component Manual" ^ SBD - 10573 P (R 6/99) "Pressure Distribution Component Manual" ^ SBD - 10706-P (N.O1/Ol) "Pressure Distribution Component Manual" Version 2.0 ^ Drip-line Effluent Dispersal Component Manual for Multi-flo Onsite Wastewater Treatment Units jVlAilr.l l~il\A1Vl..L' 1Y1V1\11 V1\L\V i.7~.a,aaJa~v Service Event a•a. Service Fre enc Inspect condition of tank(s) At least once every months (s) (Maximum 3 yrs.) Pump out contents of tank(s) When combined sludge and scum equals one-third (1/3) of tank volume Inspect dispersal cell(s) At least once every ^ months ear(s) (Maximum 3 yrs J Clean effluent filter At least once every ^ months year(s) Inspect pump, pump controls & alarm At least once every ^ months ear(s) ^ NA Flush laterals and pressure test At least once every ^ months year(s) ^ NA Valves At least once every ^ months ^ year(s) ^ NA Other: At least once every ^ months •^ year(s) - ^ NA P~oP ~f STA12T iTP . l or 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 andlor 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. Ol'I/RATION The: property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity and quality of the wastewater stream will affect the performance and longevity of your POWTS. The installation ofwater-saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water softeners, iron. removal units, other clear water treatment devices and foundation drains should be dischazged to the ground surface whenever possible. Note: this does not include laundry waste, showers, dishwater, etc. This system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable/fruit peels and seeds, bones, and: food solids such as those produced by a garbage disposal should be minimized. Toilet tissue is the only paper that should be discharged into the system. Other non-biodegradable items such as baby wipes, tampons, sanitary napkins condoms, cigarette butts, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, paint, disinfectants, pesticides, antibiotics, solvents, etc., should not be flushed into the system as they can seriously damage yourFOWTS and contaminate your drinking water supply. Maintain a regular steady flow by spreading laundry washing throughout the week. Avoid vehicle traffic over all system components. Compaction of snow over the dispersal unit may cause it to freeze up. ^ Valves. Valves shall be operated in the following manner: ~A arms.. Alarms should be tested on a regular basis. by the home owner. If an alarm sounds, contact an individual licensed to service POWTS, There is normally a 1 day reserve under regular operating conditions, however water should be conserved until any problems with the system. are corrected to prevent back-up of sewage into the dwelling or surfacing. INPEGTIONS Inspection shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule). `.c Tanks Component Tack inspections must include a visual inspection of the tank 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 backup or ponding of effiuent to the ground surface. Access openings used for service or assessment shall be sealed and/or locked upon completion of service. Any defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective locking device to prevent accidental or unauthorized entry into the tank. When the combination of sludge and scum in any tank exceeds one-third (1!3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with Chapter NR113, Wisconsin Administrative Code. The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. Provisions are to be made to retain solids in the tank. Filter cleaning maybe necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating. /L}~wnp Chamber/Treatmentranks Component (~ The inspection must include a test of all electrical equipment such as pumps, alarms and floats. A visual check must be made for leaks, backups, surfacing, missing or broken security devices and other hazdware and the condition of the filter. Any service needs or repairs shall. be promptly taken caze of. round Gravity Component Dispersal Cells The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the. regulatory authority. Ponding at depths greater than 75% of the height of the component may indicate overloadiAg or impending hydraulic failure necessitating more frequent monitoring. Page of ~ Yvlound, At-Grade, In-Ground Pressuire The inspection. shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage. or discharge. Any dischazge to the ground surface must be promptly reported to the regulatory authority. Ponding greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating mare frequent monitoring. The pressure distribution system is provided with an opening at the end of each lateral to be used for flushing, The laterals should be flushed at least once every three (3) years. Pressure checks of systems with multiple laterals should be done to ensure that equal :distribution of etlluent is occurring to promote the longevity of the system. REPORTS Reports for maintenance, inspection, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin Administrative Code. ABANDONMENT When the P4WTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is properlyand safely abandoned in compliance with Ch. COMM 83.33, Wisconsin Administrative Code. - All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. - 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 aad removed or their covers removed and the void space filled with ' -soil, gravel or other 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 repl ent system:. ~~ititable replacement azea has been evaluated and maybe 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 from existing and proposed structure, lot lines and wells. Failure to protect the replacement azea 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 notavailable 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. C7 The site has not been evaluated to identify a suitable replacement azea. 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 maybe installed as a last resort to replace the failed POWTS. ^ 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. c<WARNING» SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTIAN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTAER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THF. INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS ly ame '~C-G~^01 ~k^-5 ~ i ~ ~qr' y Phone.. J POWTS AINER Name ~ Phone LOCAL REGULATORY AUTHORITY Agency Phone K:\WPDATAIEHIPOWTS OWNER'S MANUAL.doc Page of Private On-Site Wastewater Treatment System (POWYS) Index & Title Sheet Owner: ~r ~S Project Narne and System Type: _ Location: Street Address Legal Description /~ Township/County Contents: Page 1: Sanitar~Permit Application Page 2: Plot Plan Page 3: Soil Test Page 4: State Approved Plans Page 5: Septic Tank Maintenance Agreement Page 6: Warranty Deed Page 7: POWYS Owner's Manual Management Plan Page 8: POWYS Owner's Manual Management Plan Page 9: POWYS Owner's Manual Management Plan Page 10: Certified Surve~Map Page 11: Copy of House Plans Attachments: Plumber/Designer: Mike Ro eg_rs Signed: Credential Number: 225094 Date: ~~ DS ,U; 2797P 434 STATE BAR OF WISCONSIN FORM 1 - 1998 WARRANTY DEED Limited Liability Company, Grantor, and Christopher M. 6ef9 and Pamela K. Berg. husband and wife ,Grantee. Grantor, for a valuable consideration conveys to Grantee the following described real estate in St. Croix County State of Wisconsin (the "Property"): 7942_' 1 1 KATHLEEK H. MALSH REGISTER OF DEEDS 5T. CROIK CO. , iMI RECEIVED FOR RECORD 05/05/2005 02:00P1[ MARRANTY DEED EXEMPT i REC FEE: 11.00 TRA)iS FEE: 138.00 COPY FEE: CC FEE: PAGES: 1 Lawson, Marshall, McDonald,`_ Galowitz l~ Wolle, P.A. 0}~~ 3880 Laverne Avenue North Lake Elmo, MN 55042 018-1006-90 OI8-1007-20 018-1008-20 018-I008-50 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Lot 38, Plat of Hillside Heights in the Town of Hammond, St. Croix County, Wisconsin. Together with all appurtenant rights, title and interests. Grantor warrants that the title to the Properties good, indefeasible in simple fee and free and clear of encumbrances except Dated this 4th day of Mav, 2005. (~ (SEAL) . I/ v ~ o~~ David Dalton, Organizer Cutting Edge Four, LLC. AUTHENTICATION (SEAL) Signature s) NOTARY PUBLIC - i11NNE50TA authentic Y ra,, c61ay[ E1fPI. Jan. 91. 2010 , TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by §706.06, Wis. Stats) THIS INSTRUMENT WAS DRAFTED BY Coldwell Banker Burnet 1301 Coulee Road Hudson, WI 54016. 5-32183 (Signatures may be authenticated or acknowledged. Both are not necessary.) Names of persons signing in anv capaciri must be rioed or (SEAL) ACKNOWLEDGMENT (SEAL) State of 1~1E131iii?3SX Minnesota } ss. SG1E:ifdi3C$1itl~jt County of Washington Personally came. before me this 4th day of Mav, 2005 the above named David .Dalton as Organizer of Cutting Edge Four. LLC. a Wisconsin L+ i ed Liab11 Com an to me known to be the person who executed the foregoing instrument a d ac owledge the sa ~.~.U S L.t~~- ~ Notary Public, Statd o'fM/isconsin M commissi n Is nnanent. (If not, state~expiration date: 1131 ~~~ ~~~~ •) \` STATE BAR OF WISCONSIN Wisconsin Legal Blank Co, Inc. WARRANTY DEED FORM No. 1-'1998 Milwaukee, Wis. Parcel #: 0~ $-2UU9-38-~~1) 05/13/2005 10:48 AM PAGE 1 OF 1 Alt. Parcel #: 04.29.17.1022 018 -TOWN OF HAMMOND Current ' X, ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 09/28/2004 00 0 Tax Address: Owner(s): * =Current Owner * CUTTING EDGE FOUR LLC CUTTING EDGE FOUR LLC PO BOX 268 HAMMOND WI 54015 Districts: SC =School SP =Special Property Address(es): * =Primary Type Dist # Description * 1787 119TH AVE SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 1.500 Plat: 10/31-HILLSIDE HEIGHTS 018/04 LOTS 1/66 SEC 04 T29N R17W PT NE NE BEING HILLSIDE ' Block/Condo Bldg: LOT 38 HEIGHTS ( 04) LOT 38 (1.500AC) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 04-29N-17W NE NE Notes: Parcel History:, Date Doc # Vol/Page Type 02/28/2004 775409 10/31 PLAT ~nn~ ci innnnet~v Bill #: Fair Market Value: Assessed with: ---- --------- ---- 0 Valuations: Last Changed: 03/23/2005 Description Class Acres Land Improve Total State Reason Totals for 2005: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00